Igh cny 214 october 17

in good Free Healthcare Physician Mustafa Awayda talks about Rahma Health Clinic, a center on Syracuse’s south side he founded in 2012 to care for the health of the underserved population

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October 2017 • Issue 214

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CNY’s Healthcare Newspaper

CAREGIVER IN CHIEF They are mostly women (66 percent) who are married and have a job. And they spend on average 20 hours a week providing care. Is there anyone caring for them?

Bicyclist Deaths Rise Fatal crashes jumped 12 percent in 2015, report says; men — not kids — are commonly the victim

5

Myths About Use of Medical Marijuana

We speak with UR Medicine pediatrician Cynthia Rand

America’s New Dads Are Older Than Ever

Childbirth Cheerleaders CNY Doula Connection helps families bring babies into the world

Turnips + Greens Some things are just better together: Batman and Robin, peanut butter and jelly, Simon and Garfunkel, wine and cheese. Another remarkable duo?

Turnips and their nutritious greens. Find out why

­

How to Find a Better Medicare Prescription Drug Plan

America’s New Dads Are Older Than Ever

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Cancer Care at its Best The Only CNY Cancer Practice that is &HUWLˋHG IRU 4XDOLW\ E\ WKH $PHULFDQ 6RFLHW\ RI &OLQLFDO 2QFRORJ\

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ew dads may sport a few more gray hairs than in years past, a U.S. study finds.

The average age of new fathers has risen in recent decades, research shows, raising questions about the possible social and public health impact.

The study, which analyzed federal birth records, found that fathers of newborns are now 3.5 years older, on average, than their counterparts in the early 1970s.

And the percentage of births to fathers older than 40 has more than doubled — from about 4 percent in 1972, to 9 percent in 2015.

The pattern is not surprising, since it parallels what’s been seen among U.S. women.

But much less research has explored the changing demographics of American fathers, according to senior researcher, physician Michael Eisenberg.

“I think it’s important for us to pay attention to these demographic shifts and what their implications could be for society,” said Eisenberg, an assistant professor of urology at Stanford University in California.

On one hand, he said, older fathers are more likely to have kids affected by certain health conditions, such as autism and schizophrenia.

Plus, couples who wait to start a family will likely have fewer kids, Eisenberg noted. And that could

mean a shrinking pool of working people supporting older, retired Americans.

“I’m not trying to sound alarmist,” Eisenberg stressed. “But these are issues to think about.”

The findings, published online Aug. 30 in the journal Human Reproduction, are based on records for nearly 169 million U.S. births over the past four decades.

In 1972, fathers of newborns were just over 27 years old, on average. By 2015, that average age stood at 31, the researchers reported.

The pattern was seen among fathers of all races and ethnicities, though the average age varied. By 2015, Asian men were the oldest (34 to 36 years), and black, Hispanic and Native American men were the youngest (29 to 30 years).

Few men older than 50 are becoming new fathers; they account for 0.9 percent of all births, the study found. But that is up from 0.5 percent in the 1970s.

Since men have a much longer reproductive life than women do, there is no clear definition of what an “older father” is, Eisenberg said.

“The oldest father on record was 96 years old,” he noted, referring to a man in India who had children with a wife in her 50s.

However, men do have their own biological clock of sorts. Their fertility declines with age, Eisenberg said, as does their sperm quality.

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

DMITRY NIKOLAVSKY, MD

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STEPHEN BLAKELY, MD

Male infertility, erectile dysfunction, andrology, general urology

JC TRUSSELL, MD

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IMAD NSOULI, MD

FOR QUESTIONS OR TO MAKE A REFERRAL CALL 315.464.1500 UROLOGY

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Oct. 12

Free Parkinson’s disease conference held in Syracuse The Onondaga County Office for Aging will sponsor the Fifth Annual Living an Active Life with Parkinson’s Disease Conference.

This free day of learning, offered in conjunction with Upstate University Hospital’s HealthLink, will be held on Thursday, Oct. 12, at Drumlin’s Country Club, 800 Nottingham Road, Syracuse. Check-in is from 8:10 to 8:45 a.m. and the program is from 9 a.m. to 2:15 pm. The conference host is Susan Kennedy from WCNY’s “Cycle of Health.”

The conference includes the following speakers: • Heather Zwickey, National University of Natural Medicine, Portland, Ore. She will discuss ”Nutrition and Parkinson’s Disease.”

• Becky Auyer, Inspire Care of Central New York. She will discuss “Resources for Care in the Home.”

• Christopher Morley, Upstate Medi-

cal University. He will discuss “Tools & Techniques for Making Tough Medical Decisions.”

• Fahed Saada, CNY Neurological Consulting. He will discuss “Sleep Issues and Chronic Fatigue with Parkinson’s Disease.”

There is no cost for the conference but pre-registration is required as space is limited. A light lunch is included.

To register, please call: Upstate Connect at 315-464-8668. The deadline for registration is Friday Oct. 6.

Oct. 15

Physician to speak at vegan dinner in Rochester Physician Ted D. Barnett, a diagnostic and interventional radiologist with Borg and Ide Imaging and the founder and medical director of Rochester Lifestyle Medicine, is the guest speaker at the Oct. 15 vegan dinner sponsored by Rochester Area Vegan Society. The physician will speak on “Early Results from Rochester Lifestyle Medicine: Reversing Disease and Improving Quality of Life.”

The event, at Brighton Town Park

Free Classes for Caregivers Announced Onondaga County Office for Aging has recently announced the fall 2017 free — and open to the public — class list for those who currently care for older or disabled persons, or may become family caregivers in the future:

7 p.m., Oct. 26 and Nov. 2, at UCC Bayberry.

• “Caregiving Like a Man.” From 5:30 to 7 p.m., Oct. 30, at Natur-Tyme.

October

• “Effective Communication Strategies.” From 5:30 to 7 p.m., Oct. 9, at Christ Community Church.

• “How We Change As We Age.” From 6:30 to 8 p.m., Nov. 16, at The Nottingham.

The catalog and registration form are available online at www. ongov.net/aging/icare.html. You can also receive a catalog or register by contacting Cynthia at 315-4352362 ext. 4993 or email: cstevenson@ongov.net.

• “Brain Fitness: Fact or Fiction.” From 5:30 to 7 p.m. Oct. 3 and Oct. 10 at Manlius Library.

• “Medicare: Overview & 2018 Changes.” From 5:30 to 7 p.m., Oct. 11, at Cicero Public Library.

• “Older Adult Medicine Safety.

From 5:30 to 7 p.m., Oct. 17, at Upstate Oasis Studio.”

• “Legal & Financial Issues in Healthcare Planning.” From 5:30 to

November

Lodge, 777 Westfall Road, will start at 5:30 p.m. with dinner at 7 p.m.

Dinner is a vegan potluck. Vegan means no animal products (no meat, poultry, fish, eggs, dairy products or honey). Bring a dish with enough to serve a crowd, and a serving utensil; also bring a place setting for your own dinner. Help is available to non-vegetarians or others uncertain about how to make or bring a vegan dish; by calling 585-234-8750.

Cost is $3 for non-members. For more information, visit rochesterveg. org.

Oct. 21

Cancer Resource sponsors walkathon, 5K run This annual event is a community-wide fundraiser designed to help Ithaca-based Cancer Resource Center provide support and assistance to families and individuals who have been affected by cancer.

One hundred percent of all funds raised remain in the community.

The event begins at 10 a.m. Saturday, Oct. 21, in Ithaca’s Cass Park.

Registration opens at 9 a.m. There will be zumba, live entertainment, prizes and a pancake breakfast. Online registration is available at gvgb.

Oct. 18

Breast Care Partners Offers National Breast Reconstruction Awareness Day Program Breast Care Partners, a diverse group of breast health specialists in Central New York who have partnered together to ensure each patient the best possible breast care available, will host a “Learn Your Options” presentation and panel discussion about breast reconstruction surgery from 6 to 8 p.m., Oct. 18, at Hematology-Oncology Associates’ office, 5008 Brittonfield Pkwy., E. Syracuse. Several surgeons and their patients will answer everything you ever wanted to know about post-mastectomy breast reconstruction. This event is a rare opportunity for the general public and healthcare professionals to meet some of the top local experts in a comfortable setting that includes dinner. Admission is free, but space is limited and reservations are requested by Oct. 16 at

co/WalkRun2017.

Oct. 21

New Moon Psychic Festival held in Webster The New Moon Psychic Festival & Holistic Healing Expo, now in its 16th year, will take place from 10 a.m. to 7 p.m. Saturday, Oct. 21, and from 10 a.m. to 6 p.m. Sunday, Oct. 22, at The Damascus Shrine Center, 979 Bay Road Webster.

The expo brings together an array of holistic healers, psychics and metaphysical and wellness-minded vendors — all focused on healing.

Have a question about your future?

One of the many psychics may help you. Lingering health issues that have left your doctors stumped? Perhaps a holistic healer holds the key.

The New Moon Expo is open to everyone interested in living their best life yet. Organizers invite you to stop in, look around and discover what works for you.

This year’s expo carries a special focus on breast cancer awareness, healing and survival.

For more information and a list of participants and activities, visit: www.NewMoonForYou.com or find the group on Facebook (New Moon Expo). hoabcp@gmail.com or 315-952-1318.

This event takes place on national Breast Reconstruction Awareness Day, a campaign to inspire women along their journey with breast cancer. Speakers are local Breast Care Partners’ members: physician Philip A. Falcone, from Cosmetic, Plastic and Reconstructive Surgery; physician Kara Kort, from St. Joseph’s Physicans Surgical Services; and physician William Schu, from Central New York Surgical Physicians, P.C. Some of their patients will participate in the program’s panel discussion and be available to speak personally with audience members.

“Informing women of their reconstruction options before or at the time of diagnosis is critically important to improving life after breast cancer,” said registered nurse Janet Ricciardiello, director of Breast Care Partners. “We’re excited to offer this program as part of our mission to improving breast patient outcomes in our community.”

Funding and promotion of the program are supported locally by the American Cancer Society, Allergan and Crouse Spirit of Women.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

Bicyclist Deaths Rise in U.S., Men, not Kids, Are Often Victims Report: Fatal crashes jumped 12 percent in ‘15

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icyclist deaths on U.S. roadways are up significantly, and men — not kids — are commonly the victims, a new report finds.

Biking deaths rose 12 percent in 2015, the latest year for which figures are available, according to the Governors Highway Safety Association. This jump was the largest among any group that uses roadways.

Historically, most fatal bicycle crashes involved children and teens. Now, 85 percent of bicyclists killed on the road are men, the report said.

And of the 818 bicyclists killed in 2015, the average age was 45.

“We need to ensure that bicyclists and motorists can share roads safely,” said Chris Mullen, director of technology research at State Farm, which funded the report.

“Unfortunately, bicyclists are vulnerable and much more susceptible to serious injury or death when on the roads with vehicles,” Mullen said in an association news release.

Mullen said it’s “critical that we examine the factors surrounding these crashes and leverage a variety

FLU SHOT CLINIC Open to the Public (Adults 18+)

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of proven tools to improve bicyclist safety nationwide.”

The report shed light on where and why fatal crashes between bicyclists and cars occur.

Often, drivers don’t see bikers who expect to have the right of way and can’t stop in time to avoid a collision, the report said.

Also, intersections aren’t the usual problem. Most bike-car fatalities (72 percent) occur at non-crossroad locations. And more than half take place between 6 p.m. and 6 a.m., the researchers found.

Alcohol — consumed by either the bicyclist or driver — was a factor in 37 percent of the fatalities, the report found.

Breast & Ovarian CanCer awareness

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Every day we work hard to retain that trust. It’s the reason we have grown to become the region’s largest New York state-licensed laboratory.

PANELISTS: Dr. alex Banashkevich – Upstate Cancer Center radiation Oncology at Oswego Dr. sam Benjamin – Upstate Cancer Center Hematology Oncology at Oswego Dr. Daniel Coty – Oswego County OBGYn Dr. allison Duggan – Oswego Hospital COO and General surgeon Dr. David wang – Cra Medical imaging Becky Palmer – Breast Cancer survivor and B 104.7 radio host

CommuNITy PArTNErS: senator Patty ritchie YMCa Livestrong Peaceful remedies Caring & sharing support Group Oswego Health Breast navigation

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IS MORE THAN

For more information, visit oswegohealth.org/healthy or call (315) 349-5500.

October 2017 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Meet

Your Doctor

By Chris Motola

Mustafa Awayda, MD New Cholesterol Drugs Vastly Overpriced, Study Contends

A

re new medicines for people with out-of-control cholesterol wildly overpriced? It’s a question that’s sparking debate among consumers and providers of care.

Now, researchers at the University of California, San Francisco (UCSF) report that the price of these drugs — called PCSK9 inhibitors — would have to be slashed by a whopping 71 percent to be deemed cost-effective.

PCSK9 inhibitors are a relatively new class of medicines for treating patients whose LDL (bad) cholesterol isn’t well-controlled on statins or who cannot tolerate statins. Lipitor (atorvastatin) and Crestor (rosuvastatin) are examples of first-line statins doctors typically prescribe to patients with high cholesterol.

The UCSF team didn’t question whether these new medicines are effective in reducing heart attacks and strokes.

“These are super awesome drugs, they really work,” said study co-author, physician Kirsten Bibbins-Domingo.

But the price is “far in excess” of what would be considered a reasonable cost for the clinical benefit they provide, added Bibbins-Domingo, a UCSF professor of medicine, epidemiology and biostatistics.

The list price of these newer PCSK9 drugs is upwards of $14,000 a year per patient.

Physician Kim Allan Williams, who was not involved in the study, is past president of the American College of Cardiology. He said some doctors have a difficult time with such studies because they compare patients’ lives and “events” — such as heart attack and stroke — versus dollars spent on these medicines.

The new study doesn’t change his view of the value of the PCSK9 inhibitor class.

“No one’s giving those drugs unless the patient is incapable of getting to the target [level of LDL cholesterol],” said Williams, who is chief of cardiology at Rush University Medical Center in Chicago.

“You’re only going to use it for a situation where you have no choice.”

He said he’s had patients with copays of $380 a month and others who had zero copays because the cost was completely covered by insurance. He worries, though, that poor patients may not be offered the same access to these medicines.

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Physician talks about Rahma Health Clinic, a center on Syracuse’s south side he founded in 2012 to care for the health of the underserved population Q: So you started a free health clinic in Syracuse few years ago? Tell us about it.

A: We did. We started a New York state-certified free clinic on the south side of Syracuse, the Rahma Health Clinic [at 3100 S. Salina St.].

We saw our first patient in November 2012.

Q: What does that mean for your patients?

A: There are currently three free medical clinics in Syracuse, but for all of the medical services we make available, there is no charge. What we did uniquely in our clinic is pursue Article 28 certification with the state to certify as a diagnostic and treatment center.

Q: Are your services means-tested? Do you need to make under a certain amount of money?

A: We take everybody who comes, really. Anyone who presents for services, we accept them. Some people may have insurance, but we don’t bill their insurance. We don’t ask any qualifying or income questions. About 40 percent of patients— we did recent analysis—may have insurance. What we try to do in their case is channel them through the system to find a provider who accepts their insurance so we can keep ourselves open for patients without insurance.

Q: What kind of support do you get from the state?

A: We don’t get any, actually. The whole thing started as a charitable faith-based project. The founding members all put a lot of money into it. We do annual fundraisers. We’ve done five thus far. The next is coming Nov. 5. We get a number of small grants, but they’re private grants.

Q: How did you become involved?

A: We floated the idea back in 2008.

Time flies. I’ve been in the Syracuse area for about 24 years. We were at a social gathering with a friend of ours who also has resided here for a long time. We discussed the idea of starting a free clinic for

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

charitable purposes. We estimated there were about 48,000 to 50,000 uninsured out of almost half a million living in Onondaga County.

The need was there, especially on the south side. We purchased the building in 2009. It was an old, abandoned clinic at 3100 S. Salina St. The licensing process was pretty lengthy, about two years and nine months.

Q: What services do you offer?

A: We offer adult medical services, so patients 18 and above. We don’t offer pediatric services yet.

We’ve discussed doing dental, but that requires a lot of structure to set before we can launch it. So, we do primary care.

Q: What’s the response been like from the community?

A: The response has been great.

First we attend to those without insurance. Most of these people work. Some have lost their insurance or couldn’t afford it. This was when Obamacare was first starting. So that segment found it very helpful. The other segment is migrant workers, refugees and people just visiting who might otherwise end up in the emergency room. We also have our insured patients who might have weeks or months to see their physician who we rechannel them to providers who can accept their insurance.

Q: That’s interesting. One of the main arguments you hear against broadening access to healthcare is that it will overwhelm the system, but you’re talking about improving efficiencies with these insured patients who wind up at Rahma.

A: Emergency room visits are atrociously expensive and they can get overwhelmed sometimes. These walk-ins can usually be seen somewhere else.

Also, during our analysis, we found that this zip code in particular ended up in the ER for preventable illnesses for things like asthma, diabetes, abdominal pains. So we want to make a dent in that.

Q: Tell me a bit about your own specialty.

A: I graduated from medical school in ‘91 in Lebanon from the American University of Beirut, which is actually registered with the New York Board of Regents. That made my licensure and training much easier. So it was two years in Lebanon, then three years at [SUNY] Upstate, where I graduated in ‘96. For the past 22 years, I’ve been helping the community. I worked 11 years at the Syracuse Community Health Center as a primary care provider and six years as their medical director and primary care provider. I’ve been at the VA for the last 10 years as a hospitalist.

In 2010, I went back to school at the new public health program offered jointly by SUNY Upstate and SU. I graduated last year with a master’s in public health. The knowledge from that program was key in helping me get the clinic set up.

Q: It seems like more physicians are getting involved in the business and political aspects of healthcare. Do you find it helps your mission?

A: It absolutely does. Medicine has changed so much. The financing, the laws, the policies, the social behavioral aspects of your population.

And that’s weighed against the core metaphysiology itself, the knowledge of which has probably tripled in the time of I’ve been in practice with understanding of diseases, new medication, new treatments. So medical schools have to address all of this. The clinical portion is maybe 20 to 25 percent. But all those other aspects do affect health and patient outcomes, and we need to address them.

Q: What do you think the medical sector in general can learn from free clinics like Rahma?

A: Well, the best thing they can learn is that there should be no need for free clinics. In 2008, the U.S. had 48 to 50 million uninsured. As I mentioned, the bulk were hard working people who make about the poverty level, but don’t make enough to afford private insurance out of pocket.

And it all takes is one accident, one illness to push them into bankruptcy.

Our number one cause of bankruptcy is medical expenses. If I may use the word, I think that’s slightly shameful in a very rich, powerful nation.

Another sad figure is around 40,000 people die annually in this country due to either not being able to access care or being too afraid of medical debt to do so. Obamacare was a great start, but more has to come.

Lifelines Name: Mustafa Awayda, M.D. Position: Chief hospitalist at Syracuse VA, assistant professor at SUNY Upstate Hometown: Beirut, Lebanon Education: American University of Beirut; SUNY Upstate; Syracuse University Affiliations: Syracuse VA; Crouse, University Hospital Organizations: American College of Physicians, Rahma Health Clinic Family: Married, two sons and one daughter (triplets) Hobbies: Healthcare (policy, the clinic)

Back-toSchool Worries for Parents?

National sample shows 1 in 3 parents are very concerned with bullying, cyberbullying

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ullying and cyberbullying top parents’ list of worries when it comes to their children’s health, according to a new report from the C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan. Close behind are internet safety and stress, motor vehicle accidents and school violence.

But worries differed among racial groups, with African-American parents saying they were most concerned about racial inequities and school violence affecting their children.

The report is based on responses from 2,051 adults — including 1,505 parents of children aged 0-18 — from a nationally representative household survey.

“Adults across the country recognized bullying, including cyberbullying, as the leadig health problem for U.S. children,” says physician Gary Freed, a Mott professor of pediatrics and the poll’s co-director.

This is the 11th year the Mott Poll has surveyed a national sample of adults on the top 10 health concerns rated as a “big problem” for children and teens. For the first time, this year parents were also asked to rate health concerns for their own children.

“When it came to their own kids, parents’ biggest child health concerns depended on their children’s ages,” Freed says. “For example, for parents of children ages 0-5, cancer was rated as a top health concern even though pediatric cancer is quite rare. Parents may have concerns about very serious conditions despite the small risk for them.”

As more children have access to the internet and social media, many parents also expressed concerns about their children’s safety online.

Experts have raised concerns about how cyberbullying may impact children’s mental health, with anxiety, depression and even suicide being linked to this type of harassment.

Vulnerability to online predators is also a risk.

“Parents should regularly discuss internet safety with their children and teens and ways to prevent problems,” Freed says. “Simple effective strategies may include not providing personal identifying information on social media, chat platforms, or in shared gaming environments.”

Motor vehicle accidents — which are the leading cause of death for children aged 2-14 — were also of great concern to all groups of parents. In 2015, more than 650 children died and more than 120,000 were injured in crashes.

See the full report at http://mottnpch.org/reports-surveys

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

“I would say my motivation is the constant inspiration from the stories that we cover,” she said. “When we talk to the doctors in the hospitals and what they are really trying to pursue in the name of making patients as comfortable as possible in the process of medical care—it’s really wonderful to see.”

By Matthew Liptak

E

rin McCormack, producer of WCNY’s popular health program “Cycle of Health, said that the most challenging part about her job is fitting the busy schedule of local medical experts and their patients into the burgeoning production schedule.

“When I came on board I could understand what an undertaking it was from a production point of view, to wrangle doctors with busy schedules who were still working,” she said. “Obviously they had appointments and responsibilities of their own. I would call it the biggest challenge — to really capture the stories that you want in a time frame that works for everybody.”

To simplify things, the producer began to give each program an overall theme starting with season five.

She’s proud of how it came out.

“I like all the stories in one episode to make sense together,” she said. “I like one cohesive episode — one with the mental health story really serving the other in-the-field stories.”

She cited recent examples of a story on kids’ health and how to approach a child’s experience in the hospital as notable. They went to Upstate to explore all the facets of how a child’s medical care is unique.

Originally the show included a roundtable of five doctors who explored specific patient stories. The show has evolved over the years though.

Veteran journalist Susan Kennedy moved to Syracuse and came on board with WCNY to host the show. “[She] had a big influence on the production and the types of stories chosen as well,” McCormack said.

“From there it was a perfect combination of informed doctors from lots of different areas of medicine and Susan Kennedy who was a perfect fit for a host of a show like this.”

“Cycle of Health” episodes cover a gamut of topics — the opioid epidemic, Lyme disease, you name it. Physician Rich O’Neill of Upstate explores a mental health subject related to each episode’s theme.

“He always has ideas and stories he’d like to cover, contacts that he’d like us to speak with,” McCormack said.

The original roundtable of doctors doesn’t exist anymore. Now there are doctors who speak to one specific segment. There’s quite a few doctors that appear throughout

Cycle of Health The New season starts at 8 p.m., Thursday, Oct. 5 on WCNY TV. It is re-run at 6:30 p.m., Sunday, Oct. 8 Topics of the first three episodes:

Wake up to Health

“We are an operation that is on the rise. We’re expanding. We have more content than ever,” says Erin McCormac, producer of WCNY’s “Cycle of Health’

New Season of ‘Cycle of Health’ Starts at WCNY TV Show features local experts talking about topics that affect Central New Yorkers the season. One segment at a time is done to speak to their specialties.

Susan Kennedy will be stepping back from some of her duties on the show and new hosts will be coming in for the new season, scheduled for Oct. 5.

“We are going to be talking to some new hosts for this season to host some new segments,” she said.

“We’re really excited to work with some new voices.”

The show pulls topic ideas from the staff, experts, and viewers in Syracuse and the surrounding 19 counties they cover. McCormack said, although their public television station doesn’t use a ratings system, feedback about the show has been widely positive over the years.

“If I had to guesstimate, I would say this is one of our most popular programs,” she said. “We are lucky enough to have very open communication between our members. We

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

don’t really need to go by numbers.

We go by firsthand comments.”

The producer said the show is popular enough that syndicating it to a larger audience might be in the future. The station is considering the possibility, McCormack said, by staying in touch with other public stations and evaluating what their needs might be.

“We don’t have anything specific right now, but we are certainly open to it and certainly have it in mind as we go to produce this next season,” she said. “We are an operation that is on the rise. We’re expanding. We have more content than ever.”

McCormack said she is motivated both professionally and personally to produce Cycle of Health. She cares about her own health, and the health of her family, and is invested in the segments she produces. The uplifting stories of the doctors and patients they cover keeps her going.

The show explores a before-school ‘Morning Mile’ program where students run a mile together ahead of the school bell and explains why and how this helps them throughout the day. Kelly Springer walks viewers through their favorite fast food breakfasts made quick and healthy at home. The show also visits a local wellness and yoga studio to explore finding peace and making intentions first thing in the morning, and a fitness expert wakes us up with the best workouts to get you motivated and ready for the day ahead.

Power Afternoons

The show visits an after-school program that closes the gap between school and parents returning home from work with a positive athletics program that emphasizes fun and camaraderie. Kelly Springer shows viewers how to get kids to make and eat their own healthy lunch and which after school snacks are the best for keeping energy up throughout a busy activity schedule. SUNY Upstate physician Rich O’Neill provides some tips and hints on how to give kids after school down time without technology, and a fitness expert shows us how your office can also be a relaxing workout space in late afternoon.

End of Day Fun Made Healthy

Local dance lessons that have surprising health benefits. Kelly Springer shares a delicious dinner recipe that makes three meals. SUNY Upstate physician Rich O’Neill shows us how to decompress after a work day — can a glass of wine actually help? A fitness expert gives viewers easy, lowkey workouts guaranteed to shed the day’s stress and set up for a great night’s sleep.

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Take a Stand Against Sitting Too Much Couch potatoes might help cut their risk of early death by getting up every 30 minutes, study finds

D

ays spent sitting for hours may increase your risk for an early death no matter how much you exercise, researchers say.

In a new study, people who sat the most had twice the risk of dying over a four-year period as people who sat the least. But taking a break every 30 minutes to get up and walk around might help decrease the risk, the study authors said.

“What’s most troubling is it’s like I exercise in the morning and I think I’m good, but in addition to exercise I should also be mindful of not being sedentary for long periods throughout the day,” said lead researcher Keith Diaz. He is an associate research scientist at Columbia University Medical Center in New York City.

It’s more than exercise, Diaz said.

“You have to do more. You have to move, you have to get up often and break up your sedentary habits if you want to have the lowest risk of death,” he explained.

Many people sit for up to 10 hours a day, he noted. Earlier studies that have reported a link between sitting and an early death have relied on people telling researchers how long they sat in a day. This new study, however, actually measured sitting time using a hip-mounted accelerometer that tracked movement, and correlated it with the risk of dying during the study period.

Diaz cautioned, however, that this study only shows an association between sitting and an increased risk of early death. It can’t prove that sitting causes the risk, due to the study design.

Exactly how prolonged sitting might be related to an increased risk of early death isn’t known, he added.

“There is evidence that suggests, but does not prove, that it could be about how our body handles blood sugar,” Diaz said.

“We think it’s through a kind of diabetic pathway. When our muscles are inactive, they are not using blood sugar, and we know that blood sugar can wreak terrible consequences on our body. Poor blood sugar control is

thought to be one of the ways sitting increases one’s risk for heart disease or death,” he said.

Standing up from your desk and walking around for a few minutes every half hour could be an important behavioral change that might reduce the risk of premature death, Diaz suggested.

The report was published online Sept. 11 in the journal Annals of Internal Medicine.

Healthcare in a Minute

By George W. Chapman

Hospitals Fail to Meet Expectations

A report published by Kaufman, Hall and Associates revealed only 8 percent of 125 healthcare organizations surveyed met consumer expectations. The report found that while almost all organizations say improving the patient experience is a high priority, just 30 percent have the capability to do so. Only 15 percent are making a concerted effort to improve patient access with diverse locations and digital connectivity and less than 10 percent see price transparency as a high priority. The managing director of Kaufman concluded that in the age of Netflix and Amazon, consumers expect a lot more from their providers and “consumerism” should be a core capability as it will be a key to long term sustainability. (In fairness to healthcare organizations, they are highly regulated and have nowhere near the access to capital that Amazon and Netflix have.)

Obesity Progress

After several years of rapid increases, national obesity levels have leveled off in 2015 and 2016. Industry observers worry that the relatively “good” news may cause policy makers to become complacent and ease up on the accelerator. Colorado had the lowest obesity rate at 22 percent while West Virginia had the highest rate at 38 percent. Obesity is defined as a body mass index (BMI) of 30 or more. BMI of 30 is about 30 pounds overweight. The highest concentration of obesity is in southeastern states.

ER Usage

Most payers and regulators have historically placed a lot of blame for our high cost of care on unnecessary or avoidable emergency room visits.

A recent study published in the

International Journal for Quality in Healthcare has debunked the myth that too many people use emergency rooms needlessly. Researchers studied 115,000 records representing 424 million visits over a five-year period and concluded just 3 percent of the total ER visits were “avoidable.” A number of these visits were for things most ERs are not equipped to deal with like dental or mental health problems. About 7 percent of the avoidable visits were for alcohol or mood-related disorders and about 4 percent of the avoidable visits were for dental issues. The researchers defined an avoidable visit as one that did not require diagnostic tests, screening procedures or medications.

Researchers concluded that the vast majority of us do not use ERs for primary or routine care and that we need to focus on access to dental and mental conditions after normal business hours.

Physicians Treat All the Same

Historically, government plans like Medicaid and Medicare have not paid physicians as well as most private payers. (Although in recent years private payers have tended to drop their rates closer to Medicare rates.) It would seem that people with poorer paying plans might receive less or worse care than people with better paying plans. While “you get what you pay for” is true in most industries, it is not in healthcare.

The vast majority of physicians treat the patient, not their insurance plan.

While your plan may not pay for a certain test or procedure, it is of no concern to the physician who is going to do what is best for you in his/her clinical judgment. A recent study proves this, even if in a roundabout way. The study was published in the Journal of the AMA Internal Medicine. It found no difference in the rates that low-value services

were provided to Medicaid-covered patients versus commercial/ private-covered patients. Physicians tend to order the same low-value (almost useless) tests and services indiscriminately. Also, it does not appear that Medicaid patients are forced to see “lower quality” providers. While the bad news is providers are still ordering “low-value” tests and services, the good news is that none of us are being discriminated against because of our health plan.

Just about all providers make it clear up front what insurances they accept, so once you’re in the exam room your insurance is moot.

CVS and Walgreens Sued

Consumers are claiming the two large pharmacy chains failed to inform them that it would be cheaper, less out pf pocket, to simply pay cash for certain medicines vs. going through their insurance. Insurance copayment amounts often exceeded the actual cost of the drug. This fraud is called a “clawback.” For example, the consumer has a $50 copay on prescriptions, but the drug only costs $30. According to the lawsuit, the pharmacy chains are in cahoots with the pharmacy benefits manager Express Scripts.

Aetna and Apple

The health insurance and consumer technology giants are considering making the Apple watch available to Aetna’s 23 million members.

Aetna already subsidizes the cost of an Apple watch for its 50,000 employees. This may be just a marketing ploy by Aetna to attract younger tech savvy members since most studies of wearable fitness devices are inconclusive when it comes to showing any improvement in the health of the device wearer. Proponents feel that anything that makes people more health conscious is a good thing October 2017 •

while critics are concerned about the invasion of privacy and the potential nefarious use of data derived by the insurer.

Aging

The state of Washington leads the country when it comes to helping its seniors “age in place,” according to a study by AARP and The Commonwealth Fund. Everyone prefers to live at home for as long as possible and to avoid a nursing home for as long as possible. The average cost of home care is $128 a day nationwide.

The average cost of a nursing home is $230 a day nationwide. Washington state has made support for home-and community-based care a priority. It provides adult day care, assisted living and even foster care as options for the infirmed elderly. This is far preferable to family caregivers as well. Washington also empowers home health aides to provide more care. Through its “No Wrong Door Program,” highly trained staff either answer your questions or direct you to the right place. Washington provides more housing alternatives to nursing homes than most states.

Nationwide, about 52 of 1,000 people over 75 reside in an assisted living facility. In Washington, it’s double that.

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

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 9

My Turn What You Need to Know About Thyroid Storm

By Eva Briggs

I

n the aftermath of two big storms — hurricanes Harvey and Irma — I’m inspired to write about a medical condition called a thyroid storm.

The thyroid is butterfly-shaped gland that sits in the front of the neck. It produces several hormones, T3 and T4, which regulate metabolism.

Many people don’t realize that a lot can happen to the thyroid gland, and assume that all “thyroid conditions” cause people to feel tired, cold and gain weight. Those symptoms happen with hypothyroidism, an underactive thyroid that isn’t producing enough thyroid hormones. That’s is the most common thing to go awry with the thyroid gland.

However, sometimes the thyroid goes on overdrive, producing too much thyroid hormone. That’s called hyperthyroidism. Symptoms might include a rapid heart rate, possibly with an abnormal heat rhythm called atrial fibrillation, feeling hot, increased appetite, and weight loss.

And if things really run amok, an extreme condition called thyroid storm results.

Another name for thyroid storm is thyrotoxic crisis. It really is a crisis, fatal if untreated. Even when treated 8 to 25 percent of patients may die. This extreme form of hyperthyroidism affects almost every body

system.

Hyperthyroid patients often feel too warm, are unable to tolerate heat and become sweaty. The patient in thyroid storm progresses to fever and elevated blood pressure.

The heart beats too rapidly, and abnormal rhythms ensue. The overworked heart muscle fatigues.

The exhausted heart fails, causing shortness of breath and swollen feet and legs. Unable to compensate, the blood pressure now drops too low, sometimes to the point of shock.

Hyperthyroid patients are often restless and irritable. In thyroid storm those brain symptoms progress to agitation, confusion and delirium.

Patients could even start having seizures or fall into a coma.

Gastrointestinal symptoms include abdominal pain, jaundice, vomiting and diarrhea.

What turns hyperthyroidism into a thyroid storm?

It usually takes a stressor that stimulates the body to make too much adrenaline whose effects compound the influence of the excessive thyroid hormones. Examples include surgery, infection, treatment with radioactive iodine, direct trauma to the thyroid gland, failure to take medicines prescribed to treat hyperthyroidism, or taking too much thyroid

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hormone. This is just a partial list.

There are even conditions that lead to thyroid storm in infants and children.

Fortunately, thyroid storm is treatable. Patients in thyroid storm need hospitalization in an ICU. There are medicines that block the thyroid’s production of thyroid hormone.

Other medicines, such as a class of medicines called beta-blockers, target symptoms such as rapid heart beat.

Other treatments include fluids, oxygen, measures to lower fever, and other supportive care.

Once recognized and treated, most patients improve within 24 hours and are out of the crisis with a week.

Risk factors for a poor outcome

include age greater than 60 years, and confusion and mental changes. Although an overactive thyroid might need to be removed by surgery, patients will do poorly if not first treated with medication.

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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Across upstate New York, our nonprofit health plan and parent company employ about 5,400 people in dozens of locations. We indirectly create more than 1,500 additional jobs through our purchases from regional vendors. We’re a major purchaser of services that go beyond the $5 billion in medical benefits we pay out annually. Together, our companies’ economic impact on upstate communities amounted to more than $770 million in 2016. Whether measured in jobs or dollars, we contribute in substantial ways to our local economy. We’re neighbors helping neighbors build healthier communities.

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Page 10

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

Number of Americans With Epilepsy at Record Level

M

ore Americans than ever are living with epilepsy, federal health officials reported in

August.

According to the new report, 1.2 percent of the population — about 3 million adults and 470,000 children — were being treated for epilepsy or had experienced recent seizures in 2015, the researchers from the U.S. Centers for Disease Control and Prevention said.

The number of adults with active epilepsy rose from 2.3 million in 2010. Epilepsy among children rose by 20,000 between 2007 and 2015, according to the report’s coauthor, Rosemarie Kobau, the head of the CDC’s epilepsy program.

“The increase is probably because of population growth,” Kobau said. “We don’t know if other factors are involved.”

The report, published Aug. 11 in the CDC’s Morbidity and Mortality Weekly Report, offers epilepsy estimates for every state for the first time, which shows the condition is widespread.

The number of adults with epilepsy ranged from 5,100 in Wyoming to nearly 368,000 in California, the researchers found.

The number of children with the condition ranged from 800 in Wyoming to nearly 60,000 in California.

Eleven states had more than 92,700 people with epilepsy, according to the report.

STROKES ARE PREVENTABLE

Philip Gattone is president and CEO of the Epilepsy Foundation.

In a news release from the foundation, he said, “This report confirms what many in our community have suspected: Epilepsy has been underreported. We are very grateful that we have a public health program at the CDC for epilepsy. Their new data strengthens our resolve.”

One specialist thinks that population growth is only one factor in the growing prevalence of epilepsy.

“People are living longer, and the population has increased, so you are going to have more seizures,” said physician Paul Wright.

He is the chairman of neurology at North Shore University Hospital in Manhasset, and Long Island Jewish Medical Center in New Hyde Park.

“Also, we have better diagnosis,” he said. “More people are coming to doctors when they don’t have an explanation for things like confusion and speech issues, so we are doing testing and we are discovering epilepsy,” Wright said.

Kobau explained that epilepsy is a disorder of the brain that causes seizures. “More than half the cases of epilepsy don’t have a known cause — the rest have causes like stroke, brain tumor, head injury, central nervous system infections, genetic risks or brain diseases, such as dementia,” she said. Most cases can be controlled with medications, surgery or devices that stimulate the brain,d.

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• The stroke death rate is among the highest in New York State.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 11

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Making New Friends: It’s Never Too Late

Q

uestion: I’ve been divorced for about a year now, and struggle with loneliness. I miss the friends we shared as a couple, but I’m just not comfortable socializing with these couples anymore. I’m 57, and it feels awkward to try to make friends at my age.

Any advice for me?

Answer: It’s unfortunate, but what you are experiencing often happens in the aftermath of a separation or divorce, especially if it was acrimonious. Friends’ loyalties can be split and, just as you feel uncomfortable relating to your former “couple” friends, some couples may feel uncomfortable relating to a now-single friend.

So how do you meet new people and cultivate friendships as an adult?

Here are a few tips: First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll meet. Positive people appreciate and gravitate to other healthy,

positive people.

Do what you like doing. You won’t make friends sitting alone at home. Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, learning to dance, joining a book club or any number of activities that are fun and active. You’ll meet people who share your interests and love of life. Friendships will likely follow.

Consider a support group. It’s not uncommon for new friendships to be borne out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.”

Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood meetings,

work events, etc., is one of the easiest ways to make new friends.

You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending or accepting an invitation to get together. It could be a cup of coffee, drinks after work or a walk in the park or along the canal.

Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone.

Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own.

Rekindle relationships with old friends. Sometimes old friends drift apart when you get married. That’s not unusual. New priorities take over and establishing a new married life together requires time and focus. But now, when you’re looking to find new friendships, consider reconnecting with old friends. They were an important part of your life at one point, and may still have lots to offer.

Pick up the phone.

Give a “singles” event a try. Many divorced or widowed women and men find fun and friendship in community activities organized just for singles. It could be a hike, bike ride, dinner club or dance. These opportunities are often included in community calendars online or in your local newspaper.

Volunteer or join a cause. Supporting an organization or cause you believe in will put you in contact with

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

people working toward a common goal. Community gardens, political parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place.

Join an online community of people who share your interests. Social networking sites can be a safe and satisfying way to meet people. One popular site is www.meetup.com, which facilitates group meetings in cities and towns locally and around the world. Meetup allows members to find and join groups unified by a common interest, such as nature, music, hiking, books, movies, health, pets, careers and hobbies.

Good friendships make life better. The company of someone who makes you laugh, who provides a shoulder to lean on when you need one, and who is just plain fun to hang out with is vitally important to health and happiness, whether you live alone or not. So, if you feel your social network is too small, remember you can always meet new people, make new friends and nurture existing ones. It’s never too late.

Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon. For information or to contact Voelckers, call 585-6247887 or email: gvoelckers@rochester. rr.com.

5

Myths You Should Know About Medical Marijuana Use

By Ernst Lamothe Jr.

E

veryone has an opinion on medical marijuana or marijuana in general. Years ago, few in society or the medical community voiced support for it as treatment. It was still seen as a stoners’ method to forgetting their problems more than a pain-reducing remedy.

Slowly opinions began to thaw.

In total, 29 states have legalized medical marijuana. All the states that have legalized medical marijuana require a doctor’s approval, and all states but Washington require either an ID card that needs to be shown at a dispensary or enrollment in a patient registry.

“Medical marijuana is something that has been used for centuries in countries like China for various reasons,” said physician Scott Treatman, board-certified in both family practice and occupational medicine in Syracuse. “We have this negative connotation with medical marijuana, but it can be a great help to a lot of people in pain.” Treatman, who is a partner in Complementary Health Services of Cazenovia, shares five facts and dispels myths about medical marijuana.

1.

Marijuana users aren’t in real pain.

The most common reasons for medical marijuana use are relieving pain, controlling chemotherapy-related nausea and vomiting and stimulating appetite in patients with cancer or HIV/AIDS. Glaucoma has been treated using medical marijuana since the 1970s and studies show that medical marijuana decreases intraocular pressure in patients.

“It can really be a sense of relief for patients,” said Treatman, New York state registered medical mari-

juana prescriber and NYS-certified physician acupuncturist. “This notion that they are just coming in for a fix is completely unfounded.”

2.

Marijuana is for young potheads There is a stereotype often seen in movies and television shows of the kinds of people who smoke marijuana. They are young — often teenagers or in their early 20s — constantly stoned, long-haired and an overall unproductive member of society. Those are not the patients that Treatman sees, he said.

“People are surprised when they hear that I have patients as old as 94 years old who use medical marijuana to reduce their pain,” said Treatman.

“They are not people who are simply just high all the time. They shouldn’t be judged just because people are comfortable with that kind of stereotype. They are all in real pain.”

3.

Legal marijuana is easy to get Treatman requires patients to provide records from their treating physicians that document their medical conditions. If patients meet eligibility requirements and are appropriate candidates, the doctors certify them for medical marijuana use. A patient then must go online to register with the state, which mails the patient an ID card necessary to buy medical marijuana from a dispensary.

“People think all you have to do is come in and a doctor will just give you medical marijuana without doing their due diligence,” said Treatman. “It is far easier for people to get illegal marijuana than it is to get medical marijuana.”

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There is no approved marijuana plant that could be smoked. Cannabis can also be inhaled via vaporization and there are numerous products to help facilitate this process, including portable vapes, stationary vaporizers and even dabbing instruments.

“People are surprised that medical marijuana can come in so many different forms,” said Treatman.

The basic principal for dosing medical marijuana is to start with a low dose and to go slow in taking more until the effect of the first dose is fully realized, because the effects of cannabis are not always immediately felt. Starting low and going slow allows patients to accommodate for the

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A number of small studies of smoked marijuana found that it can be helpful in treating nausea and vomiting from cancer chemotherapy. A few studies have found that inhaled (smoked or vaporized) marijuana can be helpful in treating of pain caused by damaged nerves. Smoked marijuana has also helped improve food intake in HIV patients in studies.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

SmartBites

The skinny on healthy eating

pepper. Bring to a boil, cover and reduce heat to medium-low. Simmer until turnips are crisp-tender, about 10 minutes. Uncover, increase heat to medium-high and stir in greens.

Cook for two minutes and then add garlic and Fresno pepper (if using). Cook for another two to three minutes, stirring occasionally, until liquid reduces by three-fourths. Turn off heat, blend in honey, and serve.

Turnips + Greens = Nutritional Powerhouse

S

ome things are just better together: Batman and Robin, peanut butter and jelly, Simon and Garfunkel, wine and cheese. Another remarkable duo? Turnips and their nutritious greens.

On its own, a turnip is a decent source of several key nutrients. But when considered with its greens, it turns from a decent source into a downright amazing one. We’re talking superfood status. Of course, you don’t necessarily need to eat everything at the same time to reap all the benefits, but you do need to “heed the greens.”

Why eat a turnip? The low-calorie root — only 30 per cooked cup — is a treasure trove of antioxidants, minerals, vitamins and dietary fiber.

Standout nutrients include vitamin C (about 40 percent of our daily needs) and fiber (around 3 grams).

Vitamin C, a powerful antioxidant, is a tissue-builder, immune-booster and workhorse scavenger of harmful free radicals—age-accelerating agents that have been linked to inflammation, certain cancers and other chronic diseases. Fiber is good for bowel health, helps control blood sugar

levels, lowers cholesterol levels, and keeps us feeling fuller longer.

Another reason to eat this slightly peppery bulb? As a member of the nutritious cruciferous family, turnips are loaded with unique sulfur-containing compounds that may help the body fight cancer.

Why eat a turnip’s greens? The leafy greens, much like kale and beet greens, rock with vitamins A, K and C — all mighty antioxidants that burst with a variety of other health benefits. Vitamin A is essential for growth and healthy vision; vitamin K helps maintain strong bones and regulates normal blood clotting; and vitamin C’s merits are listed above. One cup of cooked greens also provides a decent amount of fiber (5 grams) and folate, an important B vitamin that helps form red blood cells and produce DNA. Another reason to eat the greens?

They offer up some calcium — about 20 percent of our daily needs in one cooked cup. Calcium helps form and maintain healthy bones and teeth, and also plays a major role in the regulation of heart rate and rhythm.

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Helpful tips: Braised Turnips with Wilted Greens Adapted from Cooking Light

6 small (or 3 medium) turnips, trimmed and peeled 1 bunch turnip greens (from above bulbs or purchased separately) 1 tablespoon olive oil 3/4 cup water or salt-reduced stock 1 tablespoon apple cider vinegar 1/2 teaspoon kosher salt 1/4 teaspoon coarse black pepper 1 to 2 cloves garlic, minced 1 Fresno pepper, slivered (optional) 1 teaspoon honey

Choose small to medium size turnips that are heavy for their size: the smaller the bulb, the sweeter the flavor. Look for greens that are crisp and deep green in color. If you buy turnips with their greens attached, remove them from the root when you get home.

Store roots and greens in separate plastic bags and place in the refrigerator. Greens should last about four days; roots will keep for about two weeks, sometimes longer.

Anne Palumbo is a lifestyle colum-

Cut turnips into bite-size chunks.

Wash and coarsely chop or tear the greens.

Remove the stems if they are tough.

Heat olive oil in a large skillet over medium-high heat. Add turnips and cook for five minutes, stirring occasionally, until golden brown.

Add water or stock, vinegar, salt and

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

Plant-Based Diet Supports Good Health Even if you’re not a vegetarian or vegan, eating more plants can benefit your health

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any Americans don’t eat enough whole fruits, vegetables and grains. Actually, according to the Centers for Disease Control & Prevention’s Trends in Fruit and Vegetable Consumption Among Adults, New Yorkers’ fruit and vegetable consumption has decreased.

From 2000 to 2009 (the most recent statistics the CDC offers on the topic), the percent of adults 18 and older who eat fruit two or more times a day plunged from 40.7 to 38.9 percent.

Those who eat vegetables three or more times a day decreased from 27.7 percent to 24.7 percent.

Even if you’re not a vegetarian or vegan, eating more plants may benefit your health, according to several local experts.

“Stick with whole foods, fruits and vegetables,” said Shauna Burke, personal trainer at Pacific Health Club in Liverpool. “I like to say, ‘The greener, the better.’”

Fruits and vegetables are packed with vitamins and minerals and are naturally low in calories. Preparation methods such as frying add calories, as does flavoring with butter or sugar. Whole fruits and vegetables also provide fiber.

Eating more produce offers direct benefits, according to Susan Branning, registered dietitian and clinical nutrition manager at St. Joseph’s Hospital Health Center.

“Studies have found that plantbased diets can have numerous health benefits, including lower levels of obesity — lower body mass index, lower risk of death from ischemic heart disease, lower LDL levels, and lower rates of Type 2 diabetes, high blood pressure, and certain cancers,” Branning said. “Vegetarians tend to consume fewer calories, fewer saturated fats, and more fiber than non-vegetarians.”

While it’s easy to get stuck in a food jag and eat the same fruits and vegetables over and over, it’s more healthful to consume a variety of produce to consume a wide spectrum of nutrients.

Vicki VanSlyke of Syracuse began eating a whole plant-based, vegan diet March 20, basically to promote better health. She has cut out all meat, dairy, refined sugars and has cut back on oil.

So far, she has lost over 30 pounds and her cholesterol has dropped about 20 points. She has Type 2 diabetes. Her A1C test which measures her blood sugar level decreased from 9.0 to 7.3 in three months. Health care providers use the A1C test for managing diabetes.

She has been able to quit taking several of her prescription medications.

VanSlyke said that removing

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Vicki VanSlyke of Syracuse began eating a whole plant-based, vegan diet March 20. She said she has lost over 30 pounds and her cholesterol has dropped about 20 points. “You may not feel well the first couple of weeks — but stick with it, it gets easier,” VanSlyke says about a plant-based diet. off-limits foods from the home makes it easier to stick with a healthful eating plan. Cooking with new recipes and finding new, healthful foods makes the transition easier.

“Also remember that it’s an adjustment and you may not feel well the first couple of week —but stick with it, it gets easier,” VanSlyke said.

In addition to measurable results, she said that she feels healthier than ever, sleeps better and experiences greater energy. Her chronic pain disappeared.

While eating vegetarian or vegan sounds like it deserves a halo of healthfulness, it’s possible to eat a very unhealthful diet that’s technically vegetarian or vegan. For example, French fries made with vegetable oil

@

are vegan, but not nutritious.

Some people choose vegetarian or vegan foods that are highly processed. Some of these foods contain lots of sugar, such as soy-based protein bars that are little better than candy bars.

VanSlyke reads labels to find sugar and fat content. She tries to buy foods that contain five or fewer ingredients.

Learning how to grocery shop for and cook healthful foods makes it easier to incorporate more vegetables and fruits.

“The key is to remember that it’s not only what we limit in our diet that can contribute to health, but it’s also what we include in our diet,” Branning said.

Some people switching to a plant-based diet find they’re hungry sooner than when they ate more meat; however, eating nuts, beans and seeds can help them with satiety and increase their intake of protein--another challenge to focusing on produce. For people not eating vegan, cheese and eggs can help maintain sufficient protein intake.

Branning said that plant-based proteins, except soy and quinoa, lack a few of the nine essential amino acids the body requires. Eating “complementary proteins” throughout the day provides them, such as grains and seeds/nuts; grains and legumes; and legumes and seeds/nuts.

Limiting meat intake makes it harder to get B vitamins; however, dark, leafy greens such as spinach can provide these and supplementation can also help.

“It’s possible to get adequate amounts of the above nutrients from a plant-based diet, but it can also be a challenge,” Branning said.

She recommends considering supplementation, especially B12, for people who eat a 100-percent plantbased diet and calcium for those who don’t consume dairy.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Women’s HEALTH

Caregivers-in-Chief Women — mostly married and employed — make up 66 percent of all those involved with informal caregiving

By Deborah Jeanne Sergeant

A

bout 3 million caregivers provide a total of more than 2.6 billion hours of care to loved ones annually, an economic value of $32 billion, according to the New York Office for the Aging. The Family Care Alliance, a nonprofit based in San Francisco, states that an estimated 66 percent of caregivers are women.

The reasons behind the trend of women caregivers is manifold. Women tend to live longer than men. If it’s one spouse caring for another, it’s usually a wife caring for a husband.

Family dynamics also trend toward women caregivers as many women

shift from serving as the primary caregiver of the family’s young children to the caregiver of the older adults.

The average woman caregiver is married and employed. Dubbed the “sandwich generation,” women in this situation often feel stressed by the demands on their time, caring for their elderly relative — usually a parent or in-law — and their own children, plus work.

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Women provide the majority of informal care to spouses, parents, parents-in-law, friends and neighbors, and they play many roles while caregiving: handson health provider, care manager, friend, companion, surrogate decision-maker and advocate.

Source: Family Caregiver Alliance, a nonprofit based in San Francisco. provide the best care possible.

Many caregivers provide about 20 hours of care weekly, equivalent to a part-time job, in addition to their actual jobs. A growing number of women care for more than one elderly relative, as people who have divorced and remarried may have numerous connections with older adults for whom they feel responsible.

Andrea Lazarek-LaQuay, a registered nurse and chief cliniLazarek-LaQuay cal officer with Nascentia Health (formerly known as VNA Home Care), said many don’t realize how much stress they bear.

She added that many have a hard time asking for help from friends and relatives and are unaware of what community-based resources are

available to them.

“It becomes a very big balancing act,” she said.

Lazarek-LaQuay works fulltime and cares for a relative living with her who requires round-the-clock care. Hired help makes the situation workable, but she said even at work, she experiences stress ensuring all the bases are covered.

“If you can quit your job and stay home, you’re surrounded with it and you need stress relief, too,” Lazarek-LaQuay.

She copes by scheduling time each week to pursue hobbies and relax, and advises others in a caregiving role to do the same. A few hours to hike, play her instrument in the community band, and work out helps her feel refreshed in her care giving role.

Without this kind of planned break, caregivers face burnout or unhealthy coping mechanisms that ultimately can result in isolation, poor physical health, depression and substance abuse.

Elizabeth Weimer, caregiver services coordinator for Oswego County Office for the Aging, encourages caregivers to enlist other family members to assist in caregiving.

Caregiving help may be informal through friends as well, or through volunteer organizations or paid staff.

Perhaps a family friend could take over driving duties to one or two appointments a month or sit with the person receiving care for a few hours.

In-home respite can provide a companion who performs light housekeeping if the care recipient lives alone.

“Hang in there,” Weimer said.

“It’s a hard, hard thing. Reach out to other caregivers.”

For more caregiver resources, visit https://aging.ny.gov/Caregivers/Index.cfm or contact New York Connects at www.nyconnects.ny.gov, 1-800-342-9871.

on, but we’re hands-off — we don’t take the place of your partner.”

While most mothers’ partners are present for the birth, doulas can help mothers who don’t have the assistance of a birthing partner.

“We’ve helped young teenage women who didn’t have the partners going to be present. We’ve helped women who are going to give the babies up for adoption,” Herrera said.

“They don’t really have anybody because they don’t have the support of their families. We’re lucky to be able to support women in all those different circumstances.”

Doulas can also offer support to women who have suffered traumas such as stillbirth, domestic or sexual violence, medical complications or poor treatment from health care providers.

“It’s harder to hear the stories of women who have had a bad birth experience,” Herrera said. “A lot of times we get people who want to change things and make the next birth better.”

Team of doulas at CNY Doula Connection.

Childbirth Cheerleaders CNY Doula Connection helps families bring babies into the world

A

By Ashley M. Casey family expecting a baby has a lot of decisions to make: What color should the nursery be? Which pediatrician will care for the baby? Formula or breastfeeding?

Another question expectant parents might consider is who will be present during the birth of their child. Women often choose to have their partner and sometimes a parent or relative in the delivery room, but birthing moms may also consider inviting a doula to assist them.

“It’s emotional and physical support,” explained Anna Nieves-Herrera, a member of CNY Doula Connection. “In the prenatal period, it’s meeting up with your client and helping them prepare and understand what the labor process is, helping them work through their concerns about what labor will be like.”

CNY Doula Connection is a group of four independent doulas — Christine Herrera, Sherri Morris, Nicole DeCastro and Anna Nieves-Herrera — who offer their services not just in Syracuse but as far as Watertown, Rochester and Utica. In addition to assisting with childbirth, these doulas host community education events (see sidebar).

Herrera’s journey into the world of birthing support began 12 years ago, when she and her husband were living in Florida and expecting their first child. Herrera took childbirthing classes with a doula.

“It was so eye-opening. There were all the choices I didn’t even know I had,” Herrera recalled. “If it wasn’t for her, who knows how my birth would have been?”

But the family moved to Central New York, and she ended up having a home birth with the assistance of two midwives. While Herrera grew close to her midwives — who helped inspire her future career — she missed her doula back in Florida.

“I did it once without a doula, and I wasn’t going to do that again,”

Cost: What to Expect CNY Doula Connection offers a range of services and pricing. Birth services range from $800 to $900 and include a prenatal consult, unlimited phone and email support, continuous support through active labor and birth, and a postpartum home visit. Prenatal support without the doula’s attendance at your birth is $300.

Add-ons such as prenatal yoga classes, placenta encapsulation or the assistance of a second doula are available for an additional $100 to $200 each.

Postpartum care services range from $125 to $2,200 depending on the hours and level of service. For the full menu of options and pricing information, visit cnydoulaconnection.com/ our-services.html she said.

Herrera went on to have two more children with the help of doulas, and she realized she wanted to help other families have positive birth experiences. She sought training and became certified through DONA International (previously Doulas of North America) in 2006.

She founded CNY Doula Connection about 10 years ago. Since then, the network has had a rotating roster of doulas available for expectant families.

“It’s a way for us to bounce ideas off each other help our businesses grow and help the community all in one network,” Herrera said.

“Working with other doulas is such a great outlet and such a great opportunity for support,” Nieves-Herrera said. “I can’t imagine not working with other doulas.”

What does a doula do?

While many parents who hire

birth doulas are “crunchy,” preferring to give birth naturally and unmedicated, a doula’s job is to support a woman no matter what she chooses.

“There’s a misconception out there that doulas only want you to have a natural birth with no medication, but we support all kinds of birth, even if you get a C-section or schedule an induction or a natural birth,” Nieves-Herrera said. “We’re not there to support one birth choice over another. We’re just there to support you as an individual.”

Birth doulas help ease the pain and anxiety that often accompany giving birth by teaching mothers different positions for labor or breathing techniques. Doulas may also use massage, aromatherapy or even hypnosis to guide their clients through childbirth.

“Physically, we support them through massage and help them get into positions into labor,” Nieves-Herrera said. “[We] help them feel a little less uncertain about the medical procedures they might be receiving.”

Doulas are not medical professionals — they leave those decisions up to the mother and her health care providers — but they can help parents decode medical lingo and better understand their options during labor and delivery.

“Chaos can ensue in the hospital. Your midwife or OB usually doesn’t even get there until the end when it’s time for pushing,” Herrera said. “We’re the constant presence [throughout] labor.”

Just as they aren’t there to replace a doctor or midwife, doulas aren’t there to replace a partner, either.

They offer emotional support to the mother’s partner and can give them a break “A lot of partners are afraid that doulas will replace them as support, but we’re there to facilitate them working together as a team,” Nieves-Herrera said. “We’re handsOctober 2017 •

Beyond the birth In addition to assisting with childbirth, CNY Doula Connection’s services include prenatal yoga, birthing classes and placenta encapsulation. While a doula’s primary role is assisting laboring mothers, some offer postpartum care as well.

“Everyone plans for their birth but they kind of forget about the postpartum period,” Herrera said.

“That’s when your hormones are crazy. You’re just trying to figure out how to take care of the baby, and that’s when a woman is vulnerable to mood disorders.”

Postpartum doulas watch for signs of postpartum depression or anxiety. They also take some of the stress off new parents by caring for older children, helping the mother breastfeed and giving parents a break to catch up on much-needed sleep.

The entire process of a doula’s work with a family engenders a certain kind of intimacy. Nieves-Herrera recalled sharing deep conversation with a client during a lull in labor.

“It was the middle of the night and she was in the tub and we were just talking about life,” she said. “It was a simple moment in the middle of her labor.”

Herrera said she worked with a same-sex couple who decided to take turns giving birth with their first two children.

“We had two first-time births, which was kind of unique,” she said.

Many people approach the doulas at community events wanting to tell their own birth experiences.

“You get these generations of women who want to talk about it and it’s such a beautiful thing,” Nieves-Herrera said.

Some of Herrera’s clients have become her friends.

“I did a long-term postpartum care and I am totally friends with that family. We have both of our families get together and do dinner,” she said. “It’s that bond we have — now, they’re always going to be part of my life.”

Upcoming Events Each month, CNY Doula Connection hosts a “Birth Basics” event that is open to the community.

For dates and other information, visit cnydoulaconnection.com/ events-calendar.html

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

Women’s HEALTH Expanded Work Leave Benefits Families Workers will be able to take up to eight weeks off as part of the new NYS family leave program; time off will increase to 12 weeks in 2021. Benefit applies to both father and mother

By Deborah Jeanne Sergeant

T

he New York State Paid Family Leave Program, taking effect Jan. 1, will allow workers job protection for eight weeks instead of the six weeks allowed now. In 2019, workers will receive an additional two weeks of leave. In 2021, the number of weeks will top out at 12 as the new provision is completely phased in.

The maximum percent of employees’ average wage will increase incrementally as well, from 50 percent in 2018 to 67 percent in 2021.

Since the financial need to work often constrains mothers to go back to work soon after their children’s birth, receiving additional time off is a good step, according to physician James Brown, medical director for Women’s and Children’s Services at St. Joseph’s Health.

“This law will be pivotal in the next steps of equality and dignity for the home and the workplace,” Brown said. “The additional time at home with the new baby, plus the support of having a spouse at home during that time, will have tremendous ben-

efits for both the mother’s health and the baby’s health.”

The World Health Organization, American Academy of Pediatrics and Centers for Disease Control and Prevention, among many medical organizations, recommend exclusive breast feeding for at least six months and as long as mother and child wish to continue.

Having additional time at home can also help women establish breastfeeding. Nationwide, 81.1 percent of women and 82 percent in New York breastfeed the first three days after birth.

At six months, only 51.8 percent nationwide are breastfed any amount, and in New York state, it is 55.8 percent. Exclusive breastfeeding at six months is 22.3 percent nationwide and 19.7 percent in New York.

Many women who work jobs that don’t allow more than the minimum six weeks of leave can’t afford a quality electric breast pump, which can cost $300 or more.

In addition, it can take a few weeks to establish a good milk

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supply, learn how to help baby latch, develop a good sleeping and nursing routine and learn how to use a breast pump. Some babies take longer to accept bottled breast milk.

Moms benefit, too, from more time off. New moms need extra weeks to cope with sleep pattern disturbances, body image issues, and post-partum depression issues.

“For most moms, they can use that time to begin to strategize and structure their life with a baby,” said Christine Kowaleski, coordinator for the Syracuse chapter of Postpartum Support International. “Many mothers we do see with post-partum depression need that extra time.

Even if they don’t have post-partum depression, they need time to get adjusted to life with a baby.”

Kowaleski said that although the United States lags behind many other countries as far as time and amount of wages paid during maternity leave, “it’s wonderful that we’re trending on that trajectory to helping moms.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

All About Bonding “New York’s Paid Family Leave program provides wage replacement to employees to help them bond with a child, care for a close relative with a serious health condition, or help relieve family pressures when someone is called to active military service.”

“Employees are also guaranteed to be able to return to their job and continue their health insurance. If you contribute to the cost of your health insurance, you must continue to pay your portion of the premium cost while on Paid Family Leave.”

“Paid Family Leave coverage will be included under the disability policy all employers must carry. The premium will be fully funded by employees through payroll deductions.”

Source: www.ny.gov/newyork-state-paid-family-leave

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Women’s HEALTH Understanding Genital Condyloma and Human Papilloma Virus

By Timothy Byler, MD

H

uman Papilloma Virus (HPV) is the most common sexually transmitted infection world-

wide.

Although common, there are over 170 different strains included in this and only some that have obvious symptoms. Most people don’t know they have the infection and they have no symptoms.

The CDC recently reported that 45 percent of men without any visible signs tested positive for a least one strain of HPV. The HPV virus has been linked to cancers of both men and women.

The virus really became known for its connection with cervical cancer and is found in over 70 percent of cases. In fact, routine gynecology visits test to see if the virus is present. It has also been found to be involved in cancer of the penis, anus and throat.

It is important that if you notice something, you see a doctor to be evaluated and be sure it is not one of these dangerous spots.

HPV is also the cause of genital warts, a condition in which small growths appear on the penis or scrotum on males. These lead to social embarrassment and surgical removal in many cases.

Our recent research found that 2.9 percent of the US population (2.2 million men) tested positive for HPV 6 or 11, the two strains most associated with these warts. Although this is

a large number of people, only about 20 percent of those that test positive have a growth that is visible. Fortunately, we have a lot of options to remove the warts with good cosmetic outcome.

As shown above, the effects of HPV infection have a wide range and affect many people. Fortunately, there is a vaccine to prevent the nine most common strains of the virus.

The Center for Disease Control and Prevention (CDC) now recommends vaccination be given to all children aged 11-12, and in some people up to age 26. Despite these recommendations, most studies show the vaccine use is low and many people are unaware the vaccine is available. Patients should ask their primary care doctor if the vaccine is right for them.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 19

Parenting

By Melissa Stefanec

melissastefanec@yahoo.com

Turning Out ‘I am going to spend a little less time worrying about how my children are turning out and instead spend a little more time celebrating who they are’

T

his week, I took my daughter to daycare and watched her get on the bus for her first day of first grade. There was another family at our daycare who was putting their son on the bus for his first day of kindergarten. Stella, relishing the opportunity to be the big kid and in the know, laid down some ground rules for how their morning bus routine was going to go.

As the bus approached them, she put her arm to keep him from going into the street. She then looked at him and said, “I am first every day.

We wait until the bus stops, and then we cross the street.”

For her, it was a matter of fact.

As the oldest and the authority, she would lead the way. The apprehensive kindergartner gladly obliged.

And I, snickering lightly, couldn’t help but marvel at how she was turning out. Instead of correcting her,

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I took pride in what she was exactly at that moment — a strong (and increasingly independent) person who wanted to lead. Drinking in that moment was beautiful.

I found myself in a similar situation only days before. Our family was at a diner. When the waitress came to take our order, my 3-year-old son started introducing each member of the family. He rounded out his lineup with a family member we usually hide when we are outside the house. He ended, “and this is Butt Cheeks.”

In that moment, I absolutely loved my son. He was being goofy and silly, and harmlessly so. If he wants to add Butt Cheeks to our family gatherings, why shouldn’t I laugh? At that moment, I wasn’t concerned about what college degree he would pursue in 15 years. I was watching him be himself, which, in

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

this case, is a sassy 3-year-old with a passion for soliciting reactions. It made everyone laugh, and everything was exactly as it should be for a moment.

As a parent, I often find myself wondering about how my kids will turn out. I wonder what careers they will pursue. I wonder what crowd they will run with. I wonder what they will excel at and what they will struggle with. I spend a silly amount of time wondering how they will turn out. I also, as I’m sure many parents do, spend much of my parenting energy on molding, correcting and redirecting my children to help them turn into something more.

This is all well and fine, but it’s a bit like making chocolate chip cookies and waiting until they are cool to taste them. You have a much better experience eating cookie dough and melty cookies fresh from the oven. (I really like baked goods, and it’s been a long day at the office; so, please let me live vicariously through my baking metaphor right now). If you wait until something is exactly what it is supposed to be, you miss out on the good stuff along the way. You miss the present.

Parents do this because we want our kids to turn out the best they can. When I see my kids struggling with a situation or behaving poorly, I often wonder at how I can help them.

I also venture down the rabbit hole of what in their upbringing yielded those reactions or behaviors. I spend a lot of time calculating where and how I should redirect my kids’ and my energy to improve their characters. I want to make sure they turn out well, so I keep looking ahead.

However, this keeps me from taking in who they are along the way.

So, to make this parenting jour-

ney a little more fun, I am going to try to spend a little less time worrying about how my children are going to turn out.

Because, when you appreciate your kids for who they are today, you feel good, and they feel good.

When I welcomed Butt Cheeks to the diner table, we all had a nice time, because we just enjoyed things as they were. So much so, that before we left, the person sitting next to us leaned over and said, “Excuse me ma’am. I just wanted to say how nice it is to sit next to kids that are behaving in a restaurant. I am a preschool teacher, and it’s great to see.”

Sure, she caught my kids on a good day. They didn’t spend the entire meal bickering with each other or spilling things. I can’t help but think they behaved a little better because my husband and I let them be exactly who they were, without trying to steer them into something better. We could’ve tried to deter Butt Cheeks (and stopped Stella from building a creamer and jam packet tower), but that wouldn’t let them be who they are right now.

And, back to the school bus, when I let my daughter lead instead of giving a lecture in social niceties and line leaders, I let her walk onto that bus with confidence (and her friend knew he was in good hands).

Everyone felt a little better because my daughter took the initiative to lead.

As a parent, my sanity hinges on knowing what battles to pick with my children, especially when it comes to helping them grow into themselves. Right now, I am going to spend a little less time worrying about how my children are turning out and instead spend a little more time celebrating who they are.

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5 Tips to Fight Fall Allergies

I

t may seem as though every fall your allergies get the best of you rather than you coming out on top. Sneezing, wheezing, runny noses and itchy eyes can leave you feeling run down and defeated.

“If it feels as though your allergy symptoms flare up earlier and earlier every year, you’re probably not wrong,” says allergist Stephen Tilles, president of the American College of Allergy, Asthma and Immunology (ACAAI). “Climate change may actually be causing an earlier and longer fall allergy season. In addition, windy days can mean heightened allergy symptoms because wind can carry the pollen from ragweed, grasses and trees up to 100 miles from its source.”

Ragweed pollen is the biggest allergy trigger in the fall, and needs to be avoided, along with other allergic triggers like mold and grass pollen.

Here are five tips from ACAAI to help you steer clear of your worst allergy foes.

1

Plan your battle in advance.

Although they are labeled “fall

allergies” many allergic triggers start to appear in mid-to-late August. Start taking your allergy medications about two weeks before your symptoms normally start.

Getting in front of your symptoms means controlling them a lot better. Don’t stop your medications until pollen counts have been down for about two weeks.

2

Fight mold.

Mold allergies can be tough to outrun.

Mold can grow anywhere there is water, and is a frequent foe in the fall.

Mold can be found in your basement, bathroom, a leaky cabinet under your sink, or in a pile of dead leaves in your backyard. The key to reducing mold is moisture

control. Be sure to use bathroom fans and clean up any standing water immediately. Scrub any visible mold from surfaces with detergent and water, and completely dry. You can also help ward off mold by keeping home humidity below 60 percent and cleaning gutters regularly.

3

Keep pollen at bay.

Ragweed, or any pollen that triggers your allergy symptoms, needs to be kept out of your house.

Leave your shoes at the door, and take a shower, wash your hair and change clothes after you’ve been working or playing outdoors. Close both car and home windows, and use your air conditioning so pollen doesn’t get indoors.

Monitor both pollen and mold counts to help you know when

you’re less likely to be under siege.

4

Be armed for combat.

Wear a NIOSH-rated 95 filter mask when mowing the lawn or doing other outdoor chores. Wear gloves so you won’t transfer pollen to your eyes or skin. Take your allergy medication before heading outside. If you’re allergies are severe, consider having someone else do the gardening and fall raking.

5

Find an ally.

See your allergist. Allergists are trained to identify your allergies and provide a personal treatment plan.

They can also provide immunotherapy – allergy shots – which target your exact triggers and can greatly reduce the severity of your symptoms. Allergy shots can also prevent the development of asthma in some children with seasonal allergies.

If you think you might be one of the more than 50 million Americans that suffer from allergies and asthma, use the ACAAI website — http:// acaai.org/locate-an-allergist —to find an allergist in your area.

PAD: Often Misdiagnosed, This Illness Can Be Mild or Deadly Experts: Tell the doctor about your symptoms; it could save your leg

A

s we age, it is common to be concerned about heart disease or high blood pressure. But many people don’t know that those conditions are also related to another common health issue, peripheral artery disease (PAD). Unfortunately, many patients are not diagnosed until it has progressed.

PAD is caused when hardening of the arteries deprives the legs and feet of oxygen-rich blood. This occurs because the arteries become clogged, much like water pipes in an old house that build up with lime. In the body, clogged arteries don’t bring enough oxygen to the toes, feet and legs. (Less commonly, the same thing can happen to arms and hands.)

Older people are more likely to have some level of PAD. Those over 60 have a 5 percent chance; those

over 70, 15 percent; and those over 80, 20 percent. Smokers and diabetics are far more likely to have PAD. If the disease stays mild, it can cause no symptoms at all, or just a little pain in the legs while walking.

But if it progresses, it can lead to gangrene, amputation and sometimes even death.

“A lot of time when patients complain of leg pain, it is misdiagnosed as something else, such as back pain,” said vascular surgeon and researcher Katherine Gallagher of the University of Michigan. “Then they may be referred to other doctors and occasionally have procedures like back surgery that fails to relieve the pain. Only then they are diagnosed with PAD.” Patients need to know that even if they have PAD, it can be managed

conservatively with medications most of the time, she added. “Surgery or endovascular therapy should be reserved for patients who have lifestyle-limiting pain when walking, rest pain and ulcers that don’t heal.”

What can you do to avoid the severe later stages of PAD? • Don’t smoke; if you do smoke, quit. Nicotine inflames the blood vessels and increases the likelihood of PAD. Ask your doctor to help you find assistance with smoking cessation.

• See your primary care doctor regularly. Checkups are designed to catch things like PAD. • If you are having pain in your legs, feet or toes, or have sores on your feet that won’t heal, be sure to mention that in your doctor visit.

• Be sure to follow doctor’s October 2017 •

advice and take prescribed blood pressure and cholesterol medications as directed.

• Keep walking. Walking 30 minutes a day, three to five times a week can keep PAD at bay. If your legs hurt just a little, keep walking; if the pain is bad, stop for a few minutes till it goes away, then start walking again. Pushing through mild and moderate pain will increase the distance you can walk without pain over time.

• If that’s hard to manage, ask if supervised exercise therapy is covered for you.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

Peregrine Senior Living to Open New Facility on Onondaga Hill Assisted living community to care for individuals with Alzheimer’s and other types of dementia

By Mary Beth Roach

W

hat were just fields and brush along an area of West Seneca Turnpike a few months ago has been transformed.

Now, standing on this parcel of land in the town of Onondaga, near Onondaga Community College, is the framework of what will be the newest memory care facility in Central New York — Peregrine Senior Living at Onondaga Hill.

According to executive director Robert Collins, it is an assisted living community dedicated to caring for individuals with Alzheimer’s and other dementias. It has been designated by New York state as an enhanced and special needs community, the only facility with this kind of license in Central New York, according to Collins.

Peregrine officials broke ground for the facility in October, 2016, and they anticipate that the $8-million, 36,000-square-foot facility will open in December. The Peregrine company, based in Syracuse, is owned by Stephen Bowman and Mark Farchione, with 14 facilities throughout the country, including Atlanta, Colorado

and Massachusetts, and New York state, where most of their properties are.

Collins provided a recent tour of the building. The covered entrance, topped with a large cupola, will open to a vestibule and administrative offices, followed by a great room and a 1950s-themed diner, a central courtyard, and a chapel. Off the center of the building will be wings that will house dining areas, along with 60 private and four semi-private rooms, for a total of 68 beds. The semi-private rooms will allow for a patient and his or her spouse. The building will provide lots of natural light and walking areas with numerous gardens and sitting areas. Because many of those with Alzheimer’s have a tendency to wander, these particular spaces will be designed to be a destination for them, Collins explained. At night each wing will be secured for the well-being of the residents, but during the day, they can freely amble throughout the entire complex.

While the residents can keep their own private physician, Collins said, Peregrine will be contracting

with a physician’s office, and Collins is also planning to bring podiatry, dentistry and physical therapy services to the facility.

“The idea is we bring services here,” he said, “We bring everything here so people don’t have to go anywhere else.” In addition, the medical team on site will include a registered nurse, LPNs and aides. He estimates that the staff will number approximately 65 full-time employees.

But the staff’s focus is not solely on the patient, but on their families and caregivers, as well.

“One of the things that we really do that I think is very important is we embrace the whole family,” he said. “Helping people work with the disease is what we do too; working with the families on how to have a good visit with your loved one, how to deal with the issues,” Collins said.

Oftentimes, Collins explained, when family members step in as caregivers, they tend to lose sense of being that person’s husband, wife, son or daughter. It’s an experience he knows first-hand, since he, himself, was a caregiver for his mother, who

battled dementia. Peregrine Onondaga will take over the responsibilities of a caregiver, allowing the patient’s family members to remain in the role of the spouse or the child.

Collins got his master’s in health care administration from the George Washington University and did his residency in long-term care. Following that, he did a stint in acute care to get some experience. It was, he said with a chuckle, supposed to be brief but it lasted 25 years. He has been with Peregrine for 12 years and has been on the road at a number of their facilities for all that time. But as executive director of Peregrine Onondaga Hill, Collins returns to his hometown of Syracuse. Living in the same neighborhood where he was raised, he can make the commute to work in less than five minutes.

“I’ve unpacked my suitcase. I’m home,” he said.

And now he’s in charge of making a home for 68 Alzheimer’s patients at Peregrine, and he plans on making it a happy home for them.

“While life dramatically changes, it doesn’t end.”

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Page 22

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

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How to Find a Better Medicare Prescription Drug Plan

Jerome & Phyllis Charney E ARLY CHILDHOOD D EVELOPMENT PROGRAM

Dear Savvy Senior, I think I’m paying too much for the medications I take. I have a Medicare Part D prescription drug plan and my out-of-pocket spending is over $4,000 thus far in 2017. When and how can I change my Medicare drug plan?

Inquiring Carol

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Medicare Made Simple, LLC premiums, deductibles and co-pays.

Also, be sure the plan you’re considering covers all of the drugs you take with no restrictions. Most drug plans today place the drugs they cover into price tiers. A drug placed in a higher tier may require you to get prior authorization or try another medication first before you can use it.

Dear Carol,

Need Help?

You can change your Part D prescription drug plan during Medicare’s open enrollment period, which runs from Oc. 15 through Dec. 7. During this time, beneficiaries can switch drug plans or join a drug plan if you didn’t have one before. They can also switch from Original Medicare to a Medicare Advantage plan or vice versa, if they wish. Any changes to coverage will take effect Jan. 1.

In September, you should have received your “annual notice of change” from your drug plan. It outlined any changes in coverage, costs or service that will take effect in January.

If you take no action during open enrollment, your current coverage will continue next year. Yet even those who are happy with their coverage should review their plan for any changes to come.

If you need some help choosing a new plan, you can call 1-800-MEDICARE and they can help you out over the phone. Or, contact New York State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling.

They also conduct seminars during the open enrollment period at various locations throughout each state.

To find the contact information for your local SHIP visit Shiptacenter. org, or call the eldercare locator at 800-677-1116.

Change Medicare Plans If you have internet access and are comfortable using a computer, you can easily shop for and compare all Medicare drug plans in your area, and enroll in a new plan online.

Just go to Medicare’s Plan Finder Tool at Medicare.gov/find-a-plan, and type in your ZIP code or your personal information, enter in how you currently receive your Medicare coverage, select the drugs you take and their dosages, and choose the pharmacies you use. You’ll get a cost comparison breakdown for every plan available in your area so you can compare it to your current plan.

This tool also provides a five-star rating system that evaluates each plan based on past customer service records, and suggests generics or older brand name drugs that can reduce your costs.

When you’re comparing drug plans, look at the “estimated annual drug costs” that shows how much you can expect to pay over a year in total out-of-pocket costs, including

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Low-Income Assistance If you find yourself struggling to pay your medication costs, check out Medicare’s “Extra Help” program.

This is a federal low-income subsidy that helps pays Part D premiums, deductibles and copayments. To be eligible, your income must be under $18,090 or $24,360 for married couples living together, and your assets must be below $13,820 or $27,600 for married couples. For more information or to apply, call Social Security at 800-772-1213 or visit SSA.gov/medicare/prescriptionhelp.

Other resources that can help include RxAssist.org, which maintains a comprehensive database of patient assistance programs, set up by drug companies for those who have trouble affording their medications. And NeedyMeds.org, a national nonprofit organization that maintains a website of free information on programs that help people who can’t afford their medications or other health-care costs.

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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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

The Social Ask Security Office

pathways to pathways to independence independence

By Deborah Banikowski District Manager, Syracuse

How Did They Do It Without Computers?

pathways to independenceM Coordination of Services Services Coordination of (Meals, Nutrition, Transportation, (Meals, Nutrition, Transportation, Medical Appointments,etc.) etc.)

Medical Appointments,

Coordination of Services

Assistance inTransportation, Locating Assistance in Locating (Meals, Nutrition, Appropriate Housing Appropriate Housing Medical Appointments, etc.)

Arranging Care Services Services Arranging In-Home In-Home Care

Assistance inofLocating Financial Assistance for Housing Coordination Services Financial Assistance for Housing (Meals, Nutrition, Transportation, Appropriate Housing (315) 565 -7551 -7551 Medical Appointments, etc.)

sasyr .org/pathways sasyr .org/pathways Arranging In-Home Care Services Assistance in Locating Appropriate Housing Eligibility: Eligibility:

ore than 85 percent of American homes have some sort of computer. Millions of people rely on computers daily to access, formulate and store information.

People use computers for everything from sharing family pictures to shopping to banking and paying bills.

But, we haven’t always been able to count on the convenience of the computer to make our lives easier.

How did Social Security — one of the world’s largest “bookkeeping operations” — manage to keep records of our nation’s workers before we had computers? How did we match workers with their earnings?

We used a process called the “visible index” that used tiny, bamboo strips wrapped in paper that were inserted into metal panels. The panels could be flipped back and forth to view the information on each side. Clerks had to look at each strip to find the exact Social Security number for a specific person. In 1959, when Social Security began converting information to microfilm, there were 163 million individual strips in the visible index.

The workers’ names were filed alphabetically by surname using a phonetic pronunciation code to ensure consistent filing. There were hundreds of thousands of people with the same surname. How did the

Q&A

Financial Assistance for Housing

Active Medicaid Medicaid

Arranging In-Home Care Services A Chronic Physical Disability A Physical Disability Care Need for In-Home In-Home Care Financial Assistance for Housing

(315) 565-7551 (315) 565 -7551 SASYR.ORG/PATHWAYS

Q: I applied for my child’s Social Security card in the hospital but have not received it. How long does it take?

A: In most states, it takes an average of three weeks to get the card, but in some states it can take longer. If you have not received your child’s card in a timely manner, please visit your local Social Security office. Be sure to take proof of your child’s citizenship, age, and identity as well as proof of your own identity.

And remember, we cannot divulge your child’s Social Security number over the phone. Learn more at www. socialsecurity.gov.

sasyr .org/pathways Eligibility: Active Medicaid A Chronic Physical Disability Need for In-Home Care Page 24

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

Q: A few months after I started receiving my Social Security retirement benefit, my former employer offered to take me back. It’s a great offer. Can I withdraw my retirement claim and reapply later to increase my benefit amount?

A: Social Security understands that unexpected changes may occur after you begin receiving retirement benefits. If you change your mind, you may be able to withdraw your Social Security claim and re-apply at a future date. This withdrawal must

staff meet the challenge? By knowing the system. Clerks familiar with the index could locate a specific record within 60 seconds.

The index took about 24,000 square feet of floor space and was extremely heavy. No building in the District of Columbia had floors sturdy enough to support the ever-increasing load. These weighty considerations led to Social Security getting its first large-scale computer, an IBM 705. Starting in 1956, the 705 was tasked with handling most of the accounting functions for the agency. It was still humming when it was replaced by a later generation of computers in 1961.

Back in 1937, there were only about 26 million American workers; but today, Social Security processes 260 million worker’s annual wage reports. We have changed over time to meet the challenges of recording worker’s earnings correctly. Today, you don’t need a clerk or a visit to a local Social Security office to check your own information. That’s right.

You can check yours now by either using your existing my Social Security account or by setting one up at www.socialsecurity.gov/myaccount.

Changing to meet challenges is just one of the ways we secure your today and tomorrow. You can read more about the history of Social Security at www.socialsecurity.gov/ history/index.html.

occur within 12 months of your original retirement, and you are limited to one withdrawal during your lifetime.

Keep in mind, you must repay all of the benefits you received. You can learn more about the one-year period when you can postpone your benefits at www.socialsecurity.gov/retire2/ withdrawal.htm Q: I am very happy that I was just approved to receive disability benefits.

How long will it be before I get my first payment?

A: If you’re eligible for Social Security disability benefits, there is a five-month waiting period before your benefits begin. We’ll pay your first benefit for the sixth full month after the date we find your disability began. For example, if your disability began on June 15, 2017, your first benefit would be paid for the month of December 2017, the sixth full month of disability, and you would receive your first benefit payment in January 2018. You can read more about the disability benefits approval process at www.socialsecurity.gov/ dibplan/dapproval.htm.

H ealth News Crouse Hospitalist Service has new leaders Crouse Health recently announced the appointment of two highly regarded physicians to lead the Crouse Hospitalist Service, which is focused on the general medical care of its inpatients.

• James Leyhane was recently named medical director of the Crouse Hospitalist Service. Leyhane, board certified in internal medicine, earned his bachelor’s degree in biology at Siena College and his medical degree from SUNY Health Science Center, where he also served as chief resident in internal medicine. He has been a practicing hospitalist since 2001, serving, most recently, as hospitalist director at St. Joseph’s Health and previously in the same capacity at Auburn Memorial Hospital. In 2000, he received SUNY’s Outstanding Resident Teaching Award and was named physician of the year in 2007 by the Central New York Pharmacists Association. In 2013, he became a fellow of the American College of Physicians.

“I initially became a hospitalist as a backup plan when I completed my residency, but really enjoyed being a hospitalist and have stayed in the field my entire career,” Leyhane said. “The most rewarding part of my job is taking care of really sick people and seeing them leave the Leyhane hospital to return to their lives,” he says.

• Andrew Garrett, a practicing internist who has been a member of the Crouse Hospitalist Service since 2014, has been named assistant medical director of the service. He earned his bachelor’s degree in biology from Cornell University and his medical degree from Rutgers New Jersey Medical School. He completed his internship and residency at Thomas Jefferson University Hospitals in Philadelphia, where he received the internal medicine residency professionalism award in 2012.

“I really enjoy my role as a hospitalist, particularly within the innovative and compassionate culture that exists at Crouse,” said Garrett. “I’m looking forward to working with Dr. Leyhane and our team to fulfill the Crouse mission of providing the best in patient care.”

Garrent

surgery center has all the latest equipment and is staffed by highly skilled nurses and other clinicians. At Oswego Hospital, the bariatric specialists will perform laparoscopic sleeve gastrectomies, where 75 percent of the stomach is Cooper

removed, and takes on the shape of a sleeve. This is a minimally invasive surgery, They will also perform the rouxen-y gastric bypass surgery, where during surgery a very small stomach is created. Patients who undergo this procedure may be hospitalized for several days, but can lose about 65 to 70 percent of their excess weight on average within 18 months of surgery.

Along with the two physicians, the bariatric team includes a registered nurse, a psychologist and a dietitian, among others.

Oswego Health now offers bariatric surgery Oswego Health announced a life-changing service for those challenged by weight loss, through a new service led by physicians who are experts in this specialized field.

Providing care at The Center for Weight Loss and Surgery at Oswego Health will be physicians Jeffrey DeSimone and Kenneth Cooper, who are affiliated with Central New York Surgical Physicians, PC. The physicians perform nearly 450 bariatric surgeries each year and are bringing their expertise to Oswego Hospital.

DeSimone is a board certified diplomate by the American Board of Surgery. He earned his DeSimone medical degree from Georgetown University Medical College in Washington, D.C. He completed his internship, residency and fellowship at the SUNY Health Science Center.

Cooper is also a board-certified diplomate by the American Board of Surgery. He earned his medical degree from the University of New England College of Osteopathic Medicine in Biddeford, Maine. He completed his internship and residency at Upstate Medical University.

The two physicians will perform procedures in Oswego Hospital’s state-of-the-art surgery center. The

VNA Homecare Has New Name VNA Homecare, VNA Homecare Options, Home Aides of Central New York and all their respective affiliated organizations and foundations have been united into one new healthcare system — Nascentia Health.

The new organization combines the programs and services previously operated as separate entities into a unified healthcare system guided by collaboration and a shared vision, according to President and CEO Kate Rolf.

“This new system looks to the future of home healthcare in our community while honoring our history and reflecting our continued commitment to providing exceptional care,” said Rolf. “Unifying all of our existing resources into one cohesive healthcare system was an inevitable and strategic step to ensure that we’re best positioned to fulfill our mission today, and well into the foreseeable future.”

As a healthcare system without walls, Nascentia Health will take a holistic approach to patient care, addressing immediate needs, supporting positive long-term medical and lifestyle choices, and leveraging leading-edge in-home care approaches and technologies to improve outcomes and quality

of life, according to a news release issued by the nonprofit.

Specialties will include: in-home nursing and medical services; home health aides and elder care; complete cross-continuum care management; community health and wellness programs; transportation, equipment and innovative care technologies; chronic disease management; and managed long-term care.

Improving the outcomes and quality of life for the 48 counties in Nascentia Health’s catchment area will also require a commitment to community programs, long-term health education and social daycare programs. As such, the system has invested in the construction of a new, state-of-the-art facility, opening in 2018, which will help fulfill its mission to provide exceptional care and bring community members closer to the services that can assist and support them across the lifespan and continuum of care.

“Nascentia Health is more than a healthcare system,” said Chief Clinical Officer Andrea Lazarek-LaQuay. “It goes beyond the services and programs offered. It’s a promise made to the community and a promise made to each and every patient we serve.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 25

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The new building at 8324 Oswego Road in Liverpool will feature several practices, in addition to Syracuse Orthopedic Specialists.

Golden Years Family Practice Associates Moves to SOS Special edition Location in Liverpool Bugow’s Driver

Rehab Don’t miss the next issue of Family Practice Associates (FPA) dan@bugows.com In Good Health will open a new office facility in Senior adults Driver and Evaluations disabled Liverpool in October in the same CNY’s Healthcare Teens, Newspaper Driver Evaluations & Training building as the one Syracuse Ortho-

pedic Specialists (SOS) moved into in To advertise, please315-341-8811 call mid-September.

315-342-1182 www.bugows.com FPA is a group comprised of

Bugow’s Driver Rehab Senior Driver Evaluations Bugow’ s Driver Rehab dan@bugows.com

Driver Evaluations & Training dan@bugows.com

primary care physicians, physician assistants and nurse practitioners who deliver personalized medical care. FPA is relocating to a new office facility on the second floor of 8324 Oswego Road in Liverpool. FPA will combine its current offices in Liverpool and Baldwinsville into this new location.

“The FPA physicians and staff are thrilled about the new location,” said Jean Carnese, practice administrator for FPA. “Combining our two current locations into the new facility will help us with efficiency and

provide a functional space to continue to provide the highest quality care to our patients in an office space that will make them feel comfortable.”

Syracuse Orthopedic Specialists (SOS) opened its 8324 Oswego Road location Sept. 18. The new space houses SOS Orthopedic offices and SOS Orthopedic & Sports Therapy offices.

“We at SOS are extremely excited to open this new location,” said SOS CEO Michael Humphrey. “The facility was built with much detail given to the best arrangement for our physicians to provide the quality care they are known for, and the best amenities to make our patients comfortable.”

To accommodate the new office space, SOS will consolidate its staff and services of the Baldwinsville, Cicero and Clay orthopedic offices, and the Baldwinsville SOS Orthopedic & Sports Therapy offices. Staff from each location will join the new Oswego Road office. “Liverpool is a central location that allows us to meet the needs of our patients, while maintaining efficiencies,” said Humphrey. Eighteen SOS physicians, from many orthopedic specialties will see patients at the new office.

Later this year, Crouse Medical Practice-Cardiology and Syracuse Gastroenterological Associates, PC will also be moving into the 8324 Oswego Road facility.

www.bugows.com Teens, adults and 315-341-8811 disabled

Driver & Training Onondaga , OEvaluations swego, Cayuga and Madison Counties www.bugows.com 315-341-8811 in good A monthly newspaper published by

Health CNY’s Healthcare Newspaper

Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 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, Eva Briggs (MD), Ernst Lamothe Jr., Ashley M. Casey • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler

Working to Celebrate ‘Brain Aneurysm Awareness Month’

survivors who have worked with the State Sen. John DeFrancisco resenators on this initiative. Both Dunn cently visited Crouse Hospital to and Nash are patients of Crouse share a proclamation he is co-sponneuroendovascular surgeon Eric Desoring with Sen. Joseph Griffo to No material may be reproduced in whole or in part from this publication without the shaies, to whom they credit for their declare September “Brain Aneurysm Be a part of an important study to help understand how the brains express written permission of the publisher. The information in this publication is intended survival. They were joined by fellow Awareness Month” in New York to complement—not to take the place of—the recommendations of your health provider.

Crouse neurosurgeons Raghu RaDebbie Dunn,on far the right, Autism and of typically developing individuals differ state. from those Spectrum!

Consult your physician before making major changes in your lifestyle or health care regimen. maswamy, left, and David Padalino.

Bonnie Nash are brain aneurysm

Be a Researchers part of an important study to help want understand how thehow brains of typically at Syracuse University to understand developing individuals differ from those on the Autism Spectrum! children with Autism Spectrum Disorder and Typically Developing children process andwant puttotogether information.

Researchers at Syracuse University understand sensory how children with Autism Spectrum Disorder and Typically Developing children process and put together sensory information.

Participation would involve comingcoming to our lab to for our approximately 5, 2-3 hour visits and Participation would involve lab for approximately 5,completing paperwork and experiments while wearing an EEG cap (pictured left). Ages 6-30 invited to participate!

2-3 hour visits and completing paperwork and experiments while You willan earnEEG $10 an hour for each time youAges visit the lab. You will also contributing to science! wearing cap (pictured left).

6-30 invited tobeparticipate!

To learn more or to get involved in this study please contact: You will earn $10 an hour for each time you visit the lab. You Dr. Natalie Russo, 426 Ostrom Ave, Syracuse University will also be contributing to science! n

Lab Phone: 315-443-2428 Page 26

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017

Email: carelab.syracuse@gmail.com

To learn more or to get involved in this study please contact: Dr. Natalie Russo, 426 Ostrom Ave, Syracuse University, Lab Phone: 315-443-2428

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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. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-833-805-4507 and TTY 711. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.

All persons eligible for Medicare may receive a $10 reward card with no enrollment obligation. Non Aetna Medicare Advantage members must attend a sales meeting, schedule an appointment, or request an information kit to receive the offer. Current Aetna Medicare Advantage members, must call the number in the advertisement and participate in the member survey to receive the offer. Not to exceed more than one $10 reward card per person. Offer valid while supplies last. ©2017 Aetna Inc. Y0001_4002_10711_FINAL_999 Accepted 09/2017 October 2017 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 27

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2017