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DEPRESSION Experts: Many people who are depressed are not getting or seeking treatment

Okay to say ‘No thank you’ this Thanksgiving

Apps that Can Boost Seniors’ Health

CREMATION Roughly 40 percent of Americans now choose cremation. Find out how to find affordable services

Rochester–Genesee Valley Healthcare Newspaper

November 2013 • Issue 99

Why are so many hospitals merging?

MERGER MANIA

Page 9

Rochester’s Complementary Medicine Guru After 12 years leading the integrative medicine department of Clifton Springs Hospital, Dr. Moore opens his own practice in Pittsford.

Page 12

Why Married People Diagnosed with Cancer Live Longer Than Singles

RGH’s New Ambulatory Surgery Center

Nearly a Quarter Century Working with End-of-Life Patients “What it taught me is it’s very important that I have a sense of measure in the activities of my life,” says Debbie Sigrist, a registered nurse and certified hospice palliative nurse who works in Rochester.

Meet Your Doctor Dave Privitera, a sport medicine doctor, talks about injury, pain.

Page 7 November 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page Page 185 Page14 •

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Join us for the 8th Annual

Married People Diagnosed with Cancer Live Longer Than Singles

A FORUM ON DIABETES PREVENTION AND TREATMENT

�����Thursday, November 14 4:15 - 7 pm

Thompson Hospital Constellation Center for Health and Healing 350 Parrish Street, Canandaigua ”Diabetes Management: It Takes a Team” A panel discussion featuring a dietitian, dentist, pharmacist, physical therapist and sleep technicians “�Too Sweet� Dreams” The link between diabetes and sleep disorders Health screenings, exhibits and light dinner included RSVP required by November 6.

Call (585) 396-6233 or register online at ThompsonHealth.com

Donations of non-perishable items for the Blue Star Canteen of Canandaigua appreciated Presented in Partnership with St. Benedict Parish of Ontario County

ASTHMA?

CONSIDER PARTICIPATING IN THIS RESEARCH STUDY

If You Are:

• At least 18 years of age • Have moderate to severe asthma for at least 12 months not fully controlled • Currently treated with medications for asthma like combined inhaled medications such as Advair, Symbicort or Dulera • Without serious health problems You may qualify to participate in an asthma research study.

Qualified Participants Will Receive: • Study related medical exams • Study related investigational medication

For More Information, Please Contact:

AAIR Research Center

585-442-1980 300 Meridian Centre, Suite 305 Rochester, NY 14618 research@aair.info • www.aairresearch.com Page 2

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Large study finds association between marriage and cancer outcomes

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ew results from a large retrospective study of the National Cancer Institute’s SEER database show that patients with cancer who were married at the time of diagnosis live markedly longer compared to unmarried patients.

Researchers also found that married patients are more likely to be diagnosed with earlier-stage disease and much more likely to receive the appropriate therapy.

This study is the first to show a consistent and significant benefit of marriage on survival among each of the 10 leading causes of cancer-related death in the United States lung, colorectal, breast, pancreatic, prostate, liver/bile duct, non-Hodgkin lymphoma, head and neck, ovarian, and esophageal cancer.

It has been established previously that social support, including assistance with decision-making, instruction regarding coping strategies, and management of depression and anxiety, extends survival after a diagnosis of

cancer.

“Marriage probably improves outcomes among patients with cancer through increased social support,” said lead study author Ayal Aizer, a chief resident in radiation oncology at Harvard Medical School in Boston.

“Our results suggest that patients who are not married should reach out to friends, cancer support or faith-based groups, and their doctors to obtain adequate social support.”

For patients who are married, spouses are typically their primary sources of social support sharing the emotional toll of the illness, accompanying them to doctors’ visits, and ensuring they follow through with recommended treatments. It had been suggested that marriage might improve outcomes for patients with cancer, but prior studies on the effect of marital status have not been conclusive.

The study assessed clinical and demographic data from the SEER registry on 734,889 patients diagnosed between 2004 and 2008.

One-Third of U.S. Adults Are Obese, CDC Says

The number hasn’t budged for years, agency notes

T

he adult obesity rate in the United States remains as high as ever, with one in three Americans carrying unhealthy amounts of weight, according to a new federal report.

The obesity rate has remained essentially unchanged for a decade, despite the large amount of attention focused on its threat to public health, the U.S. Centers for Disease Control and Prevention found.

“It’s kind of a confirmation of what we saw last time, that the prevalence of obesity in adults may be leveling off,” said co-author Cynthia Ogden, a senior epidemiologist with the CDC’s National Center for Health Statistics. “From 2003-04 through 2011-12, there have been no statistical changes in obesity in adults.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

This persistent rate has proved frustrating to public-health experts, given that obesity is a leading risk factor for chronic illnesses such as diabetes, heart disease and arthritis.

“The goal of the human species since we evolved has been to have enough to eat, and we’ve gotten there.

Unfortunately, it’s so plentiful we can take in more than [we] need,” said Matt Petersen, managing director of medical information and professional engagement for the American Diabetes Association. “The human body and brain is wired to take in more than a sufficient number of calories, and that’s a hard thing to change. We’re talking about really powerful aspects of our metabolism.”

PERSONALIZED CARE THAT DRIVES PEAK PERFORMANCE. Whether you’re a weekend warrior or a lifelong athlete, a physical setback shouldn’t keep you on the sidelines unnecessarily. Rochester General’s team of sports medicine ������������������������������������������������������������������������������������ therapists and dedicated caregivers – will work with you to develop a personalized treatment plan that helps you quickly return to your personal best.

585.922.3458 www.rochestergeneral.org/sports-medicine

November 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Nov. 5

Online chats with Unity Diabetes Center experts Diabetes experts from Unity Health will be available to answer any questions related to diabetes during an online chat that’s open to the public from 8 – 8:30 a.m. Nov. 5. Karen Gessell, Unity Diabetes and Endocrinology Services, and Kelly Mueller, American Diabetes Association, will be the presenters. To participate in this free Q&A, log on to UnityDiabetesCommunity. com to join the chat.

Nov. 5

Hearing loss group schedules events The Hearing Loss Association Rochester chapter announced two new programs in November.

• Daytime meeting starts at 11 a.m., Tuesday, Nov. 5, and will feature Michael A. (Mike) Giardino, director

of aviation, and Jennifer Hanrahan, marketing and public relations coordinator, Rochester International Airport. Titled “ROC—Your gateway to the world,” the program will discuss how ROC serves as a model for other airports across the nation in providing services to hard-of-hearing and deaf passengers. It will also explore the amenities available to the hard-of-hearing population such as visual paging, tty phones, and interpretype (ITY) communication allowing text messaging between hearing individuals and those with hearing loss. The meeting will take place at the Vestry Room at St. Paul’s Episcopal Church, East Ave. at Westminster Road, across from the George Eastman House.

• Evening meeting will start at 8 p.m. Nov. 5 and will feature a special free film at Dryden Theatre. The theater is equipped with a state-of-the-art hearing loop system, made possible by funding from the HLAA chapter. In return, Dryden has given members of the organization free tickets. A Chinese film — Tian Ming — will show with with spoken translation of the Chinese intertitles. Dryden Theatre is located at 900 East Ave., Rochester in George

Eastman House (across the street from St. Paul’s Church). Box office opens at 7:15 pm. For more information visit www.hlaa-rochester-ny.org or phone 585-266-7890.

Nov. 9, 10

American Girl Fashion Show held at RGH The Twigs of Rochester General Hospital Association once again present their popular American Girl Fashion Show from 10:30 – 2:30 Saturday, Nov. 9, and Sunday, Nov. 10, at the Eagle Value Golf Club, 4344 9 Mile Post Road in Fairport. This fun, engaging program showcases historical and contemporary fashions from American Girl. Proceeds from the show benefit children cared for at Rochester General Hospital. To date, the Twigs have raised more than $100,000 from American Girl Fashion Shows. American Girl is the core brand of Pleasant Company, founded in 1986 by Pleasant T. Rowland and acquired by Mattel, Inc. in 1998. Tickets are $35 and must be purchased on line at twigsrgha. org. For more information, email rghtwigs2013@gmail.com.

Nov. 12

RGH to host liver cancer seminar Rochester General Health System is hosting Nov. 12 a two-hour seminar on end-stage liver cancer. The seminar will

discuss the latest in treatment options, including stereotactic beam radiation, surgery, ablation and a minimally invasive procedure known as Y-90 radioembolization. Y-90 is performed by interventional radiologists at Rochester General Hospital. In Y-90 radioembolization, tiny glass or resin beads called microspheres are placed inside the blood vessels that feed a tumor in order to block the supply of blood to the cancer cells. Once these microspheres, which are filled with the radioactive isotope yttrium Y-90, become lodged at the tumor site, they deliver a high dose of radiation directly into the tumor while sparing the normal surrounding liver. A multidisciplinary team of physicians from Rochester General Hospital will present at the seminar and will be available to answer your questions. For more information on this free seminar and to reserve your seat, call 877-937-7478 or visit beatlivertumors.org.

Correction The affiliation of physician Ellen Poleshuck was incorrect in an article about post partum depression published in this paper last month. Poleshuck is the director of Women’s Behavioral Health services at the University of Rochester Poleshuck Medical Center, not Finger Lakes Health System. We regret the mistake.

The Tax on Medical Devices The pros and cons about the new tax on medical devices

By Ernst Lamothe Jr.

T

he Patient Protection and Affordable Care Act has tried to be a delicate balance between helping the public in lowering insurance costs, while avoiding dismantling the current medical industry. One of the industries immediately affected are medical device corporations. The Affordable Care Act this year instituted a 2.3 percent medical device tax on domestic sale of medical devices, paid by the manufacturer.

That figure is on gross sales, not profit.

The medical device tax is slated to bring in around $29 billion from 2013 to 2022, according to The Joint Committee on Taxation. More than Chandra $7 million is expected to be collected in the next two years and the medical device makers’ trade associated reported that its members have already paid $1 billion this year alone. While nobody argues that the tax will bring in needed revenue to fund the Affordable Care Act, there are still mixed emotions about whether the tax will hurt the medical device industry.

The Medical Device Manufacturers Association, as expected, is against the

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tax. The industry, which encompasses makers of everything from tongue depressors to MRI machines, believes it would stifle innovation and weaken the position of the United States as a global leader in the medical device advancement.

Physician Ankur Chandra, assistant professor of surgery and biomedical engineering at the University of Rochester, understands the dichotomy of the situation. On one hand, he feels that cost control needs to be instituted to allow for newer, more advanced technology, and that the tax could help make that technology more accessible to patients. The tax could also aid in controlling the cost of the devices.

Another aspect is that the medical device industry was already going to benefit from Crawford the Affordable Care Act because millions would be added to the medical insurance roll because of the act’s mandate.

But on the other hand, he understands that this is a capital society where businesses are not in the business of losing money for the good of the

customer.

“One of my concerns is by taxing the manufacturers of the devices, will this inhibit their ability or motivation to develop new devices as time goes by?” said Chandra. “The spirit of the law is to help people, but I wonder if the tax is going to backfire and decrease patients’ accessibility.”

Chandra said the next generation of students who want to work for the medical device industry or surgeons who want to heal will have to learn how the economy and variable financial issues impact their profession. “There is a cost to medical development,” he said. “You have to talk about the economics of it if you want to get a sense of what the future might truly hold.”

Jessica Crawford, president of MedTech Association in Syracuse, has written pieces strongly opposing the tax and saying it is harming entrepreneurial efforts in the medical device sector.

“By siphoning revenues from medical device manufacturers, the tax prevents job growth, deters investment in new technologies and increases healthcare costs for everyone,” said Crawford. “Harming this industry reduces the accessibility of technologies people depend on, ultimately leading

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

to poorer patient outcomes. New York state’s biomedical industry cannot be expected to continue driving the state economy unless the federal government repeals this tax.”

One thing both sides can agree on is that there are exciting developments in the medical profession. Medical professionals have started reading about how the wave of the future is creating medical devices tailored for the individual. Recently in the New England Journal of Medicine, patient-specific devices have been used for treatment.

Doctors can take a CT scan, get exact dimensions through a three-dimensional design and implant a medical device tied to that individual.

“We now have the technology to potentially in the foreseeable future design something specific to each patient’s anatomy,” said Chandra, who is also the clinical director for the Center for Medical Technology and Innovation for the University of Rochester.

Chandra said that nobody truly knows how the changes will affect the medical device companies or the surgeons using the machines. So at the end of the day, the medical community might have to wait and see if their worst fears are realized by the tax or if it was simply paranoia that will pass.

Cataract Surgeries on the Rise as Boomers Age, Raising Access, Cost Issues Study also finds people getting procedure at younger ages, more having both eyes repaired

A

s baby boomers enter their retirement years, health care costs for complex and debilitating conditions such as Alzheimer’s disease are expected to soar. Not drawing as much attention is the likelihood of similarly rising expenses for common age-related medical procedures.

A Mayo Clinic study looked at one of those — cataract surgery — and found that more people are getting the vision-improving procedure, seeking it at younger ages and having both eyes repaired within a few months, rather than only treating one eye. The demand shows no sign of leveling off, raising the need to manage costs and ensure access to appropriate cataract treatment, the researchers say.

The findings are published in the Journal of Cataract & Refractive Surgery.

“Cataract surgery rates are rising in all age groups between 50 and 90, but the greatest increase is in the 70- and 80-year-olds. And part of that is that our older population, or the aging baby boomers, are working longer, they want to be more active, they have more demands on their vision,” says senior author Jay Erie, a Mayo Clinic ophthalmologist. “That’s why they’re looking for surgery sooner — so that they can remain independent, remain active, continue to work.”

Cataracts can blur vision and worsen glare from lights. They can make it difficult to drive safely, perform household tasks and maintain a normal level of independence. In cataract surgery, the eye lens is removed and usually replaced with an artificial lens, without requiring a hospital stay.

In the United States, age-related cataracts affect at least 22 million people and cost an estimated $6.8 billion to treat each year; the cataract caseload is expected to rise to 30 million people by 2020, the researchers noted.

Despite the common nature of cataracts, the U.S. has little current population-based data on cataract surgery, information that can help estimate demand.

For the Mayo study, research-

ers mined the National Institutes of Health-funded Rochester Epidemiology Project to identify cataract surgeries in Olmsted County, Minn., from 2005-11. The project, a partnership of Mayo Clinic, Olmsted Medical Center and other health providers, makes the county one of few places worldwide where researchers can examine medical data on virtually everyone to see how often conditions strike and whether treatments succeed.

The research found: • Cataract surgery has increased steadily, peaking in 2011 at a rate of 1,100 per 100,000 people.

• Sixty percent of people receiving cataract surgery on one eye returned within three months to have it performed on the second eye, a significant increase over the number in a previous Mayo study, which covered 1998 to 2004.

• The mean annual rate of cataract surgery for women was significantly higher than for men.

• There were significant increases in cataract surgery over the past 32 years among people in all age groups, except those 90 and older.

The trend raises questions about treatment costs and the resources needed to meet demand, Erie says.

Medicare, for example, typically covers cataract surgery for its patients; in general, cataract surgery on a Medicare patient costs roughly $3,000 per eye.

“Ophthalmology and ophthalmologists and patients and payers are beginning to look at ways they can weigh the visual benefits to the individual patient against the cost to society as a whole.

How can we maximize the outcome and minimize the cost to society?” Erie says.

SERVING MONROE, ONTARIO AND WAYNE COUNTIES in good A monthly newspaper published by

Health Rochester–GV Healthcare Newspaper

Local News, Inc. Distribution: 30,000 copies. To request home delivery ($15 per year), call 585-421-8109.

In Good Health is published 12 times a year by Local News, Inc. © 2013 by Local News, Inc. All rights reserved.

106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564.

• Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers and Contributing Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Mike Costanza, Deborah Blackwell • Advertising: Donna Kimbrell, Amber Dwyer Layout & Design: Chris Crocker Officer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

November 2013 •

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also the types of injuries, and the types of patients that I could help.

Q. What was it about those patients that drew you to sports medicine?

A. Sports medicine is a general field that takes care of people that are looking to maintain their activity level.

Often, they’re very motivated and have very high expectations, and I enjoy helping people get back to their activities.

Q. Is that why you enjoy working with the Rochester Institute of Technology’s sports teams?

A. Absolutely—I love it. I certainly have a connection looking back to when I was a college student and trying to be active, and I enjoy the spirit and the motivation of these athletes.

They’re generally just fun to be around and I enjoy watching the games and supporting them.

right now, but it potentially will incorporate emergency department physicians, physical assistants, and other orthopedic surgeons and orthopedic primary care sports doctors. One location is my Culver Road office.

Q. What kinds of patients do you see in the office?

A. I work with a mix of patients, from adolescents involved in sports to people that are older and have shoulder arthritis. In the shoulder, common problems are rotator cuff problems, shoulder instability, and arthritis. That is where it gets into the shoulder reconstruction element of my training.

Q. What other types of injuries or conditions do you see in your practice?

A. I also take care of the hip and the knee and occasionally the ankle, as it relates to sports medicine.

Q. Have you ever worked with pro athletes?

A. Yes. Throughout my residency and my fellowship, I was fortunate to have some opportunities through my attending to have some experiences with the New England Revolution, which is a major league soccer team in Boston. I was involved with diagnosing their injuries, and coming up with their return-to-play. In residency, I had an experience with the Buffalo Sabers, [a professional hockey team in Buffalo] where I was involved in pre-season participation screening physicals.

Q. You are also a member of Rochester General Sports

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

Within each joint, there is a common list of conditions that often affect people that I see in the office. The types of things that affect your foot and ankle in an athlete would be things like a stress fracture, ankle sprains, and different kinds of injuries. In the knee, I would say cartilage problems, arthritis, ligament injuries such as ACL tears—those are common. I would say the most common are subtle sprains or maltracking of the kneecap [a condition in which the movement of the kneecap goes off-track when the leg is moved].

In the hip what I see commonly is labral tears. Essentially, the bumper cartilage gets torn.

Q. More and more kids are playing organized sports more intensely and at younger ages than before. What kinds of physical problems are you encountering among the children and adolescents you treat?

A. I would say the most common types of problems that happen in kids often involve either a growth plate, or overuse. You can get growth plate injuries. Injury to the growth plate has an increased risk of early growth plate closure. [the “growth plate” is the part of a long bone at which bone growth occurs. Premature closing of the growth plate impedes bone growth].

Q. Are there guidelines parents can follow to prevent their children from suffering such problems?

A. It’s hard to set true guidelines—it depends on the young athlete, their age what sport they’re playing.

It is important to stretch before and after practices. Sometimes kids tend to get tight in their hamstrings, their calf muscles and tendons. That can kind of put them at a little more risk for getting injuries.

My general recommendations would be to parents to know their kids, and not push them through sports pain. Understand the difference between muscle aches and alarming pain.

Muscle aches are OK to kind of deal with—most people have been dealing with them. Pain while walking, causing a limp, can be a sign of something more alarming going on. Aches from kind of using your muscles generally aren’t associated with significant swelling, but injuries that are substantial are.

The other thing would be mechanical symptoms, like new catching or locking sensations that they didn’t experience before [while moving]. If the child’s complaining of a catching sensation that’s new, that’s a warning sign.

If you want them to stay active throughout the year, it’s also important to change the activities, and cross-train.

Lifelines: Current Positions: Western New York Medical Practice, specializing in sports surgery and shoulder reconstruction; member of Rochester General Sports Medicine Institute.

Education: Residency in orthopedic surgery, State University of New York at Buffalo; fellowship in sports medicine and orthopedic surgery, Brigham and Women’s Hospital at Harvard Medical School, Boston; MD, Columbia University College of Physicians and Surgeons.

Personal: Born in Rochester, grew up in Pittsford, lives in West Henrietta. Married, enjoys spending time with his wife, skiing, and playing beach volleyball, soccer, and football.

Rochester General Dedicates Ambulatory Surgery Center State-of-the-art center part of RGHS Vision for the Future of Health Care

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ochester General Health System (RGHS) dedicated on Oct. 22 the Rochester Ambulatory Surgery Center, which will bring Rochester General’s recognized clinical excellence to a new state-of-the-art outpatient surgical facility.

The center, at 360 Linden Oaks Drive in the Linden Oaks Office Park, features a customized design, created through a multi-year planning process and extensive collaboration with the community’s leading physicians who will practice there. The facility integrates the latest advances in surgical technology in a setting that optimizes clinical processes and the patient experience.

Demand for ambulatory surgery has increased significantly in recent years, and is expected to continue to grow due to advances in medical technology and techniques that have enabled increasingly sophisticated surgical procedures to be performed outside the traditional hospital environment, in more convenient and affordable settings.

“It has long been part of our vision and core strategy to bring a comprehensive ambulatory care network to the greater Rochester area,” said Mark Clement, president and CEO of RGHS. “This new facility gives our patients unparalleled access to our nationally recognized surgeons in the area’s most modern ambulatory care center. It’s the latest step towards realizing the potential of highest-quality, efficient, and cost-effective health care.”

The Rochester Ambulatory Surgery Center is a 29,000-square-foot expansion to the medical office building located at 360 Linden Oaks Drive.

It will replace the health system’s existing Lattimore Community Surgicenter.

Before breaking ground in September 2012, RGHS actively sought physician

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input in the design of the center to create the best environment for patient care.

Specific features include: • Six operating rooms, all larger and better suited for emerging technology than traditional ambulatory ORs. The 500-square-foot operating rooms provide ample space for state-of-the-art equipment and instrumentation, and uniquely feature natural lighting.

• Two minor-procedure rooms that will be similarly equipped, and specialized to accommodate less-invasive procedures.

• Features designed for the unique

needs of pediatric patients and their families, including a designated waiting area within the main lobby, a highly skilled pediatric clinical team and special Saturday hours for certain pediatric procedures.

• A configuration that will require minimal patient transport and encourage comfortable recovery.

• Free parking conveniently located close to the entrance.

• Indoor access to the 49,000square-foot medical office building, providing convenient access for the physicians who practice in that building.

Excellus: Do homework before buying insurance on the exchange

W

ith the launch of the new health exchanges in October, Excellus BlueCross Blue Shield officials say consumers should take the time to research their options.

“Consumers should at least do as much research when buying health insurance as they would when buying a major appliance or new vehicle,” said Lynne Scalzo, vice president, business strategy and health care reform, Excellus BlueCross BlueShield.

Individuals who are uninsured or pay too much for health coverage have until March Scalzo 31, 2014, to enroll in a health plan through New York State of Health (www.nystateofhealth.ny.gov/) , an online marketplace that’ll allow them to shop, compare and enroll in a new health plan.

“There’s no rush,” Scalzo added.

“Individuals have up to six months to compare plans, talk to experts and see which plan best fits their needs.”

Here is how consumers can research their options: • Figure out how health insurance works. Watch videos or read up at youtube.com/excellusbcbs.

• Estimate your 2014 income.

You’ll need to estimate your household income to determine whether you’re eligible for financial help.

• See if you’re eligible for financial help. Your premium may be reduced if your household income is below 400 percent of the federal poverty level, which is $45,960 for individuals or $94,200 for a family of four. Try the Tax Credit and Premium Estimator at nystateofhealth.ny.gov.

• Determine your health care needs. List your typical health services and costs in a given year. Use the list to help you pick a plan that best fits your situation. If you go to the doctor a lot, for example, you may want a plan with

lower copays for doctor visits.

• See what health plans work with your doctor. It can be costly to see a doctor, pharmacy or hospital that’s not in a health plan’s “network,” or group of providers who’ve contracted with the insurer. You may need to double check this information with the provider or health insurer.

“It won’t do you a lot of good to purchase a less expensive health plan, for example, if the insurer doesn’t contract with your doctor,” Scalzo said.

• Consider all costs. Don’t just shop based on a health plan’s premium. Consider other health plan costs, such as deductibles and copays for services.

“New York state’s new exchanges mark an entirely new health insurance process for everyone involved,” Scalzo said. “With a little bit of patience and the right homework, more individuals in Upstate New York will gain access to affordable health coverage.”

November 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Okay to say ‘No thank you’ this Thanksgiving

I

n addition to counting your many blessings this Thanksgiving, I encourage all my readers who live alone (as well as those who don’t) to say “No thank you” to those things that get in the way of your personal growth and happiness.

Say “No thank you” to feeling sorry for yourself. Feeling sorry for yourself only perpetuates the cycle and makes you feel sad and needy. Chances are, you’ve survived a lot this year, and have gained new self-knowledge and growth. Feel good about that.

Say “No thank you” to self-imposed isolation. We humans aren’t meant to be alone. We’re social creatures and need each other for companionship, stimulation, and inspiration. Pick up the phone!

Say “No thank you” to an unmade bed, kitchen clutter, and any other depressing signs of discontent at home that make you feel lousy about yourself, conjure up bad or sad memories, or zap your energy. Clean up and create a pleasing, harmonious home.

Say “No thank you” to languishing on the couch. The more you move your body, the healthier it gets, and the better you can feel, physically and emotionally. The good news? Studies show that

it doesn’t take an enormous amount of physical exercise to achieve healthenhancing results. About 30 minutes a day of walking, swimming, jogging, or biking can have positive health effects.

Say “No thank you” to over-spending and to credit card debt. Think twice before you make that purchase: Do you really need it? And, can you really afford it? Since most everyone spends more on credit cards, you just might want to leave home without it. Increased financial security, peace of mind, and a sense of empowerment are the rewards for those who spend within their means.

Say “No thank you” to jumping into a relationship to avoid feeling lonely. It puts you at risk. When you’re lonely and desperate, it shows. It makes you vulnerable to the advances of someone with less-than-honorable intentions. Get good at being on your own. A content and confident person is more likely to attract a quality companion.

KIDS Corner U.S. Teens More Vulnerable to Genital Herpes, Study Suggests They may have lower levels of protective antibodies to the virus than in years past

T

oday’s teens may be at higher risk than ever of contracting genital herpes because they don’t have enough immune system antibodies to shield them against the sexually transmitted virus, a new study suggests.

This increase in risk may be the result of fewer teens being exposed in childhood to the herpes simplex virus type 1 (HSV-1), a common cause of cold sores, researchers reported Oct. 17 in the online edition of the Journal of Infectious Diseases.

“HSV-1 now is the predominant herpes strain causing genital infection,” explained physician David Kimberlin, chairman of infectious diseases at the University of Alabama at Birmingham School of Medicine, and the author of a Page 8

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journal editorial.

According to Kimberlin, the new findings suggest that almost one in 10 adolescents who a decade ago would have already acquired HSV-1 and built up some immunity may now encounter HSV-1 when they first become sexually active. That could leave them more susceptible to genital herpes than young people were in the past.

“This [also] has potentially significant consequences on neonatal herpes transmission,” which occurs when a baby contracts the herpes virus from a genitally infected mother, Kimberlin said. “We must continue to monitor these changes and watch for shifts in neonatal herpes infection that possibly could result.”

Say “No thank you” to having a bowl of cereal for dinner, while standing at the sink. As the saying goes, “You’re worth more than that.” When it comes to eating alone at home, treat yourself as you would treat a good friend you are having over for dinner. Creating a pleasant “table for one” is a great opportunity to focus on yourself and to nourish your body and spirit at the same time.

Say “No thank you” to negative thinking. Negative self-talk (e.g., “I’ll never meet anyone” or “I hate my weight”) unwittingly becomes a self-fulfilling prophecy. Become aware of negativity, stop it in its tracks, and replace it with a positive thought.

Say “No thank you” to friends who complain all the time and bring you down. Instead of helping themselves or the world, complainers spread gloom and doom. Who needs it? Hang out with people who make you smile, lift you up, support you in your efforts to overcome challenges, and generally make you feel good to be alive.

Say “No thank you” to “letting yourself go.” How you look says a lot about you and how you value yourself.

Leave the house disheveled, and you’re likely to be ignored. Spend a few minutes on your appearance, put on a pleasant expression, and watch the world open up. When you care about yourself and your appearance, you radiate vitality. It’s intriguing. And it will draw people and compliments to you.

Say “No thank you” to feelings of helplessness. Children are helpless, most adults are not. Learning to master things around the house — from minor repairs to hiring a roofing contractor, from planting a garden to making lasagna from scratch — can be a real source of satisfaction and self-pride. It can also make you an even more interesting, confident, and well-rounded person.

Say “No thank you” to that second helping this Thanksgiving. As tempting as that second piece of pumpkin pie might be, you’ll feel better the day after if you pass it up. You feel proud of your self-discipline, enjoy more energy, and have more room for leftovers.

Happy “No-Thanks” giving!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops, call Gwenn at 585-624-7887 or email her at gvoelckers@rochester.rr.com.

Body Image Tied to Suicidal Thoughts in Young Teens Young people who reported that they were overweight were more likely to also report having suicidal thoughts.

S

eeing oneself as overweight or obese may be an important, independent predictor of suicidal thoughts, especially in young girls, reports a new study in the Journal of Adolescent Health.

Understanding the link between body image and suicide is critical, said the study’s lead author, Dong-Chul Seo, associate professor at the School of Public Health at Indiana University.

“The study’s findings clearly indicate that overweight perception is an independent predictor for suicidal ideation, the same as depression.”

Seo and his colleagues analyzed the responses of 6,504 middle school and high school students surveyed from 134 schools in 50 states between 1995 and 2008.

Researchers found that suicidal thoughts were higher in those who thought they were overweight com-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

pared to those who didn’t see themselves as overweight (18 percent vs.

10.4 percent), even after controlling for such variables as age, ethnicity and depression and independent of actual body mass index (BMI).

Furthermore, the effect was stronger in girls at age 10 than in boys.

Overall, there was a decrease in suicidal ideation as participants aged between 15 and 21 years old. By the time they were 28 years old, the rate of suicidal thoughts leveled off to 5.8 percent in those who didn’t perceive themselves as overweight and 6.7 percent in those who did.

Seo added, “The findings of the study underline the need for development of effective interventions to address body weight perception to reduce suicidal ideation and as well as attempts, especially among female teenagers.”

Why So Many Hospitals Are Merging?

By Ernst Lamothe Jr.

H

ow quickly a landscape can change.

Less than a decade ago, hospitals in the Rochester area were thriving. In 2006, Lakeside Health System in Brockport announced the opening of a new $1.8 million Birthing Center to woo western Monroe County patients. Just last year, Thompson Health in Canandaigua announced the purchase of an expensive new robotic surgery equipment, the da Vinci Surgical System. And Clifton Springs Hospital also announced a restructuring that would keep the hospital strong into the future.

Fast forward to 2013.

Lakeside Health System went out of business and Thompson Health affiliated itself with the University of Rochester Medical Center. In addition, Clifton Springs Hospital decided to become part of the Rochester General Hospital System. And just last month, Unity and Rochester General Health system board of directors voted to approve an affiliation agreement where the two organizations would come together to form a new health care system.

The winds of change are upon us, and in a matter of years, the Rochester area hospital landscape has changed dramatically.

Why are so many hospitals all of a sudden ceasing to exist as individual organizations? And what prompted all these changes now?

When hospitals combine forces, it allows them to centralize and reduce costs like billing, while sharing costs such as electronic medical record keeping expenses. The impact of the Affordable Care Act going into law care is significant and one of the driving forces causing many of the mergers. While many still have mixed feeling about the new health law, it may be forcing the healthcare industry to think of creative ways to cut or consolidate costs with haste similar to when school districts or municipalities decided to share services because of reduced state aid.

“You have to be realistic. No hospital system can be everything to all people. You have to figure out the best way to meet all the needs if you truly want to offer a high quality of care, and merging has become a way to do that,” said Steve Goldstein, CEO and president of Strong Memorial Hospital and Highland Hospital, which is under the University of Rochester Medical Center.

Before hospital mergers became the rage, Strong Memorial and Highland Hospital came together around 1996.

Once two separate free standing entities, they began sharing resources and it helped improve the overall status of Highland Hospital.

“It’s an early example of how a merger can really work well for everyone involved,” said Teri D’Agostino, University of Rochester Medical Center public relations and communications director. “Strong Memorial and Highland hospital have been working together in many ways that have been beneficial for both of them.”

Hospitals officials are focusing on two aspects: how to improve the quality of care and reduce the cost of care, added Goldstein. In addition, under the new federal health care law, patients can become their own advocates and compare medical prices for procedures better in hospitals that have merged. For hospital systems, they can consolidate expenses, while combining the best expertise.

When it came to the news of Unity Health and Rochester General Health systems sharing an equal partnership, it was something that was both sudden and expected at the same time. Last April, Unity and RGHS announced they had mutually agreed to enter into discussions to create a formal relationship. Sometimes discussions end just there. This time, the merger will result in a fully integrated healthcare system with a single parent company with equal representatives from both organizations. As one organization, RGHS and Unity will build and combine its information technology, primary care and community-based care management resources.

“Approval of the affiliation agreement is a milestone in the process because it moves April’s ‘handshake’ agreement between Unity and RGHS to a formal relationship that demonstrates both organizations’ total commitment to make this merger happen,” said Warren Hern, president and chief executive officer of Unity Health System.

Cost savings will also be achieved by consolidating duplicative infrastructure, streamlining costly overhead, integrating clinical services and even avoiding new, extensive capital investments.

Mark Clement, president and chief executive officer of Rochester General Health System, said the merger provides the community with something they have been looking for. “This announcement brings us another exciting step closer to providing the greater Rochester region with a communitybased health care system that enhances clinical quality, patient care and sup-

port services, improves access to health care, lowers costs and keeps our community healthier,” he said.

The Rochester General Health System operates Rochester General Hospital and Newark-Wayne Community Hospital as well as two long-termcare facilities, Hill Haven and DeMay Living Center. The Unity Health System operates Unity Hospital on the Unity Park Ridge Health Care Campus in Greece and Unity St. Mary’s Campus in Rochester. Rochester General is the area’s third largest employer, with 8,100 employees. Unity is the sixth, with 5,358.

“Dozens of successful partnerships and affiliations already exist across our region and they continue to grow — creating the best of both worlds for the community and our patients,” added Natalie Ciao, media relations manager for Unity.

She said given the profound implications of consolidation makes it clear “that the right mergers can, and do, result in great benefits for patients.

Mergers also enable providers to drive down costs by creating critical mass and building economies of scale.”

The next step is filing paperwork at both the state and federal level and mapping out a blueprint for the new organization. The process could take anywhere from six months to a year.

The University of Rochester Medical Center recently purchased most of Lakeside Health Systems assets after the hospital closed down. URMC will

take over the 156 West Ave. campus in Brockport and re-establish urgent care, orthopedic surgeons, urologist and outpatient services to westside residents. Lakeside Hospital closed earlier this year when they were unable to receive a state grant needed to transition from an inpatient hospital into a freestanding emergency department and out care facility. University of Rochester Medical Center already was collaborating with Lakeside before its closure, so the move to take over its assets wasn’t necessarily out of left field.

Newly renamed URMC’s Strong West, officials hopes to turn the campus into the ER department by next year. There will also be laboratory and imaging services, but will not include any inpatient beds. URMC will also take ownership of Lakeside’s medical records and images.

“When a hospital closes, there is a void left for patients who still need care,” added Goldstein. “We saw that we could help that need and create an emergency department for those in the area.”

The University of Rochester health system, which includes Strong Memorial, Highland, Golisano Children’s and F.F. Thompson hospitals, physician practices and other holdings, employs more than 13,700 people.

Steve Goldstein, CEO and president of Strong Memorial Hospital and Highland Hospital: “You have to be realistic. No hospital system can be everything to all people. You have to figure out the best way to meet all the needs if you truly want to offer a high quality of care, and merging has become a way to do that.”

Mark Clement, president and chief executive officer, Rochester General Health System, and Warren Hern, president and chief executive officer, Unity Health System, formalizing the affiliation agreement between the two organizations. The affiliation stipulates an equal partnership between the parent companies of Unity Health System and Rochester General Health System.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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DEPRESSION Experts: Many people who are depressed are not getting or seeking treatment

By Ernst Lamothe Jr.

S

imply put, depression is a serious, debilitating issue. But unfortunately, many people who do or don’t suffer from it aren’t taking the problem as seriously as they should.

Many people will just dismiss those who have depression as feeling a little blue or sad and nothing worth diagnosing. However, an estimated one in 10 U.S. adults reported feeling depressed, according to the Centers for Disease Control and Prevention. Odds are the numbers are vastly higher since many don’t report feeling bouts of depression.

Depression isn’t always short-lived and can’t just be fixed by watching a funny movie or having a good day. It can be crippling, affecting a person’s work and social life as well as relationships. And it can be difficult for those around them.

“Depression can cause lack of energy, inability to concentrate, thoughts of suicide, weight gain, quick agitation and an overall sense of hopelessness,” said Audrey Berger, a Rochester psychologist for 32 years. “Significant depression isn’t something that can just be pushed away by thinking happy thoughts.”

Once depression hits, it’s seldom a one-time thing. There are several types of depression, according to the National Institute of Health. Dysthymic disorder is characterized by longterm symptoms. Psychotic depression involves breaks in reality known as hallucinations, while postpartum is associated with women after they give birth when hormonal changes occur. Minor depression is characterized by having symptoms for two weeks or longer. But without treatment, minor issues can develop into major ones.

“Depression is not just people

having sad thoughts,” said Berger. “It disrupts your life and can last for a long period of time. It’s a big deal and it needs to be treated as such or things can go from bad to worse.”

Jason Knupp, a clinical social worker and therapist with office in Hilton, said some people also suffer from situational depression. That is when something out of the blue comes into your life and causes a level of stress that wasn’t there before.

“It can be because you have fallen on hard financial times from losing a job or the death of someone close,” said Knupp.

Depression can cause anxiety and an overwhelming feeling of hopelessness and both genders handle it very differently. Women tend to feel bouts of sadness and excessive guilt, while men often feel listless, the inability to enjoy once-pleasurable activities and difficulty sleeping.

“Women are slightly more in touch with their feelings so they might talk about their depression a little more,” said Knupp. “Men may keep things to themselves, but you will see their mood and behavior change. You just won’t know why because they are not talking about it.”

While there are no absolutes, Berg-

er said women tend to exhibit more of the classic signs of depression like sorrow. Men are likely to become irritable, angry and act out in ways counter to their normal personalities.

Experts believe depression is caused by a combination of genetic, biological, environmental and psychological factors. Because depression is associated with functions occurring in the brain, medical officials say people who are depressed have different looking brains when they are scanned with a magnetic resonance imaging, better known as an MRI. However these images cannot be used to diagnose depression.

Once your feel an overwhelming sense of depression, the first step is something that few people initially do.

The first step is getting a check-up with a physician. Sometimes depression is connected with a health issue such as a thyroid problem or diabetes.

A doctor or mental health specialist first interviews the patient, does a physical exam and lab test to help determine the causes or extent of depression. They may suggest scheduling an appointment with a psychologist. Sometimes talking with a stranger presents an added bonus, especially for those who are private.

“You don’t always want to sit

Who Suffers the Most The Centers for Disease Control and Prevention found in a study that certain groups of people are more likely to meet the criteria for depression • People 45-64 years of age • Women • Blacks, Hispanics, non-Hispanic persons of other races or multiple races • People with less than a high school education • Those previously married • Individuals unable to work or unemployed • People without health insurance coverage Page 10

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

across a dinner table from someone that you just disclosed all this personal information about,” added Knupp.

“That is why talking to a licensed therapist offers you a chance to talk through your issues without wondering if the person you are talking to is going to treat you any different. Sometimes friends and family alone are not equipped to help someone who is truly in a deep depression.”

For those who may feel uncomfortable with the notion of talking to someone who is a stranger, officials suggest at the minimum discuss the issue with a valued friend or family member.

“If you are stressed out about something and you are talking to your buddies at a sports bar or if you are in your home talking with a group of friends in your living room about your life, that is all a form of therapy,” said Knupp. “We just don’t think about it that way. Everyone benefits from communication.”

In addition, Berger said it’s essential to work with clients on simple things such as how to handle relationship issues, stress and means to maintaining calmness in various situations.

“There are a lot of people who are depressed who are not getting or seeking treatment,” she said. “There are even teenagers who get depressed and don’t know how to handle it. Left unchecked, depression can consume your entire life.”

Berger said people also shouldn’t shy away from medication if the situation dictates. She believes too often people let the stigma of taking medication keep them from something that is vital to handling the situation in the early stages. Popular medication includes Celexa, Lexapro, Cymbalta and Effexor, among others. And while medication is needed for some, it isn’t for everyone. “People shouldn’t have medication just handed to them just because,” added Knupp. “If you are dealing with stress or depression because of financial issues, then taking medication isn’t going to bring your money back. It really is a case-by-case basis.”

November 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Rochester’s Complementary Medicine Guru After 12 years leading the Integrative Medicine Department of Clifton Springs Hospital, Dr. Moore opens his own practice in Pittsford

By Deborah Blackwell

L

es Moore is up before the sun rises, practices tai chi or martial arts for a half hour or more, then mixes a green drink of herbs, grains and nutrients before sitting down to a light breakfast of yogurt, granola and berries.

And he does all of this before he goes to work.

This is the morning of a naturopathic doctor, who most people know simply as Dr. Moore.

“We are physical, mental, emotional, social, and spiritual people, and to be healthy is to be whole,” says Moore.

“Sometimes, some of the pieces of our life are out of balance or broken. To become healthy means to pick up these broken pieces of our life and put them back together. I can help you do it, but I can’t do it for you.”

Moore is trained as a naturopath; he is a doctor of naturopathy, a boardcertified homeopath, a licensed acupuncturist and he also has a graduate degree in pastoral and spiritual care and counseling.

Many of his patients have chronic diseases that haven’t responded well to conventional therapy, and he tries to find the root cause. But he also treats people who need a subtle shift in their lives to become more physically and emotionally healthy.

He helps with both acute and chronic health issues, treating people dealing with difficult diseases, or anxiety, or even the common cold.

A perfect example is myself. I came

to Moore for help with severe, unexplained gastric distress. After years of routine tests and procedures, continually coming up inconclusive, he prescribed a holistic treatment plan including acupuncture, herbal supplements, and his poignant words of wisdom and counseling about my life and routine.

As a result, my gastric symptoms have subsided.

When I leave his office I feel renewed, hopeful, and encouraged.

Designated health coach

“My job is to educate and coach someone to health and wholeness. It’s not me. It’s you,” says Moore. “I’m more like a health coach. I’m on the sidelines cheering you on and training you, but I’m not the one running with the ball. Many things that I show people they can do on their own, such as dietary and lifestyle changes.”

Moore is a medium-built man with a laid back, quiet confidence and a head of strawberry blonde hair.

He has a Southern accent in his voice that seems completely out of place in Upstate New York. That accent and his confidence help him guide people to better health.

Born in Fort Bragg, N.C., Moore was the son of a soldier, growing up on a small farm. He comes by his talents naturally. His father is a retired soldier who is a community herbalist in North Carolina, treating friends, family, neighbors and his church community.

He also learned a great deal from his

Checking a patient’s pulse for her constitution, to see how her organ systems are working.

Les Moore is trained as a naturopath, he is a doctor of naturopathy, a board-certified homeopath, a licensed acupuncturist.

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Dr. Les Moore takes a moment outside of his practice in Pittsford to enjoy the fresh air. In August, he resigned after 12 years as director of Integrative Medicine at Clifton Springs Hospital and Clinic to open a private practice. step-grandfather Kel Helbert, a Cherokee herbalist from the mountains of Virginia.

Moore would go into the woods with his family and find and gather different herbs, but never endangering species of plants. He also served as an active duty Army infantry officer and served in the United States, Central America, and Europe.

“My undergraduate degree was in natural resources management and forestry,” says Moore. “When I went into the Army, I found out there are people who could do some things better than me, like play the guitar, but I never found anyone who knew more about plants and how they are used than I did. I would teach the use of plants for survival and medicine in the Army when in the field.”

Moore wanted to further his career in herbalism and went to the National College of Naturopathic Medicine in Portland, Ore., and studied a combined program of naturopathic and classical Chinese medicine. He moved to the Finger Lakes region where his wife was raised, and opened a private integrative medicine practice in Ithaca.

Integrative medicine combines mainstream, conventional medicine with alternative and complementary therapies to provide a whole-person approach to healing. He went to set up and practice at the former Integrative Complementary Medicine clinic at the Sands Cancer Center, part of Thompson Health in Canandaigua. He then served as director of integrative medicine at Clifton Springs Hospital and Clinic for 12 years.

Moore recently opened a private practice in Pittsford. Its mission is to improve people’s lives through innovation and tradition in research, education and patient care with the highest quality of naturopathic, homeopathic,

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

and Asian medicine.

‘Tremendous gift’

“Les has a tremendous gift working with patients. When he is with them, it is all about them,” says Moore’s wife, Kim Moore, who is chief executive officer of Classical Formulas, a nutraceutical company. Classical Formulas offers homeopathic, nutritional and botanical supplements.

Moore has patients from around the country. Many come to his office, others have telephone consults, and patients can order supplements from Classical Formulas as recommended by Moore.

“Les tells me that every person’s visit is critical and sometimes that part is hard,” says Kim. “But I guess if he looks at all of his patients as critical, then they have a pretty good doc.”

When asking how this healer stays healthy, he laughs and says he has things going on just like everybody else. But he remains proactive. He gets plenty of sleep, takes his own course of herbal supplements, and practices a vegetarian lifestyle. He describes himself as a grill-master who will cook exotic cheese for himself while grilling chicken or steak for his wife of 19 years and their three children.

He also nurtures his creative side, relaxing by playing the guitar, dobro and mandolin.

“Sometimes it only takes a subtle movement to help restore health, be it nutrition, homeopathy, or even taking time for a hobby,” he says.

“I know I can help people in some way, with something, and I know it’s going to be a transition in their life,” says Moore. “I am privileged to be with patients while they are healing.”

To contact Dr. Moore, call 585267-7339.

SmartBites

By Anne Palumbo

The skinny on healthy eating

Get a Boost from Butternut Squash

F

or years, I avoided winter squash.

Acorn, spaghetti, pumpkin, butternut: you name it and I waltzed right past it at the market. The hard skins intimidated me. How could my dull knives ever get through that brickand-mortar exterior?

Thankfully, I sharpened my knives as well as my wits about winter squash: all are simply too delicious and nutritious to ignore.

But I admit to having a soft spot for butternut squash because it’s often available skinned, cubed and ready to cook. Go convenience!

Convenience notwithstanding, I also squeeze a lot of this particular squash into my diet because it’s loaded with vitamins and serves up a good dose of heart-healthy fiber.

Let’s start with butternut’s most noteworthy health perk: its super high concentration of beta-carotene, an orange pigment that your body automatically converts to vitamin A. A workhorse vitamin that’s essential for good health, vitamin A is needed for normal bone growth, healthy skin, eyesight, and proper tooth development. One cup of cubed,

cooked butternut squash delivers over 400 percent of your daily needs.

What’s more, butternut squash is an antioxidant superstar, boasting good amounts of three top antioxidants: beta-carotene, vitamin C, and vitamin E. Antioxidants protect and repair cells from damage caused by free radicals — damage that many experts believe plays a roll in several chronic diseases, including atherosclerosis, cancer, heart disease, and arthritis.

Worried about colds or the flu? The immune-boosting benefits of antioxidants may be your ticket to fewer aches, pains and achoos this season.

Bring on the seconds, right?

Like most vegetables, butternut squash scores low in calories (around 80 per cubed cup), fat, cholesterol and sodium. Also good: It’s a pretty decent

source of potassium, which helps to control blood pressure, and manganese, which promotes healthy bones.

Helpful tips Select squash that is firm, heavy for its size and has a dull, hard rind.

Smooth, shiny skin suggests that the squash is not ripe; soft rinds may indicate that the squash is watery and tasteless. Avoid squash with any cracks or signs of decay. Butternut squash will keep for about a month in a cool, dark place: do not refrigerate whole butternut squash. Peeled, cut squash should be stored tightly covered and refrigerated for up to 5 days.

Butternut Squash Casserole with Gorgonzola & Sage 2 packages of peeled butternut squash, cut into ¾-inch dice 2 teaspoons olive oil ½ red onion, peeled and thinly sliced 1 clove garlic, minced 1 cup grated, fat-reduced mozzarella cheese ½ cup fat-free Half & Half (or 2% milk) 1 teaspoon salt ½ teaspoon black pepper 1 teaspoon dried sage (or 1 tablespoon chopped fresh sage) 1/3 cup crumbled gorgonzola cheese 4 strips uncured bacon (optional) 1 teaspoon oil ½ cup breadcrumbs 1 cup chopped walnuts, toasted

November 2013 •

Preheat oven to 375 degrees. Heat olive oil in large nonstick skillet over medium-high heat. Add sliced onion and garlic to pan; sauté 5 minutes or until tender, stirring occasionally.

Transfer the onion mixture to a large bowl. Add squash, mozzarella, Half & Half, salt, pepper and sage. Toss gently to combine. Spoon squash into a 9x13-inch baking dish lightly coated with butter or oil.

Cook bacon in microwave for 5 minutes. Let cool, then break into small pieces. While bacon is cooking, heat 1 teaspoon oil in same skillet over medium-high heat. Add breadcrumbs and walnuts and cook for about 4 minutes, stirring until crumbs turn golden. Remove from heat. Mix in bacon pieces.

Sprinkle crumbled gorgonzola and then breadcrumb mixture evenly over squash mixture. Bake until the squash is tender and the topping is browned, about 40 minutes.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes.

She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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Page 13

NATIONAL HOSPICE MONTH

The Wrenching, and Beautiful, Last Days Nurse who has worked in hospice for 24 years reflects on living, dying

By Mike Costanza, In Good Health, Rochester’s Healthcare Newspaper www.GVhealthnews.com

T

hough it was five years ago, Debbie Sigrist speaks of the encounter as if it had happened yesterday. She was walking a woman to the elevator of the Leo Center for Caring, the Irondequoit hospice where Sigrist works. The woman’s husband, a patient at the center, had just died. Before she left, the grieving widow turned to her.

“She said, ‘I don’t get it. This has been one of the most wrenching times of life, but also one of the most beautiful,’” Sigrist recalled.

Sigrist, a registered nurse and certified hospice palliative nurse, has sought to help her patients and their loved ones experience that kind of beauty since she began working in hospice care 24 years ago.

Medical care seeks to treat diseases and injuries, prevent suffering and save lives. When medicine can no longer prevent death from drawing near, hospice care can make a patient’s last days more comfortable, and even pleasant.

“Hospice is a way of taking care of the whole person as they are Page 14

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nearing the end of life,” Sigrist says.

“Body, emotions, mental, cognitive aspects, and spirit.”

In order to qualify for hospice care, a patient must be within about six months or less of dying, and be unwilling to undergo or continue aggressive medical treatments, according to Sigrist.

“They know that the disease process has enlarged so much that these things [treatments] become a burden,” she said.

Instead of fighting the disease or condition, hospice care seeks to meet a patient’s physical, emotional, psychological and spiritual needs as the process of dying continues. Medication is used to prevent or limit the patient’s pain and symptoms, and make him or her more comfortable. Special services, such as speech or physical therapy, are provided as the patient needs them. Counselors, chaplains and other staff help the patient cope with the emotional, psychological and spiritual aspects of dying, and give bereavement care and counseling to the person’s loved ones.

A hospice patient might be able

to live at home, or in nursing home or comfort care home, while under care during the early stages of the process of dying. As that process takes its toll, he or she often has to move to a facility that provides more intensive treatment—like the Leo Center for Caring. The 10-bed inpatient facility, which is the result of a partnership between the Visiting Nurse Service and St. Ann’s Community, is designed much like a warm and inviting home—it even has a fireplace.

“It’s so quiet and peaceful up there,” Sigrist explained. “You don’t have the bells and whistles of hospitals.”

Though some patients arrive at the LCC with weeks to live, others may only have hours. A team of specially trained nurses, social workers, chaplains and other professionals and volunteers helps make them as enjoyable as possible.

“All of these truly want to do this kind of work, and are particularly skilled at it,” Sigrist said.

The patents’ wishes help guide their care. According to Sigrist, the basic desire is simple nine times out of 10.

“They say, ‘to be comfortable,” she said.

The LCC also helps patient’s loved ones and relatives cope with the dying process. A bereavement coordinator helps them prepare for the loss of the patient, and two volunteers even hold weekly “tea parties,” to help visitors feel more welcome and relaxed while there.

Sigrist said she has always been curious about the ends of stories.

“When I would read a novel, I frequently wanted to read the ending chapter first,” she explained.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

“What happens at the ending absolutely influenced how I read the whole story.”

After becoming an elementary school teacher, she encountered the work of the late Elisabeth KüblerRoss, a psychiatrist who pioneered the study of the process of dying.

Kübler-Ross was an early supporter of the hospice movement.

“I was very fascinated by the question of when everything is pulled back, all the layers are pulled away, what remains,” Sigrist explained. “That essence…I wanted to see it was, and be around it.”

Casting about for a way to answer such questions, she became a registered nurse.

“I went right into working with the dying,” Sigrist said.

Since then, Sigrist has worked with numerous patients, including those she met while volunteering in South Africa about three years ago.

She and her husband, who is also a nurse, spent six weeks at a hospice for AIDS patients in a little town named Ingwavuma.

“I really wanted to work with the children, the adults with AIDS,” she explained.

Now 64-year-old grandmother, Sigrist said that helping others move through the last stage of life has taught her lessons she can use at this stage of her own life.

“What it taught me is it’s very important that I have a sense of measure in the activities of my life,” she said. “To reflect on where it is really important to…be very manage-oriented and controlled and make things happen, and the times to yield more and mellow through whatever is happening.”

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November 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

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Dealing With Permanent Loss: The First Holiday

By Christa DiNatale

I

t has been almost a year since my father passed away. It is still so surreal and painful to think about, and I still can’t quite process it all. I’m not sure why — there seemed to have been so much time to process it. From the onset of the cancer, to the years of treatments, to the brief final illness.

People will come up to me and say that they’re sorry for my loss. For some reason I can’t accept when people say that, even though that euphemism has never meant anything serious to me until now. It’s too gentle, too soft.

There is superficiality to it that I’m not comfortable with. I’ve lost my keys, lost a sock to the dryer, lost a bet, lost a contact…all minor, trivial things that signify misplacement, something you will either find again or won’t miss when it’s gone. But to lose a person?

This first year without him has been a learning experience, and losing him in mid October meant that the holidays were mere weeks away. I could not put in perspective his loss for that first holiday season until I realized that this year’s holiday season is fast approaching and I would soon face another difficult time. Now is the time to re-evaluate the coping techniques I used before. I am once again immersed in tinsel, pine needles, and hollandaise sauce. It also seemed useful to write down the techniques and thought processes I used to survive that first holiday season, because this affects any person at any season. My hope is to help people with loved ones that have recently passed with the realities of dealing with your grief during the first holiday season without your loved one.

These may be the most difficult days during your first year without your loved one. You might be tempted to try and ignore how you’re feeing and what you’re experiencing during the holiday, but it is so important to feel emotions in order for you to grieve and eventually heal. I have found that trying to hide your sadness on these days only makes the sadness worse. Instead, try to incorporate something into the holiday that your loved enjoyed, whether it’s putting up a particular decoration, or preparing their favorite side dish for your holiday meal. Don’t try to make things too complicated; if it’s too difficult to decorate then don’t force yourself to. If you normally have a huge family get together, you might want to scale down and just enjoy a few people. You probably won’t feel like celebrating right now, and you shouldn’t feel it is compulsory.

Start small – don’t put extra stress on yourself by trying to host the big party. If you do feel like socializing then do so at your own pace. If it gets too overwhelming to be around friends and family, especially if they are grieving over your/their loved ones death too, let the host know ahead of time that you might have to leave early. That way the host can explain to the other guests so you won’t have to.

You might be so overcome with sadness that you won’t want to celebrate the holiday season at all. It is perfectly normal to not be in the Holiday spirit because your loved one won’t be there to partake in the festivities with you. You will probably be reminiscing about holidays passed and feel deeply saddened. There will undoubtedly be

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

Chuck DiNatale, a frequent contributor to In Good Health, died in October last year after battling cancer. His daughter, Christa DiNatale, reflects on her loss. memories that make you smile, which can be even more difficult to handle because then you are forced to accept that you will never get the chance to make more holiday memories with them. Coming to this realization can be a shock and it might not even surface during that first holiday, but instead you might be feeling a general sense of unease that you are unable to describe.

You will probably have days where you feel something is missing and you find it difficult to function. This is normal to feel out of place but if your sadness is so unbearable that you are unable to function, consult your doctor. He or she may suggest medication, refer you to a therapist, or suggest you join a support group. None of these things will be an instant fix however, so you may just elect to “go it alone” so to speak. It will take time to go through the grieving processes, and medications alone will not heal your pain. In my personal experience they may mask the pain and prevent you from moving forward in your healing process. However, medication can also focus you and “clear out the cobwebs” so you are able to process your grief instead of being overcome by it.

Everyone deals with grief differently, and there is no one way to grieve that is better than another. There are many support groups, online chat rooms, and other modes available to aid in your grieving processes, so don’t become disappointed if you don’t find one that works for you right away. It will take time for you to be comfortable in your own skin again, but don’t rush yourself or be too hard on yourself if you don’t “snap back” from your sadness right away. It takes months, even years before you might feel whole again, but take heart that you are not alone in the processes of grief, and ultimately, your path to healing.

Golden Years Apps Can Boost Seniors’ Health

By Deborah Jeanne Sergeant

I

f you’re a senior who enjoys a tablet or smart phone and staying healthy, plenty of apps have been developed to help you maintain good health.

Daniel Jones, owner of Daniel Teaches, a Rochester-based business that offers computer and technology instruction for seniors, said that lots of mature adults are getting tablets and using health apps on them.

“It’s the fastest growing segment of iPad purchasers: people over 65,” Jones said.

Many seniors he knows like apps that promote mental health and agility, such as brain teasers, quizzes and puzzles.

“Someone who’s already mentally active wants to keep it that way,” Jones said.

“They use apps that help them maintain their cognitive skills.”

Jones But it’s not just brain games that can help people keep their mental edge.

“Even if it’s just a recipe app, be-

cause they’re interacting with this app, it keeps them constantly learning and keeping sharp,” Jones said. “Every app does something different and they have to learn to figure this stuff out.

But everyone needs a little reminder now and then. Apps such as RxMindMe Prescription (free for iPhone, iPod) and Dosecast (free for Android) can help people with complicated medication regimens stay on track and also orchestrate the pill routines of the whole family, including pets. These apps may be programmed down to the hour and includes photos of medication to help keep pills sorted.

Many additional creative health apps relating to health are in the works.

Craig Lamb, partner at Envative, a software development company in Rochester, said that the sky is the limit.

His company is working on a mobile app that will help people capture a digital image of their prescription, transmit it to a pharmacy near them to fill it, and give users GPS-based directions to the pharmacy. This app would be particularly useful for seniors on the go, whether as snowbirds or frequent travelers.

Another app in the works at Envative is one that offers daily positive messages and health information.

If you need motivation to get moving, try FitnessBuilder (free for iPhone, iPad and Android), which can help you develop a fitness routine from among 200 available workouts. Since you’re basing the workout on your own fitness level and goals, you’re sure to find what you need. The app’s videos demonstrate moves and since it keeps track of your progress, you’ll stay better motivated—and accountable.

Pocket Yoga ($2.99 for iPhone, iPad and Android) can teach you proper body positioning for numerous levels of yoga so you can practice wherever you are.

Stretch Exercises (free for Android) can help you stay limber, whether it’s arthritis or general morning stiffness that you face every day. The several dozen exercises can be performed as part of an exercise routine or independently.

Runkeeper (free for iPhone, iPad and Android) isn’t just for those fleet of feet. Anyone walking, hiking, biking or inline skating will appreciate the GPS-

enable app that will record your speed and route via the Runkeeper website.

Since you can choose to post it to your favorite social media site, you can your friends can keep each other motivated.

My Fitness Pal (free for iPhone, iPad and Android) tracks not only output but input. The digital food and activity record can also synch with Fitbit Aris Smart Scale and the Withings Wi-Fi Body Scale to measure your body mass index. The BMI has long been touted as a more accurate measurement of health than weight alone.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Golden Years Why Should You Take Care of Your Teeth?

Problems with your teeth can have an impact on your overall health

By Ernst Lamothe Jr.

D

entist Richard Speisman sees a disconnect with some of his patients. They don’t understand that oral health is not separate from general health. He realizes that when people sit into his dental chair: he sees years of complacency and neglect in some of his patient’s mouths.

Poor oral hygiene has been associated with a number of ailments, some connected with coronary disease.

“The issues that cause problems in your arteries are the same that can cause problems in your teeth and gums and reduce your health in other areas of the body,” Speisman said Speisman, chairman of the dentistry department at Rochester General Hospital.

The body is connected in so many ways. A pain in your back could affect your quad muscles. Clogged nasal passages can lead to an inner ear infection.

And a corneal tear can cause your nose to drain liquid because it has affected the sinuses.

Dental problems work the same way and it can create dire circumstances especially for older citizens, where Medicare doesn’t cover most dental procedures, such as fillings, extractions and dentures. Oral care will become an even bigger looming issue when the number of seniors double by 2030.

“There used to be this myth that when you grew older, you were going to lose your teeth and you had no choice,” said Speisman. “But there is no reason why you can’t leave this Earth with all your original teeth.”

Seniors who don’t address their teeth will have more severe problems outside of their mouths like hypertension, cardiovascular disease, diabetes, and even stroke. Tooth decay harms

your natural teeth and affects the gums and bones that hold the teeth together.

Nearly a quarter of 65- to 74-year-olds have severe gum disease. Then there is oral cancer where people who are older than 50 years old are at the greatest risk, according to the Cleveland Clinic.

Oral cancer appears as an uncontrollable growth that can affect the lips, tongue, cheek, floor of the mouth and throat. It leads to persistent sores on the face and neck. Doctors diagnose the condition after an oral screening, which is typically part of a routine and comprehensive dental examination. The Oral Cancer Foundation states that close to 42,000 Americans will be diagCooper nosed with the disease.

It will cause more than 8,600 deaths, killing close to one person every hour for an entire year.

In addition, when gingivitis is not treated, it can advance to periodontitis, which means inflammation around the tooth. In periodontitis, gums pull away from the teeth and form spaces that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.

“When you start having chronic inflammation or are susceptible to root decay, that is what causes tooth loss and chronic infections in the gums,” said Speisman. “If you don’t follow good oral hygiene, food particles will stay between your teeth and start causing damage.”

Dentist Ada Cooper, spokesperson for the American Dental Practice, said she has seen more patients come into her office with dry mouth as they get older. While the condition might seem simply inconvenient, it’s a serious matter. We all need saliva to moisten and cleanse our mouths and digest

food. Saliva also prevents infection by controlling bacteria and fungi in the mouth.

“Dry mouth is the side effect of over 500 different medications,” she said. “It can also be indicative of some other health problems such as an increase of cavities.”

She also said too many people mistakenly believe you must have tremendous pain in your mouth for a problem to occur.

“That kind of thinking makes people not go to the dentist regularly until something is truly giving them a lot of pain,” said Cooper, who also has a private practice in New York City.

“When something begins to hurt that means that it is already going to be expensive to fix and you have possibly caused an issue to your overall health.”

She said simply going to the dentist for a cleaning twice a year shouldn’t be the only method of oral hygiene. It’s essential to routinely take care of your mouth through brushing and other methods.

“Flossing is the only way you can really remove the plaque and bacteria that may be forming in between your gums that can cause gum disease and other issues,” said Cooper.

Speisman said the way a person looks plays a role in everything in life, including employment. With job stabil-

ity no longer a guarantee, people need all kinds of intangibles when they look for employment or simply to maintain their current positions.

“There are studies that show when you are dealing with two people with the same qualifications, a nice smile or healthy teeth gets the edge over the opposite,” he said. “You don’t want to get passed over for something that is preventable.”

He hopes people start being more responsible about their mouths.

“Patients don’t give their teeth much thought unless they have a problem. And by the time you feel an ache, or your gums are bleeding or you are in intense pain, it’s no longer a small issue,” added Speisman. “We want people to start making oral hygiene part of the forefront of their minds.”

How to keep teeth and gums healthy

• Brush your teeth twice a day with fluoride toothpaste.

• Floss regularly to remove plaque from between teeth. Or use a device such as a special brush or wooden or plastic pick recommended by a dental professional.

• Visit the dentist routinely for a check-up and professional cleaning.

• Don’t smoke

Source: National Institute of Dental and Craniofacial Research

Living Better with Heart Failure by Changing What You Eat Reduce salt intake, says University of Michigan cardiovascular study

D

iet can dramatically lower hypertension and improve heart function in patients with a common type of heart failure, according to research presented in October’s Heart Failure Society of America meeting in Orlando, Fla. After 21 days of following a lowsodium Dietary Approaches to Stop Hypertension (DASH) eating plan, patients saw a drop in blood pressure similar to taking anti-hypertension medicine.

“Our work suggests diet could play an important role in the progression of heart failure, although patients should always talk to their doctor Page 18

•

before making major dietary changes,” says Scott Hummel, cardiologist at the University of Michigan Frankel Cardiovascular Center.“We’re excited to confirm these results in longer-term studies that also help us understand the challenges patients face when they try to improve their eating habits.”

Heart failure with preserved ejection fraction, or “diastolic” heart failure, happens when the heart becomes stiff and does not pump out enough blood. The condition is found in more than half of older adults with heart failure. Although taking diuretics to help the body get rid of extra fluid is useful, this type of heart failure has no

standard treatment.

The heart failure patients, most of them in their 60s and 70s, agreed to keep food diaries and eat only the meals prepared for them in the metabolic kitchen at the University of Michigan Clinical Research Unit.

The meals, which could be picked up and heated at home, matched the DASH diet eating plan, which is high in potassium, magnesium, calcium and antioxidants and is recommended for hypertension treatment by the National Institutes of Health and the American Heart Association.

The study diet also contained a daily sodium intake of no more than

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

1,150 milligrams. That’s much lower than what adults in the United States usually eat — about 4,200 mg a day for men, and 3,300 mg a day for women.

Doctors have long known that the low-sodium DASH diet can lower blood pressure in salt-sensitive patients.

The U-M study, although small, showed the DASH diet can improve left ventricular relaxation and reduce diastolic chamber stiffness, meaning a more efficient transfer of blood between the heart and arteries, Hummel says.

Golden Years

Tips for Medicare Open Enrollment

A

dults who are age 65 or older or are disabled will now have the option to keep or switch their Medicare Advantage plans for 2014.

Medicare’s open enrollment period started Oct. 15 and will continue through Dec. 7.

“Eligible individuals should first review any premium or benefit changes to their current plans for 2014,” said Michael Burke, senior vice president, Government Programs, Excellus BlueCross BlueShield.

“Even if they’re happy with their current plan, major benefit or premium changes might indicate that another Medicare option might best fit their needs,” he added.

Individuals should also consider the following: • Which “star” rating did the health plan receive? The Centers for Medicare & Medicaid Services rate the quality of Medicare Advantage plans on a scale of one to five, with five stars representing the highest quality.

• Does your doctor, pharmacist or hospital contract with the health

plan? It can be costly to see a doctor, pharmacy or hospital that’s not in a health plan’s network.

• Lower premium vs. higher premium. Would you rather pay a higher monthly premium, but pay less when you go to the doctor? Or would a lower monthly premium with higher costs for services work best?

• Consider a $0 premium plan. You’re paying $0 a month, but still receiving comprehensive benefits.

“Medicare is not part of the new health insurance exchanges,” Burke added. “The exchanges are for individuals who are not eligible for Medicare and need health coverage.”

For Medicare help, call 1-888529-0019 or find a Medicare informational seminar near you at excellusmedicare.com/seminar.

Medicare Advantage plans are a type of Medicare health plan offered by health insurers that contract with the federal government to provide hospital and medical coverage to eligible individuals.

Exercise Helps Seniors Stay Healthy Longer

By Deborah Jeanne Sergeant

Y

ou know exercise can help you stay healthy into later life. You may try to stay active but aren’t sure what type of exercise is important. Fortunately, it’s not all that complicated.

Many people envision exercise only as buying a gym membership and logging miles on a treadmill and hefting free weights. Or perhaps, working out means joining an aerobics class.

Exercise could be either, both or neither of those scenarios.

Becky Perrone, manager of rehabilitation services at Independent Living Center, affiliated with Rochester General Hospital, encourages patients to walk.

“Walking can be done outside,” she said. “In the winter, they can go to the mall.

“For their overall health, it’s a good to exercise to maintain endurance, prevent falls, maintain bone density and overall wellbeing. The lungs and heart are very important to maintain and if you’re just sitting around all the time, they will lose their capabilities. If someone gets ill, they bounce back quicker if they’ve been active than if they’re sedentary.”

For seniors whose arthritic joints prohibit walking, Perrone recommends other forms of exercise, such as swimming.

Many seniors find that balance is-

The 4 Ps of Choosing a Medicare Advantage Plan

I

f you are 65 or older, now is the time to think about your health care needs for the coming year.

Open enrollment for Medicare 2014 is underway, and seniors only have until Dec. 7 to select or change their coverage. Medicare coverage is not affected by the Affordable Care Act. Many seniors are interested in Medicare Advantage Plans. Commonly known as Part C, Medicare Advantage provides insurance for hospitalization and in-patient care (Part A) as well as doctors’ services, outpatient care and some preventive services (Part B). It may also include prescription coverage (Part D).

There are a lot of factors to consider when choosing a Medicare Advantage Plan. Fidelis Care Chief Marketing Officer Pamela Hassen offers a few tips, better known as the four Ps, to help you choose the right plan for you.

Price

While many Medicare Advantage products offer similar, comprehensive benefits, the prices may be very different. “Some products have a monthly premium but $0 copay. Others have a copay but $0 premium. Think about your health care needs in the coming year,” says Hassen. “Also, think about whether you need prescription drug coverage. That could be a deciding factor.”

Provider

Hassen says making a list of your current doctors as well as doctors you may need to see in the next year is helpful. “If your primary care physician or a specialist you see regularly isn’t in the network,

think about whether you feel comfortable making a change,” Hassen says. She also recommends looking at the hospitals in the network and finding out if you would be covered if you need medical care while traveling or visiting relatives in another part of the state.

Product

Take a look at the benefits and services offered through the product you are considering. “If you need eye exams, dental benefits, or hearing aids, find out if they are included,” advises Hassen. “You should also know if your prescription drugs are in the plan’s formulary, how much they will cost, and whether your local pharmacy participates. “A flex spending account may be an added benefit. Making a list of your over-the-counter medications and medical supplies can help you determine if flex spending will cover your out-of-pocket costs.

Peace of Mind

“When you make a Medicare Advantage Plan decision, you should feel confident you made the right choice for you,” says Hassen.

“Be sure to consider the quality and performance of the plan, health care providers, and hospitals.” Talking to friends, neighbors and relatives about choices they have made is a good start.

Hassen advises seniors to start thinking about their Medicare coverage for 2014 now. “The plan you choose will likely be your plan for an entire year. You don’t want to wait until December to start looking into your options and rush into a decision.”

sues sideline them; however, working to maintain balance can help them stay active and mobile later in life, as can maintaining muscle mass.

Perrone recommends tai chi. Pilates and many forms of dance can also help you develop better balance. Lifting weights doesn’t have to mean slinging huge dumbbells.

“If you have access to light weights, lift them with higher repetition to maintain muscle mass,” Perrone said.

Gym class calisthenics such as push-ups and squats can help a lot, too.

If you need to start with knee push-ups (instead of using the balls of the feet to support your lower body) or perform squats into a chair, that’s fine.

You don’t have to go it alone, either. Joining a senior group or community center can keep you moving, as can signing up for an exercise class that includes mature adults.

“Check high schools and recreation centers for senior time at reduced rates,” Perrone said. “You can use cans of soup for light weights. Use empty laundry or milk jugs and gradually add water. Try to buddy up with someone if

November 2013 •

you don’t have a significant other. Hold each other accountable to exercise with each other.”

Mary Grabbatin, long term care rehabilitation coordinator for Finger Lakes Health, agrees that retirees shouldn’t park in the easy chair.

“Regular exercise and maintaining activity will keep you strong throughout your lifetime will help you do what you want to as you age,” she said. “When you retire, it’s important for your overall health to stay mobile, stay flexible and maintain strength to maintain independence.”

It may seem like problems such as arthritis would feel better with rest; however, unless the doctor says otherwise, exercise is one of the best ways to get relief from arthritis pain.

“Keeping joints limber and flexible lubricates the joints and decreases the pain,” Grabbatin said. “Increasing the strength of the muscles around them helps support the joints.”

Exercise also benefits people with arthritis by helping them maintain a healthful weight, which places less stress on the joints, along with benefiting the body in many other ways such as keeping blood pressure and blood sugar under control.

After you receiving clearance from your doctor, start exercising slowly, whether it’s at a gym, class or activity you enjoy. Select something you enjoy so it easily becomes part of your routine.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

The Social Ask Security Office Column provided by the local Social Security Office

Social Security Serves Those Who’ve Served

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n Nov.11, we honor our nation’s veterans for their service to America. What better time than now to tell you — and for you to help spread the word — about the many benefits and wealth of information Social Security has available for veterans and military personnel?

Social Security recognizes those who put their lives on the line for our freedoms. Members of the armed forces receive expedited processing of their Social Security disability applications.

The expedited process is available for any military service member who became disabled during active duty on or after Oct. 1, 2001, regardless of where the disability occurs. Some dependent children and spouses of military personnel may also be eligible to receive benefits.

Visit our website designed specifically for our wounded veterans: www. socialsecurity.gov/woundedwarriors.

There, you will find answers to a number of commonly asked questions, as well as other useful information about disability benefits available under the Social Security and Supplemental Security Income (SSI) programs. Please pay special attention to the fact sheet available on that website, “Disability Benefits for Wounded Warriors.”

You’ll also find a webinar that explains the faster disability process available to wounded warriors. The

Q&A Q: I got an email that says it’s from Social Security, but I’m not so sure. They want me to reply with my Social Security number, date of birth, and mother’s maiden name for “verification.” Did it really come from Social Security?

A: No. Social Security will not send you an email asking you to share your personal information, such as your Social Security number, date of birth, or other private information.

Beware of such scams — they’re after your information so they can use it for their own benefit. When in doubt, or if you have any questions about correspondence you receive from Social Security, contact your local Social Security office or call us at 1-800-772-1213 (TTY 1-800-325-0778) to see whether we really need any information from you.

Q: I run a small business and I am hiring a few employees. How can I recognize a valid Social Security card?

A: There are more than 50 different versions of the Social Security card, all of which are valid. Although there are several versions of the card in circulation, all prior versions of the card are valid. The number is what is most important. The best way for you and Page 20

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

program covers general information about Social Security disability benefits as well as topics unique to wounded service members. The online video is less than three minutes and a great introduction to disability benefits for veterans and active duty military.

On the same webpage, you’ll also find links to useful Veterans Affairs and Department of Defense websites.

The requirements for disability benefits available through Social Security are different than those from the Department of Veterans Affairs and require a separate application.

Military service members are covered for the same Social Security survivors, disability, and retirement benefits as everyone else. Although the expedited service is relatively new, military personnel have been covered under Social Security since 1957, and people who were in the service prior to that may be able to get special credit for some of their service.

To learn more about Social Security for current and former military service members, read “Military Service and Social Security.” It’s available in our digital library at www.socialsecurity. gov/pubs.

But first, take a look at the wounded warrior page at www.socialsecurity. gov/woundedwarriors. The webinar, factsheet, and pertinent links will brief you on everything you need to know to “maneuver” your way through the Social Security process.

other employers to verify a name and Social Security number is to use the free Social Security Number Verification Service (SSNVS). Once you register for Business Services Online at www. socialsecurity.gov/bso, you can start using SSNVS. SSNVS allows you to quickly verify whether a person’s name and number match Social Security’s records.

Q: What are the benefit amounts for which a spouse may be entitled?

A: A spouse receives one-half of the retired worker’s full benefit if the spouse retires at full retirement age. If the spouse begins collecting benefits before full retirement age, we reduce those benefits by a percentage based on how much earlier the spouse retires.

However, if a spouse is taking care of a child who is either under age 16 or disabled and receiving Social Security benefits, a spouse gets full (one-half) benefits, regardless of age. If you are eligible for both your own retirement benefit and for benefits as a spouse, we always pay your own benefit first. If your benefit as a spouse is higher than your retirement benefit, you’ll receive a combination of benefits equaling the higher spouse’s benefit. Learn more at www.socialsecurity.gov.

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How to Find Affordable Cremation Services Dear Savvy Senior, Can you offer any tips for finding low-cost cremation services? I don’t want to stick my kids with a big funeral bill after I die.

Still Alive Dear Alive, Cremation is definitely one of the most affordable ways to go, when you go.

Costs usually run between $600 and $3,000, which are significantly lower than the average full-service funeral that averages around $10,000 today.

Cost is also one of the big reasons why the popularity of cremation is soaring. Roughly 40 percent of Americans now choose cremation, up from 27 percent just a decade ago. Here are some tips for locating lowcost services.

Compare Providers

Because prices can vary sharply, start by calling the funeral homes in your area (most funeral homes provide cremation services) and ask them how much they charge for a “direct cremation,” which is the least expensive option.

With direct cremation, there’s no embalming, formal viewing or funeral.

It only includes the essentials: picking up the body, completing the required paperwork, the cremation itself and providing ashes to the family.

If your family wants to have a memorial service, they can have it at home or your place of worship after the cremation, in the presence of your remains.

To locate nearby funeral homes, look in your local yellow pages under “cremation” or “funeral” or visit cremation.com.

You may also be able to get help and referrals through your nearby memorial society or local funeral consumer alliance program (see funerals. org/affiliates-directory or call 802-8658300 for contact information). These are volunteer groups that offer a wide range of information and prices on local funeral and cremation providers.

If, however, you’re not up to calling around, there are also a number of free websites — like funeraldecisions.

com and efuneral.com — that you or your family can use that can do the work for you. With these sites, you just answer a few questions, and your nearby funeral homes will provide estimates based on your request.

Low-Cost Urns

The urn is another item you need to be aware of that can drive up costs.

Funeral home urns usually cost around $50 to $300, but you aren’t required to get one.

Most funeral homes initially place ashes in a plastic bag that is inserted into a thick plastic box. The box is all you need if you intend to have your ashes scattered. But if you want something to display, you can probably find a nice urn or comparable container online. Walmart.com, for example, sells urns for as little as $25. Or, you may want to use an old cookie jar or container you have around the house instead of a traditional urn.

Financial Help

If you can’t afford your cremation costs, there are a number of places you can turn to that may help. For starters, many towns or counties provide assistance through their social services department if you or your family can’t afford to pay.

Your family should also be able to get some aid from Social Security, which pays a survivor a one-time death benefit of $255.

And if you’re a veteran, the VA provides a burial benefit that includes a free burial at a national cemetery and a free grave marker. But it doesn’t cover funeral provider or cremation costs.

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Free Cremation

Another option to consider that provides free cremation is to donate your body to a university-affiliated medical school. After using your body for research, they will cremate your remains for free, and either bury or scatter your ashes in a local cemetery or return them to your family, usually within a year or two.

To find a medical facility near you that accepts body donations, the University of Florida maintains a directory at old.med.ufl.edu/anatbd/usprograms.html. Or, call the National Family Service Desk, which operates a free referral service at 800-727-0700.

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

November 2013 •

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What They Want You to Know:

Neonatologists

By Deborah Jeanne Sergeant

T

he American Academy of Pediatrics states that a neonatologist cares for newborns who are “premature, or have a serious illness, injury, or birth defect.” In addition to their four years of medical school, neonatologists complete three years of residency training in general pediatrics, three years of additional training in newborn intensive care, certification from the American Board of Pediatrics and by th esub-board of neonatal-perinatal medicine.

There are about 14,500 births a year in the Rochester area and almost 1,200 babies are admitted to the NICU at Strong, about one out of 12 babies.

• “Neonatologists are hospitalbased and will often attend deliveries where specialty care for the newborn is anticipated.

• “Care for premature and other sick infants has improved a lot in the last 50 years because of the use of technology and specialized nursing care.

• “New York state categorizes hospitals with neonatal intensive care (NICU) to four different categories. Level 1, where normal newborns can be managed. Level 2, like RGH, are where infants may require some ventilator support, additional nutritional support and have specialized doctors and nurses. Level 3 hospitals are those that provide long term ventilator support and care for the sickest and smallest neonates. Level 4 NICUs are the regional referral centers that will treat babies not only born at their own hospital, but also accept transfers from other hospitals.”

for sick, premature babies. The most common ones we take care of are fullterm babies with unexpected problems like heart problems.

• “One of the things that has changed the most about neonatology is the role of family is valued in the care of babies. There was a time that family was considered visitors who could only come in two to three hours a day.

Now we have ‘visitor’s hours’ 24/7.

We invite them to take part in the care of the baby and decisions that relate to the baby. It’s a big paradigm shift in the last 10 years. We’re taking that paradigm to the next level to build a new children’s facility that will house single family rooms in the NICU so families can stay with their babies 24-7. One reason is that it’s difficult to establish breastfeeding if the mom isn’t available around the clock. Human milk is so valuable for premature babies. Even if a mother hasn’t decided to breastfeed, we ask if she can pump milk to provide for her baby. It also reduces the chances of NEC [necrotizing enterocolitis] and other intestinal problems.

Nirupama Laroia, neonatologist, Rochester General Health System.

• “Many people don’t realize how common it is for families to use a NICU or special care nursery. There are about 14,500 births a year in the Rochester area and almost 1,200 babies are admitted to the NICU at Strong, about one out of 12 babies. “ • “People think it’s a hard thing to do. It is a very high-risk environment.

Some babies turn out remarkably well.

When they do, there’s no greater reward than that. But on the other hand, we face some very difficult situations and we do lose some children, which is emotionally traumatic for both the families and for me as a provider. There are tremendous high points when a baby we were worried about comes back and is healthy.

• “In a NICU, we’re most famous

Tim Stevens, a neonatologist and the Medical Director of the Neonatal Intensive Care Unit, Golisano Children’s Hospital at URMC.

Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.

The simple fact that you’re reading this advertisement means someone else could be reading yours. Make In Good Health your advertising choice. Reach more than 100,000 readers for as little as $80 a month.

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Page 22

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

585-421-8109 • editor@GVhealthnews.com

H ealth News F. F. Thompson reaches milestone in EMR journey F.F. Thompson Hospital recently reached a milestone in the journey toward implementing a fully integrated electronic medical record (EMR) system, achieving stage 1 of the government’s meaningful use criteria.

Meaningful use refers to the set of standards defined by the Centers for Medicare and Medicaid Services to ensure healthcare facilities are using qualified EMR systems effectively, to improve the quality, safety and efficiency of patient care. Examples of meaningful use include: • Computerized physician order entry (CPOE), allowing physicians and other providers to electronically submit orders, increasing efficiency and eliminating the risk of errors related to handwriting.

• Computerized administration of medications, taking into account the patient’s medication history and lessening the possibility of adverse reactions to drugs.

• Wider and faster availability of patient records, with multiple users — whether on-site or off-site — able to view information at the same time.

Stage 1 is the first of three meaningful use stages. A planned upgrade to the core system at Thompson this fall will position the hospital, which launched its EMR system in June 2012, to begin stage 2 compliance in 2014.

“The hard work and dedication to patient safety on the part of our associates and our medical staff are what make Thompson’s achievements with regard to meaningful use possible,” said Thompson Health Senior Vice President of Finance/CFO Mark Prunoske.

Prunoske noted Thompson’s five family practices — in Canandaigua, Honeoye, Lima, Shortsville and Victor — achieved stage 1 meaningful use in 2012 and are currently pursuing stage 2.

In addition to making Thompson eligible for financial incentives from the government, Prunoske said, advancing through the meaningful use stages allows the health system to avoid financial penalties associated with noncompliance beginning in 2015.

MVP exits the New Hampshire market MVP has recently decided to withdraw from the New Hampshire marketplace in order to concentrate its focus on New York and Vermont. MVP Health Care serves more than 600,000 members across its three-state service area. Its membership is highly concentrated in Vermont and New York, with just 1 percent of its members being insured under New Hampshire policies.

MVP will continue to insure businesses based in Vermont and New York which have locations and employees in New Hampshire.

Under New Hampshire law, this withdrawal will be conducted over a period of time commencing with a 180-day notice to members. MVP will be accepting renewals of existing New

Hampshire insurance policies during this period, but it will not be offering coverage to new groups. MVP will then handle all of the remaining policy obligations on its New Hampshire insurance policies.

MVP has been proud to serve New Hampshire residents and will work with its brokers, customers, and regulators to ensure a smooth transition.

Minimally invasive surgeon joins Clifton Springs Physician JosephTalarico has joined the Clifton Springs Hospital medical staff and is now seeing patients at Clifton Springs Hospital and in his practice located in Victor. He specializes in minimally invasive surgery.

Talarico completed his undergrad degree from Case Western Reserve University.

He went on to receive his medical degree from the University of Toledo College of Medicine. Talarico Talarico completed his General Surgery internship and residency at the University of Illinois, Metropolitan Group Hospitals and fellowship in advanced laparoscopic and bariatric surgery at the Bariatric and Metabolic Institute at Cleveland Clinic.

Visiting Nurse Service appoints board members Visiting Nurse Service of Rochester and Monroe County, Inc. (VNS) recently elected two new members to its board of directors: Elisa DeJesus and Michael E. McRae. DeJesus is the vice president, family services division of Ibero American Action League Inc. and has been in the human service field for 26 years. McRae is executive vice president and chief operating officer of St. Ann’s Community and has spent 25 years in the healthcare industry. Together, St. Ann’s Community DeJesus and Visiting Nurse Service operate the Leo Center for Caring, a hospice partnership on St. Ann’s Irondequoit campus.

“Elisa is a gem,” said Vicky Hines, VNS’ president and CEO. “She has been serving on our board strategy committee for the last year and has unique McRae perspectives on how we might better serve those who are at higher risk for poor health outcomes.

Her history of strong community service leadership is a perfect match for VNS’s mission.”

Regarding McRae, the VNS president and CEO said: “The long-term November 2013 •

care industry is undergoing a sea of change, and Mike’s expertise in senior living and nursing home options will be essential to VNS as we forge our future path. We already have a terrific partnership with St. Ann’s, and Mike has always been a valuable and engaging partner in considering what is best for the patients we serve.”

Unity Health’s recruiting manager honored Dina Natale, manager of talent acquisition at Unity Health System, has been chosen as a recipient of the Rochester Business Journal’s 19th Annual 40 Under 40 Award.

The award honors 40 area professionals younger than the age of 40 who demonstrate leadership in the workplace and in the community.

Natale, a Webster resident, is currently on the board of trustees at Aquinas Natale Institute and is heavily involved with students on career development. She previously served on the St. John Fischer alumni board of directors and the Rochester Women’s Network board of directors. Natale came to Unity from Xerox in March 2012.

A luncheon and presentation of awards is scheduled for Nov. 21 at the Rochester Riverside Convention Center.

Brockport dental office completes expansion Dentist Maxwell Thaney recently announced the completion of his office expansion and renovation. The practice, a fixture in the Village of Brockport for decades, completed phase one of its renovation in the summer of 2011 and phase two this summer.

This most recent phase of renovation included adding an additional 980 square feet to the office, bringing the total square footage to approximately 2,938 square feet.

The renovation included adding new treatment rooms, expanding new patient consultation area, increasing the size of the business office, expanding the waiting room and adding a new state-of-the-art sterilization center. To date, the practice has invested approximately $190,000 in build out, equipment, fixtures and technology with the goal of improving the patient experience and providing the latest in dental technology.

The office is located at 64 North Main St., Brockport.

Thaney is originally from Chili. He graduated from The Aquinas Institute, earned his Bachelor of Science from Walsh University and graduated in 2004 from Case Western Reserve School of Dentistry with his Doctor of Dental Surgery (DDS) degree.

Thaney returned to Rochester and has been practicing in the area since 2004. Thaney and his wife, Mary, and two children are residents of Greece.

Rochester General has new chief of OB-GYN Rochester General Health System (RGHS) has named physician Eugene P. Toy to the dual positions of chief of obstetrics and gynecology, and director of gynecologic oncology.

Toy received his medical doctorate from the Mount Sinai School of Medicine, and completed a residency in obstetrics and gynecology at the University of Rochester Medical Center.

He completed a fellowship in gynecologic oncology at Yale University School of Medicine. He is board certified in obstetrics and gynecology, and in gynecologic oncolToy ogy.

Toy, who pioneered the use of robotics in gynecologic oncology surgery at Rochester General Hospital, has practiced in the Rochester area for the past 11 years. In addition to his clinical and administrative duties, he is an active researcher in scientific studies of cancer-causing proteins of the human papillomavirus.

“After an exhaustive search, we were delighted to find our new chief of OB-GYN services already within the Rochester General community,” said physician Robert Mayo, chief medical officer. “Dr. Toy’s exceptional clinical and administrative skills are matched by an intuitive patient-focused sensibility. We are extremely fortunate to have him rejoin our health system in this permanent and important role, as we continue to refine and enhance our OB/GYN, gynecologic oncology and robotic surgical offerings.”

RGHS is widely recognized as a national and regional leader in robotic surgical procedures; more than 5,000 robotic surgeries have been performed at RGH and Newark-Wayne Community Hospital, placing the health system in the top 5 percent of providers nationwide by volume. In addition, in 2012 Rochester General Hospital was named an AAGL Center of Excellence in minimally invasive gynecology, in recognition of the hospital’s unparalleled commitment and ability to consistently deliver safe, effective care.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 23

H ealth News William Kenyon, Thompson Health Board Chairman, Honored

Team at Center for Wound Care and Hyperbaric Medicine at Clifton Springs Hospital and Clinic. The center has received an award as a result of a survey showing outsdanding patient outcomes.

Clifton Spring’s Wound Care Center Recognized Clifton Springs Hospital physicians, leaders and clinicians recently gathered to celebrate the Robert A. Warriner III, M.D., Center of Excellence award, which was given to Center for Wound Care and Hyperbaric Medicine at Clifton Springs Hospital and Clinic because it has met the Center of Distinction quality standards for Healogics, Inc. This center has achieved patient satisfaction rates over 90 percent and a healing rate of greater than or equal to 91 percent in at least 30 median days, among other quality standards. The center was awarded this prestigious honor by Healogics, Inc., the nation’s largest provider of advanced wound care services. The award is named for physician Robert A. Warriner III, a pioneer in wound care and the former chief medical officer for Healogics.

The Center for Wound Care in Clifton Springs has achieved outstand-

ing patient outcomes for 24 consecutive months, including patient satisfaction over 92 percent, a 91 percent wound healing rate within 30 median days to heal, among other quality outcomes.

The Wound Care Center is a member of the Healogics Network of more than 500 centers, which provides access to benchmarking data and proven experience treating over two million chronic wounds. In the Center for Wound Healing & Hyperbaric Medicine, more than 5,000 patients in the community have received specialized treatment for chronic and non-healing wounds.

“Our Wound Care Center heals chronic wounds of patients who might otherwise experience an amputation or other life-threatening conditions. We are proud to provide this specialized and needed service to our community,” said physician Lew Zulick, the hospital’s CEO.

Healthcare Trustees of New York State (HTNYS) honored Thompson Health board of trustees chairman, William Kenyon, with its 2013 Trustee Leadership and Advocacy Award. This award recognizes effective leadership in positioning an organization to meet the challenges of today’s health care environment of reform and transformation.

“At a time when health care is changing rapidly and hospitals throughout the state are faced with new and varying challenges, William Kenyon shows that by strengthening partnerships and placing value on those who commit their lives to patients and residents, health systems can remain the trusted institutions their communities rely on,” said HTNYS Chairman John Lane, who is a trustee at Winthrop-University Hospital.

After serving on Thompson Health’s Foundation board for many years and as its chairman from 1993 to 2002, Kenyon joined

the Thompson hospital board, serving as chairman from 2002 to 2004.

In 2004, when the health system merged hospital and senior living boards, he joined the health system board, becoming its chairman in 2009. In 2012, when Thompson affiliated with the University of Rochester Medical Center (URMC), Kenyon joined the URMC board, as well as its finance and audit/risk assessment committees.

Kenyon runs a full-time law practice with his son and has served the legal community as a member and past president of the Ontario County Bar, and member of the New York State Bar Association. He is also a former Canandaigua Rotary Club member, served on the board of Literacy Volunteers of Ontario-Yates, and as president of Canandaigua Lake Pure Waters.

The award was presented at HTNYS’ 33rd Annual Trustee Conference in the Albany are on Sept. 20.

Williams Kenyon receiving an award from physician S. Jan Eberhard, vice chairman of Healthcare Trustees of New York State.

NYCC Enrollment at its Highest in a Decade Riveros

Burton

Combs

Gangemi

Cronin

St. Ann’s elects new board members St. Ann’s Community recently elected five new members to St. Ann’s of Greater Rochester Inc. boards of directors: Mauricio Riveros, vice president at The Pike Company; Craig J. Burton, vice president and team leader for First Niagara Bank; Thomas J. Combs, chief financial officer and chief operating officer of George Eastman House; Richard Gangemi, retired chief medical officer for Rochester General Health Systems; and Mark Cronin, chief executive officer of University Parker Cardiovascular Associates.

St. Ann’s Community also elected one new member to St. Ann’s Foundation, Inc. board of directors: Sandy Parker, Rochester Business Alliance President & CEO. Page 24

•

New York Chiropractic College’s admissions department recently announced a 10-year high in student registration, topping at 947 and comprising 669 students in the Doctor of Chiropractic (DC) degree program, 83 in the Master of Science in Acupuncture (MSA) or Master of Science in Acupuncture and Oriental Medicine (MSAOM), 93 working toward their Master of Science in Applied Clinical Nutrition (MSACN) and 76 matriculating in the Master of Science in Human Anatomy and Physiology Instruction (MSHAPI) program. Additionally, the college has enrolled two fellows in the Master of Science in Diagnostic Imaging and 24 students in the Bachelor of Professional Studies program.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

In September 2013, the college welcomed 215 new students that included 128 in the DC program, 28 in the MSA or MSAOM programs, 29 in the MSHAPI program, and 30 for MSACN. In an effort to maintain its highly regarded reputation for academic excellence, NYCC offers merit-based scholarship funding, awarding over $500,000 annually in presidential, international, legacy, and merit scholarship money to members of the incoming class.

Presenting impressive credentials, NYCC’s diverse student body hails from 44 states and five countries (including Canada, China, Korea, Japan and Saudi Arabia) and includes 48 percent female students, 52 percent male and 19 percent minority.

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From left are Fred Meservey, director of the Suicide Prevention Center of New York State; Ken Conner, director VISN 2 Center of Excellence in Suicide Prevention; and Bruce Nelson, director VISN 2 Behavioral Health Network Care Line.

Suicide Prevention Program at Canandaigua VA Receives Award In recognition of its outstanding work and commitment to suicide prevention for the nation’s veterans, the VISN 2 Center of Excellence for Suicide Prevention in Canandaigua recently received the Excellence in Suicide Prevention Award by the New York State Suicide Prevention Center.

Physician Ken Conner, the center’s director, accepted the award.

In 2007 the VISN 2 Center of Excellence for Suicide Prevention was created by the Department of Veterans Affairs. Committed to understanding and reducing suicides among the nation’s veterans, the center’s mission is to integrate surveillance with intervention development through research to inform the implementation of effective veteran suicide prevention strategies.

Located at the VA Medical Center in Canandaigua, the center collaborates

with the national VA suicide prevention program, other research and evaluation centers in VA, and the University of Rochester Medical Center, its academic affiliate.

The center also collaborates with the National Veterans Crisis Line, part of the National Suicide Prevention Lifeline, whereby pressing “1” allows veterans to access trained VA counselors. The Center’s activities are wide ranging and include partnering in a multisite evaluation of suicide safety planning, evaluating a marketing campaign for the National Veterans Crisis Line, playing a central role in developing a national database to identify suicide trends, conducting cutting edge research on sleep and suicide, and testing a novel motivational based intervention for veterans at risk.

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Unity Health welcomes three new providers Three physicians have recently joined the medical staff of Unity Health System.

• Lisa J. Downing will join Unity Geriatric Associates. She earned her Doctor of Medicine degree from the UCLA/Charles R. Drew University of Medicine & Science Combined Program. She completed her residency in family medicine from the University of Rochester Family Medicine Residency Program.

Downing is a member of the American Academy of Family Physicians and lives in Henrietta.

• Maria Morales will join Unity OB-GYN at West Main. She earned her Doctor of Medicine degree from

the University of Puerto Rico School of Medicine. She completed her residency in obstetrics-gynecology from the University of Puerto Rico School of Medicine. Morales is a member of the American College of Physicians.

She lives in Pittsford.

• Briani Kiseana Jackson will join Unity Family Medicine at Country Village. She earned her Doctor of Medicine degree from the SUNY Upstate Medical University in Syracuse.

She completed her residency in family medicine at University of Rochester Highland Family Medicine.

Jackson is a member of the American Academy of Family Physicians. She lives in Rochester.

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Dental Careers Offer Room for Growth

By Deborah Jeanne Sergeant

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���������� Experts: Many people who are depressed are not getting or seeking treatment

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��������� Roughly 40 percent of Americans now choose cremation. Find out how to find affordable services

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Why are so many hospitals merging?

MERGER MANIA

Page 9

Rochester’s Complementary Medicine Guru After 12 years leading the integrative medicine department of Clifton Springs Hospital, Dr. Moore opens his own practice in Pittsford

Page 12

Why Married People Diagnosed with Cancer Live Longer Than Singles

RGH’s New Ambulatory Surgery Center

����������������� ���������������� ����������������� �������� “What it taught me is it’s very important that I have a sense of measure in the activities of my life,” says Debbie Sigrist, a registered nurse and certified hospice palliative nurse who works in Rochester.

Meet Your Doctor Dave Privitera, a sport inujry doctor, talks about injury, pain.

Page 7

Page Page 185 Page14

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W

hether you’re looking for a first career or a better-fitting career, working in the dental field might be right for you. Working as a dental hygienist or dental assistant takes someone who loves helping others, scored high in classes such as science and biology, and holds a fascination with the human body.

A dental assistant aids a dentist during an exam and while he treats patients. A dental hygienist cleans teeth, treats teeth with fluoride takes X-rays and examines teeth, mouth and neck for disease.

Dental assistants and hygienists can build satisfying careers without a lengthy education or huge tuition debt.

Tuition for classes at Monroe Dental Assisting is only $3,525, for example.

And earning an associate’s degree in two years to become a dental hygienist is much less expensive than a four-year degree.

The remuneration for either of these careers is pretty good, too. The US Bureau of Labor Statistics estimates (based upon 2012 data) that the average annual salary for a dental assistant in New York state is $35,540. For dental hygienists, the annual mean salary is $68,340. The bureau’s job growth outlook from 2010 to 2020 is 38 percent, “much faster than average” for hygienists.

“We’re seeing growth,” said Marsha Bower, a professor in the dental studies program at Monroe Community College. “It’s always been a very popular program.”

The school offers certification for dental assisting, a yearlong program for a full-time student, and a dental hygiene associate’s degree, which is a two-year program.

“Anyone with an interest in oral health or dentistry would be a good candidate,” Bower said, “as would someone who has good hand-eye coordination and is academically strong in science. And absolutely has people skills. Communications, public speak-

ing and psychology are good pre-requisite courses. Anatomy, microbiology, and biology would be helpful, both in high school and college.”

Students who become dental assistants and want to move up to a dental hygienist find that some of their courses overlap and that their experience in the dental field will be helpful, though the two positions are different.

Monroe Dental Assisting in Rochester offers a block class program for dental assistant education. Taking classes from 8 a.m. to 5 p.m. every Saturday for 10 weeks, including clinical training, enables graduates to become dental assistants.

“The occupation is needed in the community,” said Cammellie Marzoup, an administrative representative of the school. “A lot of dentists need this kind of assistance.”

The only prerequisites are a high school diploma and “a willingness to do a lot of homework and study,” Marzoup said. “We have all kinds of students. Some are out of high school and some are wanting to change from another field. They’re of all ages. It’s a very good program.”

The Monroe Dental Assisting School is licensed and approved by the New York State Board of Education.

Bower admitted than obtaining full-time employment as a dental assistant or dental hygienist can be tough. Many assistants and hygienists work two part-time jobs in their field; however, it’s because of the economy that some graduates struggle to find full-time positions.

“I recommend this as a great career choice for men and women,” Bower said. “There’s a lot of room for advancement if you want to start as an assistant and want to even go on to dental school. There are other opportunities, not just clinical work, but with a bachelor’s and master’s, you could go on and teach. There are bachelor’s programs for this online, too.”

The simple fact that you’re reading this advertisement means someone else could be reading yours. Make In Good Health your advertising choice. Reach more than 100,000 readers for as little as $80 a month.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013

585-421-8109 • editor@GVhealthnews.com

SELECT FEATURE STORIES IN THE NEW ISSUE • Unemployed 55-plus people have harder time finding a job; if they get one, they often earn less • What happened to the hype about the so-called silver tsunami?

• The Invictas continues to entertain • Owner of Magnolia’s recalls the ‘surreal’ experience of hosting President Obama for lunch • Meet the volunteers at Pittsford Volunteer Ambulance • Volunteering is up • Man on steel: World renowed sculptor Albert Paley: • Henrietta residents reaching new heights • Fifty years after JFK assassination • Meet some tennis table pros • Library, home-delivery style

55 PLUS

• Group shares creative energy of quilting

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The Magazine for Active Adults November 2013 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 27

“I want a health plan that helps my son breathe easier.”

Quality health coverage. It’s Our Mission.

Fidelis Care offers quality, affordable New York Statesponsored health insurance for children and adults of all ages, and at all stages of life.

From New York State of Health: The Official Health Plan Marketplace, to Child Health Plus, Medicaid Managed Care, Medicare Advantage, Managed Long Term Care, and more, we have a program that meets your needs.

And, with our growing provider network, you can see a Fidelis Care doctor almost anywhere you go in New York State!

To learn more, call Fidelis Care today at 1-888-FIDELIS (1-888-343-3547) or visit fideliscare.org. We have a health insurance program that's right for you - and the ones you love.

Look for Fidelis Care in the Health Plan Marketplace,* with some of the most competitively priced products available! *Products not available in all counties.

For more information about Medicaid and Family Health Plus, call New York Medicaid Choice at 1-800-505-5678. For more information about Medicaid, Family Health Plus, and Child Health Plus, call New York Health Options at 1-855-693-6765.

Some children who had employer-based health insurance coverage within the past six months may be subject to a waiting period before they can enroll in Child Health Plus. This will depend on your household income and the reason your children lost employer-based coverage.

1-888-FIDELIS | fideliscare.org (1-888-343-3547) •

Page 28

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To renew your coverage each year, call 1-866-435-9521

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2013