In Good Health: ROC #219 - November 2023 by In Good Health: Rochester's Healthcare Newspaper

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NOVEMBER 2023 • ISSUE 219

10LONGEVITY

FOODS TO EAT FOR HEALTHY

Meet Your Doctor ALBERT S. HARTEL, M.D. Allergy and immunology doctor says Rochester is one of the worst regions in the nation for seasonal allergies. He explains why we develop allergies and talks about his own daughter’s battle with food allergy P. 4 ALSO INSIDE

5 THINGS YOU SHOULD KNOW ABOUT CATARACTS P. 14

NURSING HOMES ON THE BRINK SENIOR FACILITIES IN ROCHESTER HAVE 1,600 VACANT BEDS BECAUSE OF LACK OF WORKERS TO CARE FOR PATIENTS

HEALTHCARE WORKERS ON STRIKE P.6

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Page 2 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

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November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 3

Meet

Your Doctor

By Chris Motola

Albert S. Hartel, M.D.

Allergy and immunology doctor says Rochester is one of the worst regions in the nation for seasonal allergies. He explains why we develop allergies and talks about his own daughter’s battle with food allergy Q: What sparked your interest in allergies? A: Allergy has always fascinated me. I grew up in Rochester, which is pretty much a hotbed of allergies and asthma. I had a lot of friends and family who suffered from those problems. What really fascinated me the most was just learning about how the body reacts to all these harmless substances and causes so much suffering and misery completely unnecessarily. And so what really got me interested in it initially was learning that desensitization and shots were possible, and that they could turn these reactions off, where with so many other medical conditions we just kind of end up piling on drugs. With allergy, we can learn what to avoid and even teach our bodies to stop reacting to them, get off the medicine and live great lives. Q: What makes Rochester such a hotbed for allergies? A: Good question. We have a pretty intense pollen mix here. One of the big issues is we're trying to pack a whole year's worth of pollen into six-and-a-half months because of these long

winters. Places like Florida may have just as much pollen, but it's stretched out over the course of a year so it's not as intense. Here we have a pretty good growing season and a lot of water, so when it does grow, we get a big amount of pollen packed into a short amount of time. And as things start to get warmer here, the pollen season also get more intense. So Rochester is just climbing up the charts. We were eighth worst in the country this year for seasonal allergies. Q: What was your medical experience in Florida like in comparison? Do people get a substantial amount of relief from relocating? A: What I found is you can run but you can't really hide from allergies. If you're an allergic person, wherever you go, about two to three years after you get there your body will find something to react to. Even in the Southwest, where there are a lot fewer allergens, people still develop allergies, though they may not be quite as severe. In Florida there were a whole different set of allergens. People who moved there were good for a couple years, but then their bodies started reacting to a different set of

allergens. There's a lot more mold, more dust mites and with the longer growing season the pollen might not be as intense, but there's always something in the air. So similar picture, different players and timeframes. If you're an allergic person, your body will find something to be miserable about. Q: What kinds of allergies respond best to desensitization? A: Unfortunately we're still looking at ways to desensitize people to food allergies, but that still isn't ready for prime time. What really works the best is the environmental allergens that cause most of people's nasal and asthma symptoms. Those respond really well. The allergens that cause eczema. And one of the biggest ones that respond well is bee sting allergies. With bee sting allergies we take someone at 60% risk of having a serious reaction, put them on shots, and get the risk down to about 3%. So it takes a potentially life-threatening disease and makes in much more manageable and less scary. Q: Why are foods so hard to desensitize? A: I think some day there'll be a way to handle them, but the problem with foods is there are so many reactions to the desensitization that about 30% of people have a full anaphylactic reaction to it. So it's just too dangerous to do on a large scale. Q: At what point does it make sense to put someone on a desensitization regimen as opposed to just keeping them on Claritin, for example? A: If symptoms are mild and easily managed by an over-the-counter medication, and isn't causing a lot of debilitation, I think treating with an over-the-counter antihistamine with some environmental measures in your house might be all you need. But if you're using multiple medications every single day and it's still breaking through — or a kid is committing to a daily inhaled steroid, the best thing to do is address that problem and turn it off rather than keeping them on it for the next 80 years. I think if you're thinking about inhaled steroids daily or the OTC medicine isn't cutting it, then it's worth thinking about an allergy shot. Q: Is it best to catch them young or can you still get a good result with adult patients? A: They do show they work well at any age, but it's more likely to be a permanent fix with younger patients. Adults you can still get long-term benefits, but they're more likely to drift back into symptoms are you stop the shots. So it is beneficial to do it younger, but there's no bad age to start. Q: Why do we develop allergies? A: It's a good question and no one has a 100% answer. They say the allergy system used to be geared toward fighting off parasites and worms, so when things weren't as clean we didn't have a lot of allergies because the system was busy doing those things. But as we became industrialized, people stopped being exposed to those things, so that side of the immune system got bored and started targeting harmless things like pollen and food. What's interesting is, if you look at Ethiopia or other countries that don't have the same levels of sanitation, allergies

Page 4 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

‘If you're an allergic person, your body will find something to be miserable about.’ are almost non-existent, whereas here it's about 40% of the population. If you take Ethiopian people and bring them here, those people still have the same risk, but their kids have a risk profile that's the same as anyone else born here. So it's largely an environmental issue. So we're not exactly sure what it is, but we're probably just too clean. We're sanitizing everything, bleaching everything, and our immune systems never get the chance to activate. It's looking for something to do. Even here, kids who grow up on farms and around a lot of dirt and animals tend to have fewer problems with allergies. Q: You've taken a very family-oriented approach to your practice. How do you balance work and raising your family? A: I think these days a lot of doctors are getting burned out, or a lot of people aren't going into medicine in the first place. When you're at work you need to give your patients all your attention, but you have to be able to separate that and still have time for your family and kids. If you're happy and well-rounded you can come to work and gives your patients 100% instead of just going through the paces. We started taking Fridays off and having a three-day weekend every week. That's made a humongous difference. It's finding that perfect balance. Q: Have you been able to apply your professional knowledge to your family with regard to allergies? A: Nobody's immune. I have one daughter with asthma. Another daughter with peanut allergies and some other food intolerances. I just recently had my fourth daughter. My oldest is 21, my youngest is 2. I thought we'd avoided the whole epi-pen situation, but my youngest daughter has peanut allergies, so I'm experiencing the patient side of it.

Lifelines

Name: Albert S. Hartel, M.D. Position: President of Allergy Asthma Immunology of Rochester Hometown: Henrietta Education: Bachelor’s degree in psychology from University at Buffalo; medical degree from SUNY Upstate Medical University; specialization in pediatric and adult allergy and immunology at the University of South Florida Organizations: American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; Monroe County Medical Society Family: Wife, four daughters, two stepsons Hobbies: Camping, swimming, travel, barbecuing, archery, bike riding, building the familys annual Halloween display

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ain, 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.

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November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 5

Healthcare in a Minute By George W. Chapman

only get another prescription which they do not want; 67% fear being referred to multiple providers and still no definitive diagnosis; and 71% would leave their current position for better health insurance. The survey results are intended to educate and alert employers to the significant healthcare travails facing their female employees.

Health education vital

ON STRIKE

Healthcare Workers on Strike

s of this writing in mid-October, more than 70,000 Kaiser Permanente are on strike. This past summer, RUNAP, the Rochester Union of Nurses and Allied Professionals negotiated with Rochester Regional Health. The issues are the same for most hospitals throughout the country. Since COVID-19, thousands of healthcare workers have left their profession, leaving hospitals short staffed. Consequently, active staff are overworked and exhausted. While pay is always an issue, it hasn’t been THE issue. Strikers are mostly

concerned with burnout, turnover and patient safety. The dilemma facing just about every private and public hospital is they are operating at razor thin, if not negative, margins. Unlike most businesses, hospitals cannot simply raise prices to increase cash. (Well, they technically can raise prices, but virtually no one will pay them.) Hospital revenues are determined and controlled by Medicare, Medicaid and commercial insurers. I’m sure most hospital executives are sympathetic to union demands. They can see what’s happening as they

work there, too. Adding to hospital financial woes are the extravagant fees charged by traveling nurse businesses. If hospitals can’t fill positions locally, they are forced to rely on contract staffing. This just exacerbates the situation as higher paid contract nurses are working side by side with the lower paid local nurses. It’s an HR nightmare. Third party payers are going to have to step up their payments if hospitals are to survive and provide care under safe and competent conditions.

34 million, are enrolled in commercially administered Advantage Plans. The projected rate increase is 4%, but it won’t impact you if your stick with your current plan. Medicare Advantage Plans have been very profitable for commercial carriers.

and consumers, a federal court has struck down a Trump-era policy that allowed insurers not to count any drug manufacturer’s co-pay assistance toward the insured’s out-ofpocket obligation. The now outlawed policy permitted insurers and PBMs to counter the co-pay assistance by raising member annual out-of-pocket obligations. For example, if your copay on your diabetic drug was $100 and the manufacturer offered $50 co-pay assistance, the insurer would still consider your co-pay obligation as $100, not $50. The co-pay accumulator is a running tally that tracks what you still owe before reaching your total out of pocket obligation for the year.

Insurers faring well Meanwhile, as cash-strapped hospitals fight the battle, commercial insurers (far from the battlefield) are enjoying, in some cases, record profits. Notable profits for the first half of the year were $11 billion for United and $4 billion for CVS healthcare. Centene, Cigna, Elevance (BCBS) and Humana have all made healthy profits so far this year. Locally, WellNow urgent care is threatening to disenroll from Excellus BlueCross BlueShield effective January 2024 unless they are paid fairly. Excellus has averaged around $130 million profit annually over the last five years. Their rate increases have been around 8% annually over the last five years.

Medicare enrollment Open enrollment started Oct. 15 and ends Dec. 7. More than half of seniors eligible for Medicare, about

Costco too? Not to be outdone by the likes of Amazon, Walgreens, CVS and Walmart, the giant discounter has partnered with startup Sesame to offer virtual healthcare to its members. The cash-only plan (they don’t accept insurance) will offer virtual primary care at $29 a visit and mental health therapy at $79 a visit via 10,000 participating providers. They are marketing primarily to under insured consumers. Amazon has purchased One Medical for $3.9 billion. CVS bought Oak Street Health for $10.6 billion while Walgreens grabbed Summit Health for $9 billion. While all this money is being invested in primary care, hospitals continue to struggle financially.

Drug co-pay accumulators In a major victory for patients

Women’s health Women comprise 60% of the workforce and face $15 billion more than men in out-of-pocket expenses annually. A survey of 1,200 working women commissioned by Parsley Health revealed why women delay seeking care. 44% delay care due to time constraints; 37% delay care due to disappointment with previous visits; 33% delay care because of co-pays; 24% are worried they will

Page 6 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

In yet another survey seeking to determine patient confidence in their healthcare, OnePoll found that 48% of respondents were anxious about their next appointment, up from 39% in 2022. Insufficient education and information about their condition and symptoms were cited as the major cause of their anxiety. 43% were anxious about being referred to providers they knew nothing about. 32% admitted to Googling their symptoms prior to their visit and 28% worried about their diagnosis. Overall, patient confidence was down due to feeling unempowered. 55% of respondents suggested more education from their provider prior to and during their visit would reduce their anxiety and increase their confidence. 53% said knowing that there is effective treatment would also lower their anxiety and increase their confidence. There is certainly plenty of time spent in waiting rooms that could be better spent on education and patient empowerment.

Nice try In yet another victory for consumers, a federal judge has denied a brazen request by the US Chamber of Commerce to delay the deadline requiring drug companies to negotiate drug prices with Medicare. (The deadline was Oct. 1 and negotiations have finally commenced.) The plaintiff tried to argue that the price negotiations authorized by the Inflation Reduction Act were unconstitutional giving the government “illegal and arbitrary price control.” “Control?” Apparently, the clueless chamber (no doubt a straw man put up to challenge the government by the drug manufacturers) couldn’t understand the difference between “negotiating” prices as required by the IRA and “setting–controlling” prices. The plaintiffs also purported negotiations (or “control” as they claim) would result in less access to drugs and less investment in innovation, both of which are hollow and unfounded threats. We are talking about negotiating 10 drugs. Drug manufacturers have long negotiated prices with other countries with national health insurance. 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.

D E PAUL

Flu Shot Season Is Here: Why You (and Your Kids) Need One

t's time to get the flu shot. They're important not just for adults, but also for children, and keeping the whole family safe, according to an expert in pediatrics. “You never know how bad a flu season will be,” said Mona Patel, attending physician in the department of general pediatrics at Children's Hospital Los Angeles. “We like to think of flu shots as preventive care; getting one lessens the chances of more severe symptoms that may cause children to be hospitalized.” Several major health groups — the U.S. Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the Infectious Diseases Society of America — recommend that everyone aged 6 months and older get a flu shot. Even if this doesn't keep you from getting the flu, it can prevent severe and secondary illness related to it. Children who have conditions that put them at increased risk of illness are among those who especially need a flu vaccine, Patel said. Vaccines are designed to stimulate the production of antibodies in the body. These can then attach to the outer structures on the protein coat of the virus, disabling it. Epidemiologists and immu-

nologists at the CDC look at global patterns for flu to predict which formulation the current year's flu shots should have. “If you got a flu shot last spring — basically, if you got it during the last flu season — it may not be effective against the flu that is circulating this season,” Patel said. “You never know which variant will be passing through, which is why the vaccine needs to be reformulated for every new flu season. That's why we say it's important for people to get their flu shots every single year.” Typically, flu season starts around October and lasts through April. Getting a flu shot at the beginning of flu season can maximize the benefits, Patel said, but it's still better to get it late than to not get it at all. “You want to get it early enough that it has maximal effect a few weeks later,” she advised. “At the same time, I don't want folks to say, 'I missed it back in September and October, so I shouldn't get it.' If it's flu season, you should get the shot. It's better to have some protection than none.” Editor’s Note: See Savvy Senior column in this issue showing what vaccines seniors should get this year.

SERVING MONROE AND ONTARIO COUNTIES A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2023 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto 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.

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November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 7

Live Alone & Thrive By Gwenn Voelckers Practical tips, advice and hope for those who live alone

Embracing Solitude: A Journey Toward Contentment

n a world that constantly moves at plate who I am, what I value, and a breakneck pace, solitude can feel where I’m headed. It’s a chance to like an elusive luxury. reconnect with my “true north” and Yet I’ve come to cherish and celensure I’m on the right path. ebrate those moments when I find a An anecdote that beautifully quiet moment to reflect, contemplate illustrates this occurred during a solo and rediscover the simple joys of life. retreat I took last fall around this Gratitude and Contemplation I’ve learned that solitude is not time. With no one to talk to but myabout isolation; it’s a chance to reself, I began a conversation with my Solitude also teaches us the proconnect with oneself and everything own thoughts. It was during those found art of gratitude and contemaround us. moments that I realized I had been plation. It was a gorgeous fall In the tranquility day when I took a walk of time alone, we’re in Mendon Ponds Park better able to reflect and was filled with the One of the greatest joys of solitude is the on the blessings that joys and benefits of soliopportunity for personal reflection. In the surround us. Whether tude. On that crisp, cool it’s the taste of a warm afternoon, I heard the midst of our daily chores and chaos, it’s so cup of tea, the scent leaves crunching beneath of a distant bonfire, easy to lose sight of ourselves. We’re often my feet and listened the wonderous look to the wind rustling too preoccupied with our roles and responin a child’s eyes or a through the trees. friend’s warm hug, I was surround by sibilities, constantly reacting to the world solitude amplifies our the colors of fall, and was around us. I know I am. capacity for gratitude. reminded that solitude It makes us aware isn’t an empty space, but of life’s simple plearather an active state of sures. being present with myAt the end of the day, before self and the world around me. neglecting some of my passions and drifting off to sleep, I often take time It felt like a breath of fresh air for dreams. for calm contemplation, considering my soul. This solitude provided me with life’s many intricacies and, sadly clarity. It inspired me to make posithese days, life’s atrocities. Personal Reflection tive changes in my life. On returning This restful lull before dozing home, I rededicated myself to my off helps me count my blessings and One of the greatest joys of solimusic and my writing. appreciate the beauty that resides in tude is the opportunity for personal and around each of us. reflection. In the midst of our daily Creativity Unleashed chores and chaos, it’s so easy to lose Recharging the Soul sight of ourselves. Another remarkable gift of soliWe’re often too preoccupied with tude is its power to foster creativity. For me, one of the most valuour roles and responsibilities, conIn the peace and quiet, our minds stantly reacting to the world around are free from external distractions, al- able aspects of solitude is its role in reenergizing my soul. Life demands us. I know I am. lowing our thoughts to meander and so much attention and energy. As But when I slow down, I can merge in unique ways. Surroundmy own sole provider, I’m pulled in pause, take a step back and contemed by silence, I find myself lost in

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thought, daydreaming about stories to share or problems to solve. Solitude is a space where ideas are born and nurtured, unfettered by a “monkey mind,” which can overtake our thinking. For readers who are not familiar with monkey mind, it is a Buddhist concept that describes a state of restlessness and lack of control over one’s thoughts. The idea for this column on solitude was illuminated for me during one of my morning meditations. In that secluded moment, with my cat on my lap and no interruptions, I reflected on the topic and composed the words I am sharing with you now.

many directions, as are all those who live alone. Tranquil introspection allows me to slow down and recharge my batteries. It’s a sanctuary where I can step away from the hustle and bustle, relax and reconnect with what matters. Thanksgiving is just around the corner, as are the holidays in December. Social gatherings and obligations can be overwhelming. And exhausting. I’ve learned that stepping away for a brief period can help me regain my balance and perspective. I can then truly enjoy and appreciate the time I’m spending with the people I love.

Wrapping up ... It bears repeating: Solitude is not an escape from the world, but rather a gateway to rediscovering its profound wonder and beauty. It allows us to tap into our creativity, embrace gratitude, and recharge our spirits. While it’s crucial to nurture meaningful connections with others, we should also remember the joys of solitude, especially during hectic and challenging times. In closing, know this: In the stillness of your own company, you just might find the inner contentment you’ve been seeking all along. 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

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Benefits to Reducing Alcohol Consumption

Well, not even a glass of wine once in a while is good for your health, says Rochester doctor By Deborah Jeanne Sergeant

o you recall hearing that a glass of wine a day supports heart health? As it turns out, “that initial study about drinking a little alcohol was flawed,” said Kerry Graff, physician and an independent contractor in lifestyle medicine in Rochester. Any benefit arising from happy hour is likely because of the socializing, but not the alcohol itself. “You could get the resveratrol from grapes,” Graff said. This compound is known as an antioxidant and may lower cholesterol, reduce risk of heart attack and stroke and lower blood sugar levels. But eliminate or at least minimize alcohol. “Even one drink a day increases breast cancer risk in women by 14%,” Graff noted. “It turns to formaldehyde. You see this even in wine tasters who spit it out. If you look at it overall, it’s not health promoting. If you want to include it, it’s a choice but not

because it’s healthy. It’s a calculated risk; you don’t drink for good health. Wine itself is not healthy.” As the body ages, alcohol can increase risk for falls. Within a year, older adults who fracture a hip have a 21% risk of death after a surgical repair and a 70% chance of death if it’s not surgically repaired, according to Acta Orthopaedica. “Your balance gets worse as you age,” Graff said. “Your reaction time is slower. Your feet aren’t as good. Your nerves aren’t as good. Add alcohol to that and it’s much more prominent.” She added that the amount of alcohol needed for impairment decreases with age. There’s also risk of complications when combined with some medications. “The average senior is on eight medications,” Graff said. Although having a “nightcap” to help induce sleep seems sensible, Graff said that drinking at bedtime can make it harder to fall back asleep if they wake up in the night. This can make it harder to fall asleep without

it and establish a nightly drinking habit. For those who choose to imbibe, the recommendation is no more than one drink per day for women and no more than two for men. “If you’re not already drinking alcohol, there is no benefit to start drinking for heart health,” said Melissa Verdi, registered dietitian nutritionist at Lifestyle Nutrition WNY, PLLC in Niagara Falls. She added that drinking alcohol is linked to liver issues and heart problems, among other problems. “It can make it harder to control your weight,” she said. Logan Walker, a physician at UBMD Family Medicine, calls alcohol consumption a “modifiable risk” for health. “Our genes only account for 10% of the expression of cancer and any type of illness,” he said. “Lifestyle and environment account for 90% of the risk for expression.” Walker explained how alcohol affects the system. “Within 30 minutes of ingesting, there are negative microbiome changes that are pro-inflammatory,” he said. “Alcohol also causes damage to cells in the GI tract. It can increase the risk of autoimmune conditions and decrease nutrient absorption. It’s a toxin that increases the workload on the liver and burdens the kidneys.” These negative effects are cumulative after decades of drinking alcohol, especially when consumed in excess. Choosing to not imbibe may not reverse damage already done, but it prevents further damage. “It gives us the power in our hands that if we make changes; our genes aren’t our destiny,” Walker said.

D E PAUL November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 9

Exercise Bands Useful for Resistance Movements By Deborah Jeanne Sergeant

hey’re stretchy and springy and a staple among personal trainers and physical therapists. But what are exercise bands and what can you do with them? Kerri Howell, certified personal trainer, nutrition coach and owner of The Hourglass Mom in the Rochester area, sees exercise bands as “a great, low-impact way to build muscle. They put far less strain on your body and can help you stay injury-free.” When lifting free weights, it’s easy to jerk and drop the weight.

Exercise bands naturally create a more fluid, controlled movement. If you drop an exercise band on your foot, it won’t hurt, unlike dumbbells or kettlebells. “They’re really underutilized,” said April Ho, certified personal trainer and registered dietitian with URMC. She likes a box of 60-foot flat band, available on Amazon. Users can cut it and tie loops on the end or tie the ends together to make a loop any size they wish.

“If you buy lighter resistance bands, you can double up to create greater resistance,” Ho said. “It’s the most cost effective as opposed to buying several of them.” Jean Sica uses bands a lot with her clients. A certified tai chi instructor and certified personal trainer, Sica owns Kokoro Fitness in Rochester, she finds the bands handy for taking to sessions in clients’ homes. “I think that they’re really good for people who don’t care to know whether they’re lifting 10 or 30 pounds,” Sica said. “They are marked, but it’s just a guideline. Depending on how far you pull the band, that will make a difference as to how heavy the resistance is. They’re handy for a home gym or for travel. Bring a few bands and you can do all kinds of things with them. You can use them for triceps work and pectoral work and long thin ones you can use in different ways.” Bands come in different lengths for different uses. Flat bands are made from vinyl or cloth and cord varieties may offer handles. Some brands of bands come in different colors to signify the level of resistance

they offer. Sica recommended working the upper legs by slipping a short band around the thighs above the knees, squatting, and walking sideways like a crab. “It’s great for the glutes and quads,” she added. To work the chest and arms, Sica said to hold the ends of a short band and pull the hands apart, hold, then release. Another move for short bands to work the triceps is to hold one end close to the body with the left hand near the right side of the waist. Take the other end with the right hand and pull towards the floor, creating resistance between the arms. Switch sides after a set of 10 repetitions. “People always want to work their biceps for some reason,” Sica said. To do so, step on a long band and pull the handles upward. Ho suggested performing lateral raises to work the shoulders and upper back. “It’s performed by standing in the middle of the resistance band, holding the ends with your hands, and lifting your arms out away from your body until they are parallel to the ground,” Ho said. “Make sure to keep the shoulders down and away from the ears during this movement.” Another shoulder and upper back movement is the back fly. “Holding a resistance band out in front of you with straight arms parallel to the floor and then keeping the arms straight, squeezing the shoulder blades together until the arms are as wide as they can go, making a T shape with the torso,” Ho said. Exercise bands can be used for the classic chest press movement. Ho said that the band passes around the back and then underneath the armpits to the hands. Begin with the elbows bent and then “push your hands straight out in front of you to increase tension on the band,” Ho said. “This should feel similar to a push up motion.” Anyone new to resistance training should consult their healthcare provider before beginning a regimen.

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Page 10 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

How to Select a Personal Trainer By Deborah Jeanne Sergeant

hoosing a personal trainer can represent an important step in achieving your fitness goals. After all, the trainer is your coach, mentor and guide. Kerri Howell, certified personal trainer, nutrition coach and owner of The Hourglass Mom in the Rochester area, recommends looking for certification. “Make sure they lay everything out for you in writing,” she said. “You should be asked to participate in a fitness assessment before your first training session, or as your first session. It's also important to feel comfortable around him or her. Often fitness coaches will do a free consultation or introductory meet and greet. Take advantage of that. Ask them about their coaching style and make sure it jives with how you want to be coached.” Knowing your goals can help you know what type of trainer or coach you need — and if the potential trainers you consider can help you meet those goals. The trainer should have an education and experience in the type of training you need. “If it’s an injury, there are some individuals or companies that you should look for or align yourself with,” said Conner Lorenzo, director

of operations of Fitness Science and CHAMPP at URMC Department of Orthopaedics and Physical Performance. “If you’re looking from the sports performance side, there are other credentials.” Like Howell, he indicated that certification from a well-known organization is important, such as the National Strength and Conditioning Association. Certified trainers should have a bachelor’s degree and a board exam. “In the private sector, you’ll find people with a weekend course where everyone who pays can get the credential of ‘personal trainer,’” Lorenzo said. “Make sure they know what they’re doing from a physiological standpoint, not that they’re just in shape. In this day and age, that’s what people look for.” Lorenzo also looks for personability, since it’s tough doing something challenging alongside someone you can’t stand. He calls the trainer-client relationship a personal one because of the deeply emotional reasons many people have for wanting to get healthier, such as sensitivity about their weight, a dire health warning from their doctor or an urge to improve their physical appearance. “No matter what the goals or

Jean Sica is certified tai chi instructor, ACE certified personal trainer and owner of Kokoro Fitness in Rochester.

Kerri Howell, certified personal trainer, nutrition coach and owner of The Hourglass Mom in the Rochester area.

reason for getting into it, it’s pretty personal,” Lorenzo said. The location and availability of the trainer can make a difference as to how faithfully you adhere to the program. Driving too long or meeting a trainer at oddball times can make it easier to slough off and skip sessions. Lorenzo said that asking about the location and availability early on is important. In addition to asking about certification credentials, Jean Sica,

certified tai chi instructor, ACE certified personal trainer and owner of Kokoro Fitness in Rochester, recommended asking friends about their personal trainer as well as meeting with trainers to discuss your fitness. “Ask to sit down with them to get a sense of who they are and if you connect with them,” she said. “I’d never sign up with someone for more than one class with them in the beginning. You may not like what they do. See how it feels.”

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SmartBites By Anne Palumbo

Helpful Tips

The skinny on healthy eating

Turkey’s Many Nutrients Worth Gobbling Up

don’t eat much meat these days. But when I do, I turn to the star of 46 million tables each Thanksgiving: turkey. Not only does my beloved butterball deliver an impressive cornucopia of nutrients, but it serves them up without much fat or calories. Let’s start with turkey’s most salient nutrient: protein. Often referred to as the “building block of life,” protein plays a key role in the growth, development and maintenance of cells. Not getting enough of this workhorse nutrient can lead to weakness, muscle wasting, dry hair and skin, fatigue and much more. An average serving of turkey provides about half of our daily needs, perhaps twice that on Thanksgiving!

What’s more, this tasty bird trots out impressive amounts of B vitamins, especially niacin, B6 and B12. All together, these essential vitamins aid in red blood cell production, help convert food to energy and promote healthy nervous and digestive systems. Since B12 deficiency is common as we age—whether through diet or poor absorption—it’s good to know that turkey is an excellent source of this important vitamin. Consuming turkey also boosts your intake of selenium, phosphorous, zinc and choline. These important minerals each provide a valuable function: selenium helps your body produce thyroid hormones, phosphorous keeps bones and teeth strong, zinc fortifies the immune system, and

choline supports brain development and function. New research links low levels of choline to Alzheimer’s disease progression. What this white meat doesn’t deliver is fat, particularly saturated fat. It’s why experts recommend its consumption over red meat, which

Look for plump turkeys with a well-rounded breast. Beware of flat spots, which suggest the bird has been thawed and refrozen. If you’re looking for the cleanest option, go with an organic, free-range turkey that has been raised without antibiotics and fed an organic diet. And if you’re looking for the leanest cut, go with skinless, white meat. By the way, no hormones are ever used in the production of any US turkey.

can raise your “bad” cholesterol and put you at higher risk for heart disease. An average serving of skinless breast meat has 140 calories and just 2 grams of total fat (with scant saturated fat), while the same size serving of roast beef has 300 calories and about 20 grams of fat (with 8 grams saturated fat). If you’re wondering what makes us so sleepy after our Thanksgiving meal, well, not everyone agrees on the cause. While some point to turkey’s tryptophan, a natural sleep narcotic, others blame it on the large amounts of carbohydrates we consume.

CREAM OF TURKEY AND WILD RICE SOUP Serves 4 Serves 4 • Adapted from eatingwell.com

CALENDAR of

HEALTH EVENTS

Nov. 2

Alzheimer’s Association to host caregiver conference, retreat The Rochester Finger Lakes Region Chapter of the Alzheimer’s Association will present a full-day conference and retreat addressing the needs of people who are caregivers for those living with Alzheimer’s disease or dementia in Chemung, Schuyler and Steuben counties. The Susan Cotton Memorial

Caregivers Conference will take place from 10 a.m. to 4 p.m. Nov. 2 at the Horseheads Elk Lodge, located at 6 Prospect Hill Road in Horseheads, near Elmira, and will feature continental breakfast, a health fair, guest speakers, caregiving resources, a range of educational topics, prizes and lunch. The conference is made possible through a donation from Douglas Cotton of Horseheads, who lost his wife, Susan, to Alzheimer’s, and through a grant from the Horseheads Elks Lodge #2297. The Susan Cotton Memorial

1 tablespoon olive oil 2 ½ cups sliced mushrooms, (about 8 ounces) 1 cup chopped celery 1 cup chopped carrots ½ cup chopped onions ¼ cup all-purpose flour ½ teaspoon salt ¼ teaspoon freshly ground pepper 4-5 cups reduced-sodium chicken broth 1 cup quick-cooking or instant wild rice 3 cups shredded or diced cooked turkey ½ cup reduced-fat sour cream 1 teaspoon thyme (or spice of choice)

1. Heat oil in a large saucepan over medium heat. Add mushrooms, celery, carrots and onions; cook, stirring, until softened, about 5 minutes. Add flour, salt and pepper; cook, stirring, for 2 minutes more.

Caregivers Conference will feature several guest speakers, including attorneys, professors and dietitians. Space is limited, so early registration is encouraged. Those interested in participating can register online at bit.ly/CottonConf23 or by calling 800-272-3900.

“Hear & Beyond,” co-authored with Shari Eberts, was published in 2022. HLAA-Rochester is providing a copy of the book to each Monroe County library. The presentation is scheduled to take place from noon to 1 p.m. at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, in the vestry room. Those who want to watch it on Zoom, should preregister at the chapter web site hearinglossrochester.org and obtain a link. The HLAA will also hold several other meetings in November. For more information, view the organization web site at hearinglossrochester. org or telephone 585 266 7890. Hearing Loss Association of America – Rochester Chapter is a volunteer, charitable nonprofit organization with the mission of enhancing the world of communication to people with hearing loss by providing support, education, and advocacy.

Nov. 7

Comedian to make a presentation at HLAA program Renowned humorist and author Gael Hannan will bring insights on hearing loss issues to the November presentation at Hearing Loss Association of America – Rochester Chapter (HLAA). Author of several books and contributor to hearing related publications, she will share from her extensive experience living with hearing loss. Her latest book,

Page 12 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

2. Add broth and bring to a boil, scraping up any browned bits. Add rice and reduce heat to a simmer. Cover and cook until the rice is tender, 5 to 7 minutes. Stir in turkey, sour cream, and thyme; cook until heated through, about 2 minutes more. Add more broth, if needed.

FOODS TO EAT FOR HEALTHY

LONGEVITY

By Deborah Jeanne Sergeant

ating right represents one of the pillars of good health and longevity. As part of an overall healthful diet, every older adult

should consider including these foods, assuming they’re not contraindicated for any medication or health issues they’re experiencing.

Beans “Any kind of beans should be eaten on a regular basis,” said Susan Friedman, physician and director of lifestyle medicine at Highland Hospital. “They’re high in fiber and 97% of people in the country don’t get the recommended amount of fiber. It’s one of the nutrients we’re most deficient in as a population.” Friedman also touted beans’ versatility, high protein content and affordability.

Water While not technically a nutrient, water is vital for good health. Friedman said that many people suffer from chronic, low-level dehydration. “People who tend to run a little dry are at higher risk for strokes. Stay hydrated and have plenty of water.”

herbs & SPICES

They make food more flavorful, which can help reduce salt intake. But many herbs and spices also provide intrinsic benefits. “Cinnamon, turmeric and others can be anti-inflammatory and help with blood sugar,” Friedman said.

WHOLE GRAINS PRODUCE Beyond berries and greens, eating a variety of colorful fruits and vegetables help ensure sufficient nutrients along with decreasing caloric intake, which is important for those struggling to keep weight off. “As people get older, the caloric needs go down but the need for nutrients doesn’t,” Friedman said. “Where a teenager can get away with eating a lot of junk food, when you’re older you need to eat real food. ‘Eating the rainbow’ gives a variety of vitamins and minerals. The colors are reflective of different nutrients needed for health.”

In addition to oatmeal, she recommends eating a few other servings of whole grains daily, such as barley in vegetable soup, brown rice, wild rice, whole wheat pasta and whole grain bread; but watch out for “wheat bread” that’s low in fiber. “You want grains in their original form,” she said.

OMEGA 3 These help promote the health of the brain and joints. Graff noted that chia seeds, walnuts and ground flax seeds are great sources of omega-3s. “You need one tablespoon or so a day,” Graff said. “Watch portion size if you need to lose weight.”

greens Specifically, kale, spinach, Swiss chard, arugula, beet greens, bok choy, collard greens, mustard greens, turnip greens, Brussels sprouts, broccoli, cauliflower, cilantro parsley and asparagus are the top greens. Although green in color, iceberg lettuce isn’t as packed with nutrients as the darker greens. “They’re good for artery health,” Friedman said of greens. She noted that Caldwell Blakeman Esselstyn Jr., physician and author of “Prevent and Reverse Heart Disease” and director of the Heart Disease Reversal Program at the Cleveland Clinic, had a group of patients with end-stage heart disease and put them on a low-fat, whole food diet with a focus on greens. “What he found is those who were able to stay on that eating pattern had reversal of their heart disease,” Friedman said. “They had decrease of symptoms and very few cardiac events.”

oatmeal The breakfast staple is a whole grain that is “good for cholesterol,” Friedman said. “You can doctor it up with mixed berries, banana and cinnamon on top. You can put in apples and cinnamon or raisins. You can make it savory as well.” But beware of sweetened, flavored packets of oatmeal. “If you eat those, you might as well eat a Danish,” said Kerry Graff, physician and an independent contractor in lifestyle medicine in Rochester.

It’s easy to slip into the habit of fixing snacks instead of meals when living alone. But many times, these lack nutrients, including protein. “One of the things we know is that extra protein is beneficial as you get older,” Graff said. “It’s to maintain muscle mass.”

Susan Friedman is a physician and the director of lifestyle medicine at Highland Hospital.

Kerry Graff is a physician and an independent contractor in lifestyle medicine in Rochester.

Protein

BeRRIES Whether frozen or fresh, berries such as raspberries, blackberries, blueberries or strawberries offer many benefits. “Wild blueberries are very high in antioxidants and are anti-inflammatory,” Friedman said. “All berries are good sources of fiber.”

November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 13

Golden Years

Things You Should Know About Cataracts

most common operation performed in the United States. It is one of the easiest operations to undergo as a patient,” said Albert. “The operation is quick and painless and anesthesia is utilized to ensure the patient is comfortable and relaxed throughout the whole process.”

3.Cataract surgery

By Ernst Lamothe Jr

s you get older your eyes age as well. The most common eye ailment is cataracts, a prevalent vision-related issue which causes clouding of the eye's lens. In an eye without a cataracts, the lens of the eye is clear, allowing light to pass through to reach the retina, facilitating clear vision. However, with age and various other factors, the lens becomes cloudy and opaque. The World Health Organization estimated 95 million people worldwide are affected by cataracts. “Cataracts are the leading cause of blindness worldwide and are treatable with a minor surgical procedure that has a high success rate and safety profile,” said Desiree Albert, an ophthalmology specialist at the Rochester Regional Health Eye Care. "Having routine complete eye exams is important to monitor for the presence and progression of cataract.” While symptoms of cataracts can vary, they often include blurry or cloudy vision, light sensitivity, difficulty seeing in dim or low-light conditions, seeing halos around lights and changes in one’s perception of color. It is important to remember that symptoms of cataracts can occur gradually. Albert discusses five things you need to know about cataracts.

1.Causes

Age is a primary factor in the development of cataracts. As individuals age, the proteins in the lens of the eye clump together, causing cloudiness. In many cases, this cloudiness starts small and gradually increases over time, significantly impacting visual quality. Other factors that contribute to the development of cataracts include prolonged exposure to ultraviolet ra-

diation from the sun, certain medical conditions such as diabetes, medication usage, smoking and excessive alcohol consumption. Treatment for cataracts typically involves surgical removal of the cloudy lens, replacing it with an artificial lens. Cataract surgery is a very common and successful surgical procedure that is performed worldwide. In fact, advancements in cataract surgery techniques have greatly improved outcomes and recovery times. “The most common reason why people need cataract surgery is a noticeable and bothersome decrease in quality of vision. Often patients notice difficulty with night vision, such as trouble reading street signs at night or excessive glare from oncoming headlights,” said Albert. “Others may notice difficulty reading small print or seeing subtitles on the TV. If you feel there has been a change in your vision and you are struggling, schedule a complete eye exam with an ophthalmologist or optometrist to be evaluated.”

2.Misconceptions

Patients are often surprised to hear they have early signs of cataract when they are in their 50s, but this is usually when cataracts begin. Cataracts progress over time but this change occurs slowly. It takes years, sometimes even decades, between the early signs of cataract and when it becomes visually bothersome. Some people think that cataracts are hereditary. But the truth is that all people develop cataracts eventually. “People often fear the idea of eye surgery. They are understandably uncomfortable with the idea of their eye being operated on. The reality though is that cataract surgery is the

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The process of cataract surgery begins with a pre-operative visit done in the office a few weeks prior to surgery in order to take measurements, review cataract surgery instructions and finalize the surgical plan with your surgeon. The surgery itself is performed as an outpatient at an ambulatory surgery center. “When surgery is needed for both eyes, we always operate on the two eyes on separate days for safety purposes and these two surgeries are usually spaced apart by about two to four weeks,” Albert explained. “The surgery itself is a painless procedure done under mild IV sedation. Except in rare cases, general anesthesia isn’t needed. The procedure takes about 10-15 minutes in most cases. “We place an implant lens at the time of cataract surgery. This is considered standard of care everywhere that cataract surgery is performed in the world. The implant lens is a clear artificial lens that is placed securely inside the eye. This lens does not degrade over time and will not need to be replaced in the future,” she added.

4.Recovery

Fortunately, the recovery period after surgery is usually a very comfortable one and vision often improves rapidly. While there are some exceptions, most patients notice within one or two days of surgery that the vision is already a little bit better than before surgery. The vision tends to improve each day from there until it reaches its final clarity. “Pain in the postoperative period is not expected, though some patients feel a mild scratchy sensation for about a day or two after surgery. We instruct patients to limit activity after surgery for one week with no heavy lifting or strenuous exercise,” said Albert. “There is a medicated eye drop that is taken for approximately one month after surgery for each eye that helps with healing and helps to prevent infection.” In addition, there are a series of post op visits performed in the office after surgery, including one day after

Desiree Albert, an ophthalmology specialist at the Rochester Regional Health Eye Care: “The [cataract] operation is quick and painless and anesthesia is utilized to ensure the patient is comfortable and relaxed throughout the whole process.” surgery for each eye. If a new prescription for glasses is needed after surgery, this will be provided about one month after surgery.

5.Surgery side effects

Possible side effects immediately after surgery include blurred vision, halos in the vision, light sensitivity, eye redness and mild eye irritation or foreign body sensation. Some patients experience none of these; others experience multiple of them. In most cases these side effects are mild and improve over the course of the first few days after surgery. The most common complication after surgery is development of an “after cataract” which is a cloudiness occurring on a natural structure called the capsule which remains in the eye after surgery. When this occurs, it may cause a return of blurred vision months or years after your surgery. “The most serious risk of surgery is fortunately also the rarest, eye infection. Infection inside the eye is possible after surgery and when this occurs it can cause permanent damage to the eye if not treated quickly. The frequency of this happening is far less than one percent,” said Albert.

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By Deborah Jeanne Sergeant

erhaps you notice a vision supplement at your local drugstore or in a commercial on TV. Will this product really help preserve your vision? That depends. Eye health is not as simple as popping a pill. David Kleinman, ophthalmologist with UR Medicine’s Flaum Eye Institute, offered his expertise on the topic. “Eyes, like the rest of the body, will benefit from a healthy lifestyle,” Kleinman said. “Getting enough exercise, maintaining a healthy bodyweight and normal blood pressure, refraining from smoking, seeing your primary care physician regularly to help reduce the risk for acute and chronic illnesses and eating the right foods are very important and beneficial approaches to optimizing systemic and ocular health.” A healthful diet is not only about eschewing fried, sugary and processed foods. It’s also about focusing on the nutritious foods that support bodily health. “Foods that contain important micronutrients, including zeaxanthin, lutein and omega-3 fatty acids are thought to be helpful for keeping your eyes healthy,” Kleinman said. He listed: • Green leafy vegetables, including Swiss chard, kale, turnip greens, collard greens and spinach, green peas and Brussels sprouts. • Brightly colored fruits and vegetables including red, orange, and yellow peppers, corn, sweet potatoes, broccoli, tomatoes, watermelon, blueberries and zucchini • Plant-based sources of omega-3 fatty acids include walnuts, chia seeds, flax seeds and flax seed oil. “A low-fat, vegetable rich diet is also recommended,” Kleinman said. “There are oral supplements on the market that contain many of the important micronutrient components of food, but a healthy diet is the best place to start. “Specific vitamin combinations may be recommended by your primary care physician or ophthalmologist on a case-by-case basis, but routine use of these products by the general population has not proven beneficial for eye health. “Also, adults should have periodic, comprehensive eye examinations at a frequency determined by their eye care provider.” Many people see the AREDS2 supplement and assume that this will support general eye health. However, Kleinman explained that the nutraceutical was proven beneficial for only one population of patients: those with intermediate stage macular degeneration. “I don’t recommend it for patients in general or for those with

early-stage macular degeneration,” he said. “They will not see improvement.” The research indicates that those diagnosed with intermediate stage macular degeneration who take the supplement under the direction of an ophthalmologist or optometrist experienced about a 25% reduction in rates of advanced vision loss over five years. Kleinman said that the original AREDS formula included high levels of beta carotene, which proved to raise the risk of death among former or present smokers. AREDS2 leaves out the beta carotene and uses lutein and zeaxanthin. It also includes vitamins C and E, and zinc and copper. “It’s at pretty high doses, so I make sure the primary care provider knows but I don’t think it’s risky in any special way,” Kleinman said. “It’s not medically indicated to use AREDS in any other situation.” He is not aware of any other nutraceuticals helpful for supporting vision health, although some evidence exists that omega-3 fatty acids can help with dry eye symptoms. “Everyone should eat healthfully and eat fewer calories and eat a plant-based diet full of nutrients,” Kleinman said. “But what’s compelling is that the antioxidant properties of certain foods, patients with higher blood levels of zeaxanthins found in the macula as is lutein, those patients have lower incidence of macular degeneration. What I think that means is that patients who eat these in their diet have benefit. It’s not the same as taking a pill. You can’t undo a lot of poor habits by taking a pill.” He also added that a diet high in red meat and meat in general and processed foods is related to age-related macular degeneration, along with correlation with hypertension, diabetes and obesity. It’s also beneficial to exercise, once cleared by a physician. Kleinman recommends walking. “Start with half a mile, two and three miles a day,” he said. “It’s an incredible way to increase muscular strength and circulatory performance. Macular degeneration is a multifactorial disease. There’s some genetics, maybe 30% of the risk. But there’s a lot to control.” He added that quitting tobacco use is vital. “These changes are difficult initially, but once they hold onto them for three months, they don’t want to go back and are happier and healthier,” Kleinman said. For more information on plantbased, healthy diets, Kleinman recommends visiting the website of the Physicians Committee for Responsible Medicine www.pcrm.org/ good-nutrition/plant-based-diets and The Campbell Plan, a book by Thomas Campbell, physician.

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November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 15

Golden Years

What’s New for Medicare in 2024? By Deborah Jeanne Sergeant

f you receive Medicare, look for these changes coming in 2024:

hole

• No more coverage gap–doughnut

“The stage four catastrophic stage has been eliminated,” said Vicki James, chief executive officer of Clear Benefits Advisors, formerly MEDICARE EASY! in Rochester. “Once they’ve paid the maximum out-of-pocket of $8,000 a year, the insurance plan and Medicare pays the rest. That’s part of the Inflation Reduction Act.” • Higher rates for drug plans “The insurance companies are preparing for the additional costs they’ll have to pay,” James said. “Prescription coverage plans and stand-alone prescription plans premiums are increasing. They can’t go up more than 6%. The maximum out-of-pocket for the doughnut hole will be $2,000 by 2025, which is going to be a huge savings for people with expensive prescription drugs.” • Supplement plan (aka Medigap plans) premium hike “These premiums are anticipated to go up,” James said. “That will probably be announced toward the end of the year.” • Better dental coverage

Medicare recipients trying to maintain their oral health have struggled to get coverage for care. But that will become less costly in 2024. “Dental has finally become one of the more robust benefits,” James said. “It’s always been a pain point for clients as Advantage Plans haven’t offered much coverage. Now they’re offering for 2024 at least preventive care and many offer additional comprehensive coverage at no additional rider cost. We’re really excited about that.” • More over-the-counter “That allows you to buy things medically related like Band-Aids, aspirin or cough and flu medication,” said Lee Kern, licensed insurance agent and owner of NY Medicare Specialists in Rochester and Buffalo. This can lower costs for everyday items that help support good health. • More lifestyle inclusions “Some plans have allowed that for healthy foods, pet food and utilities,” Kern said. “It’s a lifestyle benefit. Some of the lower income supporting plans have transportation for beneficiaries.” Transportation benefits can help recipients stay current with visits to healthcare providers and seek preventative health.

He added that some new plans provide gift cards for recipients who schedule a check-up in their homes. Another offers rewards to enrollees who track their steps with an app and record sufficient steps. Lifestyle inclusions are all about promoting healthy living. • More plan counseling “They require us to go over plan benefits with clients and make sure their doctors are within their plans and to go over the formulary and explain benefits,” Kern said. Although that’s how he’s always operated his office, the review service is now a requirement for agents. “I don’t see how you could provide good service without doing

this,” he added, “because it changes each calendar year. People have to look at their annual notice of change. “It’s about finding a plan that will provide the right coverage if you’re planning on traveling. Understand the cost of a surgical procedure. If you’re using a network facility, usually, that is covered. I have a license in Florida and it seems they have a lot of fragmentation within the system.” James advises clients to talk with a local agent rather than responding to an advertisement on TV or the radio, since sometimes they may be calling a national call center operated by people who are not related to their local area.

Contact me for a no-obligation evaluation of your options.

Nancy Nimmo Licensed Insurance Sales Agent Medicare & Individual Health Insurance Consultant

585.498.4723 TTY-711 nnimmo@lawleyinsurance.com We are a Non-Government Entity. We do not offer every plan available in your area. Currently we represent 8 organizations which offer 60 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Page 16 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

Golden Years

Underused Medicare Benefits By Deborah Jeanne Sergeant

edicare benefits can be confusing, especially as plan benefits can change from year to year and among different insurance providers. It certainly can pay to talk with a qualified Medicare adviser to better understand your benefits, even if your plan remains the same because some benefits may go unused. Lee Kern, licensed insurance agent and owner of NY Medicare Specialists in Rochester and Buffalo, said that part of the reason some people don’t fully use their Medicare benefits is that the explanation of benefits is online. People who don’t go online to read up may not know everything that is included in their plan. Some pick the wrong plan. “The commercials and inbound phone calls bombard them with information,” Kern said. “The unsolicited phone calls and mail can cause people to shut it out and not choose the right plan. Using a local person where you can walk in their office or do a Zoom meeting, that’s an easier way to get away from all the mess that is Medicare. Work with someone who can explain it.” While those providing plans must receive consent from a beneficiary before contacting them, Kern said that many unscrupulous companies use overseas call centers to make cold calls to skirt the law. Once they have obtained consent, they’re switched to a domestic call center and thus technically follow the rules. Some simply cold call from the US in a phishing sch “It’s a numbers game,” Kern said. “Let’s say 40% are on UnitedHealthcare. They call and say, ‘I’m calling to review your United plan.’” The beneficiaries using UnitedHealthcare assume that the caller is from that company, so they willingly go over their plan. A few not on the named health plan may even volunteer the correct information. If the beneficiaries end up switching to the wrong plan, they may continue to go to their trusted providers but not have their visits

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covered because their benefits have changed without their knowledge. Failing to use their plan correctly can also minimize the benefits they receive. “I think that the most underutilized benefits are dentists and eye doctors,” Kern said. “They don’t accept all the insurances. A client might go to a dentist and not realize they need to fill out a form for reimbursement, so they don’t use the benefit. If you have a benefit on a plan and it’s hard to use, it’s essentially useless.” Another example of an under-used benefit is the Part B “giveback” that’s included with some Advantage Plans. “They pay the individual to be on the plan,” said Vicki James, AHIP-certified CEO of Clear Benefits Advisors, formerly MEDICARE EASY! in Rochester. “Many of those plans are $0 premium plans. A few of them do have a medical deducible, so be aware of that. Typically, the copays will be slightly higher than other zero premium plans.” In all cases, it’s vital to review your Medicare plan and any supplemental plans with a trusted, local adviser and discuss your preferred medical, dental and vision providers to ensure you understand your coverage and benefits.

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November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 17

Golden Years

Jewish Senior Life CEO Mike King: “In the past few years, wages have gone up close to 40%,” he says. “We’re all fighting for nurses and LPNs.”

Nursing Homes on the Brink Senior facilities in Rochester have 1,600 vacant beds because of lack of workers to care for patients By Deborah Jeanne Sergeant

ll areas of healthcare experienced significant challenges during the pandemic, but not as extreme as the seismic shift in long-term care facilities. Already struggling to care for a huge influx of aging baby boomers on decade-stagnant budgets, facilities faced an employment crisis, supply shortages, increased protocols and greater demand as seniors sick with COVID-19 needed someplace to go after discharge from the hospital. In more recent months, skyrocketing inflation and continuing employment and budgetary difficulties have pushed many nursing homes to the edge. Charlie Runyon, president and CEO of St. John’s Living in Rochester, said that the industrywide problem largely stems from funding, which leads to lack of staffing and fewer open beds. “Right now, the biggest issue is access to nursing home care,” Runyon said. His 455-bed facility can accommodate only 300 because he lacks the employees to care for the remainder. “In Monroe County, there are 1,600 vacant beds which causes significant backups with people waiting in hospitals for beds,” he said. This is between people requiring long-term care and to a smaller extent, those who need short-term rehab. One of the reasons for greater demand is that during the pandemic, anyone applying for Medicaid was approved without a vetting process. Runyon explained that now they have to go through the process to receive assistance. Before, facilities waited about 30 days for payment, but with so many applications flooding the system, it could be nine months before residents receive approval and facilities receive payment. “We lose $100 a day for those who are approved for Medicaid,” Runyon said. “It’s a shortfall of $100 a day. Seventy percent of our residents are on Medicaid. This is across the state.” Even worse, nursing homes across the state have gone 15 years

without a Medicaid increase. The most recent approved increase was supposed to be a combination of 6.5% from New York and 1% from the federal government, spread across three years. Runyon said that so far, his facility has received only half the amount for one of those three years and that the proposed 7.5% increase was folded into a $168 million approved by New York two years ago to fund a mandated staffing ratio legislation passed two years ago, “money we were already due,” Runyon said. The situation is like a company offering a raise and then a holiday bonus, but later reneging on the bonus, claiming that it’s part of their raise. Runyon said that receiving sufficient funding would help long-term care facilities pay better wages and attract more workers. “We were already at minimum wage and exceeded it to be in the market,” he said. “For Upstate nursing homes, between 2012 and 2022, the salary increases for RNs went up 48%. For LPNs, 53% and CNAs, 46%. We’ve increased by about 48% over that window without reimbursement. The labor market, the payrate has skyrocketed and Medicaid hasn’t come close to reimbursing us for those wages.” Nursing homes have also struggled to replace retiring baby boomer workers. “Those who are here have made a commitment to caring for elderly folks and they do a great job under very difficult circumstances,” Runyon said. “It’s more of a calling than a job.” To help sustain adequate levels of care, Runyon said that his organization has become more creative in staffing by cross-training employees such as training non-nursing staff in how to feed residents who need help at the table and assist with other non-medical care. St. John’s is also working toward becoming a hub for the community by providing educational resources for community to provide better elder care at home. It also helps fam-

ilies become more familiar with St. John’s as a resource once they need a higher level of care. Runyon hopes that continued legislative representation will help increase reimbursement by 20%. “Albany needs to hear loud and clear what a vital role nursing homes play in the continuum of healthcare,” he said. “We’ve been left out so long. Nursing homes were always an afterthought. Now with the backups in the hospital, the consequences of leaving nursing homes out of the continuum of healthcare is rearing its ugly head.” At Jewish Senior Life, CEO Mike King, has been working with advocacy with LeadingAge NY and local legislators about increasing the daily NYS Medicaid rate. Like other long-term care facilities, funding and workforce are the top issues, both stemming from inadequate reimbursement. “In the past few years, wages have gone up close to 40%,” King said. “We’re all fighting for nurses and LPNs.” Like families, the rising costs of food, utilities and supplies challenge the budgets of nursing homes. Offering other services such as rehabilitation, respite care and continuing care helps long-term care organizations scrape by. But the widespread budgetary shortfalls and employee shortages have caused hospital backups that King calls “a crisis.” “Even before the pandemic, we were on a precipice for finding staff,” he said. “You have this big exodus of people who left. Finding staff, growing staff and getting them committed to your organization is hard. We pride ourselves on a great patient experience.” King said that 70% of nursing homes in New York don’t meet the state’s mandatory staffing ratio implemented several years ago (although Jewish Senior Life does). “Some are taking beds offline for that reason,” he said. “Some close. Hill Haven shut down two years ago. That was 300 beds. Monroe County has the fastest growing older adult population of the entire state. People

Page 18 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

Charlie Runyon, president and CEO of St. John’s Living in Rochester: “We lose $100 a day for those who are approved for Medicaid,” Runyon says. “It’s a shortfall of $100 a day. Seventy percent of our residents are on Medicaid. This is across the state.” are going to need assisted living and nursing care. People try to stay home as long as they can but at some point, they will need care.” One of the ways Jewish Senior Life is meeting its staffing challenges is partnering with Heritage Christian Services to work with individuals with special needs through a 10-month internship. Heritage supplies support and Jewish Senior offers a work environment. So far, Jewish Senior Life has trained 40 people who have developmental disabilities and 20 of them work on the Jewish Senior Life campus. The organization also works with high school students who come on campus a couple of days a week to learn about agency services. “Making that connection early on, they may think this could be a potential career, working with older adults,” King said. “Once people get connected with residents, relationships flourish. It’s wonderful to see the connections between younger and older adults.” Those with a working permit can find a part-time job at Jewish Senior Life as young as 15. Jewish Senior life also trains LPNs and CNAs on-site. King wants to see more grants to help more adults afford education in nursing, but he views that as a longterm fix. “We have to figure this out as a community, especially in Rochester and in Upstate and especially in rural communities that have one or two nursing homes,” he said.

Health Insurance Enrollment for all New Yorkers By Jim Miller

Misleading Medicare Advantage Ads: What to Look Out For Dear Savvy Senior, I’m currently enrolled in original Medicare but have been thinking about switching to a Medicare Advantage plan during the open enrollment period. Many of the Medicare Advantage ads I’ve seen offer lots of extra benefits beyond what traditional Medicare offers and no monthly premiums. What are your thoughts? Considering a Switch

Dear Considering, Be very leery of the Medicare Advantage ads on TV, radio, social media and that come in the mail. While many of these ads may tout free vision, hearing, dental and other benefits with zero monthly premiums, they aren’t always what they claim to be.

Advantage Basics Medicare Advantage or MA plans (also known as Medicare Part C) are government approved health plans sold by private insurance companies that you can choose in place of original Medicare. The vast majority of Advantage plans are managed-care policies such as HMOs or PPOs that require you to get your care within a network of doctors in a geographic area. You can sign up for one of them during open-enrollment season from Oct. 15 through Dec. 7. MA plans have exploded in popularity in recent years as insurers have flooded the airways with advertisements, often by celebrity pitchmen, that promote low-cost options with lots of extra benefits. But be aware that the federal government has deemed many claims in MA ads fraudulent and misleading. Some ads imply that the Centers for Medicare and Medicaid Services endorses or prefers a specific plan. Others promise more cost savings than you really get. And if you choose the wrong plan, your doctor may not be a member of that plan’s network or you may end up paying out-of-pocket for medically necessary care. This past September, the U.S. Department of Health and Human Services began cracking down on these ads, but you still need to prac-

tice self-defense. Here are some tips to help you make a good decision. • Cover your needs: When evaluating MA plans, make sure the one’s you’re considering cover the doctors you like and the health care facilities you normally go to. Also, make sure all of the prescription medications you take are on the drug plan’s formulary. To help you compare plans, a good first step is to call the office managers of the doctors you use and find out which Advantage plans they accept, and which ones they recommend. Then go to the Medicare Plan Finder tool at Medicare.gov/ plan-compare to compare plans in your area. • Understand the details: Some MA plans promote no monthly premiums, but the reality is that you are still responsible for your original Medicare costs including your Part B premium and deductibles and copays for covered services. Moreover, you may have to pay more out-ofpocket if you see a doctor outside the network. Also, if the plan is an HMO, it generally doesn’t cover non-emergency care out of network, so an individual may be responsible for full costs. A PPO on the other hand, allows people to go out of network, but they generally have to pay more to do so. • Do some digging: Many MA plans tout free vision, hearing and dental benefits that are not covered by traditional Medicare, but these benefits are often limited. For example, a plan that offers free dental coverage may cover only cleanings and X-rays. Extensive procedures such as root canals or caps may not be covered, or the plan may limit the dollar amount it pays. Find out the coverage details so you’re not surprised later. • Get help: Reach out to your local State Health Insurance Assistance Program (SHIP) at ShipHelp.org or call 877-839-2775. These are nonprofit programs that provide unbiased one-on-one Medicare counseling and assistance. You can also report any misleading MA claims to the Senior Medicare Patrol Resource Center at SMPResource.org or by calling 800-447-8477.

Call Webster Chamber to schedule a virtual or in-person appointment for no-fee assistance with: Medicare, Qualified Health, and New York State of Health Enrollment - insurance for all New Yorkers.

Call: 585-265-3960 You don’t need to belong to the Chamber to get help with health insurance selection and enrollment. The Chamber’s service is at no cost to you. The Chamber staff is licensed, certified and experienced in health insurance enrollmentthroughout your lifetime. Watch the video here: https://www.websterchamber.com/what-we-do/health-insurance

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. November 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 19

Ask St. Ann’s By Teresa Plumeri

utilities and other costs, it becomes easier to see the value of a senior living community.

Planning for the Future When considering your financial future with a senior community, it’s important to contemplate not only your immediate needs but also potential future requirements. St. Ann’s Community at Cherry Ridge offers a comprehensive continuum of care – which mean that a full range of healthcare and housing options are available, all conveniently located on a single campus, ensuring that all of your needs can be met as they evolve.

Schedule An Appointment

Understanding the Financial Options of Living in a Senior Community By Brian Burger.

s seniors approach retirement and consider their future living arrangements, one important question is, what are the financial options? Are you renting, leasing or buying?

Understanding the Costs One of the easiest and best things you can do is to decide which communities you are most interested in and reach out to them and discuss

pricing options. Senior communities and their sales representatives are very helpful and should be fully transparent about their pricing structures, allowing you to consider what’s best for you. It’s also always helpful to sit down and itemize your costs of home ownership and compare them to the costs of a senior community. When you start to itemize your taxes, insurances, transportation, lawn care, snow removal, home maintenance,

An important step when considering senior living options is to schedule an appointment and go see the community in person. Bring a list of questions with you so you don’t forget to ask. Are there lots of people and activity in the common areas, are people working out in the fitness center, can you stay for lunch or dinner and try the food, do they have a medical practice you can go to?

Involve friends and family. You may have friends who have personally relocated to senior living communities, and these individuals are a valuable source of information. It's a good idea to inquire about what criteria they considered, why they selected the particular facilities they did, and whether they would have made different choices in hindsight. Furthermore, involving your family in your decision-making process is crucial. Those who are closest to

Build Social Connection. Prevent Loneliness. We may not think of loneliness as posing serious health risks, but if feelings of loneliness are not addressed, they can significantly impact our health. There are ways to help prevent loneliness and the resulting health impacts. If you’re feeling lonely, consider the following: • Seek support: Reach out to friends, family or a therapist. Support groups can also foster a sense of community and understanding. • Volunteer: Helping others can boost self-esteem and foster meaningful relationships. • Take up a hobby: Engage in activities that bring you joy. Join a club or group with shared interests to meet new people and build relationships. • Practice self-care: Maintain a healthy diet, get enough sleep, exercise regularly, and practice mindfulness and self-compassion. • Try something new: Step outside your comfort zone. It can be intimidating but can also lead to new connections and relationships.

Listen to our episode, “The Loneliness Epidemic” on the Community Check-in to learn more about this issue and who is most at risk. A nonprofit independent licensee of the Blue Cross Blue Shield Association

Page 20 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023

us are always looking out for our well-being, and having their support and confidence in our decisions can provide the reassurance we need when making the move.

At the end of the day, it’s about you. The decision to move to a senior community is deeply personal and can be motivated by various factors. It could be for the sake of your children’s peace of mind, or due to the challenges of managing a large home. While these are all valid reasons, it’s essential to remember that, ultimately, you are the one who will reside in your new surroundings. Those are very valid reasons to make the move, but at the end of the day – you’re the one who’s going to live somewhere new. With all of the options available in our area, there’s a place out there that’s perfect for you. Take your time in making this decision, and most importantly, ensure it’s made on your terms and your timeline. Even if you don’t plan to move for a year or more, begin exploring communities now. This level of preparedness ensures that you are ready for a seamless transition if you happen to be prepared for the relaxed retirement living lifestyle earlier than expected.

Brian Burger is marketing representative at St. Ann’s Community at Cherry Ridge. You can reach him at 585-697-6702 or bburger@mystanns.com.

Health News Excellus names Simone E. Edwards as new vice president Excellus BlueCross BlueShield recently announced the appointment of Simone E. Edwards as vice president health equity and community investments, reinforcing the health plan’s commitment to a more equitable Simone Edwards and inclusive health care landscape for all. “We are excited to have Dr. Edwards join our team and believe that her unique perspective and strategic vision will help drive positive change within our organization,” said physician Lisa Harris, senior vice president, corporate medical director at Excellus BCBS. “We look forward to working with Dr. Edwards to reinforce our dedication to high-quality care, reducing health disparities and making a difference in the lives of our members and the community.” Edwards acquired her bachelor’s degree in biology from Stony Brook University and her master’s and doctorate degrees in public health from New York Medical College. She received a certificate in leadership development to advance equity in health care from the Harvard T.H. Chan School of Public Health. Edwards has dedicated over 15 years in the healthcare field to advance the health and well-being of the underserved population. Dr. Edwards will play a pivotal role in advancing the health plan’s mission to promote health equity, cultural sensitivity and communi-

ty health. As vice president health equity and community investments, she will lead the development and implementation of innovative strategies to eliminate health disparities and promote health equity within the community. She’ll also establish partnerships with community organizations, health care providers, and stakeholders to drive impactful initiatives, and collaborate with internal teams to integrate health equity principles into the health plan’s products, services, and operations. “Health equity means everyone has a fair chance at living the healthiest life possible. It is also key to building a vital and thriving society. I look forward to taking a community-driven approach to engage and invest in activities that promote equity and ultimately member and community health,” said Edwards. She lives in Rochester and enjoys traveling.

Schirmer joins Thompson as physician recruiter With 17 years of healthcare and nonprofit recruiting experience, Jessica Schirmer of Rochester recently joined UR Medicine Thompson Health as the organization’s physician recruiter. Schirmer is a Canandaigua Jessica Schirmer native who most recently worked as the senior recruiter for Rochester Regional Health. She has professional human resources certification and is an adviser to the National Human Resources Association as well as a Pro-ROC (Professional Recruiters of Rochester) board member.

While its medical staff numbers over 800 — including providers with hospital privileges — Thompson currently employs nearly 80 physicians. The hospital and its off-site locations also have more than 80 advanced practice providers. These include nurse practitioners, physician assistants, and certified nurse-midwives. Schirmer is actively recruiting for these in-demand positions as well.

Kim McKinsey-Mabry appointed at Excellus BCBS Excellus BlueCross BlueShield recently named Kim McKinsey-Mabry as community investments and partnerships manager for the company's Rochester region. Her responsibilities in this role include overseeing straKim McKinsey tegic investments with the goal of improving access to care, advancing specific health outcomes, and supporting similarly mission-driven organizations in the region. McKinsey-Mabry will also drive strategy-aligned employee engagement with community-based organizations through board involvement and events such as volunteer days or lunch and learns; creating and delivering presentations for internal teams or employee resource groups and other similar activities. Prior to her new position, McKinsey-Mabry was employed with Monroe Community College at State University of New York since 2011, where she ascended to the role of

acting provost and vice president academic and student affairs. She also served as a liaison to the president and executive leadership team to drive actionable plans for cross-divisional projects and key initiatives that serve to advance institutional strategic goals and student success initiatives. McKinsey-Mabry is a member of the board of directors for the YWCA Rochester & Monroe County and Dress for Success Rochester. She and her family currently reside in Rochester.

OB-GYN Lauren Paraison joins Thompson Health Physician Lauren Paraison recently joined the obstetrics and gynecology practice within the Canandaigua Medical Group, an affiliate of F.F. Thompson Hospital. Paraison, a resident of Canandaigua who previously Lauren Paraison worked at Women Gynecology and Childbirth Associates in Rochester, is a member of the American College of Obstetricians and Gynecologists who is board-eligible in obstetrics and gynecology. After obtaining a bachelor’s degree in Spanish language from Tufts University in Medford, Massachusetts, she received her medical degree from the Joe R. and Teresa Lozano Long School of Medicine at the University of Texas Health Science Center in San Antonio. She completed her residency at the University of Rochester, at both Strong Memorial Hospital and Highland Hospital.

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Page 24 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • November 2023