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PRICELESS

Meet Your Doctor Hematologist/oncologist Heidi S. Puc opens integrative medicine practice in Chittenango. She talks about how integrative medicine can help cancer patients and others

ALL ALONE ON THANKSGIVING Live Alone and Thrive columnist spending her first Thanksgiving alone. She discusses her plans

5

Live a Longer, Healthier Life

CNYHEALTH.COM

NOVEMBER 2018 • ISSUE 227

SUNY Upstate geriatrician Sharon Brangman offers five tips for those who want to live a longer, healthier life. See article on page 19

CBD Oil 101

Things you should know about heartburn

Find out why more people are using cannabidiol (CBD) oil Page 13

FAST FOOD Research shows 37 percent of adults ate fast food at least once over the past 24 hours

Kumquats Anyone? If you don’t know what a kumquat is, you’re not alone. It’s in season now and it provides a tremendous amounnt of nutrients, See SmartBites inside Page 15

­

Confused? Check a list of free online resources that will help you understand your options. Savvy Senior.

Page 25


Had a Stroke. Back on Stage.

Musician Todd Hobin KNOW THE SIGNS • CALL 911 IMMEDIATELY

Central New York music legend Todd Hobin knew nothing about stroke — but he does now. That’s why he’s raising awareness about stroke risk factors and its signs and symptoms.

F.

FACE DROOPING

A. S. T.

ARM WEAKNESS

SPEECH DIFFICULTY

Fact: Stroke is the fifth leading cause of death and a leading cause of disability in the U.S. Important to know: Stroke can happen to both men and women — at any age. Good news: Stroke is preventable by managing medical risk factors and healthy lifestyle choices. What to do: Time lost is brain lost. So it’s vital to know the signs of a stroke — F.A.S.T. Four words to live by: Call 911 and say, “Take me to Crouse.“ When it comes to stroke, every moment matters. As one of just 10 hospitals in New York State to have earned Comprehensive Stroke Center status, and with the region’s newest ER and hybrid ORs, Crouse offers the most advanced technology for rapid stroke diagnosis and treatment

Read Todd’s story and learn more: crouse.org/toddhobin.

Page 2

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

TIME TO CALL 911


Medicare+Medicaid= More Benefits for You! Medicare Card NEW

You may be eligible for additional money-saving benefits through our Dual Advantage plans, including:

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HOSPITAL (PART A) MEDICAL (PART B)

PLE SAM

Coverage starts/Cobertura empieza

01-01-2018 01-01-2018

Medicaid/Common Benefit Identification Card (CBIC) NEW

Monthly OTC Card up to $100 (to pay for items like OTC medications, toothpaste, incontinence supplies, and more)

Transportation

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Care Management support

Top-quality doctors and hospitals

Discounts for hearing devices*

and many more!

OR

For a complete listing of plans in your service area, contact the plan. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Out-of-network services may require more out-of-pocket expense than in-network services. Benefit restrictions apply. Fidelis Legacy Plan is an HMO plan with a Medicare contract. Enrollment in Fidelis Legacy Plan depends on contract renewal. *Fidelis Legacy Plan partners with TruHearing for discounted purchases of hearing devices.

Call us today! 1-800-860-8707 TTY: 711

Monday–Sunday, 8:00 a.m.–8:00 p.m. from October 1–March 31 Monday–Friday, 8:00 a.m.–8:00 p.m. from April 1–September 30

www.fideliscare.org November 2018 •

H3328_FC 18170_M IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 3


CALENDAR of

Discover

Inlet, NY

November 23-25, 2018

HEALTH EVENTS

Adirondack Christmas on Main Street Avoid the crowds and start your holiday shopping with us!

In-Store specials all weekend! Lots of Holiday Activities Planned:

Candy Cane Hunt, Ugly Christmas Sweater Contest, Basket Raffle, Holiday Dog Parade, Visit from Santa, Wine & Cheese Sampling, Tree Lighting and much more!

Download the complete schedule and map at: InletChristmasonMainStreet.com

InletNY.com

FDA Approves Third of New Migraine Drugs

G

alcanezumab-gnlm (Emgality) targets calcitonin gene-related peptide (CGRP), a molecule that’s produced in nerve cells of the brain and spinal cord. Earlier this year, the FDA approved two other CGRP drugs for migraine — erenumab (Aimovig) and fremanezumab-vfrm (Ajovy). In a news release, drugmaker Eli Lilly and Co. says the injectable drug will be available to patients “shortly after approval.” “I have lived with migraine for more than 30 years, and I have experienced firsthand the impact it has on your life, including the ability to perform daily activities,” Jill Dehlin, chairwoman of the Patient Leadership Council of the National Headache Foundation, said in the same release. “Those of us living with migraine have spent years hoping for new treatment options, and I am thankful for the efforts by researchers, investigators and clinical trial patients who have helped make this possible.” In two phase 3 clinical trials that included more than 1,700 patients with episodic migraine, those who received 120 or 240 milligrams of the drug had much fewer monthly migraine headache days than those who received a placebo. A third trial, which included more than 1,100 patients with chronic migraine, had similar results. Problems reported in the three studies included pain, reactions, and skin reddening at the site of the shot. The company reports that the U.S. list price for the drug will be $575 monthly or $6,900 annually. Patients with commercial insurance could receive the drug for up to 12 months free as part of its patient support program.

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EDITOR@ CNYHEALTH.COM Page 4

Nov. 1

Nobel Prize winner to give keynote address at Turning Stone

The board of directors of the American Association for Clinical Chemistry (AACC) and the Central New York chapter of the Clinical Laboratory Management Association (CNY CLMA) present Joachim Frank as the keynote speaker for their annual scientific conference on Thursday, Nov. 1, at the Turning Stone Event Center in Verona. Frank is a professor of biochemistry and molecular biophysics and biological sciences at Columbia University in New York City. He is regarded as the founder of single-particle cryo-electron microscopy, for which he shared the Nobel Prize in chemistry in 2017 with Jacques Dubochet and Richard Henderson. Frank previously served as a senior research scientist at the Wadsworth Center, New York State Department of Health, where he started working on single-particle approaches in electron microscopy. AACC is a global scientific and medical professional organization dedicated to clinical laboratory science and its application to healthcare. Its leadership in education, advocacy and collaboration helps lab professionals adapt to change and do what they do best: provide vital insight and guidance so patients get the care they need.  CNY CLMA is a local chapter of CLMA, a national professional organization that brings together clinical

laboratory professionals from laboratories of all sizes. Clinical laboratory managers and leaders, clinical technicians, consultants, marketers and military staff can connect and share their collective knowledge. For more information, please contact secretary@cnyclma.org or Rita Romano, president-elect of CNY CLMA, and director of the operations center at Laboratory Alliance of Central New York. Romano’s email is ritaromano@lacny.com.

Nov. 2

Lactation rooms for businesses ‘lunch and learn’ session

The Rural Health Network of Oswego County (RHNOC) and The Maternal and Infant Community Health Collaborative Project (MICHC) are hosting a lunch and learn session for Oswego County businesses from noon to 2:30 p.m., Friday, Nov. 2, at Bridie Manor in Oswego.   During the event, information will be provided on how businesses or organizations can apply for lactation room funding.  Research shows that breastfeeding is the best source of nutrition for infants. The goal is to increase breastfeeding rates and improve the overall health of children in Oswego County. A guest speaker will present on breastfeeding policy for businesses and the components of a lactation room. A private space for breastfeeding mothers to feed their infant or pump and store breastmilk is key to increasing the overall rates of breast-

feeding and the health of children. The guest speaker will provide an overview on policy regarding breastfeeding in the workplace and answer questions from local businesses. The Rural Health Network of Oswego County is a collaborative of health and human service providers, higher education, and local government units who come together with a mission of facilitating partnerships and planning that contribute to a healthy and thriving Oswego County. To RSVP for the lunch and learn event, contact Leanna Cleveland at 315-592-0827 or Lcleveland@oco.org.

Nov. 10

Comedy show to benefit The Centers St. Camillus

The public is invited to an evening of laughter, courtesy of Central New York’s iconic comedy host and favorite comedian Bruno Schirripa at his show,”Bruno Presents The Original Wise Guys”. The event will benefit The Centers at St. Camillus and its affiliate Integrity Home Care Services and will take place 8 p.m., Nov. 10 at The Palace Theatre in Eastwood. After a 30-year career and six comedy night clubs in the country (including Wise Guys in Syracuse), Bruno decided to hang up his Rubber Chicken and take a break. Then five years ago, something special happened; Bruno describes it as, “God hitting him in the head with a brick,” and now Bruno Presents The Original Wise Guys is an annual event. Bruno says he will continue, “until God tells me to stop.” Tickets are $25 each and are available at brownpapertickets.com (search Wise Guys). A limited number of tickets will also be available at the door (subject to availability). A cash bar will also be available. For more information about The Centers at St. Camillus and its affiliate Integrity Home Care Services, please call 315-488-2951 or visit www.st-camillus.org.

Alzheimer’s Association announces support group meetings

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he Alzheimer’s Association, Central New York Chapter welcomes those impacted by Alzheimer’s disease or another dementia to attend one of its support groups that meet throughout the region. Support groups are a community of peers that exist to support one another. These peer- or professionally-led groups for individuals, caregivers and others dealing with Alzheimer’s disease or a related form of dementia. Caregiver support groups promote an open forum of sharing and discussion among people facing many of the same issues. The group’s power rests within its members’ ability to show compassion, develop strategies and empower its members to provide the highest quality care possible. Additionally, the chapter offers support groups for individuals living with early-stage dementia and their caregivers, LGBT caregivers, caregivers of those with younger-onset Alzheimer’s disease and Spanish-speaking caregivers. All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email cny-programs@alz.org.   Upcoming meetings n Cayuga County

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

• Auburn — 2 p.m. Nov. 1 and De. 16 at United Way of Cayuga County, 17 E. Genesee St., #302 (use rear parking lot on Seminary Street). n Madison County • Canastota — 10 a.m., Nov. 16 and Dec. 21 at Madison County Office for the Aging, 138 Dominic Bruno Blvd. • Cazenovia — 6 p.m., Nov. 14 and Dec. 12 at Community Resources for Independent Seniors, Cherry Valley Professional Plaza, 2662 Route 20 East. n Onondaga County • Baldwinsville — 6:30 p.m. Nov. 13 and Dec. 11 at Baldwinsville Methodist Church, 17 W. Genesee St. • DeWitt — 4:30 p.m., Nov. 20 and Dec. 19 at Pebble Hill Presbyterian Church, 5299 Jamesville Road. For individuals with early-stage Alzheimer’s disease or other dementia and their care partners; call 315-472-4201 for advance screening. • Liverpool — 11 a.m., Nov. 10 and Dec. 8 at Liverpool First Presbyterian Church, 603 Tulip St. • Manlius — 6:30 p.m., Nov. 27 and Dec. 18 at Manlius Public Library, 1 Arkie Albanese Way. • North Syracuse — 3:15 p.m., Nov. 20 and Dec. 18 at NOPL North Syracuse, 100 Trolley Barn Lane • Skaneateles — 2 p.m., Nov. 29 and

Dec. 27 at Grace Chapel, 1674 U.S. Route 20 • Syracuse – 5:30 p.m.. Nov. 14 and Dec. 12 at Alzheimer’s Association, Central New York Chapter, 441 W. Kirkpatrick St. Support group for caregivers of people living with younger-onset (under 65 years old) Alzheimer’s disease or other dementia – 5:30 p.m., Nov. 20 and Dec. 18 at The Centers at St. Camillus, 813 Fay Road. – 6:30 p.m., Nov. 19 and Dec. 17 at The Dunbar Center, 1453 S. State St. –1 p.m., Nov. 1 and 15, Dec. 6 and 20 at The Hearth on James, 830 James St. – 6 p.m., Nov. 6 and Dec. 4 at SAGE Upstate, 431 E. Fayette St. LGBT caregivers support group. – 10 a.m., Nov. 1 and Dec. 6 at Mundy Branch Library, 1204 S. Geddes St. Spanish language group. – 1 p.m., Nov. 7 and Dec. 5 at Syracuse V.A. Hospital, 800 Irving Ave., room B905. Non-veterans welcome.   n Oswego County • Central Square — 7 p.m., Nov. 26 and Dec. 17 at First Universalist Church of Central Square, 3243 Fulton Ave. • Oswego — 6 p.m.at Nov. 28 and Dec. 26 The Manor at Seneca Hill, 20 Manor Dr.


C-Section Rates Have Nearly Doubled Since 2000: Study

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he number of women delivering babies via cesarean section has nearly doubled worldwide since 2000, to about 21 percent, new research shows. That’s significantly higher than the 10 percent to 15 percent considered medically necessary, researchers said. When complications develop, C-sections can save the lives of mothers and their babies. But the surgery is not risk-free and has been linked to difficulties with future births. “The large increases in C-section use — mostly in richer settings for nonmedical purposes — are concerning because of the associated risks for women and children,” said physician Marleen Temmerman, lead author of three studies published Oct. 11 in The Lancet. Temmerman is a professor of obstetrics and gynecology at Aga Khan University in Nairobi, Kenya. Worldwide, C-sections rose nearly 4 percent a year between 2000 and 2015, the study found. That translates to 16 million of the 132 million live births in 2000 and 30 million of the 141 million live births in 2015. The fastest rise (6 percent) took place in South Asia, where researchers said C-section deliveries were underused in 2000 but overused 15 years later. C-sections were also overused in the United States, Canada, West-

ern Europe, Latin America and the Caribbean, where rates rose about 2 percent a year over the study period of 2000 to 2015. In North America alone, C-section births rose from about 24 percent to 32 percent during that time span, the study found. Fifteen nations, including Mexico and Cuba, had C-section rates that topped 40 percent. Some women choose an elective cesarean delivery because it allows them to skip the pain and uncertain timing of natural labor. A C-section is medically necessary when complications develop such as bleeding, high blood pressure or the baby is in an abnormal position in the womb, endangering mother or child. But the procedure is unavailable to many women in low-income countries and overused in many middle- and high-income countries, the researchers found. Six out of 10 nations do too many C-sections and a quarter perform too few, the study found. Moreover, wide differences exist between rich and poor, public and private sectors, and between regions, the researchers said. “In cases where complications do occur, C-sections save lives, and we must increase accessibility in poorer regions, making C-sections universally available, but we should not overuse them,” Temmerman said in a journal news release.

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October 13 • 9:00AM | October 24, November 28 • 4:00PM CAZENOVIA FINANCIAL CENTER 82 Albany St., Cazenovia, NY 13035

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November 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 5


Meet

Your Doctor

By Chris Motola

Heidi S. Puc, M.D. Physician discusses how integrative medicine can help patients with cancer, Lyme disease Q: You have a new practice in Chittenango. What kind of patients do you see? A: I have been board-certified in internal medicine, hematology and oncology, but I have specialty training in integrative medicine. I take care of cancer, Lyme and general medical patients from an integrative standpoint, including patients seeking prevention and wellness. That’s the focus of my practice. Q: For those unfamiliar, what is “integrative medicine?” A: Integrative medicine is bridging conventional therapy with more holistic and complementary therapy to help improve patients’ quality of life. We’ll use herbal supplements, either oral or IV or other modalities like mind/body therapy to help improve outcomes. Q: What benefits have you seen from adding holistic elements to your patients’ treatments? A: An integrative approach is helpful in reducing side effects from conventional therapies, because many times drugs do have side effects. We try to alleviate symptoms to help patients improve outcome and the quality of their lives with mindbody therapies and IV or oral herbal supplements. In many cases, patients can come down on their pharmaceuticals or come off of them completely. A lot of my patients have either cancer or chronic Lyme disease, so we use herbals in conjunction with conventional therapies. I find it helps patients tolerate conventional therapies better. I hope that it can also eventually help improve survival, and we know from the integrative literature that it can. There is definitely a positive effect on quality of life. Q: Are there any particular alternative therapies that patients seem to respond to the best, or does it vary by patient? A: It varies by patient. I try to tailor supplements by looking at which ones have an evidence-basis for particular problems. For Lyme disease, there are certain herbal blends that seem to help. For cancer, there are various supplements that can decrease inflammation, decrease pain or even help, along with chemotherapy or radiation, to control the growth of cancer. Q: How do you manage your patients’ expectations for what alternative therapies can and can’t do? A: I think every patient’s case is unique, and they come to me for a variety of reasons. I always ask my patients what their goals are, and give them realistic expectations about what integrative medicine can do. The great thing about integraPage 6

tive medicine is that it’s a partnership between the provider and the patient. Many times in conventional medicine patients are just given a prescription and feel like there is very little they can do themselves. In my practice I will encourage patients and explain the power they do have to affect their own health while I help them figure out what is appropriate. We do have the ability to certify medical marijuana for patients if it’s appropriate. We can recommend a variety of herbals and IV “nutraceuticals” like high-dose vitamin C. We also have a Reiki practitioner in the office, and focus on mind-body healing. We also have a board-certified integrative nutrition holistic health coach in the office. I develop a unique treatment plan with each patient and encourage them to embrace their own well-being. I try to undo any obstacles that interfere with a patient’s own ability to heal. Integrative medicine is very empowering for patients. I always let patients know that healing is always possible even if curing is unlikely. Q: Immunotherapy seems to be an emerging way of treating cancer. Do you see it as conventional medicine and alternative medicine aligning somewhat? A: I think they definitely can work together, and we have a lot of data in the integrative world that the use of antioxidants can support rather than impede conventional therapies. There are particular herbals that can interfere with particular drugs, but with most herbals this is not an issue. The trouble is that it’s hard to get studies funded on herbals. We do need more information on whether herbals can support these new immunotherapies or if they will be problematic. So we want to be very careful about what we recommend to go along with these newer drugs. Q: What makes Lyme disease such a complicated disease to treat? A: It’s complicated by its nature when it becomes chronic. In its acute stage, shortly after a tick bite — when you may or may not have a bullseye rash — is when it’s curable if treated appropriately. Unfortunately, many times patients don’t remember a tick bite or they’ve been treated only partially, or initial treatment was not effective. Then, they end up getting what we ILADStrained physicians [International Lyme and Associated Diseases Society] call chronic Lyme disease or what the IDSA [Infectious Diseases Society of America] physicians call postLyme syndrome. There’s disagreement over what’s actually going on

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

and whether it’s a real disease. What we’ve found, and what I believe, is that it’s an epidemic and a real problem. We ILADS doctors feel that the spirochete that causes Lyme changes shape and does persist within the body, causing a multitude of complex clinical problems. Chronic Lyme disease patients often also acquire other infections called co-infectors which can cause added symptoms. These can include everything from joint and muscular pain to central nervous system problems, heart issues, gut issues, as well as compromising the immune system and others. There are a lot of politics in terms of managing Lyme because of this disagreement in the medical community, and the fear of using longer term antibiotics. In my personal experience and practice, many patients get better with appropriate treatments with longer term treatment with herbals, antibiotics or a combination of the two, meaning from two months up to a year or more. Q: Obviously the bullseye rash is a good indicator if Lyme disease is present, but how effective is our detection of the disease otherwise? A: The problem with the testing that we have is that it takes three to six weeks for an antibody response to mount. And even then the standard Lyme test we have is not highly accurate. We tend to have a lot of false negatives. On the standard test there is even a disclaimer that we need to treat patients on a clinical basis rather than rely on the test; the test is designed for research purposes, not for clinical management of patients. So we need to look at the patient’s symptoms. We have patients who have only been treated with two antibiotic tablets for acute Lyme, which is very inappropriate. So we need better testing, but we also need to educate providers about the dangers of developing chronic Lyme disease when acute Lyme is not treated appropriately. Q: For the physicians who don’t believe chronic Lyme is a thing, what do they think is going on with these patients? A: Many of them refer to it as post-Lyme syndrome (or these patients are misdiagnosed as having a different illness). The idea is that the organism is no longer present, but it has caused collateral damage. So

In the News Physician Heidi S. Puc, a board-certified hematologist and medical oncologist with more than 20 years of experience in the private practice of adult hematology and oncology, has opened her own practice in Chittenango. The practice, Integrative Medicine of Central New York, PC, offers integrative oncology, integrative treatment of Lyme disease, integrative prevention and wellness, general integrative medicine, medical marijuana certification for NYS qualifying diagnoses, Reiki, Pranic healing, integrative nutritional health coaching, CBD oil, and essential oils. It has an infusion room and specializes in high dose IV vitamin C and a wide variety of wellness infusions. Previously, Puc was a physician owner at Hematology Oncology Associates of Central New York. they think the symptoms are caused by some kind of permanent damage the organism has done and we can’t really do much about it. It is more complicated than that. There are co-infectors that travel with Lyme disease in the tick bite, and they can cause related or different symptoms that need to be dealt with as well. We ILADS-trained doctors feel that most or all of these organisms are persistent long-term. We may not be able to completely eliminate these organisms from the system, but we can help patients go into remission and feel better. I have had many patients who were at a very low-functioning level and have gotten them back to normal or near normal functioning. The key is to maintain these patients in remission long-term.

Lifelines Name: Heidi S. Puc, MD, Fellow of the American College of Physicians (FACP), member of American Board of Integrative Holistic Medicine (ABIHM) Position: Physician/Owner, Integrative Medicine of Central New York, P.C. in Chittenango Hometown: Grew up in Ridgewood, Queens, but has made Syracuse her hometown for the last 23 years Education: Mount Sinai School of Medicine, The New York Hospital/ Cornell Affiliated Hospitals, Memorial Sloan Kettering Cancer Center. Received specialty training in Integrative Medicine through the Scripps Clinic in California, and also completed a two-year fellowship program run by Dr. Andrew Weil at the University of Arizona. Career: Former physician owner at Hematology Oncology Associates of Central New York. Worked as a physician employee at the Stram Center for Integrative Medicine Organizations: Fellow of the American College of Physicians and a diplomate of the American Board of Integrative Holistic Medicine.  Also a member of the American Society of Clinical Oncology, the American College of Physicians, the Society for Integrative Oncology, and ILADS Family: Fiancé, three children Hobbies: Exercise, hiking, camping, meditation


Sepsis Poses Deadly Risk Identifying and treating sepsis during its early stages improve a patient’s chances for survival

T

he Centers for Disease Control and Prevention reports that each year in the United States, more than 1.7 million people are diagnosed with sepsis. The sepsis death toll, which stands at 270,000 each year, exceeds annual deaths in the U.S. from breast cancer, prostate cancer and AIDS combined. Sepsis occurs when an infection triggers a serious inflammatory response throughout the body. Leading causes of sepsis include such common infections as cellulitis, pneumonia, urinary tract infections and diverticulitis. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure and death. “Identifying and treating sepsis during its early stage is very important,” said physician Richard Lockwood, vice president and chief medical officer, Excellus BlueCross

BlueShield. “Early treatment with antibiotics and large amounts of intravenous fluids improve chances for survival.” Lockwood suggests that people who are recovering from a medical procedure or surgery, especially those who are elderly, very young, have chronic health conditions or have weak immune systems, be carefully monitored. The CDC lists any combination of the following as symptoms of sepsis: • Confusion or disorientation • Shortness of breath • High heart rate • Fever, shivering, or feeling very cold • Extreme pain or discomfort • Clammy or sweaty skin “Act fast and get medical care immediately if you suspect sepsis or have an infection that’s not getting better or is getting worse,” said Lock-

Rate of Sepsis Admissions per 1,000 adults (2017)

Western New York

7.39 (9,000 adults)

Finger Lakes 5.65 (4,800 adults) Central New York

3.59 (2,000 adults)

Utica/Rome/North Country

4.00 (3,000 adults)

Southern Tier

3.70 (1,500 adults)

Upstate New York 4.68 Source: Excellus BlueCross BlueShield. Infographic about the warning signs of sepsis is available free to download at https://tinyurl.com/yafsefcd. To learn more about sepsis and how to prevent infections, visit www.cdc.gov/sepsis. wood. Treatment consists of finding the source of the infection, administering antibiotics and maintaining blood flow to vital organs. To prevent the onset of an infection that could lead to sepsis, Lockwood recommends: • Practicing good hygiene, including properly washing hands and cleaning cuts • Discussing with your doctor

the best ways to prevent infections • Getting recommended vaccines • Being aware of the warning signs of sepsis • Seeking medical care immediately if an infection does not get better or worsens

n See related story on page 31.

Healthcare in a Minute By George W. Chapman

Commercial Insurance Premiums Up Again

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ore than 150 million people are on commercial insurance through their employer. Despite the elimination of some ACA taxes, premiums are still on the rise well ahead of inflation. Family premiums  went up an average of 5 percent to about $19,600 and individual premiums went up an average 3 percent to almost $7,000, according to the Kaiser Family Foundation. Worker wage increases and inflation are both at 2.5 percent this year. In the last 10 years,

premiums have increased twice as fast as worker earnings and three time as fast as inflation. To exacerbate things for consumers, out-of-pocket deductibles have increased eight times faster than their earnings. Employers seemingly “take back” wage increases via increases in employee copays and deductibles. Some of the recent increase in premiums is due to younger people going without insurance (making risk pool older) once the mandate to have insurance was terminated.

Hospital Inspectors The Centers for Medicare and Medicaid Services (CMS) relies on independent inspectors or accrediting organizations (AOs) to ensure public and private hospital quality and safety. A Wall Street Journal investigation found that some hospitals, despite a history of ongoing problems, still kept their “accredited” status, which allows them to receive payments from CMS. Consequently, CMS is improving its oversight of these AOs. CMS has redesigned the inspection process AOs must follow and will begin posting the AO performance data and findings to Congress. CMS will also select hospitals at random to and compare the CMS audit to that of the AO. The plan is to release more detail like complaints and out of compliance data versus just the overall accreditation status of a hospital. It is still illegal for CMS to disclose actual hospital surveys performed by the AOs.

star scale. This year, two thirds of the VA hospitals (96 of 146) showed improvement. The current rankings are: Albany 3+, Bath 5+, Buffalo 4+, Canandaigua 4+ and Syracuse 3. The + indicates noticeable improvement since the last audit.   Accessing Your Records You are entitled to a complete copy of your medical record, digital if you want,  per the Health Information Portability and Accountability Act (HIPAA) of 1996. Providers are allowed to charge a “reasonable fee,” typically a fixed rate or per page rate. Usually, it is not a problem requesting and receiving a copy of your record from your physician. You have a relationship with your physician(s) and the cost to copy the record is not prohibitive because it might be just several pages in length. According to a study conducted by the Yale University School of Medicine, obtaining your record from a hospital is more of a challenge. Researchers, posing as patients, called the top 83 hospitals in the US and asked about procuring a copy of their record. One

Upstate VA Hospital Ratings The VA performs its own audits and ranks its hospitals on a five

hospital actually told the “patient” that it would be a HIPAA violation to release a copy in any event. Several hospitals said that sending the record via email was “insecure” and therefore a violation. That is not true. You are entitled to receive a copy of your record in any format as long as it is readily producible in that format. Many of the hospitals in the study didn’t even have a process for delivering the record in digital format, although required to do so by law. Many hospitals said they could only send paper copies and would charge per page. In most cases, the expense would be prohibitive as a 200-page hospital record is not atypical. However, in their defense, there are still storage units filled with boxes of paper records and accessing and copying your record is time and labor intensive. The study concluded that while patients should know they are entitled to digital copy by law, they have to understand hospitals are still transitioning to the digital age.    Medicare Premiums Level There are about 60 million people covered by Medicare. Ten thousand baby boomers (65+) are signing up for Medicare every day. It is projected there will be almost 80 million seniors on Medicare by 2030.  Medicare premiums went up an average of just 1 percent a year under Obama and continue to creep up today well below commercial premium increases. How is that possible? Skeptics have attributed this low increase phenomenon as a fluke or result of the last recession. The thought was seniors couldn’t afford the 20 percent copay so didn’t seek as much care. That has never been proven. Vanderbilt University economist Melinda Buntin has studied Medicare for years and has raised some eyebrows as she reveals her findings. The Affordable Care Act, not the recession, had way more to do with leveling/steading Medicare premiums over the last 10 years. There was a “perfect storm” of provider incentives to control November 2018 •

costs and how care was delivered. She found that Medicare and Medicaid got much better at managing dual eligibles (over 65 and poor). Value-based payments and payment bundling were effective at controlling costs without decreasing the quality of care. The dismantling of the ACA will have a negative impact and the expectation is Medicare premiums will soon increase by more than 1 percent annually.   Drug Pricing Under Control?   In what could be a sign of the times, drug manufacturer Gilead is dropping the list price of its generic Hep C drug “Harvoni.”  As reported in the Wall Street Journal recently, the list price for the eight-week treatment plan was dropped from a staggering $63,000 to a staggering $24,000.  This is “progress.” Traditionally, drug manufacturers have marked up prices in anticipation of giving discounts to pharmacy benefit managers (PBMs). The  good news for consumers is that many plans require you to pay your share based on the absurd list price versus the discounted price obtained by PBMs.  Trump Signs Spending Bill  The 2019 federal fiscal year began Oct. 1. Related to healthcare, the budget increased funding for: the DHHS and NIH, the opioid epidemic, increased access to addiction treatment, slowing the flow of illegal drugs into the US, and for states to monitor prescriptions.  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

Alone on Thanksgiving? We’re in This Together

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or the first time in 64 years, I will be celebrating Thanksgiving alone. My parents have passed on and my sister Anne, who has taken up the mantle in their absence, will be leaving town to enjoy Thanksgiving with her husband’s family down south. Unfortunately, I won’t be able to join them. I’ll be on my own. If you, as I am, are facing Thanksgiving alone for the first time, you may be anticipating a lonely and depressing fourth Thursday of November. But, it doesn’t have to be so. Whether you’re divorced, widowed or simply fending for yourself on Thanksgiving, this family-centered holiday can be an opportunity for personal growth, gratitude and self-expression. Personally, I’m taking my own best advice to heart. Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year. • Be thankful — What better time to feel and experience gratitude. Consider making a list of all the things you are thankful for this year: Your health? Your children? Those good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved

pet? Or perhaps even this opportunity in your life to learn and grow? • Take the long view — While you may be alone this year, it doesn’t mean you’ll be dining solo on leftover stuffing for the rest of your life. This one day doesn’t dictate your destiny. Who knows what the future holds? Over the next year, you may meet someone special or achieve a measure of inner peace and confidence that enables you to enjoy a holiday on your own or with your “family of friends.” • Do good — Brightening the holiday for those less fortunate can be a worthwhile and satisfying way to spend the day. Shelters and food kitchens often welcome volunteers, but — truth is — many of these agencies fill up fast with regular volunteers. You may need to plan ahead and be creative. As an alternative, you might consider participating in a local Turkey Trot, most of which benefit charities. You could burn off a few calories for a good cause or participate as a volunteer. They often need extra hands to register and cheer on runners of all ages. Instead of serving supper at the shelter, you could be serving up smiles at the finish line. • Throw your own little “Friendsgiving” for fellow single or separated persons —

s d i K Corner

Many Parents Fail to Recognize That Their Children Are Overweight

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or some kids, a few extra treats in moderation during the upcoming holiday season is harmless. But for others who indulge year-round and get little exercise, extra holiday indulgences only add to weight gain and the prevalence of childhood obesity in the United States. The problem, say researchers at University of Michigan C.S. Mott Children’s Hospital, is that large numbers of parents fail to recognize that their children are overweight or obese, and therefore may be less inclined to modify their children’s Page 8

diet and activity levels. According to a 2017 report by the C.S. Mott Children’s Hospital National Poll on Children’s Health, more than 40 percent of parents with obese children aged 6 to 11 describe their child not as obese, but as “about the right weight.” In fact, the report finds only 13 percent of parents with obese children aged 6 to 11 rate their child as being very overweight, compared with 31 percent of parents with obese children aged 12 to 17. And, less than 10 percent of parents with obese children aged 6 to 11 say they are

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

Have some fun! It doesn’t have to be elaborate or even planned far in advance. Sometimes last-minute dinner invitations can turn into the best, most memorable get-togethers. Chances are you know others who may be alone this Thanksgiving. Extend a warm invitation and ask people to bring a holiday side-dish to pass. This gives everyone a chance to make a meaningful (and delicious!) contribution. • Beware of “euphoric recall” — When you are feeling lonely, it can be easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the bickering, bad blood and woozy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing. • Rent a movie and indulge in a tasty guilty pleasure — Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart. Or find a newer movie, such as “About Time,” and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love pumpkin pie ice cream this time of year! • Pick up the phone — The difference between isolation and engagement can be as simple as dialing a seven or 10-digit phone number. My experience happily tells me that most everyone welcomes a call and warm wishes on Thanksgiving. Your invitation to go for a walk or see a matinee while the turkey is in the oven may be seen as a nice diversion and chance to get out of the house. Don’t hesitate to make a call. • Decorate your home inside and out — Do it for you. It may help put you in the spirit of the holiday. This past

weekend, I recreated my annual stacked-pumpkin display for my front porch. It gives me a warm feeling every time I pull up to the house. Create harvest accents for your home to help kindle the essence of Thanksgiving in your heart. • Write “thank you” notes — Now here’s an idea that’s so obvious it often gets overlooked on Thanksgiving. “Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, PhD, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship. Who wouldn’t love to receive a card on the day after Thanksgiving that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).” In preparation for this kind gesture, purchase cards and stamps in advance. So, there you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can be thankful you got out of bed, rose to the occasion, and enjoyed your Thanksgiving.

“very concerned” about their child’s weight. While most parents agree childhood obesity is a major health issue, many underestimate their own children’s weight and fail to take corrective steps to manage weight gain. Without intervention, childhood obesity can take a hefty toll on a person’s life-long health. “It is critical to address obesity in the childhood years — at home, and in schools and other community settings,” said physician Matthew M. Davis, director of the national poll on children’s health. “But in order to address childhood obesity at home, parents must first recognize that a child is not at a healthy weight for their height. Parents also must be concerned enough to want to do something about their children’s obesity.” One of the greatest challenges for parents is that children’s obesity may not be easy to judge subjectively, he says. Obesity is based on a child’s body mass index, or BMI. When a

child’s BMI is at or higher than the 95th percentile for children who are the same age and gender, the child is obese. For example, a 6-year-old boy who is average height (3’9 1/2’’) would be considered obese if he weighs 55 lbs. or more. Based on results from the latest report from the National Poll on Children’s Health, Davis says parents may under-estimate their children’s weight, or over-estimate their children’s height. Parent-reported height and weight for the poll indicate that 15 percent of children aged 6 to 11, and 10 percent of children aged 12 to 17, are obese. Overall, 25 percent of children in 2007 were reported as being either obese or overweight. These parent-reported estimates, however, fall short of previous data on childhood obesity and overweight obtained through national studies. The studies — in which children’s height and weight were measured in person — found that 35 percent of U.S. children aged 6 to 17 are obese or overweight

Gwenn Voelckers leads “Live Alone and Thrive” empowerment workshops for women in Mendon, Monroe County, and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase a book or invite Voelckers to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com


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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9

5/23/18 11:34 AM


5

Things to Know About Heartburn By Ernst Lamothe Jr.

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eartburn affects one in five adults, and can make life miserable. It is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach. If you have heartburn more than twice a week, you may have gastroesophageal reflux disease — GERD. (See separate story in this issue). “It’s not just what types of food we tend to eat, but also how much food we eat and when we eat it,” said Borys Buniak, gastroenterologist at the Heartburn Center at St. Joseph’s Health in Syracuse. “All of these behaviors have a negative impact on our digestive system, and often cause uncomfortable flare ups of heartburn. Buniak has these five tips for reducing heartburn.  

1.

Eat smaller meals.

It’s difficult when you are hungry to worry about portion size. However it has a direct correlation with heartburn depending on the amount and type of foods you are eating. When we overeat, sometimes we regurgitate elements into our esophagus or mouth and that is often why we have a burning sensation in our chest. “Some people describe chest pressure when this happens, which could be confused with symptoms of a heart attack,” said Buniak. “Re-

gurgitation may also cause a chronic cough or hoarseness if the vocal cords or lungs become irritated by stomach contents. To avoid this situation after a large meal, eat smaller meals and avoid bending over.” He also recommends not leaning or laying down after eating because the action tilts your stomach and allows acid to flow into your esophagus. “The only way to control heartburn is to eat smarter foods, in smaller portions,” he added. “Try eating light appetizers like shrimp and vegetables to front-load your meal, and avoid over-eating the fattier foods during the main course and dessert.

2.

Avoid bedtime snacks.

Eating late into the evening has adverse effects for many reasons. It can lead to weight gain because once you eat late there isn’t an opportunity to burn those calories away. There are times when it might slow down your metabolism. It is also one of the known risk factors for causing heartburn. “Eat meals at least two to three hours before lying down to prevent reflux,” he said. “Some people may wake up to a choking sensation if food backs up into the back of the throat. Certain foods you eat also may aggravate symptoms. Sleeping with the head of the bed elevated usually allows gravity to keep gastric contents from backing up into the esophagus. Wedge pillows are also helpful.”

3.

Avoid trigger food.

Gastroesophageal reflux disease (GERD) is one of the most common disorders of the digestive tract, affecting about one in 45 U.S. adults, according to the National Institute of Health. GERD may cause discomfort while eating and over time can lead to serious medical conditions, such as esophagitis, Barrett’s esophagus and cancer But, like many ailments, it can often be prevented or controlled through diet and lifestyle changes. There are several foods that consistently trigger heartburn. Common trigger foods include spicy meals, fatty red meat, fried foods, citrus fruits, tomatoes, raw onion, tomato sauce, butter, oils, chocolate, alcohol and caffeine. “Taking antacids, such as Gaviscon or H2 blockers, such as Pepcid or Zantac, before or after meals containing these trigger foods may alleviate most heartburn symptoms,” said Buniak. Also taking other over-thecounter medication only treats the symptoms temporarily and does not treat the actual problem that causes heartburn.

4.

Weight Loss.

When overweight, the fat surrounding your abdomen will press against the stomach, pushing acid or food upward into the esophagus. This can be aggravated by lying flat. Losing weight helps reduce heartburn. Sleeping on a wedge often helps reduce nocturnal reflux events. Sleeping on your left side may also reduce acid backup into the esophagus.

Gastroenterologist Borys Buniak

5.

Quit smoking.

By now, we all know the information about smoking being bad for individuals and the overall population. And while the statistics are encouraging with the number of young smokers dropping with each year, issues persists because other elements have filled in the void of tobacco. But there are other random facts that many people don’t know about smoking, food and digestive issues. Smoking cuts down saliva production. Saliva helps flush stomach acid out of the esophagus and it contains bicarbonate which neutralizes acid. “Nicotine also reduces the lower esophageal sphincter pressure allowing more gastric acid to back up into the esophagus,” said Buniak. “Chewing gum after meals increases saliva production and reduces esophageal acid levels. Chronic reflux and smoking also increases one’s risk for esophageal cancer.” In addition, when you quit smoking, your taste buds come back to life.

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LUNG CANCER

What is GERD?

SCREENING

Dietary changes and even surgery are indicated to treat this condition — also known as the ‘silent reflux’ By Deborah Jeanne Sergeant

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astroesophageal reflux disease (GERD) causes the acid and food in the stomach to go back into the esophagus. The happens when the lower esophageal sphincter opens when it shouldn’t. Patients suffer pain, sore throat and heartburn severe enough that the sensation even reaches the mouth. Patients presenting with chest pain should first rule out heart issues. Atypical heartburn, called “silent reflux,” can cause sinusitis, cough, and chest discomfort, not the typical heartburn. Beyond the uncomfortable symptoms, ongoing exposure to acid can cause lasting damage and even cancer. Endoscopy can lead to a diagnosis and then treatment options. For people who have a high acid load, medication can help control it. Lower potency acid reducers are available over-the-counter and higher potency by prescription. Proton pump inhibitors are another type of medication prescribed to hamper the final step of acid production in the stomach. Long term side effects from that medication can include decreased calcium absorption, diarrhea, abdominal pain and headache. Other interventions can help. Kelly Springer, a registered dietitian and owner of Kelly’s Choice, LLC in Skaneateles, encourages patients to try dietary adjustments for relief. “We get referrals from gastroenterologists,” she said. “We can help people with acid reflux and GI disorders.” She listed foods to limit, including acidic items like citrus, tomatoes and sauce, and coffee. Spicy foods like hot peppers and sauces can also irritate the system. High fat foods like fried foods, many kinds of nuts, nut butters, added fats and fatty meats can also prove bothersome, as can mint, garlic, and onions, caffeine, carbonated beverages, wine and sometimes other types of alcohol. In addition to dietary changes, Springer advises patients with GERD to make lifestyle changes. “With acid reflux, a lot of times

it’s overeating which causes acid to push up,” she said. “That can cause a lot of acid to build. They also could be making a little more acid. Eating smaller meals throughout the day, they tend to have less acid reflux.” Overweight people may find relief from losing weight, as carrying too much weight can worsen GERD. Wearing looser clothing and quitting smoking can also help reduce the effects. Springer wants patients to wait three hours after eating before lying down. She also said that raising the head of the bed nine inches can keep acid where it belongs. To generally improve digestion, she wants people to eat more probiotic foods, including kimchi, kombucha, yogurt, kefir, and fermented pickles and other vegetables. “I do think that a lot of it has to do with food choices,” Springer said. “If we had more fiber in our diets and more probiotics, we’d have less GI issues, including acid reflux. Get back to real food eaten consistently throughout the day. Some people with acid reflux skip meals throughout the day and the overeat at the next mealtime. Eat regularly scheduled meals with real food. Then these symptoms diminish.” Karen Fisk, wellness educator at Natur-Tyme in Syracuse, helps patients look into digestion for possible contributors to their GERD. She said it stems from an imbalance of digestive juices, beginning with sensors in the tongue that tell the pancreas the makeup of the food eaten. “By the time you swallow, the stomach increases the hydrochloric acid to set the stage for digestion and the pancreas has released the enzymes,” Fisk said. She said that anyone lacking enzymes can’t properly digest the food and it ferments, causing gas. That gas pushes the bile up, causing reflux. “Select foods you digest well and take digestive enzymes that do what pancreatic enzymes would do,” Fisk said. “You should have some relief and be able to minimize the excess acid because the body won’t generate what isn’t needed.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 11


My Turn Dimples: Are They Inherited? By Eva Briggs

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y husband, his mother and three of his four siblings have dimples. No one in my family has dimples. It took me three children to produce a single dimple on my youngest daughter’s left cheek. So are dimples inherited? The jury is still out. Some scientists say yes, they are passed from parents to children as a dominant trait. A dominant trait is one that requires just a single copy of the relevant gene. Others believe the apparent familial clustering is just a coincidence and that dimples are simply a random occurrence. I never really thought about what causes dimples until a friend’s high-school-age daughter announced that an abnormal muscle causes cheek dimples. It turns out she is correct. A variant form of the zygomaticus major muscle is the culprit. One end of this muscle attaches to the cheekbone. In dimpled people, the muscle is either split into two or bifid (forked). One part attaches above the corner of the mouth and the other below the corner of the mouth. When the individual smiles or makes other facial expressions, it pulls the skin into a dimple. Chin dimples, which are present regardless of facial expression, arise from a cleft in the underlying bone. The cleft a remnant of incomplete fusion of the two halves of the jaw

bone during development. Is there a purpose for dimples? One theory is that dimples are associated with infancy and trigger a nurturing response in adults. This notion suggests that adults are less likely to harm or neglect a cute dimpled infant, even if screaming and fussy at 3 a.m. This increases the odds of survival. Others think dimples enhance facial expressions, increasing attractiveness to a potential mate and enhancing communication. Facial dimples may be cute, but sacral dimples are sometimes a completely different matter. These dimples are found overlying the sacrum, the part of the spine just above the coccyx or “tail bone.” They occur in about 4 percent of people and most of the time they are harmless. A small percentage of sacral dimples, however, signal an underlying defect of the spine, such as spina bifida or a tethered cord. Shallow dimples that are fully covered with skin are usually benign. Signs that suggest a potential serious problem are a tuft of hair, a skin tag, skin discoloration or leg weakness. Sacral dimples are present at birth. The next test, if a sacral dimple appears possibly worrisome, is an ultrasound. Spina bifida is a condition where the spine does not form fully. In the most serious form, myelomeningocele, the spinal cord and its covering form a bulge. The nerves are usually

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Page 12

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

damaged, causing disability that can be serious. Meningocele is an intermediate defect where only the covering of the spinal cord bulges out, generally causing less serious nerve damage and disability. The most minor form is called spina bifida occulta. Although the bone isn’t fully formed, no spine tissue bulges out and there is usually no disability. One potential cause of spina bifida and related disorders is folate deficiency in a pregnant woman. Prenatal vitamins contain extra folate and reduce the chance of these birth defects. Because the spinal cord forms early, folate is most effective if started before a woman even realizes that she is pregnant. That’s why women of childbearing age who might become pregnant should take folate-containing vitamins even before conception. A tethered cord occurs when the

underlying spinal cord is attached or stuck to overlying tissues. As the child grows, the spinal cord is stretched or pulled, resulting in nerve damage. If discovered early it can be treated surgically before symptoms occur. Fortunately most sacral dimples aren’t dangerous. It’s a matter of opinion as to whether they are as cute as cheek dimples. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.


CBD Oil 101

More are using cannabidiol (CBD) oil for chronic pain, inflammation, anxiety, depression By Deborah Jeanne Sergeant

I

n light of the opioid epidemic, many people want an alternative means to manage chronic pain without side effects and risk of dependency. Others want pain relief for conditions difficult for typical pain medication to manage. Cannabidiol (CBD) oil, may provide help. One of the more than 100 cannabinoids inherent to cannabis sativa (cannabis or hemp), CBD oil is said to support the health of people who suffer from pain, inflammation, anxiety and depression without the “high” or lethargic effects typical of tetrahydrocannabinol (THC). David Brickman owns Hemp It Up! stores Syracuse and Rochester. The shops sell hemp-related gifts and supplements. “People produce endocannabinoids in the body,” Brickman said. “As it turns out, by supplementing cannabinoids produced Brickman in a plant, we can do ourselves medical benefits.” He said that many people come to his shop seeking relief from anxiety and depression and pain issues. And some of those have been sent in by their primary care providers. Brickman sources CBD oil from vetted companies in Colorado, he said. Though it’s legal to grow industrial hemp in approved pilot

programs in New York, it’s not widespread. The producers supplying Hemp It Up! provide third party certificates of authenticity from independent labs. “The results of these tests are available to us and our customers,” Brickman said. While FDA has not approved CBD oil as prescription medication (which, in New York, may include medical marijuana), CBD oil is considered a supplement, like vitamin C. Hemp It Up! carries CBD in a variety of formats, including topical preparations, capsules, gummies, suppositories, and edible drops. “We’ve had many, many return customers and many having been referred by other customers of ours,” Brickman said. He advises customers to check with their doctors before taking CBD oil and starting at a small serving and increasing until the desired result is achieved. For someone taking moderate servings daily, CBD costs about $40 to $100 for a 30-day supply. Karen Fisk, wellness educator at Natur-Tyme in Syracuse, hopes that more research on CBD oil will offer some evidence that it can help people. “Hemp has been much maligned for the past eight decades, but prior to that it was widely used medicinally and industrially,” she said. Her store sells a few hemp-based products that she said customers

say they help them with anxiety and insomnia. As with any other legally sold hemp-based supplement, they must each contain less than .03 percent THC, the psychoactive element that causes the “high” in cannabis

plants. “There are practitioners now who are recommending hemp products to their clients for pain, insomnia and anxiety,” Fisk said. “I find it promising.”

Upstate Doctor Skeptical of CBD Oils’ Effectiveness

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He’s also concerned about the long-term effect CBD oil seems to have on pain receptors. “We’re starting to see people using cannabinoids who have taken them long-term who are really pain sensitive,” Johnson said. “It’s treacherous. It ratchets up your pain. It might help your arthritis and then you notice the arthritis as you know it is getting worse and worse.” He thinks that CBD oil could affect the pain drivers in your brain to intensify the pain. “If you have pain, taking this is not the best idea,” Johnson said.

hysician Brian Johnson, director of the addiction medicine program at Upstate Medical University, remains skeptical about the efficacy of CBD oil. “Here’s the problem,” he said. “There are no studies, no FDA trials, on its effectiveness for pain. There are lots of other things that are active treatments like exercise and physical therapy.” He added after reviewing the medical literature and research on CBD oil, no one seems to knows how cannabinoids work to relieve pain. Anecdotally, some people taking it say it helps; others say it doesn’t.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 13


SmartBites

The skinny on healthy eating

Little Kumquats Big on Vitamin C and Fiber

W

hat’s a kumquat? If that question popped into your head, you’re not alone. My husband thought it was a root vegetable. My friend thought it was related to a mango. It’s neither. The size and shape of a large grape, the kumquat is like a baby orange in reverse, with a sweet (edible!) skin and a tart pulp. And right around now, they’re available in major grocery stores. With winter looming — and all the sniffles and sore throats that seem to accompany this season — I’m always on the lookout for ready sources of vitamin C, especially portable ones. Kumquats certainly check that box! Just five small kumquats provide nearly 75 percent of our daily needs. Because vitamin C plays such a vital role in keeping us healthy — from boosting our immune system to producing collagen to limiting the damaging effects of harmful free radicals — it’s no stranger to health-related studies. Ongoing research, for example, has demonstrated that while vitamin C can’t prevent the common cold or upper respiratory infections, it may slightly reduce symptoms. Some studies have suggested that

vitamin C from food can reduce the risk of certain cancers. Still others have found that high dietary intake of vitamin C has been associated with lower risk of heart disease. My takeaway? Consuming the proper amount of this multi-tasking vitamin should be a daily priority. Five bite-sized kumquats also deliver a big dose of fiber — nearly 7 grams of both soluble and insoluble fiber. Insoluble fiber promotes regularity, while soluble fiber helps lower glucose levels and ferry cholesterol out. Both kinds contribute to better health and longevity by helping to reduce the risk of developing such conditions as heart disease, diabetes, diverticulitis and constipation. The edible peel of kumquats serves up beneficial plant compounds with antioxidant, anti-inflammatory and cholesterol-lowering properties. Research suggests that these compounds may help protect against heart disease, cancer, diabetes and weight gain. On the topic of weight, nutritious kumquats are a dream snack: the high water and fiber content makes them filling, the calories are relatively low (around 10 calories each), and they’re super easy to carry around.

Kumquats, Dates, and Shaved Parmesan Salad Adapted from New York Times, Amanda Hesser 6 kumquats 4 big handfuls baby arugula (or greens of choice) 1/2 cup flat-leaf parsley leaves 2-3 dates, pitted and diced 1/4 cup shredded Parmesan cheese 1 clove garlic, minced 1 tablespoon lemon juice 2 tablespoons extra-virgin olive oil Kosher salt and freshly ground black pepper, to taste.

Helpful tips

Select kumquats that are firm, smooth and bright orange, with the stem attached. Pass by any that are green or have soft spots. Store them at room temperature for 3-4 days, and inside the refrigerator for up to three weeks. Whole kumquats taste best if they are gently squeezed before being eaten. Kumquat and cranberry compote (recipe at Epicurious.com) tastes great with turkey!

Anne Palumbo is a lifestyle colum-

Slice the kumquats into thin rounds, discarding the seeds. Combine the arugula, parsley, dates, kumquats and Parmesan in a large bowl. Whisk together the garlic, lemon juice and olive oil; season with salt and pepper. Pour over the salad and toss. Serves 4.

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.

team tracked data from in-person government surveys conducted with thousands of U.S. adults between 2013 and 2016. People were asked to recall what they’d eaten in the past 24 hours. The report found that Americans tend to taper off fast foods as they age. While about 45 percent of people in their 20s and 30s said they’d eaten fast food over the prior day, that number dropped to just under 38 percent for people in their 40s and 50s, and about 24 percent for people aged 60 and older, the study found.

Blacks were more likely to have eaten fast food on a given day than whites (roughly 42 percent vs. 38 percent, respectively), while 35.5 percent of Hispanics and 31 percent of Asian-Americans did so. Men tended to eat more fast food than women, Fryar’s group said. Black men were the most avid consumers of fast food — almost 42 percent had eaten the fare over the past day, the report found. The new report was published Oct. 3 as an National Center for Health Statistics Data Brief.

What Did Americans Eat Today? A Third Would Say Fast Food Research shows 37 percent of adults ate fast food at least once over the past 24 hours

A

mericans’ love affair with fast food continues, with one in every three adults chowing down on the fare on any given day. That’s the finding from a new report from the U.S. Centers for Disease Control and Prevention. When asked by researchers, 37 percent of adults said they’d eaten fast food at least once over the past 24 hours. There was one surprise: Bucking the notion that poorer Americans favor fast food the most, the report found that intake actually rose with income. For example, while about 32 percent of lower-income folks ate fast food daily, more than 36 percent of middle-income consumers had fast food on a given day, as did 42 percent of those with higher incomes, the report found. Whatever your income bracket, fast food probably isn’t doing your health any favors. That’s because it “has been associated with increased intake of calories, fat and sodium,” Page 14

the CDC team said. All that adds up to widening waistlines and hardening arteries, one nutritionist warned. “Most fast food is not good for our bodies,” said Liz Weinandy, a registered dietitian at Ohio State University’s Wexner Medical Center. “The more of it we eat, the more likely we are to be overweight or obese and have increased risk for several diseases like Type 2 diabetes, heart disease and metabolic syndrome when talking to patients,” she said. Too often, though, Americans ignore the danger. “When we see news clips of a shark swimming near a beach, it scares us into not going near that beach,” Weinandy said. But “what we should be scared of is double cheeseburgers, french fries and large amounts of sugary beverages.” The new report was led by Cheryl Fryar of the CDC’s National Center for Health Statistics. Her

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


Study: Even Light Drinking Increases Risk of Death At any age, daily drinkers 20 percent more likely to die prematurely than less frequent drinkers

D

rinking a daily glass of wine for health reasons may not be so healthy after all, suggests a new study from Washington University School of Medicine in St. Louis. Analyzing data from more than

400,000 people aged 18 to 85, the researchers found that consuming one to two drinks four or more times per week — an amount deemed healthy by current guidelines — increases the risk of premature death by 20 per-

cent, compared with drinking three times a week or less. The increased risk of death was consistent across age groups. The study is published online Oct. 3 in the journal Alcoholism:

Clinical & Experimental Research. “It used to seem like having one or two drinks per day was no big deal, and there even have been some studies suggesting it can improve health,” said first author, physician Sarah M. Hartz, an assistant professor of psychiatry. “But now we know that even the lightest daily drinkers have an increased mortality risk.” Although some earlier studies have linked light drinking to improvements in cardiovascular health, Hartz said the new study shows that those potential gains are outweighed by other risks. Her team evaluated heart disease risk and cancer risk and found that although in some cases, drinking alcohol may reduce risk of heart-related problems, daily drinking increased cancer risk and, as a result, mortality risk. “Consuming one or two drinks about four days per week seemed to protect against cardiovascular disease, but drinking every day eliminated those benefits,” she said. “With regard to cancer risk, any drinking at all was detrimental.” The new study comes on the heels of research published in The Lancet, which reviewed data from more than 700 studies around the world and concluded that the safest level of drinking is none. But that study looked at all types of drinking — from light alcohol consumption to binge drinking. The Washington University team analysis focused on light drinkers: those who consumed only one or two drinks a day. The Washington University study focused on two large groups of people in the United States: 340,668 participants, aged 18-85, in the National Health Interview Survey, and another 93,653 individuals, aged 4060 who were treated as outpatients at Veterans Administration clinics. “A 20 percent increase in risk of death is a much bigger deal in older people who already are at higher risk,” Hartz explained. “Relatively few people die in their 20s, so a 20 percent increase in mortality is small but still significant. As people age, their risk of death from any cause also increases, so a 20 percent risk increase at age 75 translates into many more deaths than it does at age 25.” She predicted that as medicine becomes more personalized, some doctors may recommend that people with family histories of heart problems have a drink from time to time, but in families with a history of cancer, physicians may recommend abstinence. “If you tailor medical recommendations to an individual person, there may be situations under which you would think that occasional drinking potentially could be helpful,” she said. “But overall, I do think people should no longer consider a glass of wine a day to somehow be healthy.”

LIFE SAVING SYNERGY Experience the cutting edge of medicine at the St. Joseph’s Health Cardiovascular Institute, as we bring together nationally acclaimed specialists from all facets of cardiovascular medicine to provide the widest range of treatment options in the region. Our commitment to constant self-improvement is strong. And with our ever-growing list of world-class services including our Minimally Invasive Cardiac Surgery Program, patients recover faster and more safely, because to us...

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IN GOOD HEALTH – CNY’s Healthcare Newspaper 10/19/18 12:45 PM

Page 15


Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

Know Your Backstories

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arents live in a world of incessant judgment and feedback. We get it from family, friends, acquaintances and strangers. We receive it while basking in the bluish glow of our smartphones or standing in the checkout line. Whether or not we want or need it, feedback is as pervasive as the tune of “Baby Shark” in our tired minds. Most of this feedback comes from people who don’t know our backstories. The best advice doesn’t use a one-size-fits-all approach, but often it’s delivered from just that perspective. If you find yourself wanting to judge people and offer criticism, ask yourself this: What would your feedback look like if you knew the whole story? Would you change it? Would you stop your feedback altogether? I pose these questions because I would like to start a conversation in the parenting sphere about how judgment divides us. Judgment from others fuels that little voice in the back of our minds that says, ‘you aren’t enough.’ Being kinder to ourselves and each other is the best way

to quiet that voice. If you are interested in progress, don’t judge before you have a person’s backstory. I am going to offer two very specific examples of how knowing my family’s backstory might have changed the way people perceived my family at two events — shopping for groceries and trips to urgent care. But, first, here is a little backstory. The Backstory My daughter recently had ear surgery. She is 7 years old, and it was not the highlight of her year. You see, my daughter has had a few health blips. She was born with two holes in her heart and a heart murmur, both of which quickly resolved themselves but still required testing. She had so many ear infections that we lost count. She eventually had a bilateral myringotomy, which is a fancy way of saying she had tubes inserted in both ears. She still got a lot of ear infections (tubes only help the ears drain during an infection; they don’t keep infections at bay), and those infections were pretty severe. Then,

when her tubes finally fell out, she was left with two perforated eardrums — only one of which healed naturally. Then, at the age of 3, she was diagnosed with juvenile idiopathic arthritis. To get that diagnosis, she endured a lot of painful and scary tests, in addition to a hospital stay. Most recently, her doctor recommended grafting her eardrum to heal her perforation. Before I go on, I would like to note two things. First, I am in no way looking for pity by sharing this. Second, I know things could be a lot worse and am thankful for a relatively healthy daughter. So, now, the scenarios. Scenario 1 After all of her doctor’s visits and testing, my daughter had negative feelings about medical exams and medical professionals. Her primary doctors understood this, but she wasn’t so lucky when we visited places like urgent care or got new nurses at our usual doctors’ offices. I can vividly recall the negative reactions I got from a number of medical professionals when my daughter didn’t want to be examined. They wrote her off as a brat or overly emotional, the disgust on their faces evident even to her. It got to the point where I told anyone who was going to touch my daughter with any medical device (even a thermometer) her backstory. If I didn’t, everyone in that room was going to leave more upset than they needed to be. If those professionals had taken the time to ask a few questions or just read her chart a little closer, they would have known my daughter’s story. Then, they might have offered a gentle smile and condolence when

she started melting down, instead of glares or disgust. Scenario 2 After my daughter’s recent ear surgery, she was quite ill. As she is already very petite, I wanted to get as much nourishment in her as possible. On our way from the hospital, we stopped to pick up groceries for the next few days. She wanted to go into the store with my husband and I, so we let her. It was my hope that picking out her own food would mean she was more likely to eat it. When we got in the store, we let her pick whatever she wanted. Some of it was healthy, but most of it was not. If you were a shopper witnessing this scenario, you might have judged us. As I asked my daughter to pick whatever she wanted, you might have thought I was raising a spoiled brat. If you had seen us in the checkout line (where we looked especially haggard after a long day), you might have judged us for all of the junk food in our basket. You may have even labeled me as a poor parent. However, knowing the backstory, I doubt you would judge me as anything other than a compassionate mother who didn’t want her child to be sick for the next three days because she had an empty stomach after anesthesia. The Takeaway Next time you want to write another parent or their child off as deficient, pause before you issue a judgment. Remind yourself that everyone has a backstory, and you likely don’t know all (or any) of it. Taking this pause might just make this world a kinder place–for yourself and the children you love.

MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

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Male infertility, erectile dysfunction, andrology, general urology, prosthetics, and Peyronies

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JOSEPH JACOB, MD

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DMITRIY NIKOLAVSKY, MD

NICK LIU, MD

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

JONATHAN RIDDELL, MD

Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology

General urology

IMAD NSOULI, MD

Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

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Incontinence, urethral stricture disease, vesicovaginal fistula, reconstructive surgery, transgender care

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MATTHEW D. MASON, MD

JC TRUSSELL, MD

Urologic oncology and endourology, robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal; kidney stones

NATASHA GINZBURG, MD

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SERGEY KRAVCHICK, MD

EDWARD IOFFE, MD

Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal

RAKESH KHANNA, MD

General urology, female and reconstructive urology

ELIZABETH FERRY, MD

General Urology; Female Urinary Incontinence

MICHAEL CASTELLO, DO

MRI fusion, male health, prostate cancer and kidney stones

TIMOTHY K. BYLER, MD

Reconstructive urology; incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery.

STEPHEN BLAKELY, MD

Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

RUBEN PINKHASOV, MD, MPH

UROLOGY FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 Page 16

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


Need a Health Coach? They can offer help on nutrition, wellness, stress and a number of other things By Deborah Jeanne Sergeant

H

ealth coaching rides the trend of preventive health, but how could a health coach help

you? Karen Fisk, wellness educator at Natur-Tyme in Syracuse, said that health coaches’ services are about putting people on a track to good health. “If we don’t think about what we eat or what level of exercise we get, we might think we’re fine. Getting an education about what’s healthful is helpful,� Fisk said. While health coaches tend to work one-on-one with clients, Fisk distributes general health tips to the customers of Natur-Tyme. “A health coach is invested in your outcomes and is hired to track you,� she said. “Consistency is key.� Physician Joanne Wu, an experienced yoga teacher, health coach and wellness expert who sees clients in Syracuse, said that health coaches engage clients to focus on a healthful lifestyle. “These skills are specialized,�

Wu said. “Many people could use inspiring and accountable people in their lives so they can make sustainable change in daunting tasks such as exercise, lose weight, eat right, sleep better, and have less stress; however, not all health coaches are certified, are properly trained, or use evidence-based counseling tools to help their clients.� The cost of health coaching — an average $50 to $80 an hour — may be covered by health insurance. However, those not covered who can’t afford to hire a health coach have other options. Seeking support in a group setting to meet health goals can often help participants succeed while they save. For example, many gyms employ personal trainers and experts in nutrition who offer group programming. Group fitness sessions can foster accountability and camaraderie. Laura Kirkpatrick has worked as a physical therapist for 20 years with HCR Home Care, which has locations throughout the state. Currently,

she works as a nutritionist and wellness coach with Metro Fitness where clients can get group fitness classes and personal training. “We offer programs with focus on nutrition and exercise and the psychological aspects,� Kirkpatrick said. “We’re doing the body boost program that focuses on improving dietary habits, getting more movement and exercise into the day and working with a licensed psychologist to adopt healthier mental attitudes toward fitness and nutrition. It’s about adopting positive self-talk and healthy habits.� Kirkpatrick also recommends trying fitness tracking apps to help count calories, encourage more movement and reach more fitness goals. Many fitness apps are free or low cost. Though a health coach may not be specifically covered under insurance, many plans cover massage therapy, chiropractic care and gym memberships — all of which may offer elements promoted by a health coach. Community-based organizations such as Oasis, YMCA, and JCC offer fitness classes for short sessions. There’s no long-term commitment so you can “try on� an activity and learn more about health. Some gyms, martial arts schools and dance studios offer trial lessons or memberships as well. While these can’t replace regular exercise, they do provide an opportunity to experiment to see what activity could become lifelong without wasting money on an unused membership. Workshops offered at the public library, health foods stores and other venues could offer a good way to learn more about good health (although these lack the ongoing motivation many need to stick with their goals). Read local periodicals and look on community bulletin boards to spot upcoming events. “Should you have a friend that practices healthy behaviors, you can always approach them and many people will help each other best they can as friends,� Wu said. “Don’t be shy.�

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 17


Integrative Lyme Disease Treatment

St. Joseph’s Receives Funding to Improve Access to Healthcare

S

t. Joseph’s Health has been awarded $749,775 in grant funding by the Central New York Care Collaborative (CNYCC) Innovation Fund. Two grants were awarded to support the St. Joseph’s health mobile integrated services team (MIST) and the healthy parenting through wrap-around mother-unborn child and mother-infant care initiatives which seek to improve the health of the community by making services more accessible to patients through innovation and collaboration. • St. Joseph’s Mobile Integrated Services Team Award: $499,932

MIST enables advanced clinical supports to be brought into the home and community-based setting, allowing care managers and home care nurses with immediate access to medical and clinical resources — such as primary care, pharmacy and behavioral health supports — to address care needs related to clinical complications, chronic illness, medications, and other components of personal health. “The mobile capability of MIST makes direct deployment of clinical services available and alleviates complications that some patients experience due to lack of transportation,

problematic environments, and other social determinants which might otherwise prevent patient care access, patient health support, or care plan adherence,” said Deborah Welch, vice president for mission integration at St. Joseph’s Health. • Healthy parenting through wraparound mother-unborn child and mother-infant care and education (healthy parenting program) Award: $249,843 Disparities in access to prenatal care lead to inequalities in health outcomes. St. Joseph’s healthy parenting program uses a collaborative approach to provide wraparound

services for women with high-risk pregnancies and continues its services to ensure healthy early childhood development. The program aims to reduce or eliminate obstacles due to economic and social stressors, food insecurity, problematic environments, transportation and other social determinants that might interfere with a mother and her unborn/infant child.  “A central driver of St. Joseph’s efforts over the past decade has been a deep understanding of the need for service integration, patient engagement, care coordination and cross-sector partnerships,” Welch said. “We are grateful for the support from the CNY Care Collaborative as well as their commitment to ensuring our region has access to innovative care models that improve the health and well-being of our community.”  

Meet Your Provider

Eye Doctor George Kornfeld Focuses on Low Vision lenses or refractive surgery, remains insufficient to do what the patient wants to do. Dr. Kornfeld considers low vision starting at 20/40 and worse when one can’t see well enough to do the tasks one wants to do even with the best glasses (contacts or refractive surgery). That is sufficient reason to seek the help of a low vision specialist.

Dr. George Kornfeld, a low vision optometrist, received a bachelor’s degree in psychology from Yeshiva University and graduated from The Pennsylvania College of Optometry in 1971. He is a fellow of the American Academy of Optometry and a member of its low vision section. He is also a member of the International Academy of Low Vision Specialists (IALVS), a group striving to enable low vision patients to access the optical and digital technology that will transform their lives. Dr. Kornfeld is passionate about low vision care and making a difference for his patients. He sees patients in Rochester, Syracuse, Buffalo, Niagara Falls, Elmira, Watertown, and Scranton Pa. Dr. Kornfeld trained with Dr. William Feinbloom, a founder of modern day low vision and the inventor of many of the low vision telescopes and microscopes used today.

Medical conditions causing low vision are age-related macular degeneration (ARMD) both wet and dry, inoperable cataracts, diabetic retinopathy, and glaucoma. Genetic conditions causing low vision are retinitis pigmentosa, albinism, Stargardt’s disease (a juvenile form of macular degeneration), and retinopathy of prematurity (ROP). Traumatic causes of low vision are stroke and traumatic brain injury.

What is Low Vision?

What is a low vision evaluation?

Low vision is caused by eye disease, genetics, trauma or other events, where fully corrected vision with conventional glasses, contact

What causes low vision?

Dr. Kornfeld determines what the eye condition is and how the patient uses his eyes. What are his goals? The idea is to help the person achieve those

goals. Dr. Kornfeld demonstrates how patients can see with the use of telescopes, microscopes, special reading glasses and other low vision aids.

Can a person with low vision drive? A person with low vision and visual acuity between 20/40 and 20/70 with a 140 degree field of Dr. George Kornfeld, a vision has the potential for driving. And vision between 20/70 and low vision optometrist in 20/100 with a 140 degree field Rochester. while looking straight ahead and also 20/40 while looking through a to enhance patients’ vision and help superiorly placed telescope mounted them gain confidence in themselves, in the glasses also has the potential for do the activities they want to do, receiving a telescopic driver’s license. and to help them maintain their This can help a person maintain his independence. Dr. Kornfeld strives or her independence. A low vision to make patients’ vision better, not evaluation may help to determine if it perfect. is a possibility. “Working in the field of low vision has made my professional Goals life most rewarding as I watch my patients who have poor and Some of the most important goals compromised eyesight begin to read of low vision patients are to read, again, walk around more confidently, watch television, recognize faces, drive cars and trucks, and in general play cards, play music and drive a get a new lease on life,” says Dr. vehicle. One of Dr. Kornfeld’s goals is Kornfeld.

866-446-2050 • | www.KornfeldLowVision.com Page 18

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


PROUD TO WELCOME

Cassandra Riggs, MD

Guest Columnist

Upstate Urology: A National Leader in Urologic Care

SPECIALIZING IN HAND & WRIST SURGERY

PROUD TO WELCOME PROUD TO WELCOME PROUD TORiggs, WELCOMEMD Cassandra Cassandra Riggs, MD

‘Many patients now fly to Syracuse not only from Buffalo and New York City, but from all over the United States and abroad to be treated by Upstate Urology doctors’

SPECIALIZING IN HAND & WRIST SURGERY M Cassandra Riggs, SPECIALIZING IN HAND & WRIST SURGERY

SPECIALIZING IN HAND & WRIST SURGERY

By Gennady Bratslavsky, M.D

I

n 2010, I received a strange phone call from the dean of Upstate Medical University to interview for the chair position in the department of urology. It certainly sounded as a huge appeal to be considered for such a leadership position at the age of 37. There was nothing more impressive that I could do to make my parents proud because I sensed an opportunity to become the youngest chairman of a urology department in the country. Yet, such a move would require an enormous sacrifice: leaving the position of senior staff member in urologic oncology branch at the National Institutes of Health and National Cancer Institute, just nine miles away from the White House. Coming to Upstate in early 2011 turned out to be a wonderful opportunity not only for professional growth but also for solidifying Upstate’s position as a provider of the most complex urologic surgeries and now a national leader in urologic care that attracts patients far beyond the region. In less than eight years, the department of urology — or Upstate Urology — has grown from fewer than three fulltime physicians to a group of more than 20 urologic surgeons of various disciplines, spanning regional coverage of close to 6,400 square miles with offices located far beyond Syracuse’s downtown office. Upstate Urology is a team with numerous fellowship-trained urologic surgeons spanning expertise in urologic oncology, robotic and laparoscopic surgery, female and pelvic floor reconstruction, pediatric urology, infertility and erectile dysfunction, kidney stones and metabolic disease, male reconstruction, transgender surgery, and all aspects of general urology. Many patients now fly to Syracuse not only from Buffalo and New York City, but from all over the United States and abroad to be treated by members of Upstate Urology who have established themselves as national and international experts in the field of urology. Physicians of Upstate Urology provide both clinical and academic mission. With a commitment to Central New York, Upstate Urology has offices in downtown Syracuse, Community Campus, Auburn,

Oneida, Cortland, Binghamton and Utica. They also take wonderful care of our veterans providing subspecialty services to Syracuse VA hospital. The commitment to academia is reflected in training three urologic residents per year for five years (Upstate is now one of the larger training programs in the U.S.) and educating many of Upstate’s medical students. The department’s notoriety is also strengthened by its high quality clinical and basic science research. The department hosts four productive molecular labs led by brilliant scientists. It also publishes many high-impact articles in the most prestigious medical journals. In summary, I can proudly state that coming to Upstate in 2011 has been a beautiful journey allowing me and my colleagues to connect with this beautiful community, help so many wonderful patients and families, educate so many bright young hearts and minds, and turning Upstate into a destination for the best urologic care. I would like to thank the entire community, patients that gave us their trust, the referring doctors who gave us a chance to succeed, and everyone who has helped us raise the flag of Upstate Urology high. For an appointment or to refer patients, please call 315-464-1500.

Dr. Cassandra Riggs is a fellowship-trained orthopedic surgeon specializing in surgery of the hands and wrists. She has joined our team of specialty trained upper extremity surgeons and is accepting new patients.

Request an appointment on sosbones.com or call 315.251.3162

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hands and wrists.

the department of urology at SUNY Upstate Medical University.

Request an appointment Request an appointment onon specializing in surgery of the hands and wrists. She has joined our of specialty sosbones.com orteam call 315.251.316 sosbones.com or call 315.251.3162 Shetrained has joined upper our team ofextremity specialty trainedsurgeonsand upper extremity surgeons is accepting patients. and is acceptingnew new patients.

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Request an appointment on sosbones.com or call 315.251.3162 November 2018 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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10/24/2018 12:08:34 PM


Hope for the Bereaved Turns 40 By Mary Beth Roach

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butterfly figurine hangs on the front of the building at 4500 Onondaga Blvd. in Syracuse, symbolizing the hope that has been fostered inside the walls of this facility for years. The building is the home of the Rosamond Gifford Hope for Bereaved Center, which has been helping people through the process of grieving for loved ones for four decades. The 40th anniversary of Hope for the Bereaved is a milestone that founder Therese Schoeneck had never fathomed when she founded the organization in 1978. Schoeneck had established the organization as she and her family grappled with the death of her daughter, Mary, in 1977. The holidays following Mary’s death were extremely painful, Schoeneck recalled. “There was just such a big hole without Mary being there,” she said. During the following year, Schoeneck, who at the time was an associate director of Family Life Education for the Catholic Diocese of Syracuse, had learned of other grieving parents. In the fall of 1978, with the holidays approaching again, she along with the director of Family Life Education, Father Joe Phillips, put together a panel on coping with the holidays. The parents that came asked if they could meet the following month. “That’s how HOPE was born,” she said. Starting with just that one support group, HOPE has evolved and now offers 12 support groups, one-on-one counseling, workshops, newsletters, various publications, and grief kits, among other resources. The organization eventually became an independent nonprofit agency, and it moved into its headquarters on Onondaga Boulevard in 1991. Today, 40 years later, Schoeneck, 86, is still executive director. Although she admits she never imagined the agency would thrive for as long as it has, she attributes its longevity to several factors, among them dedicated volunteers, free counseling services and that HOPE is willing to create new support groups and programs to meet the communi-

Rosamond Gifford Hope for Bereaved Center founder Therese Schoeneck (right) and her daughter Margie Schoeneck Nye help the organization to celebrate its 40th anniversary. ty’s needs. “We’re there. We can listen to them, walk with them, offer them realistic hope,” she said. Scourge of drug abuse One example of its ability to respond is the establishment in December of 2015 of the first support group for those who have lost someone to a drug overdose, and a similar support group was started in June in Fulton. Because of HOPE’s growth, Schoeneck said she would like to see an addition to their building in the next few years to include two more counseling rooms. What keeps motivating Schoeneck and her team? “To think that you saved marriages or you’ve saved somebody’s life or you’ve just even given them hope,” she said. She often tells those receiving services, “‘You’re never the same, but you can be a good new you. You can have a happy life.’” Schoeneck has at least three folders of positive letters from people who have received support from HOPE, and many return to the agency as volunteers. One of those who returned as a volunteer is Jo Beth Lehrer, whose

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husband, David, died in 2010. Lehrer is a retired art teacher from the Liverpool Central School District, who has put her creative skills to work throughout the center, and she has been dubbed “artist in residence.” She has painted a mural on the walls of the youth counseling room that shows the stages of grief, from an ominous rain cloud to a red cardinal in a tree, and ultimately to a scene with the sun, a rainbow and butterflies. She has also created some of the floral arrangements and assembled several gift baskets for the silent auction that will be part of

Volunteer and “artist in residence” Jo Beth Lehrer by part of the mural she created for HOPE’s youth counseling room. HOPE’s 40th anniversary event. “After a year of counseling, I wanted to meet Therese because I had never met her. I left her a note to call me or get in touch with me,” Lehrer said. The two soon got together, and Lehrer offered a donation check in memory of her husband. She also offered to help rearrange the bulletin boards at the center, and eventually took on the mural project. “It’s not a sad place. It’s comforting to be around people who know what you’re going through because it never goes away. I just find comfort here,” she said.

Celebration of Hope Dinner Hope for the Bereaved is marking the anniversary with the Celebration of Hope Dinner on Friday, Nov. 2, at the Grand Ballroom of the OnCenter in downtown Syracuse. Event chairwoman is Margie Schoeneck Nye, Schoeneck’s daughter. The theme — HOPE is a jewel! — reflects the valuable work that the organization has done over the past 40 years in helping people on their journey from grief to hope. The event includes dinner

and entertainment, a photo booth, raffles, a live auction and a silent auction, with many gift baskets lovingly put together in the memory of a family member or friend who has died. The response to the donations of baskets and other gift items has been “amazing,” according to Schoeneck. To learn more about joining in the Celebration of Hope Dinner, visit hopeforbereaved.com/events/ celebration-of-hope-dinner/

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Top Factors for a Healthy Long Life By Sharon A. Brangman, M.D.

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ging is a natural process that starts the minute we are born. Each stage of life has important milestones and adjustments that must be made so that we can enjoy the highest quality or life while we manage life’s joys and challenges. People often say they are “fighting aging” and that they are “anti-aging.” There is nothing wrong with hair dye or getting some “work done” to manage wrinkles or various sags and bags, but the people I have seen who are aging the best are those who accept that aging is a natural part of living. The happiest people accept the aging process and find a way to be grateful for reaching this important time of life. Considering the alternative, aging may not seem so bad. Here are my top five ways to help you age well.

1.

Exercise regularly You do not have to run a marathon or bench press 500lbs. Most people should take a walk for at least 30 minutes most days of the week. Add two sessions of muscle strengthening exercise for 30 minutes each session. Numerous studies suggest that exercise helps the brain remain sharp and strengthening muscles in the body may help reduce the risk of falls that are very common in older adults. Consider working with a personal trainer for muscle work which decreases the potential for injury. Walking can be a challenge in many parts of our city due to limited sidewalks and winter weather. However, there are many options for indoor walking such as local malls, indoor tracks and inside some gyms. If you take a walk every

day with a friend, you double the benefit since you get exercise while you connect with a friend, which brings us to number two.

2.

Stay socially connected Some older adults can lose contact with people when they retire or when friends and family move away. Research shows us that social isolation and loneliness can cause the same serious health problems as if the person was smoking, and can increase the chance of dying too soon. We are fortunate to live in an area that offers many opportunities for older adults to stay connected to people and the community around them. Your local office of aging is a good place to start.

3.

Get enough sleep More and more research is telling us how important it is to sleep each night. This can be a problem for some adults as they get older, due to certain medical problems which should be discussed with your health provider. We still need to sleep seven to eight hours every night as we age, so do not believe the myth that we need less sleep as we get older. Sleeping pills are dangerous and can lead to bad side effects like falls and dementia. It is important to get to the root of the problem and not cover over it with dangerous sleeping pills.

4.

Eat healthy foods Try to eat foods that come from a farm and were not processed in a factory. Processed foods contain ingredients that can raise blood pressure, increase fats in the blood and make the risk for diabetes

go up. Cut back on sugar and foods that our bodies turn into sugar as soon as you eat them such as white bread, white rice and white potatoes.

5.

Practice prevention There are many things we can do to protect our health. Stay off of ladders. Falling off a ladder, even if it isn’t a very tall ladder, can cause injuries that can change your life and reduce your independence. Wear a seatbelt every time you are in a car, even if you are in the back seat. Be sure to get a flu shot every year and get at least one vaccine to help prevent pneumonia. Finally, remember that aging is not a disease. If you have a health concern, do not simply blame it on old age. Get your health concerns checked out. Find a health care provider who can help you sort out the difference between a normal aging process and medical problem that needs attention. Sharon A. Brangman is a geriatrician at SUNY Upstate Medical University, where she is a distinguished service professor, the inaugural chairwoman of the department of geriatrics and director at Nappi Longevity Institute.

In Good Health, CNY’s Healthcare Newspaper Read it in print, online at www.cnyhealth.com In 2019, make In Good Health your advertising choice November 2018 •

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First User-Fitted Hearing Aid Approved

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he first hearing aid that doesn’t require the assistance of an audiologist or other health care provider has been approved by the U.S. Food and Drug Administration. The Bose Hearing Aid is a user-fitted device for people aged 18 and older with mild-to-moderate hearing loss, the agency said in a news release. “Today’s marketing authorization provides certain patients with access to a new hearing aid that provides them with direct control over the fit and functionality of the device,” said Malvina Eydelman, director of the FDA’s Division of Ophthalmic, and Ear, Nose and Throat Devices. Some 37.5 million adults in the United States report having hearing

loss of some degree, the FDA said. Common risk factors include aging, exposure to loud noises and certain medical conditions. The Bose device was evaluated in clinical studies involving 125 people. When participants self-fitted the device and used a cellphone app to program and make adjustments to the device settings, they “generally preferred those hearing aid settings over … professionally-selected settings,” the FDA said. While users may fit, program and control the device on their own, some state laws require that hearing aids be obtained from a licensed dispenser, the agency said. Bose Corp. is based in Framingham, Mass.

It’s Not Just for Kids: Even Adults Appear to Benefit from a Regular Bedtime

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ufficient sleep has been proven to help keep the body healthy and the mind sharp. But it’s not just an issue of logging at least seven hours of Z’s. A new study on sleep patterns suggests that a regular bedtime and wake time are just as important for heart and metabolic health among older adults. In a study of 1,978 older adults publishing Sept. 21 in the journal Scientific Reports, researchers at Duke Health and the Duke Clinical Research Institute found people with irregular sleep patterns weighed more, had higher blood sugar, higher blood pressure and a higher projected risk of having a heart attack or stroke within 10 years than those who slept and woke at the same times every day.  Irregular sleepers were also more likely to report depression and stress than regular sleepers, both of which are tied to heart health. African-Americans had the most irregular sleep patterns compared to participants who were white, Chi-

nese-American or Hispanic, the data showed. The findings show an association — not a cause-and-effect relationship — between sleep regularity and heart and metabolic health.  “From our study, we can’t conclude that sleep irregularity results in health risks, or whether health conditions affect sleep,” said Jessica Lunsford-Avery, Ph.D., an assistant professor in psychiatry and behavioral sciences and the study’s lead author. “Perhaps all of these things are impacting each other.” Still, the data suggest tracking sleep regularity could help identify people at risk of disease, and where health disparities may impact specific groups, such as African Americans. “Heart disease and diabetes are extremely common in the United States, are extremely costly and also are leading causes of death in this country,” she said. “To the extent we can predict individuals at risk for these diseases, we may be able to prevent or delay their onset.”

10 Signs You May Have Alzheimer’s

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early 50 million people worldwide are living with Alzheimer’s disease and other forms of dementia, the Alzheimer’s Association says. The association lists 10 warnings signs of Alzheimer’s:

1.

Memory lapses that affect everyday life. Challenges in planning and solving routine problems. Difficulty completing familiar tasks.

2. 3.

4. Confusion over time or place. 5. Trouble understanding spatial or

visual images. Sudden problems with speaking. Misplacing things, and not being able to retrace steps. Poor judgment. Withdrawal from social activities. Changes in mood and personality.

6. 7.

8. 9. 10.


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oretto recently announced major renovations and new construction to expand and enhance dementia care at The Nottingham in Jamesville, as well as The Heritage and The Cunningham on Loretto’s main campus in Syracuse. According to the Alzheimer’s Association, the number of Americans aged 65 and older living with memory loss — including Alzheimer’s and other dementia conditions — is projected to increase from 5.1 million in 2016 to 16 million in 2050. Close to 18 percent of that growth will be right here in New York state. “The United States is going to experience a surge of people requiring specialized memory care and memory care facilities, and Central New York will be no exception,” said Kimberly Townsend, Loretto President and CEO. “Loretto is the only organization in Central New York that can support all dementia levels and all income levels. Through this initiative, we are investing even more in the care that we provide as need the grows and this disease evolves.” n At The Nottingham, Loretto will open a Center for Aging Excellence, including a new living community dedicated to residents living with dementia. This state-ofthe-art facility will enable residents to maintain their independence for as long as possible without jeopardizing their safety, and incorporate a true neighborhood feel with a streetscape design and interior park to optimize natural lighting and sound. An additional 20,000 sq. ft. of space in the Nottingham Center of Aging Excellence will provide classrooms, offices and common spaces to support continuing education for staff and family on the care and treatment of those with dementia, as well as to accommodate partners advancing the latest research studies.  n The Heritage, the first residential program of its kind in Central New York created to care for those with Alzheimer’s disease or other dementias, will undergo renovations

to incorporate the latest designs and technology to support residents with dementia, including new apartments that optimize natural light from large windows surrounding on three sides; expanded kitchenettes to accommodate more residents with modern appliances and sensory additions to meet the unique needs of those with dementia; and a spa bathroom suite to provide an even more comfortable experience for residents. n The Cunningham, which houses a dedicated dementia floor for the most advanced-stage residents, will also undergo renovations to implement the latest designs and technology to meet the needs of those in the late stages of this disease, including upgraded floor and wayfinding cues to make wandering and pacing more enjoyable; softer lighting and upgraded scent system to address sensory needs; and upgraded window treatments to optimize use of natural light, among other changes. reduce agitation.   The Borer Center of Aging Excellence At the organization’s annual luncheon, Loretto recognized Frank and Patti Borer with Loretto’s Legacy Award for their family’s pledge of $1 million to support Loretto’s RememberMe Capital Campaign. With this commitment, the new building at the Nottingham will be named The Borer Center of Aging Excellence. Thanks to the Borers and others who have already contributed to this campaign, Loretto is already over the $3.6 million dollar mark. “Creating the space to best provide memory care is critical and must be coupled with continued investments in our programs and care providers devoted to our residents and their families,” Townsend said. “The result will not only be an enhanced ability to provide outstanding care, but will also allow Loretto to step forward as the premier center of excellence in our region.”

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Golden Years

Too Little or Too Much Sleep Hurts Cardiovascular Health By Deborah Jeanne Sergeant

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Greek study seems to indicate a correlation between obtaining too little or too much sleep and an increased risk of cardiovascular disease. Researcher Epameinondas Fountas, a physician with the Onassis Cardiac Surgery Centre in Athens, Greece, analyzed 11 studies comprised of more than a million adults and concluded that both long sleepers and shorter sleepers appeared to have a greater risk of experiencing coronary artery disease or stroke when compared with sleepers in the ideal range of six to eight hours’ sleep. For short snoozers, the risk in creased by 11 percent; for those who rested longer, risk rose by 33 percent after an average follow-up of 9.3 years. “If we are told by nature to sleep onethird of our Culebras lives, it has to be very, very important,” said Upstate Medical University neurologist Antonio Culebras. He said that some sleep disorders can increase the risk of not sleeping

well and can increase sleep apnea, which has been associated with other health issues. “Fragmentation of sleep has been known to put a big burden on the heart,” Culebras said. “There’s a big connection with good sleep and the heart.” He also listed diabetes and high blood pressure as other diseases exacerbated by poor sleep. The reasons behind getting too little or two much sleep may be what’s to blame, not the sleep length itself. Culebras said that the real takeaway from studies such as this is that establishing regular sleep patterns are good for health, and addressing sleep-disturbing issues can help improve both sleep and health. These issues could include brain injury, dementia, restless leg syndrome or behavioral issues. Many older adults are prone to napping during the day. Culebras said that while a catnap of 15 to 20 minutes may promote alertness, those who don’t sleep well at night should limit daytime napping and definitely cut out the hour-long snooze fests. People who experience sleep disturbances such as sleep apnea, lack adequate, restful sleep. Many don’t even realize that their airway is blocked over and over all night, which is why they snore in loud,

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Going to bed and rising at regular times is part of sleep hygiene, as well as eschewing late day caffeine consumption, reading or watching television in bed and using electronics before bedtime. The bed linens should be comfortable and the room kept dark and a comfortable temperature. Hot, stuffy bedrooms don’t promote good sleep. Bright night lights, streetlights, and alarm clocks may disrupt sleep, also. Goldschmidt also talks about what people do directly before bed. It’s not the time to read a gripping “who-done-it” novel or watch a scary movie. He wants people to remove television and electronics from the bedroom so it becomes a place for only sleeping and sex. Doing other things in the bedroom builds associations in the brain that the bedroom isn’t a restful place. Goldschmidt also wants people to engage in a nightly ritual that helps them wind down. Light reading, a non-sugary snack, and dimmer lighting, for example, can help the body and mind quiet down. Beyond sleep hygiene, he offers cognitive behavior therapy. “You get people to look at their beliefs about sleep that are incorrect that interfere with sleep,” Goldschmidt said. “You work through their beliefs and behaviors about sleep. You get into things you can do that help promote sleep.” Listening to dull audiobooks at a low sound threshold or white noise helps some people. To tame intruding thoughts, Goldschmidt recommends jotting them down to deal with tomorrow. “Good sleep is very important and it affects all aspects of your ability to function,” Goldschmidt said.

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ragged gasps. Not all snoring is sleep apnea, and not all sleep apnea involves snoring. However, all sleep apnea needs treatment. Culebras said that managing sleep apnea can help manage the symptoms of other conditions or even prevent some. “There’s some evidence now that poor control of sleep apnea may increase the risk of vascular dementia,” Culebras said. “We see it all the time. Individuals with poorly controlled sleep apnea are having more vascular dementia. It manifests with poor memory, loss of executive planning and power, and some gait disturbance and incontinence of urine in advanced stages. What is important is it’s preventable, if we make a diagnosis of sleep apnea and comply with the treatment.” People experiencing what they suspect is sleep apnea should see their doctor, but will likely receive a referral to a sleep specialist who may recommend devices to keep the airway open and lifestyle changes. Douglas Goldschmidt, Ph.D. and licensed clinical social worker in Syracuse, has studied cognitive behavioral therapy for insomnia. He said that he sees many patients with sleep issues. “People Goldschmidt who are anxious and have depression have poor sleep and some with depression and anxiety have major sleep issues,” he said. “It becomes a cycle.” He said that many people have poor sleep hygiene.

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

oretto has opened an eight-bed wing dedicated to end-of-life care as part of its palliative care program. It is housed at the Loretto Health & Rehabilitation building (formerly known as The Cunningham) at 700 E. Brighton Ave. on Loretto’s main campus. Loretto’s program offers specialized medical care for people with serious illness focused on providing relief from the symptoms and to improve quality of life for both the patient and the family during a loved one’s final days. “Our family-centered services are coordinated by an interdisciplinary team of nurses, social workers, nutritionists, therapeutic recreation and our spiritual care team to create a compassionate presence and individualized care plan in a homelike environment during this important time,” said Joelle Margrey, vice president of skilled nursing at Loretto. Residents will benefit from specific attention to pain, comfort and relief, as well as spiritual care that provides additional support to families. Loretto also provides overnight accommodations for loved ones and

allows pet visits, as many current and former pet owners like to have a pet nearby for comfort. “We provide soothing comfort measures, such as hand massage, reading, soft singing, sharing stories, watching favorite movies — a variety of memorable ways to nurture and provide restful care,” said Brenda McCutcheon, director of spiritual care. “We also get to know each individual person, including anticipating milestones and celebrating them early.” The Palliative Care team at Loretto honors each person at death, escorting them from the building in a ceremony surrounded by their loved ones and care partners. Local hospitals can contact Loretto’s admissions department directly to refer a patient to this new unit. “We have found this to be a very welcome, valuable service as an alternative for families who don’t have the ability to care for someone in their home in their last days,” Margrey added. A video is also available on Loretto’s YouTube channel at https:// youtu.be/oRBYr5RjA4I.


By Jim Miller

Free Resources That Can Help with Your Medicare Decisions Dear Savvy Senior, I’m considering making changes in my Medicare coverage during the open-enrollment period. Can you recommend any free resources that can help with my choices?

Swapping Senior Dear Swapping, There are a number of good resources you can turn to that can help you choose Medicare coverage that better suits your needs, that’s completely free to use. Each year during Medicare’s open enrollment — Oct. 15 through Dec. 7 — all Medicare beneficiaries can change their coverage without penalty. Doing so, given that insurers are constantly tweaking their plans and offerings, could help lower your premiums or give you access to

better care. Any changes you make to your coverage will take effect Jan. 1, 2019. Important Tools To get help with your Medicare decisions, a good starting point is to get re-familiar with the primary parts — traditional Medicare, Medicare Advantage, supplemental (Medigap) policies and prescription-drug coverage — Medicare publishes an excellent guide called “Medicare & You” that you can access at Medicare. gov/medicare-and-you. If you are already enrolled in Medicare Advantage or a Medicare Part D prescription-drug plan, it’s very important that you read and understand your “Annual Notice of Changes” and “Evidence of Coverage,” which should have arrived in the mail in September. These documents explain how your existing coverage will change in 2019 and how much you’ll pay for that coverage. Your next step is to go Medicare’s online “Plan Finder” tool at Medicare.gov/find-a-plan. Here you can

enter some basic information — your Medicare number and prescription drugs (name and dosage) — and it will produce a list of possible healthcare plans in your area, the costs involved, drug coverage and customer-satisfaction ratings. Or, if you don’t have internet access, or don’t feel confident in working through the information on your own, you can also call Medicare at 800-633-4227 and a customer service representative will do the work for you over the phone. Free Advice If you want personalized help with a Medicare specialist, contact the Medicare Rights Center or your State Health Insurance Assistance Program. The Medicare Rights Center is a nonprofit group (MedicareInteractive.org) that offers a national helpline (800-333-4114) where staff members answer questions about Medicare, and can help you choose coverage, at no charge. And your State Health Insurance Assistance Program (SHIP), which may go by a different name in your state, provides free one-onone counseling in person or over the phone to beneficiaries, as well as family members or caregivers. SHIPs are federally-funded programs that are not connected to any insurance company or health plan. To find a SHIP counselor in your area, see ShiptaCenter.org or call the Eldercare Locator at 800-677-1116. Another good resource, if you’re interested in choosing a new Medicare Advantage plan, is the HealthMetrix Research Cost Share Report at MedicareNewsWatch.com. This free website lists the best Advantage plans by area based on your health

status. Also, several Offices for the Aging in the area offer free seminars that help seniors select the best plans. Those seminars are unbiased and not affiliated with any health insurance plan. Agent Assistance Another way to get free assistance with your Medicare Advantage, prescription drug or Medigap plans is to use an agent or broker who specializes in Medicare-related insurance in your state. These people get paid a commission to sell you a policy from the insurance providers they represent. There are federal rules and state laws governing agents or brokers who sell Medicare plans, which include things like barring them from showing up uninvited at your house to pitch a plan or trying to lure you with a cash offer. They also cannot legally charge you a fee to process your enrollment. It’s also important to understand that commission-based agents and brokers will present only the Medicare plans they represent, rather than all the plans in your market. So, you may miss out on some plans that could benefit you.

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

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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, Ernst Lamoth Jr., Eva Briggs (MD), , Mary Beth Roach • 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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The Social Ask Security Office

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

edicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. If you’re a Medicare beneficiary who has been informed that you must pay more for your Medicare Part B or Medicare prescription drug coverage premium because of your income, and you disagree with the decision that you need to pay a higher premium amount, you may request an appeal. The fastest and easiest way to file an appeal of your decision is by visiting www.socialsecurity.gov/disability/appeal. You can file online and provide documents electronically to support your appeal. You can also file an appeal online even if you live outside of the United States. You may also request an appeal in writing by completing a Request for Reconsideration (Form SSA-561-U2) at www.socialsecurity.gov/forms/ssa-561.html. If you don’t have access to the internet, you can request a copy of the form by calling us at 1-800-772-1213 (TTY 1-800-325-0778).

Q&A

Q: Are Social Security numbers reassigned after a person dies? A: No. We do not reassign Social Security numbers. In all, we have assigned more than 460 million Social Security numbers. Each year we assign about 5.5 million new numbers. There are over one billion combinations of the nine-digit Social Security number. As a result, the current system has enough new numbers to last for several more generations. Q: Is it true I can save about $4,900 per year if I qualify for Social Security’s “Extra Help” with the Medicare prescription drug program? A: Yes. If your income and resources meet the requirements, you can save nearly $4,900 in prescription costs each year. Resource limits for 2018 are $14,100 (or $28,150 if you are married and living with your spouse). Income limits are $18,210 (or $24,690 if you are married and living with your spouse). If your income or resources are just a bit higher, you might be eligible for some help with prescription drug costs. To learn more, visit www.socialsecurity.gov/ prescriptionhelp. Q: My spouse died recently and my neighbor said my children and I might be eligible for survivors benefits. Don’t I have to be retirement age to receive benefits? A: No. As a survivor, you can

Learn more by reading our publication “Medicare Premiums: Rules for Higher-Income Beneficiaries” at www.socialsecurity.gov/pubs/EN05-10536.pdf. Know someone who hasn’t signed up for Medicare yet? They can use our online Medicare application if they: • Are at least 64 years and 9 months old; • Want to sign up for Medicare but do not currently have any Medicare coverage; • Do not want to start receiving Social Security benefits at this time; and • Are not currently receiving Social Security retirement, disability, or survivors benefits. Remind them that they should sign up for Medicare three months before reaching age 65, even if they are not ready to start receiving retirement benefits. They can opt out of beginning to receive retirement benefits now once they are in the online application. Then they can apply online for retirement benefits later. You can learn all you need to know at www.socialsecurity.gov/ benefits/medicare and easily share these resources with family and friends.

receive benefits at any age if you are caring for a child who is receiving Social Security benefits and who is under age 16. Your children are eligible for survivors benefits through Social Security up to age 19 if they are unmarried and attending elementary or secondary school full time. Keep in mind that you are still subject to the annual earnings limit if you are working. If you are not caring for minor children, you would need to wait until age 60 (age 50 if disabled) to collect survivors benefits. For more information about survivors benefits, read our publication “Survivors Benefits” at www.socialsecurity.gov/ pubs. Q: I got married and I need to change my name in Social Security’s records. What do I do? A: If you change your name due to marriage, or for any other reason, you’ll need to report the change and get a corrected Social Security card with your new name. You will need to fill out form SS-5. You can get a copy of this form by visiting www. socialsecurity.gov/ss5doc or by calling our toll-free number 1-800-7721213 (TTY 1-800-325-0778). You’ll also need to provide the original marriage certificate showing your new and old names. You can mail or take the documentation to your local Social Security office. In some cases, we may need other forms of documentation as well. For more information, visit www.socialsecurity.gov/ssnumber.


H ealth News

Brooks named MVP’s senior leader, quality

Shalama Brooks has joined MVP Health Care as senior leader, quality. With more than 10 years of leadership experience in quality improvement, her background includes tenures with large national managed care organizations such as UnitedBrooks Health Group and Anthem, as well as work in start-up environments for organizations brought about by the Affordable Care Act. Brooks has also led and implemented quality initiatives across all product lines and has a deep understanding of accreditation and population health management. Most recently, in her role as a full-time health care quality consultant and subject matter expert, she worked with multiple provider and payer clients, guiding them through the accreditation or re-accreditation process. Having begun her career as a survey support manager for accreditation at the National Committee for Quality Assurance (NCQA), Brooks has been immersed in accreditation standards and process improvement for health plans from the start.  She earned a bachelor’s degree in health systems management from the University of Baltimore, a master’s degree in health care administration from the University of Maryland, and a master’s degree in public health from Kaplan University.

opportunities and engaged with corporate sponsors. They also took part in an opening ceremony where they renewed their commitment to the fight against Alzheimer’s disease and heard from guest speaker Art Hayes. Hayes, a former business owner in the Syracuse, talked being diagnosed with Alzheimer’s disease last year and how his life changed as a result. “For now, I can remember what has happened in the past,” Hayes said. “I may have difficulties with the present and unfortunately I know how this will progress in the future. Hopefully, the money that is raised today will assist in the research that is desperately needed to find a prevention, treatment or cure for this disease.” A Facebook Live video of the opening ceremony, including Hayes’ remarks, is available online www. facebook.com/alzcny.

NYSID recognizes CNYers with disabilities Twelve people with disabilities in the greater Central New York area are among 57 statewide Joslin Outstanding Performers honored through New York State Industries for the Disabled, Inc.’s (NYSID) annual Joslin Awards Program, which celebrates those who have overcome individual challenges to experience meaningful employment on NYSID Preferred Source contracts.  In its 15th year, NYSID’s Joslin Awards Program has recognized 770 outstanding performers, and awarded 19 of those individuals with the final William B. Joslin Outstanding

Performance Award. The Joslin Outstanding Performers for 2018 from Central New York area are: • Lisa Camidge, St. Lawrence NYSARC (Canton), document scanning/indexing • Matthew Donella, Clarus Linen Systems (Syracuse), laundry • Karen Eisenhut, The Arc, Oneida-Lewis County Chapter (Utica), packaging • Perry Finch, JM Murray Center, Inc. (Cortland), packaging • Floyd Groesbeck, Jefferson Rehabilitation Center (Watertown), janitorial/production • Michael Kildare, Bates Troy, Inc. (Binghamton), laundry • Mary Moon, The Arc Otsego (Oneonta), packaging/assembly • Coley Perry, The Arc of Chemung (Elmira), janitorial • Nina Petrie, ACHIEVE (Binghamton), document preparation • Brian Phillips, The Arc of Madison Cortland (Oneida), food packaging • Preston Thompson, The Arc of Onondaga (Syracuse), janitorial • Richard White, Human Technologies (Utica), packaging/assembly, janitorial • Steven Collins, who works in woodworking production for Mountain Lake Services in Mineville, and Maxine Nelson, a janitor with The Arc of Dutchess in Poughkeepsie, have been named co-recipients of the 2018 William B. Joslin Outstanding Performance Award. Jefferson Rehabilitation Center in Watertown has been selected Member Agency of the Year, and eBi-

zDocs in Menands has been selected Corporate Partner of the Year. New York State Office for People With Developmental Disabilities (OPWDD) and Dutchess County have been named the state government and local government Customers of the Year, respectively. “Our lives are often shaped by the work we do, the inherent pride that comes from earning a living in our community. This is especially true for the New Yorkers with disabilities who embody preferred source employment at NYSID member agencies and corporate partners across our state,” said Maureen O’Brien, NYSID president & CEO.

Nascentia workers get Heart of Home Care Awards

Nascentia Health recently presented three employees with Heart of Home Care Awards. Presented biannually, the awards recognize employees in good standing who set an example for their peers by going above and beyond in their daily work. The award qualifications are based on the system’s foundational pillars: quality and service; growth; people; finance and investment; and facilities. Employees are nominated by their peers, and a committee led by the system’s human resources department votes to determine the winners. The most recent recipients were: n Connor Blehar, IT support technician Blehar regularly serves as a go-to resource when technological support

Alzheimer’s event raises nearly $235,000

More than 1,750 individuals from across Central New York joined the Alzheimer’s Association Walk to End Alzheimer’s presented by Loretto in the fight to end Alzheimer’s disease. Walkers raised $234,811 to fund Alzheimer’s care, support and research programs. “The Syracuse community outdid itself today,” said Catherine James, chief executive officer for the Alzheimer’s Association, Central New York Chapter. “It was a wonderful gathering of friends, families and businesses united by the common goal of defeating Alzheimer’s disease.” The top individual fundraiser at the Walk to End Alzheimer’s was Rosanne Gregory of Fayetteville, who raised $11,525. Gregory, who is the wife of former Syracuse University football player and current Detroit Lions assistant coach Steve Gregory, rallied a team of family members around her father, Richard, who has Alzheimer’s. Their team, The G Team, was the leading fundraising group at $18,315. Participants enjoyed a three-mile walk around Onondaga Community College campus, learned about Alzheimer’s Association programs and services, clinical trial and advocacy

American Heart Association representative Denise McGraw (center, with plaque) presents representatives from Nascentia Health’s leadership team and health and wellness committee with a wooden plaque in recognition of the system’s Bronze level recognition in the American Heart Association’s 2018 Workplace Health Achievement Index.

American Heart Association Recognizes Nascentia Health for Workplace Health Achievement

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ascentia Health, a local leader in home healthcare services, has achieved bronze level recognition in the American Heart Association’s (AHA) 2018 Workplace Health Achievement Index. The AHA created the index with its CEO Roundtable members, a leadership collaborative of more than 40 CEOs from some of America’s largest companies who are committed to applying evidence-based approaches to improve their employees’ overall health. The index uses science-based best practices to evaluate the overall quality

and comprehensiveness of workplace health programs. A unique feature of the index is that it calculates an average heart health score for employees of participating companies that securely submit aggregate health data. More than 1,000 companies completed the Index assessment this year. Of those companies, 75 percent received either gold, silver or bronze recognition. As part of their participation, companies also receive benchmarking reports, which allow them to identify potential areas of improvement so that they can advance their annual performance and recognition in the Index and help November 2018 •

their workforce move toward ideal heart health. “We are so proud of the steps we’ve taken to build a corporate culture of health and wellness,” said President and CEO Kate Rolf. “From our new health and wellness committee and employee gym to our weekly fitness classes and lunch and learn sessions, corporate wellness has become a top priority. This achievement is a result of that commitment, and we look forward to the chance to improve our results in 2019.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News is needed. Regardless of the nature, size or urgency of the request, Blehar makes himself readily available to help. He is always sensitive to each person’s technological capabilities, taking the time to explain the issue at hand and working diligently to find a resolution in a timely manner. He has worked for Nascentia Health for two years. n Lisa Butler, customer service center coordinator Butler provides superior customer service each and every day. Her patience and professionalism in handling challenging situations

are commendable, and she serves as a role model for her peers, treating everyone she encounters — both colleagues and patients — with dignity, respect and compassion. She has worked for Nascentia Health for five years. n Jeffrey Garrison, home health aide Garrison is an exceptional home health aide who is dedicated to his clients and his career. He is always willing to take on additional cases to ensure clients receive the care they need, and he is a joy to work with. Garrison’s kind and compassionate nature make it easy for him to build

Guests and officials during a ribbon cutting ceremony that marked the final phase of Crouse Health’s 38 million emergency services renovation and expansion project.

Crouse Marks Completion of Pomeroy Emergency Services Department Project

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rouse Health has completed the final phase of its $38 million emergency services renovation and expansion project. The hospital marked the milestone

with a formal ribbon cutting ceremony and tours of the newly completed portion of the project. The two-phase project was partially opened in July 2017, with completion of the 21,000

strong relationships with his clients and their families. He has worked for Nascentia Health for two years. “I congratulate each of these outstanding employees on this well-deserved honor and extend my sincere gratitude for their service, dedication and commitment to Nascentia Health,” said Kate Rolf, president and chief executive officer. “Through their hard work and dedication, our system continues to grow and provide our patients with the highest quality care. I am honored to recognize them for their excellence and

exceptional performance.”

square-foot main ER. This final phase entails the relocation of PromptCare from the CNY Medical Center to the main ER. The walk-in service in the main ER will now be called CrousExpress. The final phase of the project includes an additional 7,000 square feet of space and 16 new patient rooms, up to seven of which will be dedicated for CrousExpress walk-in patients. The project also includes a new front entrance for ambulatory (walk-in) patients and visitors. With more than 82,000 patient visits in 2017, Crouse’s emergency services department is the busiest in the area. “Crouse is a community asset, and the completion of this major strategic initiative is a tangible expression of our mission to provide the best in patient care for Central New Yorkers,” said President and CEO Kimberly Boynton, adding that the emergency department is the “front door” to the hospital. In fact, some 54 percent of Crouse’s overall patient admissions come from the ER. “The opening of the last phase of this project, coupled with a rapid evaluation process that quickly directs patients to the appropriate level of treatment, will allow us to treat patients sooner and more efficiently,” says physician David Mason, medical director of Pomeroy Emergency

Services. As the region’s newest, most up-to-date ER, Crouse provides nationally recognized care to match the advanced technology and efficient, coordinated and multidisciplinary process provided by over 150 staff members in the ER as well the clinical units throughout the hospital. This includes recognition from the American Heart/Stroke Associations for exceeding quality standards for stroke care, cardiac ‘door-to-balloon’ time, and heart failure care. The naming gift for the overall project is from The William G. Pomeroy Foundation. Other significant support comes from Syracuse residents Darlene and Eric Coons, in memory of relatives from the Makowski, Parkerson and Wadowiec families. Donations from both the Pomeroy Foundation and the Coons were made as part of the Crouse Health Foundation’s CrouseCares Campaign, the largest comprehensive campaign in Crouse Health history. To date, donors have committed nearly $15 million in annual and capital donations since the campaign launched in 2015, largely to the Pomeroy Emergency Services project.

Minoa instructor wins Baby Boot Camp award

Instructor Alyssa Eighmey, of Minoa, recently was recognized as the Baby Boot Camp Instructor of the Year. Eighmey has been an instructor with Baby Boot Camp Syracuse since gaining certification in 2017. and is the mother of Emma, 4. Baby Boot Camp Syracuse is a stroller fitness Contuines On Next Page

The Manor’s Shari Mezza Recognized as Employee of Distinction

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hari Mezza, the assistant activities director at The Manor at Seneca Hill, a nursing home facility in Oswego, was recently honored as an employee of distinction by LeadingAge NY at a special reception. Making the presentation was Jim Clyne Jr., president and CEO of LeadingAge NY, a statewide nonprofit long-term care association. This award is given to individuals who exemplify compassion, commitment to their organization, and who go above and beyond in customer service to the residents in skilled nursing facilities. Only 16 such awards are presented each year, two in each region, by the association, which represents

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thousands of employees who work at skilled nursing facilities. Mezza was also presented a NYS Legislative resolution that recognized her excellence in healthcare. The bill, co-sponsored by State Assemblyman Will Barclay recently passed both the Assembly and State Senate. “I am overwhelmed and humbled” Mezza said. “I can’t believe that I was selected out of all the applicants.” Mezza has worked at The Manor for 13 years. “I love the residents and my coworkers. This is a great place to work and when I go home I feel that I have done a good job assisting our residents.”

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

From left are Jason Santiago, Oswego Health vice president and the Manor at Seneca Hill’s COO; Terry Wilbur, representing State Assemblyman Will Barclay, who cosponsored a NYS Legislative resolution; Shari Mezza, Jim Clyne Jr., president and CEO of Leading Age, and Michael Harlovic, Oswego Health President and CEO.


Health News program for moms of all fitness levels, Out of more than 30 instructors nominated, six finalists were selected by Baby Boot Camp Global on the criteria of receiving three or more nominations from local members; being an instructor for more than one year; having all certifications up to date; being active in Baby Boot Camp Global’s instructor network; and attending the Baby Boot Camp Global Annual Conference and Awards Banquet Sarasota, Fla. “I’m beyond honored and humbled to be recognized as the Baby Boot Camp Instructor of the Year,” said Eighmey. “It is not only a pleasure to instruct Baby Boot Camp Syracuse classes, but a passion. I am truly thankful to be able to help others lead healthful lives, serve as a role model to my daughter and for the friendships and support developed in our #momstrong tribe.” Local members called her “the best of the best,” and discussed how “she consistently goes above and beyond to ensure that all members – new and old – feel welcomed, comfortable and challenged.”

Stroke care at St. Joe’s gets recognition

St. Joseph’s Health has recently received national certification from DNV GL Healthcare as a Primary Stroke Center. The DNV GL Healthcare Primary Stroke Center Certification is based on standards set forth by the Brain Attack Coalition and the American Stroke Association and affirms that the medical center addresses the full spectrum of stroke care — diagnosis, treatment, rehabilitation and education — and establishes clear metrics to evaluate outcomes. “It is critical for patients suffering from a stroke to get care as quickly as possible, and St. Joseph’s Health has proven that we can provide the best in stroke care,” said neurologist Kevin Thomas, chief and medical director the stroke program at St. Joseph’s Health. “It’s a combination of the right equipment, personnel and training to quickly assess and treat strokes. The rapid evaluation, transportation and coordination of care provided by our stroke team members can preserve precious brain tissue and improve the outcomes of our stroke patients. “ Neurologist Fahed Saada said, “As the number one hospital for cardiac care in the region, we fully understand each of the heart disease factors that create increased risk for stroke.St. Joseph’s consistently works to help reduce heart disease and stroke risk in our community. But if someone does suffer from a stroke, it is critical to get that patient to a hospital with expert understanding of these nuances for stroke care, like St. Joseph’s Health.” The recognition comes a few months after St. Joseph’s was designated by the NYS Department of Health as a primary stroke center. The hospital also received the Bronze Award from the American Heart Association/American Stroke Association “Get With The Guidelines”

stroke program.

New wing of The Nottingham announced

Loretto recently held a ground-breaking ceremony on its new wing of The Nottingham, known as The Glens — A Nottingham Residence. This new residence is scheduled to open in fall 2019. The two-story building with a separate entrance will house 22 new luxury apartments where residents can customize their independent lifestyle while enjoying the peace of mind knowing that they are part of a continuum of care at The Nottingham. Among the 22 units will be 15 two-bedroom apartments, four one-bedroom apartments with an office, and three one-bedroom apartments. The high-end amenities of the new space will include: • private, indoor parking for 22 cars with additional heat-controlled storage areas; • private porches;  • eat-in kitchens with full-size stainless steel appliances; and • bathrooms with heat lamps and large walk-in showers with builtin benches. The Nottingham is a senior living community that has been providing care for over 30 years, with housing options that range from cottages, independent living apartments, assisted living apartments and accommodations for skilled nursing. 

St. Joseph’s earns 5-stars for vaginal delivery

St. Joseph’s Health is the only hospital in Onondaga County to be named a 5-star recipient for vaginal delivery by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. This 5-star rating indicates that the hospital’s clinical outcomes are statistically significantly better than expected when treating the condition or performing the procedure being evaluated. According to Healthgrades, St. Joseph’s Health Hospital has the highest patient recommendation and has earned more 5-star ratings than any other hospital in Onondaga County. “The focus for our women’s and children’s services team is sustaining a highly reliable and safe perinatal service at St. Joseph’s Health,” said physician Joseph Spinale, chief medical officer at St. Joseph’s Health. “Our clinical practice is based on protocols that are developed from national guidelines and we have a dedicated culture of ‘safety-first’ to keep mothers and infants safe at all times.” “With more options than ever on where to receive care, consumers need to do their homework,” said physician Brad Bowman, chief medical officer, Healthgrades. “Hospitals that have received a 5-star rating have shown dedication and expertise, resulting in high-quality outcomes for patients.”

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November 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Care when you need it most.

Crouse to Expand, Renovate NICU Major gift from Neonatal Associates of Central New York to help $31 million NICU expansion and renovation project

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

rouse Health recently announced plans for the expansion and renovation of its regional neonatal intensive care unit (NICU), which is designated by the New York State Department of Health as the only hospital in Central New York to serve as the area’s regional perinatal center. Crouse Health Foundation also announced a $500,000 gift dedicated to the project from Neonatal Associates of Central New York, whose eight physicians care for 1,000 premature and critically ill infants from a 14-county region in Northern and Central New York annually. “As Central New York’s premier birthing hospital and home to the regional NICU, Crouse Health is deeply grateful to the physicians of Neonatal Associates of Central New York,” said President and CEO Kimberly Boynton. “This tremendous gift that will benefit children and families in our Upstate New York region, coupled with their expertise and care, are reflective of their commitment to our community.” In recent years, the need for neonatal care has grown regionally and nationally due to an increase in the number of premature and multiple births. While Crouse’s NICU is the highest level — and largest — in the region with 57 bassinets, more space is required to provide the best care

possible to its tiniest patients. Located on the ninth floor of Crouse Hospital’s Irving Unit, the renovated NICU will be expanded from its current size of 15,000 square feet to a total size of 24,000 square feet. The planned unit will incorporate lifesaving technological advances, while also providing more space for families to bond with infants, a tangible expression of the NICU’s focus on family-centered care. “As physicians, we encourage parents to play an active role in the care of infants in the NICU,” said physician Steven Gross, medical director of newborn medicine and the regional NICU. “The newly renovated NICU will provide a more comfortable and private environment for family members to be active participants, with an emphasis on physical and emotional bonding.” The Crouse Health Foundation plans to raise $10 million through private gifts to the CrouseCares comprehensive campaign to support the $31 million NICU expansion and renovation project. The plan is to raise the funds by the end of 2020. More information is available online by visiting crouse.org/crousecares. Contact Director of Philanthropy Jeff Comanici at 315/470-7054 or jeffrycomanici@crouse.org to learn more.  

Dr. Jay Chapman Receives Award

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onnextCare’s physician Jay Chapman was recently presented with the President’s Award for Outstanding Voluntary Faculty Service by SUNY Upstate Medical University at its fall faculty convocation held Sept 12. Dr. Jay, as he is affectionately known, was selected for being a vital part of the community, having taught SUNY medical students the critical roles of patient advocacy and community leadership for many years. He is noted for nurturing students for future small town practices and in the field of primary care. Chapman has served in the rural medical education program (RMED) from its inception in 1990. Since then he has trained 28 students in the Oswego and Pulaski communities because of his commitment and passion for teaching. He offers teaching experiences that highlight the importance of providing care to vulnerable populations as a primary care provider in a school-based setting in an underserved community. Chapman practices with his wife, physician Pat Chapman, at the ConnextCare Pulaski location. “The Chapmans are without a doubt some of the best physicians I have had the pleasure of working with during my time at Upstate,” said a former medical student. “Students learn not just excellent medicine, but also how to be caring, compassionate, community-engaged physicians. Dr. Chapman constantly took the time to teach procedures and explain decision-making and never made me feel like I was a burden…”

Physician Jay Chapman Physician Patrick Carguello, ConnextCare’s senior vice president and chief medical dfficer, said, “It is only fitting that Dr. Jay be recognized for some of the many other remarkable volunteer activities he engages in for the community in addition to providing outstanding medical care. Both he and his wife, Dr. Pat, are wonderful and caring individuals who are extremely dedicated to improving the overall quality of life for our rural community.”


Upstate Researcher Gets $1.5 M to Develop Approach to Preventing, Treating Sepsis

Holiday Special Issue

Don’t miss the December issue of In Good Health. All about food, gifts, diet, mental health

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pstate Medical University associate professor Juntao Luo, PhD, has been awarded a four-year $1.5 million National Institutes of Health R01 research grant to continue studying a novel technique of removing toxins and other dangerous molecules from the blood to prevent and treat dangerous sepsis. Luo resides in Jamesville. The title of Luo’s project is “An innovative hemoperfusion nanotrap for sepsis treatment.” His lab is developing a “highly efficient nanotrap for hemoperfusion therapy to remove the range of triggers and mediators of sepsis.” Sepsis Juntao Luo, PhD, occurs when the body’s response to an infection triggers a dangerous systemic inflammation, which can lead to organ failure, and in severe cases death. Removing those triggers and mediators from the blood can lower the risk of developing sepsis. The World Health Organization estimates that sepsis affects more than 30 million people a year around the world, and kills more than 250,000 people in the United States annually. “Some patients will experience that hyper inflammation,” Luo said. “We can use this technique to target those molecules and save the life of the patient. (Sepsis is) the primary cause of death in the ICU. The clinical impact could be very broad.” Luo, who has worked at Upstate for seven years, has been working on this project for about two years. The NIH grant will propel his research one step closer to a clinical translation, he said. Luo is collaborating with Upstate professors Guirong Wang, PhD, and Gary F. Nieman, MS, on this project. He is hoping to collaborate with additional Upstate departments to initiate clinical trials in the future. “With this money we can further test our concept,” Luo said. “We are excited and also confident about the importance of our data.” According to the project’s abstract, “these studies will pave the way to translate this innovative HP nanotrap technique into the clinic to improve the survival of patients with severe sepsis and septic shock. It can also be used to treat patients with high risk of cytokine storm, e.g. cardiac surgery, burn, trauma and CAR-T cancer immunotherapy.” Luo’s research areas also include nanomedicine, drug delivery, cancer imaging and cancer treatment, among others. This is his fourth NIH grant.

A community healthcare system built with exceptional people. Nascentia Health is a shared commitment to providing exceptional care. VNA Homecare, Visiting Nurse Association of Central New York, VNA Homecare Options, LLC, Home Aides of Central New York Inc., and their respective affiliated organizations and foundations are now unified as one new healthcare system – Nascentia Health. This new system reflects our continued commitment to providing the best possible care to those we serve.

In-Home Nursing & Medical Services Home Health Aides & Elder Care Community Health & Wellness Programs Complete Cross-Continuum Care Management Transportation, Equipment & Innovative Care Technology Chronic Disease Self-Management Managed Long-Term Care (MLTC) Plan

n See related story on page 7. 1050 West Genesee Street, Syracuse, NY 13204 Call 888.477.HOME November 2018 •

nascentiahealth.org IN GOOD HEALTH – CNY’s Healthcare Newspaper

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IGH CNY 227 November 18  
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