IGH - CNY 255 March 21

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CNYHEALTH.COM

MARCH 2021 • ISSUE 255

What Kids Are Losing with Virtual Learning

Online classes are effective to contain the transmission of coronavirus but they are robbing kids from having the full school experience: interacting with others, developing connections, teamwork. See story on page 17

Kids Special Inside n Schooldays at home: Ergonomics matter for children n 1 in 5 Americans, mostly young people, has STD n Speeding on U.S. roads taking thousands of teenagers’ lives n Substance dependency different in youth than adults

COVID-19: Here to Stay? Experts Say ‘Yes’

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How to Snack Better During the Pandemic

Liberty Resources Carl Coyle, CEO of Liberty Resources, on the role agency plays in CNY, the impact of COVID-19 on the delivery of services and the organization’s new 8,000-sq.-ft. facility in Fulton

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Things You Need to Know About

COVID-19 VACCINES

WEIGHT LOSS

A new drug, known as Ozempic can cut 15-20% of body weight

Anne Palumbo, author of the SmartBites column, offers several recipes that will make you feel not guilty about snacking. P. 14

CALENDAR of

HEALTH EVENTS

March 2, 9, 18

Hearing loss group presents virtual program Hearing Loss Association of America (HLAA) Rochester Chapter offers virtual programs in March for anyone interested in hearing loss. All use the Zoom platform. Preregistration is required by visiting the HLAA website at http://hearinglossrochester.org All presentations are free and in real time. Closed captioning is an option for all participants.

• Noon, March 2: Behavioral psychologist Samuel Trychin will show strategies for preventing and reducing unwanted emotional reactions to the challenges faced by people with hearing loss in “Calm during COVID.” His presentation emphasizes the stress that masking and distance have on people with hearing loss during the current pandemic, offering techniques for dealing with it. A practitioner in Erie, Pennsylvania, Trychin has authored numerous books and conducted workshops and training sessions. He specializes in understanding the psychosocial effects of hearing loss.

• 10 a.m., March 9: Prospective, new or experienced hearing aid users can share their experiences, ques-

tions, and hearing loss journeys in an informal virtual round table discussion facilitated by Joe Kozelsky, a retired audiologist and hearing aid user. Real hearing aid users discuss real problems and concerns.

• 10 a.m., March 18: This is a continuing orientation to the online “Virtual Demo Center” website. It is a review of selected assistive listening devices, captioning-capable and amplified telephones, signaling-alerting devices and smart phone APP’s related to hearing enhancement and gives the opportunity for the presenters to answer questions from those joining the Zoom meeting.

HLAA is the nation’s leading organization representing consumers with hearing loss. HLAA opens the world of communication to people with hearing loss through information, education, support and advocacy.

March 3, 9, 18 25

Virtual series focuses on orthopedic health topics Syracuse Orthopedic Specialists (SOS) and the YMCA of Central New York are sponsoring a virtual series of seminars given by orthopedic ex-

perts from SOS to provide local residents information about living with and treatment for a range of orthopedic issues. The four seminars cover topics from arthritis, osteoporosis and preventing orthopedic injury.

The series is free and open to the public, but attendees must pre-register for individual events via Zoom.

The seminars, always at 5 p.m., are scheduled for: • March 3. “Treatment Options for Hip and Knee Arthritis,” presented by physician Kevin Kopko and physical therapist Stacy Griffith.

• March 9. “Bone Health and Osteoporosis,” presented by physician’s assistant Lisa Mahon.

• March 18. “The Difference Between Bunions and Big Toe Arthritis,” presented by physician Naven Duggal, SOS foot and ankle specialist.

• 5 p.m., Thursday, March 25. “Staying Active and Injury Free this Spring,” presented by physician Todd Battaglia, head of the SOS sports medicine team.

“As partners committed to the health and welfare of Central New York residents, SOS and the YMCA of Central New York are excited to offer these educational community presentations,” said physician Brett Greenky, president of SOS. “We realize many people may have put off discussing bone health and arthritis issues with physicians because of the dominance of discussion about the coronavirus. But there is no reason for people to continue to live in pain or avoid learning about treatment when technology allows us to connect patients directly with medical professionals.”

Call 315-251-3100 for more information.

April 17

Free lung cancer screening in E. Syracuse, Auburn Hematology/Oncology Associates of CNY (HOACNY) and CRA Medical Imaging are offering a second free lung cancer screening from 9 a.m. to 1 p.m., Saturday, April 17, in two locations: HOACNY office, 5008 Brittonfield Pkwy, E, Syracuse; and Diagnostic Imaging Center, 37 W. Garden St., Auburn.

Appointments are required by calling 315-472-7504 x1133, and walkins are not allowed. Each patient will receive a COVID-19 precautionary screening and must comply with safety protocols, including wearing a mask. For individuals unable to make this date, HOACNY offers the same screening on weekdays at each of its three clinical locations.

“Lung cancer screening is part of preventive health, like a mammogram or a colonoscopy, that patients should discuss with their primary care providers,” said HOACNY physician Aref Agheli. “It is a quick and painless procedure that may find something before a person has any symptoms. And, when we find cancer in an early-stage survival rates are much higher.”

This free lung cancer screening is available for people at high risk for lung cancer, including any and all referrals from primary care providers. To qualify for the screening the person has to be between 55 and 80 years of age, be a smoker or have a history of heavy smoking. Those who quit in the last 15 years also qualify for the free screening.

Weight Loss Surgery Weight loss surgery is about more than just weight loss. It’s about reducing your risk for serious conditions like heart disease and diabetes — and regaining the stamina, mobility and confidence to take on every day.

Crouse’s bariatric surgery program offers a dedicated team of physicians and providers, as well as psychological and nutritional counseling — all with the expertise to support you every step of the way.

What’s more, you can begin the process from the comfort of your own home. View our online informational video — and then consult with members of our bariatric team via telemedicine visits to start your journey. It’s time — and now easier than ever.

Start today at crouse.org/weightloss or call 315-470-8974.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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2/18/21 10:59 AM

Meet

Your Doctor

By Chris Motola

Most Americans will Keep Wearing Masks, Distancing Even After Pandemic: Survey

W

earing masks, frequent hand-washing and avoiding large crowds may not have been part of the American culture before the coronavirus pandemic began, but those habits are likely to stick around for a while, new research suggests.

A national survey from Ohio State University’s Wexner Medical Center of more than 2,000 Americans shows that a majority of people don’t plan to return to their old ways anytime soon.

The survey found that nine of 10 Americans will continue frequent hand-washing and sanitizer use after COVID-19, while four of five will still avoid crowds. Nearly three-quarters of respondents said they planned to continue wearing masks in public.

“While the progress we’re making toward recovery is exciting, it is critical that we don’t ease up on the precautions that we know have worked thus far,” said survey leader Iahn Gonsenhauser, a physician and chief quality and patient safety officer at Wexner Medical Center.

“Masks and physical distancing are still our very best weapons for limiting spread, and now that we have a vaccine it will make those precautions even more effective and will drive new cases way down if we stay the course,” he said in a university news release.

These behaviors may help ease people’s anxiety about returning to public spaces and provide a sense of control, researchers said. Some societal changes forced by the pandemic may also continue, including telehealth for medical appointments and working from home.

Gonsenhauser pointed to this year’s flu season as proof of the effectiveness of behaviors such as hand-washing, social distancing and mask wearing.

“Flu cases and hospitalizations are way down compared to recent years, and a lot of that is likely because precautions like masking, physical distancing and hand hygiene are absolutely working for flu,” Gonsenhauser said. “I think a lot of people are realizing that what we’ve learned from COVID-19 can be applied more generally to keep our population healthy.”

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Uzma Abbasi, M.D.

Gastroenterologist at Oneida Heath discusses colorectal cancer and a new endoscopic ultrasound procedure — EUS — that allows the doctor to see detailed image of the lining of the digestive tract and the surrounding organs Q: What falls under the spectrum of gastroenterology?

A: Gastroenterology works with diagnosis and treatment of different digestive illnesses: esophagus, stomach, large intestines, small intestines, pancreatic diseases. So it’s medical treatment, plus endoscopic procedures that help to diagnose and screen for these diseases.

Q: What is EUS? A: EUS is endoscopic ultrasound.

It is considered an advanced endoscopic procedure. It gives a detailed image of the lining of the digestive tract. But, it can allow us to see surrounding organs in addition to the stomach and small intestines. So we can also visualize the gall bladder, the pancreas, the liver and bile ducts.

It helps us to diagnose growths and abnormalities that might have been picked up on a CT scan or X-ray so we can get detailed visualizations of those conditions and then take a biopsy if needed.

Q: What are some of the benefits of using this procedure?

A: The benefit of EUS is it gives us a better image through the lining of the stomach and the small intestine and also allows us to access them if we need to take a biopsy.

From the patient’s perspective, if they have chronic abdominal pain or if they’re losing weight without any explanation, then it can allow us to investigate the symptoms.

And it allows us to see cancers in surrounding structures and see the extent and spread of those cancers.

Q: Colorectal cancer seems like it’s become a major public health focus. Who is generally vulnerable to colorectal cancer and why are we taking it as seriously as we are?

A: I think all of us

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

are vulnerable to colorectal cancer.

It’s a common disease, unfortunately.

Recent data shows there are close to 150,000 new cases of colorectal cancer diagnosed every year in the United States. So it’s still the second leading cause of death of men in the United States and the third leading cause of cancer-related death in women. So it’s a big concern. The death rate from colorectal cancer has been declining since 1990. A lot of that is because of the screening we’ve been doing. We’re detecting it earlier and preventing colon cancer. The risk of colon cancer increases with age. So the recommendation from the American Cancer Society is that screening be done on everyone 45 years old and older. If they have a family history of colon cancer or digestive issues like colitis, they may have to be screened at a younger age.

Q: And this is a type of cancer that’s generally asymptomatic until it’s very advanced, yes?

A: That is correct and a challenging part. For the majority of patients, there are no symptoms for early stage colon cancer. They’re the people we want to make sure we diagnose.

Q: Why are people with conditions like colitis more likely to develop cancer?

A: It’s because of inflammation.

Since their colon is inflamed chronically for years, that inflammation increases their risk of colon cancer above that of the general population. The recommendation is that for patients who have had eight years or more of colitis to screen every two years instead of every five or 10 years.

Q: Does this apply to colon irritation more broadly, or is it more specific to colitis?

A: It’s more specific. Not all will increase your chances of getting cancer.

It’s

very specific. This is specifically inflammatory bowel diseases, which includes colitis and Crohn’s disease.

Those are specifically the ones that increase your chances of developing colon cancer.

Q: So something like irritable bowel syndrome (IBS) doesn’t put you at higher risk?

A: Correct. IBS has not been linked with colon cancer.

Q: What kinds of inventions are used if early stage cancer is found?

A: Our goal is early detection.

We can usually offer a cure if the cancer is detected at Stage I or Stage II. Patients can undergo surgical procedures to remove the tumor, which is often a cure. That’s compared to if it is detected after it’s spread to the lymph nodes, in which case they’d need other treatments like chemotherapy.

Q: So the prognosis is very good.

A: It’s very good. If we diagnose it in the early stages and the tumors are removed, they’re cured. We’ll always have to keep up with screening to make sure there’s no recurrence, but patients do great at that stage.

Q: Other than screening, what can patients do to reduce their chances of developing colorectal cancers.

A: In general, there are lifestyle and environmental factors that contribute. Smoking is a big risk factor, so is obesity. Over the years we’ve learned that diet plays a big role in colon and pancreatic cancer.

We’ve found that you should limit processed food intake, eat more fresh fruit and vegetables. So there’s a lot of diet and lifestyle involved. There was a study I was involved in New York City where we were looking at African Americans and recent African immigrants, the first group had much higher incidences of colon cancer, and a lot of that had to do with exposure to the Western diet.

Q: Is it the fiber that matters so far as diet is concerned? Or something else?

A: It’s fiber. So studies have shown that people who consume a lot of fruits and vegetables, which are high in fiber, do have a reduced risk of colon cancer and polyps.

Q: What got you interested in gastroenterology?

A: I enjoy medicine. I always liked internal medicine, especially endoscopic procedures. They let you screen and prevent cancers and still do treatments. It’s a great mix of procedures and medicine. It’s always evolving and getting more sophisticated as well, which keeps things interesting.

Lifelines Name: Uzma Abbasi, M.D. Position: Gastroenterologist at Oneida Heath Hometown: Lahore, Pakistan Education: Allama Iqbal Medical College Affiliations: Oneida Health Organizations: American College of Gastroenterology, American Society Gastrointestinal Endoscopy, American Gastroenterological Association Family: Husband, two sons (7 and 5) Hobbies: Hiking, board games

New Weight-Loss Drug Can Cut 15-20% of Body Weight ‘Drug turned out to be amazingly more effective than anything else we’ve seen come before,’ says researcher

A

new weight-loss drug is almost twice as effective as current medications, clinical trial results show, and experts say it could revolutionize the treatment of obesity.

Overweight and obese people lost an average 15% of their body weight using a weekly injectable 2.4 milligram dose of semaglutide (Ozempic), a new report reveals.

What’s more, one-third of all participants lost 20% of their body weight, a result comparable to those of people who’ve undergone weightloss (bariatric) surgery, the researchers said.

That means a person who weighs 250 pounds could wind up losing as much as 50 pounds after a year and a half on the drug, the results showed.

“This drug turned out to be amazingly more effective than anything else we’ve seen come before,” said senior researcher Robert Kushner, a physician and professor of medicine specializing in obesity treatment at Northwestern University Feinberg School of Medicine, in Chicago. “It’s the very first time we have a medication that even begins to approach the weight loss people achieve with bariatric surgery.”

Physician Ania Jastreboff, vice-chairwoman of the Obesity Society’s clinical care committee, agreed that semaglutide’s effectiveness could significantly alter the field of obesity medicine.

“This degree of weight loss is significantly more than what we’ve seen with any other medication thus far,” said Jastreboff, co-director of the Yale Center for Weight Management, in New Haven, Connecticut.

The drug’s maker, Danish pharmaceutical firm Novo Nordisk, applied for approval from the U.S. Food and Drug Administration in January based on these clinical trial results. It hopes for approval before year’s end, Kushner said. The company funded the drug trial.

Semaglutide is already on the market at a lower dose as a treatment for Type 2 diabetes.

The drug is a synthetic version of human glucagon-like peptide-1 (GLP-1), “a hormone that all of us make,” Kushner said.

“When this hormone is released, it helps reduce our appetite, reduces our hunger and helps us feel full sooner,” Kushner said.

Nearly 2,000 overweight or obese adults participated in the 68-week clinical trial, which ran from the fall of 2019 to spring 2020 at 129 sites in 16 countries.

The entire group started with an average weight of 232 pounds and a body mass index (BMI) of 38, which placed them firmly in the obese category, the researchers said. BMI is a measurement of body fat based on height and weight.

People taking semaglutide had an average weight loss of 15%, compared to about 2% for a group treated with a placebo, the findings showed.

That makes semaglutide roughly 1.5 to 2 times more effective than other weight-loss drugs, which tend to help people lose between 4% and 11%, the researchers said.

Seven out of 10 participants lost at least 10% of their starting body weight, and one in three lost 20% or more.

There are some side effects, mostly gastrointestinal, the study authors said. More than four of 10 people taking semaglutide experienced nausea.

Some others reported diarrhea, vomiting or constipation.

However, these side effects could be managed, Kushner said. Only 7% of participants had to drop out of the trial because they couldn’t tolerate the drug.

Doctors prescribing this drug probably can limit these side effects by gradually raising the dosage in new patients, Jastreboff said.

Onondaga, Oswego, Cayuga and Madison Counties

CNY’s Healthcare Newspaper

A monthly newspaper published by Local News, Inc. 35,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 2021 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 Contributing Writers: Deborah Sergeant, Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Mary Beth Roach, Payne Horning, Catherine Miller, Kyra Mancine, Brenda McCutcheon Advertising: Amy Gagliano, Cassandra Lawson Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Nitz 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.

Consult your physician before making major changes in your lifestyle or health care regimen.

• • • • •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Embrace the Joy of Missing Out!

C

hances are you’ve heard the expression: Fear of missing out — or FOMO. It refers to the anxiety that occurs when you fear you are missing out on fun, events, experiences or invitations that could potentially make your life more exciting.

Gripped by FOMO, you can become consumed with chasing any and every opportunity to be socially connected and in-the-know. The constant striving and longing, comparing and despairing, can be exhausting. And seriously stressful.

The good news? The pandemic has knocked the wind out of FOMO, given that many of us still remain anchored at home with few outside activities.

It came as no surprise then when FOMO was replaced with a better, healthier version of itself: The joy of missing out — or JOMO. It’s all about appreciating the life you have, living in the moment, and being content with your life “as is.”

JOMO means slowing down, deepening human connections, being intentional with your time, and focusing on the things that matter to you.

The poem below sums it up beautifully:

“Oh, the joy of missing out.

When the world begins to shout And rush towards that shining thing; The latest bit of mental bling – Trying to have it, see it, do it, You simply know you won’t go through it; The anxious clamoring and need This restless hungry thing to feed.

Instead, you feel the loveliness; The pleasure, of your emptiness.

You spurn the treasure on the shelf In favor of your peaceful self; Without regret, without a doubt, Oh, the joy of missing out!”

– Michael Leunig Making the most of missing out during this pandemic has been an eye-opening experiment and experience for me.

Here are a few of the joys I’ve discovered in the hopes that they might inspire you to create your own list. n The joy of guilt-free rest and relaxation I’ve embraced my inner sloth.

Even in retirement, I was running at

a frenzied pace, overprogrammed, and overwhelmed with things to do. Today, I enjoy more leisure time, often watching a matinee movie, followed by a luxurious “no-power” nap. n The joy of deepening relationships With fewer options for going out and socializing, I’ve stayed in closer touch with my dearest friends during our weekly “walks and talks” (at a safe distance). Strolling along the canal, on park trails or in residential neighborhoods, we are getting to know each other on a deeper level.

Making more meaningful connections has been one of the pandemic’s silver linings for which I am so grateful. n The joy of uninterrupted presence Having the time and space to pause and savor pleasant experiences has made an enormous and positive difference in my life. I’m determined to never let this go. I’ve made a promise to myself to stand still and admire what’s right in front of me, to take the time to internalize the beauty and goodness that’s all around us.

One simple example: Lately, I’ve been watching the birds at my feeder for longer than usual. I can now identify the species, marvel at their exquisite markings and recognize their songs.

This practice of paying closer attention to life’s sweet pleasures has been a tremendous source of joy for me. n The joy of masking up Oh, the freedom! I love not putting on make-up these days. Behind my mask I’m all “naturelle,” as the French would say. No foundation, no blush, no lipstick, no nothing. The time and effort I save at my bathroom sink can be better spent watching the birds!

My mask also provides, at times, a welcome measure of anonymity, especially when I complete the look with my big, furry winter hat. All

s d i K Corner

Just 2% of U.S. Teens Eat Recommended Amount of Veggies

I

n findings that may ring true to parents, a new government survey shows that a paltry 2% of U.S. high school students are eating enough vegetables.

The study is the latest look at teenagers’ eating habits by the U.S. Centers for Disease Control and Prevention. And experts described the results as “disappointing.”

Of more than 13,000 high school students surveyed in 2017, only 2% were getting the minimum recommended allotment of veggies: 2.5 to 3 cups per day.

Fruit, meanwhile, was only mildly more popular. About 7% of

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high schoolers were getting enough, and 100% fruit juice counted toward those servings.

The figures show no progress since the CDC’s previous report on the topic: In 2013, as well, 2% of high school kids were eating their veggies as recommended.

“The findings aren’t necessarily surprising, but they are discouraging,” said Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity at the University of Connecticut, in Hartford.

There have been some positive policy moves in recent years, according to Schwartz, who was not

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

involved in the study.

They include efforts to make fresh produce more accessible to low-income Americans through food stamps and the Women, Infants and Children (WIC) program. There are also rules around fruits and vegetables in the National School Lunch Program.

The problem is that relatively few high school students participate in lunch programs — about 39%, according to the CDC. Instead, Schwartz said, they are free to bring lunch to school or go off-campus, often to fast-food places.

“Unfortunately, that leads to a

covered up, I can sneak in and out of the local grocery store without being stopped to discuss, well, nothing actually.

Being incognito has been a gift! n The joy of cooking or not Many of my married friends have shared this particular joy: They relish being released from food shopping and the routine of preparing three square meals a day. The pandemic has relaxed many of our daily rituals and this is probably most noticeable in the kitchen.

Eating avocado toast four nights in a row? Is that so wrong? n The joy of fewer choices I just saw this headline: “The paradox of modern life: so many choices, so little joy.” That resonates with me. I think it explains my love of air travel. My choices are limited.

I’m confined to my seat, my meal options are few, and my activity pattern is reduced to reading, listening to music, and ignoring the snoring person seated next to me.

On the plane, I have no important decisions to make or complex problems to solve. It’s heaven! Too many choices can be paralyzing.

The pandemic has contracted our lives and limited our choices. It has delivered untold hardship and heartache. But it has also delivered valuable time in which to reflect and rethink the way we live, the way we love, and the way we experience joy.

Are you missing out on life?

Good for you. It’s time for a joyful celebration!

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite Gwenn to speak, visit www. aloneandcontent.com

decline in dietary quality,” she said.

The findings, published Jan. 22 in the CDC’s Morbidity and Mortality Weekly Report, paint a generally bleak dietary picture.

Vegetable intake was low across the board (among boys and girls, and white, Black and Hispanic teens). The median veggie intake was just one serving per day, which means half of the students ate even less.

The CDC said “new strategies,” such as social media campaigns, are needed to coax kids into eating more healthfully.

Any strategies would be up against a powerful marketing campaign by food manufacturers.

And research shows that such marketing, via traditional ads and social media, undoubtedly gets kids — and adults — to eat processed foods.

“There’s a reason companies spend all that money,” Schwartz said.

In contrast, she added, “fresh fruits and vegetables aren’t branded.”

Then there are the economic factors. Despite nutrition assistance programs, many families find fresh produce too expensive, Schwartz said. And if parents are not buying vegetables, kids won’t develop an affinity for them.

“I think parents are doing the best they can, with the resources they have,” Schwartz said.

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FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 March 2021 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

My Turn

By Eva Briggs, MD

Understanding the Loss of Smell in COVID-19 Patients

I

magine a world devoid of smells.

No scent of spring flowers and no aroma of rising bread. No warning of a skunk, leaking gas or a forgotten food item decaying in the back of the refrigerator.

That’s what happens to a about 80% of COVID-19 patients. The loss of smell renders most food tasteless, since odor is strong contributor to a food’s flavor.

Why does this happen? It is not mechanical congestion from too much mucus, as happens with typical colds or allergies. At first, I heard theories that the coronavirus might invade the olfactory nerve cells in the nose, which lead directly to the brain. To me that was terrifying, the stuff of science-fiction horror. A direct conduit for a deadly virus to invade my brain?

Fortunately, it turns out that is probably not the main way COVID-19 affects the sense of smell.

Scientists discovered that the virus is harming the nasal epithelium, the skin-like lining of the nose. This tissue contains support cells for the olfactory nerve cells. When these cells can’t do their job, the sense of smell suffers.

The coronavirus attaches to angiotensin-converting enzyme 2 (ACE2) receptors in order to invade cells. Olfactory nerve cells don’t have ACE2 receptors, which are present in the support cells. These cells maintain the necessary balance of salt ions in the nasal mucus. Nerve cells

require these salts to send signals to the brain.

The support cells also provide metabolic support, supplying nutrients required by nerve cells.

They provide physical support and structure to cilia in the nose. Cilia are microscopic finger-like structures vital for the sense of smell.

Experiments on Syrian hamsters found that it took just two days for the coronavirus to infect half of the hamster’s nasal support cells. The nerve cells weren’t infected. But the epithelium completely detached, similar to skin peeling after a sunburn.

Odor is a big component of food flavor. But the tongue also contains taste receptors for basic tastes of sweet, salty, sour, bitter and umami.

The tongue’s taste receptors don’t contain ACE2 receptors, but support cells on the tongue do have these receptors. Some people develop an inability to detect the basic tastes, ageusia. It may be that tongue support cells are also damaged by COVID-19.

Even chemical senses like the burning of hot peppers or the cool sensation of mint can be damaged by COVID-19. These sensations aren’t taste. They are detected by sensors similar to pain receptors. It’s not clear how COVID-19 damages these sensations.

For COVID-19 patients who lose their sense of smell, it happens rapidly, as if a light switch were turned

Over 37 million people in the U.S suffer from kidney disease, however most are unaware

By Philip T. Ondocin, MD

M

arch is National Kidney Month, and it is a great time to remind our community of the importance of our kidneys. The physicians of Nephrology Associates of Syracuse (NAS), are experts in the field of kidney care. Nephrology is the branch of medicine that deals with the functions and diseases of the kidneys.

The kidneys serve many im-

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portant functions, including filtering blood and wastes, regulating blood pressure, producing vitamin D and controlling production of red blood cells.

Nationally, over 37 million people suffer from kidney disease, however most are unaware. This is a serious concern, as by the time symptoms appear, kidney disease may have progressed to a more serious stage.

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

For COVID-19 patients who lose their sense of smell, it happens rapidly, as if a light switch were turned off. off. The support cells are constantly regenerating, and most people recover their sense of smell quickly.

But — as with all the crazy effects of this virus — a minority of people have prolonged loss of smell. Others developed parosmia. That is where everything has an abnormal smell, usually unpleasant. One sufferer stated that it made everything taste “hideous and distorted.” This may happen because the nose regenerates new nerve cells which misconnect to the appropriate brain location. With time, the brain may correct the miswiring and the parosmia can resolve.

It’s a symptom that I hope never

to have. I take a small measure of comfort in the fact that the coronavirus is probably not creeping into our brains via directly via the nose.

The potential symptoms of kidney disease include fluid retention in the legs and face, difficulty breathing, decreased appetite, difficulty sleeping, difficulty concentrating and skin itchiness. Diabetes and high blood pressure are the major causes of kidney disease. Other risk factors include heart disease, obesity and a family history.

The only way to find out if people have kidney disease is through blood and urine tests to measure kidney functioning and check for protein in the urine. Lab test results are extremely important to measure kidney function, and a convenient, on-site lab at the practice provides most results at the time of the office visit. Telemedicine virtual visits are also available.

Our physicians and staff work together to develop an individualized care plan to slow the progression of kidney disease. One-on-one in-person and virtual visits are available for patients and their family member or significant other to meet with a kidney disease practitioner, and have an in-depth discussion about the patient’s condition, options for care, diet, exercise, and more to best manage kidney health. Virtual visits are also available for medical nutritional therapy from a registered dietitian.

To prevent kidney disease and lower risk for kidney failure, control blood pressure and blood sugar lev-

els, maintain a healthy body weight, avoid smoking and check with your doctor before taking certain medications.

I recommend that individuals with risk factors or who are experiencing symptoms should be screened by their primary care physician. If warranted, your provider will make a referral for a kidney consultation at our office.

Nephrology Associates of Syracuse main office is located at 1304 Buckley Road, Syracuse. As many of our patients are frail and not able to easily travel, we offer monthly kidney care at our satellite clinics located in Camillus, Fayetteville, Fulton and Vernon.

Please refer to our web site at www.nephrologysyracuse.com or call 315-478-3311 for information.

Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.

Physician Philip T. Ondocin is board-certified in nephrology and board-certified in internal medicine. He is also a certified hypertension specialist. He practices at Nephrology Associates of Syracuse, PC., www.nephrologysyracuse.com.

Vitamin D: Good for Health, Fights COVID-19 V itamin D is an essential nutrient, and recent research has suggested it may also help guard against severe COVID-19.

But how much is enough, and how hard is it to get the right amount of vitamin D? “We know that a large percentage of the population has suboptimal levels of vitamin D. In fact, as many as half of the U.S. population may be deficient in vitamin D,” said Kristin Gustashaw, clinical dietitian at Rush University Medical Center in Chicago. “This can possibly lead to symptoms including fatigue, tiredness, hair loss, delayed wound healing, decreased immune health, muscle pain and more, with no other known causes.

“Part of the difficulty of maintaining vitamin D levels is because there are not a large variety of foods that contain much vitamin D,” Gustashaw added in a medical center news release.

The vitamin is accessible to people through some foods, supplements and even sunshine.

Food sources include egg yolks, milk, cheese, beef or calf liver and certain fish, such as salmon, mackerel, tuna and sardines. Other foods are fortified with vitamin D, including certain cereals, breads, soy milk and orange juice.

Gustashaw also recommends that people should get out in the sun for at least 15 to 30 minutes a day, but says they should be sure to get a constant source of the nutrient from their diet and supplementation.

Adults should get a minimum of 600 IU of vitamin D each day and 800 IU if over age 70. Children should get 600 IU each day. And infants up to the age of 12 months should get 400 IU/day. Gustashaw says you can determine your vitamin D levels through a blood test.

If you do have low levels of

vitamin D, it’s always best to talk to your health care provider or dietitian about the best way to boost your intake, Rush University experts said.

Certain medications can affect vitamin D absorption. These include steroids, the cholesterol-lowering drug cholestyramide, and the seizure medications phenobarbital and phenytoin.

While vitamin D toxicity is rare, there’s no proof that taking more than the upper limit of the recommended dosage is beneficial, the experts said. In some cases, excess amounts of vitamin

D can lead to renal failure, calcification of soft tissues throughout the body, including in coronary vessels and heart valves, cardiac arrhythmias and even death.

Healthcare in a Minute

By George W. Chapman

COVID-19: Experts Believe Virus is Here to Stay

T

he FDA will expedite the review process for manufacturers developing updates and boosters to counter the United Kingdom and South African strains or variants to the coronavirus. An advisory panel of independent experts will be charged with reviewing and approving the booster shots. Pfizer, BioNtech and Moderna boosters have already gone through the process. Most epidemiologists warn COVID-19 will not just go away even after we have achieved herd immunity or have it under control. Like the common flu, we may require annual boosters until a “one and done” shot is developed. The worldwide pandemic will be reduced to a manageable epidemic. In the meantime,

ACA Open Enrollment Expanded Millions of workers have lost their employer sponsored health insurance primarily due to the ravages of the pandemic. Via executive order, President Biden created a special expanded three-month open enrollment period from Feb. 15 thru May 15. The previous open enrollment period under the previous administration was only the last six weeks of 2020, Nov. 15 thru Dec. 31. The Association of Health Insurance Plans lauded the executive order and expressed no concern over possible “adverse selection.” (Adverse selection can occur when a previously uninsured person can enroll in a plan any time they want, versus only during a designated sign up or enrollment period. The fear is those who wait until they are

President Biden has invoked the Defense Production Act to get more equipment and supplies to vaccine manufacturers for increased points of care and at home testing. The goal is to have 61 million home testing kits available by the end of summer.

FEMA has awarded $1.7 billion to 27 states to establish community vaccine centers, especially in underserved areas. Overlooked and under appreciated is the role of primary care providers can play in the delivery of vaccines. Once supplies are adequate and distribution streams improved, primary care practices are clearly more appropriate for vaccine and booster administration than state fairgrounds, hospital parking lots and football stadiums. sick or injured, then sign up.)

Medicare Ad Fatigue If you’re wondering why the seemingly endless (and annoying) Medicare ads are still disrupting your favorite TV viewing long after Dec. 31, you’re not alone. In the past, all seniors were covered by “regular” or traditional Medicare. Since there was no choice, the government didn’t need to advertise. The ubiquitous ads ruining your viewing are run by Medicare Advantage plans that are administered by commercial insurers that are looking to sign newly eligible seniors as they turn 65 throughout the year. (Open enrollment, which runs October thru December, is for seniors already covered looking to switch plans.) Competition for members among commercial plans

results in a lot of TV advertising.

And for good reason. Forty percent of all Medicare eligibles belonged to a Medicare Advantage plan last year; and with the onslaught of savvy baby boomers turning 65, there is a lot at stake. Traditional or “regular” Medicare will probably phase out for adults without a disability, over the next several years as Medicare Advantage plans continue to grab most of the newly eligible seniors.

There is another reason for the heavy advertising: huge profits. Many commercial carriers are making more money in Medicare Advantage plans than employer-based commercial plans. United Healthcare, for example, covered 3.5 million members last year and expects to add another 900,000 this year. United made $15.4 billion last year, despite the pandemic. The ads claim they may reduce the amount being withheld from your Social Security check for Medicare by $100 or so a month. That is accomplished by switching seniors from their traditional Medicare plan to Advantage plans.

Hospital Pricing

As of Jan. 1 hospitals must post “prices” for 300 “shoppable” procedures such as MRI, labs, consults, obstetrics, surgeries, psychotherapy.

Unfortunately, it’s almost impossible for just about anyone to do comparison shopping. Warning: you may need psychotherapy if you try to do this. The problem is, Centers for Medicare and Medicaid Services left it up to the hospitals and didn’t provide many guidelines. Consequently, some posted spread sheets with “prices,” “fees” and “negotiated rates” while others provided online “cost estimators.” To add to the confusion, many don’t even use the universally accepted billing codes to easily identify the 300 procedures. So March 2021 •

how do you compare? You can’t. As predicted here last year, this would be a mess. Regardless of trying to find the best deal, can the typical consumer really shop around? The hospital you select may not be in your network. Your chances of getting approval to go outside of your network for one of the routine “shoppable” services is probably zero. The physician you select for a consult or procedure may not be in your network or even have privileges at the hospital you select. Even if he or she does, it may not be their preference. So right now, until there is more uniformity, shopping around for the best deal is a fool’s errand.

Pandemic Preparedness Another pandemic is inevitable. The Northeast Business Group on Health has developed a list of recommendations for employers so they aren’t caught off guard again.

1. Build a pandemic response plan; keep it simple. 2. Establish a safe workplace. 3. Enhance employee experience working from home. 4.

Have a strong return to work plan. 5.

Address employee benefits stressed by the pandemic, like behavioral care. Develop your vaccine strategy.

6. Plan for future pandemic or epidemic now.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

‘We’re actively emerging into the autism arena. We started this recently in conducting comprehensive, diagnostic evaluations for children who may be assessed as being on the autism spectrum. There is a significant backlog of children needing diagnostic assessment from Binghamton to the Canadian border. We are receiving referrals from as far as the Adirondacks and beyond.’ tic evaluations for children who may be assessed as being on the autism spectrum.

There is a significant backlog of children needing diagnostic assessment from Binghamton to the Canadian border. We are receiving referrals from as far as the Adirondacks and beyond.

Q A &

With Carl Coyle

Liberty Resources’ longtime CEO on the role agency plays in Central New York, the impact of COVID-19 on the delivery of services and the organization’s new 8,000-square-foot facility in Fulton

By Mary Beth Roach

C

arl Coyle has served as chief executive officer for 31 years for Liberty Resources, a health and human services organization in New York state and Texas. In this interview, Coyle focuses on the agency’s work in Central New York, discusses the impact of COVID-19 on the delivery of services, and talks about the organization’s new 8,000-square-foot facility in Fulton.

Q: Can you outline some of the specific services that Liberty Resources offers?

A: Liberty Resources operates six service domains or areas of practice which we focus on. We started out as a mental health organization. That was our genesis in 1979. We still operate mental health and behavioral health services today. The second area we started growing into was developmental disabilities.

We then moved into child welfare services, providing foster care and preventative services. Oswego County was an instrumental county when we started expanding, particularly in foster care. A fourth area is now care coordination as a health

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home under the Affordable Care Act for children and adults; providing care management and care coordination throughout CNY. As a fifth sector we break out our clinics – both our behavioral health and primary care clinics into its own division. We have a vice president who oversees our clinics due to their size, scope and geography [Syracuse Fulton, Rochester and 42 schools].

The recently constructed building in Fulton at Crossroads Park provides both primary care and behavioral health, including substance abuse treatment. The sixth area is early intervention and autism treatment services. We are providing services for children who are developmentally delayed or have a cognitive, developmental or physical limitation for children birth to three.

That encompasses following them as they transition into school age, 3 to 5. This predominantly consists of the disciplines of physical therapy, occupational therapy, speech language therapy and special education. We’re actively emerging into the autism arena. We started this recently in conducting comprehensive, diagnos-

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

Q: You cover such a broad spectrum of issues and care. What was the impetus for growing?

A: I can illustrate that very well when we expanded into Oswego County. It was community need.

For example, around 1990-91, I was having a conversation with the regional director of [the state’s] Office of Children and Family Services, and he said, ‘I’d like to introduce you to the DSS commissioner in Oswego County because they’re placing a significant number of children outof-county into institutions.’ It’s very expensive and it’s not always optimal separating children from their families. There was a community need. We responded to that.

The new building [in Fulton] is an example of community need. By most measures, [Oswego County] is substantially more service poor and service needy. Statistics indicate it’s the second most impoverished county in the state. Of the top 20 reasons for death in the county, five of them are related to behavioral health issues — suicide, overdoses and other conditions that are behavioral in nature. We saw a tremendous need for mental health services in Oswego County and that’s why we constructed that building and expanded our services.

Q: What counties do you serve?

A: The five primary counties of Central New York — Onondaga, Madison, Oswego, Cayuga and Cortland. We also go down into Tompkins, Tioga, Chenango, and we’re now in Monroe. We’re also across NYS and in Texas, but CNY is our home and our largest service geography.

Q: What is your agency’s budget?

A: Pre-COVID, it was about $82 million. In Central New York, that’s about 70% to 75% of that. Our early intervention program is down due to school closures but that will return to normal levels post-COVID. Q: How are you funded?

A: We’re funded by Medicaid, county-based contracts and commercial insurance.

Q: How many employees does Liberty Resources have in this area?

A: In this area, about 1,100 to 1,200; overall about 1,600. The rest are distributed throughout the state and in Texas.

Q: As CEO, what do you see as the accomplishments of your job?

A: It was the fact that we’ve expanded so much and met so much community need.

Q: What are some of the challenges?

A: Obviously, COVID is a challenge right now. I would say the larger challenge that’s more systemic is the complexity of operating multiple services. The regulatory environment underneath that is really challenging.

Q: How has the pandemic impacted services?

A: For our residential programs — group homes for people with developmental disabilities, mental health; kids in foster care with foster parents; halfway houses for people experiencing substance abuse — obviously it’s still face-to-face. We had early-on challenges of availability of PPE, hazard pay issues, and how to keep staff and patients safe.

On the ambulatory side, we moved very, very quickly to telehealth. The impact on the mental health delivery system is just through the roof.

We’re operating at about 125 percent of normal capacity, maybe a little bit greater.

However, in our early intervention program, telehealth was not authorized prior to COVID. So there had to be regulatory change, emergency orders from the governor’s office, for children to receive services via tele. We’re doing that, but when you have to do physical therapy, it’s not fully effective. The children still need it in person. They have developmental milestones they really need to try to achieve, and services were significantly interrupted. The only option we had was tele because the state mandated that we could not go into the homes and do the services in a natural environment.

That’s probably serving around 3200 children pre-COVID. We’re treating about 65% now. There’s concern that the children that aren’t getting services are going to backslide and lose momentum. Then there are the children that aren’t getting into the system. A lot of these kids get referred when they are 2-3 because they’re preschool eligible. So, if they have a known condition or known diagnosis and not getting services, they are missing those developmental milestones. We’re not seeing typical levels of new referrals because the schools are so disrupted. The districts are going to see, over a period of time, more challenging kids because they’re not treated early. There’s also some evidence starting to emerge for children’s mental health that the level of trauma the children are experiencing is going to have longterm residual effects. The pandemic is really taking a toll societally on so many levels.

Q: What are some of your future goals for Liberty Resources?

A: We are seeing great opportunity to consolidate in the health care delivery space and the mental health delivery space. What we’re doing is a significant amount of mergers and acquisitions and expect that to continue over the next several years.

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Marie Desravines, MD

Shannon Dwyer, FNP

Alex Filipski, DO

Ashley Gilbert, LCSW

Anna Gofman, DDS

Julie Hogle, LCSW-R Clinical Social Worker Oswego, Mexico, Pulaski

Joy Dolorico Magsino, MD

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Dental Hygienist Fulton

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Adult Nurse Practitioner Oswego

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March 2021 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Things You Need to Know About COVID-19 Vaccines

Separating the myths from facts about vaccines

By Ernst Lamothe Jr.

I

n mid-December, the first 170,000 doses of the COVID-19 vaccines were ushered into the state of New York. Double that number came a week later.

Slowly every state has received its initial doses of the vaccine. Now, under the new Biden administration, there is a strong push for everyone to be vaccinated. Recently, the president said that by July everyone who wants to be vaccinated will be able to do so.

There have been many questions and rumors about the vaccine as residents hope it is the first wave of good news when it comes to COVID-19 and the attempts to return to normalcy.

“The biggest myths are that the vaccine was rushed to market or is part of a political agenda. Neither is true,” said physician Duane Tull, chief medical officer at Oswego Health.

Tull answers five frequently asked questions about the COVID-19 vaccine.

1.

What was the process of the vaccination coming to market?

Some people may wonder if the vaccine was fast-tracked and created too soon. But experts say there is a reason why the vaccine came through in less time than others because COVID-19 had similar strains from Middle East respiratory syndrome (MERS) and Severe acute respiratory syndrome (SARS).

The vaccines were built upon years of work in developing vaccines for similar viruses.

More than 70,000 people volunteered in clinical trials for two

vaccines (Pfizer and Moderna) to see if they are safe and work to prevent COVID-19 illness. To date, the vaccines are 95% effective in preventing COVID-19 with no safety concerns.

“The vaccines are being offered under an emergency use authorization due to the severity of the disease. Both currently available viruses were expedited to help fight this disease. Both were tested fully, and we are assured that no compromise in scientific standards, the integrity of the review process, or safety was allowed,” said Tull.

In times of emergencies, the Federal Drug Administration can make potentially life-saving medications and vaccines available to the public, Tull said. Medical officials believe people should know that these vaccines have been fully evaluated for safety and effectiveness just as they would have been for full approval.

The emergency use authorizations permits the FDA to allow the use of an effective drug rapidly during an emergency as long as the earlier release is balanced by the benefits gained.

2.

Signing up

During the initial roll out and during the beginning of the year, federal elected officials, health care workers, those working in nursing homes and senior citizens were prioritized with the vaccine. The COVID-19 vaccine will be distributed in phases to groups of people at increased risk of exposure or severe illness. Phased distribution will take time, with vaccines not expected to be widely available

to all New Yorkers until mid-2021.

The different phases of COVID-19 vaccine distribution are determined

by New York state and may change.

The federal government determines how much vaccine New York state receives. The federal government has given New York about 300,000 vaccines per week for more than seven million people who are eligible, as a result supply is very limited.

3.

Should you get the vaccine?

There are people on either side of the vaccine who are either highly excited and plan to receive it right away and others who are skeptical and may take a wait and see approach. “Except for patients with known allergies to vaccines, I would recommend all people get the vaccine once it is available. The vaccine should limit the chances of getting the virus and at worst case should reduce the severity of the illness if you still do catch the virus,” said Tull.

4.

Have there been any side effects?

There is no COVID-19 in the vaccines and there are no serious side effects. But a few common occurrences have happened in people.

“Most frequent side effects are related to the injection itself such as a sore arm or a vague feeling of illness.

This is reported to be short-lived lasting only a day or so,” said Tull.

Physician Duane Tull, chief medical officer at Oswego Health. “The biggest myths are that the vaccine was rushed to market or is part of a political agenda.

Neither is true.”

5.

Are there any people who should consider waiting on getting the vaccine?

Tull said the major myth to dispel is that the vaccines were not properly tested and inappropriately rushed to market. He would encourage everyone to consider getting one of the vaccines. All of them have similar results and mechanisms such that the only real difference is who manufactured them.

“There is only one medical reason to not get the vaccine and that is a true anaphylaxis history to other vaccines,” said Tull. “The vaccine has been reported safe in pregnancy, the immunocompromised patient, for all ages older than 16 and even patients who have had prior COVID infections. The vaccines are the only way to offer extended immunity for yourself and to help us establish a herd immunity to once and for all end this pandemic.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

Physician Duane Tull, chief medical officer at Oswego Health, getting his COVID-19 vaccine shot.

Jacqueline Goettel-Strecansky had weight-loss surgery at Crouse in 2014, and credits the team at Crouse Health for her ongoing success. She lost more than 100 pounds and has kept the weight off in the years following her surgery. Photo provided.

High-tech Bariatric Surgery Offers Live-Saving Help Experts: The surgery can have big impact on people’s lives

By Deborah Jeanne Sergeant

B

ariatric surgery used to mean a lengthy hospital stay, notable pain and further recuperation time at home before returning to regular activity.

But advances in technology in the past decade have enabled bariatric surgeons like Jeffrey DeSimone, with Crouse Hospital, to release patients on the first post-operative day, edging closer to bariatric surgery becoming a same-day surgery.

Although robotic surgery is nothing new, recent advances have allowed its use in bariatric surgery.

“I tell the patients it’s like laparoscopic surgery with small incisions so it’s minimally invasive,” DeSimone said. “We use long trocars to exchange our instruments. We need just four to five small incisions on the abdominal wall instead of a huge incision and staying out of work six weeks.”

With much smaller incisions, patients recover more quickly and need less pain medication.

Robotic surgery also helps surgeons perform better.

“I was a little skeptical at first

about being an improvement over laparoscopic, but it appears to be,” DeSimone said. “One thing that makes it better is robotic instruments are like tiny little hands. We have more agility and freedom of movement. Instead of three degrees of freedom of movement is we have seven. The laparoscopic instruments are straight and allow us to go in and out up and down. With robotic, you also have a ‘wrist’ that you can bend and orient the wrist 360 degrees in a circle. We can have latitude to do procedures we couldn’t do laparoscopically.”

Of course, surgeons need to learn how to use the robotic equipment.

However, beyond that, DeSimone has nothing but positives about it, such as the ergonomics. Holding instruments a long time can wear on a surgeon’s hands. However, the robotic equipment helps reduce the strain.

“For some surgeons, it probably prolongs their career,” DeSimone said. “I know some who’ve had carpal tunnel and neck problems at least aggravated by surgical positions.”

Laparoscopic bariatric surgery requires four hands, so surgeons rely heavily on an assistant. But with the hand and foot controls robotic equipment provides, the surgeon can do it without that extra help.

To qualify for surgery, patients need to have a body mass index (BMI) more than 40 to qualify or a BMI more than 35 with medical conditions like high blood pressure, sleep apnea or diabetes.

“If it’s 38 but you have no medical problems, insurance will not advocate you get a procedure,” said Taewan Kim, board-certified general surgeon, with a specialty in bariatric surgery.

Before surgery can take place, patients need to undergo six months of preparation.

“Unlike other types of surgeries, when people get interested in bariatric surgery, they’ve done some soul searching as to what to do with their medical problems,” Kim said.

The patients must have medical work-ups such as blood tests to make sure they are physically sound enough for the surgery. Some will need to lose five percent of their body weight to improve their health for the surgery and also to demonstrate their dedication to making lifestyle changes necessary to lose weight.

Many bariatric patients have medical issues that require a cardiac examination, sleep study and endoscopy.

“The process itself also involves a psychological evaluation,” Kim said. “Sometimes after that, you’re asked to see support groups or other support mechanisms.”

Kim said that the psychological evaluation is because many patients have become this overweight because of past trauma has been manifesting as stress eating. Some may have experienced neglect or abuse.

“Before surgery, we help patients recognize that their eating behavior is not good for their health,” Kim said. “The other part of this is we try to make their expectations more realistic. I think that if you are going to have this procedure and you’re trying to do it to get healthier and be around for your kids or grandkids, that’s a noble goal. We do occasionally have someone who thinks their life will turn around and we don’t want them to be depressed afterwards.”

Patients also must have a nutriMarch 2021 •

tional evaluation and possibly keep a food diary. Then a dietitian counsels on their post-surgical diet.

Keeping all of these pre-op visits can become difficult for patients, particularly those who may drive three hours or more round-trip for a 15-minute appointment. Since the pandemic has helped expand telemedicine, Kim said that many patients have been able to use technology to connect with their providers.

“Even some of the imaging tests, we try to get it at a facility near to where they live,” Kim said. “It’s been a nice progress to see. On bad weather days, we used to see a lot of cancellations, but they just change to telemedicine.”

The weight loss does not happen immediately. Patients need to continue to follow the advice of their providers to see success.

“Unlike most surgeries where the results are immediate, I think patients always have this guilt that they should’ve been able to lose weight on their own,” Kim said. “You’re bombarded in the culture and media that people have been successful in losing weight by dieting and exercising.”

He referenced a study by the National Institute of Health that said obese people with non-surgical approaches to weight loss - using diet and exercise alone - experienced a much higher failure rate than those who had bariatric surgery.

“Surgery was the only modality that lasted for a year,” Kim said.

“People fail with dieting because it’s a physiology and biology issue. Our bodies were designed to preserve calories. Just a few hundred years ago, people were starving. The surgery changes the structure of the stomach or how food is absorbed. It limits the amount of food that can be eaten.

Obviously, the psychological eval and support and dietary evaluation and support is a huge factor in this.”

Insurance companies cover the procedure because it decreases other medical conditions. Kim said that after a gastric bypass, those with diabetes have an 80% chance that the condition will be resolved. Patients with high blood pressure, high cholesterol, acid reflux and sleep apnea also experience improvement in their conditions, as well as a reduction in joint pain.

“We believe it impacts just about every aspect of a person’s health,” said Ken Cooper, s bariatric surgeon at Crouse.

Many of the bariatric patients suffer from chronic back and joint pain. Before performing joint replacement, many orthopedic surgeons refer patients with high BMIs to the bariatric department.

“They still may need their joints replaced, but now the surgery will be success and they’ll have better outcomes after surgery,” Cooper said.

“We’ve seen people who could barely walk in here later running 5K races.”

In addition to the physical health benefits, patients also see improvements in their mental health, as their weight has likely influenced their self-esteem.

“Many are frankly embarrassed to be in public,” Cooper said.

“There’s bias against hiring people who are overweight. Every year I realize more and more how impactful it is. To see the transformation people go through is tremendous.

The science supports the surgery and the outcome is what keeps us coming back to perform it.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

Make healthy swaps

It’s easy and fun to come up with healthier versions of your favorite indulgences. Call a family powwow, list your most popular snacks, and assess their integrity. Too sugary?

Too salty? Too high-fat? Too devoid of any nutrients whatsoever? Highlight the ones that don’t make the healthy cut and consider alternatives.

Suggestions: If you have a sweet tooth, choose fresh or dried fruit over candy, homemade banana ice cream or smoothies over ice cream, and healthy granola bars instead of cookies. If you have a salty tooth, reach for popcorn over chips, nuts over crackers, and meat roll-ups instead of beef jerky.

Practice portion control

Remember, size matters, especially when it comes to snacks, including healthy ones. Controlling your portion can help you enjoy between-meal bites without spoiling your appetite for lunch or dinner. A few portion-control tips: Place snacks on smaller plates; brighten up where you snack (research from Cornell University found that subjects who dined in a darker room consumed 36% more food and were less accurate in estimating how much they consumed than those who ate in a bright room); and don’t give healthy foods — i.e., avocado, granola, smoothies, whole grains — a free pass just because their nutrient-rich.

Their calories can add up, too.

How to Snack Better During the Pandemic

By Anne Palumbo

W

hat do potato chips, pretzels and popcorn have in common? You may have guessed: They’ve been flying off the shelves during the coronavirus pandemic.

Same for cookies, candy and other indulgences during this stressful time.

Snack food consumption has increased by over 8% since lockdown, which is more than during the Great Recession, between 2008 and 2010, where snack-food consumption increased by only 1%.

Unfortunately, all this snacking has resulted in snugger waistbands for many, with an average weight gain of seven pounds, according to new data from a COVID-19 symptom study.

On the bright side, however, and because of our move toward healthier eating in recent years, many of us are bypassing highly processed, empty-calorie snacks for more nutritious snacks. So the issue is not the snack as much as it is the constant craving for the snack.

I can relate. After working at my desk for hours on end, my mind starts to wander … to the just-baked granola bars whose scent has made a beeline for my nose … or to the creamy hummus with my name etched in the top … or to the popcorn laced with soy sauce and Parmesan cheese. Feet don’t fail me now!

Page 14

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Unquestionably, being homebound can turn snacking into a fullfledged pastime; and, if you’ve got kids at home, well, that pastime can become a battleground.

But it doesn’t have to be. When eaten in moderation, good-for-you snacks can help manage hunger, boost nutrition, and even foster togetherness time for those living under the same roof.

Let’s take a look at six ways to snack better during the pandemic:

Prep and plan snacks ahead of time

They say not to grocery shop on an empty stomach and the same holds true for snacking: Know what’s in your snacking future and you’ll be less likely to overindulge or land on something unhealthy. Game for some fruits and veggies? Then take time the night before or in the early morning to wash and cut up your produce. After, place everything at eye level in the fridge so it’s the first thing you reach for. Do the same for other healthy snacks, such as dips, smoothies, roll-ups, hard-boiled eggs, and more. Be sure to enlist help — from snack suggestions to prep, assembly to serving.

Don’t multitask while snacking

Snacking straight out of the bag

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

while watching TV or working at your computer can lead to overeating and weight gain. Distraction and not really thinking about what you’re consuming can do that. When you’re ready to snack, eliminate distractions (screens, social media, texting), sit down, and focus on your snack. Chew slowly, savor every bite, appreciate textures and tune into your hunger-fullness scale. According to a recent study, people who ate a meal in 22 minutes consumed 88 fewer calories and felt less hungry than those who cleaned their plates in nine minutes.

Set snack times

The urge to graze is understandable these days, now that COVID-19 has upended our schedules and routines. Feeling adrift and uncertain, many of us have found ourselves reaching for snacks at all hours, with restless kiddos being particularly vulnerable. Establishing structure around snacks by setting specific times has numerous advantages, according to health experts. It establishes an expected routine and gives us purpose; it helps us feel more in control; and it reins in the urge to constantly nibble. A good rule of thumb is to snack (or provide snacks) a few hours after one meal ends and about one to two hours before the next meal begins.

Creamy White Bean Hummus

1-2 garlic cloves 1 can cannellini beans (15 oz), drained and rinsed 2 tablespoons tahini 2 tablespoons olive oil juice of 1 lemon 1 tablespoon water (more, if seems thick) 1 teaspoon cumin ½ teaspoon coriander ½ teaspoon salt ¼ teaspoon coarse black pepper ¼ teaspoon red pepper flakes (optional)

Place garlic in food processor and pulse until minced. Add remaining ingredients and process until well blended. Serve with cut-up veggies.

Bump up healthy snacks with protein and good-foryou fats

Ever eat a pretzel or cracker and feel hungry shortly after? Snacking on carbohydrate-based snacks can have that affect — even snacks made with fiber-rich whole grains.

Same with celery, carrots, apples and bananas. While their dietary fiber certainly helps us feel fuller longer, the feeling doesn’t last forever.

An excellent way to prolong the “fullness factor,” say nutritionists, is to pair your healthy snack with protein or good-for-you fats — two nutrients that take longer to digest.

Some popular snack pairings: Wholegrain toast with mashed avocado, veggies dipped in hummus or Greek yogurt ranch dip, popcorn sprinkled with grated cheese, or a scoop of peanut butter spread over a lengthwise-sliced banana.

Lastly, the internet is loaded with healthy snack recipes. From roasted chickpeas to baked sweet-potato chips, fruit roll-ups to applesauce muffins, the recipes are yours for the trying.

Here in our household, we aim to try something new every week. Not only does it give us something to do, but it encourages meaningful time together in our favorite area of the house: the kitchen!

Greek Yogurt Ranch Dressing

1 cup plain non-fat Greek yogurt 1 tablespoon fresh lemon juice or rice vinegar 3/4 teaspoon garlic powder 1/2 teaspoon onion powder 1 teaspoon dried dill or chives ½ teaspoon salt ¼ teaspoon coarse black pepper milk or water, as needed to achieve desired consistency In a medium bowl, stir together all the ingredients. Add milk or water by the tablespoon until desired consistency is reached.

Bake for 30 minutes; cool in pan for about an hour. Using parchment handles, remove from pan and cut into bars.

Ready-in-Minutes Banana Ice Cream

3-4 bananas, peeled, frozen, broken into chunks ½ cup coconut milk (lite or regular) 1 tablespoon honey or maple syrup (optional) 1 teaspoon vanilla

Baked Granola Bars

2 ½ cups rolled oats (not quick or instant) 2 tablespoons brown sugar ¼ cup flaked sweetened coconut 1 cup (total) of “extras”— chopped nuts, dried cranberries, chocolate chips 3 tablespoons canola oil ¼ cup honey 1 teaspoon cinnamon ¼ teaspoon salt 1 teaspoon vanilla extract

Preheat oven to 325 degrees.

Line a 9” x 9” square pan with 2 crisscross sheets of parchment paper (not foil), leaving extra overhang on all sides.

Combine oats, brown sugar, coconut and extras in a large bowl.

Whisk together oil, honey, cinnamon, salt and vanilla in a small bowl. Add honey mixture to oat mixture and mix thoroughly. Spread in prepared baking pan, pressing down firmly with the back of a spatula.

SmartBites

The skinny on healthy eating

Canned Tomatoes Linked to Better Health

D

o I have an unusual attachment to canned tomato products? You might think so by the stash in my pantry: diced, crushed, whole, stewed, pureed.

Truth is, of all the canned goods I tap for cooking, canned tomatoes make my heart sing more than any other.

They’re economical, convenient and never seem to spoil. I like that in a vegetable. No waste!

They’re also, much like their forbearer, high in both nutrition and flavor.

According to the Academy of Nutrition and Dietetics, canned foods can be just as nutritious as fresh and frozen foods because the fruits and vegetables used for canning are picked at peak freshness.

Although most nutrients remain relatively unchanged by the canning process, the water-soluble nutrients — such as vitamins A and C, thiamine and riboflavin — can be damaged by the high heat canning requires. On average, canning destroys from one-third to one-half of the vitamins mentioned above.

The high heat, however, has a remarkable affect on perhaps a tomato’s most valuable nutrient: lycopene.

It increases the amount. For example, one medium-size fresh tomato delivers 4 mg of lycopene, whereas a cup

Put the frozen bananas, coconut milk (shake can before opening), honey (or maple syrup) and vanilla into a blender and blend, starting at low speed and working your way up gradually to high speed until the mixture is smooth and creamy. Do not over blend (otherwise the friction will melt your ice cream).

Serve immediately as soft-serve, or transfer to an airtight container and freeze for a few hours for firmer ice cream.

nutrient don’t end there. Several studies suggest that lycopene may also be your heart’s best friend, thanks to its ability to help reduce inflammation, lower bad cholesterol, and maintain good blood pressure.

In fact, promising research from Finland demonstrated that men with the greatest amount of lycopene in their blood had a 55% lower chance of having any kind of stroke. Another V8, please!

Worried about the sun’s harmful rays? Premature wrinkling? A diet rich in lycopene may help increase your skin’s defense against sunburns and damage caused by UV rays.

While tomatoes, especially those canned or cooked, can’t substitute for sunscreen, they can provide a consistent level of skin protection, say scientists.

Anne’s Break-Out-the-Chips Salsa

of tomato soup or a half-cup of tomato puree delivers a whopping 25 mg.

Although there is no recommended daily intake for lycopene, current studies suggest daily intakes between 8-21 mg to be most beneficial.

A powerful antioxidant, lycopene helps defend your cells from damage caused by potentially harmful molecules known as free radicals. When free radicals accumulate, they can increase your risk of chronic diseases such as cancer, Type 2 diabetes, and heart disease. Fortunately, eating antioxidant-rich foods like tomatoes can help reduce the risk of these diseases.

But the benefits of this superstar

4 cloves garlic 1 jalapeno pepper (less if desired) 1 cup fresh cilantro (optional) 1 large onion 1 orange bell pepper 1 yellow bell pepper 1 tablespoon olive oil 1 28-oz. can crushed tomatoes 1 15-oz. can petite diced tomatoes fresh lime juice from 1 to 2 limes 1 tablespoon chili powder 2 teaspoons cumin 1 teaspoon sugar 1 ½ teaspoons salt (or more) ½ teaspoon coarse black pepper Finely chop garlic and jalapeno pepper in a food processor, then add cilantro (if using) and process about a minute more. Cut onion and bell peppers into large chunks and add to food processor. Pulse about 10 times or until onion and peppers look March 2021 •

Helpful tips Not all canned tomato products are created equal, so be sure to read the label and ingredient list.

Choose “low sodium” or “no salt added” if salt is a concern for you.

Look for cans that say or indicate “Non BPA” (most do). Since your body absorbs more lycopene when it’s combined with a little fat, consider adding some healthy fats, like olive oil, to your dish. evenly chopped.

In a large saucepan, heat olive oil over medium heat. Add mixture from food processor to saucepan and sauté for about 8 minutes, stirring occasionally, and lowering heat if mixture starts to burn.

Add crushed tomatoes, diced tomatoes, lime juice and all spices to saucepan; mix well. Bring mixture to a simmer and let it simmer, uncovered, for about 15 minutes, stirring occasionally. Turn heat down if it starts to boil and sputter. After 15 minutes, adjust seasonings, cover, turn heat to lowest setting and let it cook for 15 minutes more. Turn off heat and allow to cool to room temperature. Place in jars and refrigerate: good for about 2 weeks.

Anne Palumbo is a lifestyle colum-

nist, 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.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Some medical professionals are experiencing skin abrasions and breakouts from longterm mask wearing.

Maskne — the Face of the Pandemic

A new issue arises with constant use of mask: maskne

By Deborah Jeanne Sergeant

M

asks are not the only things on people’s faces during the pandemic.

Crops of acne — colloquially

called “maskne” — have also made an appearance, thanks to the face mask’s presence. Many people have to wear a mask all day, which only

exacerbates the problem.

“There’s definitely an uptick in treating acne,” said Ramsay Farah, dermatologist with Farah Dermatology in Syracuse, Watertown, Camillus and Fulton. “Acne is certainly one of the more common conditions we treat. ‘Maskne’ is a result of the changed environment of the face because of the masks we’re wearing.”

Farah explained that the microenvironment under the mask is different from the skin outside the mask. Because of the mask, there is more humidity, a physical barrier and friction. That leads to plugged pores and suppresses the skin’s natural ability to exfoliate. The humidity promotes bacteria growth. All of these factors can lead to an outbreak of acne.

Farah said that cloth can offer a gentler barrier than paper. The latter can irritate the skin.

For those with sensitive skin, using a dye- and fragrance-free detergent to clean cloth masks can reduce irritation.

“The mask may magnify things in the past that would have caused acne,” Farah said. “Occlusive makeup becomes more so under the mask.

Everyone is more stressed than before. Stress hormones contribute to acne outbreak.”

To help combat these effects, he recommends donning a clean mask at least daily and possibly more often for people who must wear masks all day.

“Take 15-minute mask breaks every couple of hours,” Farah said.

He advises gentle cleansing to remove dirt, dead skin cells and oil from the pores, but not irritating cleansers.

“Avoid harsh products, like

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IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

retinoids,” Farah said. “They can be a little too harsh at present. If possible, don’t use makeup, especially if the mask is covering a large part of your face. You can use a gentle, lightweight moisturizer in the morning or evening to combat dry skin of the season, but it has to be lightweight and noncomedogenic.

“It is okay to use some of your antiacne products in that area as long as they’re not very harsh ones. If you have questions, call your dermatologist and ask if they’re appropriate to continue.”

Some people find relief by apply a zinc-based barrier such as one used for diaper dermatitis before donning a mask.

Men wearing masks tend to experience folliculitis which can manifest as a pimple-like blemish, but it is caused by friction against a shaved hair. Using an electric razor for shave that is not so close can help. Again, the topical zinc can help, too.

Marcela Tobar, licensed esthetician at Syracuse Plastic Surgery and consultant at MT Makeup in Clay, said that using products with salicylic acid “to prevent clogged pores helps the skin as it is an anti-inflammatory.”

Friction also causes problems for women, especially if they are wearing foundation and other makeup under the mask. Like Farah, she recommends changing the mask often.

“It gets really damp in there, Tobar said. “The moisture and darkness attract bacteria. If they’re washable masks, wash them often.”

If using salicylic acid is not enough to keep the pores unclogged, “you may need something a little stronger to deal with them. You also need a daily moisturizer.”

kids special

What Kids Are Losing with Virtual Learning

Online classes are effective to contain the transmission of coronavirus but they are robbing kids from having the full school experience: interacting with others, developing connections, teamwork

By Deborah Jeanne Sergeant

A

ttending school is more than learning academic subjects and physical education.

For many children, it represents their main source of socializing opportunities with peers. Because of the pandemic, this important aspect of school has been indefinitely put on hold.

Even children who home school have lost face-to-face connections with those in their home school groups, clubs, athletic teams and other social outlets as these have been shuttered or at least curtailed during the pandemic.

While deemed necessary to curb the spread of coronavirus, online school presents a different dynamic to children.

They may be able to interact with teachers in real time and with each other on a limited basis, but they have lost the incidental socializing in a normal school day: chatting between classes, sharing stories over lunch, hanging out while waiting for the school bus, sitting with friends riding to and from school.

These moments may seem inconsequential; however, they help children learn and develop in many ways.

“Socializing is a really important part of childhood development from birth to adolescence,” said Megan Campbell, doctor of osteopathic medicine and pediatrician at Madi-

son Irving Pediatrics in Syracuse.

From the preschool age and onward, peers grow in importance to children as they learn about sharing, social skills, personal boundaries and social norms. Some of these differ from those they have experienced in their own families.

A lack of social interactions positive, negative and neutral — means fewer opportunities for developing emotional intelligence and skills that will help children navigate relationships of all sorts. Unlike planned interactions with friends through technology (a Zoom meeting between best friends), the more spontaneous interactions in a school day (learning how to befriend an irksome classmate) tend to be more educational. Children also miss chances to develop teamwork skills without group activities and sports.

“At adolescence, their peer group is very important to them,” Campbell said. “They’re learning who they are still. At that age, they’re trying to separate from their parents in preparation for adulthood. It’s very difficult during COVID to get those socialization needs.”

She added that virtual socializing can help and activities like drive-by birthday parties and socially distanced outings. But interactions at school through teams and other groups may take more time to become available to children.

Physician Geoffrey Hopkins, chairman of the department of psychiatry St. Joseph’s Health, said that restricting sports “is one of the big, important things if your child previously enjoyed sports.”

In addition to the physical activity, sports teach teamwork, sacrifice, delayed gratification and respect.

But the temporary loss of sports and other interactions should not have lasting effects on childhood development.

“Children in general are incredibly resilient,” Hopkins said.

“Allowing them to transition back to activities in a graduated matter is important. Many have had two-week quarantines from school. When they returned the first day or two of their hybrid model, they have had some anxiety. Being able to speak openly with your children and how they may feel – nervous, worried or shy – is a normal consequence of having that separation.”

In the meantime, he encourages parents to help their children to participate in activities in a safe way, such as a socially distanced winter activity with friends or engaging in outings as a family.

Since the pandemic began, school – and more – shifted to the digital world. While those who are introverted may welcome less pressure to engage with others and more barriers between themselves and social interactions, that may not be beneficial for their development. And for those who thrive on socializing, stunting

these interactions can feel as if they are hamstrung.

Hopkins encourages parents to stay attentive to their children’s emotional needs and watch for any signs of depression or anxiety, such as changes in eating and sleeping habits and extreme changes in behavior beyond the garden variety acting up or regression. Although it is not the same as peer interactions, taking time for one-on-one interaction with the children can help them feel better connected.

Taking time to pay attention to each child one-on-one can help mitigate the effects of fewer peer interactions. Especially for older children whose peer groups are even more important, it can help to connect through Facetime or Zoom with friends.

“We were built for relationships,” said Corrin Stellakis, who earned a bachelor’s degree in psychology and another in communications. She operates Fit to Reign, a coaching service in North Syracuse that promotes self-esteem and confidence in young women. “It’s making a huge impact that young people that aren’t receiving that mental interaction.”

As socializing begins to open up, Stellakis encourages parents to seek small groups that relate to their children’s interests and values so they can connect to others. It may also help to enlist the help of a personal trainer so athletic children can stay in condition for when school sports begin again.

If parents are concerned about their children’s mental health, they should consult a primary care provider, who can recommend what to do next, he advised.

Parents can help their children simply be being present in their lives.

For example, make meals together as a family, play games, and share outdoor activities such as walks or runs, Jolly suggested.

“Anything you can do together as a family will help,” he said.

Some gatherings with friends are fine, as long as everyone follows social distancing measures such as meeting in open spaces, wearing masks and staying 6 feet apart, according to Jolly.

Suicide is the second leading cause of death among people aged 10 to 34 in the United States.

Child Suicides Are Rising During Lockdown; Watch for the Warning Signs

A

mong the many dangers the coronavirus pandemic has brought, parents really need to be on the lookout for one in particular: an increased risk of suicide among vulnerable teens.

“We’ve seen an upsurge in really bad suicide attempts,” and the pandemic is likely behind that increase, said Taranjeet Jolly, an adult and pediatric psychiatrist at Penn State Health’s Milton S. Hershey Medical Center.

Social isolation during the pandemic can push youngsters with underlying mental health issues “over the edge,” Jolly said in a Penn State Health news release.

Other factors include family dys-

function and long amounts of forced time with others. Even children in socalled healthy families can feel overwhelmed. Anxiety about pandemic shutdown-related financial struggles, constant bad news and health-related worries can also transfer from parents to children.

Parents should watch for certain behavioral changes in their children, Jolly said. Have their sleep habits changed? Do they sleep more or less?

Do they have trouble concentrating?

Do they seem drowsy or lethargic?

Do they spend more time alone in their room? Do they snap at or become angry at small things?

“Don’t be afraid to reach out,” Jolly said.

March 2021 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

kids special

Children’s Mental Health Matters, Too

Experts offer ways to help children cope during pandemic

By Deborah Jeanne Sergeant

C

hildren have plenty to worry about these days.

As the pandemic drags on, they continue to study at home, missing their sports, clubs and activities.

Their parents may be out of work, working at home or working much more than they did before.

Stories of unrest populate the news, if not affecting their own cities.

“We’ve seen a big increase in depression and anxiety, even in 10-year-olds,” said Megan Campbell, a pediatrician with Madison Irving Pediatrics in Syracuse. “They see on the news that so many people have died from COVID and it’s difficult to process. Parents aren’t always realizing that kids are watching the news too and they aren’t necessarily able to process it.”

Some fear falling behind in their

schoolwork and miss connecting with classmates. Some children lack the technology to dependably connect for both schoolwork and socializing, which can keep them behind their peers. Those with learning disabilities may struggle even more. Teens stress about missing once-in-a-lifetime rites of passage like senior prom and graduation. As some schools have planned a return to classes, that can prove stressful for some children.

Campbell said that many children have also expressed concern about social unrest they see on television as well as the financial stressors adults in their home have experienced.

“You need to keep the television off and limit their exposure to news,” she said. “Even if the parents

aren’t feeling stability or are feeling anxious, they need to ‘fake it ’til you make it.’ Putting on a positive face for the kids will go a long way in helping the kids know everything will be okay. Tell them, ‘We’re going to get through this and with the vaccine, hopefully there will be light at the end of the tunnel.’”

Pretending that nothing is going on or dismissing children’s concerns – even if they are wildly inflated – will make matters worse.

“The most important thing is to not leave it as a mystery,” said physician Geoffrey Hopkins, chairman of the department of psychiatry St. Joseph’s Hospital Healthcare.

In a developmentally appropriate way, parents should answer their children’s questions and not burden them with too much of what is happening. For some families, financial hardship has hit home.

“Explain that while there is economic stress for almost all families, this is not likely to be permanent,” Hopkins said. “Explain that as we recover from COVID, lean times will pass. Focus on activities with children that take time and not as much money.”

This could include cooking more at home, tackling home repair projects together or engaging in physical activities. Hopkins said that some families have spent enough time together that they have never gotten along better. Picking up old hobbies and skills or learning new ones together has proven a means to draw closer family ties.

Parents should use these op-

portunities to pay attention to their children’s mental health.

“Behavioral changes that parents may want to look for are increase in aggression toward parental figures and siblings,” said Cam Nichols, licensed clinical social worker and director of social work with Oswego Health Lakeview Center for Mental Health and Wellness. “They may have difficulties with attention and concentration, extreme emotional reactions to situations, such as crying and anger, lack of motivation to engage in activities that they found to be enjoyable and increased refusal to comply with chores and complete school assignments at home.”

Nichols added that children may also experience psychosomatic symptoms, such as unexplained headaches, stomachaches and physical complaints and changes in eating habits and/or sleeping habits.

Evaluation by a care provider may be warranted.

Nichols recommended that parents “spend quality time together, such as watching movies, playing board games and reading books.”

Nichols suggested “Limit media exposure. Modeling healthy behaviors reactions in front of the children helps, as does encouraging children to creatively express their emotions through play, art and/or music.”

By maintaining consistency and routine where possible and allowing children to participate in some decision making, parents can help their children feel like the world is less chaotic.

Speeding on U.S. Roads Is Taking Thousands of Teenagers’ Lives

N

early half — 43% — of all fatal car crashes involving teens and their passengers are the result of speeding, a new automobile safety report reveals.

The finding stems from an in-depth analysis of all fatal motor vehicle accidents across the United States between 2015 and 2019. During this five-year period, 4,930 teen drivers and passengers died in crashes involving speeding.

And while the report acknowledges that deadly speeding is a problem at any age, it warns that the consequences of speeding pose a particularly grave danger to young drivers between the ages of 16 and 19.

“We have a culture of speeding in this country,” said Pam Fischer. She’s senior director of external engage-

ment for the Washington, D.C.-based Governors Highway Safety Association (GHSA), which represents highway safety offices across all U.S. states and territories.

Although the period studied did not include the pandemic, GHSA executive director Jonathan Adkins said in a statement that the United States “has a speeding problem that has only worsened during the COVID-19 pandemic.”

According to Adkins, “Thousands of people die needlessly on our roads because some drivers mistakenly think less traffic means they can speed and nothing bad will happen. The data tell us that teen drivers are the most likely to be tempted to speed, so the need to address this issue is more critical than ever, given traffic death

trends during the pandemic.”

Fischer noted that wide acceptance of speeding means that, in practice, many drivers view speed limits as minimums rather than maximums.

As a result, speeding has become a “national pandemic,” she said.

Fischer puts it down to a simple equation: Inexperience plus immaturity plus speeding equals deadly accidents.

As the GHSA report itself noted, “teen drivers do not have the experience necessary to recognize and quickly react appropriately to dangerous situations, which makes speeding even riskier for them.”

Fischer presented the findings earlier this year.

The study found that teen drivers who died in a speeding accident were

1 in 5 Americans Has an STD

O

ne in five people in the United States probably carries a sexually transmitted infection, the U.S. Centers for Disease Control and Prevention says.

On any given day in 2018, nearly 68 million people had a sexually transmitted disease, according to the new CDC report. There were 26 million new cases that year. The agency refers to these diseases — such as HIV, syphilis and gonorrhea — as sexually transmitted infections, or STIs. Nearly half of newly acquired STIs occurred in people aged 15 to 24 years, and new cases in 2018 would result in nearly $16 billion in direct medical costs, the report said.

Page 18

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People with STIs don’t always have symptoms. Left untreated, some STIs can increase the risk of HIV infection or cause chronic pelvic pain, pelvic inflammatory disease, infertility, and/or severe pregnancy and newborn complications, according to the report published online Jan. 23 in the journal Sexually Transmitted Diseases.

HIV and human papillomavirus (HPV) infections are the costliest STIs, according to the report. Medical expenses for these infections include lifetime treatment for people with HIV as well as treatment for HPV-related cancers.

Of the estimated $16 billion in lifetime medical costs from STIs

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

acquired in 2018, most ($13.7 billion) were associated with HIV. Another $755 million were attributed to HPV infections.

More than $1 billion in lifetime medical costs were connected with chlamydia, gonorrhea and syphilis combined, the researchers said in a CDC news release.

About 60% of those costs were among 15- to 24-year-olds. Nearly 75% of the $2.2 billion in non-HIV-related STI medical costs were among women, according to the report.

The total cost of STIs is far higher than the medical costs estimated, however, the study authors noted.

The report didn’t include costs associated with lost productivity, other

more likely to be male (37% versus 28%), and were more likely to not be wearing a seatbelt. Teen fatalities also tended to involve being run off the road and/or car rollovers.

Younger teens (16- to 17-yearolds) were found to be at the highest risk for a deadly speeding crash. But teens aged 18 and 19 were more likely to get into an accident between midnight and 5 a.m. Older teens were also more likely to have accidents while on a highway or freeway.

And when it comes to speeding fatalities when passengers were in the car, more was decidedly worse: The greater the number of teenagers in the car alongside a teen driver, the greater the risk for a deadly speeding accident.

non-medical expenses, or STI prevention.

“The burden of STIs is staggering,” said physician Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

At a time when sexually transmitted infections are at an all-time high, they have fallen out of the national conversation, he said.

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kids special Schooldays at Home:

Ergonomics Matter for Children Arrange Your Home Workspace For Comfort, Good Health

By Deborah Jeanne Sergeant

E

rgonomics in the workplace is all about ensuring workstations help keep employees in comfortable positions that fit their size and helps them perform work without strain.

The principles are just as important for children who now spend many more schooldays at home, more likely than not working at makeshift desks —or no desk at all.

Most children at home are working on laptops, devices meant for only short periods of use.

It may not seem like a big issue because children are known for sleeping and sitting in odd positions and not feeling sore as an adult would.

However, Jeana Voorhies, doctor of chiropractic and assistant professor of chiropractic clinical sciences at New York Chiropractic College in Seneca Falls, said that since children are still growing, “it can have an impact on neurological development. It puts some strain on t hose structures.

Over time, especially as a child, we’re setting them up for some bad habits and potential long-term effects.”

Ideally, parents should have a

workspace the right size for each child; however, this gets complicated as finances and space are strained in dedicated space for each child and possibly the parents as they may be working from home as well.

Voorhies said that the 90/90/90 rule is the goal. When seated, the back and hips, knees and ankles should each be bent at a 90-degree angle.

The line of vision is also important.

“We don’t want to be looking down for too long,” Voorhis said.

“Ideally, that screen should be right in your line of vision. That can be simple by putting books under the laptop. It brings it up to the line of vision so the neck is in a neutral position.”

In a regular school day, most children move around more than they may move at home. Ordinarily, they may join in activities in the classroom, PE, athletics or at least moving from class to class, depending upon their age. Voorhis said that at home, children can move their laptop to different positions such as standing to break up their day.

“One position I love to let their children do is to take the tablet or lap top and lie on their tummy, propped on their elbows,” she added. “In that position, you take your neck and spine out of that flexed posture.

It gets the spine into an extended position.”

The strain is not limited to the body. Bekir Kelceoglu assistant professor Industrial and Interaction Design at Syracuse University, said eyestrain can result in staring at screens too long.

“Focusing on a screen that is close to your eyes strains eye muscles a lot,” Kelceoglu said. “Even though you’re just going to a Zoom meeting it’s not like a regular meeting since there’s one focal point. It’s not a diversion of focus. That makes your eyes more tired.”

Other points of ergonomics include the hands. Most computer keyboards and mice are made for adults and may not be at the correct height for children.

“It’s like one size of clothing or shoes and they have to use them,” Kelceoglu said. “That’s not really working well with students. The biggest thing is to remind them that having breaks is pretty important to keep the muscles moving.”

He uses a worktable as his home office desk. The table can move to a seated position as well. He added that the table is meant for a garage space, which makes the desk is very sturdy (www.homedepot.com, Adjustable Height Work Table by Husky, Item 301809931, $179.00).

The attached wheels make it easy to move as needed.

Megan Campbell, doctor of osteopathy and pediatrician at Madison Irving Pediatrics in Syracuse, has had a lot of children present with back pain.

“You ask them and they spend 8 to 10 hours a day hunched over their computers,” she said. “They don’t get a lot of breaks and activity. I’m sending kids to physical therapy and counseling on posture. They’re still doing schoolwork in bed or on the couch.”

In addition to advising children using a desk or table, she tells parents to encourage children to get up during breaks, stretch and become active.

“It’s difficult during the winter to go on walks, but bundling up with hats, coats and gloves helps,” she said. “Take a walk 10 to 15 minutes to help the body and clear the head.”

Ensuring You Have A Comfortable Workstation

The Syracuse University Ergonomics Task Force suggests a few elements of proper desk ergonomics: • The desk height and width are crucial to a proper workstation.

• The desk or tabletop should be between 26º to 28º off the floor.

• The width of the desk/tabletop should be between 28ºto 36º.

• The work area should be neat and tidy.

• You should not have less than 3inches from the top of your legs to the bottom of the desk.

• If you are using an adjustable keyboard support, make sure it supports both your keyboard and mouse.

• Allow leg and foot clearance under the desk. Do not store boxes, waste baskets, or personal belongings under the desk.

The Right Chair

Are you using the right chair for you at your workstation? A properly designed and adjustable chair is critical to a workstation.

• The chair should be fully adjustable – height, armrests, lumbar support, and backrest.

• The height and tilt of the backrest should be adjustable. The tilt adjustment should be forward and backward.

• The chair should be sized correctly for the user.

• If a new chair is to be purchased, it is recommended the chair be loaned for a 3- to 5-day period so that the user can allow his or her body to adjust to the chair.

• The front edge of the seat on the chair should not be in contact with the user’s legs while sitting.

This will help to minimize poor leg circulation and allow the user to sit back against the backrest.

• The chair should be supported by a five-leg base for stability and glide easily along the floor surface.

• Become familiar with the operations of your chair. Many people do not know how to use all of the adjustments on their chair.

The user must be positioned properly in the chair.

• Feet flat on the floor.

• Knees and hips at a 90-degree angle.

• Buttocks back in the chair.

• Lower back should be against the backrest and be supported in the lumbar region of the back.

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Page 19

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Routine Childhood Vaccinations Slipping Many parents have skipped regular vaccine for their kids because of COVID-19

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hile the eyes of the world have focused on COVID-19 vaccination, some parents have missed their children’s routine vaccination.

During the onset of the pandemic last year, the Centers for Disease Control and Prevention advised delaying all non-emergency visits.

Once doctor’s offices reopened for these visits, some parents did not feel comfortable bringing their children in and still others faced long delays as doctors have scrambled to catch up on backlogged well child visits, the appointments when they typically administer these vaccines.

“You still have parents who are hesitant to come in,” said pediatrician Megan Campbell, who practices at Madison Irving Pediatrics Pediatrician in Syracuse. “Parents are delaying these vaccinations.”

She added that parents may bring in their child after they set up an appointment and no one in the household has been in contact with someone sick with COVID-19 or has traveled out of state.

Most facilities encourage only one parent or guardian to come into the office with the patient and require masks for anyone older than two. Normally, vaccines begin at 2 months of age.

The backlogs have decreased at her office and she said that most pediatrician offices are not as busy as they were months ago.

Some parents do not believe that the routine vaccines are necessary because their child is now 10 or older.

IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

“Don’t put it off,” Campbell said.

“I’ve had 16-year-olds who are getting their first-year vaccinations. For the most part, there is no age limit.”

Anna Reitz, Oswego County Public Health nurse and immunization coordinator, said that area doctors’ offices and clinics are very safe places to visit.

“They’re doing anything they can to keep people socially distanced and they are disinfecting the rooms,” Reitz said. “We’re all wearing medical face masks and eye protection and require patients to do so as well.

We’ve changed our clinic flow. It used to be walk-in. Because we don’t want so many people showing up, we started scheduling. We say call us when you get here and we’ll let you know when we’re ready for you.”

Many of today’s young parents do not know anyone who experienced polio or other vaccine-preventable diseases so they are not aware that these diseases are serious.

“Vaccines are victims of their own success,” Reitz said. “Seniors who lived during a time when polio and other preventable disease were still present readily accept vaccines.

They know kids who were paralyzed or walked with a limp from polio.

When vaccine is successful, people think ‘I don’t need it anymore.’ Just because it’s not endemic in your community doesn’t mean it can’t be in a very short amount of time.”

Some parents believe that skipping vaccination toughens up their children’s immune systems to become better at warding off disease.

The opposite is true. Vaccines work as a “dress rehearsal” to help the immune system respond more robustly when presented with a disease.

“Vaccinations have been one of the single best advancements in medicine,” said Andrew Rogall, family medicine physician at Oswego Health’s PrimeCare Fulton. “Vaccines have been the driving force in eradicating illness and death from disease like measles, polio and rubella.

“Vaccines are effective for primarily two reasons. First, those being vaccinated develop immunity against that pathogen greatly decreasing the risk of severe illness and asymptomatic carrier states. Second, vaccinating a large percentage of the population provides a lower risk of passing those diseases on to those who cannot receive those vaccines for medical reasons.”

He emphasized the safety of vaccines. Of all medication, it represents the most tested. The long-term use of vaccines with rare and minimal side effects point to the safety of vaccines.

Anecdotal evidence of problems caused by vaccines usually arise because of a coincidental event, such as the timing of routine vaccine happens to occur when children are developmentally capable of being diagnosed with autism.

Some parents fear that their young children receiving multiple vaccinations in one or two injections may experience an “overload” of exposure that could unduly tax their immune systems. Simply petting the family dog, crawling across the floor, placing objects in their mouths and many other common interactions expose children to many germs repeatedly all day.

HPV is one of the vaccinations that Andrea Flood, master’s in health education and immunization educator for Onondaga County Health Department, has observed families skipping since like influenza it is not required for school attendance.

Administered to children beginning at around age 11 in two doses, HPV prevents certain cancers.

“It isn’t required for school,” she said. “Plus, there are not as many vaccinations at that age. When you’re little, you go to the doctor every so often.”

She said that over the summer, a lot of parents began to assume that if their children would return to school virtually or through a hybrid model that they would not require vaccination.

“We haven’t seen as many vaccinating but whether virtually learning or not, New York State law is that they are still required to vaccinate,” Flood said.

She acknowledged that those without a primary care provider may find it difficult to get vaccinations; however, clinics and some pharmacies are still available for administering vaccinations to school-aged children. Babies and toddlers usually must be seen by a provider.

The rapid spread of COVID-19 should underscore how easy it is for a communicable disease to go global without vaccine or any natural immune response.

“The reason why we haven’t seen these diseases is nearly everyone gets those routine vaccinations,” Flood said. “We do occasionally see it as there are a couple of people who don’t vaccinated and they end up becoming sick. It is so important to get those routine vaccinations.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

Parenting

By Melissa Stefanec

MelissaStefanec@yahoo.com

Parenting Topics I Don’t Want To Write About Cleaning out some mental clutter

W

riting about parenting is a lot like actually parenting.

There is so much to cover and not enough time to cover it.

There are so many topics I simply don’t have the energy to tackle.

The topics I avoid are intimidating. They are often complicated, nuanced, controversial, self-incriminating, time-intensive or disheartening. I shy away from writing them like I shy away from cleaning out the garage or categorizing family photos. Some things are best left on the proverbial back burner.

Nonetheless, the things I never get to doing still demand my energy.

Lack of physical engagement with a task doesn’t preclude mental engagement. So, this month, I’m tackling a number of topics that I don’t want to

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write about, but I’m doing it on a micro scale (mini-columns, if you will).

1.

The real risks of childhood vaccination

There is a frightening amount of misinformation circulated about vaccines. Vaccines save lives. That is a fact. As with any medication, there are potential risks. If you want to truly educate yourself on the risks of vaccinating people (at any age), the World Health Organization maintains factsheets for all vaccines — on the internet just search “WHO vaccine reaction rates information sheets.”

The fact is, for healthy people, serious side effects from vaccines are very rare. Depending on the vaccine,

we’re talking one in several million rare. On the whole, getting a vaccine is safer than contracting the disease it aims to prevent.

If you take the time to read up on the diseases these vaccines protect us from, you will quickly learn how dangerous and life altering these diseases can be.

But, don’t take it from me or your “enlightened” friend on social media. Read these fact sheets and work from a place of vetted information.

2.

Wages and the motherhood penalty

Although I hear people talk a lot about the gender pay gap, I don’t hear as many conversations about the motherhood pay gap. I looked at data from 2017 and 2018, and it tells a frightening story.

According to an analysis by Time magazine, on average, moms working full time made 70 cents on the dollar when compared to white males. Black moms made 54 cents.

Latina moms made 46 cents. (Please note, I couldn’t find this information for Indigenous women.)

To put that in perspective, on average, women made 79 cents on the dollar compared to white men.

Black women made 62 cents. Latina women made 54 cents. Indigenous women made 57 cents.

There is a real problem here. It needs to be talked about and addressed. On average, moms made nine cents less on the dollar than the composite average for women. Black women made eight fewer cents. Latina mothers made eight fewer cents.

The motherhood wage gap is real. Bring it up at your next dinner party (you know, in 2022).

(The numbers presented for mothers use data from 2017. The numbers presented for all women use data from 2018.)

3.

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How many moms left the workforce or lost their jobs in 2020?

2.1 million. Let that sink in. That stat is from a report from the National Women’s Law Center. Some of those women left “voluntarily.”

As the pandemic drags on, the stats are becoming more frightening.

In December of 2020, the Bureau of Labor Statistics cited a net loss

140,000 jobs in America.

How many of those were women? All of them. I want to scream it from the hilltops. In December, all of the 156,000 jobs lost were lost by women. Men, on the other hand, gained 16,000 jobs.

This pandemic is robbing women of their livelihoods as they cater to childcare, schooling and unpredictable schedules. Many women’s retirement accounts, pensions and lifelong earnings will be forever altered.

Other women won’t be as lucky. It will be more than their retirement accounts that suffer.

According to information from U.S. Census Bureau, in 2016, of the 11 million U.S. households run by single parents, 8.5 million were run by women. This mass exodus from the workforce will hurt families — in their wallets, in their bellies, in their ability to thrive.

4.

The dangers of too much screen time

There are so many studies out there that reveal the potential dangers of too much screen time for kids. For example, scientific studies say screens can contribute to slower brain development, insomnia, obesity, language delays, impaired executive function, behavioral problems and worse parent-child relationships.

As if that wasn’t scary enough, there’s the laundry of list of the harmful content children can be exposed to when online. According to the American Academy of Childhood and Adolescent Psychology, that content can portray violence and risk-taking behaviors, videos of stunts or challenges that may inspire unsafe behavior, sexual content, negative stereotypes, substance use, and misleading or inaccurate information. Children who spend unmonitored time online can also be subjected to cyberbullies and sexual predators.

The risks of too much and/or unmonitored screen time are real. They are frightening. Most parents don’t like the outcomes of too much screen time, but we are in a difficult place.

So, there they are — the topics I’ve been afraid to write about.

Here’s to cleaning out the mental clutter. It’s my sincere hope that these mini-columns help someone. Thanks for reading.

By Jim Miller

How to Choose a Hospice Care Program Dear Savvy Senior, Where can I turn to find a good Medicare-covered hospice provider? My husband’s mother has a terminal condition and wants to die at home, if possible, so I’m helping out where I can.

Sad Sandy

Dear Sandy, Hospice is a wonderful option in the last months of life because it offers a variety of services, not only to those who are dying, but also to those left behind. Here’s what you should know about hospice care, along with some tips to help you choose one.

Understanding Hospice Hospice care is a unique service that provides medical care, pain management and emotional and spiritual support to people who are in the last stages of a terminal illness — it does not speed up or slow down the process of dying. Hospice’s goal is to simply keep the patient as comfortable and pain-free as possible, with loved ones nearby until death.

The various services provided by a hospice program comes from a team of professionals that works together to accommodate all the patients’ end-of-life needs.

The team typically includes hospice doctors that will work with the primary physician and family members to draft up a care plan; nurses who dispense medication for pain control; home care aids that attend to personal needs like eating and bathing; social workers who help the patient and the family prepare for end of life; clergy members who provide spiritual counseling, if desired; and volunteers that fill a variety of niches, from sitting with the patient to helping clean and maintain their property.

Some hospices even offer massage or music therapy, and nearly all provide bereavement services for relatives and short-term inpatient respite care to give family caregivers a break.

Most hospice patients receive care in their own home. However, hospice will go wherever the patient is — hospital, nursing home or assisted living residence. Some even have their own facility to use as an option.

To receive hospice, your motherin-law must get a referral from her physician stating that her life expectancy is six months or less.

It’s also important to know that home-based hospice care does not mean that a hospice nurse or volunteer is in the home 24 hours a day.

Services are based on need or what you request. Hospice care can also be stopped at any time if your motherin-law’s health improves or if she

decides to re-enter cure-oriented treatments.

How to Choose The best time to prepare for hospice and consider your options is before it’s necessary, so you’re not making decisions during a stressful time. There are more than 4,300 hospice care agencies in the U.S., so depending on where you live, you may have several options from which to choose.

To locate a good hospice in your area, ask your mother-in-law’s doctor or the discharge planner at your local hospital for a referral, or you can search online at Medicare.gov/care-compare, which provides lists and ratings of hospice providers in your area.

When choosing, look for an established hospice that has been operating for a few years and one that is certified by Medicare.

To help you select one, the National Hospice and Palliative Care Organization offers a worksheet of questions to ask CaringInfo.org.

Medicare Coverage Medicare covers all aspects of hospice care and services for its beneficiaries. There is no deductible for hospice services although there may be a very small co-payment — such as $5 for each prescription drug for pain and symptom control, or a 5% share for inpatient respite care.

Medicaid also covers hospice in most states, as do most private health insurance plans.

For more information, see the “Medicare Hospice Benefits” online booklet at Medicare.gov/pubs/pdf/02154-medicare-hospice-benefits. pdf.

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

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Page 23

What Are Social Security Representative Payees?

Betty Lillie, who is 95 years old, was the first Loretto resident to receive the COVID-19 vaccine.

The Vaccine:

Our Ticket Out of COVID-19

By Joel Amidon, M.D.

R

esidents in our Loretto facilities, and in communities across Central New York and the nation, are finally getting closer to life as we know it pre-COVID-19.

According to the CDC and local health experts, the COVID-19 vaccine is the most effective way to protect older adults from potential exposure to infections and build immunity against the virus.

Mask-wearing, frequent hand-washing and practicing other safety protocols are still important and encouraged. But unless a large percentage of the population is vaccinated and protected, we will remain in this pandemic longer than if immunizations are wide spread.

To put it simply: the more shots in arms, the sooner our lives can return to a pre-COVID-19 normal.

At Loretto, over 85% of residents across our facilities have been vaccinated. This high vaccination rate was reached in early February, just two short months after the Federal Drug Administration (FDA) approved the Pfizer and Moderna COVID-19

vaccines. In addition, almost half of all Loretto staff members half already received the vaccine through the “Shot of Hope” initiative, and more employees continue to sign up for additional vaccine clinics.

I have full confidence in the vaccines. In fact, both the Pfizer and Moderna vaccine have already demonstrated significant benefits in our community, and until we have real control of this pandemic, the vaccine is our best bet to transfer things back to normal.

Betty Lillie, who is 95 years old and was the first Loretto resident to receive the vaccine, said she did it because she wants her life to return to normal and be reunited with her families and loved ones.

Anyone with questions about the vaccine should seek out trustworthy sources like the CDC website www.

CDC.gov and the Department of Health.

Physician Joel Amidon is Loretto’s medical director.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper March 2021

Millions of people get monthly Social Security benefits or Supplemental Security Income payments.

Some need help managing their money. When we receive information that indicates you need help, we’ll assign a representative payee to manage your benefits for you. We try to select someone who knows you and wants to help you. A representative payee receives your monthly benefit payment on your behalf and must use the money to pay for your current needs, including: housing and utilities, food, medical and dental expenses, personal care items, clothing and rehabilitation expenses (if you’re disabled).

If you need help managing your benefits, tell a Social Security representative that there is someone you want to be your representative payee.

They should be someone you trust and see often, and who clearly understands your needs. Social service

Q&A Q: I currently receive Social Security disability benefits. I now have a second serious disability. Can my monthly benefit amount be increased?

A: No. Your Social Security disability benefit amount is based on the amount of your lifetime earnings before your disability began and not the number of disabling conditions or illnesses you may have. For more information, go to www.socialsecurity.gov/disability.

Q: How much will I receive if I qualify for Supplemental Security Income (SSI) benefits?

A: The amount of your SSI benefit depends on where you live and how much income you have.

The maximum SSI payment varies nationwide. For 2021, the maximum federal SSI payment for an eligible individual is $794 a month and $1,191 a month for an eligible couple.

However, many states add money to the basic payment. For more information, go to www.socialsecurity. gov/ssi.

Q: I noticed that my date of birth in Social Security’s records is wrong. How do I get that corrected?

A: To change the date of birth shown on our records, take the following steps: • Complete an Application For A Social Security Card (Form SS-5); Show us documents proving: • U.S. citizenship (if you have not previously established your citizenship with us); • Age; and

agencies, nursing homes or other organizations are also qualified to be your representative payee. Ask them to contact us.

You can write to us within 60 days of being assigned a representative payee if you don’t agree that you need one or if you want a different representative payee.

We also offer an option, called Advance Designation, which allows you to choose a representative payee in advance. In the event you can no longer make your own financial decisions, you and your family will have peace of mind knowing you already chose someone you trust to manage your benefits.

You can submit your advance designation request when you apply for benefits or after you are already receiving benefits. You may do so through your personal my Social Security account at www.ssa.gov/ myaccount, by telephone, or in person.

You can find more information at http://www.ssa.gov/payee.

• Identity; then • Take (or mail) your completed application and documents to your local Social Security office.

Note that all documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. For details on the documents, visit www.socialsecurity.gov/ ss5doc.

Q: I’m gathering everything I’ll need to file my taxes this month. Do I have to pay taxes on Social Security benefits?

Also, where can I get a replacement 1099?

A: Some people who get Social Security must pay federal income taxes on their benefits. Still, no one pays taxes on more than 85% of their Social Security benefits.

You must pay taxes on some portion of your benefits if you file an individual federal tax return and your income exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have combined income of more than $32,000.

If you are married and file a separate return, you probably will have to pay taxes on your benefits. You can read more about tax preparation in relation to Social Security at www. socialsecurity.gov/planners/taxes. htm. Social Security benefits include monthly retirement, survivors, and disability benefits. They don’t include Supplemental Security Income (SSI) payments, which are not taxable. You can also get a replacement 1099 or 1042S when you open your own personal my Social Security account at www.socialsecurity.gov/ myaccount.

H ealth News

Shades of Inspiration receives grant

Local breast cancer support group Shades of Inspiration, Inc. has received a grant from the Jim and Juli Boeheim Foundation. The grant allows the all-volunteer group to support women diagnosed with breast canDeLee cer, with care packages designed by breast cancer survivors, meals and shopping, assistance with house cleaning, rides to and support during medical care appointments and mammograms and emotional and psychosocial support.

“Our initial contact includes an in-person or private meeting with a Shades of Inspiration volunteer who provides the patient with our care package,” said Katrina DeLee, president. “We also support women throughout their journey with wellness checks from our volunteers, personal phone calls and virtual meetings, group virtual meetings and thoughtful mailings to patients we know need inspiration.”

The Shades of Inspiration support group meets the second Wednesday of every month, currently by Zoom. Anyone wishing to participate in the meetings can email or call the organization at contactus@shadesofinspiration.org or 315-863-3155 for calls or text. More information can be found at shadesofinspiration.org.

The Jim and Juli Boeheim Foundation strives to enrich the lives of kids in need within the Central New York community, as well as provide support for eliminating cancer through research and advocacy. The foundation is committed to assisting organizations in need of funding to support innovative and creative projects and/or programs.

New chief quality officer appointed at St. Joe’s Physician Cristian Andrade has been appointed St. Joseph’s Health’s new chief quality officer, a position from which he will provide leadership to the acute and ambulatory services at the hospital. His focus will be Andrade on enhancing the quality of care and patient safety throughout the St. Joseph’s Health system.

Andrade has been with St. Joseph’s Health for 18 years. The family-medicine trained physician joined the hospital as a resident in 2003 and has served as a hospitalist since 2006.

Prior to this promotion, Andrade

served as vice president of medical affairs, regional medical director and chief of hospitalist services. In the role of vice president for medical affairs, Andrade worked to transform the care that occurs in the hospital to make it more patient focused.

“Over nearly two decades of service to St. Joseph’s Hospital, Dr. Cris Andrade has provided exceptional patient care and successfully fulfilled the duties of vice president of medical affairs. He is the ideal person to assume the new role of chief quality officer and I look forward to working closely with him as we continue to navigate our ministry through this pandemic and on to a strong and vibrant future,” said Philip Falcone, a physician who serves as chief medical officer at St. Joseph’s Health.

Andrade studied at the University of Medicine and Dentistry of New Jersey in Newark and at Wagner College in Staten Island. In 2019, he completed the advanced executive leadership for physicians training at Cornell University. In addition to his employment at St. Joseph’s Health, Andrade is affiliated with Rome Memorial Hospital and Bishop Rehabilitation and Nursing Center.

Andrade is married with four children. In his spare time, he enjoys fishing, maintaining saltwater aquariums, and outdoor activities.

General surgeon joins Oswego Health General surgeon Jeffrey Witt Strain recently joined the General Surgery Associates team, affiliated with Oswego Health.

Strain is trained and board-certified in the areas of bariatric surgery, general Strain surgery and endocrine surgery with over a decade of experience in complex laparoscopy and minimally invasive surgery.

Before joining Oswego Health, Strain practiced in New Jersey where he trained and adopted robotic surgery to further enhance his procedures at both Englewood Health and Bergen Bariatric Laparoscopic Associates.

Strain earned his medical degree from Case Western Reserve University School of Medicine in Cleveland, Ohio, in 1992 and his Bachelor of Arts with a major in psychology and biology from the University of Rochester in 1987.

He completed an extensive post-graduate training program which consisted of a laparoscopic surgery fellow in colorectal surgery at Mount Sinai Medical Center in 2001; a registrar in cardiothoracic surgery at Sir Charles Gairdner Hospital in Perth, Australia, in 2000; senior registrar in general surgery at Royal Perth Hospital in Perth, Australia, in 2000; and endocrine surgery fellow at Mount Hospital in Perth, Australia, in 1998. He served as chief resident

Mother Cabrini Health Foundation Awards $125,000 to Crouse Health for Addiction Treatment Services Grant to help expand treatment services to individuals with substance use disorder to support recovery journey Crouse Health has been awarded a $125,000 grant from the Mother Cabrini Health Foundation to help support and expand services for individuals in treatment for substance use disorders.

The grant will expand access to certified recovery peer advocates (CRPA) outside of traditional treatment hours. CRPAs are individuals with lived experience who understand the toll of addiction and the treatment process. The grant will also help sustain a therapy aide as part of the multidisciplinary treatment team who supports patients and the counseling staff with a range of services, including help accessing child care and navigating paperwork.

In addition, the grant will allow Crouse to add additional counselor hours to its Celebrating Families program, which is held outside of typical clinic hours, usually on a Saturday morning, to make it more convenient for families to participate.

“We are so grateful to the Mother Cabrini Health Foundation for recognizing the need for enhanced support for individuals undergoing substance use treatment,” said physician Tolani Ajagbe, Crouse addiction treatment services medical director, adding that demand

for opioid treatment services has increased significantly in the area since the start of the COVID-19 pandemic last year.

“Getting services to people where they live, especially during a pandemic, is critically important,” added Ajagbe. To address this, the grant will also help support the purchase of equipment and software to provide more robust telehealth services for those who request it.

“These grants demonstrate our continued commitment to support a wide range of organizations like Crouse Health that are dedicated to improving the health and well-being of New York’s most vulnerable,” said Alfred Kelly, Jr., chief executive officer of Visa and chairman of the Mother Cabrini Health Foundation board.

Crouse Health’s Addiction Treatment Services is the only hospital-based provider of comprehensive substance abuse treatment services in Central New York, having established the region’s first such treatment program in 1962.

Construction is currently underway on a new, 40,000 square foot medical office building on Erie Blvd. East, where the service, offices and outpatient programs will be relocated to later this summer.

in general surgery at the University Hospitals of Cleveland in 1997, and resident in general surgery at the University Hospitals of Cleveland in 1996.

Recognized by New Jersey Magazine as a “Top Doc,” in addition to performing surgery for the past 20 years, Strain has completed fellowships for the American College of Surgeons and American Society of Metabolic and Bariatric Surgery; earned Bariatric Center of Excellence through Surgical Review Corporation; and ASMBS Center of Excellence through American Society of Metabolic and Bariatric Surgery.

Lastly, Strain holds active membership in the American College of Surgeons, American Society of Bariatric Surgeons, Society of Gastroenterological Surgeons, and American Medical Association.

Agency (CHHA), Licensed Home Care Services Agency (LHCSA) and HCR Care Management operations are now located at 290 Elwood Davis Road, suite 104. This new space expands HCR’s operations from two offices totaling 3,000 square feet to one location composed of more than 6,000 square feet.

According to a company’s news release, this expansion will enable HCR to serve more people across its Central New York footprint. To meet the emerging demand for services, HCR announced that it is looking to hire additional nurses and home health aides.

“HCR Home Care provides high-quality, in-home health care services across the Central New York region,” said Andrew Bascom, chief operating officer, HCR Home Care.

“By combining our operations into one expanded location, we will be able to serve more people in the region and do it more efficiently. In addition to providing our teams more space to collaborate, there will be a dedicated training environment allowing HCR to grow LHCSA services and coverage for the community.”

HCR’s Central New York op-

HCR Home Care opens new CNY office HCR Home Care has moved its operations into a new office location in Liverpool.

HCR’s Certified Home Health March 2021 •

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Dr. Belfield joins St. Joseph’s Physicians Surgical Services St. Joseph’s Health welcomes physician Beata E. Belfield to St. Joseph’s Physicians Surgical Services in Fayetteville.

Belfield is a general surgeon fellowship-trained in minimally invasive surgery. Her clinBelfield ical areas of expertise include minimally invasive, robotic-assisted advanced gastrointestinal surgery, foregut surgery (primary and recurrent paraesophageal and hiatus hernia, reflux disease, esophageal motility disorders, and achalasia), upper endoscopy and complex abdominal wall reconstruction (hernia repair).

Prior to joining St. Joseph’s Health, Belfield earned a bachelor’s degree from Dartmouth College in Hanover, New Hampshire, completed her medical degree at the University College of Dublin School of Medicine in Ireland, and went on to general surgical residency at the University of Connecticut School of Medicine, serving as administrative chief resident in her final year. Her fellowship training in advanced gastrointestinal and minimally invasive surgery was at St. Francis Hospital and Medical Center in Hartford, Connecticut.

During her residency and fellowship, Belfield won awards for outstanding clinical performance and for quality improvement research in minimally invasive surgery. She is an active member of the American College of Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. After growing up near Albany, she and her family are enjoying a return to the state and exploring all that Central New York has to offer.

St. Joe’s has new VP for financial operations Julie Edmunds Smith, a certified public accountant, has been appointed St. Joseph’s Health’s vice president of financial operations and planning, effective immediately.

Moving forward, Smith will be inSmith strumental in setting and achieving performance metrics as well as working with oper-

ations on new business ventures and assisting to drive St. Joseph’s strategy forward in a manner consistent with its mission and values.

Smith joined St. Joseph’s Heath in April 2016 after 14 years of progressive experience with PriceWaterhouseCoopers (PwC) in Syracuse and Atlanta, Georgia.

During her nearly five years at St. Joseph’s Health, she served first as the director of finance, then system controller. In those positions, she has been responsible for accounting, finance, budget, strategic planning and financial analysis. She has led several initiatives that improved the competency and efficiency of St. Joseph’s Health financial operations.

“Julie’s collaborative leadership style coupled with her ability to drive organizational strategy and financial performance has enabled her very successful career,” said Meredith Price, chief financial officer at St. Joseph’s Health. “She is a true professional who has a keen ability to balance mission and margin in the complex healthcare environment.”

Smith holds an MBA from the University of Phoenix and a bachelor’s degree in accounting from LeMoyne College.

Nurse practitioner joins PrimeCare Central Square Certified family nurse practitioner Deirdre A. Wahl recently joined PrimeCare Central Square, affiliated with Oswego Health.

Wahl brings over 15 years of experience providing high-quality Wahl care in both family practice and internal medicine settings. Fully licensed and certified by American Academy of Nurse Practitioners, Wahl earned her Master of Science in Nursing at SUNY Upstate Medical University College of Nursing, and her Bachelor of Science with a major in nursing from Keuka College.

Wahl joins physician Vandana Patil and nurse practitioner Cassandra Hunsberger to provide more access to primary care in Oswego County.

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