In Good Health: ROC #218 - October 2023

5 THINGS YOU SHOULD KNOW ABOUT ASTHMA

Women’s Health

SPECIAL SECTION

PAGES 16-22

A PLACE TO GROW

EQUICENTER’S ADAPTIVE COOKING AND RIDING PROGRAMS IN HONEOYE FALLS WAS SPECIALLY CREATED FOR CHILDREN AND ADULTS WITH DISABILITIES, ESPECIALLY VETERANS

OCTOBER:

Female Surgeons Bring Better Outcomes for Patients, Two Studies Show

The field of surgery has long been dominated by men, and still is today.

But two new studies show that if patients want safe, effective longterm results, picking a female surgeon might be key.

In one study involving more than 1 million Canadian surgical patients whose outcomes were followed for a year, “those treated by a female surgeon were less likely to experience death, hospital readmission or major medical complication,” wrote a team led by physician Christopher Wallis, of Mount Sinai Hospital in Toronto.

Another study — this time focused on gallstone removal, one of the most commonly performed surgeries — also found female surgeons outperforming males, on average, when it came to outcomes.

Both studies were published online Aug. 30 in JAMA Surgery.

Why the gender gap?

According to physician Martin Almquist, who wrote an accompanying editorial in the journal, it might come down to differences in attitudes toward risk-taking, the surgeon's ability to collaborate with others, and being “patient-centered” when it comes to making decisions around surgery.

In both studies, female surgeons tended to be more methodical and take longer to complete a surgery

compared to their male colleagues, the researchers noted.

“Being accurate and careful most likely beats risk-taking and speed when it comes to consistently achieving good outcomes for the patient,” concluded Almquist, a surgeon at the Skane University Hospital in Lund, Sweden.

Almquist conceded that it’s not yet proven how women outperform men in the OR.

“Perhaps personality traits more common among women contribute to better outcomes?” he said.

Regardless of the reasons, “Surely, the ideal of the surgeon as the [male] ’lonesome cowboy’ belongs to an era long gone," Almquist added.

The surgical profession remains a largely male domain, however.

For example, in the Canadian study — which looked at 25 different types of surgeries conducted between 2007 and 2019 — only about 151,000 of a total of nearly 1.2 million procedures had been conducted by women.

In the study, Wallis and his colleagues tracked 90-day and one-year outcomes for all patients.

Data was first compiled on a “composite outcome” that included deaths, hospital readmissions and/ or complications. According to the study, nearly 14% of patients treated by male surgeons experienced at

least one of these events within 90 days, compared to just 12.5% of people operated on by a woman.

At one year post-surgery, 25% of the patients of male surgeons had experienced such an event, compared to just under 21% of those treated by women. When it came to deaths, 2.4% of patients who’d been operated on by a man were deceased by one year post-surgery, compared to 1.6% of those who'd had a female surgeon.

The second study, focused on gallbladder operations, was led by physician My Blohm, a surgeon at Mora Hospital in Sweden.

It focused on more than 150,500 patients who underwent elective or emergency gallbladder surgeries between 2006 and 2019. Patient outcomes were tracked for 30 days after their procedures.

Again, the team found that female surgeons tended to spend more

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time on a surgery — an average 100 minutes for an elective procedure versus an average of 89 minutes for men.

Maybe that extra time and attention paid off for patients: For elective procedures, patients operated on by male surgeons had 28% longer hospital stays and a 66% higher odds for bleeding complications, compared to patients operated on by a female surgeon, Blohm’s team reported.

So why would a surgeon’s gender matter?

“Personal characteristics and attitudes are difficult to study, but probably affect outcomes,” the Swedish group wrote.

“This study’s important finding that female surgeons may perform safer operations and operate more slowly indicates that caution might be a favorable quality," they added.

Meet Your Doctor

By Chris Motola

Anna Rothstein, M.D.

Eye doctor talks about under-eye bags, swollen eyelids, thyroid eye disease and why learning to play piano when she was a kid helps her be a better eye surgeon

Q: When might someone need reconstructive eye surgery?

A: In cases where a patient has undergone skin cancer removal on the eyelid, subsequent lid reconstruction becomes necessary. Similarly, for individuals with eyelid lacerations resulting from trauma, it is crucial to perform the appropriate repairs. Addressing issues like drooping upper or lower lids, which are quite common, can be effectively corrected.

Q: What considerations need to be made when reconstructing an eyelid? How do you make it functional?

A: Properly functioning eyelids are essential for eye health and optimizing vision. Every eyelid reconstruction is tailored to ensure natural eyelid function, including proper opening, closing and blinking, all while aiming to minimize scarring.

Q: What does your patient base look like?

A: I provide care for patients of varying ages, tailoring my approach to their specific needs and concerns.

Q: Do you find the conditions you treat vary with age?

A: Yes. Age-related eye conditions encompass presbyopia, glaucoma, dry eyes, age-related macular degeneration and cataracts. Mean-

Q: What are common types of oculoplastic surgery?

A: The correction of drooping upper eyelids is a frequently sought-after procedure, typically involving the removal of excess skin or the tightening of a stretched muscle. Another common concern is under-eye "bags," which can often be surgically reduced. In some cases, lower eyelids may turn inward or outward, leading to redness and discomfort, necessitating corrective surgery. Many individuals opt to have skin tags, cysts or styes removed from their eyelids for both aesthetic and comfort reasons.

Q: What causes under-eye bags? Are they preventable?

A: Under-eye bags can have various underlying causes, including loose skin, pockets of fat, changes in skin pigmentation, and natural shadowing. These factors can lead to the appearance of dark circles, fatigue, or "bags under your eyes." While these traits can be hereditary and present from a young age, they often worsen with time. As we age, the tissues around the eyes gradually weaken and sag, allowing fat to protrude into the lower eyelids, creating puffiness and swelling. Additionally, fluid can accumulate in this area, contributing to the puffy appearance.

Q: How do you address these prob-

A: There are several home remedies you can try to reduce eye bag puffiness and shadowing:

1. Apply a cool compress to your

2. Ensure you get an adequate amount of sleep.

3. Sleep with your head slight-

4. Avoid consuming fluids right before bedtime and limit dietary salt intake.

5. Quit smoking, as it can exacerbate these issues.

6. Take steps to reduce allergy symptoms, which can worsen eye puffiness. In certain cases, patients may consider a blepharoplasty, a type of eyelid surgery that can help reduce under-eye bags. During this outpatient procedure, a surgeon makes an incision either beneath the lashes or inside the lower lid. Excess fat is either removed or repositioned

through the incision, and in some cases, extra skin is also addressed.

Q: What are some of the challenges of operating on and around the eye?

A: Performing eyelid surgery is a delicate combination of art and precision. My surgical approach focuses on achieving results that enhance the natural appearance, optimize eyelid function, and safeguard or improve overall eye health.

Q: Do you have any particular artistic inspirations that you draw on?

A: At the age of 7, my parents enrolled me in piano lessons, a decision that constantly reminds me of the intriguing parallels between surgery and playing the piano. The remarkable precision and focus demanded to beautifully play a musical composition bear a striking resemblance to the exacting nature of my surgical work. The dexterity honed in my fingers through countless hours of piano practice and the adeptness in using my non-dominant hand with ease have proven to be invaluable assets in refining my surgical skills.

Q: Do you perform elective surgeries as well?

A: Certainly, my practice encompasses a wide range of procedures, including medically necessary surgeries and cosmetic enhancements. I also offer non-surgical cosmetic treatments like Botox, dermal fillers, and skin tightening to provide a comprehensive array of options for my patients.

Q: What are some promising new developments in your field?

A: A groundbreaking medication named Tepezza received FDA approval a few years ago, revolutionizing the treatment of thyroid eye disease. Its success has offered new hope for managing this complex condition. Before the arrival of Tepezza, treatment options were exceedingly limited, yielding less than satisfactory results.

Q: What kinds of symptoms are typically associated with thyroid eye disease?

A: The main symptom of thyroid eye disease is bulging of the eyes. Additional symptoms include dry, gritty, red, or irritated eyes; swollen eyelids; eyelids that pull back more than usual or fail to close completely; double vision; light sensitivity; eye discomfort or pressure; and difficulty moving the eyes.

Typically, thyroid eye disease affects both eyes, although symptoms may initially appear in only one eye. These symptoms usually persist for one to two years. In rare instances, swelling around the eyes can exert pressure on the optic nerve, resulting in vision loss.

Q: What got you interested in eye surgery?

A: During my time in medical school, I had the opportunity to rotate through various medical specialties. Ophthalmology stood out to me due to its unique blend of medical and surgical approaches. What particularly appealed to me was the wide range of patients we serve, spanning from newborns to centenarians.

Q: A lot of patients see optometrists for their basic vision issues. Is there a good barometer for when a patient should take their eye concerns to an ophthalmologist instead?

A: A significant distinction be-

tween optometrists and ophthalmologists lies in their surgical capabilities. While many optometrists excel in managing most medical aspects of eye care, they do not perform surgical procedures. On the other hand, ophthalmologists are trained surgeons who can address your medical needs and perform surgical interventions. Both professionals are authorized to prescribe medications and treat eye diseases.

Another notable contrast pertains to their educational background. Optometrists undergo four years of optometry school, occasionally followed by an additional year of residency. Ophthalmologists complete four years of medical school, followed by four years of residency training. Some ophthalmologists pursue one- or two-year fellowships to specialize further, focusing on areas like glaucoma or retinal disorders. You can recognize an ophthalmologist by the presence of an MD [Doctor of Medicine] or a DO [Doctor of Osteopathic Medicine] after their name, while optometrists hold an OD [Doctor of Optometry] degree.

A good eye doctor will guide you in the right direction if you require the expertise of another specialist. Optometrists commonly refer patients to ophthalmologists for complex medical conditions such as uncontrollable eye infections, medically unmanageable glaucoma, cataract surgery, corneal transplants, or retinal issues.

Q: Do you remember much of your early childhood in Russia? What was it like?

A: One cherished memory that stands out is our apartment, where three generations coexisted under the same two-bedroom roof. I hold dear the recollection of my grandmother's culinary talents as she lovingly prepared delicious meals for our family while also caring for my younger brother and me.

Q: Did some of those recipes come with you?

A: My brother and I have our grandmother's handwritten recipe book. We have a plan to translate it into English and preserve it in digital form. One of my fondest recipes is for Ukrainian waffle cake. This delicious dessert features layers of wafers, sweet condensed milk, and crunchy walnuts. Whenever my parents come to visit, I eagerly anticipate this delightful treat they prepare.

Lifelines

Name: Anna Rothstein, M.D.

Position: Opthalmologist at The Eye Care Center in Canandaigua

Hometown: Pittsford

Personal: Immigrated to the United States at age 10

Education: Robert Wood Johnson Medical School (medical degree); Unity Health System, Rochester (internship in internal medicine); University of Rochester Eye Institute (residency in ophthalmology); fellowship in oculoplastic, reconstructive and cosmetic surgery at Ocusight Eye Care Center in conjunction with Paul N. Rosenberg, MD

Affiliations: FF Thompson Hospital, Geneva General Hospital, URMC

Organizations: American Academy of Opththalmology

Family: Husband (Ron), one daughter, one son

Hobbies: Foreign films, traveling, hiking with her dog

Pain, Tingling or Numbness in Your Feet?

By Andrea Ide

Pain, Tingling, or Numbness in your hands, feet or legs may be due to Nerve Damage. If left untreated this small annoyance can lead to big problems. Unfortunately, most people have no idea what to do abut this problem and some don’t even realize how big of a problem it is. They tell their doctor who gives them drugs and injections which only mask the pain and there is no surgery, other than amputation, that will heal/stop neuropathy from progressing.

Neuropathy is a term used to describe damaged nerves, primarily in the hands and/or feet, that are progressively breaking down due to a lack of blood supply, nutrients and oxygen reaching the nerves along with a lack of communication from the brain. Since the nerves are what the brain uses to communicate with the area and they are breaking down, the brains ability to communicate with the area lessens over tine, allowing for the progression of more breakdown and worse symptoms. It can be caused by Diabetes, Poor Ciculation, Poor Nutrition, Chemotherapy, Agent Orange, Misaligned Spinal Bones Placing Pressure on the Nerves, along with over 100 other causes. “Patients experience extreme sensations, loss of feeling, even No Feelings in their Hands and/or Feet along with muscle spasms, pain, weakness, numbness, tingling, and burning and many have a very hard time with balance” says Dr. Nathan Riddle of Riddle Wellness, a Neuropathy testing and treatment clinic.

This condition can eventually lead to further nerve damage, causing complete loss of legs or arms leading to amputation, death or brain injury due to falls, burns or other injuries that will not heal, along with organ failure in some cases.

Are you or someone you love suffering with loss of balance, numbness or pain from Nerve Damage in your hands and/or feet that just won’t heal? You don’t have to any longer. This local clinic right here in Rochester, NY is helping people find lasting relief without the use of drugs or surgery! That’s BIG EWS!

HEALING IS POSSIBLE

More than 20 million people in the U.S. Are dealing with some form of Neuropathy. Most commonly noticed first in the hands or feet, causing weakness, numbness, tingling pain and debilitating balance problems, often frustrated with no place to turn to and no hope of recovery. “By the time they come to see us, they feel like they have tried everything. Their MD put them on Anti-Seizure or Epilepsy meds like Gabapentin, Neurotin, Cymbalta or Lyrica and told them they will just have to live with the pain,” said Dr. Riddle.

ADVANCED TECHNOLOGY

With recent advancements in nerve regeneration technology and treatment options, clinics all over are seeing larger success rates and faster results with their neuropathy patients.

“This new technology paired with our multifaceted approach, has been life altering for our patients and our clinic,” said Dr. Riddle.

The development and success of these new, highly effective Neuropathy Protocols by Dr. Riddle and his team at Riddle Wellness have been the talk of the town in recent months. “Neuropathy patients have been coming in from all over the state and the results that they are getting is truly amazing,” said the Patient Coordinator at the Clinic. There are some things people can do at home to aide in the healing process of their neuropathy however, healing neuropathy is an all-encompassing process that ill require lifestyle changes, home care and may or may not include chiropractic, (varying from patient to patient) along with guidance from a medical professional that is experienced, skilled and trained to treat neuropathy.

Dr. Riddle and his skilled care team in Rochester have been treating neuropathy for years now in and judging by their 5 Star patient reviews, and all their patient video testimonials, they have been doing a very good job providing excellent patient care. One person had all but given up, they were crying in their testimonial. They were so thankful and its all because of this amazing new treatment option! They state it

New Treatment Options for Neuropathy

ing pain, numbness, tingling, pins and needle sensations, cramps and burning in your feet, or hands, along with the many other bodily symptions this horrible condition plagues people with, take action because it will progress.

Not everyone is able to start care at the clinic but, those who do are thankful! Find out if you are a candidate for their Neuropathy Protocols so they can help you regain the feeling in your hands or feet, stop the pain and start living life again! “Our Neuropathy Protocol is a multifaceted approach to heal neuropathy by nurturing the nervous system, increasing circulation, blood and oxygen, working to rebuild, strengthen and balance the body, all while stimulating the damaged nerves. Revitalizing and healing the damaged areas, enabling them to reactivate and function at an increasingly higher rate over time, all while increasing the patients quality of life dramatically,” said Dr. Riddle.

has about a 98% effective rate!

FIND LASTING RELIEF

Claim Your Voucher Now for a Consultation & Examination to determine if you are a good candidate for treatment... Dr. Riddle and his care team are here once again to help readers learn about new options for finding pain relief! Call the clinic today to receive your comprehensive (normally $250).

The clinic utilizes the most advanced Pain Free Testing and a full, easy to understand report of finding

with Dr. Riddle going over your options for care if you are able to move forward.

Call 585-670-0020 and use Code NUMB0021. They have agreed to reduce their usual cost of $250.

But hurry, due to the number of patients the office can see, this is a limited time offer, with only 25 spaces at this exclusively discounted rate. These will be on a first come, first serve basis, messages left will count. My advise, don’t suffer any longer, waiting around for it to get worse... If you or your loved one is experienc-

Over the years they have treated thousands of patients with chronic conditions of Neuropathy, Sciatic nerve pain, Back & Neck problems, Whiplash Injuries along with Knee Pain. The office is well known and has a good reputation. Patients drive hours to this clinic and the vast majority enjoy superior, lasting relief. In fact, many who have suffered and tried other treatment options with no luck, only to have been told that they are just stuck with their pain and discomfort, have credited the care team at Dr. Riddle office for giving them their lives back!

Call them now at their Rochester, NY location, for a full, thorough Consultation and extensive Neuropathy Consultation at $49. Use Code: NUMB0021 (saving you over $200) to determine if and how Dr. Riddle and his team can help you recover, just as they have helped so many others that suffer with the Pain and Numbness of Nerve Damage.

“I feel like myself again. The pain is gone and I am even sleeping through the night”

~Gill B. Rochester NY

Healthcare in a Minute

By George W. Chapman

Negotiating Drug Prices

Medicare is finally flexing its purchasing power by negotiating the prices it pays for 10 drugs that treat cancer, arthritis, diabetes and heart disease. Why did it take so long?

It took the passing of the Inflation Reduction Act (I.R.A.) to authorize price negotiations of drugs with pharmaceutical companies.

So why did it take, literally, an act of Congress to negotiate drug prices, especially considering that some 80% of us are in favor of Medicare’s ability to negotiate prices?

Well, 20 years ago, then-Presi-

Big Pharma argues that negotiating prices (remember, on a whopping 10 drugs) will lower their profits and thereby negatively impact innovation.

Interestingly, drug manufacturers spend far more on stock buy backs than innovation or research and development.

Several competing drug man ufacturers sell drugs that combat diabetes, cancer, heart disease, etc. The “winner” of the price negotiation or lowest bidder could capture more if not all the market for the drug and thereby actually increase profits.

Big Pharma won’t even use the term “negotiate” as it spins this all as “big government price controls.”

If negotiating a paltry 10 drugs with Medicare will reduce profits, why then do drug manufacturers negotiate prices with just about every country (England, France, Germany, Canada, to name a few) with national or universal healthcare? It’s because those countries have not tied their hands with laws that prevent them from negotiating and employ their substantial purchasing power to keep prices down and lower costs to taxpayers to whom they have a fiduciary responsibility. It should be noted that all the countries listed have a much lower cost of care per capita than the U.S.

dent George Bush signed a law prohibiting Medicare from negotiating drug prices.

That is the penultimate (or maybe worst?) example of the absurd amount of influence Big Pharma lobbyists have on our elected officials.

While negotiations are underway, Big Pharma has filed multiple lawsuits to block the government

and a lot of that can be attributed to paying far less for drugs. There is a lot of moaning from both sides of Congress about government spending. So why are we tying the government’s hands when it tries to act like a business?

from implementing this part of the I.R.A. Big Pharma should consider itself lucky to negotiate considering Medicare does NOT negotiate prices with physicians and hospitals. Medicare SETS the prices for providers of care. So much for the AMA and AHA lobbyists. There is plenty of time for the litigation to play out as the prices won’t take effect until 2026.

due to intense Big Pharma lobbying.

You would think it a slam dunk to allow Medicare to negotiate ALL drug prices. We have almost 65 million seniors on Medicare. That exceeds the total population of Canada which is about 38 million. Yet Canada, with far less purchasing power, negotiates all drug prices where it can. If we had a national health plan covering us all, Medicare would be negotiating prices on behalf of 334 million people. Medicare was about 10% ($888 billion) of the federal budget in 2021. 46% comes from general revenues, 34% from payroll taxes and 15% from beneficiary premiums. So, Medicare drug prices affect ALL of us, not just seniors.

The first 10 drugs Medicare chose to negotiate are: Eliquis blood thinner; Xarelto blood thinner, Januvia for diabetes; Jardiance for diabetes; Enbrel for rheumatoid arthritis; Imbruvica for blood cancer; Farxiga for diabetes, heart failure and kidney disease; Entresto for heart failure; Stelara for psoriasis and Crohn’s disease; and Fiasp for diabetes. These 10 drugs account for $50.5 billion or 20% of total part D costs. (Part D drugs are taken at home while Part B drugs are administered in a provider office.)

If you consider Big Pharma contributions to the campaigns of our elected officials, you’ll understand why Medicare is limited to negotiating just 10 prices and not ALL prices.

The Senate (100 members) averages about $76,000 per campaign or about $7,600,000 over the course of staggered six-year terms.

The House (435) averages about $36,000 per campaign or about $15,660,000 over the course of staggered two-year terms.

These contributions are why the Inflation Reduction Act barely passed.

Apparently, getting reelected is more important than doing the right thing.

The top 10 elected officials receiving the most money from Big Pharma are from both sides of the aisle.

Newcomer senator Raphael Warnock from Georgia leads the pack at $770,000. He has a commanding lead over the rest. In second place is Cathy Rodgers from Washington at $419,000. The next eight are: Scott Peters, California, receiving $400,000; Catherine Masto, Nevada, $382,000; Tim Scott, South Carolina, $351,000; Patty Murray, Washington, $351,000; Mark Kelly, Arizona, $350,000; our Chuck Schumer at $345,000; Brett Guthrie, Kentucky, $343,000; and Maggie Hassan, New Hampshire, $273,000.

Drug companies can easily afford to pay 1,500 lobbyists and tens of millions to campaigns to protect their profits while hospitals and nursing homes, with little to no cash to spare, struggle to stay open.

Most galling is instead of considering themselves lucky to having to negotiate only 10 drugs while Medicare sets payments to physicians and hospitals, some of the drug manufacturers have decided to sue Medicare for restraint of trade and overreach.

Business negotiations over price are commonplace. Drug companies negotiate prices with all the countries with national health insurance.

billion (with a “b”) outof-pocket last year on just the 10 drugs being negotiated.

Lower prices mean less out-ofpocket. Period.

More savings for taxpayers are on the horizon when Medicare can negotiate 15 prices in 2027-28 and then 20 after that. The severely limited number of prices that can be negotiated and the painfully slow implementation timeframe shows how difficult it was to pass the I.R.A.

No one really knows the price of a particular drug. It depends on whether you’re self-pay or covered by Medicare, Medicaid, or commercial insurance.

Commercial carriers or pharmacy benefit managers negotiate supposed discounts, but often off nebulous inflated prices quoted by the manufacturer. You never know if you’re getting a good deal. Basical ly, there just isn’t price competition among drug manufacturers as there is in most markets. Once Medicare negotiates a price, (which both par ties agree to) it should finally provide the public some price transparency.

But when Medicare flexes its muscle, they sue.

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.

Cost of a Pack of Marlboro Now Around $15

$1 cigarette tax hike projected to save 15,300 New Yorkers’ lives

Beginning Sept.1, New York

state’s cigarette tax will be the highest in the nation. The $1 hike is the first cigarette tax increase since 2010 and changes the tax from $4.35 to $5.35 per pack of 20 cigarettes.

A pack of Marlboro in Upstate New York costs an average $14.50. The cost varies from region to region.

Research shows a 10% increase in tobacco prices would be expected to decrease tobacco consumption by 4% in high-income countries.

Increasing the cost of cigarettes is one of the most effective ways to pro-

mote smoking cessation and prevent youth initiation.

The American Cancer Society Cancer Action Network projects the impact of the higher tax will save 15,300 New Yorkers’ lives and prevent 14,400 youth under age 18 from becoming adults who smoke.

The latest data from the NYS Department of Health show that one in five high school-age youth uses tobacco products. New York state spends approximately $9.7 billion annually on preventable smoking-related health care costs.

Booming Sales of Legal Marijuana Linked to More Car Crashes

Emergency room visits for injuries related to driving under the influence of cannabis skyrocketed in Canada after the drug was legalized, a new study reports.

In October 2018, Canada became the second country to nationally legalize recreational or nonmedical cannabis for adult use.

While known cannabis-involved emergency department (ED) visits for traffic injuries were still rare, they grew by 475% over 13 years, with a sharper rise in accidents after legalization, the researchers found.

“Our findings highlight a concerning increase in cannabis-involvement in traffic-injury emergency visits over time, with even sharper spikes following the phases of legalization and commercialization,” said lead author Daniel Myran, a post-doctoral trainee at the Institute for Clinical Evaluative Sciences (ICES), and a family physician at the Ottawa Hospital.

“Conversely, alcohol-involvement in traffic injury ED visits did not increase over the study period, which suggests that legalization of cannabis has played an important role in rising rates," Myran said in an ICES news release.

For the study, the researchers

looked at cannabis-involved ED visits for traffic injuries between 2010 and 2021, looking for changes after the October 2018 commercialization of the legal cannabis market, which expanded products and retail stores.

The investigators reviewed data from more than 947,000 ED visits for traffic injuries in the province of Ontario. Annual rates of cannabis-involved visits surged from 0.18 visits per 1,000 total collisions in 2010 to 1.01 in 2021.

Legalizing non-medical cannabis with restrictions was associated with a 94% increase in the rate of cannabis-involved traffic injury ED visits compared to the pre-legalization period.

Later, after commercialization, which overlapped with the COVID-19 pandemic, researchers saw an even greater increase of 223% in rates compared to the pre-legalization period.

Higher rates of ED visits were seen in men, those who lived in lower-income neighborhoods and those aged 19 to 21, as well as for those who had a prior cannabis-related ED visit.

The study findings were published online Sept. 6 in JAMA Network Open.

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Writers: Deborah J. Sergeant, Chris Motola, George Chapman, Gwenn Voelcker, Anne Palumbo, Ernst Lamothe Jr., Mike Costanza, Jim Miller

Advertising: Anne Westcott (585-421-8109) • Linda Covington (585-750-7051)

Layout & Design: Angel Campos–Toro • Office Secretary Allison Lockwood

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.

Live Alone & Thrive

“me time” to meditate and set my intentions for my day.

hope who alone

Practical tips, advice and hope for those who live alone

By Gwenn Voelckers tips,

Practical tips, advice and hope for those live alone

October: The Perfect Time to Turn Over a New Leaf

Fall is such a special time of year. For me, it means all good things: relaxing in front of a cozy fire, making pumpkin soup on Sunday afternoons, donning my well-worn leather jacket for long walks and turning my attention to all those inside projects I neglected over the summer.

The brilliant colors, autumnal aromas and industriousness that arrive with the falling leaves really appeal to me. But this hasn’t always been the case.

After my divorce, the month of October left me feeling melancholy. I missed sharing the beauty of the season with a special someone. And I missed the sunshine as daylight waned.

Nostalgia and wistfulness would creep in and I just wanted to retreat into myself. For those who live alone, the month of October has unique challenges.

Not one to wallow in a “poor is me” state of mind, I began to develop and employ some strategies to rekindle my love of the fall season. It can be a great time to mix it up, get busy and expand your horizons.

Below are elements of my annual fall “game plan.” Take a look and see if one or more of these suggestions might add a little color to your life palette this fall:

• Tackle indoor projects: Fall is a great time to accomplish all those

nagging indoor projects on your to-do list. I have a long list and I keep it right in front of me — a daily reminder that I have plenty of home improvements to tackle, both large and small.

Too much idle time is not a friend at any time of year, but it can become downright unfriendly when gray clouds appear and the temperature drops. So, let’s get busy: organize your storage space, do some touch-up painting, update your will or clean out your inbox.

There’s nothing like being productive to beat the autumn blues.

Don’t I know it. I just finished coating my flat-roof porch with a sticky tar sealant. Confession: it was messier than it was fun, but still, I’m proud of my accomplishment. It lifted my spirits.

• Get up and get going: Staying active when there’s a chill in the air can be difficult. I can remember many a cold morning when all I wanted to do was hit the snooze button, pull up the covers and stay in bed.

As nice as sleeping in can be from time to time, I don’t recommend it as a steady diet.

In my experience, there's no better way to start your day than to wake early to start your day. In the early morning’s peace and quiet, there is glorious time to reflect and feel gratitude. I use this important

ADHD: What Parents Need to Know

About 6 million kids have been diagnosed with ADHD as of 201

Lots of children and adolescents have the condition known as ADHD, or attention-deficit/hyperactivity disorder.

What should parents know? A number of treatments exist to help with functioning, including medications approved by the U.S. Food and Drug Administration.

Typically, ADHD begins between ages 3 and 6, according to the U.S. National Institute of Mental Health. It can continue into adulthood.

People can experience one of three types of ADHD. They are predominantly inattentive, with trouble focusing, following instructions and finishing tasks; predominantly

hyperactive–impulsive, with behavior of being “constantly on the go,” talking excessively and interrupting others; and a combination of those symptoms.

An increasing number of children are being diagnosed with ADHD. About 10% of children aged 3 to 17 — or about 6 million kids — have been diagnosed with ADHD as of 2019, according to the U.S. Centers for Disease Control and Prevention.

Boys, at 13%, are more likely than girls, at 6%, to be diagnosed with ADHD.

“Boys are also more likely to have the hyperactive-impulsive type. This type of ADHD is easier to spot

As the morning brightens, my energy grows, as does my appreciation for the precious day ahead me.

• Start moving and enjoy the great outdoors: Fresh air, sunlight and even a gentle rain can be invigorating first thing in the morning. I find a sunrise walk boosts my energy and kickstarts my day. Do I always feel like layering up and taking a walk every morning? No. Do I feel better after I make the effort? Yes, without fail.

I love an unhurried solitary walk to clear my head and be mindful. But I also love a walk with my sister, Anne, or good friend, Kate, to enjoy their company and avoid the Siren song of isolation as the days grow short and get colder.

• Learn something new: Going back to school and fall go hand in hand. Who among us isn’t reminded of the nervous excitement associated with returning to school in the fall? It’s a great time to expand your intellectual horizons.

Each fall I identify a new skill or subject to learn. Last year, I researched how to divide and relocate perennials (my irises and peonies); this fall, I’m signing up to learn French on Duolingo, the free language-learning app.

Continuing education opportunities are abundant in this community and online. Check out colleges and universities, community centers, arts and cultural institutions, your local library, and workshop listings for class and workshop offerings.

• Invite people in: Over the years, I’ve discovered a few simple and manageable ways to bring people into my world and into my home. One way is to organize a gathering around a TV show or series — yes, around the TV.

For years, I invited my single friends over to watch “Downton Abbey” with me on Sunday nights. I provided the soup and salad; they provided the good company.

So, what’s your pleasure? Whether it’s football, a favorite weekly sitcom, or “Ted Lasso” on Apple TV — all of these and other TV shows can become reasons to bring friends and family together. The benefits? You’ll hone your cooking skills (boy, do I now have some great soup recipes!) and you’ll connect with people you care about.

What better way to enjoy a nice fall evening.

There are so many wonderful and meaningful strategies to enjoy the fall season and to ward off the blues that can sometimes emerge during this changing time of year. But these strategies require effort — conscious, creative effort.

If you are feeling sluggish, lonely or isolated, try a few of the strategies above. They have stood me in good stead and have reinvigorated my love for the fall season.

If you, too, are ready to turn over a new leaf, October is the perfect time!

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

than the quieter child who is inattentive,” said child psychiatrist Tiffany Farchione, who reviews ADHD drugs at the FDA.

Untreated ADHD can have serious consequences, the FDA warns, including falling behind in school, having difficulties with friendships and experiencing conflicts with parents.

Children with untreated ADHD also have more emergency room visits and are more likely to have self-inflicted injuries. Meanwhile, untreated adolescents are more likely to take risks.

A visit with your child's pediatrician can help determine if your child has ADHD. Also have your child's vision, hearing and anything else that might contribute to inattention checked.

Stimulants and non-stimulants are both approved by the FDA to help reduce symptoms of ADHD in children as young as age 6.

Containing various forms of methylphenidate and amphetamine,

stimulants have a calming effect on children with ADHD, Farchione said. They are thought to increase brain levels of dopamine, a neurotransmitter associated with motivation, attention and movement.

Approved non-stimulants are Strattera (atomoxetine), Intuniv (guanfacine), Kapvay (clonidine) and Qelbree (viloxazine).

Some children with ADHD also receive behavioral therapy to help manage symptoms and learn coping skills. Community support groups and schools may also provide some help.

FDA-approved medications have been tested for safety and effectiveness. Clinical trials will now look at their safety and effectiveness in children aged 4 and 5.

“We know ADHD medications are being prescribed for younger children, and we think it's essential that the data from clinical studies reflect the safety and effectiveness for this age group,” Farchione said in an FDA news release.

Mehta Family Donates $1 M to Rochester Regional

Jett

Mehta, Indus Hospitality

Group President and CEO, donated $1 million to the Sands-Constellation Heart Institute (SCHI) at Rochester Regional Health (RRH), a gift that will support the expansion of programs and services throughout SCHI, a leader in cardiac care and recognized as one of the most robust cardiac programs in New York state.

Mehta’s gift is one of SCHI’s largest donations and in recognition of his support, the Welcome Center at Rochester General Hospital is now named in honor of the Mehta Family.

“It is important to me to give back to the communities we do business in. We want to show our employees and customers, we are committed to the places we live and work,” said Jett Mehta. “The Sands-Constellation Heart Institute is a wonderful resource for the community and is at the forefront of innovation and technology. I am proud to support one of the best cardiac programs in the country.”

SCHI is recognized as a center of

excellence in diagnosing, preventing, treating, and managing heart disease and conditions. Its network of clinical leaders in specialty areas stretches from Medina to Ithaca, and at its center is RGH that has consistently been recognized nationally for excellence in cardiac care.

SCHI’s physicianTimothy Malins is one of those clinical leaders and a cardiologist for the Mehta family.

“Dr. Malins taught me about the important work going on at SCHI,” said Mehta. “When given the opportunity to help with some immediate needs, I was proud to be able to make an investment that would positively impact the thousands of patients who walk through the doors each year.”

Mehta was born and raised in Rochester and serves on several boards and advisory councils. His company Indus Hospitality Group develops and owns more than 75 properties in the area including many hotels and restaurants. This is his first gift to RRH.

Clients Share How Hypnosis Changed Their Lives

had worked in the past. After a few sessions with Rekha, I noticed a marked decrease in overall anxiety. After 8 sessions, I felt in control and no longer experienced panic attacks when seeing a doctor. I recommend Rekha for anyone struggling with something. ” Anonymous ‘23

Smoking

“I went to Rekha to stop smoking. After the second session, I was not enjoying smoking. After the third session, cigarettes made me feel sick and I threw what I had left in the trash. Rekha really cares about her patients. She checks with you on Sundays to see how you are and provides tapes of the sessions.” B.N. ‘23

Mehta Family with (far left) Rochester Regional Health CEO Richard “Chip” Davis and (far right ) physician Tim Malins.

7 Lifestyle Factors Help Keep Depression at Bay

Ahealthy lifestyle — especially getting enough sleep — may offer substantial protection against depression, new research suggests.

The study, of more than 287,000 British adults, found that several lifestyle factors seemed to curb the risk of developing depression over the next nine years. Among them were eating a healthy diet, getting regular exercise, staying socially active, not smoking and — most importantly — regularly having a good night's sleep.

Each healthy habit mattered on its own, the study found. People who exercised had a lower risk of future depression than couch potatoes did, for example.

But the more good habits, the better: Study participants who adhered to at least five of seven healthy habits had a 57% lower risk of depression, versus those who followed none or only one.

And one of the important findings in this study, the researchers said, was that a healthy lifestyle benefitted people, regardless of the genetic cards they've been dealt.

"Lifestyle has a strong protective role across different levels of genetic risk for depression," said study author Christelle Langley, a research associate at the University of Cambridge.

The findings, published Sept. 11 in the journal Nature Mental Health, are based on data from the UK Biobank. It's a huge research project collecting health and genetic information from about a half-million middle-aged and older British adults.

In the study, Langley and her colleagues focused on over 287,000 participants who were depression-free when they entered the study between 2006 and 2010. All reported on their lifestyle habits at that time.

Over the next nine years, just under 13,000 people were newly diagnosed with depression. The risk was lower, however, among those who'd reported healthier lifestyles at the outset.

The big seven factors were:

• Sufficient sleep (seven to nine hours a night)

• Regular exercise — including moderate activities, like brisk walking, on most days of the week

• Limiting screen time and other sedentary activities

• A healthy diet high in foods like fruits and vegetables, fish and whole grains

for men)

Sleep was the single most protective factor, the researchers found. People who got enough shut-eye were 22% less likely to develop depression than those with poor sleep habits. Not smoking was nearly as protective.

But, Langley said, people saw the most benefit when multiple good habits were practiced together.

Among those who reported at least five of the seven healthy habits, the risk of depression was 57% lower, versus people who adhered to no more than one. In the intermediate group — two to four healthy habits — depression risk was cut by 41%.

Next, the researchers looked at genetic risk. They analyzed participants' blood samples, looking for genetic variants that have been linked to depression, and assigned each person a genetic risk score.

Again, healthy habits appeared powerful — guarding people against depression regardless of their genetic risk, Langley said.

The findings do not prove causeand-effect, but they are "compelling," said physician Ken Duckworth, chief medical officer at the nonprofit National Alliance on Mental Illness.

He noted that the genetics of depression are complex and have not been "nailed down," so the risk scores assigned in this study have limitations.

But the bottom-line message is a positive one, Duckworth said: "You're not helpless vis-a-vis your genes."

Major depression is a complex disease, with genetic vulnerability playing a key role.

• Not smoking

• Regularly seeing family and friends

• Drinking no more than moderate amounts (at most one drink per day for women, and two per day

Frank Guido couldn’t be happier he had a choice for treating his prostate cancer!

Frank chose non-surgical CyberKnife® at HOA –offering

5 treatments instead of 35!

“The original diagnosis was to treat my prostate cancer with seven weeks of radiation, five days a week. I was kind of upset that I was never given the option of CyberKnife,” said Frank. “The precise radiation achieved by CyberKnife, far fewer treatments, and the personalized care I received from Dr. Chin and his team made my decision an easy one. Better, the treatment was a real success!”

Exactly why healthy habits can be a buffer against depression is unclear. But the researchers looked for clues in study participants' MRI brain scans and blood samples. To hear more of Frank’s story and learn if CyberKnife

5 Things You Should Know About Asthma

By Ernst Lamothe Jr

The lungs and airways are an important part of the respiratory system that effectively carries and stores oxygen.

A properly functioning respiratory system allows breaths to flow in and out of the lungs and into the airways. This is not always the case for individuals because some suffer from a well-known medical condition called asthma.

One in 13 people in the United States have asthma, according to the Centers for Disease Control and Prevention.

“Certain factors can lead to worsening asthma symptoms in individuals with a prior history of asthma or cause asthma-like symptoms in individuals with no prior history of asthma,” said physician Denise M. Sanchez-Tejera, an allergist and immunologist for Rochester Regional Health.

1.Factors

Asthma appears in children and some adults that develop the medical condition later in life. Each occurrence in children and adults arises with different symptoms that are important to understand if faced with similar symptoms.

Common symptoms within this age group can include chest tightness, coughing, wheezing, dark circles underneath the eyes, and difficulty eating or sucking for infants. These symptoms can range from mild to severe.

Individuals can have situational asthma and can experience symptoms with exertion of exercise

or during working hours if they have occupational exposures in the workplace. In the younger pediatric population respiratory infections are a significant cause of asthma triggers, especially viral infections such as viruses of the common cold, flu, RSV or other viruses. A major asthma trigger in individuals with a history of allergies are allergens such as pollen, pet dander, dust mites and others.

“We recently had poor air quality days that led to an increase in asthma problems and this is known to cause asthma issues in general,” said Sanchez-Tejera. “Places with poor air quality such as urban areas typically see higher rates of asthma exacerbations. There are yet other causes including tobacco smoke, weather changes and irritants that can lead to worsening asthma symptoms.”

There is also a family history correlation with asthma.

“Asthma often has a genetic component and tends to run in families. The risk of developing asthma is higher in individuals whose parents have asthma. However, not everyone with a family history of asthma will necessarily develop the condition,” she added.

2.Bad air quality

This year we had a number of days that were labeled as 'poor air quality' stemming from the exposure to the Canadian wildfires. Smoke from wildfires can contain harmful particles and gases, and exposure to these can cause acute respiratory symptoms especially for individuals with asthma.

More American Men Now Opting for Vasectomy

Vasectomies are becoming more common in the United States, with rates surging by more than one-quarter during the past decade, a recent study reveals.

The U.S. vasectomy rate increased by 26% between 2014 and 2021, according to an analysis of commercial health claims data.

“All areas in the United States except the Northeast showed increased vasectomy rates,” said senior researcher and physician Omer Raheem. He is an assistant professor of surgery-urology with the University of Chicago School of Medicine.

Overall numbers remain low, with roughly 4% of men having undergone vasectomy, the researchers noted.

But doctors expect the demand for vasectomy will continue to increase following the 2022 Supreme Court decision that abolished the

national right to abortion.

“After the Roe v Wade overturn, there has been a significant increase in Google searches for vasectomy, as well as an uptick in vasectomy consultations and procedures,” physician Stanton Honig, division said chief for reproductive and sexual medicine at Yale School of Medicine.

“This recent study points to the fact that men are taking more of a role in reproductive health and family planning, especially when they are finished having children,” continued Honig, who was not involved with the new research.

For the study, Raheem and his colleagues gathered health insurance claims data to calculate the annual vasectomy rate among privately insured men in the United States, aged 18 to 64.

The percentage of all male patients undergoing vasectomies in

“We did see an uptick in asthma symptoms in individuals with an established history of asthma and also worsening respiratory symptoms in patients that never really had a history of asthma,” said Sanchez-Tejera.

3.Misconceptions

Some people believe that asthma is just a childhood disease. But in fact, it affects people of all ages. While it is more likely for this to begin in childhood, it can develop later in life. In addition, some myths about asthma treatment have caused some patients to avoid being seen or treated.

“We hope not to hear that asthma medications are addictive. It is not uncommon to find parents that are hesitant on starting or continuing medications because they do not want their child to be addicted to these,” said Sanchez-Tejera. “Asthma medications including inhalers and steroids are not addictive and stopping them without medical guidance can lead to uncontrolled asthma.”

“Asthma guidelines are updated periodically and we encourage individuals with asthma to regularly follow up with their allergist or pulmonologist to make adjustments on their medication,” Sanchez-Tejera added.

She also wants people to avoid thinking that people with asthma can’t have fully physical lives.

“People with asthma should continue to engage in physical activity,” she explained. “Asthma should not preclude an individual from participating in physical activities.”

4.Handling asthma

Asthma can be managed with proper medical treatment, lifestyle and education and by doing this, negative consequences of asthma can be prevented or minimized.

It is important to be in tune and recognize our symptoms and understand scenarios that can trigger asthma and this includes identifying and avoiding triggers such as allergens, smoke, pollution and respiratory infections. One should take steps to minimize exposure to these.

“Maintaining a clean environment free from allergens is also helpful. Quitting smoking and avoiding

second-hand smoke is advised,” she said. “Having a good understanding of the medications needed to control symptoms is of crucial importance. Asthma patients should know how and when to use the inhalers prescribed and follow an asthma action plan as described by their healthcare provider.”

5.Avoid smoking

Smoking is one of the worst habits for asthma and this includes active smoking as well as exposure to secondhand smoke. These can trigger asthma symptoms and make them more severe. Cigarette smoking is the number one cause of preventable death in the U.S. Cigarette smoke irritates the lungs, causing redness, swelling and more mucus. Your lungs have a natural defense to keep dirt and germs out.

“If you have asthma, we recommend quitting smoking and avoiding exposure to smoke,” she added. “Asthma can have a longterm impact on lung development and overall health. Not addressing or ignoring asthma symptoms can lead to lung remodeling that could lead to worse overall health.”

a given year increased from about 0.43% in 2014 to 0.54% in 2021, the investigators found.

The relative increases were greatest in men with no children (61%), men with an older wife (41%), single men (41%), and young men 18 to 24 (37%).

Vasectomy also remained a popular option for men with two or more children, the results showed.

Rural areas experienced greater

increases in vasectomy rates than urban areas, the researchers added.

“Given the political landscape, some men are leaning in and taking more responsibility to prevent unintended pregnancy,” said physician Monica Dragoman, system director of the complex family planning division in the department of obstetrics, gynecology and reproductive science at Mount Sinai School of Medicine in New York City.

Denise M. Sanchez-Tejera is an allergist and immunologist at Rochester Regional Health. “Asthma should not preclude an individual from participating in physical activities,” she says.

A Place to Grow

By Mike Costanza

Each week, Jaime Cox heads to EquiCenter to develop a better relationship with a horse.

“I love working with the horses,” the 57-year-old ex-Marine said. “For me, it’s just incredible.”

Cox is just one of the many adults and children who head to EquiCenter each year to grow as individuals, learn new skills or study horticulture.

The nonprofit, which is located on the 200-acre William & Mildred Levine Ranch in Honeoye Falls, offers a wealth of programs and classes to help them do so.

Though many of its programs involve horses, EquiCenter’s clients can also learn how to cook healthy meals, attend workshops on the importance of bees to horticulture, work with the crops on the facility’s three-acre organic farm or engage in many other beneficial activities.

EquiCenter’s adaptive riding program was specially created for adults and children who might not ordinarily be able to experience the pleasure of working with horses. Those who suffer from cerebral palsy, Down syndrome, spinal cord injuries, intellectual challenges and other conditions and syndromes have all been able to learn how to work with the animals and even ride them.

“We have programs that we can offer to anybody of any age, of any ability,” said Lindsay Alberts, EquiCenter’s director of equine operations. “We strive to tailor every single one of our lessons to the individual’s goals.”

Depending on their ability, some students might only be able to learn

how to groom and lead horses. Those who are more capable of riding, but still have difficulty staying upright in the saddle, could be trained to ride with the assistance of the nonprofit’s staff.

“We can have up to one leader and two sidewalkers per student for the safety of that student while on horseback,” Alberts said.

The leader leads the horse and the sidewalkers steady the rider. All work together to help the person in the saddle gain both physically and emotionally from the experience of being atop a 1,000-pound animal.

“They are very large animals, so just working around them on the ground or on their back builds self-confidence in people,” Alberts said. “It’s something they can gain strength in emotionally and physically.”

EquiCenter is an accredited member of the Professional Association of Therapeutic Horsemanship International (PATH). All of its instructors are PATH-certified, and must abide by that organization’s stringent safety rules and regulations.

A number of EquiCenter’s programs are designed specifically for those who once served their country.

Mission Mustang brings veterans and wild horses together, benefiting both. The program’s mustangs, which EquiCenter buys from the US Bureau of Land Management, were born free on the plains of Wyoming and Montana. When they arrive at EquiCenter, they are so frightened of humans as to be unapproachable.

The veterans who enroll in Mission Mustang work individually

with its horses, training them until they are ready to accept human contact. The process, called “gentling,” requires soothing, effective communications between the veteran and the horse.

“They’re constantly communicating to each other, but it’s through body language,” said Emma Minteer, Mission Mustang’s head trainer. “As a participant in the program, you have to change the way you’re communicating in a way that they understand.”

The veteran has to show leadership, but not through direct coercion.

“You’re not forcing the horse to do anything, but that horse is [eventually] willing to say ‘I trust you,’” Minteer explained.

The process benefits both horse and handler.

“You’re taking these wild horses and you’re gentling them, and in the process the individual who is working with the horse is learning a lot about themselves,” Minteer said.

During nearly 21 years with the Marine Corps, Cox saw combat in Somalia and Haiti, in Operation Desert Storm and during two tours in Iraq.

“I was an attack helicopter pilot, which is a very close-up and personal skill,” the 57-year-old Pittsford resident said.

Cox was a ground-based forward air controller in Fallujah, Iraq, when he got involved in a firefight.

“A mortar hit about five feet behind me, and the back of both legs had a significant amount of shrapnel in them,” he said. “Luckily my flak jacket and helmet protected me from the waist up!”

Cox received a Purple Heart for his wounds and left the Marines in 2008 with the rank of lieutenant colonel. He went on to become the CEO of two nonprofit organizations, the last of them the United Way of Northern New York and is currently between jobs. He took time off from his regular weekly session with a 7-year-old mustang to speak to In Good Health.

The beautiful animal didn’t have a name when Cox stepped into the paddock — EquiCenter’s wild horses aren’t named until they’ve progressed in the gentling process. That didn’t stop him from engaging with the mare in ways that benefited them both.

“When it’s just you and the horse standing in the ring, the horse is going to pick up on everything that you do, whether it be your motions, your emotions, your anxiety,” Cox said. “The more you want the horse to be trained, the more you actually have to relax.”

Cox approached her slowly and carefully, ready to respond to her reactions.

“You have to fight everything that you have to not just reach out [with a hand], because it will spook the horse,” he said.

If she tensed or backed away, Cox stood still or backed up, giving the mare room. Minteer was on hand to guide him, though she left most of the decisions up to him.

“I’ll step in and help and show, but at the end of the day it’s the participant’s job to get that horse to reach those goals that they’re striving for,” she said.

EquiCenter’s adaptive cooking and riding programs in Honeoye Falls was specially created for children and adult with disabilities, especially veterans

Cox is taking the time to train a mustang he works with at EquiCenter. Emma Minteer is Mission Mustang’s head trainer.“They’re constantly communicating to each other, but it’s through body language,” Minteer said as she discussed the relationship between Cox and the mustang.

Eventually, the horse grew comfortable with being very lightly stroked with a whip.

“I’ll use the tail end of a whip to just rub her flanks, so she can get used to touches,” Cox said.

The mare eventually came to trust Cox well enough to allow him to lightly touch her muzzle.

Minteer said each mustang is different, and there’s no way to tell how long it will take to train a wild mustang to become comfortable with human contact. Once they have been gentled, they’re sold to new homes.

Cooking classes

Veterans who are seeking a tastier experience can sign up for Cooking for Heroes, a class that teaches how to prepare nutritious meals. Chef Ellen Adams, who teaches the class, said military life leaves some who have served their country unable to function in the kitchen.

“I’ve worked with veterans who didn’t really know how to cook an egg or how to cook a carrot or a piece of chicken, because the military does that for you,” she said. “Our goal here is to teach veterans how to cook healthy food.”

Adams seems well-prepared to help veterans reach that goal. After 20 years in the US Air Force, including the time she spent in Iraq, she went on to study culinary arts — her training included an internship in Italy. Since graduating, she has taught cooking to private individuals, families and veterans. She also

founded and runs her own business, Red Hot Dish…and Great Food Too, through which she offers her services as personal chef.

In 2015, Adams decided to test her skills in a Military Vets episode of “Chopped,” the Food Network show in which contestants turn baskets of mystery ingredients into three-course meals. She didn’t win, but local veterans gained from her appearance.

“A viewer saw the show, liked my story and donated $10,000 to the EquiCenter to start the Cooking with Heroes kitchen,” she said.

One sunny afternoon, Adams helped other vets learn how to prepare a tasty lunch in EquiCenter’s kitchen that included stuffed zucchini and grilled kale with apples, almonds, ricotta cheese and homemade dressing.

“Ninety percent of everything we’re cooking today is from the farm,” Adams said. “The only thing I bought today was some sausage and ground beef.”

Over at one counter, Stacy Lundy was cutting up what she called “mini-melons.”

“Like a miniature cantaloupe family and another from the watermelon family,” the 54-year-old ex-Marine said.

Gathering with other vets to cook helps Lundy deal with the post-traumatic stress disorder she suffers as a result of her three years in the service.

“I really like to cook and it’s, like, a happy place for me,” she said.

Donna Korf enlisted in the US Army back in 1964, expecting to see the world.

“We had the Cold War going on,” the 81-year-old retired nurse said. “[I] never expected to go to war.”

Four months later, Korf was ordered to board a boat for Vietnam. When she disembarked, she found the hospital in which she’d expected to work hadn’t been built and the area was not completely secure.

“That first night, we were told not to have any flashlights, any lights, because there were Viet Cong about six blocks from us,” she said.

After two years in Vietnam, Korf headed back to the US.

“I couldn’t take another year there,” she said.

Korf became a civilian and went on to spend 25 years with the Veterans Administration before retiring. When asked what she likes about her Cooking with Heroes class, she was succinct.

“The support and the understanding from other veterans,” Korf explained. “Can’t get that elsewhere.”

In addition to preparing nutritious meals, veterans also help grow their ingredients on EquiCenter Farm, the nonprofit’s organic farm. The hands-on experience can be very valuable to them.

“Primarily, this…is a teaching-and-learning farm,” said Sarah Lichtman, who manages EquiCenter Farm. “Veterans can come, have meaningful outdoor experiences, can learn about growing things, can learn about themselves through learning about growing things.”

Even kids can stick their hands into the soil as part of EquiCenter’s Horticulture & Equine Active Learn-

ing (HEAL) program. The program regularly offers groups of students from local schools the opportunity to get hands-on experiences with horses and horticulture during field trips.

“We rotate them through stations to give them a more holistic experience, engaging both with plants and animals and other aspects of nature,” said Kevin Stewart, EquiCenter’s horticulture community outreach administrator.

Depending upon a student’s capabilities, he or she might learn how to groom or walk a horse, or just learn about the animal’s anatomy. They can also dig their hands into the soil, learning first-hand about how food is grown and the importance of horticulture.

“We make sure people know that every seed-based plant isn’t just an activity for that day, but that it’s feeding somebody in the community,” Stewart said.

In addition to the physical experiences that HEAL offers, students have opportunities to develop personally.

“We also work in team-building exercises and social-emotional learning,” Stewart said. “As students get to know horses and their natural environment, they’re also getting to know their peers and themselves to a deeper level.”

Field trips can take as little as half a day or involve multiple visits to the center. Students who participate in HEAL get to take home some of the food they’ve helped grow, but most of EquiCenter’s produce is given to food pantries and other facilities that aid the needy.

1. Sarah Lichtman is the EquiCenter Farm manager. “Primarily, this is a teaching-and-learning farm,” she says. “Veterans can come, have meaningful outdoor experiences, can learn about growing things, can learn about themselves through learning about growing things.”

2. Donna Korf, an 81-year-old retired nurse, spent two years in Vietnam. “I couldn’t take another year there,” she says. In addition to preparing nutritious meals, veterans also help grow their ingredients on EquiCenter Farm, the nonprofit’s organic farm.

3. Stacy Lundy, a 54-year-old ex-Marine, is taking part in a cooking program offered by EquiCenter. She said cooking helps her deal with the post-traumatic stress disorder she suffers as a result of her three years in the service. “I really like to cook and it’s, like, a happy place for me,” she said.

By Anne Palumbo

Boost Your Immune System with Delicata Squash

When I discovered delicata squash a few years ago, I couldn’t stop talking about it. I still can’t! The taste, the texture, the nutrition, the delicate skin…oh, if only it were available year-round.

The good news is, they’re in season now through November. And the even better news is, they can be stored safely for about two to three months in a cool, dry place.

But here’s the best news of all about this striped, pleasantly sweet winter squash: it’s chock full of nutrition, particularly vitamins C and A — two vitamins that boost immune system health. Right now, with flu and cold season bearing down on us, bolstering this all-important system seems wise.

Like other winter squashes, delicata is super low in fat, sodium, cholesterol and calories (only 40 per cup). And while it may have more carbs than some vegetables (10 grams per cup), it is by no means a carb-watcher’s nightmare. As a comparison: 1 cup green beans (7 grams), 1 cup corn (27 grams), 1 medium potato (35 grams), and — okay, this is not a vegetable but I couldn’t resist

— 1 soft pretzel (80 grams).

Delicata’s natural carbs are “complex” and take longer to digest, versus the “refined” carbs found in processed foods, such as sugary drinks, pastries, white bread, most snacks, and many cereals. The good fiber-rich carbs in delicata squash provide longer-lasting energy, more stable blood sugars, and fiber-driven heart protection. The bad fiber-depleted carbs in most processed foods, on the other hand, tend to cause spikes in blood sugar levels, which can trigger hunger and lead to food cravings. Numerous studies support that excessive refined-carb consumption may pave the way for health problems, such as obesity, Type 2 diabetes, and heart disease.

Unlike other hard-skin winter squash, delicata’s skin is edible, adding a nutty deliciousness to an already yummy squash. But that’s not all it adds: its skin is also rich in fiber, vitamins, minerals, and antioxidants. Antioxidants are beneficial molecules that fight free radicals, which, when elevated in your body, have been linked to heart disease, cancer, and other diseases.

1 delicata squash, washed and dried

1 tablespoon olive oil

¼ teaspoon kosher salt coarse black pepper, to taste

¼ cup grated parmesan cheese

1. Preheat oven to 425° F. Line a large baking sheet with parchment paper; set aside.

2. Trim the ends off the delicata squash, then slice the squash in half lengthwise and scoop out the seeds. Slice the seeded halves into ½-inch thick slices (half circles) and place them in a large bowl.

3. Drizzle the olive oil, salt, and pepper over the squash slices, tossing well to coat. Transfer

Helpful Tips

Select blemish-free squashes that feel heavy and firm, especially near the stem ends. Delicata’s thin, easy-to-slice skin does not need to be peeled before cooking. Also, this squash holds its shape during cooking, making it an excellent choice for stuffing and baking. As mentioned, whole delicata keep for several months if stored in a cool, dry place.

¼ cup whole-wheat panko breadcrumbs

1 teaspoon dried thyme

1 garlic clove, minced

1 teaspoon lemon zest (optional)

to the prepared baking sheet, arranging the slices in an even, flat layer.

4. In a small bowl, combine the parmesan, breadcrumbs, thyme, garlic, and lemon zest.

5. Sprinkle the parmesan mixture over the squash, pressing to adhere.

Roast in the center of the oven until tender and golden brown, about 25 minutes.

Breast Cancer

Understanding the Stages of Breast Cancer: 0,

1, 2, 3 and

4

Adiagnosis of breast cancer comes with many tough questions, but one of the biggest is what stage your cancer is.

Millions of women struggle with such questions every year: Breast cancer is the most common cancer in women in the United States, with the sole exception of skin cancers, according to the American Cancer Society. It accounts for roughly onethird of all new female cancers each year.

Once you receive a breast cancer diagnosis, your doctor will determine the stage of your particular cancer using the results of your diagnostic tests. Knowing the specific stage of your cancer helps determine the best treatment options for you, as well as your expected survival rate.

The most common tool physicians use to stage breast cancer is the American Joint Committee on Cancer's (AJCC) TNM system. T stands for the size of the tumor, N for whether the cancer has moved into lymph nodes, and M indicates whether the cancer has spread to other places in the body. Numbers or letters after T, N and M provide more details about each factor. Higher numbers mean the cancer is more advanced.

According to the American Society of Clinical Oncology (ASCO), breast cancer stages are broken down into five levels: Stages 0, 1, 2, 3 and 4. Below you will find expert guidance on each of the stages, along with the associated five-year relative survival rate.

Stage 0 breast cancer

In stage zero (0) breast cancer, also called noninvasive or in situ cancer, the disease is only in the ducts of the breast and has not spread to the surrounding breast tissue (Tis, N0, M0).

Stage 0 breast cancer survival rate is 99%.

Stage 1 breast cancer

Stage IA: In this stage, the tumor is small, but has invaded the breast tissue. There is none in the lymph nodes (T1, N0, M0).

Stage IB: The cancer has spread to the lymph nodes and is larger than 0.2 mm but less than 2 mm. Either there is no sign of a tumor in the breast, or it is 20 mm or smaller (T0 or T1, N1mi, M0).

Stage 1 breast cancer survival rate is 86% (Stage IB) to 99% (Stage IA).

Stage 2 breast cancer

Stage IIA:

• While no evidence of a tumor is found in the breast, the cancer has spread to one to three axillary (under arm) lymph nodes. The cancer hasn't spread to other parts of the body (T0, N1, M0).

• A tumor of 20 mm or less is found in the breast, and the cancer is in one to three axillary lymph nodes (T1, N1, M0).

• While the tumor is larger (greater than 20 mm but not more than 50 mm), it has not spread to the

axillary lymph nodes (T2, N0, M0).

Stage IIB:

• The tumor is greater than 20 mm but not larger than 50 mm. It is also found in one to three axillary lymph nodes (T2, N1, M0).

• The tumor is larger than 50 mm but none is found in the axillary lymph nodes (T3, N0, M0).

Stage 2 breast cancer survival rate is 86% to 99%, depending on whether it has spread to the lymph nodes.

Stage 3 breast cancer

Stage IIIA: This stage involves a tumor of any size which has spread to four to nine axillary lymph nodes or to internal mammary lymph nodes, but has not spread to other parts of the body (T0, T1, T2, or T3; N2; M0). This stage may also have a tumor larger than 50 mm which has spread to one to three axillary lymph nodes (T3, N1, M0).

Stage IIIB: The tumor has invaded the chest wall or has caused ulceration or swelling of the breast. There may or may not be cancer in as many as 9 axillary or internal mammary lymph nodes. It hasn't spread

to other parts of the body (T4; N0, N1 or N2; M0). It also may have been diagnosed as inflammatory breast cancer.

Stage IIIC: Any size tumor that has invaded 10 or more axillary lymph nodes, the internal mammary lymph nodes, or lymph nodes under the collarbone. It has not spread to other parts of the body (any T, N3, M0).

Stage 3 breast cancer survival rate is 86%.

Stage 4 breast cancer

This stage involves a tumor of any size. The cancer has spread to other organs, including the bones, brain, liver, lungs, distant lymph nodes or into the chest wall (any T, any N, M1). Metastatic breast cancer found when cancer is first diagnosed only occurs about 6% of the time and may be called de novo metastatic breast cancer. Usually, metastatic breast cancer isn't found until after a previous diagnosis and treatment of early-stage breast cancer.

Stage 4 breast cancer survival rate is 30%.

Breast Cancer

that women at high risk may start with annual mammograms earlier than other women, typically around age 30.

“Some women with a first-degree relative like a mother or a sister who was diagnosed at a young age have been advised to begin screening 10 years before the age that relative was when she was diagnosed,” Smith said. “Women who receive regular mammograms are more likely to have breast cancer diagnosed earlier, less likely to need aggressive treatments and more likely to be cured. However, mammograms are not infallible; they may miss some cancers, and even when issues are found in an initial screen, further testing may be needed to confirm the presence of cancer.”

Breast Cancer

‘Over-diagnosed’ Among Older Women

Study: Some women over 70, if diagnosed with breast cancer, need to weigh if pursuing treatment is the right course

By Deborah Jeanne Sergeant

Arecent study of 54,635 women aged 70-plus by Yale School of Medicine indicates that 31% of women aged 70-74 and 47% of those 75-84 were possibly “over-diagnosed” with breast cancer.

The term means that they were found to have a kind of breast cancer that is slow growing and that treatment would likely not extend their lives or improve their quality of life.

In fact, pursuing treatment such as lumpectomy, mastectomy or chemotherapy would dramatically decrease quality of life.

“There is no exact age at which women should stop getting mammograms,” said Susan Brown, registered nurse, senior director of Health Information and Publications at Susan G. Komen.

“Breast cancer risk increases with age and mammography doesn’t appear to be less effective in women 70 and older. However, there are risks of mammography in older women, including over-diagnosis and

over-treatment, when a cancer that would not have caused problems if untreated is treated and the person is subjected to side effects without receiving any real benefit from the treatment. Many major health organizations recommend women aged 70 and older continue to get regular mammograms as long as they are in good health and could benefit from treatment if breast cancer were found.”

She added that poor health may cause some women may stop routine breast cancer screening, as would the presence of other health issues that would take precedent. The organization’s stance is that women should be able to access regular screening mammograms as long as they and their providers think they should.

When to stop mammography — and when to start — relies upon many health factors.

Robert Smith, vice president of Early Cancer Detection Science for the American Cancer Society, said

Those who are 55 and older may choose to switch to every other year. But Smith said those who are 75 or older can continue annual screening as long as they remain in good health and expect to live at least another 10 years.

“There’s more to it than dying,” said Avice O’Connell, director of the UR Medicine Breast Imaging program. “There are people who ignore their cancers and it’s ulcerating through their skin and dripping. You also want them to stay comfortable. It depends on the age and health of the woman coming in. In England and Ireland, they don’t do mammograms after age 70. You’d have to pay for it yourself. It’s so much easier to take out a cancer the size of a bean or grape. You can take it out and monitor without radiation or chemotherapy.”

Although the medical protocol isn’t to ignore breast cancer, the approach is different.

“We may not want to go all out like they’re 35,” O’Connell said. “If someone’s educated and informed enough, they should make that decision. There’s nothing wrong with monitoring. Screening picks it up long before you feel it. If it is not growing, you could keep following it.”

Allison Magnuson, a breast cancer oncologist with URMC, looks at age as only a number — and only one aspect of the patient’s health profile.

“The number really doesn’t mean a lot,” she said. “We need to step back and look at overall health status and what is their remaining life ex-

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pectancy. There’s a lot of variability.”

Someone in her early 70s may have numerous comorbidities and maintenance drugs. Or she could be spry, active, eating well and in good health with no issues. That’s what Magnuson refers to as “physiological aging, not chronological aging.”

“Any type of diagnosis or treatment really has to be put into the context of someone’s overall life expectancy and health status,” she said. “A medical condition that arises for someone with a shorter lifespan, it may not bother them. An indolent, slower growing cancer may not manifest into a problem in their lifetime.”

Some older women with numerous other medical problems and a new breast cancer diagnosis may enjoy a better quality of life with medication that can help slow the growth of the cancer.

Magnuson thinks that patients should discuss their providers their overall health and life expectancy when considering mammograms and if a lump is discovered.

“If side effects outweigh the benefits, we talk about this,” Magnuson said. “Talk with your doctor about your preferences. Everyone thinks differently and makes decision differently. It’s about having that conversation with your doctor about any decision. The doctor can guide you on pros and cons, but only the patient knows what’s in their own values and what value they put on those pros and cons.”

At Elizabeth Wende Breast Care based in Rochester, there’s not an age cutoff for mammogram for patients who want them.

“At age 25, we sit down and talk about risk factors like family history, genetic mutations, and if they’re Black or other minorities or Ashkenazi Jewish and therefore higher risk,” said Nancy Wayne, marketing administrator. “We want to offer screening opportunities earlier than 40 as needed for the higher risk women who may have a genetic mutation or who’ve had breast cancer already or have had radiation to the chest wall at a young age.”

But even for women with no history of breast cancer in their family and with no issues, Wayne said that a first mammogram by 40 is recommended.

Breast Cancer

Q & A with Holly Anderson

Breast Cancer Coalition of Rochester’s director to step down after 23 years at the helm. She talks about serving a population of 7,000 breast and gynecologic cancer survivors in 27 counties, including Monroe, which she says has one of the highest rates of breast cancer in NYS

By Mike Costanza

In the early days, the Breast Cancer Coalition of Rochester had one employee, Holly Anderson —the newly hired executive director, the staff, the receptionist and program coordinator. She’s served as executive director for 23 of the coalition’s 25 years. Anderson is stepping down Dec. 31.

Q: How did you get involved with the coalition?

A: I first met the founders of the Breast Cancer Coalition in 1999 when the organization was just one and a half years old. Now, this is our 25th year. We started literally at the kitchen table. We started out with an answering machine in someone’s basement and a P. O. box in Irondequoit and then moved into our first office on Park Avenue in 2000. We are in our third location now.

Q: What is Breast Cancer Coalition of Rochester?

A: We are independent, community based. We are not part of any national organization — we are the boss of us. I have been here for 22 years as executive director. We have four pillars — advocacy, education, support and research. We started primarily in just Rochester and Monroe County, but now we serve 27 counties in Central and Western New York. The coalition offers programs and services at no charge. We work with area oncologists and other medical professionals to offer a wide variety of education programs seminars. We serve more than 7,000 breast and gynecologic cancer survivors in 27 counties.

Q: How big is your budget?

A: Our budget is $1.2 million.

Q: Where does that money come from?

A: We do three major fundraisers a year. We do a fall event. We also do a golf tournament and we do a pink and teal challenge — a 5K walk or run on Mother’s Day weekend.

Q: Is that all?

A: We are a United Way donor-designated agency and also receive direct donations from people who are giving in honor or in memory of someone. We receive grants. Third-party fundraisers from friends in the community benefit us. In October, we see a lot of high school and college teams doing events to benefit us. We feel very honored and privileged when a high school or college group picks us for where those charity dollars go. It’s tough to compete with those national organizations. You can give a $100 to a national organization, which might be like a drop of water in the ocean — or you can give it to a local organization that is serving our region where it would have a huge difference right here in our community.

Q: How big is your staff?

A: The more programs and services we added, the more staff that we needed. We started out with just me and one employee and we now have 11.

Q: So, the need is there?

A: Yes. We’ve grown and it’s been — it was never our intention to really swell in the way that we did — but it’s really the need. Monroe County has one of the highest rates of breast cancer in New York state. The numbers change from year to year. It’s a significant number in this county; we don’t know why.

So much of the attention to breast cancer when we started was on screening and early detection initiatives. Those are important, but what next? You know, what do I do now? I was diagnosed in 1999 and there was nothing out there. So much focus was on pink ribbons, screening and early detection. OK it works, but now what? We were determined to be the “now what.”

Q: How do you help people?

A: One way the coalition supports gynecologic cancer survivors is by pairing an individual with a peer mentor as part of our PALS Project. Our trained peer mentors reach out to those who desire to speak with a survivor who has faced a similar situation.

Breast cancer is not a plain vanilla disease. It is very complex. There are different sub types of breast cancer and ways of treating it. I think that is one of the greatest strengths that we have as an organization is helping people sort out what they need to know; what is it about their diagnosis that they are likely going to hear from their doctors and specialists. What’s coming at me? Those are really key parts of the discussion.

When I started, I was all alone. I’m a nurse. I’ll sit down with them and talk with each person about their diagnosis and help them understand, sort out the nuances, help them figure out what type of questions they might be asking of their care team.

We match people up with other survivors with a similar diagnosis, similar age, similar walk of life. We really try to help people connect with others that they could potentially relate to. We meet with each survivor that contacts us. In 2014, we began serving breast and gynecologic cancer survivors; there are a lot of similarities with the way these two cancers are treated.

Q: What is next for you?

A: I need a slower pace. After 22 years, it’s time to turn the reins over to some new energy. I love the public policy piece; the work that we do — trying to get safer cosmetics, personal care products, funding initiatives for research.

I don’t think people, voters, realize how much power they have. We really look at our legislators as working for us. We reach out to them; tell them what we want them to do. It’s what everybody should be doing. They should pick up the phone and direct them; because they work for us. Believe me, industry and lobbyists are in there every day telling them what they want them to do. Who they really should be working for is us.

Though I’m planning my departure from the coalition, I’m not planning to retire. I’ll be seeking a new career path that allows me increased flexibility and a bit less responsibility. I’ll always be available to share institutional knowledge or provide historical context to our leaders of the coalition.

Breast Cancer Coalition of Rochester is located at 1048 University Ave, Rochester. For more information, call 585-473-8177 or email info@BreastCancerCoalition.org.

'I think that is one of the greatest strengths that we have as an organization is helping people sort out what they need to know; what is it about their diagnosis that they are likely going to hear from their doctors and specialists. '

Breast Cancer

Brown, registered nurse and, senior director of health information and publications at Susan G. Komen. “It is hoped that AI-assisted mammograms will increase accuracy and efficiency.”

Brown noted that false positives and false negatives could be an issue with AI-read mammograms, but hopes that additional research will confirm the early studies on AI assisted mammograms.

AI Assisted Mammograms

By Deborah Jeanne Sergeant

Astudy published by Swedish researchers in August indicates that artificial intelligence (AI) can safely augment and even improve radiologists’ work in detecting breast cancer.

The study is the first trial that compares AI-assisted mammogram readings with human-only mammogram readings.

The radiologist using AI detected 20% more cancers than those read only by two radiologists without AI help. Using AI did not appear to increase the number of false positive mammograms, which is when an abnormality is noted but not actually present.

In addition to greater efficacy, using AI also reduces the work hours needed to read mammograms by 44% because AI replaces the work of one radiologist (some hospitals

require that two radiologists are required to read each mammogram). This can be particularly helpful in health systems with few radiologists, such as in rural areas.

According to the American College of Radiology, 82% the 20,970 radiologists providing patient care are age 45 and older and 53% are age 55 and older. The demand for radiologists is rising as the aging baby boomers require more care. The Bureau of Labor Statistics states that the need for new radiologists is expected to rise by 6%, “faster than average” between 2022 and 2032 compared with all other occupations. Enlisting the help of AI can help mitigate this rise in demand.

“Early research appears to show that AI-assisted mammograms may be an important tool to help radiologists detect breast cancer,” said Susan

“AI is everything in imaging,” said Avice O’Connell, director of the UR Medicine breast imaging program. “But it’s not going to take our jobs. AI is something we’ve been using for more than 20 years in mammography. In 1998 the first computer aided detection; the computer scanned images and highlighted things that could be cancer. There’s still that kind of computer-aided detection. There are usually four marks on every exam, so a human still has to look at it. It’s just an aid to make sure we’re not missing things.”

O’Connell views AI as a means to screen the “easy” cases more quickly so radiologists can pay more attention to more challenging cases. But in either, a human must be involved; AI is only a tool but doesn’t make any decisions about health.

“The patient makes the ultimate decision whether or not to have the biopsy,” O’Connell said. “We’d still follow up the patient in six months.”

O’Connell sees machine learning as the next threshold of mammography advancement, meaning that as AI technology reads more and more mammograms, it becomes more skilled at catching abnormal findings. She also thinks that AI-assisted mammography will help in areas of the world where few specialists exist.

“The vast majority of breast imaging around the world is not read by breast experts,” she said. “AI has huge value in every country.”

Nancy Wayne, marketing administrator at Elizabeth Wende Breast Care based in Rochester, wants to see additional research to show that AI plus a radiologist is just as good as two radiologists.

“AI is a wonderful tool,” she noted. “We’re still early on in the development of AI. There are multiple products out there currently. We’re still not quite able to say one product fits all. There are multiple companies with proprietary products. We’re hopeful where at some point the AI has to fulfill certain criteria to be appropriate. I’m not sure at this point we’re there. It is promising.”

Susan Brown is a registered nurse and the, senior director of health information and publications at Susan G. Komen. “It is hoped that AI-assisted mammograms will increase accuracy and efficiency.”

OMEN'S HEALTH

Oral Contraceptive to Be Available Without Prescription Early in 2024

New drug, Opill, offers a 98% rate of effectiveness in preventing conception

By Deborah Jeanne Sergeant

The FDA recently approved Opill (norgestrel) as an over-thecounter oral contraceptive.

Typically, oral contraceptives require a physician’s exam and prescription. Opill was first approved with a prescription in 1973. When taken as directed — one pill daily at the same time each day — Opill offers a 98% rate of effectiveness in preventing conception.

“I think it’s fantastic,” said Stacy Sun, OBG-YN and assistant professor in the department of obstetrics and gynecology at URMC. “It really puts patient autonomy first. It provides people an opportunity and ability to take control of what they want to do with their bodies. It’s as safe as Tylenol. Most people could take it if they chose to do so. Our patients are smart and savvy. They can take care of themselves.”

Sun said that unlike oral contraceptives that contain estrogen and progastrin, Opill is safe for people who smoke, or who have a history of blood clots, stroke or bleeding disorders.

The FDA’s website states that women who have or who have had breast cancer should not take Opill. Other contraindications include women who are pregnant or who think they might be pregnant, along

with another birth control pill, vaginal ring, patch, implant, injection or an intra-uterine device (IUD), or as an “emergency contraceptive,” also known as a “morning-after pill.” Men should also not take Opill.

Dual-hormone contraceptives typically warn that’s it’s not recommended for women 35-plus; however, Opill has no such contraindication. Its safety has been established for women as young as 15; however, sale of Opill will not be limited by age.

Opill has the typical oral contraceptive side effects. The FDA listed irregular bleeding, breast tenderness, headaches, nausea, dizziness, abdominal pain, increased appetite, and bloating.

The FDA encourages women to discuss Opill with a healthcare provider or pharmacist if they currently take a prescription for drugs to treat seizures, tuberculosis, HIV/AIDS, or pulmonary hypertension or take an over-the-counter supplement containing St. John’s Wort. Opill may interact with these drugs or become less effective. Opill can also affect the efficacy of emergency contraceptives.

Sun views Opill as a “bridge” for patients who want contraceptives but are between doctors or insurance plans. But she warned that

PAP smears and routine care are still important.

The Centers for Disease Control and Prevention states on its website that “all women are at risk for gynecologic cancers, and risk increases with age.” It’s vital that women seek preventative exams on the schedule their care provider recommends, even if they use Opill.

Women taking Opill should take it for seven days prior to relying on it for contraception to better ensure its effectiveness. For many years, doctors have routinely prescribed oral contraceptives for controlling patient’s abnormal bleeding, period pain and other similar issues. But the FDA has not approved Opill for these uses. It’s vital that women seek a provider’s care for such symptoms and not try to self-diagnose and hope Opill will take care of it.

The active ingredient in Opill concerns the Rev. Jim Harden, CEO of CompassCare, which offers reproductive counseling and sexually transmitted infection testing and treatment services in Rochester, Buffalo and Albany and statewide via telehealth.

“Peer reviewed medical articles and the World Health Organization state that this exposure to steroidal contraception increases risks of cancer,” Harden said.

Harden writes extensively on medical ethics. His book “Ethical Theory and Pertinent Standards in Women’s Reproductive Health” was endorsed by the late Edmund D. Pellegrino, MD, former chair of the President’s Council on Bioethics; senior research scholar at the Kennedy Institute of Ethics; and professor emeritus of Medicine and Medical Ethics at Georgetown University.

Harden noted the National Institutes of Health’s (NIH) statement about progestin-only oral contraceptives as “at least comparable to the risk of combined oral contraceptives” which the NIH said, “increase the risk of breast cancer” as a “Group 1 carcinogen for breast cancer, as well as for cervical and liver cancer.”

The FDA’s website states that “each Opill tablet contains 0.075 mg. of a single active steroid ingredient, norgestrel, a totally synthetic progestogen.”

'Fertile Windows'

Expert explains when women are most likely to conceive

When you're trying to become pregnant, understanding when in your cycle you're the most fertile is key to success.

Physician Rebecca Flyckt, medical director of University Hospitals Fertility Center in Beachwood, Ohio, shares what you need to know about "fertile windows."

What is a fertile window?

“A fertile window is the best time to attempt pregnancy during a given month,” Flyckt explained. “The fertile window can be predicted with confidence based on menstrual history and suspected time of ovulation.”

When do you ovulate?

According to the American College of Obstetricians and Gynecologists (ACOG), ovulation is the time in the menstrual cycle when a woman's egg is released and able to be fertilized by sperm. That's why knowing when you ovulate each

month can help you maximize your chances of getting pregnant.

“Most women with a 28-day menstrual cycle ovulate around day 14,” Flyckt said. “Although the first half of the menstrual cycle is variable in length [and can even vary in the same woman from month to month], the luteal phase [time from ovulation to expected menses] is typically 14 days long.”

This means that ovulation begins about 14 days before the start of your next period. How long does ovulation last? The ACOG says it lasts for the entire time that the egg survives, which is about 12-24 hours.

What are the symptoms of ovulation?

While ovulation occurs approximately 14 days before your next period, the American Pregnancy Association says knowing the symptoms of ovulation can help you answer the question: how many days after your period do you ovulate? This is be-

Fertility Treatments Up Stroke Risks

Scientists have spotted an elevated risk of stroke in women who became pregnant after fertility treatments.

Although the absolute number of strokes reported in the new study were low, women seeking fertility treatment should be made aware of the increased risk, said senior study author, Cande Ananth, chief of epidemiology and biostatistics at the Robert Wood Johnson Medical School in New Jersey.

Ananth offered possible explanations for the link, including that infertility procedures can cause physiological changes because women receive large amounts of estrogen during the treatments. This can lead to increased clotting, which is a strong risk factor for stroke.

“We know that women who receive infertility treatment have certain vascular complications, typically an increased risk of preeclampsia and placental abruption,” Ananth told the

New York Times.

“People who receive the treatment receive it for a reason. Perhaps there are different biological characteristics,” among women seeking treatment, Ananth added.

In the study, researchers analyzed the cases of 31 million patients who had a hospital delivery between 2010 and 2018 in 28 states. This included more than 287,000 women who had infertility treatments.

They found that women who had undergone the treatments faced twice the risk of bleeding in the brain, known as hemorrhagic stroke. They also had 55% greater risk of ischemic stroke, when blood supply to the brain stops.

About 37 women were hospitalized for stroke for every 100,000 women who had fertility treatment.

About 2% of U.S. births involved fertility treatments, such as intrauterine insemination, assisted reproductive technology, use of a surrogate

cause your body goes through certain changes right after your period (and before ovulation) due to hormone shifts.

“Women often will note that their vaginal discharge will become more transparent and thinner and stretchier right before ovulation, and some women may experience mild cramping on one side at the time of ovulation,” Flyckt said.

The American Pregnancy Association says that other signs of ovulation may include:

– Light spotting

– A slight decline in basal (resting) body temperature right before ovulation

– Stomach bloating

– A soft, open wet cervix during ovulation

– Increased sex drive

– Tender breasts

– Sharpened sense of vision, taste or smell

How long does ovulation last?

“The fertile window begins about five days before ovulation and is open until one day after ovulation,” Flyckt noted.

This is because "sperm that have been deposited into the reproductive tract before ovulation can live for up to five days and fertilize an egg, but sex after ovulation is often too late to catch the fertile window," she continued. “This is important because many couples try to time sex for the moment of ovulation, when in fact it is the sex that occurs up to and during ovulation that is the most effective."

How do you calculate the fertile window?

Flyckt says there are a few ways to calculate your fertile window.

“If you have regular periods, subtract 14 days from your first day of the menstrual period and that is likely when you ovulate,” she advised. “You can then apply that to your upcoming period to target the probable ovulation day.”

Flyckt also mentioned using an app to track when you are the most fertile. “After tracking has occurred, the app will begin to calculate an average menstrual cycle length and a predicted time of ovulation about two weeks before the next period start is anticipated,” she said.

If you already know your average menstrual cycle length, you can also use a simple ovulation date calculator to calculate your fertile window.

The American Pregnancy Association says there are two other tools to help guide your fertile window calculations:

Ovulation kits can determine the amount of luteinizing hormone in your body, which increases significantly about 12-36 hours before ovulation.

Ovulation microscopes can show changes in the appearance of saliva that occur right before ovulation.

Tips for maximizing the fertile window

Flyckt said that couples who are trying to conceive don't need to have sex every day of the fertile window.

“Every other day is fine and supported by good scientific data,” she explained. “Also, for women with regular periods, sex can be planned starting around cycle day nine [and then] every other day for one week. This pattern will likely catch the fertile window and doesn't require any apps or ovulation kits.”

Flyckt also noted that if you are using an ovulation predictor kit, “begin testing on cycle day 10, with cycle day one being the first day of full flow menses [your period]. Follow the instructions on the kit for timing of intercourse.”

When to see your doctor

“If cycles are irregular and or ovulation kits are not working within a few months, it is likely not a timing issue,” Flyckt explained. “Evaluation by a specialist can help get to the bottom of this."

and fertility preservation procedures.

Some studies have linked the treatments to increased risks during a pregnancy, though they are generally considered safe, the Times reported.

While this study, published Aug. 30 in the journal JAMA Network,

found these risks, another study of women in Scandinavian countries published earlier this month in the journal JAMA Cardiology did not. That study included 2.4 million women.

OMEN'S HEALTH

Domestic Abuse Recovery

By Deborah Jeanne Sergeant

Surviving domestic abuse or domestic violence requires not only escaping the reach of the perpetrator to achieve physical safety, but also recovering emotionally and mentally.

“There may be a period that’s crisis intervention for that person,” said Jill Woodruff, board-certified art therapist and licensed mental health counselor in private practice in Dansville, “and after that period, there used to be a term ‘battered woman syndrome’ but men also experience this. It usually involves them having to revamp their whole identity. It sounds extreme. It looks like symptoms of grief and loss.”

For a long time, the survivors denied their own thoughts, wishes and needs to fulfill the perpetrator. Some survivors were dominated by an abuser so long that they no longer know how to make decisions or even what they want anymore, from choices as trivial as what to eat for dinner to choices as important as who to date. This can place them in danger of becoming trapped in another abusive relationship again.

“Once safe, the trauma will poke at them for a long period of time depending on how they manage it,” Woodruff said. “Because the circumstances of abuse are gone, the person should feel entirely well. But they have to unlearn feelings they had during the abuse to move forward.”

She likens it to the processing required for grief and loss. The stages are not necessarily linear and it takes time to work through it, as victims have been conditioned to live under

the perpetrator’s control over every area of their lives for months and typically years. Before diving into another romantic relationship, it’s vital to recover first.

Perpetrators do more than hit. Abuse can also include intentional and persistent mental, emotional, spiritual and sexual abuse. Mental abuse includes intimidation, mind games, gaslighting and manipulation. Emotional abuse can take the form of “love bombing” followed by withdrawal, threats, cruelty and completely withholding love and affection. Spiritual abusers may restrict or force participation in particular worship and spiritual expression and use ever-shifting “rules” about spiritual practice to control the victim. Sexual abuse involves using sexual practice for manipulating the victim, such as forcing or withholding intimacy or demanding unwanted types of sexual activity. The foundation of all abuse is consistently using means to control and dominate the other person.

In addition to the brainwashing aspects of abuse, survivors suffer the loss of their relationship (difficult though it was) and often their home, pets, work, friends and possessions. Numerous areas of their lives change in a flash.

“Always with mental health, there’s no right answer as to how anyone is supposed to feel,” Woodruff said. “Give people time and space to feel. Hold a space for them and give them time.”

Woodruff advises survivors to stay in one-on-one therapy as long

as possible.

“That gives you someone outside your own head giving you input,” she said. “Find a group to participate in to feel validated.”

Caring friends can also help provide support in rebuilding a sense of self-worth and confidence. Oftentimes, survivors are more gracious to others than themselves.

“Ask yourself, ‘What would a healthy relationship look like if I saw it for someone else?’” Woodruff posed. “Your own lens is skewed by abuse. Providing reflective distance for ourselves can help us see what’s healthy for someone else is also healthy for ourselves.”

This strategy can help build better skills for navigating relationships, whether friendships or romantic relationships. Survivors need to learn how to set personal boundaries that are neither too permissive nor too restrictive.

Most abusers damage the survivor’s relationships with others as isolating the victim helps keep the abuse secret and prevents supportive friends and loved ones from helping. Becoming involved in group settings with a hobby or other activity can help rebuild friendships and build new friendships.

“Get involved in a supportive community setting with a hobby or something that feels good and is unconditional and supportive,” Woodruff said.

This can be a good time to pick up a beloved hobby that was dropped or to try something completely new. Some people find that practicing martial arts provides a supportive community of new friends, a physical activity that is both mentally and physically engaging and practical skills that can boost their confidence.

• ADVENTURES: Friends spend nine days and about 630 miles to circle Lake Ontario by bike

• VETERANS: Group of veterans from Rochester takes part in the Honor Flight program

• EXERCISE: Why you should consider tai chi

• ARTS: Arena Art Group: creating abstract art

• COVER: Bruce Barnes: Preserving the legacy of George Eastman

• MEET THE IMMORTALS: Local guys carry skills to the national level

• WORKFORCE: Growing number of older Americans continue to work

• PETS: Local counselor pens grief book • Pet cremation becomes more popular ...and so much more!

$21.00 $35.00

By Jim Miller

How Seniors Can Save on Prescription Drug Costs

Dear Savvy Senior,

I take several medications for multiple health conditions and the prices keep going up, even with my Medicare prescription drug insurance. Can you recommend any tips that can help cut my costs?

Tapped Out Tina

Dear Tina,

The high cost of prescription drugs is an ongoing problem that stings everyone, but it usually affects seniors more because they have a greater need for medications and because Medicare doesn’t cover all their drug costs.

While the Inflation Reduction Act, that was signed into law last year, will help seniors save on their medications by negotiating lower drug prices and capping out-of-pocket spending at $2,000, it will be a few years before the law is fully enacted. In the meantime, here are some different strategies that can help reduce your costs so you can afford what you need.

• Talk to your doctor: A good first step is to review your medications once a year with your doctor to find out if any of them can be stopped or reduced. If you’re taking any brandname drugs check to see if they are available in a cheaper generic form. Also, for any drugs you’re taking long-term ask your doctor for a cheaper three or six-month prescription, versus a one month. And find out if any of the pills you’re taking can be cut in half. Pill splitting allows you to get two months’ worth of medicine for the price of one. If you do this, you’ll need to get a prescription for twice the dosage you need.

• Review your insurance: Carefully review your drug coverage during the open enrollment period, which runs Oct. 15 – Dec. 7 for Medicare beneficiaries. Make sure all your regular medications are covered in the plan’s formulary; that your current pharmacy is in the plan’s network; and that your plan covers additional medication coverage in the gap. To shop and compare Medicare prescription drug plans go to Medicare. gov/plan-compare.

• Pay cash: Not using insurance for prescriptions seems counterintuitive, but in some cases, it may save you money. For example, many chain pharmacies and big-box stores like Walmart and Costco have their own prescription savings programs that may be lower than your insurance copayment. Or you can use coupons through GoodRx.com or RxSaver. com that can save you up to 80% off

the list price of generic and some brand-name drugs in certain pharmacies.

• Shop online: You can also save on regularly used medications by having them sent to you from a mail-order pharmacy. Check with your health insurer or regular pharmacy to see whether it will get you a better deal. If not, check online pharmacies like CostPlusDrugs.com or HoneybeeHealth.com. With these, you may spend less in some cases than you might with insurance.

• Buy from Canada: Because prescription drugs are often much cheaper north of the border, many Americans have chosen this option for years. While this is technically illegal in most states, the Food and Drug Administration generally does not stop people from doing it. If you want to explore this option use PharmacyChecker.com, an online tool that will help you identify reputable Canadian and international online pharmacies.

• Get more help: If your income is limited, you may also be able to get help through Medicare’s Extra Help program (Medicare.gov/basics/ costs/help/drug-costs), your state pharmaceutical assistance program (Medicare.gov/plan-compare/#/ pharmaceutical-assistance-program/ states) or patient assistance programs (Medicare.gov/pharmaceutical-assistance-program). Visit each website to see if you’re eligible and to apply.

Ask

The Social Security Office Minimizing The Risk of Financial Abuse For People Living With Dementia

From the Social Security District Office

Financial crime against older Americans is a growing problem. People living with dementia are at an especially high risk of becoming victims. That’s why we’re committed to combatting fraud.

As their memory and other thinking skills decline, people with dementia may struggle to make financial decisions. They may not remember or report the abuse — or understand that someone is taking advantage of them. This abuse can occur anywhere — including at home or in care settings.

Victims of fraud who are 80 years and older lose an average of $39,200 every year.

Studies show that financial exploitation is the most common form of elder abuse. However, only a small fraction of these incidents is reported.

You can help protect others by learning to recognize common signs of financial exploitation and abuse, including:

• Unopened bills.

• Unusual or large purchases.

• Utilities being shut off due to unpaid bills.

• Money given to telemarketers or soliciting companies.

• Unexplained withdrawals from the person’s bank account.

There are also many simple things that caregivers can do to reduce the risk of financial abuse for

people with dementia and similar conditions, like Alzheimer’s. Do your best to make sure they’re involved in deciding which safety measures to put into place.

Some options include:

• Agreeing to spending limits on credit cards.

• Signing up for the “Do Not Call” list at DoNotCall.gov.

• Setting up auto-pay for bills instead of paying them by check.

• Signing up to receive automatic notifications for withdrawals from bank accounts or large charges to credit cards.

• Requesting electronic bank and credit card statements and watching for unusual purchases or changes in how the person typically spends money.

• Asking credit card companies to stop sending balance transfer checks and opting out of future solicitations.

• Creating a separate account where you can keep a small, agreed-upon amount of money that the person can use for recreational activities, meals with friends, etc.

To learn more about combating elder abuse, visit our blog at https://blog.ssa.gov/world-elder-abuse-awareness-day-combating-injustice/.

Please share this with those who may need it.

Health News

New director of patient services named at HCR Home

Registered nurse Vincent Tata

has been named director of patient services for HCR Home Care’s Finger Lakes Certified Home Health Agency (CHHA).

Vincent Tata

In this role, Tata supervises the day-to-day clinical operations and all patient care for the CHHA.

Tata brings more than a decade of experience to this new role. Most recently, he served as senior manager of clinical operations at UR Medicine Home Care.

Tata earned a master’s degree in school administration supervision and bachelor’s degrees in sports medicine and health and physical education K-12 from Canisius College. He earned his bachelor’s degree in nursing from the University of Rochester School of Nursing.

He resides in Ogden.

Physician assistant joins Thompson’s practice in Lima

Physician assistant Bailey

Peinkofer recently joined F.F. Thompson Hospital’s Lima Family Practice in Lima.

After receiving her Bachelor of Arts in biological sciences from

SUNY Buffalo, Peinkofer obtained a Master of Health Science in physician assistant studies from Lock Haven University in Lock Haven, Pennsylvania.

the highest quality of life.”

Both organizations are celebrating benchmark anniversaries:

For 150 years, St. Ann’s has provided area seniors with a wide array of crucial services, making it Rochester’s premier senior housing and health services provider. It is also one of greater Rochester’s largest private employers, with a workforce of more than 1,100.

For 100 years, the RPO has fostered founder George Eastman’s dream of making Rochester “a truly musical city” while also making an impact well beyond the Rochester area, with performances receiving national acclaim and musicians going on to international success.

“We are delighted to join hands and partner with the RPO as we commemorate the 150th anniversary of St. Ann’s Community, coupled with their incredible century milestone,” says St. Ann’s CEO and President Michael McRae. “This collaboration beautifully synchronizes our shared histories, infusing the healing power of music and the spirit of community into the lives of those we care for."

The two organizations have a long history working together, with recent collaborations including a May 2022 RPO brass quintet performance at St. Ann’s Home for memory-care individuals. In June, the RPO and St. Ann’s partnered with Veterans Outreach Center for a special Flag Day concert celebrating both organizations many years of service.

Jewish Senior Life recognized by Fortune magazine

Jewish Senior Life was recently named as one of 25 best small and medium workplaces in aging services for senior housing and care in Fortune magazine. Fortune partnered with Great Place to Work to analyze survey feedback from 168,000 employees across the U.S.

and is the only organization on the list located in New York state.

Serving people of all faiths and ethnic backgrounds, Jewish Senior Life is Rochester’s only continuing care retirement community. Guided by the values of honoring family and aging in place, Jewish Senior Life offers all levels of care on a single campus—from independent living to skilled nursing care—along with a variety of programs and services for people living outside its campus.

Alzheimer’s Association names new senior director of programs

The Rochester Finger Lakes

active member of New Bethel CME Church, she serves as its historian, Facebook administrator and member of the Board of Christian Education and Formation.

Baden Street Settlelman has new executive director

The board of directors of Baden

Street Settlement announced the selection of Catherine “Cathy” Thomas as executive director.

Thomas has served the Rochester community in human services for over 35 years, working to provide basic needs for people in poverty to help them find stability, self-sufficiency, and happiness in their lives. She takes over for Ron Thomas, who served Baden Street Settlement for 30 years and will now serve as executive director emeritus.

Bailey Peinkofer

Prior to joining Thompson, she worked as a physician assistant at Bradford Family Medicine in Bradford, Pennsylvania, for four years.

Peinkofer is certified by the National Commission on Certification of Physician Assistants.

Lima is one of 12 Thompson primary care locations in Ontario, Livingston, and Wayne counties.

St. Ann’s Community to sponsor Rochester orchestra

The Rochester Philharmonic Orchestra (RPO) has announced St. Ann’s Community is the Philharmonics series sponsor for 2023-24, its centennial season.

“This is such a perfect partnership,” says RPO President and CEO Curtis S. Long. “The RPO and St. Ann’s have the same mission: assuring everyone in our community has

Great Place to Work assesses the quality and consistency of the employee experience by measuring survey responses across demographic groups and roles within each organization. Companies who make the list create great work experiences for all employees with varying roles, years of service, ethnicities, genders, and abilities. Employers who have the broadest range of people who report a positive workplace experience rank the highest on the list.

“We were recently recognized as a great place to work for the fourth time in July, so to be named as a best workplace by Fortune is the icing on the cake,” says Michael S. King, president and chief executive officer at Jewish Senior Life. “The health care job market is very competitive, and we are very thankful that our employees choose to work here and speak so highly of their experience. We are committed to providing an inclusive environment with employee recognition, as well as opportunities for training, scholarships, and career development. Our investment in our staff shows in the compassionate care they provide to the people we serve.”

Jewish Senior Life ranked No. 23

Region Chapter of the Alzheimer’s Association has named Arlene Wilson as its new senior director of programs. In this role, Wilson will lead the chapter’s program delivery and growth strategy to reach more people with volunteer-delivered education, awareness and support programs across the nine-county Rochester and Finger Lakes region, with a special focus on new, underrepresented and rural communities.

Arlene Wilson

Wilson has more than 20 years of nonprofit management experience and previously served as the executive director of the Cornell Cooperative Extension of Yates County. She has also served in leadership positions at the American Diabetes Association, Planned Parenthood, the Mercy Outreach Center and the Center for Disability Rights.

“One of Arlene’s many strengths is her bilingual proficiency in both English and Spanish, which will be vital in helping us extend our reach further in Spanish-language communities,” says Amanda Nobrega, vice president of programs for Upstate New York Chapters.

Wilson is a member of the board and previous board president for PathStone, a nonprofit community development and human services organization serving low-income families in Rochester, and was chairwoman of PathStone Development Corporation, which focuses on affordable housing.

Wilson was recognized for her work with PathStone with the Board Leadership Award at the 2016 Greater Rochester Awards, sponsored by the Rochester Business Journal. She also served as president of the New York Chapter of Epsilon Sigma Phi, the oldest and largest organization of Extension professionals.

She holds a bachelor’s degree in sociology with a minor in Spanish from Ohio State University and a master’s degree in public administration from the University of Pittsburgh. She has completed three years of doctoral studies in organizational management and leadership at the University of Phoenix. An

“We are excited to welcome Cathy into the role of executive director,” said Tyrese Bryant, board chairwoman. “Her experience, leadership, and commitment to Rochester align perfectly with our mission of helping people living in poverty in Northeast Rochester be supported so they can have a bright future. We thank Ron Thomas for his tremendous service to Baden Street and the Rochester community for 30 years. Ron is a true champion for people living in poverty and has changed people’s lives with his work and leadership.”

Thomas has worked in the human services field for over 35 years in Rochester, focused on advocacy for underserved children, youth, and families. Throughout her career, she has held various leadership roles at Hillside Family of Agencies, Catholic Family Center, Berkshire Farms Center and Services for Youth, James P. Wilmot Cancer Center and the Monroe County Detention Center. Thomas currently is the chief youth development and engagement officer at the Monroe County Youth Bureau.

“Baden Street Settlement has served Rochester for over 122 years, always adapting to the needs of the community to improve people’s lives,” Thomas said. “I am honored to take on the role of leading this esteemed organization to continue our work to make Rochester a better place to live.”

A native of Rochester and proud product of the Rochester City School District, Thomas is a Benjamin Franklin High School graduate, alumnus of Monroe Community College, where she was inducted into the Alpha Phi Sigma National Criminal Justice Honors Society, and SUNY Brockport, earning her bachelor’s degree in criminal justice. She also holds two master’s degrees in social work (Syracuse University, 2004) and Teaching in Health Education Professions (University of Rochester, 2016).

She assumes the position Monday, Oct 9.

Cathy Thomas

November is Lung Cancer Awareness month. As a service to our community, Hematology-Oncology Associates of CNY and CRA Medical Imaging are offering a free lung cancer screening to qualified participants.

Who: Free screenings are available for individuals ages 50-80 who:

- are heavy smokers (e.g., 1 pack a day for 20 years or 2 packs a day for 10 years)

- OR are former heavy-smokers who quit in the last 15 years

- AND have not previously received a free lung cancer screening from us.

Note: Anyone with insurance can contact our office to discuss getting a lung cancer screening at your convenience.

When: Saturday, November 4, 8:00 a.m. to 2:00 p.m.

Where: HOA’s Onondaga Hill, East Syracuse and Auburn offices

To learn more, call 315-472-7504 extension 1301 or visit hoacny.com