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in good Born At Home

Births taking place outside of the traditional hospital setting increased 29 percent between 2004 and 2009

March 2012 • Issue 79

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Rochester–Genesee Valley Healthcare Newspaper

The Vegan Diet

Special Food & Nutrition Issue

No, The Doctor Is Not In Today A new study shows that shortage of physicians in Upstate New York is getting a lot worse

Why it’s growing in popularity

of the Worst Foods to Eat While Driving

Beth McLellan

Dr. Judith Baumhauer A national leader in the field of orthopedics, URMC professor and surgeon talks about her specialty

New Study: Spanking Produces Troubled Kids

FREE

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study conducted by SmartDrive Systems, a leader in fleet safety training and techniques, compiled data from more than 34 million risky driving incidents and ranks food and beverages consumed while driving as a higher distraction than talking on a mobile phone. What are the worse food you can have while driving? See story on page 19. March 2012 •

Making a difference in the lives of children with speech, language and hearing barriers In the the past 23 years, she has been instrumental in helping children push past their speech and hearing impediments.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012


Home Births Rise Nearly 30 Percent The rise in home births is attributed to personal preference, lower cost

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here’s no place like home—when it comes to giving birth. According to a report from the Centers for Disease Control and Prevention, the rate of home births in the United States has risen dramatically since 2004. Births taking place outside of the traditional hospital setting increased 29 percent between 2004 and 2009, from 0.56 percent of all births, to 0.72 percent, or almost 30,000 births. For non-Hispanic white women, the increase was most pronounced, with a 36 percent increase. The rise in home births is believed to be attributed to personal preference, although some experts point to the lower costs of giving birth at home. Highlights in the report include: • Among white women, home births increased 36 percent, from 0.80 percent in 2004 to 1.09 percent in 2009 • For white women, home births account for one in every 90 births • In other racial and ethic groups, home births are less common • Home births are more common among women aged 35 and over, and among women who have had other children. Births that occur in the home more often involve lower risk pregnancies, with fewer among teenagers or

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Take a step toward healthy eating! Subscribe now to a Community Supported Agriculture program! Receive a basket of fresh organic vegetables, fruit and herbs from the Fellenz Family Farm each week! unmarried women, and fewer preterm, low birth weight or multiple births. In 2009, home births varied from a low of 0.2 percent in Louisiana and the District of Columbia, to a high of 2 percent in Oregon and 2.6 percent in Montana. Some of the benefits of home birth are privacy, comfort and more personalized continuing care. The biggest objection to home births are concerns about safety for both the mother and the infant.

U. S. adults binge drink more frequently and consume more drinks when they do

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Binge drinking: problem bigger than previously thought ore than 38 million U.S. adults binge drink an average of four times a month and the most drinks they consume on average is eight, according to a new “Vital Signs” report form the Centers for Disease Control and Prevention. While binge drinking is more common among young adults aged 18–34, of those age 65 and older who report binge drinking, they do so more often — an average of five to six times a month. Binge drinking is more common among those with household incomes of $75,000 or more, but the largest number of drinks consumed per occasion is significantly higher among binge drinkers with household incomes of less than $25,000 — an average of eight to nine drinks, the report said. Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men on an occasion.

Eileen Spong, LSCWR, Licensed Clinical Social Worker

Drinking too much, including binge drinking, causes more than 80,000 deaths in the United States each year, making it the third leading preventable cause of death, and was responsible for more than $223.5 billion in economic costs in 2006. Over half of these deaths result from injuries that disproportionately involve young people. “Binge drinking causes a wide range of health, social and economic problems and this report confirms the problem is really widespread,” said CDC Director Thomas R. Frieden. “We need to work together to implement proven measures to reduce binge drinking at national, state and community levels.” For more information about binge drinking and how to prevent this dangerous behavior, visit the CDC’s Alcohol and Public Health website at www.cdc.gov/alcohol/index.htm. March 2012 •

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2 Coulter Rd. Clifton Springs, NY | CliftonSpringsHospital.org IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

March 5

Knee pain to be discussed at free seminar The Evarts Joint Center at Highland Hospital, part of the University of Rochester Medical Center, is sponsoring a free seminar that will address knee pain. Titled “Why does knee pain rule your life when we could fix it for good?” the event will take place at 7 p.m. March 5 at 24 State St. in Pittsford. To sign up of for more information, call 585-784-2966 or visit the website HipAndKnee.URMC.edu.

March 6

Rochester hearing loss group to sponsor programs Hearing Loss Association (HLAA) Rochester chapter will sponsor two meetings Tuesday, March 6, in the vestry room at St. Paul’s Episcopal Church, East Avenues at Westminster Road. • At 11 a.m. presenters Tom Parrish, executive director and Bonnie Butkas, director of development at Geva Theatre Center in Rochester will will explore Geva’s implementation of programs for theater-goers with disabilities, emphasizing people with hearing loss. They will comment on Geva’s community engagement and education programs • At 7 p.m. presenter: John M. Merklinger, director of the emergency communications/911 center in Rochester will cover calling for emergency help through New York relay or tty if you’re hearing-disabled. What infor-

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mation is needed from callers? We’ll also learn about Next Generation 911 and how it could assist hearing-disabled people in the future. All programs are audiolooped. Those needing a sign language interpreter should contact Linda Siple at 585-475-6712. For more information visit www.hlaa-rochester-ny.org or telephone 585-266-7890.

March 8

Free kidney screenings to mark World Kidney Day Millions of people at risk for chronic kidney disease (CKD) may be able to prevent the need for dialysis and kidney transplantation with early identification and a dedication to healthy habits. During National Kidney Month in March and in honor of World Kidney Day, March 8, the National Kidney Foundation is calling on all Americans to protect their kidneys and prevent damage by educating themselves about CKD and the proactive ways they can reduce their risk of kidney failure. The nonprofit is offering a free screening through the Kidney Early Evaluation Program (KEEP) from 10 a.m. – 4 p.m., Thursday, March 8, at Market Place Mall. Miracle Mile Drive in Rochester. KEEP is offered to those most at risk for CKD — anyone with diabetes, high blood pressure or a family history of kidney disease. Registration for the KEEP screening is recommended. Call 800-724-9421.

friends coming together to fight back against pancreatic cancer and celebrate hope for a cure. The event will take place from 5–11 p.m., Saturday, April 14, at RIT Inn & Conference Center, 5257 W. Henrietta Road. Tickets are $40 per person and must be pre-purchased by April 7 — no tickets sold at the door. Call 585-225-3088 or email luauforlustgarten@yahoo.com for mor information. Hawaiian attire is optional but fun. The evening includes dinner, music by DJ Tony courtesy of Jimmy C’s Music Machine, and exciting auction items.

March 15

New workshops for people with chronic illnesses If you are you 55 or older and living with an ongoing health condition, consider attending a Living Healthy workshop, a six-week health education program for people with any type of ongoing health condition. You will get the support, discover better nutrition/exercise choices, learn better ways to speak with your doctors and family about your health issues, and find practical ways to deal with pain and fatigue. In the two and a half hour workshops, you set your own goals and make a step-by-step plan to improve your health. And you can bring a family member or friend. The next session begins Thursday, March 15 and continues every Thursday for six weeks from 9:30 am to noon at the Al Sigl Community of Agencies, 1000 Elmwood Avenue. For more information and to reserve your seat, call Beth Kosoff at (585)-402-7840 ext. 4.

March 16

MS chapter to honor “On the Move” Award Winners

The Healthcare Alliance of the Finger Lakes, part of the Finger Lakes Workforce Investment Board, a nonprofit agency, is coordinating a career exploration day in healthcare for high school students from Ontario, Seneca, Yates and Wayne counties. The event is scheduled for March 14 and will take place in Geneva at the campus of Finger Lakes Community College. The students will be able to attend handson presentations from professional healthcare providers in the area. They will also be able to talk with employers and training providers about opportunities that exist today and in the future. For more information, contact Michael Woloson, facilitator with Healthcare Alliance of the Finger Lakes at 315-7893131.

The National Multiple Sclerosis Society (NMSS) Upstate New York Chapter has named its On the Move award recipients. Eight individuals and two groups will be honored in five categories at the chapter’s 2nd Annual On the Move Luncheon at noon on Friday, March 16, at Locust Hill Country Club, 2000 Jefferson Road, Pittsford. Two award winners were chosen for each category. The networking luncheon, held during MS Awareness Week, shines a spotlight on some of the area’s stars — people who are on the move to create a world free of MS. They are: Young Man/Woman On the Move, Brandon Yehl and Megan Kelvie Thompson; Professional On the Move, Diana Jason and Lorrie Modica; Volunteer On the Move, Karen Gallina and Thomas Ireland; Inspirational Man/ Woman On the Move, Deb Farley and Amy Aeckerle; Group On the Move, Marbles for MS/Grossman Family and MSPubCrawl/Giunta Family. For more information, contact Susan Ashline at 585-271-0805 ext. 70344, or email Susan. Ashline@NMSS.org.

April 14

Mrch 24

March 14

Healthcare career day offered in Geneva

Dinner to benefit pancreatic Spend The Day Scrapbooking cancer research Put on your floral shirts and participate in Third Annual Luau for Lustgarten Benefit Dinner to support pancreatic cancer research. Organizers say this will be a night of fun, raffles and auctions, great food, and good

Clifton Springs Hospital & Clinic Foundation will host “Croppin’ for Clifton,” a fun-filled day dedicated to scrapbooking. Grab your scrapbooking materials and join other people from 9 a.m. – 6 p.m., Saturday, March 24, in the second floor rotary and retchless

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

rooms at Clifton Springs Hospital. The cost of the crop is $30, which includes a continental breakfast, lunch, workspace and prizes. All proceeds benefit Clifton Springs Hospital & Clinic Foundation. Representatives from Creative Memories and Stampin Up will be present for assistance with your scrapbooking needs. Preregistration is required by March 19. Registration forms are available at www.CliftonSpringsHospital. org or by calling 315-462-0120.

March 28

Free diabetes management classes in Rochester Rochester Clinical Research will host six classes to teach better management of diabetes. The free classes start March 28 and continue each Wednesday through May 2. They will take place between 5:30–7 p.m. The topics include nutrition, medications, activity, diabetes control, other risk factors and foot care. Classes will be in the Laurelton Building, 500 Helendale Road, room L20. For more info and to sign up call 585-288-0890.

April 10, 17, 24

Living Alone: Survive and Thrive on Your Own Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own” is a three-part workshop offered for women who want to gain the knowhow to forge a meaningful and enriching life on their own. Participants will discover how to think differently about living alone, overcome loneliness and other emotional pitfalls, rediscover their true selves, and socialize in a couples’ world. The workshop takes place at House Content Bed & Breakfast in Mendon from 7 – 9 p.m. on three consecutive Tuesdays: April 10, 17, and 24. The workshop fee of $125 includes a Living Alone manual, empowerment exercises, and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@rochester.rr.com.

Seasonal

Organic food direct from the farm The local community supported agriculture program — or CSA — is taking subscriptions for the 2012 growing season. The farms are organic farms that obtain subscriptions from ordinary consumers, who then receive a weekly basket (more likely bag or bags) of produce for every week of the season. Local farms say this is a great way to get consumers closer to the earth and familiar with new veggies, and a method of building autonomy and resiliency into the local food supply. These CSA programs vary a great deal in cost, length of season, work requirements (if any) and available pick-up points. For a list of these farms call 585-234-8750. For more information, check with the Northeast Organic Farming Association of New York (on the Web at nofany. org) or Local Harvest (on the Web at localharvest.org).


Extended-Wear Contact Lenses Not Capturing the Market

D. Gary Groves, D.D.S. Cynthia Kelley-Groves, D.D.S.

Modern dental methods...

Y R T S I T N E D Y L fashioned FAMI care old and concern.

Despite convenience, less than 8 percent of contact lens prescriptions are extended wear

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fter more than a decade on the market, extendedwear (EW) contact lenses still haven’t caught on among patients and eye care professionals, reports the February issue of Optometry and Vision Science, official journal of the American Academy of Optometry. espite their advantages, EW contact lenses—which can be worn continuously for up to a month— account for less than 8 percent of contact lens prescriptions. The study was based on an analysis of worldwide prescribing data, led by Nathan Efron, BScOptom, of Queensland University of Technology, Australia. The researchers analyzed 14 years of data (1997 through 2010) on contact lens fittings by eye care professionals in 39 countries. They analyzed trends in EW contact lens prescribing, including patient and characteristics and fitting patterns. Extended-wear contact lenses made of an oxygen-permeable silicone hydrogel material first came on the market in the late 1990s. Modern EW lenses are designed to be left in the eye day and night for up to a month, without the need for daily removal and cleaning. The data suggested that use of EW lenses peaked in 2006, when they accounted for 12 percent of all soft contact lens prescriptions. However, the rate decreased in more recent years, falling to 7.8 percent in 2010. The rate varied between countries, ranging up to 27 percent in Norway. Certain groups of patients were more likely to receive EW lenses, including men, older patients, and those not receiving their first contact lens prescription (“refits”). Efron and coauthors speculate that EW lenses are more likely to be prescribed for older patients who are experienced with contact lenses—and perhaps better

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able to afford the higher cost of EW lenses. Some men may prefer EW lenses because of their convenience for sports participation. Most patients with EW lenses used some form of lens care solution. That suggested that they remove and store their lenses at least occasionally, rather than wearing them full time for the entire month. Nearly 30 percent of EW lens prescriptions were for conventional hydrogel lenses—possibly because they are less expensive than newer silicone hydrogel lenses designed specifically for 30-day extended wear.

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Safety Concerns Are Key Issue “Despite the obvious benefits of lifestyle convenience” associated with EW lenses, “it seems that practitioners still prefer to prescribe, and patients prefer to wear, contact lenses for daily wear,” Efron and coauthors write. The drop in EW lens prescriptions during the mid-2000s may partly reflect the introduction of silicone hydrogel lenses designed for daily use. But safety concerns are probably the key factor behind the limited acceptance of EW lenses, Efron and colleagues believe. The first EW lenses introduced to the market were associated with high complication rates. The problems were mostly eliminated by the current generation of oxygen-permeable silicone hydrogel lenses. The rate of severe keratitis with modern EW lenses is low, around 20 cases per 10,000 lens wearers per year. However, that’s higher than the 4 per 10,000 annual rate for daily contact lens wearers. Efron and coauthors conclude, “EW prescribing…is unlikely to become a mainstream lens-wearing modality until the already low risks of ocular complications can be reduced to be equivalent to that for daily wear.”

DO YOU LIVE ALONE? Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life.

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In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, reconnect with your true self, and socialize in a couples’ world. $125 fee includes manual, empowerment exercises and other helpful resources.

For more information, call (585) 624-7887 or e-mail gvoelckers@rochester.rr.com

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In Good Health is published 12 times a year by Local News, Inc. © 2012 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: Eva Briggs (M.D.), Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, Ernst Lamothe Jr., Jessica Spies, Beth Emley, Deborah Graf, Gina Roberts-Grey, Advertising: Marsha K. Preston, Donna Kimbrell 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.

Building Futures...since 1876 For Early Childhood, K-12 School and Outreach programs and services Call: 585-544-1240 (Voice/TTY) ◆ Visit: www.RSDeaf.org ◆ E-mail: info@RSDeaf.org

March 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Dr. Judith Baumhauer A national leader in the field of orthopedics, URMC professor and surgeon talks about research, breaking glass ceilings, volunteering in Vietnam and how her specialty is evolving over time Q: You’re an orthopedic surgeon specializing in the ankle and foot. Can you give me some examples of procedures you perform? A: If your ankle is arthritic and causing you pain, I can help you out. If you broke your ankle, I can fix that for you. If your ankle is so arthritic that it needs to be replaced, I can do that for you. I can realign and reconstruct foot and ankle problems. Q: What kind of research have you been involved in? A: We have a movement analysis lab that we have in collaboration with the Ithaca College’s physical therapy group. We’ve done research looking at how different types of braces influence the ability to do functional activities. We looked at over-the-counter products to see if they’re any better than the custom-made ones that cost 10, 20 times more. We’ve also done work looking at clinical outcomes, comparing different types of surgery. A great example is bunions, which have many operation choices depending on how old you are, how bad the deformity is, what the range of motion is. We looked at the outcomes of the different procedures. Q: The estimated cost savings for patients and insurers using over-thecounter products for ankle arthritis is nearly $300,000. Why is the cost for custom products so high? A: We’ve chosen to sort of challenge dogma by not going immediately to custom braces for ankle or even arthritic foot problems. In this day and age where patients are shouldering a lot of costs, I always think of it as money coming out of my pocket if I were the patient. I would be thankful if someone found a less costly alternative for me.

craftsmanship. An over-the-counter product is prefabricated. It’s like ordering a tailored suit. Some people are shaped differently and might need the custom product. Most people can probably buy the shirt that comes in the department store and be just fine. Q: You’ve shattered a few glass ceilings in your time. You were the first female president of the Eastern Orthopaedic Association, are the first female president of the American Orthopaedic Foot and Ankle Society and the first female director of the American Board of Orthopaedic Surgery. Were these positions you had to fight for or did one thing kind of lead to another? A: Nothing just happens. I think there’s a lot of hard work and credibility that I built up over the years that allowed me to navigate my way into a leadership role in a society that hadn’t had female leadership before. I think there are people who can

help you along, but you have to put in a lot of hard work in order to advance. I sort of have a personality type that uses my sense of humor and ability to get along with others. There’s always a bit of luck, but hard work and people pulling for you make the difference. Q: Tell me about your work in Asia. A: The American Orthopaedic Foot and Ankle Society has a mission to provide humanitarian service in Vietnam. They’ve been doing that for about 11 years now. I went to Vietnam for about three weeks to donate my time and efforts. The Vietnamese government allowed us to have clinics for people who otherwise would not have the money or resources to get care. They rode in however they could get to us, sometimes by horse or wagon. We had people who would meet us for these relatively large clinics and, out of those clinics, the individuals who we thought we could help with the resources we had available, we took to the operating room. I operated on more than 40 people myself. It was really interesting, culturally. The older people didn’t really seek out help. They saved it for the younger people. Most of the people were probably 35 or younger. Q: Was that a big reversal from your patient profiles back home? A: You might say that. They believe opportunities are for the young. Remember, the young take care of the old. They live in extended households, so their responsibilities include taking care of their elders. These people would come in and they did not have

Q: Ten to 20 times more expensive is pretty enormous difference. Why is it so much? A: I think it’s the Page 6

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

tiny problems. They didn’t have hammertoes and bunions. They had their foot stuck down like it was en pointe in ballet. When you queried them to ask them why that was, most of them said it was from “the high fever,” and I think most of that was polio. So something that’s eradicated in our country is still an issue there. So we’d release some tight tissues and tendons and do tendon transfers to allow them to go from a gimping sort of walking to walking like a regular person. When you finished up, you knew it was something that was going to make a big impact in their lives. A lot of people, when they come back from medical missions, say that they got more out of it than they gave. I’m certainly one of those people. It taught me to do something with nothing. Q: Can you talk about your academic role at the University of Rochester Medical Center? A: I provide mentorship and help run the orthopedic residency. I try to provide an environment that it is conducive to advancing research and teaching. Q: How is your specialty changing and evolving? A: I might be a little biased, but I think foot and ankle may be the last orthopedic frontier. It’s just sort of come into its own. While we had ankle replacements for a long time, we finally have ankle replacements that have a longevity worthy of my patients. We have an understanding of complex medical conditions like diabetes and how they affect the foot. Those kinds of things have really advanced.

Lifelines Name: Judy Baumhauer, M.D. Hometown: Kingston, NY Education: University of Vermont (medical/residency); University of Rochester Medical Center (fellowship); Springfield College (undergrad); Middlebury College (master’s) Current: She directs the University of Rochester Medical Center’s Foot and Ankle Institute, which sees about 17,000 patient visits a year. Hospital Associations: University of Rochester Medical Center, Highland Hospital Affiliations: president of the American Orthopaedic Foot and Ankle Society; president-elect of the American Board of Orthopaedic Surgery; member—American Board of Medical Specialties Family: Husband and three daughters Hobbies: Running, crafts with daughters, skiing, hiking, swimming Awards: Recently named the winner of the 26th annual Athena Award at a special luncheon at the Rochester Riverside Convention Center.


The Doctor is Not In Today

New report: Shortage of doctors in Rochester expected to worsen as more physicians retire or leave the area By Ernst Lamothe

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ith hospitals already struggling with overcrowding due to fewer resources and more people visiting emergency rooms for non-emergency conditions, a recent report showed Upstate New York is experiencing a physician shortage. The Healthcare Association of New York surveyed 109 hospitals outside New York City and found that many are dealing with a dearth in their medical staff either through doctors retiring or leaving the state. Since 52 is the average age of a practicing physician, the pace of retirement could accelerate in the coming years. In the Rochester area, 59 percent of hospitals reported they had to reduce or eliminate services, compared to a statewide average of 26 percent. In Western New York, 82 percent of hospitals stated they had to perform patient transfers because the emergency department did not have specialty coverage, compared to 66 percent statewide. Hospitals reported they had the most difficulty recruiting psychiatrists, urologists, orthopedics, internal medicine sub-specialists, obstetrics/gynecology and primary care doctors. The problem is expected to worsen as the pace of physician departures increase and hospitals are finding it difficult to recruit new doctors. “If you graduate from a Rochester university but your family is back home in southern California, barring some special circumstance, you are probably going to go back home,” said James E. Szalados, president of the Monroe County Medical Society. “We are having problems here because whether it’s because of the weather or other factors in our area, it’s very difficult to recruit and retain physicians in Upstate New York. If they don’t have a hook to stay here, they are gone.” Solutions include offering unique or inventive experiences in researching or teaching that are not available else-

where. Founded in 1821, the Monroe County Medical Society is a nonprofit professional organization whose purpose remains elevating the standard of medical education, promoting reforms and directing public opinion in regard to the problems of medicine in the county. The organization takes up issues such as physician attrition, aware that doctors are retiring early, going into teaching or leaving the profession all together. Szalados, who is currently medical director of surgical critical care and critical care telemedicine at Rochester General Hospital, views efforts to retain quality physicians as well as recruit the next generation must be a priority to the federal government. He said better legislation on medical malpractice and reimbursements is at the epicenter of the solution along with fixing the overall costs of being a physician in New York. “While physicians go in the profession because they truly want to help people, and that is even true today with me, you can’t ignore some of the factors that are making the job harder today more than ever,” said Szalados. “And that’s not even getting into the fact that everyone in the medical profession has to do more with less resources because of budget cuts so you have doctors seeing more patients and there is definitely a fatigue factor.” He said even if reforms were implemented today, it would take at least a decade to see it come to fruition and make an impact because of the time it takes to get government funding and the time for a new crop of medical students to finish their graduate and residency programs. He also understands that the average medical student debt hovers around $160,000, which is another barrier the profession must overcome. “Students are graduating with massive debt and college tuition

areas and continue to try to continues to rise so at make the field of medithe end of the day, for cine rewarding instead of some, going to medical making it full of economic school and being buried disincentives.” in that debt isn’t worth By the year 2020, it,” added Szalado. there will be a shortage of In 2010, nearly between 100,000 to 150,000 2,300 physicians left or nationwide, according to retired from hospitals, the American Medical Ascompared to 1,600 in sociation. 2009, and an estimated Making matters worse, 510 were expected to relocally various hospitals tire last year. Statewide and organizations are outside New York City, reporting an increase in 34 percent of hospitals emergency room visits, reduced or eliminated many times for injuries services during the past or conditions that do not two years, while 66 require immediate help. percent reported times Nearly half of all ER visits when doctor shortage in Upstate New York — 44 left their ER without percent — are potentially orthopedics and neurol- James E. Szalados is the avoidable, according to ogy. president of the Monroe an Excellus BlueCross “The impacts of County Medical Society. BlueShield report. That these shortages happen adds up to 700,000 visits slowly,” said Meper year. lissa Mansfield, spokesperson for the Throughout the Rochester area Healthcare Association of New York. this winter, drivers can see large “You are suddenly waiting longer to billboards urging them to call their see a surgeon or driving farther to see primary doctors before heading to the a specialist. Pretty soon critical access ER in an effort to combat unnecessary becomes an issue, and that’s a serious trips. A primary physician can’t be on problem.” call 24 hours a day, and even during The trend hit rural areas hard with normal business hours, they have limofficials saying recruitment is made ited manpower. more challenging when you add geoMedical personnel point to training graphic location, weather, and profesand recruiting programs such as the sional isolation. More than half of the rural counties Medicare Graduate Medical Education and Doctors Across New York as a in New York state reported a decrease way to stem the tide. The state-funded in one or more categories of crucially initiative helps train and place doctors needed physicians, especially in Chein underserved areas. mung, Greene, Herkimer, Seneca and “Every patient deserves a docUlster counties. “It’s a real conundrum for the rural tor,” said Daniel Sisto, president of the Healthcare Association of New York. population because doctors tend to go “We must have policies in place to moplaces where location lures them in,” tivate and recruit physicians to practice said Szalados. “We have got to find in New York state, particularly in the the best and brightest doctors and give communities that need them the most.” them incentives to working in various

March 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 7


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Flying solo and feeling great: See the glass half full!

Every one of us has been given a great gift: the cup of life. It is half full and half empty. We choose which half to focus on, at every moment.” — Marc Allen, triathlon coach. Seeing the glass as half full rather than half empty is all about focusing on what’s positive in our lives, regardless of what comes our way. It’s about being thankful, appreciative, and grateful. It’s about concentrating on our strengths rather than our weaknesses. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass half full can make all the difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative — to close our eyes to possibilities and to begrudge what life has offered up. So, how do you view the cup of life? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I’ve encountered along my journey. Do you find yourself identifying with one perspective over another? NOT BEING MARRIED HALF EMPTY “Something must be wrong with me. All my friends are married, and here I am alone and miserable.” HALF FULL “Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I’ve always wanted to travel and try

new things, and now I have that opportunity — to create a life that’s rewarding and full of new people and experiences that bring me joy.” DECISION-MAKING HALF EMPTY “Are you kidding? I don’t know enough to buy a house or a car. Those are the big decisions my husband used to make. I wouldn’t know where to begin.” HALF FULL “Finally, I get to make all my own decisions! No one’s around to secondguess my choices. I just purchased my first car all on my own: a new Honda Civic. I did the research and was completely prepared when I went to the dealership. My color choice? Cool mist metallic!” IN A CRISIS HALF EMPTY “I’m no good in a crisis. I go to pieces. When I hear bad news, I’m embarrassed to admit that I long to be taken care of and protected, as if I’m a child. Living alone makes all this worse. There’s no one to turn to.” HALF FULL “Being alone in a crisis isn’t the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family

KIDS Corner Study: Spanking Produces Troubled Kids

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dding more fuel to the controversial topic of children and spanking, two Canadian child development experts have published a new analysis warning that physical punishment poses serious risks to a child’s long-term development. In the paper, published online Feb. 6 in CMAJ, the Canadian Medical Association Journal, the authors analyzed Page 8

two decades of research and concluded that “virtually without exception, these studies found that physical punishment was associated with higher levels of aggression against parents, siblings, peers and spouses.” While studies show that spanking has declined in the United States since the 1970s, many parents still believe it’s an acceptable form of punishment.

together. I learned I could take care of myself and others, too.” DATING HALF EMPTY “I can’t imagine dating at my age. What could anyone possibly see in a middle-aged, grey-haired retiree with grandchildren?” HALF FULL “Warm friendships, even romance, can happen at any age! I met my second husband when I was 72, after my dear Larry passed away. We met in a grief support group and the rest is history. Next year, we are celebrating our fourth anniversary.” FINANCES HALF EMPTY “He took care of all the finances, the bills, the taxes, everything! I feel helpless and, honestly, I fear dying alone and penniless.” HALF FULL “I knew it wouldn’t be easy, but I knew I could do it. Getting help with my finances was one of the first things I did after my divorce. I picked up the phone and asked for help, did my homework, and now enjoy peace of mind. I think it’s the thing I’m most proud of. COOKING FOR ONE HALF EMPTY “Why would I go to any lengths to create a special meal for just myself? It hardly seems worth it. I can fill up on chips and salsa and call it a night.” HALF FULL “Creating a pleasant ‘table for one’

A 2010 University of North Carolina study revealed that nearly 80 percent of preschool children in the United States are spanked. “Our paper is a prompt to medical professionals to apply the compelling findings of research on physical punishment in their guidance of parents,” said co-author Joan Durrant, a child clinical psychologist and professor of family social sciences at the University of Manitoba in Winnipeg. In addition to the substantial evidence that children who are spanked are more aggressive, the authors note that physical punishment is linked to various mental health problems, including anxiety, depression, and drug and alcohol abuse. What’s more, recent neuroimaging studies have shown that physical punishment may alter parts of the brain that are linked to performance on IQ tests and increase vulnerability to drug or alcohol dependence, they write. Many parents are skeptical of published findings on spanking, and question whether the aggressive behavior prompts the spanking, rather than the other way around. But the paper’s co-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

makes me feel good about myself. It means I’m nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a healthy, home-cooked meal, a sense of serenity comes over me. I feel at home with my own good company.” DISCOVERING YOUR TRUE SELF HALF EMPTY “I’m a creature of habit, too old to re-invent myself. And, what’s the point anyway? There’s no one to share my life with. HALF FULL “It’s never too late. Today, I have an opportunity to fashion a life that reflects my dreams, my style, my true self. Just recently, I signed up for piano lessons, a lifelong dream of mine. My niece is also coming into her own, and I love being a role model for her. TIME ALONE HALF EMPTY “Living alone is for the birds! I just want to stay in bed and pull the covers up over my head. HALF FULL “Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities. Used wisely, the time can be an adventure in self-discovery and reveal opportunities for personal growth and fulfillment.” If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what great adventures and joy await those who focus on gratitude and embrace the wisdom of seeing the glass half full. Drink up and enjoy life! 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 April workshop, check out the Calendar of Health Events in this issue. You can also call Gwenn at (585) 624-7887, email gvoelckers@rochester.rr.com., or visit www.aloneandcontent.com.

author says researchers have been able to tease this relationship apart. “It is the case that children who are more aggressive do tend to get hit more, but the punishment does not reduce those children’s aggression; rather, it exacerbates it,” said Ron Ensom, who worked as a social worker at the Children’s Hospital of Eastern Ontario, in Ottawa, when the paper was written. “When parents of aggressive children are instructed in how to reduce their use of spanking, and they do indeed reduce it, the level of their children’s aggression declines,” Ensom said. “And when children who all have the same level of aggression when the study begins are followed over a period of years, those who are spanked tend to get more aggressive over time, while those who are not spanked tend to get less aggressive.” The authors urged physicians to help parents learn nonviolent, effective approaches to discipline, but one child psychologist in the United States said the paper fell short in providing examples of such approaches.


Food at Children’s Hospitals?

Pretty bad, study says

Officials at Golisano Children’s Hospital react to research showing that food served at children’s hospitals is unhealthy By Deborah Jeanne Sergeant

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ne would think that food offered at a children’s hospital would include a large variety of healthful options since in general children usually do not make wise food choices. However, a recently published study in Academic Pediatrics found that only 7 percent of entrees served at 14 of California’s children’s hospital cafeterias were classified as healthful. “As health professionals, we understand the connection between Glen healthy eating and good health, and our hospitals should be role models in this regard,” said Dr. Lenard Lesser, primary investigator and a physician in the Robert Wood Johnson Foundation Clinical Scholars Program in the department of family medicine, David Geffen School of Medicine at UCLA. “Unfortunately, the food in many hospitals is no better — and in some cases worse — than what you would find in a fast food restaurant.” Although all of the facilities offered low-fat or skim milk and diet soda, 81 percent sold high-calorie, sugary items near the register, which can prompt impulse purchases of these unhealthful items. Only 25 percent offered whole

wheat bread, which is largely considered more healthful than white bread. Nearly half of the hospitals did not offer low-calorie salad dressings and half lacked signs promoting healthful entrees. Since the study was conducted in July 2010, some of the surveyed hospitals have begun to improve their food. At Golisano Children’s Hospital at the University of Rochester Medical Center, Jennifer Glen, chief clinical dietitian, said that the cafeteria promotes a healthful eating program, “Be in Balance.” “It’s to create a worksite culture where healthy eating is mainstream for employees and visitors,” Glen said. Posted nutrition information at every point of sale helps visitors remain conscious of how what they eat impacts their health. The hospital also includes several healthful items on the menu. Visitors may also find nutrition information on the hospital’s website. Pricing strategies also help, since the sodas aren’t cheaper than the water and other healthful items aren’t more expensive than not-so-healthful options. The menu always includes whole wheat bread and skim milk. “The fresh salad bar is the first thing you see as you come in,” Glen said. “Signs above the salad bar show how to make a healthful salad instead of just dumping on too much dressing. “We also have a fresh fruit bar next

to the salad bar. It has cut-up fruit, nuts, yogurt and granola. And that’s available every day, all day. Nutrition has really become our focus here.” The hospital has reduced the number of coolers offering soda last year and began offering filtered water from a cooler for diners to use provided cups or their own containers. A registered dietitian is always available to help families choose wisely if they want help in selecting items for their children. A carrot symbol in the menu indicates vegetarian foods and a heart indicates items that promote heart health. Since the hospital’s main focus is helping its patients get well, young patients may order what they wish from the menu (unless they have specific dietary restrictions). “We don’t necessarily feel it’s a time to restrict kids,” Glen said. “Some have such poor appetites anyway. It’s a time to get them fed.”

Comfort foods like macaroni and cheese may help a sick or hurt child feel more at home. Golisano’s is also remodeling and improving the cafeteria. Upcoming changes include reducing the items’ sodium content and providing more meatless dishes. “We’re constantly reevaluating to make sure there are enough vegetarian, vegan and heart-healthy items,” Glen said. “We are committed to making nutrition the focus of our cafeteria.”

Oral Needs of People with Disabilities to Be Addressed Golisano Foundation and Eastman Institute partner to help people with developmental disabilities

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he B. Thomas Golisano Foundation and Eastman Institute for Oral Health at the University of Rochester Medical Center recently announced a partnership to address the unmet oral health needs of people with developmental disabilities in the Rochester area. While it is widely known that there is a critical lack of trained and experienced dental providers to work with people with developmental disabilities, no concrete data exists related to the extent and type of unmet need for the estimated 135,000 New Yorkers affected. A newly formed community taskforce of experts will, for the first time ever, engage the community and help in the process of gathering reliable data in Monroe, Livingston, Ontario, Orleans and Wayne counties to determine the areas of significant need, clarify available resources, identify gaps and barriers for meeting needs, and develop realistic and practical recommendations to improve this complex situation. The taskforce is led by Cyril Meyerowitz, director of Eastman Institute

for Oral Health, which treats hundreds of patients with developmental disabilities and is the safety net provider for underserved populations. Other members include Project Coordinator Larry Belle, representatives from EIOH and the UR Medical Center, Rochester General Hospital, Finger Lakes Developmental Disabilities Services Office, CP Rochester, community service providers, parent advocates, dentists and dental hygienists. The task force will call upon national experts including Paul Glassman, director of community oral health at the University of the Pacific School of Dentistry in California, and Steve Perlman, senior global clinical advisor and founder, Special Olympics Special Smiles and professor of pediatric dentistry at Boston University School of Dental Medicine. “Dental care is frequently cited one of the leading unmet healthcare need among individuals with neurodevelopmental disabilities,” said Ann Costello, director of the Golisano Foundation, which is funding the study. “This project is a critical first step toward

improving oral health care for these individuals in our region. We know anecdotally that this is a longstanding problem so we are rolling up our sleeves to expedite this process. We have the right people around the table who can help us determine how best to proceed to improve access and availability of are. We’ll look forward to seeing the results of the task force and how we can address their recommendations.” Several factors contribute to the poor oral health and hygiene of people with developmental disabilities, including physical limitations, complex medical conditions, behavioral issues, and increased incidence of early decay. Other challenges arise due to access, transportation, insurance, and the small number of available dentists who can accommodate the unique needs of this population. A project website — www.urmc. rochester.edu/dentistry/developmental-disabilities/ — has been established. Family members, caregivers, group home staff, medical and dental providers are encouraged to visit to

March 2012 •

provide input, and join the discussion about how to break down barriers and find ways to improve oral health care for people with developmental disabilities in our area. “It’s estimated that 80 percent of adults with developmental disabilities now live in group homes, and the issues around measuring and tracking how patients receive care have become very complex and multi-layered,” said Meyerowitz. EIOH treats hundreds of patients with developmental disabilities and is the safety net provider for underserved populations “The website will serve as a central portal for stakeholders to provide critical information, as well as find resources and share ideas.” By summertime, the task force will have formed recommendations that will be used to seek support from state and federal agencies and foundations for launching a program designed to significantly improve the oral health services available to all people with developmental disabilities.

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My Turn

By Eva Briggs

When Snakes and Spiders Attack

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y husband and I just returned from a two-week visit to Australia. The first or second question that every one asks is, “Weren’t you afraid of the poisonous snakes and spiders?” Since we spent most of our time in Brisbane, an urban area, I didn’t spend too much time worrying about critters. Not even when my daughter told me that she had killed a family of redbacked spiders (a toxic relative of the black widow) in her kitchen cabinets the week before we arrived. Now that I am safely back home to midwinter, I thought it might be interesting to write something about venomous Australian creatures. The largest family of snakes in Australia is the “Elapidae.” This group includes the majority of venomous Australian snakes. Elapids have relatively small heads and closed-canal fangs on their upper jaws. They’ve evolved to fill various environmental niches on the continent, and are more closely related to a family of sea snakes than to terrestrial snakes found on most other continents.

It’s a mystery why so many venomous snakes devolved in Australia. It turns out that it takes a lot of energy for snakes to manufacture and maintain venom. Apparently it pays off in terms of being able to subdue larger prey, requiring the snake to spend less energy hunting. Fast-acting toxins that rapidly immobilize the prey also reduce the likelihood that the snake will be injured during a hunting accident. Subduing the prey so that it can’t escape helps ensure that the snake will be successful in the harsh and arid climate of Australia. Elapid snake venom actually consists of a laundry list of chemicals that attack the prey, at least mammalian prey, with many mechanisms of action. These chemicals include neurotoxins (interfere with nerve transmission), myotoxins (damage muscles), procoagulants (cause bleeding), anticoagulants (cause clotting), hemolysins (break down blood cells), and phospholipases (digest tissues). The effects on humans include flaccid paralysis, muscle breakdown, disordered blood clotting, secondary renal damage or renal failure, heart damage

and hemorrhage into the brain. Yikes! With that arsenal of effects, it’s amazing that anyone bitten by a snake in Australia survives. Fortunately, only 25 percent of Aussie snakebites are serious enough to require emergency treatment and antivenin. But the onset of symptoms may be delayed, and if a snake in Australia bites you, you’ll need to seek emergency treatment and be observed for 18 to 24 hours. First aid measures begin with applying a compression bandage, like an ace wrap, as if you were bandaging a sprain, and splinting the limb to keep it as motionless as possible. Do not give the victim alcohol, food, or stimulants. Don’t apply a tourniquet, cut, or wash the wound. The two most common toxic spiders are the redback spider and the Sydney funnel web spider. Only the bite of the female is toxic, and usually the spider must be provoked (as by sticking your hand into its web) before it bites. Most people react only with itching, which may be severe, and is treated with ice. There is an antivenin available.

Male Sydney funnel-web spiders are the most toxic of Australian spiders. This is unusual in the spider world, as typically female spiders are more dangerous. This spider is large (the body alone is up to 4.5 cm, about 2 inches), black, and aggressive. Most bites occur in the summer or fall when the makes wander into houses in search of mates. Not every bite results in envenomation. Symptoms include pain, mouth numbness, abdominal pain, vomiting, sweating, and salivation. If bitten, apply a pressure bandage and splint the bitten limb, then seek emergency medical care. Fortunately there is an antivenin, although only 10 percent of those bitten require it, and there is usually plenty of time to administer it. Fortunately I didn’t encounter any of these dangerous fauna on my trip. I did see and photograph many golden silk orb weavers, a large and impressive species with magnificent webs visible from a distance.

Eva Briggs is a medical doctor who works at the Fulton Urgent Care operated by Oswego Hospital and at Immediate Medical Care of CNY in Manlius.

Looking for a Good Gym? By Jessica Spies

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s bathing suits replace winter coats at department stores, you might be wondering how you’re going to squeeze into that itsy bitsy teenie weenie yellow polka-dot bikini in June. Maybe you have the healthy eating under control and are looking to step up the activity. Or maybe you’re looking to tone but don’t know where to turn. “There’s no cookie cutter for it,” said Mary Kay Polston, vice president of marketing at YMCA of Greater Rochester. “It’s going to be different for everyone.” Before you work out, you should meet with a professional to create a plan that’s going to work for you, Polston said. If you love to swim, you could work that in your program. If you hate the treadmill, you could leave that out of your program. Zumba, as well as more intense fitness classes like “body pump,” and those that involve more of a “total body workout” are popular at the Y, along with sports-related exercise, like pickleball, which is more popular with older adults. “We’re starting to see small groups form for their first 5K,” Polston said. “That’s a goal we tend to see.” Polston notes that before you start an exercise program, you should consult with your doctor, and to see what exercise is appropriate with a medical condition “especially if it’s been a long time since you’ve worked out.” Page 10

Six Aspects Your Should Consider Before Starting a Program Polston provides the following tips for starting a new workout program: 1. Find a motivation and keep it in sight. That motivation could be bathing suit season or an upcoming reunion. 2. Write it down and really track your goal. Also make note of how you’re going to get there. 3. Make short-term goals. It takes baby steps to make the change. Set something that’s achievable. Setting a goal of working out five times a week when you haven’t worked out in some time is unrealistic. 4. Make changes in your every day life like taking the stairs instead of an elevator, parking farther away from a store or trying something new every week. A goal could be: Try to get in a half hour of activity three times a week or to eat more fruits and vegetables. You’re not trying to do it all at once. 5. Set a long-term goal. Figure out what’s most important to you. Maybe you want to fit into your skinny jeans or want to be able to play with your kids without tiring. 6. Get a good support system. It helps you stay on track and keeps you accountable.

Finding a Gym Peggy Penders, the public relations marketing director for the Upstate New York Better Business Bureau, said that

navigating a slew of gyms can be a tricky process. Before you sign on with a gym, make sure you have a list of questions as to what the gym offers and what you’re looking for. It’s a given that most gyms are going to have a sign-up special, but look for the “fine print details” in these specials, Penders said. “Look at what you’re trying to accomplish,” Penders said. “If you’re interested in a short term gym membership, stick with a short-term gym membership.” Think about the location and if it is convenient for you to stop there after work or to get there easily from home. Prior to going to a gym, “make your decision before you get in the door,” Penders said. Once you have your hands on a contract, don’t rush to sign it. First read all the fine print and look it over as if you were using a magnifying glass, Penders said. Look for information included in the contract like if your membership is going to renew automatically or how you can get out of a contract if needed. Some gym membership contracts won’t let you get out of a contract unless you relocate more than 100 miles from the gym — a distance that most wouldn’t want to travel regularly, Penders said. Also, check in the contract what happens if something were to ever happen to your health. Ask them what would happen if

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

they were to go out of business before your contract ends. Gym contracts can sometimes be a bit like high pressure sales in that “you feel like the deal today is not going to be here tomorrow” and the “pressure of the experience” that you would have from joining a gym including health and wellness. A good deal will still be available tomorrow, Penders said, and you should bring the contract home with you to read through the whole thing. When considering a contract, focus on your fitness goals but also your financial goals. If you’re already a member of a gym, but your contract is ending soon, take a moment to refocus on your fitness and financial goals, Penders said. Is your gym environment clean and welcoming? Is there a professional trainer on staff? The Better Business Bureau offers information about local gyms on their website at www.bbb.org.


Food & Nutrition

Sweet, Sweet Stevia Why this new sweetener has generated so much buzz By Deborah Jeanne Sergeant

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s a society, we Americans love our sweets. Sugar or high fructose corn syrup are the sweetening agents of choice for many manufacturers of sweetened baked goods, drinks and candy; however, both of these are high in calories and offer no nutrients. Many low- or no-calorie sugar substitutes have been approved by the FDA as food additives. These include aspartame, sucralose, neotame, acesulfame potassium, and saccharin. Stevia (STEVE-eeuh) is one of the substitutes more recently gaining use in the United States. Since stevia has Tourtellotte been in use for centuries in other countries and U.S.-based studies have shown it to have no side effects, the FDA gave it a “generally recognized as safe” status and approved it as a food additive in 2008. “Clinical trials have not shown any significant side effects but Stevia has been reported to sometimes cause abdominal fullness and nausea; some people have reported headache, dizziness, numbness and muscle aches,” said Katherine Ippolito, registered dietitian and clinical nutrition special-

ist at Golisano Children’s Hospital at Strong Children’s Diabetes Center. “Stevia might lower blood sugar, and in theory may lower blood sugar when taken with herbs and supplements that people take to lower blood sugar,” she added. “It may have diuretic activity so could lead to increased levels of some medications in the blood.” Known scientifically as Stevia rebaudiana, stevia, in its refined form, can be 200 to 300 times Paige sweeter than sugar at the same volume. Its leaves are so sweet the shrub is also called “sweetleaf.” A member of the chrysanthemum family, stevia is found in numerous varieties indigenous to Paraguay and Brazil. In America, stevia is commonly known by several brand names. Truvia was created by Coca-Cola and Cargill. As of August 2011, about 20 products made by Coca-Cola worldwide use Truvia as their sweetener. PureVia, created by Whole Earth Sweetener Company, is used by Pepsico in beverages such as Trop50, a reduced-calorie juice drink. Wisdom Natural Brands makes SweetLeaf Stevia as a tabletop sweetener and ingre-

Unique Weight Loss Program in Rochester New Genesis Center for Medical Weight Loss says patients in the program typically lose 25-50 pounds in the first 12 weeks

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t New Genesis Center for Medical Weight Loss, the New Year has brought in a surge of new patients looking for medical help losing weight. The NutriMed® Weight Loss Program at New Genesis is unique to Rochester in that it is medically prescribed and supervised. After a medical evaluation, which includes a physical exam, a comprehensive laboratory evaluation and an electrocardiogram the patients are given a very low calorie diet (VLCD) which strictly follows the guidelines of the American Acad-

emy of Bariatric Medicine for effectiveness and safety. Most patients choose to take a prescription appetite suppressant to aid in weight loss. Patients typically lose 25-50 pounds in the first 12 weeks of the program by using the NutriMed® Meal Replacements. The NutriMed® Program has been operating at physician’s offices for 35 years but New Genesis has introduced it to Upstate New York; every aspect of the program is based on scientific research and on evidence based medicine. Each week patients meet with Jeff

dient for manufacturers. For diabetics, dieters or anyone looking for a sweetener that isn’t sugar or chemically-based, the rising popularity of stevia is a boon. “It’s safe for diabetics because there are no carbohydrates so it won’t impact blood sugar,” said Myrna Paige, registered dietitian who is part of the endocrine program at University of Rochester Medical Center. “It can help you increase the variety of foods you eat.” However, Ippolito cautioned, “For people with diabetes, some studies have shown that stevia might lower after-meal blood sugar but other studies did not show any effect on blood sugar in people with or without diabetes.” Unlike some sugar substitutes, stevia doesn’t give a strong aftertaste. Some liken it to a mild licorice taste. “For all of my patients who use a lot of artificial sweeteners, I like them to use a variety because we don’t know everything,” Paige said. “Anytime you can increase the variety [of sugar substitutes] it’s a positive.” Some sugar substitutes do not taste good as a tabletop sweetener; however, for most people, this isn’t the case with stevia. “Because stevia is a concentrated sugar substitute it cannot be used in a one-to-one ratio to replace sugar,” said Amanda Tourtellotte, registered dietitian with Finger Lakes Health. “Each

Leathersich, a physician assistant with 18 years’ experience. During the weekly weigh-ins and coaching sessions patients receive educational modules in nutrition, exercise and behavior modification. They also receive one-on-one behavioral coaching to address specific needs that arise. The NurtiMed® Program utilizes high-protein low-carbohydrate meal replacement shakes and bars during the weight loss phase and as part of the maintaining of weight loss. Patients need to understand that our culture is at war with their health. The message that is constantly being broadcast is to eat big, eat fast and eat conveniently. At New Genesis, meal replacements are viewed as a weapon to arm dieters with to better equip them to fight that war. With obesity being an epidemic in the US affecting 34 percent of the population there is not a primary care provider who does not have patients who need to lose weight. Such comorbidities as diabetes, hypertension, heart disease and high cholesterol can all be greatly diminished by weight loss. The challenge that many physicians have is that research has shown that for patients to lose weight and keep it off over time they not only need to “follow a diet” but behavior modification coaching, education and support. The

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sugar substitute may have a different after taste so we recommend that our patients try a few and find the flavor that suits them best.” People new to stevia will also need to use it more sparingly than what they might think. “Don’t go overboard with any sweetener,” Paige said. “It’s much sweeter than sugar. I tell people to start with less and add a little. Each company has versions as far as sugarto-stevia. But if I use the whole packet, my oatmeal is way too sweet. I use half a packet. It depends upon the brand. I tell people to try different brands.” Some sugar substitutes break down when used in baked goods. Stevia may be baked up to 400 degrees. It will not caramelize or crystalize like sugar, so desserts like crème brulee or meringue won’t work with stevia. Although stevia is derived from a plant, it is processed to achieve the form that can be used as a food sweetener. Its source is natural, not chemical-based, but it has been processed. In addition to its use as an ingredient, it’s available in liquid or powdered form. Before consuming stevia, consult with your doctor. “People should make sure there’s no drug interaction,” Paige said. “Some people have allergies to ragweed or chrysanthmums, which is the family it comes from.”

Jeff Leathersich is a physician assistant with 18 years’ experience. He coordinates the NutriMed® Weight Loss Program at New Genesis in Rochester. average primary care office is simply not set up to provide all of this. Most referrals from to New Genesis come from primary care physicians. For more information, call 585-3817280 or visit www.newgenesis.com. New Genesis is located at 3300 Monroe Ave., Suite 345, Rochester.

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Food & Nutrition Cooking at Home Helps Manage Diabetes Learning to cook from scratch can help diabetics control their carbohydrate intake and understand food better when they dine out

By Deborah Jeanne Sergeant

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ype 2 diabetics need to watch what they eat and when to help control their blood sugar. But if you’re not handy in the kitchen, that can make it more difficult. Home cooks are more accustomed to what goes into recipes and that makes dining out easier. Eating out can be a minefield. “People don’t realize everything that’s in the food they get in a restaurant,” said Natalie Johnstone, registered dietitian and certified diabetes educator with Rochester General Hospital’s Endocrine Care and Diabetes Resource Center. “Fat makes food taste good, so [restaurant food] is higher in fat and sodium. Portion sizes have grown tremendously. I’ve seen salads listed at 1,400 calories. It can be very tricky and deceptive.” Cooking at home from scratch can help. But sometimes meal helpers and other prepackaged shortcuts can sneak more carbohydrates and unhealthful elements into the diet than people are aware. “Many prepared foods are high in fat, sugar and salt so they remain shelf stable and still taste ‘good’ when you buy them,” said Amanda Tourtellotte, clinical dietitian for Finger Lakes Health’s Diabetes Education and Cardiac Rehabilitation programs. Although convenient, partially made food can be nearly as bad or worse than restaurant foods because of the additives and stabilizers; however, since they have labels, it can be

easier to track nutrition as long as you eat only the amount the manufacturer specified. This is especially important because foods like noodle and sauce side dishes “may be higher in sodium and not made of whole grain products,” Johnstone said. “The key is to be aware of where the carbs are,” she added. “Those will raise the blood sugar. Be aware of the portion size.” Learning to cook from scratch can help diabetics control their carbohydrate intake and understand food better when they dine out. “People with diabetes need to learn how to cook their own meals if those they live with are not interested in eating a normal healthy diet,” said Myrna Paige, registered dietitian and certified diabetes educator with University of Rochester Medical Center’s Endocrine Division. “The diabetic diet is a diet everyone can and should follow. When you do the cooking you know exactly what you are eating and can therefore figure out the grams of carbohydrate in your meal.” Amy L. Stacy, registered dietitian and certified diabetes educator with Lakeside Wellness Program at Lakeside Health System, agrees. “When you make your own meals you know exactly what is going into the recipe and you can manipulate the amounts of sugar, fat and salt,” she said. “It is always good to take control of this area of your life. It will result in

better control of your blood sugars.” It’s also helpful for type-2 diabetics to test their blood sugar before and after meals to help them determine how a particular dish or meal impacts their blood sugar. Investing in a few diabetic cookbooks can make it easier to prepare low-carb meals at home that the whole family can enjoy. Stacy likes the “Quick and Healthy” and “Month of Meals” series by the American Diabetes Association. “Both are very easy to follow and they have simple ingredients,” Stacy said. “Both cookbooks have pictures and easy-to-read instructions as well as a summary of the number of calories and carbohydrates in each serving. “The “Month of Meals” cookbook provides you with an entire 30 days of recipes without boring repeats. Another good one is the “Four Ingredient Diabetes Cookbook” (2007, American Diabetes Association). For computer savvy people, the Internet is also a great source for recipe ideas.” The recipes “Diabetic Meals in 30 Minutes or Less” by Robyn Webb “are also low in fat and sodium,” said Sharon Spear, registered dietitian and certified diabetes educator at Unity Diabetes Center. She also likes “Diabetic Cooking” (www.diabeticcooking.com) for its vast array of recipes because “they are free, the ingredient list is short, and they usually change according to season,”

she said. Johnstone said that diabetics can use any cookbook, not just “diabetic” ones “as long as it has nutrition information,” she said. “Most of the low calorie, light or natural cooking or clean eating magazines and books are great resources.” She subscribes to “Clean Eating” (cleaneatingmag.com). “The thing I like about it is [it features] quick, easy recipes with natural ingredients,” she said. “A lot people shy away from cooking from scratch because it takes time to prepare but it doesn’t have to.” Paige thinks that “Quick and Healthy Volume II” (2009, Brenda J. Ponichtera) is a great cookbook for diabetics because “everyone needs ‘quick’ these days,” she said. She also likes “Biggest Book of Diabetic Recipes” (2006, Better Homes and Gardens). “Each recipe includes easy-to-read grams of carbohydrate per serving,” Paige said. “The book is spiral bound and can open flat for easy reading.” “The New Family Cookbook for People with Diabetes” (2007, American Diabetes Association and the American Dietetic Association) “offers the nutrition facts in a label format as well as current diabetic exchange information,” Paige said. “Betty Crocker’s Diabetes Cookbook” (2003) features “brief helpful advice or ideas from an endocrinologist from the International Diabetes Center or has Betty’s Success tips,” Paige said. “The book includes an ‘Ask the Dietitian’ section.” The inclusion of menus can also help people who have seldom cooked at home before. “Diabetic Living Quick and Easy Meals” (2011, Better Homes and Gardens) gives home cooks nutrition facts per serving. Grams of carbohydrate per serving are highlighted next to each recipe, which is why Paige likes this one. She also turns to “Diabetes Meal Planning Made Easy,” 4th Edition (Hope Warshaw) as a resource to recommend to patients. “It’s very good for those newly diagnosed,” she said. EDITOR’S NOTE: See related story — Most Diabetic Patients in NYS Not Receiving Necessary Tests — in this issue.

Breads top list of saltiest foods M

ost of the salt in American diets doesn’t come from the salt shaker; it comes from the foods they purchase and restaurant meals. Surprisingly, bread and rolls are the No.1 source of salt in Americans’ diet, accounting for more than twice as much sodium as potato chips. According to a report released in February by the Centers for Disease Control and Prevention, the salty junk foods you would expect to see on the top of the list, such as chips, pretzels Page 12

and popcorn, occupy the No. 10

spot. The CDC said that bread and rolls are not really saltier than many other foods, but people tend to eat a lot of them. According to the CDC, breads and rolls account for about 7 percent of the salt the average American eats daily. Taking the No. 2 spot were cold cuts and cured meats, followed by pizza; fresh and processed poultry; soups; fast food hamburgers and sandwiches; and cheese. Rounding out the list, accounting

for about 3 percent each, are spaghetti and other pasta dishes; meatloaf and other meat dishes, and snacks such as potato chips and pretzels. Dietary recommendations for most Americans are no more than 2,300 milligrams of sodium per day, which is the equivalent to about a teaspoon of salt. Certain people, such as those with high blood pressure, should consume even less. The average sodium intake in the United States is around 3,000 milligrams. Just one in 10 Americans meet the teaspoon guideline. Excess salt intake has been linked

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

to a host of health problems. Salt reduction has become a recent focus of public health campaigns, and some major food makers have taken steps or announced plans to gradually reduce the amount of sodium in their products. Health experts say that consumers should read labels carefully and look at sodium content. Preparing food at home and eating more fruits and vegetables are other ways to reduce sodium intake.


SmartBites

By Anne Palumbo

The skinny on healthy eating

Helpful tips

Praise for the Potato

O

h, the poor potato. It gets such a bad rap. Long feared by many as unhealthy — too starchy! too caloric! — it has fallen by the plate-side. I can’t tell you how many times I’ve tossed perfectly good potatoes down the drain after a dinner party. But I won’t give up on the humble spud and here’s why: potatoes are good for you! Sure, they have more carbs than your average vegetable, but the carbs in potatoes are the “good” ones that nature makes, the ones with heart-healthy fiber and other valuable nutrients. Good carbs — vs. the “bad” ones found in refined foods that zip through us lickety-split — are harder to digest and thus get absorbed more slowly into our systems. The benefits? Our blood sugar levels remain more stable, we feel fuller longer, and our energy is longer lasting. Potatoes are impressively high in vitamin C, with one medium potato providing more than a fourth of our daily needs. Although no studies confirm that vitamin C prevents colds, it

spoon of butter, however, and you not only add about 100 calories, but you add fat and cholesterol, too.

may shorten the length of a cold. Beyond its immune-boosting capabilities, vitamin C helps the body maintain healthy tissues and is essential for healing wounds. This tasty tuber is also an excellent source of potassium, especially when consumed with the skin. A powerhouse mineral, potassium is crucial for key body functions and also helps to control blood pressure. According to findings from a recent study published in the Archives of Internal Medicine, increasing your potassium intake may be the key to a longer life. Still worried about the calories? Potatoes themselves are not all that caloric, averaging around 130 calories per spud. What’s more, they’re sodium-, fat- and cholesterol-free. Add a table-

Select firm potatoes (individually, when possible) that do not have sprouts or green coloration, since this color indicates that they may contain high levels of a toxin, solanine, which can cause nausea, headaches and other health problems. Store potatoes in a cool, dark place, away from onions, as the gases that they each emit will cause mutual degradation. Don’t refrigerate raw potatoes because it turns the starch to sugar and ruins the flavor. Stored properly, most potatoes last about a month.

Healthy Oven-Roasted “Fries” Adapted from Emeril Lagasse 2 large potatoes, scrubbed (recommend red- or yellow-skinned potatoes) 1 to 2 teaspoons vegetable oil 1 large egg white Seasoning blend of ¼ teaspoon each: salt, pepper, garlic powder, thyme, paprika Adjust oven rack to lower middle position; preheat oven to 425 degrees. Line a large baking sheet with parchment paper, then grease with the veg-

March 2012 •

etable oil. Scrub and dry potatoes, leaving skin on. Slice lengthwise into ½-inch thick slices, then turn each slice flat and slice again lengthwise into even fries, ½-inch thick. In a medium mixing bowl, whisk the egg white to a light froth and then mix in seasoning blend (or seasonings of choice). Add the potatoes and toss to coat evenly. Spread the coated potatoes on the prepared baking sheet, not touching. Bake for 15 minutes. With a spatula, turn the fries over and continue baking for another 10 minutes or until they are brown and crispy. Season with additional salt and pepper to taste. Serve warm. 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.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Rochester couple talks about a diet regimen they embraced more than 20 years ago By Beth Emley

T

ed Barnett jokes that he “got religion” over 20 years ago when he became a vegan and he’s not shy about spreading the gospel of the benefits of eating a plant-based diet. Barnett defines a vegetarian as one who eats eggs and dairy products but no meat while a vegan is one with a stricter diet of no animal products including dairy, eggs, fish, poultry, meat or honey. Barnett and his wife, Carol, are the leaders of the Rochester Area Vegetarian Society. They just ended teaching a course about the benefits of a plantbased diet at the Jewish Community Center (JCC) in Brighton. During an interview, Barnett pulled out his laptop computer and showed some sobering examples about what eating meat has done to Americans and how society has encouraged unhealthy behaviors. “Why Does a Salad Cost More than a Big Mac?” read one of Barnett’s examples on his computer screen. “That’s because of government subsidies,” Barnett explained. “Meat is subsidized more than fruit and vegetables.” Then he moved on to another screen that shows a map of the United States in 1985, highlighting obesity rates among the various states. During that year, only a few states were colored in to show obesity rates. Barnett clicked his computer’s mouse a few times to show screens with obesity rates increasing and then stopped on a current-day map that showed some

level of obesity in every state. Barnett said a plant-based diet is endorsed by experts, including physician Neal Barnard, who backs it in his book, “21-Day Weight Loss Kickstart.” Barnett said he thinks people used to eating meat all their lives will think being vegan and living a healthy lifestyle is too hard. Not so, he said. He can sum up his advice: simply “Eat whole foods and go outside and run around,” he said. The Barnetts, who live in the town of Rush and have been married 25 years, said they have tried to follow that regimen since they embraced the vegan lifestyle about 20 years ago. They’ve never looked back. Before she became vegan, Carol, 60, a former English professor and mother of three, said she had always been health-conscious. But after reading up on the subject — including a mailing from PETA (People for the Ethical Treatment of Animals), she became convinced of the choice to be vegan. The mailing talked about cows that were too sick to be taken to slaughter, Carol said. “I didn’t want to support it,” she said, referring to the killing of cows for meat. Ted, 57, who works as a diagnostic and interventional radiologist for Borg and Ide Imaging at Unity Hospital, said his conversion to vegan came as a result of a Sierra Club presentation he attended which talked about how being vegan is better for the environment.

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Carol and Ted Barnett have adopted a vegan style diet more than 20 years ago. (Researchers say animal production, especially for intensive agriculture, is environmentally unsustainable and animals create pollution and use up resources such as fossil fuels, water and land.) “That was my ‘get religion moment,’” said Ted of the Sierra Club presentation. The Barnetts said they both closely follow the vegan diet even though Ted says when he first started it, he thought he would let himself have lobster four times a year. “I think I only ended up having it about twice after that,” he said. They said being vegan is a choice they feel good about. Although they closely follow the regimen, Carol said others can phase it into their lives by trying it a meal at a time. “If you are 80-90 percent, it’s OK,” she said. “You always have that freedom of choice.” Carol said being a vegan can be time-consuming when one is making

the transition and learning how to use new products, but in time it gets easier. And, she said, one can be versatile with meals. “I do love to cook,” she said. “And I have found you can work with whatever style of cooking you already have.” For example, those who like gourmet meals can make them vegan. Those who like convenience foods, such as frozen meals or salads, can find what they are looking for at places like Lori’s Natural Foods in Henrietta or any Wegmans. She did note that convenience foods may be more costly, however. She said she would make a pitch for the middle ground, in terms of preparation time and cost. The bottom line, Carol said, is “if you are not interested in food preparation (even if you’re not a vegan), then you can’t be healthy,” she said. Continued on the next page

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Food & Nutrition Following a Vegan Diet Continued from previous page The Barnetts said a typical dinner for them often consists of a big salad with lots of vegetables. Over the years, Carol said she has collected many recipes. Those who eat meat may plan out their week by saying they will have chicken on Monday, fish on Tuesday, and meatloaf on Wednesday. Carol said those who are vegan can do similar planning, only with different types of meals. She said a typical week in the life of a vegan might consist of stir fry, curry, pasta, soup or chili. “It doesn’t have to be harder than it was before you were vegan,” Carol said. The Barnetts’ lifestyle has rubbed off on their three adult children, who are all vegans, they said. The couple said they find camaraderie and support through their

involvement with the Rochester Area Vegetarian Society. The Barnetts have been the group’s co-coordinators since 1995. “We’re not the revolutionaries who started it but we’re the bureaucrats who keep it going,” Ted joked. The group — which is open to vegetarians and others just interested in learning more about the lifestyle — has about 150 members and usually attracts about 50 people to their meetings. “We’re amazed by how many people who show up,” Carol said. Their January meeting was scheduled to feature a panel of organic farmers and community-supported agriculture representatives discussing where to get organic vegetables. In November, the group hosted Cornell professor T. Colin Campbell, talking about the benefits of

a plant-based diet. In September, the Vegetarian Society and the Animal Rights Advocates of Upstate New York hosted a free vegan food-tasting at the first Greentopia Festival in downtown Rochester. “We’re one of the more successful [vegetarian] organizations in the country,” said Ted, who attributed the group’s longevity to its consistency. He said some other vegetarian groups tend to just gather for sporadic events. The Rochester group meets every month at the Brighton Town Lodge for a dinner and program. They also publish a newsletter four times a year. The Barnetts just completed teaching a six-week course, “A PlantBased Diet—Eating for Happiness and Health.” The course, which ended Feb. 27, was prefaced on Jan. 16 with a showing of the movie, “Forks Over Knives” which profiles the work of T.

Colin Campbell, and Caldwell Esselstyn, scientists whose research provides much of the foundation for the course. Course topics are “How Not to Prevent Disease: A Brief History of Dietary Recommendations in the U.S.;” “ The Major Killers: Cancer, Heart Disease and Diabetes;” “ Problems with Dairy, Eggs, and Fish and Do I Need to Eat Dairy to Prevent Osteoporosis?;” “ Ages and Stages: Cradle to Grave Nutritional Adequacy and Abundance;” “ Debunking Fad Diets (and responding to other challenges from the mainstream)” and “Widening Our View; and Two Ends of the Spectrum: Super-Healthy and Indulging a Bit (for yourself and your friends.)” Each of the classes will also include a food demonstration. Although their course ended in February, the Barnetts said those interested could still participate and can call the JCC at 461-2000 to register. The couple said they may repeat the course in the future. The Barnetts said they welcome questions from those interested in the vegan lifestyle. They can be contacted via email at drveggie@aol.com or mrsvegan@aol.com or call the Vegetarian Society at 234-8750.

The following recipes have been provided by Ted Barnett and his wife Carol, leaders of the Rochester Area Vegetarian Society.

This dish is Sesame Noodles with veggies (also go to vegmondays.org for the recipe). Garnish the top with shredded carrot, chopped parsley, and shredded Misato Rose radish.

This is Easy Veggie Pasta Bake (in the lower left sector of the plate) and the recipe is available at vegmondays.org. It is a lasagna-type dish using tofu blended with herbs and other ingredients in the food processor, mixed with cooked pasta and all baked with tomato sauce on top. Add Nate’s Meatless Meatballs on top and serve it with Fake Fake, a homemade cheese substitute. Also on the plate are cauliflower, green beans, and beets.

Page 16

These are vegan pinwheels. Original recipe by Rochester Area Vegetarian Society member Wendy Gilmore. Start with a large burrito, spread with Tofutti vegan cream cheese, place roasted red pepper along the midline (pat it dry with paper towel first), throw on a handful of arugula or baby spinach, roll up and cut into narrow cross sections.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012


Food & Nutrition Healthful Vegan Eating Even some Wegmans stores now offer vegan and vegetarian food bars By Deborah Jeanne Sergeant

A

vegan diet is all plant-based. There is no cholesterol and it is very low in fat, especially saturated fat. Vegetarians avoid meat and meatbased foods. Vegans avoid all animalbased foods. In response to public health concerns, more companies have added vegan foods to their product list or menus, including Wegmans. Beyond the vegetarian and vegan offerings on the shelves, the regional grocery store chain added a ready-to-eat vegetarian and vegan food bar in its Pittsford store last summer and found it was so successful that Wegmans has since added one in each of its “hub” stores in each division. “If customer feedback continues to be positive, we will look to introduce vegetarian bars in more of our stores,” said Trish Kazacos, dietitian and Wegmans corporate nutritionist. The vegetarian bars offer both vegan and vegetarian hot and cold dishes, including almond crusted tempeh, vanilla glazed carrots, and citrus carrot & chickpea salad to go or to eat at the Market Café seating area. In the Rochester area, Wegmans’ vegetarian/vegan bar is also available in Canandaigua. Natural Oasis, a wellness center in Rochester, offers a vegan buffet. Owner Solomon Kebede said that since vegan eating is a “growing trend,” his location’s vegan bar has become a popular feature of Natural Oasis. “It’s important on many levels,” Kebede said of the vegan bar. “It offers people a choice here. It’s also what I believe. We also believe in local foods.”

Challenges to Eating Right Eating local, fresh foods is part of eating healthfully as a vegan and avoiding eating as a “junk food vegan,” a phrase coined to describe vegans who, out of busy lifestyles or culinary ineptitude, rely upon convenience foods that are technically vegan but don’t offer a full range of nutrients. These foods include microwave popcorn, candy, packaged vegan snack foods and soda pop. But vegans who eat right still have a few dietary challenges. “A vegan diet can provide all the essential nutrients for health and fitness at any age or calorie requirement by including a wide variety of food sources—fresh or dried fruits, colorful vegetables, nuts, seeds, legumes, whole grains, and grain products,” said Kathryn Pridey, registered dietitian with Rochester General Hospital. The trouble is that some nutrients are hard to obtain from only plantbased sources. Joanna Lipp, a dietitian with Wilmot Cancer Center at the University of Rochester Medical Center, cautions

Wegmans has added a ready-to-eat vegetarian and vegan food bar in its Pittsford store last summer and found it was so successful that it has since added one in each of its “hub” stores.

vegans to make sure they eat foods fortified with vitamin B-12 or take a supplement. “There is no vegan source of vitamin B-12,” she said. “That is probably the primary issue. There is no vegan source of long chain omega 3 fatty acids. Some people say you can get that from algae, but that’s a supplement not a food source.” Beef is rich in iron. To make sure they get enough iron, vegans must find plant-based sources. Pridey recommends that vegans eat dried fruits, iron-fortified breads and cereals, wheat germ, blackstrap molasses, nutritional yeast, tofu, dried beans, dark green vegetables such as spinach, beet and mustard greens, or watercress, and seeds, such as pumpkin and sesame. Getting too much iron isn’t good for the body, either. Factors such as menstruation or post-menopause iron loss can make it hard to know if a woman has enough iron. “A deficiency in [iron] should be diagnosed by a doctor and can also be improved by increasing vitamin C-rich foods and legumes, not drinking tea with meals and cooking in cast iron skillets,” said Amy Alquist, registered dietitian with Clifton Springs Hospital. Though many non-vegans ask about protein, whole grains and beans are good sources of protein in place of meat, eggs and dairy. “Most starchy beans and legumes like lentils, garbanzo beans and navy are 18 to 27 percent protein,” Lipp said. “If you choose wisely, you can get a fair amount of protein from a vegan diet unless you have to limit the volume of food you’re eating. You can certainly

meet your protein requirements with a vegan diet.” Tourtellotte recommends keeping on hand “black beans or kidney beans as a great source of carbohydrates and protein and are inexpensive,” she said. Carol Barnett, one of the leaders at Rochester Area Vegetarian Society, likes using natural nut butters as a protein source. Since vegans eschew diary, she and husband Ted must turn to other foods as a source of calcium. “You can get a fair amount of calcium from broccoli and leafy greens,” Lipp said. “Some have almost as much absorbable calcium as a cup of milk.” The body generates its own vitamin D when exposed to sunlight but this can be difficult during the wintertime in the northeast. Many people depend upon fortified milk, but that’s not an option for vegans. “There’s not a lot of food sources of D in food,” Lipp said. Some varieties of mushrooms that are exposed to light during the growing process offer vitamin D. Some breakfast cereals and soy beverages are fortified with vitamin D. “There is a lot of research that says that eating a plant-based diet can help control a lot of our chronic diseases like cancer, heart disease and diabetes,” Lipp said. “A well-chosen plant based diet with lots of soluble fiber can lower cholesterol as much as the drugs. It’s something American should do: go more toward a plant-based diet. It would benefit a lot of people.” Since not everyone is able or willing to entirely give up on animalbased foods, reducing consumption of the worst offenders can help improve

March 2012 •

anyone’s health. These would include processed meats (including salami, bacon, cured ham), chicken with the skin still on, and fatty cuts of meat. Opt for modest portions of lean cuts of meat instead. Low-fat or fat-free dairy can help reduce one’s saturated fat intake and reduce caloric intake, too. “The bottom line is that all diets in this age require thoughtfulness to obtain the variety that a body needs to function optimally; a vegan diet is no exception,” Alquist said. She recommends a visit to veganhealth.org and veganoutreach.org top learn more about the diet. “A visit with a registered dietitian can make sure that you are obtaining all the nutrients that you need,” Alquist added. “Don’t leave good nutrition to chance.”

Growing in Popularity How popular is veganism? Amy Alquist, registered dietitian with Clifton Springs Hospital, said, “A Vegetarian Resource Group poll in 2009 estimated that 3 percent (or 6 to 8 million) of American adults did not eat meat, fish or poultry. Of that group, 1 percent did not consume dairy, eggs or honey and are considered vegan. Many believe that these numbers have increased since that time.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 17


Food & Nutrition

Running on Clean and Green

Runners credit vegan, vegetarian diets with boosting their energy By Deborah Graf

V

ictoria Freile runs all day. Whether she is reporting breaking news or training for a marathon, this multimedia reporter with the Democrat and Chronicle keeps quite a pace from sunrise to sunset. How does she keep herself going? Vegetables. Freile is a vegetarian and endurance runner. Growing up hearing the words, “eat your vegetables,” was music to Freile’s ears. She was not born a vegetarian but she grew into the alternative diet by age 20. Freile, 35, a native of Pennsylvania Dutch country where comfort food ranks high, uses her philosophy about vegetarianism to fuel her equal passion for running. “I just feel better and always listen to my body,” she says. “My dad made steak every Sunday. He made excellent steak, I just didn’t like it,” she says. “I ate it until I couldn’t stand it anymore, somewhere around 10th grade.” Meals were never again the same for Freile, who began to slowly cut meat out of her diet until she eventually adopted her own version of vegetarianism. “I was meatless in college rather than vegetarian, because I didn’t know what I was doing,” she says. “I began reading and learned there are so many healthy alternatives for vegetarians.” Vegetarianism is a personal lifestyle choice based on various principles all rooted in removing meat from the diet. Practiced for thousands of years, some forms focus on ethics (cruelty

to animals,) economics (costs of meat products,) nutrition (lower fat and cholesterol,) and some are based in religious practices. Vegans follow more strict guidelines limiting all animalbased items from their diet, including most dairy products. But regardless of the requirements, proper nutrition is crucial. “Options really are not limited for vegetarians or vegans,” says Emily Shearing, 26, former D&C reporter and a current graduate student at Syracuse University. She has been a vegetarian since she was 11, and about a year ago became a vegan after her second marathon. “I decided to become vegan because I had heard good things about how good you feel by eating cleanly,” says Shearing, who went completely vegan during six months of training for a marathon, and has been vegan ever since. “I feel really great, I have a lot of energy, I have more muscle mass, I am more trim, and I actually shaved about a half an hour off of my running time.” Time, energy, and food all matter to marathon runners, who will train for several months prior to running 26 miles for a full marathon, or 13 miles for a half. Endurance is a key factor during training and running, and runners must be careful about how to fuel their bodies for the long haul. “The question is,” asks John Klibanoff, an orthopedic surgeon in Rochester, “Where do you get your protein? It is a requisite essential for muscle recovery.”

Victoria Freile, 35, smiles proudly with former Mayor Robert Duffy at the finish line of the Flower City Half Marathon in Rochester, April 2010. Page 18

Victoria Freile, 35, runs 8-miles through Greece in February 2011 for the Greater Rochester Track Club’s Freezeroo, a series of winter races in Rochester.

Emily Shearing, 26, vegan, a former reporter for the D&C, runs in the Toronto Waterfront Marathon Oct. 16. Smiling at 12.5 miles into the race on the streets of Queens Quay and Harbourfront Center, Shearing had been a vegan for seven months. Photo courtesy of Bill Shearing. Klibanoff has worked with hundreds of runners and is also a marathon runner, but not a vegetarian. He explains that runners need appropriate nutrition to optimize performance, and says vegetarians recover differently than endurance athletes who take in protein from lean red meats, especially in the case of injury or strain. More specifically, he explains that branchedchain amino acids, which are found in meat and dairy products, are critical for recovery and building and repairing of muscle, and says the appropriate amounts cannot be found in vegetables and grains alone. “Red meat offers you the building blocks for your muscle and connective and soft tissue attachments,” he says. “Vegetarians need to be educated on what they need to do within the constraints of their dietary restrictions.” Freile and Shearing, running partners who also share their love of vegetarian-style eating, are both conscious of finding the right balance of protein and carbohydrates, as well as vitamins and iron. “There are a lot of preconceived notions about what vegans can and cannot eat,” says Shearing. “But you have to find out what you can eat, just like when you have food allergies. You ask questions.” Some of the answers are found by examining real evidence, as Klibanoff does when caring for his endurance athlete patients. “The vast majority are women runners between 35 and 50 who may be injured or have become malnourished,” he says. “Sometimes you have to show

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

a runner, especially a vegetarian runner, proof about whether or not they are being detrimental to their body.” For committed vegetarians and vegans who are also endurance athletes such as runners, Klibanoff suggests having whey protein three times a day, light carbohydrates in between meals to maintain efficient metabolism, and keeping a calorie count and exercise journal to then calculate the balance of caloric input and output. Klibanoff recommends vegetarians and vegans tp read “The Triathelete’s Training Bible,” by Joe Friel, 2009, Velo Press. Both Shearing and Freile feel that their no-meat philosophy helps them with their sport. Marathon runners and vegetarians often go hand in hand. Both require commitment and dedication, both require knowledge and practice, and both claim an end result of feeling good through achievement. “Learning to adapt to a new food lifestyle is like training for a sport,” Freile says. “Start with what you can do and build it up. It gets easier as you do it more often, your body gets used to it.” Both Freile’s and Shearing’s families support their lifestyle choices and cheer them on both around the dinner table and also during their long distance runs. “After a while my friends and family started to understand how serious I am about being a vegan runner and they have come to appreciate my dedication,” Shearing says. “You have to want it, it’s all about being healthy.”


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Food & Nutrition most dangerous foods to eat behind the wheel

By Gina Roberts-Grey

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ehind the wheel seems like a great place to calm a grumbling stomach or squeeze lunch into your already crammed schedule. But eating while driving could have your rearview mirror filled with a cop’s flashing lights or worse. Eating while driving can cause accidents, injuries and even death. Is the craving for drive-thru junk food or ice cream really worth all that? A study conducted by SmartDrive Systems, a leader in fleet safety training and techniques, compiled data from more than 34 million risky driving incidents and ranks food and beverages consumed while driving as a higher distraction than talking on a mobile phone. And experts agree. Talking or texting while driving is extremely distracting. But experts say eating is really just as bad when you’re behind the wheel. Marcel Just, a leading neuroscientist and expert on multitasking at Carnegie Mellon University says eating while driving can be just as distracting as texting while driving. “It takes your mind off of driving and forces you to try to succinctly perform too many things at once; eat without choking or spilling, etc., and drive following all the rules of the road.” Just says that’s just too much for one brain to do all at once. And if you’re unable to follow those rules of the road, food-related distraction can send your car insurance rates skyrocketing. “Traffic violations and crashes resulting in claims being filed with your car insurance company become part of your ‘insurance history report’,” says Jack Smith a member of the Independent Insurance Agents and Brokers of New York. “If you get a ticket because you were eating and didn’t notice the speed limit, that $5 burger could become an awfully expensive lunch.” Any food can get you into trouble because eating is distracting. But experts say these take the cake at being the most dangerous to eat behind the wheel.

Potato chips This triple-threat has experts seeing red — as in the color of lights atop police cars and ambulances. That’s because the salt turns your attention toward looking for something to drink and the grease has you looking for a napkin instead of a car turning in front of you. “An alert driver needs 1.5 seconds to react to something that happens while they are driving. A distracted driver who is splitting attention between eating and driving needs three seconds to react,” says Stephanie Schwartz, a driving instructor and

owner of Road Runner Traffic School, in Phoenix. Oh yeah, then there’s the choking hazard. Paul Bryson, a specialist at the Cleveland Clinic Head & Neck Institute, says eating chips behind the wheel poses a significant choking risk. “The jagged edges make them tough to swallow if you accidentally swallow one without chewing it thoroughly.” And while you’re trying to dislodge a chip from your throat, you could bash into another car, tree, mailbox, or a host of other objects in your path.

Ice cream in a cup Ice cream cones get all the credit for being distracting because they drip all over and distract you with the need to lick or find a napkin. After all, who wants an ice cream blob on the front of their shirt? But cone’s counterpart, the ice cream cup, is an even bigger danger. Sure, cups eliminate the drip factor making them cleaner. But they require two hands to eat. That is, unless you’ve managed to master holding the cup and spoon in one hand. Even so, onehanded driving doesn’t ensure proper control should something (or someone) suddenly appear in front of you. “You need two hands on the wheel to maintain the best control of the vehicle,” says Schwartz. And don’t even think about trying to hold the cup in your lap or steer with your knees. “You’re asking to lose control and risking your life,” she adds. All for a scoop of chocolate swirl.

Pizza Debra Jaliman, assistant professor

of dermatology at Mount Sinai School of Medicine and a spokesperson for the American Academy of Dermatology, says you should never ever eat pizza while driving. “Within seconds the hot, greasy cheese dripping down your face can cause a first or second degree burn on the face,” she says. The most common place to be burned is the corner of your mouth, where Jaliman says your skin is more delicate and thin than on the rest of your face. “The pain will be distracting and so will the urge to look for a napkin or something to cool your skin,” she says. “Even if you’re not burned, a slice of pizza is distracting. The grease makes it hard to properly hang onto the wheel, operate a turn signal, etc., so you’re going to turn your attention to finding a napkin and won’t pay full attention to the road,” says Schwartz. “And eating a slice that has toppings that tend to fall off (like mushrooms, onions, peppers, etc.) often requires two hands to eat, so you can’t safely steer your car stuffing your face with a slice.”

Burgers with the fixins This staple in American’s diets is pure ooey gooey goodness. And as a bonus, you can get one in about 60 seconds courtesy of drive thrus. Yum! Schwartz says you shouldn’t keep on trucking after buzzing through a drive-thru. “Stop, park and then eat,” she urges. That’s because burgers (even without the cheese) are drippy and greasy. And to keep all those fixin’s off your lap, car seat, or running down your chin, you need two hands to eat them. A plate helps, too! By the time you stow your burger

March 2012 •

someplace it won’t leave a stain (like in the wrapper you fished out of the passenger seat) in order to get even one hand firmly on the wheel, it could be too late. “You will have hit the car that cut you off or the dog that ran out in the road,” she says. By the way, hot dogs, sub sandwiches and other foods loaded with condiments are just as dangerous!

Soda without a straw To be fair, any drink that doesn’t have a straw (like bottled water and tea) can be dangerous, but soda is one bottle often snagged off convenient store shelves. “It’s hard to unscrew a soda bottle cap with one hand, and since you should always have at least – preferably two hands – on the wheel. It’s nearly impossible to open bottles,” says Bob Surrusco, general manager of the Safe America Foundation and the SAF Teen Driving Institute, in Marietta, Georgia. It’s also tough to recap them in order to keep the beverage from sloshing out if you happen to come to a fast stop or make a hard turn. “When something spills, the driver’s first instinct is to quickly clean it up. That can take the driver’s attention away from the road, which increases the odds of getting into a car accident,” says Surrusco. Then there’s that pesky choking hazard again. “If you do get the bottle open and happen to stop fast mid chug, you could choke because the liquid might ‘go down the wrong pipe’,” says Bryson. And that can turn a near-miss on the road into a full on accident.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Profile

Beth McLellan Making a difference in the lives of children with speech, language and hearing barriers By Ernst Lamothe

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eth McLellan started in a classroom of 12 preschool and kindergarten-aged children who had significant speech and language barriers. Facing an obstacle of handling many children who were not learning at their grade level and had stunted motor development skills, she never viewed the situation as an overwhelming challenge. She just knew that once you unlocked each individual child’s learning patterns and habits, success was behind the door. “Every child has something they need to overcome even if they don’t have hearing and speech problems,” said McLellan, early intervention services manager at Rochester Hearing and Speech Center. “It’s just about finding a way to get them to process the information and push through that mental block.” Rochester Hearing and Speech Center, 1000 Elmwood Ave., identifies, evaluates and provides treatment for children and adults with speech, language and hearing problems. Throughout the past 23 years, McLellan has been instrumental in helping children push past their speech and hearing impediments. Children going through the program must learn in different ways. Instead of parents teaching their kids words by telling them “say pen” or “say fork,” the parent has to hold up the object and just tell them it’s a pen, often repeating the word. “There is a process where you can use repetition with a child over and over and then they will pick it up. And the pressure is off the kid because they don’t feel like they are being forced to say something,” said McLellan, of Webster. “Or you hold up a cookie and say ‘Oh you want a cookie. Yes, I can see you want a cookie. This cookie is good.’ Saying it three times will help the child absorb the word.” One of the programs she helped guide and she credits to improving child development for those with speech and language delays remains the Teaching Age Appropriate Language for Kids (T.A.A.L.K) program. The early invention initiative for kids 18-36 months teaches parents ways to help their children at home by attending a classroom program with their children one morning per week and receiving individual services at home. “I remember we had a 2-year-old in the program and we videotaped the interaction between the parent and the child on the first day and you could see they could hardly connect with the child just sitting on the wall and the parent was trying so hard but couldn’t get through,” said McLellan. “Then five months later, we did the same thing and you could see them playing right next to each other and they connected so much and the child was responsive to everything the parent did or said. It’s a wonderful feeling to see Page 20

a relationship progress and to see the child learning something new.” Scott Perkins, who has been on the Rochester Hearing and Speech board and is currently the director of marketing for the organization, has seen the changes that can happen with kids in the program. Viewing education as the great equalizer, he knows early intention programs like the ones run by McLellan make a lasting difference. “A child comes to a fork in the road in their language and social skills,” said Perkins. “If the child begins to falter in the beginning and school becomes something they don’t enjoy, we all know what the end result is going to be. They will view that first failure as the first step in a succession of failures. That’s what makes Beth so special because you can tell she cares and makes an investment in the children who come through our program.” There are several measuring marks each child should have, and if they don’t, might indicate they having hearing and speech issues. From birth to 1 years old, a child should be able to react to voices and sounds, vocalize pleasure with laughs and giggles and understand the word ‘no.’ At 2 years old, a child should know at least 200 words, point to simple body parts and combine two words such as “want juice” or “more juice.” When they turn 3, they should master nearly 1,000 words and people should understand their speech at least 80 percent of the time. By 4, they are using sentences with four or more words, can identify colors and express ideas and feelings rather than just talking about the world around them. And at age 5, they can retell simple stories, can understand opposites like dark

Beth McLellan and her husband Dave at a ceremony that honored her with a career achievement for her efforts to help children with speech, language and hearing problems. and light or rough and smooth and can answer questions such as “What would you do if?” Officials say early detection can reduce potential difficulties later in life. A “wait and see” approach can result in lost time or, in some cases, it can delay a child who would have been a few months way from entering kindergarten. McLellan said some parents are in denial about the help their child needs,

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

while others recognize the need but are still standoffish in asking for help. “You have to walk a fine line when parents come in because some don’t want to be told how to teach their kids so you may have to demonstrate techniques to help the child and hope the parent goes home and actually practice these techniques,” said McLellan. “But helping a child succeed is why I am still here after all these years.”

Beth McLellan onstage: She is being announced as an award winner by the Rochester Business Journal.


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By Jim Miller

Organ Donation: You’re Never Too Old Dear Savvy Senior Is there an age limit on being an organ donor? At age 73, I’m interested in being a donor when I die, but am wondering if they would still want my organs. What can you tell me, and what do I need to do to sign up? Willing But Old Dear Willing, There’s no defined cutoff age for being an organ donor. In fact, there are many people well up into their 80s who donate. The decision to use your organs is based on health, not age, so don’t disqualify yourself prematurely. Let the doctors decide at your time of death whether your organs and tissues are suitable for transplantation. Donating Facts In the United States alone, more than 112,000 people are on the waiting list for organ transplants. But because the demand is so much greater than the supply, those on the list routinely wait three to seven years for an organ, and more than 6,500 of them die each year. Organs that can be donated include the kidneys (which are in the greatest demand with more than 90,000 on the waiting list), liver, lungs, heart, pancreas and intestines. Tissue is also needed to replace bone, tendons and ligaments. Corneas are needed to restore sight. Skin grafts help burn patients heal and often mean the difference between life and death. And heart valves repair cardiac defects and damage.

istry. You can do this online at either donatelife.net or organdonor.gov. Both sites provide links to all state registries. If you don’t have Internet access, you can call your local organ procurement organization and ask them to mail you a donor card, which you can fill out and return. To get the phone number of your local organization, call Donate Life America at 800-355-7427.

Identify yourself Designate your decision to become an organ donor on your driver’s license, which you can do when you go in to renew it. If, however, you don’t drive anymore or if your renewal isn’t due for a while, consider getting a state ID card — this also lets you indicate you want to be a donor. You can get an ID card for a few dollars at your nearby driver’s license office.

Registering Add your name to your state or regional organ and tissue donor reg-

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Tell your family Even if you are a registered donor, in many states family members have the ultimate say whether your organs may be donated after you die. So clarify your wishes to your family. It’s also a good idea to tell your doctors and include it in your advance directives. These are legal documents that include a living will and medical power of attorney that spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. If you don’t have an advance directive, go to caringinfo.org or call 800-6588898 where you can get free state-specific forms with instructions to help you make one.

More Info For more information on organ and tissue donation and transplantation, visit the U.S. Department of Health and Human Services Donate the Gift of Life website at organdonor.gov. Also see the United Network for Organ Sharing at unos.org, and transplantliving.org which offers information on being a living donor.

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How to Donate If you would like to become a donor, there are several steps you should take to ensure your wishes are carried out, including:

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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. March 2012 •

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Most Diabetic Patients in NYS Not Receiving Necessary Tests New Report Highlights Missed Opportunities to Improve Diabetes Patient Outcomes, Encourages Successful Strategies

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nly 37.7 percent of diabetics in New York state received all three recommended medical tests in 2009, with 12.8 percent not receiving any, despite being more likely to see their doctors on a regular basis than the rest of the population, according to a new report by the Healthcare Association of New York State (HANYS) and funded by the New York State Health Foundation (NYSHealth). The report, “Managing Diabetes Care: Moving an Underlying Chronic Condition to the Forefront,” outlines the missed opportunities to educate diabetes patients within hospital and primary care settings, and highlights the successful strategies of integrated patient care. “A diabetes patient will see his or her primary care physician to address an acute symptom, not to address chronic disease prevention,” said HANYS President Daniel Sisto. “It is increasingly clear that the coordination

of services for chronically ill patients, such as diabetics, is crucial and that providers and patients must work together for successful outcomes.” Hospitals across the state have been implementing comprehensive disease management programs, such as participation in the patient-centered medical home model, which allows for coordination between different care sites and all members of the care team. Also, some hospitals have begun using electronic medical record systems and disease registries that remind providers about the need for best practice standards, such as standard diabetic blood tests and eye exams. “Hospital admissions and readmissions are key cost drivers for the care of patients with diabetes,” said James R. Knickman, president and chief executive officer of NYSHealth. “Improving diabetes care management for patients across the health care system can lead to lower readmission

rates, better patient outcomes, and a reduction in health care costs.” Patients with diabetes were 2.4 times more likely to be readmitted to the hospital for any reason than patients without diabetes. The report found that diabetics need a transition plan between the hospital and primary care provider to ensure the stability and management of diabetes after being discharged. While the benefits of more fully integrating diabetes care into primary practices is well established, in many hospitals, such programs are not part of routine discharge plans. For example, an inpatient hospital

Rochester Coalition to Take on Identity Theft of Older Adults Group available for presentations to educate older adults

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ifespan is the lead agency in a new Finger Lakes Identity Theft Coalition that is focusing on the victimization of older adults (age 60 or older). A regional network of professionals and community leaders is now making presentations to educate older adults and their caregivers about ID theft and to assist older adults who have been victimized. The target region for the project includes eight counties in western New York: Cayuga, Livingston, Monroe, Ontario, Schuyler, Seneca, Wayne and Yates. According to the coalition, identity theft is a growing problem affecting nearly 10 million Americans annually. While older adults are not the exclusive targets of identity theft, they can be especially susceptible to victimization. Coalition members include aging service providers, elder abuse and adult protective staff, legal and criminal justice professionals, law enforcement units, and financial services institutions. The coalition is developing a network of providers in the region who can help older victims take appropriate legal action to recover assets, when possible, and to receive supportive services to restore a sense of safety and integrity. Older adults have a number of strategies available to them to prevent becoming a victim of ID theft. They can Page 22

also take steps to report ID theft and correct the situation if they find they have been victimized, such as immediately notifying credit card companies and banks, filing a police report and

placing a “temporary fraud alert” on their files with credit agencies. Older persons who need assistance with ID theft issues should call Lifespan/Eldersource at 325-2800. Orga-

stay could provide diabetic selfmanagement education and make certified diabetes educators available to complement clinical care. The study found patients who had a diagnosis of diabetes for more than 20 years showed improvement after one year of diabetes education. There was statistically significant improvement in self-care knowledge, quality of life and self-management behavior, including monitoring blood glucose and good foot care. EDITOR’S NOTE: See related story — Cooking at Home Helps Manage Diabetes — in this issue.

nizations interested in scheduling a presentation on ID theft or interested in learning more about the coalition may contact Paul Caccamise, vice president for program at Lifespan, 585-244-8400 ext. 115, pcaccamise@lifespan-roch.org or Carlos Rodriguez, coalition chairperson, 585- 737-4365, c.rod5100@yahoo. com. More information is also available at www.identitytheftnetwork.org.

CENTENARIANS Larry Marro Turns 100 at Ashton Place

Larry Marro recently celebrated his 100 birthday. He lives at Ashton Place, a senior living community in Clifton Springs.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

Residents of Ashton Place and family and friends of Lawrence Marro (Larry) gathered to celebrate his 100th birthday Feb. 3 at Ashton Place in Clifton Springs. Marro is a World War II veteran who was wounded in the battle of the Bulge. He received a Purple Heart for his service to his country and is a very proud, active senior. He and his many friends at Ashton Place celebrated his life of achievement with refreshments, wine and live music.


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

What They Want You to Know:

Medicare Part B Deadline Approaching

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f you didn’t sign up for Medicare Part B medical insurance when you first became eligible for Medicare, you now have an opportunity to apply — but time is running out. The deadline for applying during the general enrollment period is March 31. If you miss the deadline, you may have to wait until 2013 to apply. Medicare Part B covers some medical expenses not covered by Medicare Part A (hospital insurance), such as doctors’ fees, outpatient hospital visits and other medical supplies and services. When you first become eligible for hospital insurance (Part A), you have a seven-month period in which to sign up for medical insurance (Part B). After that, you may have to pay a higher premium — unless you were covered through your current employer’s group health plan or a group health plan based on a spouse’s current employment. You are given another opportunity to enroll in Part B during the general enrollment period, from Jan. 1 to March 31 of each year. But each 12-month period that you are eligible for Medicare Part B and do not sign up, the amount of your monthly premium increases by 10 percent. There are special situations in

Q&A

Q: I lost my Social Security card, should I get a new one? A: If you know your Social Security number, you may not need a replacement card. You can replace your Social Security card for free if it is lost or stolen, but you are limited to three replacement cards in a year and 10 during your lifetime. Learn more at www. socialsecurity.gov/ssnumber. Q: I worked for the last 10 years and I now have my 40 credits. Does this mean that I can stop working and get the maximum Social Security retirement benefit when it’s time to retire? A: The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base the amount of the benefit on those credits; we base it on your earnings over your working lifetime. To learn more about Social Security retirement benefits and how your benefit amount is figured, read our online publication, Retirement Benefits, at www.socialsecurity.gov/pubs/10035.html. Q: I want to estimate my retirement benefit at several different ages. Is there a way to do that? A: Use our Retirement Estimator at www.socialsecurity.gov/estimator to get an instant, personalized retirement

which you can apply for Medicare Part B outside the general enrollment period. For example, you should contact Social Security about applying for Medicare if: • you are a disabled widow or widower between age 50 and age 65, but have not applied for disability benefits because you are already getting another kind of Social Security benefit; • you worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program and became disabled before age 65; • you, your spouse, or your dependent child has permanent kidney failure; • you had Medicare medical insurance (Part B) in the past but dropped the coverage; or • you turned down Medicare medical insurance (Part B) when you became entitled to hospital insurance (Part A). You can learn more about Medicare by reading our electronic booklet, Medicare at www.socialsecurity. gov/pubs/10043.html. Or visit the Medicare website at www.medicare. gov. You may also call Medicare at 1800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

benefit estimate based on current law and your earnings record. The Retirement Estimator, which also is available in Spanish, lets you create additional “what if” retirement scenarios based on different income levels and “stop work” ages. Q: I currently receive Social Security disability benefits. Is there a time limit on how long you can collect Social Security disability benefits? A: Your disability benefits will continue as long as your medical condition has not improved and you cannot work. We will review your case at regular intervals to make sure you are still disabled. Learn more by reading our publication, “Disability Benefits,” at www.socialsecurity.gov/pubs/10029. html. Q: Is it true that a person can own a home and still be eligible for Supplemental Security Income (SSI) benefits? A: Yes. A person who owns a home and lives in that home can be eligible for SSI benefits. Although there is an asset limit for people to qualify for SSI, some things don’t count toward that limit, such as a house, a vehicle, and some funds set aside for burial expenses. To learn more about SSI and the eligibility requirements, browse our booklet, “Supplemental Security Income” at www.socialsecurity.gov/ pubs/11000.html.

Dentists

By Deborah Jeanne Sergeant

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he American Dental Association states that “dentists are doctors who specialize in oral health. Their responsibilities include: diagnosing oral diseases, promoting oral health and disease prevention, creating treatment plans to maintain or restore the oral health of their patients, interpreting X-rays and diagnostic tests, ensuring the safe administration of anesthetics, monitoring growth and development of the teeth and jaws, performing surgical procedures on the teeth, bone and soft tissues of the oral cavity, and managing oral trauma and other emergency situations. • “As medical providers, it is important for the dental team to be aware of the patients’ medications, allergies, and medical conditions. It makes our job easier when the patient brings in a list of updated medications and dosages at each visit. • “In the human body there are many diseases such as high blood pressure and high cholesterol that can be silent until the disease process is quite advanced. The same holds true for dental disease. Very often periodontal disease and tooth decay are painless until they reach the point that the tooth becomes loose, needs a root canal, and may have a guarded prognosis. Waiting for something to hurt can result in more involved and more expensive treatment.” Paul I. Sussman, dentist with Center for Cosmetic Dentistry in Rochester • “In dentistry, the old adage that every patient agrees with is that ‘there’s no dentistry like no dentistry.’ Preventive care is least expensive. Those that are conscientious with routine care prevent problems. • “They get more benefit from a cleaning than any other procedure we can do. I tell patients that barring a chronic illness or finances go down the drain, even if they can’t have comprehensive care they should keep up with cleanings. The medical and dental benefits are so broad. The toxins that cause decay have a far more reaching effect on the heart and pancreas. There’s more involved than just the

March 2012 •

teeth. Hippocrates said the mouth is the barometer to total body health. Oral health is very important.” Gary D. Groves, dentist with Groves & Kelley in Rochester • “In going to the dentist, a lot of people have fear. Maybe they’ve had a bad experience. But if you maintain everything and get routine dental work done, things don’t build up over time. It shouldn’t be a painful experience. • “People seem to be afraid of us and we have to try to win them over and make them understand we’re here to help you and make you feel comfortable. That is the most important thing for people to understand.” Michael S. Adsit, dentist with Johnson Health Group, Newark • “I could’ve retired eight years ago but I’m enjoying dentistry. • “We have excelled anesthetics to numb the gum so people don’t even know they’ve had an injection. We haven’t used Novocain in years. We have other very potent anesthetics that render most dental procedures painless. It’s very rare a patient needs to be put to sleep for a procedure. • “If you’re been putting off a visit because you’re afraid of pain, [dentistry] is a whole other ball game today. I don’t hurt people anymore. • “If people all came on time that would be great.” Jeremy Leichtner, dentist with Leichtner & Reed, DDS, Rochester

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.

REACH THE MEDICAL COMMUNITY. ADVERTISE WITH IN GOOD HEALTH Email inquiries to “editor@GVhealthnews.com” IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Medications & Your Pet 10 Questions to Ask Your Vet

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o prevent or treat an illness in your pet, your veterinarian may prescribe a medication. Understanding important information about the medication and how to treat your pet can help your animal’s recovery or continued good health. “Just as you would talk to your doctor about a medicine prescribed for you or your children, you should talk to your veterinarian about your pet’s medications,” says Bernadette Dunham, director of the Center for Veterinary Medicine at the Food and Drug Administration (FDA). “And if you have any questions after you leave the animal clinic, don’t be afraid to contact and follow-up with your veterinarian.” Here are 10 questions you should ask your vet when medication is prescribed. 1. Why has my pet been prescribed this medication and how long do I need to give it? Your veterinarian can tell you what the medication is expected to do for your pet and how many days to give it. 2. How do I give the medication to my pet? Should it be given with food? Your pet may have fewer side effects, like an upset stomach, from some drugs if they are taken with food. Other medications are best to give on an empty stomach. 3. How often should the medication be given and how much should I give each time? If it is a liquid, should I shake it first? Giving the right dose at the right time of the day will help your pet get better more quickly. 4. How do I store the medication? Some medications should be stored in a cool, dry place. Others may require refrigeration.

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5. What should I do if my pet vomits or spits out the medication? Your veterinarian may want to hear from you if your pet vomits. You may be told to stop giving the drug or to switch your pet to another drug. 6. If I forget to give the medication, should I give it as soon as I remember or wait until the next scheduled dose? What if I accidentally give too much? Giving your pet too much of certain medications can cause serious side effects. You’ll want to know if giving too much is a cause for concern and a trip to the animal emergency room. 7. Should I finish giving all of the medication, even if my pet seems to be back to normal? Some medications, such as antibiotics, should be given for a certain length of time, even if your pet is feeling better. 8. Could this medication interact with other medications my pet is taking? Always tell your veterinarian what other medications your pet is taking, including prescription medications, over-the-counter medicines, and herbs or other dietary supplements. You may want to write these down and take the list with you to the vet’s office. 9. What reactions should I watch for, and what should I do if I see any side effects? Your veterinarian can tell you if a reaction is normal or if it signals a serious problem. You may be asked to call your vet immediately if certain side effects occur. FDA encourages veterinarians and animal owners to report serious side effects from medications to FDA’s Center for Veterinary Medicine at 1-800-FDAVETS.. 10. When should I bring my pet back for a recheck? Will you be calling me to check on my pet’s progress, or should I call you? Your vet may want to examine your pet or perform laboratory tests to make sure the medication is working as it should.


H ealth News Pluta Cancer Center has new patient coordinator Kim McDonough has been appointed Pluta Cancer Center’s new patient coordinator. McDonough will be the first point of contact for referring physician’s offices and new patients and coordinate all aspects of the new patient process. She will be in charge of communicating patient information between Pluta Cancer Center medical doctors and referring physicians, along with ensuring rapid appointment scheduling within 72 McDonough hours of initial inquiry. “Kim is a dedicated member of our staff whose outstanding communication and customer service skills will help her excel in this new, pivotal role for the Center,” said Pluta Cancer Center President and CEO Kelly McCormick-Sullivan. McDonough has 20 years of experience in healthcare and has been a member of the Pluta Cancer Center team since 2007. She resides in Rochester.

Dr. Lee Pollan changes locations after 37 years After 37 years at his Buffalo Road location, oral and maxillofacial surgeon Lee Pollan is changing locations of his practice to join the University of Rochester Faculty Practice full time. “I am transitioning into the University of Rochester for full-time academic practice and teaching and supervising the oral and maxillofacial surgery residents,” Pollan said. “I have always been passionate about educating residents and this move allows me to do it full time.” Not only did Pollan and his staff become a steadfast part of the Chili commuPollan nity, but in the lives of many families, as well. He has treated hundreds of area adults for various facial or jaw issues, such as reconstructive surgery, dental implants or obstructive sleep apnea. Many of Pollan’s patients married, and he then treated their children and other relatives to remove wisdom teeth and provide other specialized care. “In many ways, the Chili community feels like an extension of my own family,” Pollan added, “and I look forward to serving them at our new location.” Pollan, of Pittsford, is an associate professor of dentistry at the University of Rochester School of Medicine and Dentistry and served as program director and interim chair of the oral and maxillofacial division since 1980. His special areas of interest include trauma care, temporomandibular joint, dentoalveolar surgery, dental implants and reconstructive surgery.

For now, Pollan will continue to see patients at Strong Memorial Hospital, and later move to join the rest of the Faculty Practice at Clinton Crossings. Patients can call 585.275.5553. Pollan is past president of the American Association of Oral and Maxillofacial Surgeons (AAOMS), and serves on the board of directors of the Oral and Maxillofacial Surgery Foundation. After earning his dental degree from the University of Pittsburgh School of Dental Medicine in 1971, Pollan completed his oral and maxillofacial surgery residency at Georgetown University Medical Center. He earned his master’s of science from Georgetown the same year. He is a diplomate of the American Board of Oral and Maxillofacial Surgery and is a fellow in the American and International College of Dentists.

RGH Opens Patient Access Center

Rohit Kumar Sahai joins Rochester General Hospital

The patients of Rochester General Hospital (RGH) will now find the stress and hassle of pre-admission tests, paperwork and interviews to be a lot easier. The new Rick Constantino, M.D. Patient Access Center, a key element in Rochester General Health System’s comprehensive effort to improve the level of care and service available in the community, was officially dedicated in January and is open to the public. “Today is exciting for two reasons,” said Mark Clement, president and CEO of Rochester General Health System. “First, we are excited to know that our patients will enjoy a better experience, one more aligned with our values of service excellence and convenient access. Second, we have the opportunity to honor Rick Constantino, an extraordinary physician who is both admired and respected by his patients.” The center itself was made possible by a series of gifts made in Constantino’s honor by friends,

Rochester General Hospital welcomes Rohit Kumar Sahai to its medical and dental staff. He specializes in surgical oncology. Sahai attended the University of Michigan in Ann Arbor, completed his residency at the University of Pittsburgh Medical Center and a fellowship in surgical oncology at Roswell Park Cancer Institute, Buffalo. Sahai is board certiSahai fied in general surgery and a member of the Society of Surgical Oncology. He lives in Brighton.

Auburn hospital explores affiliation with RGHS Auburn Memorial Hospital (AMH) has begun exploring a potential affiliation with Rochester General Health System (RGHS). In August 2011, AMH began the process of exploring the potential for an affiliation with a larger health system to further enhance its 120-year tradition of providing compassionate, quality acute and long-term care services. AMH and RGHS have entered into discussions and due diligence which will likely span the next three months to determine the viability and exact nature of an affiliation, including consideration of legal, regulatory, financial, clinical and operational factors. In making its decision to pursue further discussions, the AMH board cited RGHS’ successful track record of collaboration with smaller standalone hospitals, its reputation for innovation, a sterling record of patient safety, and a national reputation for quality. “One core element of our strategic plan is the collaboration with regional healthcare providers to help them better carry out their missions within their local communities,” said Mark C. Clement, president and CEO of RGHS. RGHS currently enjoys a number of such collaborative relationships with

hospitals including Cayuga Medical Center in Ithaca and United Memorial Medical Center in Batavia as well as Newark Wayne Community Hospital, an owned affiliate of the system. RGHS is the only area health system to be nationally rated by SDI — a premier healthcare analytics firm — as a Top 100 Integrated Health Network. Integrated care networks are consistently recognized for delivering higher levels of quality, service, patient safety and efficiency. AMH and RGHS plan to provide the next public update at the conclusion of the due diligence process in approximately three months.

Acupuncturist receives Mei Zen certification Rochester acupuncturist Michelle Grasek announced she received the Mei Zen Cosmetic Acupuncture certification. She says she is one of only three

March 2012 •

family members, co-workers and patients. A total of 87 donors contributed just over $1.1 million toward construction of the PAC. A respected physician and former president of RGH, Constantino has been an RGH mainstay for over three decades. “Rick’s warm and caring nature will now help greet our patients for years to come,” said Clement. The Rick Constantino, M.D. Patient Access Center will now be the first destination for surgery and GI/endoscopy patients. The location of the unit, on the ground floor in the Eugene Polisseni Pavilion, is convenient to find, easily accessible and in close proximity to the Portland Parking Garage and valet parking services. Equipped with state-of-the-art medical equipment, such as examination tables that are bariatric appropriate, the Constantino Patient Access Center is designed to conveniently and comfortably house pre-surgical testing in a low-stress, easily manageable environment.

Mei Zen certificate acupuncturists in New York state. Mei Zen Cosmetic Acupuncture is a patented technique that uses ancient Chinese methods to help reduce fine lines and wrinkles and firm the jaw line, according to a press release. Hair-thin Grasek needles are inserted into precisely mapped points on the face and neck to improve the flow of energy (or ‘chi’) and blood to the face and neck. The needles are inserted into the layer of the skin called the dermis to increase collagen and elastin in the skin. This helps to improve skin tone and texture while reducing fine lines, wrinkles and puffiness without the use of surgery or injectables. Grasek said the procedure is a safe, gentle, natural alternative to the better known, more invasive options.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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H ealth News St. Ann’s Community Hires Four Professionals St. Ann’s Community recently hired four professionals. Brian Chamberlain of Rochester was hired as a staff pharmacist. Chamberlain was previously employed by Wal-Mart as a pharmacy manager. Bernardine Culhane-Ricotta of Greece was hired as the nurse manager for the third floor of St. Ann’s Home. She oversees the staff and residents’ day-to-day care and Chamberlain activities. CulhaneRicotta previously worked as the clinical coordinator for the residency program at Unity Health. Karen Kozak of Hamburg (Erie County) was appointed associate director of staff development. She oversees nursing education Culhane-Ricotta and infection control and is responsible for programmatic development to enhance quality of care and expand the clinical services available to the patients and residents of St. Ann’s Community. Kozak was previously employed by Catholic Health continuing care division as the sub-acute assistant Kozak director of nursing. Melissa MacKay Wang of Williamson was appointed nurse manager for the transitional care program. In her new role, she is responsible for overseeing the nurses who work in the program, the transition to St. Ann’s new transitional Wang care center, and she is responsible for ensuring the new nursing model works as efficiently as possible. MacKay Wang previously worked for HCR Homecare as weekend nursing manager.

Former YNN Anchor Joins Pluta Cancer Center Pluta Cancer Center recently announced the appointment of Amy Young as director, development and marketing. In her new role, Young will be responsible for advancement of the center’s overall development strategy. She will implement and oversee various community efforts including fundraising, donor cultivation, Young major gifts, special Page 26

events and volunteer activities. Young joins Pluta Cancer Center after a 20plus year career in television and radio news. Most recently, Young was the evening news anchor for YNN Time Warner Cable’s Rochester, Buffalo and Jamestown markets. “Amy’s strong communication skills will be a powerful asset to our team,” said Pluta Cancer Center CEO Kelly McCormick-Sullivan. “She is going to help tell the Pluta story throughout the region.” Young attended Wells College, where she earned a Bachelor of Arts degree in communications. She lives in Penfield with her husband and two children.

Unity Health System has new HR senior director Unity Health System announced that Michelle Grazulis has joined Unity in the role of senior director of human resources. Grazulis was previously with Xerox Corporation, where she served in several roles, including HR business partner for Xerox North America. Grazulis holds a Bachelor’s of Science Grazulis degree in economics from Siena College and is a graduate of the strategic leadership for women program at Simmons College. Grazulis is a resident of Pittsford.

Bryan Kenny, CPA, audit manager, Deloitte and Touche; Richard J. Mengel, CPA, managing partner, Mengel, Metzger, Barr & Co., LLP; and Karen L. Waldron, branch manager, Key Bank NA For more information, visit www. msupstateny.org.

Eye Bank gives $20,000 to local researcher The Rochester Eye & Tissue Bank (RETB) has awarded a $20,000 grant to University of Rochester Medical Center researcher Collynn F. Woeller for his research project, “A new approach to prevent tissue scarring.” Woeller’s project seeks to better understand the development of cells that are responsible for tissue scarring and to develop a therapy to prevent scarring associated with corneal injury as well as in other tissue and organ transplants.

This grant continues a program begun in 1954 through which more than $1 million has been awarded to local researchers conducting transplantation and vision-related research. Founded in 1952, the RETB is a nonprofit agency serving the Western, Central, Finger Lakes and Northern New York regions, as well as North Central Pennsylvania.

SHARE YOUR NEWS Any newsworthy news item you want to share with our readers? Editor@GVhealthnews.com

MS Upstate group has new board members The National Multiple Sclerosis Society (NMSS) Upstate New York Chapter recently welcomed two new members to its board of directors. Mary Jean Kinkel, of Williamsville, is an office administrator for Kinkel Neurologic Center; Charles Cleary, of Webster, is retired, and a former board chairman for the NMSS Upstate New York Chapter. According to a news release, these new members bring expertise, ambition and momentum to the National MS Society and the current board of directors, chaired by Thomas D. Muller. With these additions, the National MS Society Upstate New York Chapter now consists of 15 members. Continuing board members are: Thomas D. Muller, chairman, senior vice president/director of sales and service, The Lyons National Bank; Christine Sisto Mertes, vice chairman, principal/ owner of Capital Affairs, LLC; James J. Smith, vice chairman, secretary, retired; attorney Steven V. Modica, immediate past board chair, partner, Modica & Associates; Kathy A. Birk, a physician; Mark Boucher, vice president, operational administration, Price Chopper; Anthony M. Cortina, relationship manager, ESL Federal Credit Union; Patricia Dow, vice president, customer service, PAETEC; Keith Edwards, a physicians with Empire Neurology River Hill Center; attorney Nancy Tantillo Holtby;

Peter K. Dougherty associate executive director of the VA Homeless Veterans Initiatives Office (right), presented an award to veteran Robert Van Keuren of Canandaigua .

Department of Veterans Affairs Honors Canandaigua Man Robert Van Keuren of Canandaigua in January received the 2011 Secretary’s Award for Outstanding Achievement in Service to Homeless Veterans. The event took place at a the Syracuse VA Medical Center. Peter K. Dougherty, associate executive director of the VA Homeless Veterans Initiatives Office presented the award. Van Keuren, a Navy veteran, recently retired from the Canandaigua VA Medical Center after serving as the coordinator for VA Health Care Upstate New York Homeless Veterans program. He was honored for his four decades of service to Veterans, which includes serving in the Vietnam War on more than 200 combat missions, serving as director of a the Vietnam Veterans of San Diego and working for VA on homeless

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2012

veteran issues for 18 years. He, along with his long time friend and fellow Vietnam veteran Jon Nachison, is credited with initiating the first stand down for homeless veterans 25 years ago this July. Stand down is a military term often employed to provide exhausted combat units time to rest and recover in places of relative security and safety. Applying the stand down concept to assist homeless veterans by providing them with a respite from life on the street and easy access to onsite medical, mental health, employment, and dental services was an innovative, ground breaking, and dynamic approach to providing outreach, referral, and direct assistance to large numbers of homeless Veterans at a fixed location on a scale that had never been done before.


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Some feature stories inn this month’s issue: COVER STORY:

At 65, radio personality Brother Wease still going and going

LIVING

Betty & Guy Falling in love again, at 80

GRANDPARENTING

More local grandparents are raising their grandchildren

EMPLOYMENT

Getting ready for the big job interview

GETAWAY

Staying closer to home for a romantic weekend

RETIREMENT

Former Kodak employee devoted to helping others

CHANGES

Look, Grandma just got a tattoo

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