IGH CNY #217 January 2018

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in good


Top Doc at St. Joe’s Joseph W. Spinale, a cardiologist with an MBA, is now the chief medical officer at St. Joe’s. He talks about the industry and his plans for the Syracuse hospital

How Bad is It in the Healthcare Industry?

Hospital Affiliations


January 2018 •  Issue 217

CNY’s Healthcare Newspaper

What to Eat This Winter How do we stay warm and happy, fit and healthy during the winter months?

• Three North Country hospitals sign clinical affiliation agreements with Crouse Health • Auburn Community Hospital, St. Joe’s and University of Rochester Medical Center announce collaboration agreement

Heard the Latest on Yoga?


Health Trends to Watch New Year’s Resolution

Off-beat ways to perform yoga — with goats, on horses, in the air — have become a huge trend, thanks, in part, to a new generation of yogis

Moving past the weight loss plateau. Local experts weigh in on the subject

Grapefruit Don’t look to the grapefruit to melt fat, but do look to this mouth-wateringly tart fruit for a host of other health benefits. See three reasons you should eat more of it


Who’s More Distracted Behind the Wheel? Men or Women? And what’s the most common source of distraction? You’ll be surprised. It’s not texting or talking on the phone.

Doctor-Patient Relationship

Patients React Poorly When Docs Say ‘No’


atients used to see doctors as kindly-but-firm professionals, experts who knew what they were talking about and whose advice should be heeded, even if it wasn’t necessarily welcome. But these days, people have become demanding health care consumers, and they don’t respond well when a doctor disagrees with them, a new study shows. The researchers found that two-thirds of patients arrive at their doctor’s office with a specific medical request already in mind — seeking a drug or a test or a referral. When their doctor turns down that request, they’re more likely to be offended and to trash the doctor on a patient satisfaction survey. Satisfaction scores plummet when doctors deny patients’ requests for nearly anything, but especially when patients have asked for a drug prescription or a referral, the study found. The problem for doctors is that their pay has become increasingly tied to their patient satisfaction scores, said the study’s lead research-

er, Anthony Jerant. He’s a professor of family and community medicine with the University of California, Davis School of Medicine. “A lot of physicians are tempted to just acquiesce and give them the pain medication or give them the test, even though they know it’s really not that likely to be helpful,” Jerant said. “We really need to rethink reimbursing physicians partly on their satisfaction scores.” For this study, Jerant and his colleagues reviewed 1,319 visits to 56 family physicians at the UC Davis Family Medicine Clinic. The visits were made by 1,141 adult patients. The patients were asked to fill out a questionnaire after their visit. Patients came into their doctor’s office with a specific request 68 percent of the time, the researchers found. They most often asked for a lab test (34 percent), a referral (21 percent), pain medication (20 percent) or some other new medication (20 percent). About 85 percent of the time, the doctors fulfilled their patients’ requests, the findings showed.


“In general, doctors will listen to patients and, if they think the request is reasonable, will say sure,” Jerant said. “But some of those requests maybe should not have been fulfilled.” Today, people in doctors’ waiting rooms are much more likely to have learned about a new drug from a TV ad or to have searched “Dr. Google” about their symptoms, said Cynthia Smith, vice president of clinical programs for the American College of Physicians. “Chances are, people have already tried to troubleshoot their problem by searching the internet,” Smith said. According to Joseph Ross, an associate professor at the Yale School of Medicine, “Patients may have multiple reasons for requesting a

service or referral. They may have seen an advertisement for the service on TV or have a friend or family member who’d received it in the past who experienced a good outcome. Or perhaps they are already unsatisfied or concerned with how their care is being managed and want a referral to a specialist.” When doctors turn down patients’ requests, the patients react poorly, the investigators found. Satisfaction scores plummeted an average of 20 points when doctors denied a request for a referral or new medication, and 10 points when they said no to a painkiller prescription, according to the report. Doctors also got worse evaluations when they turned down requests for lab tests and imaging screenings.


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

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

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

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©2017 Aetna Inc. January 2018 •


IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Who’s More Distracted Behind the Wheel? Study finds that “fiddling with the radio” was the most common source of distraction while driving


exting, talking on cellphones, eating, drinking — distractions such as these are a driving hazard, and are more likely to occur among young men, new research shows. People most prone to distracted driving also often tend to think it’s “no big deal” and it’s socially acceptable, the Norwegian study found. These drivers often also felt that they had little control over being distracted. On the other hand, older women, and people who felt they could control their distracted behaviors, were most able to keep their focus where it belongs — on the road ahead. “I found that young men were among the most likely to report distraction,” said study lead author Ole Johansson of Norway’s Institute of Transport Economics. “Others more prone to distraction include those who drive often, and those with neurotic and extroverted personalities.” According to the study authors, the World Health Organization estimates that more than a million

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lives are lost on roadways each year due to distracted driving. And it only takes two seconds of looking away from the road for risks of an accident to rise significantly, the researchers noted. There was good news, however, from the survey of Norwegian high school students and adults: Overall rates of distracted driving were low, and “fiddling with the radio” was the most common source of distraction. The study was published Nov. 17 in the journal Frontiers in Psychology. One way to reduce distracted driving may be to have drivers devise their own prevention plans, Johansson said. For example, simply presenting people with information about distracted driving made people aware of the problem. Interventions like those “could focus on at-risk groups, such as young males with bad attitudes to distracted driving and a low belief that they can control their distraction,” Johansson said in a journal news release.

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

January 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Joseph W. Spinale, D. O. A cardiologist with an MBA is now the chief medical officer at St. Joe’s. He talks about the industry and his plans for the Syracuse hospital Q: How did you become chief medical officer at St. Joe’s, one of the largest medical centers in Upstate New York? A: I was chief medical officer for a similarly-sized hospital in Providence, R.I. I wasn’t really looking to move, but then I got a call from a recruiter. I didn’t jump on it the first time, but the second time they called I agreed to come out for an interview, mostly to preserve my relationship with the recruiting firm. But once I met with everyone, saw the community, saw the hospital, it became clear that this would be where I’d be coming. Q: What do you see as the primary challenges St. Joe’s faces? A: First off, I think St. Joe’s is a great facility with a great mission. But like all health care systems in the country, it’s faced with the ever-changing healthcare reimbursement landscape. So, as we move from a fee-for-service model to a population health reimbursement model, hospitals and health systems need to adapt and modernize the way they deliver care in order to be successful. That’s part of my job, to help this institution achieve those goals. Q: Can you give an example of what that might look like? A: Sure. So, physicians have, since the inception of modern medicine, been trained to be autonomous. The reimbursement simply paid them for the amount of work they did. For example, if you are a gastroenterologist, you get paid by the number of endoscopic procedures you perform. So, it’s in your interest to perform as many of those procedures as you can. What population health tells us to do is to reimburse driving down the rates of colon cancer. In order to do that, we need to align our clinicians with that line of thinking and find ways to provide the best care at



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

the lowest cost. Q: Syracuse is a hospital-rich city for its size. To what degree do you see St. Joe’s as being in competition with the other hospitals versus seeing them as partners? A: Syracuse in many ways is very similar to Providence. Both cities were industrial giants in their day, industry moved out, leaving health care and education as the major supports. Rhode Island has 10 or 11 hospitals that compete and cooperate to varying degrees. Same thing here in Onondaga County. By nature, I like to collaborate. I think our mission, in order to meet the AAA rating, is to improve the health of our population. I think we can, and have to, all collaborate on that. We can also collaborate on reducing the overall cost of health care. Now, for all of us to offer, say, cardiac services might be redundant while being competitive. But I think every institution needs to be able to create a margin so that it can support its mission and invest in its infrastructure. Q: Seeing as how St. Joe’s is known for its cardiac services, do you see the community avoiding duplication of services in that area? A: I do. I think in a city this size, it probably doesn’t make sense to have competing cardiac surgery programs. But I think each institution should do what its strength is. Treating cardiovascular disease is one of our competitive advantages. One of my deliverables is to insure and improve upon that competitive advantage. Q: Are you also managing the hospital’s affiliates? A: Yes. I’m really here in this role to integrate and organize our provider network. My goal is to take all our physicians who have been practicing on their own and form them into a highly integrated, highly efficient multi-specialty group. We already talked about maintaining our competitive advan-

tage. My third major goal is to bring physicians into the decision-making process at every level of the organization. And the fourth thing we also talked, getting everyone ready to move toward the new reimbursement system. Q: What are some of the benchmarks used to gauge quality in the new reimbursement system? A: I’m a cardiologist by training. I’ve been in all kinds of practice groups, but what I really enjoy is process improvements. So how do we make a process better? That could imply putting patients through the emergency room. It could apply to a financial metric, say the revenue per square foot metric. Whatever it is, it’s about making it better. But to directly answer the question, it’s about how the patient navigates through the system and have a great healing experience, and not be harmed by that experience, and how do we deliver that experience as cost effectively as possible. Q: On that note, one of the criticisms of the American healthcare system is its complexity. How does that affect patient experience and what can you do about it? A: Where the complexity comes in is with the vast nature of our healthcare reimbursement system. The number of hospitals, the number of network. So, from our perspective it’s asking how we define the networks and standardize the care. There’s a lot of disruption in the industry right now, but we moved from the era of individual hospitals to hospitals getting together into systems, so now systems are joining together to become super-systems. That means pushing some hospitals out of the system and acquiring other hospitals so that they can be geographically located in an optimal way. That’s hard work. And it’s hard work when you’re dealing with such a heavily regulated industry with so many stakeholders. But I’m very confident that we’ll achieve all those goals. I think St. Joe’s is already ahead of the curve.

Lifelines Name: Joseph W. Spinale, D.O Position: Chief medical officer, St. Joseph Health since Sept. 7 Hometown: Warwick, R.I. Education: Doctor of Osteopathic Medicine from Ohio University in Athens, Ohio; Master of Business Administration from University of Massachusetts Amherst, Amherst, Mass Affiliations: St. Joseph’s Medical Center; previously chief medical officer at Kent Hospital in Warwick, R.I., where he also served as chief of cardiology Organizations: American College of Cardiology; American College of Physicians; American College of Healthcare Executives Career: Spinale has served as an examiner for the Malcolm Baldrige National Quality Award through the National Institute of Standards and Technology since 2014. Fellow of the following organizations: American College of Cardiology, American College of Physicians, American Society of Nuclear Cardiology, American College of Healthcare Executives, and the American Association for Physician Leadership. Family: Married, two children, two dogs Hobbies: Sailing, photography

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

than last year’s. Official encourages people to get vaccinated against flu. “It’s never too late,” he says


he number of confirmed flu cases in New York state is greater than the number of cases reported by this time last year, according to an Excellus BlueCross BlueShield review of New York state health data. As of Dec. 9, 1,820 cases of the flu have been confirmed in New York state. A year ago, New York state had reported 1,264 confirmed cases of the flu. The number of hospitalizations associated with influenza this year (684 as of Dec. 9) is also greater than the number of influenza-associated hospitalizations at this time last year (491 as of Dec. 10, 2016) “Most of the flu cases being reported now are from the influenza A strain, which is a component of this year’s flu vaccine,” said physician Richard Lockwood, a vice president and chief medical officer of Excellus BlueCross BlueShield. “The annual flu vaccine is designed to protect against three or four flu strains during a season.” According to Lockwood, different flu strains can circulate at different times during a flu season that can extend to as late as May. “It’s never too late to get vaccinated,” he said. During the 2016-2017 flu season in New York state, only half of the population aged 6 months and older got the flu vaccine. That resulted in 65,000 New Yorkers getting the flu. “The health of a community hinges on increasing the percentage of people who are vaccinated,” said Lockwood. “That’s especially true this year, when the number of reported flu cases is on pace to exceed last year’s total,” he continued. “A flu shot not only protects you from getting the flu, but also protects others from catching the flu from you, so there’s

a community benefit to getting a flu shot.” Statistically, every 100 people who get the flu will infect 127 others. One person with the flu can infect other people one day before any symptoms develop, and up to about seven days after he/she becomes sick. The virus can spread to others who are within 6 feet of the infected individual, mainly through microscopic droplets that are expelled into the air when people cough, sneeze or talk. For some people, the flu results in a fever, the chills, body aches, a cough and perhaps a runny nose. But for the very young, the very old, women who are pregnant, and individuals with certain health conditions, catching the flu can place them at high risk for much more serious complications, including death. “It isn’t always obvious who among us is most vulnerable,” said Lockwood. “The best protection against the flu for you and for others is a yearly vaccination.” The Centers for Disease Control and Prevention estimates that in the 2015-2016 flu season, the flu vaccine prevented approximately 5.1 million cases of the flu in the U.S., 2.5 million influenza-associated medical visits, 71,000 hospitalizations, and an estimated 3,000 pneumonia and influenza deaths. The CDC recommends annual flu vaccines for everyone 6 months and older. It takes about two weeks after the vaccine is administered for it to provide protection. Officials encourage people to call their doctor to schedule a flu shot today, or visit vaccinefinder.org to find a clinic, pharmacy or other location that offers immunizations near you.

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By George Chapman

Health Trends to Watch

The State of Healthcare in the US: Where We Stand Going into 2018


Cost of Care Everyone agrees it is just too expensive. We spend much more per capita on healthcare (about $10,500) than any other developed country in the world. Healthcare is now 19 percent of our GDP and costs are rising faster than our economy grows. The federal budget is about $3.65 trillion. Healthcare accounts for the biggest chunk of the federal budget at 28 percent or $1.022 trillion. To put that into perspective, pensions account for 25 percent; defense, 21 percent; welfare 9, percent; interest on debt, 7 percent; education, 3 percent; protection, 2 percent; transportation 2 percent and other 2 percent miscellaneous; and finally general government, 1 percent. Premiums for 2018 are hard to project because of the uncertainly in the market created by the White House. The actual cost for care will increase around 12 percent due to factors like medical inflation, aging and morbidity adjustments, and the ACA tax to cover the medically indigent. Experts warn that the conflation of terminating the individual mandate (everyone buys insurance), terminating the subsidies for the indigent (who buys insurance on the exchanges), and just general uncertainty over what Washington is doing could cause rates to jump another 17 percent.


Coverage or Who Pays Almost half of all Americans, 156.8 million people or 49 percent, are covered by their employer. On average, employers pay for about two thirds of the employee’s premium. The other half is covered by some sort of government program. 64 million people, or 20 percent of us, are covered by Medicaid. Medicare covers 44.8 million seniors or 14 percent of us. 22.4 million or 7 percent of us are covered by non-employer groups. The 7 million people who purchase individual coverage on the exchanges are part of this group. The VA and federal employment cover 6.4 million or 2 percent of Americans. The remaining 26.6 million of us (or 8 percent) are still uninsured. If the federal government follows through on cutting

‘The average profit for healthcare insurance companies is just 3.2 percent for health insurance companies. The average profit margin for drug manufacturers is 20.8 percent; medical instruments and supply companies average 12.5 percent; medical appliance and equipment sellers average 9.5 percent. Hospitals’ profit average is 3.7 percent.’ the subsidies on the exchanges, most likely the uninsured rate will climb.


The Culprits Our costs are high mainly because of prices, (particularly for drugs and implantable devices), administration, inefficiently delivered and unnecessary services, fraud and emphasis on treatment versus prevention. All told, it is estimated that the above “culprits” cost us around $765 billion per year. Ironically, a contributing culprit could be we don’t see/use our physicians enough. We average 4.1 doctor visits a year. People in developed countries with far lower costs and better health status see doctors more often: Australia, 6.7 times a year; Canada, 7.4; France, 6.8; Germany, 9.7; and the U.K., five visits a year. Our high deductible plans may be keeping us from seeing the doctor when we should. Drugs developed in the US are cheaper in most other countries. For example, in 2015 the heartburn medication Nexium sold in the US for about $215. It was $60 in Switzerland, $58 in Spain, $42 in England and $23 in the Netherlands.


Profit Margins Most people believe the insurance companies are making the big money. Highly publicized CEO salaries and the president threatening to “cut the subsidies to greedy insurance companies” may contribute to this belief. The average profit margin for insurance companies is 3.2 percent. The ACA actually capped how much of the premium an insurer could retain for operations at 15 percent. If an insurer spent only

80 percent on claims, retaining 20 percent, they had to refund 5 percent of the premium to consumers. The 15 percent covers marketing, reserves, administration and profit. So, after covering their operating expenses, the average profit was just 3.2 percent for insurance companies. The average profit margin for drug manufacturers is 20.8 percent; medical instruments and supply companies average 12.5 percent; medical appliance and equipment sellers average 9.5 percent. Hospitals average 3.7 percent. While profits are quite healthy for the drug and manufacturing companies, medical debt is the No. 1 for personal bankruptcies for people with insurance and without insurance. 62 percent of filings for personal bankruptcy are due to medical bills. Job loss, excess credit, divorce and unexpected expenses round out the top 5 reasons for personal bankruptcy.


Performance Ever since comparisons have been made, our healthcare system pales when compared to other developed countries. Based on a variety of measurable and accepted factors, the highly reputable World Health Organization ranks the US No. 37. Ahead of us are countries like France, Italy, Spain, Japan, the U.K., Germany, Canada, Australia, Greece, Norway, Ireland and Sweden. The Commonwealth Fund compared 11 countries on things like: prevention, safety, coordination, accessibility, affordability, timeliness, administrative efficiency, equity throughout all income levels and nine measures of healthcare outcomes or status. We January 2018 •

came in dead last behind No. 1 U.K., No. 2 Australia, No. 3 Netherlands, No. 4 New Zealand, No. 5 Norway, No. 6 Sweden, No. 7 Switzerland, No. 8 Germany, No. 9 Canada and No. 10 France.


Hospitals There are about 5,500 hospitals in the US with almost 900,000 staffed beds admitting 35 million of us per year. 80 percent of hospitals are nonprofit. In NYS, all 195 hospitals are nonprofit. 1,800 hospitals are located in rural communities and they are the most vulnerable financially in an increasingly competitive and volatile market. Hospital consolidation, through mergers and acquisitions will save many of the at-risk rural and smaller suburban hospitals. The Accountable Care Act was the catalyst for increased merger and acquisition activity, encouraging larger, integrated, comprehensive and more efficient delivery systems. It will very be rare in the near future to find an independent stand-alone hospital. Most will become cogs in a huge clinical wheel. The FTC is keeping a wary eye on hospital consolidation. So far, consolidation has saved some failing hospitals and improved recruitment of physicians but it has not resulted in lower prices for consumers. If consolidation ultimately results in a virtual monopoly that won’t negotiate price with insurers, the FTC will step in and break it up.


Physicians More than half of all active physicians are now employed by a hospital or healthcare system. As the business side of medicine becomes more regulated, confusing and complicated, the trend away from the hassle of private practice will continue. Depending on your source, the number of active physicians varies significantly. According to the Kaiser Family Foundation, there are about 923,000 professionally active physicians. According to the Association of American Medical Colleges, there are about 861,000. Dire predictions of a severe shortage of physicians seem to highly exaggerated. If you split the above difference in the number of active physicians and call it 900,000, that would be about one physician per 360 of us. (US population: about 323,000,000).

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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‘In 2015 the heartburn medication Nexium sold in the US for about $215. It was $60 in Switzerland, $58 in Spain, $42 in England and $23 in the Netherlands.’ About half the active physicians are in primary care. That would still be just 720 of us per primary care physician which seems more than manageable despite our aging population. Some of these self-serving predictions fail to account for or minimize the impact of 88,000 physician assistants, 160,000 nurse practitioners, technology, telemedicine and increased consumer involvement in our care.


The Leading Killers The average life expectancy in the US is 79 years. 75 percent of all deaths can be attributed to just 10 causes. Heart disease is the No. 1 killer at 23 percent of all deaths. Cancer is No. 2, causing 23 percent of all deaths. Chronic lower respiratory disease (COPD) is No. 3 causing 5.6 percent of all deaths. The rest are: No. 4, accidents; No., 5 strokes; No. 6, Alzheimer’s; No. 7, diabetes; No. 8, flu and pneumonia; No. 9, kidney disease; and No. 10, suicide. Moving quickly up the top killer list is overdose from opioid/heroine. 140 people a day or 51,000 a year die from overdosing on oxycodone, fentanyl, codeine, hydrocodone, etc. Once the prescription expires, addicts turn to cheaper heroine.


Good Health fifty percent of good health is impacted by your “life.” That includes factors such as income, disability, education, social exclusion, social safety net, gender, employment or working conditions, race, diet, housing and sense of belonging to your community. twenty-five percent of good health is impacted by your healthcare, including access to care, the system you choose and wait times. Fifteen percent of good health is affected by your biology and genetics. Finally, ten percent of good health depends upon air quality and civic infrastructure. Of the factors you can control, keeping in contact with your primary care physician is the best thing you can do to reduce or mitigate, if not completely prevent, untoward health events.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com. Page 10

Get Off the Treadmill, Run Outside This Winter

‘Being out there when it’s cold or snowy makes you feel more invigorated,” says a Manlius running coach By Ken Sturtz


any runners retreat inside as winter approaches, sacrificing the freedom of the outdoors during the warmer months for a treadmill or other cardio machine. A common refrain is running outside in winter is too difficult for all but the most diehard runners. But seasoned runners say with some preparation and planning even a beginner can get off the treadmill and enjoy winter running. The key to getting into winter running is putting yourself in the right mindset, says Jenna Green, a runner from West Monroe who recently qualified for the Boston Marathon. “Make yourself a schedule, set a time and stick to it,” she says. “The winter months are challenging, there’s no lying about it.” Be consistent and don’t let the temperature be an excuse for taking an unplanned day off. It’s also a good idea to give yourself a couple weeks of running outdoors to get used to it before deciding if it’s for you. That’ll give you a chance to appreciate what winter running can offer. “It’s my quiet time,” Green says. “I don’t hear my kids. I don’t hear my other half.” Running outside can help combat the winter blues and maintain a positive mood, says Jill Perry, a champion ultra-runner and running coach from Manlius. Running when everything is beautiful and snow-covered is peaceful Perry says. “Actually, being out there when it’s cold or snowy makes you feel more invigorated,” she says. Randy Sabourin, owner of Metro Fitness, has a running partner for motivation: his dog Molly. They run a few miles each morning, stop so Molly can go to the bathroom and then run home. Sabourin says he enjoys getting outside because he spends most of his day cooped up indoors. “I tend to like being outdoors” he says. “I’d rather run and look around experiencing nature.” Many beginners give up, however, because they don’t have the

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

Jenna Green, a runner from West Monroe who recently qualified for the Boston Marathon, says the key to getting into winter running is putting yourself in the right mindset. “It’s my quiet time,” Green says. “I don’t hear my kids. I don’t hear my other half.”

Randy Sabourin, owner of Metro Fitness, has a running partner for motivation: his dog Molly. “I tend to like being outdoors” he says. “I’d rather run and look around experiencing nature.” proper gear. Protecting your face and throat from bitter cold, especially on windy days, is crucial, running coach Perry says. Finding a hat and scarf you like is a good start. Many runners also wear Buff brand headgear, Emily Kulkus, marketing director at Fleet Feet Sports in

Syracuse. The stretchable fabric tube can be worn different ways to cover most of the face and the material breaths well. Runners should wear layers of clothing, Kulkus says, so they can remove a layer once they warm up. Mittens can help keep hands from getting numb on longer runs. Check the weather before your run to avoid overdressing, which leads to sweating and getting cold during a run. A good pair of winter running shoes is essential, Kulkus says. Shoes made with water-resistant material such as Gore-Tex can help keep feet dry on wet, slushy roads. A good pair of shoes can also reduce the chances of falling, a major concern for winter running. “I talk to a lot of people on a regular basis who are scared of falling,” Kulkus says. Shoes designed to provide traction on slippery surfaces are preferred. Shoe attachments can also be added for extra grip. Perry has fallen on black ice several times and suggests running on the side of the road instead of on it, or choosing to run on trails. Green wears grippers on her shoes. On roads, it’s important to know the route you plan to take and pick roads that that don’t have too much traffic. “Know your route,” Green says. “Know where you’re going to go once you step outside. Make sure it’s safe.” Sabourin runs around his neighborhood in Brewerton where he’s familiar and there isn’t much traffic. He says it’s important to wear reflectors and carry a flashlight, especially since people tend to run before or after work when it is dark. And if you need a little extra motivation to start winter running, Kulkus says, Fleet Feet offers a group training program during the winter. “Just running with other people can be a great way to stay in shape through the winter months,” Kulkus says. “That can be a great thing, especially for folks who have never done it before.”

New Diabetes Drug Gets FDA OK Under ‘Abbreviated’ Pathway


dmelog (insulin lispro), a short-acting form of insulin, has been approved by the U.S. Food and Drug Administration to treat people with either type of diabetes, for patients aged 3 years and older. It’s the first drug approved as a “follow-up” product based on an abbreviated new process dubbed 505(b)(2), the agency said Monday in a news release. A new drug approved this way relies on the agency’s finding that “a previously approved drug is safe and effective, or on published literature to support the safety and/or effectiveness of the proposed product, if such reliance is scientifically justified,” the FDA said. The abbreviated process “can reduce development costs, so products can be offered at a lower price to patients,” the agency explained. “In the coming months, we’ll be taking additional policy steps to help to make sure patients continue to benefit from improved access to lower cost, safe and effective alternatives to brandname drugs though the agency’s abbreviated pathways,” said FDA Commissioner Scott Gottlieb. Admelog was approved under the new process in part due to its similarity to the diabetes drug Humalog, the agency said. Admelog itself was evaluated in clinical trials involving about 1,000 people. The most common side effects included hypoglycemia (low blood sugar), itching and rash. A less common but more serious adverse reaction could include life-threatening allergic reaction, including anaphylaxis, the FDA said. Admelog should not be used by people with hypoglycemia, or by people who are “hypersensitive” to the drug’s active ingredient insulin lispro, the agency warned. And people at risk of too much blood potassium (hyperkalemia) should be monitored carefully while taking Admelog. Short-acting insulin products are typically given just before meals to help control blood sugar after a person eats. This type of drug is more likely to be used by a person with Type 1 diabetes than a person with Type 2, the agency said. Admelog is produced by the French firm Sanofi-Aventis, whose U.S. headquarters is based in Chattanooga, Tenn.

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Cancer Connects Makes Sure Patients Aren’t on Their Own Growing nonprofit offers a variety of support to cancer patients, including financial By Matthew Liptak


ancer Connects, based in East Syracuse, was formed 11 years ago as Unique Connections Inc. a volunteer mentor program for cancer patients under the guidance of Hematology-Oncology Associates of Central New York, PC. In more recent times though, the nonprofit added two more areas of service and has grown substantially. “I believe it was in 2011 when we added our complimentary therapy program,” said Cancer Connects’ program coordinator Emily Doucet. “Then we added a financial assistance program as well. We have three signature programs — the mentor programs, the complimentary therapy and financial assistance.” The complimentary therapy program has grown very popular. Cancer Connects offers vouchers and funding for therapies like massage, reiki, acupuncture and reflexology for cancer patients. “The complimentary therapy program has really just exploded,” Doucet said. “We get so many requests for that. People absolutely love it. These therapies help manage symptoms from side effects and restore control and vitality. They work in tandem with a patient’s medical treatment plan.” These therapies often offer patients some down time away from

Page 12

Doucet the pokes and prodding of their medical treatment, Doucet said. It’s their time, where they can focus on themselves and feeling better, rather than the disease they are fighting. The complimentary therapy has been one of Cancer Connects latest success stories, but the original success story is the nonprofit’s volunteer mentor program. There are 75 volunteer mentors in the program. They receive two days of training. These individuals once had cancer themselves and help current patients navigate their journey with cancer. “It gives them someone to talk

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

to,” she said. “They can’t talk about how bad they feel because family members are worried about them. This gives them somebody that they can really be honest with about their biggest fears.” But Cancer Connects hasn’t forgotten about the caregivers either in their mission to help those coping with the disease. They offer a caregiving-mentoring program for those helping patients at home. “Sometimes the caregivers really don’t feel good and they’re a little cranky,” Doucet said. “They get a little overwhelmed and it’s frustrating for a caregiver, so [the mentor] really understands how hard it can be and how frustrating it gets with a person you love. It’s a nice way to provide a lifeline for them.” Cancer Connects has two avenues for helping patients with financial assistance. The nonprofit gets a grant from the St. Agatha Foundation to help breast cancer patients. “We can do a lot for people with breast cancer in terms of helping them pay their copays — things like that,” Doucet said. For other cancers, there is the Angel Fund. It is funded 100 percent by public donations. There are multiple fundraisers each year. Doucet said Cancer Connects expected to serve 500 to 700 people last year. While they have a small office in Hematology-Oncology Associates of Central New York, they are no

longer affiliated with the medical provider. The nonprofit is growing and so is its budget. The answer to why it’s growing is simple and evidence of the legacy of a lackluster local economy. “This is an economically-depressed area and cancer is an expensive diagnosis,” she said. “If you don’t have great insurance, the copays are prohibitively expensive. A lot of people are out of work for a while. When people hear that we provide financial assistance, that’s very exciting.” The program coordinator not only serves those who are coping with cancer, but has been touched by it herself. She lost her father to lung cancer when she was 4 years old. “From a very early age I realized how much a cancer diagnosis can affect a family,” she said. Despite personal loss, Doucet draws strength from working for Cancer Connects clients. Thanks to Cancer Connects patients are not taking the journey alone, and there is plenty of hope and healing going on. “I get to talk to amazing people who are showing incredible strength and resilience through a really difficult journey,” Doucet said. For more information, visit www.cancerconnects.org.

Tried to Quit But Discover the Secret... Teacher Loses 33 pounds, Learns to Love Retirement Still Smoking? Help’s On the Way


hen it comes to kicking the smoking habit, if at first you don’t succeed, try, try again, the U.S. Food and Drug Administration says. To help encourage adult smokers to quit, the FDA is launching a new public education campaign called “Every Try Counts.” It will target smokers aged 25 to 54 who’ve tried to quit smoking in the past year but haven’t been successful. The campaign will feature messages of support that highlight the health benefits of quitting smoking. The Every Try Counts campaign begins in January in 35 markets nationwide and will include print, digital, radio and billboard ads. The FDA plans to focus its ads in and around retail locations, such as gas stations and convenience stores places that not only sell cigarettes but are favorite targets of cigarette advertising. As part of the campaign, the FDA has teamed up with the U.S. National Cancer Institute to create a website that will provide resources and tools to help smokers quit. “Cigarette smoking remains the leading cause of preventable disease and death in the U.S.,” physician Jerome Adams, the U.S. Surgeon General, said in an FDA news release. “Sustained and comprehensive efforts, including the FDA’s Every Try Counts campaign, are critical to encouraging more Americans to quit smoking and preventing the harms associated with cigarette use.” FDA Commissioner Scott Gottlieb said the new campaign “encourages smokers to rethink their next pack of cigarettes at the most critical of

places — the point of sale.” Gottlieb pointed out that “tobacco companies have long used advertisements at convenience stores and gas stations to promote their products, and we plan to use that same space to embolden smokers to quit instead.” Cigarette smoking causes about 480,000 deaths in the United States each year. Despite declining smoking rates among adults, 15 percent of American adults (36.5 million) were cigarette smokers in 2015. Of those, more than 22 million said they’d like to quit, according to the FDA. However, though more than 55 percent of adult smokers tried to quit in 2015, the agency said that only about 7 percent were successful. Mitch Zeller directs the FDA’s Center for Tobacco Products. “Tobacco advertising in retail environments can generate a strong urge to smoke, prompting a relapse among those attempting to quit,” he said in the news release. “This campaign offers smokers motivational messages in those environments with the intention to build confidence and instill the belief within each smoker that they are ready to try quitting again,” Zeller explained. “We want smokers to feel good about each attempt to quit because it is getting them closer to one day leading a healthier life free from cigarettes, reducing their risk of tobacco-related death and disease,” he added.

I’m Peg Markham, and I’m retired from the Baldwinsville Schools. I WORE A SACK For my retirement party, I had to wear a sack. I had thought I looked better than I did in the pictures of the event. I was never able to wear the bathing suit I wanted, never the dress I wanted. NAGGING PROBLEM I always thought, “My life is perfect, but I’d like to lose 35 pounds.” I exercised daily, but couldn’t control my eating. PAIN I started getting problems. I had knee and heel problems. High cholesterol. I felt less pretty, less sexy. I TRIED MANY TIMES I wondered, “What’s wrong with me? I’d give anything to lose weight!” I tried commercial programs and counting calories. I often lost weight, but it always came back. DOCTOR-APPROVED I asked my physician. He said he had many patients who had success with Alternative Hypnosis. I WAS SKEPTICAL I thought I couldn’t be hypno-

tized. I thought people would control me. It’s not like that at all. FREE NO-PRESSURE SCREENING I got in right away for my free screening. I was impressed at how thorough and no-pressure it was. I decided that very day that Alternative Hypnosis was right for me. There was no pressure and everything was explained. I’VE KEPT 33 POUNDS OFF My heel and knee problems went away. I can bend over again. It’s much easier to do things: housework, walking, shoveling. My cholesterol came down. This time, I’ve stayed at my goal weight. After Alternative Hypnosis, I know I’ll never have a weight problem again, guaranteed. HYPNOSIS HELPED ME DO WHAT I KNEW I NEEDED TO DO Hypnosis helped me to get control of food and increase my exercise. When I need to eat, it’s usually healthy. REASONABLE FEES To be healthy and the size you want to be the rest of your life is almost priceless. CALL THEM NOW! I give Alternative Hypnosis all the credit and recommend them all the time. It’s like I’m on a soap box. I never lost weight for good until I went there!


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Page 13

My Turn

By Eva Briggs

Outdoor Safety for Those Who Stay Active in the Winter Winter is just getting started, so it’s time to equip yourself for safety to reduce your chance of becoming an accident victim


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

s I write this in December, the daylight hours are short and snow is swirling. That translates to poor visibility and dangerous conditions for runners, dog walkers, snow shovelers and others who spend time outdoors. Proper gear can enhance the ability of motorists to detect pedestrians and reduce the chance of accidents. First, consider the color of your clothing. Light colors show up better in the dark — though perhaps not white in the winter, due to its similarity to snow. Bright colors — think fluorescent yellow-green, fluorescent orange-red, and fluorescent red — stand out in daylight. In fact, testing by the American National Safety Institute suggests that fluorescent yellow-green is the most visible in fore disappears at night. The other is daylight, though the fluorescent orange-red and fluorescent red become small and brown and can scarcely be seen against dry brown leaves. But increasingly visible under low light for just a few dollars, they’re each conditions. decked out in a high-viz dog vest for For the science nerds, the wavetheir nighttime walks. Other options length of that most visible yellow-green is about 550 nanometers. It for canine safety include lighted turns out that the light-detecting cells collars, lighted leashes, and lights that snap onto the dog’s collar. An in our retinas are most sensitive to advantage of the vest is that it won’t light at 550 nanometers. Add reflecbe covered by long hair like a lighted tive stripes to enhance nighttime collar or tag. visibility. Don’t forget proper footwear to Lightweight high-viz vests can reduce the chance of slipping and be ordered from Amazon for less than $10, though you can spend more falling. Several brands of shoes now sell footwear with Vibram arctic if you desire a sturdier model with grip soles. They’re supposed to grip more features. You might as well get even wet ice to prevent falls. They’re two, and toss one in your car in case pricey, but if they really work, they’re of a nighttime breakdown or other cheaper than a doctor’s bill and emergency. And if you don’t want a missed day at work. vest, you can get a belt, armbands or Other options include various wristbands. strap-on traction devices, such those Next add some light. You can made by YakTrax and Katoohla. carry a flashlight or wear a headlamp. Or you can go a bit more technical with armbands, clip on lights, Eva Briggs is a even shoe lights. Most lights have a medical doctor flashing setting to make you stand who works at out even better. two urgent care Bugow’s A few people take their bicycles Driver centers (Central Rehab out in the winter. If you do, strap on Square and a headlight and taillight.dan@bugows.com For best Fulton) operated visibility, also had wheel lights. by Oswego Senior Driver and Evaluations Teens, adults disabled If you walk a dog,Driver you’ll want Health. Evaluations & Training to make sure he or she is visible too. 315-341-8811 One of my dogs is black and there-


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I lost 135 lbs. and found my inner athlete. Bruce played high school and college sports. Yet as the years passed, he moved less and gained more. Overweight with heart disease and diabetes, he knew — at 60 — that he had to get healthier to reach his golden years. Since having weight-loss surgery at Crouse, Bruce has found his love of physical activities. He’s also found a caring and compassionate team, including trusted surgeons, nutritional experts and an active support group, to help him every step of the way. Come to our next weight-loss surgery seminar and discover what you can find.

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Alcohol Identified as Raising Cancer Risk

heart events. But Kohman isn’t convinced of the benefits of drinking alcohol. “No one should start drinking alcohol for heart health benefits,” she said. “People should think about what they’re most at risk for. The By Deborah Jeanne Sergeant benefit gained by a small amount of alcohol for heart health is also ew Year’s Eve represents a cancer, for example. achievable by healthy body weight, night where many people “Alcohol is definitely a risk facappropriate diet and exercise. The raise a glass, but you may tor for breast cancer which women same things for cancer prevention are want to rethink what’s filling it — have not been aware of in the past,” for heart and vascular disease.” and how many glasses you consume. Kohman said. Consumer definitions of “moderThe Journal of Clinical Oncology She listed various head and neck released a statement in November cancers, breast cancer, colorectal, and ate” drinking can also vary widely. “Interestingly, most people do that states alcohol has been identified liver cancer as all having an attribunot know the definition of a standard as a risk factor for numerous types tion to alcohol. drink and most of the time the stanof cancer, including cancer affecting “For many of these cancers, distilled spirits (hard alcohol), 5 oz. areas of the mouth and head, breast especially of the dard sizes are commonly exceeded,” of wine or 12 oz. of beer. said physician Kara C. Kort, medical cancer, liver cancer and colorectal head and neck, “All of these types of alcohol are cancer. the combination director, breast care and surgery at St. associated with increased risk,” she Joseph’s Physicians Surgical Services. said. “The cancers that seem to have While few people who imbibe of smoking and The clinical would consider completely eliminatalcohol is a clear causal relationship to alcohol definition of ing alcohol, cutting back may be a extremely use are certain head and neck cancers “moderate” good idea, especially if they bear othdangerous in (oropharyngeal and larynx), esophadrinking is up er risk factors for cancer, according to initiating geal cancer, liver cancer, breast cancer to one drink per and colon cancer.” physician Leslie Kohman, chairwomcancer.” day for women an of the American Cancer Society’s Why the She said that most studies show and up to two Upstate New York area board and risk increases that even moderate drinking can drinks per day distinguished service professor of isn’t entirely increase risk slightly and the greater for men. Kohman surgery with Upstate University clear; however, risk is among heavy drinkers. “Heavy” Hospital. it may have to do with inflammation “Since risk factors can be addidrinking for “I think people should re-think and irritation with tissue it contacts, tive, certainly those individuals who women is it,” Kohman said. “It’s the third most effects on hormones, damage to DNA KaraKort are already at increased risk for other defined as eight reasons, should watch their alcohol important modifiable risk factor and, in cases of excessive consumpor more drinks per week, or three or involving cancer.” tion, the body’s ability to metabolize intake,” Kort said. more drinks per day; for men, 15 or Smoking and excess body large amounts of alcohol. Along with reducing or eliminatweight, are the first and second, “Alcohol stimulates appetite and more drinks per week, or four or ing alcohol intake and eliminating more drinks per day. “Saving up” the tobacco use, people can reduce their respectively. in heavy drinkers inhibits healthful week’s worth of drinks for a binge on risk of cancer by eating a healthful Though the standard of two food intake,” Kohman said. “They one day isn’t safe and would qualify drinks per day for a man and one for get most of their calories from alcodiet with plenty of whole produce the patient as a heavy drinker. a woman maximum has been estabhol and there’s no room to consume and grains and little red meat and The size of a standard drink can lished for general health, Kohman foods you need for healthful diet.” processed foods; and engaging in also vary based upon the drinker’s said that even drinking less For years, various studies have to help regular physical exercise. Diet and Bethan a part of an important study understand how the brains perception and glassware. Kort said an average of one drink daily can stated the benefit of red wine for exercise also affect the risk of heart a standard drink ounces of increase a woman’s of breast developing improving survival of patients with disease. of risk typically individuals differthat from those onis 1.5 the Autism Spectrum!


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

Participation would involve comingcoming to our lab to for our approximately 5, 2-3 hour visits and Participation would involve lab for approximately 5,completing paperwork and experiments while wearing an EEG cap (pictured left). Ages 6-30 invited to participate! 2-3 hour visits and completing paperwork and experiments while You willan earnEEG $10 an hour for each time youAges visit the lab. You will also contributing to science! wearing cap (pictured left). 6-30 invited tobeparticipate!

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

Lab Phone: 315-443-2428

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January 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

Page 15

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Build a Home in Your Heart in 2018

“Build thy home in thy heart and be forever sheltered.” – Anonymous


love this saying. It captures so beautifully what I practice every day and what I preach in my Live Alone and Thrive workshops — that the relationship with ourselves is the most enduring of all and that it is worth nurturing. Most of the women and men whom have made peace with living alone are busy leading interesting lives and making it their own. They have challenged, as have I, the age-old and deeply held belief that marriage, as it has been traditionally defined, is the only state in which we can be happy, fulfilled, secure and successful. We have come to consider our time alone as a gift, not a burden. Whether divorced or widowed, we are not spending this precious time bemoaning our fate. We have overcome adversity and we are the stronger for it. We have taken our lives into our own hands and have embraced the choices and possibilities that living alone has to offer. This is what we know . . . Living alone doesn’t mean being alone. All you need to do is pick up the phone, text a friend or email a colleague.



Accepting party invitations is worth doing, even if it’s a party with mostly couples. Keep in mind that guests often separate into groups of women and men, so singles blend right in. Traveling solo is an adventure in self-discovery. Whether it’s Paris or Peoria, striking out on your own will expand your horizons and build self-confidence. Figuring out how to replace the flapper valve in your toilet — all by yourself — can be very rewarding! The stereotyped images of single women and men as desperate and miserable are exaggerated and just plain untrue. Recent studies on the subject bear this out. Rediscovering your “true self” and identifying those things that bring meaning and joy into your life can turn living alone into an adventure of the spirit. Pursuing a new career or college degree in midlife can be liberating and fun. Doing a “random act of kindness” is a great antidote when you’re feeling lonely and sorry



5. 6.

7. 8.

for yourself. Friends matter. Reach out. Nurture your friendships. Honor your commitments. Accepting a dinner invitation does not obligate you to anything. Paying your own fair share on a date can feel good and empowering. Loneliness is not a “state of being” reserved for single people. Were you ever lonely in your marriage? Letting go of the idea that you need to be married to have any chance of being happy and fulfilled is essential. This idea will only keep you mired in self-pity. Treating yourself well builds esteem. Prepare and enjoy decent meals at home. Get enough sleep. Exercise. You’re worth it. Tell yourself so by taking good care of yourself. Your children are your first priorities, even in the face of an enticing romance. Getting out of your comfort zone is worth the discomfort. Try something new — dancing, a book club, golf lessons… whatever. It’s a great way to have fun and meet people. Isolating on holidays, birthdays, Sundays, etc. is no good. Solitary confinement is punishment for criminals, not single people. Make plans. Comb your hair. Lose the sweat pants. Put a smile on your face. It’s important to create your own positive feedback. Looking good tells people you value yourself. It will draw people (and compliments) to you. Who doesn’t need and want that?

19. 20.

shut off their technology before bed. And don’t let the cellphone be next to them while they sleep,” advised Fuller. She is a medical student at the Penn State Hershey College of Medicine. It’s important to note, however, that while the study found associations between technology use at bedtime and some negative outcomes, the study wasn’t designed to prove a cause-and-effect relationship. About 40 percent of youngsters have their own cellphone by fifth grade, according to background notes in the study. And there are now electronic and tablet-based children’s toys for even younger kids, the study authors noted. Children who watched TV or

used their cellphones at bedtime were more than twice as likely to be overweight or obese, the study findings showed. Unsurprisingly, kids who played more sports or played outside more often were less likely to be overweight. Also, kids who watched TV or played video games at bedtime got about 30 minutes less sleep nightly than those who didn’t watch TV, according to the study. The video gamers also had more trouble staying asleep. In general, kids who used their phones or computers at bedtime lost about an hour of sleep each night compared to those who put their technology away earlier.

9. 10. 11. 12. 13. 14. 15. 16. 17. 18.

There’s no shame in asking for help. It’s not a sign of weakness. On the contrary. Self-confidence and humor are powerful aphrodisiacs; neediness and desperation are not. Doing anything alone means you enjoy life and your own company; it does not mean you are a loser. Expanding your definition of love beyond “romantic love” will stand you in good stead. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. Hanging out with negative people is a real downer. Put yourself with people who make you feel good about yourself and about life. Living alone takes practice. Know that there is always someone you can call or something you can do to improve your situation. So there you have it, two dozen tips for building thy home in thy heart. I’ll end as I started, with another quote I love. This one is by Gilda Radner:

21. 22. 23. 24.

“Whether you’re married or not, whether you have a boyfriend or not, there is no real security except for whatever you build inside yourself.”

Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon. For information or to contact Voelckers, call 585-624-7887 or email: gvoelckers@rochester.rr.com.

s d i K Corner

Tech at Bedtime May Mean Heavier Kids Study shows that use of electronic gadgets in bed disrupts children’s sleep


ids and their smartphones aren’t easily parted, but if you want your children to get a good night’s sleep and to stay at a healthy weight, limiting bedtime screen time appears key, new research suggests. Parent surveys revealed that using a smartphone or watching TV at bedtime was tied to a greater body mass index (BMI). BMI is an estimate of body fat based on height and weight. And using any technology at bedtime — cellphones, TVs, laptops, Page 16

iPads and video games — was linked to getting about an hour less sleep, poorer sleep and, not surprisingly, morning fatigue. The one bit of good news from the study was that technology use didn’t seem to increase the risk of attention problems. “Parents should have a conversation with their child’s pediatrician about age-appropriate use of technology,” recommended the study’s lead author, Caitlyn Fuller. “You want kids to be getting a good amount of sleep, so ask kids to

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

What to Eat This Winter How do we stay warm and happy, fit and healthy during the winter months? By Anne Palumbo


ome winter — a season of short days, long nights, chilly temps and lavish holiday spreads — it’s easy to make some unhealthy food choices. We’re cold; we’re bored; we’re tempted; we’re restless. And some of us, no thanks to the decrease in sunlight, may also feel seriously down in the dumps. Compound all of the above with dry, itchy skin and a cold that won’t relent, and it’s no wonder we’re reaching for that second helping of mashed potatoes. Of course, we may also be reaching for that second helping simply because it’s winter and our appetite is heartier for comfort foods: stews, mac ‘n’cheese, pancakes, pies. While some experts suggest our cravings are a throwback to the days when we needed an extra layer of fat to survive the cold, most say it’s just physiology. “When outdoor temperatures drop, your body temperature drops, and that’s what sets up a longing for foods that will warm you quickly,” says nutrition expert and registered dietitian Kristin Herlocker. “Carbohydrate-rich foods provide the instant ‘heat’ boost your body is longing for.” So, how do we stay warm and happy, fit and healthy during the winter months? Read on for healthy food choices that are easy to implement.

If you’re gaining weight, reach for better snacks Studies indicate that the average person gains 1 to 2 pounds during the winter months, with those who are already overweight likely to gain more. Nutritionists suggest that consuming sugary, starchy fillers between meals may be the culprit, as these foods often don’t satiate us the way harder-to-digest foods do. Instead of snacking on chips or candy, eat a high-protein, high-fiber snack

between meals — a snack that keeps you feeling fuller longer and your blood sugar steadier — like peanut butter on celery sticks, low-fat cheese on whole-grain crackers, or some nuts. Nutritious snacks will fuel the body’s heat mechanism — and the toastier we stay, the less we crave carbs. What’s more, healthy snacks are typically much lower in calories than unhealthy snacks. For example: One cup of unbuttered air-popped popcorn—30 calories; one cup of potato chips — 150 calories; one cup of strawberry halves — 50 calories; one Snickers bar — 250 calories.

If you’re feeling blue, try these mood-boosting foods Being cooped up during the coldest, darkest days of the year can make us feel so listless and down. Is it any wonder our sweet tooth flares during the wintertime? Oh, if only that cookie were a legit fix! Unfortunately, a steady diet of simple carbs is the last thing our moods need in the winter. What we need, according to experts, is to consume foods with proven mood-boosting nutrients and fatty acids, such as vitamin D, the sunshine vitamin (found in fortified dairy products, eggs and mushrooms); folate, a B vitamin, that may help lessen depression (abundant in spinach, asparagus and lentils); and omega-3s, brain-building fatty acids believed to stabilize moods (found in salmon, walnuts and flaxseed). And chocolate? Many studies support that consuming chocolate can help improve your mood, especially dark chocolate, which stimulates the production of endorphins, chemicals in the brain that create feelings of pleasure. Dark chocolate also contains serotonin, a mood-boosting antidepressant. The key with chocolate, however, is moderation.

If you’re susceptible to colds and coughs, fortify your body with these superstars Most of us come down with something over the winter months, no matter how rigorous our hand-washing, no matter how sterile our environment, no matter how dutifully we’ve instructed those around us to sneeze into a tissue. But we can lessen our chances, experts say, by keeping our immune system healthy. While the jury is still out on which nutrients strengthen our immune system most, there is some evidence that foods rich in vitamins A, B, C and E (all powerful antioxidants), as well as zinc, iron, folate and selenium, do an immune system good! In other words, a balanced diet that’s high in a variety of fruits, vegetables, nuts and whole grains. A few superstar recommendations: broccoli, dark leafy greens, almonds, oatmeal, sweet potatoes, pumpkin seeds and garlic. Will loading up on vitamin C during the cold months keep you sniffle-free? Doubtful. Studies, so far, have found no evidence that vitamin C prevents colds. What some studies have found, however, is that higher doses taken at the onset may help shorten the length of your cold and reduce the severity of symptoms. How much vitamin C? The National Institutes of Health suggests that adults consume no more than 2,000 mg each day, as too much vitamin C may cause kidney stones, nausea and diarrhea. To pack the ultimate vitamin C punch, think outside the OJ carton and load up on these fruits and vegetables (which have more C than an orange): red and green bell peppers, broccoli, cauliflower, strawberries and kiwis. And what about Grandma’s favorite cold remedy: chicken soup? January 2018 •

There’s hard science that supports Granny’s claims! Research shows that chicken soup can ease your symptoms and may help you get well sooner — thanks, in part, to an amino acid in chicken that helps thin mucous to calm your cough and stuffed up nose. Welcome news for those pressed for time: Store-bought soups are just as effective.

If your skin is dry and itchy, add these skin-boosters to your diet From the wind chill outside to the dry air inside, winter is not your skin’s best friend. Thankfully, the right foods can alleviate some common cold-weather skin woes by providing the nutrients needed to help skin cells stay strong, supple and hydrated. When it comes to relieving dryness, foods containing healthy fats are the ultimate power food for skin. Healthy fats — from the omega-3 fatty acids found in salmon to the monounsaturated fats found in nuts and avocados to the polyunsaturated fats found in corn oil — are known to strengthen skin membranes by locking in moisture and protecting skin cells. Eating a variety of colorful fruits and vegetables also promotes optimum skin health. Loaded with skin-protecting antioxidants and vitamins A, C, and E, fruits and vegetables help fight dry skin by keeping it renewed, elastic, and plump. Of course, water is a must and probably one of the most important nutrients you can consume to keep your skin hydrated and itchfree.

Note: The foods suggested throughout are merely recommendations, the tip of the iceberg when it comes to healthy eating. You know best what foods work for you.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 17


The skinny on healthy eating

What’s So Great About Grapefruit? E ver since the infamous Grapefruit Diet made its debut — back in the l930s to help starlets lose weight — grapefruits have been associated with weight loss. Fans claim it contains enzymes that help burn off fat. Some studies have shown that people who eat half a fresh grapefruit or drink grapefruit juice before each meal lose more weight than people who do not. But not all studies have shown the same weight-loss benefit; and scientists can’t say if the weight loss was specifically due to the grapefruit or to filling up on a low-calorie food in general. Final word from nutritionists: Don’t look to the grapefruit to melt fat, but do look to this mouth-wateringly tart fruit for a host of other health benefits.

Great factor No. 1: All

grapefruits pack a hefty dose of vitamin C, with the red and pink ones providing a good dose of vitamin A, too. A powerful antioxidant, vitamin C plays a vital role in the formation of collagen, may speed wound healing, and has even been linked with wrinkle reduction. An equally essential nutrient, vitamin A promotes good vision, normal bone growth, and all-around good health. Both vitamins work hard to keep our immune systems humming, which is especially important during flu season.

Great factor No. 2:

Grapefruit can help lower “bad” cholesterol. Numerous studies have shown that grapefruit eaters, particularly those eating red, had a notable drop in LDL cholesterol. While researchers can’t pinpoint why grapefruits have this affect on cholesterol, they do suggest its cho-

lesterol-clearing fiber, high concentration of antioxidants and beneficial phytonutrients may all contribute to this heart-healthy benefit. More good news for your heart: Grapefruit appears to lower levels of triglycerides, another type of “bad” fat that can clog up arteries.

Great factor No. 3:

Grapefruit may lower blood pressure. Grapefruit, especially grapefruit juice, provides enough potassium to be included in the DASH (Dietary Approaches to Stop Hypertension) Diet, a healthy diet plan that was developed by the National Institutes of Health to lower blood pressure without mediation. Numerous studies suggest that boosting your potassium intake, while curbing salt and sodium, can significantly reduce your risk of stroke and heart disease. A grapefruit’s high vitamin C content may also reduce blood pressure, according to research that links vitamin C with this positive effect.

Not-so-great factor:

Grapefruit and grapefruit juice can seriously interfere with some prescription medications. Because these interactions can cause potentially dangerous health problems, experts recommend you ask your pharmacist

Helpful Tips

Select grapefruits that are firm, smooth, heavy for their size and yield to light pressure. The thinner the rind, the sweeter the grapefruit. Go for the imperfect-looking grapefruit with a discolored rind: they’ll be sweeter than those with uniform color. Store grapefruits at room temperature for up to a week or refrigerate for up to three weeks. Bring refrigerated grapefruits to room temperature for maximum flavor. Rinse grapefruits under cool water before you dig in.


Page 18

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

Grapefruit, Kale and Toasted Walnut Salad

Adapted from Health.com

1 bunch kale, rinsed 2 pink grapefruit 1 shallot 1/4 cup fresh lemon juice 1/2cup plain yogurt 2 to 3 tablespoons extra-virgin olive oil 1/2 teaspoon kosher salt 1/4 teaspoon coarse black pepper 1/2 cup toasted walnuts

Remove the tough ribs from the kale; discard. Chop the kale leaves into small, bite-sized pieces and transfer to a mixing bowl. Sprinkle the kale with a dash of salt and use your hands to massage the kale by scrunching up the leaves. Peel and segment grapefruit, reserving 2 tablespoons of the juice for the dressing. Cut shallot in half, horizontally: mince half; slice other half into thin rings. In small bowl, whisk together minced shallot, reserved grapefruit juice, lemon juice, yogurt, oil, salt and pepper. Add more oil if dressing tastes too tart. Toss dressing with kale. Top with shallot rings, grapefruit, and toasted walnuts.

Anne Palumbo is a lifestyle colum-

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

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Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

Unattainable Resolutions: The 2018 Edition


t’s become a tradition to kick off the new year with a column dedicated to parenting-themed resolutions. I used to take a peek back at the list from the previous year, but that got sad, pathetic and demotivating real quick. Every year I say I am going to set the bar a little lower in order to set myself up for success. However, I still find myself falling short of expectations. So, this year, instead of pretending I can resolve myself to control much of anything about parenting, I am going to provide a list of resolutions and immediately debunk the likelihood of them occurring. If you can’t laugh, you might just cry about your 8:30 bedtime on a Friday night (because you made it to the finish line and need to fall down) or all of the floating crumbs in your favorite beverage (courtesy of a stealthy toddler’s loose regulations on drink sharing). Happiness and contentment are intrinsically linked to expectations. So, in 2018, I am deciding to have very few of those pesky things.

Resolution No. 1

I will stop eating the food my kids don’t finish. No, I won’t. Instead, I will look at my 3-year-old’s nearly untouched food and think to myself how awesome dinosaur-shaped chicken nuggets and cold broccoli will be for lunch tomorrow. It’s a work lunch that I don’t have to prep, so I will count this second-hand food as a win.

mingling at these events. It’s a survival/saving face technique.

Unattainable Resolution No. 5

I will teach my daughter to tie her shoes. I think it’s best for both of us if we just skip this. She can hang out in sandals, Velcro shoes and shoes with speed laces for the rest of her days. When she gets older, her not being able to tie her shoes can be a funny quirk. It will be a great thing to share at those team-building, ice-breakertype sessions.

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I will play with my kids every night after work. I will feed my kids dinner every night after work. I will attend to their personal hygiene needs. I will read them a book and sing them a song. They can play with each other while I am tirelessly cooking food they won’t eat for dinner. (Please note I said I would feed them dinner. I have no illusions about them consuming it).

Unattainable Resolution No. 8

Unattainable Resolution No. 3

I will make more parent friends at school activities This one gets a probability rating of unlikely. I may think I am going to charm the pants off some mom at the winter soccer, but more than likely I will spend much of time at such events alternating between observing my daughter and running down my son in a crowded gym. Running interference will take precedent over

Over 25 years of Experience Kevin L. Gretsky, PT

Unattainable Resolution No. 7

I will stop picking up after my kids. That would be impossible, but I think I will make one of those handy chore matrices, just so my kids can disregard a piece of paper before they ignore my requests to do something. This way, I won’t take it personal. (Seriously though, my kids can be pretty awesome about pitching in. So, I resolve to be thankful about that).

Unattainable Resolution No. 4


Unattainable Resolution No. 6

Unattainable Resolution No. 2

I will lay off the pastries. And take away the one surefire thing to take me out of a funk? Sweet, sweet pastries are a steadfast friend. When the day has been hard, there is always ganache. I am not kicking this habit to the curb. I’ll take the calories in 2018.


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I will get to and leave work early This would involve getting to bed and getting up earlier than I already do. Enough said?

I will get to the gym at least three times per week. I will get to the gym once a week or maybe twice. I will do some planks. I don’t want to work out too hard and give my kids an unrealistic expectation of what a woman’s body should look like. I need them to grow up with the proper perspective on such things.

I will go the bathroom behind a locked door. Or, I can go the bathroom with the door wide open, like I’ve been doing my entire adult life. A midpee hug from one of my kids is way better than hearing them loudly and physically rebel against a locked and closed door. Keeping the door open also lets me listen to all the things my kids think I can’t hear while I am otherwise detained.


Unattainable Resolution No. 9


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Unattainable Resolution No. 10

I will get my son potty-trained. I could, but then what would we argue about if not his lack of desire to go anywhere near a toilet? I would hate to be one of those families that never fight and agree on almost everything. That sounds boring. Unlike my parenting resolutions in years past, I already feel very good about these ones. I know that parenting is full of unpredictability and battles of the will. Luckily, that same unpredictability makes for a lot of laughter. Those battles of the will mean I am raising strong kids. I resolve to stay strong, ride the waves and laugh in 2018. Those are three resolutions my whole family can keep. January 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 19

New Diabetes Drug Gets FDA OK Under ‘Abbreviated’ Pathway

Mallory Wisniewski is a certified yoga instructor who teaches yoga at Elevate Fitness in Syracuse. She is also one of the area instructors who leads goat yoga classes at Purpose Farm in Baldwinsville. “It’s beautiful how friendly the animals are,” Wisniewski said.


dmelog (insulin lispro), a short-acting form of insulin, has been approved by the U.S. Food and Drug Administration to treat people with either type of diabetes, for patients aged three years and older. It’s the first drug approved as a “follow-up” product based on an abbreviated new process dubbed 505(b)(2), the agency said Monday in a news release. A new drug approved this way relies on the agency’s finding that “a previously approved drug is safe and effective, or on published literature to support the safety and/or effectiveness of the proposed product, if such reliance is scientifically justified,” the FDA said. The abbreviated process “can reduce development costs, so products can be offered at a lower price to patients,” the agency explained. “In the coming months, we’ll be taking additional policy steps to help to make sure patients continue to benefit from improved access to lower cost, safe and effective alternatives to brand-name drugs though the agency’s abbreviated pathways,” said FDA Commissioner Scott Gottlieb. Admelog was approved under the new process in part due to its similarity to the diabetes drug Humalog, the agency said. Admelog itself was evaluated in clinical trials involving about 1,000 people. The most common side effects included hypoglycemia (low blood sugar), itching and rash. A less common but more serious adverse reaction could include life-threatening allergic reaction, including anaphylaxis, the FDA said. Admelog should not be used by people with hypoglycemia, or by people who are “hypersensitive” to the drug’s active ingredient insulin lispro, the agency warned. And people at risk of too much blood potassium (hyperkalemia) should be monitored carefully while taking Admelog. Short-acting insulin products are typically given just before meals to help control blood sugar after a person eats. This type of drug is more likely to be used by a person with Type 1 diabetes than a person with Type 2, the agency said. Admelog is produced by the French firm Sanofi-Aventis, whose U.S. headquarters is based in Chattanooga, Tenn.

Page 20

Heard the Latest on Yoga? Off-beat ways to perform yoga has become a huge trend, thanks, in part, to a new generation of yogis By Deborah Jeanne Sergeant


oga: would you do it on a boat? Would you do it with a goat? Today’s yoga scene sounds like it took a page from Dr. Seuss’ “Green Eggs and Ham.” But yogis are practicing on boats, with goats — and in hammocks, on horseback and with a lap full of puppies or kittens. Off-beat ways to perform yoga has become a huge trend, thanks, in part, to a new generation of yogis looking for a fun, quirky way to enjoy an ancient practice. “Some are fusing other forms of exercise, like hooping or Pilates to the yoga program,” said physician Joanne Wu, an integrative and holistic medicine and rehabilitation doctor practicing in Rochester, who also teaches yoga in Syracuse. “Others are a brand new form of movement. It makes it more fun and keeps people challenged. For yoga practitioners, it helps remain mindful of their exercise program while trying something new.” Wu teaches aerial yoga, which uses silk fabric and hammocks as props to help students perform circus-like movements with yoga; piyo, which merges Pilates and yoga; barre yoga, a mix of ballet and yoga; acrobatic yoga, where a partner aids in achieving poses; and SUP yoga, which uses a stand-up paddleboard on the water. “There are definitely ways to make yoga fun and lighthearted, but maintain the mind/body connection that makes yoga what it is,” Wu said. “I’ve worked on blending different exercises with a yoga core. People want to stay active and still learn new things while keeping old traditions. They want something a little different incorporated into their

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

program. “Alternative yoga is helpful for a yogi who wants to stay grounded with mat practice, but expand their horizons and meet more people in the community.” For example, animal lovers may try goat yoga for the sake of the critters, even if they’re not that familiar with yoga. Mallory Wisniewski is a certified yoga instructor who teaches yoga at Elevate Fitness in Syracuse. She is also one of the area instructors who leads goat yoga classes at Purpose Farm in Baldwinsville. She thinks that participants enjoy the animals, practicing outdoors, and knowing that they’re “helping support these rescue animals,” she said. Proceeds from goat yoga help pay for the care of the 40 animals living at the farm. Purpose Farm has rescued 67 animals since opening in 2012, according to its website. Animals that don’t obtain permanent placing remain at the farm for their natural lives. In addition to the novelty of the location and helping a good cause, goat yoga enhances the tranquility of the session and, at times, adds a lighthearted touch as the farm’s handful of goats frolic among the yogis. “It’s beautiful how friendly the animals are,” Wisniewski said. Wisniewski also leads wine &

Aerial yoga is one alternative ways to practice yoga. It’s increasingly more popular in the area. yoga classes, which she said encourage camaraderie among participants. Both Wu and Wisniewski said that alternative yoga classes aren’t just for advanced students. People of any ability should be able to participate, “from people who have never tried yoga, to those who can do head stands,” Wisniewski said.

Sexual Harassment in the Healthcare Industry Power, pay and reputation: How sexual harassment affects the medical community By Julie Halm


t seems that these days, more than ever before, women are feeling empowered to speak out regarding sexual harassment, whether it took place recently or decades in the past. The national eye has turned toward a number of politicians, entertainers and TV celebrities who stand accused of such misconduct, and it seems that the issue is rampant in those particular career fields. But what of the medical field? Are employees of hospitals subject to harassment at a higher rate than in other industries? According to the Equal Employment Opportunity Commission, sexual harassment includes unwelcome sexual advances, requests for sexual favors and other verbal or physical harassment of a sexual nature in the workplace or learning environment. A new ABC News-Washington Post poll released in October, found that more than half of all women in all industries had experienced un-

wanted and inappropriate sexual advances at some point and 30 percent of those women said that they had been harassed while on the job. While hard numbers on an industry-to-industry basis are difficult to come by, according to Buffalo-based lawyer Lindy Korn, who focuses on illegal employment discrimination, sexual harassment and retaliation, some conditions in the medical field lend themselves to just this kind of issue. According to Korn, sexual harassment is more likely to take place when there is a power differential between the two parties involved. “Sexual harassment is about power and the abuse of power and so I think that doctors in particular have a very high status in the United States. They’ve always been revered and respected and I think they’re better paid than some other jobs and that all goes toward some definition of power,” said Korn. According to Korn, the work

conditions of medical facilities, particularly hospitals, might also cause such an issue to arise. The long hours and high-stakes nature of the jobs which are undertaken by doctors and nurses can create strong bonds between co-workers. These bonds and close personal relationships can cause boundaries to become blurry and open the door for unwanted conduct to take place. “What I’m trying to say is, it’s not just doctors, but doctors have the right ingredients,” said Korn. Recently, a social media campaign took place where participants — primarily women — posted #metoo in order to denote that they have been a victim of some type of sexual harassment or assault. The campaign went viral and many experts, including Korn, think that it has the potential to be a very positive message. “I think this national conversation is powerful and it is necessary. It’s really a catharsis and it’s wonderful,” she said. Betty Preble, president of the Buffalo branch of American Association of University Women, agrees wholeheartedly, whether a woman is observing or participating in the campaign, it can bring hope and a sense of justice. “I think that’s terribly empowering for a woman who has been suffering for 30 or 40 years with this emotional trauma,” she said. The AAUW works on a variety of issues and fronts, from providing scholarships to supporting legislation and equal pay is high up on that list. According to the Henry J. Kaiser Family Foundation, roughly 34 percent of physicians in the country are female, whereas just over 83 percent of professionally active nurses are female, making the issue of equal pay a prominent one in this field. According to Korn, in addition to pay, the issue of reputation can cause a power differential, and a problematic situation for a victim of sexual harassment in the instance of a wellknown medical practitioner. “Allegations go to the heart of someone’s reputation and beyond and so sometimes there unbelievable in the public’s eye because the person seemed to be so talented, so kind, everything good, that they couldn’t possibly have this side to them,” said Korn. Whether in the medical field or not, Preble noted that the best course of action for someone who feels they are being harassed is to document everything they possibly can.

Crouse to Begin New Program to Help At-risk Young Men


en ages 18 through 25 with substance abuse disorders who have been arrested for non-violent offenses, can often struggle to succeed in treatment and in life. To help local men in this target population, Crouse Health’s Chemical Dependency Treatment Services has forged a new partnership with the Syracuse Community Treatment Court, made possible by funding from the federal government’s Substance Abuse and Mental Health Services Administration. The HYPE (Helping Young People Excel) grant — providing $853,000 — was awarded recently to Crouse through the NYS Unified Court System. The goal is to treat 135 individual men through the unique program, according to Monika Taylor, director of behavioral health at Crouse. The program will combine traditional treatment with other services that address educational/vocational counseling; anger management; stress management and wellness, among other topics. Two unique aspects of the program will include the use of certified peer recovery coaches and a smartphone app for immediate recovery support. To learn more about the HYPE program, contact Taylor at 315-4708302 or visit crouse.org/addiction.


Almost 30% of Women in Medicine Experience Sexual Harassment


ew research shows that while 4 percent of men in academic medicine endure sexual harassment, nearly 30 percent of women in the same field do, according to Reuters. The finding comes from a study in the Journal of the American Medical Association (JAMA), released in May 2016. Researchers surveyed 1,719 individuals who had received the National Institutes of Health’s K08 and K23 grants — which give career support to young researchers — between 2006 and 2009. Around 1,000 recipients responded. Here are three findings from the study and its related background.


Thirty percent of females reported experiencing sexual harassment of some kind — whether through unwanted sexual comments, attentions or advances — at some point in their career. Nearly 50 percent of these females claimed the experience had negatively impacted their career. According to the JAMA study, 70 percent of women said they’d seen gender bias in the workplace, and 66 percent said they’d personally endured it. Comparatively, 22 percent of males noticed a gender bias in the workplace. Only 10 percent of men said they’d personally experienced it.



A similar 1995 study found 5 percent of males and more than 50 percent of females in academic medicine faculty positions had experienced sexual harassment. Physician Reshma Jagsi, tthe lead author of the study, pointed out that the women in 1995 had started their careers when less than 10 percent of medical school classes were female. “I really thought that harassment would be much less commonly experienced by women in our sample, who went to medical school when the proportion of women among medical students had exceeded 40 percent,” Jagsi said. Source: Becker’s Hospital Review January 2018 •

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Page 21

Women’s HEALTH New Year’s Resolution: Moving Past the Weight Loss Plateau See what four local experts have to say about overcoming weight loss plateaus By Deborah Jeanne Sergeant


as your New Year’s weight loss resolution hit a plateau? Don’t worry. According to the Centers for Disease Control and Prevention, people who lose weight steadily and slowly — about one to two pounds per week — tend to keep it off successfully. One pound of body weight equals roughly 3,500 calories, so to lose weight, a body needs to negate 500 to 1,000 calories per day by eating less and burning more to achieve the goal of one to two pounds lost weekly. If a couple weeks pass and the scale won’t budge, take heart, try these tips from area experts. Tips from Jill Murphy, certified personal trainer with a master’s in exercise science, co-owner of Mission Fitness Corp., East Syracuse: • “A couple of plateau breakers I recommend is increasing cardiovascular activity, as it places a demand on burning more energy. • “Look at the diet for things you can cut back on, like sugars and non-complex carbohydrates. • “Another thing we do is the ketogenic diet, which emphasizes lowering carbs. That causes ketosis, a state where your body burns stored fat more quickly. • “We do intermittent fasting, which allows your body to be more

insulin sensitive. You fast intermittently for 14 hours or so. • “A lot of times, I give these specific rules to clients and they have a hard time implementing them because a lot of times when they hit a plateau, they’re internally dealing with things that prevent them from losing weight. These emotional issues can keep them from moving forward, so they have to address, ‘What is preventing you from moving forward? Is there self-sabotaging behavior hindering you?’” Tips from Joanne Wu, an integrative and holistic medicine and rehabilitation physician who specializes in wellness and practices in Rochester and Buffalo and teaches yoga as a certified instructor in Syracuse: • “Many people, when they work on weight loss, work on only one part. It should include what you eat, well being, stress management and exercise — what they do for movement. • “Set reasonable goals and take steps toward them. If you still plateau, we look at what we can refine. • “Don’t just look at the New Year to make short-term changes, but a long-term wellness program for mind, body and soul. You want to enhance a healthy lifestyle. If we always approach weight loss with

that approach, we’re much more consistent at weight loss.” Tips from Mallory Wisniewski, certified personal trainer and certified yoga instructor at Elevate Fitness, Syracuse: • “Try circuit training. You can do timed training, where you do the activity for a certain length of time, or by reps, where you do a certain number of repetitions of a movement. It tricks the body into losing weight because you use so many parts of the body. • “Don’t keep doing the same thing and working the same area of the body all the time. If you run marathons, but suddenly notice you’re gaining weight, try boxing and you’ll notice losses since you’re using different muscles.” Tips from Laura Kirkpatrick, nutrition and health coach with Metro Fitness and physical therapist with Onondaga Physical Therapy: • “Practice mindful eating and enjoy your food through your senses. Don’t eat in front of TV or computer as this tends to lead to overeating. • Plan, prepare, and pack meals and snacks ahead of time. • If dining out, steer clear of items that are deep fried, shallow fried or pan fried, sautéed, or made

with heavy sauces/breading. Look for steamed, roasted or baked cooking methods. • “Drink plenty of water. A general rule of thumb is to aim for at least half your weight in ounces of water consumed. I like to start my day off with a big glass of warm water with lemon • “Aim for two to three cups a day of unsweetened tea. • “Sugar substitutes give the false sense of satisfaction and can lead to greater caloric intake and weight gain. Avoid aspartame, sucralose, acesulfame, agave, brown rice syrup, concentrated fruit juice, corn syrup and cane juice. • “Consuming more healthy omega-3 and monounsaturated fats are key to mobilizing and burning fat. They’re in foods such as avocado, hemp seed, almonds, walnuts, salmon, chia and flax seed and olives, nut butters. Studies support consuming citrus with healthy fats to aid in metabolism boosting effects as foods work synergistically, such as combining grapefruit with avocado toast with a drizzle of olive oil for breakfast or a snack. • “Get plenty of sleep. Aim for at least seven hours of good quality sleep and practice good sleep habits.”

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Women’s HEALTH Hot Flash Relief Experts discuss ways women can reduce incidence of hot flashes By Deborah Jeanne Sergeant


hances are if you’re a peri-menopausal woman you experience hot flashes as one of the 75 percent of American women who do, according to the North American Menopause Society. “Some hot flashes are easily tolerated, others are annoying or embarrassing and others can be debilitating,” the organization’s website states. Physician Leila Kirdani is a board-certified in both metabolic medicine and family practice. She operates Quality of Life Medicine in New Hartford and Rochester. She beKirdani lieves that stress to the body, in addition to hormonal

changes, causes hot flashes. “If we’re stressed too long and the adrenal glands struggle to supply enough cortisol, one of our stress hormones and one of the primary hormones that regulate the body, that can be experienced as a hot flash as well,” Kirdani said. “I find it important to look at where people’s stress levels are to know how best to balance their hormones.” She believes that healthful diet, including leafy green vegetables and balancing the electrolytes — sodium, potassium and chloride — help prevent the body from being depleted at the cellular level. Kirdani also encourages women in menopause to consider replacing their DHEA (dehydroepiandrosterone), a hormone the body produces in smaller amounts as it ages. “If the adrenals struggle to make DHEA and cortisol and the ovaries are shutting down because of menopause, we have trouble,” she said. She said that 25 mg. of orally dissolved DHEA in the morning sup-

ports better energy and if hot flashes are caused by low adrenals, it will help reduce hot flashes, too. Environmental controls she recommends include medication, relaxation, “and, as I like to say, to minimize the to-do list,” Kiridani said. “Schedule in time in your week for yourself.” Kirdani recommends menopausal patients exercise, as that helps de-stress the mind and body (many like swimming), and better stabilize blood sugar levels. “When our metabolism is slowing down, we don’t metabolize carbs as well,” she said. “Women realize if they eat carbs before bed, they’ll have more hot flashes.” Instead, they should eat more produce, serve meat as a side and include whole grains while eschewing processed foods. Supplements she suggests include chaste berry, black cohosh, and dong quai, depending upon the patient. Laurel Sterling, health educator for Carlson Labs in Arlington Heights, Ill. and a registered dietitian practicing in Canastota, recommends taking vitamin E, magnesium nitrate or Sterling

magnesium glycinate, and red clover, as well as black cohosh. “Non-gmo fermented soy products are a dietary way to get relief, like miso and tempeh,” she added. “Red raspberry leaf tea and sage tea at room temperature help. Essential oils such as lavender extract, rosewater, evening primrose and sage provide a calming effect for some women. Lifestyle also makes a difference. Sterling said that unmanaged stress “is the number one thing that kicks off a hot flash for many women,” she said. Dressing in layers can help women better manage their body temperature so that as they heat up, they can peel off layers. Breathable, moisture wicking fabric can also help them stay more comfortable if they become sweaty. At night, it makes sense to follow suit with layered blankets and keep a fan nearby.

probably have incontinence if their BMI is 35 or 40.” Advanced maternal age also increases the risk, as women in their mid-30s have experienced more wear and tear on their pelvic floor. That’s also the age at which people begin losing muscle tissue. “They’re also more likely to be overweight and diabetic and, if they’ve been smoking, they’ve been smoking longer than younger women,” Doyle said. Genetics also play a role. The more children a woman bears, the greater risk she has of urinary incontinence, but the risk doesn’t increase much more after the third or fourth pregnancy. “The pelvic floor muscles which play a vital role in both types of incontinence,” said Elizabeth Loycano, who earned a doctorate in physical therapy and practices at Finger Lakes Health. “The stress of delivering a baby directly affects these muscles.” Loycano earned additional certification related to women’s pelvic health. She helps women learn movements that strengthen the core mus-

cles, including the pelvic core. “Good body mechanics, such as when lifting the baby or car seat and remembering to keep a flat back and engage abdominal muscles, can help,” Loycano said. This advice applies for both vaginal and C-section births, once cleared for exercise. Despite the difference in delivery method, both experience the months of hormonal changes that result in lax connective tissues and the pressure of carrying a baby. Most women recover from child birth-related urinary incontinence within three months of delivery. Especially for those who don’t, “a physical therapist can tailor a program if you have urge or Kirdani stress or both to figure out the kind of contraction you need and the kind of exercises do to,” Loycano said.

Gotta Go. Fast… Nearly half of middle-aged women are affected by urinary incontinence. See what local experts say about the problem By Deborah Jeanne Sergeant


f you’re a woman experiencing urinary incontinence, you’re like many other American women. The National Institutes of Health estimates that about 20 to 30 percent of young adult women experience urinary incontinence; that rises to 30 to 40 percent of middle-aged women and then to 30 to 50 percent of elderly women. Urinary incontinence involves urge incontinence — the feeling of needing to urinate — and stress incontinence, which occurs when the patient sneezes, coughs, laughs or otherwise moves in a way that causes urine to leak. The leaks are significant enough to cause health or social problems. Thankfully, women can do something about it, even if their children are long since past babyhood. Physician Leila Kirdani, a board-certified in both metabolic medicine and family practice, operates Quality of Life Medicine in New Hartford and Rochester. She recommends Kegel exercises. To find the right muscles, try to stop a flow of urine while on the toilet and then engage those muscles elsewhere throughout the day, increasing the time holding the muscles for each

repetition. “Do them throughout the day until you work up 50 or 100 a day,” Kirdani said. Of course, women need to wait until they’re cleared for exercise and have healed from delivery. Older women may also benefit from balancing their hormones. Kirdani said that low estriol can affect urinary control but topical, over-thecounter estriol cream can help. So why does this issue happen? Several factors relate to urinary incontinence, including childbirth. During pregnancy, the body decreases support in the pelvic floor and produces hormones that relax the connective tissues to make birthing easier. The growing baby places pressure on the bladder and can stretch tissues as well. Preventing urinary incontinence during and after pregnancy depends mostly upon maternal weight, according to Paula Doyle, OB-GYN with University or Rochester Medical Center. “Have a body-mass below 25 before becoming pregnant,” Doyle said. “If a woman’s BMI is 30 or higher before pregnancy, for every BMI point above 30, the risk is 3 percent higher during and after pregnancy. They’ll

January 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Women’s HEALTH faster causing a person to always feel hungry and never satisfied which can lead to mindless eating and therefore additional calories resulting in weight gain. • “When we skip meals or restrict our diets, our bodies will adapt to the calorie restriction/deficit and will automatically use fewer calories to perform routine tasks. The body will hold on to those calories because it thinks it is going into starvation or famine mode and will need to do more with fewer calories. This is often the case when people go on very low-calorie diets that are too restrictive in calories. Restrictive diets will promote rapid weight loss; however, it is very difficult to sustain the weight that was lost.”

Lose Weight Fast: Ramp Up Your Metabolism By Deborah Jeanne Sergeant


fast metabolism — how quickly your body burns through calories — seems the Holy Grail for weight maintenance. Instead of carefully watching every spoonful, some people seem to eat what they want and not gain an ounce. Local experts say there isn’t really one way to “hack your metabolism” despite what social media and advertisements claim. But you can make a few changes that can improve your metabolism. Try these expert tips from local experts: Tips from Kathleen Bump, registered dietitian nutritionist, Nutrition Team leader, Cornell Cooperative Extension Onondaga County: • “Many factors affect a person’s metabolism/metabolic rate such as age, gender, height, weight, body composition, health status, hormones and genetic makeup. Individuals with more lean muscle mass will typically have a faster metabolism and will require more fuel/energy than people with a higher percentage of body fat. As we age our muscle mass decreases.

• “Metabolism is like a furnace that needs constant and consistent f uel to function properly. Providing your body with meals at regular intervals throughout the day is important to keep the furnace burning and functioning properly. Nutrient-dense foods keep you fueled for longer to keep the furnace burning. • “Unfortunately, there is little evidence to support that any particular food will jumpstart or slow our metabolism. A balanced diet comprised of lean protein, fruits, vegetables, low fat dairy and whole grains will keep our bodies satisfied. Eating energy dense foods like refined carbohydrates and processed foods will have the opposite effect. Energy dense foods are often loaded with added sugar, salt and saturated fat. These types of foods are digested

Tips from Jill Murphy, certified personal trainer and co-owner Mission Fitness Corp., East Syracuse: • “Try a cardiovascular workout called HIIT: high intensity interval training. That’s where we often have clients do it on the elliptical machine. There’s not a lot of impact on joints. You work as hard as you can 30 seconds, then allow the heart and lungs to recover 90 seconds, then do it again. Do eight intervals — 30 seconds, plus a rest is one interval — with a warm up and cool down. Because the intensity is high, don’t do it every day, but least one time week. • “The number one thing that would increase metabolism is weight training because the more muscle someone has, the more calories they burn at rest. Women don’t have the testosterone as men have to get big and bulky. It’s about getting in the gym once or twice a week and pushing to failure at each resistance exercise with a short rest. Do five to 10 reps for the upper body and eight to 15 reps for the lower body. The key is you go very slow at a controlled pace. You keep momentum out of the equation so you don’t jar the joints. It stimulates the muscle. As your body repairs itself is how you can increase your metabolism. After 25, our bodies begin to lose muscle.” Tips from physician Leila Kirdani, board-certified in both metabolic medicine and family practice and owner of Quality of Life Medicine in New Hartford and Rochester • “The biggest thing with this is exercise. It’s a sad, hard truth for

people who don’t like to exercise. When you build muscle, you build microchondria. It has a higher metabolic rate than other cells. Walking is wonderful, but if you’re really trying to speed up your metabolism, it requires a more aerobic exercise and weight training. • “High intensity interval training has been shown to increase metabolism more quickly than conventional exercise. It’s not as good at reducing obesity and helping cholesterol levels, but if the goal is to increase metabolism, it’s fabulous. • “Things that help microchondria health include supplementing with alpha lipoic acid. This is an enzyme helper where the body makes molecules of energy. It can help increase the metabolism, keep cholesterol panels good and is a powerful antioxidant. • “Supplement with D-ribose, a sugar that doesn’t raise your blood sugar but makes up part of the molecule of energy. If you take it before a workout, your body will able to burn more energy.” Tips from Laura Kirkpatrick, nutrition and health coach with Metro Fitness and physical therapist with Onondaga Physical Therapy • “Green tea and spices help with satiety, increased metabolism and therefore help with weight loss or maintaining a healthy weight. Also, increase satiety and boost the metabolism with oatmeal (preferably steel cut or organic oats), eggs (up to two, three times a week), almonds, beans, lentils, peas, Greek yogurt, healthful fats, berries, and up to two cups of coffee daily. • “Foods that negatively impact the metabolism include high sugar foods and drinks, highly processed foods and convenience foods and foods high in saturated fat and trans fat. • “Try not to eat too close to going to bed. Plan to have consumed most calories at least three hours prior to going to bed. • “Try to eat majority of (preferably complex) carbohydrates during the first part of the day and fill the dinner plate mainly with lean protein, healthy fats and non-starchy vegetables. Include a cup of tea after dinner or prior to bed.”

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rinking three to four cups of coffee a day is not only safe for most people, it might protect against heart disease or an early death, a new review suggests. The finding, which applies to so-called “moderate” coffee drinking, stems from a review of more than 200 previous studies. The fresh analysis also linked moderate coffee drinking to a lower risk for developing prostate, endometrial, skin and liver cancers, Type 2 diabetes, liver disease, gout, gallstones and dementia. Some of the studies in the review also showed a lower risk for Parkinson’s disease, depression and Alzheimer’s. However, the review did not prove that coffee drinking caused these health risks to drop. And it also found that coffee may be somewhat problematic for pregnant women and slightly increases the risk for fracture among all women. The review was led by physician Robin Poole, a specialist registrar in public health at the University of Southampton in England. He col-

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s the baby boomer population ages, the number of Americans with Alzheimer’s disease will double by 2060, researchers report. The study findings, which show cases of Alzheimer’s and mild cognitive impairment going from 6 million this year to 15 million in four decades, highlight the need to better identify people with a brain-related disease, and to slow its progression. “There are about 47 million people in the U.S. today who have some evidence of preclinical Alzheimer’s,” said study author Ron Brookmeyer. He is a professor of biostatistics at the Fielding School of Public Health at University of California, Los Angeles. “Many of them will not progress to Alzheimer’s dementia in their lifetimes. We need to have improved methods to identify which persons will progress to clinical symptoms, and develop interventions for them that could slow the progression of the disease, if not stop it altogether,” Brookmeyer said in a UCLA news release. The researchers used information from large Alzheimer’s studies to create a computer model to estimate the number of future Alzheimer’s

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cases. The investigators determined that by 2060, about 5.7 million Americans will have mild cognitive impairment and another 9.3 million will have full-blown Alzheimer’s. Of those with Alzheimer’s, about 4 million will require intensive care, such as that provided in nursing homes. “Estimates by disease state and severity are important because the resources needed to care for patients vary so much over the course of the illness,” Brookmeyer said. People with mild cognitive impairment (MCI) have significant short-term memory loss but do not necessarily have problems with daily functioning. While those with MCI are more likely to go on to develop Alzheimer’s disease, MCI does not always lead to dementia. In fullblown Alzheimer’s, the symptoms are more severe, and include memory loss as well as impaired judgment and thinking, problems with performing normal daily activities and, sometimes, personality changes. The study was published Dec. 7 in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association.

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Recognizing and Treating Depression in Retirement Dear Savvy Senior, Since retiring a few years ago, my husband has become increasingly irritable and apathetic. I’m concerned that he’s depressed, even though he may not admit it. Where can we turn to get help with this, and what, if anything, does Medicare pay for?

Concerned Spouse Dear Concerned, Depression is unfortunately a widespread problem among older Americans, affecting approximately 15 percent of the 65-and-older population. Here’s what you should know, along with some tips and resources for screening and treatments, and how Medicare covers it.

Identifying Depression

Everyone feels sad or gets the blues now and then, but when these feelings linger more than a few weeks, it may be depression. Depression is a real illness that affects mood, feelings, behavior and physical health, and contrary to what many people believe, it’s not a normal part of aging or a personal weakness, but it is very treatable. It’s also important to know that depression is not just sadness. In many seniors it can manifest as apathy, irritability or problems with memory or concentration without the depressed mood. To help you get a handle on the seriousness of your husband’s problem, a good first step is for him to take an online depression-screening test. He can do this for free at Mental Health America, a national nonprofit organization that offers a variety of online mental health screening tools at MentalHealthAmerica.net — click on “Take a Screen” in the menu bar. Or at HelpYourselfHelpOthers.org, which is offered by Screening for Mental Health, Inc. Both of these tests are anonymous and confidential, they take less that 10 minutes to complete, and they can help you determine the severity of your husband’s problem.

Get Help If you find that he is suffering from depressive symptoms, he needs to see his doctor for a medi-

cal evaluation to rule out possible medical causes. Some medications, for example, can produce side effects that mimic depressive symptoms — pain and sleeping meds are common culprits. It’s also important to distinguish between depression and dementia, which can share some of the same symptoms. If he’s diagnosed with depression, there are a variety of treatment options including talk therapy, antidepressant medications or a combination of both. Cognitive behavioral therapy (CBT) is a particularly effective type of talk therapy, which helps patients recognize and change destructive thinking patterns that leads to negative feelings. For help finding a therapist who’s trained in CBT, ask your doctor for a referral, check your local yellow pages under “counseling” or “psychologists,” or check with the Association for Behavioral and Cognitive Therapies (FindCBT.org), or the Academy of Cognitive Therapy (AcademyofCT.org). And to search for therapists that accept Medicare, use Medicare’s Physician Compare tool. Go to Medicare. gov/physiciancompare and type in your zip code, or city and state, then type in the type of profession you want locate, like “psychiatry” or “clinical psychologist” in the “What are you searching for?” box.

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Medicare Coverage You’ll be happy to know that original Medicare currently covers 100 percent for annual depression screenings that are done in a doctor’s office or other primary care clinic. They also pay 80 percent of its approved amount for outpatient mental health services like counseling and therapy services, and will cover almost all medications used to treat depression under the Part D prescription drug benefit. If you and your husband get your Medicare benefits through a private Medicare Advantage plan, they too must cover the same services as original Medicare but they will likely require him to see an in-network provider. You’ll need to contact your plan directly for the details.

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

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

Rosie The Riveter: Working Women’s Icon By Deborah Banikowski

Rosie the Riveter” is an American icon representing women working in factories during World War II. These women learned new jobs and filled in for the men who were away at war. They produced much of the armaments and ammunition to supply the war effort. They also paid FICA on their wages, contributing to the Social Security program. These “Rosies” embodied the “can-do” spirit immortalized in a poster by J. Howard Miller. Both the image and the spirit live on today. If you asked Rosie about Social Security, she would use her rivet gun to drive home the value of Social Security for women. More Rosies work today, and nearly 60 percent of people receiving benefits are women. Women tend to live longer than men, so Social Security’s inflation-adjusted benefits help protect women. You can outlive your savings and investments, but Social Security is for life. Women provide their own basic level of protection when they work and pay taxes into the Social Security system. Women who have been married and had low earnings or who didn’t work may be covered through their spouses’ work. Today’s Rosie will turn her “cando” spirit to learning more about Social Security and what role it will


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

Q: Is it illegal to laminate your Social Security card? A: No, it is not illegal, but we discourage it. It’s best not to laminate your card. Laminated cards make it difficult — sometimes even impossible — to detect important security features and an employer may refuse to accept them. The Social Security Act requires the Commissioner of Social Security to issue cards that cannot be counterfeited. We incorporate many features that protect the card’s integrity. They include highly specialized paper and printing techniques, some of which are invisible to the naked eye. Q: I have never worked but my spouse has. What will my benefits be? A: You can be entitled to as much as one-half of your spouse’s benefit amount when you reach full retirement age. If you want to get Social Security retirement benefits before you reach full retirement age, the amount of your benefit is reduced. The amount of reduction depends on when you will reach full retirement age. For example, if your

play in her financial plan for the future. She focuses on our pamphlet called “What Every Woman Should Know.” available at www.socialsecurity.gov/pubs/10127.html for a game plan. She rolls up her sleeves and sets up her “my Social Security” account (www.socialsecurity.gov/myaccount) to review her earnings and estimates. If she finds an incorrect posting, she’ll locate her W-2 form and quickly contact Social Security to correct it because she understands these are the earnings used to figure her benefits. She dives into understanding benefits at our planner pages at www.socialsecurity.gov/planners. She examines how marriage, divorce, death of a spouse, work, and other issues might affect her benefits. She studies our fact sheet “When to Start Receiving Retirement Benefits” at www.socialsecurity.gov/pubs/ to help her decide when it’s time to lay down the rivet gun. And when the time is right, she will file for retirement benefits online at www. socialsecurity.gov/retire. Whether it was keeping the war effort production lines humming or discovering what is available to her from Social Security, Rosie symbolizes the motto: “We Can Do It.” Rosie and millions like her rely on the financial protection provided by Social Security in assembling their own financial futures.

full retirement age is 66, you can get 35 percent of your spouse’s unreduced benefit at age 62 (a permanent reduction); if your full retirement age is 67, you can get 32.5 percent of your spouse’s unreduced benefit at age 62 (a permanent reduction). The amount of your benefit increases if your entitlement begins at a later age, up to the maximum of 50 percent at full retirement age. However, if you are taking care of a child who is under age 16 or who gets Social Security disability benefits on your spouse’s record, you get the full spouse’s benefits, regardless of your age. Learn more about retirement benefits at www.socialsecurity.gov/ retirement. Q: Who is eligible for Supplemental Security Income (SSI)? A: People who receive SSI are age 65 or older, blind, or disabled with limited income and resources. Go to www.socialsecurity.gov for income and resource limits. The general fund of the United States Treasury makes SSI payments. They do not come out of the Social Security Trust Fund.

H ealth News Judy Hayman Appointed Director of the Syracuse VA Medical Center Judy Hayman has been appointed as the new director of the Syracuse VA Medical Center. Hayman will oversee delivery of health care to more than 52,000 veterans, an operating budget of $300 million and 1,700 employees at one of Upstate New York’s largest VA Medical Hayman Centers. “We are excited that Dr. Hayman has been appointed as the new director of the Syracuse VA Medical Center,” said Joan E. McInerney, Veterans Integrated Service Network (VISN) 2 director. “Her sound leadership qualities and proven experience will be valuable assets for the facility, the employees and volunteers and, most importantly, for the veterans we are honored to serve.” Hayman joined the VA more than 10 years ago and has held progressive leadership positions at the Syracuse VA Medical Center. Most recently, she served as the associate medical center director at the Syracuse VA Medical Center and, since April of 2017, she has been the acting medical center director. Hayman holds a Doctor of Philosophy degree in clinical psychology from Fairleigh Dickinson University, Teaneck, N.J. She is a member of the American College of Healthcare Executives and a graduate of the Health Care Leadership Development Program. The Syracuse VAMC is a 136-bed general medical and surgical referral center including a 16-bed acute care psychiatric unit as well as a 48-bed community living center and a spinal cord injury center. It provides a full range of patient care services, education and research to include primary care, mental health care, tertiary care, long-term care, physical medicine, rehabilitation, neurology, oncology, dentistry, telehealth and home based primary care. It is a teaching facility affiliated with SUNY Upstate Medical University and operates community-based outpatient clinics in Massena, Watertown, Auburn, Rome, Oswego, Binghamton, and Tompkins/Cortland in Freeville.. It serves serving 13 counties in Central New York.

New chief of spinal cord injury at the VA Physician Steven W. Brose has been appointed as the new chief of the spinal cord injury and disabilities service at Syracuse VA Medical Center. He will oversee delivery of health care to veteran patients with spinal cord injuries and other related disorders and disabilities at the medical center’s Spinal Cord Injury and

Disorder Center. “We are fortunate Dr. Brose has joined the Syracuse VAMC as a valued leader in the position of chief of spinal cord injury and disorders center. Dr. Brose will be leading the expanded implementation of specialty SCI/D clinical programs,” said Judy Hayman, the newly Brose appointed Syracuse VA Medical Center director (see related news item in this issue). Brose comes to the Syracuse VA from the SCI service in Cleveland, where he served as medical director of the spinal cord injury outpatient clinic at the Louis Stokes VA Medical Center and as professor of specialty medicine at Ohio University. Brose earned a Bachelor of Science degree from Ohio University in Athens, Ohio, in 2001 and Doctor of Osteopathic Medicine degree in 2005. He then proceeded with residency training in physical medicine and rehabilitation at the University of Pittsburgh Medical Center, where he also served as chief resident and then spinal cord injury fellow. Board-certified in both physical medicine and rehabilitation and spinal cord injury medicine, Brose is a funded investigator in electrical stimulation for bowel and bladder management and is a recent recipient of a three year, $1.65 million merit review grant investigating the clinical application of genital nerve stimulation to inhibit bladder hyperreflexia in persons with SCI. He is an associate editor of both the American Journal of Physical Medicine and Rehabilitation Journal of Spinal Cord Medicine, and is an active participant of the research and awards committee at the American Spinal Injury Association where he recently designed a fellowship award program to recognize distinguished members of the field. The Syracuse VAMC opened the SCI/D Center in 2013 and has rapidly expanded since then. It serves more than 640 patients in a threestate area and provides a full range of inpatient acute care services, outpatient SCI/D primary and specialty care, telehealth, and home based primary care.

MedTech adds six leaders to board of directors MedTech Association, a membership-based trade association for the bioscience and medical technology industry in New York state, has added six highly-qualified community and industry leaders to its 20172018 board of directors. MedTech is based in Syracuse. The new board members are Jennifer Barrett, associate director client services and director of business development, Axon Communications; Ben Burton, president

Oneida Healthcare Continues to Score Among Best in NYS For a third consecutive time, Oneida Healthcare’s Hospital received an “A” from The Leapfrog Group for its commitment to keeping patients safe and meeting the highest safety standards in the U.S. It is the only area hospital to receive an “A” for patient safety throughout Onondaga, Madison, Oneida, Oswego, Cayuga and Herkimer counties, according to the hospital. “Our commitment to exceptional care, always, continues to be evident with yet another outstanding result that recognizes our staff’s continued focus on patient care,” said Gene Morreale, president and CEO of Oneida Healthcare. “Earning a third consecutive “A” grade for hospital safety is an impressive achievement and a reflection of the exceptional outcomes our patients are receiving every day from OHC medical staff members and employees.” Morreale said Oneida Healthcare represents just one of only 1 of 7 hospitals to receive an “A” throughout the state of New York. The Leapfrog Group provided and CEO, iuvo BioScience; Kathi Durdon, director of operations and innovation partnerships, CNY Biotech Accelerator; physician Irfan Khan, founder and chief strategy officer, Circuit Clinical; Brian Toglia, vice president, Tanner-Ibbotson, Inc.; and Lou Walcer, director, The Kevin M. McGovern Family Center for Venture Development in the Life Sciences, Cornell University. MedTech connects New York state’s bio/med industry through collaboration, education and advocacy. It is an active association of nearly 100 pharmaceutical, biotech and medical technology companies, their suppliers and service providers and research universities.

Oswego Health welcomes new psychiatrist Psychiatrist Vintee Narang has recently joined Oswego Health’s behavioral health services staff. Narang earned her medical degree from Ross University School of Medicine where she completed her psychiatry clerkship at Bergen Regional Medical Center, and said she instantly knew psychiatry was the specialty she would pursue as a January 2018 •

grades for 2,639 hospitals nationwide, with 823 earning the top letter grade. Only 19 percent of the hospitals in New York state earned an ‘A,” while 17 percent nationwide were presented the top grade three times in a row. Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses 27 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. hospitals twice per year. It is calculated by top patient safety experts, peer reviewed, fully transparent and free to the public. To compare local hospital safety grades, visit hospitalsafetygrade.org. “It takes consistent, unwavering dedication to patients to achieve the highest standards of patient safety. An ‘A’ safety grade recognizes hospitals for this accomplishment,” said Leah Binder, president and CEO of The Leapfrog Group. “We congratulate the clinicians, board, management and staff of Oneida Healthcare for showing the country what it means to put patient safety first.” Oneida Healthcare serves an area comprised of approximately 24 communities in Madison and western Oneida counties with a population of approximately 100,000. career field. “It was a very thorough rotation in a large hospital and it all fell into place for me,” she said. Narang added that her five years of training in a community health setting during her behavioral health residency training completed at Eastern Virginia Medical School and Child and Adolescent Fellowship training at Brookdale Narang University Hospital was invaluable and prepared her for her position at Oswego Health. She will provide care at the health system’s outpatient clinic on Bunner Street, Oswego, and for its assertive community treatment program, also known as the ACT team. Narang earned her Bachelor of Science degrees in biology and philosophy, graduating with honors from the University of Alabama at Birmingham. In her spare time, Narang enjoys going to the gym.

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H ealth News Three North Country Hospitals Enter Into Clinical Affiliation Agreements With Crouse Health Agreements between Carthage Area Hospital, Claxton-Hepburn Medical Center, River Hospital and Crouse Health to enhance community health care quality and access while maintaining local governance


he boards of directors of Carthage Area Hospital, Claxton-Hepburn Medical Center, River Hospital and Crouse Health announced in December clinical affiliations to enhance health care quality and access in Central and Northern New York. The agreement allows the three Northern New York hospitals to develop strong professional and clinical relationships between one another and Crouse Health in Syracuse. The affiliations do not represent a merger or acquisition, but instead will allow each institution to strengthen patient services and share best practices and expertise. Under the affiliations, each institution will continue to operate as an independent, separately licensed community-based hospital and maintain its existing board governance structure. Additionally, each partner will continue singular responsibility for assets, operations, liabilities and budget. Labor agreements between each institution and its professional unions are unaffected. “During the past three years, our team has worked hard to strengthen Carthage Area Hospital and cement

a sustainable future,” said Richard A. Duvall, chief executive officer, Carthage Area Hospital. “From realigning the organization to serve its communities more efficiently and effectively to improving staff and finances, the board and leadership are confident that a clinical affiliation with Crouse Health, Claxton-Hepburn Medical Center and River Hospital will strategically position us for years to come.” “Claxton-Hepburn Medical Center is committed to sustaining and enhancing the services we provide to our community,” said Nate Howell, president and chief executive officer, Claxton-Hepburn Medical Center. “An affiliation with Crouse Health, further backed by Northwell Health, will provide the tools we will need to successfully navigate upcoming health care challenges. Furthermore, I am excited that this partnership will further align CHMC with Carthage and River Hospitals, as it will enable us to tailor efforts for the North Country as a region.” “The river communities we serve are deeply aware of the need for, and value of, a strong local Critical Access Hospital. The affiliation strength-

ens River Hospital by providing our patients access to a whole new level of specialized care,” said Ben Moore, chief executive officer, River Hospital. “With the ability to access physicians at partner institutions and the availability of advanced telemedicine supported through Crouse Health’s affiliation with Northwell Health, our patients and neighbors will receive an unprecedented level of comprehensive and compassionate care through a trusted local institution.” “Crouse Health is proud to be affiliating with Carthage Area Hospital, Claxton-Hepburn Hospital and River Hospital to enhance access to health care services in the North Country. Crouse shares many of the same attributes as these hospitals, including similar missions, open and transparent cultures and a focus on physician and employee engagement,” said Kimberly Boynton, Crouse Health president and CEO. “Our focus will be on keeping health care local, where it belongs, but also offering the three hospitals the ability to develop relationships with Crouse for clinical programs or services that may not be available in the North Country, improve coordination of care, and take advantage of our partnership with Northwell Health,” said physician Seth Kronenberg, Crouse Health chief medical officer. “The hospitals will also be able to collaborate to share best practices, both clinical and operational, and benefit from other economies

of scale to ensure long-term financial, quality and operational sustainability.” Through the affiliations, patients will gain access to specialized care and physicians throughout Central and Northern New York. They will be able to see specialists from the hospitals participating in the agreement when needed, either in the hospital, in physicians’ offices or through advanced telemedicine, which will be supported through Crouse Health’s affiliation with Northwell Health. This will enable quality diagnosis and treatment while eliminating unnecessary travel time or delays for patients in the North Country. In May, Crouse Health signed a similar clinical affiliation agreement with New Hyde Park–based Northwell Health. Northwell Health is New York state’s largest health care provider and private employer, with 22 hospitals, more than 550 outpatient practices and 62,000 employees. Northwell is also the nation’s 14th largest health system. Northwell has significant experience and expertise in areas such as care management, quality improvement, population health, data analytics and other key areas that will be of significant benefit to both Crouse and the three partner hospitals as health care transitions from a fee-for-service to a value-based model of care delivery.

Auburn Community Hospital, St. Joe’s and URMC Announce Collaboration Agreement “As our health care system Today, ACH is a health care deAgreement is designed to improve community health and quality of care for Auburn-area residents by sharing information and resources across the three systems.


he board of trustees of Auburn Community Hospital (ACH) in Auburn has recently approved a collaboration agreement with St. Joseph’s Health in Syracuse and the University of Rochester Medical Center (URMC) in Rochester. The agreement enables the three health systems to jointly develop and share new programs and services to enhance care for Central New York. ACH will continue to operate as an independent, separately licensed community hospital and maintain its existing board governance structure. The agreement is designed to improve community health and quality of care for Auburn-area residents by sharing information and resources across the three systems. Health professionals in Auburn will be able to more easily collaborate with those in Syracuse and Rochester, Page 30

and patients will benefit from easier access to the services of the larger hospitals. Whether they receive care close to home or need more specialized care in Syracuse or Scott Rochester, patients can find nearly any service they need within this collaborative network. ACH is the largest employer in Cayuga County, with a workforce of over 1,000 employees. The hospital has a combined medical staff of more than 300 medical professionals and multiple primary care sites.

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

livery system that includes the hospital, an 80-bed long term care and rehabilitation center, three urgent care centers, as well as primary care and specialty care services. “Over the past 10 years as we have worked to keep ACH strong and strategically-positioned for the dynamic environment we are in, we have been engaged in numerous discussions with multiple organizations,” said Scott Berlucchi CEO. “Among the key criteria our board, physician leadership and senior leadership team used to evaluate potential partners was a strong alignment and compatibility with the ACH culture as well as our mission, which is to provide the best in patient care and promote population health. This was a thoughtful and focused process, and we were steadfast that whichever partner we chose to align with had to be in sync not only with our mission, but also with our core values. I am confident that we have these synergies with St. Joseph’s Health and URMC.” The agreement commits the three health systems to work more closely together to identify and meet the overall community healthcare needs.

evolves, there is a growing need for us to work with larger health systems to improve access to specialty services right here in Cayuga County,” Berlucchi said. “In this case, we have the opportunity to formalize a long-standing relationship with one of the premier hospital systems in Central New York with St. Joseph’s Health, and the region’s largest academic medical center, the University of Rochester Medical Center. We believe this mean greater convenience and more comprehensive care for our local patients and their families.” As part of this new relationship, St. Joseph’s Health and URMC will support ACH’s primary care network, and help develop care management programs and other services that will position the hospital and its affiliates to meet the challenges of population health. St. Joseph’s Health and URMC will also assist ACH with physician recruitment, quality improvement initiatives and the sharing of other best practices to increase clinical and operational efficiencies, and improve patient safety and the overall patient experience. We expect new services to include: Neurology, Cancer Care, Orthopedics, and Cardiology, among others.

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