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n Sleep Key to Kindergarten Success P. 20 n School Children Face Anxiety This Year P. 21 n 5 Issues Kids Face Today P. 22
CNYHEALTH.COM
AUGUST 2022 • ISSUE 272
BACK TO SCHOOL SPECIAL
Are Our Schools Safe? Nineteen children and two teachers were killed in a shooting at Robb Elementary School in Uvalde, Texas. As kids gear up to return to our local schools, how safe are they? Page 19
CORD BLOOD BANK Physician Matthew Elkins is in charge of Upstate Cord Blood Bank in Syracuse. He explains what the bank does and how donated umbilical cord blood (usually discarded) can save lives. P 4
HOSPICE PROGRAM IN OSWEGO COUNTY MAY CLOSE Official cites nursing shortage as main cause. “We can’t find anyone who will even apply [for the job], he says. P. 26
Julie Flack of Syracuse has been a Hematology-Oncology Associates of CNY patient since 2006. Next to her is husband Irwin Flack, also a patient at HOACNY. The Syracuse-based practice is celebrating 40 years in business.
Hematology-Oncology Associates Turns 40 P.11
- ON N SIGONUS B
crouse.org/careers/RN
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Page 2 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
THESE THESE FLOWERS FLOWERS HAVE A HAVE A LOT OF LOT OF FIGHT IN FIGHT IN THEM. THEM. The Alzheimer’s Association Walk to End Alzheimer’s®Association is full of flowers, each The Alzheimer’s Walk to carried by someone committed to each ending End Alzheimer’s® is full of flowers, this disease. Becausecommitted like flowers, carried by someone toour ending participants stoplike when something’s this disease. don’t Because flowers, our in their way. They keep raising funds and participants don’t stop when something’s awareness a breakthrough in the and fight in their way.for They keep raising funds against Alzheimer’s and all other awareness for a breakthrough in dementia. the fight It’s timeAlzheimer’s to add yourand flower to thedementia. fight. against all other It’s time to add your flower to the fight.
Join us at alz.org/walk Join us at alz.org/walk
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August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 3
Meet
Your Doctor
By Chris Motola
Matthew Elkins, M.D. Post-Stroke Memory Loss Can Resolve for Some Patients
M
emory loss is a common symptom after a stroke, but there’s hope for some that those memories could return. A new study from Norway examined 86 patients with relatively mild strokes and found many had improved mental functioning after 12 weeks. “Our study shows that around half of patients suffering a stroke had various forms of memory impairment one week after the stroke. But by three months after the stroke, about one-third of those with memory impairment had improved memory function,” said physician Ramune Grambaite. She is a psychologist and head of the neuropsychological outpatient clinic at the Norwegian University of Science and Technology (NTNU). Nearly 800,000 Americans suffer a stroke each year, according to the U.S. Centers for Disease Control and Prevention. While more stroke patients survive now than they did in the past, stroke remains a serious and potentially deadly condition. Survivors may experience anxiety, depression and fatigue afterwards, in addition to memory loss and a reduced ability to learn. Bente Thommessen, chief physician at Akershus University Hospital, said the proportion of patients seen with mild strokes has increased in recent years. “But the consequences in terms of concentration problems, reduced stamina and changes in memory function are common even in patients with mild strokes,” Thommessen said in an NTNU news release. The study was published July 12 in the journal Nevropsykologi (Neuropsychology). “Memory improvement is common after a stroke, but there are large individual differences,” Grambaite said. “Some stroke survivors continue to experience memory impairment and need to learn to live with it.” The researchers noted that good follow-up and support from friends and family is important in the recovery process.
Doctor in charge of Upstate Cord Blood Bank explains what the bank does and how donated umbilical cord blood (usually discarded) can save lives Q: What is the Upstate Cord Blood Bank? A: So the Upstate Cord Blood Bank is a public cord blood bank where we are collecting, processing and storing umbilical cord blood that’s donated from donors at Crouse Hospital, St. Joe’s and Community campus. And those cord blood stem cells are then available for use for patients who need bone marrow transplants. So that’s the short, short version. Q: I’m old enough to remember the initial excitement over stem cells many years ago, but it fell off pretty quickly. What are we now able to use stem cells to do? A: I just want to clarify that we’re not using embryonic stem cells, which have gotten a lot of bad press. That’s not what we’re talking about. These are stem cells in umbilical cord blood that would otherwise be thrown away. We’re not damaging an embryo or taking a life. The promise of stem cells actually is looking greater and greater. As with anything, we hope that it will be instantaneous that we’ll get everything we ever wanted, but the primary use of stem cells from cord blood is for bone marrow transplants. Bone marrow transplants using cord-derived or adult-derived bone marrow stem cells have been done for decades and they are life-changing and life-saving for patients who have leukemia, lymphoma or have other cancers that are so destructive or require so much chemotherapy that their own marrow fails. Or for people who have genetic defects and their own cells don’t work that well. Those are all proven and mainstream, standard- of-care treatments. In addition to that, there are some 80 diseases that have potential treatments using cord stem cells. That includes things like recovery after heart attack, neural degeneration after stroke, cerebral palsy. A lot of this is in the research phase, in clinical trials. They’re
Page 4 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
looking great and patients are gaining benefits off those clinical trials, but they’re not mainstream yet. Q: What does a new parent have to do to get their kid’s cord blood to you? A: We do have our website, upstatecordblood.com, and we describe everything there. But we’ve also connected with all of the clinicians who deliver at each of the three hospitals: obstetricians, midwives. The doula program we’re trying to connect with. So they all have the information if expectant mothers and families are interested in donating. Donation is relatively simple. There is a booklet we provide on cord banking that answers most of the frequently asked questions, but also included in that book is a consent. Because this is a medical procedure with medical and legal responsibilities, we want to make sure that no one has mistakenly said yes or no when they didn’t. So we have a formal document for consent. There’s also a questionnaire in there that’s about seven pages long, but you’d recognize a lot of the same questions if you’ve ever donated blood. Those are required, mainly to avoid risks from infectious diseases. We don’t want to tell a patient at the other end that they have brand new bone marrow and HIV. That’s frowned on for some reason. So we try to keep the questions brief, but we ask all the ones the FDA requires. Q: Are there any medical risks involved in donating? A: No. Less even than donating blood to the Red Cross. There’s no real risk to Mom or baby. After the baby’s out, the cord is clamped and cut. The blood we’re collecting is actually in the placenta. It’s not mom’s, it’s not the baby’s. It’s just the blood that’s left. So the main difference is just that, rather than throwing it away, we’re keeping it. Q: Why isn’t collection standard operating procedure?
A: There are countries and states where the default is to collect it with patients allowed to opt out. Here it’s opt-in. Which is unfortunate, because the general rule is about 20% of people will opt-in if the default is not to donate, and about 20% will opt-out if the default is to collect it. Nobody likes doing paperwork. So New York state is an opt-in state, but even if it wasn’t we’d still want people to be informed and comfortable with their decision. But it would be easier if we were an optout state. Q: Do donors get a say as to what it can be used for? A: Yes and no. If someone donates, there isn’t a way to restrict who it’s used for; it’s put into a pool. Parents are giving up legal ownership. And we’re talking about our primary use, which is clinical use. Now, for units that do not actually meet criteria for clinical use, we actually have a question on the consent form that asks if the cord turns out to not be able to be used for clinical purposes, can we divert it to some of our researchers who are doing research into uses for medical cord blood. There are other groups that buy it to test cosmetics or as a manufacturing starting point. There’s nothing wrong with those uses, but they aren’t our mission, so we only partner with researchers who are looking into other medical uses for cord blood. So there’s a checkbox on the form if Mom’s not comfortable with the cord blood possibly being used for research. If the blood meets the criteria for clinical use, there’s no problem. If it doesn’t, and Mom has checked no, then it will be discarded. Q: How much of a yield do you get out of each donation? A: So if you’re looking at stem cells for a bone marrow transplant, the other source is adult donors, which you collect by literally sucking it out in the OR, or a process where you give donor medication to produce a lot more stem cells. Those both have downsides, but you can get a larger amount of stem cells from them than you can from a single cord blood donation. So even though cord blood is rich in stem cells, adults are much bigger. So from a single cord blood donation, we’re getting about enough for one bone marrow transplant if they’re a child. Adults will typically get two cord blood units. There’s not enough for multiple patients from one donation, although there is research that suggests it may be possible in the future, but we don’t know that yet.
Lifelines
Name: Matthew Brian Elkins, M.D. Position: Laboratory director and medical director of the Upstate Cord Blood Bank Hometown: Livonia, Michigan Education: University of Illinois; University of Michigan Affiliations: SUNY Upstate Medical University Hospital Organizations: Association for the Advancement of Blood & Biotherapies; American Society for Apheresis; Blood Bank Association of New York State; College of American Pathologists Family: Wife (a family physician), two children Hobbies: Helping with his church’s sound and electronics
Having a Doctor Matters Staying healthy requires much more than just a quick fix. Even after diagnosis and treatment for an illness, follow-up care is important, too. The goal is to stay healthy and happy on a long-term basis.
To do that, you need a primary care physician.
We’re now accepting new patients in Fulton and Oswego. Visit oswegohealth.org/primarycare to learn more.
WE’VE DOUBLED OUR HEART TEAM
THE CARDIOVASCULAR GROUP OF SYRACUSE JOINED UPSTATE CARDIOLOGY FACULTY.
PHYSICIANS FROM TOP LEFT:
Dana C. Aiello, MD Larry S. Charlamb, MD Mark J. Charlamb, MD Christopher A. Nardone, MD Matthew S. O’Hern, MD Charles Perla, MD Theresa Waters, DO Andrew M. Weinberg, DO
UPSTATE PHYSICIANS FROM LEFT: Timothy D. Ford, MD Robert L. Carhart, Jr., MD Debanik Chaudhuri, MD Hani Kozman, MD Sakti Pada Mookherjee, MD Amy Tucker, MD Daniel Villarreal, MD
Our united expertise brings you advanced technology and streamlined care. As part of the Upstate Heart Institute, we provide connections to research and surgical care.
OUR OFFICE LOCATIONS
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August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5
988 Suicide and Crisis Lifeline Already in Operation
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f you or someone you know is contemplating suicide or having a mental health crisis, you can dial just three numbers — 988 — to get help. Callers will be connected to a trained counselor at a local call center and ultimately routed to potentially lifesaving support services. The three-digit code for the 988 Suicide and Crisis Lifeline replaces the 10-digit number for what was formerly known as the National Suicide Prevention Lifeline. The new three-digit number is easy to remember, free, available 24/7 and confidential, said Thea Gallagher, a clinical assistant professor in the department of psychiatry at NYU Langone Health in New York City. “If 988 becomes just as ubiquitous as 911, we are saying that mental
health and physical health are on the same level, and that breaks stigma,” she said. The need for such access and services has never been greater, Gallagher said. “With the ongoing pandemic, we have seen an increase in depression, anxiety and suicidal thoughts and behavior, so we know mental health has never been more negatively impacted,” she said. In 2020, more than 47,000 Americans died by suicide, a 33% increase from
2000, according to The Pew Charitable Trusts. The new number will also accept texts, and live chat is available, said physician May Lau. She is a pediatrician at the University of Texas Southwestern Medical Center and the medical director of the Adolescent and Young Adult Clinic at Children’s Medical Center Dallas. Crisis counselors speak multiple languages and are culturally competent at counseling members of the LGBTQ community. There are also resources available for people who are deaf
or hearing-impaired, Lau said. “The text function is only in English for now, but most of the people who feel comfortable texting are younger, and many of them are bilingual,” Lau noted. The new line is not just for people who are contemplating suicide. Counselors are also skilled in discussing self-harm, addiction, domestic violence and other mental health issues. If a caller needs immediate medical attention, 988 will collaborate with local police or hospitals to dispatch services. “We are trying to help people deal with crises before they become life-threatening,” said Anthony Wood, interim CEO and COO of the American Association for Suicidology. The group has been calling for a three-digit suicide hotline for years.
respondents) revealed what they consider to be the most important social determinants of health: access, 85%; substance abuse, 66%; gun violence, 53%; climate change, 51%.
ed by COVID-19, early retirements and a recession. Consulting firm Kaufman Hall says a solid one-third of their clients are suffering with no end in sight. Ninety percent of KH clients cite labor shortages as their No. 1 threat followed by overall rising expenses, supply chain problems, diminished consumer demand impacted by COVID-19, cyber threats and resulting pressure on remaining staff.
Healthcare in a Minute
By George W. Chapman
CMS Initiative Designed to Protect Local Rural Hospitals
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ne in five of us lives in a rural community. Since 2010, 138 rural hospitals have closed, typically for financial reasons. Nineteen rural hospitals closed in 2020 alone. People that live in rural areas are subject to shorter life spans and higher mortality than those living in urban and suburban areas. Consequently, CMS is proposing a new designation, “rural emergency hospital,” to bolster services and financial viability. In addition to supporting emergency services, Center Medicare & Medicaid Services is looking to support and stabilize maternal, behavioral and addiction services. While this is well intentioned, few rural hospitals, despite the REH designation, will survive alone.
Recruiting and retaining qualified physicians, nurses and ancillary service providers like pharmacists and techs, will still be a struggle. To survive, REHs must affiliate or integrate with a larger healthcare system. Otherwise, staffing shortages will be their downfall. In addition to protecting rural hospitals per se, CMS must also protect rural EMT services. EMTs are overworked and underpaid, especially those servicing rural areas. Once you have been stabilized at a rural facility, it is the EMT who cares for you when you are transferred to a larger hospital post -accident, -heart -attack, -stroke, -overdose or -complicated delivery. The REH designation would be affective January 2023.
ACA: 30 Million Are Now Covered By It
develop back-up plans if the ARP is not renewed by Congress.
More than 35 million Americans, or one in 10, are covered by the Affordable Care Act. Millions rely on expanded Medicaid or income-based subsidies. Originally, for those who don’t qualify for Medicaid, premium subsidies ended once you earned more than 400% of federal poverty guidelines. (In 2022, the individual poverty level is $13,590; for a household of three it’s $23,000.) Once over than the 400% threshold, you paid the full premium. Consequently, millions of people dropped insurance. Consequently, Congress passed the American Rescue Plan which gave relief to those making just more than 400% of poverty guidelines. It limited the amount spent on insurance to 8.5% of income. If not renewed, the ARP will expire end of this year. The Kaiser Family Foundation estimates premiums would double for 3.4 million people causing most to drop coverage altogether. Savvy states are scrambling to
Social Determinants of Health Your family history and your genes have a lot to do with how long you will live and your overall health. But the social determinants of health can easily negate your family history and the best of genes. Physicians and insurers agree that without addressing these social determinants, the best efforts of providers can be for naught. Among the social determinants impacting health status are food and shelter security, access to care, gun violence, climate change and addiction. Large insurers are investing in food and shelter for members in need. For example, United Health has invested $45 million in goods and resources for at-risk populations, saving the member $1,200 to $1,500 in out-of-pocket expenses annually. Keeping healthcare costs down helps everyone, not just the insurance company. A recent Medscape survey of physicians (2,342
Page 6 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
Over 380,000 Mental Health Apps
Since COVID-19, both apps on your phone and companies offering services online or via telehealth have increased exponentially. Digital Healthcare Elsewhere mental health, for better or worse, has become the darling of venture I just returned from touring Scotcapitalists. The potential benefits are land, England and France. All three clear: access, privacy, personal, low countries have universal coverage, cost. There are more than 380,000 direct-to-consumer apps on your Apple basically “Medicare for all” in our or Android phone and 20,000 are spe- parlance. Naturally, (of course!), I queried unsuspecting tour guides, cific to mental and behavioral health Uber drivers, wait and hotel staff, like Talkspace and Calm. There are and anyone I befriended at bars and apps by which providers can prescribe like reSET. There are platforms restaurants about their healthcare. The vast majority were satisfied designed for employers and insurwith access, providers, quality and ance companies like Ginger, Lycra their overall care. There were the Health and Modern Health. But do usual complaints about government they all work? Naturally, the rapid bureaucracy. But then again, don’t proliferation of digital mental health we complain about our insurance has engendered a lot of skepticism among traditional face-to-face mental companies? The one thing everyone stressed, (once realizing I was Amerhealth providers, academia and ican), is citizens are covered and lack insurers. Many of the startups went of money is not a barrier to getting bankrupt, leaving patients stranded. care like in the U.S. They cannot But to be fair, access to traditional fathom why such an advanced counface-to-face care is difficult so you try as the U.S.A. doesn’t guarantee can’t blame someone for trying healthcare for all. They expect their digital. Unless the severe shortage of mental health professionals improves, government to guarantee care and even when complaining about their digital is the answer for millions system, they became very defensive of consumers. The digital industry when I poked holes. The prevailneeds validation, which comes from ing attitude was there are plenty of research and then academic publicathings to worry about in this life and tion. A more global issue with digital getting healthcare should never be a mental health is integration and worry. coordination with a patient’s primary care provider, healthcare system and electronic medical record. If this George W. Chapman is not effectively accomplished, we is a healthcare busiare just continuing down the road ness consultant who of expensive, disjointed, ineffective works exclusively healthcare. with physicians, hospitals and healthcare Labor Shortages organizations. He operates GW Chapman According to a survey of hospital Consulting based in and medical group CFOs, their No. 1 Syracuse. Email him concern effecting financial viability, at gwc@gwchapmanaccess and patient experience is the consulting.com. continuing labor shortage exacerbat-
Pig Hearts Successfully Transplanted Into 2 BrainDead Patients
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enetically altered pig hearts could soon become a viable transplantation alternative for people with life-threatening heart disease, new experiments show. A team at NYU Langone Health has successfully transplanted two such pig hearts into brain-dead humans on life support, making advances that may soon help address the nationwide organ shortage. No signs of early rejection were observed in either organ, which were transplanted in surgeries performed over several hours on June 16 and July 6, doctors report. The hearts functioned normally for three days without additional mechanical support, using standard post-transplant medications. After three days, the experiment ended and the patients were taken off life support. “It was, I think, one of the most incredible things to see a pig heart pounding away, beating inside the chest of a human being,” physician Robert Montgomery, director of the NYU Langone Transplant Institute, said during a recent media briefing. “It is a great privilege for me to have witnessed that in my lifetime.” The goal of these experiments is to create a pig heart that can be transplanted using techniques and medications nearly identical to the procedures now used to implant donated human hearts, said physician Nader Moazami, surgical director of heart transplantation for NYU Langone’s division of heart and lung transplantation. “It brings me great excitement to tell you that the function of the heart was excellent,” Moazami said at the briefing. “We did have to make some tactical surgical modifications at the time of transplantation. Part of that is because the pig heart is very similar, but it’s not identical to the human heart.” If progress continues, the first transplant of a genetically modified pig heart into a live human using NYU Langone’s procedures could take place by 2025, Montgomery said. A steady supply of functional pig hearts could be critical in saving the lives of tens of thousands of patients
on the verge of dying from heart disease, said physician Alex Reyentovich, director of the NYU Langone advanced heart failure program. “There are 6 million individuals with heart failure in the United States,” Reyentovich said during the briefing. “About 100,000 of those individuals have end-stage heart failure. And we only do about 3,500 heart transplants a year in the United States, so we have a tremendous deficiency in organs. There are many people dying waiting for a heart.” The hearts were procured from pigs that had undergone 10 genetic modifications, including four pig gene alterations intended to prevent rejection and abnormal organ growth, and six human genes added to make the hearts more compatible with human biology. The first whole-body donor to receive one of the pig hearts was Larry Kelly, a 72-year-old Vietnam veteran. “He was an organ donor and would be so happy to know how much his contribution to this research will help people like him, with heart disease,” said his partner, Alice Michael, who’d been with him for 33 years. Michael said she didn’t know it was possible for someone to donate their whole body, even if their individual organs aren’t suitable for transplant, until NYU Langone approached her. “I didn’t even have to think about the decision,” Michael said. “I knew he would want to do it, and I had to do it.” A new infectious disease protocol developed by NYU Langone also prevented any sign of porcine cytomegalovirus, which is considered a risk to successful transplantation.
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In Good Health is published 12 times a year by Local News, Inc. © 2022 Local News, Inc. All rights reserved. P.O. Box 276, Oswego, NY 13126 Phone: 315-342-1182 • Fax: 315-342-7776 • Email: editor@cnyhealth.com Editor & Publisher: Wagner Dotto • Associate Editor: Steve Yablonski •Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, Melissa Stefanec, Eva Briggs (MD), Mary Beth Roach, Kimberly Blaker, Steve Yablonski, Ken Sturtz, Ernst Lamothe Jr., Amy Feeney • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Kris Adams • Office Manager: Bernadette Driscoll
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August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Alone and Content: Rediscover Your True Self
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here’s no magic pill for getting good at living alone. Like mastering any new skill, it requires effort and a lot of practice. My own path to contentment took some time, some growing pains, setbacks as well as successes and some aching losses before I rediscovered my true self. It hasn’t always been easy, but it’s been well worth the journey. The reward has been a life on my own filled with more peace, freedom and joy than I could have imagined. The journey began with a set of soul-searching questions to identify and clarify my beliefs, values, likes and dislikes. I was careful to focus on what matters to me and to steer clear of “shoulds” and other people’s agendas. The result? I created a list of personal principles and preferences that illuminated the way forward and shaped my future as a self-sufficient, independent woman. Now, in the happy third chapter of my life, I am comfortable being me and expressing my true self. In no particular order, below are just a few examples of my insights (some profound, others practical and a few whimsical) that have inspired and guided me: • Gratitude, forgiveness and loving kindness are life staples to embrace, practice and model on a daily basis. • Gathering with friends and
R
family around a flickering fire, indoors or out, enhances life. It’s warm, relaxing and hypnotic — a life essential in my book. • If I am unhappy with an aspect of my life and choose to stick with the status quo, nothing will get better. • For me, a stick shift is hands down preferable to an automatic transmission. Driving is so much more fun. It’s all I’ve ever
owned. • Hardship, failure and loss can build strength and self-awareness. Taking time and turning inward can create space for reflection and renewal of the spirit. I remind myself after losing something or someone I love: after rainbows there are rainbows. • An honest-to-goodness listener (not a pretend listener) melts my heart. • Music makes life better. I enjoy playing and listening to all genres of music, but I always return to the Great American Songbook. • As an introvert, solitude, nature and meditation recharge my batteries. • Letting go of old ways of thinking, of a poor self-image or of destructive thoughts or behaviors can free us up to embrace life’s blessings. • Gardening is a great teacher. Fertile ground exists in each of us, and a little planning, caretaking, and patience can produce beautiful results. • Solo travel is an adventure not
25 Million Kids Missed Routine Vaccinations Worldwide in 2021
oughly 25 million children around the world missed critical vaccinations during 2021, as the pandemic continued to disrupt routine medical care, a new report from the World Health Organization and UNICEF shows. “This is a red alert for child health. We are witnessing the largest sustained drop in childhood immunization in a generation. The consequences will be measured in lives,” UNICEF Executive Director Cather-
ine Russell said in a news release issued in July. “While a pandemic hangover was expected last year as a result of COVID-19 disruptions and lockdowns, what we are seeing now is a continued decline. COVID-19 is not an excuse. We need immunization catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems.” Between 2019 and 2021, vac-
Page 8 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
to be missed. It’s good for the mind, deepens the soul and fosters confidence. • Living alone doesn’t mean being alone. We are social beings. We need each other to feel safe, happy and whole. Relationships are the glue. For those coming out of a long relationship, determining or rediscovering “who you really are” can be a daunting process. After years of focusing on the needs and desires of a spouse and family, many discover that, somewhere along the way, they have disappeared around the edges and lost their own sense of self. Rediscovering yourself and identifying those things that bring joy and meaning into your life can turn living alone into an adventure of the spirit. Once you establish your individual interests and means of self-expression, you may find that time alone and the silent moments between events no longer feels empty. Below is an exercise to help you get back in touch with your true self. These are but a few of the questions to contemplate on your road to self-discovery. Spend some time answering these 10 questions: 1. Search back. What hobbies did you pursue as a child that gave you joy? What did you do particularly well or (perhaps secretly) take pride in? 2. More recently, when do you completely lose yourself in something? What activities make you feel alive and complete, as though nothing is missing? 3. What do you hold most dear? 4. How do you want to be remembered? 5. What is your biggest regret? If you could have a “do-over,” what would you do differently? cine coverage dropped to 81%, with a 5-point drop recorded in the percentage of children who received three doses of the vaccine that protects against diphtheria, tetanus and pertussis. The vaccine, DTP3, is used by the two international agencies as a marker for broader vaccine coverage. “As a result, 25 million children missed out on one or more doses of DTP through routine immunization services in 2021 alone. This is 2 million more than those who missed out in 2020 and 6 million more than in 2019, highlighting the growing number of children at risk from devastating but preventable diseases,” the UN officials said. Nearly two-thirds, or 18 million, of the children, most of whom live in low and middle-income countries, didn’t receive even one dose of the childhood vaccine. Decreases were also seen in HPV
6. How would your life change (or get better) if you were a more curious person? 7. What brings tears to your eyes? 8. If you were to dedicate your life and resources to a particular cause or charity, what would it be? 9. What does your perfect day look like? 10. How do you want to describe yourself and your life a year from now?
Then, take action After answering these questions, ask yourself how you can use these insights to influence the direction of your life. What can you do today to reconnect with a past love or pursuit, to delve more deeply into an existing interest, or to fulfill a new passion or purpose? When you identify your values and the things you love to do, and pursue them, you will feel more integrated and in touch with your true self. You’ll be spending your time immersed in pursuits that bring you personal satisfaction — pursuits that reinforce who you are and who you want to become. Those of us who live alone have the gift of abundant time to ourselves. Use it wisely. Use the time to get to know yourself all over again. With each passing day, I am confident you’ll find your internal compass, unique to you, pointing toward the truth — your true self.
Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com vaccinations, with over a quarter of the coverage achieved in 2019 lost, and measles, with first-dose coverage dropping to 81% in 2021. WHO officials noted this is the lowest level since 2008 and means 24.7 million children missed their first dose in 2021. No region of the world was spared, with the most dramatic declines seen in East Asia and the Pacific region. The biggest factors behind the shift include conflict or other fragile settings, a growing vaccination misinformation campaign and COVID-19-related issues. “Planning and tackling COVID-19 should also go hand-in-hand with vaccinating for killer diseases like measles, pneumonia and diarrhea. It’s not a question of either-or, it’s possible to do both,” WHO Director-General Tedros Adhanom Ghebreyesus said in the news release.
Swimming area at Mexico Point Park in Oswego County. Officials were able to open but have dealt with challenges finding enough lifeguards.
Lifeguard Shortage Puts Damper on Summertime Fun
Some pools struggled to open and the situation is only expected to worsen in late summer By Ken Sturtz
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s she wrapped up her freshman year at Clarkson University Reatha von Holtz felt confident she wouldn’t have to look hard to find a full-time summer job when she returned home. The 18-year-old worked summers in high school as a lifeguard at Mexico Point Park in Oswego County and picked up hours lifeguarding at her high school pool. Last year the park struggled so much to hire lifeguards that von Holtz helped recruit people she knew from the swim team. A nationwide shortage of lifeguards that has grown during the pandemic has left major cities and small towns scrambling to hire enough staff to open public pools and beaches this summer. In many cases, municipalities short of lifeguards have been forced to cut hours at pools and beaches or shutter some entirely. The American Lifeguard Association estimates about one-third of pools in the country that require life-
guards are closed this summer due to the ongoing shortage. “The shortage is the worst I’ve seen in my entire career,” says Bernard J. Fisher II, the association’s director of health and safety, who began lifeguarding as a teen a half-century ago. The soaring demand for lifeguards mirrors the overall labor market. Employer demand for workers has remained high, unemployment is hovering around historic lows and workers are continuing to leave lower-paying jobs for better opportunities in other industries. “Staff shortages go beyond the aquatic industry and the increased competition for workers has made it difficult for aquatic facilities to hire and retain staff,” says Dan Hartman, of the American Red Cross — Eastern New York Region. After two years of pandemic-related disruptions, many facilities have had to recruit, hire and train 100% of the staff needed to operate, including lifeguards, water safety instructors
and managers, Hartman says. Some facilities have responded by canceling swimming classes and using the instructors to fill lifeguard openings (water safety instructors must be certified lifeguards). But that leads to fewer children who know how to swim. About 4,000 people drown annually in the United States, according to the Centers for Disease Control and Prevention, and drowning is one of the leading causes of death for children. Drowning death rates declined in the past decade, but ticked up last year. About 150 lifeguards are needed to staff the city of Syracuse’s eight outdoor pools, depending on how many individuals work full time versus part time. So far this summer the city has only been able to open five of its pools, says Commissioner Julie LaFave, who oversees the city’s recreation program. Another 50 lifeguards would be needed to open the remaining pools. “Attracting lifeguards has been
a problem for a while now,” LaFave says. “This is just a level we’ve never seen before.” The city is continuing to hire with the goal of possibly opening its remaining pools later in summer. LaFave says she believes Syracuse has been more successful hiring lifeguards than cities of comparable size. The city recruits throughout the year, subsidizes the cost of certification courses and does its training inhouse instead of relying on an instructor to teach their lifesaving classes. Syracuse also began offering free swimming lessons to youth at its community centers and works with the city school district to expose children to the idea of becoming lifeguards, LaFave says. The shortage of lifeguards is nothing new. Fisher says one cause is the number of lifeguards has not kept pace in recent decades with the development of new pools and beachfront swimming areas, particularly in hotels and condos. The beach at Joseph F. William Memorial Park on Oneida Lake was a popular swimming area, but the town of Cicero struggled for years to hire enough lifeguards, says Teresa Roth, director of parks and recreation for Cicero. She says that was partly because the beach was frequently closed due to water quality issues. The closures meant staff were sent home and lost pay, which in turn made it more challenging to recruit new lifeguards. In 2019, the town couldn’t recruit enough lifeguards to open the beach to swimmers. The town hasn’t opened its beach to swimming since, but maintains a small wading area and plans to install a splash pad on the beach. “I was glad we didn’t have to hire lifeguards,” Roth says. “I can’t even imagine trying to hire eight or nine aquatics staff members knowing how difficult it was for us to hire for other areas within our department.” Roth, who worked as a lifeguard through high school and college, says teenagers are less likely to become lifeguards than in the past for a variety of reasons, such as the cost associated with the training classes and the fact that the Red Cross lifeguard certification now has to be renewed every two years instead of three. The financial incentives have also waned over time. In the past lifeguards tended to be paid more than other similar age recreation staff. But that difference has narrowed as the pay for other positions has been bumped to keep pace with minimum wage increases, Roth says.
Need nutritional help? Here’s news to chew on. Did you know FamilyCare Medical Group provides medical nutrition therapy services for people living with chronic health conditions such as diabetes, obesity, kidney disease, heart disease, Celiac disease, and other digestive conditions? Assistance with these concerns and disorders are available with our Registered Dietician and Certified Diabetic Educator, Carolyn Allen, MS, RD, CDN, CLC – practicing at The Synergy Center. Schedule an appointment today!
Let our family care for yours! 315-472-1488 • fcmg.org
August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 9
Celebrating 40 years
of proven cancer expertise in CNY.
Auburn | Syracuse | East Syracuse Page 10 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
Julie Flack has been a Hematology-Oncology Associates of CNY patient since 2006. Flack praises HOA for both its quality of care and collaborative spirit. Next to her is husband Irwin Flack, also a patient at the practice.
Hematology-Oncology Associates of CNY Celebrates 40 Years By Deborah Jeanne Sergeant
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or the past four decades, Hematology-Oncology Associates of CNY has cared for patients with cancer and blood disorders as a private, community-based practice. Much has changed since 1982, when doctors John J. Gullo and Santo M. DiFino established the practice. Not long after, two other doctors, Jeffrey J. Kirshner and Anthony J. Scalzo, joined the practice. “I was their first employee,” Scalzo recalled. Since then, the practice has grown to 16 medical oncologists, four radiation oncologists and nearly 300 others, including nurse practitioners, physician assistants and administrative staff among its locations in East Syracuse, Syracuse and Auburn and Camillus. Since his joining the practice in 1982, Scalzo has observed cancer changing from a death sentence in many cases to becoming a curable or manageable chronic illness in many cases. “Many of the treatments we use now had not even been invented in 1982,” Scalzo said. One changes since then includes development of monoclonal antibodies. Scalzo explained that the body produces antibodies to fight off infections. “Monoclonal antibodies are artificial antibodies that can coat cancer cells and that leads to the destruction of the cancer cells,” he said. Identifying gene mutation represents another advance in oncology. Scalzo said that certain mutations in normal cells cause them to become cancerous. Treating them with new
Anthony J. Scalzo, is board-certified in internal medicine and medical oncology, and joined Hematology-Oncology Associates of CNY in the early 1980s. “I was their first employee,” Scalzo recalls.
Maryann Roefaro is the CEO of Hematology-Oncology Associates of CNY. She has been with the practice for 20 years. “The patient is in the center of all we do,” she says.
medication that can block the activities of mutations means that cancer cells lose their ability to continue to grow. Another big discovery is immune checkpoint inhibitors. “These are the medicines you see advertised on TV,” Scalzo said. “Cancers block our immune systems from attacking the cancer. They produce substances that put the brakes on our immune systems. With these new medicines, it allows us to take the brakes off the immune system and it becomes more active to attack the
cancer. It harnesses our own immune system to attack the cancer cells.” These advances help Scalzo and his colleagues achieve better outcomes with patients. The practice has also developed an integrated approach to patient care, including the social, psychological, dietary, physical therapy, spiritual and emotional aspects. As more cancer patients are surviving and living longer, HOA developed a survivorship program that cares for patients throughout their entire treatment and beyond.
“Our goal is not just to help you live longer but to live better,” Scalzo said. “You have got to have a good quality of life.” Julie Flack has been his patient since 2006. She takes medication that turns off her cells’ cancer-causing mutation which otherwise would have caused her death within a couple years of her diagnosis of lung cancer, according to Scalzo. “I’m metastatic and have been from the day I was diagnosed,” Flack said. “Nine to 12 months was my prognosis. I was 48 at the time.” She receives checkups every four months, which may seem stressful. However, she feels reassured that her providers can catch progressions of the cancer in time. She has had surgery, oblation, Cyberknife, chemotherapy and her ongoing regimen of medication. Flack praised HOA for both its quality of care and collaborative spirit. She has sought care from specialists in her type of lung cancer at different facilities and received only encouragement from her team at HOA, “which means a lot for anyone going through this. I know many people who’ve had cancer and that’s not always the case.” Flack also appreciates the support group at HOA. Since her husband, Irwin Flack, received a diagnosis of multiple myeloma five years ago, they both attend a support group, along with other HOA patients and patients treated by other facilities. The group is for people who are treating cancer to prolong quality and length of life, not those who anticipate full remission. “This is really helpful,” Flack said. “We’re facing death every day. We need to be with people who are in the same boat. It was wonderful for them to recognize we need a place. As time goes on, metastatic people are living longer than ever.” She also lauded HOA’s creation of Cancer Connects, which links mentors with people newly diagnosed for one-on-one support. “The organization also provides financial support for economically disadvantaged patients and free services like acupuncture and massage to patients in four counties,” Flack said. The patient-centered care is one of the aspects of HOA that makes the practice stand out, according to Maryann Roefaro, CEO of HOA, who has been with the organization 20 years. “The patient is in the center of all we do,” Roefaro said. “We are very much a culture of compassion and accountability, and we have very high standards for how our employees treat other employees and our patients.” She believes that employees are very much in touch with the fragility of life and that hones their ability to express empathy in a variety of ways, from verbalization to thoughtful, caring acts. “Everyone is dedicated to patient care and a very high level of compassion to our patients,” Roefaro said. “We have every certification you can possibly have to underscore our quality and commitment to patient care. All our equipment and instruments are cutting-edge. Because we’re an independent practice, we can develop new programs and we have incredible flexibility in what we do. Put it all together and it’s a recipe for success.”
August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 11
hospital see patients who are unable to afford medications, like insulin. Often patients who need multiple medicines will only purchase medications for the symptoms they recognize, which can lead to more health problems in the future,” Balotin said. “High blood pressure left untreated can cause kidney problems, heart problems and other complications.”
Jewish Family Service Gets Funds to Support Holocaust Survivors
Over 17,000 uninsured people in Onondaga County
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yracuse Jewish Family Service (SJFS) at Menorah Park has received a $20,000 grant from the New York State Office of Aging to support Holocaust survivors. Funds will be used to provide care management and mental health services from SJFS staff. Funds are available through January 2023. Holocaust survivors include both individuals who were impacted by the Holocaust as well as their adult children. Services will primarily be provided to individuals residing in Onondaga County, but may also be available to individuals living in Cortland, Madison, Tompkins, Oswego and Oneida counties. AgeWise Solutions care management services may include providing assistance with a variety of tasks, such as: • Bill paying, organizing financial affairs, and assigning a power of attorney • Arranging transportation to medical appointments, family occasions, social events • Accessing health care professionals, advanced care planning, coordinating medical care • Identifying social activities to reduce isolation and improve quality of life • Coordinating home aides and companions • Securing good nutrition through delivered meals or grocery shopping • Identifying contractors for home maintenance and to improve home safety and security • Addressing Immediate housing needs as well as developing plans for future housing options • Managing family dynamics and decision making • Managing crises and follow-up care Mental health services are either provided by or supervised by licensed clinicians with expertise working with older adults. Eligible individuals who wish to receive care management or mental health services should contact Ellen Somers, SJFS Assistant Director at 315446-9111, ext. 225, or via email at somerse@sjfs.org.
Uninsured and Indigent in Onondaga County to Get Prescription Drug Free of Charge
New prescription drug dispensary at Upstate brings hope to the needy in Onondaga County
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illions of Americans without health insurance often go without life-saving prescriptions because they can’t afford them. Now, for the uninsured and indigent in Onondaga there’s hope — the Dispensary of Hope. Eligibility to participate in the Upstate’s medication access program is based on the annual published federal poverty rates. According to the program website, applicants must be at or below 300% of federal poverty guideline and have no prescription insurance. The program started July 24, and is for any Onondaga County resident who is uninsured and meets income eligibility. Upstate’s outpatient pharmacy at Community Hospital, located at 5000 W. Seneca Turnpike, is now
receiving medication from Dispensary of Hope, a national nonprofit drug distributor that takes billions of doses of excess drugs that would have otherwise been destroyed and disseminates them to nonprofit pharmacies and clinics. Available medications include those to treat high blood pressure, high cholesterol, stomach ulcers, and more. Most notably this program includes insulin, which constantly makes headlines for its high cost, up to $300 per vial. “This program is community-changing,” said Eric Balotin, Upstate’s director of retail/specialty pharmacy services. “It fits the mission of what Upstate is all about— improving the health of the community we serve. “Our ambulatory clinics and
In Central New York, a 2019 study by the United Hospital Fund and the Health Foundation of Western & Central New York shows that as many as 50,000 people are uninsured, more than 17,000 in Onondaga County alone. In addition, Syracuse has the highest child poverty rate in the country among large cities. Syracuse is also a sanctuary city for refugees, many of whom may not be insured. “The Dispensary of Hope program is extremely helpful to provide access to important, life-saving medications, such as antithrombotic medications, to patients who would not otherwise have access,” said Meaghan Murphy, Upstate’s ambulatory care pharmacy coordinator. “The program also aids health care providers,” Murphy continued. “A lack of insurance can lead to medication being prescribed based on cost and access, rather than the optimal medication regimen based on patient-specific factors. Upstate’s Dispensary of Hope is the first such program in the state outside of New York City, which currently has five. Upstate will pay an annual fee to receive unlimited access and shipping to all the drugs available. Drugs from the program will only be available from the outpatient pharmacy at Community, as inventory must be managed and tracked separately. Interested participants simply need to send their prescriptions to the pharmacy, where the pharmacy team will check for eligibility (income and insurance status). If eligible, patients will be enrolled in the program. Current cash customers of the pharmacy will be checked for eligibility.
Memory Care Corral Opens in Tully New equine program for individuals with memory loss and their caregivers now open
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emory Care Corral has opened July 25 at From the Ground Up Therapeutic Horsemanship, Inc in Tully. This innovative program will provide the Central New York community with therapeutic equine assisted services for individuals with early-stage dementia and their caregivers. Guided sessions with horses provide both the individual with memory loss and their loved one with therapeutic, non-riding activities. No horse handling experience is necessary. These one-hour sessions enable both participants to better communicate and support each other, according to a news release issue by the
Page 12 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
nonprofit. Research has shown that the human-horse connection helps participants feel relaxed, confident and happy. Both the individual with dementia and the caregiver can experience reduced isolation, depression and stress, according to Andrea Colella, the executive director of From the Ground Up Therapeutic Horsemanship. “The benefits of humans being in the company of horses are numerous; lowers cortisol level, heart rate and blood pressure,” said Colella. “The reactions we feel have an effect on us physically, cognitively and emotionally.” The Memory Care Corral program has been the outcome of a collaboration of several organizations
dedicated to the enhancement of the quality of life for those with memory loss and their caregivers. The training of volunteers has been provided by the Alzheimer’s Association, Central New York and by the Connected Horse program in California. Start-up funding has been provided by the Athelda Fund, a family fund dedicated to enabling individuals living with dementia to remain at home and engaged in their community for as long as possible. All sessions are for both the individual with memory loss and their caregiver. Sessions are $10 per person ($20 per session for the two participants). Preregistration is required by emailing contactftgu@gmail.com
Meet our Pulaski Area Providers
Mary Barbara, PA Physician Assistant Pulaski
Lisa Beagle, PNP Pediatric Nurse Practitioner Lura Sharp School
Nicole Brubaker, FNP Family Nurse Practitioner Sandy Creek School
Jill Brushaber, FNP Family Nurse Practitioner Pulaski
Patrick Carguello, DO Family Practice Physician Pulaski
Celeste Carnes, FNP Family Nurse Practitioner Pulaski, Mexico
Annette Digby, FNP Family Nurse Practitioner Pulaski
Sarah Dunn, DDS Dentist
Mikayla Fox, PA Physician Assistant Pulaski
Dean Gardner, FNP Family Nurse Practitioner Pulaski
Brittany Gehrke, RDH Dental Hygienist Pulaski, Sandy Creek School
Anna Gofman, DDS Dental Pulaski, Fulton
Lauren Hehir, AGNP Adult-Gerontology Nurse Practitioner Pulaski
Jody Hipple, FNP Family Nurse Practitioner Pulaski High School
Megan Hollister, FNP Family Nurse Practitioner Pulaski
Annalise Isgar, RDH Dental Pulaski
Blaze Kravec, FNP Family Nurse Practitioner Pulaski
Kwi Lee, DDS Dentist
Grace Nasri, MD Family Practice Physician Pulaski
Melissa Noel, DDS Dentist
Megan Pecha, MD Pediatrician
Pulaski, Fulton
Jessica Overton, RDH Dental Hygienist Pulaski, Fairgrieve School
Richard Salvagno, DDS Dentist Pulaski
Mary Shaben, FNP Family Nurse Practitioner Pulaski
Glenn Thibault, MD Family Practice Physician Pulaski
Dorese Vecchio, RDH Dental Hygienist Pulaski, APW Schools
Jenna Walker, RDH Dental Hygienist Pulaski
Edward G Wolfe Jr., RPA-C Physician Assistant Pulaski
Pulaski
Marissa Taber, RDH Dental Hygienist Pulaski
Pulaski
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Like us on Facebook! August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 13
My Turn
By Eva Briggs, MD
Myths and Misconceptions About Tick Bites and Lyme Disease
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’ve seen many tick bites and Lyme disease lately, making this a good time to revisit this condition. There are still many myths and misconceptions. A corkscrew shaped bacterium from the genus Borrelia causes Lyme disease. Bites from infected ticks, the blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in our area. The western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast. Tiny young nymphal ticks are most likely to spread the disease. They are small (less than 2 millimeter) and easily overlooked. People are more likely to discover the larger adult ticks and remove them early. A tick must attach and feed for 36-48 hours to transmit Lyme disease. Ticks find their hosts by questing. They attach to plant stems by their rear legs while waving their front legs around. If a host happens by and brushes against the tick, it latches on with its front legs and starts crawling around seeking a suitable place to bite and feed. Ticks don’t jump, fly or drop out of trees. Once on the host, the tick cuts the skin and inserts its barbed feeding tube. It secretes a cement to keep it firmly in place. The barbs combined
with cement makes them hard to remove. Ticks also secrete saliva with anesthetic properties, enabling them to remain attached undetected. To remove a tick, grasp it firmly close to the skin with tweezers and slowly pull straight upwards. Or use a tick removal tool. It’s a myth that coating a tick with Vaseline or burning it with a match will cause the tick to release. These methods only annoy the tick making it attempt to burrow deeper and may make the tick regurgitate its stomach contents into your blood stream. This increases the chance of disease transmission. If the mouthparts are left behind, you can try to remove them with tweezers. But if they won’t come out, it’s safest to leave them in place and let them work their way out. No need to cause pain, infection or scarring by digging out the mouthparts. If the tick has been attached more than 24 hours or is engorged, a single dose of doxycycline in adults may reduce the chance that Lyme disease develops. This is called postexposure prophylaxis but there is currently no recommendation for this in kids. Lyme disease develops in three stages.
STAGE 1 LYME DISEASE occurs one to 28 days after a tick bite. There may be a low-grade fever. The classic rash is called erythema migraines. It is a flat expanding red rash. It is often painless although it can itch or burn. It often expands for a few days and may have concentric rings like a bullseye. But often it appears uniform in color. The bullseye appearance is not necessary to make the diagnosis in areas where Lyme disease is common (like Central New York) and the person may have been exposed (has not stayed sealed up indoors.) If a patient has symptoms of stage 1 Lyme disease, blood tests are useless. Blood tests for Lyme measure antibodies produced by the body. But antibody production takes weeks, so the test is likely to be negative at the time of stage 1
“Ticks also secrete saliva with anesthetic properties, enabling them to remain attached [to human bodies] undetected.” Lyme disease. If the patient is treated promptly with antibiotics, the blood test may never turn positive. So, it’s a clinical diagnosis, and if your doctor thinks you have early Lyme disease, take the treatment. Don’t waste time and money on a blood test. And don’t do the test later on, it will not tell you whether the rash was truly Lyme disease or not. Although the rash usually occurs at the site of the tick bite, it can occur elsewhere on the body. There may even be multiple lesions. It is not necessary to remember a tick bite. STAGE 2 LYME DISEASE, early disseminated Lyme disease, indicates that the bacteria have spread via the blood stream and requires antibiotic
treatment. This starts three to 12 weeks after the initial infection. Symptoms include fever, dizziness, headaches, muscle pains and chest pain. Since these symptoms are nonspecific, blood test for Lyme are useful at this stage. Other possible symptoms include an assortment of neurologic symptoms (headache, Bell’s palsy, encephalitis, meningitis), eye symptoms — double vision, inflammation of the cornea) — and arthritis (swollen, red painful joints). STAGE 3 LYME DISEASE occurs months to years after infection. This also includes neurologic conditions (Bell’s palsy, aseptic meningitis) and arthritis. There may also be heart rhythm disturbances. Ticks are tenacious and I doubt that it will ever be possible to prevent 100% of tick bites. But there are measures you can take. Wear long pants and long sleeves when possible. Light colored clothing makes it easier to spot ticks. Treat your clothing with permethrin to repel ticks. Permethrin, when wet, is toxic to cats, but once the treated clothes have dried, it’s safe. Use an effective tick repellant containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. The Environmental Protection Agency has a list on its website. Check your body for ticks when you return indoors. Remember to check your clothes as well as your body. Kill ticks in your clothing by washing in hot water or tumbling your clothes in a hot dryer. Cold and medium temperature washing will not kill ticks. Also remember to check equipment such as daypacks and check your pets. Showering within two hours of coming indoors helps reduce the chance of acquiring tickborne illnesses.
SHORT-TERM REHAB
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Newly expanded program with predominantly PRIVATE ROOMS! Our therapy and nursing teams work closely with onsite physicians including Upstate Physical Medicine and Rehabilitation Physical, Occupational, Speech/Language and Respiratory therapies offered alongside 24/7 Nursing Care Build strength and independence before returning home from your hospital stay
Page 14 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
MEETING YOU WHERE YOU ARE
Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.
SmartBites By Anne Palumbo
Helpful tips
The skinny on healthy eating
Latest Buzz on Beets I f you haven’t eaten beets in a while, you might want to head to the nearest farmer’s market. This in-season veggie, known for its luscious colors and earthy flavor, is packed with a bounty of nutrients and antioxidants, enough to grant it superfood status. A beet’s color contributes to many of its unique health benefits. Betalains, the pigments responsible for this tuber’s jewel-like hues, are plant compounds esteemed for their antioxidant and anti-inflammatory properties. While antioxidants help to protect cells from free-radical damage, anti-inflammatories help to suppress inflammation that can damage arteries, organs and joints. Although more research is needed, recent studies suggest that betalains could help lower the risk of heart disease, cancer, Type 2 diabetes, obesity and more. Worried about your blood pressure? Reach for a beet! Beets are rich in two nutrients that may lower blood pressure: dietary nitrates and folate. In your body, dietary nitrates are converted into nitric oxide, a molecule that dilates blood vessels and lowers blood pressure. Folate, a B-complex vitamin, is thought to reduce the risk of high blood pressure by helping blood vessels relax and improve blood flow. Folate also reduces levels of homocysteine, a protein
in the blood that has been linked to heart disease. If you’re thinking all this improved blood flow is good for brains, you are correct! More blood means more oxygen, and more oxygen means improved mental performance. Of course, beets have many more nutritional perks that make them a great addition to most diets. First, they’re super low in fat and calories (only 40 calories per average serving), but high in water, which keeps you hydrated and satiated. Second, despite their meager calories, they contain moderate amounts of protein and fiber, two more nutrients that promote feelings of fullness. In other words, beets may help with both weight maintenance and weight loss. And while beets do have more carbs than your average vegetable, they’re the good-for-you carbs that take longer to digest and that have been linked to healthier weight, happier guts, and lower risks of Type 2 diabetes and heart disease. On the subject of diabetes, the American Diabetes Association encourages the consumption of this non-starchy vegetable, as there are no known risks to eating beets if you have diabetes. Since their glycemic index is medium and their glycemic load is low, beets should not have a major effect on blood sugar levels.
Your Salt Shaker May Prove Deadly, Study Finds
Roasted Beet Salad with Goat Cheese and Toasted Walnuts Serves 4 3-4 medium beets, scrubbed and ends trimmed 2 tablespoons balsamic vinegar 1 teaspoon Dijon mustard 1 clove garlic, minced Kosher salt and coarse black pepper, to taste 3 tablespoons olive oil 4-6 cups baby arugula or other fresh greens mix ½ cup toasted walnuts ½ cup crumbled goat cheese fresh basil for garnish Preheat oven to 400 degrees. Drizzle beets with scant amount of olive oil, season with salt and pepper, wrap in foil, and place on a baking
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eople who douse their meals in salt may have a shorter life than those who rarely reach for the salt shaker, a large new study suggests The study, of more than 500,000 British adults, found that those who always sprinkled salt on their food at the table were 28% more likely to die prematurely than people who rarely added salt to their meals. On average, salt lovers shaved about two years off of their life expectancy at age 50. The findings do not prove the salt shaker is a deadly weapon. But they do support going lighter on the condiment, said lead researcher, physician Lu Qi, of Tulane University School of Public Health and Tropical Medicine in New Orleans. “It’s a simple behavior people can modify,” Qi said. Processed foods and ready-togo meals are often heavy in sodium, and best limited. But, Qi noted, it can be tricky to avoid the sodium lurking in prepared foods. Resisting the salt shaker on your kitchen table is straightforward. Health experts have long advised limiting sodium in the diet — largely to help control blood pressure levels. Yet studies have been mixed as to whether that lengthens people’s
Beets that are small or medium-size are more tender and tastier than large ones. They should be heavy for their size and firm, with no nicks or cuts. If the edible greens are still attached, they should look bright and fresh, not wilted. Beets, unwashed and placed in a tightly sealed bag, will last up to two weeks in the refrigerator. Note: Raw beets and their greens contain high levels of oxalates, which can contribute to kidney stones and also hinder the absorption of certain nutrients. When boiled, however, a beet’s oxalate content is markedly reduced. sheet. Bake until beets are fork-tender, about 55-60 minutes. Let cool for 10-15 minutes. Meanwhile, whisk together the vinegar, mustard, garlic, salt, pepper, and olive oil and set aside. Peel cooled beets with a small sharp knife, then cut into wedges, slices, or bite-sized pieces. Place the arugula or greens in a separate bowl and toss with enough vinaigrette to moisten. Put the salad on a serving platter or individual plates, then arrange the beets, walnuts, and goat cheese on top. Drizzle with additional vinaigrette if desired, sprinkle with salt and pepper to taste, and then garnish with fresh basil. Serve immediately.
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.
lives. One likely reason is the way that studies measure sodium intake, Qi said. Some have measured sodium in participants’ urine samples, which only reflects their recent salt intake. Others have asked people about the foods they’ve eaten in the past month or so, which is also an imperfect estimate. In contrast, Qi said, a habit of topping every meal with salt says something about a person’s longterm taste preferences. The findings are based on 501,379 adults taking part in the UK Biobank Study. When they were recruited, between 2006 and 2010, they answered questionnaires on their diet and lifestyle habits. Over nine years, more than 18,000 participants died prematurely — which the researchers defined as before age 75. When they assessed each person’s life expectancy, they found that the risk of an untimely death was 28% higher among people who’d said they “always” used salt at the table, versus those who never or rarely did. Of course, there may be many differences between those groups of people. The “never” group is likely to have other healthy habits, for example.
August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 15
Corliss Varnum has more than 39 years of experience in the medical field. He recently retired from private practice in Oswego and now works as a physician at Oswego County Correctional Facility. “It’s a need of our community. Getting a doctor there can be difficult; not only getting them to come, but getting them to stay,” he says.
The Doctor Will See You Now – in Jail Longtime Oswego physician now treating inmates at the Oswego County Correctional Facility By Steve Yablonski
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hysician Michael Nupuf retired in May from his position as the medical director for the Oswego County Correctional Facility. But he found a more than capable successor —Corliss Varnum. A family medicine specialist in Oswego, Varnum has more than 39 years of experience in the medical field. “One day, he called the office and talked to my partner, [physician Matt Liepke}, and he said something about whether he’d be interested in doing a little something at the jail. He said, ‘No, but Dr. Varnum may be coming into some extra time.’ He was talking about my retirement, which wasn’t formerly announced yet,” Varnum recalled. Varnum said he was under the impression that he would be filling in from time to time so his friend could get some time off. “So, I said ‘OK’ and went in and talked with the staff,” he said. “This way I could keep my hand in the stew of medicine in a different kind of medicine.” “These [inmates] have a whole different set of problems — medical needs and all that,” he added. “I was primary care, family practitioner from newborn all the way right up.” It’d be a nice augmentation, Varnum thought. “I’m retiring … thinking about keeping myself current,” he added. “Every community needs help. So I met with the sheriff and un-
dersheriff and then I realized that [Nupuf] is stepping down. And, it’s all going to be me — but hopefully keeping it part-time,” Varnum said. “The staff is very knowledgeable and dedicated. So I went along with it and I’ve been there since,” he said. “I did it back when I first came to town — back in ’86 — for a short while, at the old jail. It was the same kind of thing. You had a room for examinations and the inmates’ biggest complaints were whether they could get an extra mattress at the time.” The staff works up a schedule of people that need to be seen — it could be a follow-up of something the doctor did before for them. They line them up. They could have a complaint, they could have any number of things, could be diabetic or whatever, Varnum explained. “Do they need to continue their medication? Depends on how long they are going to be there — that depends on what they did, I guess,” he said. “Some are inmates headed for federal prison but haven’t gone there yet, obviously in for the long-haul.”
Filling a need “It’s a need of our community,” Varnum said. “Getting a doctor there can be difficult; not only getting them to come, but getting them to stay. “It’s a half day a week. That’s the way Mike did it and it’s stayed that way. I don’t want it to be an eighthour a day kind of thing, five days a week. I’m retiring, too.” There are nurses and an EMT
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person there as well. Nurses call with a concern about an issue or a medication and the doctor takes the call. “And then, you know, the corrections officers are there, right around the corner,” Varnum said. So far, everything has been OK. No really outlandish aggression problems or anything like that, he added. “Enjoying? Yeah, I am. You know, it’s still medicine — different concerns, different problems. A lot of them, you know, they have drug issues, other issues, probably why they got in jail. Some of them get out, go home and never get back in. Some of them do come back. It’s almost like [at jail] they have a regulated life; they have food and they have shelter over their head,” he said. “I enjoy working with the staff. They’ve been very helpful and patient.” “It’s sad. You talk to some of these folks, they’re not only taking oral drugs, they’re taking intravenous drugs. I’ve seen evidence of that, track marks as they used to say,” he said. “I’d say, ‘did you get your COVID vaccination?’ and they’d tell me, ‘no I didn’t get that— that could kill me!’ “With injectible drugs, which many of them are doing, you worry about HIV, hepatitis B as well as hepatitis C. All those things are there and then the question is, are they there long enough for us to do anything to help?” Basically high blood pressure, diabetes, and a fair number have hepatitis C, Varnum said.
“They go home and you try to set them up with care, but they don’t always follow up. They may not find a doctor who will take their insurance or they don’t have any insurance at all. So that all gets in the way and after a while they don’t get treated,” the physician said. “Some of these guys have been in and out more than once; can’t seem to break the cycle in their life. It’s a tax burden, but inmates are entitled to care, medical care.” If they need to go to the ER, they have to send a guard with them. That pulls [the guard] away from the facility. They are pulling an officer away and that leaves them with a hole at the facility. All those things play into trying to get inmates medical care. So it’s not as easy as you come in and you see your doctor,” Varnum explained. So far, he hasn’t had a problem for getting pre-authorization for things like X-rays or CAT scans, he added. “Sometimes things can get advanced before they get treated. But [the county] is doing everything it can—it just isn’t as smooth as they’d like it to be. They are doing the best they can with what they’ve got,” he said. “Currently, I am the only M.D. there. As far as I know, that’s the way it’s been for ever.” “It’s a part of our community. This part is kind of invisible, I guess you’d call it. You don’t want anything tragic to happen to anybody in jail,” he continued. “What would I be doing if not this?” he asked rhetorically. “I’d be trying to keep up with today’s medicine, keeping up with new developments. That’s certainly kept me more in tune with COVID and all that stuff, new treatments and vaccines.”
5
Things You Should Know About Men’s Health
By Ernst Lamothe Jr.
3.
MEN ARE RELUCTANT
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hysicians understand getting male patients to come to their offices remains challenging. Men have many reasons not to skip their doctor’s visits. The top 10 health ailments that men suffer from more than women are heart disease, cancer, stroke, chronic pulmonary disease, accidents, pneumonia, influenza, diabetes, suicide, kidney disease, chronic liver disease and cirrhosis, according to the World Health Organization. “We want to live long enough to enjoy our grandchildren. Being healthy is going to keep you alive longer and functioning at a higher level,” said physician Douglas Guenter, who provides care with Oswego Family Physicians as part of Oswego Health. “We don’t want something bad to happen to us in a crippling way early in life.” Guenter discusses five tips for men’s health.
1.REGULAR CHECK UPS
Regular health checks can identify any early signs of health issues. The issue is that many Americans either use the emergency room as their primary care physician or begin scheduling appointments with their primary care doctor when they notice something wrong. While it is helpful to see the physician any time, when you only see them when there is some alarming symptom you may discover you are in the latter stages of a disease or ailment. “This is an opportunity to measure vitals and blood sugar so we can see if a person is having any early signs of diabetes and high cholesterol,” he said.
2.EARLIER SCREENINGS
At ages 40-65, there are many preventive screenings from prostate to colon. In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer exams starting at an earlier age. Now we see an increase of colon cancer between ages 40 and 50 so the American Cancer Society has recommended men be tested as early as 45 years of age. “A colonoscopy is a great tool for early detection because it can prevent
Physician Douglas Guenter provides care with Oswego Family Physicians as part of Oswego Health. colon cancer. It’s not always the easiest prep for the procedure the day before, but once you go in that day then people are amazed how quick and easy it is,” said Guenter. Beginning at about age 45, or and as young as 40 if you are African American or have a strong family history of prostate or other cancers, all men should talk to their doctor about screening for prostate cancer. Routine screening starts with a PSA blood test and may include a rectal exam. Prostate cancer screening starts with a PSA test. This is a blood test. If your doctor is already drawing blood for other tests, the PSA test order can be added. Results should be back within a few days. “Now many of the recommended ages for screenings are getting younger,” said Guenter. “One in 25 Americans will develop prostate cancer and that number increases to one in five if you have family history. Just like you perform maintenance checks on your car, your body is even more important.”
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A recent Cleveland Clinic survey revealed some of the reasons why men don’t visit the physician regularly. Some men just don’t like talking about their health, the survey found — even when they do see a doctor. One in five admitted they haven’t been completely honest with their physicians. Common reasons included embarrassment or discomfort with discussing certain issues and not wanting to be told that they should change. “Men in particular often do not want to see their doctors. They neglect themselves,” said Guenter. “Also, men don’t like to ask for help. It’s the old adage of ‘I don’t need to stop for directions, I know where I am going.’ But the truth is we don’t always know where we are going and we could use some guidance. If you have plumbing issues and you don’t know how to fix it you hire a plumber. There is no shame in that, so there should be no shame in consulting with a doctor.”
4.HEART DISEASE
Although heart disease is the leading killer of both men and women, almost twice as many males die of conditions that affect the car-
to 68 per 1,000 at ages 85-94. The average age of a person having a first heart attack is 65.8 for men and 70.4 for women, according to the American Heart Association. Risk factors for heart disease include increasing age, male sex, family history and race, smoking, high blood cholesterol, high blood pressure, physical inactivity, obesity and overweight, and diabetes. “When your heart is not healthy, you are less functional and not living life at full capacity,” said Guenter.
5.ERECTILE DYSFUNCTION
Guenter said there was a misconception when the erectile dysfunction drug Viagra came out. For a short time, men’s health cost tripled. Many wondered if it was associated with men deciding to buy the pills once the new drug became available. “What we found out is that not only is erectile dysfunction common but it has a physical, not emotional component. Men who have developed ED often have a lot of issues such as diabetes, smoking, obesity, high cholesterol and high blood pressure. It is an underlying condition and all of a sudden men were going to their physician to request a pill and finding out they had other health ailments,” said Guenter. “I also tell
“Men don’t like to ask for help. It’s the old adage of ‘I don’t need to stop for directions, I know where I am going.’ But the truth is we don’t always know where we are going and we could use some guidance.” diovascular system. According to the CDC, one in four men has some form of heart disease. Average annual rates of the first heart disease complication rise from seven per 1,000 men at ages 35-44
my patients it may feel embarrassing but don’t be afraid to talk to your doctor about these sensitive subjects and don’t be embarrassed to ever seek out medical attention.”
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launched was to develop the opioid treatment program in Oswego, which provides medication-assisted treatment for people with opioid-use disorder. There was a significant need for that with the level of overdoses and people that were struggling with addiction to opioids. We started that in 2017 out of our Oswego clinic. That clinic now serves around 260 patients. And we just opened another opioid treatment program location in our Mexico clinic. We’re starting to work to open in Auburn by the end of the year. Opioid treatment programming has been a big focus for us. Peer support services is another area we’ve really grown. We started with one certified recovery peer advocate in 2016. We now have eight that provide recovery supports all across Oswego County.
Q A &
with Eric Bresee
Director of Farnham Family Services in Oswego discusses his agency’s mission, how COVID-19 made situation of substance abuse disorder worse and how he measures the success of his organization By Mary Beth Roach Q: Can you briefly describe the work of Farnham Family Services? A: It is an organization that works to prevent and treat substance abuse disorder. We do that through various community and school-based prevention programs; comprehensive outpatient treatment; recovery support services — this includes peer support and vocation education — and harm reduction approaches to recovery. Q: How many clients do you serve? A: There are currently approximately 700 individuals admitted to our outpatient clinics. Q: What is your service area? A: Currently Oswego County, but we’re also working towards the development of an opioid treatment program in Auburn.
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Q: How many staff members do you oversee? A: 90. Q: How big is your budget and how are you funded? A: It’s about an $8 million-ayear budget, primarily funded by federal, state and local grants, as well as insurance billing for outpatient treatment services. Q: You came in as executive director in 2015. What programs have you implemented at Farnham that you are most proud of? A: When I started, it was November 2015. Farnham, at that time, had 20 employees and about a $1.8 million budget. That was the time when the opioid epidemic was really starting to surge in our community. One of the first initiatives that we
Q: In the six or seven years that you have served as executive director, has there been an increase in addiction, and if so, what do you think is causing that increase? A: I can comment on coming through the pandemic, there was a lot of isolation for folks. If you had a family that had any sort of trouble, whether it be abuse, or domestic violence, or even something simple like challenging communication— just different challenging family dynamics — we’re going to put that family dysfunction in a pressure cooker over COVID, where we’ve got everyone in the house, packed away together, more disconnected from typical support systems, normal routines. I think that ended up driving a lot of substance use disorder and mental health conditions, like anxiety, depression. What we’ve seen is a surge in people coming for alcohol-use disorders. Opioid-use disorder has been the primary substance treated at Farnham since I’ve been there. Opioid-use disorder in 2014 was about 35% of the primary substance served. By 2018 that grew to 59%, so almost 60% of the people we were seeing were for opioid-use disorder. Alcohol-use disorder had dropped to 19%. There’s been a surge in the last couple of years where alcohol-use disorder is now up to 35% and opioid-use disorder has dropped to 41%. Q: Have there been changes on the state or national level that have been enabled you and your staff to better serve your clients perhaps? A: In recent years, I think there’s been a recognition in coming through COVID of the significant level of need. You probably saw some of the articles coming out about the record level of overdoses that we’ve had nationwide for 2019 and continued into 2020. With that recognition of need has come more funding. We’ve been the fortunate recipient of a
good amount of that money. That’s really allowed us to do the expansions I was speaking to with opioid treatment programs, increasing the amount of peer supports, and our prevention services. Q: In an article a few months ago, you mentioned that you’re seeing a shift in your clients and that more people are coming in on their own as opposed to being court-ordered. Do you see this as a continuing trend? A: I do see it as a continuing trend. We see a lot more people coming in and saying, ‘I need some help.’ Medication-assisted treatment is a lot more prevalent and available now. And that’s particularly helpful if you are struggling with opioid addiction. Q: Is there a take-away from that — in that more people are recognizing on their own that they need help? A: I hope so. I hope we’re continuing to reduce the stigma associated with substance-use disorder. It’s a medical condition. We’ve really got to continue to work to defeat the shame that’s associated with it, and really continue to encourage people that if they need help or their struggling in any way, to come in and get help. We also provide services to loved ones of people with substance use disorders. If you have someone in your life that’s struggling with addiction, and it’s impacting you negatively, that makes you eligible for outpatient therapeutic services at Farnham. Q: How do you measure the success of your programming? A: We’re helping people to get healthier. Folks are coming out feeling better than they did coming in, if they’re achieving more of their goals, they’re happier, they’re healthier. That’s on the treatment side. On the prevention side, I look at — are we helping kids make better choices, have better self-esteem; are those pro-social factors becoming more prevalent in the young people we’re trying to help? Do they have better refusal skills? Do they have good connections with parents, teachers, other adult role models? Those are the sorts of things that we try to infuse on the prevention side in order to keep young people from using, delaying the onset of use, and hopefully avoiding any sort of addiction or substance-use disorder down the road. Anyone looking for help or more information can call the area resource center at 315-413-4676 or go to NYproblemgambling.org or nyproblemgamblinghelp.org. Under the “Find Help” tab is a map of New York state. Select your region and see the different ways to contact a resource center and other helpful information.
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BACK TO SCHOOL
Are Schools Safe? Nineteen children and two teachers were killed in a shooting at Robb Elementary School in Uvalde, Texas. As kids gear up to return to our local schools, how safe are they?
By Deborah Jeanne Sergeant
W
ith school shootings dominating the news, it can seem like the school grounds are not the safest place for children. How can parents feel that their children will be safe if an active shooter situation arises? And how can they reassure their children? For school district administrators, it is not about a knee-jerk reaction to specific events but continuing to improve safety measures, according to John Nobrega, vice president of Blackhawk Training Academy in Syracuse. His firm places security officers and equipment in school districts. This can include cameras with closed-circuit TVs, automatic door locks on buildings and locks on classrooms. “We’re moving towards arming our guards in school districts because of the way things are,” Nobrega said. “A lot of schools have armed security or are moving towards it. It’s important to make sure the students and staff are secure and not in a vulnerable position.” He added that arming security guards who are trained in handling weapons in these scenarios can pro-
vide a timelier, life-saving response in case of an active shooter situation. Oftentimes, this can mean hiring retired or current law enforcement officers. Nobrega uses the Active Shooter program, which trains personnel for that kind of scenario, so they have a greater chance of survival. Nobrega said that it can take five to 10 minutes for law enforcement back-up to arrive on the scene. “Now, the first officer on the scene moves forward to take out the intruder, not waiting for back-up,” he said. “By waiting, a lot of damage could happen. The first on-site enter the building and looks for the shooter and tries to take them out.” He cited policies such as one point of entry during the school day and not propping doors open help keep schools safer. “That’s something a person can use to gain entry,” Nobrega said. “These shooters study the school before they make their decision. Usually, they have some type of connection to the school, but not always. Sometimes it’s based on race or other things.” Ramped up security measures may cause children to think that violence is likely at their school. This
can contribute to worrying not about if but when an active shooter situation will happen. Exposing children to too much news on active shooting incidences can contribute to this misperception. “Limit that media exposure. That constant sense of fight-or-flight mode is from seeing it 24/7,” said Jennifer Meyers, master’s in school psychology and national certified as a school psychologist. She’s practiced for 20 years in Phoenix Central Schools. She is also a CNY representative for the New York Association of School Psychologists. Too much news can make children feel “like they’re in immediate, constant danger. It’s not healthy. Remind them that adults are here to keep them safe. That’s why we do safety drills and fire drills It’s to keep you safe. It’s that continual reassurance,” she said. Parents should also monitor their own responses to current events. Obsessing over current events will only make children think that school violence is likely to happen at their school. “They need reassurance that school is safe, in addition to modeling for how to appropriately express
their feelings,” said Sara Dool, school psychologist at a Liverpool-based school and a CNY representative for the New York Association of School Psychologists. Listening to the children’s concerns can also help them work through feelings of anxiety about returning to school. “Parents can help their children feel safer about returning to school by providing them the time and space to express their feelings, as well as to have their feelings validated,” Dool said. “Children need to understand that feeling upset about current events is natural and OK. Making the time to talk and keeping information developmentally appropriate is key. Many children will want to talk, while others may want to do something else as an outlet, such as drawing. Parents may also want to review safety procedures for home and school and provide concrete examples.” For example, families wear seatbelts and schools practice fire drills, but car crashes and school fires are rare.
About 1 in 7 U.S. Kindergarten Kids Now Obese
D
espite reports that rates of childhood obesity are decreasing, kids seem to be packing on pounds at younger ages. In 1998, just under 73% of children entering kindergarten in 1998 had a normal body mass index (BMI), while 15.1% were overweight, and 12% were obese. However, fast forward 12 years and just 69% of kids started kindergarten at a normal BMI, a new study finds. And while the percentage of kids entering kindergarten who were overweight in 2010 didn’t change from 1998, the percentage who were obese jumped to 15.3%, the study showed. That’s about one in every seven kids.
“We were hoping we would see a decrease in the incidence of obesity,” said study author Solveig Argeseanu Cunningham, an associate professor of global health and epidemiology at Emory University in Atlanta. “We were negatively surprised to find that this newer [group] of kids was experiencing obesity even younger and reaching higher levels of obesity than they were 12 years ago.” The new findings suggest that efforts aimed at getting kids to move more and make healthier food choices aren’t working as well as hoped, she said. For the study, the researchers compared rates of obesity in kids from kindergarten through fifth grade during two time frames: 1998 to 2004, and 2010 to 2016. August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 19
BACK TO SCHOOL
Long, Regular Sleep Key to Kindergarten Success
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ong, restful and — most importantly — regular sleep is key to helping kindergarteners adjust to school, and a new study urges parents to start forming good sleep habits a full year ahead of time. Researchers found that kids who regularly got 10 hours of sleep or more before beginning kindergarten reaped big benefits. These children were more engaged learners and had better social and emotional skills than drowsier classmates, the study found. They also had better executive functioning, meaning they were more focused, able to remember instructions and juggle multiple tasks effectively, and their academic outcomes were also better.
ADDICTION
Experts: marijuana especially dangerous for teens, young adults By Deborah Jeanne Sergeant
S The finding that sleep regularity in the year before kindergarten was so important was a surprise, said lead author Douglas Teti, a professor of human development and family studies at Pennsylvania State University, in University Park, Pennsylvania. “It was the regularity of 10-plus hours of sleep before kindergarten began that was especially predictive,” Teti said. “What that tells me is that if we’re going to be intervening and working with families with kindergarten children who have sleep problems, we really need to be starting significantly before kindergarten begins.” Sleep is a bodily process as important as healthy eating and exercise, Teti said. People who get better sleep tend to do a better job of regulating their emotions and behavior, are more organized and function better. The new study included 221 families. For seven days at a time, children wore wrist devices to clock their sleep at four points during the year: July and August (pre-K); late September (early K); late November (mid-K); and mid to late April (late-K). The researchers also got feedback from teachers and had observer assessments. “We looked at the transition across the entire kindergarten year, which very few people have done,” Teti said. The findings were published online July 11 in the journal Pediatrics.
ince New York’s legalization of recreational marijuana use, its perception as a safe substance has grown. Teens and young adults should realize their increased risks before using it for recreation or to self-medicate for health or mental health issues. “As cannabis use becomes increasingly legal and accessible, it is important to be aware of the risk factors for youth and adolescent cannabis use,” said Mary DiGiovanna, licensed mental health counselor and national certified counselor and director of the Child & Adolescent Clinic at Helio Health in Syracuse. “Our brains continue to grow and develop until our mid to late 20s, meaning that any substance use during adolescence and emerging adulthood ages has implications for social, academic, and occupational functioning due to impairment in thinking, problem solving, attention span, coordination, and social skills.” Just as with alcohol, it is illegal to drive while affected by marijuana. DiGiovanna also said that using marijuana often leads to using “harder” drugs, as the user does not perceive any harm from cannabis and desires to experiment further. Although the teen years are about pushing boundaries and experimentation, trying marijuana just one time is not a good idea. It is not legal for anyone under 21. Marijuana purchased as street drugs “can be altered with very dangerous or toxic chemical additives,” DiGiovanna said. “By and large people think of marijuana as a harmless plant, unaffected by chemical manufacturing that other illicit substances undergo. Unfortunately, this is not always the case, such as with the ‘spice’ or ‘spike’ product. Within the last month, Onondaga County saw an increase in spike overdoses, related
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to having fentanyl or opioid in the substance.” Although teens would likely turn down sushi handed to them by a sketchy looking stranger on a street corner, they are willing to try marijuana from an unknown source because a friend hands it to them. Some adults tell teens that it’s OK to experiment with marijuana vape pens since they used hookahs as teens. However, the percent of psychoactive THC in vape devices used for marijuana could be 70% to 80%, versus marijuana bought on the street, which could be 12%. Most people know about marijuana’s hallucinogenic effects. They may not realize that marijuana use can cause long-term changes to the brain. While low-dose marijuana can be prescribed for therapeutic use, taking it at higher levels or without the guidance of a healthcare professional invites disastrous results. “Whenever you add a psychoactive substance to the brain, it interferes with its development,” said Kristin Botwinick, licensed clinical social worker and clinical director of Professional Counseling Services in Camillus. “Use of marijuana products at that young age can drastically increase the chances of psychosis and severe mental illness. Contrary to what some popular myths are, it can worsen anxiety and depression and it also interferes with prescribed medications.” Additional research has correlated marijuana use with impairment of cognitive function, memory and motivation. The effects are user-specific, but can be worse for users younger than 15, who have an 11-times greater risk of developing schizophrenia, a chronic lifelong brain disease. Young users can also experience an increased risk of psychotic illness in their 20s. Youth of any age with a first-degree relative with bipolar disorder, anxiety or depression have a much greater risk for developing these with marijuana use. Other raised risks include lifelong lower emotional function,
lower cognitive processing, reduced language development, attention deficits and IQ drop of up to eight points. While most of the youth who try marijuana will not develop a substance use disorder or psychosis, the devastating effects for those who do makes it not worth trying. Botwinick encourages parents to talk with their children about marijuana risks and to avoid glorifying their own youthful drug experimentation. Instead, answer any questions honestly and warn teens that the marijuana of a generation ago was far different. “For a long while now, it’s been ‘Do as I say, not as I did,’” she said. Instead, she wants parents to share that they did not realize that they could have fun in other ways than experimenting with drugs and that they were lucky they did not experience greater harm. Talking about past drug use as if it were the “good old days” confuses teens and is inappropriate. Setting boundaries with clear consequences can help teens feel secure that you care about their health and safety. Both parents should agree on their stance on drug use and share their agreement with their children. Leading by example can help discourage drug use. “Kids model what they see,” Botwinick said. “If they see parents drinking alcohol or vaping on their off time, that lends itself to thinking, ‘This is how I relax.’ Model healthy choices.” Turning to physical activity, sports and engaging hobbies can help teens find healthful ways to mitigate stress and feel self-confident. Parents should also help them seek treatment for any mental health issues, so they are less likely to try self-medicating with marijuana. Knowing their children’s friends and where they are after school and in the evening can also give parents insights as to their children’s likelihood of trying drugs.
School Children Face Anxiety This Year By Deborah Jeanne Sergeant
P
andemic adjustments, economic difficulties, school violence, racial tension: a lot of big issues have caused some major upheavals in the lives of American families. The stress from these challenges affects children’s mental health. As they return to school, that additional stressor may cause some to manifest mental health issues. “Data and anecdotal reports continue to highlight the mental health crisis among America’s youth,” said Monique M. Winnett, psychologist and licensed clinical psychologist at St. Joseph’s Health. “A notable decline in youth mental health was evident prior to the COVID-19 pandemic and related changes and concerns have exacerbated preexisting trends.” Although the decrease COVID-related restrictions should continue to promote a more normal school experience, Winnett does not see youth mental health concerns dissipating soon. She continues to see rates of depression and anxiety higher than pre-pandemic levels. “Decreased socialization and increased use of electronics has likely contributed to this trend,” she said. “In addition, the acuity of symptoms appear escalated, as are rates of youth suicide.” The stress within their home has also affected youth, as families feel concern about their income, work, housing and relationships. Winnett added that spikes in parental mental health issues “impact a youth’s behavior, mood and performance when in school.” She also said that youth have reported increased rates of racism and bullying. “Of note, LGBTQ youth are significantly more likely to experience behavioral health symptoms than youth who identify as heterosexual,” Winnett said. “Trends of increased fighting and violence within schools continue to be troublesome. Feeling unsafe at school, including fears of gun violence due to ongoing school shootings, prove distracting and increase anxiety.” Current events can cause anxiety about returning to school. Fearing violence, bullying, or becoming ill from COVID-19 can cause some children to not want to attend school. “Maintain a calm, supportive environment at school and home,” said Jennifer Meyers, who holds a master’s degree in school psychology and is nationally certified as a school psychologist. “When adults validate and co-regulate, it helps. Limit media exposure, because 24-hour news doesn’t allow your minds to rest. Children need to feel safe.” Meyers has practiced school psychology for 20 years in Phoenix Central Schools and is a CNY representative of the New York Association of School Psychologists. It may seem like knowing all about a topic would help children feel safer. However, the opposite can happen. While sensible caution is
warranted, children should not have so much information that they obsess over what could happen. Meyers said that keeping kids connected can help them feel more secure. Socializing both with peers and adults “helps them build the skills they haven’t developed. Take them to playgrounds and parks. Get them involved in peer activities. This supports a culture of connection.” It also helps for children to feel a sense of predictability with a printed schedule. Consistent bedtimes, mealtimes and other home routines help children know at least in part what to expect. Meyers also recommends children have sufficient down time for craft, free play, creativity, going outdoors and pleasure reading, which can help mitigate stress. Shelagh Thompson, mental health counselor with Oswego Health, encourages parents to both talk with children and listen to their concerns. “Kids will tell you a lot if you listen to what they are telling you and you validate their feelings,” she said. “Listen to what they’re saying and respond in a sense that they know you support them.” As a parent, it is easy to slip into the “fix-it” mode or become judgmental and forget that sometimes children just want to vent and feel understood. Simply listening can help children feel validated and that their parents care about them. “They know you will be there to support them,” Thompson said. “It will help them come to you when serious stuff is happening.” Oftentimes, children open up about their concerns while occupied with something else, such as a car ride, while performing household chores or during dinner. Trying to purposefully schedule time to only talk will likely backfire with tweens and teens. “Don’t judge them when they tell you stuff, even if it’s cringey,” Thompson said. “The more you listen and don’t necessarily add your two cents, the more they’ll tell you.” She wants parents to realize that the massive changes taking place in the past two years has been a difficult adjustment for children and teens. It may take more time to feel safe in school and not anxious about the future, socializing and friendships. “It’s not something that can change overnight,” Thompson said. “Hopefully, as a sense of normality returns, kids will adapt as they are resilient and can adjust to their circumstance.”
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www.ariseinc.org August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 21
BACK TO SCHOOL
FIVE ISSUES KIDS FACE TODAY
NOT JUST A JOB
A VALUED CAREER
By Deborah Jeanne Sergeant
W
hile returning to school in the fall should be a time of excitement for children, it can present issues that cause stress. These include:
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Page 22 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
1. FALLING BEHIND ACADEMICALLY Missing a few months of school in 2021 and attending hybrid school for part of the past school year means many students have acquired gaps in their education. This can be deeply troubling for students who have worked hard to earn good grades. ➜ WORK AROUND: “This past year has been readjusting to being back into a school setting for a lot of kids,” said Shelagh Thompson, In Good Health mental health counselor with Oswego Health. “I feel that as time goes 13.75"H) on, (4.79"W they’reXgoing to be continuing to adjust to being in school for six to seven hours a day, a teacher in charge of the classroom and having that their school day spent with the teachers. Online learning is a whole other platform of learning that most of these children had not experienced except for COVID. They’re adjusting to that and then going back to being in class.” 2. SCHOOL VIOLENCE With school shooting frequently in the news, it is little wonder some children may feel unsafe about returning to school. “Safety is a big issue for kids,” Thompson said. “Unfortunately, this year with what happened in Texas, that question of safety comes to a lot of kids’ minds. Am I safe to be in school? Who will protect me? I feel that the school districts have tried to rally around and find solutions to reassure kids that they’re safe.” ➜ WORK AROUND: She advises parents to limit exposure to media and assure them that their school administration is working to make their school as safe as possible. 3. CYBERBULLYING Cyberbullying is especially injurious because the taunting can go far beyond the schoolyard. In mere moments, anyone can see a hurtful photo, video or comment and it can remain online indefinitely. School officials have little control over what students do off-campus and social media provides bullies with the perfect platform to instill fear and to dominate others. Shifting learning to online during the pandemic only made the issue worse. “I’ve seen with my caseload and with my own children, the level of cyber bullying increase,” Thompson said. “Kids had that protection of not having to see a bully for a year and a half. Now they’re into a setting with peers. Cyberbullying spills over into school.”
➜ WORK AROUND: Limiting online interactions and teaching children to report their concerns can help curtail the problem. Parents should also instruct their children to never say anything hurtful about others—even in jest—online or in-person. 4. VAPING While use of cigarettes has decreased among youth, using vape devices such as Juul has skyrocketed. The FDA and CDC state in their 2021 Annual National Youth Tobacco Survey that more than two million US middle and high school students said they used e-cigarettes, accounting for 7.6% of that demographic. ➜ WORK AROUND: Kristin Botwinick, licensed clinical social worker and clinical director of Professional Counseling Services in Camillus, wants parents to learn about the dangers of vaping. “Be very aware that as popular as vaping has become and although it doesn’t have the stigma of cigarette smoking, it’s proving far more dangerous for cardiopulmonary health,” she said. Breathing water vapor seems harmless. However, the liquid refill pods use chemical flavoring agents and most of them contain nicotine. Ninety-five percent of all refill pods come from China. These goods lack the rigorous level of scrutiny for product safety compared with products manufactured elsewhere. In late June, the FDA denied market authorization for Juul products for sale in the US. However, consumers may still possess and use them, and other e-cigarette brands remain unaffected. 5. MENTAL HEALTH ISSUES With all the typical and non-typical challenges facing children going back to school this year, parents should reach out to their school’s mental health support if their children are not returning to their baseline mental health after a few weeks. ➜ WORK AROUND: “Families are reaching out for help more than ever,” said Jennifer Meyers, master’s in school psychology and nationally certified as a school psychologist. Meyers has been practicing 20 years in Phoenix Central Schools and is CNY representative of the New York Association of School Psychologists. She counts the reduced stigma surrounding mental healthcare as one positive outcome of the pandemic. “Reach out if your child needs help,” she added. “These resources are available. The ongoing need for mental health staff at school is the most important it’s ever been.” Parents may notice behavioral changes, lower grades and children withdrawing from activities they used to enjoy, social activities with peers and family activities.
Parenting By Melissa Stefanec MelissaStefanec@yahoo.com
W
Things I Will Never Make My Children Do
hen you’re raising children, you’re bound to learn some universal truths. One of those truths is: you can’t make another human being do something. No matter how much you want or need someone else to do something, you can’t make them. Humans are blessed with free will, and no human, even a parent, can trump that will. When my kids were very young, I quickly discovered children are no exception. I couldn’t force my kids to do things. Instead, I had to motivate, coach and convince them. I had to learn how to use my own actions, praise, love and consequences to drive the behaviors I wanted my children to exhibit. When you’re raising children, you also learn a parent is a child’s greatest influencer. I may not be able to make my kids do things, but I hold a lot of power over them. This great responsibility has led me to a lot of introspection. That introspection has led me to questions like: What behaviors
should I never squander my power on? What battles aren’t worth fighting? What age-old wisdom and common practices are patently wrong? What should one human never “make” another human do? After more than a decade of introspection, here is a list of those things. • Finish everything on their plates There is a fine line between being wasteful and gorging oneself. Although I offer my children small amounts of new foods, I never make them eat these foods. Force feeding my kids isn’t going to make them like that food. Instead of forcing my kids to overeat, I talk to them about the implications of food waste. I also withhold dessert if they don’t finish their food. • Swear allegiance to a religion I know this is a touchy subject. I know plenty of amazing parents who indoctrinate their children in a faith. I’m not here to fault people for that. Personally, I believe faith and spirituality are far too important and beautiful things to force another
person into. I talk to my kids about a lot of different faiths and belief systems and invite them to explore these systems for themselves. • Be nice to someone who is being unkind to them There is a difference between being respectful and being a doormat. I teach my children to use kind words and actions as ammo against mean people. If that doesn’t work, I teach them to walk away. If their interrogator follows and persists, I have taught my kids to breathe fire. • Kiss or a hug someone Affection is earned. It’s not a guarantee. People don’t owe it to each other. We should have jurisdiction over our own bodies. If I make my kids kiss or hug (or accept kisses or hugs) when they don’t want to, what am I teaching them? It’s never OK to force yourself on another human or have another human force themselves on you. Age shouldn’t be a factor. • Say “I love you” to someone “I love you” is one of the most beautiful gifts we can give each other. Saying it should be special and heartfelt. Most importantly, it should be sincere. Forcing someone to say “I love you” teaches a child the opposite. My children say “I love you” because they feel it. • Act, behave or dress a certain way because of their sex I was a tomboy. I’ve always liked traditional boy things as much as (or more than) girly things. Throughout my life, people made me feel bad for that. I can tell you it did zero good. It only hurt me. People should be comfortable being themselves. I am teaching my children the value of authenticity and self-love.
• Ignore their fear In present-day society, fearmongers have given the emotion a bad name. However, at its core, fear is a valuable emotion. It’s trying to tell us something. It’s trying to warn us. I teach my children to respect fear. Fear is a great protector. I teach my children to listen to their gut instincts. • Lie or shrug off being hurt I don’t teach my children to swallow their pain. Whether that pain is physical or emotional, it’s real. As an adult, I would feel so much shame if people told me I was a whiner when I was hurting. I don’t teach my kids to get over things. I teach them to embrace and work through difficulties and pain. • Match their clothes Matching is so overrated. If we aren’t going to a special occasion or posing for family pictures, I let my kids think tie-dye bottoms match tie-dye tops. My son has been known to sport a pair of camo shorts and a Hawaiian button-down shirt. They have their whole adult lives to worry about fashion. • Read only certain kinds of books My kids read all kinds of books. From comic books, to graphic novels, to childhood soap operas, to nonfiction, to children’s stories, to serious novels, my kids dabble in it all. They are reading and enjoying books. That’s all that matters. • Act like other children I do not compare my children to other children, especially when I am frustrated with them. Comparing them to other children does one thing; it makes them feel ashamed. As a parent, I aim for introspection, not shame. Shame does bad things to a human’s psyche.
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August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 23
Medical Career
Health Career: Respiratory Therapist By Deborah Jeanne Sergeant
W
ith only an associate degree, a licensed respiratory therapist can make an annual mean wage of $71,010 in the Syracuse area. The career is ranked at sixth in the US News & World Reports’ Top Health Care Jobs. The US Department of Labor states that by 2029, they expect a 19%-plus increase in demand for respiratory therapists. These professionals take care of patients of all ages who have breathing difficulties. This can include assessing, treating and supervising respiratory therapy technicians in in-patient and outpatient settings. Stephen G. Smith, respiratory therapist and past chairman and extended member of the New York State Education Department Respiratory Therapy Licensure Board, said that 74% of respiratory therapists work in hospitals. That is because it is not covered by Medicare or health insurance, making it a costly service for doctor’s offices to provide. Large healthcare systems can more easily absorb the expense. “One of our concerns is that they need to work in inpatient and outpatient settings,” he said. He is working to require a bachelor’s degree for the profession.
However, that can only help respiratory therapists gain employment because it will open the way for health insurance companies to cover their services. Medicare requires a bachelor’s degree as a minimum for this type of provider to be covered and typically, health insurers follow Medicare’s lead on what’s covered. “What would happen is those practicing now would be grandfathered in,” Smith said. “Once the bill became law, those in school, whether associate degree or bachelor’s, would require a Bachelor of Science in respiratory therapy to practice.” Then, the person needs to pass a licensure exam to practice.
The role has room to grow with positions in supervision and management, positions in academia for those willing to achieve the necessary experience and, as needed, further education. In addition to these roles, Smith has also operated his own durable medical equipment business that specialized in chronic pediatric cardiopulmonary cases. “You have to be strong in math and the sciences,” Smith said. “You have to have good interpersonal skills and be able to talk with people and educate people with cardiopulmonary diseases and their families. That’s a big responsibility.” For Taylor Iannuzzo, registered respiratory therapist at Crouse Hospital, becoming a respiratory therapist seven years ago fulfilled her lifelong dream of working in healthcare. She likes the age range—preterm babies through geriatric adults—and the variety. “There’s something different every day,” Iannuzzo said. “Yesterday, I was working in the NICU. I went from helping with an intubation with an infant to a cardiac arrest in the ER.” Every three years, respiratory therapists must renew their licenses and show proof of sufficient continuing education credits. They can also specialize in credentials like adult care or NICU care to further their skills. “I like building the relationships with our patients,” Iannuzzo said. “There are a lot of patients we see
frequently. You start to build relationships with them. Every time they come in, you know what they need to get them better and out of the hospital.” She listed the desire to work hard, compassion and the ability to quickly make decisions among the traits necessary for respiratory therapists. The work can also be challenging such as when “we don’t get the outcome we want,” Iannuzzo said. “But there are many good days where we’re part of a good team, celebrating successes with patients, which is very rewarding.” Adrienne Hickey, associate director for respiratory therapy at Upstate Respiratory, had not heard of respiratory therapy until her high school guidance counselor told her about it. She had a science-heavy career track and liked the idea of caring for people. She began working in the field in 2005 and started in her current role in 2020. “Math and science are helpful, but not necessary,” she said. “The problem solving needs to be there. Respiratory therapy, unlike nursing, is equipment-driven. We use a lot of machines that help you with breathing. You don’t have to know every single piece of equipment but should know your equipment well.” Hickey likes the fact that respiratory therapists have so many options. Some respiratory therapists eventually work in equipment sales or, with additional training, in academia or managerial roles. “I love my job because it’s different every day,” she said. “I love the education, the equipment and love, love, love the people part. That’s the best part: the patients.”
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Hospice Program in Oswego County May Close Nursing shortage cited as main cause By Steve Yablonski
F
acing a dwindling supply of qualified nurses, Oswego County’s hospice program may not survive this year. In June, the Oswego County Legislature notified the state, that unless it was otherwise required to continue, it would end its hospice services at the end of 2022. The county has submitted to the state a closure plan, according to Legislator James Karasek, chairman of the county’s health committee. “It will be closed if we don’t find nurses,” he added. “We can’t find anyone who will even apply. This isn’t just a county problem. This is an issue across the country.” “It is what it is. We are working on wage restructure for a lot of issues. This is not a negative comment—I want to make it clear—you can’t pull a piece out of the union contract and say, ‘we are going to pay these people this much more, but we are not going to pay everybody that same increase.’ So nurses [who specialize in hospice care] are leaving our county and going to jobs where they are starting at $20 an hour more than what they make at the county,” Karasek said. Nurses all over are doing that, it’s not just in Oswego County, he pointed out.
Legislator James Karasek, chairman of Oswego County’s health committee. “[Hospice] will be closed if we don’t find nurses,” he says.
There are hospitals that are flush with grant monies, state money and they are able to pay these wages. And they just bill the insurance companies, he said. “We can’t do that,” he explained. The health department has too few hospice-trained nurses to ensure proper patient care and prevent burnout of the remaining nurses in the program. Using nurses from other areas is not an option as they lack the required training in hospice care and it would also result in shortages in other areas, he explained, adding,
that recruitment efforts have not been successful. “I happened to run into a former county nurse and I said, ‘I really miss you; you did a hell of a job.’ She wasn’t even a hospice nurse. She was in another program. She said, ‘Jim, they called me up and said they’d pay me 20 bucks more an hour to start.’ How are we going to compete against that? That’s what’s going on at DSS, also. Counties that have money—Onondaga County for example—they’ve got so much money that they put out a poll to ask people what they should spend it on. “We have had people who come to us, they get their training, they get their certificates to do their job and the next thing you know they are transferring to some county that’s paying them $5 more an hour than what we’re paying them,” Karasek said. Competition for nurses is intense nationwide. Better pay and benefits is an issue. “So now we are short-staffed and how do you fill it? We do have a task force that was just put together for looking at wages, and what can we do to help solve the problem? You know, short of raising the hell out of taxes,” he said. “The number of the program’s patients has been reduced, which negatively impacts revenue— revenue will not meet the cost of operation.” Currently, other county nurses are assisting with the five people in the hospice program. “We do not surrender those patients. We are open until they are gone and then we have what they call a grief counseling program; that goes on for like 12 months so we
have time. CNY Hospice is picking up our new patients right now. So there is a hospice program. Friends of Hospice, they are still around still functioning. They’re not going away. Everybody’s being served,” Karasek said. Hopefully, the county can find a way in this next year to find a way to recruit some nurses and save the county’s award-winning hospice program, he said, adding, “It’s one of the top programs of the country. It’s worth saving.”
Friends of Oswego County Hospice will continue Although a nursing shortage may force Oswego County Hospice to possibly discontinue operation, the Friends of Oswego County Hospice will continue to support hospice patients in the county, regardless of the future of OCH, Elena Twiss, executive director of FOCH said in June. “We are not closing, in spite of what may happen to the county program,” Twiss said. “Moving forward, the Friends of Oswego County Hospice is dedicated to helping enhance the time that Oswego County patients and their families have together by providing financial assistance and nonmedical support. We want the county hospice program to continue, but in the event that it is unable to, we—as a separate, independent, nonprofit organization— will continue to operate and assist patients in Oswego County through whatever organizations are providing services.” For additional information, visit www.friendsofhospice.org or call 315-343-5223.
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How to Sell Unwanted Burial Plots Dear Savvy Senior, How do I go about selling unwanted burial plots in my hometown cemetery? When my parents died about 25 years ago my husband (at the time) and I bought two plots near them in the same cemetery. But we’ve gotten divorced since then and have both moved out of state. Besides that, I would like to be cremated instead of buried. — Looking to Sell
Dear Looking, Life changes such as relocating, family disputes and divorce, along with the growing popularity of cremation in the U.S., is causing more and more people to sell previously purchased burial plots they don’t intend to use any longer. But depending on where you live and the location of the cemetery, selling a plot can be difficult. And, if you do sell it, you’ll probably get less than what you initially paid for it. Here’s are a few tips to get you started. • Contact the cemetery: Your first step in selling your unwanted burial plots is to contact the cemetery and find out if they would be interested in buying them back, or if you’re allowed to sell them yourself to another person or family. And if so, what paperwork will you need to complete the sale and is there a transfer fee? Some states require sellers to offer the plot back to the cemetery before selling it to others. • Selling options: If you find that it’s OK to sell your plots yourself, many people choose to use a broker. There are a number of companies — like PlotBrokers.com
and GraveSolutions.com — that will list your plots for sale and handle the transaction for a fee and possibly a commission. If you go this route, you’ll sign paperwork giving the broker permission to work on your behalf. Listings can last up to three years or until the plots sell. Alternatively, or simultaneously, you can also list them yourself on sites like The Cemetery Exchange, GraveSales.com along with eBay and Craigslist, and handle the transaction yourself. In the ad, be sure to post pictures, describe the area where the cemetery is located and give the plot locations. • What to ask: Appropriate pricing is key to selling your plots. It’s recommended that you find out what the cemetery is selling their plots for today and ask at least 20% less. If you’re pricing too close to what the cemetery charges, there’s no incentive for potential buyers. • Beware of scammers: If you choose to sell your plots yourself, it’s not unusual for scam artists to reach out and try to get your personal financial information. Phone calls tend to be more genuine than emails and text messages. • Donate them: If you don’t have any luck selling your plots, and if money isn’t an issue, you can donate them to charity such as a religious congregation, a local veteran’s group or an organization that aids the homeless. To get a tax deduction, you’ll need an appraisal, which a cemetery or broker may supply for a fee.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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The Use of Adaptive Recreational Technology for Seniors
Ask The Social
Security Office
Technology helps bridge the communication gap By Amy Feeney
R
ecreational therapy has many benefits for seniors. It can improve mood, self-esteem, social connections, cognitive function, physical health and more. With all the great benefits, it is no surprise that this recreational therapy is popular among long-term senior care facilities. Recreational therapy includes leisure activities such as sports, art, music, games, etc., repurposed for therapeutic purposes. But it can vary considerably based on the therapy participants and their ability level. In senior care, one consideration for recreation therapists is communication. No two residents are the same, but many deal with communication barriers that can stem from cognitive function, generation gaps and hearing deficits. Adaptive technology provides great tools to help bridge communication gaps among residents and recreational therapists. For example, therapists can tailor equipment and activities to individual memory care residents based on their past interests, and even more importantly, their current abilities. Therapists can also use technology in group settings to encourage engagement and interaction. The average age for a recreational therapist is around 45, while almost half of all people who live in a nursing home are 85 years or older. But therapists are able to leverage their familiarity with adaptive technology to connect with older generations. One example of recreational therapy technology is the iN2L or “It’s
From the Social Security District Office
Never Too Late” system. iN2L uses touch screens to bring customized content to senior care communities, including cognitive games, sensory experiences, guided physical activities, realistic reminiscing videos, music and more. After receiving a grant from M&T Bank, Loretto was able to implement the iN2L system throughout several facilities, including The Commons on St. Anthony, The Heritage, and Loretto Health & Rehabilitation. iN2L has completely changed the level of engagement that therapists can have with memory care residents. A favorite feature among many memory care residents is the music, which can help to spark a memory and improve moods. iN2L offers sing-alongs, music trivia, dancing and “name that singer.” Another feature shows catchy commercials and jingles from residents’ younger days. Not only might this spark a memory, but it can also spark a conversation or an interaction between older adults and therapists. Learn more about Loretto’s memory life communities and recreational therapy at https://lorettocny.org/ loretto-life/memory-care
Amy Feeney is the director of therapeutic recreation and volunteers at The Commons on St. Anthony, part of Loretto.
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Use ‘my Social Security’ to Instantly Check the Status of Your Benefits Claim
f you applied for Social Security benefits or have a pending reconsideration or hearing request, you can instantly check the status online using your personal “my Social Security” account. If you don’t have an account, you can create one at www. ssa.gov/myaccount to see the following information about your claim: • Date of filing. • Re-entry numbers for incomplete applications. • Current claim location.
Q&A
• Servicing office location. • Scheduled hearing date and time, if applicable. • Publications of interest, depending on the claim and current step in the process. Use your personal “my Social Security” account to instantly check the status of your application or appeal at www.ssa.gov/myaccount. If you have questions about retirement, disability, Medicare, or survivor’s benefits, as well as Supplemental Security Income, visit our webpage at www.ssa.gov/benefits.
Security number fraudulently, you should report it to the Federal Trade Commission (FTC) right away. You Q: What is the average Social Security can report it at www.idtheft.gov retirement payment that a person re- or you can call FTC’s hotline at 1-877-IDTHEFT (1-877-438-4261) TTY ceives each month? (1-866-653-4261). A: The average monthly Social Security benefit for a retired workQ: I served in the military, and I’ll reer in 2022 is $1,657. The average ceive a military pension when I retire. monthly Social Security benefit for a Will that affect my Social Security bendisabled worker in 2022 is $1,358. As efits? a reminder, eligibility for retirement A: You can get both Social Secubenefits still requires 40 credits (usurity retirement benefits and military ally about 10 years of work). retirement at the same time. GeneralQ: I am receiving Social Security retire- ly, we don’t reduce your Social Secument benefits and I recently went back rity benefits because of your military to work. Do I have to pay Social Securi- benefits. When you’re ready to apply for Social Security retirement benety (FICA) taxes on my income? fits, go to www.ssa.gov/applyonline. A: Yes. By law, your employer must withhold FICA taxes from your This is the fastest and easiest way to apply. For your convenience, you can paycheck. Although you are retired, always save your progress during you do receive credit for those new your application and complete it earnings. Each year Social Security later. We thank you for your military automatically credits the new earnservice! ings and, if your new earnings are higher than in any earlier year used Q: I applied for disability benefits, but to calculate your current benefit, was denied. I’d like to appeal. Can I do your monthly benefit could increase. For more information, visit www.ssa. it online? A: Yes. In fact, the best way to gov or call us at 1-800-772-1213 (TTY file a Social Security appeal is online. 1-800-325-0778). Our online appeal process is conveQ: A few years ago, I lost my Social Se- nient and secure. Just go to www.ssa. curity card. Now my credit report shows gov/disability/appeal to appeal the that someone might be using my Social decision. For people who don’t have Security number. I’m afraid they might access to the internet, you can call us at 1-800-772-1213 (TTY 1-800-325ruin my credit. What should I do? A: Identity theft and fraud are se- 0778) to schedule an appointment to visit your local Social Security office rious problems, not just for you, but for the financial integrity of our agen- to file your appeal. cy. It also puts our national security Q: How can I become a representaat risk if someone dangerous is using tive payee? your number to obtain other forms A: If you know someone who of identification. It’s against the law receives Social Security or Suppleto use someone else’s Social Security mental Security Income (SSI), and number, give false information when who needs assistance managing their applying for a number, or alter, buy payments, contact your local Social or sell Social Security cards. Keep in Security office about becoming their mind, you should never carry your representative payee. Go to www.ssa. Social Security card with you. If you gov/payee for more information. think someone is using your Social
Health News Two Crouse employees receive award
T
wo Crouse Health employees have recently received the Joan Fernbach Kingson Award. • Bridget Busia, a nursing assistant at the 6 S. Irving Ave. facility, was nominated for her mentorship, friendly disposition and strong sense of teamwork. Her nomination said: “Bridget joined the unit in 2021, when the nursing assistant team was undergoing a lot of change. She jumped in with both feet and took on the job of rebuilding the unit. She brought her sister-in-law on board and other former coworkers whom she respected and admired. Bridget become the main orientor on the unit and she embraced the role.” “Bridget is always upbeat and friendly,” the nomination read. “She goes above and beyond each day to ensure her patients are respected, comforted, well cared for and strives to put a smile on their face.” • Ryan Courtright, a physical therapy assistant, was nominated for his actions with a particular patient who was not dealing well with a new
diagnosis of Crohn’s disease. The nomination read: “The patient was very resistant to our staff’s attempts to help him. The only person who was able to make a connection was Ryan. Recognizing this, Ryan would spend extra time at his physical therapy sessions working with him; hours over the course of the hospitalization. Even when not assigned to this patient, Ryan took the time to provide continuity of care. Many times, the patient would comment on looking forward to seeing Ryan.” The nomination remarked on Ryan’s overall friendly and caring disposition not only to patients but to his co-workers as well. The Joan Fernbach Kingson Award was established to recognize service or technical workers like Bridget and Ryan, whose special interactions with patients and families give vivid expression to the values of care which Kingson was committed to in her work with children and families. Those values include treating
The Center for Wound Healing at Oswego Health earns national recognition
P
hysicians, leaders and clinicians gathered to recognize The Center for Wound Healing at Oswego Health for receiving two national awards by Healogics, the nation’s largest provider of advanced wound care services. The Center for Wound Healing at Oswego Health is a recipient of the Center of Distinction award and the Robert A. Warriner III, M.D., Clinical Excellence Award. The Center of Distinction award is given to centers that achieved outstanding clinical outcomes for twelve consecutive months, includ-
ing a patient satisfaction rate higher than 92%. In addition, The Center for Wound Healing scored in the top 10% of eligible Healogics Wound Care Centers on the clinical excellence measure, which is the Compre-
Bridget Busia
Ryan Courtright each patient as an individual; respecting the social, emotional, intellectual, spiritual and physical needs of others, and welcoming families, especially the young, into the caring process. hensive Healing Rate weighted by wound mix. The center was awarded this prestigious honor named after Dr. Robert A. Warriner III, a pioneer in wound care and the former chief medical officer for Healogics. “I am so proud of the team here at the center. Receiving these two prestigious awards is a true testament to their dedication to their patients,” said medical director for The Center for Wound Healing at Oswego Health, physician Carlos Dator, Jr. The Center for Wound Healing at Oswego Health is a member of the Healogics network of over 600 Wound Care Centers and offers highly specialized wound care to patients suffering from diabetic foot ulcers, pressure ulcers, infections, and other chronic wounds which have not healed in a reasonable amount of time.
ConnextCare announces 2022 Kathy A. Ellis scholarship Winner
C
onnextCare recently announced the winner of its annual Kathy Ellis Scholarship. This year’s $500 scholarship winner is Carrie Kelley, a licensed practical nurse. The Kathy A. Ellis Scholarship is awarded annually to an individual entering a program or continuing education in the field of nursing. Kelley works at ConnextCare and is continuing her education to become a registered nurse through Excelsior College. In Kelley’s application she
outlines her goals of continuing her education in health care stating; “I plan to continue my education and hope one day to follow in Kathy Ellis’s footsteps and not only become a registered nurse, but eventually a clinical nurse practitioner committed to patient care and rural health care excellence.” Kathleen A. Ellis, was the first nurse practitioner in New York state. Ellis was well known locally for her passion and commitment to serving the rural population. She worked at Northern Oswego County Health
Scholarship winner Carrie Kelley holds the check surrounded by ConnextCare staff. Services, Inc. (NOCHSI), which is now ConnextCare, at the Pulaski location, and spent four years working at NOCHSI’s Mexico Health Center. The community mourned the loss of Ellis when she lost her battle with cancer and died in December of 1996 at the age of 52.
Onondaga Physical Therapy acquires Carey & Daley Physical Therapy
O
nondaga Physical Therapy recently announced the acquisition of Carey and Daley Physical Therapy. The acquired clinics are located at 8390 Oswego Road in Clay and 12010 E. Main St. in Wolcott. Onondaga Physical Therapy is a local familyowned and operated company that has five other locations: Fairmount, Baldwinsville, Cicero, Liverpool and DeWitt. The company is led by physical therapist Lauris Rigdon, founder and chief executive officer, who has crafted a company mission and developed core values to ensure patients will receive one-on-one personal attention. “You have a unique advantage when choosing Onondaga Physical Therapy and it is simple, delivering individualized one on one treatment so patient’s feel valued and get the attention they deserve to accomplish their goals,” Rigdon stated in a news release. The entire staff of the former Carey & Daley Physical Therapy have joined the Onondaga Physical Therapy team. They have committed to continuing to offer Clay and Wolcott area residents with pain relief from injuries, accidents, and everyday aches. Onondaga Physical Therapy offers traditional manual physical therapy, as well as multiple specialties, including rehabilitation for sport-specific rehab, workrelated injuries, gait & balance disorders, pre- and postoperative care as well as injury prevention and performance enhancement for all ages.
August 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 29
ONE NAME SAYS has IT ALL Adolescent Clinic Adolescent Psychiatry Adult PACU Adult Psychiatry Adult Surgery Advanced Practice Ambulatory Medicine Bariatrics Bone Marrow Transplant Breast Care Center Burn Care Cardio-Pulmonary Intensive Care Cardiovascular Cardiac Cath Lab Cardiac Step Down Case Management Children’s OR Children PACU Clinical Research Unit Dialysis Electrophysiology Lab Emergency Employee Health Endocrinology Endoscopy ENT Clinic Epilepsy Monitoring Family Birth Center Gamma Knife Geriatrics Golisano After Hours Golisano Center for Special Needs Heart Failure Hepato-Biliary Surgery Hyperbaric Inclusive Health Intensive Transitions Team Joslin Diabetes Center Medical ICU Medical/Surgical Medicine Neuro Intensive Care Neurology Neurosurgery Nursing Quality Nursing Research Oncology Oncology Surgery
One-Day Surgery/ Ambulatory Procedures Operating Room Ophthalmology Clinic Orthopedic Navigation Orthopedics Outpatient Cancer Center Outpatient Neurology Outpatient Operating Room Outpatient Pediatrics Pediatric Center for Development, Behavior and Genetics Pediatric Emergency Pediatric GI Pediatric Hem/Onc Pediatric ICU Pediatric Medicine Pediatric Nephrology Pediatric Peritoneal Dialysis Pediatric Primary Care Pediatric Pulmonary Pediatric Rheumatology and Integrative Medicine Pediatric Surgery Perinatal Center Physical Medicine and Rehabilitation Poison Control Pre-Admission Testing Procedural Float Pool Radiation Oncology Radiology Stroke Surgery Surgical Intensive Care Surgical-Trauma Intensive Care Telehealth Telemetry Thoracic Thoracic Surgery Throughput Transplant Trauma Triage and Transfer Urology Vascular Access Team Vascular Surgery Women’s Health Wound Care
MORE SPECIALTIES TO ADVANCE YOUR CAREER.
UPSTATE.EDU / NURSING Page 30 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2022
Health News Garrett Smith joins Upstate Urology of Auburn
president and CEO for Loretto Health & Rehabilitation. “She has contributed to a culture of trust and performance excellence benefiting employees, residents and family members.” Lyon has been a part of Loretto Health since joining in 2016 as a finance specialist. Her career path includes serving as operations manager for Loretto Skilled Nursing and Rehabilitation where she was responsible for daily operations to ensure patients and residents receive high quality care. In her current role, Lyon ensures oversight, follow-up and collaboration among directors and staff to provide appropriate and effective care and services. Lyon holds a Master of Science degree in healthcare administration from Utica College and is a licensed nursing home administrator. She earned her Bachelor of Science in biological sciences from Le Moyne College in 2012.
Urologist Garrett Smith has recently joined Upstate Urology of Auburn and Auburn Community Hospital. Smith attended Upstate Medical University, College Garrett Smith of Medicine in Syracuse, where he is a resident in urology and general surgery. Smith has trained under renowned urologist Gennady Bratslavsky, chairman of Upstate’s urology department and director of the prostate cancer program at Upstate. The urology residency program at Upstate Medical University is one of the finest urology organizations in the country with the goal of developing the highest possible level of clinical expertise. A hallmark of Upstate Medical’s program is its emphasis Haidy on research. This provides a distinct Marzouk, an advantage in both academic careers ear, nose and and private practice. throat physician, “Having been born and raised in has joined St. Central New York, it is a privilege Joseph’s Health for me provide care in a place so ENT Practice in close to home. I attended high school Fayetteville. in Camillus, went away for college Marzouk, a at Ursinus College near Philadelboard-certified phia, Pennsylvania, then returned to otolaryngologist, Syracuse for medical school followed has been treatby urologic surgical training at SUNY Haidy Marzouk ing the Syracuse Upstate Medical University. As a community for general urologist, I will welcome seven years. Prior to joining St. Joseeing any patient or problem, from seph’s Health, Marzouk saw patients urologic cancers to stone disease and at other hospitals based in Central BPH bladder outlet obstruction. It is New York. an honor to join the strong medical “I have had the honor of serving staff at Auburn Community Hospithe population of Central New York, tal,” Smith said. “We are thrilled to have Dr. Smith both young and old,” said Marzouk. join our practice. He has exceptional “Helping to make a difference in their lives through comprehensive ENT training from SUNY Upstate and we care, both medically and surgicallook forward to working with him,” said Ryan Sidebottom, an urologist at ly, has given me immense purpose and satisfaction in my career. I look Auburn Community Hospital. forward to continuing this career of service as part of the St. Joseph’s Health family.” “We are very excited to have Dr. Marzouk join our expanding ENT practice,” said Julianne Himes, Courtney chief executive officer of St. Joseph’s Lyon, adminisHealth Physicians. “Her experience trator for Loretto with a wide range of patients and Health & ReENT procedures will continue to habilitation, regrow and enhance our ENT services ceived the New at St. Joseph’s Health.” Administrator of Marzouk earned her medical the Year award degree from SUNY Downstate Colfor Central New lege of Medicine and her bachelor’s York from The degree from New York Institute of American ColTechnology. In 2018, Marzouk comlege of Health pleted a fellowship with the AmerCourtney Lyon Care Adminisican Academy of Otolaryngologic trators New York Chapter. Allergy where she gained advanced Lyon was promoted to administraining and education in the comtrator in 2020. After two of the most prehensive management of allergy challenging years in healthcare, she and inflammatory disease in head received the award in recognition of and neck surgery. her exceptional commitment as well A physician and an educator, as her demonstrated potential in the Marzouk has taught otolaryngology areas of administrative capability, at universities in New York state and leadership, innovation, creativity, is a faculty member at SUNY Upstate motivation, attitude and leadership. Medical Center. “Courtney is exactly the type of administrator and leader that our industry and our community need right now,” said Kim Townsend,
Long-time ENT doctor joins St. Joe’s
Courtney Lyon named administrator of the year for CNY
Living Like Loretta Starts with Loretto. As one of Central New York’s largest and most comprehensive continuing healthcare organizations, Loretto delivers personfirst, affordable adult care. Through our 19 specialized programs and communities, we empower each resident and patient to continue living their best life, Like Loretta. Want to live like Loretta?
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