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Meet Your Doctor

APRIL 2018 • ISSUE 220


Physician Andras Perl, chief of rheumatology at Upstate, discusses the new center for lupus and other autoimmune disorders. Page 6


How women can address hair thinning Heart disease: 10 things women should know When sex is a real pain • Monthly tracking apps Four myths about midwives Page 17

Transgender Surgeries Up

PLUS: For the First Time, Women Outnumber Men in Med School

Gender-affirming surgeries increase nearly fourfold since 2000. Page 5


Students pursuing chiropractic degrees have every reason to look forward to a satisfying, solid career. Page 10

Toughest Healthcare Jobs to Fill

Savvy Senior: How to Choose a Memory Care Unit


Eat Brown Rice While white rice certainly has some nutritional merit — as it’s enriched with some of the nutrients it loses in the milling process — it pales in comparison to its tawny cousin. SmartBites. Page 12


Which Medications Work Best to Deal with Your Spring Allergies? Page 16

What’s a Bigger Threat: Wolves, Bears, Sharks…

or the Family Dog?


ogs, farm animals and insects — not wild animals — are the cause of death for most U.S. residents killed by animals, according to a new study. The study reported that 1,610 people in the United States were killed by animals between 2008 and 2015. “Importantly, most deaths are not actually due to wild animals like mountain lions, wolves, bears, sharks, etc.,” said the study’s lead researcher, Jared Forrester, a physician. Rather, they’re “a result of deadly encounters with farm animals, anaphylaxis from bees, wasps or hornet stings and dog attacks,” said Forrester, with Stanford University’s Department of Surgery. “So, while it is important that people recreating in the wilderness know what to do when they encounter a potentially dangerous animal, the actual risk of death is quite low,” Forrester said. Forrester made his remarks in a news release from the journal Wilderness & Environmental Medicine, which published the study in its March issue.

The death rate overall from animal encounters “has remained relatively stable” from the last time this analysis was performed, covering 1999-2007, he said. Nonvenomous animals accounted for 57 percent of the deaths in the latest analysis. Most of those cases involved what the researchers classified as “other mammals” - including cats, horses, cows, other hoof stock, pigs and raccoons. Previous research has shown that most deaths from “other mammals” occur on farms, and that horses and cattle account for 90 percent of such farm accidents. “Preventing potentially fatal farm animal encounters should be a better-promoted and -supported public health initiative,” Forrester said. “Farming remains an industry with a deficit of work-related injury reporting, and opportunities exist to improve safety measures and injury reporting on farms in the U.S.” Dogs were the second most common cause of nonvenomous animal-related death, the study found. Children younger than 4 years had the highest dog-related death rate, at


4.6 deaths per 10 million people. That rate was almost two times higher than the next most vulnerable group — people older than 65 — and four times higher than other age groups. “The burden of fatality upon young children after dog encounters remains troubling,” Forrester said. “These are preventable deaths.” Venomous animals accounted for about 86 deaths a year during the study period. Most of those were caused by wasps, bees and hornets.

To reduce these deaths, Forrester said, people who know they’re allergic to insect stings should carry a portable epinephrine delivery device with them at all times. “With an estimated 220,000 annual visits to the emergency department and nearly 60 deaths per year due to stings from hornets, wasps and bees, effective and affordable treatment [for severe allergic reactions to stings] is critical,” he said.


From 2012-2016, Excellus BlueCross BlueShield’s annual operating margin has averaged 0.3 percent, considerably lower than the average of the four major for-profit health plans. Based on a comparison of earnings before interest and taxes, we would have needed to collect $1.6 billion more in premium revenue to achieve the same level of earnings as the major carriers over that period. Because we’re a business, not a charity, we need to earn a margin. But we do not pay dividends to shareholders. That works in your favor. We’re a nonprofit health plan, so we deliberately budget for low margins to keep coverage more affordable. We know you have other important things that matter. We’re neighbors helping neighbors build healthier communities.

A nonprofit independent licensee of the Blue Cross Blue Shield Association.

Page 2

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

Quality health plans & benefits Healthier living Financial well-being Intelligent solutions

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Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. You must continue to pay your Medicare Part B premium. The Part B premium is covered for fulldual members. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other pharmacies, physicians and/or providers are available in our network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de idiomas. Visite nuestro sitio web en www.aetnamedicare.com o llame al número de teléfono que se indica en este material. 繁體中文 (CHINESE): 請注意:如果您說中文,您可以獲得免費的語言協助服務。請造訪我們的網站 www.aetnamedicare.com 或致電本材料中所列的電話號碼。 Y0001_4002_9196_FINAL_1 Accepted 01/2017

©2017 Aetna Inc. April 2018 •


IN GOOD HEALTH – CNY’s Healthcare Newspaper

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April 4

Audiologist to hold free lunch, seminar Community members are invited to learn more about the latest hearing services and products at a free Oswego Health “Lunch and Learn” event from 11:30 a.m. to 1:30 p.m., Wednesday, April 4, at GS Steamers in Oswego. Participants will also be able to see the latest hearing products first hand. Speaking will be Oswego Health audiologist Kathleen Burch who has more than 20 years of experience and provides diagnostic evaluations for hearing and balance, as well as hearing aid consultations, fitting and service. Joining her will be Eric Loewenguth, who has worked as a territory manager for Signia/Siemens Hearing Systems for 11 years. Registration is required and can be made by calling 315-326-3792.

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JCC offer yoga class for preschoolers The Sam Pomeranz Jewish Community Center’s Jerome and Phyllis Charney Early Childhood Development Program will offer a Kids Yoga class for preschool children from 1:15 p.m. to 2 p.m. on Tuesdays starting April 10. The class is open to children between 3 and 5 years of age and will run through May 1. It will be taught by Bridget Langstaff, an experienced yoga instructor specializing in children’s yoga. “Starting yoga at an early age allows kids to get intune with their body and to respect its needs,” says Langstaff. “That’s the essence of yoga.” Registration for Kids Yoga will continue through the class’ start date. The cost is $50 ($45 for JCC members). Spots are limited and early registration is recommended. Children do not need to be enrolled in the JCC’s Early Childhood Program and JCC membership is not required to take the class. For more information, call the JCC’s Early Childhood Program at 315-445-2040, ext. 120, or vis-

it www.jccsyr.org.

April 14

Good Samaritan 5K & 10K held in L’pool Christian Health Service of Syracuse (CHSOS) will hosting its fifth annual Good Samaritan 5K & 10K Run/Walk April 14 at Long Branch Park in Liverpool. Over the years, funds raised by the race have helped provide funding for staff and an additional 500 patient visits per year to people that otherwise couldn’t afford primary healthcare. CHSOS’ mission is to reach the medically under-served of CNY with high quality healthcare. The event begins at 9:30 a.m. with the Kids’ Sprint for children aged 5-12 years old, followed by the certified 10K and the 5K Run/Walk courses at 10 a.m. Cost for the 5K is $25 per participant and $30 per participant for the 10K. (children 12 and under are free.) Water and refreshments will be available. Activities include an awards ceremony with prizes for the top three finishers in each age group for the 5K (all 10K participants will receive a medal), concessions, family-oriented fun, live music, and vendors. Participants can register online at www.goodsamaritanrun.org. Packet pickup will be in the Community Room at Fleet Feet Sports, 5800 Bridge Street in Dewitt from 11a.m. to 6 p.m., April 13. Participants will receive a swag bag.

April 14

PAWS of CNY to hold free therapy dog evaluations PAWS of CNY, Inc., Central New York’s largest nonprofit provider of pet-assisted wellness services, will hold free therapy dog evaluations at Paws and Effect Saturday, April 14, on Route 1, Oswego. Pet owners in Oswego County who are interested in certifying their dog or cat to participate in PAWS of CNY’s pet therapy program are encouraged to submit an application to PAWS of CNY and

book an appointment. Qualified applicants will be scheduled for evaluations on April 14. PAWS of CNY is looking for well-mannered dogs and cats and generous members of the community who are interested in volunteering their time in one of PAWS of CNY’s pet assisted wellness programs. “There is a great need for pet therapy in Oswego County” said Jessica Marabella, president of PAWS of CNY. “We are looking for individuals interested in taking their dogs and cats to college campuses, nursing homes, hospitals and community events to bring comfort and emotional wellness to those in need. We are looking for dogs with solid basic obedience skills, a loving demeanor, and who can tolerate being near other dogs without distraction. We are looking for calm, good-natured cats who enjoy sitting on laps and being petted.” The PAWS of CNY therapy pet evaluation is the first step for dogs and cats looking to earn their PAWS of CNY therapy pet certification. Individuals interested in scheduling their dog or cat for a free therapy pet evaluation should submit an application to PAWS of CNY. Applications can be found at pawsofcny. org/apply.

April 16

Oswego psychologist to discuss autism treatment Oswego Health psychologist Tina Stassin Head will provide an “Ask The Doctor” that focuses on the treatment of autism on Monday, April 16, at GS Steamers in Oswego. Stassin presentation, “So Your Child Has Autism: What’s next?” will offer an overview of the autism spectrum disorder (ADS) with a focus on treatment. She will also discuss the new related diagnosis of “social (pragmatic) communication disorder;” as well as what happened to the former diagnosis of Asperger’s disorder and how to get an evaluation for those where an ASD is suspected. Stassin provides care at Oswego Health’s Child and Family Services program, located in Fulton. She is a licensed clinical psychologist, who earned her Ph.D. at Western Michigan University. Her internship and fellowship were completed at the Kelberman Center in Utica, a regional center of excellence for individuals with autism spectrum disorder. The “Ask The Doctor forum is a

Continued on page 24

2018 KATYHRYN FISH LECTURE SERIES Sunday, April 15th from 1-2 p.m. Dr. Jim Yonai

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

• Cheerleading • Circus • Coding

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• Rocketry • Theatre • ...and more!

• SyraCruisin’ Travel Camp for grades 7–10

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Transgender Surgeries on the Rise Gender-affirming surgeries increases nearly fourfold since 2000


he number of transgender people in the United States who’ve had gender-affirming surgery has risen with the expansion of insurance coverage for the procedures, a new study finds. There are an estimated 1.4 million transgender adults in the United States. Their gender identity differs from their biological sex, prompting some to seek hormone treatments, facial contouring and genital and breast surgeries, researchers from Johns Hopkins Medicine explained. The researchers found that more than 4,100 such surgeries had been done between 2000 and 2014, according to their analysis of medical records in a nationwide database. They also found that the number of gender-affirming surgeries increased nearly fourfold during that time. How people paid for these surgeries changed over time, according to the study. About half of those who had gender-affirming surgery from 2000 to 2005 paid out of pocket. That rose to 65 percent from 2006 to 2011. However, from 2012 to 2014, that percentage dropped. Just 39 percent paid out of pocket in 2014, with the rest covered by Medicare, Medicaid or private insurance. The Affordable Care Act banned discrimination on the basis of gender identity, leading to an increase in insurance coverage for gender-affirming surgeries, the researchers said. The data also showed that no deaths from gender-affirming surgeries had been recorded. That finding challenges critics who say the surgeries are not safe, the researchers said. The study was published Feb. 28

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521 E. Washington St. Syracuse, NY. 315-218-7366 • 315-469-7322 in the journal JAMA Surgery. Before this research, little was known about how many of these procedures take place and how they’re paid for, according to Brandyn Lau, director of research for the Johns Hopkins Center for Transgender Health in Baltimore. “Without data specific to transgender patients, we can’t tell what we’re doing right and what we need to improve, and this study was an attempt to address that problem with the best data we have available now,” Lau said in a Hopkins news release. As more data is collected, he said, researchers will be able to assess outcomes and disparities among transgender patients in the same way that they can now make assessments by age, race and sex. “Eventually, we can move from bean counting about how many gender-affirming surgeries have been done to patient- and clinic-reported outcomes,” said fellow researcher Joseph Canner, co-director of the Hopkins Center for Surgical Outcomes Research. That would “put these procedures in the same sphere as virtually all other types of surgeries.”

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CNY’s Healthcare Newspaper

A monthly newspaper published by 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. © 2018 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, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Maria Pericozzi, Sergey Kravchick (M.D.), Kimberly Blaker, Douglas Tucker (M.D.) • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 5


New Masthead


e’re excited with the new masthead of In Good Health. This is the third change we’ve made since the inception of the paper in Central New York in October 1999. Newspapers don’t change mastheads frequently but we thought this was a great time to introduce something new, fresh, more contemporary, something that better reflects the paper’s mission of disseminating news related to health, the healthcare industry and wellness. We believe the new masthead has the power to generate some new interest for In Good Health. It is cleaner than the one it replaces, more visually appealing and we hope will help draw more readers who see the paper at hundreds of high-traffic locations, including all Wegmans’ locations. We’re pleased that Melanie Watson accepted our invitation to come up with new ideas for the masthead. Watson has been a professional graphic designer for more than 25 years and has extensive experience in designing publications, logos, marketing collateral and a number of other products. In nearly two decades on the design team at Rochester Business Journal, Watson received nearly 20 awards from the New York Press Association and the Alliance of Area Business Publishers. Watson submitted not one or two ideas. In a matter of a day — we thought it would take at least a week — she was able to come up with seven designs for the masthead. Even better, all seven were outstanding. It was tough to pick the winner from among her ideas. “When designing the logo for In Good Health, I was focused on what the paper’s demographic might be attracted to,” she explains. “I was showing health as a lifestyle instead of a medical only issue. And the bold font simplifies the message,” We highly recommend Watson for any design work readers might need. Some of her work can be viewed at melaniewatsondesign.com. Please drop me a note, let me know what you think. If you have any story ideas, please feel free to drop me an email. And, please, consider In Good Health for advertising. We reach tons of people in the community.

Your Doctor

By Chris Motola

Andras Perl, M.D. Chief of rheumatology at Upstate discusses the new center for lupus and other autoimmune and inflammation disorders Q: Can you talk about the new Dr. Paul Phillips Lupus, Autoimmunity, Inflammation and Immune Health Center of Excellence (PLACE) in place at SUNY Upstate? A: This is a project that’s been long in coming. We’ve been working on autoimmunity for more than 25 years. This center stems from the discovery many years ago that metabolism is changed in patients with lupus. Metabolism of sugar, amino acids and other nutrients. How we process these nutrients profoundly effects how the immune system works. So we’ve been working on the pathogenesis of the disease and we’ve discovered some biomarkers that can tell you what’s wrong in the immune system. We focused on metabolic pathways and used these markers to understand how the disease develops, how it spreads and how to provide treatments for it. We conducted clinical trials studying these metabolic defects, which apparently work. So this center will allow us to expand our studies and conduct clinical trials starting with lupus, but perhaps eventually other autoimmune diseases. Q: I’m not sure laypeople have a great idea of what lupus is. There was even an enduring joke on television about how any mysterious symptom could be lupus. What is it? A: Yes, it is poorly defined, but it’s defined enough to the point where someone like me, who knows about it,

Wagner Dotto is In Good Health’s publisher and editor. To contact him, send an email to wagnerdotto@ gmail.com. Page 6

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

can diagnose a patient without much problem, but many people can’t. So we have that clear definition of what it is, but different patients with lupus might look very different from one another. That’s because the disease can affect almost any organ in the body. In some individuals it may affect the kidneys, but not the skin or joints. In another it may affect the musculoskeletal system. So it’s not so much that it’s hard to diagnose as that it’s underdiagnosed. And by the time it’s diagnosed, it may have caused a lot of damage. So the whole idea is to better understand the disease and develop better criteria for helping get patients diagnosed. There are a lot of patients who would have been diagnosed had they been referred to a rheumatologist. So one of the things we’d like to do at the center is to increase awareness and hold lectures for general practictioners. for?

Q: What symptoms do you look

A: There are two groups of autoimmune diseases. One is systemic, involving more than one organ of the body. The other affects are confined one organ. An example of that would be Type 1 diabetes, which is confined to the pancreas or MS [multiple sclerosis]. Systemic diseases include lupus and rheumatoid arthritis. So these conditions have particular symptoms. Patients with MS will have neurological symptoms. Diabetic patients will have problems with their blood sugar. Patients with

lupus could have symptoms of any of the individual diseases. I’ve had patients diagnosed with multiple sclerosis who actually had lupus. One of the early signs you can see with lupus would be arthritis or a photosensitive rash that people notice. Problems with the kidneys might go unnoticed. Q: Autoimmune diseases seem challenging to treat since you have to supress the immune system to do so, which leaves patients more vulnerable to infections and cancers. How do you work around that? A: So if you consider the pathogenesis you have to look at what part of the immune system is affected. Depending on the arm of the immune system affected, if you understand the disease, you can specifically block those. Conventionally we use cytotoxic drugs that can open up the body to infections, and there are still uses for those drugs. But the newer interventions can more specifically target arms of the immune system. Q: Since these diseases have a large genetic component, why do they persist? Did they have an advantage at one point? A: Very good question. There must be something, right? Why did they survive? We don’t have a very good answer, but take lupus. Lupus is more common in women and much more common in African American women. It is thought that it’s more common because it may have been beneficial to have a more hyperreactive immune system to counter infectious diseases like malaria. But when there’s no malaria, it may turn on itself. We find the autoimmune response is activated by another virus, which is then retargeted to the self. But the causes are multifactorial. Definitely genes play a role, but there are environmental factors like viruses that play a role. Q: You mentioned viruses. Are these activating the trait in people already disposed to it? A: So, yes, viruses have been implicated as initial triggers. One is the Epstein-Barr virus, which can’t be eliminating from the body after you’ve been infected. I’ve been looking for years for patients with lupus who are Epstein-Barr negative and I have yet to find one. But I believe it’s a very important causative agent. Lupus causes organ damage overtime in flares, during which organs are scarred. So a question becomes “what causes these flares?” We believe herpes viruses can be involved, for example. So the organism that initiated the disease and the one causing flares could be different.

Lifelines Name: Andras Perl, M.D., PhD Position: Chief of Rheumatology at SUNY Upstate Medical University Hometown: Budapest, Hungary Education: Semmelweis Medical University; University of Rochester Affiliations: Upstate University Hospital Organizations: American Association for the Advancement of Science; American Association of Immunologists; American College of Rheumatology Family: Wife; three children Hobbies: Rowing, biking

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Healthcare in a Minute By George W. Chapman

Survey Shows Toughest Healthcare Jobs to Fill


f the top 10 hardest jobs to fill in the U.S., half are in health care, according to CareerCast, which took into consideration Bureau of Labor forecasts, trade association data, graduation rates and their own job listing database. No. 4 is home health aide. No. 6 is medical services manager. No. 7 is nurse practitioner. No. 8 is personal care aide. Coming in at No. 9 is physical therapist.

Top US Hospitals. None from NYS IBM Watson Health just released its top 100 hospital list. A total of 2,840 hospitals were graded on publically available clinical, operational and patient satisfaction data to create a balanced scorecard. The 100 best hospitals outperformed the rest of the pack in survival rates, complications, infections, length of stay, ED wait times, patient satisfaction and expenses. Ohio led the way with 15 hospitals in the top 100. Texas was second with nine hospitals, followed by third place Illinois with eight hospitals making the top 100. New York state had no hospitals in the top 100.

Value-based medicine In a move toward paying physicians for outcomes or value versus just plain volume, new Health and Human Services Secretary Alex Azar proposed a four-point plan. 1. Give control of the patients’ records to patients. Poor interoperability among the many electronic record systems out there makes it almost impossible for patients to have control of their own information. 2. Establish

incentives for providers to be more transparent about their fees. Because of higher deductibles and out-ofpocket expenses, consumers are more price-conscious. 3. Use Medicare and Medicaid to drive change. Commercial insurance companies are not getting it done and Azar knows they tend to mimic/follow Medicare’s lead. 4. Reduce regulatory burdens. Frankly, most providers would be thrilled if the government would simply stick to a set of regulations rather than constantly changing them.   Another huge merger Not to be outdone by the announced, but unapproved, merger of Aetna and CVS, Cigna has announced it will buy Express Scripts for $67 billion. The companies in both mega mergers are promising more services for consumers at thousands of locations; increased collaboration and coordination of care with providers; and additional opportunities for personalization via data analytics. Insurance companies are aggressively taking matters into their own hands, virtually wresting control away from providers.  

Top exercises Running is tough on both joints and digestive system. The Harvard HealthBeat Newsletter suggests five other types of exercise, three to four days per week, for losing weight, strengthening muscles and improving mental health. 1. Swimming, considered the perfect exercise, for 30-45 minutes per day. 2. Tai chi. 3. Strength training using weights or your own body weight. 4. Walking 30 to 45 minutes. 5. Kegel exercises.    VA in NYS Veterans are allowed to receive care from community providers when timely care cannot be received from the VA system. But according to a survey of 746 community providers by the RAND Corp, only 2 percent of civilian or private providers say they can accommodate veterans in timely manner. NYS ranks fifth in the number of veterans served. Spending for NYS veterans exceeds $6 billion annually. There are over 900,000 vets living in NYS.    ACA hanging in Despite repeated attempts to repeal or sabotage the Affordable Care Act, it remains the only viable option for individuals seeking health insurance. A recent poll by the Kaiser Foundation found that 54 percent of us have a favorable view of the ACA. Currently, about 20 million people are covered by the ACA. Seven million purchase private insurance on the exchanges and 13 million people are eligible through Medicaid. Seventy percent of survey respondents feel non-disabled Medicaid recipients should be required to work. Meanwhile, a bipartisan congressional committee is scrambling to stabilize the insurance market that has been disrupted by the repeal of the mandatory requirement to have insurance April 2018 •

and the continued uncertainty in the marketplace. Insurance companies have until this summer to decide if they will continue to participate in the exchanges in 2019.   Healthy Cities WalletHub used 40 metrics to grade US cities on healthy lifestyles. According to them, the top 10 healthiest cities are: No. 1 San Francisco. No. 2 Seattle. No. 3 Portland, Ore. No. 4 San Diego. No. 5 Washington, D.C. No. 6 Burlington, Vt. No. 7 Scottsdale, Ariz. No. 8 Honolulu. No. 9 Irving, Calif. No. 10 Denver. The top 10 unhealthiest cities are: 1. Brownsville, Texas. No. 2 Laredo, Texas. No. 3 Augusta, Ga. No. 4 Shreveport, La. No. 5 Gulfport, Miss. No. 6 Fort Smith, Ark. No. 7 Detroit. No. 8 Jackson, Miss. No. 9 Corpus Christi, Texas. No. 10 Memphis.    Telemedicine/telehealth Congress has passed a law, whose acronym is CHRONIC, expanding Medicare reimbursement to providers for telemedicine. The committee that drew up the law felt Medicare was far behind when it came to embracing available the technology which will both save money and get critical services to remote rural areas. It is expected that most commercial plans will follow suit.    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 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

April Showers Bring May Flowers... and So Much More!


h, the promise of spring! The warmer weather makes me want to bust open my windows and break out my “spring cleaning” supplies. I’m ready to pull on my rubber gloves and get busy. But scrubbing my tubs is only part of it. Creating a clean, soothing and safe haven for myself after my divorce was an essential part of starting my life over as a woman on her own. Intuitively, I knew I needed to walk through my new front door and into my very own “warm hug,” a place where I would be embraced and inspired by all things familiar and friendly. So I set out to create a retreat — a personal sanctuary where I could feel safe, sound and at peace. It was what I needed at the time. Now, years later, my home has evolved into much more than just a nurturing place. My living space became a pallet of personal expression where I gained a true appreciation for the value of having space to create and live freely, as Virginia Woolf

explored in her enlightening book titled, “A Room of One’s Own.” With yourself as your sole guide and decorator, your kitchen, living room and bedroom can become portraits of your values, your loves, and your life. Making a home your own becomes an adventure in autonomy and a chance to explore and express — perhaps for the first time in your life — your own tastes unleashed, without compromise. It can be liberating. Energizing. Even healing. One of the first things I did when I bought my own home (after I tore out the grass-green shag carpet!) was to frame and display photographs of my family and friends. I wanted to see their faces when I entered a room and to be reminded of good times and the love that surrounds me. This was just the beginning of a series of decisions that made living alone in my own space not just pleasant, but lovelier and more wondrous than I could have imagined. Paying attention to your sur-

roundings can have an immediate and lasting impact on how you feel about yourself and about living alone. What better time than now to put out the welcome mat and make your home your own. Here are some tips: n Follow your heart. You’re on your own now. There’s no one around to second guess your decisions or rain on your preferences. You are free to express yourself in the colors you choose, the fabrics, the art and the accessories. Don’t know where to start? Look at your wardrobe. There, you’ll find a reliable reference for your style and tastes in color. n Decorate with your senses. Is the hollow sound of loneliness bouncing off your walls? Is there a musty smell wafting up from the basement? Are your counter tops sticky to the touch? When I started paying attention to more than just visual aesthetics, my home became even friendlier territory. Transform your solitary space by creating a beautiful atmosphere filled with lovely music, pleasing aromas, and clean surfaces. n Banish the negative. If something makes you feel bad when you look at it, either get rid of it or repair it. Ratty dishtowels, old lampshades, faded curtains: Their very existence in your home can dampen your mood and erode your self-esteem over time. Don’t underestimate the negative power of unsightly or outdated objects. n Exhibit the positive. On the other hand, surround yourself with images and objects that lift your spirit and reinforce who you are or want to become. Photos of loved ones work for me. So do fresh flowers and original pieces of art I collect on my travels.

I believe in the symbolic nature of objects and find inspiration in what fills my home. n Reduce the clutter. Closets crammed with forgotten clothing, drawers loaded with useless stuff, dark corners made darker by a tower of boxes — all of these contribute to negative energy, according to the tenets of feng shui, the ancient Chinese practice of organizing space to achieve harmony and balance. In the same vein, the Danish philosophy of hygge promotes a way of life that embraces coziness and well-being. Similarly, Sweden advances the virtues of moderation and balance in a new lifestyle trend call lagom, which captures the Goldilocks principle of “not too little, not too much, just right” for any given moment, gathering or situation. I’m intrigued by all these concepts and have incorporated bits and pieces of each into my life. It’s made a positive difference; I encourage you to check ‘em out. Your home can become an oasis of independence and autonomy — a place that’s unconditionally yours, absent of compromise. Claim it. Fill it with who you are. Because once you make your personal space your own . . . there’s no place like home!

attainment, which in turn was related to greater occupational prestige and income later in life,” she said in a journal news release. “This study highlights the possi-

bility that certain behaviors at crucial periods could have long-term consequences for a person’s life,” she said.

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

s d i K Corner

Success in High School, Success Later in Life


eing a good student in high school seems to translate into a better job and higher pay down the road, a new study suggests. “Our research found that specific behaviors in high school have long-lasting effects for one’s later life,” said study lead author Marion Spengler. Those behaviors and achievements included being a responsible student, being interested in school and having good reading and writing skills. The results? Occupational success decades later. Specifically, having a better job both 11 years and 50 years after high school, the study found. The finding came from an analysis of data on Americans who were high school students in 1960, inPage 8

cluding follow-ups on nearly 82,000 of them in 1971 and on about 2,000 people again in 2010. The study found that positive high school factors were associated with higher income 50 years later, regardless of the person’s IQ or their parents’ income. The findings were published Feb. 26 in the Journal of Personality and Social Psychology. “Educational researchers, political scientists and economists are increasingly interested in the traits and skills that parents, teachers and schools should foster in children to enhance chances of success later in life,” said Spengler, who’s from the University of Tubingen in Germany. “Student characteristics and behaviors were rewarded in high school and led to higher educational

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

CancerEXP_IGH_half.qxp_Layout 1 3/28/18 3:21 PM Page 1


CLOSE TO HOME Massage therapist Margaret Miner working with some of her clients at her studio in Oswego. She has recently become a “nutritious movement-certified restorative exercise specialist” and now offers a program that begins to change “bad muscle habits” that cause pain and damage to bodies.

Oswego Therapist Now Offering ‘Restorative Movement’ Specialized approach works to change bad muscle habits that cause pain, damage to bodies By Maria Pericozzi


argaret Miner, licensed massage therapist in Oswego, is one of only three restorative exercise specialists who are presently teaching in the Central New York area. Two years ago, Miner discovered nutritious movement training, which is a program that begins to change “bad muscle habits” that cause pain and damage to bodies. It does this through learning alignment principles and using specific movements. Miner became a nutritious movement-certified restorative exercise specialist through the Nutritious Movement Institute in Sequim, Wash. “I first discovered it after I was having issues with my knee and foot, making it very difficult to hike,” said Miner. “For me, it sounded like a program to make myself better, and it did work.” Miner said she got thinking about her massage clients who have issues and mystery pains, and she decided to become an instructor to help them. “For me, it is one more thing to add to my services,” Miner said. “Some people just want massages, while other people ask, ‘What can I do to help myself?’” Miner has lived in Oswego her entire life. She has been a licensed massage therapist for 18 years, working with Strands & Essence Salon and teaching classes at North Coast Yoga. She opened her own studio in February, located at 22 W. Oneida St., Oswego. At her studio, she offers many different massages in half-hour and one-hour sessions, as well as onehour sessions of restorative movement.

Private restorative movement sessions are $75, and group sessions are $15 per person. Katy Bowman, the woman who launched the nutritious movement, is a biomechanist who looked at movement from a biomechanical standpoint, studying the external and internal movements on the body. “It’s not just if you can stretch and how far you can stretch,” Miner said. “It is often how you get into it.” During class, Miner breaks down how students move, and tries to develop strength and flexibility in muscles that have not been used, improving quality of movement. “Katy likes to describe it as, ‘Movement matters and a lot of our conditions these days are diseases of affluence,’” Miner said. “In our culture, we don’t move as much as we used to. Back in the day when we farmed, we walked everywhere. You got a variety of movements in there that were nutritious to muscle health. Now we sit there, drive, and keyboard.” Miner strives to encourage her students to practice the corrective moves she teaches. “You’re working movement into your life by changing how easy or how hard you make it to do things,” Miner said. “We like doing things the easy way, which is great, but not so great for our bodies.” Miner’s students have reacted well to restorative movement and have been supportive. “I try to encourage them, because you can always modify,” Miner said. “I can make it challenging for people who find it easy. For people who are struggling, we can make changes to make it easy.”

If you’re facing a diagnosis of cancer, turn to the experts at the Upstate Cancer Center. As the region’s only medical university, Upstate provides advanced knowledge, leading technology, greater access to cancer research and clinical trials. Here, most of our doctors are also professors at our medical school. These specialists unite their knowledge to create precise treatment plans for each patient. With offices in Syracuse, Oneida and Oswego, Upstate offers another significant benefit to patients at a challenging time — cancer care close to home.


April 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9

Chiropractic: A Promising Career Doctors of chiropractic still in high demand, with plenty job opportunities, experts say

other types of practitioners enables them to minimize overhead to make up for low reimbursements. Others forgo working with insurance companies so they can charge more realistic rates and spend the time with patients that they need. “It’s mainstream now, as far as acceptance by insurance companies and referrals by other specialists because of all the research and evidence,” Sportelli said. “Chiropractic is very efficient and cost-effective for any muscular-skeletal problem. Insurance companies are trying to make sure they’re getting their money’s worth.” He also thinks that the opioid crisis has spurred more people to seek non-medicinal pain relief. Since chiropractic employs natural, conservative methods to relieve pain and resolve patient’s issues, it can provide an answer for people with chronic pain issues. Sportelli advises recent chiropractic graduates to find a mentor and work for an experienced chiropractor. Eventually, settling on a specialty can help the chiropractor develop a following and, perhaps, a practice. “Like all medical schools, kids come out of chiropractic school with debt,” Sportelli said. “You’ve got to be very focused on what you plan on doing and getting right into the occupation and being successful in taking care of patients and giving the best treatment possible.”

By Deborah Jeanne Sergeant


tudents pursuing chiropractic degrees have every reason to look forward to a satisfying, solid career. Chiropractor J. Todd Knudsen, vice president of institutional advancement and special projects at New York Chiropractic College in Seneca Falls, said there is a growing need for chiropractors. “Alumni of our doctor of chiropractic [DC] program have a wide variety of professional opportunities from which to choose,” Knudsen said. “For example, they might decide to be a principal in a solo practice, become an associate practitioner working for another chiropractor or seek employment in a multi-disciplinary or medical practice such as a VA medical center or a regional hospital. “A DC graduate can also pursue residency training and specialize in additional areas like nutrition, sports medicine, diagnostic imaging,

orthopedics, neurology, pediatrics, teaching or spine care.” Over the past 10 years, chiropractic has developed and advanced over in many ways, including public perception. Knudsen, who is also a diplomate of the American Chiropractic Board of Radiology (DACBR) — meaning he is a certified specialist in diagnostic imaging who can order and interpret advanced imaging such as a CT scans, MRIs and ultrasounds — said that a “strong body of scientific research” shows the value of chiropractic care as an effective alternative to taking medication and undergoing surgery for the issues it treats. Many people wary of prescription pain medication, including opioids, want an alternative approach to their pain. For those whom chiropractic is appropriate, they can often resolve issues more quickly than through rest alone. Chiropractic is also integrating

with overall health care organizations such as the VA health system. “It’s a great time to get in now,” said Vincent Sportelli, doctor of chiropractic and owner of Sportelli Chiropractic Health & Wellness Center in Syracuse. “The median age of our population is getting older. Because of deterioKnudsen ration of joints and bones as one ages, there are more muscular-skeletal conditions that respond well to chiropractic. “For someone who joins as an association or starts a practice, it’s an up-and-coming profession evolving since 1895. I see nothing but a good future.” For some, forming or joining a practice with massage therapists and

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

Median Salary for Chiropractors: $67,520 Tuition and fees to become a chiropractor at New York Chiropractic College in Seneca Falls is $122,820 for the standard 10-semester program. The alumni have a .8 percent rate of student loan default. Studentloandebt.com states that the rate is 11.35 overall for two- and four-year schools nationwide and 8.05 for New York. The Bureau of Labor Statistics’ outlook for chiropractors is 12 percent job growth nationwide from 2016 to 2026, compared with 7 percent for all jobs. The median pay nationwide was $67,520 in May 2016. New York’s annual mean wage for chiropractors is $90,570. In the Rochester area, it’s $67,880; in Western New York and it’s 63,380. No data was available for Syracuse / Central New York.

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of typically developing individuals differ from those on the Autism Spectrum!

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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

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April 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

• Page 11 2/22/18 4:10 PM

My Turn

By Eva Briggs

Dealing with a Person with Dementia


p to 75 percent of people with dementia have behavior changes that could drive even the most patient caregivers bonkers. They might have delusions, an insistent belief in something irrational and false. My friend’s father, married for more than 60 years, became convinced that his devoted wife was trying to steal their home and boot him out into the street. Some people have hallucinations: seeing, hearing or feeling something that simply isn’t there. Hallucinations could be frightening events, visions of the past or reliving old experiences. Another disturbing behavior is wandering. I belong to a search and rescue team, and have seen some tragic outcomes. Wandering dementia patients often keep going for surprising distances until meeting a physical barrier like a cliff or impenetrable brush, before stopping. Anger, agitation and aggression affect some patients. All of the above contribute to caregiver exhaustion and burn out. There is no easy fix. Medicines — more about them at the end of this article — are best used only after nondrug strategies fail. Dementia behavioral issues aren’t rational. No amount of reasoning or explaining will help. When you start to feel frustrated, remember that your loved one isn’t deliberately trying to be mean or difficult. n Step 1 — Rule out physical or psychological stressors that trigger problems: hunger, thirst, pain, nausea

or toileting difficulties. Is the patient sleep deprived, fatigued, depressed, lonely, bored or over stimulated? Is the room temperature too hot or too cold? Is there excessive background noise? Is lighting inadequate? Any of these could spark emotional meltdowns. n Step 2 — Strive to establish routines. Predictable patterns — for eating, bathing, toileting, dressing, medication administration, sleep, and socializing — are calming. n Step 3 — What can you do when a dementia patient becomes agitated or argumentative despite your efforts to ensure comfort and routine? Arguing or repeating explanations goes nowhere. Redirection, turning the patient’s focus to something different or distracting, works better. n Step 4 — Try to remain calm, confident and agreeable. The patient isn’t logical. So your response to an agitated patient doesn’t have to be logical so much as agreeable. The hundredth time that someone says, “Is it time to eat” shortly after a big meal or asks, “When are we going home?” you can smile and say “OK, we’ll have lunch in a bit” or “We’ll be going soon, in the meantime how about we take a walk?’ n Step 5 — Consider starting a conversation about his or her interests. Ask the patient for help with a simple task such as folding towels. Perhaps redirect the patient toward simple exercise or activity. n Step 6 — Limit choices to two options rather than asking unlimited open-ended questions. Avoid argu-

ing, ignoring, raising your voice, shaming, or demanding. To make the environment safer, remove firearms and weapons. Add locks, alarms or tracking devices as needed for wanderers. Of course none of this is easy. Sometimes medication adds to (rather than substituting for) behavioral measures. There is only limited evidence that psychiatric medicines benefit dementia patients. Side effects can cause harm. No medicines are FDA-approved for treating behavior problems in Alzheimer’s patients. Reserve drugs for behaviors that could harm the patient or others: physical assaults, verbal assaults or dangerous wandering. Antidepressants may relieve for depressed mood, anxiety and irritability. Antipsychotics have been tried for hallucinations, delusions, aggression, agitation and uncooperativeness. Antipsychotic medicines increase the risk of stroke or death in

patients with dementia, and are used with extreme caution in the lowest possible dosage for as short a time as possible. Any medication should be directed toward specific symptoms that can be monitored to determine effectiveness. Only one medicine should be started at a time, and at the lowest possible dose, and adjusted slowly. Check out the Alzheimer’s Association website for more information. www.alz.org/care/ Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

Chronic Prostatitis: One of the Most Common Urologic Problems By Sergey Kravchick, M.D.


hronic prostatitis is very common in men aged 36 to 50 and is the most common urologic problem in men younger than 50 years of age — and the third most common urologic problem in older men. According to the National Institutes of Health, the prevalence of prostatitis was 10 percent in a population of men aged 20-74 and accounted for approximately 6 – 8 percent of all urological visits in the United States. The predominant symptom of chronic prostatitis is pain, which is most commonly localized to the perineum, suprapubic area, and penis, but can also occur in the testes, groin or low back. Patients also suffer from urgency, frequency, hesitancy, and poor interrupted flow, while some men also experience pain during or after ejaculation.

Diagnosis Chronic prostatitis is subdivided into two groups: chronic bacterial prostatitis (CBP) and chronic pelvic Page 12

pain syndrome (CPPS). The former accounts for only 5 –10 percent of men with symptoms of prostatitis and is most often caused by Escherichia coli or other gram-negative Enterobacteriaceae. Analysis of urine specimens and prostatic fluid was used to confirm the diagnosis. Currently this test was substituted for a more cost-effective “two-glass test,” in which urine is sent for culture before and after prostatic massage. Positive bacterial cultures in the post-massage sample is the main diagnostic criterion for CBP. The diagnosis of chronic pelvic pain syndrome (CPPS) assumes no proven infection or other obvious local pathology that can cause pain. Careful examination and palpation of external genitalia, groin, perineum, coccyx, external anal sphincter (tone), internal pelvic floor and side walls may pinpoint prominent areas of spastic myofascial pains. These painful trigger points help make the diagnosis and develop treatment plans.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

Treatment Antibiotics are still the most commonly prescribed treatment for the chronic prostatitis, including bacterial and non-bacterial forms. In patients with bacterial prostatitis antimicrobial therapy helps to eradicated infection, while it may benefit CPPS patients by a strong placebo effect, the eradication or suppression of microorganisms that failed to be cultured, or the independent anti-inflammatory effect of some antibiotics. Thus, antibiotics could be considered empirical treatment for CPPS, but their benefits should be appraised after a minimum of 2 to 4 weeks of therapy. Treatment with alpha-blockers (terazosin, alfuzosin, doxazosin and tamsulosin) has shown significant improvement in pain and voiding symptoms. In addition, treatment with anti-inflammatory drugs can further decrease pain, including pain during and after ejaculation. Although the role of phytotherapy in patients with chronic prostatitis is still controversial, recent systematic review and meta-analysis found that this treatment can significantly

decrease pain scores. For patients with chronic prostatitis and dysfunction of the pelvic floor muscles, it is very helpful to learn how to relax the muscles when the pain starts. Physical therapy helps patients with pelvic floor pains to stretch the muscle and interrupt the circle of pain-spasm-pain. This can be combined with manual facial trigger point release and low-energy extracorporeal shock wave therapy. Upstate Urology offers these treatment modalities to patients with chronic prostatitis.

Physician Sergey Kravchick specializes in general urology, endourology, male health: chronic prostatitis/chronic pelvic pain syndrome and testicular pain and practices at Upstate Urology at UHS and Wilson Hospital in Binghamton, NY. Kravchick

When it Comes to Tobacco Prevention, NYS Gets an ‘F’ Budget to fight tobacco use in New York state only 20 percent of CDC’s recommended amount, says report


he American Lung Association has given New York state an F grade for tobacco prevention and cessation funding, as part of its newly-released 2018 State of Tobacco Control report. The state’s 2018 funding for tobacco control programs is just over $39 million, which is only 20 percent of the CDC’s recommended $200 million for state tobacco control programs. “While $39 million may sound like a lot, that funding is spread very thin across the state as we and other similar organizations work to prevent tobacco use and help users quit their tobacco addiction,” said Christopher Owens, director of the Central New York Regional Center for Tobacco Health Systems at St. Joseph’s Health. “And while our funding has remained the same, the need for these services has grown in recent years as more teens are starting to use tobacco products and more of our addicted residents are looking for help in quitting.” The Central New York Regional Center for Tobacco Health Systems at St. Joseph’s Health is one of nine NYS Department of Health Bureau of Tobacco Control grant funded programs for Tobacco Health Systems, and receives only 1.5 percent of the state funding for tobacco control programs. The local center promotes evidence-based methods and treatments that help tobacco users quit, working with health care organizations across 14 counties in Central and Northern New York to implement systems to screen patients for tobacco use and assist clinicians in treating patients who struggle with tobacco addiction. In the 2018 ALA report, New York received an A grade for smokefree air, a B grade for tobacco taxes, a C grade for access to cessation services, and a D grade for Tobacco 21. A local coalition of hospitals and other organizations spent the past year advocating for Tobacco 21 legislation to raise the age for sale of tobacco to 21. The law was passed in Onondaga County in December 2017, and Onondaga is one of a dozen counties in the state to have passed Tobacco 21. But New York received a D grade because this legislation has not yet been passed at the state level. In New York, smoking is prohibited in government and private workplaces, schools and childcare facilities, restaurants and bars, retail stores, and recreational and cultural facilities. And New York is tied with Connecticut for having the highest state cigarette tax in the country.


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The skinny on healthy eating

Brown Rice Bursts with Health Benefits


ike many baby boomers, I grew up on white rice — at home, in restaurants, at the school cafeteria. And since I saw it as a backdrop to whatever was ladled on top, I never thought twice about its nutritional value, besides being starchy and filling. These days, I always consider what I consume, which is why, when it comes to rice, I only eat the wholegrain version: brown rice. While white rice certainly has some nutritional merit — as it’s enriched with some of the nutrients it loses in the milling process, like thiamine, folate, and iron — it pales in comparison to its tawny cousin. Brown rice, which hasn’t been stripped of its husk, bran and germ, is a good source of fiber, providing about 3.5 grams of fiber per cup (comparable to oatmeal). Current research shows fewer incidents of heart disease, diabetes and cancer in people who eat diets high in fiber. What’s more, people who eat more high-fiber foods tend to be thinner than those who don’t and also have lower blood pressure and cholesterol counts. Health-promoting antioxidants, which abound in the bran portion of a whole grain and help thwart the damage caused by free radicals, reign supreme in brown rice. According to the Harvard T. H. Chan School of Public Health, abundant evidence suggests that eating whole fruits, vegetables, and whole grains — all rich in antioxidants —

provides protection against cell-damaging free radicals that contribute to many chronic diseases, including cancer, heart disease, Alzheimer’s, and vision loss. Brown rice is an outstanding source of manganese, an essential mineral that plays an important role in bone health, energy production, nutrient absorption and blood-sugar regulation. A powerhouse antioxidant with anti-inflammatory properties, manganese is a widely known remedy for the treatment of sprains and arthritic symptoms, despite no reliable evidence as yet to indicate that it actually helps. Can you eat rice if you’re watching your carbs or have diabetes? Although no rice can really be considered a low-carb food (one cup of cooked brown rice has about 45 grams), whole-grain brown rice is healthier than refined white rice. Thanks to its fiber and protein, which both slow the absorption of glucose into the blood, brown rice contributes to more stable blood sugar levels. Switching to brown rice may also lower your risk of developing Type 2 diabetes, according to a Harvard School of Public Health study. All rice is contaminated with inorganic arsenic (a carcinogen), whether brown, white, organic or conventional. Brown rice has the most, however, which is something to consider if arsenic concerns you. While the Food and Drug Administration has set a limit on the amount of inorganic arsenic allowed in infant

rice cereal, they have not set a limit on the amount of rice adults should eat, recommending instead that adults maintain a diet that includes a variety of whole grains to minimize any health risk. Many experts agree that the levels of arsenic in rice are only a concern if you’re eating multiple servings of rice every day.

Place the rice into a sieve and rinse under cold running water; drain. Put rice and 4 cups of water in a large saucepan and bring to a boil over medium-high heat. Reduce heat to low and simmer, covered, until the rice is tender and most of the liquid has been absorbed, about 45 minutes. Let stand 10 minutes, then fluff with a fork. For the dressing, put all the ingredients into a glass jar and shake well to combine. Combine the cooled rice and remaining ingredients in a large bowl. Add the dressing and mix well. Let stand for at least 15 minutes for the rice to absorb all the flavors. Taste; adjust seasonings; add more oil, if needed.

Helpful Tips

Brown Rice Salad with Crunchy Vegetables Adapted from the Naked Food cookbook; serves 6 2 cups brown rice 4-5 scallions, thinly sliced, including light green parts 1 red pepper, chopped 1 green pepper, chopped 1-2 carrots, shredded 1 cup slivered almonds, toasted 1/2 cup flat-leaf parsley, finely chopped Dressing: 1-1/2 tablespoons olive oil 1 tablespoon sesame oil 1 tablespoon soy sauce 2 tablespoons lemon juice 1 tablespoon balsamic vinegar 1-2 garlic cloves, finely chopped Crumbled feta (optional) coarse black pepper and salt, to taste.

Those concerned about arsenic levels should (1) first rinse their rice; (2) cook their rice in six times the normal amount of water, which reduces the arsenic level by about half, according to the FDA; and (3) buy brown basmati rice from California, India or Pakistan, according to Consumer Reports. Store uncooked brown rice in the refrigerator or freezer in an airtight container: brown rice should last 6 months in the fridge and up to 2 years in the freezer. Store cooked brown rice in the fridge for up to 3 days.

Anne Palumbo is a lifestyle colum-

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

Drinking 100% Fruit Juice Leads to Weight Gain: Study Data from more than 49,000 women concludes that drinking 100 percent fruit juice leads to weight gain, while consumption of fresh whole fruit results in weight loss


he study, led by Brandon Auerbach, an internal medicine and primary care physician at Virginia Mason Medical Center, was posted online Jan. 9 by Preventive Medicine. “American adults gain an average of one pound per year, and it is a public health priority to determine which foods and beverages contribute the most to this gradual weight gain,” the report states. Specifically, this study analyzed data from 49,106 women in the United States enrolled in the Women’s Health Initiative between 1993 and 1998. Food-frequency questionnaires assessed food and beverage consumption, while their body weight was measured during in-person clinic visits. The study found that an increase of one six-ounce serving of 100 percent fruit juice per day was associated with a modest amount of Page 14

long-term weight gain. The average weight gain of 0.4 pounds (6.4 ounces) per person over three years was similar to two earlier published studies on this topic. This amount of weight gain was also similar to weight gain associated with increasing regular soda consumption (0.6 pounds or 9.6 ounces). On the other hand, increasing consumption of whole fruit by one serving per day resulted in the loss of 0.9 pounds (14.4 ounces) over three years.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

“It is biologically plausible that drinking 100 percent fruit juice is associated with long-term weight gain,” the study concludes. “One six-ounce serving of 100 percent fruit juice contains 15-30 grams of sugar, 60-120 calories, little or no dietary fiber, and has a moderately high glycemic load. Even high-pulp, 100 percent orange juice is not a significant source of dietary fiber.” The study’s findings support recommendations of the “2015-2020 Dietary Guidelines for Americans”

that individuals should drink 100 percent fruit juice in moderation and choose whole fruits over fruit juice when possible. “Adults should have at least two servings of fruit a day, ideally more,” Auerbach said. “Even though 100 percent fruit juice has lots of vitamins, minerals and nutrients like antioxidants, it’s really better to get your daily fruit in the form of whole fruit. Especially for adults trying to lose weight, 100 percent fruit juice is not your friend.”

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Which Medications Work Best to Deal with Your Spring Allergies? And how much do you need to take to be effective?


ow much suffering is too much when it comes to spring allergies? Anyone who has moderate to severe seasonal allergies knows that when you reach a certain point — when your itchy red eyes, runny nose and sneezing become overwhelming — you need relief. But what does relief look like and how do you get there? “Bottom line, very few people suffer from the same allergies or symptoms,” says allergist Bradley Chipps, president of the American College of Allergy, Asthma and Immunology (ACAAI). “You have to

create a personal treatment plan by first avoiding the things you’re allergic to, and then treating your specific symptoms. The question for many people is whether over-the-counter remedies are enough, or if prescription medications are needed.” According to a new practice guideline from the Joint Taskforce on Practice Parameters, more medications aren’t necessarily the way to go. Nasal steroid sprays are extremely effective and easy to get. They’re also relatively inexpensive and don’t have a lot of side effects. They are a good place to start for those over the age of

12, according to the guidelines. “The guidelines recommend nasal steroid sprays as the first line of defense instead of an oral antihistamine,” says allergist physician Dana Wallace, past ACAAI president and co-author of the guideline. “The task force didn’t find evidence of better results if oral antihistamines were added to treatment along with the nasal steroid sprays. And oral antihistamines can cause sleepiness.” For people with moderate to severe seasonal allergies who are older than 12, the guidelines suggest adding an intranasal antihistamine

spray to treatment along with a nasal steroid inhaler. The additional medication provides added benefit for those with more severe allergies. Allergists advise people to start taking medication two to three weeks before symptoms normally start. According to ACAAI, if you begin your allergy medications before the worst symptoms hit this spring, your suffering won’t be as bad. Although people think spring starts in April, symptoms can begin earlier in warmer areas. Keep in mind when your symptoms normally appear and start your medication well in advance. Many people go in search of “natural” remedies. They might not know that immunotherapy — in the form of allergy shots and tablets — is a very natural treatment. During allergy shots, you are given gradually larger doses of your exact allergens. The slow increase causes your immune system to become less sensitive, which reduces future allergy symptoms. Allergy tablets, taken under the tongue, are available to treat pasture grasses, ragweed and house dust mite and, to be effective, must be started 8-12 weeks before the allergy season starts.

Find a Mental Health Care Provider You Can Trust By Kimberly Blaker


t least 100 million people currently living in the United States will, at some time in their lives, experience problems in relationships, become depressed or develop anxiety so serious that they will merit psychiatric diagnosis and would benefit from the services of a mental health care professional, according to Larry E. Beautler, Bruce Bongar, and Joel N. Shurkin in “A Consumer’s Guide to Psychotherapy: A Complete Guide to Choosing the Therapist and Treatment That’s Right for You.”  Unfortunately, countless mental health care professionals lose their licenses each year as a result of patient abuse, sexual misconduct, fraud, substance abuse, unlicensed practice, medication violations and more. Should you be faced with a crisis, know how to find a reputable mental health care provider with the expertise you need and that you can trust. Finding a trustworthy, reputable therapist Most mental health care professionals adhere to ethical guidelines. But as with any field, there are always exceptions. So know how to screen. Begin your search by asking family or friends for recommendations or obtain a referral from your primary care doctor. You can also contact area clinics for recommendations or consult your yellow pages or online directory. Phone three or four therapists and ask about their credentials, policies and treatment methods. The following are good questions to ask: • What are your areas of expertise? • How much experience do you Page 16

have with my particular issues? • Are you licensed or certified by the state? • Has your license ever been suspended or revoked? If so, can you tell me about the situation? • What are your professional affiliations? • What forms of treatment and therapy do you provide? What evidence is there to support its effectiveness? Is there controversy among mental health care professionals regarding this treatment? • What are your fees? Do you accept my insurance or work on a sliding scale? If you can’t get answers to these basic questions over the phone, look elsewhere. If you’re satisfied with the therapist’s responses, check with your state-licensing department to verify the license status and to make sure no actions have been taken against the therapist. Evidence-based practice Once you begin therapy, complications could still arise. According to Beautler, Bongar, and Shurkin, therapists who base their beliefs on personal experiences often reject scientific findings that don’t coincide with their beliefs. As a consumer, do your research to assure the validity of your diagnosis or form of therapy or treatment. If you discover contradictions from reputable sources, discuss it with your therapist. It may be a simple misunderstanding or data of which your therapist was unaware. If your therapist rejects the information, ask why and determine if the reason is valid or is based on personal opinion.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

If it’s preventing you from obtaining a proper diagnosis and/or treatment, find a therapist that recognizes those findings. Though rare, unethical therapists have been known to misdiagnose for financial gain. More common, those with questionable practices may recommend unnecessary, inappropriate, outdated or unproven treatments. That said, “Your therapist is obligated not to take advantage of you, either intentionally or unintentionally through negligence or ignorance, and to act only in your best interests,” explain Jack Engler, Ph.D. and Daniel Goleman, Ph.D. in “The Consumer’s Guide to Psychotherapy: The Authoritative Guide for Making Informed Choices About All Types of Psychotherapy.” Mental health care ethics There are certain rules set by state licensing divisions as well as the American Psychological Association and other mental health associations providers must follow. Be aware that mental health care providers may not: • disclose information about you without prior written consent or even verify that you are being seen by the therapist except under certain situations, such as when child abuse is reported. • suggest that you do something that is undeniably harmful, immoral or illegal. • treat you for or offer services that are outside his or her area of expertise. • offer experimental or unproven therapies without informing you of such. • make sexual advances whether

you approve of them or not. • treat you if you have any kind of relationship with the therapist outside of therapy. • degrade you because of your values or problems or pressure you to change them. These are only some of the ethics therapists must uphold. Handling ethics violations and negligence If you feel your rights have been violated or your therapist has treated you with negligence, there are several options according to Engler and Goleman. If the violations are minor, you might want to discuss the problem with your therapist. You can also seek a second opinion to determine whether it’s a misunderstanding or a valid complaint. If your complaint seems valid and is serious enough, you can file a formal complaint with the appropriate ethics committee or with the state licensing or certification board. This is an important step if there’s concern that someone else might be harmed by the therapist’s practices. Finally, if your therapist acted negligently, rather than just unethically, a civil malpractice suit may be in order. Remember though, most people have positive experiences with their therapist. By being aware of unforeseen problems and taking precautionary steps, you’ll reduce the risk of a negative experience. Kimberly Blaker is the author of a kid’s STEM book, “Horoscopes: Reality or Trickery?” She also writes a blog, “Modern FamilyStyle” at modernfamilystyle. com.

Women’s Health

For the First Time, Women Outnumber Men in Med School ‘Notable milestone,’ says president of Association of American Medical Colleges By Deborah Jeanne Sergeant


n 2017, more women entered medical school than men for the first time, according to the Association of American Medical Colleges (AAMC). Last year, women represented 50.7 of new medical school enrollees, compared with 49.8 percent the year before. “We are very encouraged by the growing number of women enrolling in U.S. medical schools,” said physician Darrell G. Kirch, AAMC president and CEO in a press release. “This year’s matriculating class demonstrates that medicine is an increasingly attractive career for women and that medical schools are creating an inclusive environment. While we have much more work to do to attain broader diversity among our students, faculty, and leadership, this is a notable milestone.” The same somewhat holds true locally at SUNY Upstate. While the percentage of women medical students is 50 percent this year — 84 women and 84 men — the growth in number of women has steadily increased over the years. In 1998, the ratio of SUNY Upstate medical students was 83 males to 70 females. By 2008, a decade later, the number of men stayed the same (83), while women increased to 77 students. Kathleen E. Dyman is the exec-

utive vice president of the Medical Societies of the Counties of Oneida, Herkimer, Madison, Chenango, Oswego, Cayuga and St. Lawrence. She said that the medical field has changed and schools are reaching out to recruit more women. Additionally, male physicians have become more open to working with women as equals, as have patients to receiving care from women. “There is greater acceptance of women in medical professions,” Dyman said. “Some patients strictly want to see a female physician.” She also believes that employment in the medical field is “more catered to family life and that’s why more women are going into it,” she said. Women bring a different perspective and dynamic to the bedside, exam table and operating room. Dyman said that in general, many women exhibit strong skills in compassion and communication — traits which they learned as young people — that they can use in the health care field. As the medical paradigm shifts to that of more patient-centered care instead of focusing on illness and disease treatment, the so-called “soft skills” which many women inherently possess, become even more valuable. Physician Ann Botash, senior

associate dean for Faculty Affairs and Faculty Development and SUNY Distinguished Teaching Professor at Upstate Medical University, said that women still have a ways to go in the medical professions. “Women continue to be underrepresented in some medical specialties,” Botash said. “Fewer women than men hold leadership positions in academic centers. Inequalities in pay continue to be an issue for many women.” Interruptions of their career to have families and care for elderly relatives compound the problem of unequal pay. Women also may not seek better-paying specialization or promotion but stay within their initial positions because of the time constraints involved with caring for their families. Dyman “Most significantly, women in medicine face subtle biases, similar to women in other careers,” Botash said. Botash referenced comments about appearance and stereotypes about gender-based roles still permeate healthcare — and both “can undermine not only career success

Physician Ann Botash, senior associate dean for Faculty Affairs and Faculty Development at Upstate Medical University said despite increase in the number of women in medical schools, women have a long way to go. “Women continue to be underrepresented in some medical specialties,” Botash says. “Fewer women than men hold leadership positions in academic centers. Inequalities in pay continue to be an issue for many women.” but also accomplishment of projects and patient care,” she said. Despite these challenges, Botash thinks that women will continue to enter medicine school in greater numbers. They have many reasons to do so, including greater financial security, an opportunity to influence society as leaders and the desire to follow in the footsteps of mentors in medicine both male and female. “The road to medicine has been paved by many strong women who have reduced the gender specific hurdles and who provide role models,” Botash said. “More than in the past, I believe girls expect to be supported in medical and scientific fields. We, as a society, are doing a better job of helping them to achieve their goals.”

10 Things Women Should Know About Heart Disease


early every minute, a woman dies from heart disease in the United States — it is the No. 1 killer of women, causing one in three deaths each year, according to the American Heart Association (AHA). When it comes to heart disease, women experience unique causes, symptoms and outcomes compared to men. In addition, certain conditions appear to increase heart disease risk in women, including pre-eclampsia and eclampsia, gestational diabetes, migraine headaches with aura, early onset menopause and autoimmune diseases such as lupus and rheumatoid arthritis. Physician Holly Andersen, at the Ronald O. Perelman Heart Institute at NewYork-Presbyterian/Weill Cornell Medical Center, and Jennifer Haythe, a cardiologist specializing in cardiac health during pregnancy at NewYork-Presbyterian/Columbia University Irving Medical Center, say more work needs to be done. Here’s why: Women are more likely to die from heart disease than men, according to the AHA.

1. 2.

Despite outreach efforts, a Women’s Heart Alliance survey of more than 1,000 women

between 25 and 60 years of age found that 45 percent of women still don’t know that heart disease is the leading cause of death for women in the United States.

3. 4. 5.

Women are less inclined to call 911 when they believe they may be experiencing heart attack symptoms. Cardiovascular disease complicates up to 4 percent of pregnancies, and that number has been increasing. Women’s heart attack symptoms are often different from men’s. They may experience shortness of breath, nausea, palpitations, jaw discomfort or overwhelming fatigue, according to the AHA.

6. 7.

Women are less likely to be referred for cardiac rehab after a heart attack.

Women’s heart disease is under-researched: only 35 percent of participants in clinical trials of cardiovascular disease are women, and just 31 percent of the studies report outcomes by gender.


Pre-eclampsia is an independent predictor of developing cardiovascular disease later in life. Women who have had pre-eclampsia should be mindful of having their blood pressure, fasting glucose and cholesterol checked annually.


Women are less likely to receive bystander CPR in public than men (45 percent in men versus 39 percent in women). Learning hands-only CPR can help save a life. April 2018 •


Recent blood pressure guidelines from the American College of Cardiology recommend all people to have a blood pressure target of 120/80 or lower. Additionally, after the age of 65, hypertension (high blood pressure) is more common in women. Stay up-to-date on your annual physical and have your doctor check your blood pressure and other cardiovascular disease risk factors.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Women’s Health The photos of are of clients of Jeanine Stevenson at Genesis II Hair Replacement Studio in North Syracuse. They show the same client over the course of 10 months.

Women Can Address Hair Thinning Hair loss affects more than 40 percent of American women; problem may be more than an appearance issue, experts say By Deborah Jeanne Sergeant


any men with thinning hair shave their heads or just accept thinning hair as part of middle age. For women, the social stigma surrounding hair thinning and hair loss can make the experience emotionally devastating. Forty percent of Americans with hair loss are women, according to the American Hair Loss Association. For most of them, it’s overall thinning, not the horseshoe-shaped pattern of baldness common to men with male pattern baldness. Nicole Capria, hair replacement technician with Profiles by Kristin in Syracuse, said that most women with thinning hair think they need a complete hair replacement, such as a wig. “They don’t know what’s

available,” Capria said. “We do an analysis during a one-on-one consultation to determine what they’re a candidate for. We determine if the client would have success with that method.” Her office provides scalp treatments, laser treatments, supplements, hair replacements, wigs and extensions. “We’re affiliated with several doctors, so we can make referrals,” Capria said. She suggests women seek medical help to rule out any health issues. Causes of hair loss could include physical stress, eating disorders, childbirth, thyroid, anemia, poly-cystic ovary syndrome, weight fluctuations, psoriasis or autoimmune or hormonal disorders. Discussing these possible factors could help find ways to decrease shedding. Jeanine Stevenson, partner at Genesis II Hair Replacement Stu-

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nutrients into the scalp. You receive simple injections and it’s your platelet rich plasma only. There’s no chance of a reaction. When doing PRP therapy injections, we do it along with hair loss control products, so it’s a multi-faceted approach.” Alopecia areata, an autoimmune disease, causes patchy hair loss on the head. Alopecia totalis bares the entire head and alopecia universalis causes all of the body’s hair to fall out. Some people see patchy regrowth and even times of remission with substantial re-growth. Patchy hair loss of alopecia is often treated with steroid injections into the places missing hair. Stevenson’s office provides hair transplantation of the clients’ own hair from a donor site where hair is thicker. Genesis II also fits clients with hairpieces made of human hair, ranging from partial to full coverage, with temporary, semi-permanent and permanent bonding. Permanent models are bonded to existing hair, similar to how hair extensions are applied. Prosthetic adhesives ensure they cannot come off. Semi-permanent pieces are removed every three to six weeks for servicing and temporary ones may be removed by clients at home. Genesis II can affix hair extensions, which can enhance the fullness of thin hair while also remaining undetectable. Stevenson urges women to “do their homework and research because everyone out there will tell you they have something that will help. You have to be the right candidate for these products.” Treatments started at the earliest signs of thinning also tend to work better. “We help you through it,” Stevenson said. “When you see it working, it’s wonderful. Women don’t have to suffer from hair loss.”

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dio in North Syracuse, encourages patients to see a doctor to explore a medical possibility for their hair loss. Some types of medication may cause thinning. Asking about alternatives could help slow shedding and restore what was lost. At her office, Stevenson begins her private consultation with a medical history and scalp analysis. Stevenson also discusses nutrition. “Everything in our body, including our scalp, needs oxygen and nutrients,” Stevenson said. “When breastfeeding or having a medical issue, the body will distribute nutrients elsewhere and the first place it pulls it from is the hair.” Androgenetic alopecia, commonly called female pattern hair loss, involves thinning on the top of the head. Women may notice their part seems wider than it used to. Usually, this happens gradually; however, an abrupt case can indicate a hormonal change. For the right candidates, she recommends all-natural alternatives to monoxodil. “If she’s in the more severe stage and the last chance for it should grow, I’ll go for something with monoxidil,” Stevenson said. Another option to help those with female pattern hair loss is cold light-based laser technology, delivered with a comb or cap to stimulate re-growth. “It stimulates blood flow and opens up the scalp to get oxygen it needs,” Stevenson said. “The laser you can use in the privacy of your home. They get significant results. I have before and after pictures. It’s amazing.” In addition to laser therapy, Stevenson’s office also offers blood platelet injections, which involve a patient’s own blood cells injected into the scalp skin to stimulate growth. “It has been proven to grow hair,” Stevenson said. “It’s a boost of

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

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When Sex is a Real Pain Many factors can cause women to feel pain during sexual intercourse By Deborah Jeanne Sergeant


or a variety of reasons, many women experience pain with sex. Sexually transmitted diseases, vaginal infections, low hormone levels, vulvar skin issues, very tight or weak pelvic floor muscles, endometriosis and unknown issues can cause women pain during sex, for example. Age matters as well. For older women, “hormones fluctuate,” said Laurel Sterling, natural health educator and a registered dietitian practicing in Canastota. For post-menopausal women, pain during intercourse is most often due to lower estrogen levels, which cause vaginal dryness and thinning of the vaginal tissue. “For vaginal dryness, use coconut oil and, internally, vitamin E oil,” Sterling said. “Taking sea buckthorn oil internally also help increase areas in the body with mucosal linings.” Women of any age may experience chronic pain, vulvodynia, which means an unexplained pain or discomfort in the vulvar area during intercourse. Some older women experience the pain constantly, but it could be related to other bodily issues. “Sex should never be painful,” said physician Pebble Kranz, owner of Rochester Center for Sexual Wellness. “It is always an issue that should be investigated by a healthcare provider and sometimes it takes a long time to get to the root of these issues and to find a provider who is skilled Kranz in evaluating and treating sexual pain, but one shouldn’t lose hope.” Sometimes pain during sex causes a vicious cycle of exacerbating the issue. As the woman experiences pain, she becomes more fearful of intercourse, according to Kranz. When the fear causes her body to tense up, the pain worsens. Libido can taper off. “This is made worse because many women keep the problem hidden, even from their partners, and feel shame about it,” Kranz said. She added that many care providers minimize women’s complaint and are not aware of sexual medicine as a specialty that includes physical and mental health. Treating sexual pain can include medication, physical therapy for the pelvic floor, mental health, relationship counseling and education. It’s important that these women get referred to physical therapists who have specific training in the pelvic floor, according to experts. Kranz recommends a book by physicians Irwin Goldstein, Andrew Goldstein and Caroline Pukall, “When Sex Hurts: A Woman’s Guide to Banishing Sexual Pain.” “It is not only a great overview of

the problem, but also helps women advocate for themselves within their relationships and with their medical providers,” Kranz said. For further reading, “Sex Rx” by Lauren Streicher explores how decrease in estrogen levels can cause vaginal and vulvar thinning and dryness, among other reasons for sexual pain. “[Decrease in estrogen levels] is the most common cause for sexual pain for women past menopause,” Streicher said. She is a physician who serves as assistant clinical professor at Northwestern University’s Feinberg School of Medicine in Chicago. About half her patients Sterling experiencing sexual pain are younger women. More of those seem eager to seek treatment. Streicher said that many mature women don’t seek treatment because of stigma or belief that painful sex is a normal part of aging. “Everything is fixable,” Streicher said. “That’s not what women are hearing from their doctors.” For some, finding a good lubricant solves their problem. Personal lubricants include many formulations, so trying a few may be warranted. If the over-the-counter types don’t work, a doctor can prescribe medication to help. Some could relate to trauma of the muscular-skeletal structures or the soft tissue. During pregnancy, the tissues receive more blood flow and can become more sensitive. During the last trimester, the uterus can sit so low that sex hurts. After delivery and recuperation, moms may experience pain during intercourse for other reasons. Breast feeding women can experience tissue atrophy as they have high progesterone levels. In only the most rare cases does a patient need surgery to resolve her sexual pain issues. Streicher recommends that women experiencing painful intercourse seek help from an expert in sexual pain or a menopause expert. “I’ve yet to have a woman with painful sex for whom I wasn’t able to alleviate the problem,” Streicher said. “Get yourself in the hands of someone who can help you. It may be a general gynecologist and maybe not. “If someone says there’s no solution, don’t believe it. Or if they’re dismissive and says, ‘This is a normal part of menopause,’ or that it’s normal after cancer of is a part of diabetes, don’t believe it.” Particularly since so many conditions can contribute to pain during intercourse, it’s important for physicians to take their time to fully evaluate the patient to determine the cause.

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Women’s Health

Boost Your Energy Busy routine has brought you down? Try a few things to get your energy back By Deborah Jeanne Sergeant


any women from their mid40s and older experience chronic low energy and

fatigue. Aside from the aging process, the responsibilities at work and home seem to peak around the 40s and 50s. School-aged children and teens need lots of time, as do elderly parents. Women are also in the most demanding part of their career as they’ve risen through the ranks but maybe not to the level where they have a personal assistant. At home, many women still perform the majority of household care and managing the family’s social life. “Typically, thyroid issues pop up more around age 40-plus,” said Laurel Sterling, natural health educator and a registered dietitian practicing in Canastota. “Stress and trying to do it all saps energy.” It’s important to speak with a health care provider to rule out other health issues. That conversation should include discussing medication which can cause fatigue.

While usually not immediately life threatening, fatigue can be related to stress, anxiety and depression. Fatigue could signal a medical condition such as anemia, thyroid or autoimmune diseases. Better self care can help women reclaim their energy levels to better face everyday challenges and feel healthier. Of course, eating a variety of colorful produce, mostly whole grains, modest portions of healthful fat and sufficient protein is the first step in improving nutrition; however, Sterling wants more women to stop“ grabbing sugar-rich and high-carb foods, and lots of caffeine,” she said. “That saps our adrenals more so.” Blasting through the mid-afternoon slump with an energy shot, fancy caffeinated drink or candy bar may work short-term, but it’s not healthful. It’s important to remember that a serving of coffee or tea is eight ounces, not the giant cups offered by many restaurants. Ideally, it should

be drunk without added sweetener. “Foods rich in B vitamins, protein, and good fats fuel us,” Sterling said, “Along with diets rich in colorful fruits and vegetables, green — like kale, broccoli — grains like quinoa, which is higher in protein than most grains, green tea, and even 70 percent-plus dark chocolate. These foods are higher in antioxidants, too.” In addition, most people need seven to nine hours’ sleep per night, a goal that most women don’t get. While exercising seems counterintuitive to people who have little energy, its effects include renewed energy because exercise releases naturally occurring chemicals in the body that help women stay more relaxed and better able to sleep--and sleep more deeply. Lisa Emmons, owner of Mother Earth Baby in North Syracuse and Oswego, advises women to keep better hydrated. “Take a good supplement with vitamin C, vita-

min D and B vitamins and things that support the immune system,” Emmons said. “The one thing that’s in common with all these energy shots is that they have B vitamins.” But since they also contain caffeine and sugar, sticking with the supplement is more healthful. “We don’t tend to take care of ourselves when we’re overwhelmed with the routine,” Emmons said. “We need to eat well and try to manage stress. Don’t take on more than you can.”

Go with the Flow Painful menstruation cycles? Experts suggest way to cope with the problem By Deborah Jeanne Sergeant


en out of every 100 women experience menstrual pain that’s so intense that they cannot perform normal activities, according to the National Center for Biotechnology Information, U.S. in Bethesda, Md. But women can take steps to make menstruation easier. Knowing when it’s going to happen can help women plan ahead and stay prepared with products to deal with flow and cramps. The average cycle is 28 days long; however, it’s perfectly normal for a cycle to be as long as 36 days. To help anticipate the next period, Clue, Eve, Pink Pad, Flo, Period Tracker and other apps (all on iOS and Android) remind users of when to expect their period, along with other helpful tips. Laurel Sterling, natural health educator and a registered dietitian practicing in Canastota, said that quite a few supplements, herbs and foods may ease symptoms, listing red raspberry leaf tea, ground flax, fish oil, more B6 and magnesium. “Take baths, use lavender and engage in stretching,” Sterling said. “Be gentle with yourself and relax as much as possible this time of the month. Decrease any inflammatory foods.” Page 20

Lisa Emmons, owner of Mother Earth Baby in North Syracuse and Oswego recommends Monthly Comfort tea to post-partum and menstruating customers. “It has organic red raspberry leaf, nettle, alfalfa, ginger, cinnamon and herbs designed to be used during monthly cycle,” she said. “It’s soothing for the system and helps ease cramping.” She added that menstruating women can use essential oils, such as ylang ylang, clary sage, bergamot, and lavender. “You can apply or diffuse them,” Emmons said. For women who want better means of dealing with flow, menstrual cups may provide an easy way to get long-lasting protection. Brands such as Luna Cup or Diva are made of medical-grade silicone. Users fold the cup in half length wise, insert, and let it go so it resumes its previous shape while it forms a seal that prevents leaks and odors. The cup catches menstrual flow rather than absorbing it like tampons and pads. Many women can wear a cup up to 12 hours, depending upon her flow, without emptying it instead of changing a pad or tampon every few hours. Cups are reusable and long-last-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

For women who want better means of dealing with flow, menstrual cups — such as The Diva Cup — may provide an easy way to get long-lasting protection. ing, which saves both money and landfill space. “A lot of folks are becoming more conscious of the environment find these a good choice,” Emmons said. “It’s convenient. Usually, women are pretty satisfied with them. I find that we’re selling more for the younger population — college age right now — and they’re really enjoying the ease of the product.” Women using menstrual cups never “run out” of their period supplies and avoid the skin irritation that disposable pads can cause. Cloth menstrual pads are also catching on. Emmons said that customers with chemical sensitivities favor the natural materials. “There’s lots of stuff in the disposable ones that is irritating,” Emmmons said. “Many who turn to cloth find it’s more comfortable and definitely less waste. A pad is made of the same materials as a disposable diaper. You don’t have to continually

go out and purchase them. “There are definitely alternative products that are certainly healthier for you and the environment. Many say it’s so much more comfortable.” Taking over-the-counter pain medication in advance of the period can lower inflammatory response. Using heating pads or microwavable rice bags may ease pain. While it may seem a good time to curl up on the sofa hugging a pillow, exercise may improve symptoms, since exercise releases endorphins, the body’s “feel good” hormone. A little pampering is also appropriate. Websites such as www.mylola.com and www.theperiodstore.com provide mail-order subscriptions for products helpful during menstruation; however, The Period Store includes both utilitarian and luxury items to make this time of month a little easier.

Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

If You Can’t Say Something Nice…


t happens at grocery stores, schools, department stores, restaurants, the workplace and just about any place parents frequent. It starts out as small talk and then quickly devolves into something bigger. It may seem (or even be) well-meaning, but the people on the receiving end find it anything but. I’m referring to unwanted observations regarding children. All too often I see a parent doing something mundane such as shopping or eating when these observations about children strike. A bystander starts asking questions. Are there more of them? Are they girls or boys? What are their names? That’s often when the conversation takes a darker turn. Based on the responses people get to their seemingly benign questions, they digress into unwanted feedback. “You have five kids! Four just wasn’t enough?” “All girls, huh? Those teenage years are going to be nightmare!” “All boys? Bet your house smells like a gym! At least boys always love their mothers. You can’t count on that with girls.” “You have all boys/girls? Don’t you wish you had a girl/boy?” “Duke? That’s usually a dog’s name.” The list of unwanted, unsolicited and hurtful observations goes on. Some people try to pass these comments off as small talk or adages, but they don’t seem small or cliché to the parents and children on the receiving end of this banter. Chances are, the parents standing in line at the grocery store just want to buy juice boxes and snack crackers. They didn’t go shopping to have their reproductive choices heckled by the person ahead of them in line. The next time you want to make an observation about someone’s winnings or losses in the genetic lottery, the number of times they procreated, what they chose to name those procreations or anything else related to their kids, please consider the following things before letting your remarks fly. The golden rule If you were dragging four young children through the grocery store and each of them were pulling at shelves from different angles, would you really want someone to remark on how full your hands were? When you have four children each begging for a different cereal, of course four seems like too much. You don’t need a stranger to rub that in your face. Parenting isn’t about the tough times, it’s about the beautiful ones, like when you get home and snuggle up for movie night with all four of those cereal-grubbing children. Question your motives When you want to remark on someone’s reproductive choices,

what is your motive? If your motive is small talk, talk about the weather, the adorable shirt a child is wearing, how delicious the chips they are purchasing are or about the youthful energy the children bring to the atmosphere. Small talk shouldn’t make others feel small. Never underestimate what you don’t know What if that dad you are chatting with has all boys but wanted a little girl more than anything in this world? Asking him if he wanted a girl or telling him boys are easier and girls are troublesome as they age isn’t going to make things easier. Maybe the mom with a single child in tow wants nothing more than a second and a third. Is telling her that these people who have three or more kids are crazy going to help? That name you want to pick on or have a snarky reaction to might be the name of that parent’s beloved and deceased grandmother. Do you see where I am going with this? The list of things you don’t know about a stranger is near infinite, so don’t gamble with someone else’s emotions.


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Who is winning? When you make snarky or backhanded statements to total strangers, no one is winning, even if that stranger commiserates with you because he or she doesn’t have the energy to do anything else. When you put more negativity into the world and bring down a parent who is likely tired already, both of you lose. Why not be positive? The next time you find yourself wanting to make comments about someone’s reproductive choices, pump out some positivity. Tell that tired mom with four loud children how beautiful her family is. When you ask what that baby’s name is, tell the parent the name is perfect. When someone tells you they have four girls, tell them you always wished you had more sisters or daughters (even if that’s not really true). Because, if you are asking questions for any other reason than to react positively to a stranger, the least you can do is catch yourself and redirect. There’s enough negativity in the world; be a small talk trailblazer. That mom or dad that you are kind to might just walk out of that store and feel good. In fact, they might just climb back in the car, look at their beautiful family, smile and enjoy the rest of their day. It’s time to start recognizing that our acts, even those like small talk, set off chain reactions.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 21

Medication Management for Older Adults By Douglas Tucker, M.D.


roper medication management is essential to ensure the correct treatment of medical conditions and overall health. But this can be difficult for many older adults. Medication-related problems are one of the top five causes of death in seniors, according to the American Society of Consultant Pharmacists, and a major cause of confusion, depression, falls, disability and loss of independence. Seniors are especially at risk for medication-related problems due to physiological changes of aging, higher incidence of multiple diseases and conditions, and greater consumption of prescription and over-the-counter medications. The Aging Life Care Association says that many older adults also face declining eyesight, grip strength, mobility and memory issues. And as our bodies change, the way medications work in the body also changes. Medicines may stay in the body longer and may cause more severe side effects if doses are not properly adjusted and monitored — leading to a higher risk of drug interactions in older adults. The National Center for Biotechnology Information has found that older adults who live alone and people with multiple prescribing providers were more prone to medication errors. But patients who were given a medication card with a list of current medications were more compliant with their medication regimen. Patients who participate in pharmacy delivery programs and refill reminders have fewer adverse drug events and higher compliance


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than those who do not. And nursing assistance for medication management can also help prevent unnecessary hospitalizations and emergency department visits, as well as improve quality of life. Here are 10 tips to better manage medication: 1. Schedule frequent doctor appointments; 2. Use one pharmacy for all medications; 3. Arrange for medications to be picked up from the drug store or delivered to you; 4. Store medicines in a particular—and safe—location; 5. Set reminders, use a timed pill box, or ask for reminders from another person; 6. Identify a “patient navigator” within your healthcare team to help navigate the healthcare system and help you take prescription medicines as prescribed; 7. Maintain a medication list with written directions and a check list; 8. Know which medications to take together; 9. Know if you need to take foods or liquids with certain medications; 10. Dispose of old drugs. Physician Douglas Tucker is chief medical officer of PACE CNY, a Loretto program of all-inclusive care for the elderly. For more information about PACE CNY program, visit www.pacecny.org.


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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse

What You Should Know About Enrolling in Medicare Parts A & B


nderstanding Medicare isn’t as difficult as you might think. It’s a benefit most working Americans can count on. Here are some facts you might not know about the program. n Can I still get Medicare at 65? Yes, you’re still eligible for Medicare starting at 65, no matter what year you were born. If you or your spouse worked and paid Medicare taxes for at least 10 years, you’re eligible for Part A (hospital insurance) at age 65 for free. Part A helps pay for inpatient care in a hospital or skilled nursing facility following a hospital stay. It also pays for some home health care and hospice care. You’re also eligible for Part B (medical insurance) if you choose to get it and pay a monthly premium. Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services. If you are receiving Social Security benefits already, you will be automatically enrolled in Medicare Parts A and B at age 65. Because you must pay a premium for Part B, you can choose to turn it down. However, if you don’t enroll in Part B when you’re first eligible for it, and choose to enroll later, you may have to pay a late enrollment penalty for as long as you have Part B coverage. If you’re not receiving Social Security benefits, you have a seven-month period (your initial enrollment period) to sign up for Part B. Generally, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after your birth month. n If you are covered under an employer group health plan, you may have a special enrollment period for Part B. If you are 65 or older and covered under a group health plan, either from your own or your spouse’s


Q: What can I do at www.socialsecurity.gov? A: There are many things you can do on Social Security’s website. You can conduct most of your Social Security business with us online at www.socialsecurity.gov/onlineservices. You can get an estimate of future benefits, find out if you qualify for benefits now, and even apply for benefits. You can complete a number of other tasks online, too, including replacing your Social Security card in some states. You can estimate your retirement benefit using our Retirement Estimator, which allows you to get an instant, personalized estimate of your future benefit based on different retirement ages and scenarios.

current employment, you may have a special enrollment period during which you can sign up for Medicare Part B. This means that you may delay enrolling in Part B without having to wait for a general enrollment period and without paying the lifetime penalty for late enrollment. Additional rules and limits apply, so if you think a special enrollment period may apply to you, read our Medicare publication at www.socialsecurity.gov/pubs/, and visit the Centers for Medicare and Medicaid Services at Medicare.gov for more information. n To avoid a tax penalty, you should stop contributing to your Health Savings Account (HSA) at least six months before you apply for Medicare. If you have an HSA when you sign up for Medicare, you can’t contribute to your HSA after you your Medicare coverage begins or you may have to pay a tax penalty. Premium-free Part A coverage begins six months before the date you apply for Medicare, but no earlier than the first month you were eligible for Medicare. To avoid an unwanted tax penalty, you should stop contributing to your HSA six months before you apply for Medicare. You can withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses like deductibles, premiums, coinsurance, or copayments. If you’d like to continue contributing to your HSA, you shouldn’t apply for Medicare or Social Security benefits. n How Much Does Part B Coverage Cost? You are responsible for the Part B premium each month. Most people will pay the standard premium amount, which is $134 in 2018 if you sign up for Part B when you’re first eligible. This amount can change every year. You can find up-to-date premium amounts on Medicare.gov. You can learn more about Social Security and Medicare at www.socialsecurity.gov/benefits/medicare.

You can even open your own my Social Security account to plan for and manage your benefits at www. socialsecurity.gov/myaccount. Q: Will my son be eligible to receive benefits on his retired father’s record while going to college? A: No. At one time, Social Security did pay benefits to eligible college students. But the law changed in 1981. We now pay benefits only to students taking courses at grade 12 or below. Normally, benefits stop when children reach age 18 unless they are disabled. However, if children are still full-time students at a secondary (or elementary) school at age 18, benefits generally can continue until they graduate or until two months after they reach age 19, whichever is first.

Living•Working•Playing By Jim Miller

How to Choose a Memory Care Unit Dear Savvy Senior, My mom has Alzheimer’s disease and has gotten to the point that she can’t live at home any longer. I need to find a good memory care residential unit for her but could use some help. Any suggestions?

Exhausted Daughter Dear Exhausted, Choosing a good memory care residential unit for a loved one with Alzheimer’s disease is a very important decision that requires careful evaluation and some homework. Most memory care units, sometimes called special care units, are housed within assisted living or nursing home facilities. At their best, they offer staff extensively trained in caring for people with dementia, individualized care that minimizes the use of dangerous psychotropic drugs, a home-like environment and activities that improve residents quality of life. But at their worst, they can offer little more than a locked door. Here are some steps that can help you find a good facility and avoid a bad one. n Make a list: To identify some good memory care residential units in your area ask your mom’s doctor for a referral, and use the Alzheimer’s Association online tool at CommunityResourceFinder.org. Make sure the facilities on your list are close to family members and friends who can visit often, because residents with frequent visitors usually get better care. n Research your options: Once you’ve made a list, contact your local long-term care ombudsman (see LTCombudsman.org). This is a government official who investigates assisted living and nursing home complaints and can tell you which facilities have had problems in the past. If you’re looking at a memory care unit within a nursing home facility, use Medicare’s nursing home compare tool (Medicare.gov/nursinghomecompare), which provides a 5-star rating system. n Call the facilities: Once you’ve identified a few facilities, call them to find out if they have any vacancies, if they provide the types of services your mother needs, what they charge and if they accept Medicaid.

n Tour your top choices: During your tour, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Also be sure to taste the food, and talk to the current resident’s family members, if available. Also, find out about staff screening and training procedures, their turnover rate, and the staff-to-resident ratio. They should have at least one staff member for every five residents. Make sure the facility offers quality activities that can keep your mom engaged, even at night when she may be awake. Ask how they respond to residents who may wander or become aggressive. If the answer is locked doors and antipsychotic drugs, that’s a red flag. Because transitions can be unsettling for dementia suffers, make sure that your mom will be able to remain at the facility for the foreseeable future. And find out what, if any, health conditions might require your mom to leave the facility or move to a higher and more expansive level of care. It’s also a good idea to make multiple visits to the facility including an unscheduled visit at night or on weekends when the staff is more likely to be stretched thin. To help you evaluate your visit, the Alzheimer’s Association offers a checklist that you can access at ALZ. org/residentialfacilities. n Paying for care: The national average costs for memory care within an assisted living facility is over $5,000 per month, and over $7,500/ month for nursing home care, but costs can vary widely depending on your location. Since Medicare does not cover long-term care, most residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid (if available) once their savings are depleted. To help you research your financial options, visit the National Clearinghouse for Long-Term Care Information website at LongTermCare.gov.


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April 28

Fashion show, luncheon to benefit St. Camillus The Friends of St. Camillus will sponsor a benefit fashion show and luncheon to benefit The Centers at St. Camillus, nonprofit health care facility offering comprehensive inpatient, community-based and home care services in Syracuse. It will be held from noon to 3 p.m., Saturday, April 28, at the DoubleTree by Hilton on Route 298, off Carrier Circle in East, Syracuse. Attendees will enjoy a live fashion show by Jane Morgan’s Little House of Aurora and have the opportunity to shop its on-site boutique with a portion of sales also benefiting the Friends of St. Camillus. Also new this year, the fashion show will feature four guest models who are Central New York VIPs or celebrities. They are: Evelyn Carter, director of community relations at Wegmans; Christie Casciano, author and anchor at WSYR News Channel 9; Barbara Rothschild, executive vice president at Syracuse Auto Dealers Association (SADA); and Lindsay Walsh, provider onboarding specialist at St. Joseph’s Health. Wlash is also the wife of the new Mayor of the City of Syracuse, Ben Walsh. Presenting sponsors of the event — dubbed “Thank You for Being a

Friend” — are the Geddes Federal Savings and Loan Association and the Kinney Drugs Foundation. Tickets are $35 each. Proceeds benefit the mission of the Friends of St. Camillus, meant to enhance the daily quality of life of St. Camillus residents and patients.  For tickets, sponsorship opportunities or to donate raffle items, call 315-703-0822 or email michael. connor@st-camillus.org.  

April 18

Senior fair at the Cicero NOPL Nancy Aureli of Community Living Advocates and Joan Sardino of Serving Seniors have teamed up with Cicero Northern Onondaga Public Library to host a Senior Information Fair from noon to 2 p.m., Wednesday, April 18. This fair is for seniors, caregivers and for all caring advocates for the CNY senior community. Various representatives from Alzheimer’s Association, PACE CNY, Cicero Senior Center and more will be available. There is no fee for this event. It is simply an opportunity for seniors to gather information from local organizations. The organizers are Community Living Advocates, a local online directory for caregivers, seniors and people with disabilities (www. CommunityLivingAdvocates.com) and Serving Seniors, a locally owned and independently operated agency that provides services to local seniors (www.cnyservingseniors.com). For more information about the fair, call 315-382-4300.

April 21

Workshop to address anxiety, depression  

The public is invited to attend the workshop “Rethinking Anxiety and Depression: Anxiety and Ally, Depression a Discovery Device.” Learn underlying assumptions about anxiety and depression, identify the positive aspects of anxiety and depression, and emphasize the individual’s role in vilifying anxiety and depression, and rethinking viewpoints that play a key role in relieving symptoms associated with anxiety and depression.   The workshop will be facilitated by Monica Gullotta, an educator, lecturer and author. Gullotta launched and facilitated the Upstate Group for Panic, Anxiety and Depression for over 16 years. She opened the Ray of Hope Wellness Center in 2009, where she acted as a mental health mentor, providing one-on-one sessions educating individual’s contending with anxiety and depression. In 2008, Gullotta received the Volunteer of the Year Award from the Mental Health Association of Onondaga County for her innovative techniques giving people the tools they need to help themselves. Gullotta has a master’s degree with a specialization in counseling. The workshop will be held from 10 a.m. to noon, Saturday, April 21, at Cafe at 407, 407 Tulip St., Liverpool. Tickets are $25 per person. For more information or to register, call 315-352-0866, or visit www.monicashelp.com.   

May 10

Celebration luncheon for Onondaga County seniors

er and executive director of Onondaga County Office for Aging, has announced the 2018 Celebration Luncheon for Onondaga County Seniors. It will be held at noon, Thursday, May 10, at Drumlins Country Club, 800 Nottingham Road, Syracuse. This event celebrates National “Older Americans Month” which is every May. Several individuals will be honored this year. They are: • Dorothy L. White, selected as senior citizen of the year; • Merriette Chance Pollard, of Dunbar Center, and Brian Evans, Sr., senior companion program, Interfaith Works & PACE CNY, have been selected as serving seniors honoree of the year; • Mary Anne Barth, selected Flanders Memorial Caregiver of the Year. “We find that Onondaga County seniors long to remain integral members of our community, helping others with their knowledge and their time,” said Deputy Commissioner Headd. “The theme of Older American’s Month this year is ‘Engage at Every Age’ and we believe that statement accurately describes those we are honored to serve each day and also celebrate at this yearly event.” To participate in the event, seniors aged 60 or older and their guests must register by Friday May 4. The meal cost is $5, and has been kept to a minimum due to the generosity of local contributors. Checks can be made payable to “Onondaga County Elders, Inc.” and should accompany the registration form. This event is sponsored by Onondaga Elders, Inc. and the Onondaga County Office for Aging. For more information, or to receive a registration form, call 315435-2362, ext. 4945. The registration form is also available at www.ongov. net/aging/news.html

Pete Headd, deputy commission-

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

H ealth News Crouse appoints new chief financial officer

Crouse Health has announced the appointment of Michael Tengeres as chief financial officer. A native of Western New York, Tengeres will assume the position April 30. Tengeres has served most recently as corporate vice president and chief financial officer for Bassett Healthcare Network in Cooperstown, where he was responsible for the integrated healthcare system’s financial operations, Tangeres including long-range forecasting, operating and capital budget development. Prior to Bassett, Tengeres was senior director for international finance operations for the Cleveland Clinic, where he helped establish the full spectrum of financial operations for the Clinic’s operations in Abu Dhabi.  In his role at Crouse, Tengeres will oversee and provide strategic direction and leadership for all financial aspects of Crouse’s integrated delivery network, including finance, revenue cycle, purchasing and oversight for facilities. “We are fortunate to have someone of Michael’s caliber, background and expertise join the Crouse leadership team,” says Kimberly Boynton, president and chief executive officer. “The depth of his financial leadership at leading healthcare organizations will be invaluable to Crouse as we continue to expand our network and strategic affiliations.”

Tengeres holds an MBA from the William E. Simon Graduate School of Business Administration at the University of Rochester. He has also held leadership positions with MedStar Health System in Baltimore and Strong Memorial Hospital in Rochester.

New vascular surgeon joins St. Joseph’s Health

St. Joseph’s Health welcomes Eugene Palchik to its top-rated and nationally recognized vascular surgery team. “Dr. Palchik joins a diverse team of highly qualified physicians providing comprehensive vascular services care to the community at our Vascular Center for Excellence.” said physician Joe Spinale, chief medical officer for St. Joseph’s Health. Palchik “Our award-winning vascular program is committed to delivering excellent patient outcomes through high-quality care and innovative surgical solutions. Palchik’s joining the team is an expression of our continued growth and excellence in vascular care.” Palchik is certified in vascular surgery by the American Board of Surgery and is licensed to practice medicine in New York, New Jersey and Rhode Island and holds registered physician in vascular interpretation (RPVI) certification from the Alliance for Physician Certification and Advancement.

A graduate of the doctor of medicine program at New York University’s Mount Sinai School of Medicine in New York City, he completed his residency in general surgery at University of Rochester in Rochester. Palchik received specialized training in vascular surgery during his two-year fellowship in vascular surgery at Temple University Hospital in Philadelphia and as a clinical research fellow in vascular surgery at his alma mater. His research has been published in multiple journals including the Annals of Vascular Surgery, the Journal of Vascular Surgery and the Journal of Endovascular Therapy. Before joining St. Joseph’s Health, Palchik provided vascular surgery coverage for a network of four hospitals as a vascular surgeon with Vascular & Endovascular Associates of New Jersey in Paramus. At Landmark Medical Center, Palchik served as medical director of the Wound Care Center in addition to his surgical duties.

Oswego Health welcomes ne breast surgeon Oswego Health welcomes breast surgeon Lisa Lai, who will provide community members with a range of services through General Surgery Associates. Lai will provide care to patients at the Fulton Medical Office Building and Oswego Hospital’s advanced surgery center. Lai She will

Loretto’s New Brand: ‘Extraordinary People, Exceptional Care’ Loretto, a Syracuse-based organization that offers a variety of senior care services throughout CNY, has recently unveiled a new mission statement, new tagline and a new logo. “As we went through this journey of self-discovery, we spoke with our employees, our residents, our board members, community leaders and others,” said Loretto President and CEO Kimberly Townsend. “Several key themes emerged, including leadership, trust, value and, above all, family.” The new tagline that was developed from this feedback is “Exceptional People, Extraordinary Care” — which is dedicated to recognizing the people Townsend says make every day extraordinary at Loretto. The updated mission statement goes hand in hand with the tagline: “To be a family of exceptional people caring for and about each other.” The centerpiece of the new

Loretto brand is the “Lifecircle” logo. The new logo was chosen as a result of its symbolism of inclusiveness. A symbol that Townsend says pays homage to Loretto’s ongoing mission to provide care for all, across the continuum. Townsend also said the new brand is for both the individuals who use Loretto’s services and the individuals who provide those services. “Our focus is just as much on providing our employees with the support they need — whether that’s health care, transportation assistance, our new diaper bank, or many other employee programs — as it is on our residents and program participants,” said Townsend. The reason for the rebrand came as the result of a desire to recognize

employees and Loretto’s evolution of services. “We decided to invest in a new brand and a new mission because our previous brand and mission reflected an outdated business,” said Julie Sheedy, vice president of marketing and the Loretto Foundation. “It is important for our current family to be properly recognized, and it is also important for our employee recruitment efforts, as well as for the financial stability of our programs and facilities, that the community truly understands who Loretto is and all that we do.” Signs at Loretto’s 19 locations, along with other areas and materials that use the Loretto logo, will be updated over the coming months. April 2018 •

provide a complete range of care from screenings, to evaluation of breast masses or other concerns, management of abnormal breast imaging and surgery for benign or malignant disease including lumpectomies and mastectomies. Lai is affiliated with the Cancer Center at Upstate Medical Center and serves as the medical director for the breast cancer program. She brings a continuum of services through the partnerships between Upstate and Oswego Health. This collaboration provides radiation oncology and medical oncology services locally for the convenience of cancer patients. This partnership will further benefit local breast cancer patients who require specialized care or choose to have plastic surgery following a breast procedure. A Buffalo native, Lai received her medical degree and undergraduate degrees from SUNY Buffalo, graduating from both programs Summa Cum Laude. She completed her surgery residency at SUNY Upstate Medical University and a fellowship in breast surgical oncology at Emory University School of Medicine in Atlanta. In her spare time, Lai enjoys spending time with her husband and young son.

Nephrology Associates recognized for lab services Nephrology Associates of Syracuse has met all criteria for laboratory accreditation by COLA, a national healthcare accreditation organization. According to a news release, accreditation is given only to laboratories that apply rigid standards of quality in day-to-day operations, demonstrate continued accuracy in the performance of proficiency testing, and pass a rigorous on-site laboratory survey. Nephrology Associates of Syracuse has earned COLA accreditation as a result of a long-term commitment to provide quality service to its patients. COLA is a nonprofit, physician-directed organization promoting quality and excellence in medicine and patient care through programs of voluntary education, achievement, and accreditation. COLA is approved by the federal government and sponsored by the American Academy of Family Physicians, the American Medical Association, and the American College of Physicians- American Society of Internal Medicine.

St. Joe’s adds HALO Bassinest Swivel Sleepers

St. Joseph’s Health Hospital has introduced HALO Bassinest Swivel Sleepers to its mother- and baby-centered features in the women and children’s unit, allowing mothers and babies to be closer and safer than ever before. According to a news release, St. Joseph’s is the first hospital in New

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“I call it the big little hospital,” said Joe Caruana, of Hannibal. “It’s big in service, but still small enough to make you feel at home. And, it’s just seven miles from my house.” Joe and his family have used several services at Oswego Hospital, including the Emergency Department and Surgical Services. “It’s been excellent from the first person to the last,” he said. “Everyone is friendly, helpful, efficient and courteous. They stick to their schedules too, just as they promise, including the physicians.” Joe, a former Hannibal Superintendent of School adds, ” The physicians are key and the nurses are first class. I’m happy they are in our county.”

— Joe Caruana

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2018

York state to incorporate HALO Bassinests into its birth unit which sees approximately 2,000 deliveries per year. A grant from the Flora Bernice Smith Foundation assisted the hospital in purchasing five sleepers. “As the only designated “baby-friendly hospital in Central New York, St. Joseph’s supports personal birth choices and provides an environment where bonding with baby is facilitated,” said Gael Gilbert, director for the women and children’s service line at St. Joseph’s Health. “The HALO Bassinests make it possible for new moms to safely sleep with their newborns in a way that promotes bonding and skin-to-skin contact while encouraging safe sleep habits for families before newborns go home.” What makes the HALO Bassinest unique is the product’s attention to safety for mother and baby. The sleeper’s 360-degree swivel feature is ideal for those recovering from complicated births, C-section or disability and also minimizes fall risks by limiting mom’s need to move around the room. Additionally, the clear construction and retractable sidewall makes seeing and access to baby easy, empowering mother and baby to connect and encouraging nursing. “St. Joseph’s Health continues to be a leader in safety and equipment innovations. We are grateful for the support of funders like the Flora Bernice Smith Foundation that make it possible for us to provide a higher level of care to patients–especially those just making their way into the world,” said Gilbert.  

Two employees promoted at Loretto

Loretto has recently promoted two of its employees to assistant director positions.  • Nurse Manager Meredith Boss has been named assistant director of nursing for the sub-acute rehabilitation units and the new restorative care unit at Loretto’s Fahey location, which is planned to open in April. Boss holds an Associate in Applied Science degree in nursing from Crouse Hospital College of Nursing and a Bachelor in Science degree of nursing from Keuka College. She will complete her master’s in nursing as an advanced practice family nurse practitioner in June 2020. She has been with Loretto for almost two years, and has significant experience in critical care, including cardiac care as a registered professional nurse in the cardio vascular intensive care unit at St. Joseph’s Health Hospital. She holds certifications in advanced cardiovascular life support and cardio pulmonary resuscitation from the Red Cross, as well as certification in adults with autism from the Rochester Regional Center for Autism Spectrum Disorders. • Therapeutic Recreation Specialist Megan Mawhinney has been promoted to assistant director of recreational therapy at Loretto’s Cunningham and Fahey locations. Mawhinney holds a bachelor’s degree in music therapy from Nazareth College, and is expected to earn her certificate of advanced study in therapeutic recreation in May 2018. She has been with Loretto for more than a decade.

For me it’s personal! Upstate legacies: lifesaving and life-changing In 1993, my son David was on top of the world! He had graduated from a prestigious culinary institution and was building his reputation as an executive chef. Then David suffered a career-ending and life-altering spinal injury in a skiing accident. After months of outstanding care and physical therapy David is able to live an independent and productive life, BUT that’s not all! today, groundbreaking research is taking place at Upstate Medical University that we hope will one day restore all of David’s functions and reverse spinal cord injuries for thousands of others in Central New York and beyond. Through The Upstate Foundation, I have established A New Beginning Fund for spinal cord research, and I have remembered Upstate with an estate gift to fund this research and benefit many in our community for years to come. it’s also personal for you since every Upstate legacy dollar stays right here in Central New York to help assure happy, healthy and longer lives for your loved ones, friends and neighbors.

I invite you to join me in creating a legacy gift through your will or financial plans. Together we can do great things for Central New York. Ruth Schwartz Charitable Giving Planner, The Upstate Foundation

For free and confidential information on how to make a low cost, high impact legacy gift contact, or have your professional advisor contact, John Gleason at 315-464-4416 or email us today at FDN@Upstate.edu Our legal name is THE UPSTATE FOUNDATION INC.

www.UpstateFoundation.org April 2018 •

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