Igh cny 202 oct 16 final

in good

Breast Cancer Awareness Month

Mammograms Oneida Healthcare radiologist Ryan Dockery explains why 3-D is becoming the standard in breast cancer diagnostic

Pregnancy & Exercise Mothers-to-be are advised to continue exercising but choose types of exercises more carefully

October 2016 •

Issue 202

cnyhealth.com

CUPPING Grows in Popularity It’s scary to the eyes, but ever since Olympian Michael Phelps appeared on national TV with his body dotted by what appeared to be bruises, the ancient practice of cupping therapy has gained momentum.

It’s recognized for pain relief, fast healing, relaxation. Should you try it?

CNY’s Healthcare Newspaper

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Page 19

Benefits of Infrared Sauna On Course to Become No. 1 Killer of Americans

Dry saunas offer health benefits — without the steam, experts say

Hospital-owned Physician Practices About a quarter of medical practices are now owned by hospitals. More than 140,000 physicians (40 percent of all physicians) are now employed as of last year. See Healthcare in a Minute inside

Number of People on Gluten-free Diet Triples in Five Years ­

What a Local Woman Did After Getting a Breast Cancer Diagnosis

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Whole Grain Bulgur

‘Bulgur — wheat that’s been parboiled, dried and cracked into nibbly bits — is one of my favorite whole grains.’ See SmartBites inside

­

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Prostate Exam End finger exam in men, says urologist.

More U.S. Adults Using Marijuana Than Ever Daily use nearly doubled between 2002 and 2014, study finds

A

s perceptions of marijuana change, more American adults are using pot than ever before, and they’re using it more often, a new study finds.

Over 13 percent of adults surveyed in 2014 said they’d used marijuana in the previous year, up from roughly 10 percent in 2002.

Also, daily or near-daily use — five days or more a week — rose from less than 2 percent to almost 4 percent of adults during that time period.

“This increase has corresponded with the legal and social acceptance of marijuana, and so it is not such a surprise,” said lead study author, physician Wilson Compton, deputy director of the U.S. National Institute on Drug Abuse.

He pointed out that over the past 20 years, medical marijuana has been

legalized in 25 states and the District of Columbia.

However, noting that marijuana’s potency has increased, Compton’s team said education about the harms of pot is essential.

“We need to think about how to do appropriate prevention messaging to make sure people aren’t putting themselves at risk for becoming dependent and other problems associated with the drug,” he said.

These harms could include “difficulty with their work performance and with their ability to think clearly and function,” Compton said.

For the report — published Aug. 31 in The Lancet Psychiatry — researchers surveyed nearly 600,000 adults from 2002 to 2014.

Greater pot use was associated with a drop in the percentage of

people who associate smoking marijuana with harm. Where just one-third of Americans once considered marijuana safe, now half do, according to the report.

It’s too early to tell if these trends will continue, researchers said.

College students

A separate study has shown that American college students’ use of marijuana continues to increase, but the appeal of other drugs, including amphetamines and opioids, may be waning.

The proportion of college students who reported past-year use of marijuana rose from 30 percent in 2006 to 38 percent in 2015, according

to the study from the University of Michigan Institute for Social Research.

Daily or near-daily pot use (20 or more times in the previous 30 days) reached nearly 6 percent in 2014 — the highest level of daily use in the last 34 years. But it then fell slightly to less than 5 percent in 2015, researchers found.

One possible reason for growing use of marijuana may be a decrease in perceived risk. The proportion of young adults aged 19 to 22 who consider regular marijuana use dangerous fell from 58 percent in 2003 to 33 percent in 2015, according to the report.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

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Page 3

CALENDAR of

HEALTH EVENTS

Oct. 1

Walk to End Alzheimer’s to take place in Liverpool The Alzheimer’s Association invites Central New York residents to unite in a movement to reclaim the future for millions by participating in the Alzheimer’s Association Walk to End Alzheimer’s presented by Loretto. The Walk to End Alzheimer’s will take place on Oct. 1 at Long Branch Park in Liverpool.

Check-in begins at 8 a.m. The

opening ceremony takes place at 10 a.m. with the walk immediately following.

The Walk to End Alzheimer’s is more than a walk. It is an experience for thousands of expected participants in the Syracuse area to learn about Alzheimer’s disease and how to get involved with this critical cause, from advocacy opportunities and clinical studies enrollment to support programs and services. Walk participants also honor those affected

by Alzheimer’s disease with the poignant Promise Garden ceremony.

The 2015 event raised nearly $225,000 for the organization.

To start or join a team, visit alz. org/walk. To learn more about the disease and available resources, call the toll-free Alzheimer’s Association 24/7 Helpline at 800-272-3900.

Oct. 12, 19, and 26

Workshop for women who live alone Do you live alone? Is it a challenge for you? Living Alone: How to Survive and Thrive on Your Own is a three-part workshop offered for women who want to rediscover joy and contentment, and to gain the know-how to forge a meaningful life on their own. You’ll meet others in similar circumstances and learn practical strategies to overcome loneliness, rediscover your true self, socialize in a couples’ world and make the best of this opportunity on your own.

The workshop takes place from 6:30 to 8:30 pm. at House Content Bed & Breakfast in Mendon on three consecutive Wednesdays: Oct. 12, 19, and 26. A daytime workshop may also be offered on Friday mornings (same weeks), if there is interest.

The workshop fee of $135 includes a Living Alone binder, empowerment exercises, and helpful resources you can trust. Home-baked goodies and refreshments are served.

To learn more, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@rochester.rr.com.

Oct. 10

Multiple Sclerosis Resources Presents:

2016 Health and Wellness Expo!

Aurora of CNY to offer free vision, hearing screening Aurora of CNY, a nonprofit promoting independence, opportunity and full access for individuals who are blind, visually impaired, and deaf, will offer a free vision screening and free hearing aid cleaning from 11 a.m. – 2 p.m Oct.10 at the Mary Nelson Resource Center, 2849 S. Salina Street in Syracuse.

This event won’t have a formal presentation and speakers, but agency officials will on be on hand to answer any questions about resources and referrals. Aurora will also offer free hearing aid cleaning as well as information on available resources and referral assistance.

For more information, contact Donna Reese at 315-422-7263 or visit www.auroraofcny.org.

Oct. 13 Wednesday, Oct.19 3 to 6 p.m.

Barbagallo’s Restaurant (Diamond Room) 6344 E. Molloy Road East Syracuse, NY 13057

Come visit over 35 vendors!

All Participants Will Be Entered To Win A TV! Flu Shots Available!

315-438-4790 Page 4

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

Event to focus on life with Parkinson’s Living an Active Life with Parkinson’s Disease Conference. This free day of learning offered by the Onondaga County Office for Aging and Upstate University Hospital’s HealthLink will be held on Thursday, Oct. 13 at Drumlin’s County Club, 800 Nottingham Road, Syracuse. Check-in is from 8:15 to 8:45 a.m. and program from 9 a.m. to 2:30 p.m. There is a coffee hour for persons recently diagnosed. Then conference host Susan Kennedy (host of WCNY’s “Cycle of Health”)

continued on page 27

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Number of Americans on Gluten Free Diet Tripled in 5 Years

G

luten-free diets seem to be the latest fad, yet the number of people being diagnosed with celiac disease hasn’t budged, new research shows.

Celiac disease is an autoimmune disorder, in which foods containing gluten trigger the immune system to attack and damage the small intestine, according to the Celiac Disease Foundation. Gluten is a protein found naturally in grains like wheat, barley and rye.

People with celiac disease have no choice but to avoid gluten in their diet. If they don’t, their small intestine is damaged every time they eat something with gluten.

Gluten-free diets also appear to have become a trendy way to address

any sort of gastrointestinal problem, said lead author Hyun-seok Kim, an internal medicine resident at the Rutgers New Jersey Medical School in Newark, N.J. “People may have a gluten sensitivity or non-specific gastrointestinal symptoms, and simply assume that a gluten-free diet will help their symptoms,” Kim said.

The number of Americans following a gluten-free diet tripled between 2009 and 2014, but diagnoses of celiac disease remained stable during that same period, the researchers found.

It’s possible that decreased gluten consumption could be contributing to the plateau in celiac disease, the study authors said.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Ryan N. Dockery, M.D. Oneida Healthcare radiologist compares 2-D and 3-D mammography and explains why 3-D is becoming the standard in breast cancer diagnostic Q: Give us an overview of your practice and the types of patients you see.

A: I work at Oneida Healthcare and see patients from around Madison and Oneida region. I'm part of a radiology group. We basically run the radiology department at Oneida.

I'm officially trained as an interventional radiologist, but I perform pretty much all aspects of radiology.

So that's the imaging side, as well as procedures. I might have to put in a drainage catheter, or [do] a biopsy if I find an area of concern.

Q: Breast cancer screening is probably the type of screening most wellknown to the public, but apparently those screenings had been missing a pretty substantial percentage of cancers. What does 3-D imaging allow you to see that 2-D doesn't other than, of course, the third dimension?

A: Your traditional mammography is done by taking two pictures of the breasts, so you get two different views and you're looking for cancer within those two views. The breast tissue is super-imposed on itself, so it can be a bit of an issue when you're dealing with a patient with very dense breast tissue. If it happens to overlap on both images, it can hide cancer.

Q: How does 3-D imaging address the problem?

A: 3-D imaging will take multiple images and process them through a computer, allowing me to scroll through the breast much like a CTU scanner, so I can see around corners and behind things. So I'll be able to see breast cancer that's hiding behind dense breast tissue. You can't do that with a 2-D image. It gives me a lot more ability to see what I need to see and distinguish normal breast tissue from abnormal breast tissue.

Q: Roughly how much more effective would you say it is?

A: I think it absolutely makes evaluating and diagnosing breast cancer easier.

This is especially true for dense breasts. When I have a case that's only 2-D, it's harder to have faith in what you're looking at.

You feel more comfortable giving a report when

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

you've been able to move through the breast tissue at different angles.

It's not a subtle difference, in my opinion. It's enormous.

Q: Is a patient likely to have an idea whether or not she has dense breast tissue?

A: We usually calculate it based on imaging, so there's not really a way to do it through a physical exam. If the patient has had imaging before, she might know. Even if you don't have dense breast tissue, 3-D imaging can be helpful. It still makes it easier to see cancer. A lot of hospitals are moving toward using it for all patients, not just patients with dense breast tissue.

Q: So it's not quite the standard of care yet?

A: It's moving toward that.

Not every place has the equipment.

It's relatively new. A lot of it has to do with the computers being a lot better. It's like how CT came out and got progressively better. It can take awhile to figure out the best approach and have computers that can process it well. They also had to figure out a way to do it with low radiation and still get good images. So there have been a lot of technological advances recently that have helped get it to this point. But this is a fairly recent development.

Q: Does it have any applications for treatment as well?

A: It's mainly a diagnostic tool.

You can use it for screening. By that I mean you could skip the 2-D mammogram and just get a 3-D mammogram. In the past, you'd get a 2-D mammogram and, if there was anything questionable about it, you'd get called back for additional testing.

So this decreases the amount of callbacks you have to and decreases the need to do as many biopsies, since it's easier to tell when something you find has benign features. It also reduces patient anxiety since we don't have to leave them hanging on the idea that we've found something, but aren't sure what it is. sis?

Q: Is there a risk of over-diagno-

A: Over-diagnosis is actually a problem with 2-D mammography.

You might see a density on the image, but not know what it is, so then you might call for a biopsy. With 3-D imaging, you have a better chance of seeing what it actually is and skipping an unnecessary biopsy. So it actually decreases over-diagnosis.

Lifelines Name: Ryan N. Dockery, M.D. Position: Head of radiology at Oneida Healthcare Hometown: Memphis, Tenn.

Education: Columbia University Medical School College of Physician and Surgeons (MD); Mt. Sinai-St. Luke’s-Roosevelt, fellowship in interventional radiology; Tulane University, residency; Malmonides Medical Center, preliminary training, internal medicine; Affiliations: Oneida Healthcare; Lewis County General; Warsaw County Community Health; Canton-Potsdam, Massena Memorial Organizations: American College of Radiology Family: Single Hobbies: Photography, design

Healthcare in a Minute

By George W. Chapman

Hillary vs Donald

The Kaiser Foundation conducted a poll last month to determine which candidate people believed would do a better job when it comes to healthcare. There were questions regarding women’s healthcare, the future of Medicare and Medicaid, the ACA, access, affordability, the cost of drugs, opioid abuse, Zika virus and AIDS. Clinton led Trump on basically every issue by double digits except the future of Medicare, which was almost even between the candidates.

Two thirds of the respondents felt the top health priorities for both candidates should be the future of Medicare, access and affordability. When it comes to the Affordable Care Act, the poll was split 40 percent favorable and 42 percent unfavorable.

Hospital-owned physician practices.

About a quarter of medical practices are now owned by hospitals, according to a report by nonprofit advocacy group Avalere Health.

Hospitals acquired 31,000 practices between 2012 and 2015, which is a 50 percent increase in activity over prior years. More than 140,000 physicians (40 percent of all physicians) were employed as of last year. This trend is greatest in the Midwest where almost 50 percent of physicians are employed. Advocates for private practices believe increasing regulations, costs and payment “reform” favor large systems of care and that smaller, independent practices will go the way of mom and pop stores.

Uninsured.

Through the first quarter of this year, about 27 million people or 8.6 percent of us are without health insurance. This is an historic low, down from 16 percent uninsured in 2010.

Experts contend that the uninsured rate will go down very slowly from here on unless there is universal coverage.

Single payer system?

Public funding (tax dollars) is by far the dominant payer in healthcare.

According to a study by the UCLA Center for Public Policy, public funds now account for 71 percent of the healthcare expenses in California. In addition to Medicare and Medicaid, tax dollars subsidize employer-sponsored insurance, insurance for public employees, and ACA tax credits for the indigent. (Premiums paid by employers and their workers are tax exempt so the authors of the study argue that these “forgone taxes” could be diverted to a single payer.)

Of the total $3 trillion (figure $10,000 per person) in national spending, 65 percent is funded by taxpayers. The authors argue that since we are close a single payer (government) why not consider one and how much the taxpayer money would save through far less red tape and tremendous purchasing power.

Low-value services.

These are medical services and diagnostic tests that, for the cost, have little benefit or use. Research published in JAMA Internal Medi-

cine found that about 8 percent of us have received a low-value service.

Among the most expensive low-value services are: spinal injections for lower back pain and imaging for headaches and lower back pain.

While spending on unnecessary or over-used services has declined overall, it is still relatively high in employer-sponsored plans. Patients in consumer-directed plans were less likely to use low value services.

Largest HIPAA fine.

The Health Insurance Portability and Accountability Act protects your health information and privacy.

Chicago-based Advocate Healthcare Network will pay the largest fine, $5.55 million, ever levied against a single entity. Four desktop computers containing information on almost 4 million people were stolen. The information included health, credit card, demographic and insurance information. The investigation by OCR (Office for Civil Rights) revealed widespread HIPAA noncompliance at Advocate.

Aetna challenged.

A letter to the Aetna CEO, signed by several US senators, challenges Aetna’s reason for withdrawing from the exchanges. Aetna seemed committed to continuing to participate in the exchanges up until the point where the Department of Justice started to push back on Aetna’s proposed merger with Humana. All of a sudden Aetna started to claim the exchanges were too risky. The senators

October 2016 •

accuse Aetna of basically threatening to pull out of the exchanges if their proposed merger with Humana is denied. Through the first half of this year, Aetna grew total revenues by 5 percent to reach $14 billion. Ironically, most of the increase in revenue was attributed to higher premium yields and membership growth — in its government business.

Quality hospitals save money, improve outcomes.

Medicare saves money when procedures are performed at higher quality hospitals. Medicare followed the overall costs resulting from five types of major surgery performed on 100,000 members. Outcome considered 30-day post-surgery mortality rates and patient experiences. The bottom line was Medicare saved an average $2,700 per patient when the surgery was performed at a high quality hospital. Most of the savings were attributed to less post-acute care like rehab and home health care.

George W. Chapman is a healthcare consultant who works with hospitals and medical groups.

He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

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Page 7

my story

REHABILITATION AT THE MANOR After suffering severe injuries from a car accident, Ken Bartlett said it was the staff at the Manor who enabled him not only to return home, but also walking again.

“The Manor was the foundation of getting better,” Bartlett said. “It’s been a long road, but I am in a good position because of the care I received at The Manor.”

— Ken Bartlett, Volney Resident and Car Accident Survivor

Oswego Health

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Dry saunas offer health benefits — without the steam

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

ost people are familiar with the traditional Finish steam sauna. The warmth is said to improve circulation and detoxify the body as users sweat while sitting in the steam.

Infrared saunas, also called dry saunas, provide heat to the body without steam. Using infrared radiation, a kind of electromagnetic light energy, infrared saunas heat similarly to the sun, though without the harmful ultraviolet rays.

Instead of heating the air with steam, like a humid rainforest, infrared saunas’ dry heat mimics the arid climate of a desert, but also penetrates deep into the user’s body.

The infrared sauna’s main benefit is boosting circulation, according to Mike McAfoose, president and owner of Syracuse Sauna. Fourteen years ago, he felt so impressed with the benefits of infrared sauna that he became a dealer of the devices.

“These changed my health,” he said. “I take no meds, partially because of the sauna.”

He said that the deep, penetrating heat of infrared saunas is what stimulates increased circulation, which supports healing.

People with heart disease, high blood pressure, respiratory issues or asthma could not go in steam saunas, but are encouraged to use infrared dry saunas for those conditions, he

said.

McAfoose said that because infrared saunas penetrate deeper than steam saunas, they’re effective at lower temperature, only 120 degrees, compared with the near 200-degree temperatures commonly used in steam saunas.

Since the saunas use no water, sauna owners can install their equipment in more locations and they resist growth of mold, fungus and bacteria.

Gina Insalco, owner of Saunacuse in Syracuse, said that many use her facility’s infrared sauna to de-stress, loosen tight muscles and improve circulation. In addition, she said, infrared sauna may help support weight loss, clarify the skin, and promote general relaxation. She added that it can also support general good health.

“When you elevate your body temperature, allergens, virus and bacteria are fought off,” Insalco said.

“You’re creating an artificial fever for 30 minutes, which is not a prolonged elevated body temperature. It won’t raise your body temp for more than a couple of degrees.”

People using infrared sauna should stay well hydrated, drinking 8 oz. of water every 20 minutes and use the equipment for no more than 45 minutes. Usually beginners try 20 minutes their first session.

brother, Alex, was diagnosed with the disease two years ago. And there is still a chance that Marc himself or his older brother Michael could be diagnosed with the disease.

Today Marc is a student at Cornell University studying atmospheric science. He hopes to go on to get his master’s or PhD. He said he will keep raising funds to fight the disease until there is a cure.

“My dad was the most inspirational and positive person I’ve

ever met,” he said. “So much in life seemed to be going against him, but he continued to fight the disease and stay positive. In a way, I like to think that my brothers and I are my dad’s legacy. He taught us so much just from his attitude toward life. Together, my brothers and I will work to carry on this attitude, keeping my dad’s legacy alive.”

To learn more about ataxia or to join in the fight go to ww.ataxia.org. ly ignoring other themes.

Allessi family: They created a local event — Walk for Dave — that has raised $25,000 for the National Ataxia Foundation. Dave Allessi was the father who lost his life to ataxia, a disease that leads to the deterioration of the cerebellum, a part of the brain. The family started the event to honor his life and raise funds to find a cure for the disease. From left, From left, Luis Torres, friend of family; Marc Alessi, son, 20; mom Terry; son Alex Alessi, 19; and son, Michael, the oldest. Photo taken aAug. 6 during the Walk for Dave evnet at Onondaga Lake Park.

Attacking Ataxia: Mother and Sons Team Up to Defeat Rare Disease

By Matthew Liptak

S

pinocerebellar ataxia Type 2 is a disease that leads to the deterioration of the cerebellum, a part of the brain. There is no known treatment or cure.

When the father of one local family lost his life to the disease in October 2011 his family didn’t sit idly.

Marc Allessi, a son of the man who died from the disease five years ago, created the Walk for Dave. The money raised from the fundraiser goes to the National Ataxia Foundation, which is researching a cure for the disease.

In four years the event has raised $25,000 to go research to find a cure for the disease that killed Dave Allessi.

The three-hour event held at Onondaga Lake Park’s Willow Bay Aug. 6 raised over $7,000 this year alone.

“The walk was a huge success this year,” Marc Allessi said. We had about 50 to 100 people show up on the day of the walk, but the overall support for the event comes from over 200 donations from friends, family, supporters, and businesses.”

The event has humble beginnings, having started as one of Marc’s high school class projects.

“The idea for Walk for Dave first came during my health class junior year when we were assigned a community service involvement project,” Marc Allessi said. “We were expected to help volunteer in a fundraiser in the community and present what we did later in the year. My friend and I decided to take it a step further and raise money for the National Ataxia Foundation which is coordinating research for a cure.”

Marc’s mom, Terry, said, “I was not surprised at all to hear him

exclaim that he wanted to organize a fundraiser/walk to raise awareness of this condition. In fact, I gave him a chuckle and informed him that this was a huge undertaking. He didn’t even bat an eye and exclaimed that he had better get going on it!”

The rare hereditary form of ataxia that Dave had strikes about one in 100,000 people. For the Alessis, though, it hit close and it has been very personal. Marc’s younger

October 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Living Alone Is No Laughing Matter . . . Or Is It?

W

hen is the last time you laughed till your side hurt?

Enjoyed a carnival ride?

Played with a puppy? Or acted silly?

Sure, living alone can be serious business, what with all the chores and responsibilities that rest solely on our shoulders, but let’s not forget to laugh a little and have some fun along the way.

“Why focus on fun?” you might ask. Because having fun, letting your hair down and relaxing means letting go of your problems and worries for awhile.

When that happens, you have time to “breathe” emotionally. Not occupied with troubling thoughts, your mind is free to wander, which can make room for new insights and understanding. You see things in a different light. And what might seem insurmountable at the moment (a Saturday night alone) can become more manageable.

My life was no “barrelful of monkeys” after my divorce. In fact, having fun was a low priority on my to-do list. I was busy trying to put my life back together as a single person, and finding entertainment wasn’t among my goals.

But then I took a ride that changed everything.

A couple of friends, determined to rescue me from my somber existence, coaxed me to join them on a road trip to Martha’s Vineyard.

Declaring that I would be no fun to be with, I nonetheless agreed to go.

We poked around the island for a few days and then found our way to one

of its most charming harbor towns, Oak Bluffs. It’s a magical little place that is home to colorful, whimsical cottages.

Oak Bluffs is also home to our nation’s oldest platform carousel.

I stood there admiring it, commenting on the warm patina of its “flying horses” and remarking on how much fun the kids were having. That’s when my friends elbowed me and said, “Oh, come on, let’s take a ride.” After complaining that I was just too old for that sort of thing, they ignored by protests and lifted me onto a bright yellow horse. It was so much fun! I loved it! I even grabbed for the brass ring, in hopes of winning a second free ride, but a fresh-faced 11-year-old beat me to it.

Riding that carousel made me giggle and laugh and feel like a kid again. It felt foreign and unfamiliar.

But, more importantly, it felt fabulous! I was reminded of how much better my life could be if I just “got back on that horse” and made having fun a priority.

So things changed after my trip to Oak Bluffs. I became deliberate about weaving fun and laughter into my life. And I encourage you to do the same.

Below are a few tips to help you tickle what may be a dormant funny bone: Hang out with fun (and funny!) people. My sister Anne is the funniest person I know. Opportunities to be with her trump almost everything else on my calendar. We laugh, poke fun at each other, and otherwise just

enjoy each other’s company.

When I’m with Anne, my cares drift away and life is good. Take a look at the people you hang out with.

While we all need supportive friend with whom we can sort through life’s difficulties, we also need some fun-loving souls. Be sure to connect with them on a regular basis.

Diversify your entertainment. While I love classical music performances and can’t resist the showing of an Ingmar Bergman film classic, those events don’t tickle my funny bone.

No, to have fun, I need to dance till the cows come home or watch people make lighthearted fools of themselves in a karaoke club.

When’s the last time you went bowling, played a midway game or went to a comedy club? There’s no time like the present!

See the humor around you. I’ve also discovered that we don’t have to manufacture our own amusement.

It’s there for the taking, if we just look around. Yesterday, I saw something funny happening right in front of my eyes. A dog was pacing back and forth in the back seat of the car ahead of me, sticking its head out the windows on each pass. It looked ridiculous!

I could have observed this scene

with indifference, but I decided to enjoy the moment and embrace its inherent humor. Do the same. Enjoy the absurdity that surrounds us.

And finally, be silly and don’t take yourself too seriously. Oh, come on, you can do it! Let go, let loose. Life is short, time is precious, and, besides that, who cares what other people think?

I’m proud to say I’ve tried contra-dancing, laughed out loud while watching America’s Funniest Home Videos, sung in the shower, and found great joy on a swing, perfecting my leg-pumping and jumping-off skills. You get the point. It feels good to be silly.

There’s nothing like a little fun and a good laugh to brighten your day and lift your spirits, whether you live alone or not. So go for it. Grab for that brass ring. And enjoy the ride!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite her to speak, call 585-624-7887, or email gvoelckers@rochester.rr.com.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

SmartBites The skinny on healthy eating

Whole Grain Bulgur Bursts with Goodness

T

rue confession: For much of my life, I never gave a hoot about whole grains. Happily raised on white bread, white rice, white crackers, and white Twinkies, I ambled along this unhealthy path for decades until I had a wake-up call: children.

Yes, it took motherhood to open my eyes to the importance of eating whole versus refined grains.

Why are whole grains important — so important that the USDA recommends that all Americans make half or more of their grains whole grains? In a word, whole grains, which have not been stripped of their

urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16

nutrient-dense-antioxidant-rich bran and germ, are much more nutritious than their refined cousins.

Multiple studies, in fact, have shown that eating whole grains instead of refined grains lowers the risk of many chronic diseases, such as heart disease, Type 2 diabetes, some cancers and obesity. Some studies have even demonstrated that eating whole grains over refined grains contributes to weight loss.

Bulgur — wheat that’s been parboiled, dried and cracked into nibbly bits — is one of my favorite whole grains. I’m fond of this particular grain, a Middle Eastern staple, because it’s a knockout source of some vital nutrients and it’s super easy to prepare. One cooked cup contains 8 grams of fiber, over half of our daily needs for manganese, about 6 grams of protein and a bounty of other vitamins, minerals, phytonutrients and essential fatty acids.

On the fiber front, bulgur contains mostly insoluble fiber — the rough stuff that keeps us regular and can also improve bowel-related health problems, like constipation and hemorrhoids. Much 1:12 PM Page 1

like soluble fiber, which bulgur also has, insoluble fiber can play a role in controlling weight by staving off hunger pangs.

Bulgur’s protein is complete, with all nine essential amino acids, which means you don’t need to combine bulgur with another protein source to reap this nutrient’s benefits.

Protein is a powerhouse building block for muscles, cartilage, skin and blood, and also plays a critical role in immune-system health.

This versatile whole grain is also a super source of manganese, a trace mineral that plays an important role in many body processes, from collagen production to calcium absorption to blood-sugar regulation.

A final reason to make bulgur your body’s BFF? It’s low in fat, sodium, cholesterol and calories (only 150 per cooked cup).

Helpful tips Store uncooked bulgur in an airtight container in a cool, dry place.

It will keep at room temperature or in the refrigerator for five to six months. Frozen, it keeps indefinitely.

Cooked bulgur lasts between three to five days in the refrigerator. If buying bulgur from the bulk section, make sure the bins are covered and there is no evidence of moisture present.

al)

2 to 3 garlic cloves, minced 2 tablespoons tomato paste 1 (14.5 ounce) can petite diced tomatoes (don’t drain) 1 (15 ounce) can black beans, drained and rinsed 3 cups broth or water (more if needed) 1 tablespoon chili powder ½ teaspoon cumin salt and pepper to taste 3/4 cup bulgur Optional toppings: sliced scallion, chopped cilantro, grated cheese Heat oil in large pot over medium-high heat. Add onion, peppers and garlic. Cook, stirring occasionally, until the onion is soft, about five minutes. Stir in the tomato paste until it is evenly distributed and then add the tomatoes, beans, broth, chili powder, cumin, and a good sprinkling of salt and pepper.

Bring to a boil and then turn down the heat so the mixture simmers; cook, stirring occasionally, for about 15 minutes. Stir in the bulgur and cook for 10 minutes more, then turn off the heat and let it sit for about 15 minutes. If mixture seems too thick, add some water and reheat for a few minutes. Garnish with topping of choice.

Bulgur Chili with Black Beans Adapted from Mark Bittman; four to six servings 1 ½ tablespoons olive oil ½ onion, chopped 2 bell peppers, any color, chopped 1 jalapeno pepper, diced (option-

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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GENNADY BRATSLAVSKY, MD ZAHI N. MAKHULI, MD Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology

NATASHA GINZBURG, MD Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

MATTHEW D. MASON, MD

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RAKESH KHANNA, MD General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.

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JESSICA E. PAONESSA, MD

DMITRY NIKOLAVSKY, MD

Male reconstructive surgery, urinary diversions, general urology

General urology, female and reconstructive urology

ELIZABETH FERRY, MD

JONATHAN RIDDELL, MD

Incontinence, urethral stricture disease, pelvic organ prolapse, vessico vaginal fistula, reconstructive surgery

General female urologic health

TIMOTHY K. BYLER, MD

Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

STEPHEN BLAKELY, MD

Male infertility, erectile dysfunction, andrology, general urology

JC TRUSSELL, MD

General urology

IMAD NSOULI, MD

FOR QUESTIONS OR TO MAKE A REFERRAL CALL 315.464.1500 UROLOGY

October 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

What a Local Woman Did After Getting a Breast Cancer Diagnosis

By Deborah Jeanne Sergeant

B

reast cancer hit Camillus resident Lynn M. Connors out of the blue. With no symptoms or health concerns, the Syracuse resident scarcely imagined that a irregularity in her routine mammogram would change her life in so many ways.

March 17, 2016, her radiologist spotted “something very small,” Connors said. An ultrasound later that day revealed a small spot. The very next day, she underwent a needle biopsy. The pathology report indicated breast cancer: stage 1A invasive ductal carcinoma.

“My whole life came to as screeching halt,” Connors recalled.

“You hear the ‘c-word’ and it scares you. That was a tough day for me.”

Connors discussed various options with breast surgeon Kara Kort with St. Joseph’s Hospital Health Center. Connors chose bilateral mastectomy, which she received April 27, followed by reconstructive surgery.

Between diagnosis and surgery, Connors reached out to many friends and family who had received the same grim news before. One neighbor who had fared well during treatment recommended that she seek alternative health advice at The Stram Center for Integrative Medicine in Delmar, near Albany, to support her body’s recovery.

Anticipating her first chemotherapy treatment June 2, Connors began changing her lifestyle May 11, the day she met physician Heidi Puc, integrative oncologist with The Stram Center. Connors learned about the importance of a healthful diet, supplements, and continuing to lose weight. Puc also suggested an organic, plant-based, non-inflammation diet.

“Some changes were as simple

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as eating mushrooms, bok choy, kale, and cauliflower, which are all anti-inflammatory,” Connors said.

Other goals were tougher to achieve. Connors had joined Weight Watchers before her diagnosis to lose some weight and she incorporated all of Puc’s suggestions into her Weight Watchers diet.

She eliminated artificial sweeteners, canned soup, margarine and other processed foods. In their place, she began using natural sweetener stevia, green tea, home cooked foods and natural butter.

She also changed some of her personal care items, such as underarm deodorant to organic ones to reduce her exposure to chemicals.

“Analyze the foods you eat and what you put in and on your body,” Connors said.

Puc also said she should exercise five to six times weekly, including cardiovascular exercise and strength training. She still walks and runs between 15 and 20 miles weekly.

Connors dropped 24 pounds, and also appreciates the mental benefits from regular exercise.

After surgery, she took off only a week from her job as a reverse mortgage sales manager with Commonfund Mortgage Corp. in Syracuse. She also experienced no nausea throughout her 12 weeks of receiving chemotherapy.

Aug. 18 marked her final chemotherapy treatment. She continues to take another drug that she’ll receive every three weeks for a year through June, 2017. Plus, she must take an estrogen blocker for five years.

“When I was first diagnosed, I thought my summer would be awful, but in all honesty, I have felt so good,” Connors said. “I feel healthier than before diagnosis. I attribute it

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

to the alternative forms of medicine.”

In addition to eating right and exercising, she also received acupuncture, which she says helped support her immune system and bolster her energy.

“My oncologist once said, ‘We should make a poster of you for how well you’re doing,’” Connors said.

Connors encourages women with a breast cancer diagnosis to get off the Internet and tap into their support system: supportive friends, family, neighbors and coworkers.

“I still get meals, flowers and cards,” Connors said.

“You may not realize how helpful it is, but it means the world to people. You also have to be willing to accept their help.”

When Lynn M. Connors was diagnosed with cancer She added that many people prayed for her during she started the standard treatment for the disease.

In addition, she drastically changed her lifestyle. her treatments.

She changed her diet, started exercising and lost Her office allowed her to take off all the time she weight. Today she is free of cancer. “It’s been an needed to heal and permitamazing journey. I want others to realize this isn’t ted her to work home on Fri- a death sentence. You can stay active and strong.” days after her chemotherapy treatments on Thursdays.

“So many companies don’t offer life,” Connors said. “Fight and get that kind of support,” Connors said. your body as healthy as it can be to “You have enough to deal with menfight through this whole process. Retally. When you know your company maining active and taking great care is behind you, that is incredible. I lost of my body helped me rally through very little work time.” chemotherapy.

Connors said her husband of 31 “It’s been an amazing journey. years, Jeffrey, was “my rock” and her I want others to realize this isn’t a adult children, Sean and Meghan, death sentence. You can stay active helped out with household chores, and strong.” cooking and general moral support.

“You can’t let this take over your

Prostate Exam: End Finger Exam in Men, Says Urologist

T

he dreaded finger exam to check for prostate cancer used to be a mainstay of check-ups for older men. With its value now in question, some doctors share the risks and benefits with their patients and let them decide. So, should they or shouldn’t they?

“The evidence suggests that in most cases, it is time to abandon the digital rectal exam (DRE),” said Ryan Terlecki, a Wake Forest Baptist urologist who recently published an article on the topic in Current Medical Research and Opinion.

“Our findings will likely be welcomed by patients and doctors alike.”

Terlecki said the DRE, referred to by some urologists as a “clinical relic,” subjects a large number of men to invasive, potentially uncomfortable examinations for relatively minimal gain. In addition, it may deter some men from undergoing any test for prostate cancer.

The issue Terlecki’s team explored was whether the DRE is need-

ed when another more accurate test that measures prostate-specific antigen (PSA) in the blood is available.

PSA is a protein that is often elevated in men with prostate cancer.

“Many practitioners continue to perform DRE in attempts to identify men with aggressive prostate cancer who could die from the disease,” said Terlecki.

“In the era of PSA testing, we wanted to explore whether it’s time to abandon the digital exam.”

To reach their conclusion, Ter-

lecki’s research team reviewed both medical literature and the results of a nationwide screening trial in which 38,340 men received annual DRE exams and PSA tests for three years.

They were then followed for up to 13 years.

Of interest to Terlecki’s team were the 5,064 men who had a normal PSA test but an “abnormal” DRE. Only 2 percent of these men had what is known as clinically relevant prostate cancer, which means it may need to be monitored or treated.

“The DRE does capture an additional small population of men with significant prostate cancer, but it also unnecessarily subjects a large number of men to the test,” he said.

Until 2012, men over 50 (age 40 for African-Americans) were urged to have both DRE and PSA tests annually.

That was before the United States Pre-

Cancer on Course C to Become No. 1 Killer of Americans Report shows it will probably eclipse heart disease as leading cause of death in coming years.

ancer is on track to become the leading cause of death in the United States, closing in on heart disease as America’s No. 1 killer, a new government study shows.

Heart disease has consistently been the leading cause of death for decades, and remained so in 2014, according to a report from the National Center for Health Statistics (NCHS) at the U.S. Centers for Disease Control and Prevention.

But the gap between heart disease and the second-leading cause of death, cancer, has been narrowing since 1968, the researchers said.

Cancer actually surpassed heart disease as the leading cause of death for 22 states in 2014, the study found.

Back in 2000, Alaska and Minnesota were the only two states where cancer killed more people than heart disease.

In addition, cancer is now the leading cause of death for a number of minority groups, including Hispanics, Asians and Pacific Islanders, the report showed.

“It’s been edging this way for a while,” said co-author Robert Anderson, chief of the mortality statistics branch at the NCHS. “We’ve taken for granted that heart disease is the leading cause of death, but now October 2016 •

ventive Services Task Forces recommended against routine PSA testing because it could lead to over-treatment of slow-growing, non-harmful tumors. The panel did not address DRE, which was the primary method of detecting prostate cancer prior to the blood test.

As a result of the task force’s recommendation, there has been confusion and controversy about whether men should be screened for prostate cancer. Some organizations recommend against any screening and others recommend PSA screening, but only if men are counseled about the potential benefits and risks.

In previous studies, PSA had been shown to outperform DRE in detecting significant disease. The current analysis confirmed that PSA is superior to DRE as an independent screen for prostate cancer. PSA testing detected 680 cases of significant cancer, compared to 317 cases for DRE. “When PSA testing is used, the DRE rarely assists in diagnosing significant disease,” said Terlecki. “In cases where PSA testing is used, the DRE should be abandoned in common clinical practice.”

There is still a place for DRE testing for certain patients, Terlecki said.

For example, a patient with abnormal PSA who is “on the fence” about having a biopsy, may feel more comfortable proceeding with the procedure if a DRE is also abnormal, he said.

because of prevention efforts and advances in treatment, we’re making substantial progress with heart disease, to the point where now it’s roughly on par with cancer.”

Annual heart disease deaths have decreased nationwide from a peak of just over 771,000 in 1985 to nearly 597,000 in 2011. In the meantime, cancer deaths have nearly tripled from just under 211,000 in 1950 to almost 577,000 in 2011, the report stated.

Physician Mariell Jessup is a spokeswoman for the American Heart Association. She pointed out that new medicines have made it easier for people to control their blood pressure and cholesterol, treatment advances like angioplasty and heart bypass surgery saves the lives of many heart patients, and more people have quit smoking and started eating healthier diets.

“One could argue that we’re doing a better job of keeping people with heart disease alive,” said Jessup, who is a professor at the Hospital of the University of Pennsylvania in Philadelphia. “It’s not that people aren’t experiencing heart disease, but they’re not dying from it.”

The report was published online Aug. 24 in the CDC’s NCHS Data Brief.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

What’s Involved in Cancer Research Funding Millions of dollars are donated annually for cancer research, but where does the money go?

By Deborah Jeanne Sergean

W

hile most people know what the pink ribbon symbolizes (breast cancer) other types of cancer seem less “popular” when it comes to media attention and awareness campaigns.

Cancer research efforts, however, are mostly based upon other factors, according to Martha Ryan, senior director of community engagement for the American Cancer Society (ACS) Western New York, which serves the area from Buffalo to Syracuse.

“We don’t necessarily fund research that is for a specific kind of cancer,” Ryan said. “It’s general, broadbased research, so it will have an impact across the gamut.”

The ACS has invested more than $4.8 billion nationwide in both internal and external research projects and has become the second-largest source of cancer research funding behind the federal government.

Across the state, the ACS currently funds nine research grants totally $6.14 million, including University of Rochester Medical Center, Roswell Park Cancer Institute in Buffalo, Cornell University in Ithaca and University at Buffalo.

The organization funds research based upon the proposal’s merit. The

ACS’s selection process includes a blind, peer review. No demographic or organization information remains on the application so reviewers won’t know who submitted the request.

The stringent process has helped the ACS find “the best and brightest, so whatever their research is, others can use their findings and a lot of times, we may be the initiator,” Ryan said.

A grant from the ACS may also provide a stepping stone for a young researcher to receive additional grants in the future.

The ACS also advocates for additional research funding from the federal government. Once the ACS has depleted its grant money, the organization turns to corporate and private donors to fund promising research projects.

“We encourage young researchers to reach out to us so we can help them in that application process so their proposal is very strong,” Ryan said.

Otherwise, promising research could be delayed while the researcher has to resubmit his proposal or decide to apply to a different organization for funding.

“Almost every major cancer breakthrough has been associated with one of our researchers,” Ryan said.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

She said that private donors can earmark the type of cancer research their donation will fund, usually a type of cancer or promising potential treatment that connects with the donors.

The ACS annual report details research projects and their results.

Ryan said that 75 percent of funds go toward programming, which includes education and research.

“I really do think the organization as a whole does a good job in focusing on what it needs to focus on,” Ryan said. “Compared with where we were 10 years ago, and what’s going on now, we are really making a difference.

When we receive a check, we’re going to put it to good use.”

In June, the ACS announced a goal to double its annual funding for research by 2021, amounting to $240 million.

Generating funding for research is “a long-term process,” said Leszek Kotula, associate professor of urology and biochemist with molecular biology with SUNY Upstate University and associate director of Upstate Research. “In all cases, there is a rigorous review process. In most cases, it’s based on the peer review process.

“In the US, there’s a huge amount of money given to cancer research and the public benefits greatly from that. It’s so, so important for all of us. Anyone who gives any amount of money should be cherished for their generosity and good heart.”

Kotula believes that a particular cancer’s “popularity” may play a role in donors’ preference; however, the merit of a particular research proposal determines if a specific research project receives funding.

“In many cases, donors have a dramatic story of losing someone close,” Kotula said. “It’s our obligation to give back our time to the people who give money to research.”

Physician Leslie J. Kohman, SUNY distinguished service profes-

sor and surgery director of outreach at Upstate Cancer Center, said that it’s important for donors to understand the types of cancer research in which scientists engage: investiKohmam gator initiated, where the scientist has an idea; contract, where an entity or foundation decides they want to do research on a topic; cooperative group research, which is clinical trials through the National Cancer Institute; corporate research undertaken by pharmaceutical companies; and foundation-based research. Private foundations fund what they like, but researchers working for public organizations must receive approval from their internal review committee, plus achieve funding.

Like Ryan, Kohman said that a lot of cancer research isn’t about a particular disease, “but on a mechanism of disease that could apply to a lot of different cancers, not just lung, breast or colon or other type of cancer.”

She thinks that common cancers receive lots more attention, such as breast cancer, since many people know someone who has experienced the disease. Others, such as lung cancer, don’t receive as much positive association because smoking — an avoidable factor — causes many lung cancers.

Though donating toward the research of a particular cancer may make a heartfelt gesture, donating a general gift for cancer research can help entities disbursing finances “target it to the current needs to the people working in research,” Kohman said.

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October 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 15

Women’s HEALTH

Pregnancy Not an Excuse to Skip Exercising But mothers-to-be are advised to choose exercises more carefully

By Deborah Jeanne Sergeant

M

any aspects of a woman’s life change during pregnancy; however, the need for exercise doesn’t. Taking nine months off from fitness doesn’t benefit mom or baby.

“The benefits of exercising during pregnancy include improving cardio-respiratory fitness, weight management, decreasing urinary incontinence, increasing psychological well-being, decreasing the chance of gestational diabetes, decreasing the chance of a cesarean section, and decreasing the need to operate during vaginal deliveries,” said Patrice Paolucci, osteopathic doctor with Associates for Women’s Medicine and St. Joseph’s Hospital.

Of course, pregnant women should take precautions with exercise. Kicking off a campaign to lose weight and getting into shape once pregnant isn’t recommended.

“Exercise during pregnancy is recommended and should be tailored based on each individual woman’s personal history,” Paolucci said.

For example, a pregnant woman accustomed to running miles a day can likely handle more exercise than one who has never exercised.

Paolucci added that the few contraindications to exercise or activity during pregnancy include contact sports, such as hockey, soccer and martial arts sparring.

Activities with a likelihood of falling, such as inline skating, skiing, horseback riding are also ill advised. Even diving or surfing can place too much imPatrice Paolucci, pact on the osteopathic doctor with body. Scuba Associates for Women’s diving is Medicine also off limits since babies can experience decompression sickness upon the mother’s surfacing. Women should also avoid lying on their backs after the first trimester.

Paolucci suggested swimming, stationary cycling, low impact aerobics, yoga, Pilates, running/jogging, and strength training as generally safe, low impact activities.

Some activities may be modified. Jessica Mustafa, a certified yoga instructor, leads classes for CNY Healing Arts in Syracuse.

“Everything in prenatal yoga is designed to benefit the pregnant woman in any stage of her pregnancy,” Mustafa said. “In regular yoga,

Hysterectomy Not Only Answer for Uterine Fibroids

By Deborah Jeanne Sergeant

A

pproximately 20 to 80 percent of women develop uterine fibroids by age 50. The muscular tumors grow in the uterine cavity, in the wall of the uterus, or on the outside of the uterus, either as a cluster of tumors or as a single tumor.

They vary in size from tiny to the size of a grapefruit.

Sometimes, physicians discover fibroids by feeling their mass during a routine pelvic exam; however, since fibroids don’t lead to cancer, physicians leave them alone if fibroids remain asymptomatic.

Fibroids can also cause abdominal pain, pressure on the rectum or bladder, painful sex and heavy menstrual bleeding. Women presenting these symptoms usually seek medical help.

“Women with fibroid uteruses have an alternative treatment than surgical hysterectomy: uterine fibroid embolization,” said physician Mitchell I. Karmel, who practices at

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Upstate University Hospital.

Karmel is an interventional radiologist trained in image-guided treatment and diagnosis of disease.

Using an image-guided catheter, he can treat uterine fibroids utilizing an embolization procedure.

“If a woman has clinically significant symptomatic uterine fibroids, we place a small catheter into the artery that supplies the uterus and use the vascular supply to the fibroids to inject small particles that will block off their blood supply,” Karmel said.

“This causes the fibroids to atrophy.

In a large percentage of time, this eliminates the need for surgery. Once the fibroids lose their blood supply, they decrease in size which reduces their symptoms.”

Patients usually stay overnight, mostly for short-term pain control. The procedure eliminates the hospital stay required for patients undergoing hysterectomy. This also reduces the risks associated with gy-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

you see deep twists and back bends.

We avoid those. We avoid most back bends. I have women stay off their back after week 20 and also avoid lying on their belly. Most movements can be modified. Yoga props can help you, too.”

She added that yoga’s controlled breathing can help women while birthing.

“Whether medicated or not, they need to focus on breathing and managing pain,” Mustafa said. “Focused breathing is the best way.”

She said that women need to listen to their bodies. Just as when they’re not pregnant, expectant mothers should make sure they stay well hydrated before during and after class, and that holds true for any type of activity.

Warming up and stretching should be part of every exercise routine. In addition to aerobic exercise, strength training helps keep bodies healthy.

Doctors generally place more

restrictions on pregnant women at risk for preeclampsia, previous premature delivery, cervical or placenta problems, bleeding, severe anemia or growth restricted babies.

“If you have any shortness of breath, calf swelling, bleeding or other medical conditions that are new, don’t do anything until evaluated,” said Mary LaRussa, fellowship-trained nurse practitioner, women veterans program manager and maternity care coordinator with the Syracuse VA Medical Center.

Also, women should stop exercising and immediately contact their doctors if they experience vaginal leaking, feelings of dizziness, irregular or rapid pulse, or lowered fetal movement.

Even without elevated pregnancy risks, pregnant women should discuss their exercise plans with their doctors so that they can keep themselves and their babies healthy and safe.

necologic surgery, such as infection and adhesions.

“Embolization has been shown to reduce the size of fibroids up to 50 percent,” said physician Aaron Sharma, who has a certificate of added qualification for vascular and interventional radiology, practices at CRA Medical Imaging in East Syracuse.

Losing half the fibroid mass “can make a big difference,” Sharma added.

In addition to sparing patients the pain and recovery of an invasive surgery, embolization costs a lot less money than hysterectomy.

“We want to try what’s easiest, least invasive and least expensive,” Shamra said. “A lot of these are women who are working, have kids at home and want to get back to their active lives.”

Because it’s just a nick to open the skin instead of major surgery requiring weeks of recovery time, patients experience little downtime.

Undergoing major surgery for hysterectomy, combined with a more lengthy hospital stay, also increases a patient’s risk of infection.

Myomectomy can remove the fibroids. While more invasive than embolization, myomectomy leaves the uterus intact.

Ultrasound can also heat and

destroy fibroids without opening the skin.

Medication may also help shrink fibroids by reducing the hormones that help fibroids grow.

Ultimately, women with fibroids should discuss all the options and effects before deciding which route to take.

Who Gets fibroids?

T

he US Department of Health and Human Services’ Office on Women’s Health states that several factors can increase a woman’s risk of developing fibroids: • Age. Fibroids become more common as women age, especially during the 30s and 40s through menopause.

• Family history. Having a family member with fibroids increases your risk.

• Ethnic origin. African-American women are more likely to develop fibroids.

• Obesity. Women who are overweight are at higher risk for fibroids. .

• Eating habits. Eating a lot of red meat is linked with a higher risk of fibroids.

Women’s HEALTH

Weight Loss Surgery: Don’t Gain it Back

Study shows that half the laparoscopic sleeve gastrectomy patients regain the weight they lost after surgery

By Deborah Jeanne Sergeant

F

or people who are morbidly obese, bariatric surgery may provide a means to quickly shed weight that threatens their health and hampers their quality of life.

However, a study published in the Journal of the American Medical Association in November shows that over time nearly half the laparoscopic sleeve gastrectomy patients regained the weight they lost shortly after surgery.

Additional studies have made similar findings for other types of weight loss surgery.

According to several local physicians, the key to success lies in viewing the surgery as a tool, not panacea, for weight loss.

Weight loss surgeon William A. Graber said that follow-up is what helps patients continue their weight loss success.

“Bariatric surgery isn’t magic but a powerful tool,” Graber said. “It’s a lifelong process to keep the weight off. It’s not just the surgery but diet vigilance, lifelong monitoring blood work.”

Graber owns William A. Graber, MD, PC, in Utica and Syracuse, which is associated with St. Joseph’s Hospital Health Center.

Those who revert back to their old habits of inactivity and careless eating see the pounds pile on.

“You can’t outrun your fork,” Graber said. “The amount of exercise you’d have to do to burn off the calories in one little cookie is a lot. At that point, you’re breaking even. You want exercise to go towards weight you’ve stored, so your diet has to change.”

His staff monitors electrolytes and ensures patients obtain all the nutrients they need.

Sticking with the follow-up and guidelines is the hardest part, according to physician Kaushal B. Nanavati, clinical assistant professor in the department of family medicine at Upstate Medical University.

“They need to be consistent with the nutrition and physical exercise component,” Nanavait said. “The weight will come back if they haven’t addressed the underlying reason that

led to the weight gain, like psychological or physiological.”

Patients must shun the very foods and lifestyle habits that contributed to their obesity, so they must develop coping mechanisms to stack on track.

“The behaviors and hunger returns and if you haven’t figured out how Scinta to deal with them before surgery, they will come back to bite you,” said physician Wendy Scinta, medical director of Medical Weight Loss of New York in Fayetteville and assistant professor of Family Medicine at Upstate Medical University.

She said that 15 to 20 percent of her patients have had bariatric surgery before. She feels that a lack of patient incentive contributes to the eventual weight gain after bariatric surgery, but surgeons don’t receive coverage for teaching nutrition and behavioral modification.

“Some surgeons have very defined programs and others give them a handout and send them on their way,” Scinta said. “The best approach is an obesity medicine specialist to work with them before and after.”

Solid planning and consistent follow-up helps patients succeed long term. Working with a personal trainer, support group or fitness class can provide more motivation.

October 2016 •

T

Understanding Weight Loss Surgery

he type of gastric bypass surgery used depends upon many factors, all of which are discussed before surgery. Here's a rundown of the kinds of surgery available: • Roux-en-Y is not reversible.

It involves reducing the size of the stomach and attaching the small intestine to it. Patients cannot eat as much food as they used to and their ability to absorb nutrients is limited as well.

• Biliopancreatic diversion with duodenal switch removes most of the stomach and bypasses most of the small intestine. Patients cannot eat as much as they could before, and increases the risk for absorption issues.

• In laparoscopic adjustable gastric banding, the surgeon places a band around the top part of the stomach to separate it into two areas. The tiny pouch in the uppermost part cannot hold much food, so patients eat less. The tightness of the band may be adjusted. Patients may not lose as much weight with this method.

• Vertical banded gastroplasty, commonly called "stomach stapling," surgically divides the stomach to control food intake. The top portion of the stomach empties food into the rest of the stomach. While this slows eating, many patients find they don't achieve lasting weight loss.

• Sleeve gastrectomy, or vertical sleeve gastrectomy, is like biliopancreatic diversion with duodenal switch, but without changing the placement of the small intestine. By changing the shape of the stomach, patients eat less but may not lose as much weight as with other methods.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

Parenting

By Melissa Stefanec

The Plight and Reign of No. 2

A

s anyone who’s ever had a sibling knows, there’s something to the whole birth order thing.

People make trite statements and jokes about it all the time, but the place you were born in the chronology of your siblings affects the person you become.

As the first child, I know my childhood was molded by the fact I was the first child for my parents and the first grandchild for both sets of my grandparents. The ups and downs of being the oldest played a critical role in who I was as a child and who I am today.

As I watch my children grow up, I can’t help but analyze how their ages and place in the birth sequence is affecting their childhoods and, ultimately, their lives.

There’s no question my husband and I are raising No. 2 a little differently than No. 1, and most of that is out of necessity. Typically, it’s physically and emotionally impossible for us to give our son our full attention.

However, for all the times he isn’t

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getting the same hands-on parenting our daughter received, he is also hitting the toddler jackpot (which looks something like a tablet playing Caillou in one hand and a no-spill snacking cup in the other). Watching my son grow up, I feel as though he is living a paradoxical life; he is enjoying a plight and a reign.

The plight

• A spotlight for two For the first few years of her life, my daughter got unbridled attention and plenty of one-on-one time with her parents and relatives. She was dutifully doted upon and admired.

My son, River, doesn’t know what it’s like not to share the spotlight. His sister, Stella, is a big part of his life and, unfortunately, she finds him to be a real pest. This has to be a hard thing. He admires her so much, and she is often very frustrated by him.

I wish his little brain didn’t have to deal with that.

• The daredevil Although I’ve never been a

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

helicopter parent, River is more of a free-range toddler than his sister was.

Between my possessing only one set of eyes and his uncanny ability to teleport, he often gets into mischief.

This leads him to get into more dangerous predicaments than his sister did.

• It’s not cute anymore In many ways, Stella probably got away with far more than River does. My husband and I are no longer naïve; we are wise to the toddler game. What was once cute to us has become something to rein in so we don’t make all of the same mistakes twice.

• Only one book We read to our children almost every night, but the quantity and quality has definitely diminished.

When you have to put two kids down at almost the same time, you can’t offer thirds and fourths on the reading thing. The only-one-book concept extends far past bedtime stories. If there is something to be had in life besides love, River is getting less of it because that something is necessarily divided by two.

The reign

• He does what he wants ‘cause he wants to Although my husband and I rein in a lot of behaviors, we also let River have way more independence and free time. This is often to our detriment; as soon as our backs are turned, he is capitalizing. If I think I am going to sneak in a potty break, he is going to squirrel my tablet out of its hiding place. If I think I am going to make some dinner, he is going to explore anything that’s off limits in

our home. River has a freedom that is only enjoyed by being born farther down the line.

• The baby expectations When it comes to childish behavior, my son probably gets let off the hook when he shouldn’t. That’s because he is a baby and doesn’t know much better. We tell Stella this all the time and encourage her to help him by teaching him. It has to feel a little nice to be forgiven so frequently because you are the baby.

Easy forgiveness is hard to come by and, as the second born, he is often raking it in.

• So, it’s actually a little cute Because we aren’t planning on having any more children, every stage seems more ephemeral than it did with Stella. Every big moment is also a last moment, and that makes our son extra adorable. This isn’t our first rodeo, so we can savor and enjoy the beautiful moments of childhood a little more. That makes River special in a very important way.

• Bedtime tears I’m not talking about his; I’m talking about mine. Some nights, after I have my youngest all snuggled in and he is drifting off to sleep, I have to turn around and stare before I walk out of his room. I look at his perfect little body and perfect blonde locks of hair and think about how much I love him. I think about how he is my last baby and how much of a treasure he is. I am so overcome that I tear up a little.

There is something intrinsically beautiful about being little and being a baby and being treated and loved that way. As he grows, this isn’t going to change.

Cupping Grows in Popularity

Ancient therapy that offers pain relief gained popularity thanks to Olympian Michael Phelps

By Deborah Jeanne Sergeant

M

ost recently popularized by Michael Phelps and other Olympians, cupping therapy has been used since ancient times.

The technique involves using a cup to create a vacuum on the skin to pull it upwards, away from the body, and suspend it.

The modality has been recognized for its ability to increase circulation, speed healing and break up scar tissue, all benefits any Olympian would prize. But local experts say that everyday people my benefit from cupping as well.

Joanne M. Verone, chiropractor and licensed massage therapist at Delphi Healing Arts Center in Syracuse, has practiced for 50 years.

But she said that cupping therapy far exceeds her career span.

“Cupping is one of the oldest modalities,” Verone said.

She referenced ancient Egyptians as early practitioners of cupping, who used it to help with issues involving fever, pain, vertigo, menstruation, appetite, constipation and wound healing.

“It reduces stiffness, cramps, joint pain and scar tissue caused by injury,” Verone said. “The cups help increase the blood flow and repair those little tears.”

Unlike massage therapy, which pushes tissue inward, cupping pulls the skin outward to stimulate blood flow and the movement of lymph.

Sessions usually last five to 10 minutes, but Verone accompanies cupping with other modalities.

Kristen Gilbert, licensed acupuncturist and Chinese medicine practitioner with CNY Fertility & Healing Arts in Syracuse, said that

drinking water can improve the results of a cupping session because “cupping helps detoxify the body so drinking water before and after helps in the process.”

As the Olympic athletes evidenced, cupping can leave behind ring-shaped marks; however, Gilbert

said that the process isn’t painful.

Clients usually feel a little tension in the skin, but find cupping relaxing.

Gilbert said the marks are part of its therapeutic effect as it improves circulation.

“It’s also helpful to bring clothing that covers where the cupping is

A patient of Joanne M. Verone, chiropractor and licensed massage therapist in Syracuse, receiving cupping therapy. “It reduces stiffness, cramps, joint pain and scar tissue caused by injury,” Verone says of the therapy. “The cups help increase the blood flow and repair those little tears.”

October 2016 •

performed,” Gilbert said. “Exposure to cold or wind can cause the muscles to constraint, lead to pain and be counterproductive to the healing process.”

Most practitioners use silicone or glass cups that create a vacuum using a pump. For chronic pain issues, most people require several sessions for a few weeks, and then a maintenance session about every three months. Verone said that the effect varies depending upon the condition the client is experiencing and the individual himself.

Some in Western medicine greet many integrative modalities with skepticism; however, cupping has gained credibility.

“They say there’s no proof it works, but I’ve used it for years and years,” Verone said. “If it’s useless, why do people do it? A lot of celebrities use this. They can have the most expensive therapies available to them. Why would they do it if they didn’t see some results?”

Practitioners offering cupping may include massage therapists, physical therapists and acupuncturists. If the practitioner includes cupping with other modalities in a therapy session, it’s usually covered by insurance.

“I find that it works and I love it,” said Patrick M. Fuller, licensed massage therapist, owner of a selfnamed practice in Fayetteville. “The people who seek it out love it and I’m more than happy to offer it to them.”

Fuller said that contraindications include people with wounded, thin or fragile skin; those who are immune compromised; or, for pregnant women, not on the abdomen.

Rachel McClean, licensed in massage therapy and acupressure, practices at Terra Organic Spa in Fayetteville, advises anyone interested in the modality to “receive cupping from a healthcare practitioner and one who has a good reputation in what they practices like acupuncture, physical therapy or massage therapy.

It depends upon what their methods are.”

McClean routinely takes a health history to assess the patient’s health and form the best treatment plan.

“It’s an odd treatment at first, but it grows into a life-changing treatment,” McClean said. “Cupping has revolutionized my practice. Even if relaxation is your only goal, I want you to reach your goal. cupping has had such a great effect for clients.”

A patient of chiropractor Joanne M. Verone in Syracuse receiving a cupping therapy.,

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 19

Interventional Radiology: Guiding Medicine from Diagnosis to Treatment Field has dramatically expanded the role it plays in treatments, diagnosis

By Deborah Jeanne Sergean

M

any people become familiar with radiology through a diagnostic such as X-ray or sonogram.

But the field has grown dramatically in the past several years to make the radiologist a vital part of treating diseases and disorders from head to toe.

One example is interventional radiology, which can enable minimally invasive procedures.

“For the most part, we work on the whole body,” said physician Aaron Sharma, who earned a certificate of added qualification for vascular and interventional radiology.

He practices at CRA Medical Imaging in East Syracuse with privileges at Crouse Hospital, Oswego Hospital and Syracuse VA Medical Center.

“At our practice, we don’t do much above the neck, as there are specialists for that,” he added.

By using medical imaging, physicians can offer precision-guided treatments. For example, repairing blocked arteries requires just a nick instead of a more invasive procedure. Blood clots to the brain may be broken up by insertion of a small catheter.

Vertebrae repair offers another

example. For an elderly patient, a fractured vertebrae begins a sharp physical decline as mobility minimizes. That can also lead to lack of social interaction and further de-conditioning. But thanks to radiology, physicians can perform a vertibroplasty, a procedure that involves injecting cement to stabilized the fractured bone through a 1/8-inch incision.

For elderly patients unable to tolerate general anesthesia and invasive surgery, the procedure has proven life-changing.

“We put tubes into a lot of places for vascular access, catheters for IV access, or implanted ports completely under the skin for chemotherapy,” Sharma said. “We also put tubes into kidneys to access kidney stones for surgery or because someone has a stone that can’t be removed. We can put tubes into bile ducts.”

Mitchell I. Karmel, interventional radiologist with Upstate Medical Center, said that men with excessive veins in the scrotum can experience infertility because of the additional body heat generated by the blood vessels. For this issue, interventional radiologists can perform a testicular varicoseal. By accessing a vein in the abdomen, he can place coils in the veins to shut down the superfluous

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veins and reduce heat in the scrotum.

“Women with fibroid uteruses don’t have to undergo hysterectomy,” Karmel said.

Radiologists can use an artery in the leg or groin to embolize the blood vessels and shrink the fibroids until they become asymptomatic.

Karmel keeps patients in the hospital for pain control overnight, a far cry from the numerous days’ stay for hysterectomy. Plus, patients avoid the risk of adhesions and scar tissue associated with abdominal surgery, as well as the increased risk of infection from an invasive procedure.

Radiology can also treat cancer patients without dramatically compromising their quality of life. Radioembolization of liver tumors, for example, places radioactive particles to radiate only the tumor from the inside out, while the organ maintains good blood flow.

“Those patients are in and out the same day,” Sharma said. “They have almost no side effects. It’s a technique that’s under-utilized.”

His office began recently using the microwave oblation technique, in which the imagery-guided probe emits intense microwave radiation and burns the tumors out.

Medical imaging can also help

stop patients’ internal bleeding and to drain large-scale infection. Instead of a large opening, physicians can use a tiny opening and use medical imaging to guide scopes and tubes.

Sharma said that using this technique recently helped an elderly patient who otherwise likely would have died of internal bleeding due to a complication for an unrelated procedure since most surgeons would not perform an open surgery on someone that old.

Radiology’s minimally invasive procedures won’t replace general surgery, but for some conditions can reduce recovery time while providing the same or even better results.

For many of these procedures, a little sedation and a numbing medication is all patients need instead of general anesthesia. Using imaging can help reduce the length of hospital stays and turn some procedures into out-patient treatments.

“I see interventional radiology going into more oncologic applications,” Sharma said. “The future of oncology will change as a whole.

There will be more targeted treatments and less invasive techniques like these to prolong life and improve quality of life.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

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My Turn

By Eva Briggs

Lyme Disease Remains Significant Tick-borne Problem

A

lthough summer is over and insect season is drawing to a close here in the northeast, there was a lot of news this year about Zika virus and the need for mosquito bite prevention.

Here in Upstate New York, Lyme disease remains a significant tickborne problem. It seems like an apt time to review insect repellants.

DEET (N,N-diethyl-m-toluamide) was developed in the 1940s by the Department of Agriculture for military use, and has been available to civilians since 1957. It has the best documented efficacy against mosquitoes. It also repels ticks, chiggers, fleas, gnats and some flies.

DEET comes in concentrations ranging from 5 percent to 100 percent. 20 percent is required to deter ticks. But going higher than 50 percent won’t add effectiveness.

Some formulations provide protection for up to 12 hours. It’s generally safe for children age 2 months and older. The American Academy of Pediatrics advises using concentrations of 10-30 percent. Rarely children who ingest DEET, or have excessive or prolonged use, develop

toxic encephalopathy (brain malfunction). So it’s a wise idea to keep DEET out of reach of small children, to keep them indoors during periods of high mosquito activity, and to use mosquito nets over strollers.

In fact, avoiding exposure to biting insects when possible is good advice for people of all ages.

Picaridin, the active ingredient in some formulations of Avon SkinSo-Soft and other products, protects against mosquitoes, ticks, flies, fleas and chiggers. It’s been used since 2001, in concentrations from 5-20 percent. Higher concentrations last longer, up to 10 hours. 20 percent picaridin works as well as the 33 percent DEET used by the military.

Although it may irritate the skin and eyes, picaridin seems less irritating than DEET. It’s safe in children in concentrations of 5-10 percent. Picaridin has no odor and isn’t greasy. It doesn’t damage fabric or plastic but can discolor leather and vinyl.

IR3535 (insect repellant 3535 or ethyl butylacetylaminopropionate) is found in some formulations of Avon Skin-So-Soft. It was registered for use in the U.S. in 1999, thought it

was used in Europe for 20 years before that. IR3535 repels mosquitoes, deer ticks, and flies. It can prevent mosquito bites for several hours.

Oil of lemon eucalyptus (OLE) occurs naturally in the lemon eucalyptus plant, but is chemically synthesized for commercial use. It can protect against mosquitoes for up to 6 hours.

It doesn’t work as well as DEET or picaridin to deter ticks. OLE isn’t recommended for children less than 3 years old.

A variety of plant-based essential oils - such as clove, geraniol, and patchouli - are touted as insect repellants. But they don’t provide much protection against mosquitoes. While high concentrations might work better, they are more likely to irritate the skin.

Unlike the above substances, meant to be applied to skin, permethrin is an insecticide used on clothing, tents, sleeping bags, and mosquito nets to repel mosquitoes and ticks. Home-applied permethrin remains active for weeks, lasting through several launderings.

Clothing treated commercially with permethrin can retain its mosquito

repellant prop- erties for as long as one year.

In one study, performed in an indoor laboratory, people wearing permethrin treated socks and sneakers were 73 times less likely to be bitten by ticks!

According to the CDC, DEET, picaridin, IR3535, and OLE are safe during pregnancy. And there is no data showing any harm from permethrin to pregnant or nursing women, or to their children.

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

Staff from Oswego County Opportunities (OCO) accepts delivery of the OCO Health Education mobile HIV Testing Van from Longley Bros. Dodge in Fulton. Made possible through a grant from NYS Department of Health AIDS Institute and acquired and equipped through collaboration with Longley Brothers Dodge, OCO’s Mobile Testing HIV Van will travel throughout Oswego County offering free testing for HIV and Hepatitis C, along with education, referrals to support services, and safe sex options. Above from left are: Bryan Seamans, commercial sales manager and Chris Atwater, general sales manager for Longley Bros. Dodge; OCO Collaboration Manager Toni Ross, and OCO Health Educator Sarah Woodworth; Co-Owner of Longley Bros. Dodge Dennis Longley; Co-Owner / General Manager Doug Longley; and OCO CFO Brian Greenshouse.

I

n a direct response to Gov. Cuomo’s plan to end the HIV epidemic in New York state, the NYS Department of Health AIDS Institute has awarded Oswego County Opportunities (OCO) a grant to begin a mobile HIV testing initiative in Oswego County.

The grant is one of only three that were awarded in the Upstate area and is the only one that serves such a rural community as Oswego County.

OCO Health Services was able to obtain a customized van that is fully equipped to administer testing for HIV. The van will travel throughout all of Oswego County and provide community members with easy access to HIV testing.

“It’s exciting to think of the opportunities the HIV testing van opens up for our outreach program,” said OCO Health Education Services Coordinator Ellen Lazarek. “The van allows us to easily reach out to all of Oswego County to conduct tests and offer support groups to towns and villages where we do not have offices and there are limited transportation services.”

Through its association with the OCO Reproductive Health program and collaborations with other agencies, OCO Health Services staff will be able to test individuals on the spot, let them know the results, and

refer them to the proper agency so that they will be able to access treatment as soon as possible.

“We are thrilled that our health education team has secured the mobile van to provide HIV testing throughout the county,” said OCO Reproductive Health Program Coordinator Inga Back. “These efforts complement what we do in our Centers for Reproductive Health and extend our reach into the community by linking individuals to our clinics for more comprehensive family planning services.”

The HIV testing, to be done by individuals trained in NYS HIV confidentiality and testing, uses a rapid test technology that can detect the virus faster than previous testing options. The quicker results allow for individuals whose test produced a reactive result to begin treatment sooner so that their viral load can be suppressed, thus leading to a better health outcome. They will also be able to take the necessary precautions and be less likely to transmit the virus to someone else.

To ensure the success of the HIV testing van OCO Health Education has established a strong collaboration with a number of key partners that includes educational and medical services to meet the needs of those tested.

Health Coverage

Understanding Medicare Enrollment this year is from Oct. 15 through Dec. 7.

By Jon Selzer

F

or most of us, Medicare planning is complex and confusing.

A brief review of the basics can help determine which plan is best suited for you.

“Original Medicare” is broken into two sections: Part A which covers hospital in-patient care, hospice care, and limited skilled nursing care. For most, Part A is available at no monthly cost. The second section of “Original Medicare” is Part B which covers medical providers, out-patient services, tests and certain therapies. For the majority of us the Part B monthly premium is currently $121.80.

• Parts A & B do not cover all medical care costs in full, or prescription medications. There are also deductibles, coinsurance percentages, and co-pays to consider. These additional costs add up quickly, and therefore many of us will need to consider additional options to manage out-of-pocket expenses.

The options are to purchase either a Medicare supplement (Medi-Gap) plan, or a Medicare Advantage Plan.

(Regardless of which approach you ultimately choose, you must first be enrolled in Medicare Part B).

• Medicare supplement plans (private insurance) offer various options to cover some of the additional expenses that Original Medicare (Parts A&B) do not. Depending upon your current health and circumstances, you may wish to purchase more (or less) coverage. The most expensive plan available right now, that fills nearly all of the “gaps” left

by Parts A&B currently costs approximately $190 per month here in Central New York. However, it still does not cover prescription medications.

Therefore, an individual purchasing a Medicare Supplement Plan would still need to purchase a prescription drug plan (Medicare Part D).

• Medicare Advantage Plans (sometimes referred to as “Medicare Part C”) are a more recent addition to the Medicare Planning process.

Within the Advantage Plan, “Origi-

nal Medicare” (A&B) is “outsourced” to a private health insurance company, who must provide at least an equal benefit to that available in the Original Medicare plan and may offer plans that provide additional benefits. Most of these plans have prescription drug coverage built in at no additional cost. Medicare Advantage plans do have co-pays, deductibles and coinsurance; however, these costs tend to be modest and help to lower a person’s overall costs. Each plan comes with a stated maximum out-of-pocket limit that an individual would pay over the course of a year.

Another note on prescription drug coverage, as this is often one of the biggest healthcare expenses that many of us will encounter: whether it is a free-standing Part D plan, or embedded within a Medicare Advantage Plan there are generally co-pays required depending upon the type of medication necessary. Most plans have a tiered pricing structure for covered drugs, and Part D plans have three stages, under which you pay differing prices for your prescription drugs during each stage: initial, gap (often referred to as the “doughnut hole”) and catastrophic. Federal guidelines determine these stages and they are implemented by the insurance carrier.

If all of this information seems confusing and overwhelming — it is understandable! Companies offer a multitude of coverage alternatives, and it can be quite an undertaking to sort through all of the information available. Working with someone familiar with these choices can be an efficient, effective way to determine which plan is best for you.

Remember, open enrollment this year is from Oct. 15 through Dec. 7.

Please call your adviser to review your options now!

Jon Selzer is a financial adviser with Marathon Financial Advisors, Inc. in Syracuse. He can be reached at 315-4465797. For more information, visit www. marathonfinancialsvc.com.

Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by

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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamothe Jr. Eva Briggs (M.D.), Jon Selzer • Advertising: Amy Gagliano, Cassandra Lawson • Design: Eric Stevens, Jeff Adkins • Office Assistant: Michelle Kingsley No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider.

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Page 23

The Social Ask Security Office

By Jim Miller

Meal Service Delivery Options for Seniors Who Don’t Cook Dear Savvy Senior, What types of healthy meal delivery options can you recommend for seniors who live at home, but don’t cook and don’t get out much. Since mom passed away, my dad’s diet is terrible and I worry about his health.

Long-Distance Daughter Dear Long-Distance,

There are various healthy meal service delivery options available to non-cooking seniors who live at home, but what’s available to your dad will depend on his location and budget. Here are several to check into.

Senior Meal Programs

A good place to start is to find out if there’s a senior home delivery meal program in your dad’s area.

Meals on Wheels is the largest program that most people are familiar with, but many communities offer senior meal delivery programs sponsored by other organizations that go by different names.

To find services available in your dad’s area, visit MealsOnWheelsAmerica.org, which offers a comprehensive directory on its website, or call the area aging agency near your dad. Contact the Eldercare Locator at 800-677-1116 to get the number.

Most home-delivered meal programs across the U.S. deliver hot meals daily or several times a week, usually around the lunch hour, to seniors over age 60 who have problems preparing meals for themselves, as well as those with disabilities. Weekend meals, usually frozen, may also be available, along with special diets (diabetic, low-sodium, kosher, etc.).

Most of these programs typically charge a small fee (usually between $2 and $6) or request a donation, while some may be free to low-income seniors.

Measure Meals (goodmeasuremeals. com), and many others.

These companies offer a wide variety of tasty meal choices, and will usually post the nutrition information for their meals right on their website. Most companies will also cater to a host of dietary and medical needs, such as low-sodium and low-carb meals, diabetic meals, gluten-free, dairy-free and vegetarian options.

Most of the food arrives frozen, but a few companies ship food fresh.

Prices generally start at around $10 to $13 per meal, plus shipping, however most companies provide discounts or free shipping when you order meals in bulk.

Grocery Stores and Restaurants

Depending on where your dad lives, he may also be able to get home delivered meals from local grocery stores or restaurants. Some grocery stores offer a selection of pre-cooked meals and foods, including roasted chicken, mashed potatoes, and fresh soups and salads. Contact the grocery stores in your dad’s area to inquire about this option. Or check with some of his favorite restaurants to see if they offer home delivery.

Personal Chefs

Another option for non-cooking seniors with a bigger budget is to hire a personal chef from time to time.

A personal chef can provide your dad with a do-it-all service that will help plan his meals, do the grocery shopping and prepare him several weeks worth (or more) of tasty meals in his home, which he can freeze and eat whenever he wants. Or, they can prepare it in their own kitchen and deliver it. Chef’s fees range between $200 and $300 plus groceries. He may be able to save money by sharing meals with you or another family member, or a friend or neighbor.

To find a personal chef in your dad’s area, check the listings at the American Personal & Private Chef Association (personalchef.com) or the United States Personal Chef Association (hireachef.com).

Online Meal Delivery

Another option that’s a bit more expensive is to purchase your dad’s meals online and have them delivered to his home. There are a number of companies that offer this type of service like Magic Kitchen (magickitchen.com), Home Bistro (homebistro.com), Personal Chef To Go (personalcheftogo.com), Good Page 24

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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www. savvysenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

By Deborah Banikowski District Manager, Syracuse

Providing Disability Benefits For 60 Years Aug. 1 marked the 60th anniversary of the Social Security Disability Insurance (SSDI) program, signed into law by President Dwight D. Eisenhower in 1956. Originally, the program was limited to individuals who were 50 years of age or older. It also had a six-month waiting period, and there were no benefits payable to spouses or children. The disability program has undergone many changes to become the program it is today. Now, people who receive Social Security disability benefits can also receive Medicare coverage after 24 months, and their dependents may be eligible to receive benefits on their earnings records. There are also work incentives in place to help people with disabilities go back to work.

As of June 2016, there are more than 10 million disabled workers and dependents receiving a portion of the more than $11 billion that is sent each month in Social Security disability payments. It can happen to

anyone: studies show that a 20-yearold worker has a one in four chance of becoming disabled before reaching their full retirement age.

To meet the challenges of providing benefits to so many, the agency has evolved, using technology to operate more efficiently.

Access to online applications for disability benefits, reconsiderations, and hearings have given applicants more service options when applying for benefits. Our health IT initiative allows Social Security to access electronic medical records, including those from the U.S. Department of Defense, which reduces administrative costs, streamlines operations, and speeds up service to veterans.

Social Security is committed to securing today and tomorrow for our millions of disabled workers. For more information about the disability program, please visit ww w.socialsecurity.gov/disabilityssi.

Health News Dautrich named RRL manager at Lab Alliance Michelle Dautrich of Baldwinsville has been promoted to manager of Laboratory Alliance’s Rapid Response Laboratory at Upstate University Hospital Community Campus.

She joined Laboratory Alliance in 2012 and most recently served as techniDautrich cal supervisor of chemistry at the hospital laboratory.

Dautrich has more than 21 years of experience in the field of laboratory medicine, including 14 years in supervisory roles.

After working for 17 years in different facets of healthcare and pharmaceutical laboratories, she took on her first supervisory role in 2002 at A.L. Lee Memorial Hospital in Fulton, and then went on to manage the physician’s office lab for Associated Medical Professionals of New York.

Dautrich earned her degree from the University of Buffalo and is licensed by New York State in Clinical Laboratory Technology.

St. Joseph’s nurse receives national award Liverpool resident Ann Yankay, who works as a nurse in the emergency department at St. Joseph’s Hospital Health Center, has recently received national recognition with the 2016 Nursing Practice and Professionalism Award from the Emergency Yamkay Nurses Association (ENA).

The ENA award recognition program recognizes not only exemplary professionals, but also exemplary emergency departments, talented and committed state leaders, and leaders active in the determination of health care policy.

Yankay received the 2016 Nursing Practice and Professionalism Award during the Awards Gala at ENA's Emergency Nursing Conference in Los Angeles.

This award recognizes a nurse who exemplifies outstanding nursing practice as demonstrated through clinical skills, care and compassion.

This nurse is recognized by peers as an expert in emergency nursing and consistently exhibits traits associated with professional behavior and commitment to professional values.

This individual may demonstrate outstanding commitment to a spe-

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Meals on Wheels has new program director Jennifer Covert has recently joined North Area Meals on Wheels as the program director. In that position she will be responsible for all day to day activities related to the clients, volunteers, kitchen staff, case assessors and general administration of the program.

Covert The director also focuses on the pursuit of grants, care and support to volunteers, and client growth.

Previously, she was the president of the Autism Association of Northeast Arkansas. Covert attended SUNY Potsdam and has over 10 years of leadership and management experience. She lives in Baldwinsville.

Oswego Hospital earns gets accreditation Oswego Hospital has earned The Joint Commission’s Gold Seal of Approval for Hospital Accreditation by demonstrating continuous compliance with its performance standards.

The Gold Seal of Approval is a symbol of quality that reflects an organization’s commitment to providing safe and effective patient care, according to a hospital news release.

Oswego Hospital underwent a rigorous, unannounced four-day onsite survey in May. During the review, a team of Joint Commission expert surveyors evaluated compliance with hospital standards related to several areas, including emergency management, environment of care, infection prevention and control, leadership, and medication management. Surveyors also conducted onsite observations and interviews.

“I would like to commend the staff for achieving this important accreditation from The Joint Commission,” said Oswego Health President and CEO Chuck Gijanto.

“The surveyors indicated it was the strong professional and personal commitment of the physicians and staff to provide excellent high–quality care, which led to this being one of the most positive surveys in hospital history.”

The Joint Commission has accredited hospitals for more than 60 years. More than 4,000 general, children’s, long-term acute, psychiatric, rehab and specialty hospitals maintain accreditation from The Joint Commission.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Health in good

CNY ’S HEALTHCARE PAPER

EMPLOYMENT Putting people first – that’s what sets us apart.

At Syracuse Home providing the highest quality health care is part of who we are. And that’s what health care is meant to be.

RN NURSE MANAGER Syracuse Home is seeking s RN with a strong commitment to TEAMWORK to lead a 40-bed unit in a residential health and rehabilitation facility. Candidates should possess nursing leadership experience and care planning expertise with knowledge of MDS, state and federal guidelines in LTC, and QAA process. Competitive salary, excellent benefits including generous paid time off, health/ dental/life insurance, 401K with employer contribution, free parking and free meals.

Reach thousands of healthcare professionals every month. Advertise with In Good Health Call 315-342-1182 for more info or email: editor@cnyhealth.com

Open Interviews Wednesday, July 20 1:00 p.m. - 5:00 p.m.

For interview location & available positions Visit: www.accesscny.org Work directly with people with disabilities in their homes. Various hours available.

All positions require a valid NYS drivers’ license and at least a high school diploma or GED. Criminal background check required.

For more information contact Russ Gentile: 315-410-3376

Since 1851 we have been committed to providing excellent services to those entrusting us to their care.

If you are interested in joining our legacy:

Monroe Community Hospital

Apply at or Send Resume to: Director of Human Resources 7740 Meigs Road, Baldwinsville, NY 13027 Fax: 315-638-2552 Phone: 315-638-2521 E-mail: llongyear@mcharrielife.org E.O.E.

LPNs and RNs for Baylor Program

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016

is seeking

Work 32 hours on weekend, paid for 40.

Weekdays off and full time benefits To learn more and apply, please visit www.monroehosp.org or call 760-6226

ADMINISTRATOR ADULT CARE FACILITY An adult care facility in Auburn, New York is looking for an experienced Administrator who demonstrates excellent leadership qualities, is attentive to detail, enjoys working with the elderly and disabled, is responsible for the care and well-being of up to 53 residents, while supervising and overseeing a staff of 35-40 employees.

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RN Supervisor

This is your chance to expand your nursing career by using your extensive nursing education and experiences, and develop your leadership and management experience in a long-term care facility. Accountable for the supervision of patient care within LTC/brain injury/subacute units. Must have current NYS RN license. Part-time 3 p.m. to 11 p.m. www.st-camillus.org/careers/

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CALENDAR of

HEALTH EVENTS

from page 4 will introduce programs on surgical treatments, designs for home modifications, exercise and movement including dance. Participants will also enjoy a light lunch at no cost.

There is no cost but pre-registration is required as space is limited.

To register, call Upstate Connect at 315-464-8668. The deadline for registration is Friday, Oct. 7.

Oct. 17

Guest to discuss how to help animals used in lab People for Animal Rights based in Syracuse will sponsor a seminar on how animals are treated in laboratories — and what can be done about it.

Guest speaker will be Amber (Coon) Canava, who began fighting for animal rights in her teens. In the past, working as a campaign coordinator for PETA, Canava focused on the campaign to shut down the massive primate importation industry based in Florida. Animals used in experimentation often seem beyond help, according to a news release:

they are hidden away in secretive facilities and are treated in a cruel way.

Canava will share information about progress for reducing and eliminating the use of animals in experimentation and how people can advocate for animals in laboratories.

She will include examples of animal experimentation in the CNY area.

The event will take place at 7 p.m., Oct. 17 at Onondaga Free Library, 4840 W. Seneca Turnpike, Syracuse. It’s free and open to the public For more information, contact People for Animal Rights, P.O. Box 15358, Syracuse 13215-0358, 315-488PURR or visit peopleforanimalrightsofcny.org

Oct. 27

Spirituality and addiction workshop in Syracuse Ellen E. Vachon, the founder of the Southern Tier of New York Methamphetamine Prevention Program (STNYMPP), an organization created to inform the community of the threat posed by methamphetamine

Experience / Qualifications: Experience working in an adult home or long term care facility/environment preferred. Familiar with SSI and Medicaid. Knowledgeable and current on New York State Department of Health regulations, standards and guidelines.

Application Process: Send resume with references on or before December 1, 2016 to

Education: Bachelors Degree - 2 years related AuburnJobOpportunity@gmail.com experience – 1 year supervisory preferred or Associates Degree – 3 years related PO Box 43, experience – 1 year supervisory Auburn, NY 13021.

High School Diploma – 4 years related experience – 2 years supervisory

Salary: Dependent on education and experience.

and to prevent its proliferation, will be the guest speaker during a workshop about spirituality and addiction. The meeting will explore the relationship of spirituality and recovery, as well as look at the role spirituality plays for the treatment/ prevention professional.

Vachon has been training students and professionals throughout New York state as a certified trainer for the New York State Office of Alcohol and Substance Abuse Services

Potential starting date spring 2017.

(OASAS) for over 20 years. She is currently certified to deliver trainings on 30 OASAS sanctioned topics. She hold a Ph.D. in addictionology and a master’s degree in the field with particular interest in adolescents.

The class will be held from 9 a.m. to 4 p.m. Oct. 27 at Prevention Network, 906 Spencer St., Syracuse.

Cost is $60. For more information, call 315-471-1359 or visit www.preventionnetworkcny.org/index.php/ training-casac.

Hospice of Central New York Seeks Nomination for ‘Best Doctor’ Hospice of Central New York is seeking nominations for The Anita Award, which will be presented in January.

The award, established at hospice in 1998 by friends and family in memory of Anita Stockman, is designed to heighten awareness of the importance of physician communication and support to patients and their families facing life-threatening illness and to promote this understanding among physicians in training.

This award is to be presented to a physician who is attentive to his or her patients, who communicates openly, honestly and sensitively, who respects patient decisions and remains actively

October 2016 •

involved with the patient in his/ her final journey.

Nomination letters for the Anita Award are solicited from people in the community who have experienced personally responsive care from their physicians.

Nominations should be sent

by Dec. 2 to Anita Award, Hospice of CNY, 990 Seventh North St., Liverpool NY 13088 or by email to info@hospicecny.org. Include your name and phone number, and why you think this physician merits this award.

A few previous recipients are physicians Joseph Navone, Ajeet Gajra, Benny Wong, Michael Glowacki, Jacqueline Bays and Jesse Williams.

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If you’re facing a diagnosis of breast cancer, turn to the experts at the Upstate Cancer Center. Our highly personalized care includes the advanced knowledge and technology found at the region’s only academic medical center. With convenient locations and services for everything from routine screening to genetic testing, the power of teamwork is the backbone of Upstate’s extensive multidisciplinary team. The team includes board-certified physicians and oncology-certified nurses to consider all options to create your treatment plan.

As part of a research university specializing in cancer, Upstate also offers access to clinical trials.

MORE INFORMATION CALL 315-464-HOPE OR VISIT UPSTATE.EDU/CANCER

CARING FOR PATIENTS. SEARCHING FOR CURES. SAVING LIVES. Page 28

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2016