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PRICELESS

Meet Your Doctor Trillium Health chief medical officer Rob Biernbaum talks about the stigma against HIV patients and the agency’s effort to help those with substance abuse disorders

ALL ALONE ON THANKSGIVING

GVHEALTHNEWS.COM

NOVEMBER 2018 • ISSUE 159

Live a Longer, Healthier Life Highland Hospital geriatrician Susan Friedman offers 10 tips for those who want to live a longer and healthier life. See page 20

Live Alone and Thrive columnist spending her first Thanksgiving alone. She discusses her plans

CBD Oil 101

Safer Roads

Find out why more people are using cannabidiol (CBD) oil

Dentist Visits

Campaign in Rochester aims at reducing number of injuries and deaths involving motor vehicles and bicyclists/ pedestrians

Study released by Excellus BlueCross BlueShield shows nearly 30 percent of adults in region skip annual visits

Health Coach

Page 20

Should you hire one? They are great, but they come at a price

Kumquats Anyone? If you don’t know what a kumquat is, you’re not alone. The good news, it’s in season now. See why you should eat it. SmartBites

Page 15

­

Confused? Check a list of free online resources that will help you understand your options. Savvy Senior.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018


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Living Well Companion Care provides non-medical services to make living in your own home feel manageable again. We can support you with daily routines, transportation, housekeeping, basic home repairs and home safety modifications. Companions undergo comprehensive background screenings. We only hire Companions we would trust to care for our own loved ones.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of Nov. 16

HEALTH EVENTS T

UsTOO holds symposium on prostate cancer UsTOO Rochester, a nonprofit organization that raises awareness of prostate cancer, will host the UsTOO Prostate Cancer Symposium from 9 a.m. to 3 p.m., Friday, Nov. 16, at Unity Hospital. Living with prostate cancer will be addressed by leading experts in the field. It will be hosted by Radiation Oncology at Park Ridge Wilmot Cancer Center and presented by UsTOO Rochester. Join other survivors and partners at this free conference to learn new cancer treament options. A light lunch will be provided. For details contact Mark Richardson, chapter leader at ustoorochesterny@gmail.com or call 585-662-5155.  

Nov. 18

‘Plant-based Kids’ to be discussed at meeting Rochester Area Vegan Society will host physician Natalie Santiago, who will speak on the topic “Plant-Based Kids: A Chicago-Based Pediatrician Leads by Example.” The event will take place starting at 5:30 p.m., Nov. 18, at Brighton Town Park Lodge, 777 Westfall Road in Rochester. Following the discussion, the group will hold a vegan dinner, which starts at 7 p.m. Dinner is a vegan potluck. Vegan means no animal products (no meat, poultry, fish, eggs, dairy products or honey). Bring a dish with enough to serve a crowd, and a serving utensil; also bring a place setting for your own dinner. It’s free to RAVS members. $3 guest fee for non-members, plus bring a vegan dish.  For more information, call 2348750 or visit rochesterveg.org.

Lifespan holds various workshops in November Lifespan, a Rochester-based nonprofit that has been helping older adults and caregivers approach aging with greater information, supportive services and guidance, has announced a series of workshops for November. All of the programs take place at Lifespan, 1900 S. Clinton Ave. The workshops are free and open to the public. Reservations are re-

CORRECTION A story published in the October issue of In Good Health—Rochester’s Healthcare Newspaper included the wrong telephone number for eye doctor George Kornfeld, a low-vision optometrist. The correct number is 585-271-7320. Page 4

November is Eye Donation Month

quired. Go to www.lifespanrochester. org or call 585-244-8400, ext. 201. They are: n Home Care Options This will cover types of home care, how to access services and how the services are paid. From 9 to 10:30 a.m. Monday, Nov. 5. n Supportive and Assistive Housing Options for Older Adults Explanation of the multiple levels of care including independent with services, assisted living, enriched, special certifications and skilled nursing.  From 9 to 10:30 a.m., Tuesday, Nov. 6. n Transportation Options Learn about various transportation options available for older adults. From 9 to 10:30 a.m., Wednesday, Nov. 7. n The Opiate Epidemic: Effects on Older Adults This workshop will provide education regarding opiate use and misuse among older adults. Narcan training will be provided and each participant will receive a Narcan kit. From 3 to 4:30 p.m., Thursday, Nov. 8. n Understanding and Responding to Dementia-Related Behaviors Learn to decode behavioral messages, identify common behavior triggers and acquire strategies to hep intervene with some of the most common behavioral challenges of Alzheimer’s disease. From 10 to 11:30 a.m., Friday, Nov. 9. n Dementia Conversations: Driving, Doctor Visits, Legal and Financial Planning This workshop offers tips on how to have honest and caring conversations with family members about going to the doctor, when to stop driving, and making legal and financial plans From 10 a.m. to 1 p.m. Wednesday, Nov. 28. Lunch is provided n The ABC’s of Home Care Gain a basic understanding of providing personal care at home including tips to avoid bed sores; infection control and basic wound care; bathing and dressing in a bed or chair; healthy diet and bowel management; safe transfers; managing medication; and, knowing when to call the doctor or nurse. From 10 to 11:30 a.m., Friday, Nov. 30.

Dec. 6

Fundraising to benefit Arc of Monroe initiatives The Arc of Monroe will hold a holiday fundraising event at Alex and Ani from 5 to 7 p.m., Thursday, Dec. 6, at 145 Culver Road Armory in Rochester. Fifteen of all proceeds will benefit people with intellectual or developmental disabilities supported by the Arc of Monroe. Light snacks and beverages provided. Come shop for your holiday gifts and support the Rochester community.

o mark Eye Donation Month, the Eye Bank Association of America (EBAA) will be raising awareness about the life-changing opportunities that are created through eye donation. Eye Donation Month 2018 will focus on all the individuals who make the gift of sight possible. Eye bank staff, funeral directors, medical examiners/coroners, hospital administrators, cornea donor families and cornea recipients are the enduring champions for the millions of people around the world whose lives were transformed through cornea donation and transplantation. During Eye Donation Month, EBAA and its member banks will promote cornea donation and transplantation awareness, encourage individuals to register as eye, organ and tissue donors, honor donors and their families, and celebrate cornea recipients. EBAA is the nationally-recognized accrediting body for eye banks. Since 1961, EBAA member eye banks nationwide have made possible more than 1.8 million sight-restoring corneal transplantations.

Individuals interested in learning more about cornea donation and transplantation should visit the EBAA website at restoresight.org.  While there, visitors can also get information on how to register as a donor to leave the lasting legacy of the gift of sight.

Cornea Donation at a Glance

• In 2017, more than 50,000 corneas were provided for transplant with a more than 95 percent success rate. • Almost anyone can be a cornea donor, regardless of vision, age or past ocular health issues such as cataracts or laser vision correction.  • The transplants performed each year increase their recipients’ productivity and reduce their healthcare costs, contributing $6 billion in benefits to the U.S. healthcare system • It all starts with registering to be an eye, organ and tissue donor and sharing your decision with your family and loved ones. Source: Eye Bank Association of America.

Excellus BCBS to Be Tour de Cure Presenting Sponsor Partnership with American Diabetes Association will raise awareness and bring community together to stop diabetes

N

onprofit health insurer Excellus BlueCross BlueShield will be the presenting sponsor of Rochester’s American Diabetes Association Tour de Cure beginning in 2019. The Rochester event is the largest Tour de Cure in the nation, with participants cycling, walking and running to raise money for diabetes education and research. Last year the event raised more than $1.1 million locally, through the support of individuals and the business community.  “The Tour de Cure not only raises funds to help change the future of diabetes, but provides people with the opportunity to come together and be physically active, which helps people living with diabetes better manage their disease,” said American Diabetes Association Development Director Kerrie Anne Merz. “Excellus BlueCross BlueShield is a community leader in health and wellness and I cannot think of a better partner to

help increase our impact and raise awareness. “Diabetes is one of the most serious chronic conditions we face as a community and as the area’s largest health insurer,” said Christopher C. Booth, chief executive officer of Excellus BCBS. “Diabetes is a disease that’s increasingly prevalent across the country and right here in Rochester. One out of every 10 adults in Upstate New York has diabetes.”  “I have had the pleasure of working with Excellus BlueCross BlueShield as a corporate team and sponsor for several years and witnessed the company’s commitment to our community and to its employees. I cannot wait to see what we will accomplish together,” said Merz. For more information, sponsorship opportunities or to register for the 2019 Rochester Tour de Cure presented by Excellus BlueCross BlueShield visit www.diabetes.org/RochesterTour or call 585-458-3040 ext. 3473.

Inaugural Healthcare Guide Don’t miss advertising in the inaugural issue of the 2019 Rochester Healthcare Guide, packed with information about the healthcare industry, profiles of healthcare leaders and an extensive resource directory with information about nonprofits, support groups, senior services and much more. See our ad on page 22

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018


At Trillium Health, we offer a full spectrum of health care, including care tailored for you as you age. We understand that with every year comes different health issues to be aware of and be managed. But we also understand that we’re here to help you live your healthiest life exactly the way you want to live it. It’s personalized care that starts by getting to know the person. And it continues by understanding that the person you really are doesn’t change with the passage of time.

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the full spectrum of care— including golden November 2018 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Robert M. Biernbaum, D.O. Trillium Health chief medical officer talks about the ‘unfortunate’ stigma against HIV patients and the agency’s effort to help those with substance abuse disorders in the Rochester area Q: How would you describe what Trillium Health does? A: We were founded during the peak of the AIDS/HIV epidemic. We’ve had multiple different names, but we’ve been doing this work since the ‘80s. Our mission has always been to ensure care for people living with HIV in addition to serving our community and primary care for people who are HIV-negative. We’ve been doing both medical care and outreach in the community for several decades. Q: HIV doesn’t dominate the headlines like it used to in the ‘80s and ‘90s. Now that we’re more able to control the disease, what do patients with HIV/AIDS need medically, and what’s their quality of life like? A: The medications have significantly advanced. Many people only need to take one pill a day. That suppresses the virus to the point where we can’t detect it in their blood stream. Years ago it was multiple pills, multiple times a day. The big thing that still exists, unfortunately, is there’s a lot of stigma associated with being HIV positive. It’s unfortunate and it’s not OK, especially considering how far medicine has advanced. We have people diagnosed in their early 20s, who start on medication, their virus is under control, and they have no other medical problems. They’re very healthy people. The HIV isn’t going to cause them any issues if they’re taking their medicine. But the stigma’s still there. Q: The drug cocktail you used to need to control HIV was notoriously expensive. Has that gotten any better? Is the medicine accessible? A: As you know, drug costs are a significant issue in our

country, and the medication is expensive. But here at Trillium we have a great pharmacy and we’re a federally qualified health center [FQHC] lookalike. That allows us to keep medical costs and prescription costs down for patients. Our average co-pay for patients for every medicine, including this one, is $3 or less. Q: Is that with or without insurance? A: Because we’re a FQHC lookalike, that’s not something patients have to worry about. Part of our mission is to ensure health equality without any concern for the ability to pay. We have people here who work with patients to make sure they’re getting the insurance they deserve. If they’re under-insured, we have programs to help cover their medical costs. Q: When you say FQHC “lookalike,” what does the “look-alike” part mean? A: When you’re first designated as a FQHC, you’re called a “lookalike.” When more money comes in from the federal government, you become what’s called a “new access point.” We’re held to the exact same standard as a FQHC without the “look-alike” part, but that’s our official designation right now. There are some things that we don’t receive in our current status because we’re not a full access point, but we act like we are, we treat our patients like we are. We have a sliding fee scale for patients. And

we ensure that all our patients are able to receive care. Q: I hear you’re a bit of a jack-ofall-trades at Trillium. You’re also doing work treating opioid addiction. A: As I’m sure you’re aware, there’s an opioid epidemic in this country, and it’s getting worse. One of our locations is a harm-reduction site. One of the things we do there is syringe exchange. That is for people who actively use IV drugs. So we’re trying to decrease the spread of infectious disease. When anyone in the community is ready to start their journey toward sobriety, we have a number of providers here who can prescribe Suboxone [buprenorphine]. We’re trying to do everything we can for this epidemic and wish everyone was, because there are a lot of people suffering who really need help. Q: Socially, do you think we’re making any progress in viewing addiction as a medical issue rather than a criminal one? A: How we see it? Or how society sees it? Q: Both. A: For various substance abuse disorders, there’s a medical diagnosis. I think one of the issues is that people are still trying to criminalize people who have substance abuse disorders, whether it’s opioid dependence or alcohol dependence. It doesn’t matter the substance. People who are, say, using IV heroin. That’s not just something they want to do. They’re doing it because if they don’t, they get sick. One of the issues we have right now is that we criminalize people with substance abuse disorders. That’s not the way to deal with this. The answer is to treat them and treat them with dignity and help them along whatever journey they want to be on. Hopefully that journey leads them to not using any substances. But when we criminalize that, it flies under the radar and no one seeks help. So I see this as a disease like diabetes. We would never criminalize diabetics, and we shouldn’t do that to people with substance abuse disorders. So it’s a big issue. Until we accept people, we’re going to have an epidemic that kills a lot of our young people. It’s heartbreaking to watch. Q: How do you work around these taboos and stigmas? A: For us, having the harm-reduction program helps. It shows them that we’re opening to partnering with them. That’s something we’d love every health center to do. They’re just patients, and they have a medical condition we can help them with. Q: How effective are treatments for helping addiction patients? A: Very. The medicines are just part of what helps, but Suboxone helps people fight cravings and if they relapse, it helps prevent people from overdosing. However, as is the case with alcohol dependence, having social support is very important in order for people to do well, so we encourage that as well. Q: I understand you’re into MMA (mixed martial arts). Are people surprised a physician is into it? A: I started doing martial arts when I was 7 or 8 years old. My parents did that because I was having a hard time focusing in school.

Page 6

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

About Trillium Health Trillium Health was formed in January 2010 as a result of the merger of AIDS Community Health Center and AIDS Rochester. Trillium Health was created so that its parent organizations could most effectively use their combined resources to prevent additional HIV infection and provide the best services possible for those already infected. AIDS Rochester was established 26 years ago as part of the New York State Health Department’s network of community service programs (CSPs). The organization started with a one-person staff and a one-room office. By 2009, the agency had 50 staff members dedicated to providing a continuum of prevention and social services for people living with HIV and their loved ones. AIDS Community Health Center, formerly known as Community Health Network, was founded in 1989 by two infectious disease physicians, Steven Scheibel and William Valenti, as a community medical and diagnostic clinic for those who were infected with HIV/AIDS. When the doors opened in 1989, 76 patients came to receive care. By 2009, the agency’s 60 staff members were serving more than 600 people. The main offices of both organizations moved to one joint facility at 259 Monroe Ave. in October 2009 just before the official merger. Trillium Health also maintains satellite locations in Bath, Geneva and on Central Avenue in downtown Rochester. I’ve trained in different forms over the years. Did some boxing. Competed. As we age, competing gets harder to do, so I coached for years. I really just love the art of the sport. I’ve had to kind of slow down on coaching, but I still work with a lot of people who compete. A lot of them are my patients as well. I see it as a sport, a way to stay in shape, and to reach out to the community. Where I used to coach we didn’t charge.

Lifelines Name: Robert M. Biernbaum, D.O. Position: Senior vice president and chief medical officer at Trillium Health since March 2016 Career: Formerly a physician at MultiCare Health System, a health system with five community hospitals and many neighborhood clinics based in Tacoma, Wash. Previously he was Rochester Regional Health System’s chief medical information officer Hometown: Pittsford Education: University of New England College of Osteopathic Medicine; University at Buffalo Affiliations: Highland Hospital Organizations: Monroe County Medical Society; Opioid Epidemic Committee; Monroe County Opioid Task Force Family: Partner (Christina); six children, two grandchildren Hobbies: Time with family, martial arts


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Need a Health Coach? Most will reinforce the importance of wellness, nutrition. But they come at a cost. By Deborah Jeanne Sergeant

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ealth coaching rides the trend of preventive health, but how could a health coach help

you? Phil De Angelo, fitness director and personal trainer at Penfield Sport & Fitness in Rochester, believes it’s “absolutely essential” to receive help in nutrition, since food labels and health claims have become very confusing. “A fitness coach or personal trainer can oversee all this,” De Angelo said. He said that his organization bases its health advice on that of the Cleveland Clinic and each person who comes for personal training receives a complete evaluation and medical history to assess the person’s goals and issues. Daniel DiMarco, manager of the Riedman Campus Wellness Center at Rochester Regional Health, views a health coach as a “mentor and wellness authority who helps clients feel their best through food and lifestyle changes.” These changes come about through custom wellness programs. Health coaches function as more than weight loss gurus (although many clients need help in that area). “The health coach is also responsible and will reinforce the

importance of practicing all aspects of wellness to move toward optimum health,” DiMarco said. Physician Joanne Wu, an experienced yoga teacher, health coach and wellness expert practicing in Rochester, said that health coaches engage clients to focus on a healthful lifestyle. “These skills are specialized,” Wu said. “Many people could use inspiring and accountable people in their lives so they can make sustainable change in daunting tasks such as exercise, lose weight, eat right, sleep better, and have less stress; however, not all health coaches are certified, are properly trained, or use evidence-based counseling tools to help their clients.” Some health insurance plans or company’s health benefits include health coaching; however, those not covered who can’t afford to hire a health coach have other options. Seeking support in a group setting to meet health goals can often help participants succeed while they save. For example, many gyms employ personal trainers and experts in nutrition who offer group programming. Group fitness sessions can foster accountability and camaraderie. Community-based organizations such as Oasis, YMCA and JCC offer

fitness classes for short sessions. There’s no long-term commitment so you can “try on” an activity and learn more about health. Some gyms, martial arts schools and dance studios offer trial lessons or memberships as well. While these can’t replace regular exercise, they do provide an opportunity to experiment to see what activity could become lifelong without wasting money on an unused membership. Workshops offered at the public library, health foods stores and other venues could offer a good way to learn more about good health

(although these lack the ongoing motivation many need to stick with their goals). Read local periodicals and look on community bulletin boards to spot upcoming events. “Should you have a friend that practices healthy behaviors, you can always approach them and many people will help each other best they can as friends,” Wu said. “Don’t be shy.” People interested in hiring a health coach should expect to pay anywhere from $50 to $80 an hour. Some insurance plans may cover the expense.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

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Let’s get every child covered. If your child needs health insurance, Fidelis Care is just a call, click, or visit away.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone on Thanksgiving? We’re in This Together

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or the first time in 64 years, I will be celebrating Thanksgiving alone. My parents have passed on and my sister Anne, who has taken up the mantle in their absence, will be leaving town to enjoy Thanksgiving with her husband’s family down south. Unfortunately, I won’t be able to join them. I’ll be on my own. If you, as I am, are facing Thanksgiving alone for the first time, you may be anticipating a lonely and depressing fourth Thursday of November. But, it doesn’t have to be so. Whether you’re divorced, widowed or simply fending for yourself on Thanksgiving, this family-centered holiday can be an opportunity for personal growth, gratitude and self-expression.

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Personally, I’m taking my own best advice to heart. Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year. n Be thankful — What better time to feel and experience gratitude. Consider making a list of all the things you are thankful for this year: Your health? Your children? Those good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved pet? Or perhaps even this opportunity in your life to learn and grow? n Take the long view — While you may be alone this year, it doesn’t mean you’ll be dining solo on leftover stuffing for the rest of your life. This one day doesn’t dictate your destiny. Who knows what the future holds? Over the next year, you may meet someone special or achieve a measure of inner peace and confidence that enables you to enjoy a holiday on your own or with your “family of friends.” n Do good — Brightening the holiday for those less fortunate can be a worthwhile and satisfying way to spend the day. Shelters and food kitchens often welcome volunteers, but — truth is — many of these agencies fill up fast with regular volunteers. You may need to plan ahead and be creative. As an alternative, you might consider participating in a local Turkey Trot, most of which benefit charities. You could burn off a few calories for a good cause or participate as a vol-

unteer. They often need extra hands to register and cheer on runners of all ages. Instead of serving supper at the shelter, you could be serving up smiles at the finish line. n Throw your own little “Friendsgiving” for fellow single or separated persons — Have some fun! It doesn’t have to be elaborate or even planned far in advance. Sometimes last-minute dinner invitations can turn into the best, most memorable get-togethers. Chances are you know others who may be alone this Thanksgiving. Extend a warm invitation and ask people to bring a holiday side-dish to pass. This gives everyone a chance to make a meaningful (and delicious!) contribution. n Beware of “euphoric recall” — When you are feeling lonely, it can be easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the bickering, bad blood and woozy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing. n Rent a movie and indulge in a tasty guilty pleasure — Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart. Or find a newer movie, such as “About Time,” and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love pumpkin pie ice cream this time of year! n Pick up the phone — The difference between isolation and engagement can be as simple as dialing a seven or 10-digit phone number. My experience happily tells me that most everyone welcomes a call and warm wishes on Thanksgiving. Your invitation to go for a walk or see a matinee while the turkey is in the

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

oven may be seen as a nice diversion and chance to get out of the house. Don’t hesitate to make a call. n Decorate your home inside and out — Do it for you. It may help put you in the spirit of the holiday. This past weekend, I recreated my annual stacked-pumpkin display for my front porch. It gives me a warm feeling every time I pull up to the house. Create harvest accents for your home to help kindle the essence of Thanksgiving in your heart. n Write “thank you” notes — Now here’s an idea that’s so obvious it often gets overlooked on Thanksgiving. “Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, PhD, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship. Who wouldn’t love to receive a card on the day after Thanksgiving that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).” In preparation for this kind gesture, purchase cards and stamps in advance. So, there you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can be thankful you got out of bed, rose to the occasion, and enjoyed your Thanksgiving. Gwenn Voelckers leads “Live Alone and Thrive” empowerment workshops for women in Mendon, Monroe County, and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase a book or invite Voelckers to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com


Dentist Visits: Nearly 30% of Local Adults Skip Annual Visits

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wenty eight percent of adults in the Finger Lakes Region did not visit a dentist within the past year, according to the results of a new survey commissioned by Excellus BlueCross BlueShield. “The lack of annual routine dental care by such a large segment of the population is surprising, because 76 percent of respondents report having a regular dentist,” said physician Martin Lustick, corporate medical director at Excellus BlueCross BlueShield. The American Dental Association recommends that everyone visit his/her dentist for an exam and cleaning at least once a year (and preferably once every six months). Good dental care isn’t just about checking for cavities and gum disease. Many diseases that affect the entire body often first become apparent as mouth lesions or other oral problems. More than 90 percent of all systemic diseases produce oral signs and symptoms, reports the Academy of General Dentistry.  The following health conditions may be identified by a dentist during a routine oral exam: • Diabetes • GERD (gastroesophageal reflux disease) • Cancers of the head, neck, mouth and throat • Osteoporosis • AIDS (acquired immune deficiency syndrome) • Autoimmune diseases, including Sjogren’s syndrome, rheumatoid arthritis and lupus   • Celiac disease • Anemia • Chronic kidney disease “People should view routine dental care the same way they view other routine medical care, such as wellness visits, standard immunizations, and screenings for high blood pressure, high cholesterol, diabetes and various cancers,” said Lustick. “You shouldn’t just go to the dentist when you think there’s something wrong.”   Excellus BCBS commissioned One Research to conduct an online general population survey of adults who live in 39 Upstate New York counties and are 18 and older.

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Two-thousand individuals completed the survey. Data were weighted to census targets of age, sex, race and ethnicity, and were tested at a 95 percent confidence interval, assuring that results accurately represent Upstate New York adults. Respondents’ top three reasons for not visiting a dentist: • 40 percent believe there is no need if they don’t have signs of a tooth problem • 24 percent are concerned about the cost • 16 percent expressed fear Among adults who do not receive once-a-year cleanings, about one-third said a cash incentive or gift card would motivate them to get cleanings. Seventeen percent want a dentist located closer to where they live or work, and 16 percent want a dentist who participates in their dental insurance network. An Excellus BCBS infographic containing tips for better dental care is available free to download at https://tinyurl.com/y9dkc9yb   View complete survey results at https://tinyurl.com/yaq38na3  

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. © 2018 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, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Colleen M. Farrell, John Ellie (DMP) • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

November 2018 •

oakorchardhealth.org Oak Orchard

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Members of Hearing Loss Association of America’s Rochester chapter celebrated the group’s 35th anniversary with a picnic in August.

The Importance of Being Heard The local chapter of Hearing Loss Association of America is in its 35th year of connecting those with hearing loss to resources — and each other By Colleen M. Farrell

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n a recent rainy Tuesday morning, about a dozen people gathered inside a Rochester church to talk. The topics? Picking the right audiologist. How to have a conversation amid a lot of background noise. Ensuring a hearing aid’s proper fit. Remembering to wear said hearing aid. “Not wearing hearing aids and going into a noisy situation is like

training for a marathon by laying in bed,” audiologist Joe Kozelsky told the group. With a little humor and a lot of camaraderie and understanding, tips and tactics for managing hearing loss were exchanged as part of HOPE, or Hearing Other People’s Experiences. It is an outreach of the Hearing Loss Association of America’s Rochester chapter. The local HLAA was founded in 1983 by nine individuals.

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The next year, that group became an official member of Self Help for Hard of Hearing People, or SHHH, which is today known as the Hearing Loss Association of America. As the Rochester chapters turns 35 years, it can now count more than 200 members. It has become one of the most active chapters in the country. Losing the ability to hear can be an isolating and scary experience. Missing out on conversation. Not being able to enjoy entertainment like movies and live performances. Feeling less safe because you can’t hear noises around you. Adapting to the changes hearing loss brings can be confusing, too. “We understand, and so we share, because we know how difficult it is,” said Margaret Cochran, a member of HLAA Rochester’s board of directors. The chapter offers a couple of different resources in addition to HOPE. Day and evening programs are held on the first Tuesday of each month from September to June. Guest speakers share knowledge and information on a variety of topics. An induction hearing loop and live captioning are used at every meeting. All programs, unless otherwise noted, are held at St. Paul’s Episcopal Church at 25 Westminster Road in Rochester. The group has information that is useful to people at every stage, according to Cochran. She started suffering from hearing loss around 2000 as a result of Meniere’s disease, an inner ear disorder. She came to HLAA Rochester at the suggestion of a friend. Though she’s been a part of it for nearly two decades, Cochran said she still learns something new.

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She encouraged the attendees to look at the literature on display. “If you don’t see what you need, ask for it, because chances are, someone will be able to help you in some way,” she said. Marjorie Buck of Chili has attended HOPE twice. A hearing aid wearer since 1998, she said she has picked up useful information by attending the sessions. “We especially enjoyed this part of it,” she said. The chapter also puts out a newsletter from September to June. It includes information on events, chapter news, listings of local captioned theater productions, helpful tips and more. It can be found online at www.hearinglossrochester.org or received via mail for a nominal fee. Another resource is the assistive listening device demo center at Lifespan, 1900 S. Clinton Ave. It is open from 10 a.m. to 2 p.m. on the third Thursday of each month (except for July and August). Visitors can learn about the latest in assistive listening devices from volunteers. In addition, the organization has awarded over $100,000 in scholarship funds to more than 120 hard-of-hearing students headed off to college. Next year, HLAA will hold its national convention in Rochester from June 20-23. Author, psychotherapist, disability rights advocate and extreme athlete Rebecca Alexander will be the keynote speaker. Cochran encourages anyone dealing with hearing loss to get involved with HLAA. “It’s a very personal experience and it’s different for everyone, but it’s comforting to know you are not alone,” she said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org


Hospital Admissions for Sepsis in Finger Lakes Region Higher than Upstate New York Average

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he Finger Lakes Region’s hospital admission rate for adults with sepsis is slightly higher than the Upstate New York average according to an Excellus BlueCross BlueShield analysis of 2017 claims data. The Centers for Disease Control and Prevention defines sepsis as the body’s extreme response to an infection. Without timely treatment, it can rapidly lead to tissue damage, organ failure and death.   Sepsis occurs when an infection in a person triggers a serious inflammatory response throughout the body. The inflammation can rapidly spread and damage multiple organ systems, causing them to fail. Leading causes of sepsis include such common infections as cellulitis,

pneumonia, urinary tract infections and diverticulitis. According to the Sepsis Alliance, there are 1.7 million cases of sepsis and 270,000 deaths each year in the United States. The sepsis death toll exceeds annual deaths in the U.S. from breast cancer, prostate cancer and AIDS combined. “Increased awareness and tracking of sepsis may account for the regional differences,” said physician Gregory Carnevale, Excellus BlueCross BlueShield chief medical officer for value-based payments.  Hospitals in the Finger Lakes region had nearly 4,800 adults ages 18 and older admitted for sepsis in 2017. In half of the cases, the length of stay lasted from four to nine days. Twenty percent of the cases required

Rate of Sepsis Admissions per 1,000 adults (2017)

Western New York 7.39 Finger Lakes Region 5.65 Utica/Rome/North Country 4 Southern Tier 3.70 Central New York 3.59 Upstate New York 4.68 Source: Excellus BlueCross BlueShield treatment in an intensive care unit. “It is vital that we identify and treat sepsis during its early stage,” said Carnevale. “Early treatment with antibiotics and large amounts of intravenous fluids improves chances for survival.” Last year in Upstate New York, there were about 800 reported hospital admissions for sepsis that occurred within 30 days of a medical/surgical admission. Carnevale advises monitoring people who are recovering from a medical procedure or surgery. The CDC lists any combination of the following as symptoms of sepsis: 

• Confusion or disorientation • Shortness of breath • High heart rate • Fever, or shivering, or feeling very cold • Extreme pain or discomfort • Clammy or sweaty skin “Act fast and get medical care immediately if you suspect sepsis or have an infection that’s not getting better or is getting worse,” said Carnevale. An Excellus BlueCross BlueShield infographic about the warning signs of sepsis is available free to download at https://tinyurl.com/ yafsefcd.

Healthcare in a Minute By George W. Chapman

Commercial Insurance Premiums Up Again

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ore than 150 million people are on commercial insurance through their employer. Despite the elimination of some ACA taxes, premiums are still on the rise well ahead of inflation. Family premiums  went up an average of 5 percent to about $19,600 and individual premiums went up an average 3 percent to almost $7,000, according to the Kaiser Family Foundation. Worker wage increases and inflation are both at 2.5 percent this year. In the last 10 years,

premiums have increased twice as fast as worker earnings and three time as fast as inflation. To exacerbate things for consumers, out-of-pocket deductibles have increased eight times faster than their earnings. Employers seemingly “take back” wage increases via increases in employee copays and deductibles. Some of the recent increase in premiums is due to younger people going without insurance (making risk pool older) once the mandate to have insurance was terminated.

Hospital Inspectors The Centers for Medicare and Medicaid Services (CMS) relies on independent inspectors or accrediting organizations (AOs) to ensure public and private hospital quality and safety. A Wall Street Journal investigation found that some hospitals, despite a history of ongoing problems, still kept their “accredited” status, which allows them to receive payments from CMS. Consequently, CMS is improving its oversight of these AOs. CMS has redesigned the inspection process AOs must follow and will begin posting the AO performance data and findings to Congress. CMS will also select hospitals at random to and compare the CMS audit to that of the AO. The plan is to release more detail like complaints and out of compliance data versus just the overall accreditation status of a hospital. It is still illegal for CMS to disclose actual hospital surveys performed by the AOs.

star scale. This year, two thirds of the VA hospitals (96 of 146) showed improvement. The current rankings are: Albany 3+, Bath 5+, Buffalo 4+, Canandaigua 4+ and Syracuse 3. The + indicates noticeable improvement since the last audit.   Accessing Your Records You are entitled to a complete copy of your medical record, digital if you want,  per the Health Information Portability and Accountability Act (HIPAA) of 1996. Providers are allowed to charge a “reasonable fee,” typically a fixed rate or per page rate. Usually, it is not a problem requesting and receiving a copy of your record from your physician. You have a relationship with your physician(s) and the cost to copy the record is not prohibitive because it might be just several pages in length. According to a study conducted by the Yale University School of Medicine, obtaining your record from a hospital is more of a challenge. Researchers, posing as patients, called the top 83 hospitals in the US and asked about procuring a copy of their record. One

Upstate VA Hospital Ratings The VA performs its own audits and ranks its hospitals on a five

November 2018 •

hospital actually told the “patient” that it would be a HIPAA violation to release a copy in any event. Several hospitals said that sending the record via email was “insecure” and therefore a violation. That is not true. You are entitled to receive a copy of your record in any format as long as it is readily producible in that format. Many of the hospitals in the study didn’t even have a process for delivering the record in digital format, although required to do so by law. Many hospitals said they could only send paper copies and would charge per page. In most cases, the expense would be prohibitive as a 200-page hospital record is not atypical. However, in their defense, there are still storage units filled with boxes of paper records and accessing and copying your record is time and labor intensive. The study concluded that while patients should know they are entitled to digital copy by law, they have to understand hospitals are still transitioning to the digital age.    Medicare Premiums Level There are about 60 million people covered by Medicare. Ten thousand baby boomers (65+) are signing up for Medicare every day. It is projected there will be almost 80 million seniors on Medicare by 2030.  Medicare premiums went up an average of just 1 percent a year under Obama and continue to creep up today well below commercial premium increases. How is that possible? Skeptics have attributed this low increase phenomenon as a fluke or result of the last recession. The thought was seniors couldn’t afford the 20 percent copay so didn’t seek as much care. That has never been proven. Vanderbilt University economist Melinda Buntin has studied Medicare for years and has raised some eyebrows as she reveals her findings. The Affordable Care Act, not the recession, had way more to do with leveling/steading Medicare premiums over the last 10 years. There was a “perfect storm” of provider incentives to control

costs and how care was delivered. She found that Medicare and Medicaid got much better at managing dual eligibles (over 65 and poor). Value-based payments and payment bundling were effective at controlling costs without decreasing the quality of care. The dismantling of the ACA will have a negative impact and the expectation is Medicare premiums will soon increase by more than 1 percent annually.   Drug Pricing Under Control?   In what could be a sign of the times, drug manufacturer Gilead is dropping the list price of its generic Hep C drug “Harvoni.”  As reported in the Wall Street Journal recently, the list price for the eight-week treatment plan was dropped from a staggering $63,000 to a staggering $24,000.  This is “progress.” Traditionally, drug manufacturers have marked up prices in anticipation of giving discounts to pharmacy benefit managers (PBMs). The  good news for consumers is that many plans require you to pay your share based on the absurd list price versus the discounted price obtained by PBMs.  Trump Signs Spending Bill  The 2019 federal fiscal year began Oct. 1. Related to healthcare, the budget increased funding for: the DHHS and NIH, the opioid epidemic, increased access to addiction treatment, slowing the flow of illegal drugs into the US, and for states to monitor prescriptions.  George W. Chapman   is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Things You Should Know About Quitting Smoking By Ernst Lamothe Jr.

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moking rates in the U.S. have declined in recent decades. However, about 15.5 percent of the population — or about 37.8 million adults — still smoke cigarettes, according to the latest numbers from Centers for Disease Control and Prevention. And with the popularity of e-cigarettes, which are battery-operated devices that people use to inhale an aerosol that typically contains nicotine, the problem is not going away. Smoking is an issue that leads to disease and disability, and harms nearly every organ of the body. It is still the leading cause of preventable death. In addition, thousands of young people start smoking cigarettes every day, according to the CDC. “One reason why some people continue to smoke despite knowing the health risks such as lung cancer, heart disease and stroke is that it’s so hard to quit,” said Patricia Mallaber, a certified tobacco treatment specialist and nurse practitioner for UR Medicine’s Wilmot Cancer Institute in Rochester. “That’s because of a substance found in cigarettes called nicotine that makes cigarettes and other tobacco products quite addictive. But there is hope. While it’s challenging, many people are able to quit smoking with a bit of planning and dedication.” Mallaber, who works each day to help those who’ve been diagnosed with cancer and those who want to stop smoking, shares five tips on how to quit.

1.

Find a ‘Quit Buddy’ — Quitting smoking can be complex and complicated,

but it can be made easier when you have help from others along the way. Whether it’s your spouse, significant other, best friend or a co-worker, find someone who you can lean on for support during your quit journey. “This could be thought of as a ‘quit buddy’ which is someone who wants to quit along with you, so you can be there to help each other. In addition, reach out to your health care team as they can be a great resource to have on your side,” said Mallaber. The American Lung Association has also created a program where people can start their journey with a click of a button. Called “Freedom From Smoking Plus,” it is a user-friendly interactive program that creates a personal quit smoking plan on your desktop, tablet or smartphone. It also offers a surround sound of support from its Lung HelpLine counselors and other quitters through an online community. Also for those who are interested, phone support is available in state by calling the NY State Smokers Quitline at 1-866-NY-QUITS. The free and confidential service provides coaching as well as nicotine replacement therapy for those who qualify. A number of well-established and reliable online resources may also help.

2.

Consider medications — Many people don’t know that there are seven Federal Drug Administration-approved medications to help people quit smoking. Some of these medications, such as the nicotine patch, gum and lozenges, are available over the counter. Some can be used along with nicotine replacement therapy; however, you often need to start taking them in the weeks before, according to the American Cancer

Society. Experts say smokers who are significantly dependent on nicotine should consider nicotine replacement or drug therapy to help them quit. Signs of severe dependence include smoking more than one pack a day, smoking within five minutes of waking up, smoking while sick and waking up at night to smoke. “Reach out to your health care provider to inquire which may be beneficial for you,” Mallaber said.

3.

Change your routine — Ask yourself, during what points in your day you want to smoke most? Think about your triggers and try to avoid them. For example, for some, coffee can be a big challenge when quitting. Think about changing brands of coffee or switching to tea. “For those who tend to smoke when drinking alcohol, it may be wise to cut down on alcohol use,” said Mallaber. “Avoid places where you would normally smoke or try to set goals, like no smoking in the house or no smoking on the porch. You could also try changing up your routine and getting out of the house to a public place, as many public areas do not allow smoking and being in a smoke-free place may help you avoid temptation.”

4.

Distract yourself — When you have a craving, it is important to stay busy for a few minutes. Before you know it, the craving will pass. Keep reminding yourself that the cravings are temporary and will improve over time. To help, you could try sucking on hard candies. You could also try plain chewing gum. “That being said, avoid using junk food as a distraction,” she said.

Patricia Mallaber, a certified tobacco treatment specialist at UR Medicine’s Wilmot Cancer Institute. “Try healthy snacks like celery/carrot sticks or fruit instead. Be sure to stay hydrated with plenty of water, and consider brushing your teeth and using mouthwash throughout the day.” In addition to distracting your mouth, distract your hands by working on crossword puzzles, Sudoku, coloring books, journaling or playing a game on your phone/tablet.

5.

Think of the reasons why you want to quit and focus on them — In life finding out your motivation can be key. Set a quit date and give it a try. “It can take multiple quit attempts before some are successful. If things don’t work out, don’t give up! Every time you try to quit, you learn things that work well and also things that do not. Try to modify and keep moving forward,” she said.

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SmartBites

The skinny on healthy eating

Little Kumquats Big on Vitamin C and Fiber

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hat’s a kumquat? If that question popped into your head, you’re not alone. My husband thought it was a root vegetable. My friend thought it was related to a mango. It’s neither. The size and shape of a large grape, the kumquat is like a baby orange in reverse, with a sweet (edible!) skin and a tart pulp. And right around now, they’re available in major grocery stores. With winter looming — and all the sniffles and sore throats that seem to accompany this season — I’m always on the lookout for ready sources of vitamin C, especially portable ones. Kumquats certainly check that box! Just five small kumquats provide nearly 75 percent of our daily needs. Because vitamin C plays such a vital role in keeping us healthy — from boosting our immune system to producing collagen to limiting the damaging effects of harmful free radicals — it’s no stranger to health-related studies. Ongoing research, for example, has demonstrated that while vitamin C can’t prevent the common cold or upper respiratory infections, it may slightly reduce symptoms. Some studies have suggested that

vitamin C from food can reduce the risk of certain cancers. Still others have found that high dietary intake of vitamin C has been associated with lower risk of heart disease. My takeaway? Consuming the proper amount of this multi-tasking vitamin should be a daily priority. Five bite-sized kumquats also deliver a big dose of fiber — nearly 7 grams of both soluble and insoluble fiber. Insoluble fiber promotes regularity, while soluble fiber helps lower glucose levels and ferry cholesterol out. Both kinds contribute to better health and longevity by helping to reduce the risk of developing such conditions as heart disease, diabetes, diverticulitis and constipation. The edible peel of kumquats serves up beneficial plant compounds with antioxidant, anti-inflammatory and cholesterol-lowering properties. Research suggests that these compounds may help protect against heart disease, cancer, diabetes and weight gain. On the topic of weight, nutritious kumquats are a dream snack: the high water and fiber content makes them filling, the calories are relatively low (around 10 calories each), and they’re super easy to carry around.

Kumquats, Dates, and Shaved Parmesan Salad Adapted from New York Times, Amanda Hesser 6 kumquats 4 big handfuls baby arugula (or greens of choice) 1/2 cup flat-leaf parsley leaves 2-3 dates, pitted and diced 1/4 cup shredded Parmesan cheese 1 clove garlic, minced 1 tablespoon lemon juice 2 tablespoons extra-virgin olive oil Kosher salt and freshly ground black pepper, to taste. Slice the kumquats into thin rounds, discarding the seeds. Combine the arugula, parsley, dates, kumquats and Parmesan in a large bowl. Whisk together the garlic, lemon juice and olive oil; season with salt and pepper. Pour over the salad and toss. Serves 4.

Helpful tips

Select kumquats that are firm, smooth and bright orange, with the stem attached. Pass by any that are green or have soft spots. Store them at room temperature for 3-4 days, and inside the refrigerator for up to three weeks. Whole kumquats taste best if they are gently squeezed before being eaten. Kumquat and cranberry compote (recipe at Epicurious.com) tastes great with turkey!

Anne Palumbo is a lifestyle colum-

nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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CBD Oil 101 More people are using cannabidiol (CBD) oil for chronic pain, inflammation, anxiety, depression By Deborah Jeanne Sergeant

I CBD Oil: Common Questions Marge Pickering Picone, a certified nutrition consultant, is CEO of Professional Nutrition Services in Rochester. Her business sells CBD products. She said the following represent common questions about CBD oil: n Can I still pass a urine drug test? “The research shows no response on the drug test,” Pickering Picone said. “Tests were done on 700 mg. a day consumption, which is a large serving. It takes three to five days to get out of your system, but it doesn’t show up on drug tests. Hemp is not typically something that shows up on drug tests because it contains endocannabinoids, which are natural to our system.” n How long do its effects last? “I use it on my hip flexors and knees, as I have rheumatoid arthritis. It works six to eight hours for me.”  n How can I find good quality? “It’s not just buying any kind from a gift shop. They may carry only 15 mg. strength, which isn’t strong enough for things like chronic pain. Get organic, pure and a product with party testing. You want 100-percent pure product. That’s the key to it. A lot of them use leftover stems to make a less expensive product. Make sure there’s an analysis certificate you can see.” n What are its side effects? “Hemp or CBD is non-psychoactive and doesn’t cause a high.” n What about contraindications? “I have not had anyone that has reacted with CBD.” n Is CBD a drug? “It’s not a drug. It’s an herb, like passion flower, lemon balm and chamomile.” n Can it help me? “It doesn’t help everything. It’s very specifically oriented to anxiety. Another aspect is if you have problems that are muscular like fibromyalgia, pain points, rheumatoid arthritis, and other autoimmune diseases, you will definitely notice a difference because it calms the system down.” 

n light of the opioid epidemic, many people want an alternative means to manage chronic pain without side effects and risk of dependency. Others want pain relief for conditions difficult for typical pain medication to manage. Cannabidiol (CBD) oil may provide help. One of the more than 100 cannabinoids inherent to cannabis sativa (cannabis or hemp), CBD oil is said to support the health of people who suffer from pain, inflammation, anxiety and depression without the “high” or lethargic effects typical of tetrahydrocannabinol (THC). David Brickman owns Hemp It Up! stores in Rochester and Syracuse. The shops sell hemp-related gifts and supplements. “People produce endocannabinoids in the body,” Brickman said. “As it turns out, by supplementing cannabinoids produced Brickman in a plant, we can do ourselves medical benefits.” He said that many people come

to his shop seeking relief from anxiety and depression and pain issues. And some of those have been sent in by their primary care providers. Brickman sources CBD oil from vetted companies in Colorado, he said. Though it’s legal to grow industrial hemp in approved pilot programs in New York, it’s not widespread. The producers supplying Hemp It Up! provide third party certificates of authenticity from independent labs. “The results of these tests are available to us and our customers,” Brickman said. While FDA has not approved CBD oil as prescription Tunison medication (which, in New York, may include medical marijuana), CBD oil is considered a supplement, like vitamin C. Hemp It Up! carries CBD in a variety of formats, including topical preparations, capsules, gummies, suppositories and edible drops. “We’ve had many, many return customers and many having been referred by other customers of ours,”

More stores like Hemp it Up in Rochester are selling CBD oil. Page 16

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

Brickman said. He advises customers to check with their doctors before taking CBD oil and starting at a small serving and increasing until the desired result is achieved. Jodi Tunison owns CBDepot in Rochester. Like at Hemp It Up!, her CBD oil products are all vetted and tested, she said. “You’d be amazed about the number of doctors who are sending people in,” Tunison said. “I had a guy with migraine headaches who has basically missed the past seven to eight years of his life with his family.” For someone taking moderate servings daily, CBD costs about $40 to $100 for a 30-day supply. Tunison said that her average sale is $66 and she offers CBD in numerous formulations. She said about half her business is repeat business. Tunison opened the store in May 2018. She founded the store to bring to others the same relief her mother experienced in 2016, after she was diagnosed with stage-four lung cancer that had metastasized to her brain. Tunison said her mother had six to 12 months to live, depending on treatment. They eventually decided to forgo chemotherapy and try CBD. Tunison said that CBD helped her mother enjoyed a much better quality of life for the year she lived after the diagnosis. That chapter in her life left Tunison with a desire to share CBD with others. Brenda Vice owns and operates Kali Durga Grass Roots, LLC, an educational entity in Ontario that promotes the hemp industry, but doesn’t sell hemp products. She’s certified in medicinal marijuana medicine and Vice has owned a life coaching business for more than 20 years. She said that the endocannabinoids form the “very foundation of what our immune system consists of,” and that these compounds support the immune system, brain health, stress management, and “whatever your body needs.” Physician Hemant Kalia, interventional pain and cancer rehabilitation specialist with Rochester Regional Health, said that the non-addictive, non-psychotropic qualities of CBD make it attractive to people seeking relief from chronic pain issues. “CBD doesn’t act on receptors to make people high but has properties of anti-inflammation. Some preliminary studies may show it decreases inflammation and helps with pain, especially for cancer patients who have nerve and joint related pain.” So far, the studies have been small. Kalia said that anyone interested in using CBD should discuss the possibility with their doctor to ensure no contraindications. “This is definitely not the panacea for chronic pain,” Kalia said. “We have not advanced enough to come up for a cure for chronic pain condition. It may be helpful as a adjunct in the multi-disciplinary approach to pain. Patients shouldn’t rely only on medical marijuana or CDB oil to manage chronic pain condition.”


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rinking a daily glass of wine for health reasons may not be so healthy after all, suggests a new study from Washington University School of Medicine in St. Louis. Analyzing data from more than 400,000 people ages 18 to 85, the researchers found that consuming one to two drinks four or more times per week — an amount deemed healthy by current guidelines — increases the risk of premature death by 20 percent, compared with drinking three times a week or less. The increased risk of death was consistent across age groups. The study is published online Oct. 3 in the journal “Alcoholism: Clinical & Experimental Research.” “It used to seem like having one or two drinks per day was no big deal, and there even have been some studies suggesting it can improve health,” said first author, physician  Sarah M. Hartz, an assistant professor of psychiatry. “But now we know that even the lightest daily drinkers have an increased mortality risk.” Although some earlier studies have linked light drinking to improvements in cardiovascular health, Hartz said the new study shows that those potential gains are outweighed by other risks. Her team evaluated heart disease risk and cancer risk and found that although in some cases, drinking alcohol may reduce risk of heart-related problems, daily drinking increased cancer risk and, as a result, mortality risk. “Consuming one or two drinks about four days per week seemed to protect against cardiovascular disease, but drinking every day eliminated those benefits,” she said. “With regard to cancer risk, any drinking at all was detrimental.”

The new study comes on the heels of research published in The Lancet, which reviewed data from more than 700 studies around the world and concluded that the safest level of drinking is none. But that study looked at all types of drinking — from light alcohol consumption to binge drinking. The Washington University team analysis focused on light drinkers: those who consumed only one or two drinks a day. The Washington University study focused on two large groups of people in the United States: 340,668 participants, aged 18-85, in the National Health Interview Survey, and another 93,653 individuals, aged 4060 who were treated as outpatients at Veterans Administration clinics. “A 20 percent increase in risk of death is a much bigger deal in older people who already are at higher risk,” Hartz explained. “Relatively few people die in their 20s, so a 20 percent increase in mortality is small but still significant. As people age, their risk of death from any cause also increases, so a 20 percent risk increase at age 75 translates into many more deaths than it does at age 25.” She predicted that as medicine becomes more personalized, some doctors may recommend that people with family histories of heart problems have a drink from time to time, but in families with a history of cancer, physicians may recommend abstinence. “If you tailor medical recommendations to an individual person, there may be situations under which you would think that occasional drinking potentially could be helpful,” she said. “But overall, I do think people should no longer consider a glass of wine a day to somehow be healthy.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Making Rochester a Safer Community for Road Users Nearly 4,000 injuries and deaths involving motor vehicles and bicyclists/pedestrians occurred in Rochester from 2010-2017. Coalition launches campaign to revert trend

S

ixteen local groups, ranging from health organizations to cyclist groups to government, have banded together to launch a new community campaign aimed at reducing the number of crashes among motor vehicles and pedestrians and bicyclists. The effort features a new media campaign that asks drivers to remember the three S’s of safe driving: • slowing down • scanning for pedestrians • spacing their vehicle at least three feet away from bicyclists The campaign’s website — drive2Bbetter.com — features important safety tips for drivers. Nearly 4,000 injuries and deaths involving motor vehicles and bicyclists/pedestrians occurred in Rochester from 2010-20171. Data shows that a pedestrian or cyclist is involved in a crash 1.3 times per day in Rochester, and driver error is the cause of 94 percent of crashes.  Injuries and fatalities caused by traffic crashes are not random and — because they are preventable — are not accidents. That’s why the campaign specifically uses the term “crash” vs. “accident” to make that point. Why focus on drivers? Because drivers have the most power on the road. A driver crashing into a pedestrian or bicyclist has a high probability of injuring or killing them. If struck by a vehicle traveling 40 mph, only one in 10 pedestrians will survive a crash. But if struck by a vehicle traveling 20 mph, nine out of 10 pedestrians will survive. In a recent survey3. More than half of Monroe County drivers admitted that they frequently exceed the speed limit. Enforcement of speed limits, traffic engineering and education campaigns are three ways communities improve traffic safety. In terms

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

of enforcement, local police departments are out every day working to make our streets safer. The campaign also comes at a time when cities and towns in Monroe County are using traffic engineering to create more walkable and bikeable communities. Traffic slowing features, such as curb bump outs, raised crosswalks, and buffered bike lanes, continue to be installed in Rochester and surrounding communities. The effort is led by Causewave Community Partners and Common Ground Health. The groups involved are AARP, Center for Disability Rights, City of Rochester, City of Rochester Police Department, Genesee Transportation Council, Injury Free Coalition for Kids of Rochester, Monroe County Department of Health, Monroe County Department of Public Safety, MVP Healthcare, Reconnect Rochester, Regional Transit Service, Rochester Cycling Alliance, School 19-Rochester City School District, and United Way of Greater Rochester.  “Whenever we tackle an issue as complex and important as this one, we know it will take the work of many partners to have the impact we’re after,” said Todd Butler, president and CEO of Causewave Community Partners. “We’ve worked for nearly two years with local organizations and Antithesis Advertising to develop a strategy and messaging that will change driver behavior. By delivering a simple, focused message around slowing, scanning and spacing, we’re giving drivers tools to improve safety for everyone who uses the road.” Rochester advertising agency Antithesis Advertising donated time and talent totaling more than $80,000 to develop the campaign’s advertising and social media presence. For more information on the campaign, go to drive2Bbetter.com.  


Golden Years

First User-Fitted Hearing Aid Approved

T

he first hearing aid that doesn’t require the assistance of an audiologist or other health care provider has been approved by the U.S. Food and Drug Administration. The Bose Hearing Aid is a user-fitted device for people aged 18 and older with mild-to-moderate hearing loss, the agency said in a news release. “Today’s marketing authorization provides certain patients with access to a new hearing aid that provides them with direct control

over the fit and functionality of the device,” said Malvina Eydelman, director of the FDA’s Division of Ophthalmic, and Ear, Nose and Throat Devices. Some 37.5 million adults in the United States report having hearing loss of some degree, the FDA said. Common risk factors include aging, exposure to loud noises and certain medical conditions. The Bose device was evaluated in clinical studies involving 125 people. When participants self-fitted the

It’s Not Just for Kids: Even Adults Appear to Benefit from a Regular Bedtime

S

ufficient sleep has been proven to help keep the body healthy and the mind sharp. But it’s not just an issue of logging at least seven hours of Z’s. A new study on sleep patterns suggests that a regular bedtime and wake time are just as important for heart and metabolic health among older adults. In a study of 1,978 older adults publishing Sept. 21 in the journal Scientific Reports, researchers at Duke Health and the Duke Clinical Research Institute found people with irregular sleep patterns weighed more, had higher blood sugar, higher blood pressure and a higher projected risk of having a heart attack or stroke within 10 years than those who slept and woke at the same times every day.  Irregular sleepers were also more likely to report depression and stress than regular sleepers, both of which are tied to heart health. African-Americans had the most irregular sleep patterns compared to participants who were white, Chi-

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nese-American or Hispanic, the data showed. The findings show an association — not a cause-and-effect relationship — between sleep regularity and heart and metabolic health.  “From our study, we can’t conclude that sleep irregularity results in health risks, or whether health conditions affect sleep,” said Jessica Lunsford-Avery, Ph.D., an assistant professor in psychiatry and behavioral sciences and the study’s lead author. “Perhaps all of these things are impacting each other.” Still, the data suggest tracking sleep regularity could help identify people at risk of disease, and where health disparities may impact specific groups, such as African Americans. “Heart disease and diabetes are extremely common in the United States, are extremely costly and also are leading causes of death in this country,” she said. “To the extent we can predict individuals at risk for these diseases, we may be able to prevent or delay their onset.”

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device and used a cellphone app to program and make adjustments to the device settings, they “generally preferred those hearing aid settings over … professionally-selected settings,” the FDA said. While users may fit, program and control the device on their own, some state laws require that hearing aids be obtained from a licensed dispenser, the agency said. Bose Corp. is based in Framingham, Mass.

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Golden Years

10

Tips to Live a Long, Healthy Life

By Susan Friedman, MD

Special for In Good Health, Rochester’s Healthcare Newspaper

T

he best estimates are that only about a third of health is determined by our genes. That is great news! It means that you can do a lot to increase not only how long you live, but how well you live. Some diseases have a strong genetic component, but many of the most common chronic conditions can be significantly impacted by lifestyle. Here is a Top 10 list for living a long, healthy and happy life.

1.

Move it or lose it — Sedentary behavior increases the risk of both chronic disease and death. On the other hand, regular activity and exercise have many benefits, including better strength and better mood. Many chronic diseases, like diabetes, high blood pressure and heart disease (to name a few) can be controlled by exercising. What kind? How much? That could easily be the topic of several other articles, but you can learn more at www.health.gov/ paguidelines/guidelines/. And it’s not too late to start. One study looked at people who were in their 60s and did not have chronic disease when the study started. Eight years later, those who became active were three times as likely to avoid chronic disease, functional decline and depression as those who remained inactive. And even studies on much older and more frail people have shown that exercise improves health and function.

2.

Eat more vegetables — Your grandmother was right. Many studies have found that eating a diet that focuses on plant sources, and avoids processed foods, reduces your risk of heart disease, certain cancers and dementia. Inflammation is the common pathway for a lot of our common chronic diseases, and eating more unprocessed plant-based foods can reduce inflammation. Adding more vegetables, fruits, beans, whole grains, and nuts to your diet can open up many possibilities for a culinary adventure. Why not try out a new recipe — and invite some friends to try it with you!

substantially. The 5-year mortality was two to three times higher in those with no ties when compared to those with all four types of ties. Don’t smoke — The connections between tobacco use and poor health are well known. Smoking is a risk factor for heart disease, stroke, lung disease and many cancers. Smoking not only impacts the individual, but those around him or her.

4.

5.

Sleep well — Many things can impact getting a restful night’s sleep, including demands of work, social and family responsibilities, medical conditions and sleep disorders. Sleep requirements vary, and sleep patterns change with age, but most people do best on seven to eight hours of sleep a night. Unfortunately, many people do not get this and, according to a recent National Health and Nutrition Examination Survey, more than onethird of individuals reported sleeping less than seven hours per night on weekdays or workday nights. Chronic sleep deprivation can lead to cognitive deficits, increased risk for accidents, poor immune defenses, and chronic diseases such as high blood pressure and heart disease.

6.

longevity, I would have to say it is avoiding worry, stress and tension. And if you didn’t ask me, I’d still have to say it.“ People who are faced with multiple stressors are at higher risk of developing illness. Often, these stresses cannot be avoided; what you can adjust is how you respond to them. Some things to consider are, first, recognizing when you are stressed, and then limiting other, more avoidable stressors, talking with friends or family, or meditating.

7.

Keep learning — Both formal and informal education play a role in healthy aging. Estimates are that a college education can delay the impact of aging by nearly a decade, so that individuals with a college education reach levels of disability and death about 10 years after those with less education. Cognitively stimulating occupations can help preserve cognition. Some studies have shown an association between cognitively stimulating leisure activities, like chess, bridge and doing crossword puzzles, with maintaining cognitive function, but results are mixed, and more work needs to be done to

Manage stress — As George Burns once said, “If you ask what is the single most important key to

3.

Nurture your relationships — In good times and in bad, we tend to do better when we have support from friends, family and community. According to an analysis of the Established Populations for the Epidemiological Study of the Elderly, fewer ties with spouse, close friends and relatives, church and other groups, increases mortality — Page 20

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

establish causal relationships.

8.

Maintain a healthy weight — Being either overweight or underweight is associated with higher risk of mortality. The rate of obesity has increased substantially over the past two decades. The 2014 edition of the American Health Rankings reported that 29.5 percent of US adults were obese, a 7 percent increase from 2013. Obesity increases the risk of chronic illness and disability.

9.

Embrace change — There is a saying that “change is the only constant in life.” A person who is 100 years old today has seen an amazing number of changes in their lifetime. Two world wars. The introduction of antibiotics. The first moon landing. Cell phones and the internet. And that is just scratching the surface. People who age well are people who can adapt to changes as they occur.

10.

See your primary care provider regularly — Your primary care provider can help you maintain health in several ways. First, they can provide guidance for prevention of disease, through interventions like vaccines and falls prevention. Second, they can detect disease early, to provide curative treatment. Third, they can guide management of chronic disease, to slow its progression and limit loss of function that may develop as a consequence. And finally, they can provide education on health promotion, so that a healthy lifestyle can limit risk in the first place. By following some or all of these suggestions, there is a good chance that you can live a longer, healthier, and more enjoyable life. So grab a friend, and plan to make a change today!

Physician Susan Friedman holds a Master of Public Health degree and is an associate professor of medicine at the University of Rochester School of Medicine and Dentistry. She is a geriatrics hospitalist at Highland Hospital, and sees patients at Rochester Lifestyle Medicine.


Golden Years Opiates & Seniors

‘No One Wants to Be Another Example on TV’ The opioid epidemic knows no bounds, and that includes how it is affecting older populations By Colleen M. Farrell

T

alk of the dangers of opioid medication has dominated local and national headlines for the last couple of years. Much of that conversation has centered on young people. But studies have shown that no one is immune — including senior citizens. That’s why many health care providers are spending more time discussing the use of opioid medication with their older patients. Misuse of opioids among older Americans is increasing, according to the Substance Abuse and Mental Health Services Administration. The agency reported in 2017 that opioid misuse in people aged 50 and up was higher in 2014 than it was in most years between 2001 and 2011. While the proportion of older Americans abusing opioids is relatively small compared to young adults, the agency has labeled it a public health concern. It’s an issue that garnered attention from the Senate Special Committee on Aging. Members held a hearing on it in May, soliciting input from recovering addicts, medical providers, and health care experts. In light of that, doctors are talking about how to manage pain without opioids, how to properly use them if they are necessary, and how to keep pain medication secure if, indeed, it is prescribed. Opioid use is discussed more today than it was a decade ago, according to physician Steve Ryan, chief of geriatrics at Rochester Regional Health and medical director for ElderONE, an all-inclusive program for the elderly.

“Twenty years ago, it was a discussion that these drugs might help you on a limited basis, help you walk more, help you get out of bed — and that’s a good thing,” he said. “Today, there are cases where that still may be the case, but some patients or members of the family could have trouble controlling the medication.” Those conversations have ramped up in particular over the last five years. “I think more people are aware,” Ryan said. “You turn on the news any night and you hear something kind of frightening, so no one wants to be another example on TV.” Seniors can be especially vulnerable to Ryan drug dependency, according to Joseph Talarico, general surgeon and the director of the Hernia Center of Excellence and co-director of the Robotic Center of Excellence, both at F. F. Thompson Hospital. “Those that live alone or who lack a strong social network are exceptionally vulnerable,” he said. That is why it’s critical for doctors to not only know what medications their patients are on, but why. “It is important to discuss risk and benefits of each drug individually and in context with other drugs,” he said. Practitioners are talking about

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a couple of different topics with their patients, Ryan said. The first is screening them about any past use of narcotics and other substances, including alcohol. Doctors ask if patients ever had trouble stopping use of medication. Doctors also want to know about a patient’s home environment and lifestyle. They want to know how patients will keep their medications safe so they don’t fall into the wrong hands. As for lifestyle, doctors want to know if the patient has any chronic stress, like caring for an ill loved one or a demanding job. Such stressors can increase the potential for developing a problem. Alcohol use is also a very important piece of information in a patient’s treatment plan, according to Mark Winsberg, medical director of Rochester Regional Health Chemical Dependency Services of Monroe County. “It’s not unusual for somebody to, say, be drinking alcohol at a certain level and they may not be officially an alcoholic, but they may be drinking a fair amount. If you give them opioids along with that, that can be a pretty dangerous combination,” Winsberg Winsberg said. There are other factors that can make a senior susceptible to developing a problem with opioids, according to Winsberg. The body’s metabolism changes as we age and that, coupled with being on other medications, affects how drugs are metabolized in the body. They can last longer, potential-

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ly making them more dangerous. The medications can affect one’s balance, leading to falls, as well as one’s judgment and memory. Because opioids pose risks, doctors are having more conversations with their patients about pain control after medical procedures, Ryan said. Pain is part of the healing process, he noted, adding that not all forms of pain require narcotics. It’s critical to discuss potential discomfort and how it will be treated, Ryan said. Topics should include the type of medication that will be used, the duration, and what to do if the medication is not sufficient. “I think most of my surgical colleagues have a more concrete plan today compared to a decade ago,” Ryan said. Talarico agreed. “There is a role for opiates in pain control,” he said. “However, in the older Talarico population, we have begun to carefully examine what pain medications we routinely use. We are more focused on non-opiate based in control and use a combination of Tylenol/ibuprofen/ muscle relaxant.” Ryan said that he also sees patients who are adamantly opposed to taking strong medications. It behooves the practitioner to consider each patient on a case-by-case basis and develop the best form of treatment for him or her, he said. “Folks don’t need to be afraid of taking medication that they need. They just need to work with their doctors and ask questions periodically and keep that conversation going,” Ryan said.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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or seniors who suffer from arthritis or have other hand weaknesses, an electric toothbrush is a great solution to keep your teeth clean. At the push of a button, an electric toothbrush will do everything but shake, rattle and roll to do the cleaning for you, and most come with a wide handle and rubberized grip that make them easier and more comfortable to hold on to. How to Choose

With dozens of different electric toothbrushes on the market today, here are several key points you’ll need to consider, to help you choose: • Cost: The cost of electric toothbrushes will range from $15 up to around $300. How much are you willing to spend? • Brushing action: Brush heads tend to be either “spinning” (they rotate very fast in one direction, then the other, and bristles may pulsate in and out) or “sonic” (they vibrate side to side). Both methods are effective and a matter of personal preference. • Electric versus battery: Choose a brush with a built-in rechargeable battery and an electric charging station. They’re much more convenient and cost effective than toothbrushes that use replaceable batteries. • Brushing timer: Since most dentists recommend brushing for two minutes (and most adults brush less than 60 seconds), get a power toothbrush with a built-in timer. Some brushes will even split the two minutes onto four 30-second intervals and will notify you when it’s time to switch to a different quadrant of your mouth. • Extra features: Most higher-priced electric brushes come with various settings such as sensitive (gentler cleaning) or massage (gum stimulation), a charge-level display and more. There are even “smart” toothbrushes on the market that connect to a smartphone or tablet via Bluetooth to track brushing habits. What extra features do you want or need?

Easier Flossing Products If flossing is difficult too, a good alternative to traditional string floss is floss picks. These are disposable plastic-handle tools that have floss threaded onto them, which makes them easier to hold and use. DenTek, Oral-B and others sell packages for a few dollars, or check out the Reach Access Flosser, which comes with a toothbrush-like handle for a better reach. Some other flossing devices to consider that are easy on the hands include: The WaterPik power flosser ($7), which gently vibrates to dislodge embedded food particles between your teeth; Philips Sonicare AirFloss water flossers ($50 or $90) that uses burst of water or mouthwash to and clean in-between your teeth; and WaterPik Water Flossers ($50 to $130), which use high-pressured pulsating water to remove food particles and plaque and will stimulate your gums in the process. All of these dental care products can also be found at your local pharmacy or retailer that sells personal care items or online.

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While there are many makes and models of electric toothbrushes to choose from, two of the best-selling, top-rated products to consider are the Oral B Pro 1000 (spinning brush head) and the Philips Sonicare 2 Series (vibrating brush head). Both are simple, very effective at removing plaque, and reasonably priced — around $50. They also both offer two-minute timers, rechargeable batteries and a range of brush heads to meet your needs. To learn more about these electric toothbrushes and a wide variety of other options, visit OralB.com and Sonicare.com. And for more information on choosing an electric toothbrush, visit Toothbrush.org/ best-electric-toothbrush.

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The Ontario County OFA Offers the The Ontario County OFA Offers the Aging Mastery Program Aging Mastery Program

By Jim Miller

Free Resources That Can Help with Your Medicare Decisions Dear Savvy Senior, I’m considering making changes in my Medicare coverage during the open-enrollment period. Can you recommend any free resources that can help with my choices?

Swapping Senior Dear Swapping, There are a number of good resources you can turn to that can help you choose Medicare coverage that better suits your needs, that’s completely free to use. Each year during Medicare’s open enrollment — Oct. 15 through Dec. 7 — all Medicare beneficiaries can change their coverage without penalty. Doing so, given that insurers are constantly tweaking their plans and offerings, could help lower your premiums or give you access to better care. Any changes you make to your coverage will take effect Jan. 1, 2019. Important Tools To get help with your Medicare decisions, a good starting point is to get re-familiar with the primary parts — traditional Medicare, Medicare Advantage, supplemental (Medigap) policies and prescription-drug coverage — Medicare publishes an excellent guide called “Medicare & You” that you can access at Medicare. gov/medicare-and-you. If you are already enrolled in Medicare Advantage or a Medicare Part D prescription-drug plan, it’s very important that you read and understand your “Annual Notice of Changes” and “Evidence of Coverage,” which should have arrived in the mail in September. These documents explain how your existing coverage will change in 2019 and how much you’ll pay for that coverage. Your next step is to go Medicare’s online “Plan Finder” tool at Medicare.gov/find-a-plan. Here you can enter some basic information — your Medicare number and prescription drugs (name and dosage) — and it will produce a list of possible healthcare plans in your area, the costs involved, drug coverage and customer-satisfaction ratings. Or, if you don’t have internet access, or don’t feel confident in working through the information on your own, you can also call Medicare at 800-633-4227 and a customer service representative will do the work for you over the phone. Free Advice If you want personalized help with a Medicare specialist, contact

the Medicare Rights Center or your State Health Insurance Assistance Program. The Medicare Rights Center is a nonprofit group (MedicareInteractive.org) that offers a national helpline (800-333-4114) where staff members answer questions about Medicare, and can help you choose coverage, at no charge.  And your State Health Insurance Assistance Program (SHIP), which may go by a different name in your state, provides free one-onone counseling in person or over the phone to beneficiaries, as well as  family members or caregivers. SHIPs are federally-funded programs that are not connected to any insurance company or health plan. To find a SHIP counselor in your area, see ShiptaCenter.org or call the Eldercare Locator at 800-677-1116. Another good resource, if you’re interested in choosing a new Medicare Advantage plan, is the HealthMetrix Research Cost Share Report at MedicareNewsWatch.com. This free website lists the best Advantage plans by area based on your health status. Also, several Offices for the Aging in the area offer free seminars that help seniors select the best plans. Those seminars are unbiased and not affiliated with any health insurance plan. Agent Assistance Another way to get free assistance with your Medicare Advantage, prescription drug or Medigap plans is to use an agent or broker who specializes in Medicare-related insurance in your state. These people get paid a commission to sell you a policy from the insurance providers they represent. There are federal rules and state laws governing agents or brokers who sell Medicare plans, which include things like barring them from showing up uninvited at your house to pitch a plan or trying to lure you with a cash offer. They also cannot legally charge you a fee to process your enrollment. It’s also important to understand that commission-based agents and brokers will present only the Medicare plans they represent, rather than all the plans in your market. So, you may miss out on some plans that could benefit you. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. November 2018 •

Have Have You You Mastered The ofAging? Aging? Mastered TheArt Art Of Have You Mastered The Art Of Aging?

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eet are the unsung heroes you count on every day to carry your weight, act as shock absorbers, help you walk and maintain your balance. To keep your feet in excellent condition as you age, regular visits to a podiatrist for a foot, toe and ankle exam should be part of your healthcare regimen. Athlete’s foot, corns, ulcers, a fungal infection of the nails, blisters, redness or calluses may be the first sign of more serious medical conditions like arthritis, diabetes, or nerve and circulatory disorders. Accurate diagnosis and treatment by a podiatrist are necessary to prevent infection and maintain good health. Ignoring the signs or avoiding treatment may lead to the amputation of a toe, foot or leg. Five steps to better foot health

At the Podiatry Clinic at St. Ann’s Community in Irondequoit, we recommend that seniors with diabetes have at least three foot checkups a year; those without chronic medical conditions should have an annual check-up. In between visits, these daily foot-care practices will help keep your feet healthy and happy: Wash and dry every day. Washing with soap and drying in between your toes reduces the risk of athlete’s foot fungus and nail thickening and discoloration. It also helps prevent bacteria that can cause infections. Perform daily checks. Examining your feet for any abnormalities, pain, injury or changes is important; many situations seen by podiatrists are easily treatable in the early stages. If you’re unable to look at your feet, ask a family member, friend, or health care provider to check them for you. Keep toenails trimmed. Clip your toenails straight

1.

2.

3. Age 3:

Despite my being camera shy, Dad loved taking my picture.

Age 19:

By John Ellie, DMP

across — never down into the corners or down to the flesh — and file them. If you have painful ingrown toenails, have your podiatrist trim them using sterile instruments; this will help deter infections and accidental trauma to your skin. Wear good shoes with support. Invest in comfortable footwear correctly sized and fitted for your foot. A stiff-soled sneaker or shoe will support your arch and foot better than flip-flops or walking barefoot. Without adequate support, your arches could collapse, leading to worsening of arthritis, heel pain, and other abnormalities. If you need inserts, the team at St. Ann’s Podiatry Clinic can evaluate your foot and create prescription orthotics for a fraction of the cost of store-made custom shoe inserts. Walk more! Going for a walk not only gives your feet a workout but it also increases your blood flow, exercises your heart and promotes weight loss, mental health and longevity. Afterward, put your feet up when you sit down and be sure to stretch your feet when you stand up. Every ounce of TLC you give your feet will help them—and you — stay healthy and happy, so you can stand on your own two feet for years to come.

4.

5.

John Ellie is a doctor of podiatric medicine (DPM) at the Podiatry Clinic at St. Ann’s Community, an outpatient program serving the greater Rochester community. Contact him at jellie@ MyStAnns.com or 585-642-6100, or visit www.stannscommunity.com.

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H ealth News Canandaigua VA improves quality of service The Canandaigua VA Medical Center has achieved a 4-star rating in the hospital start rating system, which evaluates and benchmarks quality of care delivery at VA medical centers (VAMCs) across the nation. The local VA was a 3-star rating until recently. Tucker “The Canandaigua VA continuously strides to improve the quality of care and health care outcomes for veterans living in the greater Rochester/ Finger Lakes region we have the privilege of caring for. We are proud of our employees’ efforts that have led to the improvements made in call center responsiveness, mental health services and primary care same day access and we are committed to sustaining these results.” said Bruce Tucker, interim medical center director. The star rating designation is designed to help VA identify best practices of its top performing hospitals and share them across VA’s health care system to achieve system-wide improvements. Compared with data from the same period a year ago, the release of VA’s Strategic Analytics for Improvement and Learning (SAIL) report shows 66 percent of VA medical centers (VAMCs) have improved in overall quality in the third quarter — with the largest gains seen in areas where there were VA-wide improvement initiatives, such as mortality, length of stay and avoidable adverse events. Six VAMCs had a decrease in quality, and improvement activities are underway at each of these facilities. Additionally, of the medical centers placed under the Strategic Action for Transformation program (StAT), an initiative that monitors highrisk medical centers and mobilizes resources to assist them, eight are no longer considered high risk and 80 percent (12 medical centers) show measurable improvements since being placed under StAT in January 2018. “There’s no doubt that there’s still plenty of work to do, but I’m proud of our employees, who work tirelessly to move VA in the right direction for veterans and taxpayers,” said VA Secretary Robert Wilkie.

Highland’s family medicine program turns 50 The University of Rochester/ Highland Hospital department of family medicine in October celebrated its 50-year anniversary. The department is one of the oldest and most prestigious in the country, with a nationally recognized residency program that trains physicians in the

medical, psychological and social factors involved in caring for patients and families throughout their lifetimes. “We are extremely proud of our residency program, which has prepared hundreds of doctors over the years to become practicing physicians in urban and rural settings across the nation,” said physician Thomas L. Campbell, who has served as department chairman for the past 15 years. “Our program also includes tracks for global health and political advocacy and many of our physicians have spent time caring for the underserved in third world countries. Alumni of our program have also achieved top positions in high profile organizations like the Centers for Disease Control and the Society for Teachers of Family Medicine and have become active in the quest for health care reform as well.” The department includes Highland Family Medicine, a community health center in the South Wedge, a Level 3 certified Nation Committee for Quality Assurance (NCQA) patient-centered medical home, serving more than 23,000 patients annually.

U of R School of Nursing gets diversity award For the second straight year, the University of Rochester School of Nursing has been selected to receive the Health Professions Higher Education Excellence in Diversity (HEED) Award from INSIGHT Into Diversity magazine. The UR School of Nursing is one of 11 schools of nursing across the country — and the only one from New York or New England — to be awarded the only national honor recognizing U.S. medical, dental, pharmacy, nursing, osteopathic and allied health schools that demonstrate an outstanding commitment to diversity and inclusion. The school is one of 35 award-winning health professions schools to be featured in the December 2018 issue of INSIGHT Into Diversity, the oldest and largest diversity-focused publication in higher education. “I’m thrilled that the UR School of Nursing was once again selected as a recipient of the Health Professions HEED Award,” said Kathy Rideout, dean of the school and vice president of the University of Rochester Medical Center. “Our sustained commitment to cultivating a culture of diversity and inclusion is reflected — among other ways — in our student body and their soaring graduation rates, putting us at the vanguard among our peers in higher education. “We’re not only building a community that looks like the world outside our walls, but by exposing our students to different viewpoints and life experiences, we’re creating a better educated, more culturally sensitive and attentive workforce that will be well prepared to meet the varied needs of the individuals we serve.” The UR School of Nursing has a rich history of diversity, welcoming future nurses of varying ages, backNovember 2018 •

Team from MVP recognized by the American Heart Association recently. From left, Angela DeFeo, MVP Health Care human resources; Jen Maser, MVP Health Care marketing & communications; Jen DiMarzio, MVP Health Care marketing & communications; Marc Natale, executive director, American Heart Association; and Patrick Glavey, executive vice president, Medicare programs at MVP Health Care and AHA board member.

American Heart Association recognizes MVP Health Care

T

he results of the American Heart Association 2 018 Workplace Health Achievement Index have been announced and MVP Health Care achieved gold level recognition for taking significant steps to build a culture of health in the workplace. MVP attained silver level recognition in 2017. This year’s gold level recognition reflects MVP’s sustained focus on creating a healthful workplace, and the success of the programs and services it brings to employees. “Achieving gold level recognition for our employee well-being program from the American Heart Association is a testament to MVP’s sustained dedication to enriching not only our employees’ professional lives, but their personal health as well,” said Lynn Manning, senior leader of human resources for MVP Health Care. “We are committed to ensuring that our workplace culture includes access to resources and

grounds, and talents. Its most recent class of 66 students in its accelerated bachelor’s program for non-nurses (ABPNN) included students from across the U.S. and countries such as Kenya, Guyana, India, Cameroon, England and South Korea. Thirty percent of the new ABPNN students were from underrepresented groups, and 21 percent were male, more than two times the national average of men in the nursing workforce. Overall, 29 percent of the school’s full-time students are from groups underrepresented in nursing, and 22 percent are male.

RMC gets $2.16M to study HIV infection in women of color Researchers at the University of Rochester Medical Center have been awarded a $2.16 million grant to

activities that offer every employee the opportunity to enhance their physical, mental, financial, and social well-being. We are thrilled to be recognized for our efforts.” The American Heart Association’s Workplace Health Achievement Index allows companies to measure the effectiveness of their workplace health programs as well as the overall heart health of their employees. Unlike other existing organizational scorecards, the index also scores companies on the heart health of their employees based on Life’s Simple 7® – the American Heart Association’s scientifically validated definition of ideal heart health. The assessment is grounded in data-driven science and a quality improvement framework. More than 1,000 companies completed the index assessment this year and, of those companies, 75 percent received either gold, silver or bronze recognition. 

study disproportionately high HIV infection rates affecting women of color. Women account for 20 percent of new HIV diagnoses in the U.S. each year, with the vast majority of those infections occurring in black and HisMcMahon panic women. Although they make up 30 percent of the female population, black and Hispanic women comprise 77 percent of all new HIV cases among women. Gender-based social inequalities and men’s control over prevention methods, such as condoms, have traditionally limited the HIV protective options available to women. The development of HIV pre-exposure prophylaxis (PrEP), which can be taken

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 25


H ealth News as a once-daily pill under the brand name Truvada, provided a commercially available and highly effective prevention method that can be independently controlled by women. Yet, only 4 percent of females at high risk of HIV take the drug. Despite being at the highest risk, black and Hispanic women are statistically the least likely to take PrEP. “Women of color confront dual HIV-related health disparities: They have disproportionately high rates of HIV infection but disproportionately low rates of PrEP use for HIV prevention,” said the study’s lead investigator, James McMahon, PhD, associate professor and endowed chairman for innovation in health care at the School of Nursing.

“Our study, conducted in New York City and Rochester, will help to understand the multitude of reasons underlying these disparities and provide evidence to develop tailored HIV prevention interventions and services for women at risk.” The study, funded by the National Institutes of Health, will enroll more than 300 women who either take or are eligible for PrEP and assess survey and health data quarterly over a 12-month period. Researchers will also conduct interviews with more than a dozen clinical providers to explore how providers’ attitudes, practices, and environments shape PrEP adherence and patient interactions.

Approximately 300 guests attended the Gala hosted by UR Medicine Thompson Health at the Inn on the Lake in Canandaigua on Sept. 7. The gala raised more than $140,000 for Thompson’s capital campaign, which will expand its intensive care unit from seven to 12 beds, enabling the hospital to provide critical care to as many as 330 additional patients each year.

Gala Raises $142,000 for Thompson’s ICU Campaign

T

he annual gala recently hosted by UR Medicine Thompson Health raised approximately $142,000 to benefit the new intensive care unit (ICU) at F.F. Thompson Hospital in Canandaigua. Held Sept. 7 at the Inn on the Lake in Canandaigua, with music by The Skycoasters, the event had approximately 300 people in attendance. The total proceeds include nearly $60,000 raised during the event’s “cash call.” All proceeds went toward the more than $8.3 million raised, to date, for Thompson’s $11-million capital campaign for its new, 12-bed ICU. Going from the current seven ICU beds to 12 will enable Thompson to have full-time coverage from intensivists — physicians specially trained in the care and management of critical care patients. In addition, the hospital will send fewer patients to Rochester due to limited capacity,

Page 26

caring for an additional 250 to 330 critically ill patients annually. A new pulmonary clinic on the ground floor of the new ICU — triple the size of Thompson’s current pulmonary clinic in order to accommodate higher patient volumes — will see patients suffering from chronic lung conditions such as asthma, emphysema, congestive obstructive pulmonary disorder (COPD) and other diseases. The F.F. Thompson Foundation is grateful to all who attended the gala and to its sponsors, with special thanks to vineyard sponsor constellation brands and Top Shelf Sponsor, The Boev Clinic. For more information about the project, visit www.ThompsonHealth.com/OurICU. To make a gift to the ICU Campaign, contact The F.F. Thompson Foundation at 585-396-6155.

CDR’s grant to help Rochester Rookies program The Center for Disability Rights (CDR) has recently received a $15,356 grant from the Rochester Area Community Foundation as part of the inaugural grant round of the Ralph C. Wilson Legacy Fund for Youth Sports. Over the past 43-year history, the Rochester Rookies has provided a structured, character building leadership experience to youth with physical, learning and developmental disabilities, through participation in track and field training and competitions. The Rochester Rookies

promotes independence for young individuals with all types of disabilities, aligning with the mission and vision of CDR. CDR is a disability-led, nonprofit corporation that provides services to people with disabilities and seniors within the framework of an independent living model which promotes independence of people with all types of disabilities, enabling choice in living setting, full access to the community and control of their life. CDR advocates for the full integration, independence, and civil rights of people with disabilities. Additional information is available at www.cdrnys.org.

Competing in the Food Fight Champion sponsored by St. Ann’s were, from right, Todd Klugh, executive chef, St. Ann’s Community at Chapel Oaks; Ellen Adams, certified personal chef and executive chef and owner of A Red Hot Dish… and Great Food Too!; and Kimberly Roth, executive chef and owner of The Bamboo Panda Catering Company (winner of the competition) and Daryl Cronk, executive chef at St. Ann’s Community at Cherry Ridge.

Food Fight Champion Defends Title in Competition Benefiting Residents of St. Ann’s Community

S

t. Ann’s Community held its signature fundraising event, Food Fight – An Epic Culinary Competition, Sept. 14 at the Hyatt Regency Rochester. A record-setting, sold-out event, Food Fight raised nearly $200,000 for Annie’s Angel Fund which supports quality-of-life activities for St. Ann’s Home residents with limited financial means. The Angel Fund makes possible such things as lunch out with friends, tickets to a baseball game, a trip to the hair salon, and other simple pleasures to enrich the lives of St. Ann’s long-term-care residents. Food Fight featured two of St. Ann’s own executive chefs, along with two local chefs, each competing

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

in a 30-minute cooking challenge to make an entrée from mystery ingredients. The winner of the 2017 competition, Kimberly Roth, who appeared on Gordon Ramsay’s “Hell’s Kitchen,” defended her title and was crowned Food Fight champion for a second year. Todd Klugh, executive chef, St. Ann’s Community at Chapel Oaks in Irondequoit, was crowned the first annual ‘People’s Choice Award’ winner. Some of corporate sponsors of the event includes Alesco Advisors LLC, Burke Group, Glenn-Douglas Constructors LLC, GMR Associates, Harter Secrest & Emery LLP, LECESSE Construction, SWBR Architects and Antithesis Advertising.


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Taste of the Season atatChapel St. Ann’s Community Cherry Oaks Ridge

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2018

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