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PRICELESS

Meet Your Doctor

CNYHEALTH.COM

DECEMBER 2018 • ISSUE 228

HOLIDAYS

Auburn orthopedic surgeon Brian Tallerico values practicing in smaller towns. “Healthcare in smaller hospitals is just as good if not better than what you get in the big university settings,” he says

If the winter holidays are the most joyous time of the year, why do so many people get depressed? INSIDE • This is a great time to put your family’s health history together • Six ways to go heartburn-free this season • How to pick healthful food gifts for college students, parents, seniors

Starts on page 20

Tonsillectomies It turns out most tonsillectomies are not needed

NY Ranks High in New Cases Fifty to 100 new cases per year are identified in the Rochester region alone

Identical Twins Marry Identical Twins

How genetically similar would their children be? page 2

Mussels These scrumptious mollusks possess the most impressive nutritional profile of all shellfish, especially when it comes to vitamin B-12, selenium and manganese page 17

­

Fitness If it seems like everyone you know is trying yoga or meditation, you might be right. A new survey shows a surge in the past few years. page 8


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.

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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.

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

TIME TO CALL 911


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CALENDAR of Dec. 7

HEALTH EVENTS

Author of The Fly Creek Cider Mill Cookbook comes to Hamilton

Identical twins Brittany and Briana Deane recently married identical twins Josh and Jeremy Salyers. Credit: TLC

Identical Twins Marry Identical Twins How genetically similar would their children be?

A

couple of identical couples recently doubled up for life. Identical twins Brittany and Briana Deane first met identical twins Josh and Jeremy Salyers last August at The Twins Day Festival in Ohio, according to ABC News. A year later, the couples had their weddings, together, wearing the same wedding outfits, at this year’s Twin Day Festival. Their weddings were documented for a TLC special called “Twins Marry Twins,” scheduled to air in 2019. The double Deane-Salyers weddings raise a question: If one set of identical twins marries another set of identical twins, how genetically similar would their children be? “In theory, we would expect their children to be genetically as similar as full siblings are to each other,” said Laura Almasy, a professor of genetics at the University of Pennsylvania. Siblings born to the same set of parents share about half their genes with one another. For every child that’s born, “it’s like drawing a handful of marbles from a jar — you get half of your DNA from mom and half from dad,” Almasy said. Cousins don’t draw from the same jar. But in this case,

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the children of the two sets of parents would be drawing from two separate, but identical jars. “So, the expectation would be that they would share half their DNA like full siblings would,” Almasy said. But just like typical siblings, “any particular pair of individuals could share more or less” of those genes. What’s more, the identical twin parents may not have completely identical DNA; instead, there may be slight differences in their genes that could have occurred in the womb or because of environmental factors throughout their lives. These slight differences can also influence how similar the babies would be to one another. “Environment doesn’t affect which genes [babies] get from their parents,” Almasy said. But the environment in which the parents grew up could change how an inherited gene is expressed in other words, how it turned off and on, she added. For example, if one mother smoked throughout her life and the other didn’t, both babies could receive the same gene, but the gene could express and influence the baby very differently.

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

The Colgate Bookstore in Hamilton hosts its annual holiday open house from 8 a.m. to 6 p.m., Dec 7 with store-wide sales. Most items will be 13 percent off. Brenda Michaels, author of “The Fly Creek Cider Mill Cookbook”, will be at the bookstore from noon to 4 p.m. with delicious samples from her cookbook. Fly Creek Cider Mill and Orchard is one of New York state’s oldest working cider mills. Owned by authors Brenda and Bill Michaels, the mill sits on the banks of Fly Creek near historic Cooperstown, where for more than 150 years visitors have come to watch as apples are pressed into fresh cider. Released to commemorate the 160th anniversary of the mill, The Fly Creek Cider Mill Cookbook captures the history of this treasured operation through stories, photography, and more than 100 apple- and cider-based recipes. These recipes range from sauces and drinks to breads and soups to starters and main courses. Each recipe has been selected with the home cook in mind. Contributed by mill employees and friends, each dish has been vetted by James Beard Award–winning cookbook author Judith Choate, who is a friend of the Michaels family. More than 175,000 people visit the mill each year to experience a time-honored tradition that expresses the essence of another era. Colgate Bookstore is locate at 3 Utica St., Hamilton.

Dec. 9

Church to host live action nativity program

A local church will be doing a live nativity program with live animals. The event will feature live animals, horse-drawn carriage rides, hot chocolate, snacks and more. The nativity program will be from 4 to 6 p.m., Dec. 9, at The Vineyard Church, 312 Lakeside Road, Syracuse. The event is free of charge. “I can’t wait for this year’s live nativity! We want to make the Christ-

mas story come alive for families in CNY,” said John Elmer, the lead pastor of the Vineyard Church. “We want kids and parents alike to say, “wow” when they see this presentation.” Families attending the event can get a live action experience interacting with the animals. Fort Rickey Children’s Discovery Zoo and Mini Ark Farms are providing the animals to help bring the nativity scene to life. Along with the nativity program, families can enjoy snacks and carriage rides giving an all around Christmas experience. 

Jan. 19

Bands sought for JCC Battle of the Bands

The Sam Pomeranz Jewish Community Center is once again seeking rock and other musical groups to enter and play in its Battle of the Bands concert. This 17th annual competition exclusively for high school bands will be held at 7 p.m., Jan. 19 at the JCC of Syracuse, 5655 Thompson Rd., DeWitt. The winning band will receive a $200 cash prize and eight hours of studio time at More Sound Recording Studio in Syracuse. The Battle of the Bands entry form is available online at www.jccsyr.org and at the JCC’s main entrance reception desk. Registration is $40 per band. The deadline to enter is Jan. 11. All bands entering the JCC Battle of the Bands competition must have a majority of its band members enrolled full-time at a local high school. Each band entered will have 30 minutes to play. The Battle of the Bands concert has typically drawn up to 10 bands from all over Central New York. The shows are filled with quality talent and get the house rocking. Last year’s winner was classic rock band Churches and Graveyards from Marcellus Sr. High School. Admission to the show is $10 and open to the public. For every high school student admission, the JCC will donate $1 to his or her school district’s music department. For more information about the Battle of the Bands, including registration details, contact Amy Bisnett at 315-445-2040, ext. 122, or abisnett@ jccsyr.org.


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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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5/23/18 11:34 AM


Meet

Your Doctor

By Chris Motola

Turns Out That Most Tonsillectomies Not Needed

T

onsillectomies were once very common. According to Medscape, 1.4 million tonsillectomies were performed in the United States in 1959. However, by 1987 — less than 30 years later — that number had dropped to 260,000, and it is even smaller today. Now, a new study revealed that doctors may still be performing too many tonsillectomies. According to a study conducted by the University of Birmingham and published in the British Journal of General Practice, seven out of eight tonsillectomies are unnecessary. Researchers analyzed the medical records of more than 1.6 million children from the United Kingdom. What they found was that of the 18,271 children who had their tonsils removed, only 2,144 (or 11.7 percent) actually needed the surgery. What’s more, they found many children who actually need tonsillectomies are not receiving them: 15,764 children had records showing sufficient sore throats to undergo surgery but only 2,144 (13.6 percent) actually received them. Physician Tom Marshall, professor of public health and primary care at the University of Birmingham, explained in a statement, “Research shows that children with frequent sore throats usually suffer fewer sore throats over the next year or two.” For kids with enough documented sore throats, the improvement is slightly quicker after having a tonsillectomy, which means surgery makes sense in those situations, he added. But the research suggests children with fewer sore throats don’t benefit from the procedure enough to justify surgery because those sore throats tend to go away anyway. Of course, one may wonder what the harm is in performing an unnecessary operation, especially on a body part we can certainly live without. However, according to the Mayo Clinic, tonsillectomies come with numerous risks, including uncontrolled bleeding, reactions to anesthetics or infections. “Children may be more harmed than helped by a tonsillectomy,” Marshall said in the statement. As such, researchers are hoping doctors and parents weigh the pros and cons of the procedure more closely.

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Brian Tallerico, D.O. Auburn orthopedic surgeon values practicing in smaller towns. “Healthcare in smaller hospitals is just as good if not better than what you get in the big university settings,” he says Q: We’ll start with the important stuff from your bio. How did you go from wanting to be a Jedi Knight to an orthopedic surgeon? A: Every kid who grew up in the ‘70s and ‘80s wanted to be a Jedi Knight, right? When I got to college, I knew I wanted to go into healthcare, but I wasn’t sure what. Where I went to college, they had something called intercession, where in the month of January you rotated through different fields or took a nice trip to Europe or Australia or something. I stayed in Pennsylvania and did a clerkship with an orthopedic surgeon, which was my first exposure to it. By day one I was pretty certain that that’s what I wanted to be. I was just impressed with the technical aspects of the surgery, seeing them use hammers and saws on one case and then on the next doing micro-surgery on a hand or finger. But watching surgeon for a month, I was able to see him put people back together and really help them get back to a normal active lifestyle. I knew I wanted to be a doctor, and one that fixes people, not just treats them with medications. Q: Does the more physical nature of orthopedic surgery appeal to you? You mentioned the saws and hammers. A: Yeah, for sure. It’s a physical job. One of my partners is a little older than me and he called it having to be a surgical athlete. It sounds kind of corny, but he’s right. You’re working out all day. If you’re doing the more delicate cases like hands it’s a different story, but certainly being involved physically is one of the aspects I

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

like about it. Q: You’ve talked about wanting to leave a legacy. Do you see your work as a vehicle for that? A: I think it’s both. I think it’s important for citizens to want to leave a legacy, whether it’s through their occupation, their family life, their charity work, their altruism. I want to leave a legacy of taking care of people and treating them the way I want to be treated. And that there’d be a lasting positive effect from what I’d done. Q: Do you feel it’s easier to make that kind of impact in a smaller, rural hospital like Auburn Community? A: Yeah, I do. I grew up in a very small community in Western Pennsylvania. And every job that I’ve had in private practice has been in a smaller community. I have affinity for smaller town medicine. I used to say I just want to be a good old-fashioned country bone doctor. This is small town America in Upstate New York. I think healthcare in smaller hospitals is just as good if not better than what you get in the big university settings. We may not have all the super specialists, but we can deliver more one-on-one care, and it’s really neighbors taking care of neighbors. People respond to that and I think they cherish that. Q: I know surgeons don’t always get a ton of time with their patients, especially conscious time. Is that easier to get in a smaller setting? A: Absolutely. It can be

hard to eat in a restaurant sometimes because people would come up to you and talk about their surgery and recovery. I’ve only been here a couple months and it’s already starting to happen. I enjoy that personal touch. It resonates with the community. I like getting to know my patients, and I like them being able to get to know me as a normal guy. Q: I hear you met former Vice President Dick Cheney at one point. A: I did. I was flying into Jackson Hole and I had been upgraded to first class with points. And I’m sitting there and a lady starts talking to a man in a cowboy hat and being very complimentary. So I was trying to figure out who it was. Another person came up to him in the luggage area and shook his hand, thanking him. So I knew Dick Cheney still had a house in Jackson Hole. So I introduced myself, shook his hand and told him I was active duty while he was in the White House. So he thanked me for my service, so that was a neat exchange with the former vice president. Q: You were in the Navy? A: Yes. I was active duty as an orthopedic surgeon for four years active duty, and nine years in the reserves. Best four years of my career. I have no regrets. It was a fantastic opportunity. I miss it sometimes, a lot of the aspects of being a military physician. Q: What are some of the differences between practicing in the military versus civilian sector? A: There’s pros and cons. The pros are you just take care of everybody. You don’t have to worry about pre-authorization or insurance companies authorizations surgeries or labs. You just show up and you take care of people. What I really liked was being able to meet heroes from different generations. This was back in the early 2000s, so there were still World War II veterans who weren’t young, but were still active in their 70s. So I saw veterans from all of the wars from then to the present day. I got to know them, hear their stories. It is still a government bureaucracy, and you have to deal with that, but the pros far outweigh the cons in my opinion. Q: In terms of bureaucracies, which do you find easier to deal with? A: Ten years ago I might have had a different answer for you. I think it’s state-dependent. I would say the bureaucracy of the military was that you were in a branch of the government, but it also didn’t really interfere with patient care.

Lifelines Name: Brian Tallerico, D.O. Position: Orthopedic Surgeon at

Auburn Community Hospital Hometown: Eighty Four, Pa. Education: Midwestern University; Ohio University of Osteopathic Medicine Affiliations: Auburn Memorial Hospital Organizations: American Osteopathic Association; American Osteopathic Academy of Orthopedics; Arthroscopy Association of North America Family: Married (Karen), three children (Hannah, Sarah, Caleb) Hobbies: Outdoors, traveling, sports


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By George W. Chapman

‘Experimental’ Treatment: Jury Awards $25.5 M to Family

I

nsurance companies typically will not pay for procedures/treatment that they consider to be “experimental” or “investigational,” even in cases where the patient’s life is at stake. Recently, a jury awarded $25.5 million to the husband of a woman who died after being denied proton beam therapy to treat her brain tumor. The jury wanted to send a message to her insurer, Aetna, in what was called a “bad faith” case. Aetna’s “experts” argued the treatment was experimental while the plaintiff’s experts argued proton beam therapy is a well- established form of treatment and is paid for by Medicare. The couple mortgaged their home and raised over $90,000 through “Go Fund Me” to pay for treatment at a renowned cancer treatment center while suing Aetna, but it was too late and the patient died. The question is how does

an individual insurance company eventually move treatments off their “experimental” list and on to their “approved” list? Proton beam therapy has been around for years. There is virtually no national oversight or agreement on what is considered to be experimental. It is left up to the insurer. A solution would be a panel of experts comprised of clinicians, payers and researchers empowered to determine what treatments are globally considered to be “experimental” and then which of them are either ineffective or approved for payment. There could be a federal fund established to pay for experimental procedures. How else will we know if the treatments are effective if people can’t afford to go through with them? Aetna could have treated almost 300 patients for the $25.5 million they shelled out for “bad faith.”

Insurance Administrative Costs Our average administrative costs for health insurance are the highest in the world. The Affordable Care Act limits what commercial insurers can retain for profit and administrative costs to 15 percent of their premium. That means they must spend 85 percent of the premium on actual claims. If they spend less than 85 percent on claims they must refund the difference to their members. Medicare, purportedly, has the lowest administrative costs of all insurers at just over 1 percent. So, is “Medicare for all” a way to lower premiums for all? Skeptics argue the 1 percent is artificially low because: the IRS col-

lects the taxes, Social Security collects the premiums, the FBI handles the fraud and then another seven federal departments also do work for Medicare. But Medicare’s annual report accounts for these costs. However, one third of Medicare eligible people are insured by private/commercial Medicare Advantage plans versus directly though Medicare. Including the administrative costs of these Medicare Advantage plans results in a combined 7 percent administrative costs which is much higher than Medicare’s 1 percent. Private plans average about 13 percent administrative costs, which includes profits.

Drug Ads on TV No one really knows what drugs actually cost: manufacturers raise their prices to exorbitant levels to account for “discounts” given to pharmacy benefit managers; your out-of-pocket cost depends on your insurance plan; the same drug is cheaper in other countries. The Trump administration — CMS and DHHS — has vowed to control drug pricing or at least make it more transparent. Trump is proposing to require drug companies that sell drugs covered by Medicare and Medicaid to include their list price for covering a typical course of treatment in their ubiquitous TV ads. DHHS Secretary Alex Azar said, “We will not wait for an industry with so many conflicting and perverse incentives to fix itself.” CMS Administrator Seema Verma said, “We are committed to price transparency across the board and prescription drugs are no different.” The drug industry spends over $4 billion annually on TV ads. Of course the powerful drug lobby is pushing back and will challenge the policy in court arguing it violates their free speech. The drug lobby counters with providing language in their TV ads directing patients to online resources to determine what their cost would be. The AMA says this is a step in the right direction, but not a solution. Affordable Care Act There have been 70 attempts to repeal the astonishingly resilient ACA (Affordable Care Act) over the last 10 years. The last attempt to repeal was thwarted by the late Sen. John McCain’s “no” vote. Failing to repeal the law, the Trump administration started gutting the ACA by: reducing advertising 90 percent and navigator funding 40 percent; allowing states to reduce coverage for pre-existing conditions; terminating the individual mandate; changing basic coverage requirements; December 2018 •

and basically just making it difficult for insurers to hang in the market places. A promised “much better plan” was never offered — 20 million people depend on the ACA for their insurance. Ironically, concerns over the most popular and basic tenet of the ACA — pre-existing conditions — probably cost Republicans the House. Democrats made it an issue and Republicans running for office claimed they were always in favor of it. Now, with the House under Democratic control, it will be interesting to see if the ACA is resurrected (and improved) rather than slowly bludgeoned to death. NRA v. AMA In addition to asking if you: exercise, smoke, drink excessively, use a seat belt, etc. to determine your health risks, your physician may also ask you if there are guns in the house. After the recent mass shootings, the AMA came out with a position paper calling gun violence a pubic health crisis. The NRA pushed back and told the AMA and several tweeting emergency room physicians to “stay in their lane.” The AMA is focusing on legislation that virtually prevents the Centers for Disease Control and Prevention from doing research on gun violence. As Many as35,000 of us die from gun violence each year and of that 21,000 are suicides. 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


Yoga, Meditation Surging in Popularity in U.S.

I

f it seems like everyone you know is trying yoga or meditation, you might be right. A new government survey shows that the number of Americans practicing the “mindfulness” techniques has surged in the past few years. In 2017, more than 14 percent of U.S. adults said they’d practiced yoga in the past year — up from 9.5 percent in 2012. Meanwhile, the number of meditation practitioners more than tripled — from 4 percent to 14 percent. Even kids are getting into mindfulness. In 2017, the study found, more than 8 percent of 4- to 17-yearolds had practiced yoga in the past year — up from 3 percent five years earlier, the U.S. Centers for Disease Control and Prevention reported in November. And while few kids were taking time to meditate in 2012 (less than 1 percent), more than 5 percent were doing so in 2017. The survey did not ask people why they’d taken up these ancient practices. So it’s not clear what’s driving the rise in popularity, said researcher Lindsey Black, of the CDC’s National Center for Health Statistics. She said it’s unclear how many Americans might have turned to yoga or meditation to manage health conditions, or simply for “general wellness.” Nor did the survey ask people whether they regularly practiced or had just dabbled in the techniques. “We just know these practices are becoming more popular,” Black said. According to marketing claims, belly breathing, tree poses and other time-honored techniques can help kids de-stress, navigate social cliques, and even fend off flu. Adults are told they’ll develop a

better outlook, better posture, better sleep and more if they use their yoga tools. Media focus could be boosting the popularity of yoga and mindfulness, said Ted Meissner, of the University of Massachusetts Medical School’s Center for Mindfulness. The university is the birthplace of mindfulness-based stress reduction (MBSR), a guided program that combines particular meditation techniques and gentle yoga. It’s considered the “gold standard” mindfulness technique in scientific research. In recent years, Meissner said, there has been a “sharp spike” in studies looking at the effects of various mindfulness approaches such as whether they can help treat health conditions as diverse as chronic pain, heart disease, memory problems, anxiety, depression and addiction. That has come with a surge in media coverage, Meissner said. But much of that research has had major limitations, he added. For one, most studies have lacked control groups where people get some other intervention for comparison. The media have also given lots of attention to studies showing that when people meditate, their brain activity changes. But the significance of those findings to daily life is unknown, Meissner said. What is mindfulness? The Center for Mindfulness offers this definition: the intention to pay attention to each and every moment of our life, non-judgmentally. But when it comes to research, there isn’t even a universally accepted definition of the term, Meissner said. It’s much less straightforward than studying a drug, he noted.

Onondaga, Oswego, Cayuga and Madison Counties

CNY’s Healthcare Newspaper

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

In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Chris Motola, 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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UROLOGY FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 December 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Asking for Help: It Brings Blessings, Not Burdens

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elp with hanging holiday lights. A ride to the doctor’s office. Help with moving a heavy piece of furniture. An emergency pet-sitting request. We all need a helping hand from time to time. Giving and receiving help from my friends and family has proved to be a wonderful way for me to deepen relationships and strengthen bonds. It’s another one of the many “life lessons” I’ve learned while on my own — that asking for help brings blessings, not burdens. If asking for help is difficult or awkward for you, know that you’re not alone. Many people — and, regrettably, many of those who may need it most — find it hard to reach out and ask for help in times of need. And why don’t they? There are many reasons, but my experience tells me that lots of women and men who live alone avoid asking for help because they fear being seen as weak or vulnerable. I know that after my divorce I was reluctant to ask for help. I wanted to show the world that I was perfectly fine, thank you. When I really could have used some help, I avoided asking anybody for anything, determined to muscle through

on my own. It led to isolation and pointless hardships. But the biggest shame? Not asking for assistance kept me distant from friends and family. I denied myself (and them) the chance to connect on a genuine and meaningful level. Looking back, it’s clear to me that my healing and personal growth were compromised as a result. I encourage you to let go of any excuses not to ask for help, in favor of being true to yourself and to those who love and want to support you. Below are some words of encouragement and a few tips to help you help yourself: n Be honest. What keeps you from asking for help? Could it be pride? Do you think you’ll be seen as incapable or weak? Are you concerned about being a bother? Or, would asking for help force you to acknowledge that, indeed, you need it? Take a moment and reflect on what keeps you from asking for assistance. n Redefine what it means to be strong. Everyone needs support every once in a while, and seeking help is not a weakness. In fact, the strongest people are often those who have the courage to admit they need some assistance and reach out.

s d i K Corner

Sharp Rise Seen in Kids’ ER Visits for Mental Health Woes

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ental health issues are sending more and more kids and teens to hospital emergency rooms, and that increase has been most dramatic among minorities, a new report shows. Between 2012 and 2016, overall admissions shot up 50 percent in the United States, the researchers said. “Prior to our study, we knew that an increasing number of children with mental health concerns were coming to the nation’s pediatric emergency departments,” said study author physician Anna Abrams. She is a resident physician with the Children’s National Health System in Washington, D.C. “What this new research demonstrates is that not only are these visits increasing at a staggering rate, but

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that there are significant racial and ethnic disparities in the trends of who visits pediatric emergency departments for mental health issues,” Abrams said. Why this is so remains unclear, she noted. “Our study really was an effort to characterize the frequency of these emergency department visits,” Abrams explained. “It was not designed to investigate the potential reasons that triggered these visits. We do plan to investigate this question in future work.” The study team said that more than 17 million American children struggle with some form of psychiatric illness. In recent years, that has meant that somewhere between 2 percent to 5 percent of all pediatric

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

I’ve always admired this quality in others. Real strength is knowing your personal limitations and having the confidence to recruit assistance when you need it. n Have a little faith. Believe that people truly want to help. Just turn the tables and think about how you’d respond if a friend, family member or co-worker asked for a helping hand. Chances are you wouldn’t hesitate. You might even feel slighted if not asked, especially if someone you cared about was having real difficulty. Know that others, too, want to be there for their friends and family in need. n Take a chance. When you choose to be vulnerable and ask for help, you are opening yourself up and exposing your authentic self. While it may feel risky, when you are “real” like this, you have an amazing opportunity to cultivate deeper, more meaningful bonds with others. It can be a positive, life- and relationship-changing experience, but only if you are willing to take a chance and make your needs known. n Make the ask. As a first step, put some thought into where you could really use some support and then ask for help with one specific item. It could be something as simple as asking a neighbor for help shoveling snow to something as important as requesting a recommendation for a financial adviser. If finding just the right words is hard to come by, you might start out by saying, “You know, I’m not very comfortable asking for favors, but I wonder if you might be able to help me with something?” n Express your gratitude. You know

this, of course. A heartfelt thank you in person or in writing will be warmly received by the person whose help you have accepted. No need to go overboard. Remember, people want to help others, and don’t expect to be remunerated for doing a good deed. n Offer help in return. Because giving can be as gratifying as receiving, you’ll want to make it known that you, too, are available to return the favor. We all have gifts, we all have needs, and we all can be of great assistance to one another. Look around, and you’ll find plenty of opportunities to help those who have helped you during your time of need. Asking for help becomes easier with practice. Just as I did, you’ll soon discover the benefits that lie in the aftermath of the ask — benefits that include stronger relationships with existing friends and family members, as well as the prospect of making new connections with others. The rewards inherent in accepting help and expressing your gratitude are many and go both ways. So, take it from me: Life can be better, just for the asking.

visits to the emergency department have been related to mental illness concerns. To drill down on the trends, the investigators sifted through data that had been collected by the Pediatric Health Information System. The team focused on the overall number of mental health-related visits to an emergency department among children up to the age of 21. The mental health issues covered by the analysis included: acute anxiety and delirium states; adjustment disorders and neuroses; alcohol abuse; drug abuse (including opioid abuse); bipolar disorders; childhood behavioral disorders; depression; major depressive disorders; disorders of personality and impulse control; eating disorders; psychosis; and schizophrenia. During the study period, investigators determined that more than 293,000 children — who were an av-

erage age of just over 13 — had been diagnosed for some type of mental illness in a pediatric emergency room setting. Overall, these visits rose dramatically during the study period, up from about 50 visits for every 100,000 children in 2012 to nearly 79 visits per 100,000 by 2016, according to the report. But when broken down by race, the investigators found that the observed rise had not unfurled at an equal pace. For example, nearly 52 out of every 100,000 white children were visiting an ER for a mental health issue by 2016. But among black children, that figure shot up to 78. Among other non-Hispanic minorities, the number rose to more than 79. The majority of all pediatric mental health visits (55 percent) was covered by some form of public insurance, the study authors noted.

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


Andrea Atcheson is a physician assistant at the Syracuse VA. Thanks to her knowledge of food and working with patients with heart conditions, she developed a website — thehearthealthacademy.com — that guides people to a healthier life.

Cookin’ up a Cure Physician assistant combines passion for food to create online Heart Health Academy program By Mary Beth Roach

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ndrea Atcheson has a degree as a physician assistant, and she loves to cook, so she has mixed the two to come up with the recipe for her own Heart Health Academy website — thehearthealthacademy.com. It’s an online program she created about 10 months ago that offers clients one-on-one coaching sessions aimed at addressing chronic medical concerns with diet and lifestyle changes. Working at the Veterans Administration Hospital in Syracuse in the anti-coagulation unit, the Baldwinsville native graduated from the Roch-

ester Institute of Technology in 1999 with a bachelor’s degree in physician assistant. She worked at the then Genesee Hospital in Rochester before moving to San Diego, where she worked in the cardiology field. It was there that she was able to explore her passion for cooking by attending and graduating from culinary school. “I love food, love to make it, love to eat it,” she said. Although she was still working for a cardiologist in San Diego, she found time to start a small catering business on the side called “Andrea At Your Table,” and taught cooking

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classes in the community and at people’s homes. She even did a guest spot on The Food Network’s “Grill It! With Bobby Flay.” It was in San Diego, too, that she would meet her future husband, Todd. The two married and had a son, Nicholas. Wishing to be closer to family in Baldwinsville, the Atchensons moved back to Central New York. Andrea is the mother of Nicholas, 6, and Ethan, 4. Throughout her medical career, she has often found there’s not enough time during patients’ visits to thoroughly review their overall medical state and develop plans to

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help them. “I want to do more,” she said. She said with her HeartHealthAcademy, she can do more. Her goal is to teach clients with health conditions to develop healthy eating habits, help them manage medications, and offer a support system for them. She’s quick to point out that she is not a nutritionist, but with her culinary interest, she said, she can help point out healthy eating options. As she notes on her website – thehearthealthacademy.com — good nutrition and how it affects the body’s ability to function is critical. “I continue to learn how something as simple as food can improve, if not rid, many chronic diseases,” according to her website. The academy offers three different programs -- what the website refers to as “options.” The first session is what she calls a “medical blueprint” or “organizing your health,” in which she and her client will talk about his or her medical conditions and medications. According to her website, Atcheson will devise specific ways to apply what the client has learned so the client scan progress to accomplish his or her goals. “Option 2” is called “You Are What You Eat.” The steps in this program, which focuses on heart-healthy diets, include identifying what clients eat and why (for example, are they emotional eaters?); creating a food plan; making over the clients’ cupboard or pantry; and incorporating all these changes into the clients’ lives. Heart Healthy Academy Signature Coaching “Option 3” explores clients’ medical issues, reviews medications and focuses on lifestyle changes. Atcheson will develop a food and fitness plan and then check in with clients via phone or Skype to provide support and address specific issues that might arise as her clients continue their progress. “That’s the ultimate goal for me – to see transformation, even if it’s a tiny bit. I just wanted to see improvement with whatever we’re working on.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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NEW YEAR’S SPECIAL

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Working Together Established in 2015, CNY Care Collaborative works to improve delivery of healthcare services to Medicaid patients in CNY, cutting avoidable hospital use by 25 percent

Logo of CNYCC

Population Health Management System CNYCC is also working with IBM Watson Health to develop a population health management system that integrates data from a variety of electronic medical record systems across the region and can offer advanced analytic capabilities. The technology will offer a community-wide view of the many factors that can impact care and help improve delivery of services. “With this technology, care providers will be able to identify the high-risk patients and address areas where they can make the biggest difference,� according to Adigun.

CNYCC has established a network with 125 organizations across the region that provide a wide range of services. These organizations include hospitals, senior care facilities, mental healthcare providers and community-based organizations, which often are more familiar with the most vulnerable populations in an area. CNYCC recently began running ads on local media to increase awareness across the region. “Anybody involved in healthcare or social service has the opportunity to be part of our partnership. That’s why our advertisement focuses on working together across the region to improve the overall health of our community,� Opipare said. CNYCC, she added, helped establish the navigator program in local emergency departments to assist patients that frequently use the ER. The navigator program, funded by CNYCC, allows local hospitals to employ ER Navigators that can identify patients using the emergency department for non-emergency situations. The navigators can determine if there are underlying reasons for the repeated visits to the ER, according to Bj Adigun, director of communications. “The patient may not have their own primary care doctor. Or they may be homeless, which is one reason they’re showing up in the ED. Or they may not have had a decent meal in a few days. Being able to connect that individual with resources in the community that can help address some of those social needs� will hopefully prevent them from having

 Measuring Success To determine the ongoing effectiveness of the program, the state has quality measurements for each PPS, including the overall project progress; system transformation, clinical improvement and the impact population-wide. In addition to the quality measures, the relationships forged by different partners is also a sign of success, according to Adigun. Attending a recent meeting with partners in one particular county, Adigun said that one of the things he kept hearing was that it used to be rare that these organizations would be all together in the same room. “For us, that was pretty significant,� he said. “It shows the power of those partnerships and how they can lead ultimately to helping the community.� And yet another sign of success is the support CNYCC can provide to expand services across the community. With a $250,000 grant CNYCC provided to AccessCNY, which serves people with disabilities, the agency was able to open a respite home at the beginning of 2018, for adults experiencing mental health and drug abuse issues. It is known as Berkana Crisis Respite. After the opening, representatives from AccessCNY told the story at one of the CNYCC’s board meetings of one of their patients and how the respite center had changed his life.  If you can do that for one, that means something. If you can help one life make a big difference, that’s important. And our goal is to help as many as possible,� Opipare said.

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ou may have seen the ads on local media promoting an initiative called CNY Care Collaborative and its message of “Working Together.� But what is the CNY Care Collaborative all about? The CNYCC is one of the lead agencies in this region helping to lead the state’s efforts to transform healthcare to better serve the Medicaid patient population and prepare the region for a different payment system — one that is value-based as opposed to fee-based, according Virginia Opipare, executive director. In 2014, New York state announced its Medicaid redesign team reforms, a five-year plan aimed at improving the delivery of healthcare services as well as cutting avoidable hospital use by 25 percent. In an all-too-common scenario, individuals in need of medical treatment go to an emergency room because they don’t have a primary healthcare provider, and they don’t know where else to turn. They are treated and released. But because they are not connected to any care provider, where they might receive ongoing or preventive care, their chances of repeated visits to the ER are high. And it’s a major factor in rising Medicaid costs. The main means for implementing the reforms has been the delivery system reform incentive payment program (or DSRIP), with 25 different performance provider systems (PPS) to cover each region in the state. The CNY Care Collaborative, established in 2015, is the PPS for the six-county area of Cayuga, Lewis, Madison, Oneida, Onondaga, and Oswego. To achieve its goals CNYCC has been taking a multi-pronged approach. “Ultimately, we wanted to establish a network that better coordinates care across this region and develop programs that enhance access,� Opipare said. She discussed some of their initiatives, among them improved connections across health-care agencies; development of a navigator system in local emergency rooms; and creation of a population health management system.

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

to chronically use the ED, Adigun said “The key is making sure we connect the patient to the type of service that they need.� Opipare said.


$2 Million Grant to Tackle Childhood Lead Poisoning in Syracuse

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More than 11 percent of Syracuse children tested in 2017 were shown to have elevated blood lead levels

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he Central New York Community Foundation will be investing more than $2 million over four years to help end childhood lead poisoning in Syracuse. Its new LeadSafeCNY initiative will fund a variety of approaches to address the region’s alarming childhood lead poisoning rates. More than 11 percent of Syracuse children tested in 2017 were shown to have elevated blood lead levels, according to the Onondaga County Health Department. The initiative’s first grants are going to support new housing construction, existing home renovations, community outreach and training and workforce development, totaling $439,750. Among the grants are: • $150,000 to Home HeadQuarters to pilot a window and exterior door replacement program; • $1,000 to PEACE, Inc. to refer applicants to the new Home HeadQuarters replacement program; • $150,000 to Housing Visions Unlimited to construct new affordable rental apartments; • $43,750 to the Greater Syracuse Land Bank to conduct lead inspections of its properties; • $20,000 to Home HeadQuarters to offer EPA certified workforce lead removal training; • $30,000 to Tomorrows Neighborhoods Today and Home HeadQuarters to educate residents on the importance of lead testing and remediation. The Community Foundation will focus its initial efforts in and near two Syracuse census tracts that were found in 2017 to have the highest blood lead levels in children. The first is tract 23, which is located just north of Interstate 690 between Pearl and Lodi streets. Here, more than 21 percent of children tested were shown to have elevated lead levels. Large refugee communities live in this neighborhood, which boasts a 29 percent foreign born population. Census tract 54 is located in the Brighton neighborhood of Syracuse’s Southside and includes the immediate area around the Beauchamp Library. Here, a striking 46 percent of residents live below the poverty line. In this region, more than 24 percent of children tested had elevated lead levels. This

blood lead level data was provided by the Onondaga County Health Department. “We are grateful to the health department for making this data set available to us because it allows those organizing around this issue to focus their efforts where it is needed the most,” said Frank Ridzi, vice president, community investment at the Community Foundation. “By annually analyzing this information, we’ll be able to measure our effectiveness over time.” In an statement published on its website, the Community Foundation states that it is taking action now because “lead poisoning is entirely preventable,” yet it currently hinders children’s ability to enter the classroom ready to learn. “The effects lead has on the mind and body undermine all community efforts to increase literacy rates, encourage high school completion and mentor our young people into successful careers,” said Peter Dunn, Community Foundation president and CEO. “Lead poisoning is preventable, which makes this a social, economic and environmental injustice that is simply unacceptable to continue.” Elevated blood lead levels in young children have been found to cause reduced brain function, impacting the skills needed for academic success, physical activity and social interaction. It can lead to a higher likelihood of ADHD diagnosis, absenteeism, criminal behavior, violence and suicide. Lead is a toxin that affects the brain, nervous system and multiple organs in the human body. Children under the age of 6 and pregnant women living in homes that have chipping, flaking and peeling paint are most susceptible. Lead paint chips tend to have a sweet flavor when eaten, making them enticing to young children. Another common source of ingestion is the inhalation of dust particles in the air from the friction of painted surfaces when windows, doors and cabinets are opened and closed. Syracuse’s aging housing stock is much to blame for the high rates of elevated lead levels in resident children. More than 90 percent of the city’s occupied units were built before lead paint was federally banned from use in 1978.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 13


My Turn

By Eva Briggs

All About Cannabis The consensus is that NYS one day will legalize recreational marijuana — but is it a good thing?

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few days before writing this column, I attended the annual toxicology teaching day at Upstate University Hospital. One of the interesting presentations was a point/counterpoint discussion about legalizing cannabis. Both speakers presented interesting viewpoints. Their final consensus was that New York will probably someday join the 10 other states with

legalized recreational marijuana, so it’s a good idea to know the pros and cons. One basic principle of toxicology is that for any substance, be it food, drug or supplement, is that dose makes the poison. For example, take water. It is essential to drink water but too much water dilutes the bloodstream, causing imbalance in electrolytes. The result is confusion, disorientation, heart rhythm abnormalities and seizures. In the worstcase scenario, water intoxication can kill you. Here are some points of caution regarding cannabis. It’s been touted as a remedy for pain and nausea.

Vasectomy Reversal By Sergey Kravchick, M.D.

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n the U.S. between 175 000 and 354 000 men undergo a vasectomy each year — about 6 percent of these patients request a reversal procedure. There are two options to achieve fertility in these patients: vasal repair or testicular sperm extraction (TESE) with intracytoplasmic sperm injection (ICSI). Vasal repair includes two different techniques: vasovasostomy (VV — when the re-anastomosis between two ends of the vas is performed) and vasoepididymostomy (VE— when the anastomosis between vas and a part of the epididymis is performed). Pre-operative assessment and predictors of successful operation. The physical examination includes the size of the testicles, a Page 14

palpable vasal defect, the presence of a sperm granuloma and the length of the testicular vasal segment. Formal vasography is unnecessary. Laboratory investigations should be considered for patients with small testes, a history of abnormal/borderline semen analysis before the vasectomy, or impaired sexual function. Patients’ age (more than 40 years), time from the vasectomy (about 10 years), decreased the pre-operative level of LH (luteinizing hormone) and increased level of FSH (follicle-stimulating hormone) — all can be considered as a negative predictor of success. As the VE is a more technically challenging and has a lower success rate than the VV, the following model for VE prediction may be used: (age X 0.31) + (obstructive interval X 0.94). If the prediction score is greater than 20, then the chance for VE is high. If you are in

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

Studies haven’t demonstrated an effect in acute pain. There might be some effect on chronic pain and nausea, but existing medications are more effective. Some reports link cannabis to heart problems. There have been reports of heart rhythm disturbances such as atrial fibrillation. Cannabis may possibly damage the heart muscle, causing diseases such as cardiomyopathy and myocarditis. There have also been cases of heart attacks that may be linked to cannabis use. Smoking marijuana has been associated with pneumothorax, a collapsed lung. It seems to cause a fourfold increased risk for lung cancer. And what about psychiatric problems? There is no evidence that cannabis causes new serious psychiatric diseases such as schizophrenia. It might make mood disorders, such as depression, worse. A recent study showed that cannabis affects thinking ability in teenagers. Cannabis use affected memory, reasoning and the ability to control inhibitions. Marijuana use is associated with traumatic injury caused by impaired driving. About 50 percent of people who drive while high have also been using alcohol. Cannabis slows reaction time, impairs the ability to remain in the correct lane and decreases attention. But there isn’t any Breathalyzer test for marijuana as there is with alcohol. Further, blood levels of cannabis don’t necessarily correlate with degree of impairment. There’s also the cannabis hyperemesis syndrome. Some long-term heavy marijuana users develop cyclical episodes of vomiting, producing severe dehydration. Edible cannabis forms increase the risk of overdose. Some are packaged to resemble candy, tempting children to eat them. Smoking marijuana produces effects within minutes, but the high from edible marijuana takes 30 minutes or more to begin. This has led

some users to keep eating more and more when the effects don’t begin quickly. They mistakenly think that they have not taken a large enough dose. Now some counterpoints. First, overdose death from cannabis is extremely rare compared to opioid overdose, which kills 90 to 100 people per day. The lethal dose of marijuana is orders of magnitude greater than the lethal dose of heroin or fentanyl. For example, the lethal dose of heroin is five times the effective dose, the lethal dose of alcohol is 10 times the effective dose, and the lethal dose of marijuana is more than 1,000 times greater than the effective dose. Remembering that the dose makes the poison, an adult can be killed by drinking six liters of water at once, or 118 cups coffees or 13 shots of alcohol. Although it’s possible that marijuana causes dangerous health effects, some legal substances also cause medical harm: think cigarettes and lung cancer or alcohol and liver disease. When marijuana is not legal and is sold on the black market it’s not regulated. There is no age check. Sellers can’t call the police if they are robbed. There is no regulation of the maximum dose per serving, and no labeling of the product. In contrast, legal marijuana can be regulated, the dose can be regulated, and it can be packaged in individual servings. Those are a few of the facts surrounding the debate about legalizing recreational marijuana.

one of these categories, consider TESE with ICSI.

heavy physical activity for three or four weeks, as well as to avoid sexual activity for three or four weeks after surgery. Semen analyses can be done at one, two (first analysis after VE), four and six months postoperatively. The mean patency rate for VV and VE is 87 percent (range: 80-98 percent) and 64 percent (35-72 percent), respectively. The mean pregnancy rate for VV and VE is 72 percent (range: 68-92 percent) and 48 percent (range: 33-61 percent), respectively. Upstate Urology offers these treatment modalities to patients who consider vasectomy reversal.

Surgery Although a VV or VE may be performed by using local, regional or general anesthesia, general anesthesia is chosen in most cases. Generally, bilateral incisions are made 1 cm lateral to the base of the penis. An extension of this incision can be undertaken in cases of VE. The mean operative time for VV is two-three hours, while for VE it can be three-four hours (especially for bilateral VE). To assess the patency of the abdominal vasal end, the surgeon intubates the abdominal end, and a one mL saline is injected gently through a 24-gauge angiocatheter. The vasal fluid from the testicular end is collected on a glass slide for macroscopic examination includes fluid opacity and viscosity and the microscopic examination. If there is no sperm, then VE can be considered. Postoperative period and outcomes Patients should use a scrotal supporter for six weeks and to avoid

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

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


Career in Healthcare

Lactation Consultants

Profession expected to experience a 15 percent job growth rate from 2016 to 2026 By Deborah Jeanne Sergeant

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he Bureau of Labor Statistics projects that registered nurses with credentials as lactation consultants will experience a 15 percent job growth rate from 2016 to 2026. The BLS doesn’t account for independent lactation consultants, but with that rate of growth and the resurging interest in lactation, working as a lactation consultant sounds like a solid career option. That’s not why most lactation consultants pursue this type of work, however. It’s a work of love. Sue Derby, a registered nurse, wanted to pass on more information to her patients about breastfeeding and augment her training as a registered nurse. As a new mom, she learned firsthand about the benefits of breastfeeding. In the 1980s, she Derby completed training and passed the International Board Certified Lactation Consultant (IBCLC) exam, even though the

certification doesn’t mean a pay bump for most healthcare providers. “I always felt like breastfeeding was the natural thing to do,” she said. “I wouldn’t do any differently. I became more passionate about it when I learned how much better it was for babies than formula. It’s a live organism. How important it is for when a baby is first growing — and how not good for the gut formula is.” Though she’s retired from working in a motherhood program for the Cayuga County Health Department, Derby still offers lactation consulting. Lactation consultants help mothers who want to learn more about breastfeeding or experience problems with milk supply, the baby latching on properly or other issues. Women who have undergone breast reduction or augmentation may face issues with breastfeeding. Adoptive mothers of newborns may want to induce lactation and could use the help of a consultant. Physician Jayne R. Charlamb, associate professor and director of the division of breast health and breastfeeding medicine at Upstate Medical University, also completed training and passed the IBCLC exam.

It may seem like a physician working in obstetrics would already know all about breastfeeding; however, Charlamb said, “I got next to no training on lactation during my medical education. I knew very little about it when I had my own babies.” Charlamb added that while breastfeeding is perfectly natural for babies, many young mothers weren’t breastfed themselves or don’t know other moms whom they can ask about nursing. They need someone who can mentor them in breastfeeding. Since numerous health organizations have promoted the benefits of Charlamb breastfeeding, including the American Academy of Pediatrics, National Institutes of Health and World Health Organization, breastfeeding is on the rise. The need for lactation consultants can only grow to help bridge the generation gap of formula feeding. Before sitting for the IBCLC

exam, a lactation consultant candidate must complete sufficient required health science classes (or have completed training such as an registered nurse or obstetrician), complete a minimum of 90 hours lactation-specific education and complete a required number hours of supervised breastfeeding clinical support. The requirements vary depending upon the individual’s educational background and if they take the mentorship route. According to www.salary.com, a median annual income for lactation consultants is $79,007, but that was based upon registered nurses who have completed lactation consultant training. Since many work independently or else completed training to augment other related work, it’s difficult to estimate how much a lactation consultant makes. Lactation consultants work in obstetric and pediatric offices; as a midwife, doula or labor and delivery nurse; or as part of a women’s wellness/health practice. Independent lactation consultants charge around $125 to $150 to meet with a client and engage in follow-up calls and emails. The rates depend upon several factors, including if it’s an in-home session. Many hospitals offer ongoing consulting as part of the birthing experience. “I find it highly rewarding because when you help one mom and baby through breastfeeding, it affects their relationship for months to come,” Charlamb said. “If we can help her continue, she finds it rewarding for years down the road.”

WE SPEND AN AVERAGE OF 13 HOURS A DAY SITTING STAND UP! More than half of your

day is likely spent sitting. Too much sitting is linked to heart disease and other serious issues. Sit all day at work? Set a reminder to stand every hour. Stand when on a conference call or eating lunch. Or, try a walking meeting with a co-worker.

December 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 15


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Obamacare Enrollee Numbers Aren’t Falling: Report H ealth insurance coverage rates have held steady in the United States, despite continued commotion over the future of the Affordable Care Act, a new government report shows. About 28.3 million Americans were uninsured during the first quarter of 2018 — not significantly different than 2017, and 20.3 million fewer than in 2010, before the health insurance reform law (often called Obamacare) was passed. “Things are relatively stable. During a time with a lot of uncertainty — there’s been a lot of political turmoil over what will or won’t happen with Obamacare — these gains we’ve made in reducing the number of uninsured have held pretty steady,” said health economist Ellen Meara. She is a professor with the Dartmouth Institute for Health Policy & Clinical Practice, and was not involved with the new report. About 8.3 million Americans now carry health insurance plans purchased through an Obamacare state-based marketplace, according to the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). Millions more are covered under the Affordable Care Act’s expansion of Medicaid. In Medicaid expansion states, the percentage of uninsured adults has decreased from 18.4 percent in 2013 to 8.7 percent this year, the report found. But in states that haven’t expanded Medicaid, there’s been a slight uptick in the uninsured, from 17.5 percent in 2015 to 18.4 percent in early 2018. The NCHS report, “Health Insurance Coverage: Early Release of

Estimates From the National Health Interview Survey, January-March 2018,” was published Aug. 29. Claire McAndrew is director of campaigns and partnership at Families USA, a health care consumer advocacy group. “People fare better in terms of access to coverage if their state has expanded Medicaid,” she said. “The fact that the poor and nearpoor still remain disproportionately uninsured really points to the need for states that have not yet expanded Medicaid to do so,” McAndrew added. The numbers show that actions taken by President Donald Trump have not yet resulted in the undermining of Obamacare, McAndrew and Meara said. These actions include expanding the sale of cheap plans that can deny coverage to people with pre-existing conditions; cutbacks in funding to promote open enrollment and assist people in buying insurance; and reductions to cost-sharing payments to insurance companies, the experts said. “People want health insurance. They’ve become accustomed to the consumer protections and financial assistance available to them,” McAndrew said. “Even though the Trump administration has been doing work to undermine health coverage, people still are fortunately getting coverage and care.” There are some troubling trends within the numbers, however. The percentage of adults with high-deductible health plans increased from 43.7 percent in 2017 to 47 percent this year, according to the report.

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

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SmartBites

The skinny on healthy eating

Mussels pack a mighty nutritious punch

M

y husband and I eat a lot of mussels throughout the year and especially during the holiday season. We like them because they’re inexpensive, quick to cook and delicious. We also appreciate how incredibly nutritious they are. According to some experts, in fact, mussels possess the most impressive nutritional profile of all shellfish. Mussels are protein superstars, with about 10 mussels serving up 20 grams, an amount that satisfies a good chunk of average daily needs. Unlike some red meat’s protein, a mussel’s protein is lean, with much less total fat, saturated fat and (depending on the cut) up to half the calories. As a 3-oz comparison: trimmed sirloin steak, 300 calories; 10 mussels, 150 calories. An essential nutrient that powers many chemical reactions, protein helps us build up, keep up and replace tissues. Mussels are also a great source of many vitamins and minerals, with respectable amounts of several B vitamins, vitamin C, iron and zinc. But these scrumptious mollusks really show their might when it comes to vitamin B-12, selenium and manganese. Just 10 cooked mussels provide around 300 percent of our

daily needs for both vitamin B-12 and manganese, and 100 percent of our needs for selenium. Vitamin B-12 — a “high-priority” vitamin that’s critical to good health — helps produce red blood cells and DNA, keep nerves healthy, support bone health and synthesize serotonin (a.k.a. the “happiness” chemical). Studies support that vitamin B-12 may help to boost energy, slow mental decline, prevent osteoporosis and improve moods. The manganese that’s abundant in mussels not only plays an important role in bone health and energy production, but helps to regulate blood sugar, as well. Selenium, on the other hand, supports the thyroid gland and boosts immune system health. Both are noteworthy antioxidants that help to reduce inflammation and fight cellular damage. Though low in fat, mussels boast an appreciable amount of hearthealthy omega-3 fatty acids: about 750 mg per 10 mussels. These special fats appear to benefit hearts by decreasing the risk of irregular heartbeats, lowering blood pressure and reducing the growth rate of plaque in arteries.

These scrumptious mollusks possess the most impressive nutritional profile of all shellfish, especially when it comes to vitamin B-12, selenium and manganese.

Coconut Curry Mussels

stir in lime juice and cilantro. Serve with crusty bread.

Adapted from Martha Stewart Recipes

1 tablespoon unsalted butter or olive oil 3 garlic cloves, minced 2 tablespoons minced, peeled fresh ginger (from a 2-inch piece) 1 can (13.5 oz) lite coconut milk 1 tablespoons red Thai curry paste 3 pounds mussels, rinsed, scrubbed and de-bearded (most come de-bearded) 2-3 tablespoons fresh lime juice ¼ cup chopped fresh cilantro Fresh, crusty bread (optional) In a wide, shallow pot or sauté pan with a lid, melt butter over medium-high heat. Add garlic and ginger and cook until fragrant, one minute. Whisk in coconut milk and curry paste; bring the liquid up to a boil and immediately lower it to a lively simmer. Add mussels and stir to combine. Cover and cook until mussels open, about 5 to 7 minutes, stirring once. Remove pot from heat, discard any unopened mussels, and

Helpful tips

Choose fresh-smelling, live mussels with tightly closed shells. Mussels taste best the day purchased, but can be stored in the refrigerator for a few days. To store, place mussels in a bowl and simply cover with a damp paper towel (never store in water). Rinse mussels under water before cooking and tap any mussels that are still open. If it closes, it’s alive; if it doesn’t, it should be tossed.

Anne Palumbo is a lifestyle colum-

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

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Don’t Count on an American to Do CPR Just over half of Americans know how to perform the emergency procedure.

I

f someone collapsed in front of you, could you perform CPR? If you answered no, you’re hardly alone. Just over half of Americans know how to perform the emergency procedure. And even fewer know the recommended hands-only technique for bystanders, a new Cleveland Clinic survey reveals. The survey also found that many Americans can’t tell the difference between heart attack and stroke symptoms. This could lead to delays in patients receiving proper treatment. “When someone is suffering from cardiac arrest, time is not on their side,” physician Steve Nissen, chairman of cardiovascular medicine, said in a clinic news release. “Immediate CPR can be the difference between life and death, doubling or even tripling a person’s chance of survival. It’s a skill that can be easily learned, and we encourage everyone to equip themselves with this knowledge and not be afraid to use it during an emergency,” Nissen said. The online poll queried more than 1,000 U.S. adults. Fifty-four percent of respondents said they know how to perform cardiopulmonary resuscitation. However, only one in six knew that hands-only (just chest compressions, no breaths) is the recommended CPR method for bystanders. And only 11 percent knew the correct rate (100 to 120 a minute) for chest compressions. An automated external defibrillator (AED) can also be a lifesaver when someone suffers cardiac arrest, but only 27 percent of respondents said there is an AED where they work, the survey found. The survey also found that heart attack and stroke symptoms were frequently confused. Fifty-nine percent falsely believed that sudden numbness or weakness of the face, arm or leg is a symptom of a heart attack. And 39 percent incorrectly thought that slurred speech is a heart attack symptom. These actually are common stroke symptoms.

Page 18

NY Ranks High in New Cases Local experts say HIV figures in the state are skewed by the high numbers seen in New York City By Deborah Jeanne Sergeant

N

ew York ranked fourth in the nation for new cases of human immunodeficiency virus (HIV) in 2015, and ninth in 2016, according to statistics provided by the Centers for Disease Control and Prevention. Of those infected with HIV, one in seven doesn’t realize it. Nicola Jennings, certified health education specialist at Upstate Medical University, said that New York’s high ranking is somewhat skewed by New York City. “It has always been toward the top with new rate infection,” she said of New York City. “Some things we’re doing to end the epidemic are exciting,” Jennings said. “Now we’re working on Gov. Cuomo’s plan to end the epidemic by 2020, Ending the Epidemic Task Force.” The plan’s goal is to reduce the rate of annual new infections below 750 total, thus eliminating its status as an epidemic. Healthcare providers want to get more people tested so that when they know their HIV status, they can obtain medication. “We want to retain people in care quickly and effectively,” Jennings said. “It may be a community-based organization. They’re linked to places for HIV care. If someone tests positive, we don’t want them to not engage in care. We want to make sure they stay in care and we don’t lose them or they don’t drop out.” She said that patients may not comply if they’re also struggling with housing, insurance, employment and daily necessities. By facilitating with those, Jennings said that they obtain better compliance with medication protocols. No cure for HIV exists, although a bevy of medications can slow it, improve quality of life for those infected, and even decrease its ability to spread. The message of “use condoms for safe sex” alone isn’t working, according to Jennings. “The reality is we know that the general population is not using

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

People Living with HIV in CNY

Number of cases

County

48

Madison

83

Oswego

187

Cayuga

1,092

Onondaga

27,818

New York City

Source: Robert Wood Johnson Foundation, 2015 data. condoms as a whole,” Jennings said. “We say condoms are good to use as they can prevent the spread of other STIs [sexual transmitted infections]. We know condom usage isn’t widespread or we wouldn’t have so many STIs.” That’s why many providers believe that the medication emphasis will dramatically reduce the number of new cases of HIV and why medication is a tool in the Ending the Epidemic Task Force plan — not just education about condoms. Pre-exposure prophylaxis (PrEP) is prescribed to HIV-negative people with high risk for infection who aren’t likely to adhere to behavioral changes. A daily dose has proven 99 percent effective or higher in suppressing transmission through sexual behavior, according to Jennings. Researchers have not determined if the same holds true for those sharing needles. Post-exposure prophylaxis (PEP) is part of another strategy. When a diagnosis is made, the health care providers can work with patients to contact others who may have been exposed so they can take PEP to reduce their risk of infection. PEP should be started within 36 hours but no later than 72 hours after exposure to HIV. Beginning treatment within that timeframe, it’s 80 percent effective.

By identifying higher risk populations, health organizations can know where to focus their attention on promoting screening and testing for HIV. “We look at demographics of who’s getting it at a higher rate,” Jennings said. “We particularly see that men who have sex with men of color are getting HIV at higher rates. That’s where we target some of our prevention methods. We look at populations of intravenous drug users, making sure we’re educating the community so they know what puts them at risk.” The CDC states that 9 percent (3,425) of new HIV infections nationwide are among those who inject drugs (that figure also includes 1,201 diagnoses among gay and bisexual men who inject drugs). The CDC also says on its website that gay and bisexual men accounted for 67 percent (26,570) of all new HIV diagnoses nationwide and heterosexual contact accounted for 24 percent (9,578) of HIV diagnoses. Jiancheng Huang, public health director at Oswego County Health Department, said that his office is addressing HIV by “working closely with local healthcare providers and state department health to address HIV. The state has a large program to monitor and address HIV and AIDS issues.”


Holiday Greetings

Learn More About Your Family Health History Holidays are a great time to put your family’s health history together By Deborah Jeanne Sergeant

A

s you gather with your family this time of year, consider asking a few questions about your family’s health history. It may seem a strange topic for conversation, but it can affect your health in significant ways. Focus on your immediate family related by blood: parents, siblings and grandparents. Ask a relative who has a clear recollection of family health about major medical issues that have been diagnosed, not their best guesses. Sue Derby is a retired nurse from

the Cayuga County Health Department. She now works as a internationally board certified lactation consultant in Cato. She said that it’s vital to ask family members about not only causes of death, but also the age of onset, environmental factors and ethnic background. Cause of death means why the person died. Age of onset means when the disease started. Environmental factors refers to outside contributors to the disease, such as working with asbestos resulting in cancer. Or lifestyle factors that

Why Do Some People Experience Depression During the Holidays? Many people with depression symptoms experience a worsening of mood over the holidays

T

he holidays can be a time of emotional highs, but also lows. It’s not uncommon to feel loneliness, anxiety, sadness interspersed with happiness. The bad news is the holiday blues can worsen depression symptoms in people struggling with chronic depression. n For Many With Depression, Loneliness is Heightened During the Holidays Many people with depression symptoms experience a worsening of mood over the holidays. A study of 420 Chicago-area college students investigated their feelings about the Christmas holiday and found that three of the most common themes are loneliness, anxiety and helplessness. In another study, Canadian patients

who were being evaluated in a psychiatric emergency service during the Christmas season reported feeling depressed and cited loneliness and being without a family as the most common stressors. n The Biggest Cause of Holiday Blues in Unrealistic Expectations Experts say one of the biggest causes of holiday depression symptoms is unrealistic expectations. Studies have confirmed that the primary reason for holiday depression is belief in the myth that everyone else is having a good time and engaged in loving family relationships. While this is certainly a common wish, it’s not necessarily a fact. You may be holding on to what

affected health. Many families share the same habits that can shape their health. “Ask about the health issues your relatives had, even if it wasn’t cause of death,” Derby said. Someone with prostate cancer, for example, may live with the disease for a couple decades and die from something else. But it’s still important to know about risk of prostate cancer because early detection can help patients make more educated decisions about treatment. Derby said that for women planning for children, it’s important to know the birth experiences of their mothers and grandmothers. “Did they have a vaginal birth or were they born by C-section?” Derby said. Sometimes the reason for the caesarean section, such as certain complications, may be inherited or influenced by environmental factors. It’s also important to ask about relatives with advanced longevity. “It might be good to ask the lifestyle of the person, if the person lived to be 100,” Derby said. “It might be interesting to ask about their lifestyle. Part of it may be genetics.” Also talk with your in-laws for the sake of your children. Knowing what health conditions run in your family can’t guarantee you won’t succumb to them but the knowledge can help you mitigate the effects or possibly prevent them from happening, according to Jiancheng Huang, public health director for the Oswego County Health Department. “Our health is determined by our biologic and social factors, the latter weight more as recent researches show,” Huang said. “It is important to know genetic background of a person. As many behaviors come

with the environmental we live, such as kids with smoking parents have more potential to smoke than those kids, their parents are non-smoker, family history provides important behavioral trail information, too.” He said it’s important to talk about the diseases and behaviors the parents, grandparents and siblings have. Discussing your family health history with your care provider can also influence recommendations about health habits and other lifestyle choices--factors that may have contributed to your family’s health conditions. Many people who have experienced the loss of a loved one feel especially vulnerable during the holiday season. Bring up the topic gently, such as, “I’d like to learn more about any health risks the children and I may have. Could I ask Huang about family health history?” Ask if anyone in the family has died unexpectedly from any cause and also ask about cardiovascular disease, cancer at any age, endocrine disorders, gastrointestinal conditions and any chronic illnesses. While talking openly about health, ask about your relatives’ health care proxy and advanced care planning to ensure they have settled who will make health care decisions on their behalf if they’re incapacitated and their end-of-life choices.

you remember as an ideal holiday from years gone by. Inevitably, you won’t be able to reproduce it. You may also have the unrealistic expectation around the holidays that ‘everything must be perfect’, and perfection is, of course, rarely obtainable. n Symptoms Range from Fatigue to Family Tensions to Financial Limitations Besides all the unrealistic expectations, other reasons for feeling blue around the holidays are numerous. According to the National Mental Health Association, fatigue, financial limitations, missing loved ones and family tensions are all common reasons for feeling sadness and depression symptoms during the holidays. If you’re like most people, you associate the holidays with family and togetherness. But in today’s world of high divorce rates and fragmented family units, it’s common to feel stress and sadness when trying to work out how time between family members is shared. Being separated from loved ones, whether because of death, financial limitations, or divorce can be especially painful around the holidays. Source: UHN — University Health News. December 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 19


Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

It’s the Most Wonderful Time of the Year

I

f your kid has access to other children or cable TV, chances are they never stop asking for stuff. It’s a year-round occurrence that escalates during the holiday season. After I pick my kids up from daycare, I am often hit with numerous requests for strange-sounding things. My kids see commercials at daycare (things that I am blissfully unaware of, thanks to Netflix), and those expertly targeted marketing campaigns take hold of my kids’ brains and don’t let go. Many of my car rides home sound something like this: “Mommy, I want the kitty that drinks from a dish. It isn’t real, but it can blink its eyes and purr.” “Mommy, I want the robot that changes into a dinosaur and roars and crushes buildings.” “Mommy, I want the toy that comes in a mystery lollipop container. The toy you get is a surprise, but I want the orange cat one not the green bird one.” I usually mumble something about Santa and good behavior. If I hear the same request enough times, I try to find out what my kids are actually carrying on about. I try Googling dinosaur robot building

crusher so I can send the proper URL to Santa, but I either come up short of results or am dumbfounded by the associated price tag. It’s right around that time my dislike for stuff starts creeping in. Nonetheless, be it by family, my husband and me, or Santa, my kids end up with some of the toys from their favorite commercials. The results are usually the same. They are over-the-top excited for a day or two, and then the under-performing and over-promising toy is cast into the lowermost parts of the toybox. Six months later, I consign it for a fraction of the original cost. This scenario isn’t good for anyone. It reinforces the futility of trying to find lasting joy in short-term gratification. It teaches kids to value things. The planet is pillaged to make said stuff. It’s a circle that needs to broken. For the record, I’m not against gifts. I want my kids to receive a few thoughtful gifts for holidays and birthdays. Gifts that take into account the child and not the trends seem to be ones that get lasting use in our house. I’m against the onslaught of crap. Most parents I know share this sentiment. However, they also

Holiday Greetings feel like trying to stop it is futile. The ones that do try to stop it are often met with pushback or resentment from loved ones. I am here to persuade you to give differently and better. We owe it to ourselves and our kids. If you are a giver of stuff for the sake of stuff, try shopping off this holiday list instead. The best thing about many of these gifts is they include the gift of time. What tells a child you love them more: 52 tiny pieces of plastic or a day of quality activities?

My Gift List • Zoo passes and a day at the zoo • Sponsor their babysitter course • Art class • Music Class • Craft class • Family fitness class • Movie tickets • Concert/theater tickets • Athletic park admission • A fun volunteer stint • Ice skating • Sports tickets • Board game day • Parks and recreation activities • Sponsor a sport • Baking day • Cooking class Many of these examples don’t involve a big financial obligation. They just involve quality time and some transportation. Kids love spending time with people other than their parents, and they are typically on their best behavior for other people, making any of these gifts a win for

everyone involved. Some people fear that if they don’t give kids enough stuff, they will be disappointed. In my experiences, this isn’t the case. Most kids don’t notice how much money is spent on a gift and are genuinely thankful for anything they receive. If the child in your life is resentful about a perceived lack of bounty, that child needs a gift off my list pronto. Don’t teach people in your life that money + stuff = love. I want to close with an example from my own childhood. I had one aunt whom I spent a lot of time with growing up. I’m sure she gave me a lot of gifts throughout my childhood, but I only remember one. She paid for me to take a class at our local zoo. It was a class on preparing food for the animals. I got to go in the zoo kitchen and use knives. I diced fruit and veggies and carried them into exhibits. I got to feed a giant snake a frozen rat. I thought it was the coolest thing in the world at the time (and, truthfully, it still sounds cool), and I often look back at this as one of the best gifts I ever received. (I also want to give a shout-out to the Super Nintendo — thanks Mom and Dad.) We all know that what makes the winter holidays great is spending time with family and friends, eating delicious food and giving thoughtful gifts to the people you love. Stuff is just stuff, but time is what memories and fondness are made of. This year, I challenge you to give less stuff to your loved ones, whether they are young or old. After you put a little time and thought into your gift giving, you might just discover it is indeed the most wonderful time of the year.

Help Older Adults Feel Less Lonely During Holidays

T

he holidays can be a difficult time for older adults who no longer live in their own home or who have recently lost a spouse, sibling or other loved ones. Studies by the Centers for Disease Control and Prevention (CDC) estimate that 7 million American adults over the age of 65 experience depression each year, and depression becomes more common in people who also have other illnesses or whose function becomes limited. Additionally, AARP estimates over 40 million adults aged 45 and older experience chronic loneliness. Loneliness and depression aren’t just the results of aging, they can also cause more problems. According to WebMD, depression in the elderly often increases their risk of cardiac

diseases and reduces an elderly person’s ability to rehabilitate. The holidays can be a particularly difficult time for older adults who are alone. That’s why it’s important to spend time with older family members and reach out to elderly neighbors. The international data and analysis company Bloomberg says that strong social relationships boost a person’s chances of staying alive by 50 percent. That’s about the same improvement to mortality as the one that comes from quitting smoking. If your loved one seems either sad and withdrawn, or extra talkative and seeking extra physical contact, or if they start spending a lot of time with someone they just met — they may be experiencing loneliness and

the early stages of depression. Here are 10 tips to help older adults feel less lonely — during the holidays, and year-round: 1. Visit more often. 2. Encourage other family members and friends to do the same. 3. Help your loved one write and send holiday cards. 4. Decorate their home or room. 5. Pick up the phone to call your loved one when you can’t visit. 6. Offer to bring your loved one on his/her errands. 7. Consider a pet. 8. Encourage senior activities and social groups. 9. Look for support programs. 10. Take this opportunity to help them remember the real meaning of your holiday celebrations.

F.A.S.T.: You’re Having a Stroke When…

T

he common acronym that is used to identify the most common symptoms of a stroke is F.A.S.T. According to the National Stroke Association, this stands for: n Face: Ask the person to smile. Does one side of the face droop? n Arms: Ask the person to raise both arms. Does one arm drift downward? Page 20

n Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange? n Time: If you observe any of these signs, call 9-1-1 immediately. Being able to recognize a stroke, call 9-1-1, and get the patient to a hospital quickly can help improve the patient’s recovery.

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

In addition to offering special activities to help older adults during the holidays, Loretto also offers a year-round “one-to-one” volunteer program. Sponsored by Interfaith Works Agency, this program supports older adults who are lonely, who have very few visitors or have little or no family support. Volunteers visit residents one-on-one and provide emotional support and active-listening. Interfaith Works Agency also sponsors the senior companion program that sends volunteers to other Loretto programs, including PACE-CNY and Buckley Landing. For more information, visit LorettoCNY.org. Submitted by Loretto.


Holiday Greetings

Give Healthful Food Gifts

M

By Deborah Jeanne Sergeant

any people enjoy giving (and receiving) food gifts. They don’t end up as clutter and offer a treat the recipient might not otherwise indulge in. Giving food also bears a few caveats, however. It helps to know the preferences of the recipient and any dietary restrictions, both medical and self-imposed. Consider these healthful suggestions. We interviewed two local experts. Here are their suggestions

Suggestions by Kelly Springer, registered dietitian and owner of Kelly’s Choice in Skaneateles

For people trying to maintain a healthful weight “Oranges are a traditional holiday gift and are high in vitamin C to boost immunity. Nuts are a fantastic gift, as they have fiber, omega-3 fatty acids and minerals. Manuka honey is a powerful support for inflammation and it has antibacterial properties. It’s honey made from nectar of the manuka plant in Australia and New Zealand. It’s expensive, so someone might not buy it for themselves.” “Give matcha tea. Tea is always a nice gift and this one is right on trend. While very popular at the moment, there are amazing health benefits associated with this Japanese tea. Packed with antioxidants, it boosts metabolism and burns calories, detoxifies effectively and naturally, and has been shown to increase energy levels and endurance.” For children “Kind Bars and organic fruit strips without added sugar are good for kids.” “Granola is easy to make and easy for kids to eat as a snack or on the go. Granola is a great source of fiber and many important vitamins and minerals necessary for proper growth and development, like sodium, potassium, zinc, phosphorus, magnesium, calcium and iron, vitamins C and E. Just make sure it’s made with natural sugars and there is no added sugar.” For diabetics “They might like something fun like strawberries dipped in dark chocolate. They are delicious. Coffee and tea are also fantastic. You can get specialized with a tea ball so they can add herbs. Put a fun mug with it.” For seniors “Almonds or nuts flavored with natural flavoring such as cinnamon, nutmeg or cumin are important for the older adult as they are a good source of omega-3 fatty acids. Omega-3 fatty acids are associated with a reduced risk of cogitative decline, Alzheimer’s disease and dementia. Bone broth has so many benefits: joint health, improves bone density, boosts immunity, high protein and it’s hydrating. All you have to do it warm it up, so it’s easy to prepare for the older adult.” College student “They might like something fun like strawberries dipped in dark chocolate. They are delicious. Coffee and tea are also fantastic. You can get specialized with a tea ball so they can add herbs. Put a fun mug with it.”

Suggestions by Ashley Russo-Leone,

registered dietitian, board member with the Central New York Dietetics Association Suggestions by Julie Mellen, registered dietitian and outpatient dietitian and nutrition counselor at University Health Care Center For people trying to maintain a healthful weight “Give a spice basket with different spices, veggie/ herb garden basket, coffee/tea, homemade granola, infused olive oil, homemade jam, canned vegetables or homemade sauces. Fruit baskets are always great or a popcorn basket with seasonings. Blend popcorn salt with chili powder or other seasonings.” For children “Cocoa mix with a mug is nice. You can make the mix yourself. Personalizing the gift is always a nice thing, like personalized hot chocolate with different mix-ins.” For diabetics “Salsa, as a tomato-based dip, it is very, very low in carbohydrate with minimal to no impact on blood sugar levels. Generally speaking, fresh salsa is made up of tomato, a great source of carotenoids and vitamin C; onion, which contains polyphenols; and bell peppers, that have vitamins C, E and B6 and folate. Avoid the generic jarred salsa off the grocery store shelves which will generally be packed with salt and preservatives and look for a more specialty salsa, or even homemade. Not only can a good quality olive oil be an attractive and classy gift, there are many health benefits that it provides: minimal effect on insulin levels and blood sugar control, is a ‘good fat’ cooking substitute for butter or lard and has been shown to lower risk of heart disease. For those who are in the pre-diabetes category, studies have shown that including olive oil in your diet regularly, while following a Mediterranean style diet, reduced the risk of T2 diabetes by almost 50 percent compared to a low-fat diet.” For seniors “Give out-of-season fruit, homemade muffins or something like that or a meal itself. Sparkling cider would be a nice option. Or cold-brew coffee. There are so many varieties of teas. You could do loose tea and a tea ball and mugs. Mason jars recipes in a jar, like baked goods in a jar or soup in a jar. Make Spanish soup, or Asian soup to mix it up. It’s such a nice thing to just add some liquid and it’s good to go. Or make hot chocolate in a jar.” College student “Choose dark chocolate that contains 50 to 90 percent cocoa solids. Dark chocolate contains high levels of cocoa flavanols, which have been shown to help lower blood pressure and improve cognition important for all that studying. The higher the percentage of cocoa solids, the higher the caffeine content, also important for those late night cramming sessions.”

SIX Ways to Go HeartburnFree This Season

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igh-calorie meals, decadent treats and festive drinks tempt people from Thanksgiving to New Year’s Day, inviting the fiery sensation of heartburn and the bitter taste of reflux as unwelcome guests to the holiday festivities. Approximately 20 percent of Americans have gastroesophageal reflux disease (GERD), according to the National Institute of Diabetes and Digestive and Kidney Diseases. Heartburn is the most common symptom of GERD.  Here’s how you can avoid this unpleasant sensation while partaking in holiday fun. Tight clothing – Our stomachs need room to digest food. Tight clothing, like skinny jeans and leggings, restricts the stomach from emptying properly. When that happens, acid builds up and you end up with reflux. Big meals – Instead of three big meals a day, eat four or five smaller portions throughout the day so your stomach has time to digest food. If you know you’re going to eat a big meal in one sitting, try to eat earlier than usual so you have time to digest properly. Alcohol – Not only is alcohol acidic, but when digested it creates even more acid in our stomachs. You add a lot of alcohol to a large, fatty holiday meal and you have a recipe for acid reflux. Skip the after-dinner mints – Peppermint relaxes the muscles between the stomach and esophagus, which can allow stomach acid to flow back into the esophagus. While reflux triggers vary from person to person, other common triggers include tomato-based products, citrus fruits and juices, spicy cuisine, high-fat foods, chocolate and caffeinated beverages. Chew gum – Chewing gum stimulates acid-neutralizing saliva production. The more you swallow, the more the saliva helps to clear acid from the esophagus. Take a short walk – While it’s tempting to lie down after indulging in a holiday feast, the best thing for preventing reflux is a post-meal walk to help gastric juices flow properly. Try to wait at least two hours after eating before lying down to allow time for food to go down.

1.

2.

3. 4. 5. 6.

Source: Gulchin Ergun, gastroenterologist at at Houston Methodist Hospital. December 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 21


Annual Pap Test a ‘Thing of the Past?’

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he United States Preventive Services Task Force (USPSTF) has released new recommendations on screening for cervical cancer. These latest recommendations continue the trend of decreasing participant burden by lengthening screening intervals, making the “annual Pap” a historical artifact. Since its introduction 75 years ago, exfoliative cytology commonly known as the Pap test has been the “gold-standard” screening test for cervical cancer. In the August issue of the Journal of the American Medical Association (JAMA), the USPSTF, an independent panel of experts in primary care and prevention, updates its 2012 recommendations for cervical cancer screening with one important addition. This is the first time the USPSTF has recommended a method of cervical cancer screening that does not include the Pap test. A leading obstetrician/ gynecologist Lee A. Learman, senior associate dean for Graduate Medical Education and Academic Affairs and professor at Florida Atlantic University’s Schmidt College of Medicine, is lead author of an editorial in this JAMA issue.  The new USPSTF guidelines recommend that women ages 21 to 29 years be screened for cervical cancer every three years with the Pap test alone. This recommendation remains unchanged from 2012. For women aged 30 to 65 years, the USPSTF recommends screening for cervical cancer with primary high-risk human papillomavirus (hrHPV) test alone every five years. As an option, they also recommend the previous guideline of hrHPV test and Pap test together (co-testing) every three years. What was novel in the 2012 USPSTF recommendations was that women aged 30 to 65 years were given the option for the first time to be screened with hrHPV test and Pap test together every five years to lengthen their screening interval. The 2018 recommendations go one step further by including, for the first time, the option of hrHPV testing alone, without a Pap test, every five years. welcomed its inaugural class of 36 residents in its first University-sponsored residency in internal medicine and graduated its first class of internal medicine residents in 2017.

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Things You Should Know About SAD By Ernst Lamothe Jr.

Winter is prime time for seasonal affective disorder. Here’s what you need to know

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t often doesn’t get the attention it deserves, but seasonal affective disorder victims know the truth. They understand the condition is real and can alter their mood and behavior for months at a time. Called SAD, it is a seasonal mood disorder related to reduction of light, which happens during the winter months. It can affect between 4 to 6 percent of Americans, according to the American Association of Family Physicians. Another 10 to 20 percent has been diagnosed with a mild version of the condition. Places that rain for weeks at a time or people who live in cloudy cities such as Syracuse and other parts of Central New York are often most vulnerable. SAD doesn’t always fall under the same umbrella symptoms as general mental health depression but can look very similar. “A lot of people don’t feel comfortable talking about how they feel to others,” said Tarun Kumar, who works as an attending psychiatrist in the comprehensive psychiatry emergency program at St. Joseph Hospital in Syracuse. “Sometimes it is a source of shame or sometimes they just don’t believe others will understand so they keep it to themselves which can also worsen the problem. But seasonal affective disorder is a prevalent condition that does affect people,” said Kumar, who is certified by the American Board of Psychiatry & Neurology in adult psychiatry, child/adolescent psychiatry, and forensic

psychiatry. Here are five facts you need to know about SAD.

1.

The most effective way to battle through SAD and depression is light therapy. The body needs light and many times during the winter cloudy and cold days produce an inability for that to occur. Kumar recommends purchasing an artificial light therapy lamp. “I tell any of my patients that they should purchase it and use it early in the day. Usually the depressed feelings can start as soon as you wake up,” said Kumar. “I suggest they use it for 30 minutes each day and can increase it if that is not working for them.” The average living room has 100 lux as a unit of light flow, while a sunny day measures between 20,000 to 100,000 lux. The average light therapy box that someone purchases is about 10,000 lux, which is akin to being outside on a cloudy day.

Tarun Kumar, attending psychiatrist in the comprehensive psychiatry emergency program at St. Joseph Hospital in Syracuse.

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

Buying a light therapy box should be your first solution.

2.

It is a chemical issue

SAD is triggered because of lack of daylight — it’s not related to low temperatures. A large reason why experts believe some people suffer from it is because the lack of sunlight increases the melatonin production in the body. Melatonin

helps regulate sleep and can cause depression. “There is a science to why some people suffer more than others. This issue causes people to get into a depressive state and it can be difficult for seasonal affective disorder patients to concentrate or have any energy,” said Kumar. “That lethargic state is part of the chemical imbalance they are fighting through.”

3.

Stress is a factor

Stress is often the underlying factor in many health condition and SAD is no different. If a person has a history of seasonal affective disorder, they sometimes struggle in compartmentalizing or dealing generally with stress. The lack of sun and increasing dark days makes it more challenging for them to regularly do their jobs because they are more tired. Those who deal with SAD often have a hard time sleeping regularly. “That is one of the reasons we recommend people receive some kind of counseling, therapy or simply talk with others about their condition because they have to speak about what is affecting them,” said Kumar.

4.

Antidepressants work

There are prescription medications that can help with serotonin levels in the brain. The biggest reason why that is an asset is because when we don’t produce enough serotonin, we can become depressed. Antidepressants — such as Prozac and Zoloft — can often raise serotonin levels. It can be a successful temporary use but physicians do not recommend it long term. “Antidepressants have been shown to definitely help people who have moderate to severe depression,” said Kumar.

5.

Watch for the effects of light therapy

Some say that light therapy has no side effects, but others disagree. It simply depends on the person, according to Kumar. Some people experience mild side effects, such as headaches, eye strain or nausea. However, some light therapy users say that the side effects are temporary and subside with time or reduced light exposure. Most scientists agree that there are no long-term side effects, but remember to consult your physician before any treatment decisions are made. “There are some patients that have suffered side effects from looking into the light box. It could be problematic with those who have eye problems and can cause headaches for others,” said Kumar. “You have to make sure that the light therapy isn’t causing disruptive aspects to your life that could be worsening another problem.”


Career in Healthcare

Rheumatologists in Short Supply By 2030 the nation will have only half the number of professionals it needs

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f you need to see a rheumatologist, get in line. You will have a long way to go until you see one — and this waiting period won’t improve anytime soon. By 2030 the nation will have only half the number of rheumatologists it needs. Presently, the U.S. is at 13 percent below the ideal number of rheumatologists, according to research by Rheumatology Service at San Antonio Military Medical Center in Texas. “It’s been a long-standing problem and hasn’t changed,” said physician Thomas Madejski, who specializes in internal medicine, geriatric medicine, hospice and palliative care, and leads the Medical Society of the State of New York. He said that many issues have caused the shortage, such as liability issues and, locally, “the hassles” of working in New York. “The state medical society is working to improve the practice environment in New York state and its liability rate. We want to reduce the regulatory burden and make it less expensive for doctors to practice,” said Madejski. The demand for care has also increased, including the aging baby boomer population as well as better diagnostic efforts and more treatment options. Madejski said that for 80 to 90 percent of osteoarthritis cases, a primary care, internists or family physician could provide sufficient care; however, some patients demand more care, which has affected the issue to a small degree. Physician extenders — nurse practitioners and physician assistants — can help rheumatologists see more patients; however, Madejksi said that many primary care physicians even lack the experience and training to feel comfortable in prescribing some of the newer medication to treat patients with rheumatologic disorders. “We need to re-examine how we educate and train physicians,” Madejksi said. “We should be training physicians more at this level. With telemedicine and tele-health we can leverage rheumatologists more to distill the essence of what we need: diagnosis and treatment so we can make it more efficient for them.” Locally, the shortage persists as well, according to physician Andras Perl, distinguished professor of medicine, division chief of rheumatology and co-director of the MD/PhD program at Upstate Medical University. Patients aren’t turned away, but scheduling can challenge providers at times. “There’s no doubt there’s a shortage,” Perl said. “We schedule people when they’re referred to us. We don’t put them on a waiting list. If they have to wait a long time, then we try to fit them in when cancellations occur.” He said to a large degree, it’s a

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resource allocation. More students training to be doctors want to specialize in rheumatology than they have opportunities to learn. “Upstate pays one training position to train rheumatologists out of five slots,” Perl said. “The others are from other sources, like grants, so I have to work hard to support training positions. We would like to increase that.” For private practices, compensation is a big reason behind the dearth of rheumatologists. Perl added that compensation also influences hospitals to a degree, since they focus on the more lucrative in-patient specialties than out-patient ones such as rheumatology. Michael Carr, president of Carr Recruiting Solutions in Baldwinsville, said that rheumatology is similar to a lot of other very specific disciplines in the medical field. “Even with a teaching hospital locally and local nursing schools, the competition for qualified medical personnel is intense to say the least, whether a small medical practice or hospitals,” Carr said. He added that medical organizations are offering perks unheard of in their industry, such as part-time, flex time, and generous relocation packages. “There’s a lot of creativity to get people to come aboard or relocate here,” Carr said. “Every medical practice and entity is different but we’re seeing them sweeten the package.” For example, the organization might allow a physician to work two evenings a week to lighten the patient load in addition to their day position elsewhere. With aging baby boomers and many skilled physicians retiring, Carr feels sure this problem will last. “At least if you’re good at what you do in this field, you will find work, so that’s a positive,” Carr said. According to salary.com, New York state rheumatologists make an average of $ 231,375.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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while lifting the weight and inhaling through the nose while lowering the weight. Of course, swimmers breathe in through their mouths and out of their noses to avoid taking in water. For any land-based exercise, inhaling through the nose helps filter out debris. While exhaling through the nose is also fine, most people find that difficult while exercising vigorously. Physician Joanne Wu, an experienced yoga teacher, health coach and wellness expert who sees patients in Syracuse, calls breathing “an art” because of how many ways it affects the body. She said that slowing respiratory

cycles can help people relax, which can benefit some activities. “However, there are forms of exercise where rapid breathing is helpful to build core strength and work out more effectively, such as dance and Pilates,” she said. Cameron Apt, senior performance specialist at University of Rochester Medical Center, said that poor posture and sitting for long periods has ruined how many people breathe. “We become chest breathers,” he said. “The lungs elongate down towards the stomach. We try to expand the chest outwards more than usual. It can lock up the shoulders and neck so they tense up.” Improper breathing can even contribute to shoulder, neck and back pain. Breathing from the core makes a difference in all of these areas, as well as in athletic performance. “The diaphragm is where you should breathe, not the upper back,” Apt said. “That’s where people get in the habit of breathing. Breath deep into your stomach. It helps realign things.” Apt also said that proper deep breathing helps improve balance, which can be important for activities that emphasize balance such as martial arts. Breath that originates from the core prevents the shoulders from rising, for example. If you want to learn the difference between breathing from the core and chest breathing, lie on your back and breathe deeply enough so the belly button rises and lowers. That is core-based breathing.

noon, and 20 oz. around dinner. “You’ll have less chances of UTIs, decreased joint pain and fewer headaches,” Springer said. “It’s healthier for digestion and supports a boost in immunity.” And what about the home remedy of cranberry juice? Springer said that cranberries naturally contain an active ingredient that prevents the bacteria from sticking to the urinary tract. “That’s why cranberries can greatly reduce the risk of recurring UTIs,” she said. “It could be cranberry juice blended with other juices. As a dietitian, I’d rather have you reduce sugar intake, as that can impaired the immune system. You can do dried cranberries as well. Cranberries in jam, dried ones in a coleslaw, or raw cranberries with a little honey, which is delicious. There are lots of ways to use cranberries.” The recommended serving is 8 ounces daily. Springer also tells clients to generally support the immune system

with protein, which can help ward off UTIs. “It’s recommended to get 15 to 30 grams of protein at each meal,” she said. “You don’t need more than that because the body can’t store it. Laurel Sterling, registered dietitian, nutritionist and educator with Carlson Laboratories in Canastota, is also a fan of cranberries for UTI prevention. “Drink 100 percent juice with tons of water,” she said. She also said that fermented foods provide beneficial bacteria that support a healthy immune system, such as sauerkraut, Greek yogurts low in sugar, kombucha, kefir, pickles, and kimchi. She added that it’s important to eat sufficient vegetables and minimize intake of fruit. Although it’s natural sugar, fruit is high in sugar. “Keep away from sugars and alcohol as much as possible,” Sterling said. “Extra probiotics and cranberry supplements with d-mannose are very helpful.”

percent compared to non-vegetarians — people who eat meat at least once a week. Besides eating less meat, the vegetarians in the study ate fewer sweets, snacks, refined grains and high-calorie beverages and more fruits, vegetables, whole grains, beans and nuts. However, the protective effects vary with the type of vegetarian diet, the researchers said. By the study’s numbers: • Pesco-vegetarians: Eating fish and seafood, but avoiding other meats lowers colorectal cancer risk by 43 percent. • Lacto-ovo vegetarians: Avoid-

ing meat, but eating eggs and/or dairy products lowers colorectal cancer risk by 18 percent. • Vegans: Avoiding all meat, eggs and dairy lowers colorectal cancer risk by 16 percent. • Semi-vegetarians: Eating meat less than once a week lowers colorectal cancer risk by 8 percent. Research can’t yet explain exactly how eating vegetarian helps. But one theory says it could be because vegetarians often follow other healthy behaviors, such as exercising and not smoking, which also reduce cancer risk.

Breathe Better While Working Out By Deborah Jeanne Sergeant

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ant a more effective workout? Try breathing correctly. While exercising, your muscles work harder than they do while at rest. Since they’re working harder, they need more oxygen than while performing at a lower level. The heart increases its rate to deliver the oxygen. Without the oxygen, you can’t perform as well. Beyond a less-than-ideal performance, not breathing properly can have some unpleasant results. “Proper breathing technique is crucial while exercising,” said Karly Frigon, a personal trainer at Metro Fitness in Syracuse. She said that not breathing

properly can cause blood pressure spikes, stress on the lungs and blood vessels and, sometimes, chest pains, increased blood pressure and lightheadedness. Holding the breath while exerting the most effort, taking shallow or fast breaths while running, or inhaling and exhaling at the wrong time can increase blood pressure and lower performance. While lifting a weight, many hold their breath as they focus on performing the movement to focus on the lift. At that moment, their body needs more oxygen. Instead of holding the breath, Frigon advises exhaling through the mouth

How Food Can Affect UTIs By Deborah Jeanne Sergeant

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f you frequently suffer from urinary tract infections, consider your diet. It can make a difference. To better support urinary tract health, consider making a few dietary changes. Karen Scanlon is certified holistic health practitioner and owner of Intuit Nutrition in Liverpool. She asks clients who experience UTIs about their diet, particularly alcohol and starchy carbs such as white flour and sugar. “Sugar is always a huge, red flag,” Scanlon said. “Staying away from processed foods is important. Sugar feeds all the stuff you don’t want. Coffee, depending upon the person, can make a difference. The adrenals sit right on the kidneys. Kidneys are part of the bladder organ set. Especially if you have a UTI, don’t have a lot of coffee.”

Scanlon said that to support good urinary tract health, people should eat more beans, sea vegetables like seaweed, dark leafy greens, berries, cucumbers and watermelon. “If the kidneys are depleted, you’ll want warming spices like cinnamon, clove, black pepper, fennel or anise,” Scanlon said. Drinking more water can make a big difference in reducing UTIs. Kelly Springer, registered dietitian and owner of Kelly’s Choice, LLC in Skaneateles, said that water is “crucial to flush out the bacteria. It moves things through and rids the body of toxins. Hydration is a huge point. “Just by adding water,” she continued, “it’s amazing how much health increases.” She recommends drinking 20 oz. of water in the morning, 20 oz. at lunch, 10 oz. at snack time mid-after-

Going Vegetarian to Cut Colon Cancer Risk

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here’s no disputing the fact that regular colonoscopies, now suggested to start at age 45 for those with an average risk of colorectal cancer, can help prevent the disease by finding — and removing — precancerous growths. And a study of 77,000 adults published in JAMA Internal Medicine found that you can also lower your risk of this cancer by making Page 24

changes in your diet right now, whatever your age. Doctors know that eating red and processed meats raises the risk of colorectal cancer, while eating fiber-rich foods lowers it. The JAMA findings got more specific about different types of diets. On average, eating vegetarian may lower colon cancer risk by 19 percent and rectal cancer by 29

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


Scan-Away Hunger at Grocery Checkout

W U.S. Smoking Rates Hit Record Low

ith the scan of a coupon at grocery checkout, shoppers can provide a meal for people who might otherwise go hungry in Central New York. The Rescue Mission’s 26th Annual Scan-Away Hunger campaign invites shoppers at Wegmans and other participating stores to donate $2.24 at checkout to feed a hungry neighbor.

The Rescue Mission provides three free meals every day of the year to men, women and children who might otherwise go hungry. In Syracuse, the Mission serves nearly 700 hundred meals a day, and nearly a quarter million meals every year. Scan-Away Hunger coupons are available at checkout in participating stores through December: Wegmans

in Central New York, Green Hills in Nedrow, Nichols in Liverpool and Nojaim in Marcellus Scan-Away Hunger coupons are also available at Rescue Mission Thrifty Shopper stores. For more information on ScanAway Hunger, go to www.scanawayhunger.com.

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igarette smoking rates have dropped to the lowest level ever recorded, U.S. health officials reported in November. “This new all-time low in cigarette smoking among U.S. adults is a tremendous public health accomplishment — and it demonstrates the importance of continued proven strategies to reduce smoking,” Centers for Disease Control and Prevention Director Robert Redfield said in an agency news release. Among adult smokers, the smoking rate fell from 15.5 percent in 2016 to 14 percent in 2017. That rate was 67 percent lower than it was in 1965. Among young adults (aged 18 to 24), the rate fell from 13 percent in 2016 to 10 percent in 2017, according to the report. “Despite this progress, work remains to reduce the harmful health effects of tobacco use,” Redfield added. Matthew Myers, president of the Campaign for Tobacco-Free Kids, agreed. “Despite our progress, tobacco use still kills more than 480,000 Americans and costs $170 billion in health care expenses each year,” Myers said in a news release from the advocacy group. He said full implementation of key initiatives — higher tobacco taxes, comprehensive smoke-free laws, hard-hitting mass media campaigns and raising the smoking age to 21 — could lower rates further still. The report found that one in five adults used a tobacco product in 2017, including smoked, smokeless and electronic tobacco products. Among adults with serious psychological distress, two in five used tobacco products. Cigarettes were the most commonly used tobacco product (14 percent) among adults, followed by cigars, cigarillos, or filtered little cigars (3.8 percent); e-cigarettes (2.8 percent); smokeless tobacco (2.1 percent); and pipes, water pipes, or hookahs (1 percent). Of the 47 million U.S. adults who use any tobacco products, about 9 million (19 percent) use two or more. The most common tobacco product combination was cigarettes and e-cigarettes. The report was published in the CDC’s Nov. 9 Morbidity and Mortality Weekly Report. About 16 million Americans currently have a smoking-related illness, the CDC researchers noted.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 25


U.S. Hospitals Making Headway Against Infections

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ou’re less likely to pick up a nasty infection during a hospital stay in the United States than you were just a few years ago, a new report finds. Between 2011 and 2015, a patient’s risk of catching a hospital-acquired infection dropped 16 percent, researchers said. “The findings are encouraging. Progress is being made in infections affecting hospitals in the United States. But more work needs to be done,” said the study’s lead author, physician Shelley Magill, a medical officer with the U.S. Centers for Disease Control and Prevention. Health care-associated infections are a significant threat to patient safety. The study authors estimated that in 2011, about 648,000 patients had at least one health-care associated infection in the United States. Pneumonia was the most common infection, followed by digestive infections and surgical site infections, the study found.

Most of the digestive infections were caused by Clostridioides difficile. These  C. difficile  infections are typically related to antibiotic use, and can be deadly. Magill said these infections didn’t show a decline. Working with 10 state health departments, the researchers recruited up to 25 hospitals in each state to participate in the study. Each participating hospital chose one day during a specified time period to record how many patients had infections. In 2011, 183 hospitals participated. In 2015, 199 hospitals were included. Four percent of hospital patients had a health care-associated infection in 2011. By 2015, that number had dropped to 3.2 percent. The biggest declines were seen in surgical site infections and urinary tract infections, according to the study. Magill said fewer people had urinary catheters in 2015. Also, she said, there was a focus on getting those

Frequent, thorough hand-washing by health providers is one of the most important steps in infection prevention, according to experts. catheters out of patients as soon as possible to reduce infection risk. The types of surgical site infection vary, but Magill said specific efforts to reduce these infections appear to be paying off. However, the new study didn’t collect information on the specific practices hospitals were taking. Physician Ashish Jha, director of the Harvard Global Health Institute, said this was a very well-done study that captures data from a lot of hospitals. “We’ve been making progress against health care-associated infections, and it’s hard to move the needle on a national level. But progress

is still slow. These findings shouldn’t make us complacent. We have a lot of work ahead still,” said Jha, who wasn’t involved with the study. What can patients do to protect themselves? One of the most important steps in infection prevention is remarkably simple — frequent, thorough hand-washing. Jha said if you haven’t seen a doctor or nurse washing their hands before they exam you, it’s fine to ask. “There’s nothing wrong with making sure people are doing what they’re supposed to be doing,” he said.

Kinney Drugs Offers New Product for Foot Pain, Plantar Fasciitis

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inney Drugs, a leading pharmacy chain in New York and Vermont, is partnering with Plantar Pro in marketing a new item: the FootRest Pillow. The locally developed product was released in select Kinney Drugs stores across New York this summer. The FootRest Pillow was developed in partnership with Clarkson University’s Shipley Center for Inno-

vation to relieve foot and heel pain along with plantar fasciitis. Andy Jennings, a Lowville -based inventor, came up with the idea while trying to relieve his own case of plantar fasciitis foot pain. He found a company to cut foam to his patented shape, then proceeded to ask Facebook friends who also suffer from foot pain to test his prototype. Jennings then brought his idea to Clarkson University and

was accepted into their innovation program which allows students and professors to help with market research, brand development, and patent and trademark application filings. When the patent and brand development were accomplished, Clarkson helped connect the FootRest Company with North Country-based pharmacy Kinney Drugs to

develop a marketing outlet. Meanwhile, Jennings worked with ARC New York to sew FootRest pillowcases and package the pillows for shipment to Kinney stores. Jennings is currently working with ARC Herkimer Industries in Herkimer. Now this North Country innovation has come full circle and is on the shelves in select Kinney Drugs stores throughout Upstate New York.

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


Overlooking Onondaga & Tully Valleys

By Jim Miller

How to Get Veterans’ Funeral and Burial Benefits Dear Savvy Senior, Does the VA provide any special burial benefits to old veterans? My dad, who has late-stage Parkinson’s disease, served during the Vietnam War in the 1960s.

Only Child Dear Only, Most U.S. veterans are eligible for burial and memorial benefits through the Department of Veterans Affairs (VA) National Cemetery Administration. Veterans who were discharged under conditions other than dishonorable are eligible. To verify your dad’s discharge, you’ll need a copy of his DD Form 214 “Certificate of Release or Discharge from Active Duty,” which you can request online at Archives.gov/ veterans. Here’s a rundown of some of the different benefits that are available to veterans that die a nonservice-related death. National Cemetery Benefits If your dad is eligible, and would like to be buried in one of the 136 national or 111 grant-funded state and tribal VA cemeteries (see www. cem.va.gov/cem/cems/listcem.asp for a list), the VA provides a host of benefits, at no cost to the family, including: a gravesite; opening and closing of the grave; perpetual gravesite care; a government headstone or marker; a United States burial flag that can be used to drape the casket or accompany the urn (after the funeral service; the flag is given to the next-of-kin as a keepsake); and a presidential memorial certificate. National cemetery burial benefits are also available to spouses and dependents of veterans. If your dad is cremated, his remains will be buried or inurned in the same manner as casketed remains. Funeral or cremation arrangements and costs are not, however, taken care of by the VA. They are the responsibility of the veteran’s family, but some veteran’s survivors are eligible for burial allowances, which are explained below. If you’re interested in this option, the VA offers a preneed burial eligibility determination program at www.cem.va.gov/pre-need or call the National Cemetery Scheduling Office at 800-535-1117.

Private Cemetery Benefits If your father is going to be buried in a private cemetery, the benefits available include a free government headstone or marker, or a medallion that can be affixed to an existing privately purchased headstone or marker; a burial flag; and a Presidential memorial certificate. Funeral or cremation arrangements and costs are again the responsibility of the family (some burial allowances may be available), and there are no benefits offered to spouses and dependents that are buried in private cemeteries. Military Funeral Honors Another popular benefit available to all eligible veterans buried in either a national or private cemetery is a military funeral honors ceremony. This includes an honor guard detail of at least two uniformed military persons, folding and presenting the U.S. burial flag to the veteran’s survivors, and the playing of “Taps” by a bugler or an electronic recording. The funeral provider you choose will be able to assist you with all VA burial requests. Depending on what you want, certain forms may need to be completed which are always better to be done in advance. For a complete rundown of burial and memorial benefits, eligibility details and required forms, visit www.cem.va.gov or call 800827-1000. Burial Allowances In addition to the burial benefits, some veteran’s survivors may also qualify for a $300 burial allowance (or $780 if hospitalized by VA at time of death) and $780 for a plot, to those who choose to be buried in a private cemetery. To find out if your dad is eligible, see Benefits.va.gov/ benefits/factsheets/burials/burial. pdf. To apply for burial allowances, you’ll need to fill out VA Form 21P530 “Application for Burial Benefits.” You need to attach a copy of your dad’s discharge document (DD 214 or equivalent), death certificate, funeral and burial bills. They should show that you have paid them in full. You may download the form at

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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The Social Ask Security Office

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I

n the digital age, frauds and scams are an unfortunate part of doing business online. During the holiday season, Social Security has traditionally seen a spike in phishing scams, and we want to protect you as best we can. We urge you to always be cautious and to avoid providing sensitive information such as your Social Security number (SSN) or bank account information to unknown individuals over the phone or internet. If you receive a call and aren’t expecting one, you must be extra careful. You can always get the caller’s information, hang up, and — if you do need more clarification — contact the official phone number of the business or agency that the caller claims to represent. Never reveal personal data to a stranger who called you. Please take note: there’s a scam going around right now. You might receive a call from someone claiming to be from Social Security or another agency. Calls can even display the 1-800-772-1213, Social Security’s national customer service number, as the incoming number on your caller ID. In some cases, the caller states that Social Security does not have all of your personal information, such as your Social Security number, on file. Other callers claim Social Security needs additional information so the agency can increase your benefit payment or that Social Security will terminate your benefits if they do

$21 — 1 year $35 — 2 years

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

Q: I’m trying to figure out the best time to retire based on my future earnings. How can I calculate my own retirement benefit estimate? A: We suggest you use our retirement estimator at www.socialsecurity.gov/estimator. Our retirement estimator produces estimates based on your actual Social Security earnings record, so it’s a personalized, instant picture of your future estimated benefit. Also, you can use it to test different retirement scenarios based on what age you decide to start benefits. For example, you can find out your estimated monthly payments if you retire at age 62, 70, or any age in between. Try it out now at www. socialsecurity.gov/estimator. Q: How do I know if I meet the eligibility requirements to get Social Security disability benefits? A: To qualify for Social Security disability benefits, you must have worked long enough in jobs covered by Social Security (usually 10 years). You must also have a medical condi-

not confirm your information. This appears to be a widespread issue, as reports have come from people across the country. These calls are not from Social Security. Callers sometimes state that your Social Security number is at risk of being deactivated or deleted. The caller then asks you to provide a phone number to resolve the issue. People should be aware the scheme’s details may vary; however, you should avoid engaging with the caller or calling the number provided, as the caller might attempt to acquire personal information. Social Security employees occasionally contact people by telephone for customer-service purposes. In only a few special situations, such as when you have business pending with us, a Social Security employee may request the person confirm personal information over the phone. Social Security employees will never threaten you or promise a Social Security benefit approval or increase in exchange for information. In those cases, the call is fraudulent, and you should just hang up. If you receive these calls, please report the information to the Office of the Inspector General at 1-800-269-0271 or online at oig.ssa.gov/report. Remember, only call official phone numbers and use secured websites of the agencies and businesses you know are correct. Protecting your information is an important part of Social Security’s mission to secure today and tomorrow.

tion that meets Social Security’s strict definition of disability. We consider an adult disabled under our rules if he or she has a medical condition, or combination of medical conditions, that are expected to last for at least one year or result in death, and that prevent the performance of any type of work. If you think you may be eligible to receive disability benefits and would like to apply, you can use our online application at www.socialsecurity.gov/applyfordisability. Q: Why is there a five-month waiting period for Social Security disability benefits? A: The law states Social Security disability benefits can be paid only after you have been disabled continuously throughout a period of five full calendar months. Social Security disability benefits begin with the sixth full month after the date your disability began. You are not able to receive benefits for any month during the waiting period. Learn more at our website: www.socialsecurity.gov/ disability.


H ealth News Excellus earns highest accreditation for quality

Dr. Weinstock recognized for diabetes work

Excellus BlueCross BlueShield’s commercial plans have received the highest accreditation status available, a rating of “Excellent,” from the National Committee for Quality Assurance. The rating applies to Excellus BlueCross BlueShield’s HMO, point of service, preferred provider organization and exclusive provider organization plans. Excellus BCBS’s commercial plans were previously rated Commendable. NCQA is a nationally recognized evaluation that purchasers, regulators and consumers can use to assess health plans. NCQA’s Health Plan Accreditation evaluates how well a health plan manages all parts of its delivery system — physicians, hospitals, other providers and administrative services — in order to continuously improve the quality of care and services provided to its members. An Excellent accreditation is awarded to health plans for service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement.   “The NCQA seal of excellence affirms that our members are receiving a high quality of care,” said Christopher Booth, chief executive officer, Excellus BlueCross BlueShield. “It not only reflects the hard work and dedication of our employees, but also reflects the quality of our community’s doctors and hospitals.” Health plans that earn an Excellent accreditation must also achieve NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) results that are in the highest range of national performance. HEDIS is the most widely used performance measurement tool in health care.   

Physician Ruth Weinstock, who has helped transform diabetes care, especially in New York state, has been named the recipient of the 2018-2019 Samuel Eichold II Memorial Award for Contributions in Diabetes. This national award is given to a Weinstock member of the American College of Physicians or to an organization that has made important health care delivery innovations for diabetic patients resulting in improved clinical or economic outcomes; or a member of the ACP who has conducted research that significantly improves quality of care or clinical management of diabetes.  Weinstock is distinguished service professor and division chief of endocrinology, diabetes and metabolism at SUNY Upstate, as well as medical director of the clinical research unit and medical director of the Joslin Diabetes Center, also at Upstate. She is a fellow of the American College of Physicians and the American Association of Clinical Endocrinologists.  Weinstock was the driving force behind the establishment of the Joslin Diabetes Center at Upstate, which serves as the only comprehensive, multidisciplinary diabetes center serving adults and children in Central New York. Her past work with the Veterans Administration (VA) locally and nationally contributed to the development of a model for diabetes care that the VA system adopted nationwide. 

With an extensive publication history, Weinstock has assumed essential roles in several national collaborative research projects, including treatment options for Type 2 diabetes in adolescents and youth (TODAY), and the Informatics for diabetes education and telemedicine (IDEATel) demonstration project. She has been an investigator in more than 100 clinical research projects. She has served on grant review panels for the National Institutes of Health (NIDDK), on the National Board of Directors and numerous committees of the American Diabetes Association, as associate editor of Diabetes Care and section editor for Endocrinology for the Mayo Clinic Proceedings, on the editorial board of Endocrinology, on national committees for the Department of Veterans Affairs, as well as on other national, regional and local committees and task forces related to diabetes research and improving diabetes care. Locally, she serves on the board of directors of the JDRF (Juvenile Diabetes Research Foundation). Weinstock has received numerous honors and accolades for her work, including the SUNY Research Foundation Award Honoring Research in Science, Engineering and Medicine, the SUNY Chancellor’s Award for Excellence in Scholarship and Creative Activities, and in 2017 the American Diabetes Association Outstanding Physician Clinician Award.  Weinstock will receive the award in April at the ACP’s Internal Medicine Meeting in Philadelphia.

Loretto announces promotion, hiring Loretto has promoted Jeff Placito from recruitment and retention specialist to assistant administrator at The Bernardine, a Loretto communi-

Mohawk Valley Health System names new president/CEO Darlene Stromstad has been appointed president and chief executive officer of the Mohawk Valley Health System, effective Jan. 1. Current MVHS President/ CEO Scott H. Perra announced his retirement last January. Perra began his work at St. Luke’s-Memorial Hospital Center more than 30 years ago in 1985. He served in a leadership role through the consolidation of Faxton Hospital to form Faxton St. Luke’s Healthcare and again with the affiliation of FSLH and St. Elizabeth Medical Center to form MVHS. Following Perra’s announcement, the MVHS board of directors formed a search committee to find a new CEO and selected Stromstad after nearly a year of searching and vetting extremely qualified candidates. Stromstad has decades of experience in health care and has led a variety of health care organizations across the country. She most recently was in Boston, where she

served as interim CEO of Fenway Health, one of the nation’s premier and largest federally qualified health centers. Prior to that, Stromstad was in Connecticut where she served as president/CEO of Waterbury Hospital and the Greater Waterbury Health Network, now known as Waterbury HEALTH. During her six-year tenure at Waterbury Hospital, Stromstad helped to stabilize the organization’s financial position, rebuild its employee culture and morale, and assure its future through a strategic partnership and acquisition. Prior to that, she served as president and CEO of Goodall Hospital in Sanford, Maine, where she also was instrumental in strengthening the hospital’s finances and expanding health care services for the community. Stromstad is known nationally for her leadership and active engagement in organizations such as the American College of Healthcare

Executives, where she served as a member of the board of governors. She also served on the American Hospital Association’s Metropolitan Advisory Council. “I am delighted to be joining MVHS at this exciting time in its history,” said Stromstad. “It’s amazing how this organization has evolved from three distinct hospitals into a robust health system and is now on the precipice of building a new, state-of-the-art medical center.” Stromstad received her Master of Business Administration from Rivier College in Nashua, N.H. and her Bachelor of Arts degree in journalism from the University of North Dakota in Grand Forks, N.D. Stromstad December 2018 •

ty. Placito has been with Loretto since 2015 and helped recruit hundreds of employees for the organization. He has implemented new training tools and techniques, as well as new partnerships in the community. Placito He holds a bachelor’s degree in communication from the University at Buffalo. Loretto has also hired Ryan Kanavy as marketing associate. Kanavy previously served as a marketing intern at Loretto. He holds Kanavy a bachelor’s degree in public relations from SUNY Oswego.

St. Joe’s named one of best for cardiac surgery St. Joseph’s Health Hospital is one of America’s 50 Best Hospitals for Cardiac Surgery, according to a national study by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. Every year, Healthgrades evaluates hospital performance at almost 4,500 hospitals nationwide for 32 of the most common inpatient procedures and conditions, as well as tracking outcomes in appendectomy and bariatric surgery using all-payer data provided by 15 states and the District of Columbia. The achievement is part of findings released Oct 23 in the Healthgrades 2019 Report to the Nation. The new report demonstrates how clinical performance differs dramatically between hospitals nationally, regionally and at the local level, and the impact that this variation has on health outcomes. From 2015 to 2017, patients treated at hospitals receiving the America’s 50 Best Hospitals for Cardiac Surgery Award have on average a 51.1 percent lower risk of dying than if they were treated in hospitals that did not receive the award. Additionally, from 2015-2017, patients treated at hospitals which did not receive the America’s 50 Best Hospitals for Cardiac Surgery Award are on average 2.04 times more likely to die than if they were treated at hospitals that did receive the award. “Hospitals that have achieved the Healthgrades America’s 50 Best Hospitals for Cardiac Surgery have proven their dedication to quality care and exceptional outcomes,” said Brad Bowman, chief medical officer at Healthgrades. “Consumers should consider hospital quality when navigating their care journeys, and this recognition distinguishes St. Joseph’s

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 29


H ealth News Health in the marketplace.” St. Joseph’s Health has invested funds and resources into its vision for regional cardiovascular services. In addition to expanding the reach of cardiac services throughout the system’s 16-county service area through hiring highly-trained physicians and surgeons, St. Joseph’s recently invested $32 million into their new Cardiovascular Institute and opened the Care Flight Helipad. “Our team is committed to providing excellent cardiac care to our community and in the region. Recognitions by third-party organizations like Healthgrades reaffirm our efforts,” said Leslie Paul Luke, president and CEO at St. Joseph’s Health.

Lifetime Benefit Solutions has new president Lori Florack has been named president of Lifetime Benefit Solutions, a full-service, third-party benefits administrator that employs 170 people in Syracuse, Rochester and Buffalo and serves 4,000 corporate customers in Upstate New York. Florack succeeds Tom Cauthorn, who retired earlier this year. For the past eight years, Florack worked at Excellus BlueCross BlueShield, where she most recently served as human resources leader. Florack also led the sales trainFlorack ing and talent management teams. Prior to joining Excellus BCBS, she spent several

years working in sales in New York City and Upstate New York. After graduating from the State University of New York at Fredonia, Florack received a Master of Science degree from Baruch College of the City University of New York. Florack serves on the board of the Rochester Education Foundation, and volunteers with the Literacy Volunteers of Rochester and the United Way of Greater Rochester. She also serves as a community mentor for the National Human Resources Association. In 2014, Florack received “Rochester’s Up and Coming Businesswoman” award from the Rochester Women’s Network.

St. Joe’s named ‘Most Wired’ recipient

St. Joseph’s Health has received national recognition as a health system at the forefront of using health care information technology (IT) to improve the delivery of care, embracing new technology and applying it strategically to achieve great outcomes. This is the eighth time St. Joseph’s Health has been recognized by the College of Healthcare Information Management Executives (CHIME) “Healthcare’s Most Wired” survey results. Healthcare’s Most Wired, now in its 20th year, traditionally tracked the adoption of health care IT in hospitals and health systems. CHIME took over the Most Wired program and revised the survey questions and methodology this year to highlight strengths and gaps in the industry. The goal is to identify best practices and promote the strategic use of health care IT to elevate the health and care of communities around the

Upstate Golisano Children's Hospital wins grant from St. Baldrick's Foundation Upstate Golisano Children’s Hospital is one of 29 institutions nationwide selected to share $1.7 million in grant money from the St. Baldrick’s Foundation to advance patient access to clinical trials. Upstate’s portion of the grant totals $59,075 and is earmarked to support the Center for Children’s Cancer and Blood Disorders’ Pediatric Hematology/Oncology Clinical Research Program at Upstate Golisano Children’s Hospital and Upstate Cancer Center. In addition to providing salary support for a second clinical research assistant (CRA), it provides funding for educational opportunities for the members of the multidisciplinary team. Having access to clinical trials is vital in the treatment of childhood cancers. Nearly 80 percent of childhood cancer patients at Upstate Golisano Children’s Hospital are enrolled in a clinical trial, a number consistent with national trends. “Clinical research trials are so important for continuing to find the Page 30

best treatments for childhood cancers. Since most childhood cancers are rare, a center often needs to have more than 50 studies open to make sure that as many children as possible have access to these important clinical trials,” said physician Melanie Comito, division chief of pediatric hematology/oncology and professor of pediatrics at Upstate Golisano Children’s Hospital. “The infrastructure needed for small centers is tremendous and this grant support allows us to have the 2 full time clinical research assistant needed to open, maintain, and enroll children on trials. By having so many studies open, we can treat patients here and not have to send to larger centers just to enroll on a clinical trial.” According to the Children’s Oncology Group, an international research organization supported by the National Cancer Institute, survival rates for childhood cancer have risen from 10 to 80 percent over the last 50 years. Outcomes in acute lymphoblastic leukemia have gone from a six-month median survival to an 85 percent overall cure rate. In

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

Wound Care Team Adds to Certifications and Clinical Expertise Nurses on the wound care and healing team at St. Luke Health Services in Oswego continue to add to their certifications and expertise in the treatment of complex and hard to heal wounds. Pictured (from left) are registered nurses Suzanne Burdick, Brandi Durval and Victoria Nelson. Burdick and Nelson hold special wound care certifications through the National Alli-

ance of Wound Care and Ostomy (NAWCO). The certification affirms that team members possess the qualifications to deliver the highest standard of wound care to patients. It means that the team is able to meet medically complex needs locally through St. Luke’s short-stay rehabilitation and long-term skilled nursing programs.

world. CHIME designated St. Joseph’s Health for 2018 Most Wired recognition at its Fall CIO Forum in San Diego. “St. Joseph’s Health is committed to enhancing connectivity and improving the coordination of patient care system-wide through innovative advancements in information technology,” said Chuck Fennell, vice president for information services

and chief information officer at St. Joseph’s Health. “One of our most significant advancements are in our new Cardiovascular Institute. The institute features state of the art imaging technology, and a supply inventory management system (TecSys) using RFID technology to track high cost items and automate replenishment which results in improved process and cost efficiencies.”

addition to clinical trials, the Children’s Oncology Group is committed to looking at the biologic parameters of cancers and therapies. This series of grants brings the St. Baldrick’s Foundation’s funding total

to more than $26 million awarded in 2018. Since 2005, St. Baldrick’s has awarded more than $258 million to support the most promising childhood cancer research, no matter where it takes place.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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