Gv igh rochester jan 2016

in good Flu? What Flu?

GVhealthnews.com

January 2016 • Issue 125

So far, number of cases has been very low, according to experts.

When will the flu season start?

Hard to predict, they say

priceless

Rochester’s Healthcare Newspaper

Why Premiums Keep Going Up And why you’ll have to pay a higher penalty If you don’t have health insurance in 2016 Plus: Choosing a plan not as easy as in the past

Talking shop with Tibor Becske, MD, clinical director of neuroendovascular services at Rochester General

Soup Can Aid in Weight Loss Soup contains no ‘magical’ properties that cause weight loss but it can replace higher calorie choices

Living Alone: Making the Best of 2016

Better Health Through Juicing Store on University Avenue helps those who want better health through juicing

Turmeric

Why you should add this Indian spice to your diet

­

Stress Levels Doctor Burnout Rates on the Rise January 2016 •

Yes, Women Make Less in Healthcare Industry, Too Women’s pay lacks parity with men’s, according to experts

U.S. Abortion Rate Hits Record Low: CDC

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 1

When Will Flu Season Start?

The start of flu season is hard to predict. So far, number of cases has been very low

T

here's not much flu going around in the United States so far this season, according to a new report released in mid December by the Centers for Disease Control and Prevention.

Between Oct. 4 and Nov. 28, the percentage of people visiting the doctor who were there because of a flulike illness was just 1.9 percent, which is actually slightly lower than the percentage typically seen in the "off season," or the summer months, the report said.

And during the last week of November, 44 states reported minimal flu activity (the level of activity that's normal for the off season), while just two states (Oklahoma and South Carolina) reported increased, or moderate flu activity. No states reported high flu activity. "[Flu] activity is still really low," said Lynnette Brammer, an epidemiologist in the

CDC's influenza division. "There are multiple ways that we measure flu activity ... [and] any of that data that you look at, there's just not a lot going on flu-wise," Brammer said.

And the start of flu season is hard to predict, Brammer said.

Last year, flu activity started to rise in late November and peaked in December. Sometimes, flu outbreaks can start as early as October, while in other years, flu activity has not increased until February.

"You will start to see it begin to increase, but it's really hard to predict when it's just going to really kick in and take off," Brammer said.

Doctor Burnout Rates on the Rise

B

urnout is a growing problem among American doctors, a new study indicates.

Analyzing the results of 2011 and 2014 surveys of more than 6,000 doctors across the U.S., researchers found that the number who met the criteria for burnout rose from 45 percent to 54 percent over that time.

Burnout rates rose in nearly all specialties, but the highest rates of burnout were among those in general internal medicine, family medicine and emergency medicine. There was no increase in work hours or in rates of depression among doctors.

Doctors' satisfaction with worklife balance fell between the two surveys, according to the study, which was published Dec. 1 in the journal Mayo Clinic Proceedings and conducted by Mayo Clinic researchers in partnership with the American Medical Association.

"Burnout manifests as emotional exhaustion, loss of meaning in work, and feelings of ineffectiveness," study author, physician Tait Shanafelt, said in a Mayo news release.

"What we found is that more physicians in almost every specialty are feeling this way, and that's not good for them, their families, the medical profession or patients."

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Jan. 5

Hearing program to focus on cochlear implants All community members interested in hearing loss are invited to Hearing Loss Association of America Rochester Chapter's two presentations set for Tuesday, Jan 5. "You can advocate for hearing accessibility" begins at noon. "Cochlear Implant Surgery" is at 8 p.m. Meetings are held in the Parish Hall at St. Paul’s Episcopal Church, East Avenue at Westminster Road, across from the George Eastman Museum.

Bob Sickmond, an Eastman Kodak retiree, will discuss ideas, examples and ways that we can make the area a better place for people with hearing loss by advocating for improved accessibility.

In the evening program, Paul O. Dutcher, dean of Rochester cochlear implant surgeons and an associate professor at URMC, will explore the cochlear implant surgical experience.

This presentation is recommended for anyone whose severe or profound hearing loss might make them a candidate for a cochlear implant.

Cochlear implants can be prescribed for children or adults with severe to profound hearing loss.

They do not restore "normal" hearing but are prostheses which directly stimulate the auditory nerve in the brain, bypassing diseased or dead hair cells in the inner ear. Among the points Dutcher will cover are: what a cochlear implant is, financial issues, criteria for candidacy, description of surgery before, during and after.

Hearing Loss Association of America is a nationwide organization dedicated to advocacy, education and support for people with hearing loss.

For more information visit www. hlaa-rochester-ny.org or call 585 266 7890.

Jan. 7

How to cope with changes Neutral Ground Support Organization, Inc., a nonprofit peer support group for people who are divorced, widowed, separated or ending a significant relationship, will host a program to discuss how people can cope with changes in their lives. It will feature Cheryl Minchella, MVP's community health educator living well programs. The program will take place from 7 – 9 p.m. at 1400 Lehigh Station Road, Henrietta. A donation of $5 is suggested. For more information, call Nancy Morrissey at 585-730-3327.

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Alzheimer’s Monthly Support Meetings The Alzheimer's Association Rochester & Finger Lakes Region invites caregivers and families to join its free monthly caregiver support group or community education session. Below is a complete schedule. For more information, call 585-760-5417.

Support Groups Brighton Marian’s House, 980 S. Clinton Ave. Third Monday of the month 5:30–6:30 p.m.

A support group for people with dementia meets at the same time at this location.

Brockport.

Brockport Free Methodist Church, 6787 4th Section Road Second Thursday of the month 7–8:30 p.m.

Fairport..

Church of the Assumption, 20 East Ave. First Tuesday of the month 12:30–2 p.m.

Gates Seabury Woods, 110 Dalaker Drive, Rochester Third Tuesday of the month.

5:30–7 p.m.

Greece Greece Community & Senior Center, 3 Vince Tofany Blvd., Greece Third Wednesday of the month 6:30–7:30 p.m.

Henrietta Pieters Family Life Center, 1025 Commons Way, Rochester Fourth Wednesday of the month 6:30–8 p.m.

This support group is for individuals caring for a loved one with younger-onset dementia (diagnosed at age 65 or younger).

Penfield First Baptist Church 1862 Penfield Road Third Wednesday of the Month 7–8 p.m.

Pittsford.

United Church of Pittsford, 123 S. Main St. Second Wednesday of the Month 1:30–2:30 p.m.

Rochester Finger Lakes School of Acupuncture & Oriental Medicine of New York Chiropractic College School of Applied Clinical Nutrition

2360 Route 89 • Seneca Falls, NY 13148

Monroe Community Hospital, room 406 435 East Henrietta Road First Thursday of the month 1–2 p.m.

A support group for people with dementia meets at the same time at this location.

Rochester Monroe Community Hospital, Page 4

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

third floor education center 435 East Henrietta Road Third Tuesday of the month 6–7:30 p.m.

A support group for people with dementia meets at the same time at this location.

Rochester St. Ann’s Community, foundation’s boardroom 1500 Portland Ave. Last Tuesday of the month 5–6 p.m.

Rochester St. Bernard’s Complex, Building 5 2260 Lake Ave. Last Monday of the month 11am to Noon Caregivers may bring their loved one with dementia to the day program at St. Bernard’s while they attend the support group meeting.

Webster Cherry Ridge Community 900 Cherry Ridge Blvd., Webster Second Wednesday of the month 3–4:30 p.m.

Education Sessions Registration is required for community education sessions. To register for a class please call 1-800272-3900.

Brighton Brighton Memorial Library 2300 Elmwood Ave., Rochester Second Wednesday of the month 6:30–8:00 p.m.

Focus: Grief and guilt

Greece Greece Public Library 2 Vince Tofany Blvd., Rochester Fourth Thursday of the month 6:30-8 p.m.

Focus: Middle stage, part three – considerations

Rochester Monroe Community Hospital 435 E. Henrietta Road Fourth Wednesday of the month 2-3:30 p.m.

Focus: Communication

Rochester Central Library of Rochester & Monroe County 115 South Ave. Third Saturday of the month 11 a.m. – 12:30 p.m.

Focus: Managing challenging behaviors

U.S. Abortion Rate Hits Record Low: CDC Greater use of more effective birth control may help explain trend, expert says

T

he U.S. abortion rate has declined by more than one-third over the past two decades to a record low, federal officials reported Friday.

Abortions fell 35 percent between 1990 and 2010, reaching 17.7 procedures per 1,000 women aged 15 to 44, said report lead author Sally Curtin, a statistician for the Centers for Disease Control and Prevention's National Center for Health Statistics.

That's the lowest abortion rate since the CDC began tracking the procedure in 1976, Curtin said.

"Abortion has been on a nearly steady decline since the rate peaked in 1980," she said.

The pregnancy rate also hit an all-time low in 2010, according to the report.

Many factors likely contribute to the reduction in abortions, but increased use of highly effective birth control is one of the most important trends, said report co-author Kathryn Kost, principal research scientist at the Guttmacher Institute, a sexual and reproductive health think-tank.

Pregnancy rates have been declining across the board for women

under age 30, according to the CDC report. That includes a 67 percent reduction for teens 14 or younger and a 50 percent reduction for teens

15 to 19.

At the same time, pregnancy rates increased for women 30 and older between 1990 and 2010, suggesting that men and women are using effective contraception and

US Life Expectancy Holds Steady; Infant Death Rate Drops

I

nfant mortality dropped to a record low in the U.S in 2014, and mortality rates for several leading causes of death among adults have decreased as well, according to a report from the Centers for Disease Control and Prevention.

The infant mortality rate dropped from 596 infant deaths per 100,000 live births in 2013 to 581 infant deaths per 100,000 live births in 2014 — a rate that’s a “historic low,” the researchers wrote in their report, published Dec. 9.

When the researchers looked more closely at this drop, analyzing the rates of the 10 leading causes of infant death, they found that the rates remained largely the same from 2013 to 2014. The only significant change was in the rate of deaths from respiratory distress in newborns, which dropped from 13.3 deaths per 100,000 live births to 11.5 infant deaths per 100,000 births, according to the authors of the report.

There was also a slight decrease in the rate of death among adults,

choosing to start families later in life, Kost said.

"Across the states, the rate of unintended pregnancy is going down," Kost said. "That suggests that fewer women are getting pregnant when they don't want to. It's happening across the board, and affects the birth rate and the abortion rate."

which dropped from 731.9 deaths per 100,000 people in 2013 to 724.6 deaths per 100,000 people in 2014, according to the report. This rate also represents a new record low, the researchers wrote.

The rates of death decreased significantly for five of the 10 leading causes of death among adults: heart disease, cancer, chronic lower respiratory diseases, diabetes, and influenza and pneumonia (these two conditions are grouped together). On the other hand, the rates of death increased significantly for unintentional injuries, stroke, Alzheimer’s disease and suicide.

There was no change in the rate of death from kidney disease.

Healthcare in a Minute

By George W. Chapman

Healthy competition

Competition among insurance companies is good — up to a point.

According to studies published in the recent edition of Health Affairs, the addition of just one more insurance company doing business in a market tended to lower rates for the one existing plan that was considered the benchmark or dominant plan in its market by an average of 3.5 percent.

However, the impact on the benchmark plan’s premium with the addition of two or more plans was nominal. Going “too low” in the market can result in disaster. So, a choice of two or three plans is good.

Health Republic, a New York-based insurance coop, was one of 17 plans offered on the NY Exchange. It came in with premiums way below market.

It had no impact on the premiums of market-dominant plans.

In November, Health Republic, citing claims expenses far exceeded premium revenues, went out of business. “Healthy’ competition means that the plan you select would still be around for the foreseeable future.

Like anything else we buy, if the price seems too good to be true …

Exchange deadline

To enroll for healthcare coverage via the exchange, you must do by Jan. 31. In previous years, there was a special enrollment around April 15.

If you elect not to buy insurance, you will be fined the greater of $695 or 2.5 percent of your household income.

Affordable Care Act 2017

It’s hard to predict what will happen to the ACA once President

Obama is out of office at the end of 2016. He won’t be around to veto any more attempts to repeal it.

However, it is safe to say that the entire law will not be repealed because too many Americans count on the ACA for insurance. Certain basic features like insurance portability from job to job, the elimination of lifetime limits and an insurer’s right not to cover preexisting conditions are all firmly incorporated into all commercial and government plans.

Also to be considered, but still fairly transparent to most consumers, is the impact of the ACA on hospitals, physicians and even insurance companies. The entire delivery system and how providers will be paid is being revamped. It will be close to impossible to turn back this tide.

Billions have been invested on electronic records, information technology and the formation of large, integrated comprehensive healthcare systems — accountable care organizations — that encourage and reward cooperation and coordination between physicians and hospitals.

Most likely, any efforts to reform the ACA post 2016 would include eliminating the individual and employer mandates, the medical device tax and the Cadillac tax on super-rich benefit plans.

Cost is top concern

Not surprisingly, a recent Gallop poll revealed that the biggest concern among us is cost. Twenty-two percent of respondents indicated this as their No. 1 concern. A family premium averages about $20,000 a year. The No. 2 concern was access January 2016 •

to care. Regarding the No. 1 concern, cost-containment measures are slowly being introduced to the delivery system under the ACA. Most will take effect by 2018.

Despite how much it costs, only 53 percent of those polled rated U.S. healthcare as good or excellent, which is the lowest rating in 10 years.

It is hoped that the development of more consumer-focused delivery models will improve satisfaction scores.

Concierge practices

Also referred to as direct primary care, “concierge” medicine is still a very small component of the healthcare system. Almost all of these practices have four or fewer physicians. The average monthly cost to a patient is around $100. According to one survey, 84 percent of these practices relied only on the monthly fee. It should be noted that most of their patients also carried traditional insurance to cover all other care not provided by the concierge practice.

Concierge or DPC medicine is still an emerging model, so there still isn’t a lot of reliable data proving it provides better care than traditional practices.

In 1915

Or 100 hundred years ago: Average life expectancy: 47 years.

Homes with a phone: 8 percent.

Average hourly wage: about 25 cents.

Physicians with college education: 10 percent (They attended so-called medical schools right out of high school.) Leading causes of death: flu, tuberculosis, diarrhea, heart disease,

stroke. Number of states: 45. High school graduates: 6 percent of population. Available over the counter: Marijuana, heroin, morphine.

Who we still trust

Despite all the problems consumers have with costs, accessibility, quality and the overall “medical establishment” per se, according to a study published in the New England Journal of Medicine, most of us trust and value our own physician. So, physicians can play a huge role in mitigating the confusion and fear among consumers trying to fend their way through the maze of our increasingly faceless healthcare system.

A lot of confusion and fear is created by the drug industry through direct to consumer advertising. In a largely symbolic gesture, the American Medical Association has recently voted to support a ban on drug advertising that drives up both the cost and unnecessary utilization of drugs.

While the U.S. is only 4-5 percent of the world’s population, we consume 50 percent of all the drugs.

The powerful drug industry counters that it is merely creating an informed consumer.

George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York.

To reach him, email gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Transplanted Face May Age Prematurely Transplanted faces seem to age faster than normal, a new study suggests.

More than 30 face transplants have been performed worldwide, but there is little information about recipients’ long-term outcomes, the researchers said.

In this study, three fullface transplant patients were followed for three years. They had a significant decrease in facial volume that resembled premature aging, said physician Bohdan Pomahac, of Brigham and Women’s Hospital and Harvard Medical School, both in Boston.

This change in appearance was the result of bone and muscle loss rather than the reduced facial fat or skin thickness that occurs in normal aging of the face, said Pomahac, who in 2011 led the first full-face transplant in the United States.

The study was published online Dec. 3 in the American Journal of Transplantation.

The findings show the need to find ways to prevent, delay or reverse muscle and bone loss in face transplant patients, Pomahac said.

Cornell: Private Hospital Rooms Cut Infection In the war against infections, constructing single-patient rooms — rather than sick-bay style, multi-patient rooms — reduces hospital-acquired infections among patients.

A new Cornell-led study finds that the purported high building costs of private hospital rooms are more than offset by the financial benefits of keeping patients safer from infection.

“We showed that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms — all of this by avoiding costs associated with hospital-acquired infections,” said Hessam Sadatsafavi, Cornell postdoctoral researcher and lead author of a recent paper in the Journal of Critical Care.

Meet

Your Doctor

By Chris Motola

Tibor Becske, M.D. Clinical director of neuroendovascular services at Rochester General focuses on brain, spinal chord. Explains why he accesses the brain through the groin Q: Give us an idea of what your subspecialty entails.

A: Essentially we're at the intersection of radiology, neurology and neurosurgery. Essentially what we do is deal with vascular things within the brain and the spinal chord. So let's say someone has an acute stroke in a large blood vessel within the brain. We go in through the groin with catheters, go up into the brain to the clot and try to remove it using different methods. Or if someone has an aneurism in the brain, we'll go up the same way and close the aneurism. We'll accomplish that with small coils or sometimes stent-like devices. If someone has other vascular pathologies in the brain, we can will usually go in before surgeons and try to take care of the lesions as much as possible because they tend to be very bloody.

It takes a lot of precision and skill for them to operate, so it helps to have the vascularity decreased. So we'll go in with catheters filled with a liquid that functions a bit like Crazy Glue. Sometimes we see people with carotid disease who are either not candidates for surgery or have stenosis on their artery. So we'll go in and open up that vessel. So these are the things we do,

along with similar procedures on the spinal chord.

Q: So most of your surgical work is minimally invasive?

A: Correct.

Q: This might be a dumb question, but isn't it a long way from the groin to the brain? Why do you enter from there?

A: Yeah, people wonder about that. Back in the 20s and 30s, almost 100 years ago, people had the idea that we'd eventually be able to go in through the carotid artery in the neck. The problem is, imagine you have someone with carotid artery disease. You've punctured that artery, you've dislodged material that's accumulated there. You also have to remove it and make sure the bleeding isn't a problem. All of that is much more dangerous when you're going in through the neck.

So eventually we came up with the idea of going in through the groin.

All of our arteries are connected. So we just navigate our way up

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

through the large vessels. It's not that difficult.

Q: How much time does a patient have after having a stroke to interventional treatment without sustaining serious damage?

A: There's not one answer to this, but obviously the sooner the better.

In some cases, it can be as long as 10 to 12 hours. It depends on the location and how lucky you are. If you're lucky, you can suffer a major vessel lesion and have a small deficit that can be reversible in a small amount of time. If you have a lifelong history of diabetes, smoking, high cholesterol, etc., there's a much smaller window for intervention. Our neurologist colleagues tend to give patients a clot-busting medication that can be given within the first three to fourand-a-half hours. Beyond that it's not as safe to give that medication.

As far as intervention, we don't like to do it after five or six hours because the outcome is less likely to be good. So we try to figure out how much salvageable brain there is before we start a procedure. We have ways of looking at that without catheters. So in cases where a patient woke up with a deficit and doesn't know when they had the stroke, in those cases we try to define the vascular anatomy and get an idea of whether it's a good idea to go in and open up a vessel.

Q: What is the recovery time from the interventions?

A: From the procedure itself? If you're talking about a patient without pre-existing damage, the recovery is a few hours. We try to keep them overnight, possibly two nights for observation before letting them go home. With stroke patients, the intervention isn't much of a recovery issue, but the stroke itself is. If everything works out in their favor, they can be sitting up in a chair, reading a newspaper the next day. Obviously that's an idealized outcome. Even in that case, we'll probably keep them for a few days to investigate the cause of the stroke.

Q: The neurological specialties have a reputation as one of the hardest disciplines to master. Having gone through rotations, does that seem accurate to you?

A: I'm the wrong person to ask.

I'm in it because I love this stuff. It's one of those things that if you have an affinity for it, it doesn't seem that hard. My fellowship was very strenuous, I didn't get home too often and I ate when I could, but I was completely happy with the situation. Let me put it this way: you can't do this stuff unless you love it. But if you love it, it doesn't seem that difficult.

Lifelines Name: Tibor Becske, M.D. Position: Clinical director of neuroendovascular services at Rochester General Hometown: Beregszasz (Berehove), Ukraine Education: NYU Medical Center; SUNY Downstate Medical Center; Semmelweis University of Medicine Affiliations: Rochester Regional Health System Organizations: Society of Neurointerventional Surgery, Society of Vascular Interventional Neurology Family: Married, one son, one daughter Hobbies: Piano, guitar, travel, reading

Tattoo Removal Growing in Popularity More than one in five people regret having tattoos or seek or have completed their removal

By Deborah Jeanne Sergeant

A

bout 45 million Americans have at least one tattoo, according to the Pew Research Center. Of them, about 17 percent regret a tattoo and 11 percent are seeking or have completed tattoo removal. Unfortunately for them, it's not cheap or easy. Tattoos cost from $45 to $150 to obtain, but around $1,000 to $3,000 or more to remove.

So why the change of heart?

Brett Shulman, board-certified dermatologist with Rochester General Health System, speculated that changed circumstances often contribute to why people want to get eliminate their tattoos.

"You may have the wrong girlfriend's name on your arm, or you chose something cute that doesn't

work now that you're in the corporate world," he said. "Plus, tattoos fade over time. It's one of those things about which people have remorse for a variety of reasons."

Shulman advises clients on cosmetic camouflage, surgical removal and chemical peels for lighter and smaller tattoos. He doesn't offer laser removal.

Shulman believes that tattoo "removal" creams do not work.

"Most of the home products have bleaching agents in them," he said. "They use acids, and at the end of the day, what you're really doing is replacing what's there with scar.

We've seen a few people who've used creams and that magical component has not been our experience."

Short-pulse lasers offer a treatment that causes less pain and scarring. Sherrif Ibrahim, assistant professor in the department of dermatology with University of Rochester and dermatologist with University Dermatology Associates, said that laser removal offers the industry standard for tattoo removal.

"It does have some sting, as the pulses do damage the surface of the skin," he said. "People have a wide range of pain threshold, but people with a tattoo know what that kind of pain feels like."

Some clients liken the pain of removal to the pain of getting inked.

Laser tattoo removal on thinner skin, such as the fingers, can cause greater pain as the laser pulses deeper into the layers of skin. Ibrahim said that using a numbing agent or medication helps.

Spacing the several treatments a month apart allows patients' swell-

ing and skin damage to heal, though to some clients dislike the appearance of a half-gone tattoo.

The laser works by shattering the ink under the surface of the skin. Then the body absorbs and processes

Shulman the ink as waste.

Black tattoos remove the easiest since the laser can differentiate it from light-pigmented skin. That's why laser removal doesn't work as well on darker skin tones. Tattoos with yellow, green, red, turquoise and blue prove more difficult to remove because the colors are lighter.

Ibrahim said that typically, the laser treatment only lightens skin pigments as a negative side effect, but doesn't change the texture. The lightened pigment may normalize over time.

"Most people are pleased with the results, but it's a commitment," Ibrahim said. "You have to have several treatments."

For people who want to modify a tattoo, such as to change a name or alter an unwanted statement, laser removal can provide a blank area for the tattoo repair.

Laser tattoo removal "is generally a very safe procedure that's gaining in popularity," Ibrahim said. "We have newer devices that do the same thing in fewer treatments. That will continue to evolve."

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Making the Best of 2016 A little gratitude can make a big difference

W

hen loss is gripping my heart, when change feels threatening or when disappointment overcomes me, I find it helpful to revisit and add to my “gratitude list.”

Lately, it’s been a daily ritual. I’ve kept my list close at hand and have used it to lift my mood and renew my hope.

I have found the process of writing down and reflecting on those things for which I’m grateful to be a fulfilling, even healing, exercise. More and more, I am relying on my gratitude list to bolster my spirits.

By focusing on gratitude, we become more aware of the positive aspects in our lives, which in turn can help shift our thinking and attitudes.

One of the easiest ways to make it a part of your life is to start a gratitude journal. The following five steps may help you get started: First step: Purchase a blank notebook or journal in which to write

every day. Any kind will do, but I suggest choosing one that reflects your own individuality. Mine is a beautiful little spiral-bound journal covered in handmade paper, with a decorative satin ribbon.

It’s pretty just to look at, and very inviting. I keep it within easy reach on my bedside stand.

Second step: Find a time to write in your gratitude journal each day.

It might be the last thing you do before you go to sleep or the first thing you do in the morning. What’s important is that you find a quiet time when you can be alone with your thoughts and feelings. I’ve found I do a better job of keeping my journal when I make a commitment to write at a regular time each and every day.

Third step: Think back over your day. Identify those things or people or places that made an impression on you or that touched your heart.

Great or small, it could be the sound of a breeze through the trees, a new

Pregnancy Diaries

By Jessica Gaspar

Final Pregnancy Column

A

s you’re reading this, I have likely already given birth to my son. My official due date was Jan. 2. His name is Timothy Lawrence Gaspar after my father and grandfather.

On Tuesday, Dec.8, I felt what I thought might be contractions for about two hours. I called my doctor’s office, and the nurse told me to go to Strong Memorial Hospital to be checked. By the time I made it to the hospital, the pain stopped and I was not at all dilated, so they sent me home.

Two days later at my 36-week check, I did have to have a nonstress test since my doctor was concerned about the effect my treated chronic high blood pressure might have on the baby. That went well, Page 8

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and my doctor scheduled another non-stress test for my 37-week check, which I assume will be fine as well.

The baby’s car seat has been installed in my car. I had to make the decision to actually purchase a new vehicle since the longevity of my 16-year-old Toyota Avalon with nearly 210,000 miles was questionable.

I wanted something more reliable for the baby, so I am now leasing a new 2016 Toyota Camry.

Before I go into the five-star crash test rating, its various safety features, and the wonderful reputation and reliability of Toyota, I do have to add that I am actually employed fulltime at a local Toyota dealership so my personal opinion may be seen as partial.

As I reflect on the 40 weeks of my pregnancy, I am amazed at how

assignment at work, your daughter’s decision to go back to school or a stranger’s warm hello in passing.

Make your list personal, and try to come up with at least two blessings. If nothing comes to mind, just take your time and keep thinking.

You may be surprised at what surfaces, and discover the transformative power of gratitude.

Fourth step: Start every day with an open heart and with a view to see the positive and the possibilities in life. If you bump into an obstacle, try to appreciate the opportunity it presents to overcome it. When you focus on the wonderful things in life, wonderful things begin to happen. It reminds me of the law of attraction.

Your positive thoughts and energy can become a magnet and draw even more positive thoughts and energy in your direction.

Document these miraculous moments in your journal.

Fifth step: Make your gratitude journal your own. Make your writing come to life by adding doodles, photos, quotes, scripture, or magazine clippings. I love embellishing my journal with my favorite sayings and simple sketches.

So, what will I include in my gratitude journal before I turn in for the night? I have so much to be thankful for, but today, I am especially grateful for my family and friends: — I’m grateful for my parents’ influence, which I feel in the deepest part of me, even in their absence. I’ll forever be grateful for my mother’s strength, sensitivity and caring touch.

Her big smile and warm hug when I came to visit was always so reassur-

smoothly everything really went.

Over the summer, I did have some swelling that caused carpal-tunnel-like symptoms, but those symptoms went away on their own in mid-October. Then there was the Down syndrome scare on an ultrasound, but the bloodwork for that came back as normal. As for my weight gain, I only gained about six to eight pounds through my entire pregnancy. I had no strange cravings or anything stereotypical of pregnancies.

Now I know every woman is different, but when I compare my pregnancy to my sister and sisterin-law, I consider myself lucky. My sister gained about 80 pounds by the end of her first pregnancy, had preeclampsia, and then had a scheduled induction. And my sister-in-law who also gained 80 pounds by the 32nd week of her first pregnancy, had preeclampsia and required an emergency caesarean section. My nephew spent three weeks in the neonatal intensive care unit at Strong hospital, but now he is a happy, healthy 8-month-old baby.

Right now, my biggest fear is childbirth. Being my first pregnancy, I obviously don’t really know what to expect except for what others have told me. I try not to listen to many child-birth stories since, again, everyone is different. To make myself feel more at ease and prepared, I had a pedicure done and my hair cut.

While this pregnancy column is now closed, I welcome you back next month to read my first-ever parenting column. I am looking forward to writing about my new experiences as a mom.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

ing and welcome.

I am also reminded of and thankful for my father’s creative, entrepreneurial ways whenever I pick up a tool, dare to take a risk, or find the courage to be direct in my dealings with others.

— I’m grateful for my sister Anne’s gigantic heart, sense of humor and passion for her family and friends. She knows me like no other, and still enjoys my company! When I’m with her, I’m inspired to be a better person (and a sillier one, too). Our relationship is precious and brings me so much joy!

— I’m grateful for my dear friend Terry’s generous and determined spirit. When confronted with life’s uncertainties, he perseveres with resourcefulness and conviction. We share a wonderful friendship, and I just smile when I think of his patience, warmth and engaging personality.

Even after years of gratitude journaling, I am struck by how the simple act of writing down what I value and love every day can change my world for the better.

It’s simple. It’s free. And it can work wonders. So give it a try, and count your blessings!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call her at 585624-7887, email her at gvoelckers@ rochester.rr.com.

Cholesterol Levels Are a Problem for Many US Kids About 20 percent of U.S. children have problems with their cholesterol levels, such as high levels of "bad" cholesterol or low levels of "good" cholesterol, according to a new report.

The report found that, overall, 7.4 percent of children ages 6 to 19 have high levels of total cholesterol, meaning their cholesterol levels are at or above 200 milligrams per deciliter.

High cholesterol levels are more common in children who are obese, the report found. Among obese children in the study, 11.6 percent had high total cholesterol levels, compared with 6.3 percent of children whose body weight fell into the normal range.

In addition, the researchers found that girls were more likely to have high cholesterol levels than boys: nearly 9 percent of girls had high total cholesterol levels, compared to about 6 percent of boys.

The most common cholesterol problem in kids was having levels of "good" cholesterol that were too low, meaning having levels of HDL cholesterol below 40 mg/dL, the report found. Overall, 13.4 percent of children had low HDL cholesterol, but the rate was much higher among obese children. About 33 percent of children with obesity had low HDL cholesterol, compared with only 6.8 percent of children with a normal weight.

Do We Exercise Too Much?

All stats on injuries in the anterior cruciate ligament (ACL), knee and hip replacements are way up. Are we abusing our bodies?

By Deborah Jeanne Sergeant

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f it seems like everyone you know is getting total knee replacement — or hip replacement — you’re not imagining things. Physician Chris Brown, director of the sports medicine program at Rochester Regional Health System, said that the procedure is increasing.

“One reason is it’s gaining more acceptance,” Brown said. “We have an aging population with our baby boomers. It’s the baby boomers that want to remain more active than people the same age in years past.

“If you take that and combine it with sometimes overuse injuries, that’s why we’re seeing more of them.”

He also said that people who are overweight place more strain on their knees than those of a healthy weight.

When people engage in “weekend warrior” behavior — performing rigorous athletic activity only sporadically — they raise the risk for an acute injury. Events such as a 5K run, tough mudder or warrior dash are too demanding for people who don’t regularly work out.

Although exercise benefits the body and mind in numerous ways, engaging in it carelessly, especially as you age, can result in injury that can keep you sidelined and de-conditioning even more.

By the Numbers: Knees, Hip, ACLs By 2010, knee replacement has become the top reason for in-patient surgery for people 45 and older, according to the National Hospital Discharge Survey. Hip replacement is also on the rise. The 2010 survey further states:

• 5.2 million knee replacements have been performed between 2000 and 2010.

• The total number of knee replacement surgeries in the US in 2010: 719,000 • The total number of hip replacement surgeries in the US in 2010: 332,000 • The rate of surgeries has doubled from 2000 to 2010.

• The average knee replacement patient’s age in 2000: 69.

• The average knee replacement patient’s age in 2010: just over 66.

Anterior cruciate ligament (ACL) injuries are also on the rise. According to the New York Statewide Planning and Research Cooperative System: • The rate of ACL repair surgeries on people aged 3 to 20 grew from 17.6 per 100,000 people in 1990 to 50.9 in 2009.

• Peak age for those seeking reconstruction was age 17.

Serving Men, Women and Children Schedule your Make sure your activity fits your age. You likely can’t do the same workout that a college football player can if you’re 50. That’s not to say you can’t improve your physical performance and condition, however. It just takes time.

“I like to tell patients that you should use the 10 percent rule,” Brown said. “Increase 10 percent of the time length you exercise per week.”

He encourages patients to strength training, work on balance and flexibility, as well as use the proper technique to lessen their chance of injury.

To learn specific movements to help prevent injury, he recommends the site of the American Academy of Orthopedic Surgeons (www.aaos. org) and that of Finger Lakes Sports Medicine (www.fingerlakessportsmedicine.com).

Kevin Silverman, certified personal trainer with Brighton Personal Training, tells clients to build balance and stability on the knees by standing on one leg at a time (hold onto a stable object if you might fall).

Another move that can help is seated leg raises, keeping the leg straight.

“A lot of injuries come because maybe the surrounding muscles can’t keep up with the dynamic exercise,” he said.

One example of an activity that’s hard on the knees is skiing. Its twists, turns and bumps stress the connective tissues. Running also batters the knees because of the hard, weight bearing impact.

Silverman recommends elliptical machines and recumbent bicycles as knee-friendly equipment, since unlike treadmills, knees don’t bear as much weight and pounding. Swimming also takes off the pressure.

As with any change in your fitness regimen, seek a doctor’s approval before beginning an exercise program or new activity, especially if you have not regularly engaged in physical fitness recently. Slowly increase intensity to help prevent injury.

Should you feel any acute pain, stop immediately and seek medical attention if it doesn’t subside in a few days with rest, ice, compression and elevation. Muscle soreness that occurs a day or two after exercise is normal.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Soup Can Aid in Weight Loss Experts: Soup contains no ‘magical’ properties that cause weight loss; however, it can replace higher calorie choices well

By Deborah Jeanne Sergeant

N

o reputable dietitians advocate trying fad diets like the cabbage soup diet to lose weight; however, eating more soup this winter as part of a healthful, balanced diet, paired with adequate exercise, may help you lose a few of those holiday pounds.

Perception helps soup make a good meal choice for weight loss.

"People often eat with their eyes first," said Berit Young, regisYoung tered dietitian with Healthy Living Center in Rochester. "If they see a big bowl of hearty vegetable soup, they're almost satisfied before eating. We can eat more of soup by pure volume alone."

Soup appeals emotionally, too.

Young compared the effect of eating a warm bowl of soup to the comfort offered by hot tea. She added that soup makes cutting calories easy because measuring servings is simple.

Soup contains no "magical" properties that cause weight loss; however, it can replace higher calorie choices well.

"There's water in soup, so it increases the volume of what you're

eating," said Sandra Jolley, registered dietitian with Highland Hospital.

"I'm always a big proponent on mindful eating. That's all part of obesity prevention. When we eat soup, we slow down. We smell it, slurp it off the spoon. We tend to eat soup slower than other types of foods and slower eaters notice signs of fullness more quickly."

That's why soup can help you feel more satisfied while eating fewer calories. Depending upon the type of soup you eat, soup can increase your intake of low-calorie, nutrient dense foods, which can also help you feel full.

"Soups that have more vegetables, lean meats and whole grains are good choices," Jolley said.

"Soup can fit into healthy eating plans."

Add leftover vegetables.

Chopped kale or spinach taste great in Italian-based soups. Diced carrots taste good in many Jolley varieties.

Although veggies dish up plenty of vitamins, soups that skimp on protein can lead to overeating later.

Jolley said that's one reason it's important to include protein at each meal.

"Chili, vegetarian or made with lean beef or ground turkey, has lots of protein," Jolley said. "The beans are a good source of fiber and you get tomatoes and vegetables, too."

If your soup lacks McHugh protein, serve sides like low-fat Greek yogurt, lowfat cheese on crackers, or nut butter spread on apple slices or wholegrain crackers.

Maggie McHugh, registered dietitian and senior nutritionist with Finger Lakes Eat Smart NY, a program of Cornell University Cooperative Extension Wayne County, said that balance is key. “I think soup can help, but I wouldn't recommend

having soup for lunch and dinner every day, since we won't have a healthy balance," McHugh said.

She tells clients to cover half their plates in fruits and vegetables, one-quarter with a lean protein source and one-quarter with carbohydrates, preferably whole grain sources. To help accomplish this with soup, she advises adding vegetables and beans to soup to ramp up fiber and protein. Varieties such as chicken noodle lack vegetables and protein if it's the kind with just broth, noodles and tiny bits of chicken.

McHugh said that soup with vegetables and beans "helps promote a sense of satiety which helps you lose weight."

Beware of Sodium in “Salty Six” Foods Eating too many salty foods can create many health problems, including high blood pressure ,which can lead to stroke, the No. 5 killer of Americans. But did you know the majority of the sodium we consume is not from a salt shaker at the dining table? It’s from common foods we enjoy every day.

The American Heart Association/American Stroke Association is increasing

awareness of sodium and the “Salty Six” — common foods that may be loaded with excess sodium that can increase your risk for heart disease and stroke.

Sodium overload is a major health problem in the United States.

The average American consumes Page 10

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about 3,400 milligrams of sodium a day — more than twice the 1,500 milligrams recommended by the American Heart Association/American Stroke Association. That’s in large part because of our food supply; more than 75 percent of our sodium consumption comes from processed and restaurant foods.

Salty Six top sources for sodium in today’s diet Breads and rolls. We all know breads and rolls add carbohydrates and calories, but salt, too? It can be deceiving because a lot of bread doesn’t even taste salty, but one piece can have as much as 230 milligrams of sodium. That’s about 15 percent of the recommended amount from only one slice, and it adds up quickly. Have two sandwiches in one day? The bread alone could put you close to 1,000 milligrams of sodium.

Cold cuts and cured meats. Even foods that would otherwise be con-

sidered healthy may have high levels of sodium. Deli or pre-packaged turkey can contain as much as 1,050 milligrams of sodium. It’s added to most cooked meats so they don’t spoil after a few days.

Pizza. We know that pizza is not exactly a health food, because of cholesterol, fat and calories but pizza’s plenty salty, too. One slice can contain up to 760 milligrams of sodium — and frozen varieties can be even higher. Two slices can send you over the daily recommendation in just one meal.

Poultry. Surely chicken can’t be bad for you, right? Well, it depends on how you prepare it. Reasonable portions of lean, skinless, grilled chicken are OK but may still contain an added sodium solution.

And when you start serving up the chicken nuggets, the sodium also adds up. Just 3 ounces of frozen and breaded nuggets can add nearly 600 milligrams of sodium.

Soup. This is another one of those foods that seems perfectly healthy.

It can’t be bad if Mom gave it to you for the sniffles, right? But when you take a look at the nutrition label it’s

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

easy to see how too much soup can quickly turn into a sodium overload.

One cup of canned chicken noodle soup can have up to 940 milligrams of sodium. And remember that soup cans typically contain more than one serving.

Sandwiches. This covers everything from grilled cheese to hamburgers. We already know that breads and cured meats may be heavy on the sodium. Add them together, then add a little ketchup or mustard and you can easily surpass 1,500 milligrams of sodium in one sitting.

Be sure to keep in mind that different brands and restaurant preparation of the same foods may have different sodium levels.

The American Heart Association Heart-Check mark—whether in the grocery store or restaurant helps shoppers see through the clutter on grocery store shelves to find foods that help them build a heart-healthy diet. For more information on sodium and nutrition visit www.heart. org/sodium or www.heart.org/nutrition.

SmartBites

The skinny on healthy eating

The Amazing Health Benefits of Turmeric Why does India have one of the lowest rates of colorectal, prostate and lung cancer in the world? Why do elderly villagers in India have one of the world’s lowest rates of Alzheimer’s?

Interest in turmeric — and especially curcumin, the active ingredient in the spice credited with its numerous health benefits — began years ago when researchers went looking for answers to these important questions and arrived at this possibility: The reason may be the turmeric that they consume in their daily curries.

Turmeric, a brightly colored relative of ginger, is a major ingredient in Indian curries, makes American mustard yellow, and adds a distinctive zing to most dishes. It is also believed to have anti-inflammatory, antioxidant and perhaps even anticancer properties, which explains why turmeric is one of the most researched medicinal plants in history.

What has the research revealed?

Let’s begin with turmeric’s anti-inflammatory properties, since chronic inflammation and its link to a plethora of diseases seems to top many of our health-worry lists.

In some studies, turmeric’s anti-inflammatory effects have been shown to be comparable to potent drugs, from hydrocortisone to Motrin. That’s good news. Also good: Unlike the drugs, which may produce side effects, turmeric is relatively side-effect free. Recent research suggests that turmeric may help quell inflammatory bowel disease, may offer relief for arthritis,

and may even play a role in protecting us from life-threatening diseases linked to inflammation, such as heart disease and Alzheimer’s.

Turmeric is a powerful antioxidant, the Michael Jordan of the spice world. Antioxidants minimize cell damage that may lead to heart disease, cancer, Alzheimer’s and other diseases by neutralizing toxic free radicals that attack healthy cells and tissues. According to a study published in the journal Basic and Clinical Pharmacology and Toxicology, mice receiving turmeric showed significant decrease in oxidative stress and notable increase in a liver-produced enzyme that acts as an antioxidant. Another study showed that turmeric may improve liver function by increasing its detoxification abilities.

This bright yellow spice may also turn out to be a bright light in our fight against cancer. While there is no definitive research on humans that shows that turmeric can prevent or treat cancer, early trials have shown some promising results. In a recent American study that combined curcumin with chemotherapy to treat bowel cancer, cells in a laboratory showed that the combined treatment killed more cancer cells than the chemotherapy alone. In another American study, mice appeared to show that curcumin helped to stop the spread of breast cancer to other parts of the body.

While our culture is not one of “daily curries” — a dietary behavior that may explain the low rates of certain cancers in India — there are

With Living Well Companion Care, mealtimes don’t have to be lonely. Our trained staff offers seniors companionship and conversation, as well as 24/7 help with non-medical assistance, including:

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How much turmeric should we consume to reap benefits? Amounts vary because turmeric can be consumed in many forms, from the fresh root to the dried root powder. The University of Maryland Medical Center recommends ½ to 1 ½ teaspoons per day of powdered turmeric, while other sources say the ideal turmeric dosage is about 1 teaspoon per day.

Almost all sources recommend eating turmeric with black pepper and some fat, as the combo boosts absorption of curcumin. Best bet on amount?

Check with your doctor or nutritionist.

Cauliflower Steaks with Ginger, Turmeric, and Cumin Adapted from The Kitchn (Serves 3-4)

1 large head cauliflower Salt and pepper 2 tablespoons olive oil, divided 1 teaspoon freshly grated ginger (or ¼ tsp. dried) 1 teaspoon ground cumin ½-1 teaspoon ground turmeric Small handful of cilantro, chopped

Preheat the oven to 400°F. Remove the leaves and trim the stem end of the cauliflower, leaving the core intact. Using a large knife, cut the cauliflower from top to base into three 3/4-inch-thick "steaks." Season each steak with salt and pepper on both sides. (Reserve any loose florets for another use.)

Heat 1 tablespoon of olive oil in a large skillet over medium-high heat. Sear the cauliflower steaks until golden brown, about 2 minutes per side. Gently transfer the steaks to a baking sheet.

Whisk together the remaining 1 tablespoon of olive oil, ginger, cumin, and turmeric. Brush or spoon the mixture onto the cauliflower steaks.

Roast in the oven until tender, about 15 minutes. Garnish with cilantro.

Suggestion: Serve atop a bed of quinoa; add chickpeas for more protein Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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easy ways we can bolster our diet with turmeric.

We can add it to scrambles, frittatas and rice; toss it on roasted vegetables; eat more curried dishes; consume extracts in tablet and capsule form; and drink turmeric tea (I add ¼ teaspoon directly to my mint tea).

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Pregnancy: Kicking the Habit Helps Moms and Babies Experts: Make it harder for people to smoke

By Deborah Jeanne Sergeant

A study from the University of Edinburgh reviewed more than 10 million births and indicates that rates of premature deaths, stillbirths, and newborn deaths decreased by nearly 8 percent since a ban to prohibit smoking in public places.

The study’s researchers estimate that 1,500 lives were saved because of the measure between 1995 and 2011.

The theory is that making it harder to smoke encourages quitting, and by quitting, more moms shield their babies from the effects of smoking.

“Is a societal health problem that is very hard to overcome,” said James Woods, OB-GYN with University of Rochester Medical Center.

Woods believes that restricting where people can smoke, along with educating moms, can help reduce the number of smoking mothers. Smoking while pregnant can dramatically affect babies’ health.

Woods added that the “huge number of chemicals” cigarettes contain “affect the lining of your blood vessels. Carbon monoxide’s affect on the placental vascular reduces nutrients and oxygen to the fetus.”

Neil S. Seligman, assistant professor of the division of maternal-fetal medicine at Strong Memorial Hospital, believes there’s “a direct correlation between smoking cessation and improvement in the rate of prematurity, low birth weight, stillbirth, and neonatal mortality.

“It’s the leading modifiable risk factor for poor perinatal outcome.”

In addition to hampering the delivery of nutrients and oxygen to the baby, smoking “alters fetal development, and exposes the fetus to thousands of toxins.”

The March of Dimes states that half of all pregnancies are unplanned, which means that many smoking women unwitting expose their babies during the earliest Page 12

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sudden infant death syndrome because nicotine on hands and clothing can still be absorbed into the infant’s blood stream,” Seligman said. “Having a parent or parents who smoke is one of the main reasons that children start smoking.”

Cessation can also help parents stay healthier so they can remain active parts of their children’s lives in the decades to come.

Smoking has been identified as a factor in cardiovascular disease, numerous types of cancer, stroke and many other life-threatening health problems.

“Smoking is one of the most important issues that relate to a person’s long-term quantity and quality of life,” said David Gandell, clinical professor of obstetrics and gynephases of development. Seligman cology at the University of Rochessaid that although quitting before ter Medical Center. “Getting women pregnancy is ideal, quitting as soon to stop smoking wherever they are as possible still benefits baby. in their reproductive years is so “Women who quit during the important, but especially if they’re first trimester will see much more looking to get pregnant.” benefit compared to those who quit Even for children born seemingin the second or third trimesters,” ly healthy to smoking mothers, the Seligman said. “Cutting down on exposure can cause long-term probthe number of cigarettes is a positive lems for the youngsters. Gandell step but is not as effective at improv- listed learning disabilities, asthma, ing outcome compared to complete and greater likelihood of infections. cessation.”

“As for the laws prohibiting After baby is born, it’s important smoking in more places, I absolutely for new moms to continue to stay agree,” Gandell said. “We know it tobacco-free. In addition to secpans out as far as lowering canond-hand smoke, which negatively cer risk, and I’m sure it does with affects babies’ development, soimproving pregnancy outcomes as called third hand smoke, the toxins well. clinging to the smoker’s skin, hair, “The more we do to make it and clothing, can also affect infants. hard to smoke, the better everyone’s “Smoking outside the house health.” doesn’t completely protect against

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

How to Quit The experts’ best tips for quitting include:

• Setting a target quit date.

Write it on a calendar.

• Making plans to quit, such as disposing of ashtrays and lighters.

• Preparing for withdrawal symptoms.

• Asking for support from friends and family.

• Replacing smoking with a healthful habit, such as taking a walk instead of smoking after meals.

• Keeping the hands busy doing something else, such as knitting.

• Avoiding e-cigarettes. They are filled with chemicals that aren’t FDA-regulated and do not help smokers really kick the habit.

The following free resources can help pregnant women quit smoking:

• 1-800-QUIT-NOW, 1-866-NY-QUITS • www.becomeanex.org/pregnant-smokers.php • www.smokefree.gov, www.nysmokefree.com • www.cdc.gov/reproductivehealth/TobaccoUsePregnancy/ Resources.htm • www.marchofdimes.org/ pregnancy/alcohol-and-drugs. aspx Experts: Make it harder for people to smoke. It would make it easier for them to quit

Yes, Women Make Less in Healthcare Industry Their pay lacks parity with men's, according to experts

By Deborah Jeanne Sergeant

F

emales working full time in Rochester made 84 percent of what men did in 2014, according to the American Association of University Women in Washington, D.C. The median earnings for women was $40,773 compared with men's $48,555.

That's still better than the national figure of women earning only 79 percent of what men earn.

But what about women in the healthcare industry?

The American College of Healthcare Education has found that in the industry, more women work in entry level, administrative and care giving roles than men and that more men work in higher management positions, 57 percent compared with 44 percent of women.

In those higher positions, women receive 18 percent less salary than men in the same position, even with the same levels of education and experience. The organization has observed this trend since it began studying the issue in 1990.

Julie Anderson, a research associate for The Institute for Women’s Policy Research in Washington, D.C., hopes to improve these figures.

"More and more women are

Health

getting education and moving up the ranks in medicine, but change is very slow," she said. "We know the value of mentoring and networking. It takes a critical mass of women at the top to pave the way. Women tend to want female mentors to help them. It's a gradual process."

Ironically, the higher positions that women occupy, the greater the wage gap grows, according to experts.

Though women usually care for children or elderly family members, that's not a main factor in the wage gap. The American College of Healthcare Education states that "career interruptions of three or more months did not markedly dimin-

in good

ish women’s salaries when compared to women with uninterrupted careers."

Anderson said that women who leave work for care giving tend to do so because they have no other choice.

Options such as flextime, paid leave and working remotely can help manage family obligations; however, women must work out the arrangement with employers, which isn't always possible.

Some women choose starting their own practice as a means of balancing family and work life; however, the costs of setting up a business takes years to recoup.

Anderson points more blame at lack of knowledge than care giving. Most employers frown upon employees sharing salary information with each other, or talking openly about the promotion process.

She also believes that career counselors and other mentors should talk with girls more about their potential earning level.

"We talk a lot of talking with girls about going into STEM [science, technology, engineering and math]," Anderson said.

"But we need to talk with girls about

income. It's not a correct assumption to assume people know how much different job titles earn.

"We need more transparency.

They don't know about how much income they'd make for a job that would give them equal satisfaction but more income."

She also encourages women to negotiate a better salary from the getgo, as that benchmark helps decide their salary for years to come. Anderson said that many women balk at discussing salary with their employer, but doing so can help them earn what they're worth.

"Do research to know if you deserve more," she said.

Kevin Miller, senior researcher with The American Association of University Women, says that his organization has been developing workshops to teach women about negotiating for more money.

"Women can certainly look into learning about what they're worth and how to talk about the value they bring to their employer," Miller said.

"It can be risky, but women who feel they're being discriminated against, they can get information on if they're getting paid less than their male coworkers."

Officials from Finger Lakes Health, Rochester Regional Health and University of Rochester declined to comment for this story.

Anderson

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• Someone who ensure medical billing codes are current in anticipation of a new billing platform • Someone who can write policies and procedures in line with the Nurse Practice Act • Someone to develop our Certificate of Need • Someone to oversee the Nursing Services budget • Someone to handle on-going development and growth of Aging and Wellness Programs •Someone to directly supervise two Nurse Team Leaders and oversee a nursing staff of 10. Shared/limited on-call responsibilities.

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3071 County Complex Drive Canandaigua, NY 14424 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

•

Page 13

No Health Insurance?

It's Going to Cost You Those who don’t have insurance will have to pay up to $900 in penalty this year; amount to go up to $2,085 next year

By Deborah Jeanne Sergeant

I

f you don’t have a health insurance policy, you likely paid a penalty when you filed your income taxes last year. Expect that penalty to sharply increase this year and to go even higher for the next year.

The penalty for the 2015 ranges from $162.50 per child under 18 to $325 per adult with a $900 maximum.

Next tax season, expect more than double that amount, $347.50 per child, $695 per adult with a $2,085 family maximum.

“Last year, it was pretty bad,” said Thomas M. Giunta, owner of Thomas M. Giunta Tax Service in Farmington, referring to the number of clients who paid the penalty. “But I think we’ll still see people who pay the penalty instead of premiums they think they can’t afford. There are more paying the penalty than the ACA writers originally thought.”

Last tax season, about 7.5 million paid the penalty out of 138 million taxpayers, according to the IRS. Giunta said that the people skipping health insurance include retirees who aren’t yet 65, the self employed, part-time employees, those who make too much money to qualify for Medicaid but can’t afford health insurance premiums and those working for exempted companies of fewer than 50 employees.

Some opt out of their company’s bare-bones plan if the portion of the premiums that they pay stretches their budget too far.

“I think the big issue is the fact there’s a disconnect between what the employee can afford and what the employer provides,” said Erick Bond, owner of Bond Benefits Consulting in Rochester.

The mandated premium contribution cap — it must be less than 8.5 percent of the gross household income — pushes premiums out of reach for some people such as those with large households. Those with no chronic health problems seldom require health care. Some would rather pay the penalty than pay more for services they don’t use.

As another factor, the difficulty in signing up may turn off some people.

“There’s no one in charge of getting people signed up,” Bond said.

“Brokers are left out of the mix there.

People fall thru the cracks because they don’t know where to go. If they connect with an employee navigator, they can know where to go next.”

The online Health Plan Marketplace has received criticism for its difficulty of navigation and, during open enrollment periods, crashes and glitches. But the wait time for the Page 14

•

call center can drag on for nearly an hour, plus the time it takes to wade through all the questions.

Despite these problems, Bond anticipates more people signing up for health insurance as the penalty rate rises.

Another catalyst for new enrollees includes the Essentials Plan offered by Excellus BlueCross BlueShield. The plan offers income-based premiums as low as $0 to $20 for people whose employers don’t offer insurance and whose income is

Deadline to Enroll is Jan. 31 If you don't have health insurance, you have until Jan. 31 to enroll for 2016 unless you qualify for a special enrollment period.

These include changes in your family status or employment that affect insurance. To avoid paying any penalty, you must carry

below $23,540 for individuals and $48,500 for households of four.

The Essential Plan provides free preventive care and basic health benefits such as doctor’s visits, doctor-ordered tests, prescription drugs, and inpatient and outpatient hospital care.

“If you look at this versus a [stripped-down] version of a higher level plan, it offers a lot and you can afford this,” said Thomas Flynn, principal with Mercer, a benefits and insurance for the entire year.

Want to figure out the penalty you may owe if you don't have health insurance coverage?

Visit www.healthinsurance.org/ obamacare/obamacare-penalty-calculator. For more information on health insurance in New York, visit www.healthinsurance.org/new-york.

The official site for signing up for insurance is https://nystateofhealth. ny.gov.

If you have no insurance, you may not pay the penalty if: • Your income is low enough that your share of premiums (after federal subsidies and employer con-

financial firm which maintains New York offices in Rochester, Melville and New York City. “The plan has no deductible. Most of the cheap plans have a high deductible, which isn’t feasible for these people.”

Flynn anticipates more people signing up for health insurance as the penalty increases.

“That has gotten people’s attention,” he said. “People realize it’s for real and they might look into getting insurance because they see the big penalty coming.” tributions) would total more than 8.5 percent of your income • You don't make enough money to file income taxes.

• You had a short gap in coverage during the year, that lasted no more than three months (if you’re uninsured for more than three months, the penalty is prorated) • You qualify for a religious exclusion.

• You are a member of a Native American tribe.

• You are an illegal immigrant or are incarcerated.

• You qualify for a hardship exemption.

Why Premiums Keep Going Up Consumers need to carefully examine coverage options when it comes to heath insurance

By Ermst Lamothe Jr. The healthcare landscape has drastically shifted, causing numerous initiatives, mergers, joint programs, unintended consequences and unanswered questions.

Unfortunately, increasing health care premiums is the only constant during the past decade and especially during the last few years.

Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation/Health Research & Educational Trust, a national organization which surveys results each year. Since 2005,

premiums have grown an average of 5 percent each year, compared to 11 percent annually between 1999 and 2005. The average annual premium for single coverage is $6,251. In many states, more than half the plans offered for sale through HealthCare. gov, the federal online marketplace, have a deductible of $3,000 or more, according to The New York Times.

“Health insurance is getting more complicated and costly,” said Dr. Katy Votava, president and founder of Goodcare, a nationwide, independent healthcare- consulting firm in the Rochester area. “Because of this issue, people have to look ahead of time at all the health plans

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

that are available and be their best advocates.”

Since 2010, both the share of workers with deductibles and the size of those deductibles have increased sharply, according to Kaiser.

These two trends together result in a 67 percent increase in deductibles since 2010, much faster than the rise in single premiums (24 percent) and about seven times the rise in workers’ wages (10 percent) and general inflation (9 percent).

Votava said too often people put continued on next page

Since 2010, both the share of workers with deductibles and the size of those deductibles have increased sharply, according to Kaiser. These two trends together result in a 67 percent increase in deductibles since 2010, much faster than the rise in single premiums (24 percent) and about seven times the rise in workers’ wages (10 percent) and general inflation (9 percent). from previous page themselves in tough situations by not doing their own due diligence.

Whether it is because of the time to look through plans, difficult to understand healthcare language or a general laissez-faire attitude, she sees a knowledge gap in people understanding their coverage.

“I think if people did a little more of their homework and looked at all their options, they would be better off,” he added. “I advise people to look at various health care plans and really see what fits them best. Find out what medications you have to take and what doctors you want to see and find something that makes sense for you.”

Votava has also written an ebook called “Making the most of Medicare: The Guide for Baby Boomers.” The book talks about how people should be educating themselves about updates regarding Medicare a minimum of six months to a year. This guide highlights the most important factors to help you plan for your Medicare transition right now.

Develop a strategy

Votava also reveals how some savvy financial planning before you enroll in Medicare can have a big impact on how much you pay. She hopes that her advice and books help people become less afraid of health care insurance and simply better informed.

“Some people are still eligible to look for health care options until the end of January and that is something that not everyone knows,” said Votava. “You need to find out what window of opportunities you have because when the window is closed, you can’t make changes.”

But the conversation often turns back to the inescapable premiums.

“Unfortunately, we are seeing premiums increase where they are going up 10 to 15 percent each year in most markets,” said Brooks Wright, sales and marketing at KBM Management in Syracuse.

The organization provides employers with cost-containment strategies and implementation to better manage their health and Workers’ Compensation insurance business.

They do a thorough market analysis, fiscal management, budget guidance and personalized customer service.

Through analysis performed by the company, he is seeing higher deductibles for any business with 100 or less employers. He said it is not uncommon to see an individual having a $4,000 to $6,000 deductible.

“It’s a trend that doesn’t seem to be changing anytime soon,” said Wright.

Businesses are looking at either high-deductible health plans or health reimbursement arrangements

to offer to employees.

“They are setting up a situation where employees will pay more if they want better benefits, but also offering other plans where if you are healthy, then you might be fine having a higher deductible,” he added.

Sometimes employers mitigate cost simply by passing it on to those doing unhealthy risk behaviors.

“The first step we are going to see is groups making smokers pay a higher percentage of the premiums,” Wright added.

Another trend he sees is families putting their children under a different plan than their employer such as New York State Child Health Plus. To be eligible for either Children's Medicaid or Child Health Plus, children must be under the age of 19 and be residents of New York state. Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income.

Michael Szymoniak, employee benefit consultant for Lawley in Buffalo, said one of the biggest trends today is the buffet of choices consumers have.

“It used to be the human resources or finance team gave employees two or three plans and they were stuck to choose between them. Today, the number of plans are rapidly growing, and it is not uncommon to see as many as six or eight different plans, and some companies even going as far as 10 to 12 plans,” added Szymoniak. “Employees at least get to be in the driver's seat of picking the plan that works best for them.”

Because variety is the theme of the moment, Lawley wanted to educate its employees about their different options. During enrollment season, employees can log onto a computerized tool that asks them questions about their projected health care needs and gives them options about what plans might work best for them. “It allows people to feel more educated about their insurance, which is key to making a good decision,” said Szymoniak. “We have received great feedback and it does make people spend more time as they should looking at health care insurance.”

Just like every other company, Szymoniak said Lawley has heard complaints about premiums on the rise. “Nobody likes spending more money than they have to,” he said.

“But we are a little luckier in New York state where the medical increases are not going up as rapidly as what I am hearing in other states.

That can be thousands and sometimes tens of thousands of dollars in savings in New York than other areas.”

January 2016 •

Highland Hospital becomes first in the area to use SpaceOAR for prostate cancer patients

U

R Medicine’s Wilmot Cancer Institute at Highland Hospital is the first in the Rochester region to offer the SpaceOAR System to shield healthy tissues and reduce complications from high-dose radiation treatments for prostate cancer.

Radiation therapy is a common treatment for prostate cancer, which affects one in seven men during their lifetime, according to the American Cancer Society. The close proximity of the prostate to the rectum makes it challenging to deliver adequate radiation doses without risking injury to the rectum.

SpaceOAR, which stands for Spacing Organs Zhang at Risk, is a temporary hydrogel spacer that is injected between the prostate and the rectum to protect the rectum and allow effective doses of radiation to be given.

Physician Hong Zhang, chief of radiation oncology at Highland Hospital, was instrumental in bringing this innovation to Highland. Zhang and her team were involved in the

multi-center, randomized clinical trials of SpaceOAR, which the U.S. Food and Drug Administration (FDA) cleared for use in April.

The goal is to use SpaceOAR with most prostate cancer patients who require radiation therapy and do not have medical conditions that may prohibit them from being injected with the hydrogel.

For a visualization of how the SpaceOAR works, visit http://www. spaceoar.com/what-is-spaceoar/.

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•

Page 15

Start the New Year

with NEW SOUNDS!

The Social Ask Security Office

By Deborah Banikowski

Access Affordable Health Care and the Insurance Marketplace Open enrollment ends Jan. 31 The Affordable Care Act (ACA) provides Americans with better health security by expanding coverage, lowering healthcare costs, guaranteeing more choice, and enhancing the quality of care for all Americans.

Everyone is entitled to affordable healthcare.

Under the law, a new “Patient’s Bill of Rights” gives the American people the stability and flexibility they need to make informed choices about their health. Some of the benefits of this coverage include:

The Smart Hearing

Experience!

Ending pre-existing condition exclusions for children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition.

• Small, barely noticeable hearing aids packed with incredible features.

Keeping young adults covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.

• Experience sounds by streaming directly to your bluetooth-enabled hearing aids.

Shown in ear.

• Discreetly adjust settings with a tap or swipe on your smartphone.

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purchase of a pair of Siemens level 3 binax digital hearing aids.

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Welcome Aetna, Excellus-BCBS and Medicare Advantage HMO plans.

Attention all NY State and Federal Employees, Retirees and Spouses: You may be eligible for hearing aids at minimal or no cost. Call us for more information!

www.hearusa.com

© 2016 HearUSA, All Rights Reserved.

Ending arbitrary withdrawals of insurance coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.

Q&A

Q: What is a Social Security statement, and how can I get a copy?

A: Your online Social Security statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability and survivors benefits you and your family may be eligible for. You can get your personal statement online by using your own my Social Security account. If you don’t yet have an account, you can easily create one.

To set up or use your account to get your online statement, go to www.socialsecurity.gov/myaccount.

We also mail statements to workers attaining ages 25, 30, 35, 40, 45, 50, 55, 60 and older, three months prior to their birthday, if they don’t receive Social Security benefits and don’t have a my Social Security account. If you don’t want to wait for your statement, you can access it online, whatever time of year you need it.

Q: My son, who gets Social Security, will attend his last year of high school in the fall. He turns 19 in a few months. Do I need to fill out a form for his benefits to continue?

16010116 HearUSA Ad_In Good Health_5.25x14_to run 01-1_02.indd 1 12/17/15 1:47 PM Page • January IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

You now have the right to ask that your plan reconsider its denial of payment.

Open enrollment began in November and ends Jan. 31. Compare healthcare plans so that you can find the best one for you, and sign up before the enrollment period ends. You can learn more about the insurance marketplace and how to apply for benefits at www.healthcare.gov.

If you are 65 or older, you are entitled to Medicare. Certain people younger than age 65 can qualify for Medicare, including those who have disabilities and those who have permanent kidney failure. The program helps with the cost of healthcare, but it does not cover all medical expenses or the cost of most long-term care.

You can access everything you need for Medicare, including online applications and publications, at www.socialsecurity.gov/medicare.

Social Security and affordable healthcare go hand-in-hand. The Affordable Care Act and Medicare help ensure that you and your family are covered.

A: Yes. You should receive a form, SSA-1372-BK, in the mail about three months before your son’s birthday. Your son needs to complete the form and take it to his school’s office for certification. Then, you need to return page two and the certified page three to Social Security for processing. If you can’t find the form we mailed to you, you can find it online at www.socialsecurity.gov/forms/ ssa-1372.pdf.

Q: My neighbor, who is retired, told me that the income he receives from his part-time job at the local nursery gives him an increase in his Social Security benefits. Is that right?

A: Retirees who return to work after they start receiving benefits may be able to receive a higher benefit based on those earnings. This is because Social Security automatically re-computes the retirement benefit after crediting the additional earnings to the individual’s earnings record. Learn more by reading the publication, How Work Affects Your Benefits, at www.socialsecurity.gov/ pubs.

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By Jim Miller

How To Write Your Own Obituary Dear Savvy Senior, Can you provide any tips on how to write your own obituary? At age 80, I am in the process of preplanning my funeral and would also like to take a crack at writing my own newspaper obit, too.

Still Alive Dear Alive, For many people, writing their own obituary can be a nice way to sum up their life, not to mention avoid any possible mistakes that sometimes occur when obituaries are hurriedly written at the time of death. Here’s what you should know, along with some tips and tools to help you write one.

Obit Tips

Before you start writing your obit, your first step is to check with the newspaper you want it to run in.

Some newspapers have specific style guidelines or restrictions on length, some only accept obituaries directly from funeral homes and some only publish obituaries written by newspaper staff members.

If your newspaper accepts self-written obits, find out if they have a template to guide you, or check with your funeral provider.

Most funeral homes provide forms for basic information, and will write the full obituary for you as part of the services they provide.

You also need to be aware that most newspapers charge by the word, line or column inch to publish an obituary, so your cost will vary depending on your newspaper’s rate and length of your obit — most range between 200 and 500 words.

What to Include

Depending on how detailed you want to be, the most basic information in an obituary usually includes your full name (and nickname if relevant), age, date of birth, date of death, where you were living when you died, significant other (alive or dead), and details of the funeral service (public or private). If public, include the date, time, and location of service.

Other relevant information you may also want to include is: cause of death; place of birth and parents names; your other survivors including your children, other relatives, friends and pets and where they live; family members who preceded your death; high school and colleges you attended and degrees earned; your work history and military service; your hobbies, accomplishments and any awards you received; your church or religious affiliations; any clubs, civic and fraternal organizations you were members of; and any charities you feel strongly about that you would like people to donate to either in addition to or in lieu of flowers or other gifts.

You’ll also need to include a photo, and be sure to leave copies with your funeral director and/or immediate family members.

Need Help?

If you need some help writing your obituary there are free online resources you can turn to like legacy. com, obituaryguide.com or caring. com/obituary, which offer tips, templates and sample obits.

Or, if you want your obit to be more memorable, purchase the ObitKit (obitkit.com). This is a $20 workbook that helps you gather the details of your life so you can write an obituary that will reflect your personality and story.

Ethical Will

If you’re interested in writing your own obituary, you may also be interested in writing a legacy letter or ethical will.

A legacy letter is a heartfelt letter that you write to your loved ones sharing with them your feelings, wishes, regrets, gratitude and advice.

And an ethical will (which is not a legal document), is like an extension of a legacy letter that many people use to express their feelings as well as explain the elements in their legal will, give information about the money and possessions they’re passing on, and anything else they want to communicate.

For help in creating these, there are lots of resources available like celebrationsoflife.net and personallegacyadvisors.com, which offers practical information, examples and materials you can purchase to help you put it together.

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.

January 2016 •

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GOLDEN YEARS SPECIAL Don’t Miss the Next Issue of In Good Health, featuring seniors and golden years issue Call 585-421-8109

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

•

Page 17

H ealth News Galbier to serve in Gov. Cuomo’s council Teresa Galbier, president/CEO of the Alzheimer’s Association Rochester & Finger Lakes Region, has been appointed to Gov. Andrew M. Cuomo’s NYS Coordinating Council for Services Related to Alzheimer’s Disease and other Dementias.

The council was formed to facilitate Galbier interagency planning and policy-making, review specific agency initiatives for their impact on services related to the care of persons with dementia and their families, and provide a continuing forum for concerns and discussions related to the formulation of a comprehensive state policy for Alzheimer’s disease and other dementias.

The council is charged with providing reports to the governor and the New York State Legislature every two years.

“Teresa Galbier brings a wealth of knowledge and experience to the governor’s council, and will be a welcome addition to this important panel,” Assembly Minority Leader Brian Kolb (R-C, Canandaigua) said. “For more than three decades, she has been a fierce advocate for patients and families coping with Alzheimer’s disease in our local communities.”

Galbier brings over 30 years of experience in human services with nearly 13 years in her role as president/CEO of the Alzheimer’s Association. She is also the treasurer of the Coalition of New York State Alzheimer’s Association Chapters, which advocates on behalf of the 380,000 Empire State residents living with Alzheimer’s disease and related dementias and their families and caregivers.

She lives in Victor.

Excellus earns top marks for LGBT workplace Excellus BlueCross BlueShield received a perfect score of 100 percent on the 2016 Corporate Equality Index, a national benchmarking survey and report on corporate policies and practices related to workplace equality for lesbian, gay, bisexual and transgender employees. The index is adminSearles Page 18

•

istered by the Human Rights Campaign Foundation.

Excellus BCBS joins the ranks of 407 major U.S. businesses which also earned top marks this year.

“We’re proud that the Corporate Equality Index again recognized Excellus BCBS for its workplace inclusiveness,” said Joseph Searles, corporate director of diversity and workforce inclusion, Excellus BCBS. “Workplace equality is extremely important to our organization, which is why we continue to make strides to support our lesbian, gay, bisexual and transgender employees, their families and the community.”

"Several of our employees, for example, led an effort this year so that the company, as a matter of policy, will turn down requests for donations and sponsorships from organizations that have a written policy of discrimination against persons or groups on the basis of gender identity or sexual orientation," he said.

The 2016 CEI rated 1,027 businesses in the report, which evaluates LGBT-related policies and practices, including non-discrimination workplace protections, domestic partner benefits, transgender-inclusive health care benefits, competency programs and public engagement with the LGBT community.

Excellus BCBS’s efforts in satisfying all of the CEI’s criteria resulted in a 100 percent ranking and the designation as a Best Place to Work for LGBT Equality.

For more information on the 2016 Corporate Equality Index, or to download a free copy of the report, visit www.hrc.org/cei.

HCR among top performing agencies HCR Home Care in Rochester and the Finger Lakes region is among the best performing home health care providers in the country, according to an independent review.

The 2015 HomeCare Elite winners list, a compilation of the most successful home care providers, named HCR among the top 25 percent of more than 9,000 agencies in the United States. The company was judged one of the most successful home care providers in the nation based on a host of performance measures, such as quality of care, quality improvement, patient experience, process measure implementation and financial management.

“HCR Home Care is extremely proud to be cited as one of the top home care agencies in the country, based on our outstanding clinical outcomes and other performance measures,” said HCR President Elizabeth Zicari. “This national recognition of our localized care is a testament to our clinicians, our leadership team, and all of our employees, who are dedicated to improving people’s health across the Finger Lakes region.”

Published by OCS/National Research and DecisionHealth, Home-

Care Elite is a market-leading review.

The list is compiled using publicly available data from Home Health Compare and the Centers for Medicare & Medicaid Services (CMS).

Bonomo named nursing director at HCR Home Karen M. Bonomo has joined HCR Home Care as a director of nursing in the company’s licensed home care services agency division.

In this role, Bonomo supervises agency professional clinical and paraprofessional services to facilitate and assure the delivery of high quality patient care.

She is responsible for the clinical quality and excellence Bonomo of patient care, program compliance and operational management of the licensed home care services agency division.

Bonomo previously served as a reimbursement specialist at Jewish Senior Life and as assistant director of patient services at Sibley Nursing Personnel Services Inc./Lifetime Care. She also held positions at Traditions in Caring, St. Ann’s Community and Highlands of Brighton.

Bonomo earned her bachelor’s degree from Empire State College and her nursing diploma from the Arnot Ogden Medical Center School of Nursing. She resides in Hilton.

eHealth Technologies appoints Markin as COO eHealth Technologies, the leading provider of clinically informed referral solutions, has appointed Jeff Markin as chief operating officer. Markin succeeds Greg Foust, who has led operations at eHealth Technologies since 2007 until his retirement in December.

“Jeff is a Markin trusted leader who consistently delivers results. He brings a wealth of experience and expertise in healthcare information

technology and operational excellence that will greatly benefit eHealth Technologies,” said Ken Rosenfeld, CEO and president.

For over 30 years, Markin has worked in the healthcare industry in various positions including holding positions as chief executive officer and chief operating office, and divisional manager of operations, manufacturing, and research. His experience includes work at Eastman Kodak Company, VirtualScopics, and Bio-Optronics.

As COO of eHealth Technologies, he will oversee the customer support operations while contributing to the development of business strategies, operating plans, process and quality improvement, customer satisfaction improvement, and business transformation initiatives for these critical functions.

94 students get Doctor of Chiropractic Degree New York Chiropractic College held commencement exercises Dec. 5 in the Standard Process Health and Fitness Center, conferring 94 Doctor of Chiropractic and 27 Bachelor of Professional Studies degrees.

Associate Professor WilVentiniglia liam Lauretti spoke on behalf of the faculty; Student Government Association President, Bryan Kent gave the student address.

The commencement address was delivered by Thomas R. Ventimiglia, dean of the college’s postgraduate and continuing education division.

Ventimiglia has been employed at NYCC since 1986 in various capacities. Since assuming the position of dean in 2004, he has expanded the scope and offerings of postgraduate courses making NYCC a leader in New York and New Jersey. In addition, he owns and operates a private practice in Queens.

He served as president of the NYS Chiropractic Association, district 3 in 1998, and as president of the American College of Chiropractors from 2010-2013. He currently serves as chairman for the subcommittee for postgraduate education for the Association of Chiropractic Colleges and is president of the Northeast Council of Chiropractors.

Center for Disability Rights Opens First Social Adult Day Program in Ontario County The Center for Disability Rights (CDR) recently opened a new Social Adult Day Services (SADS) program in Canandaigua, the first in Ontario County, which will be located at 195 Parrish St. CDR will operate a structured group day program designed to provide meaningful therapeutic and age-appropriate activities, and support to participants with activities of daily living, meals, socialization, programs and life enrichment. It will be open to the public from 8 a.m. to 6 p.m.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

CDR is a nonprofit service and advocacy organization devoted to the full integration, independence, and civil rights of people of all ages with all types of disabilities.

With services all across New York state and offices in Rochester, Corning, Geneva and Albany, and program sites in Rochester and Canandaigua, CDR represents the concerns and rights of thousands of people with disabilities.

For more information, contact Kristin Salter at 585-546-7510 orksalter@cdrnys.org.

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From left, Howard J. Berman Prize winners David Zapfel, executive director of Gerard Place in Buffalo; Bonnie Ross, executive director of The Partnership for Ontario County; and Ellen Polimeni, member of The Partnership's board of directors and mayor of Canandaigua.

The Partnership for Ontario County Gets Award For the first time in its 12-year history, the 2015 Howard J. Berman Prize has been awarded to two Upstate New York nonprofit organizations: Gerard Place in Buffalo and The Partnership for Ontario County in Canandaigua.

The Partnership for Ontario County was created in 1998. Its mission is to create, support and administer alliances to cultivate positive social change. In 2014, the group served nearly 2,000 individuals with more than 200 volunteers. The Partnership for Ontario County operates under a system of care philosophy with programs that are youth and family driven. Its seven core programs and initiatives are the Ontario County Youth Court, Child Advocacy Center for the Finger Lakes, Family Support Centers, Partnership for Success, Never Alone Club, With Youth For Youth, and Youth Mental Health First Aid. It serves also as a support agency for Nowhere to Go, for issues of homelessness.

“Through the years, the Howard

Berman Prize has been awarded to a variety of deserving organizations across upstate New York,” said Sandra Parker, chairwoman of the prize selection committee. “This year, The Howard Berman Prize Committee was fortunate to have two outstanding organizations that are each worthy of this honor.”

The Howard J. Berman Prize, which includes a $10,000 cash award and a handcrafted sculpture, is named for the former chief executive officer of The Lifetime Healthcare Companies, parent company of Excellus BlueCross BlueShield and Univera Healthcare. Financed through private donations from more than 160 of Berman’s colleagues and admirers, the prize was established to honor Berman’s leadership and commitment to serving at-risk populations. The prize recognizes and rewards upstate community-based, nonprofit organizations that pursue local initiatives to improve access to health care regardless of ability to pay, and the quality of life for those in need of support and services.

Palliative Care Our palliative care programs benefit anyone with an advanced, life-threatening illness. They focus on relieving the suffering associated with pain or other symptoms, along with the distress caused by difficult treatments.

Experienced and compassionate caregivers help patients and their families coordinate treatment options and collaborate with providers for the best quality of life.

A palliative care physician is on staff to provide in-home consultations for patients who are referred by their providers.

Visit lifetimecare.org or call 585.214.1000.

GOLDEN YEARS SPECIAL Don’t Miss the Next Issue of In Good Health, featuring seniors and golden years issue Call 585-421-8109

Serving Monroe and Ontario Counties in good A monthly newspaper published

Health Rochester–GV Healthcare Newspaper

by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high traffic locations.

In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved.

154 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: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Jessica Gaspar, Lynette Loomis Advertising: Donna Kimbrell, Anne Westcott Layout & Design: Eric J. Stevens • Office Manager: Alice Davis 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.

January 2016 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Damaris Pinedo (right) owns Just Juice 4 Life on University Avenue, Rochester. She holds a master’s degree in medical management and has screened patients for cancer and infectious diseases for close to a decade. “I realized that we all needed to shift the way we think about how to manage our health. Returning to the basics of fruits and vegetables was the answer — not a prescription or a pill,” she says. On the left is Willow Pickard, a customer.

Better Health Through Juicing Store on University Avenue helps those who want better health through juicing

By Lynette M. Loomis Many of us grew up in homes in which fruits were apples, oranges, bananas and grapes. Vegetables were green beans and corn all cooked to death in a boiling pot of water until even the dog wouldn’t eat them with enthusiasm — and dogs eat everything, right?

Enter “health” and the awareness of the relationship between healthy diet and prevention of medical conditions including diabetes, cancer and heart disease.

The mantra is now to eat five servings of fruits and vegetables a day. While we all know this, we fall short on execution. Only about one in three Americans eats the recommend number of servings.

We do a little better with fruit than vegetables and we tend to coat our veggies in oil and salt. Shopping for, cleaning and cutting vegetables seems to slow us down as we race from one part of life to another.

One popular response to increasing fruit and veggie intake is juicing.

Vegans, vegetarians and carnivores alike are juicing to improve nutrition and increase their fruit and vegetable intake.

Using fresh, well-washed organic ingredients, juicing is a convenient approach. You may also want to count on the help from a holistic health coach.

Damaris Pinedo owns Just Juice 4 Life on University Avenue, Rochester. She holds a master’s degree in medical management and has screened patients for cancer and infectious diseases for close to a decade. She became a caregiver for a cousin diagnosed with ovarian cancer and her interest in holistic health turned into her life's mission. Her Page 20

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goal is to spread the word that true wealth is health.

“I realized that we all needed to shift the way we think about how to manage our health. Returning to the basics of fruits and vegetables was the answer — not a prescription or a pill.” Pinedo said. “I believed that with additional training, I could help people impact their nutrition through raw, living organic juice. Not just orange juice, but fresh juice made with organic greens, herbs, vegetables and fruit."

According to Joanne Wu, MD, juicing is a nutrient-dense option of adding vitamins and minerals to our diet.

“When used in moderation, juices can help cleanse, detoxify and nourish not only the physical being but the mind/body connection through reconnecting your palate to fresh whole foods,” Wu said. “It should never be used as a permanent meal replacement, as it can lack the fiber intake necessary for gut health, but when done right, it can enrich one's diet with health and rejuvenation.”

Some of Pinedo’s customers feel strongly about the health benefits of juices, including Willow Pickard. "I was told I had a year to left to live after being diagnosed with Stage IV primary liver cancer at the age of 18.

I started juicing and here I am a year later close to remission. Juicing has saved my life and I'm thankful every day to have walked into Damaris' juice shop. I continue to learn and grow and now I will take another step forward as I adopt a vegan lifestyle. I have never felt more balanced physically, mentally, emotionally, and spiritually.”

Pinedo says, “To be accepted by people, juice blends have to be tailored to their individual health needs and be tasty, although some flavors are an acquired taste.”

To add fun to the concept of juicing, Just Juice 4 Life offers Juice Flights, Power Shots, and Custom Juice Cleanses.

The store also offers office delivery and catering. “Peer support makes trying something new feel more like an adventure than a chore.”

Margaret O'Neill is a home economist and program director of Friends of the Rochester Public Market. "Many of us don't regularly eat as many servings of fruits and vegetables for good health. Juicing fruits and veggies into an easy-to-consume beverage is good way to pack more nutrients into our diets. Taking advantage of fruits and veggies when they are in fresh and in-season, is a healthy and economical way to enjoy great tasting nutrient-rich beverages.

“To make the most of juicing, supplement your fruit and vegetable consumption with juices rather than replacing them, as your body needs the fiber found in whole foods.

The B and C vitamins are more easily absorbed

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2016

in juices than other vitamins, so consider leafy greens veggies, bell peppers, strawberries and citrus fruits. Experiment with mixing fruits with leafy green or other veggies to get a flavor combo that you enjoy," O'Neill said.

Pinedo also has some recommendations to juicing newbies.

“Don’t expect that drinking juice followed by fast food binges or evenings on the couch will result in a major overhaul of your health. If you are serious about feeling better, you will likely need to make some lifestyle changes. Juicing is a great way to cleanse your palate so that you make and crave healthier choices.”

She adds, “It's important not to overlook fiber in your diet to maintain bowel regularity, reduce cholesterol, and maintain healthy blood sugar levels. Working on the principle of bio-individuality means that each of us has individual food and lifestyle needs. An effective holistic health coach will help you to make positive changes that are based on your unique needs, lifestyle, personal preferences, and background and help you select the right juices or elixirs for you.”

As we challenge our healthy eating habits over the holidays, juicing might be just the way to get us back on track.”