in good Meet Your Doctor Steven W. Brose, new chief of the spinal cord injury and disabilities service at Syracuse VA, plans to greatly expand services locally. He also talks about the latest in spinal cord injury treatments
February 2018 • Issue 218
Can older adults enjoy sexual intimacy? Read what several experts have to say about it. Also in this “Golden Years” special edition: • Too many meds = increased health risks. What to do about it • Mediterranean diet a recipe for strength in old age • Want to get in shape? Hire a trainer •Gift shop helps aging nuns in Syracuse
Questions to Syracuse VA’s New Director
Judy Hayman is the first woman to lead the Syracuse center, one of the largest in Upstate
Help with ED
In news that will delight men who’ve had difficulties in the bedroom, two generic versions of the erectile dysfunction drug Viagra hit the market in December.
CNY’s Healthcare Newspaper
Sex After 90?
Why this is one of the hottest careers in medical field today. The mean wage for PAs in Rochester area is $98,390
Healthy Tips for 2018
Flu Outbreak Hammering CNY Situation in Onondaga, Oswego counties one of the worst in NYS. Cayuga County also registers high number of cases
Dark Chocolate Don’t feel guilty about eating dark chocolate, says SmartBites writer. There are tons of good things going for it.
Food & Meds Foods and medications can interact, reducing the medications’ effectiveness or increasing the risk of harmful side effects. Find out what you should not eat if you’re taking certain medications.
An apple a day will keep the doctor away, but a glass of apple juice might not, says physician Roy Buchinsky as he encourages people to eat fruit, not drink it. with everyday hassles. Remind yourself that from challenges, come opportunities.
6. Healthy Tips for 2018 Tips to help maximize your chances of a long, strong and resilient life
“If the food is white, it’s probably not right.” Avoid processed white carbohydrates such as white bread, bagels, rice, pasta and pizza. Replace with whole-grain products such as whole-grain bread, brown rice — or try pasta made from quinoa or brown rice.
“Don’t drink your fruit when you can eat your fruit.” Fruit in its natural form is healthiest. It is filled with fiber and antioxidants with their inherent benefits. When fruit is liquefied, you lose much of the fiber and increase the concentrated sugar load on your body. An apple a day will keep the doctor away, but a glass of
apple juice might not.
“Sitting is the new smoking.” Increase your daily physical activity by moving more every day. Aim for 10,000 steps per day — no ifs, ands or buts. “Don’t skimp on sleep.” Aim for seven to eight hours per day. This will allow you to function at your best and ward off many illnesses that are associated with sleep deprivation.
“Maintain a gratitude attitude every day.” Looking at life with a positive attitude can help you deal better
“Don’t sweat the small stuff.” Don’t get upset over minutia in life and focus on the big-ticket items, health, family, work, religion.
“Avoid toxins such as tobacco, excess alcohol and BPA.” Take care of the environment and the environment will take care of you.
“Prevention is the best intervention.” Vaccinations might not be foolproof, but they are very powerful in preventing common illnesses such as influenza, pneumonia, HPV, hepatitis, shingles, diphtheria, etc. Remember these ‘bugs’ are devilishly clever.
about things that are out of our control. If you focus predominantly on items that are actually within your control, you will be able use your energy productively.
“Take your work seriously, but don’t take yourself too seriously.” As the inimitable Charlie Chaplin said, “A day without laughter is a day wasted.” Source: Physician Roy Buchinsky, director of wellness at University Hospitals Cleveland Medical Center and the Robert and Susan Hurwitz Master Clinician in Wellness.
“Control the controllable.” So much energy is spent worrying
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
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Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. You must continue to pay your Medicare Part B premium. The Part B premium is covered for fulldual members. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other pharmacies, physicians and/or providers are available in our network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de idiomas. Visite nuestro sitio web en www.aetnamedicare.com o llame al número de teléfono que se indica en este material. 繁體中文 (CHINESE): 請注意：如果您說中文，您可以獲得免費的語言協助服務。請造訪我們的網站 www.aetnamedicare.com 或致電本材料中所列的電話號碼。 Y0001_4002_9196_FINAL_1 Accepted 01/2017
©2017 Aetna Inc. February 2018 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Living the Final Chapter
A Symposium for Compassionate Care for Persons at the End of Life
Friday, March 9, 2018 7:15 a.m. - 4:00 p.m.
Genesee Grande Hotel, Syracuse, NY Keynote Speakers
B.J. Miller, Jr., MD
Hospice and Palliative Care Specialist, UCSF Medical Center
Sharon Brangman, MD
Director, Center of Excellence for Alzheimer’s Disease, SUNY Upstate Medical University
7 additional breakout sessions to choose from Registration: firstname.lastname@example.org
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Taste of Chocolate to benefit Lafayette food pantry
Columbian Presbyterian Church is sponsoring “A Taste of Chocolate” event that will benefit Lafayette Outreach, the town’s local food pantry. The event will take place from 10 a.m. to 2 p.m., Feb. 10, in the church’s session building. The church is located on the corner of Routes 11 and 20 in Lafayette. This is a food-sampling event where participants can purchase samples of dozens of home made goodies with one thing in common: Chocolate. Choose from white, dark or milk chocolate in cookies, muffins, candies, breads and more. Samples are only 50 cents, or 22 samples for $10. Fifty percent of the proceeds will be donated to Lafayette Outreach. Taste some treats here, then fill a box for your sweetheart. For more information, call 315-6773293, email email@example.com or visit www.ColumbianPresbyterianChurch.com
Nominations wanted for Office for Aging event
May is Older Americans Month and the Onondaga County Office for Aging is offering a unique opportunity for people to nominate outstanding Onondaga County community members for: • Senior Citizen of the Year: This award will recognize an Onondaga County resident, age 60 or older, who demonstrates the power of making a
difference through civic engagement. • Serving Seniors Honoree of the Year: This award honors an individual (either currently employed or retired) who has made significant contributions in a career field that serves people age 60 or older. • Flanders Memorial Caregiver of the Year: This award recognizes an individual of any age, who provides care for a person or persons age 60 or older, and whose actions, philosophy and coordination of services serve as a model and inspiration to other caregivers. Readers can find the nomination form at: www.ongov.net/aging/ news.html. Submissions are due by Feb. 16. For more information, or to be mailed a nomination form, contact the Office for Aging at 315-435-2362. Winners will be honored Thursday, May 10, at the Celebration Luncheon for Onondaga County Seniors at Drumlins Country Club, 800 Nottingham Road, Syracuse.
Hair show competition to benefit ACR Health
“Blowout 2018: “Superheroes & Villains,” sponsored by Gilead Sciences and Goldwell NY, will be a colorful, video-worthy fantasy hair show that pits the best salons in Central New York in a lively competition. The event will be held from 3 to 6 p.m., Feb. 18, at the historic Landmark Theatre in downtown Syracuse. Competition takes place on the main stage where models strut their most outrageous over-the-top looks along 70 feet of runway.
Nonprofits Invited to Apply for Excellus Grants A total of up to $95,000 will be awarded to various nonprofits with projects that improve the health or health care of a specific population. Deadline for application is Feb. 19 Nonprofit organizations in Upstate New York can apply for Excellus BlueCross BlueShield Community Health Award grants that add up to a total of $95,000, which the company is offering to help fund health and wellness programs in Upstate New York. Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s 31-county Upstate New York region are invited to apply for an award of up to $4,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Programs that improve the health status of the community, reduce the incidence of specific diseases, promote health education and further overall wellness will be considered. The deadline to submit an application to be considered for an
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
Excellus BlueCross BlueShield Community Health Award is Monday, Feb. 19. To access additional information and the online application, go to www.excellusbcbs.com/community. Awards will be announced in March. “The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said Jim Reed, regional president, Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in upstate New York.” Last year, eight Central New York organizations were selected as Excellus BlueCross BlueShield Community Health Award winners from among 200 submitted applications in the 31-county Upstate New York
Guest host, Michael Benny, WTVH-TV CBS 5 anchor, will call play by play from the catwalk. Tickets are $25 for general admission and $50 VIP and available at the door; online at ACRHealth.org; and at participating salons. The salon selling the most tickets will receive the Ally Award. All proceeds support ACR Health’s mission to create healthy communities by opening doors for those fighting addiction, poverty, LGBTQ inequality, and AIDS.
Vegan group to host president of food institute
Rochester Area Vegan Society will hold a dinner program that will feature Antonia Demas, Ph.D., who will speak on “Why We Need to Make Food Literacy an Educational and Health Priority.” Demas is president of the Food Studies Institute, visiting scholar at the Johns Hopkins School of Public Health and clinical assistant professor at the University of Illinois College of Medicine at Rockford. She is the creator of the award-winning “Food is Elementary” curriculum, which has been used in more than 3,000 schools in 33 states and several countries. The event will start with a vegan share-a-dish dinner at 5:30 p.m., Feb. 18, at Brighton Town Park Lodge, 777 Westfall Road, Rochester. The program will start at 7 p.m. Dinner is a vegan potluck. Vegan means no animal products (no meat, poultry, fish, eggs, dairy products or honey). Those attending the program are encouraged to bring a dish with enough to serve a crowd, serving utensils and place setting for own dinner. Program is free to members and $3 for non-members, plus bring a vegan dish to pass. For more information, call 585234-8750 or visit rochesterveg.org.
region. The winning Syracuse-based organizations included Brady Faith Center, Catholic Charities of Onondaga County, Home HeadQuarters, Liberty Resources, REACH CNY and Syracuse Model Neighborhood Facility. Calvary Food Pantry in Auburn and McGraw Lions Club, McGraw, were also 2017 Community Health Award winners. Excellus BlueCross BlueShield divides its 31-county Upstate New York operating area into four regions: the Central New York region, which includes Cayuga, Cortland, Onondaga, Oswego and Tompkins counties; the Central New York Southern Tier region, including Broome, Chemung, Chenango, Tioga, Schuyler and Steuben counties; the Rochester region, encompassing Livingston, Monroe, Ontario, Seneca, Wayne and Yates counties; and the Utica region, comprising Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Otsego and St. Lawrence counties. The company’s corporate giving follows all applicable laws and regulations and does not support funding organizations that conflict with its corporate mission, goals, policies or products.
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(Onondaga County, Fayetteville, NY) Local doctor Dr. David Cifra has been peer-nominated and/or recognized by the International Medical Advisory Board on Spinal Decompression. All doctors are Board-Certified This advanced training and presentation took place at the National Spinal Disc Disorders training facilities in North Palm Beach, Florida. The certification was presented by the Co-Chairman of the International Medical Advisory Board on Spinal Decompression (I.M.A.B.S.D.), Dr. Eric Kaplan. This advanced certification is provided in conjunction with DISC Centers of America which sets the gold standard in training & research of the latest & most effective options for the alleviation & treatment of Spinal Disc Disorders which often cause low back pain, neck pain, sciatica, numbness, tingling, pins & needles & more. Dr. Cifra has demonstrated an exemplary level of excellence in the diagnosis and treatment of Spinal Disc Disorders. Dr. David Cifra continues to provide the latest & most cost-effective options for the treatment of Spinal Disc Disorders. His facilities are considered state-of-the art and Dr. David Cifra is committed to providing 1st class care to patients who often travel from long distances to seek out a Doctor who has made a commitment to help his patients avoid narcotics, epidural injections & unnecessary surgeries. Non-surgical Spinal Decompression provides safe, gentle & effective relief for upwards of 90% of patients that qualify for care. Dr. David Cifra is located at: Lyndon Office Park, 7000 East Genesee Street, Fayetteville, NY 13066. His phone number is: 315-454-0656 & his website is: www.syracusedisccenter.com. He is presently accepting NEW PATIENTS. Call for priority treatment and an initial FREE Consultation.
South Carolina Dr. Luke Henry, D.C. 3101 S. Hwy. 14, Ste.1 Greenville, SC 29615 864-288-7797
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Chris Motola
Good News, Guys: Viagra Prices Start to Tumble In news that will delight men who’ve had difficulties in the bedroom, two generic versions of the erectile dysfunction drug Viagra hit the market in December. One of the new generics is made by Teva Pharmaceuticals, and the other by Greenstone, a subsidiary of Pfizer, the company that manufactures Viagra. The generic versions of the little blue pill (sildenafil) are cheaper than brand-name Viagra for most men. And more generic versions are expected this year, which could drive prices even lower. Viagra came on the market in 1998 as the first drug to treat impotence. Cialis (tadalafil) and Levitra (vardenafil) are two other erectile dysfunction medications. They work by relaxing muscle cells in the penis, which allows for greater blood flow, according to the Urology Care Foundation. Pfizer says the current wholesale cost for a 50 milligram or 100 milligram Viagra is $61.54 a pill. Greenstone will sell the generic version for between $30 and $35 a pill. However, both of those figures represent the price the drug maker charges. A number of variables affect the final cost a consumer pays, such as mark-ups from pharmacy benefit managers or pharmacies, and insurance coverage and copays. “Cost has been a tremendous issue for patients. Many patients have been unable to obtain the medication since insurance companies don’t pay for it and outof-pocket costs are astronomical,” said physician Aaron Katz, chairman of urology at NYU Winthrop Hospital in Mineola. “The hope is that [the introduction of generics] will reduce the cost, and patients will have greater access to Viagra, which has been an important medication for healthy men with erectile dysfunction,” Katz added. Generic versions “will be of real benefit to the majority of men,” he said. “The brand erectile dysfunction drugs are often not covered by commercial payers [insurance companies], or are covered but with substantial co-pays and restrictions on the number of pills covered per month,” he said. For older men on Medicare, he said the brand-name drugs can cost as much as $50 for one pill. The doctor said this has led many men in the United States to buy erectile dysfunction drugs online or in Canada. Page 6
Steven W. Brose, D.O.
New chief of the spinal cord injury and disabilities service at Syracuse VA talks about latest treatments in the field, has plans to greatly expand services locally Q: Can you give us a sense of what your role is as chief of spinal surgery at the Syracuse VA? A: This is a spinal cord injury center. The VA separates spinal cord injury into its own service. It’s a service that provides comprehensive care for veterans with spinal cord injuries and a variety of other disorders such as ALS, multiple sclerosis and a variety of other spinal cord-related neurological conditions. Our services are set up for both acute and lifelong care of veterans. Our service at the Syracuse VA started fairly recently, in 2013. It’s now rapidly expanding to provide additional inpatient and outpatient services to veterans with spinal cord injuries. Q: Are you primarily dealing with war injuries? A: It’s a very interesting group of people we serve. There are certainly people who have been injured during the course of their military service. There are also people we’ve served who have injuries that are service-connected but who may not have received a battlefield injury. We also serve veterans who have been injured after their time in the service from more mundane traumas like falls. Also, the population of spinal cord injury patients has been aging, so we’re treating a lot more older veterans than we have in prior years. That’s also in part due to advances in acute care which has resulted in an aging spinal cord patient population. Q: A spinal cord injury seems like one of the most devastating traumas you can sustain. What can we do now to help patients with those injuries? A: We have a lot of
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
exciting research going on in the field of spinal cord injury. My own research is in the application of functional electrical stimulation (FES). My own research is in using FES to treat pelvic dysfunction, which includes bladder and erectile dysfunction due to spinal cord injury. There have been studies showing that patients rate sexual dysfunction and bowel and bladder dysfunction as the most important problems to manage. We have an exciting new $1.6 million research grant to apply electrical stimulation to help people with neurogenic bladder and prevent urinary incontinence. It’s a non-invasive technology, so it’s a surface electrical stimulation. We’re looking to actively enroll veterans to see if we can help them manage their bladders more effectively. There are other exciting things going on here. We’re expanding the number of inpatient beds for spinal cord injury patients from 20 to 30. We’re building a full outpatient clinic to provide tele-health services in rural areas. We’re also hiring 70 new positions to serve all these needs, including four additional physicians. Q: With the electrical stimulation, is that something you apply periodically? Consistently? Is there a battery? Or is it a larger device? A: Excellent question. We’re developing a wireless technology that doesn’t require a lot of electricity, so there is a battery. It’s a device that the patient can apply to their surface of the skin. It helps inhibit the bladder to prevent leakage. It can be used continuously or intermittently. We recently published a paper that shows the stimulation is well-tolerated either in people who still have sensations, so there’s no pain or anything like that.
Q: Why does the VA separate spinal injury services? A: So we have the Paralyzed Veterans of America. It’s a group that advocates for veterans with spinal cord injuries. That’s they’re primary focus. So, separating the service provides a lot of benefits for veterans. We’re able to get a lot of the best equipment and brand new medications. We have robotic exoskeletons as well that some of their veterans are trying out that can allow them to walk even if they have no use of their legs. We also have robotic feeding devices and other advanced prosthetic technologies. Q: Does actual repair of the spinal cord look possible? A: There’s ongoing research into stem cells and nerve grafting. While the research I do is very important, neural regeneration research is ongoing and very important. Q: You mentioned the staff increases. What kinds of services will they be bolstering? A: It’s for all kinds of spinal cord-related treatment. They may come in for annual examinations. They can also get wound care and be treated for issues they’re more likely to have like pressure ulcers. We’re also able to do inpatient and outpatient Botox injections to treat spasticity. The increased capacity will allow us to treat a lot of patients with spinal injuries. The tele-health services are going to be exciting. Upstate New York is very rural, so this will allow us to check on a lot of our patients remotely. With the growth of our outpatient services, we’ll also be providing primary care for our spinal cord injury patients. Q: How does the tele-heath monitoring work? A: We have three-dimensional wound care technology that can map a wound remotely, in addition to more traditional technology like video conferencing. This allows us to see patients more often who live far away and may have a hard time coming in due to their spinal cord injuries.
Lifelines Name: Steven W. Brose, D.O. Position: Chief of the Spinal Cord Injury and Disabilities Service at Syracuse VA Medical Center. Most recently 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 Hometown: Athens, Ohio Education: Doctor of Osteopathic Medicine degree in 2005 from Ohio University. 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 Affiliations: Syracuse VA; SUNY Upstate Medical University Organizations: Serves as 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 Family: Married, two sons Hobbies: Martial arts; chess; weightlifting.
Stephen Hawking Turns 76: How Has He Lived So Long With ALS?
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enowned physicist Stephen Hawking turned 76 Jan. 8, an age well beyond what he was expected to reach when he was diagnosed with the incurable neurological disease, amyotrophic lateral sclerosis (ALS), more than 50 years ago. Hawking was 21 years old when he was diagnosed with www.Suburbantransport.com ALS in 1963, and he was given Info@Suburbantransport.com just two years to live. The disease causes the progressive degeneration and death of the nerve cells that control voluntary muscle movements, such as chewing, walking, talking and breathing, according to the National Institute of Neurological Disorders and Stroke (NINDS). But how has Hawking lived so long with a disease Stephen Hawking turned 76 in January. that is typically fatal after just a few Neurofeedback, a medication free alternative Few people suffering from ALS live more years? than 20 years. Neurofeedback is a specialized form In fact, no one knows for certain why Hawking has survived so long of biofeedback that improves mental Studies have also found that bewith ALS, which is also known as performance, emotional control and ing diagnosed with ALS at a younger Lou Gehrig’s disease. But researchphysiological stability. Symptom relief age is linked with a longer survivers do know that the progression of is achieved by strengthening regulatory al time. (Hawking was relatively the disease varies depending on the young when he was diagnosed with control through brain exercise. person. ALS; the disease is most commonly Although the average life exdiagnosed in people ages, 55 to 75, pectancy after a diagnosis of ALS is Mind & body relax; anxiety dissolves; about three years, about 20 percent of according to the NINDS.) racing thoughts quiet; mood lifts; The Food and Drug Administrapeople live five years after their dipain lessons; energy, memory, agnosis, 10 percent live 10 years after tion has approved two drugs to treat attention,sleep and behavior improve. ALS, called riluzole (Rilutek) and their diagnosis and 5 percent live 20 edaravone (Radicava). Each of these years or more, according to The ALS drugs can prolog survival by about Association. Syracuse Neurofeedback One factor that likely plays a role six months, but the drugs likely don’t Priscilla Young 315-492-3789 account for an exceptional survival in patients’ survival time is genetics; time like the one Hawking has expe170 Intrepid Lane scientists have identified over 20 rienced, Geraci said. different genes involved in ALS, said Syracuse, NY 13205 Early symptoms of ALS can physician Anthony Geraci, director of Call today for free consultation include muscle weakness or slurred the Neuromuscular Center at Northspeech, and eventually, the disease www.syracuseneurofeedback.com well Health’s Neuroscience Institute her so everyone benefits United Way Central New York’s Community Campaign can cause people to lose of the ability to in Manhasset, New York, who is not move, speak, eat or breathe on their involved in Hawking’s care. own, according to the Mayo Clinic. “ALS is probably 20 or more difPeople with ALS typically die ferent diseases when one considers United Way of Central New Investing together from respiratoryto failure, which For one hundred years, the annual Community Campaign the genetic underpinnings,” Geraci donations York’s Community Campaign So everyone benefits occurs when the nerve cells conInvesting together so everyone benefits United Way of Central New York’s Community Campaign said. Some of these genetic differencInvesting together so everyone benefits United Way of Central New York trolling the breathing muscles stop have changed lives and made our community a better place! es appear to affect various aspects of working or from malnutrition and the disease, including survival. For one hundred years, donations to the annual can occur when For instance, a gene called SOD1, dehydration, whichFor one hundred years, donations toFor the one annual Community Campaignto the annual Communi hundred years, donations the muscles that control swallowing Community Campaign have changed lives and which is linked with a type of ALS have changed lives and made our community a better place! deteriorate. have changed lives and made our community a bette that runs in families, is associated made our community a better place! nt years, we invite you to Learn about United Way of CNY Initiatives including: Original article appeared in with a more rapid course of the diswww.livescience.com. d” with support of ease, your said Geraci. Work Train, Early Childhood Alliance, Literacy Coalition, and
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Working Out in Cold Weather
Experts recommend plenty of ways to get active in wintertime By Deborah Jeanne Sergeant The weather may be frightful, but don’t let this winter “go to waist.” Area experts recommend plenty of ways to get active and stay fit. Tips from Randy Sabourin, personal trainer and team leader at Metro Fitness in Fayetteville and Syracuse: • “Try something new. I just recently got a fat tire bike. It’s like a mountain bike you can ride in the sand or snow. It’s a tough workout. • “I run and walk outside, but layering is key to make sure you won’t get hyperthermia. If you are nervous about vehicles sliding into you, try Onondaga Lake Park. I go there all the time. I use Yaktrax that slip onto my sneakers to I won’t fall. Especially if you are walking/running at night, get a headlamp, which can be purchased at sporting goods stores, and a reflective vest. If you’re walking a dog, get a reflective dog vest.
• “If you do belong to a gym, use your time inside to find a new class you haven’t tried before. Mix it up. There might be a class on the schedule you might stick your nose up at, but give it a shot. It helps avoid overuse injury. Something new refreshes and excites you.” Tips from Joseph Jones, health and fitness coordinator with a bachelor’s in exercise and sports science and certified personal trainer at Greater Syracuse YMCA: • “One of the best things I recommend at home is a routine to do in the morning. While I wait for the coffee to brew, I do some alternating lunges or squats with an alternating kick. I also have watched the morning news and hold a plank during the commercial break. Use those times while you’re doing a mundane task and functionally multi-task. • “For a lot of people who love to run outside in a group, they can
take advantage of trying new exercise classes and trying out some new things. It’s a sense of reliability and camaraderie. All winter, as testament to that, I took over a Friday group exercise class, Circuit Blast, and I made it a partner-based class. I have grown it in 12 weeks from four to 20. Incorporate more social-based activities. It’s cold out and you come to the treadmill over and over brings nothing new to the table without external challenges around.” Tips from physician Joanne Wu, board-certified integrative and holistic medicine and rehabilitation doctor, who sees patients in Syracuse and elsewhere in Upstate: • “I’m a big outdoorsy person, so I always coach people about getting
outside. If it is a nice day, I tell people to ski, take hikes and snowshoe. • “Ice skating is somewhat accessible. • “Curling is something I talk with people about. Some are shy about it, but it’s a winter sport. You don’t have to be out in the elements-you can do it in an indoor ice skating rink-but it is a winter sport and it gets people active and together. • “But if there’s a blizzard, you can stay active without going out. Indoors, try new things I don’t normally do when the weather is nice. Look up things exciting things like maybe rock climbing or indoor volleyball that are one-off of what you’d normally do. • “Try indoor leagues for soccer.”
Cold Hands or Toes? You May Have Raynaud’s Up to 10 percent of the population experience extreme sensitivity to cold, according to organization By Kyra Mancine
s winter weather rushes in, we often we feel the chill in our fingers and in our toes. People pass this off as a sign of the season. However, for some, it can be a symptom of a more serious condition known as Raynaud’s. Raynaud’s is a little known, yet relatively common disorder that causes poor blood flow to the hands and the feet as a result of dropping temperatures. People with this condition experience “attacks” when the smaller arteries that supply blood flow are disrupted. These vasospasms (narrowing of the blood vessels) result in fingers and toes turning white or blue as blood flow is lost. This is accompanied by pain and numbness, often described as a throbbing, tingling or burning feeling. After an attack, skin color changes to red (or becomes blotchy) and, eventually, back to normal. Attacks can last for a few minutes to much longer. The disorder impacts fingers more than toes, women more than men, and is more common in colder climates. Primary vs. Secondary If you have primary Raynaud’s disease, you experience attacks described as above, but do not have underlying medical issues. This is the Page 8
more common disorder. Secondary Raynaud’s disease is less common and can be the result of an underlying medical condition, such as lupus, scleroderma or rheumatoid arthritis — even frostbite. Workers who work with vibrating power tools can also develop Raynaud’s. There is no cure for the disorder, although for secondary Raynaud’s, doctors can prescribe calcium blockers that help alleviate some of the symptoms. This type of medication is often prescribed for people with high blood pressure. The most severe Raynaud’s cases, while relatively rare, can result in skin sores or gangrene. However, according to the National Heart, Lung and Blood Institute, a majority of people who have Raynaud’s will not suffer from long-term tissue damage or disability. Preventing an attack If you have Raynaud’s, prevention of attacks is key. Stock up on hand warmers (hint – Dollar Stores have the best deal on them), get one of those pillows you can microwave and place on your hands, wear layers to keep the rest of your body warm, get into dry clothes as soon as possible after any outdoor activity where you might get wet (skiing, snow shoeing, ice skating, etc) and try to
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
People suffering from Raynaud’s disorder usually have the skin color of their hands and fingers changed to red during colder weather. keep your stress level low. Mittens are recommended instead of gloves, as they trap air and can keep you warmer. You need to be very mindful of weather conditions and attire when you have this chronic condition. In winter, the cold and damp can exacerbate symptoms, although attacks can happen all year. Air conditioning can also be a trigger. Prevention is possible, but you need to be proactive. 9 tips to try 1) Keep your overall body warm. Cold impacts Raynaud’s sufferers more than other people. You may have to wear layers/coats/sweaters during times when others will not have to dress in a similar fashion. 2) Use hand warmers — these portable heat generators make a big difference! 3) Have mittens or gloves to wear when needed. This can include when you shop in the grocery store or pump gas. Reaching into a cold freezer or handling a gas pump can cause an immediate flare up for some people. 4) Cut back or quit smoking — it
can exacerbate symptoms 5) Eliminate or limit caffeine, as this can be a trigger 6) Limit exposure to the elements as much as you can 7) Practice mindfulness and stress reduction techniques 8) Use cold or allergy over-thecounter medications with caution — they have been known to contribute to attacks 9) Educate your friends, family and coworkers on your disorder. People can dismiss what they don’t understand. Help spread the word! During an Attack If you do have an attack, there are things you can do, such as: 1) Running your hands under warm (not hot) water to help bring them back to normal 2) Move your arms in a windmill type motion (to increase circulation) 3) Go to a quiet area out of the cold, slow your breathing and try to remain calm For more information, resources and support, visit the Raynaud’s Association website: www.raynauds.org.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Flu Outbreak Hits CNY Hard Situation in Onondaga, Oswego counties one of the worst in NYS
By Payne Horning
ew York is wrestling with a widespread outbreak of influenza. Every county has been affected this year, but the situation in Central New York is one of the worst in the state. The rate per 100,000 in the region people has been among the highest statewide. There were 177 laboratory confirmed cases of influenza in Oswego County as of the week ending Jan. 14. That’s up from 22 at the same time last year. In Onondaga County this year, 820 cases were reported by the same date. Onondaga County Health Department medical director, physician Quoc Nguyen, says one of the reasons for the large outbreak is the early start to the season. Cases of the flu were first reported in the county in October. The number dipped in early November, but continued to grow in the following weeks, spiking in January. “Our season is a couple weeks earlier than the rest of the state,” Nguyen said. “We somehow got the disease earlier so that we have more people sick faster than other parts of the state.” That could be a result of the harsh winter this year. Jodi Martin, supervising public health nurse for the Oswego County Health Department, said it’s a double whammy. “You can be more prone [to the flu] during the winter time, but a good portion of it is everybody is together,” Martin said. “When it’s cold outside and nasty, more people stay inside and they don’t get outside in the fresh air. So when you have a lot of people in small spaces, it’s more likely that they can pass on the illness to somebody else.” Nguyen says those colder winters upstate, combined with Central New York’s older population relative to downstate, may be another factor in the region’s large number of flu
Cases of Flu in Onondaga and Oswego Counties Oswego — figures as of Jan. 14
2017: 22 cases 2018: 117 cases
Onondaga — figures as of Jan. 14
2017: 188 cases 2018: 820 cases
Sources: Onondaga and Oswego health departments. cases. People age 65 years and older are at higher risks of flu complications that could lead to hospitalization and even death. “Influenza is a potentially deadly disease, and getting vaccinated is the best thing New Yorkers can do
to protect themselves and those around them,” said New York State Department of Health Commissioner Howard Zucker. The flu shot is especially important for those adults aged 65 years and older who are at high risk for serious complications, young children and pregnant women. Family members who have regular contact with these individuals are also encouraged to get vaccinated because the virus can spread through coughing or sneezing. Although the flu season is well underway, health officials like Nguyen say it’s not too late to get vaccinated since the flu season can last until May in some years. And getting the shot can at the very least reduce the severity of the symptoms.
Flu Cases Also on the Rise in Cayuga County The number of flu cases in Cayuga County has been rising significantly in January. From Oct. 1, through Jan 22, 393 cases of flu have been reported to the Cayuga County Health Department (CCHD). The Centers for Disease Control and Prevention (CDC) reports that so far influenza A (H3N2)viruses have been the most common this season. The Cayuga County Health Department has seen 325 cases of influenza A compared to 68 cases of influenza B. Of the 393 total cases, 76 were reported in children 18 years of age and younger. Last year at this time, there were only 48 laboratory confirmed cases, eight of those were in
children under 18 years of age. Kathleen Cuddy, public health director at the Cayuga County Health Department is encouraging residents to: 1. Prevent flu by getting vaccinated: Anyone 6 months and older should get a flu shot. It’s not too late to get your flu vaccine, she said. 2. Practice precautions to stop the spread of flu infection: If you are sick, do not go to work or school. 3. Call your healthcare provider immediately if you think you have the flu, especially if you are at high risk to develop severe complications. (Submitted by Cayuga County Health Department).
The prevalent virus this season is Influenza A (H3N2). This year’s flu shot included that strain. But according to the Onondaga County Health Department, vaccine effectiveness against this particular strain of A has been lower than others in the past, and it is typically associated with more severe illnesses. Nyguen says that could be the case this year but it’s too early to know for sure. One of the best ways to avoid the flu and prevent the spread of it is good hygiene. The Onondaga County Health Department encourages practicing precautions like social distancing, covering your cough and sneeze and washing your hands often with soap and water. And Jodi Martin of Oswego County Health Department says one of the most important things to do is stay home if sick until you’re fever-free for 24 hours without the use of any medications. “That’s a big thing is people get sick and they don’t want to miss work, so they go to work or they don’t want to miss school and they go to school,” Martin said. “Then they subject employees or students to that sickness.” If you develop flu, health officials recommend you contact your doctor, in addition to hydrating and treating the symptoms. But Nguyen cautions against rushing to the emergency room or prompt care. “Talk to your doctor’s first because the emergency room is a very busy place in the cold months and the added patient flow will stress them further and makes the work hard,” Nguyen said.
Childhood Vaccination Rates in Syracuse Among Highest in the Nation
hildhood vaccination rates in Syracuse are among the highest in the nation, according to a new study of medical claims by the Blue Cross Blue Shield Association. The study examined U.S. claims data for 843,610 children, born in 2010-2013 and commercially insured by Blue Cross Blue Shield plans, and followed their care continuously from birth to 3 years of age. Focusing on completion rates of the Centers for Disease Control and Prevention’s recommended seven-vaccine series for children, the study found that 73.5 percent of children nationwide and 64.2 percent of Page 10
children in New York state were upto-date on their CDC-recommended vaccinations during the seven-year span from 2010 to 2016. In Syracuse, the total childhood vaccination rate was 84.4 percent, a rate that is among the top 20 of all metropolitan statistical areas examined in the study. “Childhood vaccination is one of the most significant public health accomplishments of the 20th century. We have all but eradicated many devastating diseases and health conditions with vaccinations, preventing an untold amount of illness, disease, and death,” said Excellus BlueC-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
ross BlueShield Corporate Medical Director Martin Lustick, a physician. “It’s very important for the healthy development of all children that they be vaccinated.” While overall vaccination rates are strong nationwide, 23 percent of children born in 2013 still did not receive the CDC-recommended seven-vaccine series within the first three years of life. For children who are not completely vaccinated, missed well-child visits were the primary reason for under-vaccination. “The results of the national study highlight how important well-child visits are to improving vaccination
rates,” said Lustick. “Physicians in our community are doing a great job with well-child visits, so we’re not surprised by the high vaccination rates.” Lustick added, “The fact that the Central New York region has the lowest uninsured rates in modern times also helps explain why we have among the best records on vaccinations in the country.” According to the U.S. Census Bureau’s American Community Survey, the 2016 uninsured rate in CNY was 3.96 percent, which is lower than the uninsured rate in the state (6.06 percent) and in the nation (8.58 percent).
Raw Meat Not the Safest Choice for Your Dog … or You
hile your dog or cat might love the taste of raw meat, a steady diet of it might be a bad idea, a new study warns. Raw meat diets for pets have become increasingly popular, but there is no evidence that they are healthier than typical pet foods, the researchers said. In fact, some studies have reported that raw meat diets may pose a threat to pets and their owners due to the potential presence of bacteria and parasites. To learn more about these risks, the Dutch researchers analyzed 35 commercial frozen raw meat diet products for pets that are widely available in the Netherlands. E. coli bacteria was found in eight products (23 percent), listeria bacteria was discovered in 15
products (43 percent) and salmonella was detected in seven products (20 percent). Eight products contained Sarcocystes parasites and two products (6 percent) contained Toxoplasma gondii parasites. The two types of Sarcocystesparasites found in the products do not affect people but pose a risk to farm animals. T. gondii can cause disease in people, the researchers said. The study was published Jan. 11 in the journal Vet Record. “Cats and dogs that eat raw meat diets are also more likely to become infected with antibiotic-resistant bacteria than animals on conventional diets, which could pose a serious risk to both animal health and public health,” lead researcher Paul Overgaauw, from Utrecht University, and
colleagues said in a journal news release. Pet owners should be informed about the risks of feeding their pets raw meat diet products. They should
be educated about proper handling of the products and personal hygiene measures, and the products should include warnings and handling instructions, the investigators said.
Healthcare in a Minute By George W. Chapman Hospital Ratings CMS has released its 2017 star ratings for US hospitals. CMS is constantly tweaking the rankings to make them more meaningful for both hospitals and consumers. More than 3,700 hospitals were ranked from one star to five stars. The rankings break down as: one star, 7 percent; two stars, 21 percent; three stars, 32 percent; four stars, 31 percent; and 5 stars, 9 percent. The number of 5 star hospitals tripled to 337 from just 102 in 2016. You can get the star rating for any hospital at www.medicare.gov/ hospitalcompare. Enter either the zip code or name of the hospital. ACA Individual Mandate The Affordable Care Act has not been “repealed” with the recent removal of the individual mandate requiring all citizens to have health insurance or else pay a penalty. The individual mandate made insurance premiums more affordable for all ages by including younger and healthier people in the risk pool. With the termination of the individual mandate, many younger and/ or healthier people will stop buying insurance, thereby leaving the risk pool with a higher mix of older and/ or less healthy members. All insurance premiums, not just those sold on the exchange, will be negatively impacted. The Congressional Budget Office estimates that the removal of the individual mandate will: increase the uninsured by 13 million, increase premiums by at least 10 percent and reduce the federal deficit by $338 billion over the next 10 years. (The deficit decreases because the government will be subsidizing fewer premiums.) Despite the removal of the individual mandate, at the last count, 8.8 million people enrolled for insurance on the federal exchange, down slightly (4 percent) from 9.2 million at the end
of 2016. The number of additional people insured by the ACA through expanded Medicaid is around 15 million. Women Physicians For the first time in history, the number of women entering medical school has exceeded the number of men. According to the Association of American Medical Colleges or AAMC, 51 percent of incoming students are women, which is a culmination of the slight trend over the past few years. This class of medical students is also more diverse: 13 percent African American, 15 percent Latino. However, despite these encouraging numbers, the number of overall applicants to medical schools was the lowest in 15 years fueling the concern about a physician shortage. The AAMC continues to lobby congress to authorize Medicare to pay for more residency slots. Congress has not increased the number of US residency slots since the mid-90s. Millennial Point of View Currently, there is an equal number of millennials and baby boomers. At 75 million people apiece, they are the two largest segments of the US population. This is significant for both political and economic reasons. The highest uninsured rate is in the 26 to 34 age cohort. (Parents can cover their children up to 26.) This uninsured rate is sure to increase with the removal of the individual mandate. One can’t blame millennials for going without insurance. The world today is far different for millennials than it was “back in the day” for boomers. In 1980, when boomers were still young, 80 percent of insurance was paid by employers. Today, employers pick up an average 50 percent of the premium. Consequently, a lot of millennials can’t
afford insurance, let alone the high deductibles and copays that are part of today’s insurance policies. Many figure the deductibles (out of pocket) attached to today’s premiums are so high, insurance won’t even kick in. Millennials are just one catastrophic event from bankruptcy. On average, millennials have more medical debt than older boomers who have enjoyed better coverage for most of their lives. The actuarial problem is clear: by not purchasing insurance, younger and healthier people are not diluting the risk pool. If health insurance is to be mandatory, there has to be a solution/incentive for millennials. MD Job Creation Always overlooked in discussions about the cost and effectiveness of care is the number of jobs created by physicians. According to a study by the American Medical Association, physicians are responsible for 12.6 million jobs, generating about $2.3 trillion in economic activity. The study measured the impact of 737,000 physicians based on four economic indicators: employment, wages and benefits, and state and local taxes. Every dollar from physician services supports another $2.64 in other business activity. The American Hospital Association claims it supports one in nine jobs. Osteopathic Physicians The number of osteopathic physicians (DO vs. MD) is increasing rapidly. There has been a 68 percent increase in their numbers in the last 10 years. There are now more than 108,000 practicing DOs in the US or about one in seven physicians. Osteopaths are fully licensed physicians and practice in every specialty. They emphasize treating the whole person with a focus on prevention. They February 2018 •
receive special training in the musculoskeletal system which is comprised of nerves, muscles and bones. More than half of DOs are in primary care. Currently, about 25 percent of all medical students are enrolled in a college of osteopathic medicine. MDs are technically “allopathic” physicians. Be a Better Patient in 2018 1. Understand how your insurance works. It’s your responsibility, not your providers’. Four in 10 of us don’t understand our benefits or what the policy pays. 2. Be an active partner in your care. Busy providers prefer an involved and responsible patient vs. an uninvolved and passive patient. Don’t be afraid to ask questions. 3. Be compliant. Once you have agreed upon an approach to your care, stick with the game plan. 4. Keep your own records. You do for everything else. 5. Review your bill. If it confuses you, call the office. 6. Take advantage of preventive care. Most insurances will pay for it. 7. Never be afraid to get a second opinion. Your physician will not be offended. 8. Don’t be a “no show.” If you can’t make an appointment, be sure to call at least 24 hours ahead to reschedule. Considering the lead time to get an appointment, it is an expensive waste to have the slot go unused. 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 firstname.lastname@example.org.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Questions to Syracuse VA’s New Director
Judy Hayman is first the woman to lead one of Upstate New York’s largest VA centers with more than 1,700 employees By Payne Horning
udy Hayman, associate director at the Syracuse VA Medical Center, is assuming the top leadership post at the facility — the first woman to hold the position. She succeeds James Cody, who ran the facility for 17 years. With more than 1,700 employees who serve 52,000 veterans, the Syracuse VA center is one of the largest of its kind in upstate. We asked Hayman seven questions about her new role.
Identify the main challenges the Syracuse VA Medical Center face and what you plan to do to tackle those? A. We are very proud that the Syracuse VA remains among the highest-performing and most patient-centric VA’s in the country. I strongly believe that organizations should continuously assess and improve their systems, and we are making every effort to do just that. One of our challenges is identifying and enrolling eligible veterans in VA healthcare. While not all veterans need or are eligible for VA healthcare, we know that we are not reaching some who we could help. We have dedicated resources to various outreach efforts that will enable us to locate those veterans and provide services to them. Another challenge we face has to do with facility space. Because of where we are located, we have exhausted all expansion opportunities within our main medical center footprint. As a result, finding space for some of our new programs and services can be difficult. We work hard at making the best use of our space and, where possible, have located services in the community through the use of leased space. We have seven community-based outpatient clinics located from Massena to Binghamton and three Vet Centers. Here in Syracuse, we have behavioral health and dental services at satellite
locations within the city.
What kind of problems do VA facilities in general face? A. VA Secretary Dr. David Shulkin and his staff are working very hard make the changes necessary to ensure that all veterans are treated with compassion and dignity — and receive exceptional care at the right time in the right location. To that end, Dr. Shulkin has established five key priorities going forward: providing greater choice for veterans; modernizing our systems; focusing our resources more efficiently; improving timeliness of services and suicide preven-
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Tell us about your background. What has prepared you for this job? A. I have been in the health care field for almost 20 years, working in a variety of settings to include inpatient and outpatient care. I have also worked in private practice in addition to my
You’re the first female director of Syracuse’s VA. What do you think that will add to your administration? A. I am honored to have been given this remarkable responsibility and remain fully committed to continuing the Syracuse VA’s long tradition of providing excellent healthcare services. I work with many talented males and females who, regardless of gender, share the noblest of goals, which is to serve the men and women who defended our country’s freedom.
What do you hope to accomplish, specifically, in your tenure as director and do you plan to stay as long or longer, than your predecessor, who ran the facility for 17 years? A. I hope to build upon my predecessor’s legacy of maintaining our focus on the needs of our veteran patients by ensuring the delivery of safe, high quality care; providing resources and removing barriers so staff are able to perform at the highest level possible; engaging staff to identify continuous improvement opportunities; and striving to remain the health care provider of choice in our catchment area. My predecessor served as the medical center director for approximately 17 years. I too plan on remaining in my current role for the long term.
Tell us about yourself: family, interests, and interesting tidbits. What do you enjoying doing in your spare time? A. I am originally from the West Coast and the majority of my family remains there. My husband and I have lived in Syracuse for 15 years and spend time outdoors whenever possible. We love to travel and enjoy the beauty of Central New York, particularly the Thousand Islands and Finger Lakes. We like to hike and spend time with our family and friends.
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VAs have come under an increasing amount of scrutiny in recent years. Do you believe there is an accountability issue and if so, how will you address it at your facility? A. The VA has made significant progress in serving veterans and their families, and increased accountability is a major reason for this progress. Dr. Shulkin has increased transparency by posting national wait times for appointments, veterans’ satisfaction with VA care and services, facility quality scores and accountability actions. At the Syracuse VA, we are fully engaged in all these initiatives. We have a dedicated and engaged workforce. Approximately 30 percent of our employees are veterans and many of those individuals choose to receive their care from our facility. We take great pride in the professional, caring manner with which we treat our veterans every day. Feedback from patient surveys and comments from veterans and their family members consistently reinforce the excellent, compassionate and timely care that is provided by our talented staff.
VA experiences. I have a background in business and retail management and the combination of my clinical and administrative experiences have prepared me well for my current role. I started my employment at the Syracuse VA as a provider and have held positions of increased responsibility over the past 10 years.
Note: 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.
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tion. Every day, we strive to operationalize these priorities at the Syracuse VA.
GYNECOLOGY Stephen Brown, MD Carla Liberatore, MD Myron Luthringer, MD Navpriya Oberoi, MD
UROLOGY David Albala, MD Po Lam, MD Andres Madissoo, MD Nedim Ruhotina, MD Harvey Sauer, MD Jeffrey Sekula, MD Daniel Welchons, MD
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
New Diabetes Drug Gets FDA OK Under ‘Abbreviated’ Pathway
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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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By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
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s d i K Corner
US Childhood Mortality Rates Lag Behind Other Wealthy Nations Leading causes of death are prematurity and injuries
n a new study of childhood mortality rates between 1961 and 2010 in the United States and 19 economically similar countries, researchers report that while there’s been overall improvement among all the countries, the U.S. has been slowest to improve. Researchers found that childhood mortality in the U.S. has been higher than all other peer nations Page 14
since the 1980s; over the 50-year study period, the U.S.’s “lagging improvement” has amounted to more than 600,000 excess deaths. A report of the findings, published Jan. 8 in Health Affairs, highlights when and why the U.S. performance started falling behind peer countries, and calls for continued funding of federal, state and local programs that have proven to save
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
This collection of essays offers hope and encouragement for those searching for answers. Here, you’ll find practical and inspirational advice for overcoming loneliness, rediscovering your true self, and coming into your own with confidence, curiosity, and a renewed love for life.
Teresa Jackson Live Alone and Thrive Workshop Participant
“For anyone who has wondered, ‘Will I ever be happy again?’, Alone and Content’s gentle wisdom and practical insights will light a new and hopeful way forward.”
with independence. But, don’t take my word for it. Here’s what BJ Mann, highly respected founder of BJ Mann The thoughtful counsel in this book will Sally help you develop a new, stronger sense of Mediation Services, had to sayWard about self and experience the freedom that comes Certified Professional with being alone and content. the book: “As a divorce mediator Coach, PCC, CPCC (for 17 years) IGwenn have seen thousands Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women, a newspaper and sought-after After her of clients yearn forcolumnist, a guide to speaker. help divorce, she overcame loneliness and loss to create a life of fulfillment and joy on her own. Today, she is dedicated them move from sadness to hope. to helping others embrace their independence and feel “at home” with themselves. Gwenn lives with her dog, Gwenn’s gentle nudges and positive Scout, in an 1830s English cottage in upstate New York, where she operates House Content Bed & Breakfast. suggestions are a blueprint for being yourwww.aloneandcontent.com best self and loving your own company. The book provides the key for thriving not just surviving, for living not just healing.” With the right attitude, you can turn the life you are living into the life you want. Possibilities can open up. When that happens, living alone becomes secondary to living fully! SELF-HELP USA $11.95 CAN $14.95
Cover design: Rebecca Nolen Author photograph: Amanda Kinton Photography
Writing this book has been a labor of love. And gratitude. First, I’m grateful to my “workshop women,” those resilient women who have attended my Live Alone and Thrive workshops and generously shared their stories, struggles and triumphs. Their courage touched me deeply and inspired not only the essays in my book, but my ongoing commitment to helping women live alone with confidence, peace, and joy. Next, my heartfelt thanks go to Wagner Dotto, publisher and editor of “In Good Health” and “55 PLUS” magazine. He invited me to become a contributing columnist over a decade ago and has been my biggest fan ever since. This book would not exist were it not for Wagner’s foresight and support. All my best, Gwenn
children’s lives. Among the leading causes of death for the most recent decade, the researchers say, were premature births and Sudden Infant Death Syndrome (SIDS). Children in the U.S. were three times more likely to die from prematurity at birth and more than twice as likely to die from SIDS. The two leading causes of death for those 15 to 19 years old in the U.S. during the same time period were motor vehicle accidents and assaults by firearm. Teenagers were twice as likely to die from motor vehicle accidents and 82 times more likely to die from gun homicide in the U.S. than in other wealthy nations. “Overall child mortality in wealthy countries, including the U.S., is improving, but the progress our country has made is considerably slower than progress elsewhere,”
I’m delighted to announce the publication of my book “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” The book is a collection of essays I handpicked and adapted from the series of monthly columns I have written for “In Good Health” over the past decade. Now, all in one place, my collection of essays is available for those who live alone after losing a spouse or partner through divorce, death or other life circumstance. Many often wonder, “Will I ever be happy again?” As a divorced woman, I know how painful it can be to find yourself living alone, especially after a long relationship has ended. I also know it’s possible to reclaim your life, to determine who you really are and to turn living alone into an adventure of self-discovery and personal growth at any age. My book opens with a “How Content Are You?” quiz, followed by a simple scorecard designed to help readers assess their level of happiness and satisfaction with life. While not scientific, this quiz and scorecard can provide a helpful baseline for
moving forward on the road to contentment. After the quiz is taken, readers can then pick and choose from over 25 essays full of thought-provoking and practical advice. The essays are organized into six chapters: • Coming into Your Own • Overcoming Challenges • Designing a Home Sweet Home • Surviving the Holidays and Special Occasions • Exploring Relationships and Romance • Spreading Your Wings Each essay is followed by two compelling questions, under the heading, “What You Can Do Today.” These questions are designed to inspire action and motivate readers to take healthy steps toward creating a life of fulfillment and joy on their own. While the book is intended for women, men can also benefit from my experience and helpful advice. It’s my hope that those who pick up my book will find encouragement, inspiration and even a few laughs within its pages. Ideally, “Alone and Content” will awaken readers to new ways of thinking about living alone and to the pride, pleasure and power that can come
You’re not alone. Gwenn Voelckers has been there—and so have hundreds of women who’ve attended her Live Alone and Thrive workshops to move forward after a divorce, death, or other painful separation.
“This book is a gift for those who live alone!”
Alone & Content: Inspiring, Empowering Essay to Help Divorced Women Feel Whole and Complete on Their Own
Live Alone & Thrive
re you wrestling with the end of a relationship? Does the thought of creating a full and intentional life on your own seem impossible?
Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own
“This book is a gift for those who live alone!” Teresa Jackson, Live Alone and Thrive workshop participant. To Purchase The Book Alone and Content is available for purchase in both paperback and Kindle on Amazon.com and can be ordered through Barnes and Noble. You can also find the book on Gwenn’s website:
Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops, book, or to invite Gwenn to speak, call 585-624-7887, email firstname.lastname@example.org, or visit www.aloneandcontent.com.
says physician Ashish Thakrar, an internal medicine resident at The Johns Hopkins Hospital and a lead author of the study. He adds: “Now is not the time to defund the programs that support our children’s health.” Thakrar notes that while the U.S. spends more per capita on health care for children than other wealthy nations, it has poorer outcomes than many. In 2013, the United Nations Children’s Fund ranked the U.S. 25th in a list of 29 developed countries for overall child health and safety.
U.S. Hospitals Still Prescribe Too Many Antibiotics: Study
bout 20 percent of U.S. hospital patients who receive antibiotics experience side effects from the drugs, researchers report. The new study included nearly 1,500 hospitalized adults who were prescribed antibiotics. The findings revealed that one-fifth of those who experienced antibiotic-related side effects didn't require the drugs in the first place. The results add to growing evidence that antibiotics are overused, according to the Johns Hopkins Hospital researchers. "Too often, clinicians prescribe antibiotics even if they have a low suspicion for a bacterial infection, thinking that even if antibiotics may not be necessary, they are probably not harmful. But that is not always the case," said physician Pranita Tamma. She is director of the hospital's Pediatric Antimicrobial Stewardship Program. Antibiotics can cause real harm and doctors should always consider if they are necessary, Tamma said. "If the patient develops an antibi-
otic-associated adverse reaction, even though that is, of course, unfortunate, we should be able to take some comfort in knowing that at least the antibiotic was truly necessary," Tamma said in a Johns Hopkins news release. Tamma is also an assistant professor of pediatrics at Johns Hopkins School of Medicine in Baltimore. Patients in the study were hospitalized for reasons ranging from trauma to chronic disease. All received at least 24 hours of antibiotic treatment. Overall, 20 percent had one or more antibiotic-related side effects
within a month of leaving the hospital. The most common were digestive upsets (42 percent), kidney problems (24 percent), and blood problems (15 percent), the findings showed. For every additional 10 days of antibiotic treatment, the risk of side effects rose by 3 percent, the investigators found. Over 90 days, 4 percent of study patients developed a bacterial diarrhea called Clostridium difficile, which can be severe. In addition, 6 percent developed infections that were potentially drug-resistant. The study was published this
summer in the journal JAMA Internal Medicine.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
By Eva Briggs
Ear Pain Sometimes it represents a serious, life threatening disease
ost people assume that when their ear hurts, it must be an infection. But otalgia — the technical term for ear pain — can stem from an assortment of conditions. Sometimes the cause is primary, due to problems with the ear itself. Other times, the pain is secondary to a problem in another part of head, neck or even chest. How can it be that problems with other body parts can cause ear pain? Think of hearing a noise and being able to determine the general direction but not the exact source of the sound. Sometimes the same thing happens in the part of the brain that detects pain. The pain center senses that that a particular nerve is broadcasting a pain signal. But there’s a mix up because a single nerve may extend to several anatomical structures. The brain mistakenly assigns the pain to the ear even though it started someplace else. For example, the trigeminal nerve connects to the face, sinuses, and teeth. The facial nerve receives input from the tongue and soft palate. The glossopharyngeal nerve
serves the tongue, tonsils, pharynx, and middle ear. The vagus nerve senses signals from the heart, lungs and gastrointestinal tract. Primary ear pain, originating in the ear itself, can arise from infection. Infection in the middle ear, otitis media, is the familiar earache common in small children. Otitis externa, often called swimmer’s ear, involves the ear canal. The outer part of the ear, or auricle, can also be infected. A common noninfectious form of ear pain is eustachian tube dysfunction, a failure to equalize the pressure between the atmosphere and the middle ear. Other less common causes of primary ear pain include mastoiditis (infection of the air cells contained in the bones adjacent to the ear), shingles affecting ear structures, relapsing polychondritis (noninfectious cartilage inflammation), tumors, infected cysts, and injury. That’s only a partial list! When it comes to secondary ear pain, the possibilities are multiple. Common causes include sinus and dental infections. Pain can originate in the joint between the temple and
the mandible, TMJ syndrome. Sometimes ear pain represents a serious, life threatening disease. While pain from a heart attack typically is in the chest, neck, arms or upper abdomen, a few people experience the pain in the ear. Clues to the real cause include associated symptoms like sweating, nausea, palpitations or shortness of breath. There might also be signs like an abnormal pulse or blood pressure. Temporal arteritis, a type of inflammation of the blood vessels, can present as ear pain. The pain might be worse with chewing, because the inflamed artery can’t provide enough blood flow to the chewing muscles. This disorder requires immediate treatment because it can block blood flow to the eyes and cause permanent blindness. With so many potential causes of ear pain, you’ll need to see a healthcare provider who can perform a careful history and exam to identify the cause and the proper treatment.
Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
Bladder Cancer: 9th Most Common Cancer Northeast U.S. has the highest incidence of bladder cancer in the country By Joseph Jacob, MD
ladder cancer is the ninth most common cancer in the world and unfortunately accounts for 17,000 deaths per year in the United States. The median age of diagnosis for men and women is approximately 70. Interestingly, the northeast United States has the highest incidence of bladder cancer in the country. The most common risk factor for developing bladder cancer is smoking cigarettes and tobacco use. Other risk factors include mainly occupational exposures to carcinogens seen in metal workers, painters, rubber industry workers, hairdressers and various Physician Joseph Jacob is a urologist at Upstate Urology and treats complex oncologic diseases, including bladder cancer, testicular cancer, kidney cancer, penile cancer, and prostate cancer,among other urologic problems. Page 16
other manufacturing jobs with exposure to industrial chemicals. Diagnosis Most commonly, patients present with blood in the urine. Patients with hematuria should be referred immediately to a urologist who will perform cystoscopy and usually a contrasted CT scan with delayed images to evaluate the renal pelvis and ureters. If a tumor is identified, a urologist will use a cystoscope with instruments to resect this tumor through the urethra. This resection is diagnostic and can also be therapeutic. The pathologist then will determine if the tumor is invasive or non-invasive. Treatment Most bladder cancers are non-invasive and can be treated with chemotherapies or immunotherapies that are instilled in the bladder. Invasive bladder cancers are more likely to metastasize and therefore
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
complete removal of the bladder and pelvic lymph nodes is standard. Some non-invasive bladder cancers can become invasive if not treated. Therefore, it is vital to offer patients intravesical therapy in order to avoid the need for bladder removal.
Upstate Urology offers all aspects of bladder cancer care, including immediate diagnosis, intravesical therapy and removal of the bladder. It also offers clinical trials to help patients preserve their bladders after failing standard intravesical therapies.
The skinny on healthy eating
Lots to Love about Dark Chocolate B efore I became aware of dark chocolate’s nutritious ways, I used to feel a tad guilty whenever I indulged, fearing that I was consuming empty calories (and a lot of them). But I haven’t felt that way in years and here’s why: Dark chocolate is chock-full of health benefits. Let’s start with dark chocolate’s most noteworthy health perk: its super-high concentration of antioxidants. We want to include antioxidants in our diets because they gobble up cell-damaging free radicals (present in all of us), which are unstable molecules that may contribute to heart disease, cancer, Alzheimer’s and other age-related diseases that shorten lives. What’s more, the particular kinds of antioxidants found in chocolate — flavonoids and polyphenols — may boost heart health, by improving blood flow, lowering blood pressure and reducing bad cholesterol. Another health perk to behold? Dark chocolate is surprisingly full of nutrients. A 1-ounce portion serves up 3 grams of fiber (as much as a banana!) and is rich in iron, copper and manganese. Current research shows that fiber may lower blood pressure, improve blood cholesterol levels
and reduce the “inflammation” now attributed to cardiovascular disease. Iron, copper and manganese all play a role in energy production and overall good health. Dark chocolate is a bona fide brain booster and mood elevator, as it triggers the release of endorphins and serotonin — neurotransmitters that make us feel up and good. A study published in the Journal of Nutrition showed that participants over age 70 who reported regularly consuming chocolate scored higher on cognitive performance tests. Fortunately — because dark chocolate runs high in fat and calories — only 1 ounce (about 150 calories; 10 grams of fat) is needed to achieve health benefits. On average, a few truffles or 3 squares of a 3.5-ounce bar are equal to about 1 ounce. More sweet news: Chocolate, like nuts, induces satiety, so a little goes a long way in helping us feel fuller longer. Not all chocolate is created equal, so choose your chocolate wisely. Most nutritionists recommend minimally processed dark chocolate with at least 70 percent cocoa content or higher to reap the aforementioned benefits. While milk and white choc-
olate are delicious, they have fewer antioxidants and nutrients, scant fiber and nearly twice as much sugar.
Helpful Tips Double-Chocolate Black Bean Brownies 1 (15-ounce) can of black beans, rinsed and drained 3 eggs 3 tablespoons vegetable oil ½ cup unsweetened 100% cocoa powder ¼ teaspoon salt ¼ teaspoon baking powder 1 teaspoon vanilla extract 2/3 cup white sugar (or less, if prefer) ½ cup semi-sweet or bittersweet chocolate morsels ½ cup chopped nuts (optional)
Preheat oven to 350 degrees. Lightly oil or coat an 8-inch baking pan with nonstick cooking spray. Combine the black beans, eggs, oil, cocoa powder, salt, baking powder, vanilla extract, and sugar in a blender or food processor. Blend until smooth. Gently stir in chocolate morsels. Add ½ cup of chopped nuts if you like. Pour the batter into the prepared
f the prescription label says “take with meals,” does it matter what you eat? It depends on the medication. Many meds should be taken with food — any food — to increase their absorption and reduce the risk of side effects. But some foods and medications can interact, reducing the medications’ effectiveness or increasing the risk of harmful side effects. To stay safe, you should always talk to your doctor or pharmacist to learn the ins and outs of your prescriptions, along with what foods and beverages to avoid while you’re on it. In the meantime, here are some foods you should stay away from for some commonly prescribed drugs. n Cholesterol Medications: If you take a certain statin drug to control high cholesterol like Lipitor, Zocor, Altoprev, Mevacor or generics atorvastatin, simvastatin or lovastatin, you should avoid grapefruit and grapefruit juice. Grapefruit can raise the level of the drug in your bloodstream and increase the risk of side effects, especially leg pain. n Blood Pressure Medicine: If you take an ACE inhibitor drug like Capoten, Vasotec, Monopril, Zestril and others to lower your blood pressure, you should limit food that contain potassium like bananas, oranges, tomatoes, spinach and other leafy greens, sweet potatoes, and salt substitutes that contain potassium. ACE inhibitors raise the body’s potassium levels. Eating too many potassium rich-foods while taking an ACE inhibitor can cause an irregular heartbeat and heart palpitations.
Don’t Eat This if You’re Taking That By Jim Miller n Blood Thinning Medications: If you are taking Coumadin, Jantoven, or the generic warfarin, you should limit kale and other greens, including broccoli, cabbage, spinach, and brussels sprouts that contain vitamin K. These foods can block the effects of these blood-thinning medications putting you at risk for developing blood clots. You also need to watch out for garlic, ginger, vitamin E and fish oil supplements because they can increase these medications blood-thinning abilities putting you at risk for excessive bleeding.
pan and sprinkle with 2-3 tablespoons more of the chips you are using. Bake 28 to 30 minutes, or until the edges start to pull away from the sides of the pan and a toothpick comes out clean. Let cool at least 15 minutes before cutting and removing from the pan.
n Antidepressants: If you take a monoamine oxidase inhibitor (MAOI) antidepressant like Marplan, Nardil, Emsam, Parnate, or generic isocarboxazid, phenelzine, selegiline or tranylcypromine, avoid aged cheeses, chocolate, cured meats and alcoholic drinks. These contain tyramine, which can raise blood pressure. Normally, the body controls tyramine levels with an enzyme called monoamine oxidase, but the MAOI antidepressant block that enzyme. n Thyroid Medications: If you take a medication for hypothyroidism like February 2018 •
Store chocolate in an airtight container in a cool, dark place. Ideally, it shouldn’t be stored in the refrigerator, as chocolate is a magnet for odors and more likely to discolor (or “bloom” with a whitish coating) from the fridge’s moisture. Bloom doesn’t affect flavor, but it does affect how appealing chocolate looks. If refrigeration is a must, however, first wrap your chocolate tightly, then seal it in an airtight container. When stored properly, solid dark chocolate keeps for two years; filled chocolates, such as truffles, keep for three to four months, sometimes longer.
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 email@example.com.
Synthroid, Levoxyl, Levothroid or generic levothyroxine, you should avoid eating tofu and walnuts, and drinking soymilk. All these can prevent your body from absorbing this medicine. n Anti-Anxiety Medications: If you take medication for anxiety like Xanax, Klonopin, Valium, Ativan, or generic alprazolam, clonazepam, diazepam or lorazepam, you should avoid alcohol. These medications act as sedatives, binding with the brain’s natural tranquilizers to calm you down. But when you mix these drugs with alcohol, the side effects intensify, and can cause you to feel lightheaded, sleepy and forgetful. n Antibiotics: If you’re taking an antibiotic like Sumycin, Dynacin, Monodox, or generic tetracycline, doxycycline or minocycline, you should avoid dairy — milk, yogurt and cheese and calcium supplements and fortified foods — for a couple hours before and after taking the medicine. Calcium in dairy products binds to the antibiotic and prevents your body from absorbing it, making it ineffective. To find more dietary guidance on the drugs you take, see reliable health sites like MedlinePlus.gov or MayoClinic.org, or consider the excellent new AARP book “Don’t Eat This If You’re Taking That: The Hidden Risks of Mixing Food and Medicine” available at Amazon.com and BN.com for $13.
Jim Miller is the author of the Savvy Senior column, published in In Good Health every issue.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
Parenting By Melissa Stefanec MelissaStefanec@yahoo.com
To My Child with Sparkling Purple Toenails An open letter to my son
e are going on vacation to Florida this week, so I painted my toenails. As soon as you and your sister caught wind of it, you were in my vanity drawer picking out which color you wanted for your toes. After your bath, you sat next to each other on the ottoman, and I painted your toenails a luminescent purple. I coated that lovely purple in a sparkling pink. When I couldn’t get much polish on your tiny pinky toe’s nail, you reminded me to paint that one. You didn’t want a single one missed. I finished painting 20 little toes and blew gently on them to speed up the drying. For two, young squirming bodies, the amount of time it takes polish to dry seems like an eternity. So, I blew until you both laughed and told me to stop tickling. I got polish on the skin of your toes, but you, having the wonderful perception of a child, only marveled at my work and said,
“Thank you, mommy.” Then you smiled at your toes and strutted off down the hallway to brush your teeth before bed. You were elated to finally have your toes sparkling. When your toes dried, you put on varsity-themed footie pajamas and got into bed. It was a very ordinary night in our household. Son, there will be times in this world when it’s hard to be yourself. There will be people along the way who will try to persuade you to be anything but. There are people whose minds are so small and fragile, they will want you to be exactly like something you aren’t. Quickly and gently move away from those people. There are others out there with open hearts and minds. Find them and travel through life with them. I know you wanting painted toenails at 3 years of age is likely a developmental blip. You want to be like your big sister more than almost
anything in this world. If she is doing something, you want in on it, and toenail painting is no exception. I also know most children love bright and sparkling things. So, you want your toenails painted. Mommy and daddy haven’t told you that boys don’t paint their toenails, because that isn’t true. Sometimes, boys paint their nails. And in the circles we travel, and the circles I wish for you to grow into, people don’t care if you paint your nails. They care about the content of your character and how you treat others. More than likely, one day, social norms will start having just as much influence as Mommy and Daddy. You will hear an adult issue some careless comment about your toes, and this time you will really hear it and it will sink in, you will feel wrongfully ashamed. Or, maybe, it will be a kid on the playground, whose parent repeated the adage that boys don’t paint their nails, who breaks the news to you. Because I can’t protect you forever, there will likely come a day when your sister asks for her toes to be painted and you are nowhere to be found. The “me too” chorus will be gone, and it will be another bittersweet transition that marks the road to your future self. You will still chase toads in the yard and ride your Powerwheel, but this time it will be with all-natural toenails — not necessarily because you don’t want polish, but because you aren’t supposed to have polish. Or, maybe, you will always want your toenails painted. Maybe you will never be afraid to march to your
own beat. Whatever your choice, your parents support you. Mommy and Daddy love you because you are yourself. Whatever that self becomes, as long as it’s kind, Mommy and Daddy will be on your side and support it. You see, when we signed up to be your parents, there weren’t a lot of conditions in the contract. There weren’t clauses that nullified our love or respect if you didn’t turn out the way we expected or if your lifestyle choices ran counter to outdated norms. However, there were a few things your dad and I agreed to. One of those things was to guide you into adulthood and love you unconditionally. When we brought you into this world, we made a pact to be there for you when the less desirable parts of this world snuck into your life and heart. We promised to stand up for you and teach you to stand up for yourself. So, as you go through this life, we will love and support whatever you turn into, as long as you aren’t harming yourself or others. When you inevitably make choices that harm someone, we will love you and support you in making better decisions. But, I promise to do my best to not tell you how you are supposed to be. I will let you call those shots. I hope you find friends who love and respect that same you. I hope you find people who want those around them to be real and true. But, for now, we will go on vacation. I will marvel at your purple toenails and strut beside you in the sand. I will be proud of you.
urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 1:12 PM Page 1
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
Physician Assistants’ Mean Wage in CNY: $104,440 Field for PAs growing “much faster than average,” according to NYS Dept. of Labor By Deborah Jeanne Sergeant
he physician assistant (PA) has become one of the most lucrative and employable position in health care. PAs provide direct care to patients in conjunction with a physician and can focus on a medical specialty. Most schools in New York offer a five-year program that is an accelerated bachelor’s and master’s degree, which is followed by required certification. The 2016 Statistical Profile of Certified Physician Assistants, a report by the National Commission on Certification of Physician Assistants, states that more than 115,000 certified PAs work nationwide, an increase of 44 percent in the previous four years. According to the Department of Labor’s most recent statistics gathered in May 2016, Syracuse employs 1.75 PAs per 1,000 people. Their average mean wage is $104,440. The average mean wage statewide is $107,030. The Department of Labor predicts 37 percent increase in employment change between 2016 and 2026, cited as “much faster than average” growth. “I think it continues to be a good job opportunity with very high possibility of employment for people interested in working in the medical field,” said Elle Abel, PA and representative of the Central New York Physicians Assistant Association. “We’ll continue to need to fill positions with PAs. They’re vital to the structure of medical field, especially with our physician shortage that physician’s assistants and nurse practitioners help fill. It only makes sense that the need for care providers has increased. With the jump in insured patients thanks to the Affordable Care Act and the decrease in providers as baby boomer physicians retire, demand for care providers has steadily risen. Many physicians use “physician extenders” —physician assistants and nurse practitioners — to help meet their patients’ needs. Abel speaks enthusiastically about her chosen career path at SUNY Upstate Cancer Center of Oneida, Syracuse/Oneida. “I still think it’s a good, satisfying career,” she said. “We get to help people a lot and help them become their own, best advocate.” The physician assistant career also has room for advancement
through specializing, thanks to fellowships and residencies. “These [fellowship] programs, located throughout the United States, provide advanced training and skills beyond the curriculum included in entry level PA training programs,” said Sandra Banas, PA, chairwoman and assistant professor at Department of Physician Assistant Studies at the College of Health Professions at SUNY Upstate Medical University. On-the-job training also helps PAs learn specialties. The career flexibility is just one of the pros Banas listed for physician assistants, along with a good salary, flexible hours, and continuing education. Sandra Banas PAs practice in every surgical and medical care setting. A few examples include emergency medicine, cardiac care, general surgery, obstetrics, psychiatry and neurosurgery. Beyond the patient care setting, PAs may also find roles in administration of a health care facility or as faculty. In addition to good math and science skills, PA candidates should possess interpersonal communication skills. “The soft skills are really, really important,” said Mary Springston, director of the PA program and clinical associate professor at LeMoyne College. “It’s more than the technical skills of caring, but understanding the whole patient.” Any previous medical experience, such as working as an emergency medical technician or paramedic, may also help the candidate become familiar with medical settings and give a small taste of a few of the tasks PAs do daily. “It’s a rewarding field because you’re able to care for patients and make a difference in someone’s life,” Springston said. “There are so many opportunities to impact the health care system as a PA. You can impact someone’s life and hopefully make it a healthier one.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Golden Years Getting in Shape? Get a Trainer W By Deborah Jeanne Sergeant
alking laps, playing a sport or following an exercise video can help you improve your health. But dropping pounds and gaining muscle is harder now than ever before. Especially if you’re mid-life and looking to get in shape, consulting with a personal trainer may help you improve your chances of achieving your fitness goals. Here’s why, according to a few local experts.
• “I think it comes down to accountability, injury and motivation. Having a personal trainer should ensure that you have all three of these things considered as you get into your mid 50s and 60s. The accountability of having someone waiting for you to show up can really help keep you on task, especially when you are just starting out. “I also think by working with a trainer you will become more active on the other days and be more likely to go out for a walk, participate in an appropriate sport or recreSabourin
ational activity because a good trainer will ask you what else you are doing. • “Most people over 55 have a few old, nagging injuries. They may have had a surgery or procedure and may be taking some medications now. Personal trainers who are certified and knowledgeable about this age group will design an exercise routine considering these concerns. • “For people over 55 who are trying to get themselves into shape, the process of working with a personal trainer should begin by discussing health and exercise history and conducting some sort of baseline physical assessment to establish a physical baseline and do periodic comparison analysis after 90 days. • “It’s hard to stay motivated at any age but as we get older, I think it gets easier to give up on our fitness goals. Maybe it’s because you feel exercise is aggravating an old injury, or because you don’t see results in the mirror. A lot has changed in the fitness industry and its a personal trainer’s job to keep up with the trends and continuing education for his or her certifications. • “Also, it’s the trainer’s job to help get you to where you want to be and at 55-plus, it becomes more important to avoid age-related discom-
forts and potential disease related to a sedentary lifestyle.” Randy Sabourin, personal trainer and team leader at Metro Fitness, Fayetteville and Syracuse. • “Mid-life adults can use a coach or trainer, someone they’re accountable to, because they respond well to structure. • “They may not know where to begin. It becomes a lot more seamless to have a trainer than a random way to get fit. A trainer can define goals because they’re experienced in how to clean up the diet and get moving. • “In midlife, you may start to have arthritis, blood pressure issues and other things you have to monitor. If you go at it yourself, you may have an injury or more problems down the road. • “A lot of people enjoy the socialization aspects of working out. You may not readily have a group of friends who want to work out, so a personal trainer can help you feel more socialized and it’s a person who’s a confidant. It’s not peer pressure as sometimes is in a large group.” Physician Joanne Wu, board-certified in integrative and holistic medicine, specializing in wellness and serving clients in Syracuse, Rochester and Buffalo. • “If you have an appointment with someone and they expect you to show up, you’re less likely go skip that workout, especially if there’s money involved. Depending upon the personal trainer and their policy,
you maybe have to let them know 24 hours in advance if you cancel. • “If someone is brand new to working out, they could go online and look up workouts, but I’ve gone through training and have expertise and extra knowledge they might not have as to what suits them, especially if someone’s coming off an injury. • “We have access to certain equipment they might not have at home. • “A personal trainer can be the cheerleader. You might have to lift a weight 10 times. If you hit 8, you might say, ‘I can’t do it.’ But if someone’s cheering for you, you might get it in.” Deborah A. Sindone, wellness supervisor at North Area Family YMCA, Liverpool
Mediterranean Diet a Recipe for Strength in Old Age A
Mediterranean diet may make seniors less likely to become frail and help them maintain their health and independence, new research suggests. Frailty — characterized by weak muscle strength, weight loss and low energy — is common among seniors. Frail seniors are at increased risk for falls, fractures, hospitalization, disability, dementia, nursing home placement and premature death. It’s believed that nutrition may play a role in frailty, so researchers reviewed data from four studies to determine if a healthy diet might reduce the risk for frailty. The studies included nearly 5,800 older adults in France, Spain, Italy and China. They found that following a Mediterranean diet appears to be beneficial. That diet is high in fruits, vegetables, whole grains, legumes Page 20
and nuts. The findings were published online Jan. 11 in the Journal of the American Geriatrics Society. “We found the evidence was very consistent that older people who follow a Mediterranean diet had a lower risk of becoming frail,” said researcher Kate Walters, from the University College London. “People who followed a Mediterranean diet the most were overall less than half as likely to become frail over a nearly four-year period compared with those who followed it the least,” she said in a journal news release. However, it’s unclear whether people who followed a Mediterranean diet had other factors that may have helped prevent frailty. And the study did not prove that a Mediterranean diet actually caused frailty
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
Mediterranean-style food includes fish, vegetables, herbs, chickpeas, olives and cheese, among other products. risk to drop, just that there was an association. “While the studies we included adjusted for many of the major factors that could be associated — for example, their age, gender, social class, smoking, alcohol, how much they exercised, and how many health conditions they had — there may be
other factors that were not measured and we could not account for,” Walters said. “We now need large studies that look at whether increasing how much you follow a Mediterranean diet will reduce your risk of becoming frail,” she concluded.
Golden Years Too Many Meds = Increased Health Risks Experts warn about the dangers of polypharmacy By Deborah Jeanne Sergeant
he older patients become, the more likely they need prescription medication. According to the AARP, people 45 and older on average take four prescriptions daily. While needed medications improve length and quality of life, taking too many unnecessary prescriptions can have the opposite effect. Joanne Wu, board-certified integrative and holistic medicine and rehabilitation physician, specializes in wellness and sees clients in Syracuse and other places in Upstate New York. She believes that one reason that some older adults take unnecessary medications is that their care providers lack to time to comb through their patients’ medical records and discuss their health goals. Many also don’t re-evaluate how well medication is working. “We’re striving for better cholesterol, diabetes and blood pressure numbers, which prevent mortality in the long run, but if you’re taking three to four drugs and the num-
bers are not well controlled, at some point, the primary care team may need to sit down and review it,” Wu said. The patient’s physicians may not realize all the medication taken. At this age and stage, many patients see numerous specialists who may not always communicate with each other. Despite the prevalence of electronic medical records, the systems don’t usually transfer data between them. By law, they also require signed paperwork from patients to transfer data. Older patients also seldom self-advocate. “A lot of older adults don’t have the medical literacy to understand that a drug may cause harm,” Wu said. “It takes a strong primary care team and support for that older adult so they can understand they have a choice in the matter as to whether they take that drug or not. “If people take time to talk about those goals with the family and
Craig Rowland, Hometown Pharmacy in Cato. “One of the biggest problems we face and that seniors face is getting your prescriptions or even over-the-counter items from multiple sites or from multiple sources,” he said. patient, we’d probably cut down on polypharmacy.” Wu added that some older adults taking over-the-counter, herbs and supplements don’t realize the potential for negative drug interactions. “One of the biggest problems we face and that seniors face is getting your prescriptions or even over-thecounter items from multiple sites or from multiple sources,” said Craig Rowland, owner and pharmacist at Pine Hill Hometown Pharmacy in Cato. “As an independent, community pharmacy, we are strong believers in getting your prescriptions in one store.” He explained that the pharmacist not only monitors for interactions among prescriptions, but also among over-the-counter options because the organization keeps a record of prescriptions on site. “Individuals who use mail order are at risk because their records do not interface with our records,” Rowland said. “We don’t know if they’re taking a blood thinner through a mail order pharmacy that we’re completely unaware of.” That can be problematic if the patient asks about over-the-counter pain medication but fails to mention
the blood thinner when asked. Older adults who travel or spend winters South use different providers and pharmacies, making it more difficult to keep track of what they’re taking. For elderly adults, taking multiple medication may become difficult-and more dangerous-because of cognitive impairment. Rowland added that many older adults see several different specialists who practice within different health systems, so the electronic medical records don’t transfer unless the patient signs a release. Most insurance companies require a CMR annually, but Rowland likes to perform a comprehensive medication review (CMR) every time the patient’s prescriptions change in any way, such as a new one added, an existing one ending or a dosage change. He also encourages clients to talk with their providers about any side effects that bother them. Rowland sometimes reaches out to the providers himself. Patients taking medication to mitigate the side effects of other prescriptions may be able to reduce their medication load by changing to a different prescription with fewer side effects.
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Sex After 90? By Deborah Jeanne Sergeant
an older adults enjoy sexual intimacy? Local experts say yes. “Barring any physical ailment, they can have sex,” said Rita Worlock, licensed clinical marriage and family therapist practicing in North Syracuse and Ithaca. “I’ve had some folks come in with hip issues and they still have very healthy sex lives and are very intimate. It’s a case-bycase dependant situation.” She said that many problems with intimacy can be solved with communication — even the physical ones, such as women who experience difficulty because of vaginal dryness or men with erection problems, because keeping the conversation about sex as honest and open means the couple feels free to seek help without embarrassment. While they may not experience sex in the same way as when they were younger, many older adults can
enjoy their time together. Vaginal atrophy represents a common issue for older women, as age or lack of use can make intimacy difficult, but taking more time and using an over-thecounter lubricaWorlock tion can remedy the problem. When physical problems make sex hard, they should talk with a doctor, who may counsel on various physical issues. Medication, for example, can inhibit satisfying intimacy. Doctors can also discuss ways to combat these problems. “The rule of thumb is to ‘rule out organic before the psychiatric,’” said
Jim Feinberg, licensed clinical social Study: 25% of Men Over worker and clinical hypnotherapist in private practice in Syracuse. 85 Still Do It He said that a primary health care provider According to “Older Adults usually obtains and Sexual Health: A Guide for a sexual health Aging Services Providers,” a study history, includpublished by ACRIA, many older ing any sexualadults are engaging in intimacy. ly transmitted The New York City-based organidiseases. Once zation promotes HIV research and physical education. problems are Their survey indicates that ruled out, the 75 percent of those between the provider may ages of 57 and 64 state that they’re refer to a sexually active. Of those between mental health 65 and 74, more than half engage in Feinbreeg care provider. sex. Over one-quarter of people 75 Non-medical issues can create to 85 do. barriers to intimacy, such as sex For those over 85, the number drive. drops to 10 percent for women “It can help someone embrace and remains at 25 percent for men, where they are physically and emoaccording to data compiled by tionally,” Feinberg said. “It’s worth Dr. David Lee, a researcher from trying to solve for people who aren’t Manchester University’s School of sexual. There can be a lot of grief and Social Sciences, and professor Josie loss. You peel back so many layers to Tetley, from the English Longituget to what’s going on. dinal Study of Ageing, which was “I encourage more feeling, less published in Feb. 2017. thinking when it comes to sex. PeoPerhaps indicative of Ameriple can over-think about it and focus ca’s tendency towards ageism and only on what’s negative in a relationyouth obsession, little data exists ship. Focus on what we have rather from American sources on intimacy than what we don’t have. Give each for people 85-plus. other permission to feel. What are you willing to do to make positive “One of the HIV ranges is people change?” 50-plus,” Feinberg said. “Their docOlder adults who have lost a tors are not talking with them about spouse through death or divorce may sex. A lot of providers think people feel finding someone new is daunt70-plus are not sexual. There’s a large ing, especially for people who had segment going untreated for STDs. been married for decades. It’s a population that’s so under“Do they want to take the risk of served.” someone else dying?” Feinberg said. Bugow’s “We need a picture of the whole per-Driver Using condoms provides a son to heal the whole person.”Rehab measure of protection against many sexually transmitted diseases; howOlder people who are interested email@example.com ever, the only foolproof way to avoid in intimacy won’t experience unSenior adults Driver and Evaluations Teens, disabled them is to only engage in sex in a wanted pregnancy; however, they Driver Evaluations & Training mutually monogamous relationship have same risk of sexually transwith someone who does not have 315-341-8811 mitted disease as a sexually active any infections. www.bugows.com person of any age.
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Golden Years Gift Shop Helps Aging Nuns in Syracuse
Franciscan gift shop has served the community for two decades — it’s still going at new address on Buckley Road By Matthew Liptak
ot many businesses have an immediate built-in clientele, but that is what the Around the Corner Gift Shop has at the Franciscan Villa at 6900 Buckley Road in Syracuse. This residency of up to 96 Franciscan nuns is served by the gift shop and its many volunteers. The gift shop moved to the villa only in 2014 when it opened for the sisters and for the wider community. The villa was a solution to the Sisters of St. Francis of the Neumann Communities problem of deteriorating convents in the city. It partnered with Hearth Management to provide residencies for aging and retiring sisters in a modern complex. “This year [we’re] 22 years old,” said Sister Helen Hofman, who directs the shop. “I’ve been involved with it for about 18 years. It’s grown tremendously over the years. It was a little shop that had cards and small
gifts and religious articles on Court Street that mainly took care of our senior sisters and the cooking staff and the nursing staff. Then when we came here we were able to expand the gift shop a lot more. We put notions [toiletries] in for the sisters. We have people who come in from all over Liverpool and Syracuse that give donations and contributions. Our sales have increased 100 percent since moving here from Court Street.” The shop offers many spiritually oriented gifts — rosaries, pet medals, saint statues, cross pendant necklaces — and some that are more generic. It pulls in many of the worshipers who attend the daily mass at the villa’s chapel. Hofman declined to say what the shop’s sales were, but did say revenue from Around the Corner went back into covering the overhead for the whole villa. “Anything that comes in is strictly for the benefit of the sisters,” she
said. “It helps pay bills. It helps pay our medical bills. It helps pay anything and everything. You have lights and electricity, rent. It’s not a success because of the monetary value, it’s a success because of what it does for the sisters — giving them the ability to come in here and feel free when they can’t go out because of their infirmities.” The gift shop was originally the idea of Sister Maria Goretti Smith, who had the dream of establishing a convenient place to shop for senior sisters and others. Hofman explained that many times senior sisters were reluctant to ask others to go out to pick up items for them since they would feel like they were being a burden. With the gift shop located right in the villa, the sisters could come themselves to shop. Volunteers make the shop possible. They allow the sisters to keep the shop open by tending to it Monday through Saturday. There are 15 volunteers in all. “Since I retired I want to give back, so I volunteer here,” said Pat Mathews of North Syracuse. “I also volunteer at hospice. What I like about it is meeting new people and finding out interests people have. I found out a couple had interests in crocheting so I joined one of their crochet groups at the library. You come in saying I want to be here. When you leave, you leave happy.” The sisters have been an integral part of the community for centuries. Saint Marianne Cope was a member of the order. She started St. Joseph’s Hospital in Syracuse before
tending to those stricken with leprosy in Hawaii. The focus remains on their vocation more than the bottom line. “It’s been a life-giving ministry for me besides the other things I can do for the community,” Hofman said. “I enjoy coming in here. My personal motivation is for the love of the sisters.” Hofman said the field of selling religious articles is not waning, although many in the modern age may have moved away from organized religion. “We do have the Catholic store which is called Hearts which is in the Solvay area,” she said. “There is a Christian gift shop which is Sacred Melody in Eastwood. You can’t have a lot of religious stuff because there’d be too much competition where you’re outdoing each other.” The gift shop like the community of sisters itself hopes to have a presence in Syracuse for years to come. Hofman can see the need for it, whether it’s for the sisters or for the wider community. It fills a niche and fulfills a mission started two decades ago, but one that is just as vital today. “We’re not going to grow past this little spot here, but definitely I can still see the necessity of a gift shop,” Hofman said. “We’re always going to have our sisters here. We’re always going to have our senior sisters so they will always need to shop. As long as we continue to have our daily masses here people from around the area will still be coming in.”
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February 2018 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
2018 State of LongTerm Care Industry
The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse
By Kim Townsend
he world of long-term care is changing in 2018, and this will impact the future of care in Central New York. • Memory Care Trends — Not only is dementia affecting more people, but it is also starting to affect younger people. Loretto is making a significant investment in memory care to help ensure we have the appropriate professionals and the facilities for victims of this disease. • Telemedicine Trends — To help address rising health care costs and best leverage new technology, Loretto will be working to improve patient care and reduce readmission rates through the incorporation of telemedicine to enhance our rehabilitation services. • Workforce Development — There continues to be a shortage of the skilled nursing and other professional staff in this region. Recruiting, training, employing and supporting these individuals is a key area of focus for Loretto in 2018. Loretto has hired more than 300 graduates through CenterState CEO’s Health Train initiative over the past three years with an 89 percent retention rate, higher than the industry standard. And we offer some of the greatest employee benefits — from low-or no-cost health insurance or car buying programs, family support
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and tuition for higher education. • Tax Reform — Some of the most significant challenges we will face in 2018 and the near future come in the form of legislation. Any changes to MedKim Townsend, icaid, Medicare President & CEO at or Social Security would have Loretto. a significant negative impact on the people who live in residential facilities, like those at Loretto. And residents coming into our facilities are now living with us for 10 to 20 years, which was not the model when Medicaid was introduced in the 1960s. Even those who may have saved for retirement likely didn’t anticipate living to 90 or 100, and at some point will need Medicaid assistance. • Looking Ahead — To meet the challenges ahead, we must focus on initiatives that promote Loretto’s strength as a high volume, low cost provider of exceptional quality services that not only meet the current needs but also exceed the expectations of our community.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
What Day of The Month Do I Get My Social Security Payment?
iming is everything, and the arrival time of your monthly payment from Social Security can be key to keeping your financial house in order. As you budget to pay your bills and save for future needs, keep in mind that your monthly retirement or disability benefit will be paid at the same time each month. To see your next payment date, create or log on to your my Social Security online account at www.socialsecurity.gov/ myaccount and go to the “Benefits & Payments” section. In general, here’s how we assign payment dates: • If you were born on the first through the tenth of the month, you’ll be paid on the second Wednesday of the month; • If you were born on the 11th through the 20th of the month, you’ll be paid on the third Wednesday of the month; and • If you were born after the 20th of the month, you’ll be paid on the fourth Wednesday of the month. There are exceptions. For example, children and spouses who receive benefits based on someone else’s work record will be paid on the
Q: What is the average Social Security retirement payment that a person receives each month? A: The average monthly Social Security benefit for a retired worker in 2018 is $1,404 (up from $1,360 in 2017). The average monthly Social Security benefit for a disabled worker in 2018 is $1,197 (up from $1,171 in 2017). As a reminder, eligibility for retirement benefits still requires 40 credits (usually about 10 years of work). The Social Security Act details how the COLA is calculated. You can read more about the COLA at www. socialsecurity.gov/cola. Q: Can I refuse to give my Social Security number to a private business? A: Yes, you can refuse to disclose your Social Security number, and you should be careful about giving out your number. But, be aware, the person requesting your number can refuse services if you don’t give it. Businesses, banks, schools, private agencies, etc., are free to request someone’s number and use it for any purpose that doesn’t violate a federal or state law. To learn more about your Social Security number, visit www.socialsecurity.gov/ssnumber. Q: How do I report a lost Social Security card? A: You do not have to report a
same day as the primary beneficiary. For others, we may issue your payments on the third of each month. Among other reasons, we do this if: • You filed for benefits before May 1, 1997; • You also receive a Supplemental Security Income (SSI) payment; • Your Medicare premiums are paid for by the state where you live; or • You live in a foreign country. Individuals who receive SSI payments due to disability, age, or blindness receive those payments on the first of each month. If your payment date falls on a federal holiday or weekend, you can expect to receive that month’s payment on the weekday immediately prior. You can see a current schedule for Social Security and SSI benefit payments in an easy-to-read calendar at www.ssa.gov/pubs/EN-05-100312018.pdf. Social Security is with you through life’s journey, helping you to secure today and tomorrow through important financial benefits, information, and planning tools. To learn more, please visit www.socialsecurity.gov.
lost Social Security card. In fact, reporting a lost or stolen card to Social Security will not prevent misuse of your Social Security number. You should let us know if someone is using your number to work call 1-800772-1213; TTY 1-800-325-0778. If you think someone is using your number, there are several other actions you should take: • Contact the Federal Trade Commission online at www.ftc.gov/ bcdp/edu/microsites/idtheft or call 1-877-ID-THEFT (1-877-438-4338); • File an online complaint with the Internet Crime Complaint Center at www.ic3.gov; • Contact the IRS Identity Protection Specialized Unit by calling 1-800-908-4490, Monday – Friday, 8 a.m. – 8 p.m.; and • Monitor your credit report. Q: My brother had an accident at work last year and is now receiving Social Security disability benefits. His wife and son also receive benefits. Before his accident, he helped support another daughter by a woman he never married. Is the second child entitled to benefits? A: The child may qualify for Social Security benefits even though your brother wasn’t married to the second child’s mother. The child’s caretaker should file an application on her behalf. For more information, visit us online at www.socialsecurity. gov.
Men’s Health Special
Don’t miss the next issue of In Good Health
By Jim Miller
What To Do When a Loved One Dies Dear Savvy Senior, This may seem like a strange question, but can you tell me what steps need to be taken after a loved one dies? My 80-year-old father has a terminal illness, and I would like to find out what I will need to do when he passes.
Only Daughter Dear Only, I’m sorry about your father’s situation but this is a great question many families inquire about when a loved one’s death becomes imminent. Here’s a run-down of some things you can do now, and after his death, that can help keep a sad event from becoming even more painful.
Before Death Occurs There are several tasks you can do now while your father is still living, that will make things a lot easier and less hectic for you after he dies. For starters, find out where your dad keeps all his important papers like his will (also make sure it’s updated), birth certificate, marriage and divorce certificates, Social Security information, life-insurance policies, military discharge papers, financial documents, and keys to a safe deposit box or home safe. Also, if your dad doesn’t have an advanced directive, help him make one (see CaringInfo.org for free state-specific forms and instructions). An advanced directive includes a living will that specifies his end-oflife medical treatments, and appoints a health-care proxy to make medical decisions if he becomes incapacitated. In addition, you may also want to get a do-not-resuscitate (DNR) order, which will tell health care professionals not to perform CPR when your dad’s heart or breathing stops. Your dad’s doctor can help you with this. You should also pre-arrange his funeral and burial or cremation.
Immediately After Death Once your father dies, you’ll need to get a legal pronouncement of death. If no doctor is present, you’ll need to contact someone to do this. So, if your dad dies at home under hospice care, call the hospice nurse, who can declare his death and help facilitate the transport of the body.
If he dies at home without hospice care, call 911, and have in hand his DNR document. Without one, paramedics will generally start emergency procedures and, except where permitted to pronounce death, take the person to an emergency room for a doctor to make the declaration. If no autopsy is needed, you will need to call the funeral home, mortuary or crematorium to pick up the body. If your dad is an organ or tissue donor, contact the funeral home or the county coroner immediately.
Within a Few Days If funeral plans were not pre-arranged, you’ll need to make arrangements and prepare an obituary. If your dad was in the military or belonged to a fraternal or religious group, you should contact those organizations too, because they may have burial benefits or conduct funeral services.
Up to 10 Days After Death To wind down your dad’s financial affairs, you’ll need to get multiple copies of his death certificate. These are typically provided by the funeral home. If you’re the executor of your dad’s estate, take his will to the appropriate county or city office to have it accepted for probate. And open a bank account for your dad’s estate to pay bills, including taxes, funeral costs, etc. You also need to contact your dad’s estate attorney if he has one; tax preparer to see if estate or final income taxes should be filed; financial adviser for information on financial holdings; life insurance agent to get claim forms; his bank to locate and close accounts; and Social Security (800-772-1213) and other agencies that provided benefits to stop payments and, if applicable, ask about survivor benefits. You should also cancel his credit cards and, if relevant, stop household services like utilities, mail, etc. For more information on the duties of an executor, a great resource is “The Executor’s Guide: Settling A Loved One’s Estate or Trust” available at Nolo.com for $32.
For more information, call 315-342-1182 or email editor@cnyhealth
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
Golden Years Alzheimer’s group schedules support meetings
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The Alzheimer’s Association, Central New York Chapter welcomes those impacted by Alzheimer’s disease or other dementia to attend one of its support groups that meet throughout the region. Support groups are a community of peers that exist to support one another. These peer- or professionally-led groups for individuals, caregivers and others dealing with Alzheimer’s disease or a related form of dementia. Caregiver support groups promote an open forum of sharing and discussion among people facing many of the same issues. The group’s power rests within its members’ ability to show compassion, develop strategies and empower its members to provide the highest quality care possible. Early-stage support groups provide peer-to-peer conversation and support for individuals specifically diagnosed in the disease’s early stages. Groups are open to the individual with the disease and the caregiver, and advanced screening is recommended prior to attending by calling the number listed with the support group. All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email firstname.lastname@example.org. Upcoming meetings include:
Early-Stage Support Groups
• DeWitt Pebble Hill Presbyterian Church, 5299 Jamesville Road 4:30 p.m., third Wednesday Feb. 21 and March 21 Advance screening recommended by calling the chapter
Caregiver Support Groups
• Auburn United Way of Cayuga County, 17 E. Genesee St., #302 (Use rear parking lot on Seminary Street) 2 p.m., first Thursday Feb. 1 and March 1
• Canastota Madison County Office for the Aging, 138 Dominic Bruno Blvd. 10 a.m., third Friday Feb. 16 and March 16 • Cazenovia Community Resources for Independent Seniors, Cherry Valley Professional Plaza, 2662 Rte. 20 East 6 p.m., second Wednesday Feb. 14 and March 14
• Baldwinsville Baldwinsville Methodist Church, 17 W. Genesee St. Page 26
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
6:30 p.m., second Tuesday Feb. 13 and March 13 • Liverpool Liverpool First Presbyterian Church, 603 Tulip St. 11 a.m., second Saturday Feb. 10 and March 10 • Manlius Manlius Public Library, 1 Arkie Albanese Way 6:30 p.m., fourth Tuesday Feb. 27 and March 27 • North Syracuse NOPL North Syracuse, 100 Trolley Barn Lane 3:15 p.m., third Tuesday, Feb. 20 and March 20 • Skaneateles Grace Chapel, 1674 U.S. Route 20 2 p.m., ast Thursday Feb. 22 and March 29 • Syracuse Alzheimer’s Association, 441 W. Kirkpatrick St. 5:30 p.m., second Wednesday Feb. 14 and March 14 Younger-onset (under 65 years old) caregiver support group • The Centers at St. Camillus, 813 Fay Rd. 5:30 p.m., third Tuesday, Feb. 20 and March 20 • The Dunbar Center, 1453 S. State St. 6:30 p.m., third Monday, Feb. 19 and March 19 • Syracuse The Hearth on James, 830 James St. 1 p.m., first and third Thursday Feb. 1 and 15, and March 1 and 15 • SAGE Upstate, 431 E. Fayette St. 6 p.m., first Tuesday, Feb. 6 and March 6 LGBT caregiver support group • Spanish Action League, 700 Oswego St. 6 p.m., first Tuesday, Feb. 6 and March 6 Spanish language support group • Syracuse V.A. Hospital, 800 Irving Ave., Room B905 1 p.m., first Wednesday, Feb. 7 and March 7 Non-veterans welcome
• Central Square First Universalist Church of Central Square, 3243 Fulton Ave. 7 p.m., fourth Monday, Feb. 26 and March 26 • Oswego The Manor at Seneca Hill, 20 Manor Dr. 7 p.m., fourth Wednesday, Feb. 28 and March 28
Bright Light Therapy at Midday Helped Patients with Bipolar Disorder Six weeks of light therapy decreased depression, increased daily functioning in patients
aily exposure to bright white light at midday significantly decreased symptoms of depression and increased functioning in people with bipolar disorder, a recent Northwestern Medicine study found. Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects. Compared to dim placebo light, study participants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light. The group receiving bright light therapy also had a much lower average depression score of 9.2 compared to 14.9 for the placebo group
and significantly higher functioning, meaning they could go back to work or complete tasks around the house they hadn’t been able to finish prior to treatment. The study was published Oct. 3 in the American Journal of Psychiatry. “Effective treatments for bipolar depression are very limited,” said lead author, physician Dorothy Sit, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “This gives us a new treatment option for bipolar patients that we know gets us a robust response within four to six weeks.” Patients also experienced minimal side effects from the therapy. No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors. “As clinicians, we need to find treatments that avoid these side effects and allow for a nice, stable response. Treatment with bright light at midday can provide this,” said Sit, also a Northwestern Medicine psychiatrist.
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Liberty Resources Integrated Health Care BEHAVIORAL HEALTH + PRIMARY CARE
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Cancer Program Cardiology ER/Urgent Care Family Care General Surgery Home Care Imaging / Laboratory Orthopedics Rehabilitation Services Senior Services Women’s Services
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February 2018 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
H ealth News Crouse has new VP for revenue cycle management Carolyn Hastings has been named vice president, revenue cycle management for Crouse Health. Hastings first joined Crouse in 1985 and served as director of health information management from 2002 to 2016. She most recently was director of coding and health information management for Palmetto Health in Columbia, S.C., where she provided strategic leadership Hastings and oversight for the 1,439-bed health system. Hastings will oversee all aspects of the revenue cycle to ensure full reimbursement for services provided by Crouse Health. This includes patient access, health information management, clinical documentation, billing and collections. Hastings also oversees strategic direction of business office, health information management and patient access functions of the Crouse system.
Crouse appoints director of patient access Jeffery Youngs has been appointed director of patient access for Crouse Health. Youngs has been with Crouse since 2007, most recently serving as manager of health information management for both Crouse and Community Memorial hospitals. Youngs will provide strategic direction and oversight for all aspects of the patient access function, including admitting, compliance with third-party payers, financial counseling, charity care and denials. Youngs is pursuing his bachelor’s degree in health information management from SUNY Polytechnic
Longtime Oswego County healthcare providers honored at event The Rural Health Network (RHN) of Oswego County honored two longtime healthcare providers for their dedication to their patients and the community during a Health Champion Award Ceremony. Recognized with the awards were Mario Magsino, medical director for Farnham Family Services who also provides care at the Veterans Administration’s (VA) Oswego location, and Ellen Holst, who retired in June from Oswego County Opportunities (OCO). Seated from left are Magsino and Holst. Standing are Eric Bresee, executive director of Farnham Family Services and Daniel Dan, CEO of Northern Oswego County Health Services Inc. Leanna Cleveland, Rural Health Network coordinator, said the two individuals were chosen due to their commitment to improving services in Oswego County, she said. “Ellen was selected for her dedication to the health and nutrition services department at OCO and her decision to continue to serve on community committees after her retirement. The committee also recognized Dr. Magsino’s ongoing work as the medical director at Farnham and the patient care he provides at the VA.” in Utica. He is currently president-elect of New York Health Information Management Association, past-president of Central New York Information Management Association, and an active member of American Health Information Management Association. He is also a partner/career coach for the Pathways in Technology Early College High School (P-TECH) program with Henninger High School and serves as a clinical supervisor with Onondaga Community College.
Interventional spine specialist joins Crouse Health Crouse Health welcomes interventional spine specialist David Moorthi to Crouse Medical Practice. Moorthi, most recently with St. Joseph’s Hospital in Syracuse, will collaborate with referring providers to intervene at the onset of acute spine pain through development and coordination of treatment plans designed to prevent unnecessary treatment. Moorthi, who brings more than
SBH Awarded $2.4 Million to Improve Health and Treatment Outcomes Syracuse Behavioral Healthcare has been awarded $2,418,000 over three years to fund the work of a group of five entities coming together to form a Behavioral Healthcare Care Collaborative (BHCC) IPA. The organizing partners are: The Inclusive Alliance IPA, the Upstate Community Health Collaborative IPA, Upstate Cerebral Palsy, Liberty Resources, and Syracuse Behavioral Healthcare. The organizations involved in this effort will be either network or affiliate partners and to date some of those organizations include Syracuse Behavioral Healthcare, Liberty Resources, Oswego County Opportunities, Catholic Charities of Onondaga County, Conifer Park, Circare and Farnham Family SerPage 28
vices, among others. Other healthcare organizations may be eligible to join the BHCC and may email SusanZ@sbh.org to express interest or learn more about joining. The funding award will aid behavioral health providers to transform to a business model of value-based payment, which rewards quality of care and better health outcomes, rather than the volume of services they provide. Funding will assist the BHCC to enhance the quality of the care patients receive to improve behavioral and physical health outcomes. Awards will be used for a wide variety of healthcare improvements. The awards are being funded through the NYS Office of Mental Health, the NYS Office of Alcohol-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
ism and Substance Abuse Services, and the NYS Department of Health. Funding has been awarded regionally to ensure statewide coverage over the next three years. “This funding will support healthcare providers coming together to build a more comprehensive, and higher quality system of care for people in Central New York,” said Jeremy Klemanski, president and CEO of SBH. “We want the best behavioral healthcare in the world to be available in Central New York.” For more information about SBH’S role in the formation of the BHCC or the impact to SBH, contact Jeremy Klemanski at Jeremyk@ sbh.org or by phone at 315-4745506 ext 202.
20 years of experience in interventional spine diagnosis and treatment to Crouse, earned his Doctor of Medicine degree from University of Madras, Stanley Medical College in Madras, India. He completed a fellowship in anesthesiology pain management, and completed residency training in physical medicine and rehabilitation at Strong Memorial Hospital in Rochester. Moorthi is a member of the American Academy of Physical Medicine and Rehabilitation, the Medical Society of State of New York and is board-certified by the American Board of Physical Medicine and Rehabilitation.
Three executives promoted at Loretto Loretto has recently promoted three of its employees to executive positions. They are: • Joelle Margery has been named vice president, skilled nursing. She will lead the administrative staff at all three Loretto skilled nursing facilities — Loretto Health & Rehabilitation, The Commons on St. Anthony, and the skilled nursing unit at the Nottingham. Margery has been at Loretto for more than 10 years, and previously served as the director of nursing for Loretto Health & Rehabilation. She also had experience in several inpatient and outpatient settings before joining Loretto, including labor and delivery, the intensive care unit, and short-term rehabilita-
tion. She earned her registered nurse degree from St. Elizabeth College and her Bachelor of Science in Nursing degree from Southern New Hampshire University. She is also a certified legal nurse consultant. • Jennifer Ingerson has been promoted to vice president, housing. Ingerson will oversee Loretto’s five assisted living facilities — Buckley Landing, Sedgwick Heights, The Bernardine, The Heritage, and The Nottingham, as well as Loretto’s community residences. Ingerson has been at Loretto for over 25 years, and previously was the executive director of housing. She also had several years of experience as a senior housing consultant for organizations across the Northeast and managed other senior housing programs for Loretto. Ingerson is currently vice president of the NYS LeadingAge Retirement Housing Cabinet. She holds a master’s degree in health services management from The New School of Social Research, green B\belt certification in Lean Six Sigma, and is a graduate of CenterState CEO’s Executive Leadership Development Series. • Stephanie Button has been promoted to vice president, PACE CNY. PACE CNY is Loretto’s program of all-inclusive care for the elderly. Button will manage operations across both PACE sites — The Sally Coyne Center in North Syracuse and Catherine McAuliffe Health Center in East Syracuse. Button has been with Loretto and PACE CNY for more than 15 years, and previously served as the executive director of PACE CNY. She also had several years of social services experience with nursing homes in the Bronx, Queens, and Newark, Wayne County. She holds a master’s degree in social work from Syracuse University, with a certificate of achievement in gerontology from the Maxwell School of Citizenship
and Public Affairs, and a Bachelor of Arts in sociology from St. Bonaventure University.
St. Joseph’s named one of ‘America’s Best Hospitals’ St. Joseph’s Health Hospital is the only hospital in Central New York to be named one of America’s Best Hospitals for orthopedics, bariatrics, obstetrics and heart care by the Women’s Choice Award, America’s trusted referral source for the best in healthcare, the hospital announced in a press release. “To be selected again as one of ‘America’s Best Hospitals’ for multiple services really demonstrates our commitment to providing high-quality and innovative health care services for women,” said Leslie P. Luke, president and CEO for St. Joseph’s Health. “Our team provides the highest level of care, and that is supported by highly trained providers, cutting edge technologies and the latest in research.” Highlights of the announcement: • St. Joseph’s Health is one of 422 hospitals that have met the highest standards for bariatric surgery across the country. This puts St. Joseph’s in the top 9 percent of 4,812 U.S. hospitals reviewed the America’s Best distinction. • St. Joseph’s Health is also in the top 9 percent of 4,812 U.S. hospitals offering heart care services. • St. Joseph’s Health is one of 452 hospitals that have met the highest standards for obstetrics and is in the top 17 percent of 2,720 U.S. hospitals offering obstetrics. • St. Joseph’s Health is one of 357 hospitals that have met the highest standards for orthopedics care in the country, placing St. Joseph’s in the top 11 percent of 3,230 U.S. hospitals offering orthopedics services.
National Institutes of Health to fund PTSD study Researchers at Syracuse VA Medical Center and SU to collaborate The National Institutes of Health recently announced that it will fund physician Kyle Possemato at the Center for Integrated Healthcare at the Syracuse VA Medical Center to conduct a study that will adapt and test the effectiveness of a brief mindfulness training for veterans with post traumatic stress disorder. This study is a collaborative effort with physicians Dessa Bergen-Cico at Syracuse University and Wil Pigeon at the VA Center of Excellence for Suicide Prevention. The study began in January and will be complete in December 2020. This project will first teach VA mental health providers and peer support specialists to co-deliver the brief mindfulness training to veterans and gather feedback from the providers and peers on any modifications needed to optimize the intervention. Next, the trained providers and peers will deliver the mindfulness training to veterans with PTSD
as part of a multi-site randomized clinical trial. To accommodate the study, one of the large labs in the research wing of the medical center will be converted to a meditation and yoga studio by early 2019. Veterans from the Syracuse and Canandaigua VA primary care clinics will be recruited to the study. “Primary care patients with PTSD are often hesitant to engage in traditional mental health services, but some are willing to participate in a mindfulness training class. In an earlier pilot study we have found that the mindfulness training improved PTSD symptoms and made veterans more willing to engage in tradition PTSD psychotherapies” said Dr. Possemato. For more information on this study or the Center for Integrated Healthcare at the Syracuse VA Medical Center, visit https://www.mirecc. va.gov/cih-visn2.
IT’S ALL CONNECTED
KNOW THE SIGNS OF A HEART ATTACK.
• Chest discomfort: pressure, squeezing, fullness or pain in the center of the chest that lasts more than a few minutes, or that goes away and comes back.
• Discomfort in other areas of the upper body: one or both arms, the back, neck, jaw or stomach.
• Shortness of breath: with or without chest discomfort. • Other signs: breaking out in a cold sweat, nausea or light-headedness.
KNOW THE SIGNS OF A STROKE. THINK FAST. F • Face droops on one side A • Arm drift downward S • Speech sounds slurred T • Time to call 911.
IF YOU SUSPECT A HEART ATTACK OR STROKE, CALL 911 AND ASK FOR THE EXPERTS. ASK FOR UPSTATE.
February 2018 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
H ealth News Upstate to Build Inpatient Adolescent Psychiatric Unit
Daniel Dey, president and chief executive officer at Northern Oswego County Health Services, Inc., with Susan LaMay, Rebecca Vann and Tricia Peter-Clark, vice president and chief operating officer. LaMay and Vann were recently honored for their longevity on the job.
NOCHSI Recognizes Two for Years of Service Northern Oswego County Health Services, Inc. (NOCHSI) recognized two of its long term employees for years of service. • Rebecca Vann, a licensed practical nurse, celebrated 30 years of employment with the organization. She began her tenure in 1987 with Lee Memorial Hospital and then Oswego Health at the Phoenix Health Center. She spent the last five years employed with NOCHSI, which assumed the operation of the Phoenix Health Center in 2013. She supports patient care with NOCHSI physicians and advanced practice professionals (nurse practitioners and physician assistants). • Susan LaMay celebrated 25 years of employment. She began
her tenure as a medical records and business office supervisor in 1992 with Oswego County Opportunities (OCO). She also spent the last five years employed with NOCHSI after it assumed OCO’s Fulton and Owego Health Centers in 2013. LaMay currently serves as clerical manager for NOCHSI’s health center practices. She plays a vital role is ensuring effective daily operations and services to patients, according to the organization. “NOCHSI is highly appreciative of Becky and Susan’s efforts and their longevity is a tribute to their many valued contributions”, said Daniel Dey, NOCHSI’s president and chief executive officer.
pstate University Hospital, the teaching hospital of SUNY Upstate Medical University, has been given the green light by two state agencies to open an eightbed inpatient adolescent psychiatric unit. The opening is planned for early 2019. The state Health Department and Office of Mental Health approved Upstate’s plans for the unit last month. Upstate currently does not provide inpatient, hospital-based services nor does it currently perform intensive emergency-room based child or adolescent psychiatric services. The $3.2 million unit will measure 7,580 square feet and be located on the seventh floor of the main hospital on the Downtown Campus. In addition to the eight beds, it will feature a family lounge and visiting area. While the opening is still 15 months away, construction is expected to begin this spring. The unit will provide treatment for individuals, ages 12 to 17 with a length of stay between five to seven days. “We appreciate the state’s approval of this much-needed unit,” said physician Thomas Schwartz, professor and chairman of the Department Psychiatry and Behavioral Sciences. “This unit will keep children and their families together in our community while they receive this care, but this is only the beginning as there is much more work to be done in bringing additional mental health services to children to
Auxiliary Makes $50,000 Donation to Oswego Health The Oswego Health Auxiliary has made a donation of $50,000, which the health system will use toward the purchase of 13 new defibrillators. Page 30
The high tech defibrillators will be placed throughout Oswego Hospital for use by staff members. The auxiliary raised the donated funds from its annual fall bazaar and var-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018
ious other fundraisers, as well as the sales from the Oswego Hospital snack bar and the Fulton Medical Center’s 510 Café.
our region.” On average about eight, but as high as 23, children and teens a day are at Upstate awaiting transfer to a facility that provides inpatient psychiatric care. Some of these children are transferred out of the area to centers in Buffalo and Saratoga Springs. Many more children are waiting in other area hospital Emergency Departments for access to inpatient psychiatric treatment. An increase in the number of inpatient adolescent psychiatric beds in Central New York was one of 17 recommendations included in the Final Report of the Youth Mental Health Task Force, created in 2015 by U.S. Rep. John Katko and New York Assemblyman William Magnarelli.
Upstate earns recognition as ‘Gold Safe Sleep Champion’ Upstate University Hospital has been recognized by the National Safe Sleep Hospital Certification Program as a “Gold Safe Sleep Champion” for its commitment to best practices and education on infant safe sleep. Upstate is the only hospital in Syracuse with this designation. “Preventable sleep related infant death is one of the leading causes of death to children under the age of one in not only Onondaga County, but New York state, said Michelle Jeski, advanced practice resource nurse with Upstate Golisano Children’s Hospital. “Statistically, we know our community needs more support on how to keep their baby safe during sleep. This certification recognizes our work to become the leading educator in our community on how to prevent sleep related infant deaths.” The National Safe Sleep Hospital Certification Program was created by Cribs for Kids, a Pittsburgh-based organization dedicated to preventing infant, sleep-related deaths due to accidental suffocation. In addition to being Cribs for Kids partners, Upstate University Hospital was recognized for following the safe sleep guidelines recommended by the American Academy of Pediatrics (AAP), and providing training programs for parents, staff and the community. “Providing newborns with the safest and healthiest start to life is our top priority,” said Laurie Fegley, nurse manager with the Jim and Dede Walsh Family Birth Center, located on the Community Campus. “Our safe sleep efforts extend beyond the hospital. We want to ensure that when parents are at home, away from the hospitals and nurses, that they know how to put their babies to sleep in the safest way possible.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2018