in good Meet Your Doctor
April 2017 • Issue 208
CNY’s Healthcare Newspaper
Orthopedic surgeon Robert Sherman is the first in Upstate to perform knee replacement with Mako Robotic-Arm Assisted Surgery System
That Kill Women the Most What disease kills more women than any other? Breast cancer? Lung cancer? Ovarian cancer? Colorectal cancer? ALSO INSIDE 5 THINGS YOU NEED TO KNOW ABOUT MISCARRIAGE
Saved by ECMO
Tricia Steed’s heart stopped during an emergency C-section at Crouse Hospital. That’s when the hospital team used the extracorporeal membrane oxygenation (ECMO) machine that saved her life and the lives of her twin daughters
People who were married or lived together had sex 16 fewer times a year in 20102014 than in 2000-2004, according to a survey by San Diego State University. It shows married couples over the age 65 had sex 20 times a year vs. 80 times a year among people in their 20s. page 7
Six ways to determine if the research on autism you read or hear is accurate
I adore cheese, most kinds, but the cheese I adore most is cheddar. And the reason my heart cheers for cheddar is because it’s a nutritional superstar, packed with protein, calcium and phosphorous. Read more in SmartBites
Fat Cats, Fat Dogs You’ve guessed: More than half of dogs, cats in the Land of Plenty weigh too much, says CDC
Fat Cats, Fat Dogs
FDA: More than half of dogs, cats in the Land of Plenty weigh too much
merica’s weight problem extends to its pets, with a majority of cats and dogs dangerously overweight, a federal government veterinarian warns. “Just as obesity has become a serious problem in people, it’s also a growing problem in pets, one that can seriously harm your pet’s health,” said veterinarian Carmela Stamper, of the U.S. Food and Drug Administration’s Center for Veterinary Medicine. About 58 percent of cats and 54 percent of dogs in the United States are overweight, according to a 2015
survey by the Association for Pet Obesity Prevention. “The diseases we see in our overweight pets are strikingly similar to those seen in overweight people,” Stamper said in an FDA news release. These include life-shortening conditions such as Type 2 diabetes, high blood pressure, osteoarthritis, heart and respiratory disease and kidney problems, she noted. So, what exactly signals obesity for Fido or Kitty? In general, 20 percent over ideal body weight is obese. And Stamper
said age, breed, body type and metabolism can help tip the scales. “In dogs, some breeds seem more inclined toward obesity than others,” Stamper said. Labs, beagles and long, low dogs such as dachshunds and basset hounds are some examples. Although America’s cats are also fattening up overall, veterinarians say no specific feline breed is prone to pudginess. Stamper outlined some ways to determine if your pet is at a healthy weight. Look at your pet from above to see if it has a definite waist.
“If not, and her back is broad and flat like a footstool, she is likely overweight,” Stamper said. Run your hands along your pet’s side. Can you easily feel the ribs, or do you have to push hard to feel them? Check your pet’s abdomen/ stomach. If you can easily grab a handful of fat, that’s a sign your pet is overweight. If you’re concerned about your pet’s weight, or want to know how to keep your pet at a healthy weight, talk to your veterinarian, Stamper said.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
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Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. You must continue to pay your Medicare Part B premium. The Part B premium is covered for fulldual members. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other pharmacies, physicians and/or providers are available in our network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de idiomas. Visite nuestro sitio web en www.aetnamedicare.com o llame al número de teléfono que se indica en este material. 繁體中文 (CHINESE): 請注意：如果您說中文，您可以獲得免費的語言協助服務。請造訪我們的網站 www.aetnamedicare.com 或致電本材料中所列的電話號碼。 Y0001_4002_9196_FINAL_1 Accepted 01/2017
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April 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
ARISE to honor professor, nonprofit foundation ARISE, a nonprofit organization that provides services to people who have disabilities, is hosting the fourth annual Celebrating Inclusion & Achieving Independence dinner, Tuesday, April 11, at the Oncenter in Syracuse. Cora and Jim True-Frost are chairing the event at which Champion of Independence Awards will be presented to Professor Arlene S. Kanter, from Syracuse University College of Law, and the Richard S. Shineman Foundation. The award recognizes individuals and organizations in the community that have made a tremendous impact on the quality of life for people with disabilities. The event will be emceed by Megan Coleman, CNY Central anchor/ reporter. For underwriting, table, ticket and program book ad information, contact Nancy Kern Eaton at 315-671-2903 or email@example.com.
Unbiased Medicare Q&A takes place in Auburn Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? Cayuga County Office for the Aging offers complimentary monthly classes to help seniors make sense of Medicare. Here you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, you’ll learn about programs
to help pay for your insurance coverage, as well as a listing of the free and low-cost preventive care under Medicare. The class will be held in the basement training room of the Cayuga County Office Building. Classes are scheduled for 1 to 3 p.m. Thursday, April 13. Registration is required and all classes are open for enrollment now. For more information or to register, please call the Cayuga County Office for the Aging at 315-253-1226, or visit our website at www.cayugacounty.us/aging under the News & Activities section. Future classes will take place May 10 and June 6.
The Good Samaritan 5K & 10K Run/Walk The Good Samaritan Run/Walk begins at 10 a.m. on Saturday, April 22 at Long Branch Park in Liverpool. New 10K race added this year. Cost is $30 per participant. Course will be an out and back on the West Shore Trail of Onondaga Lake. Regular 5K will be on the East Shore trail of the lake. Cost is $25 per participant. (Children 12 and under are free for the 5K.). Event includes a Kids’ Sprint ($10 per child) for ages 5-12 beginning at 9:30 a.m. Awards ceremony, concession stands, family-oriented activities, live music, and vendors are included with the event. Water and refreshments will be available. Inspirational music, vendors, entertainment, and concessions will be on site from 9 a.m. to noon. Immediately following the race, there’ll be an award ceremony with prizes for the top three finishers in each age group for the 5k, and top 2 for 10k. All participants receive a swag bag of goodies. Proceeds enable Christian Health Service of Syracuse to continue
offering quality healthcare to those in need. Space is available for vendors in the health and wellness-themed Vendor Village. Monetary gifts may be sent by check payable to: Christian Health Service of Syracuse, attn: Good Samaritan Run, 3200 Burnet Ave., Syracuse, NY 13206. Submit questions to goodsamaritanrun@ gmail.com
Event to raise funds for autism research SmartHealth, a nonprofit based in Skaneateles, is sponsoring its Autism 5K Walk/Run event, which will take place starting 11 a.m., April 27, at Willow Bay – Saw Mill Shelter, Onondaga Lake Park in Liverpool. Early registration is $30 and includes T-shirt. Kids under 18 participate at no charge; college students pay $10. First place prize is a sports massage certificate. Proceeds will support SmartHealth’s prevent autism research. For more information and registration, visit www.smarthealth4u.org.
Astrologer to discuss ‘Metaphysics of Love’ Dennis Cole, a transpersonal astrologer and life management consultant who operates Aquarius Services in Liverpool, will present “Metaphysics of Love — The Journey to Meet Self” course from 7 to 9 p.m. on three consecutive Thursdays starting May 4. The course will take place at OCM BOCES main campus, 110 Elwood Davis Drive in Liverpool. Through interactive lecture and Q & A, Cole will discuss the what, whereto, how and why of people relating experiences in their journey through life. Cole says this course and the information provided during the series can prove to be empowering and enlightening. For more information or to sign up, call 315-453-4500 or email firstname.lastname@example.org. To visit Cole’s website, vist denniscole@ aquariusservices.net.
SAFE Fair in Oswego Presents Healthy Alternatives to Drug Use By Nicole Shue The VOW Foundation will hold its fourth annual SAFE (Substance Awareness Family Education) fair from noon to 5 p.m. April 30 at the Oswego Elks Lodge, 132 W. Fifth St. in Oswego. The free event partners with more than 30 service provides to bring outreach and education to the community. Upstate New York Poison Control Centers Lee Livermore will be the keynote speaker. “It’s a nice day of activities,” said organizer Teresa Woolson, president and founder of the The Victor Orlando Woolson (VOW) Foundation. “We’re all here to try and change the stigma associated with drug use and reduce its prevalence.” The VOW Foundation is a nonprofit 501(c)3 organization created to raise awareness of the dangers of synthetic drugs and bath salts and to Page 4
advocate for stronger legislation. Woolson lost her 19-year-old son Victor in 2012 from a fatal reaction to synthetic marijuana that was packaged as incense. He purchased the K2/Spice legally in a shop in Oswego after bans were in place by New York state and the federal government. Unfortunately, Woolson says, the drug crisis has gotten worse in the last five years. Street drugs are being cut with substances like Fentanyl. Anti-drug programs like D.A.R.E have been cut in local elementary schools. “Kids just aren’t getting as much prevention education,” said Woolson. “Heroin is on the rise and it’s not just a strung out user on a street corner, or a big city problem, it’s here and in prominent areas too. Synthetics too are still a real, real problem. We have a lot of work ahead of us.”
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
Woolson hopes this year’s fair will bring out an even bigger crowd than last year’s. The fair offers food, free entertainment, raffles, door prizes and games and activities for kids. Youth can visit the exhibits for healthy alternative information and a stamp in their passport. These passports can be redeemed for a chance to win an Apple product. Stop DWI will be in attendance and bring with them a new activity, a distracted driving simulation mat. They will also demo alcohol and marijuana simulations. The VOW Foundation is still seeking donations and sponsorships. Call Teresa Woolson at 315-402-6119 or visit the upcoming events page at www. vow-foundation.org.
About 50 Paid Summer Internship Positions Open at Excellus Excellus BlueCross BlueShield has about 50 summer internship positions available for college students at its locations in Upstate New York. Summer internship positions include jobs in finance, sales, marketing, information technology and corporate communications. Internships are available at health plan locations in Rochester, Buffalo, Syracuse and Utica. “Our goal is to attract an internship class of students from a wide range of cultures, backgrounds and life experiences, which will help drive the innovation needed to best serve our customers,” said Joseph Searles, corporate director, diversity and workforce inclusion at Excellus BCBS. The 10-week paid internships will generally run from June 2017 through Aug. 2017. To qualify for an internship, students must be actively enrolled in a college degree program at the time of the internship. Goals of Excellus BCBS’s diversity and inclusion internship program include: •Providing professional career development opportunities for students, helping them gain hands-on experience and jump starting their careers. •Helping the company attract and retain the best talent. Students will be offered development workshops, networking opportunities and meaningful work experiences that will help them become qualified applications for future job openings. Former students have shared their experience at YouTube.com/ ExcellusBCBS. Students are encouraged to apply for internships as soon as possible. Positions will close as candidates are selected for the internships. To apply for the internships, go to excellusbcbs.com/careers Excellus BCBS has recently received several workforce accolades. For the third consecutive year, the Corporate Equality Index named Excellus BCBS a Best Place to Work for Lesbian, Gay, Bisexual and Transgender (LGBT ) Equality. Excellus BCBS also received a 2017 Diversity Leader Award from “Profiles in Diversity Journal.” Last year, the company was certified as a “great workplace” by the independent analysts at Great Place to Work. The company earned this credential based on extensive ratings provided by its employees in anonymous surveys.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
In Good Health Ad.indd 1 Page 6 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
3/15/17 10:34 AM
‘Not Tonight’ Biggest drop in sexual activity seen for those married or living together, survey finds “Not tonight” seems to be an increasingly familiar refrain in America’s bedrooms, according to a new study that found people are having less sex than they previously did. Researchers surveyed more than 26,000 Americans, and found that adults had sex about nine fewer times a year in 2010-2014 than in 1995-1999. For married couples, the survey had even more potentially discouraging news — people who were married or lived together had sex 16 fewer times a year in 2010-2014 than in 2000-2004. “These data show a major reversal from previous decades in terms of marriage and sex,” said study author Jean Twenge, a professor of psychology at San Diego State University. “In the 1990s, married people had sex more times per year than never-married people, but by the mid-2000s that reversed, with the
after 2000,” Twenge said. “In a previous paper, we found that the happiness of adults over age 30 declined between 2000 and 2014. With less sex and less happiness, it’s no wonder that American adults seem deeply dissatisfied these days.” People might be quick to blame
increased working hours. Surprisingly, the study found that people who worked more hours actually had sex more often. The findings were published March 7 in the Archives of Sexual Behavior.
never-married having more sex,” she said in a university news release. And here is another twist: younger Americans are having less sex than their parents or grandparents did when they were younger. “Despite their reputation for hooking up, millennials and the generation after them (known as iGen or Generation Z) are actually having sex less often than their parents and grandparents did when they were young,” Twenge said. “That’s partially because fewer iGen’ers and millennials have steady partners.” The researchers also found that age is a major factor. People in their 20s have sex more than 80 times a year. By age 45, that falls to 60 times a year. And, at 65, that number is just 20 times a year. Each year after the peak of sexual frequency at 25, sexual activity decreases about 3 percent. “Older and married people are having sex less often — especially
Healthcare in a Minute By George W. Chapman
Social media (SM) is having more and more of an impact on consumers and their behaviors every year. 40 percent say information gleaned from SM affects how they deal with their health. 19 percent of smartphone owners have at least one health related app. 41 percent of us say SM influences our choice of providers and hospitals. 30 percent of healthcare professionals use SM for networking. When it comes to sharing health info via SM, 43 percent of us are comfortable sharing with hospitals, 47 percent with physicians, 38 percent with insurers and 32 percent with pharmacies. 60 percent of physicians report SM actually improves the quality of health in their patients.
Dementia & Sleep
46 million people worldwide suffer from some sort of dementia. In the US, 5 million people have Alzheimer’s disease. One in three seniors will die from dementia complications. Dementia costs us about $236 billion a year. Researchers at Boston University School of Medicine found that people who sleep more than nine hours on average are twice as likely to develop dementia than those who sleep less than nine hours on average.
More and more insurance companies are paying for telehealth. The immediate benefits are easier access, enhanced doctor/patient communication and remote monitoring of incapacitated patients. It will take more time and experience to determine whether or not the increased utilization of physician services via telehealth is eventually outweighed by cost reductions in other areas like
inpatient care and drug utilization. A study published in Health Affairs followed three years of claims for respiratory infections. The study concluded that nine of 10 telehealth visits (for this condition) represented new or additional utilization versus visits that substituted for an in-person encounter. The authors of the study recommended insurers or even providers might want to increase patient out-of-pocket costs to prevent frivolous or unnecessary telehealth utilization and that telehealth might have more of a positive impact for those patients with traditionally undertreated conditions like diabetes and mental health.
some of the changes, but it has expressed concern about the potential decline in coverage and the negative impact on our most vulnerable populations. The American Medical Association flat out will not support the new bill. The hospital lobby says the probable increase in the uninsured will cost hospitals billions. Washington observers and healthcare policy experts believe the bill, as written, will not garner enough support in the Senate. The Congressional Budget Office still has to determine if the new bill’s numbers add up. The CBO has estimated that 15 million people could lose their insurance.
Affordable Care Act
Critics of the ACA have maintained many consumers really don’t have choices because one in three markets has only one insurance company left on the exchange. Consequently, consumers, physicians and hospitals could potentially be at the mercy of monopolistic pricing. Insurance companies maintain that mergers (resulting in less choices) will allow them to reduce costs and increase efficiencies which would benefit the consumer. The Department of Justice isn’t buying that and has blocked the mega merger of Anthem and Cigna, the second and third largest commercial insurers in the nation. Incredibly, Cigna is now suing Anthem to end the merger agreement and for damages. Anthem has countersued. The AMA has expressed its strong concern over the possibility of politically driven settlement negotiations between Anthem and the DOJ that could result in Anthem closing the deal with Cigna.
A bill to replace the ACA, called the “American Healthcare Act,” has just passed the Ways and Means committee in the Republican controlled House. The bill would: eliminate many of the taxes that support expanded Medicaid and the premium subsidies on the exchanges and replace them with consumer tax credits, provide block grants to the states for Medicaid, and discontinue the individual mandate requiring all to have insurance or pay a penalty. The bill would continue, however, the basic cornerstones of the ACA: allow children to remain on a parent’s plan until age 26, no lifetime monetary caps on illnesses, and insurers cannot deny coverage for pre-existing conditions. Rather than going through a disruptive and highly political repeal and replace process, many industry observers wonder why the changes proposed in the new bill were not simply introduced in Congress, over the last six years, as amendments to the ACA. The insurance lobby (AHIP) has expressed approval of
Mega merger drama
Accountable Care Organizations ACOs were established by the April 2017 •
ACA to cut costs and improve access and quality. More than 850 ACOs across the country care for over 28 million people. Hospitals, physicians and insurers have been collaborating the past six years. The majority of ACOs participate in shared savings programs with Medicare and commercial insurers. Industry experts are confident ACOs will survive any changes in the laws of the land.
In a study published in “Cell Metabolism,” researchers found that a dopamine deficit may be the major cause of physical inactivity which has often been blamed on obesity. Lab mice were divided into two groups. The first group was fed low-fat food while the second received high-fat food. The mice on the high-fat diet naturally gained more weight, but researchers noted all mice were inactive — due to low dopamine levels — to start. So weight gain itself did not lead to inactivity in these mice.
And finally this. “Nobody knew that healthcare could be so complicated.” President Donald Trump, Feb. 27, 2017. 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 firstname.lastname@example.org.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Chris Motola
Robert Sherman, M.D. Orthopedic surgeon first in Upstate to perform knee replacement with Mako Robotic-Arm Assisted Surgery System. “It’s even better than I thought it would be,” he says Q: Give us an overview of your specialty and the kinds of patients you see? A: I’m an orthopedic surgeon at Upstate Bone and Joint Center at Upstate. I specialize in hip and knee replacements. I’m fellowship-trained at hip and knee replacements and trained for both total and partial robotic knee replacements. Q: What advantages are offered by robotic surgery? A: The advantage of robotics in general is that they’re more likely to produce precise, accurate and reproducible outcomes. In medicine, we’re lagged, especially in the surgical world, in producing accurate and perfect results consistently. It’s not as good as we’d hoped. But robotic knee replacement means there’s a high likelihood that the results of the surgery are going to be as accurate and reliable as we plan for, pre-operatively. Q: How does it work? A: So, in a total knee replacement, we remove the arthritic bone from the femur, tibia and patella, and we replace the surface with a metal implant, and the cartilage with plastic. We do a lot of precise, mathematic planning, but at the end of the day, the way the bone is removed and the way the implant goes in is dependent on the surgeon’s eye. The robotic system [Mako Robotic-Arm Assisted Surgery System] uses a pre-operative CT scan, which gives us 3-D image of the patient’s knee. We can then make a planned approach prior to even going into the operating room. So we’ll take an individual, we’ll evaluate their anatomy and put the implant in to match them instead of trying to make the patient’s knee match the implant. So we’re making more of an individualized, surgical approach. In the operating room, we’ll go in, we’ll do a conventional surgical approach and mark out different landmarks on the knee. The robotic system will then go in and recognize the landmarks and correlate them to the 3-D scan, so it will know exactly where we are. Then we’ll fine-tune our pre-operative plan and make changes as needed to help put it into a very accurate, precise alignment. And then when we go to remove the bone, the instruments that we utilize are connectect to a robotic Page 8
arm, so we can take away less bone and make the implant fit better. That mean, hopefully, that it will fit better and last longer. The additional benefit is it can help make rehab easier. Q: What effect does it have on the longevity of the implant? A: An average knee replacement will last somewhere between 15 to 25 years. Our hope is that, due to a combination of better implants and better positioning, that they’ll last longer. It also depends on how heavy and active the patient is, as well as other factors that are out of our control. But we do know that, if you put the implants in at a less-than-optimal position, they will wear out quicker. So it is all important. The materials are getting better, but it’s a slow process, making sure everything is aligned well. We also think the robotic surgery helps speed up the recovery
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
Q: Who is a good candidate for this? A: The best news is that all patients who are candidates for knee replacement surgery are good candidates for robotic knee replacement. There are really no exclusions. There’s a subset of patients, however, that otherwise may not have been offered surgery who can now qualify for this type. So if you had previously had hardware or deformity in your knee, it was hard to do a knee replacement through conventional means. Obviously, you need to have arthritis, pain and limitations in your everyday activities and have a painful knee and haven’t been responding to conservative treatments like weight loss, muscle-strengthening and anti-inflammatories — you might be a good candidate for robotic knee replacement. Q: How well does the system play with advances in minimally invasive surgery? A: One of the nice things about the system is that it can be used in a lot of different ways. One nice thing it allows us to do is avoid using cement since the cuts are so accurate that the implant will fit snugly with the bone. It also lets us work through a smaller incision. Q: How many have you performed so far? A: On average, I do about 400 joint replacements a year. We’ve had the robotic total hip and robotic partial knee system for about two years. I’ve done about 250 of those in that time. We’ve only had the total knee system for the last month. It’s actually yet to be commercially released. There are less than 50 centers currently using it. It’ll be getting a broader release in late spring, early summer. The work my colleagues and I have done with the robotic hips and partial knee replacement, we were selected as one of the trial centers. We’ve had about 20 cases so far.
Q: How do you like it? A: I’m very excited about it. It’s even better than I thought it would be. Patients are doing very well. Patients who I’d previously done a replacement on who are getting their other knee done all report a much easier recovery than the other side. Q: How involved are you in pre-surgical treatment? A: The patients will usually come in complaining of knee or hip pain. We provide care from the very beginning through the very end. We often will make the diagnosis. We’ll initiate physical therapy, we’ll prescribe anti-inflammatories, we do injections to the knee of either steroid or lubricating gels. We’ll obtain braces for them. We encourage weight loss, muscle training and flexible programs. When those treatments no longer offer release, we’ll suggest surgical options. Q: How well do non-surgical interventions tend to work? A: Really well on most patients, but it doesn’t last forever. So in patients who have never had any treatment at all, we can often provide months to years of improved quality of life. But it depends on how bad the arthritis is. There’s no cookie-cutter plan. Q: Exercise seems like a double-edged sword when it comes to joint health. Where’s the sweet spot between harming your joint and strengthening it? A: We know that impact-loading, especially with arthritis present, can cause increasing pain as well as worsening arthritis. So running, jumping, cutting, impact sports are taxing on your joints. Low-impact activity is fantastic though. So we want patients to remain as in shape as possible. Obesity is associated with both poor outcomes as well as incidences and intensity of arthritis. We know that activities such as walking and swimming are much kinder on your joints. An arthritic joint would rather see less force and more repetition, so doing less more often is better than doing a lot once. Q: How does obesity affect joints? A: There are surgical complications, but the heavier you are, the more force you’re putting on your knee. For normal, everyday walking, it’s between one-to-three times your body weight of force on your knee. Stairs are between three to five times. Jumping is between 10 to 15 times your body weight.
Name: Robert Sherman, M.D. Position: Medical director of hip and knee program at SUNY Upstate Hometown: East Amherst, NY Education: University of Michigan; Wayne State University; SUNY Upstate Medical Center; Cleveland Clinic Affiliations: SUNY Upstate University Hospital; Community General Hospital; Crouse Organizations: American Academy of Orthopedic Surgery Family: Married; one two-year-old; expecting a son Hobbies: Hockey, football, travel
Excellus Awards Hospitals $22.9 Million for Quality Improvements
orty Upstate New York hospitals and health centers, including eight in Central New York, shared $22.9 million in quality improvement incentives paid by Excellus BlueCross BlueShield. Quality incentives reflect 2016 performance against specific quality measures. Since the program launched in 2005, the health insurer has paid $232 million in hospital quality incentives. “We’re pleased that our collaboration with providers has resulted in higher quality scores and increased value for our members,” said Tony Vitagliano, Excellus BlueCross BlueShield vice president for health system performance. The eight hospitals in the Central New York region that participated in this program in 2016 shared $5.7 million in quality improvement incen-
tive payments. The hospitals are Auburn Community Hospital, Auburn; Cortland Regional Medical Center, Cortland; Crouse Hospital, Syracuse; Oswego Hospital, Oswego; Samaritan Medical Center, Watertown; St. Joseph’s Hospital Health Center, Syracuse; and Upstate University Health System (two sites in Syracuse). Hospitals and health systems were evaluated on 244 measures, including target outcomes jointly agreed upon by each participant and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement, and others. Hospitals that earned incentive payments achieved at least 85 percent of their quality targets.
Special Golden Years Issue
Don’t miss the next issue of In Good Health.
Sunday, April 23rd from 1-2 p.m.
Dr. Jim Yonai - The Power of Groups; Interactive Experiences May 21st – Karen Schwarz, LMHC – Professional Counselor The Mental Illness/ Addiction Connection
Come Visit The Farm!
Meet: “Big Bad Ben” the Blond Belgian
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Eva Briggs
After Winter… the Allergy Season
s I write this during a blizzard, I hope that winter — the season of colds and influenza — will soon be replaced by spring, a prime allergy season. Patients with running noses and nasal congestion often attribute these symptoms to sinus infections and wonder whether they need an antibiotic. A more accurate term than sinusitis is rhinosinusitis. This reflects that inflammation occurs both in the lining of the nasal cavity (from the Greek rhino meaning nose) as well as the lining of the sinuses. Viruses cause most infectious cases. And antibiotics don’t kill viruses. So how do you know? There isn’t a simple test to differentiate viral and bacterial cases. The first clue is duration of the illness. Viral rhinosinusitis typically lasts seven to 10 days. Symptoms may linger longer, but should start to improve by that point. Even in patients with symptoms lasting more than 10 days, the probability of a bacterial cause is 60 percent. Bacterial sinus infections often show a pattern of “double sickening.” Symptoms start to improve and then become worse in five to 10 days. That’s why doctors are reluctant to prescribe antibiotics for a patient who has been sick for just a few days. Most of the time the antibiotics are not needed. There are real downsides to antibiotic overuse. Antibiotics can
trigger allergic reactions. They can create resistant bacteria. Antibiotics can lead to vaginal yeast infections. They can kill the good bacteria in your intestines, allowing Clostridium difficile bacteria to flourish and cause serious diarrhea. Treating patients with early rhinosinusitis with antibiotics only helps about one out of every 11-15 patients treated to get better faster. But one out of every eight patients treated is harmed by antibiotics. Severe symptoms, like a fever lasting more than a day or severe facial pain, suggest a possible bacterial infection. Are there any tests? X-rays aren’t routinely recommended, because viral and bacterial rhinosinusitis look the same on X-ray. For patients with recurrent symptoms or chronic (more than 12 weeks) symptoms, a CT scan may help. CT can identify structural changes that block sinus drainage and increase the risk of infection. Some conditions increase risk of bacterial rhinosinusitis. Because the roots of upper teeth reach the floor of the maxillary sinuses, dental infections and procedures can cause sinus infections. Medical procedures that interfere with nasal drainage, such as nasogastric tubes or packing to treat a nosebleed, can trigger an infection. Another risk factor is damage to cilia, microscopic hair like structures in
the sinus and nasal lining. Smoking, cystic fibrosis, and other diseases can harm cilia. People with abnormal immune systems are also predisposed to bacterial rhinosinusitis. So — if you don’t need an antibiotic — is there anything that can help? Your best bet is nasal saline delivered by sprays, drops, or Neti pot. It won’t make the disease go away faster but can make you feel better. Oral decongestants might help but have many side effects. Topical decongestants (nose sprays that shrink swollen nasal passages) may help. But don’t use them for more than a few days to avoid rebound congestion more severe swelling when the drops wear off. Nasal steroid sprays help when allergies cause nasal symptoms, but provide little help for infectious rhinosinusitis. Here are three myths about rhinosinusitis. 1. “I need an antibiotic because I always get better if I get an antibiotic right away.” If you are starting the antibiotic within a few days of symptom onset, and get better, it doesn’t prove that you needed an antibiotic. Most rhinosinusitis is viral and goes
away without an antibiotic. Unless you have a risk factor, wait it out. You only need an antibiotic for symptoms lasting more that a week or for “double sickening,” explained earlier in this article. 2. “I need Zithromax.” Actually, that’s not a recommended first or second choice antibiotic. It doesn’t treat the most common causes of bacterial rhinosinusitis. 3. “I need an antibiotic because my mucus turned green or yellow.” The color change comes from your body’s white blood cells that are fighting infection. True, bacterial rhinosinusitis likely causes green or yellow mucus. But viral rhinosinusitis causes it too. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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I lost 85 lbs. and found my strength and spirit. Overweight with diabetes, Nerissa wanted to get — and stay — healthy to be around for her young son. Since her weight-loss surgery at Crouse, she’s found a pursuit that’s built her own strength and spirit. She’s also found a caring and compassionate team to support her every move. Down 85 pounds and off medications, Nerissa’s on to an active new life. Hear Nerissa’s story at crouse.org/weightloss. A partnership with CNY Surgical Physicians
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
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4 Tips to Get Savvy on Autism Research By Deborah Jeanne Sergeant
he prevalence of autism spectrum disorders is one in every 54 live births, according to the Centers for Disease Control. If autism affects your life, you likely home in on stories about it. Or well-meaning friends tag you about new autism research. Though widespread, autism remains little understood by the medical community. Because scientists have discovered little about what causes Jacobson autism, it’s only natural for parents, grandparents, teachers and others interested in autism to seek answers from perhaps less-than-accurate sources. Consider these tips for finding accurate information on autism. 1. Turn to well-known, nonprofit foundations, such as the Autism Society. Since they’re not selling anything, organizations such as this will likely offer more accurate information.
“With the internet, there’s tons of information,” said Jean Jacobson, PhD, managing director of clinic and educational services at The Kelberman Center in Syracuse. “Certainly, I caution parents. There’s lots of information that may be inaccurate or talking about treatments that are not necessarily well researched. Autism Speaks and The Autism Society of America are good places to start.” “Interactive Autism Network has a great breakdown of therapies,” said Robert Myers, executive director of the The Kelberman Center in Syracuse. 2. Anecdotes can sound very convincing because of the emotional element and personal information they contain, but they hold the least amount of weight. It’s not that parents of autistic children purposefully lie about their experience; however, many other factors may be involved which they have not considered. Or they may cite factors that have nothing to do with their child’s autism. “Every child with autism is different,” Jacobson said. “We encourage parents to talk with other parents. Get support and validation. Don’t expect that what worked for them will work for you.” 3. Take a wary look at a small, short-term, local study.
“Look at the sample size of the population,” said Lawana Jones, founder and executive director of The Autism Council of Rochester, certified autism specialist and parent of a child on the autism spectrum. “Is it a complete representation of the data? What are some of the different elements of the data, like the race and ethnicity of the subjects? Myers Ages? Make sure it’s a broad range of ages and sample size. If they don’t have a good sample size, it should make you wonder.” 4. Organizations selling information or products may be the least reliable sources. That doesn’t mean their ideas have no merit; however, their claims may be overinflated since they want to profit. “That is not a site they want to use as a source,” Jones said.
What is Autism?
Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. ASD is defined by a certain set of behaviors and is a ‘spectrum condition’ that affects individuals differently and to varying degrees. There is no known single cause of autism, but increased awareness and early diagnosis/intervention and access to appropriate services/ supports lead to significantly improved outcomes. Some of the behaviors associated with autism include delayed learning of language; difficulty making eye contact or holding a conversation; difficulty with executive functioning, which relates to reasoning and planning; narrow, intense interests; poor motor skills and sensory sensitivities. Again, a person on the spectrum might follow many of these behaviors or just a few, or many others besides. The diagnosis of autism spectrum disorder is applied based on analysis of all behaviors and their severity. Source: Autism Society:
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
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ell, tis’ theContract# season . . . the tax you stand financially in the present. Acct# A1ZGFE Sales Rep: GRIMALDI, JENNIFER L Size: HCN6 Ad Id: AMZHMA1 5544766 It starts with gathering together all season that is. April 11th, 5:45 to 7 PM This time of year always your financial documents in one reminds me how important it is for place. those living alone to take responsiI cleared out a file drawer in bility for their financial my desk, purchased new April 13th, 6 to 7 PM health. hanging file folders, and The fear of ending up started labeling the files 4863 East Genesee St. (315) 445-4894 upstateyogainstitute.com “alone and penniless” is a according to the instrucseemingly universal fear tions in David Bach’s book shared by many women titled, “Smart Women Fin(and some men) who are ish Rich.” It didn’t take as Diabetes? divorced or widowed in long as I thought it would mid-life, either by choice and I felt a great sense of Flat Feet? or by chance. accomplishment once I It certainly was the Plantar Fasciitis? had everything collected case for me. together. You may be eligible for shoes at little or no cost! While shared reAnd guess what? sponsibility for financial This simple step helped matters is becoming more me feel in more control. common these days, it is Almost immediately, my fears began still true that in many marriages the to lessen. men pull the purse strings and manage the financial decision-making. Get help, if you need it. It’s the “way it was” for many traditional couples, when the man Once I had my “stuff” organized, was the primary bread winner, but I was in a much better position to it’s also the “way it is” for more promake sense of my financial situation. gressive couples who simply want to I continued to work through Bach’s divide and conquer when it comes to book, but I found I needed more — I managing household responsibilities. needed a real, live person to help me Problem is, once a spouse is out take the next step and make more of the financial loop, he or she often progress. remains uninvolved for the long That’s when I engaged the help haul, which can put them at a real of a financial representative who disadvantage. Their knowledge of helped me align my spending, saving and self-confidence around money and investing with my needs and primatters becomes very diminished. orities. He’s been an invaluable coach Simply put, when one spouse and motivator. controls the finances, the other can If you are like me, you may be left in a vulnerable position if and benefit from engaging a professional. when the marriage ends. If you are more self-directed and inI consulted with my financial clined to educate yourself on money adviser and together we identified matters, there are excellent resources a few essential steps to help those out there in books, magazines and on flying solo to gain control of their money and make progress toward the web. AMZHMDNLM 14-Mar-2014 07:57 financial autonomy: Peace of mind and a sense of empowerment are the rewards for Come out from under the covers. women and men who get their finanIgnorance is not bliss when it cial house in order. Solid informacomes to financial management. tion, personal discipline and good Women, and men alike, need to find help from a trusted adviser can turn the courage to get “up close and financial uncertainty into financial personal” with their financial circum- security. sting Information: stances. I avoided looking into my With increased self-confidence financial mirror for years until the and awareness, you can better fear of not doing anything was great- protect your future and more fully er than the fear of facing reality. embrace the pleasures of living alone Fear, in my case, turned out to be . . . with a little left over to splurge on change, please contact your sales representative a blessing in disguise — a real motisomething special just for you! Book Customer Service at 1-800-891-1899. vator. It prompted me to get my act AAMZHMB2DNLMA together and seek help. There’s no Medical Office Center time like the present to take charge of ______________________ St. Joseph’s Hospital Campus your money and your destiny.
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See us online @ cnyhealth.com Page 12
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
Tricia Steed of Binghamton with her twin daughters, Alva and Della. The mohter heart stopped during the emergency C-section at Crouse Hospital. Steed credits a treatment she received at Crouse as responsible for keeping her and her daughters alive.
Physician David Landsberg, critical care co-director, Crouse ICU, and Wendy Fascia, manager of respiratory care services. “In 1971,” Landsberg says, “an ECMO would take up -an entire room. Now it’s portable and strikingly smaller — about 25 pounds.”
A Machine that ‘Stops Death’ Saving Lives at Crouse By Aaron Gifford
ricia Steed’s only memory from Nov. 30, 2016 was going to sleep. She doesn’t remember the seizure, the emergency C-section that was performed that night in the delivery of her twin daughters, the large blood clot in her lungs, or the device that helped save her life after her heart stopped twice. “I think about it every day,” said the Binghamton mother of two healthy daughters, Alva and Della. “It’s a blessing to be here.” Steed’s pregnancy was considered high risk because her water broke 23 weeks prematurely. When her heart stopped during the emergency C-section, physician David Landsberg, Crouse Hospital chief of medicine, called for the extracorporeal membrane oxygenation (ECMO) machine. ECMO is a specialized type of life support device that uses cardiopulmonary bypass technology to temporarily take over the work of the heart and lungs in cases of extreme cardiac or respiratory failure. It works by sending the patient’s blood through an artificial membrane that infuses oxygen, removes carbon dioxide and monitors critical blood parameters, including venous oxygen saturation, hemoglobin, hematocrit and arterial and venous blood temperature. ECMO provides the patient enough support to survive and can be used for a period of several days to weeks, while the lungs or heart recover.
Steed and her husband, Christopher Steed, are both employed as cardiac nurses, so they were especially impressed with how this situation was handled. Tricia’s heart is back to normal, and there were no side effects. At the present time, she added, none of the Binghamton area hospitals use ECMO devices. Tricia Steed remembers waking up in Crouse’s intensive care unit, noticing she was hooked up to a ventilator, “and then looking at my husband with some pretty mean eyes,” she said with a laugh. “Prior to this I was in the best shape of my life, so I was going to demand an explanation from him!” But seriously, she added, “Without that technology in place, it’s often too late [to save a patient]. The heart sustains that level of damage. Without that machine, I would not be here today.” Interestingly enough, ECMOs have been around since at least the early 1970s, though the technology and techniques for using them have improved dramatically in recent years, physician Landsberg explained. Crouse has used the device with tiny premature NICU infants for several years now, and began applying the technology on certain adult patients in 2012. “In 1971,” Landsberg said, “an ECMO would take up an entire room. Now it’s portable and strikingly smaller — about 25 pounds.” At one point in the 1970s, the
mortality rate for adults who were treated by ECMO was approaching 100 percent. The medical community essentially walked away from it and had dismissed it as an unacceptable treatment for adults. A series of studies in the decades that followed determined that in certain circumstances, the device could be used effectively. Over time the machines were improved to inhibit blood clotting, and the infection rates at hospitals across the country were going down, making the use of ECMO a safer risk. In order to make the ECMO a standard practice for candidates who meet the criteria for that type of treatment (not terminally ill, good neurological condition, no massive wounds or critical instances like a massive stroke with pneumonia), Crouse formalized an ECMO program that requires one dedicated nurse to sit with the machine around the clock when the machine is needed, and one nurse who is dedicated to the ECMO patient at all times. A critical care team at Crouse determines who is a candidate for this type of treatment. So far, Landsberg has supervised the care of all but one of the adult EMCO patients. “There’s a tight loop with this because standardization is important,” he said. “To have two dedicated nurses for this can be an institutional barrier for hospitals. It’s not a standard of care, but a life-saving modality.” April 2017 •
In 2016, there were nine ECMO patients at Crouse. The durations ranged between two days and 30 days; patients with heart complications typically had shorter stays than those who had problems with their lungs. ECMO is only a bridge, Landsberg cautioned, and the key to recovery involves a plan of care that is followed after the patient leaves the hospital. “All it does is stop death,” he said. Landsberg also cautioned that only a very small fraction of the estimated 1,700 patients that were treated in Crouse’s intensive care unit last year were candidates for ECMO treatment, though there is hope that medical advances in the years to come will bring life-saving technology to a greater percentage of patients. The possibilities are exciting. In Europe, physicians are reporting tremendous success with ECMOs being used at accident scenes or inside patients’ homes. “They’re placing patients on an ECMO where they drop,” Landsberg said. “The technology exists to bring those capabilities here.” St. Joseph’s Hospital Health Center and Upstate Medical University Hospital also have ECMO capabilities. The institutions had shared their equipment in the past but now all three have their own devices. “There’s been enormous inter-institutional coordination,” Landsberg said, adding that Crouse put tremendous resources into its own ECMO program. “People can get the same level of care here that they could get at the bigger cities across the country.” “It’s tough to walk up to a family and say it’s not going to get better,” he added. “It’s nice not to have to say, ‘I’m sorry.’”
IN GOOD HEALTH – CNY’s Healthcare Newspaper
The skinny on healthy eating
Cheers for Nutrient-Rich Cheddar
as your relationship with dairy products soured? You’re not alone, especially when it comes to cheese. Fearing the relatively high fat, calorie and sodium content of some cheeses, many of us have curtailed our consumption of this beneficial food. I’m not one of them. For me, a life without cheese would hardly be a life worth living. Yes, I adore cheese, most kinds, but the cheese I adore most is cheddar. And the reason my heart cheers for cheddar is because it’s a nutritional superstar, packed with protein, calcium and phosphorous. A 1-ounce portion (think a pair of dice) fulfills 14 percent of our protein needs with 7 grams, 20 percent of our calcium needs, and 14 percent of phosphorous. All together, this powerful team supports our muscles, bones, teeth, tissues and immune system. I’m also a huge cheddar fan because its bold flavor helps me eat it in moderation, which is the key to eating cheese, according to the American Dietetic Association. On the fat front, cheddar serves up 9 grams of total fat per ounce,
with 6 of those being saturated fat. The American Heart Association recommends that we consume no more than 13 grams of saturated fat a day due to its propensity to raise our bad cholesterol, which may then increase our risk for heart disease and stroke. Some recent studies, however, have indicated that cheese — even in high amounts — may not raise bad cholesterol after all. While more research is clearly needed, scientists think multiple mechanisms are involved, possibly related to calcium (shown to reduce the absorption of fat during digestion), protein and a cheese’s unique nutrient matrix. Something else to cheer about: Cheddar may protect our teeth, according to a study published in General Dentistry. Research has revealed that eating cheddar at the end of a meal helps to neutralize acids that form while eating, which may then thwart cavity formation. Cheddar for dessert, anyone? Much like some other delicious foods that are good for us — nuts, avocados, peanut butter, olive oil — cheddar is no slouch when it comes to calories: a 1-ounce slice has about
115 calories. Eat a few slices at a cocktail party and you’re over 200. What cheddar calls for then is moderation. Depending on your dietary needs, it may also call for eating some of the reduced-fat versions. A final cheer: Sodium-wise, cheddar has less salt than most cheeses per 1-ounce slice, clocking in at 174 mg. The same amount of Parmesan has 450 mg.
and set aside. Top four of the bread slices with cheese; spread with avocado mixture and top with tomato slices. Add the four remaining bread slices on top. Heat 1½ teaspoons canola oil in a large nonstick skillet over medium-high heat. Add 2 sandwiches to pan; top with another heavy skillet. Cook 3 minutes on each side or until golden; remove sandwiches from pan. Repeat procedure with remaining oil and sandwiches. PS: Celebrate: April 12 is National Grilled Cheese Sandwich Day! According to a reader’s opinion poll, grilled cheese sandwiches are among one of the top comfort foods in the United States.
Grilled Cheese with Mashed Avocado and Tomato Adapted from Food.com
1 ripe peeled avocado 1 tablespoon lemon juice ½ teaspoon ground cumin ¼ teaspoon kosher salt ¼ teaspoon coarse black pepper 1 teaspoon dried basil 8 slices whole-grain bread 6 ounces cheddar cheese, sliced 1 large tomato, thinly sliced and patted dry 1 tablespoon canola oil, divided In a small bowl, mash together avocado, lemon juice, cumin, salt, and pepper until smooth. Stir in basil
Choose sharper cheddars with stronger flavors to help monitor intake. Lactose intolerant? Aged cheeses like cheddar contain relatively low levels of lactose. Read cheese labels carefully: some reduced-fat versions contain fillers and additives that don’t suit everyone. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at email@example.com.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
athy Ozzard Chism — author, holistic wellness educator, plantbased nutrition counselor, and Bach flower therapist — lives her life to help heal others. A close call with death in 2009 forced her to find new paths for healing. Now at age 60 — pain-free, medication-free, and full of renewed energy — she shares her road back to health and how others may benefit from her journey.
consultation [$195] involves a complete holistic workup — nutrition, stressors, childhood experiences, and more. Most of the products I recommend for healing are in my boutique. My customers have peace of mind knowing all the products at Soul Soothings have been carefully vetted.
Q. You are a Bach flower therapist and offer this therapy and the 38 essences at your boutique. These all-natural essences address emotional factors like depression, anxiety, fear or trauma that may impede physical healing. Can you share an example of how this therapy helped a client? A. One client was locked in grief for almost two decades from the deaths of her parents. Although most clients see improvement from this therapy in one or two sessions, it took her 12 sessions for a breakthrough... yet even she found joy again!
Q. You nearly died from stress, which slowly shut down four of your organs and stopped your ability to assimilate nutrients from food. You also had severe degenerative arthritis. What in particular jumpstarted your return to health? A. I connected with a brilliant naturopath and research scientist, Jim Reese, who prescribed the correct combination of vitamins and supplements my body needed. Jim also helped rid my body of toxic heavy metals with zeolite, an all-natural product I continue to take daily, and taught me how to correctly balance my pH and alkalinity levels.
Q. You mentioned your stress resulted from “doing too much” and “having a hard time saying no.” Is it easier to say “no” now? A. Definitely. I take care of me first now, so I can give more to others. When asked to do something, I check my body’s reaction. If the request feels stressful, I simply say “no” in a kind and loving way.
Q. Your journey back to health resulted in your book, “The Power of Know: 30 Days of All-Natural Ways to Heal Mind, Body and Spirit.” These ways are titled “wisdom snacks”— inspirational bits of wisdom for optimal health. Can you share some of the more influential wisdom snacks? A. All 30 are equally important for optimal health; but, for starters, I strongly encourage people to get their pH and alkalinity in balance. It’s easy to test and not difficult to restore by consuming the right foods, like organic green veggies and alkaline water, and by eliminating the wrong foods, like sugars, meats and coffee. A pH around 7.4 is ideal; below 7, you are “acidic” and more vulnerable to diseases like osteoporosis, diabetes, cancer, and more. I’m also a firm believer in ridding one’s body of toxic heavy metals, harmful chemicals, and toxins on a daily basis with zeolite and/or organic wheatgrass juice.
Q. You also used positive affirmations to assist your healing. Was there one you felt helped the most? A. “I am 100 percent healthy now and always.” I said this over and over, even when I didn’t believe it. I still say it every day.
Q. What do you believe is keeping Americans from optimum health? A. Eating unhealthy foods, drinking unhealthy drinks, not managing stresses and negative emotions, not exercising enough, not drinking enough pure water. Not removing heavy metals, not spending enough time in nature, not getting enough sleep. Not balancing pH and alkalinity, not investing in water filters for tap water, not buying organically grown produce. Putting toxins on hair, skin and nails, which are in the bloodstream within 10 minutes, and are cumulative. It’s all about choosing wisely. Dealing with cancer, heart disease, or diabetes is far more expensive and harder than making simple changes to help prevent them.
Author and holistic wellness educator Kathy Ozzard Chism in her Soul Soothings boutique in Manlius. Photo by Alexis Emm
10 By Anne Palumbo
Questions for Holistic Wellness Educator Kathy Ozzard Chism
Q. As a vegetarian since age 16 who now holds a certificate in whole-food, plant-based nutrition from Cornell University, you are a strong advocate for eating an organic plant-based diet for all your meals and avoiding foods that are manmade, processed, genetically modified, and grown with pesticides and chemicals. More thoughts on nutrition? A. Hundreds! Here are three: 1) at every meal your plate should be 75 percent all-organic veggies, and the other foods (organic grains and proteins) in 4 oz. amounts; 2) drink organic green juices, especially those made with organic wheatgrass, considered to be “nature’s finest medicine,” but go easy on spinach, kale, and chard, which have oxalates and can cause kidney issues; 3) don’t eat the nightshade vegetables (tomatoes, white potatoes, eggplant, and peppers), as they cause inflammation in the body. My degenerative arthritis completely disappeared when I
stopped eating them.
Q. You own Soul Soothings, a boutique in Manlius, that provides holistic wellness consultations and gifts for healthy living. Who is your typical client? What does a consultation entail and cost? A. My typical client is a woman, aged 35 to 75, eager to relieve her stress and feel better. The three-hour
Q. Are you investigating any new therapies? A. Yes: brain neuroplasticity techniques to rewire the “limbic system trauma loop,” which is formed by age 5. These techniques help with stress and conditions like multiple chemical sensitivities, chronic fatigue syndrome, and many others, including ones considered “untreatable.”
Q. Finally, what is the first thing you do when you get up in the morning? And, the last thing at night? A. Every morning I add three drops of zeolite to an 8-ounce glass of purified water to rid my body of heavy metals, and wait an hour to have breakfast. At night, I list 10 things I was grateful for that day, do some deep breathing, drink a glass of purified water, and, if needed, put a few drops of the Bach Flower White Chestnut essence in my water to calm any “mind chatter.”
Soul Soothings Boutique Location: 131 W. Seneca St., Suite 1, Manlius, NY 13104 Phone: 315-692-2290 Hours: Tuesday to Friday, 11:30 a.m. to 5:30 p.m. Saturday, 10 a.m. to 5 p.m. Websites: soulsoothings.com; kathychism.com Coming soon: Soul Soothings online store April 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Women’s HEALTH What Disease Kills Women the Most? By Deborah Jeanne Sergeant
hat disease kills more women than any other? Breast cancer? Lung cancer? Ovarian cancer? Colorectal cancer? Wrong. Heart disease is the leading cause of death among American women, totaling 161,698 deaths annually, according to WomenHeart. That’s more than one-third of all deaths for women. Compared to that, only 40,861 women die every year from breast cancer. Mary McGowan, CEO of WomenHeart, The National Coalition for Women with Heart Disease (www. womenheart.org), hopes that by promoting education about heart
disease risks and signs of heart attack in women, her organization can help drive down those statistics. One means is Women Heart’s National Hospital Alliance program, which aids hospitals in educating clinicians and patients. Many women don’t realize that heart attack often presents differently in women than men. “It’s important for women to understand the difference because this can be lifesaving information,” McGowan said. Men may experience sharp pain in the chest, but women may feel short of breath, pain in the arm and
Parenting By Melissa Stefanec
The Monster in My Closet
back, extreme fatigue and nausea. Russell Silverman, cardiologist with St. Joseph’s Health, said that the symptoms “may even go unrecognized in younger women.” He added that although there are more similarities than differences between how heart attack manifests in men and women, “women are less likely to have significant associated symptoms.” Women also may feel symptoms when at rest or in response to mental stress instead of with physical exertion like men tend to. “Psychosocial factors are also important as women drastically underestimate their own risk of coronary artery disease,” Silverman said. While prenatal health care may put women on the track for regular health care visits, once a child arrives, it’s harder to stay faithful to a regular health care regimen for some women, especially considering over-the-counter contraceptives can eliminate the need for doctor visits for prescribed contraceptives. Women can also use long-lasting contraceptives. Since they’re not seeking regular physicals, some women overlook the risk factors for heart disease, which include high blood pressure, family history, high cholesterol, diabetes, smoking, and being post-menopausal. McGowan added that female-specific risk factors include pregnancy if
When I had trouble tackling a big project, I axed the big project and aimed smaller. Maybe I couldn’t tackle all the closets in one weekend, but I could start with one closet. If it was a particularly busy weekend, I talked myself into organizing and cleaning out to just one bathroom or dresser drawer. I talked myself into going through one toy basket. Small acts do indeed add up.
Bring your trusty sidekicks
My effort to de-stuff my house — a long and hard process
s I sit here writing, there is something that is distracting me and filling me with dread. This something is in a closet downstairs. It’s in my kids’ closets. It’s in the shop room in my basement. It’s a creation somewhat of my own doing, but it’s also a product of my family’s doing. It’s something that I try to forget about, but know I must one day face. On my best days, there is a monster in my closet. On my worst days, I find the monster everywhere. It is staring at me in my living room and kitchen. I try to keep it at bay, but it has a way of sneaking up on me. This monster doesn’t have wiry fur, sharp teeth or a grumbly roar. Its fright lies in its towering cardboard boxes, bags and bins. It instills fear with board game paraphernalia, puzzle pieces and dog-emblemed dominoes. It creeps into my thoughts with clothes I will wear when I lose 10 pounds and clothes my children will outgrow that need to be con-
signed. The monster is stuff — and it’s everywhere. Stuff, crap, junk, clutter. No matter what you want to call it, it isn’t doing us any favors. If you run an internet search materialism and well-being or the psychological effects of clutter, the prognosis isn’t good. Material possessions, especially ones that aren’t being put to use, aren’t doing us much good. Parents know all too well how annoying stuff can be. Kids come with a lot of stuff. That stuff takes up a lot of space. That stuff requires cleaning and organization. That stuff costs a lot of time and energy that most parents don’t have. So, to that end, I’ve been trying to de-stuff my house. It’s been a long process, but every time I make some progress, I feel a little more successful and in charge. Here are some ways I’ve been showing this monster who’s the boss.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
I tackled each project with two bags or boxes in tow. One I filled with garbage, and the other I filled with items to donate. Within two days, I donated the items slated for donation. I didn’t let my donation pile create a new stuff monster. I also brought along paper towels and cleaner so I could wipe down whatever I was cleaning out.
Don’t go into battle alone
When it came to kid stuff, I involved the kids. I know some parents like to get their kids out of the house and gut the toy masses. I want my kids to learn how to get rid of things. Kids need to learn that stuff isn’t all that valuable, and it comes and goes. They were surprisingly good about cleaning out their toy stashes.
I started small, but I moved incrementally. For me, it felt very good to say there was a whole room or area that I de-cluttered. It gave me a sense of a larger accomplishment and a goal to work toward. Also, by moving incrementally, it gave me a chance to notate my donations so I can itemize them at tax time.
the mother experiences hypertension and pre-diabetes related to the pregnancy. “The science is showing that pregnancy is a first cardio stress test for many women,” McGowan said. “These issues that develop during pregnancy can be precursors for heart disease later in life.” Healthy women who become pregnant don’t elevate their risk of heart disease during pregnancy, but all women should receive prenatal care. Patients aren’t the only ones not thinking about heart disease. Women Heart literature states, “A 2005 American Heart Association study showed that only 8 percent of primary care physicians and 17 percent of cardiologists knew that heart disease kills more women than men.” More women need to ask for the screenings that could save their lives. These include blood pressure, cholesterol, body mass index, and pulse, which can detect arrhythmia. It makes sense to get evaluated for heart disease risk since physicians can prescribe medication to protect against heart attack. But once heart damage is done, it’s done. On Feb. 3, WomenHeart is offering complementary screenings in 46 states at Burlington stores. Call store locations for more details.
Take charge of future you
Once you drive the stuff monster out of your home, don’t let it sneak back in. No one fills a house with stuff in a week’s time. Once you have purged, don’t start refilling. Before you buy something, ask yourself if you really need it. If you are buying it to replace something you already have, immediately dispose of or donate the old item. Use impulse control to keep future monsters at bay.
Be assertive with others
Any parent knows that stuff doesn’t just come from parents. It also comes from family, friends and colleagues. I had a kind and honest conversation with my loved ones about stuff. I explained to them that I felt like too much stuff wasn’t a healthy thing for my family. I told them I didn’t want my kids to put too much value on things. I encouraged them to think of a couple of special gifts and make deposits in my kids’ college funds if they wanted to give any more than that. These conversations were surprisingly well-received.
Plan for parties
This year, my daughter turns 6. She will want to invite friends to her birthday party. I am going to try a donation birthday party. My daughter loves animals, so we are going to ask anyone who wants to give a gift to donate to a local animal shelter. I am then going to have my daughter bring the donations in. She will still get gifts from close family and friends, but I am hoping my daughter’s upcoming birthday teaches happiness isn’t derived from stuff.
Things You Should Know About Miscarriage
By Ernst Lamothe Jr.
or pregnant women, a miscarriage is an unexpected and emotionally devastating loss. Regina Farrell, an OB-GYN with St. Joseph’s Hospital, understands the affects it can have on a person. Miscarriage, which is the spontaneous loss of a pregnancy in the first 22 weeks, is the most common type of pregnancy loss. About 10 to 20 percent of known pregnancies end in miscarriage, according to the Mayo Clinic. The risk of miscarriages can change with age and history. Most miscarriages — about 80 percent — Farrell occur before 12-weeks of pregnancy. While it is impossible to prevent a miscarriage, Farrell does believe there are some helpful tips that can increase the chances for a successful full-term pregnancy. “It’s important for women to know that a miscarriage is not their fault. There are numerous things that can cause a miscarriage that may be out of your control,” said Farrell. “Sometimes it just happens by chance.” Farrell is a board certified by the American Board of Obstetrics and Gynecology and member of the American Congress of Obstetrics and Gynecology.
Talk to your physician
While the decision to have children is an intimate conversation between partners, Farrell suggests having a talk with a physician early on. A simple pre-consultation or overall exam can help, especially in high-risk pregnancies, which include the mother having high blood pressure, diabetes, taking multiple medication or family history illness. “Even a conversation about the stresses you may have at home and work or even discussion on your workplace environment can help a physician determine so much,” said Farrell. “Talking about your family history that could include thyroid issues or autoimmune diseases offers valuable insight on the road to pregnancy.”
Farrell believes ensuring proper nutrition is key to a successful pregnancy. That includes prenatal vitamins with folic acid, iron and calcium. In addition, prenatal multivitamins have vitamin C, B6, B12, zinc and other essential nutrients for the body. The vitamins plus a balanced diet should provide the mother with all she needs during her pregnancy. Farrell stressed that vitamins alone will not make up for
poor nutrition. “Regardless if you are pregnant, the body needs a balanced source of vitamins, minerals and essential foods to work at its optimal speed,” said Farrell. “That magnifies itself when you add a newborn inside of you who needs those nutrients as well. You can’t abandon good nutritional habits while pregnant.”
Optimize your health
Dealing with chronic disease is hard enough on its own even before pregnancy begins taking center stage. Nutrition is a moving target. It seems like every week we are finding out something new that was once considered detrimental to us that is no longer or the opposite as well. Farrell said the right kind of foods along with light exercise should be part solution to a solid pregnancy. “Exercising can help with your overall health, and it gives you the energy you need during pregnancy,” added Farrell. “There are plenty of studies that have talked about the importance of staying active.”
Keep up with your shots
Vaccination health is not simply for kids. The Centers for Disease Control and Prevention has guidelines for the vaccines needed before, during and after pregnancy. Some vaccines, such as the measles, mumps and rubella, should be given a month or more before pregnancy. Doctors recommend a Tdap vaccine (combination vaccines against three infectious diseases in humans: diphtheria, pertussis, and tetanus) to help protect against whooping cough during pregnancy. Other vaccines, like the flu shot, can be given before or during pregnancy, depending on whether or not it is flu season. “It’s essential to discuss each vaccine with your healthcare professional before getting vaccinated,” said Farrell.
It’s important for couples to know that when a woman has recurrent losses, it is not the woman’s fault. That’s a hard concept for women to accept because they often think they did something wrong or failed to do everything to ensure a healthy pregnancy. The loss of a pregnancy should be grieved and dealt with, as with any loss. “That’s why at St. Joseph’s we have services that can help people through their grief,” said Farrell. “We have individual and group counseling sessions because we understand that a traumatic event like this can cause depression and undue personal blame. You never want to go through something like this alone.”
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Sitting the Month Chinese practice calls for moms to do nothing for a month after delivering a baby
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raditional Chinese mothers practice “zuo yuezi” — or “sitting the month” — after delivering their babies. Whether it’s assistance from relatives at home or at a facility designed to aid new moms — and staffed with nurses and nutrition experts — these mothers take it very easy for 30 days. They eat special foods to help them recover and avoid chills to help restore their body’s balance. Beyond nursing, they literally do nothing and go nowhere for a month. While taking it this easy for a month may not be possible or advisable for many mothers, new moms should call upon whatever support they need to take care of their babies and themselves. Unfortunately, isolation from extended family and employment demands often mean that women don’t get the help and rest they may need. “One problem with modern life is we were meant to be in small villages with family units to help new mothers and help in the process and be supportive,” said Rob Kiltz, founder and director of CNY Fertility in Syracuse. “We’re herd animals and meant to be interactive.” Kiltz is a diplomate of the AmerKiltz ican Board of Obstetrics and Gynecology and board-certified in reproductive endocrinology and infertility. Kiltz said that post-partum support should do more than just ease mom’s burden, but should include help from the family. “It’s not just about ‘Let me help you do nothing’, but as a village, tribe, family and group, ‘Let’s work together for the greater good.’ Rais-
ing a child is meant to be done as a family. That’s where we get our best creativity and joy out of life.” Women’s bodies change a lot from pre-pregnancy to pregnant to post-partum. “Like everything else, the type of activities for each woman is different,” said Sunday Asaju, an OBGYN with St. Joseph’s Health. Some women feel driven to become active soon; others prefer Asaju a longer recovery. Asaju listed other factors such as whether the woman delivered vaginally, tore or experienced a C-section. “In general, we advise that women at least take it easy for the first six weeks, avoiding heavy lifting, strenuous exercise,” Asaju said. “We advise them to not stress themselves and with a C-section, to not lift anything but the baby. They should wait six weeks, if not more, before strenuous exercise.” For women who want to become active, Asaju said that walking may prove beneficial. “We advise them to not lie in bed too much because they can have blood clots in their legs, and that can be dangerous to their health,” Asaju added. “If a family member, like their mother or auntie or a support group can help them, especially in lifting, and with strenuous activities, they should employ their help.” Asaju said that individuals’ financial and cultural background also affects their time frame of returning to work and activities, but overall, following their doctor’s advice can help them maintain the right balance between activity and rest.
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In Good Health is published 12 times a year by Local News, Inc. © 2017 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamothe Jr. Eva Briggs (M.D.), Aaron Gifford • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler
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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.
By Deborah Jeanne Sergeant
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
Women’s HEALTH Shift Work May Hamper Conception Harvard study suggests that women who work late shifts may have problems conceiving a baby By Deborah Jeanne Sergeant
study recently released by the Harvard T.H. Chan School of Public Health in Boston states that women who work second or third shift may experience a reduced ability to conceive. The disrupted sleep schedule — resting while others are awake and working when most are asleep — may be partly to blame. “Anything that disrupts the circadian rhythm throws off our hormonal and endocrine and even our immune system,” said physician Rob Kiltz, founder and director of CNY Fertility in Syracuse. “The stress factors that go along with that and the fact that we may not be in synch with the partner, that probably doesn’t help.” Kiltz is a diplomate of the American Board of Obstetrics and Gynecology and board-certified in reproductive endocrinology and infertility.
He said that disrupting the circadian rhythm affects ovulation dysfunction, “likely affecting the hormonal environment that supports the early embryonic environment. It could throw off the hormones that support early pregnancy.” Other work factors can reduce the woman’s ability to conceive, such as performing heavy physical labor. The study indicated that wemon working physically intense jobs had fewer eggs than women working sedentary jobs. Kiltz said that these somewhat androgenic activities release cortisol, the stress hormone. That promotes inflammatory conditions that can negatively affect how egg and sperm interact, ovulation and implantation of a fertilized egg. While exercise is healthful, strenuous and heavy activity may make having a baby tougher. In addition to
physical stress, emotional stress can also inhibit conception. “This is why we recommend yoga, exercise, acupuncture, going for a walk, listening to nature and soothing music and reading a good book,” Kiltz said. “Turn off the TV news. If you do have shift work, imagine you’re able to come home, reduce the light, and change that circadian rhythm a bit to get a quiet time of rest and relaxation.” He also recommends limiting carbohydrates in the diet. Physician Sunday Asaju, who specializes in obstetrics and gynecology, said that although studies appear to show an association between late shift work and reduced fertility, more studies should be conducted to establish a causal relationship between the two. Asaju works at St. Joseph’s Primary Care West and at the Primary
Care Center at St. Joseph’s Hospital. He did say that shift work can disrupt the menstrual cycle of a woman. “The person who works 8 to 5 is more regular. If the menses is irregular, it may affect their chances of pregnancy,” Asaju said. “The association is strong between shift work and lowered chances of pregnancy. They’re trying to postulate as to why that should be but no one really knows,” Asaju added. He said that some researchers think that exposure to light at night could negatively affect hormones. Until more research can be completed, women seeking pregnancy may want to seek first-shift work. Working with an OB-GYN and fertility expert can help women struggling to conceive to eliminate factors that decrease their likelihood of pregnancy.
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OCO Establishes Paid Leave for Cancer Screening
swego County Opportunities (OCO) recently announced a new policy that provides its full-and part-time employees with up to four hours of paid leave annually to undergo cancer screenings. The policy is wide ranging and may be used for any form of cancer, including breast cancer, prostate cancer, cervical cancer, skin cancer, colon cancer, ovarian cancer, bladder cancer or lung cancer. In a news release, OCO stated that the organization is among the first to implement a paid leave policy for cancer screening in New York state and the first nonprofit agency to do so in Oswego County. “OCO’s administration is well aware of the benefits of routine cancer screenings,” said Carolyn Hand-
N E T
ome Memorial Hospital and St. Joseph’s Health have announced they have finalized an affiliation agreement entering into a collaborative relationship. Under the agreement, Rome Memorial will continue to operate as an independent, separately licensed hospital with community representatives providing strong local governance. “St. Joseph’s Health shares our commitment to providing patients with high-quality, patient-centered care that is coordinated and easily accessible,” said RMH President/and Chief Executive Officer David Lundquist. “The signing of the affiliation agreement provides the principles for RMH to work together with St. Joseph’s Health in collaboration to deliver the highest level of quality healthcare services to meet the needs of our patients.” St. Joseph’s President and CEO
ville, coordinator of OCO’s cancer services program. “Regular tests such as imaging, biopsies, Pap smears, prostate screenings, mammograms, blood tests, and even surgical procedures for the purpose of detecting cancers are essential to maintain good health. Cancer is the second leading cause of death in New York state. Early detection can save lives as it finds cancer when treatment is more likely to be successful and in some instances before it even develops.” Diane Cooper-Currier, OCO’s executive director, said, “We care about our employees and their health and felt it was important to offer them paid time off to obtain life-saving cancer screenings” states.
Leslie Paul Luke said, “We are very excited about our relationship with Rome Memorial Hospital because it creates a seamless connection between our healthcare systems, improving patients’ access to the highest level of care. St. Joseph’s and RMH share the mutual goal of making health care more accessible in local communities by coordinating resources.” RMH and St. Joseph’s announced plans to affiliate less than a year ago and progress has already been made toward creating a regional integrated health care delivery network. RMH and its affiliated physician practices joined St. Joseph’s Accountable Care Organization and Clinically Integrated Network, which were formed to achieve healthcare’s “Triple Aim” to improve the patient experience of care, improve the health of populations, and reduce the per capita cost of health care.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
Make $45,000+ with an Associate’s Degree Great opportunities in the health industry available for people who have only a twoyear degree By Deborah Jeanne Sergeant
oining the health care field doesn’t require 12 years of training to become a medical doctor. Many good-paying, satisfying positions in health care require only an associate’s degree. Though not medical doctors, various ancillary roles are “widely employable,” according to Nancy Page, chief nursing officer with Upstate University Hospital. These careers limit the amount of debt the student acquires as they’re attending classes only two years. Plus, many community colleges and smaller, less expensive institutions offer the coursework required. In addition, students uncertain of their career path invest only two years in their education. Some of these positions also may segue into provider positions with additional education. The annual mean wage and projected growth (through 2024) statistics are according to the Bureau of Labor Statistics, specific to Syracuse. Food Services Manager The food services manager’s role includes working with dietitians, medical staff and social workers to meet patients’ dietary needs while in the hospital. It’s also a managerial role, involving working with staff that prepare and deliver meals. Food knowledge and good people skills
combine in this career. “Culinary degrees are two-year degrees,” said John Bergemann, director human resources at Crouse Hospital. “It’s not just a prep cook, but cooking food for patients and employees. It’s about safe serving, hygiene and keeping food the right temperature. We have dietitians that help plan the meals for patients with special needs, so cooks will have to learn how to prepare.” Onondaga Community College (www.sunyocc.edu) offers an associate’s degree in hospitality management and a specialty in food service/ institutional management. Annual mean wage: $52,020 Projected growth: 5 percent Respiratory Therapist Whether from an injury of lung illness or disease, patients seek the help of a respiratory therapist to improve their breathing. Like a physical therapy assistant, a respiratory therapist should relate well to people, record accurate information in patient charts and exhibit an ability to think creatively to help patients who struggle with completing their exercises. Many respiratory therapists work in hospitals. Cayuga Community College (www.ccc.edu) offers a certificate in respiratory therapy.
Median annual salary: $58,840 Projected growth: 12 percent Radiographers and MRI Technologist At hospitals, outpatient clinics and independent diagnostic offices, radiographers perform diagnostic tests, including X-rays, and MRI techs perform MRIs. People with empathy and attention to detail can fit well in these careers. Cayuga Community College (www.ccc.edu) offers certificates in radiation therapy technology. Median annual salary: (MRI) $73,270; (radiographer) $59,120 Projected growth: 9 percent Medical Sonographer Working in outpatient, hospital and physicians’ offices, the medical sonographer operates equipment used to perform diagnostic tests on organs and soft tissues. They can specialize in maternity, children, breasts or other areas. Upstate Medical University’s (www.upstate.edu) ultrasound program takes two years to complete. Median annual salary: $70,150 Projected growth: 24 percent Dental Hygienist Dental patients often spend more time with their dental hygienist than the dentist. But they do far more than just clean teeth. They also perform patient intakes, update charts, screen for a variety of oral health issues and take X-rays. Dental hygienists need a warm personality as well as close attention to detail. OCM BOCES (www.ocmboces.org) is one example of a local school offering dental hygienist certificates. Median annual salary: $66,130 Projected growth: 19 percent
Radiation Therapist Usually working with oncologists, radiation therapists treat cancer patients in hospital and cancer clinic settings. Radiation therapists work with equipment that delivers doses of radiation, so complying with safety guidelines is extremely important. Solid science and math skills and also exceptional people skills are required for the radiation therapist, as they work with patients and families facing what’s often a life-changing diagnosis. Cayuga Community College (www.ccc.edu) offers a two-year program in radiation therapy. Median annual salary: $69,700 Projected growth: 14 percent Of course, the employee’s location, specific employer, experience, and coursework can influence the annual salary. The New York Office of College and University Evaluation website (www.nysed.gov/heds/ IRPSL1.html) can help you determine the educational requirements of these professions and what New York-based institutions can help you obtain the education required to practice these careers in New York. When exploring any of these or other health-related occupations, ask about continuing education. Nancy Page, chief nursing officer with Upstate University Hospital, said that many positions at Upstate offer educational benefits after six months. “By then, we know if we like you and you know if you like us,” Page said. “We have $1.2 million for just for educational benefits at Upstate. So many programs are online now. You’re not limited to just what’s local.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
By Deborah Banikowski District Manager, Syracuse
Representative Payee: Help a Loved One With Social Security
here are nearly 57 million people living with disabilities in the United States, according to the Census Bureau. Thirty percent of American adults help provide care for a sick or disabled family member. Caregivers provide physical and emotional support for the people in their care. It’s a demanding job with its stresses and rewards, but it can also be a labor of love. Social Security is committed to you throughout life’s journey, helping secure today and tomorrow for every American. This is especially true for people who need help managing their benefits. We work closely with caregivers through our representative payee program. A representative payee is someone who receives and oversees the Social Security or Supplemental Security Income (SSI) benefits for anyone who cannot manage their benefits. This can be a child or an adult incapable of managing their own funds. You can learn more about our representative payee program at www.socialsecurity.gov/
Q: I applied for a Social Security card for my child at the hospital and the card came back with the first name misspelled. What should I do? A: Go to your local Social Security office or card center to ask for a corrected card. We need to see at least two original documents proving your child’s: • U.S. citizenship; and • Identity. We also must see proof of your identity, as the parent. The documents you show us must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies. To find out more, go to www.socialsecurity.gov/ssnumber. There, you can learn what documents you need, fill out and print an application, and then bring or mail the information to us. You may also want to read the publication, Social Security Numbers For Children, available at www. socialsecurity.gov/pubs. Q: I own a small business. How can I verify employees’ Social Security numbers? A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting
payee. A representative payee is usually a trusted family member or friend of the beneficiary, but when friends or family are not able to serve as representative payees, Social Security looks for qualified individuals or organizations to represent the beneficiary. You can learn about becoming a representative payee by watching our new series of videos on the duties of a representative payee at www.socialsecurity.gov/payee. It’s our hope that these videos will not only educate individuals about the roles and responsibilities of being a representative payee, but also provide further insight, broaden community awareness, and provide key resources to deal with the growing incidents of elder abuse, neglect, and financial exploitation. Caregivers are valuable and irreplaceable assets to our great nation. Please join us in celebrating them for all they do for those who cannot do for themselves.
purposes. For more information, go to www.socialsecurity.gov/employer/ssnv.htm. Q: I know that Social Security’s full retirement age is gradually rising to 67. But does this mean the “early” retirement age will also be going up by two years, from age 62 to 64? A: No. While it is true that under current law the full retirement age is gradually rising from 65 to 67, the “early” retirement age remains at 62. Keep in mind, however, that taking early retirement reduces your benefit amount. For more information about Social Security benefits, visit the website at www.socialsecurity. gov/r&m1.htm. Q: I was speaking with my sister and she told me that she receives half of her spouse’s benefit. Why am I not eligible for benefits from my spouse? A: If your spouse is eligible for Social Security benefits, you could be eligible for one-half of their benefit at your full retirement age. However, if you worked and are eligible for Social Security benefits on your own record, your own benefit may be higher than what you could be eligible for on your spouse’s record. If you have questions regarding your eligibility for benefits, please call 1-800-772-1213 (TTY 1-800325-0778) between the hours of 7 a.m. and 7 p.m. Monday through Friday.
By Jim Miller
How to Help Older Drivers Give Up the Car Keys Dear Savvy Senior, What tips can you recommend that can help me deal with my mom’s bad driving? At age 83, her driving abilities have declined, but I know she’s bound and determined to keep driving as long as she’s alive. Nervous Nelly Dear Nelly, There’s no doubt that giving up driving can be a tough step for many elderly seniors, as well as a difficult conversation for concerned family members. While there’s no one way to handle this sometimes touchy topic, there are a number of tips and resources that can help you evaluate and adjust your mom’s driving, and ease her out from behind the wheel when she can no longer drive safely.
Assess Her Driving
To get a clear picture of your mom’s driving abilities, your first step — if you haven’t already done so — is to take a ride with her and watch for problem areas. For example: Does she drive at inappropriate speeds, tailgate or drift between lanes? Does she have difficulty seeing, backing up or changing lanes? Does she react slowly, get confused easily or make poor driving decisions? Also, has your mom had any fender benders or tickets lately or have you noticed any dents or scrapes on her vehicle? These, too, are red flags. For more assessment tips see SeniorDriverChecklist.info. If you need help with this, consider hiring a driver rehabilitation specialist who’s trained to evaluate older drivers. This typically runs between $100 and $200. Visit AOTA. org/older-driver or ADED.net to locate a specialist in your area.
Transitioning and Talking
After your assessment, if you think it’s still safe for your mom to drive, see if she would be willing to take an older driver refresher course. These courses will show her how aging affects driving skills, and offers tips and adjustments to help ensure her safety. Taking a class may
also earn your mom a discount on her auto insurance. To locate a class, contact the local AAA (AAA.com) or AARP (AARP.org/drive, 888-2277669). Most courses cost around $20 to $30 and can be taken online or in a classroom. If, however, your assessment shows that your mom really does need to stop driving, you need to have a talk with her, but don’t overdo it. If you begin with a dramatic outburst like, “Mom, you’re going to kill someone!” you’re likely to trigger resistance. Start by simply expressing your concern for her safety. For more tips on how to talk to your mom about this, the Hartford Financial Services Group and MIT AgeLab offers a variety of resources at TheHartford.com/lifetime — click on “Publications” on the menu bar, then on the “We Need To Talk” guidebook.
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Refuses to Quit
If your mom refuses to quit, you have several options. One possible solution is to suggest a visit to her doctor who can give her a medical evaluation and, if warranted, “prescribe” that she stop driving. Older people will often listen to their doctor before they will listen to their own family. If she still refuses, contact your local Department of Motor Vehicles to see if they can help. Or, call in an attorney to discuss with your mom the potential financial and legal consequences of a crash or injury. If all else fails, you may just have to take away her keys.
Once your mom stops driving, she’s going to need other ways to get around, so help her create a list of names and phone numbers of family, friends and local transportation services that she can call on. To find out what transportation services are available in her area, contact the Rides in Sight (RidesInSight. org, 855-607-4337) and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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April 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Health News Eric Allyn elected vice chairman at HTNYS
for the hospitals and healthcare systems of the state of New York,” said Scott A. Berlucchi, ACH president and CEO. “We are grateful for his tireless advocacy for the accessibility and quality of care for the patients of our community.”
Eric R. Allyn, a member of the board of trustees of Auburn Community Hospital, was recently elected vice chairman of the board of governors of the Healthcare Trustees of New York State (HTNYS). Allyn also participates on the board of the Healthcare Association of New York State (HANYS) as a HTNYS repreUpstate University Hospital sentative. announces the following: HTNYS, an affiliate of HANYS, • Physician Clyde Satterly has is comprised of healthcare trustees been named interim chairman of the across New York state. The HTNYS department of family medicine, board is composed of 25 trustees, effective March all of whom are volunteers, who 6. Satterly represent different types of hospijoined family tals, continuing care organizations medicine in and health systems from all regions 2006 as assistant across the state. Board members professor and have responsibility for providing medical direcguidance and oversight for the tor. Besides his activities and programs of HTNYS administrative that aim to strengthen the healthcare and practice system of New York state through responsibilities, improved leadership and increased he has also involvement by healthcare trusttreated adolesSatterly ees. Additionally, HTNYS supports cents at Hillhospital and health system trustees brook Detention through education, communication, Center and directed medical care at and advocacy efforts that promote The Brownell Center. He currently the delivery of quality healthcare to provides medical oversight to the all communities in a cost-effective Onondaga Nation Health Clinic since manner. 2011 and has been the quality control Allyn has been a member of the Driver Bugow’s Rehab officer for Upstate University Hospiboard of trustees of Auburn Comtal’s clinical quality improvement firstname.lastname@example.org munity Hospital since 2007. He was committee since 2013. chairman from 2008 to Teens, 2014. Senior adults Driver and Evaluations disabled Roger P. Greenberg, PhD, of Fayette“We are honored to have one of Driver Evaluations & Training our own board members assume this ville, has received the Award for 315-341-8811Distinguished Career Contributions key healthcare leadership position to Education and Training in Psywww.bugows.com
Upstate announces appointments, honors
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chology from the American Psychological Association. Greenberg was recognized for his “scholarship that has generated important evidence of psychotherapy process and outcome, personality theories, psychosomatic conditions and the comparative effectiveness of psychological Greenberg and biological treatments for mental disorders.” His award citation, biography and a selected bibliography were published in American Psychologist. Greenberg hold the rank of distinguished professor • Brian Pratt has been named the advanced practice resource nurse for the medical intensive care unit. Pratt earned his bachelor’s and master’s degrees from Upstate’s College of Nursing. He holds various certifications, including critical care and trauma. • Amy Payne has been named director for ambulatory analytics, responsible for developing the analytics strategy for the division that includes performance management, reporting and quality improvement initiatives. Prior to Upstate, Payne was a managing director for analytics at Teach For America and served at the American Cancer Society in a variety of operations, including the manager of business intelligence and director of customer analytics. • Rev. Terry Culbertson, manager of spiritual care, supervisor of clinical pastoral education and clinical assistant professor of medicine at Upstate Medical University, has been awarded a three-year recertification as a thanatologist in death, dying and bereavement by the Association for Death Education and Counseling. • The following physicians have joined Upstate University: Rhonda
Diescher, emergency medicine; Carolyn Dudley, radiology; Michelle Goni, radiology; Norman Jones, radiology; Kedar Kulkarni, radiology; Charles Mulhern, radiology; Melissa Nelson, pediatrics; Beth Piper, interal medicine; Kenneth Rhee, OB-GYN; and Arthur Schneider, radiology. • Also joined Upstate University Hospital: physician assistants Jainty John (surgery), and Brandon Wolfenden (orthopedics).
Family nurse practitioner joins Oswego Health Oswego Health’s cardiology team welcomes family nurse practitioner Judith Stallings to its medical practice. Stallings joins the health system with extensive cardiac care experience. Prior to working at Oswego Health, she served as the Stallings coordinator at the Marcus Heart Valve Center-Piedmont Heart Institute in Atlanta. She also was previously employed by Piedmont Hospital in Atlanta in several cardiology capacities, including education coordinator, clinical coordinator for cardiovascular services and as a registered nurse in the cardiovascular intensive care unit. She earned her master’s and family nurse practitioner degrees from the University of Mississippi Medical Center in Jackson, Miss. Stallings is a member of the Preventive Cardiology Nurses Association, the American Academy of Nurse Practitioners and the American Nurses Association. She was a nominee for the Atlanta Journal and Constitution’s Nurse of the Year Award.
Driver Evaluations & Training
A team of workers at Oswego Health has signed the pledged to help increase colorectal cancer screening rates by supporting the 80% by 2018 initiative.
Oswego Signs ‘80% by 2018’ Pledge Oswego Health has signed the pledge to help increase colorectal cancer screening rates by supporting the 80% by 2018 initiative, led by the American Cancer Society, the Centers for Disease Control and Page 26
Prevention and the National Colorectal Cancer Roundtable. Community members over the age of 50 can improve their health by undergoing colon cancer screenings, which include colonoscopies, as they
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017
help the health system achieve its 80 percent goal. The 80% by 2018 campaign is a National Colorectal Cancer Roundtable initiative in which more than 1,000 organizations, including
Oswego Health, have committed to substantially reducing colorectal cancer as a major public health problem for those 50 and older. “Most colon cancers are found in patients who do not have any symptoms,” said Oswego Health gastroenterologist Bishnu Sapkota. “By achieving the 80 percent of screening colonoscopies of the eligible population, we will identify more colon cancer or the polyps that can lead to cancer, therefore decreasing incidents of the disease and its risk of death.” These initiative’s partnering organizations are working toward the shared goal of 80 percent of adults aged 50 and older being regularly screened for colorectal cancer by 2018. While the national rate is 65 percent, Oswego County’s rate is 74.2 percent, according to the New York State Prevention Agenda Dashboard for the county.
Syracuse VA Chief to Retire After 40-Year Career Syracuse VA Medical Center Director James Cody announced he will retire April 21, capping a federal government career of more than 40 years. He is the longest serving director of the Syracuse VA having assumed the position in January 2000. Altogether, he has been with the VA system for about 38 years. A search is underway for Cody a successor. “Working with the Syracuse family of employees for the past 17 plus years has been, personally, both a privilege and an honor. You have consistently demonstrated to me that you are uniquely special with respect to our efforts on behalf of our veterans,” Cody said in a message to the VA employees. The Syracuse VA is a 136-bed general medical and surgical referral center and teaching facility with a 16-bed acute care psychiatric unit as well as a 47-bed community Living center and community based outpatient clinics in 7 surrounding sites in a 13-county region. During his time as director, Cody has overseen a major expansion of services and facilities to
include the construction of a $90 million, 30-bed spinal cord injury center. He has had direct responsibility for the successful administration of the medical center’s total financial and personnel resources with an annual operating budget of $290 million and 1,700 employees and the coordination of these resources to meet the health care needs of more than 48,000 veterans in Central and Northern New York. Cody earned a master’s degree in public administration with a concentration in health administration from New York University in January 1981 and a bachelor’s degree in health education from SUNY Cortland in May 1976. He entered the VA system in July 1978 as a safety specialist at VAMC Brooklyn, and progressed through positions of increasing complexity and responsibility at the VA central office and then at VA medical centers in Washington, DC; Baltimore, Md.; Lyons, NJ: and Providence, RI. He was selected to receive the Presidential Rank Award for meritorious executives in 2009. Cody and his wife Lois will continue to reside in Jamesville and he said he plans to remain active in the healthcare, academic and public service community, along with his continuing pursuit of running, golfing and rowing personal bests.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2017