In Good Health: Mohawk Valley #214 - December 2023 by In Good Health: MV's Healthcare Newspaper

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DECEMBER 2023 • ISSUE 214

THE HOLIDAYS AND OUR Mental Health

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NURSE COACH: AN INNOVATIVE OPTION

SLEEP DISORDERS CAN BE DANGEROUS

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Q&A with

VICTORIA CATALDO Edwin J. Wadas Foundation gives $1 million every year for the betterment of local youth. P. 7

U.S. Men Are Dying Much Earlier Than Women, as Death 'Gender Gap' Widens

he gap in life expectancy between American men and women is now the biggest it has been since the mid-1990s — almost six years. The pandemic and opioid overdoses are key factors in the gender difference in longevity, said researchers from the University of California, San Francisco (UCSF) and Harvard University T.H. Chan School of Public Health. "There's been a lot of research into the decline in life expectancy in recent years, but no one has systematically analyzed why the gap between men and women has been widening since 2010," said the first study author, physician Brandon Yan, a resident in internal medicine at UCSF. In 2021, the gender gap in life expectancy rose to 5.8 years, its largest since 1996, he and his colleagues report. In 2010, the gap was its smallest in recent history, 4.8 years. Life expectancy in the United States was 76.1 years in 2021. That's down from 78.8 years in 2019 and 77 years in 2020. Researchers cited the pandemic as the biggest factor in the widening gender gap; it took a heavier toll on men. Unintentional injuries and

poisonings (mostly drug overdoses), accidents and suicide were other contributors. Another factor in Americans' shrinking lifespan: so-called "deaths of despair." That's a nod to the rise in deaths owing to such causes as suicide, drug use disorders and alcoholic liver disease. These are often linked to economic hardship, depression and stress. "While rates of death from drug overdose and homicide have climbed for both men and women, it is clear that men constitute an increasingly disproportionate share of these deaths," Yan said in a joint news release from UCSF and Harvard. He and colleagues from around the country used data from the National Center for Health Statistics to zero in on the causes of death that were contributing most to shrinking life expectancy. After that, they examined how much different causes were contributing to the gap. For a number of reasons, men were more likely to die of COVID-19 during the pandemic. Researchers pointed to differences in health behaviors as well as risk of on-the-job exposure, reticence to seek medical care, being in jail and housing instability. Also factoring in were chronic

metabolic disorders, mental illness and gun violence. The findings were published online Nov. 13 in the journal JAMA Internal Medicine. "We have brought insights to a worrisome trend," Yan said. "Future research ought to help focus public health interventions towards helping reverse this decline in life expectancy." He said the findings raise questions about the need to develop specialized care, such as in mental

Single-Port Robotic Surgery:

E X P E R I E N C E M AT T E R S As the region’s leader in robotic-assisted surgery Crouse Health is the only area hospital to offer the latest, minimally invasive technique for prostate surgery using a single, small incision. The da Vinci SP system uses advanced technology designed for access to tissue in the body with greater precision and enhanced mobility. A pioneer in robotic-assisted surgery, urologist Po Lam, MD, is the ﬁrst and only surgeon in the region to utilize the da Vinci Single Port robotic system for prostate removal. His experience with the SP system places him in the top tier* of robotic surgeons in the U.S. using this innovative technology. *Intuitive Surgical

See interview with Po Lam, MD, and SP patient Dan Cannucciari:

crouse.org/RoboticsSinglePort crouse.org/ Ask your physician if Single Port robotic surgery is appropriate for you.

Page 2 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

health, for men. Senior author Howard Koh, a physician and professor of public health leadership at Harvard, said follow-up will be needed to see if the trends change after 2021. "We need to track these trends closely as the pandemic recedes," he said. "And we must make significant investments in prevention and care to ensure that this widening disparity, among many others, does not become entrenched."

Build Social Connection. Prevent Loneliness. We may not think of loneliness as posing serious health risks, but if feelings of loneliness are not addressed, they can significantly impact our health. There are ways to help prevent loneliness and the resulting health impacts. If you’re feeling lonely, consider the following: • Seek support: Reach out to friends, family or a therapist. Support groups can also foster a sense of community and understanding. • Volunteer: Helping others can boost self-esteem and foster meaningful relationships. • Take up a hobby: Engage in activities that bring you joy. Join a club or group with shared interests to meet new people and build relationships. • Practice self-care: Maintain a healthy diet, get enough sleep, exercise regularly, and practice mindfulness and self-compassion. • Try something new: Step outside your comfort zone. It can be intimidating but can also lead to new connections and relationships.

Listen to our episode, “The Loneliness Epidemic” on the Community Check-in to learn more about this issue and who is most at risk. A nonprofit independent licensee of the Blue Cross Blue Shield Association

Let us help you breathe easier with a free lung cancer screening! November is Lung Cancer Awareness month. As a service to our community, Hematology-Oncology Associates of CNY and CRA Medical Imaging are offering a free lung cancer screening to qualified participants. Who:

Free screenings are available for individuals ages 50-80 who: - are heavy smokers (e.g., 1 pack a day for 20 years or 2 packs a day for 10 years) - OR are former heavy-smokers who quit in the last 15 years - AND have not previously received a free lung cancer screening from us. Note: Anyone with insurance can contact our office to discuss getting a lung cancer screening at your convenience. When: Saturday, November 4, 8:00 a.m. to 2:00 p.m. Where: HOA’s Onondaga Hill, East Syracuse and Auburn offices To learn more, call 315-472-7504 extension 1301 or visit hoacny.com

This free screening event is co-sponsored by:

December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 3

Healthcare in a Minute By George W. Chapman

The Big Squeeze: Physicians’ Fees Cut Again While Operating Costs Go Up

edicare is proposing to reduce physician payments in 2024 by 3.36%. That comes on the heels of a 2% reduction this year. The American Medical Association (AMA) figures that, adjusted for inflation, it is tantamount to a 26% cut in reimbursement over the last 20 years. If you factor in the fact that staff and overhead expenses increase at about 3% a year, physicians are getting squeezed from both ends. Medicare has offered alternative payment models to physicians which have basically made attaining their

fees more complicated, risky, expensive and frustrating. To use a hackneyed sports reference, the Centers for Medicare & Medicaid Services (CMS) keeps moving the goal post. To make matters worse, commercial payers mimic Medicare when it comes to establishing their physician and hospital fees. It seems like CMS is trying to kill private practice. Over half of all practicing physicians are now employed by either a hospital, gigantic health system or a corporation like CVS or Walmart. That number will go much higher as most physicians finishing their residency

opt for employment versus the hassle of private practice. Ironically, CMS determined reimbursement rates for physicians and hospitals are becoming less relevant as more and more seniors opt for Medicare Advantage plans which are administered by commercial insurers like the Blues, United, Aetna and Cigna. Sooner than later, large health systems with several hospitals and thousands of physicians will sit across the negotiation table with Advantage plans to negotiate fees rather than having to lobby Congress.

RxPass

employers to drop health insurance altogether for their workers. That never happened. The Employee Benefit Research Institute found that between 2014 and 2022 workers eligible for health coverage increased 5 percent. As of 2022, for all employers in aggregate, 81% of private sector workers are eligible to be covered by their employer’s plan. Eligibility is 99% among workers in businesses with more than 1,000 employees. It’s 97% for businesses with 100-999 workers; 80% for businesses with 25-99 workers and 25% for businesses with less than 10 employees. The ACA did away with denying coverage for pre-existing conditions and established basic coverage requirements for three levels of coverage: bronze, silver and platinum. Critics have tried to repeal the ACA more than 60 times.

authored a resolution to at least maintain neutrality, versus outright disdain, for a single payer system. It was narrowly defeated 53 to 47. But the shift in attitude is palpable. Coincidentally, those numbers (53-47) reflected the 53% of docs in private practice versus the 47% of employed docs. Today, 2023, more docs (over 50%) are employed than in private practice. Times have changed. Commercial insurers are earning billions of dollars annually on both their commercial and Advantage plans, while physician fees are slashed. The hassles of private practice, corporatization of medicine and the desire for better life-work balance among younger docs are driving the AMA ever closer to outright endorsing some sort of single payer or Medicare for All plan.

AMA “Leaning Into” Single Payer

AI in Claims Processing

The old-fashioned proprietary drug store on the corner was replaced decades ago by corporate chain stores operated by Rite Aid, CVS, Walgreens, etc. Now, the corporate chain stores are being replaced. Rite Aid recently filed for bankruptcy and pharmacists at CVS and Walgreens staged a three-day walk out over working conditions. To cut costs, the chains have understaffed their stores causing poor working conditions. Basically, brick and mortar drug stores are struggling. Who better to come to the “rescue” than Amazon, which has almost single handedly closed thousands of retail stores? Prime members will be issued their RxPass which guarantees twoday delivery in select cities so far: Austin, Seattle, Phoenix, Indianapolis and Miami. And it will someday be delivered via drone.

Impact of ACA When the Affordable Care Act became law in 2010, naysayers said the new minimum requirements for insurance coverage would cause

For almost a century, the American Medical Association was staunchly opposed to any kind of healthcare reform. Any. It lobbied to defeat reform efforts in the 1930s and 1940s. The AMA delayed Medicare for years and killed attempts by President Clinton (famously spearheaded by Hillary) to overhaul our expensive and disjointed healthcare system. But then….. it endorsed the ACA in 2009. In 2019, the proactive medical student section of AMA delegates

Providers are already experimenting with AI when it comes to electronic medical records and answering high volume inquiries from patients (ChatGPT). Congress is now concerned with Medicare Advantage plans using artificial intelligence algorithms and tools to deny claims. (This could also be an issue with commercial plans.) Con-

Page 4 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

gress is concerned Advantage plans will deny more claims than traditional Medicare. Again, Advantage plans are operated by for-profit commercial carriers. A committee is recommending CMS compare Advantage plans to traditional Medicare when it comes to elapsed time between care and denial, the diagnosis, the reason for denial and whether an algorithm is corrected once a certain denial has been reversed in most cases.

Medical Debt While medical debt can no longer affect your credit score, a survey conducted by the Commonwealth Fund of 6,100 INSURED adults revealed medical debt is still a problem. 27% reported medical debt more than $500 and 15% reported debt more than $2,000. Besides causing anxiety, respondents said the debt causes them to postpone care or cut back on prescriptions. And 43% of those covered by employer coverage reported they are struggling with debt. 57% with individual plans reported they are struggling. Also 45% covered by Medicaid and 51% covered by Medicare said they were struggling with medical debt. One can only imagine what the average medical debt is for people without health insurance.

Life Expectancy The good news is that US life expectancy has risen, moderately, from 78.93 years in 2020 to 79.11 in 2023. The bad news is, despite spending more per capita than ALL developed countries, 40 of them have better life expectancy than the U.S. The leaders are Hong Kong 85.29, Japan 85.03, Macao 84.68, Switzerland 84.25, Singapore 84.07, Italy 84 and Spain at 83.99. Most of the 40 countries ahead of us have universal plans or in our vernacular, Medicare for All.

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

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U.S. Infant Mortality Rate Climbs for First Time in 20 Years

ollowing nearly two decades of decline, U.S. infant death rates edged up by 3% in 2022, new provisional government numbers reveal. “This was the first year we saw statistically significant increased rates of infant mortality in about 20 years,” said study author Danielle Ely, a statistician at the U.S. National Center for Health Statistics. Infant mortality measures how many babies die before they reach their first birthday. The study wasn't designed to say why more babies are dying, but at least one expert suggested that the pandemic, which put a strain on the health care system, could have played a role. “The U.S. was still in the throes of COVID in 2022, which had myriad and varied impacts across the U.S. and disparate impacts by race, ethnicity, maternal age and geographical region,” explained Deborah Campbell, a neonatologist at the Children's Hospital at Montefiore in New York City. “The impact of COVID on pregnancy and delivery care nationwide

was dramatic, affecting access to and utilization of maternity care, and pregnant people avoiding pregnancy care and hospital births," she noted. For the study, researchers looked at birth certificates and infant death data collected through the U.S. National Vital Statistics System for 2021 and 2022. They found that the infant mortality rate in 2022 increased for moms aged 25-29. In addition, the rate also rose for preterm babies, male infants and infants born in Georgia, Iowa, Missouri and Texas. Infant death rates climbed by more than 20%, from about 7.4 deaths per 1,000 births to more than 9 deaths per 1,000 births, for infants born to American Indian or Alaska Native women. Meanwhile, infant mortality rates for white women increased by about 3%. Death rates for infants of Black women did not increase by that much, but Black infants still experienced the highest overall rates of infant mortality, Ely noted. The findings were published in the November issue of Vital Statistics Rapid Release Reports.

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In Good Health is published 12 times a year by Local News, Inc. © 2023 by Local News, Inc. All rights reserved. 4 Riverside Drive, Suite 251, Utica, NY 13502 Phone: 315-749-7070 • Email: IGHmohawkvalley@gmail.com

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Live Alone & Thrive By Gwenn Voelckers Practical tips, advice and hope for those who live alone

with positive energy. Say “yes” to invitations and show up for your happiness fix! Or become the initiator. Identify a holiday concert or event you’d like to attend and invite family and friends to join you. Take on the role of “social secretary” and you’ll gradually feel your holidays, social life, and social circle becoming more active and interesting.

Say YES to creating a new holiday tradition

Be Happier This Holiday Season: Say ‘YES’ “Thank you so much for thinking of me. I would love to attend but have another commitment. So sorry.”

o you find yourself using this familiar refrain? When feeling overwhelmed with life after my divorce, my first line of defense was to say “no” to invitations and opportunities. This was especially true during the holidays when I was alone and coping with all the decisions and choices and shopping and schlepping. Saying “no” was my way of keeping life simple and more manageable during a hectic, emotion-laden time. I thought it would make life easier and, therefore, happier. But it didn’t. Experience has taught me that there’s a downside to “no.” Declining invitations, deciding not to send holiday cards and discounting the value of holiday traditions and gatherings didn’t make me any happier. In fact, the opposite happened. By not showing up I felt empty and lonelier than ever. One of the world’s longest studies on happiness (conducted by Harvard researchers) revealed that good, close relationships are what keep people happy and healthy throughout their lives. Saying “no” keeps us apart. Saying “yes” brings us together. And it’s the togetherness that contributes

to happiness. In the end, doing the things that nurture our relationships is what lifts our spirits. Whether you celebrate Christmas, Hanukkah, Kwanzaa or the December solstice, the holidays can be a real challenge if you’re newly divorced or widowed. They were for me until I took the reindeer by the horns and decided to say a resounding “YES” to life during this festive time of year. Consider the following:

Say YES to slowing down Better yet, stop what you’re doing altogether. Find a quiet moment to ask yourself what the holidays really mean to you. Rebirth? Hope? Generosity and goodwill? Love and connection? Revisit your most deeply held beliefs about the season and make a conscious decision to participate in the holiday rituals, traditions and activities that align with your values, views, and spiritual underpinnings.

Say YES to accepting and extending invitations It’s the most wonderful time of year to meet and greet old and new friends. This is a joyful time and people at holiday gatherings are typically in good moods and filled

This is especially important if you are bemoaning the loss of irretrievable traditions of a “past life.” Consider instituting your very own “signature” tradition of volunteering to help others. When you give of yourself, you reap two big rewards: First, you’ll develop connections with people who share your spirit of giving and second, you’ll nurture your soul. I love serving as a gift-wrapping volunteer at my local book store. The tips go to a good cause and I get to chat with patrons about their purchases and delight in finding just the right book for a loved one. The entire experience warms my heart.

Say YES to random acts of kindness If volunteering doesn’t fit into your schedule, bake some holiday goodies for your family and friends. Or leave a little something (maybe a pine-scented candle?) on a neighbor’s doorstep. When you are thinking about and doing for others, you “get outside” of yourself and feel less lonely – more a part of the world and of this season of giving.

Say YES to inviting people over It will give you an incentive to decorate, if you don’t feel motivated to deck the halls for yourself. No need to plan anything elaborate. Inviting a few friends over for brunch, to make wreaths or to watch a holiday special on TV can brighten your day (and theirs!). Consider including children in your planning. For years, I hosted a cookie-decorating party for my friends and their kids. The children’s silliness, curiosity and wonder added a magical (and messy!) dimension to the holidays.

Say YES to sending out holiday cards Take this occasion to go “old

school” and send season’s greetings by snail mail. I love getting an unexpected card from a long-lost friend and I delight in tracking down and sending holiday wishes to those who might be surprised to hear from me. Sure enough, good things happen when you reach out to others. I encourage you to address a few envelopes this season.

Say YES to being realistic For those who live alone, some degree of loneliness can be considered normal during the holidays. It’s a good time to remember that feelings of loneliness aren’t terminal, nor are they a “state of being” reserved for single people. Loneliness has very little to do with being alone. It has everything to do with your state of mind. Prayer, meditation, mindfulness and communing with nature can remind you of your intrinsic belonging to your inner self, to others, and to all of life. Embrace the felt experience of belonging to an all-encompassing universe.

Say YES to happiness Let go of the notion that you need to be married or in a romantic relationship to enjoy the holidays. The potential for happiness is all around you. You’ll find it in the personal connections with family, friends, neighbors, colleagues, even people you meet in passing. You have a choice. Choose to be with people rather than isolate. Choose to deepen and strengthen your ties with loved ones. Choose to appreciate what you have rather than focus on what you’re missing. Choose to say “yes” and be happier this holiday season!

Gwenn Voelckers is the founder and facilitator of Alone and Content empowerment workshops for women (now on hiatus) and the author of "Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own" To contact Voelckers or purchase her book, visit www.aloneandcontent.com

Local News Inc. is hiring free-lance writers to write news and feature stories for In Good Health, Mohawk Valley’s Healthcare Newspaper and 55 PLUS magazine.

WRITERS WANTED

Stories range from profiles of newsworthy people in the community to medical issues to nonprofit organizations. View the publications online at www.MVhealthnews.com and cny55.com. We’re only hiring people who have writing experience, preferably in a daily or weekly newspaper. Please email resume and copies of recent published stories to IGHmohawkvalley@gmail.com

Page 6 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

Interview with Victoria Cataldo, executive director of the Edwin J. Wadas Foundation

heart disease, lower rates of obesity, and diabetes, just to name a few of the health benefits.

Q: Many people in our area have never heard of the Edwin J. Wadas Foundation, in fact, I am a lifelong resident of this area and I just recently discovered it. What is the history of this foundation? A: Well first let me tell you a little bit about the man who started it, Mr. Edwin J. Wadas. For about 60 years he was involved in local youth sports as an announcer or a scorekeeper. He just loved youth sports. He grew up locally in New York Mills, a suburb of Utica. Mr. Wadas never married, nor had any children. Regarding the foundation, in 1990 he established the foundation. His goal–mission was to invest money into youth sports in both Oneida and Herkimer counties.

Q: Let’s say for example I am a football coach at a local high school who is need of additional equipment. How do I start the process of being considered for a grant from this foundation? A: Great question. One of things as the executive director that I felt was extremely important was to make sure the process of applying for funds was easy and not complicated. So, with that in mind, we accept applications on an on-going basis. We tell people to go onto our website; there they will find the grant application. The application has about 10 questions and once completed it is sent to me.

Q: Youth sports encompass so much. Specifically, where is the money from this foundation going? A: So, the money has gone to school districts, nonprofit organizations and municipalities throughout both counties. The money has to be used for youth ages 5-18. Mr. Wadas had a vision of enhancing already existing programs. So, for instance, enhancing can be different between all three areas. For example, for a school district enhancement of programs is not a budgetary substitution. An enhancement might be the school has a basketball team; we might give money to that school to purchase a “shooting machine” because that is what keeps it really fun for the kids. For a municipality those enhancements are different. An example of this would be a town park. We would want to know what would it take for kids in that community to utilize that town park. We might put in a playground and-or a baseball field. Wherever we invest, our focus is supporting the joy of youth athletics.

Q A &

with Victoria Cataldo

Edwin J. Wadas Foundation gives $1 million every year for the betterment of local youth, says executive director David L. Podos

Q: Let’s talk about the health aspects of playing sports. How important is that for our youth? A: Playing sports certainly has physical, emotional and social benefits. So, what we have seen is this. Kids who participate in sports at an early age are less likely to engage in risky behaviors, they are more likely to become physically active adults, participating in physically active lifestyles. This can lead to lower rates of

Q: When the application is received where does the process go from there? A: Once I receive the application, I place a call to the applicant to go over everything as well as getting any other information I might think I would need so a proper assessment is made. Q: Give me an idea of the dollar amounts that your organization gives out. Are you limited in the amount? A: Well, it really depends on the need. We have funded things from a few hundred thousand dollars for instance, but it really depends on your program that you want funded, your need for additional money and how that is going to enhance youth sports. Q: So, where does this money come from that fund your foundation? A: Mr. Wadas created this foundation with his own assets. He was a self-taught and very savvy investor. When he passed in 1990, he left the remainder of his estate to the foundation. Presently, we have more than $20 million, because we are so fortunate to be fiscally solid, we do not accept financial gifts from anyone. We have a financial adviser that I, along with our board of directors, work very closely with. We roughly give away each year about $1 million. Q: How does someone get in touch with you to start the process of potentially receiving a grant from the Wadas foundation? A: They can call 315-982-9003. Also, please visit our website at wadasfoundation.org

The Neighborhood Center Purchasing New Cots for Tots

he Neighborhood Center, Inc. is asking for help to raise funds to purchase new cots for its childcare programs. The goal is to purchase 80 new cots and sheet sets for children in the programs. For each cot and sheet set the cost is $30. The community can help in one of two ways: individuals can donate online at www.neighborhoodctr.org

$30 for each cot and sheet or they can buy a Tempur-Pedic mattress set from any Joe Tahan’s Furniture location and Tahan’s Furniture will donate the cot and sheet set for every mattress set sold. “Community partners like Joe Tahan’s Furniture are invaluable to The Neighborhood Center. Through this partnership, we will be able to give our children a comfortable place

to rest,” said Jennifer Benn, director of development and public relations at The Neighborhood Center. The mission of The Neighborhood Center, Inc. is to enrich the lives of individuals and families through cooperative opportunities, resources, and advocacy that embrace diversity, promote empowerment, and foster responsible citizenship. Through its

sustained pattern of activities that benefit children, families, and the community since 1905, The Neighborhood Center, Inc. continues to advance in our enduring mission of truly “human” service. For more information about The Neighborhood Center, call 315-2722600, or visit www.neighborhoodctr. org.

December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 7

Health Career

Nurse Coach: An Innovative Option By Barbara Pierce

hristina Henry is a nurse coach, specially trained and certified as a transformative, holistic, health and wellness coach, owner and operator of Vessel: Bodhi, Mind, and Soul, LLC in Boonville. Q: What is a nurse coach? A: I’m a registered nurse and I’ve had additional training in health and wellness coaching. It’s a brand-new specialty in nursing — just like Florence Nightingale! To become a nurse coach, you must first be a registered nurse; then become certified in health coaching. It combines the medical expertise of a nurse with the health and wellness knowledge of a health coach. Q: What exactly do you do on a day-to-day basis? A: I work with people individually, help them set goals, help them figure out the way that will work best for them so that they can reach those goals. Together, we form action plans, so that they can be successful — so that they can get from point A to point B. I offer many different holistic modalities, like guided meditation, sound vibration for healing, mediative art, book clubs. I help people make small gains every day. I offer retreats for women; next year we’re going to Ireland. When the beautiful three days end, the women will take away tools and skills that will help them throughout their lifetime. I don’t treat medical conditions, but discuss any health concerns and come up with strategies

to manage your health and wellness goals. I’m a nurse in the community to help you, to advocate for you, to help you get across the barriers you encounter. Q: How did you become attracted to this specialty? A: I started out as a barber; I cut hair. Many barbers and cosmetologists go into nursing. As a barber, I took care of people; I was their counselor, unofficially. After my son was born, several years ago, I ended up in the hospital. One of the nurses who took care of me told me: “Continue with what you feel in your gut!” That nurse, made me want to become a nurse. She helped me realize that I need to pursue what I’m passionate about. I went to nursing school at Utica College, where I got a BS in nursing (and was an honor student). Following school, I worked at Rome Memorial Hospital, in the ICU, then inpatient oncology, where I worked with the sickest of the sick patients. I won the MVHS Caring Heart Award in 2021. I knew I wanted more; I wanted to expand my knowledge, to better meet patient needs. So I went for nurse coach. Q: What training did you have to become certified? A: My nurse training certification took about 10 months to complete. I completed it through the Nurse Coach Collective, an online evidence-based curriculum. I’m certified as a transformative, holistic, health

and wellness nurse coach. After I became certified as a nurse coach, I worked for an insurance company as an infusion nurse, going to people’s homes to give them infusion — chemotherapy, hydration, antibiotic, special things people need; people who were in pain and couldn’t get to an infusion center. I taught them how to give themselves their therapy. Advocating for their needs was my biggest role, being a teacher and an advocate. When I was laid off, I realized the door is open for me. I went to work for Trinity Health, one of top 10 healthcare systems in country. I helped people transition out of the hospital to home. The high-risk, the sickest patients; I helped them. I talked to them about every aspect of their health — emotional, sexual and mental. Together, we came up with a plan for them to set goals and achieve those goals. I assisted them to get the services they needed. I bridged the gap between patient care and the physician’s office. Our medical system can’t handle the sickest patients. It’s set up for acute patients. As patients, we have a role to be equal participants in our wellness. In June of this year, I transitioned into owning my own business. Q: What are the rewards of being a nurse coach? A: ‘Reward’ isn’t even a good enough word for it! It’s amazing to see people come in, transform their life, maybe fulfill their dreams. For

Excellus BCBS Announces 2023 Health Equity Innovation Award Recipients $85,000 is being awarded to support three initiatives in Mohawk Valley

xcellus BlueCross BlueShield recently announced the recipients of its 2023 Health Equity Innovation Awards. The awards represent more than $520,000 in financial support for community programs that address racial and ethnic health disparities across the Health Plan’s Upstate New York service area. “At Excellus BlueCross BlueShield, our mission is to help people lead heathier more secure lives through access to high-quality, affordable health care. We’re committed to community partnerships and using our resources to support initiatives that directly target health disparities, promote access to care, and address the underlying social

determinants of health, to help ensure everyone can reach their full potential,” said Simone E. Edwards, Excellus BCBS’s vice president health equity and community investments. Earlier this year, Excellus BCBS invited organizations to apply for awards of up to $30,000 each to help fund initiatives, programs, and research that specifically target the root causes of health inequities, with a focus on addressing structural racism. Award categories include, but were not limited to, improving the community’s physical and mental health, reducing social disparities in health care, and ensuring access to health care services. Excellus BCBS’s funding will support 20 nonprofit, 501(c)(3) orga-

nizations across the Rochester, Central New York, Utica/North Country, and Southern Tier regions. With more than 180 applicants, a comprehensive review process included input from individuals with diverse backgrounds and experiences to assess each proposal. Grant recipients were selected based on clear, defined goals and measurable results for reducing health disparities and improving health equity. In the Utica region, $85,000 is being awarded to support the following three initiatives: • Madison County Rural Health Council, Inc.— Doula Initiatives. Program provides doula services to pregnant residents in Madison County who qualify as low-income

Page 8 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

Christina Henry is a nurse coach. She is the owner and operator of Vessel: Bodhi, Mind, and Soul, LLC in Boonville. example, maybe they lost someone and are stuck in grief; they need someone to help them figure out how to pick up and move on. Maybe they’re diabetic and need to lose weight or they’ll have a heart attack. I help them figure out what steps to take and I keep them to their goal. Q: What are the challenges? A: The challenges is that this is a relatively new field and not a lot of people know about it. There are currently only 2,000 nurse coaches in the U.S. Many nurses are finding this field of interest. Any nurse can call me for more details.

or may have challenges accessing prenatal, birth, and postnatal support. • Mohawk Valley Prenatal & Maternity Support — Sister Circle, Black Birth & Breastfeeding Initiative. Program will provide a three-day culturally sensitive workshop-training taught by DONA International-certified doula trainers. Through a rigorous application process, women of color (preferably mothers themselves), who are passionate about childbirth and breastfeeding, will be selected to be trained as labor doulas and postpartum doulas, which includes lactation support training. • AdkAction.org, Inc .— Nourishing our Neighbors with the Fair Food Program. Program will provide access to local foods by distributing monthly stipends through vendor-restricted smart cards. Smart cards give participants the ability to purchase foods they enjoy and want to cook, from fresh produce to pasture-raised meat, local eggs, dairy, and grains. For the latest information on the health plan’s community investments and partnerships, members, providers and employers are encouraged to visit, ExcellusBCBS.com/community.

SmartBites By Anne Palumbo

Helpful Tips

The skinny on healthy eating

Why You Should Try Almond Flour

mericans purchase and consume more flour during December than any other month, according to the research elves at Fleischmann’s Yeast and Karo Syrup. No surprise there! Who doesn’t love to give as well as receive homebaked cookies, cakes, breads and pies during the holidays? I love to bake — and this year I’m shaking things up by baking with almond flour, a gluten-free flour with enough health benefits to give Santa pause. While I won’t use it for all recipes—the lightness of the real deal is hard to replicate—I’ll use it for many. Made from blanched almonds that are ground and sifted into a fine flour, almond flour has an astonishing array of valuable nutrients. One-fourth cup of almond flour (the amount typically found in one baked good) contains around 7 grams of protein, 3 grams of fiber, and 70 mg of calcium—all of which join hands to keep us strong, regular and full of energy. Almond flour teems with vitamin E, a powerhouse nutrient that acts as an antioxidant, neutralizing harmful free radicals that accelerate

aging and increase your risk of heart disease and cancer. Several studies, in fact, have linked higher levels of vitamin E intakes to lower rates of heart disease and Alzheimer’s. Consuming flour made of almonds also boosts levels of magnesium, an important nutrient that may help lower blood pressure and control blood sugar. Foods made with refined wheat flour—which are high in carbs but low in magnesium and fiber—may cause spikes in blood sugar followed by rapid drops. Some studies estimate that between 25-38% of people with Type 2 diabetes have a magnesium deficiency. Although almond flour is slightly higher in calories and fat than wheat flour, its fat is mostly monounsaturated fat—the beneficial fat that helps protect your heart by maintaining levels of “good” HDL cholesterol while reducing levels of “bad” LDL cholesterol. Another tempting reason to reach for this nutritious flour: Almond flour is both wheat- and gluten-free, making it a great alternative for those who can’t tolerate wheat or gluten.

For lighter, less-grainy baked goods, look for almond flour that says “super fine or finely sifted,” like Bob’s Red Mill Super Fine Almond Flour or Blue Diamond Finely Sifted Almond Flour. Many recipes recommend additional sifting for an even fluffier result. In most cases, almond flour can replace wheat flour in a l:1 ratio. Almond flour should be stored in a fridge, freezer or cool pantry to keep from going bad.

CHOCOLATE CHIP COOKIES WITH ALMOND FLOUR Adapted from simplyhomecooked.com | About 24-30 cookies ¾ cup butter, softened ¾ cup brown sugar 1½ teaspoons vanilla extract ¼ teaspoon almond extract (optional) 1 large egg and 1 large egg yolk

3 cups almond flour ½ teaspoon baking soda ½ teaspoon salt 1¼ cups semisweet chocolate chips ¾ cup chopped nuts: pecans, walnuts, or almonds

1. Preheat oven to 350F line two large baking sheets with parchment paper. 2. In a large mixing bowl, beat ¾ cup softened butter with ¾ cup brown sugar at medium speed for 3 minutes. 3. Add both extracts (if using almond, too), egg and egg yolk, and then mix on medium-high speed until well blended. 4. In a separate bowl, whisk together almond flour, baking soda, and salt. For a cookie with a finer texture, sift the dry ingredients right into the mixing bowl and mix at a slow speed until well blended.

Otherwise, slowly add the dry ingredients to the mixing bowl and blend well at a slow speed. 5. Fold in chips and nuts (if using). 6. Drop by large, rounded tablespoons onto prepared sheets and bake for 10 to 12 minutes or until golden brown. Cool on baking sheets for 2 minutes; remove to wire racks to cool completely. Note: For a more festive cookie, replace dark chocolate chips with white chips and chopped nuts with dried cranberries.

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December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 9

Holidays

The Health Risks of Christmas and How to Avoid Them By Barbara Pierce

or many people this holiday season won’t be the most wonderful time of the year. The holidays create more health problems than any other time of year, according to the CDC. Here are some of the common holiday health issues which we may encounter and how to deal with or avoid them.

Overeating The holidays are a time for indulgence. Most of us pack on a few pounds in the Halloween-to-New Year’s stretch, but it doesn’t have to be that way, even at food-centric holiday gatherings when nearly every gathering features a voluminous buffet of delicious things we know we shouldn’t eat. Occasional overeating isn’t terrible, though it can cause stomach pain and heartburn — and if you have diabetes, will cause your blood sugar to spike and can be difficult to get it down. If you have heart issues, it can cause serious problems. Tossing aside your healthy eating habits for two months straight can disrupt your eating pattern permanently and cause challenges. Tips to help you get through: Don’t skip meals; the combination of being hungry with an abundance of appealing holiday food isn’t good. It’s especially important not to skip breakfast. Eat protein with most meals so you’ll have the energy to handle the long busy days. Focus on drinking plenty of water to help your digestive system process the overload. Take the focus off food. Tell yourself you’re there to enjoy being with the people you’re with, not for

the food. Fill half your plate with fruits and vegetables. Then pick the foods that you think you will most enjoy and skip the foods you might not enjoy. Eat slowly and savor every bite. Try to wait 10 minutes before having seconds.

Holiday drinking It can be easy to consume too much alcohol without realizing it. Binge drinking during the holidays is a big law enforcement and public health problem. Celebratory drinking paired with bad weather and more cars on the road, the statistics aren’t festive. And excessive alcohol takes a toll on many organs of your body. Monitor how much and how quickly you’re consuming your drinks. If you think you may drink more than you want to, decide at the beginning of a party how many drinks you’ll have and stick with the plan. Have an exit plan. Or, choose non alcoholic options.

Holiday Depression The holidays — with all the demands and stressors — are triggers for anxiety and a low mood. “Plus, we’re in the shortest days of the year which could be a dark hole that feels like it’ll last forever,” said James Anderson, P.h.D., chief of the department of psychiatry at Bassett Healthcare Network in Cooperstown. “The holidays can be a time of joy, but if you’re already feeling alone, estranged or sad, these feelings can be magnified,” he added. See more on dealing with depression elsewhere in this issue.

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Most of us pack on a few pounds in the Halloween-to-New Year’s stretch. Overeating is just one of the problems with the holidays. reduces stress. Prioritize self-care; schedule time for activities that make you feel good, like reading a good book, seeing a movie, getting a massage, listening to music you love. Don’t resort to eating comfort foods, drinking and binge-watching TV. Connect with people who are supportive of you and get plenty of sleep.

Relationship Challenges Relationships fall into four categories: family, friends, lovers, and acquaintances. Regardless of the type, they’re never easy during the holidays. For many people, spending time with family is a mixed blessing or just incredibly painful. If you’re in the “I can’t stand my family” boat, find ways to limit your exposure. Making an appearance for a little while, then politely skip out, saying you have another commitment, may be a mentally healthier way to get through it.

Holiday-related accidents

Holiday stress Stress levels reach a fever pitch for many of us. This excess stress wears on our bodies. It triggers the release of cortisol, which can cause health problems. Spiking blood pressure and a racing heart are both very common. Migraines and stomachaches may also be a result, as well as insomnia. Find ways to relieve your stress: Do physical activity every day, preferable outside. Schedule time to get out, walk or bike. Time in nature

Emergency departments tend to see a sharp rise in accidents associated with the holidays. Decorating related falls are common, many caused by falls from ladders. Take caution. There’s a sharp uptick in automobile accidents this time of year, due to alcohol, bad weather and an increased number of drivers on the road. Leave plenty of time to reach your destination, avoid drinking and driving, never text while driving and pay attention to the other drivers around you. Remembering what the season is actually about — family, love, togetherness, perhaps your religious beliefs — is important in making it through the season with joy.

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Holidays

Survival Guide for a Stress-Free Holiday Season By Kimberly Blaker

o you dread the hustle and bustle of another holiday season? Between shopping, wrapping, baking, holiday cards, parties and many other obligations and tasks, surviving the season can be a feat, let alone finding the time to enjoy it with your family. This year, why not make a pact to eliminate stress by following these tips?

Early planning First, close your eyes and think back to the last couple of years and how hectic and stressful they felt. What percentage of holiday activities and tasks would you need to eliminate to make the season truly enjoyable and relatively stress-free? During this process, don’t think about what you can’t remove. Just determine the percentage of reduction you need to make. Next, make a list of everything you need to do during the holiday season, to which parties you’ll be invited, and how much money you’ll spend. Now cross off the least important, least necessary and least popular events and tasks. Then review the list and calculate how much time and expense you’ve shaved off. If you haven’t reached your predetermined reduction, go through your list again. Once you’ve decided which parties you’ll attend and the commitments you’ll make, plan how you’ll say ‘no’ to all the others, so you’re not caught off-guard.

Share in the preparation Enlist your family to help prepare for the holidays, and divvy up the tasks. Don’t expect perfection from yourself or your family. Remember, you probably don’t notice or mind the imperfections in others’ holiday gatherings. They’re just as unlikely to see any in yours. Also, keep in mind the holiday season isn’t the time to be head cook. Plan potluck gatherings. Then, either suggest what each person should bring or, to avoid duplicates, ask guests to let you know what they’ll bring.

Holiday time-and-energy savers Save time in gift-wrapping by setting up a station in a spare room or the basement. Or stock a large box or basket with wrapping paper, ribbon, bows, tags, tape, scissors, and pens, so everything is stored in one place. Have extras of everything on hand. Keep cleaning to a minimum during the holidays. Dismiss unused areas guests won’t see or use, and clean only the obvious in rooms that will be seen. The barely-visible layer of dust on your baseboards is unlikely to be noticed with all the holiday decorations and festivities. Make everyday meals quick and easy throughout the season. Soups, sandwiches, fresh fruit and vegetables, cottage cheese, pre-cut veggies and dip, and other prepared

or semi-prepared healthy foods will suffice for one month of the year. Do your holiday shopping early in the day on weekdays while your energy is high and crowds are small. Shop online or by catalog. If an item lacks details, search for a manufacturer’s website to get the information you need. Give gift cards. Hard-to-shop-for recipients will appreciate something practical. Gift cards to restaurants, department stores, sporting good outlets, and specialty shops, or for a massage, pedicure, or round of golf make great gifts. Don’t overdo the baking. Your guests will likely have had their fill of holiday treats long before your gathering arrives. As for the warm gesture of taking a plate of baked goodies to friends or neighbors, instead, show they’re in your thoughts by visiting or calling them to wish them a happy holiday season.

Money saver Does your gift list grow each year? Decide with whom it’s essential to exchange gifts. Then talk to extended family, friends, coworkers, and others about forgoing gift exchanges, putting a cap on the price, or doing a drawing instead. You’ll likely learn many feel the same as you do.

Care for yourself Enjoy holiday treats in moderation. High fat and sugary foods and the lack of healthy meals can lead to

tiredness and stress. Keep goodies stored in the freezer where they’ll be less of a temptation. Have plenty of convenient, healthy snacks such as raw vegetables and nuts on hand. Prepare low-fat meals that won’t bog you down. Pace yourself, and don’t try to do everything in one day. Finally, give yourself a break. Get plenty of exercise such as a brisk walk in the fresh air, and set aside time for relaxation, like a long bubble bath.

Things to do for next year Start your shopping early. Create a new tradition with a friend or family member and set a monthly shopping date for the upcoming year. By making a scheduled commitment, you’ll be more likely to follow through. Keep the early holiday shopping fun and choose a different town or shopping center for each trip, focusing on unique malls or trendy cities. Also, get a label printing software program or app early in the year and enter all of the addresses on your holiday card list. When the holidays roll around, you can print the labels and eliminate the most time-consuming aspect of sending out holiday greetings. Finally, remember the holiday season should be a joyful time for everyone, including yourself, to join in the good cheer with family and friends. Maximize ways to ease your stress to keep the ‘happy’ in your holidays!

December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 11

The Balanced Body

By Deborah Dittner

Giving During the Holiday Season There is no need to go into debt trying to purchase a gift for a loved one by overspending By Deborah Dittner

iving — or gifting — during the holidays brings joy to many. For others, even the thought of gifting may bring stress into your seasonal spirit. Some may feel obligated to give gifts whether gifting to family members, friends or neighbors, but others give gifts because they truly want that person to know how much they are appreciated and loved. Then, there is the stress of finding just the right gift and one that doesn’t break the bank. So many decisions to be made. One way to rediscover the joy and happiness of giving gifts is to first honor yourself by setting financial limitations. There is no need to go into debt trying to purchase for a loved one by overspending when all is said and done. A more expensive gift is not a sign that you care more. Try to think of what the person may need to make their life a bit better. What could make their life simpler, easier or most helpful? Planning is not only time saving but also has financial benefits. With prices rising on most everything these days, look towards helping everyone as much as possible by shopping for a variety of healthful and ecological products. Set an intention for each person on your list. What do you want the gift to say to the receiver? How do you think the gift will make them feel when they receive the gift? Creating purpose for the gift will help make the search and purchase easier. Ask others for inspiration if you get stuck. Are there cooks–budding chefs

on your gifting list? Consider compiling a booklet of your favorite family recipes. Create a basket or bowl of items needed to make a certain dish or bread with a recipe including adding a wooden spoon and dish towel. Cocoa mix, sauces, jam or jelly and spice mixtures can be pre-made and included with a special cup or loaf of bread. Monthly subscriptions for children to learn cooking techniques, how to read and create a recipe and learn to eat healthy meals can be purchased with the sous chef in mind. Subscriptions also are great for coffee and tea lovers. As the holiday approaches, listen intently to what the people you will be gifting have to say. Oftentimes in conversation, you will hear exactly what they may want or need. Possibly they saw a specific sweater that you know would help keep them warm. Or a larger family may want a crock pot to help prepare meals in advance. Someone may want a specific experience or go to a specific event that they have never done or been to before. These life experiences will last for days, weeks even years as wonderful memories. Some may actually prefer the gift of time. Do you know a young family where the parents could use a date night? Offer your time as babysitter for the night and possibly add movie tickets. Do you know someone who may have had surgery and need their home cleaned? Offer to clean the home before they arrive back home. Or will they be out of commission for a while? Possibly go in on a group gift with a house cleaner for a certain

amount of time. Do you know someone who has been laid up after an injury? Offer to walk the dog or go out to get groceries. As the cost of food continues to rise, some may be having difficulty feeding their family. Grocery store gift cards or Farmer’s Market–CSA boxes will help those in need. Or gift a family a homemade meal ready to enjoy. Other ways to help those in need is to volunteer at soup kitchens or in preparing or serving holiday dinners. Everyone is in need of some self-care. What do the people on your list like to do that makes them relax? Do they read? Consider a book or specific magazine subscription. Do they like to soak in a tub? Make a spa-like basket of homemade Epsom salts with essential oils, bath mitt or loofah, facial mask makings, and a tray to hold a book to read while they soak. Do they like to work out? Consider a contribution to their gym membership, home weights or a yoga mat or blocks. Do they meditate? Consider a salt lamp to provide that special glow which also helps to purify the air of allergens. Do they like to laugh (well who doesn’t)? There are a variety of movies and shows on disc that create laughter. A bedtime routine is an important step to learn at a young age. Gifting an evening basket for the family

can be filled with a variety of niceties. A warm bath with lavender scented Epsom salts will help any age to relax and settle in for a great sleep. A relaxing and calming cup of tea such as chamomile or turmeric will soothe and eliminate stress. Take a few minutes at the end of the day to write down those things that you are grateful for in a special journal. Keeping a regular schedule will ease the mind and allow for a restful night’s sleep. Giving and gifting during this holiday season can consist of a variety of experiences, donated time and practical gifts all of which will make the giver and receiver happier and healthier to enjoy the upcoming New Year.

Deborah Dittner is a family nurse practitioner and health consultant. Her mission is to transform as many individuals as possible through nutrition and lifestyle changes. www. debdittner.com

Take Headaches Seriously During the Holidays By Barbara Pierce

here’s no doubt the holidays are stressful for most of us. Decorating, buying gifts, cooking, rushing here and there. Our long to-do list seems all the more daunting when a pestering headache won’t go away. In most cases, they are just nuisances that go away with an over-the-counter pain reliever, food, caffeine or rest. There are many different types of headaches. Don’t dismiss your headache. If you’re throbbing with one, figure out the cause and get relief. While most headaches aren’t a cause for concern, certain types indicate something serious and require treatment. The most common headache is a tension headache. A dull, non-throb-

Page 12 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

bing pain involving both sides of the head. The pain tends to be worse in the scalp, temples or back of the head. It can be triggered by lack of sleep, increased stress, hunger, alcohol or too much caffeine. Sinus headaches are less common, caused by swelling in the sinuses, resulting in pain behind the cheeks, nose and eyes. Often, the pain is worse when you bend forward. They could indicate a bacterial infection which requires treatment. Cluster headaches are rare but severe. The pain hits in clusters, up to several times a day over a period, then none. See your health care professional for medication. Migraine headaches are one of

Things You Need to Know About Depression By Barbara Pierce

epression is a common and serious illness, agonizing for those suffering as well as the family and friends around them. We’ve asked James Anderson, Ph.D., chief of the department of psychiatry at Bassett Healthcare Network in Cooperstown, to help us better understand depression.

exactly is depres1.What sion? How common is it?

“Depression is one of the top two commonly diagnosed mental health conditions,” Anderson said. [The other is generalized anxiety disorder.] “We all have sad days, bad days. That’s the nature of the human condition. But what we define as major depression is distinctly different,” he said. Feelings of sadness or that bad day usually go away quickly and don’t impact your life in a big way. Major depression is a syndrome with severe, concerning symptoms that last two weeks or more and cause serious impact your quality of life.

focus your thinking, have a problem with concentration, i.e., can’t follow plot of a movie. Any thoughts of suicide should be taken seriously. These behaviors stacked on each other could indicate depression, Anderson explained.

3.What are the causes?

“We don’t have a definitive answer for cause,” Anderson said. “Is it caused by nature or nurture? Genetics or environment? It’s both. Depression does run in families. If you have parents, grandparents or siblings with depression you have an increased risk of running into that problem. There is a genetic component.”

What can I do if I or a family 4. member may have depression?

Anderson explained if you have a constellation of these symptoms for at least two weeks: Feeling down and depressed much of the time is an indication of major depression. Folks with depression have a reduced interest in things; the things they used to enjoy don’t seem to have the same buzz for them. Other indications are ongoing fatigue, every day; eating, either not enough or overeating; sleeping, either too much or not enough. With depression, you can’t

There are things that help, Anderson said. People who exercise regularly are more resilient to depression and anxiety. Getting active, forcing yourself to get engaged with life can be helpful; can help people pull out of it. We all have a rough day once in a while, but if these days stack on one another, get your life going. If you wait to feel better, that day won’t come. Family members are affected by the sufferer’s negativity — the never-ending complaints, the steady stream of criticisms, the lack of emotional closeness, and the loss of the ability to have fun together are some of the unintended consequences of depression. If you’re consistently irritable and negative, that’s one of the side effects of depression. That pushes

the most commonly misunderstood, misdiagnosed and mistreated disorders, said a Yale School of Medicine professor online. They are the second leading cause of disability worldwide, responsible for a diminished quality of life for those suffering. Migraines have a variety of symptoms, most notably a throbbing headache on one side of your head. Migraines often get worse with activity, lights, sounds or smells. They usually last at least four hours, even for days. All migraines are severe. However, they are much more than a severe headache, said clevelandclinic.org. They are a neurological disease that can cause a variety of symptoms in addition to pain, including tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking. If your headache is severe and doesn’t go away with over-the-counter pain reliever, it may be a migraine. Get treated early by your health care professional to prevent it from escalating and avoid a lot of pain.

A migraine is defined as at least five headaches lasting from four to 72 hours, a throbbing sensation often accompanied by nausea, vomiting or sensitivity to light and sound. Migraines do run in families. That migraines are accompanied by an “aura” is a myth, said experts. Some do have a brain disturbance that typically occurs 30-60 minutes before the headache, seeing flashing lights, zigzagging lines, losing your vision temporarily or feeling pins and needles on their arms or legs. Some have speech disturbance, they can’t understand things or can’t speak properly. While every person who suffers from migraines has unique triggers, some weather patterns can increase the severity and frequency of migraines. One of the most important things in treating headaches is figuring out your triggers. This is the first step to finding relief. And your health care professional can tailor treatment to your triggers. Keep a diary that includes weather changes, sleep, stress

How do I know if I or a 2. family member could have major depression?

people away. As a family member, be aware of this — listen, talk, extend empathy. Don’t minimize the depression. Avoid saying things like ‘Snap out of it,’ or ‘It’s all in your head.’ They really can’t snap out of it. Help the depressed person reach out for help. Start with your primary care professional. 988 is the 24-hour national suicide and crisis hotline; have that available. Don’t wait. The sooner you reach out to get treatment, the sooner things will be better, Anderson stressed.

major depression 5.Does respond to treatment?

Major Depression won’t go away on its own; you do need to seek treatment. It does respond to treatment. Your primary care provider can prescribe antidepressant medication, like Prozac or Zoloft. They’re well tolerated by most people and they’re effective. Usually, you will need to take them for at least a few weeks before they’re really effective. If you don’t feel any benefit after four weeks, talk to the prescribing professional. In combination with medication, Anderson also recommends effective psychotherapy, like cognitive behavioral therapy or interpersonal therapy; both are beneficial. “If your depression doesn’t re-

spond to medication and psychotherapy, there are almost always addition steps we can take,” Anderson said. “We’re seeing promising signs from more aggressive new treatments.” “If you or a loved one has depression, you’re not alone,” Anderson added. “You’re not broken or damaged. This is an illness than can happen to anyone and it is treatable. You may feel hopeless, but, it’s a fact — people do get better.”

levels, exercise, menstrual cycles and the severity and length of your migraines. (Many women get migraines around their period or mid-cycle.) “Headaches can sometimes be red flags for something more serious, and, therefore, need to be properly diagnosed by a medical professional,” said acupuncturist Greyson Ross, owner and operator of Greyson Ross Acupuncture in New Hartford. If you suspect you have migraines, while you wait for your health care professional to diagnose and treat, here are things you can do to manage symptoms: Get regular sleep: Lack of sleep is a common migraine trigger, as is getting too much. Naps can help relieve a headache. Skipping meals can trigger a migraine. And some foods can be a trigger, including chocolate, certain cheeses, processed meats, red wine, artificial sweeteners, MSG. • Caffeine can be a trigger. Experiment to find your caffeine limit. • Drink water; being hydrated will relieve a headache.

• Limit alcohol as it can cause headaches. • Dim the lights. Sensitivity to light is a common symptom; keep the lights low. • Stress is one of the biggest triggers; find ways to reduce your stress; consider psychotherapy. After your headache has been diagnosed by your health care professional, a range of treatments are available, including acupuncture. “Acupuncture is used to manage a variety of headaches including tension headaches, migraines, sinusitis pain, trigeminal neuralgia and cluster headaches,” said Ross. “Acupuncture can help decrease the frequency, duration, and intensity of the headache pain. Most patients can expect to see some improvement by about six treatments. After the initial course of treatment, patients will typically need treatment once a month; some go months in between sessions.” If your headache comes on suddenly, reaches intense pain within one minute, it’s important to seek immediate medical attention.

James Anderson, Ph.D, is the chief of department of psychiatry at Bassett Healthcare Network in Cooperstown.

December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 13

Between You & Me

By Barbara Pierce

Calm the Christmas Chaos lights, Christmas carols, a new snowfall — when all is white and quiet and so beautiful. I’m going to focus on those things that I truly love about Christmas. What I don’t like is the pressure to track down the right gift for everyone, the office Christmas party, over-crowded stores, over-spending, eating too much, getting gifts I don’t want. I’m going to exclude as many of these things as I can. If you’re already running a tight schedule with little time left over to do Christmas right, consider some of these suggestions to downsize the fiasco that Christmas has become: Money is the top cause for stress for most of us during the holidays. Money spent on gifts. And the stress of finding those gifts. The pressure to buy the perfect gift for everyone. Instead, have open conversations with family members ahead of time about gifts and ways to scale down. Consider focusing on making memories with those you love. By prioritizing experiences instead of stuff, you can keep it simple while still enjoying yourself and making it special for those around you. Things like enjoying the Christmas lights, cozying up in front of the fireplace to read Christmas stories with your kids, making snow angels or popping popcorn for a Christmas movie

marathon. Consider a gift exchange where you each buy for only one family member. Families who want to halt the gift-giving mania and restore fun and sanity to the holiday might take a tip from a friend of mine. Her family instituted a gift exchange that’s the high point of the season. On Christmas Eve all adults and kids gather. Each brings one wrapped unisex gift for less than $20. They each draw a number from a playing card deck. Number one selects a gift and opens it. Number two can take the opened gift or choose one of the unopened one. Along with finances, activities related to eating are another major stressor for most of us. Given how nerve-wracking Christmas can be, it’s no wonder we resort to eating more of the wrong things. If you want to cut back and do things differently about food, talk with your family ahead so they can make plans. Be willing to compromise. Look for simpler recipes or buy prepared meals. Scale down the meal. Or consider the ease of going to a restaurant. Instead of cooking a big Christmas dinner, purchase prepared meals you can warm up in the oven. Less stress, less mess. You can find many suggestions online. Or instead of an entire meal, just have desert and coffee. Everyone’s favorite is desert anyway. Keep social activities under control. All those dinners, potlucks, holiday parties, concerts and perfor-

mances get overwhelming and leave you exhausted. Be intentional about what obligations you agree to — and don’t feel bad saying no. Attend the events that feel meaningful and bring you joy and skip the ones that feel more like a chore than a celebration. Don’t go overboard with decoration. We haul out boxes of lights, ornaments, figurines, wreaths, candles and cover every inch of space with red-and-green everything. Not only does it take a ton of time and energy to put all that stuff out, you’ve got to put it all back. Consider dialing the decorations back and focusing on the pieces that bring you the most joy. Consider skipping the tree. It demands time and energy. If you have pets or small children, you know it doesn’t work. It’s a hassle to keep it watered and maintained. Just focus on friend and family — what you really enjoy and you’ll make happy memories.

That group, said study author Brenda Penninx, also “lost weight, improved fitness and reduced heart rate and blood pressure.” The medication group did not see those benefits. Penninx, a professor of psychiatric epidemiology and vice chair of the department of psychiatry at Amsterdam University Medical Center in the Netherlands, presented her findings in October at the ECNP meeting, which focuses on the science and treatment of brain disorders. The research was published earlier this year in the Journal of Affective Disorders. All told, she said, the findings suggest that “we should pay much more attention to lifestyle improvement in mental health care.” Patients in the study all struggled with depression or anxiety. When given a choice between the two options, nearly two-thirds chose to tackle their depression with running sessions that were regularly scheduled over a four-month period. The remaining third chose to take escitalopram. The team noted that in both groups there were patients who saw no benefit of any kind when it came to curtailing depression or anxiety. In fact, only just over four in 10 patients (44%) in both the running and medication groups experienced a mental health boost. But those in the running group who did also went on to shed some weight and reduce their waist circumference. Improvements in blood pressure and overall heart func-

tion were also seen. That was not the case among those taking escitalopram. There was one downside seen in the running group: The likelihood that a running patient stuck with the full exercise program was considerably lower than it was for patients who chose escitalopram. Somewhere between 52% and 58% of runners maintained their running routine throughout the study period, compared with 82% to 85% adherence in the medication group.

Expressing little surprise at that finding, Penninx noted that “lifestyle change is known to be difficult.” Still, patients might benefit by being given a choice as to what they feel might work best for them, she said. “Unfortunately we don’t know yet what works for whom,” Penninx acknowledged, adding that a combination of both treatments “may be best” when it comes to upping the chances for managing depression.

By Barbara Pierce

his time of year, we talk a lot about peace on earth and goodwill toward men. We wish everyone a “Merry Christmas” or “Happy Holidays.” It’s the most wonderful time of the year! Yeah, right! For the most part, it’s not peaceful, merry or happy. It’s overwhelmingly stressful. I love Christmas! I really do. I love the lights on the houses, the Christmas tree, getting together with family and friends. And all that great food! What I don’t love is the stress and exhaustion it’s become! Christmas is frenzied chaos, a never-ending list of things to do, places to go. While my credit card balance grows at an astounding rate as I try to find just the right gift for everyone on my list. Then in January, I’m stressed out, worn out, anxious, out of money, feel let down and wonder why I didn’t do a better job of putting the brakes on. So I’m taking a different approach to Christmas this year. I’m going to simplify, focus on what really matters to me instead of trying to do it all. This year, I’m going to remember what I truly love about it. Making Christmas cookies with my grandkids, the smell of a real Christmas tree in my living room, Christmas

Running vs. Meds: Which Works Best to Beat Depression? Exercise has been dubbed “nature’s antidepressant” by doctors for years, and now a new study confirms the notion. The finding follows a four-month look at the impact that running had on anxiety and depression when compared to a common antidepressant. SSRIs (selective serotonin reuptake inhibitors) work by boosting levels of serotonin, a neurotransmitter that’s a key player when it comes to regulating mood, depression and anxiety. But among 140 depression patients, those who engaged in regular group running — meaning two or three 45-minute runs each week — actually saw their depression levels drop a bit more than those who took the popular SSRI medication escitalopram (Lexapro). And those who treated their depression with exercise reaped an added reward, with improvements seen in their physical health as well.

Page 14 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

Barbara Pierce is a retired licensed clinical social worker with many years of experience helping people. If you would like to purchase a copy of her book, “When You Come to the Edge: Aging” or if you have questions for her, contact her at barbarapierce06@yahoo.com.

Benefits to Reducing Alcohol Consumption

Dietitian: ‘Even one glass of wine raises our risk for diseases’ By Deborah Jeanne Sergeant

o you recall hearing that a glass of wine a day supports heart health? As it turns out, “it’s not even clear red wine is beneficial,” said Mike Merrill, physician and internist and chief medical officer of Brook Health. “The core thinking now is alcohol is overall not beneficial. That’s the consensus.” Merrill serves as associate clinical professor of epidemiology at University at Buffalo. He added that alcohol contributes excess calories to the diet, which can make it easy to gain weight. Consider the foods typically accompanying alcohol in social settings, such as cheese with wine or greasy “bar foods” with beer. These pairings can also ramp up calorie intake. Says Drew Michael Hemler, a registered dietitian in private practice in Syracuse: “Mortality increases with even one glass [of alcohol].” Hemler added that the idea that red wine is good for heart health stems from the resveratrol naturally

occurring in grape skins that is still present in wine after processing. “Everything should be taken in context,” Hemler said. “To receive the active dose that’s beneficial, you’d have to consume more than 10 bottles of wine.” “Only one serving per person is the recommended maximum for those who do drink,” Hemler said. “The benefits of reducing alcohol are virtually endless.” A few he listed are better skin, as alcohol contributes to dehydration. “Alcohol intake can exacerbate skin conditions like eczema, rosacea and psoriasis,” Hemler said. Too much booze can hamper digestive health and chronic alcohol intake raises the risk for gastritis and pancreatitis. Hemler also said that reducing intake improves nutrient absorption. “When we reduce alcohol intake, we can improve weight management,” Hemler said. “Drinking alcohol is drinking empty calories, which contributes to excessive total

intake which leads to unintentional weight gain.” Alcohol offers no improvement for longevity. Any health benefit arising from happy hour is likely because of socializing, but not the alcohol itself. Instead, drinking alcohol increases the risk of some cancers and some heart problems. “Excessive can replace consumption of wholesome foods and affect absorption of nutrients,” said Carolyn Allen, registered dietitian and owner of Rural Roots Nutrition in Manlius. “It can add too many calories and lead to weight gain. Because it can change mood, behavior and memory, it can lead to choosing more nutrient-void foods and more processed foods.” “Regular alcohol use, especially heavy use, increases risk of heart disease and stroke,” said Gregory Faughnan, board certified physician in primary care at St. Joseph’s Physicians Primary Care in Syracuse. He said that cutting back on alcohol can also improve sleep. Although having a “nightcap” to help induce sleep seems sensible, drinking at bedtime can make it harder to fall back asleep if

one awakens in the night. This can make it harder to fall asleep without it and establish a nightly drinking habit. Alcohol, a depressant, also interferes with mental health. “Reducing alcohol intake can improve mental health by decreasing anxiety and depression symptoms,” Faughnan said. Faughnan also said that alcohol use “often leads to a weakened immune system, making you more susceptible to certain infections.” “Reducing alcohol consumption can decrease an individual’s risk of fall and subsequent injury,” Faughnan said. It can also improve liver function. “Regular or excessive alcohol consumption can lead to liver damage or inflammation,” Faughnan said. “Sometimes this can even be reversed by reducing one’s use.” Minimizing use also helps improve memory for those whose use has caused reduced cognitive function and memory. “Cutting back will improve brain fog, focus, attention and memory,” Faughnan said.

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December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 15

Golden Years

Nursing Homes on the Brink

78% of the nursing homes in Upstate are operating at losses, says Loretto CEO. ‘It’s reached a crisis point,” she says By Deborah Jeanne Sergeant

ll areas of healthcare experienced significant challenges during the pandemic, but not as extreme as the seismic shift in long-term care facilities. Already struggling to care for a huge influx of aging baby boomers on decade stagnant budgets, facilities faced an employment crisis, supply shortages, increased protocols and greater demand as seniors sick with COVID-19 needed someplace to go after discharge from the hospital. In more recent months, skyrocketing inflation and continuing employment and budgetary difficulties have pushed many nursing homes to the edge. “Across New York State in 2022, all nursing facilities collectively lost more than $756 million,” said Joe Murabito, president and managing member of Elemental Management Group based Oswego. His business manages living facilities, residential care centers and rehabilitation and nursing centers in Oswego, Joe Murabito is Oneida, Monroe president and and Chemung managing member counties. He is also part of the of Elemental Management Group. New York Providers Alliance, a group of 50 for-profit and nonprofit longterm care organizations from Buffalo to Lake Placid. This figure comes from the New York Providers Alliance most recent report. Murabito said that the report clearly indicates that Downstate for-profit nursing homes made a $133 million profit as a group, but in every other category — nonprofits statewide and for-profits Upstate — “lost significant hundreds of millions of dollars,” Murabito said. He believes this stems from Medicaid bias and disproportionate funding allocation.

“These numbers demonstrate while there’s a collective problem, a very big one, it’s not across the board,” Murabito said. “There have been influences over time that allow the for-profit nursing homes in Downstate to operate differently than all other in other areas.” One factor is wages, employers in New York City have been paying mandated higher minimum wages compared with Upstate, which places Upstate employers in a position of trying to catch up. Despite ubiquitous budget struggles at long-term care facilities, Upstate facilities are spending proportionately more on wages to raise them to a competitive level. Staffing shortages have caused lower occupancy rates. Upstate facilities lag around 83% occupancy rates while Downstate, the rate has rebounded nearly to pre-pandemic levels. “The census recovery for Upstate is much slower for skilled nursing,” Murabito said. “That’s part of the answer.” The aging population both creates more demand for skilled nursing and thins the ranks of older workers. Murabito said that the projection of those 75-plus who will need assisted living or skilled care is 183% from 2016 to 2036, which he called “a significant increase in need and not the same labor projection to meet those needs. Whatever we’re feeling now for access, that will continue to get worse if we don’t find some way to incentivize people to work in the profession.” He thinks that increased funding for both paying for education and more instructors will help bring in more care providers. Greater access to education through technology may also help, especially for mid-career workers. Each day, the average Upstate facility loses $46 per person per day, according to the NYPA report. That averages $2.1 million per facility annually. “The level of the crisis is higher than anyone knows,” Murabito said. “These losses are not sustainable. We’re approaching a ledge. There needs to be a targeted Medicaid rate increase of 12%. The need is not at Downstate proprietary facilities.” He added that in 30 years of working in the industry, he has not seen such dismal numbers. “If these numbers aren’t addressed in the right way, this is a survival issue for a lot of facilities,” Murabito added. “You can’t sustain losses like this for more than a year.” He said that hiring sufficient staff to meet minimum staffing require-

ments has been “a big challenge. We have significant agency use across the region.” One of the reasons that nursing homes across the state are in such financial distress is that they have gone 15 years without a Medicaid increase. The most recent approved increase was supposed to be a combination of 6.5% from New York and 1% from the federal government, spread across three years. So far, facilities have received only half the amount for one of those three years and that the proposed 7.5% increase was folded into a $168 million approved by New York two years ago to fund a mandated staffing ratio legislation passed two years ago. The situation is like a company offering a raise and then a holiday bonus, but later reneging on the bonus, claiming that it’s part of their raise.

Low reimbursement, higher wages, shortage of workers Kim Townsend, president and CEO at Loretto, said that the biggest challenges her organization currently faces are “in no particular order: the recently enacted staffing mandate, our unprecedented healthcare worker shortage Kim Townsend is and our low president and CEO reimbursement of Loretto, CNY’s rates.” Although largest senior she agrees that facility. proper staffing rates lead to high quality care, the mandates focus on medical staffing, which ignores therapists, social work staff and dietary staff. “In long-term care, evidence-based practice suggests that the best staffing and care goes to the individual needs of the residents,” Townsend said. “Some residents require more clinical services; some require more social or therapy services. Their care plans should reflect the services needed for their wellbeing. A minimum staffing ratio sets that aside. It not only ignores the needs of the individual residents but also the important role that other staff members play in delivering their care.” By demanding a certain number of clinicians, the mandate forces organizations to allocate funding to those roles rather than other important roles. The staffing shortage also makes meeting staffing mandates challenging. Townsend said that 20% or 400,000 frontline caregivers have left the long-term care industry since the pandemic’s beginning in 2019. Although some of those have shifted to other healthcare roles, she said that some have left healthcare as a profession. “If you don’t have staff to staff beds, then you have to take those beds offline,” Townsend said. “In Central New York, we have 1,600 fewer nursing home beds online today than 2019.” The lack of staffed, available beds in nursing homes affects more than just the elderly and their families. When hospitals discharge an older patient who needs in-patient rehabilitation or long-term care, they’re unable to do so if beds are unavailable at an area nursing facility. Other patients needing acute care cannot

Page 16 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

receive admission right away if the hospital has no space to put them. “That impacts every person who lives in this area,” Townsend said. “This is particularly pronounced in Central New York and Rochester.” Her organization experiences up to a $100 loss per resident per day because the reimbursement rates have stagnated. Although other employers have raised their payrates, long-term care facilities cannot afford to do so. Townsend likened the cost of a day at a nursing home to that at an average hotel, which is about $235 per day. “You get a room, bathroom and maybe a breakfast buffet,” she said. “The average reimbursement rate for skilled nursing $235 per day. You get a room, meals, therapy, medical care, activities, dietary service, personal laundry, case management and therapy. There’s a real disconnect between cost of services and reimbursement.” To help fund adequate levels of care, Townsend said that her organization has become more focused on community needs for high acuity care. Loretto’s restorative care unit allows people to discharge from the hospital three to five days earlier. They receive monitored beds and therapy at the bedside. “We try to jumpstart their rehab and then they’re on the move to our regular rehab the remainder of their stay,” Townsend said. “This really helps our hospital partners, particularly those with cancer centers and trauma centers.” Loretto also relies upon donations from community members and grants from private organizations in the state. The community also participates in Loretto’s mission through volunteering. Because many of their volunteers are retirees, their numbers are fewer since the pandemic. “Volunteers provide a critical role in socialization and another pair of hands for basic needs,” Townsend said. “It’s not back to the way it was.” Townsend fears for the entire long-term care industry. Offering other services such as rehabilitation, respite care and continuing care helps some long-term care organizations scrape by. But the widespread budgetary shortfalls and employee shortages make it hard to staff these additional revenue streams. “Seventy-eight percent of the nursing homes in Upstate are operating at losses,” Townsend said. “It’s reached a crisis point. “This was a system that was invisible in its crisis, but the pandemic made it visible. When occupancy dropped, costs went up and staffing problems appeared, you could really see the lack of funding from New York state.” Unless funding increases, she foresees many nonprofit long-term care facilities selling to for-profit entities, which she believes operate more for the benefit of shareholders than to benefit the community. Townsend believes that funding the education of healthcare workers, creating sufficient openings for education and providing sufficient qualified preceptors willing to work with clinical students are part of the solution to the workforce issues. “We can’t afford to let our regional healthcare networks collapse,” Townsend said. “We have to have a smooth, functioning regional healthcare network. The long-term care piece of that is a critical piece to keep hospitals functioning.”

By Jim Miller

How Seniors Can Get Help Paying for Everyday Needs

Dear Savvy Senior,

What types of programs are available to help seniors struggling with their everyday bills, and how do I go about finding them? Since I lost my husband last year, my Social Security survivor benefit is barely enough to get by on. Searching Senior

Dear Searching, I’m very sorry for your loss, but you’ll be happy to know that there are dozens of different financial assistance programs and government benefits that may be able to help you with your everyday costs. To locate these types of programs, your best resource is Benefits CheckUp.org. This is a free, confidential online screening tool designed for older adults and people with disabilities. It will help you find federal, state and local benefits programs that can assist with paying for food, utilities, health care, medications, housing and many other needs. This site — created by the National Council on Aging in 2001 — contains nearly 2,000 programs across the country. To identify benefits, you’ll first need to type in your ZIP code and choose the types of benefits you’re interested in. Then you’ll need to answer a few questions regarding your personal and financial situation. Once completed, you’ll get a list of programs to choose from, followed by a personalized report that explains each program, and tells you where you can get help or how to apply. If you need some assistance or you don’t have internet access, you can always speak with a benefits support specialist by calling 800-7946559. You can also get help in-person at any of the 85 benefit enrollment centers located across 41 states. See NCOA.org/article/meet-our-benefits-enrollment-centers to search for a center in your area.

Types of Benefits Depending on your income level, location and circumstance, here are a few of the many different benefits you may be eligible for: • Nutrition assistance: Programs like the Supplemental Nutrition Assistance Program (SNAP) can help pay for food at the grocery store. The average SNAP benefit for 60-and-older households is around $105 per month. Some other nutrition programs that are available to seniors include the Senior Farmers Market Nutrition Program and the Commodity Supplemental Food Program.

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• Utility assistance: There’s the Low-Income Home Energy Assistance Program (LIHEAP) that provides assistance in lowering home heating and cooling costs. And for broadband assistance, the Affordable Connectivity Program provides a $30 monthly subsidy that can be applied toward your home internet costs. • Health care and medicine: Medicare Savings Programs and Medicaid can help or completely pay for seniors’ out-of-pocket health care costs. And for assistance with medications, there’s a low-income subsidy program called ‘Extra Help’ that helps pay premiums, deductibles, and co-payments on Medicare (Part D) prescription drug coverage. You can also search for prescription drug help through patient assistance programs or your state pharmaceutical assistance program at Medicare.gov. • Supplemental Security Income (SSI): Administered by the Social Security Administration, SSI (see ssa. gov/ssi) provides monthly payments to very low-income seniors, age 65 and older, as well as to those who are blind and disabled. In 2023, SSI pays up to $914 per month for a single person and up to $1,371 for couples. In addition to these benefits, there are dozens of other programs BenefitsCheckUp can help you identify, like housing assistance, property tax reduction, home weatherization assistance, tax relief, veteran’s benefits, senior transportation, caregiving support, free legal assistance, disability services, job training and more. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 17

Sleep Disorders Can Be Dangerous

The Social Ask Security Office

By David L. Podos “Catch your dreams before they slip away, dying all the time, lose your dreams and you will lose your mind” - Ruby Tuesday by the Rolling Stones.

registered polysomnographer. Luley has more than 15 years working with sleep disorders. When asked what causes sleep disorders, Luley said there is no one ne of the most fabled verses answer. from the 1967 iconic song, “There are a lot of different Ruby Tuesday, actually holds reasons why people experience sleep a lot of truth. Lose your dreams you disorders. For instance, many people might actually lose your mind. when they think of a sleep disorder According to sleep and dream they think sleep apnea or insomnia. expert Rubin Naiman Ph.D., “we are What happens with sleep apnea is at least as dream-deprived as we are when you lay your head down and sleep-deprived.” are in a supine position on your back, As it turns out this can be a very the muscles in the back of your throat serious health problem for many tend to weaken and the airway people. starts to close and creates Naiman concluded an obstruction. We see from a comprehensive this kind of condition review of data that more often with elderly was published in the patients. However, Annals of the New younger patients can York Academy of Scihave this condition as ences that many of the well.” health issues people According to the face, the root of their American Medical illness is from dream Association, it is beloss, which can contribute Eileen Luley works at the lieved that more than to compromised memory, sleep lab at Rome Health. 30 million Americans anxiety and depression to suffer from sleep apnea. name just a few. The condition can be quite serious if “We need sleep and we need not attended to, causing high blood to dream,” Naiman said. “We need pressure, heart disease or stroke to both.” name a few. In an article written by Amanda Many people with sleep apnea MacMillian — “Why Dreaming May need to wear a CPAP (continuous Be Important for Your Health,” in the positive airway pressure) mask at October 2017 Time Magazine —she night. Some find them uncomfortable mentions that “doctors have warned and claustrophobic. Luley said that for years that Americans are not technology has advanced to help getting enough sleep, with health people with that problem. consequences ranging from drowsy “There are numerous devices driving and irritability, to an increase a patient can use to help with their of dementia, heart disease and even sleep apnea. Many masks are now early death.” quite small as well as the use of nasal Then there are the cultural differ- devices. A doctor who specializes ences regarding sleep such as, how in sleep disorders can after working important is sleep and does a person with the patient, make the proper really need eight or more hours of recommendation. With insomnia you uninterrupted sleep to function well? can’t shut your mind off once in bed, How do different societies feel it might be you are having anxiety about mid day napping in the, acissues or are depressed. It could also ceptable or looked upon as laziness? be some other underlying condition For example, a daytime nap as well. So it’s important to contact or siesta in many Mediterranean your medical doctor for an examinacountries is quite acceptable and tion.” encouraged. Spain is a good example Sleep is not just sleep; there are with a long tradition of a mid day stages that we all go through. siesta. Daytime naps have also been Stage one is when we are just popular in countries like China and starting to fall asleep, stage two takes Africa as well as in Japan. Though you into a nice good sleep, stage with the increasing modernization of three is deep sleep then finally stage society along with social media and four REM sleep (rapid eye movethe expectation in many countries to ment), and in that state we dream. increase economic production, the REM sleep is so important because mid day nap is not as ubiquitous as it that’s where you get your restfulness. once was. So, if you never get into REM (from Research shows that there are waking up) say in stage two or three, differences in the amount of sleep and don’t get back to sleep to enter that people get depending on the into stage four, you are going to be country in study. Of course, not all tired, Luley said. research shows the same outcomes so Luley said there are ways a it can be rather difficult to say what person can help themselves to get a research is more precise than anothbetter night’s sleep. er. For instance, in one study it was “Keep a good sleep schedule, a found that Japan had the shortest good routine. Go to sleep the same sleep duration, averaging less than time each night and wake up the seven hours, while Finland had the same time this applies to weekends longest, averaging eight hours or as well. No electronics before going more. When looked into deeper to to bed, (cell phones, etc.), do not find out why the discrepancy, it often eat and or drink alcohol just before elicited more questions than answers. retiring to sleep and no exercise an Eileen Luley works at the sleep hour before bedtime. “Keeping your lab at Rome Health. She holds a Mas- bedroom on the cooler side also aids ter of Science degree in education, is in helping to get a good night’s sleep, a registered respiratory therapist and 65-70 degrees,” Luley said.

From the Social Security District Office

Social Security Benefits Increase In 2024

ore than 71 million Americans will see a 3.2% increase in their Social Security benefits and Supplemental Security Income (SSI) payments in 2024. On average, Social Security retirement benefits will increase by more than $50 per month starting in January. Federal benefit rates increase when the cost-of-living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W). The CPI-W rises when inflation increases, leading to a higher cost-of-living. This change means prices for goods and services, on average, are higher. The cost-of-living adjustment (COLA) helps to offset these costs. We will mail COLA notices throughout the month of December to retirement, survivors and disability beneficiaries, SSI recipients and representative payees. But if you want to know your new benefit amount sooner, you can securely obtain your Social Security COLA notice online using the Message Center in your personal My Social Security account at www.ssa.gov/myaccount. You can access this information in early December, prior to receiving the mailed notice. Benefit amounts will not be available before December. Since you will receive the COLA notice online or in the mail, you don’t need to contact us to get your new benefit amount. If you prefer to access your COLA notice online and not receive

Q&A Q.: Do members of Congress have to pay into Social Security? A.: Yes, they do. Members of Congress, the president and vice president, federal judges, and most political appointees, have paid taxes into the Social Security program since January 1984. They pay into the system just like everyone else, no matter how long they have been in office. Learn more about Social Security benefits at www.ssa.gov. Q.: I’m trying to figure out how much I need to save for my retirement. Does the government offer any help with financial education? A.: Yes. For starters, you may want to find out what you can expect from Social Security with a visit to Social Security’s Retirement Estimator at www.ssa.gov/estimator. The Financial Literacy and Education Commission has a website that can help you with the basics of financial education: www.mymoney.gov. Finally, you’ll want to check out

Page 18 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • December 2023

the mailed notice, you can log in to your personal my Social Security account at www.ssa.gov/myaccount to opt out by changing your preferences in the Message Center. You can update your preferences to opt out of the mailed COLA notice, and any other notices that are available online. Did you know you can receive a text or email alert when there is a new message waiting for you? That way, you always know when we have something important for you — like your COLA notice. “Social Security and SSI benefits will increase in 2024, and this will help millions of people keep up with expenses,” said Kilolo Kijakazi, acting commissioner of Social Security. January 2024 marks when other changes will happen based on the increase in the national average wage index. For example, the maximum amount of earnings subject to Social Security payroll tax in 2024 will be higher. The retirement earnings test exempt amount will also change in 2024. Learn more at www.ssa. gov/news/press/factsheets/colafacts2024.pdf. Be among the first to know! Sign up for or log in to your personal my Social Security account today at www.ssa.gov/myaccount. Choose email or text under “Message Center Preferences” to receive courtesy notifications. You can find more information about the 2024 COLA at www.ssa. gov/cola.

the Consumer Financial Protection Bureau, which offers educational information on a number of financial matters, including mortgages, credit cards, retirement, and other big decisions. Visit the Consumer Financial Protection Bureau at www.consumerfinance.gov. Q.: I worked for the last 10 years and I now have my 40 credits. Does this mean that I get the maximum Social Security retirement benefit? A.: Probably not. The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base your benefit amount on those credits; it's based on your earnings over a lifetime of work. To learn more about how you earn Social Security credits and how they work, read or listen to our publication How You Earn Credits, available at www.ssa.gov/pubs.

Health News Nancy Levett named chief information officer at Rome Nancy Levett of Bridgeport has been named vice president–chief information officer at Rome Health. She will lead the system’s health information system initiatives to yield an infrastructure that supports caregivers in delivering Nancy Levett the best-in-class quality, safety and patient experience. Levett has more than 35 years of experience in healthcare, serving most recently as regional IT operations director at St. Joseph’s Health for 14 years, where she was responsible for all strategic and operational information services initiatives. During her career, she also provided operational leadership for revenue cycle departments, including patient accounting and patient access departments and the business office. “Nancy’s breadth of experience in operations and information technology enables her to bring stakeholders together to develop systems and processes that support high reliability organizations,” said President and Chief Executive Officer AnneMarie Czyz. “We are at a pivotal time at Rome Health when we need to develop a strategic pathway forward to support our colleagues with an integrated health information system

that enables them to deliver the best care out there, here.” Levett earned her Bachelor of Science degree in information systems from SUNY Fredonia in 1986 and graduated from New School for Social Research with a Master of Science degree in health administration in 1995.

Arc, Oneida-Lewis CEO Karen Korotzer joins ACHE Arc, Oneida-Lewis Chapter Chief Executive Officer Karen Korotzer has joined the board of directors of the American College of Healthcare Executives of Upstate New York, the official local chapter of the national ACHE. Korotzer has been a member of the American College of Healthcare Executives national organization since 2006, earning the prestigious Fellow of the American College of Healthcare Executives (FACHE) accreditation in March 2023. “I felt strongly that ACHE of Upstate New York’s values of integrity, lifelong Karen Korotzer learning, leadership, and diversity aligned with those of The Arc, Oneida-Lewis, and my own, making this a perfect fit. I’m beyond honored to serve on the board of directors,” said Korotzer.

Excellus BCBS awards Upstate hospitals $28 million Thirty-one Upstate New York hospitals and health centers earned a combined $28 million in quality improvement payments from Excellus BlueCross BlueShield last year as part of the nonprofit health insurer’s hospital performance incentive program. Since 2005, Excellus BCBS has paid out more than $400 million in quality improvement incentives. “It’s part of our mission to ensure that all in our communities have equitable access to high quality health care,” says Excellus BCBS regional president Eve Van de Wal. “The foundation for achieving that is a collaborative relationship with our local hospital and physician partners.” Eight hospitals in the UticaRome-North Country region participated in this program in 2022, sharing $818,254 in quality improvement incentive payments. Participating hospitals included Adirondack Medical Center-Saranac Lake, Champlain Valley Physicians Hospital, Faxton St. Luke’s Healthcare, Mary Imogene Bassett Hospital, Oneida Health Hospital, Rome Health, Samaritan Medical Center and St. Elizabeth Medical Center. “In 2022, Excellus BCBS’s Hospital Performance Incentive Program evaluated participating hospitals on projects that are in alignment with and responsive to the ever-changing health care environment,” says physician Lisa Y. Harris, senior vice president and chief medical officer at Excellus BCBS.

Dr. Cooley joins Rome Health Primary Care Rome Health Primary Care has welcomed a new physician to its practice located in the medical center on the hospital’s main campus. Elizabeth Cooley is board certified in family medicine and is accepting new adult patients. She provides primary care. Elizabeth Cooley C o o l e y earned her medical degree from the University of Vermont College of Medicine and completed her residency in family medicine at St. Joseph’s Hospital Health Center in Syracuse in 2010. She has been practicing in the Mohawk Valley for more than 12 years with experience in urgent care, women’s health, family medicine and long-term care. “Having a primary care doctor you feel comfortable with can be critical to your well-being,” said Cooley. “Patients are more likely to be open about their physical and mental health needs with someone they trust.” Since the medical center opened in November 2022, Rome Health has been expanding access to primary care for the community. The primary care practice now has a team of five doctors and five nurse practitioners on the hospital’s main campus, with access to X-ray and pharmacy on site.

New Agency Aims at Helping Health-related Businesses

ertified personal trainer Vanessa Colangelo has combined her passion for health and fitness with her 15 years of branding and design experience to help businesses whose objectives are to improve the lives of others. Her new business, LifeWelBranded, builds powerful and motivational brands for professionals in the ever-expanding wellness industry. “With entrepreneurship on the rise, professionals are beginning to realize the importance of investing in their brand. Starting out with a strong identity rooted in strategy that tells a story and builds trust and credibility, helps businesses connect to clients on an emotional level,” said Coangelo. Based in Whitesboro, LifeWellBranded was created to

empower entrepreneurs with the tools, knowledge and confidence needed to maintain their brand presence easily, conveniently, and affordably for the entire life of the business, according to Coangelo. Potential clients include fitness instructors, nutritionists, life and wellness coaches, counselors, mental health professionals, holistic healing practitioners as well as postpartum supporters. “I know firsthand how difficult it can be to convince people to put themselves first and to view improving their physical or mental health as a valuable investment,” said Colangelo. For more information, visit www.lifewellbranded.com/difference.

Vanessa Colangelo is the owner of the recently launched LifeWellBranded, an agency that provides services to health and wellness professionals.

December 2023 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 19

GET YOUR SHOT Vaccines for COVID-19, Flu, and RSV Are Now Zvailable What to know to be protected this winter

he U.S. Centers for Disease Control and Prevention (CDC) recommends all Americans consult with their health care provider about receiving vaccines for COVID-19 and seasonal influenza (flu). In addition, an RSV vaccine may be recommended by health care providers for adults ages 60 and over and for pregnant people. Preventative treatments or therapies for RSV may be recommended for infants and young children. “Vaccines not only protect the individual who is vaccinated, but also those with whom they come in contact,” says physician Lisa Y. Harris, senior vice president and chief medical officer at Excellus BlueCross BlueShield. “When we are out in public, it isn’t readily apparent who among us has a compromised immune system, and for whom catching COVID-19, flu, or RSV could be deadly.” Harris also notes that since COVID-19, RSV, and flu are each caused by a virus, antibiotics are not a treatment option. Prevention is key, and vaccines provide the best protection.

All about the updated COVID-19 vaccine • Who should get an updated COVID-19 vaccine? CDC recommends everyone 6 months and older get an updated COVID-19 vaccine to protect against the potentially serious outcomes of COVID-19 illness. If you have not received a COVID-19 vaccine in the past two months, an updated COVID-19 vaccine can protect you. There are updated COVID-19 vaccines from Pfizer-BioNTech and Moderna. • Why do we need to keep getting COVID-19 vaccines? The virus that causes COVID-19 is always changing, and protection from COVID-19 vaccines declines over time. • Do COVID-19 vaccines really work?

According to the CDC, last season, those who received a 20222023 COVID-19 vaccine saw greater protection against illness and hospitalization than those who did not receive a 2022-2023 vaccine. Vaccination also reduces the chance of suffering the effects of Long COVID, which can develop during or following acute infection and last for an extended duration.

All About the Flu and Flu Vaccine • What is the Flu? Seasonal influenza (flu) is a potentially serious disease that can lead to hospitalization and sometimes even death. During typical flu seasons, millions of people get flu, hundreds of thousands of people are hospitalized and thousands to tens of thousands of people die from flu-related causes. • How do flu vaccines work? Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against flu illness. • Are any of the available flu vaccines recommended over others? All flu vaccines in the United States are “quadrivalent” vaccines, which means they protect against four different flu viruses. There is no preferential recommendation for people younger than 65 years. For people 65 years and older, there are three flu vaccines that are preferred by the CDC. • Who should be vaccinated? Everyone 6 months and older in the United States should get the flu vaccine every season with rare exception. • Can I get the flu even though I got a flu vaccine this year? It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). If you go get the flu, being vaccinated may reduce the severity. • Can I get the flu from a flu vaccine?

Lisa Y. Harris

You cannot get flu from a flu shot. The viruses in a flu shot are killed (inactivated). • Are there side effects of flu vaccine? Low grade fever, muscle aches, nausea, fatigue, runny nose, wheezing, headache. If these problems occur, they begin soon after vaccination and usually are mild and short-lived. • What is the best time of year to get the flu vaccine? The flu season typically lasts from late August until early May. Ideally, everyone should be vaccinated by the end of October. It is never too early, or too late to get the flu vaccine. • Why do I need a flu vaccine every year? A flu vaccine is needed every year for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual flu vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the composition of flu vaccines is reviewed annually, and vaccines are updated to protect against the viruses that research indicates will be most common during the upcoming flu season. • Does flu vaccine work right away? It takes about two weeks after vaccination for antibodies to develop in the body and provide protection.

All About RSV and the RSV vaccine • What is RSV? Respiratory syncytial virus (RSV) is a highly contagious lung infection. Anyone of any age can get it. Symptoms in kids and healthy adults are usually mild and like a cold. In older adults (age 60+), people with heart and lung disease, and anyone with a weak immune system, RSV can lead to bronchiolitis and pneumonia, result in hospitalization, and can even cause death. The CDC estimates there are 60,000–160,000 hospitalizations and 6,000–10,000 deaths annually due to RSV among adults aged 65 years and older. • What vaccines are approved for older adults for prevention of RSV, and is there a difference be-

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tween them? There are two RSV vaccines approved for adults ages 60 years and older – one from GSK and the other from Pfizer. CDC does not have a preferential recommendation for either vaccine. Patients who are 60 years and older may receive whichever vaccine is available, in consultation with their health care provider. • The RSV vaccine for pregnant people? The CDC recommends the RSV vaccine for pregnant people to protect their babies from severe RSV disease. Pregnant people should get a single dose of Pfizer’s bivalent RSVpreF vaccine (Abrysvo) during weeks 32 through 36 of pregnancy during September through January. Consult your health care provider to see if the RSV vaccine is recommended. • Are there preventative treatments or therapies for RSV for infants and young children? The Advisory Committee on Immunization Practices recommends the nirsevimab for infants less than eight months of age born during or entering their first RSV season, and for infants and children ages eight to 19 months who are at increased risk of severe RSV disease and who are entering their second RSV season. Consult your pediatrician to see if the RSV vaccine is recommended. • Which older adults are most likely to benefit from RSV vaccination? RSV can cause serious illness in adults with certain underlying medical conditions or other risk factors. Adults aged 60 years and older who are at higher risk for severe RSV include: those with chronic medical conditions, those who are frail, those of advanced age, those who reside in nursing homes or other long-term care facilities, those with other underlying medical conditions or factors that a health care provider determines might increase the risk of severe respiratory disease. • What are the side effects of RSV vaccine? The most common side effects after RSV vaccination are pain, redness, and swelling where the shot is given, fatigue, fever, headache, nausea, diarrhea, and muscle or joint pain. These side effects are usually mild. • What is the best time of year to get the RSV vaccine? Ideally, the vaccine should be given before the fall and winter RSV season. The CDC recommends getting the RSV vaccine as early as possible. Submitted by Excellus BlueCross Blue Shield.