in good CDC: Too Many Younger Teens Still Getting Pregnant
Rochester–Genesee Valley Healthcare Newspaper
May 2014 • Issue 105
The NP will see you now... New state law gives nurse practitioners more freedom to practice medicine. Medical organizations oppose the law Page 918 Page
The Power of Massage Page 7
VOA Clinic Brings Out the Smiles You’ve bought insurance on the exchange. Now what?
Meet Your Doctor Stephen Hammes of UofR studies role of testosternone in female fertilifty
Into the Great Wide Open Rochester resident Marty Robinson is one of 18 hikers in the United States being sponsored by the Thru-Hike Syndicate as he attempts to complete Page 24 the Appalachian Trail May 2014 •
A New Way to View Alzheimer’s In a new book, local geriatrician G. Allen Power argues that people living with dementia / Alzheimer’s can still lead quality lives
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Page 15 •
Lab-Grown Vaginas, Noses Herald House Cleaning New Options for Patients Reliable & Honest Scheduling weekly, bi-weekly or monthly visits. Reasonable rates 19 years in business References available Senior discounts Independantly owned and operated
CALL FOR AN ESTIMATE Vicki DeFazio 585-738-4831
Reach Health Providers, Consumers In Good Health newspaper reaches both providers and consumers. With a distribution of 35,000 copies it reaches every corner of the market. One ad and you’re covered for the entire month. Get a discount just to try us out. Please call 585-421-8109
Regenerative surgery takes a leap forward, two studies show
octors have successfully implanted laboratory-grown vaginas into four teenage girls suffering from a rare birth defect, creating new organs with feel and function comparable to that of a “natural” vagina, a new study reports. Another research team is reporting the first successful nose reconstruction surgery using laboratory-grown cartilage. In both cases, doctors harvested the patients’ own cells and used them to create new tissue that was then grafted back onto the body. The two studies, published online April 11 in The Lancet, show how years of research into tissue engineering for skin grafts is being put to practical use for other purposes, said physician Samuel Lin, an associate professor of surgery at Harvard Medical School and site director of Harvard’s plastic surgery residency training program. “Perhaps now we’re just seeing the translational products of all that research that has been going on for years,” Lin said. One study involved girls aged 13 to 18 who were born with Mayer-Rokitansky-Kuster-Hauser syndrome, a rare genetic condition in which the vagina and uterus are underdeveloped or absent. Researchers harvested muscle cells and epithelial cells from a biopsy (surgically removed tissue sample) of
each girl’s genitals. Epithelial cells line body cavities and are able to generate or release fluid and detect sensation. In a process that took three to five weeks, doctors grew the cells into larger tissue cultures that were then attached to a biodegradable “scaffold” hand-sewn into the shape of a vagina. The scaffolds were tailor-made to fit each patient and are made of the same type of material used in surgical sutures. Once the new vaginas were ready, surgeons created a canal in each patient’s pelvis and stitched the scaffold to the girls’ reproductive structures. The girls’ bodies proceeded to form nerves and blood vessels into the grafts, and gradually replaced the engineered scaffold with a new, permanent organ. “It’s just like when you’re having plastic surgery and they place a skin graft on you to replace damaged tissue,” said physician and senior author Anthony Atala, director of the Wake Forest Baptist Medical Center’s Institute for Regenerative Medicine in Winston-Salem, N.C. “The graft will re-grow blood vessels and nerves,” he said. In the other study, Swiss scientists harvested nasal cartilage cells from five patients, aged 76 to 88, who had severe defects of their noses following skin cancer surgery. During skin cancer surgery, doctors
often have to cut away parts of cartilage to remove a tumor. Surgeons usually reconstruct the nose using cartilage from the person’s ear or ribs, but the procedure can be very invasive and painful. The researchers at the University of Basel in Switzerland grew the cartilage cells into new tissue 40 times the size of the original biopsy in one month, and then used that tissue to rebuild the noses of the patients. One year after the reconstruction, all five patients were satisfied with their ability to breathe as well as with the appearance of their nose. None reported any side effects. Doctors from the research team said the same technology could be used to engineer cartilage for reconstruction of eyelids, ears and knees.
IT’S ONLY SUPER IF YOU TAKE IT. According to the National Institutes of Health, up to 20 percent of patients fail to fill new prescriptions, and 50 percent of people with chronic health conditions discontinue their medication within six months. If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember: If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/ TakeAsDirected.
#TakeAsDirected A nonprofit independent licensee of the Blue Cross Blue Shield Association
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
May 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Vegan dinner in Brighton open to the public The public is invited to attend the May 4 meeting of the Rochester Area Vegetarian Society. The after-dinner program will be a talk by Susie Coston, director at Farm Sanctuary’s National Shelter. Coston will speak on the topic of “Farm Sanctuary: Changing Hearts and Minds.” The event will take place 5:30 p.m., when dinner is served, followed by the program at 7 p.m. Location is the Brighton Town Park Lodge, 777 Westfall Road. Dinner is a vegan potluck. Vegan means no animal products (no meat, poultry, fish, eggs, dairy products or honey). Bring a dish with enough to serve a crowd, and a serving utensil; also bring a place setting for your own dinner. The organization can help non-vegetarians or others uncertain about how to make or bring a vegan dish. Cost if free for RAVS members and $3 for other guests. For more information, call 585-234-8750,
Hearing loss group holds two meetingS The Hearing Loss Association of America Rochester chapter has scheduled two meetings for May 6, both at St. Paul’s Church, located at East Avenue and Westminster Road in Rochester. The daylight meeting takes place from 11 a.m. – 1 p.m. and is titled “How We Hear: Where Listening Meets the Brain.” Physician Elise de Papp will present the talk. She will be introduced bu registered nurse Donna Kiikka. The evening meeting will take place from 7 – 9 p.m. and is titled “Actions speak louder: Skits related to hearing loss,” which will be present-
ed by members of HLAA-Rochester chapter. For more information visit www. hlaa-rochester-ny.org or call 585 266 7890.
May 6, 13, and 20
Workshop for women who live alone Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own” is a three-part workshop offered for women who want to find joy again and gain the know-how to forge a meaningful and enriching life on their own. Participants will meet others in similar situations and learn practical strategies to overcome loneliness, rediscover their true self, socialize in a couples’ world and think differently about living alone. The workshop takes place at House Content Bed & Breakfast in Mendon from 7 – 9 pm. on three consecutive Tuesdays: May 6, 13, and 20. The workshop fee of $125 includes a Living Alone binder, empowerment exercises and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@ rochester.rr.com.
Annual fashion show takes place at Unity Health The Park Ridge Auxiliary will host the 6th Annual Fashion Show to raise funds for Unity Health System. The event will take place at 11 a.m., May 10, at the Rochester Airport Marriot, 1890 W. Ridge Road in Greece. Fashions by Chico’s will be modeled by Park Ridge auxiliary members. Tickets are $28 (pre-pay). Payment can be sent to Park Ridge Auxiliary, 1555 Long Pond Road, Rochester, NY 14626. For more
information, contact Sharlene Penna at 585-861-8104 or email spenna415@ gmail.com.
Fibromyalgia group to hear from disability expert The Fibromyalgia Association of Rochester New York (FARNY) has scheduled a support group meeting between 7– 8:30 p.m., Tuesday, May 13, at the Greece Town Hall Meeting Center, 1 Vince Tofany Blvd. in Rochester. Mary Perry, an accredited disability representative who is an expert in winning Social Security disability cases for more than 20 years, will be the keynote speaker. She will discuss how to obtain Social Security disability and supplemental security income when you cannot work. The meeting is free and open to the public. For more information, visit www.farny.org, email publicity@ farny.org or call 585-225-7515. FARNY was formed in spring 1993 to educate and inform others about Fibromyalgia Syndrome (FMS), as well as to serve as a support system.
Nazareth College hosts ninth teen book festival Nazareth College is hosting the highly anticipated ninth annual Greater Rochester Teen Book Festival (TBF). The event brings thousands of teens with all kinds of literary tastes together to meet their favorite authors. TBF will take place from 8:45 a.m. to 5 p.m., Saturday, May 17, at Nazareth College, located at 4245 East Ave., Rochester. This event is free and open to the public and kicks off with an author parade led by the Eastridge High School Lancers Drum-Line. For more information visit www.tbflive.org or contact Stephanie Squicciarini at the Fairport Public Library at 585-223-9091.
Mediatios retreat to take place in Canandaigua Usha Shah, a meditation and sound energy healing coach in Rochester, is
facilitating a retreat from 9:30 a.m. to 5 p.m. Saturday, May 17, at Notre Dame Retreat House overlooking Canandaigua Lake. Shah said spring brings the opportunity to practice renewal and transformation. The retreat will include qigong and meditation session, dialogue on how to deepen the power of presence and the showing of the movie “The Dhamma Brothers.” There will be time to explore the grounds in silence. Cost is $60 and includes lunch and snacks. For more information, email firstname.lastname@example.org or call 585442-8141.
Free spring concert to feature variety of music New Horizons Bands is bringing its spring concert to Kodak Hall at Eastman Theater, 60 Gibbs St. in Rochester, at 7 p.m., May 19. It’s free and open to the public. The concert will bring 90 minutes of Broadway, classics, marches and a grand finale with 125 members on stage. New Horizons Music programs provide entry points to music making for adults, including those with no musical experience at all and those who were active in school music programs but have been inactive for a long time. For more information on the concert and the organization, visit www.rocnewhorizons.org.
Chronic pain group schedules program American Chronic Pain Association (ACPA) local Rochester area support group will meet at 6:45 p.m., May 20, at The Baptist Temple, 1101 Clover Street and Highland Avenue in Rochester. Speaker for the night is physician Stephanie Su, who will discuss how conditions and medications can affect the eyes and what can be done preventively to protect the eyes. ACPA holds meetings at The Baptist Temple on the third Tuesday or each month from February to December. Meetings include a social hours and a different speaker each time. For more information or questions call Rita-Marie, facilitator at 585-458-4954.
Lifespan Hosting Free Workshops for Seniors in May Medicaid Managed Long-term Care May 5, 1:30–4 p.m. Location: The Village at Unity, Village Square, 1477 Long Pond Road NYS is changing the way people receive care through Medicaid. Individuals must choose a managed long-term care (MLTC) plan if they are chronically ill or have disabilities and need health and long-term care services.
When Every Day is Saturday
May 6, 1–2:30 p.m. Location: The Lily Café at the Maplewood YMCA, 25 Driving Park What will you do when every day is Saturday? This presentation highlights opportunities and benefits of volunteering.
Revving Up Your Metabolism
May 7, 1–2:30 p.m. Location: The MVP Health Care Page 4
Living Well Center at the Westside YMCA; 920 Elmgrove Road This program describes metabolism and how it converts the food we eat into the energy needed to power everything we do, from moving to thinking to growing. Learn how to raise your metabolic rate to burn calories more efficiently.
Medicaid & Financing Long-term Care
May 8, 2–3:30 p.m. Location: St. John’s, Brickstone, 1325 Elmwood Ave. Learn more about how to prepare financially for the possibility of nursing home care.
Introduction to “Living Healthy with Diabetes”
May 9, 1–2:30 p.m. Sweden Senior Center, 133 State St. Brockport Come see if “Living Healthy with
Diabetes,” a six-week, peer-led health education program, is for you. The course enhances skills and the ability to manage health and maintain an active and fulfilling lifestyle.
Overview of Lifespan Services
May 12, 1–2:30 p.m. Location: Lifespan, 1900 S. Clinton Ave. Learn about the services available for older adults and caregivers through Lifespan.
Total Recall: Memory and Aging
May 13, 1–2:30 p.m. Location: The MVP Health Care Living Well Center at the Westside YMCA; 920 Elmgrove Rd. Take a look at the mechanism of memory and relieve concern that changes are unavoidable as we age.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
Peace of Mind Planning Rd.
May 14, 1–2:30 p.m. Location: Beatrice Place, 600 Denise
Learn about this service designed to help you organize all of your important legal, financial and medical information.
Housing Options for Older Adults
May 15, 1–2:30 p.m. Location: Lifespan, 1900 S. Clinton Ave. Housing options are numerous, confusing and sometimes expensive. In this session we will review what is available in our community.
Legal Checklist to Protect You and Your Family May 16, 1–2:30 p.m. Location: The Summit at Brighton, Continued on page 12
Too Many Younger Teens Still Getting Pregnant: CDC Girls aged 15 to 17 account for about one-quarter of teen births, report shows
espite a drop in teen birth rates in recent years, too many girls under 18 are still getting pregnant, U.S. health officials said in April. Even though births to teens aged 15 to 17 have declined, a quarter of teen births occur in this age group — nearly 1,700 a week, according to the U.S. Centers for Disease Control and Prevention. “There have been noted declines in births to teens, and that’s good news,” Ileana Arias, principal deputy director of the CDC, said during a news conference. “However, we can’t be complacent when we hear about these declines. We still need to make more progress in reducing health disparities and the public health burden related to teen pregnancies and births. Younger teens still account for one in four teen births,” she said. Arias noted that pregnancy and birth can interfere with finishing high school and can lead to sacrificing education, career and income. “The young teen years are a critical time when a teen, especially a young woman, could jeopardize her future if
Take a step toward healthy eating! Subscribe now to a Community Supported Agriculture program! Receive a basket of fresh organic vegetables, fruit and herbs from the Fellenz Family Farm each week! 3 locations: Pittsford Canandaigua Geneva 1919 Lester Rd., Phelps, NY 14532 585-260-2477 • www.FellenzFamilyFarm.com
CERTIFIED ORGANIC PRODUCE FARMSTAND U-PICK STRAWBERRIES
Bridges For Brain Injury invites the Community to our first Open House Celebrating our New Location and our 6th Anniversary! Wildlife Encounters, Refreshments, Raffles and More!
Friday, June 6th • 3-6pm she cannot complete high school or go to college,” she said. Young fathers may also have to limit their education and defer their plans, Arias said.
“Successfully helping the disabled obtain their Social Security Disability/SSI benefits for 23 years.”
Rochester–GV Healthcare Newspaper
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In Good Health is published 12 times a year by Local News, Inc. © 2014 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers and Contributing Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Mike Costanza, Chris Motola, Lynne Scalzo, Maria Petricola • Advertising: Donna Kimbrell, Marsha Preston Layout & Design: Chris Crocker Officer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
May 2014 •
Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life. Need a jump start?
Living Alone: How to Survive and Thrive on Your Own Mondays, May 6, 13, and 20 7:00 pm - 9:00 pm House Content B&B, Mendon, NY
In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, take charge of your finances, and socialize in a couples’ world. $125 fee includes manual, empowerment exercises and book. For more information, call (585) 624-7887 or visit www.aloneandcontent.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
By Chris Motola
Stephen Hammes, M.D., PhD Doctor studies role of testosterone in female fertility Q: Are you mainly involved with research now or do you maintain a practice on top of it? A: I do both. I probably do about 25 percent clinical, 50 research; the rest is other stuff.
bly have some positive effects. Now, there’s never been a good, controlled study to prove this. Now, based on our studies, we can explain why these androgens may have a helpful effect on these patients.
Q: I think a lot of people would be surprised to hear that testosterone plays a role in the female reproductive system or even that women naturally have the “male” hormone in their systems. You’ve been doing research on that. Can you elaborate? A: We have known for many years that women who have too much testosterone get this disease called polycystic ovary syndrome (PCOS), which is the leading cause of infertility in women who are of reproductive age. So we see a lot of that in the clinic. So we knew too much testosterone was bad, but nobody had looked at whether it was all bad, or if an androgen like testosterone — which we think of as a male hormone — had an important function in women. So there had been some research that suggested that it might be necessary for normal ovarian function. Most of that work had been done in a lab and not with live animals. So we’ve been focused on using live animals to figure out if testosterone is important in reproductive processes. What we found in mice is that, if you remove the receptor for testosterone in the ovaries, then there are fertility problems. Follicles don’t grow normally, they don’t ovulate normally and they don’t have as many baby mice. So we found in mice that testosterone needs to be there for normal fertility.
Q: I grew up hearing horror stories in health class about women growing beards from taking steroids. How risky is it for women to take androgens? A: Too much testosterone in women is clearly a bad thing and no one would advocate women taking testosterone on their own, or for long periods of time, or taking high doses. If it’s going to work at all, you want to have fairly low doses for very short periods of time around the time you’re ovulating. Again, I should emphasize that there are no studies on this or scientifically proven protocols. Some patients are trying this based on the very early studies.
Q: Do the implications look strong that this is the case in humans as well? A: As I mentioned, we know about PCOS, but there really aren’t diseases where you can clearly tell that the patient has too little testosterone. But there are patients whose follicles don’t grow normally and who don’t ovulate normally. Even with in vitro fertilization, it’s difficult to get them pregnant. Independent of our research, some people have discovered that if they take an androgen precursor — not testosterone, but an overthe-counter androgen called DHEA — they believe it improves their ability to ovulate. So it may possiPage 6
Q: What other functions does it have in women? A: There’s actually a lot of debate about that. Some studies suggest it may affect libido and sex drive, but they’re not really great studies. Certainly in mice, when you get rid of the testosterone you see decreased muscle mass. So there’s some indication it serves some of the same functions as it does in men, just to a lesser degree. Q: As far as possible applications for your study, what seems most promising? A: The main thing, I think, is that larger studies need to be done in a more controlled way to see if androgens really have a positive affect on ovulation, because people are using it, but they’re not really in a very scientific way. So the next step is to look at this in more detail in humans to see if there’s something worth pursuing. Q: Do you see any implications from this study with regard to male infertility? A: Men need testosterone for a lot of things, including libido and normal sperm production. So for men it’s pretty obvious that we need testosterone within a normal range. It’s hard for a man to have too much testosterone unless you’re taking a drug that makes it that way. It’s rare to see men with enough testosterone to experience negative effects. Too little testosterone in men, however, can lead to fertility problems.
Q: How much testosterone is normally present in women? A: Women have roughly a tenth as much naturally occurring testosterone as men.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
Q: Are fertility clinics administering DHEA patches or is this purely a patient-driven thing? A: I don’t think that any clinics are administering them. Some are allowing their patients to try them or may even be suggesting they try it. But right now the gels and patches are designed for men and have too much testosterone in them. Even the lowest dose is more than you’d want to give a woman.
Q: So you would caution women against trying this on their own? A: I would strongly recommend that they not try it, or anything like it without consulting their physician and arriving at an informed decision together. Q: Can you talk a bit about your practice? A: My practice is general endocrinology and, because we have a really strong diabetes center here, we tend to send our diabetes patients to them. So I tend to see everything but the diabetes patients. I see a lot of thyroid patients, patients with adrenal problems, PCOS problems, and patients with calcium problems. But the division, in general, sees mainly diabetes patients. Q: What’s usually going on when a gland is secreting hormones properly? A: There are a lot of things that can be going wrong. When of the ways the thyroid gland can stop working normally is because the body is producing antibodies – an autoimmune process – which attack the thyroid (in the case of hypothyroidism) or stimulate it (in the case of hyperthyroidsism). That’s the most common cause of thyroid and adrenal gland problems. Autoimmune diseases are rarely the cause of fertility issues, on the other hand. Q: Are the autoimmune diseases typically genetic? A: Nobody knows. It’s really the million dollar question. It’s more common in women than men. Maybe testosterone protects you or maybe estrogen makes you susceptible. We just don’t know. Q: What should the average person know about maintaining good endrocrine health? A: The endrocrine system controls a lot of different things, so it’s not something people should worry about, but they should be aware of. Obviously diabetes is the most common endrocrine problem. If you eat healthy and watch your weight, you can avoid most cases of diabetes. It can also help prevent PCOS in women, which is heavily linked to diabetes.
Lifelines: Name: Stephen Hammes, M.D., PhD Lives In: Rochester Hometown: Ithaca Education: Bachelor’s degree in biology from Cornell University; medical and PhD degrees from Duke University; residency and endrocrinology training at University of California, San Francisco Medical Center Affiliations: UR Medicine Organizations: Endrocrine Society, Society for the Study of Reproduction. Has been named editor-in-chief of Molecular Endocrinology, a leading journal in the field of endocrinology Family: Married, two teens, one bulldog Hobbies: Tennis, piano and other instruments
You’ve bought insurance on the exchange. Now what? By Lynne Scalzo
ntrepreneurs, part-time employees, small businesses, the unemployed and the previously uninsured were among the first to purchase health insurance plans on the new NY State of Health marketplace. Many individuals spent hours comparing options, talking to experts, determining subsidy eligibility and seeing whether their doctors and hospitals were part of the insurer’s network. Now what? Whether you’re newly insured or a health coverage veteran, there are eight things you might Scalzo want to do in 2014 to get the most out of your new health insurance plan: 1 — Pay your monthly bill as soon as possible. If you pay your bill late, you risk having a gap in coverage. Your bill is likely due by the first of each month. 2 — Don’t forget your health insurance identification card. Bring the card with you to save time at the pharmacy or doctor’s office. 3 — Understand your coverage before you need it. Do you have to meet a deductible before your health insurance kicks in? Are you familiar with your various co-pays for services? Visit youtube.com/excellusbcbs to watch educational videos on the basics of health insurance. 4 — Get paid for joining a fitness
facility. All health plans on the NY State of Health marketplace offer up to $600 a year in reimbursement for membership to a fitness facility. Excellus BCBS members can go to excellusbcbs. com/exerciserewards for details. 5 — Contact NY State of Health if you experience a major life event. You might have to recalculate your subsidy or choose a new plan. Major life events could include a move, a new baby or a change in your financial situation because of a divorce or job loss. You could be eligible for more financial help. 6 — Before you visit a new health care provider, make sure he or she is part of your health insurer’s network. You can confirm this information by asking your doctor or health insurer. You’ll typically pay less for services when seeing an in-network health care provider. 7 — Don’t skip your annual flu shot or routine preventive care. Much of that is now covered by your marketplace health plan at no charge to the consumer. 8 — Don’t hesitate to call your health plan with questions. Excellus BCBS members can call the customer service number on the back of their identification card. The NY State of Health website, nystateofhelth.ny.gov, lists contact information for insurers.
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Poison Centers Issue Warning About Electronic Cigarette Devices, Liquid Nicotine
he American Association of Poison Control Centers and the experts at America’s 55 poison centers are urging the public, especially parents, to use caution when using e-cigarette devices and highly concentrated liquid nicotine and to keep them up and away from children, according to John Fiegel, AAPCC interim executive director. Poison centers are reporting a recent uptick in calls about exposures to e-cigarette devices and liquid nicotine. In 2013, AAPCC found 1,414 reported exposures to either e-cigarette devices or liquid nicotine; through March 24, there have been 651 reported exposures. Slightly more than half of these reported exposures have occurred in young children under the age of 6. Some children and toddlers who come in contact with e-cigarette devices or liquid nicotine have become very ill; some even requiring ER visits with nausea and vomiting being the most significant symptoms. Adults should
Need a helping hand?
use care to protect their skin when handling the products, and they should be out of sight and out of the reach of children. Additionally, those using these products should dispose of them properly to prevent exposure to pets and children from the residue or liquid left in the container. The American Association of Poison Control Centers recommends the following steps: • Protect your skin when handling the products. • Always keep e-cigarette devices and liquid nicotine locked up and out of the reach of children. • Follow the specific disposal instructions on the label. • If you think someone has been exposed to an e-cigarette device or liquid nicotine, call your local poison center at 1-800-222-1222 immediately. For the most up-to-date data, please visit the AAPCC Alerts section at www.aapcc.org/alerts.
Test again at Lead paint poisons more than 500 kids in Monroe County every year. The damage to their bones and brains is permanent. Make sure your children are tested at one and again at two years old. Have your home tested today. You can get the information you need to protect your children. Call 585-256-2267. Or visit www.letsmakeleadhistory.org.
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May 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Would you like to feel better about living alone?
or some women, living alone in mid-life is a welcome change, especially if they are coming out of an unhappy marriage. Being alone can offer a respite from the stress and heartache of a relationship gone bad. But even when change is welcome, the prospect of living alone can still appear on the horizon as a daunting challenge. The ending of my own marriage years ago was not a welcome change, but it was a change nonetheless and one I had no choice but to accept and ultimately to embrace. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to organize and offer workshops to support other women in the similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a threepart workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for almost 10 years now, and often get questions from “In Good Health” readers about what the workshop covers and how it is organized. In this month’s column, I am pleased to answer the most frequently asked questions: Q. What is the purpose of the workshop and what do you cover? A. Because I’ve walked in a similar
pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self, socialize in a couples’ world and otherwise embrace what may be a once-in-a-lifetime opportunity to create a wonderful and rewarding life on your own. Getting good at living alone takes practice. There’s no magic pill and it doesn’t happen overnight. But it can happen — and good things can result. Feeling comfortable with your independence will improve your chances of finding contentment and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel better about yourself — more confident and resourceful — life on your own or with a special someone can be richer and more satisfying Q. Who attends the workshop? A. Most, but not all, of the women who attend the workshop are between
KIDS Corner Is It Just A Cold Or Is It Allergies? Experts give parents tips on how to tell the difference
ne of the problems that parents may have during the springtime is deciphering whether their children’s sneezing is due to a cold or allergies. “Runny, stuffy or itchy noses, sneezing, coughing, fatigue, and headaches can all be symptoms of both allergies and colds but when parents pay close attention to minor details they will be able to tell the difference,” says Michelle Lierl, a pediatric allergist at Cincinnati Children’s Hospital Medical Center. Page 8
“Children who have springtime or fall allergies have much more itching of their noses; they often have fits of sneezing and usually rub their noses in an upward motion. They also complain about an itchy, scratchy throat or itchy eyes, whereas with a cold, they don’t,” she said. Lierl also said that nasal discharge for allergy patients is usually clear and has the consistency of watery mucus, while patients who have colds usually have yellowish mucus discharge. Lierl said that there is a blood
the ages of 40 and 70 and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist, and/or their congregation. Q. I’m still grieving the loss of my marriage/ spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women become more confident and independent on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I’m not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hit and misses, I found my way and now thoroughly enjoy the freedom and independence
test called the Immunocap, or RAST, that can screen for allergy to specific foods or airborne allergens. RAST can be ordered by any doctor, but it is important that patients or their parents talk with their doctors first. Children experiencing seasonal allergy symptoms should be tested for environmental allergens present during that season and not for food allergies or allergens present during seasons when they had no symptoms. The results of the RAST test are back after seven to 10 days, whereas allergists can do allergy skin testing in one day in the doctor’s office. If parents discover that their children have allergies, Lierl suggests the following tips to combat symptoms: • Windows should be kept closed during periods of very high pollen and fungal spore levels. • Change air conditioner filters every month. • Change children’s clothing when they come inside from the outdoors. Clothes should also be washed thoroughly to rid them of all of the outdoor pollutants. • Children should wash their face, hands and hair after being outside. • Wash the child’s eyes and nose with a non-prescription saline solution when the child has been outside to
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
that comes with living alone. My time-tested experience, valuable resources, and tried-and-true tips and techniques have inspired and helped many workshop participants. Q. How large are the workshops? A. Ideally, I like to have eight women in each workshop, although, on occasion, I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at email@example.com. You’ll find information about my upcoming workshop in the Calendar of Health Events included in this issue. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming May workshops, check out the calendar listing in this issue or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@ rochester.rr.com.
remove the pollen and fungal spores from the eyes. • Minimize early morning outdoor activity since pollen counts are higher in the morning. • Keep vehicle windows closed while traveling with an allergic child in the car to keep allergens and pollen out. • Most important, make sure children take their allergy medicine daily during the pollen season. For more information about springtime allergies, please search the American Academy of Allergy, Asthma and Immunology’s website at www. aaaai.org.
Nurse Practitioners To Gain More Powers New law will give more freedom for NPs; goal is to alleviate shortage of doctors in the state By Ernst Lamothe Jr.
s a family nurse practitioner, Marilyn Dollinger has long wanted the opportunity to operate more independently of doctors, while still having a collaborative relationship. She has fought to take away the stigma that nurse practitioners were not capable of doing many of the tasks that were routinely part of their jobs as well as being able to practice medicine without the medical version of a signed consent form from a physician. A new law finally grants some of her wishes. Taking effect Jan. 1 next year, the Nurse Practitioners Modernization Act has been called by some a way to advance greater patient access to care and recognize the roles that nurse practitioners play as independent healthcare professionals. There are 13 states that allow nurse practitioners to practice with complete independence: Alabama, Arizona, District of Columbia, Iowa, Idaho, Maine, Montana, New Hampshire, New Mexico, Oregon, Utah, Washington and Wyoming. New York is 14th. In the wake of doctor storages in the region, officials believe the new law was monumental. By the year 2020, there will be a shortage of between 100,000 to 150,000 doctors nationwide, according to the American Medical Association. New York itself is short about 1,200 doctors. The new law removes the requirement of a written practice agreement between an experienced nurse practitioner and a doctor as a condition of opening their own practice. Any nurse practitioner with more than 3,600 hours of practice or two years will be able to continue extending their expertise and freedom beyond the current limitations. Previously, that signed written collaborative agreement with the physician was as narrow or broad as the medical doctor was willing to go. Dollinger strongly supports the
new law. In fact, she would like it to go even further and not require written consent with doctors at all. “There is a shortage of primary care providers and nurse practitioners are doing a very good job filling in the gaps,” said Dollinger, who is also the associate dean of the Wegmans School of Nursing at St. John Fisher College. “We focus on the whole care of people and their families and manage anything from acute health issues to regular check-ups.” Nurse practitioners practice in a variety of primary and specialty care settings, including ambulatory, acute, long-term and primary care. They are licensed and certified by New York State Education Department to diagnose illness and physical conditions, perform therapeutic and corrective measures, order tests, perform health screenings, annual checkups and prescribe medications without direct supervision. In addition to their advanced certification by the nursing board, many NPs are certified by national accrediting agencies in one or more practice specialties. When Jeanine Santelli heard the news, her first thought was it’s about time. A gerontologic nurse practitioner herself, she saw the collaborative practice agreement as cumbersome and unnecessary. “We always understood what we can and can’t do so there was never a need for the paperwork,” said Santelli, professor and chair of the nursing department at Nazareth College. “There was never a need for
people to worry about us overstepping our boundaries or stepping on anyone’s toes.” She said the many states that passed the law much earlier than New York shows that nurse practitioners are seen as a welcome sight in many needed areas. “Nurse practitioners are there helping to give greater access of care to people. We can do it at less expense to the patient,” added Santelli. “It will free up doctors to take care of more complex
cases. We are here to add benefit and not replace anyone.” Those who disagreed with the law said a physician’s training is far superior to that of a nurse practitioner, which is why the collaborative, written consent was something essential to the health care system. Official say physicians train five to 10 years more than an NP before they join the workforce because of medical school and residency. Nurse practitioners typically can start participating fully in the work force two to four years after they receive their Bachelor of Science because they don’t have a residency program. Dollinger disagrees with the assessment that there will be any drop in care after this law. She believes the role of NPs are becoming more understood and appreciated nationwide. A 2010 Institute of Medicine future of Nursing Report stated that NPs provide high quality care, are cost effective and the patient satisfaction scores are consistently high. “The Institute of Medicine reviewed all of the data and determined that lifting the restrictions on practice was the right thing to do. If it is good enough for the Institute of Medicine to value our worth then not much more needs to be said,” said Dollinger, who is also the co-chair the legislative committee for the regional NP Association. “This is an important evaluation from a non-partisan expert group and should have credibility.” Joyce P. Griffin-Sobel has been waiting for this law to become official. She said every nurse practitioner has a bachelor’s and a master’s and are well equipped to handle many aspects of health care. “The law was basically just an exercise in paperwork,” said Sobel, a registered nurse who is also the dean and professor of the College of Nursing in SUNY Upstate Medical University in Syracuse. “We provide wonderful care for so many primary care needs on numerous specialties. Nothing happens quickly in New York state, but this is a step in the right direction.” She views nurse practitioners as essential for taking care of a growing patient population. “There have been studies that mention there are better health outcomes when people deal with a nurse practitioner in certain situations than a primary care doctor. Often they have more time to work with patients, have better patient satisfaction scores and have a higher rating when it comes to following up on the patient,” added Griffin-Sobel.
Medical societies oppose new legislation: NPs can’t perform same functions as MDs
he new nurse practitioner law has been met with mixed reaction — from jubilation to worry. Medical societies throughout New York state have weighed in on the issue. Nancy Adams, executive director of the Monroe County Medical Society, said nurse practitioners are a valued and integral part of the medical team. “However, some nurse practitioners have been trying for many years to expand their scope of practice to allow them to perform the same functions as a physician,” said Adams. “Their graduate-level education consists of two-to-four years with no residency and a total of 500-720 hours of total patient care hours required through training. This compares with four years of medical school, three to seven years of residency, and 12,000-16,000 hours
of total patient care required through training for the physicians to which they claim to be equivalent.” She said medical degrees cannot be legislated and that written practice agreements are in the best interest of patients and promote high quality care. “Nurses who want to practice medicine independently should go to medical school,” added Adams. James Coulthart, executive vice president of the Onondaga County Medical Society, said there have been a wide range of opinions from physicians in the area. He believes the previous system with coloration with the nurse practitioners was working fine and didn’t need alterations to the extent that the new law has placed. “You need someone to be the team captain and that is a role best played
by the physician,” said Coulthart. “We do have physicians that are concerned about this new direction.” Elizabeth Dears, senior vice president for legislative affairs for the Medical Society of New York, said the new law strikes a delicate balance for both sides. Nurse practitioners no longer need the written consent after 3,600 hours; however, doctors have the right to decide whether they want to enter into a relationship with a nurse practitioners even if they surpass the required hours. She said that leaves both sides empowered because NPs can select physicians who support the new measures and work with them, while doctors can choose to only deal with nurse practitioners who are fine with a written consent form. There were some nurse
May 2014 •
practitioners who wanted the law to go even further with no consent necessary regardless of the number of hours they worked, a measure the Medical Society of New York greatly disagrees with. “Nurse practitioners do not have anywhere near the same training in medicine as physicians. As a whole, physicians do not believe they should be able to practice independently of doctors,” she said. “The relationship should be collaborative, with the doctor as the lead of the team.” She added that she was happy that the new law specifically states that if a physician and nurse practitioner disagree with the mode and method of treatment, the doctor’s decision prevails. By Ernst Lamothe Jr.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Neurofeedback Gains Popularity Technique used to treat ADHD, depression, anxiety, traumatic brain injury and alcoholism and drug addiction, among other conditions By Deborah Jeanne Sergeant
eurofeedback sounds like a technique pulled from a sci-fi flick: electrodes applied all over the scalp can change a victim’s — or, in this case, patient’s — thinking and behavior patterns. But the practice has gained in popularity worldwide. Cynthia Kerson serves as executive director of the International Society for Neurofeedback and Research, an advocacy group for neurofeedback practitioners. Kerson estimates that 7,500 US practitioners offer neurofeedback and more than 100,000 have tried it in the past 10 years. Few research projects of any size can vouch for neurofeedback’s efficacy. Practitioners learn how to perform it through hands-on learning instead of formal, curriculum-driven education. The FDA regulates biofeedback equipment Rosen upon which neurofeedback techniques are based and classifies it as for relaxation, not treating learning and behavioral issues. But local practitioner Dan Rosen said business is booming, though driven by anecdotal success passed on by word of mouth. A licensed clinical social worker by
profession, Rosen operates the Neurofeedback Center of Rochester. Rosen learned how to use neuralfeedback methods by training with more experience practitioners. Practitioners say that neurofeedback works by using electrode sensors to track brainwaves and compare a client’s real-time brain activity with a brain map to show the practitioner what areas of the brain are working at that moment. As the brain’s electrical impulses fire, the sensors pick up on their frequencies. In real time, neurofeedback equipment “rewards” the client with pleasant stimuli such as pleasing sounds or visuals the client likes. For example, if a client with ADHD experiences erratic thought patterns sensed by the electrodes, the equipment dims video he is watching. When his thought patterns focus, the video automatically adjusts and brightens to normal viewing mode, mostly without the client’s conscious awareness. Clients select their own videos or sounds. “The equipment only records your brainwaves,” Rosen said. “It does not add electric current. Amazingly, after just a few reinforcing auditory beeps or signals, the brain responds by adjusting brain wave patterns. Also, if adequate brain training has been delivered, then the client can reproduce
healthy brain wave patterns without the use of equipment.” Rosen said that the technique may be used to treat ADHD, depression, anxiety, traumatic brain injury, post-traumatic stress syndrome, alcoholism, and drug addiction. He said that it’s largely not effective for cigarette smoking. “The general principle of biofeedback has long been established,” Rosen said. “If you let someone know how their physiology is doing, they do better. If you’re watching a video of you playing golf and the instructor says to tuck your butt under, you can now see why the instruction said that. If you want to learn how to wiggle your ears, look in the mirror to see if you can make them move, then learn to control that movement.” The treatment may seem bizarre to the uninitiated, but Rosen said that one reason it’s becoming popular is that “people are concerned about taking psychiatric medications. Some of them are invaluable and people need them to remain stable; however, the long-term analysis of ADHD medications is that they may not be as effective over the long term. “Medications have significant side effects and often don’t provide a complete treatment,” Rosen said. “Some symptoms are not completely addressed. For recovery from TBI,
neuralfeedback is pretty much the only treatment that will address abnormalities that develop in the brain.” He said that after a traumatic brain injury has healed physically, neuralfeedback can help stimulate parts of the brain to the organ’s fullest potential for healing. Rosen also offers the treatment for stress management and anxiety. Most practitioners charge around $100 per session and may require as many as 30 sessions, depending upon the individual and what issue needs attention. Most health insurance doesn’t cover the treatment. “Most of my practice is psychotherapy,” Rosen said. “Biofeedback isn’t a magic bullet. Most people respond, but some are just not good candidates.” Rosen denies a placebo effect; however, he said that if a client wants to improve his condition, it does help the treatment to work better.
The Transformative Power of Massage By Maria Petricola
ave you ever received a professional massage? If you have, I hope you have experienced how powerful and healing touch can be. Touch is one of the most basic human needs, and today’s massage therapists are trained in the science and art of professional, therapeutic touch. Massage has often been thought of as a luxury, but getting a massage on a regular basis can also be a very enjoyable way to maintain and improve your health and wellness. Probably the most important medical benefit of massage is that it helps relieve stress and conditions associated with it (such as muscle tension headaches). Massage has also been shown to help manage pain, boost immune function, improve physical fitness and reduce sports injuries, and positively affect mental health (e.g. decrease anxiety), among others. Massage has a very long history, and some form of touch has been a part of healing and medicine in many cultures around the world for thousands of years. Massage therapy as a profession became popular in the U.S. around the turn of the 19th century when people sought more natural means of healthcare and medical health spas became popular (e.g. the
mineral spring spas of Clifton and Saratoga Springs). The profession boomed again in the 1980s as the public became more interested in natural health and fitness, and the positive effects of massage on health received more scientific validation through research studies. Massage therapists in New York state are required to have 1,000 hours of education in specific subject areas, and must pass a rigorous state licensing exam in order to practice. Their education includes coursework in Western and Eastern forms of massage and bodywork, anatomy and physiology, pathology, business, and massage law and ethics. Educational requirements vary from state to state, but professional licensure is now the norm in nearly all states. Massage therapists work in a variety of settings, including day and destination spas, resorts, fitness centers, hospitals, nursing homes and other medical settings such as the offices of physicians or chiropractors. Many therapists pursue additional training after graduation and licensure, and continuing education hours are required by New York state. Some areas of specialization that require advanced training are sports and orthopedic massage, pregnancy
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
and infant massage, medical massage, and geriatric massage. If you are looking for a qualified massage therapist, finding the right therapist for you is important. A referral from a friend, family member or health care provider is always good place to start. Also, the American Massage Therapy Association website has a “Find a Massage Therapist” feature that can help you locate an AMTA member therapist in your area (www.amtamassage.org). For those who may be interested in pursuing massage therapy as a career, there are several massage training programs in the region, including an associate in applied science degree program at Finger Lakes Community College, where I teach. Maria Petricola is a chiropractor and a licensed massage therapist. She is a 2000 graduate of the Onondaga School of Therapeutic Massage in Syracuse, and a 1996 graduate of New York Chiropractic College in Seneca Falls. She lives in Canandaigua and is an instructor of biology and coordinator of the Therapeutic Massage/Integrated Health Care program at Finger Lakes Community College.
By Anne Palumbo
The skinny on healthy eating Why Shrimp Are a Nutritious Catch
hen it comes to seafood, we love our shrimp. From shrimp cocktail to scampi to kabobs, these curled crustaceans are America’s most widely consumed seafood. But, wait. Aren’t shrimp high in cholesterol? Yes, they are: an average serving can amount to a full day’s allotment for some people. However, much like nutrient-dense eggs, the benefits of eating shrimp typically outweigh the drawbacks. Let’s look at why those in the know — including the Academy of Nutrition and Dietetics—say yes to shrimp, even for those with elevated cholesterol. To begin, shrimp are an excellent source of low-calorie protein. A typical serving (around six shrimp) supplies about 25 grams of protein for a mere 135 calories. For the average adult, that amounts to nearly half of your daily needs. Protein, as many know, is a workhorse nutrient that’s essential for tissue repair and muscle building. Shrimp also serve up a healthy dose of selenium, an antioxidant mineral that plays an important role
— in contrast to most other foods high in cholesterol — are super low in fat, with almost no saturated fat at all. Because saturated fats raise bad cholesterol levels more than dietary cholesterol itself, they’re the ones to watch out for. The bottom line? Shrimp, enjoyed in moderation and prepared in a healthy manner, can be part of heart-healthy diet.
in preventing cell damage from free radicals. Growing evidence suggests a possible link between selenium intake and reduced risk of certain cancers, including lung, bladder, colorectal and prostate. To top things off: Brains love shrimp! Not only are shrimp rich in omega-3s, which can keep the mind agile and protect against Alzheimer’s disease, but they also brim with vitamin B12—a vitamin that may ward off depression. Our bodies need this important B vitamin to make blood cells and maintain a healthy nervous system OK, back to cholesterol and why shrimp are no longer considered taboo for lots of us watching our intake. While eating shrimp does indeed raise cholesterol levels, studies have shown that shrimp boost the good (HDL) cholesterol slightly more than the bad (LDL). Go HDL! What’s more, shrimp
Farmed or wild-caught? Domestic or imported? If you want to minimize your risk of exposure to unwanted contaminants in shrimp, check out the latest guidelines issued by the Monterey Bay Aquarium Seafood Watch (seafoodwatch.org) and follow those. Fresh shrimp should look translucent and moist with no black edges or spots; frozen shrimp should not have ice crystals (a sign that the shrimp were thawed and re-frozen at some point). Since shrimp naturally have a somewhat high sodium content, rinsing with plain water helps to remove some of the sodium. Choose spices other than salt to boost flavor of shrimp.
Roman-Style Shrimp with Mint Adapted from Mark Bittman Serves 4 2 tablespoons extra virgin olive oil 3 - 4 garlic cloves, coarsely chopped 4 cups chopped fresh tomatoes (or 1 28-ounce can plum tomatoes, chopped, with their juice) 2 - 3 teaspoons red pepper flakes (optional) Coarse black pepper, to taste 1 pound shrimp, peeled and dev-
eined 1 cup chopped fresh mint or 2 tablespoons or more dried mint Goat cheese, crumbled, for garnish (optional) Heat olive oil in large, deep skillet over medium heat. Add garlic and cook until just brown, about 3 minutes. Add the tomatoes. Turn the heat to medium-high and bring to a boil, then reduce heat to medium and simmer for 10 to 15 minutes, stirring occasionally. Add red pepper flakes and black pepper, to taste. Add the shrimp and cook, stirring occasionally, until they are all pink, about 5 to 10 minutes. Stir in the mint. Serve with crusty bread or over wholewheat pasta. Garnish with goat cheese, a relatively low-salt cheese. Correction: Oops! We forgot the star ingredient of last-month’s Pea Guacamole: 1 16-ounce bag frozen peas. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at firstname.lastname@example.org.
Having A Hard Day’s Night? No Matter What The Cause, We Can Help You Rise To The Occasion
Therapeutic Massage/Integrated Health Care
Make a hands-on difference. Prepare for a career that helps heal others through massage therapy. FLCC is one of only a few accredited schools in New York State to offer a massage program. At FLCC, you’ll also learn about life sciences, alternative therapies, and a holistic approach to well-being in a program that is less expensive than private massage schools in New York State. In addition to learning about different types of massage, the history of massage, and various massage techniques, you’ll also study anatomy and physiology, kinesiology and myology, psychology, and more. This comprehensive degree program will challenge you and prepare you for a career as a massage therapist. Visit www.flcc.edu/massage to learn more!
Low Testosterone & Erectile Dysfunction Therapies That Work.
For Personalized Medical Treatments May 2014 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
VOA Clinic Brings Out the Smiles Dental clinic ‘breaking the cycle of poor oral health’ among kids By Mike Costanza
ulie Volschow leaned over Kayden Walker as the 2-year-old sat in a chair in the Dental Center of the VOA Children’s Center. “Are we ready for some vitamins on your teeth?” the dental hygienist asks. With a grin, the little boy nodded. Volschow quickly applied the “vitamins,” which help Kayden’s teeth fight off decay, and the little boy bounced out of the dental chair, smiling the smile of one whose teeth are nice and clean. The Dental Center has helped kids like Kayden continue smiling since it opened in September of 2013. Established by a partnership JoAnne Ryan, between the Volpresident and CEO of unteers of AmerVolunteers of America ica Upstate New York and the Western New York. Rochester General Health System (RGHS), the clinic provides comprehensive dental services for children who are enrolled at the VOA Children’s Center. Those between the ages of 6 weeks and 12 years can enroll in the facility’s programs, which include Head Start, universal pre-kindergarten and after-school programs, and summer camps. The Volunteers of America Western New York owns the facility, which sits on Lake Avenue in Rochester. Though programs like Head Start benefit kids, good dental care is essential to their overall health. Unfortunately, many parents whose children come to the VOA Children’s Center lack the transportation, time or other resources they need to take their kids to dentists’ offices. “Access and availability are two of the key barriers for the families that we’re serving,” says JoAnne Ryan,
president and CEO of Volunteers of America Western New York. About two years ago, the VOA and RGHS began working together to help remedy that problem. “Part of our mission is to provide care to the community,” says dentist Richard Speisman, chief of dentistry at Rochester General Hospital. “Breaking the cycle of poor oral health, and poor health in general, is key to getting another generation that doesn’t have a high risk for dental disease.” To help break that cycle, the VOA set aside Dental hygienist Julie Volschow leaned over Kayden Walker as the 2 year old sat in a chair in the Dental 440 square feet of space Center of the VOA Children’s Center. The center is partnership between the Volunteers of America Upstate in the heart of its RochNew York and the Rochester General Health System. ester facility to be used for the Dental Center. RGHS outfitted it with state-of-the-art equipment, includ- that they will gain more from their help the adults and their kids become visit. ing two brandmore comfortable using dental care in “We actually have really good new dentist’s the future. success, because the teachers, the staff chairs, instru“That’s what we’re trying to do there has such good relationships with ments, computhere, is start it early, and get some eduthe kids,” says er screens and cation early,” Mooney explains. Nicole Mooney, other important RGHS paid the $120,000 cost of one of the devices—there’s outfitting the dental clinic, according to RGHS dentists even an X-ray Speisman, and is searching for grants that currently machine. to use to recover those funds. The help staff the One day health system also pays for the medical Dental Center. every two professionals that staff the clinic, and Though weeks, dentists the office workers who help them. As some parents and hygienists of last December, 22 of the approxipay for the treat- mately 270 kids who attend programs put aside their ments through regular work at the VOA Children’s Center had private insurfor RGHS to enrolled at the clinic. Ryan and SpeisRichard Speisman, ance, most do so man hope to raise that number in the help provide chief of dentistry at through Mediccomprehensive coming year, and operate the clinic Rochester General aid. They need dental treatment nearly full-time. Hospital. at the clinic, “The ideal goal would have all the Nicole Mooney, one of not accompany including clean- the RGHS dentists that their kids to the children coming through, and having clinic, though ings, checkups, fillings, extractions and their exams, checkups and treatments currently help staff the Mooney and instruction in dental hygiene. VOA at the center, along with educating care Dental Center. her co-workers staff escort the children to the clinic providers, parents and…the kids,” from their classes or programs, helping encourage them to attend the visits, Speisman says. if they can. By doing so, they hope to them relax and increasing the chance
Lifespan Hosting Free Workshops for Seniors in May Continued from page 4 2000 Summit Circle Dr. Learn about power of attorney, health care proxy and other advanced directives to help protect you and your loved ones.
AARP Caregiving Workshop
May 19, 2–4:00 p.m. Location: Brighton Public Library, 2300 Elmwood Ave. Join us for a special forum featuring local experts to help connect family caregivers to the services and supports they need.
May 20, 10 a.m –12 p.m. Location: The Brightonian, 1919 Page 12
Elmwood Ave. An easy-to-follow explanation of Medicare.
The Needs of Caregiving Families
May 21, 1–2 p.m. Location: Lakeside/Beikirch Nursing Home, 170 West Avenue, Brockport The emotions and challenges of caregiving can be difficult. This session will focus on how communication skills can alleviate some of the challenges of caregiving.
Rocco M. Vivenzio Memorial Symposium May 22, 6 p.m. Distinguished geriatrician, William
J. Hall, M.D., Rocco Vivenzio was a geriatrician who strived to bridge the gap between the medical and social work communities. In this symposium, physician Hall will speak about Vivenzio’s impact on the Rochester community, geriatric medicine today and the impact of the Affordable Care Act.
How to Choose a Person-Centered Nursing Home
May 27, 1–2:30 p.m. Location: Lifespan, 1900 S. Clinton Ave. A short or long-term stay in a nursing home may be needed unexpectedly. How do you find a home that truly practices person-centered care? Learn what to look for and what questions to ask.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
Services for Older Adults with Disabilities May 29, 1–2:30 p.m. Location: 1900 S. Clinton Ave. Current trends regarding services for older adults with intellectual and developmental disabilities
Home Care Options and How to Pay for Them May 30, 1–2:30 p.m. Location: Lifespan, 1900 S. Clinton Ave. Having help at home is often the key to maintaining longer term independence. We will talk about types of home care, how to access services and how the services are paid. Reservations are required. Call 585-2448400, ext. 401.
Study: Alzheimer’s Underreported
Disease is more widespread in the US than reported in the past, according to study in ‘Neurology’ By Deborah Jeanne Sergeant
yons resident Neil Washburn, 59, enjoys an active retirement. A year ago, he completed his 25-year career as director of administrative services at Wayne County Social Services, what he calls “the most enjoyable and challenging work.” Now he divides his time among volunteering, participating at Palmyra First United Methodist Church and serving on the board of the Wayne County Nursing Home. He also lives with a diagnosis of early onset Alzheimer’s disease. Receiving the news in 2011 shocked him and his family. He wondered how long — or if — he could keep working. Washburn isn’t alone. A study published in the March 5 issue of Neurology, a journal by the American Academy of Neurology, states that Alzheimer’s disease is more widespread in the US than reported in the past. In fact, Alzheimer’s may contribute to more or as many deaths as heart disease or cancer, diseases listed as first and second on the Centers for Disease Control and Prevention’s list of causes of death. That would move Alzheimer’s disease up from its present sixth-place listing and would mean that about six times as many people die from Alzheimer’s disease as previously thought. “It’s overlooked by the government,” said Charles Fuschillo, CEO of the Alzheimer’s Foundation of America based in New York City. “Alzheimer’s is a stepchild as far as recognition compared with the funding for other diseases. I hope the government will increase funding for providing care and for research. “Hopefully one day there will be a cure for it. There are a lot of trials out there.” Fuschillo said that one of the reasons Alzheimer’s has been overlooked as a cause of death is that it diminishes the person’s ability to communicate his symptoms to health care providers until the point where an illness such as pneumonia takes his life. “It’s critically important that a caregiver communicates properly with a primary care giver,” Fuschillo added. Physician Bill Hall, professor of medicine and head of the Center for Healthy Aging based at Highland Hospital, said that early in his medical training, Alzheimer’s was not even recognized as a cause of death. “In and of itself, at some point in time, it takes away a lot of the body’s defenses,” he said. For example, if Alzheimer’s makes swallowing challenging, the person can aspirate liquid into his lungs more easily. Or if eating becomes more difficult, the person deteriorates more quickly. “This is directly related to the continued destruction of the brain,” Hall said. “It takes away the ability to recognize basic bodily needs. We now recognize Alzheimer’s leads in mortality to virtually everyone who has it.” Part of the reason for the seeming increase in Alzheimer’s cases is better,
Washburn earlier diagnosis. Previously, someone like Washburn would have been overlooked since he has remained relatively stable since onset and does not fit the typical earmarks of an older, frail Alzheimer’s patient. A single father of two adult sons, Wasbhurn lives alone. His concern about his own memory loss grew since about 2008 as he began realizing that “it seemed like time seemed to rush by, or, by logical deduction, I was acting and reacting slower. I was taking more time to achieve less. That was an awareness trigger.” After a referral from his primary physician and subsequent testing by a neurologist, Washburn received an Alzheimer’s diagnosis. In the past, autopsies provided the best way to absolutely confirm Alzheimer’s. But imaging, blood tests and diagnostic tools can pretty much confirm a diagnosis now. “There are lots of aspects as to how this disease approaches people,” Washburn said. “A portion have it attacks them one way and probably have a completely different exposure. Long distance memory is usually not affected, but the current stuff.” Keeping meticulous notes, setting reminder alarms and taping reminders in conspicuous places helps Washburn keep on top of his appointments and obligations. “I’m still capturing and producing the quality [of work] I always have had but it’s a much bigger struggle to maintain a focus,” he said. “Before this issue, your brain kicks in and just does it for you.” Two prescription medications help slow the disease’s devastation, buying time for Washburn. Keith Harrington, director of programs and services for the American Alzheimer’s Association Chapter of Rochester & the Finger Lakes, said that early diagnosis has become an important part of helping people and their families cope. “We have a number of early stage programs as far as learning about the disease, how to live with it, and, as well as one can, live well with it,” Harrington said. “We also have social-oriented programs. Knowing earlier, you
can plan better. By the time a lot of people find out about the disease, they aren’t able to cognitively make the decisions they could have earlier in the disease.” The organization serves people who are in their 30s through those who are elderly. “We’re seeing an increase of early onset — those under 65,” Harrington said. “Just because someone finds out he’s diagnosed doesn’t mean his life is over. It can progress from two to 20 years. There’s a lot of living left. We emphasize quality of life. You can have good quality of life despite its progression.” As for Washburn, he takes a philosophical approach to knowing what may cause his death. Though he will likely miss out milestones many others typically experience, his diagnosis has helped him develop “a greater appreciation for healthiness and life activities. I’m living on borrowed time.” He has made his final wishes known and wrapped up his legal affairs to make things easier on his family. He has thought of creating a “bucket list” of things he wants to do while he
May 2014 •
can still do them. “I think what I want to do with the time I’ve got and mental faculties is to squeeze every minute of the day into time well lived and enjoyed and make an achievement of having done things with and for other people that not only makes things better for them, but in the same process but makes me feel better about myself and the whole process of how people, together, should do the best for others,” he said. He enjoys volunteering with fellow church members to repair homes for needy people in the community. “How can you be sad when things are being done for good reasons to people who need it?” he asked. “It takes my mind off my own problems. ‘Do as much good as you can for as many people as you can for as long as you can,’ one of our ministers said. Then you have no regrets.” He also realizes that no one knows when he will die, and that death will surely come to every person. “Whatever life we have left, it’s fitting to give it to help others who are in need or are otherwise would not be able to do things,” Washburn said.
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or the first time in history, the number of people who are 65 years old and older outnumber those who are younger than 18, according to the U.S. Census Bureau. As the population continues to get older — by 2030, there will be more than 72 million people who are senior citizens — new concerns about dental care arise among dentists. “My advice regarding seniors and oral health is that they routinely go for dental examinations with a dentist who is up to date with treating an older patient population,” said dentist Jeffrey Arigo, president of the Seventh District Dental Society, which represents more than 800 dentists in the New York counties of Cayuga, Livingston, Monroe, Ontario, Seneca, Steuben, Wayne and Yates. The Journal of the American Dental Association recently conducted a study that concluded many tips on catering to an older population including reassurance, listening and advising patients properly being deemed as three pillars of good dental care communication. Early diagnosis of oral health-related problems enables people to act quickly and avoid getting their teeth removed. In many ways health education remains a barrier for seniors. Younger adults not only have better access to information but they seek it out. “Seniors may still feel some anxiety regarding a dental visit they experienced years before,” added Arigo. “This may also need to be addressed in some fashion.” Officials suggest scheduling longer appointment times with seniors so that they can explain various situations without the rush of having to take care of another patient. Research showed dentists averaged less time with older patients than their younger counterparts. With older patients commonly having a longer medical history, they should require more time with medical personnel. They also suggest asking patients to come in with a list of questions prepared going into the appointment. “Seniors often present with complex medical histories and oral health care needs. They are often taking a number of medications, as well,” said Arigo. “The dentist must be willing to take the necessary time required to learn about the patients’ overall health and needs.” During the appointment, researchers found the best results were when dentist kept significant eye contact with patients and when they limited all distractions in the room. Patients often reported that one of their biggest turn offs was when they felt their doctor was not listening to them. “It is so vital if you have an senior coming into the dentist office that you give them more time during their first
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evaluation,” said dentist Judith A. Jones, a spokesperson for the American Dental Association. “You want to put them at ease early and sit with them eye level so they feel comfortable. Some young practitioners when they first get going don’t pay the kind of attention they should to an older patient. When they don’t feel like they are getting your full attention, it can be disconcerting to them especially since they may have some trepidation about being there in the first place.” When it is time to give people advice, many medical officials fall into the rabbit hole of jargon. It’s enough to confuse even young people, but it does seem to have a stifling effect when used with an older population. Officials propose dentists use the same plain spoken dialogue that is often found in pamphlets sitting in their waiting room to discuss issues with patients. In addition using visual aids to convey points can also be useful. The National Institute of Health recommended that healthcare providers speak slowly, clearly and loudly, but without a patronizing or condescending tint. After the appointment, one of the most critical things a dentist can do is provide written instruction for the patient to review at home. Also follow up with a phone call to check on the patient’s condition in cases of extraction, root canal therapy and implants. “If you want people to remember key points during the appointment, you should go through those points one at a time instead of overwhelming patients with information,” said Jones, who is also a professor and chair of the Department of General Dentistry at Boston University School of Dental Medicine. “You have to make sure that they repeat in their own words what you are trying to tell them. You want to give them a simple list of instructions on what they need to do once they get home.” The Journal of the American Dental Association also recently surveyed a cross section of more than 2,100 people who were 65 years old and older. Women, married people, those who were not poor, had high educational background and those with private insurance were the people who utilized dental care. Men are less likely than women to regularly go to the dentist. And those with lower income who may not see going to the dentist as a priority. “You are not healthy without good health overall,” said Jones. “Your mouth is the central part of your face. If the mouth doesn’t look good and it is not functioning the way it is supposed to, then it is harder for you to feel like you are functioning overall. We use our mouth to eat, laugh, smile and interact with people and it is the beginning of our digestive process.”
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Alcohol Effects Older Drivers More
By Deborah Jeanne Sergeant
rinking and driving is never a good idea. However, a study from the University of Florida suggests that the effect of drinking one alcoholic beverage on driving may be more profound for older adults. Researchers analyzed the driving skills of 72 people, half of which were 25 to 36 and half were 55 to 70. Researchers benchmarked the groups’ driving skills with a driving simulator, including staying centered in the lane, driving at the same speed and using the steering wheel appropriately. After one drink, which did not cause any participants’ blood alcohol levels to exceed the legal maximum, the older group exhibited worse driving skills on a simulator. The younger group’s skills appeared unhampered. Physician Bill Hall, professor of medicine and head of the Center for Healthy Aging at Highland Hospital, felt the study is unrealistic, since a simulated lab environment isn’t exactly like actually driving a car. But he also thinks the study sends an important message. “If anything, the study’s conditions would probably underestimate the affect of alcohol,” Hall said. “The study pointed out a problem that we’re increasingly aware with older people and driving with or without alcohol. Some of the important coping skills would be diminished well before the legal limit of alcohol consumption.” Among any given population, impairment because of alcohol may occur at different levels for different people. But among older people, more factors may come into play. Cindy St. George, licensed insurance broker with Christopher Williams Agency, Inc. in Pittsford, instructs for Empire Safety Council Defensive Driving School for Wayne County. She thinks the study makes “total sense, because they probably have medication, whether prescription or overthe-counter,” she said. “They could be more fatigued or under stress than the younger person. They also have slower metabolism, so it would take longer to process the alcohol.” Safe driving also demands our bodies and minds to effectively perform multiple tasks simultaneously. Hall said that the ability to quickly multi-task and make snap judgments accurately diminishes with older age. Although each person processes al-
cohol differently and coordination and reaction time through older age varies, “this study establishes that any alcohol and driving is likely to be more dangerous for people as they get older,” Hall said. “It enhances the risk of some kind of disaster while driving. This is completely preventable.”
Tips on Safe Driving for Seniors
If you’re worried about your driving ability, physician Bill Hall, professor of medicine and head of the Center for Healthy Aging at Highland Hospital, offers a few tips: • “Constantly evaluate and enhance your skills with a safe driving course for older adults. • “Most insurance companies will guide people to a program like that and may reduce rates after completing a course. • “Be aware that with aging, there are inevitable changes, like progressively losing our visual ability to distinguish objects in the dark as compared with daytime. The receptors in the eye that interpret things in the dark are different than ones in the daytime. You may have asymptomatic cataracts. • “Make sure you’re hearing OK. These are times where older people will have less auditory discrimination if the radio is on. • “Most automobile accidents of older adults are caused by arthritis in joints where they can’t get their foot on the break as fast or turn their necks far enough to see traffic well.” Cindy St. George, licensed insurance broker with Christopher Williams Agency, Inc. in Pittsford, instructs for Empire Safety Council Defensive Driving School for Wayne County. She offers these tips: • “Once you’re not comfortable driving after dark, get things done before dark. Or have someone ride with you who can be the driver. • “Drive the right kind of car. If your reflexes aren’t what they used to be, you may need to go to a smaller one. • “Know what your medication may do to you. • “Know how to get to your location. • “Don’t be in a hurry. Give yourself plenty of time to get to where you’re going. • “Put away distractions like cell phone, eating and drinking. Keep your eyes on the road.” May 2014 •
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GoldenYears How to Gain Weight For some, gaining weight may be a challenge By Deborah Jeanne Sergeant
any people in the United States should lose weight. The Centers for Disease Control states, “more than one-third of U.S. adults... and approximately 17 percent — or 12.5 million — of children and adolescents aged 2 to 19 years are obese.” But some people need to gain weight, including frail elders and people recovering from surgery or illness. Gaining may seem a snap for those who struggle to drop pounds; however, healthfully gaining weight requires some knowledge of nutrition. Jane Braband, dietitian with Rochester General Health System, said that eating a balanced diet can help “make sure all their nutrients are in there, including protein and vitamin C, to help with the process of healing and getting stronger.” Braband She likes the US Department of Agriculture’s site, www.myplate.gov to help develop balanced meals; however, people who need to gain should select higher calorie options. For example, “use regular salad dressing instead of low-calorie dressing,” Braband said. “Choose healthier fats, like heart-healthy oils — canola oil and olive oil. Use avocados in sandwiches and on salads. Nuts and peanut butter are good, too.” Buying nuts from the snack aisle usually means added sodium and sugar; however the nuts in the baking section are usually plain and can be added to foods such as salad, yogurt and hot or cold cereal. Keep nutritious, high-calorie foods such as nuts and eggs on hand for snacks and to augment meals. Wheat germ or ground flax seed provide extra calories and nutrients, too. “Eat three small meals and two to three snacks a day,” Braband said. “Have protein with each, such as cheese and crackers, a peanut butter and jelly sandwich, and Greek yogurt.” Lisa Fischer, registered dietitian and pediatric GI nutrition specialist at Strong Memorial Hospital, agrees that a balanced diet is important even for those who want to gain weight. “If you’re eating empty calories from chips and pastries that are calorie-rich but nutrient-poor, it won’t help,” Fischer said. “They don’t help build bone or tissues. Empty calories can weaken the immune system. It can make it more likely you’ll catch the flu or lengthen the time it takes to recover.” Eating enough can challenge peoPage 16
ple recovering from illness, surgery or injury. Fischer recommends drinking smoothies along with meals to add more calories. Combine in a blender unsweetened Greek yogurt, nut butter, flax seed, frozen fruit, a peeled carrot and a little honey to whip up a nutritious, calorically dense drink. Store-bought smoothies usually do not contain whole ingredients and also serve up a bevy of additives and preservatives. “If a person has a serious illness like cancer, or an illness where despite their best effort, they keep losing weight, he may need a dietitian,” Fischer said. Fischer She usually recommends that an elderly people trying to maintain weight should eat 35 to 36 calories per kilogram of their ideal body weight per day. “Someone who’s undergoing physical stress may need higher calories,” She said. “A dietitian can help them taper off their caloric intake when they reach the point where they’ve gained enough weight.”
How to Put on Some Pounds Caring for someone who needs to gain weight? Lisa Fischer, registered dietitian and pediatric GI nutrition specialist at Strong Memorial Hospital, offers a few tips: • “Keep in mind their ability to chew, but keep it palatable. Try serving roast beef hash, not pureed steak. • “We have to take social aspects into effect. Serve things like soup, which can be extremely dense nutritionally. You don’t have to have pureed baby food while everyone else is eating a normal meal. • “If you serve a nutrient dense beverage before a meal, it can fill them up quickly, so have the solid food, the primary meal, and on the side with or after the meal, have the smoothie available so they can sip on it . • “Ask them about what they enjoy and their top five favorite foods and meals.”
5 Easy Ways to Protect Your Ears
By Sarah Klimasewski
any things change as we age; the human body was not designed to last forever, and we are all well aware that the better we take care of our body now the more miles we will get out of it down the road. This philosophy of being proactive is especially important when it comes to ears. Why? Because most changes that occur in the ear are permanent. You can’t go back and undo some of the bad habits you had when you were younger; like standing in front of the speaker at the Duke Jupiter concert at Charlotte Beach. Oh wait, that was me! But it’s never too late to start, as well as to model good behavior to the next generation. Here are five things you can do now to keep your ears up to the task they were designed to do: hearing. 1 — Protection, protection, protection — If you chose to remember only one thing on this list, this is by far the most important! Noise induced hearing loss is 100 percent preventable. Turn down the iPod or radio. Wear protection at concerts or when using loud equipment. Be smart: if you think it’s too loud, move away from the noise source or use something to cover the ear protect the cochlea, the sensory organ of hearing. 2 — Vaccinate — Preventable diseases such as measles, mumps, rubella and whooping cough have the potential to cause hearing loss. Avoid the chance by making sure vaccinations are current
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
for yourself and family members. 3 — Exercise — Recent studies indicate people who partake in regular aerobic exercise have better hearing that those that are more sedentary, even if they listen to music while they do so. A healthy blood supply to all parts of the body, including the cochlea, is essential to inner workings of this organ of hearing. 4 — Eat right — A diet rich in vitamins A, C, folic acid, magnesium and omega-3 fatty acids may play a role in protecting certain structures in the inner ear. 5 — Avoid head injuries — Trauma to the head may impact the middle and or inner part of the ear and cause hearing loss. Wear a helmet when needed, wear a seatbelt in a car and seek medical attention when there is concern of a concussion. The cochlea is housed in the skull and generally pretty well protected, but is vulnerable to injury when head trauma occurs.
Sarah Klimasewski is an audiologist and community outreach coordinator at Hart Hearing Centers, HartHearing.com.
GoldenYears A New Way to View Alzheimer’s In a new book, local geriatrician argues that people living with dementia/Alzheimer’s can still lead quality lives By Saby Reyes-Kulkarni
Suffering is always hard to quantify, especially when the pain is caused by as cruel a disease as Alzheimer’s. Most illnesses attack the body; Alzheimer’s destroys the mind and in the process, annihilates the very self,” wrote Time magazine senior editor Jeffrey Kluger in a 2010 article. In the same article, titled “The Impact of Alzheimer’s Disease by the (Very Scary) Numbers,” Kluger went on to cite projections from a then-current report issued by the nonprofit organization Alzheimer’s Disease International. The number of Alzheimer’s cases, according to ADI’s findings, is expected to increase to 65.7 million — nearly doubling — by the year 2030. Local geriatrician G. Allen Power is no stranger to such figures or to the dread through which we as a culture tend to regard Alzheimer’s, one of a group of conditions classified in formal medical terms as dementia. But Power, former assistant director and culture-change agent at St. John’s Nursing Home in Rochester, stresses the importance of expanding our viewpoint. As debilitating as memory loss can be, Power argues that people living with dementia/Alzheimer’s can still lead quality lives. In over two decades of work in elder care, Power witnessed firsthand how a dementia patient’s “self” actually remains very much intact. In his upcoming book, “Dementia Beyond Disease” (Health Professions Press), he outlines a framework for a change in outlook with enormous potential to improve our current model of care. The new book, which is scheduled for release in July, serves as a sequel of sorts to Power’s first book, 2010’s “Dementia Beyond Drugs” (Health Professions Plus). By 2009, Power had begun doing speaking engagements and educational seminars on behalf of the Eden Alternative, a nonprofit organization now based in Rochester that promotes a regimen of culture change in elder care. Currently, over 200 elder care facilities in the United States and abroad have been certified as members in the Eden Alternative network, including St. John’s. Power serves on the Eden board of directors and also holds a position as clinical associate professor of medicine at the University of Rochester. After writing the first book, Power immediately began to build on his initial concepts as he traveled all over the world presenting his ideas and courses to audiences made up of eldercare staff, administrators, specialists, educators, elder home and community residents living with dementia and their families.
Challenging conventional thinking
“The purpose of my first book was to challenge the dominant bio-med-
ical paradigm that was leading us to overuse these potent and potentially harmful psychiatric medications — primarily anti-psychotics — as a response to dementia-related distress,” he said. “I felt that we were missing the larger issue. At the time I wrote the book, the idea that these drugs weren’t necessarily the best option for people was still a minority view. I still consider that book to be a really good introduction into this kind of thinking. But, as you’d expect, my thinking has evolved and grown.” In “Dementia Beyond Drugs,” Power touched briefly on Eden’s concept of the “seven domains of well-being.” This time around, well-being acts as the primary focus and driving tenet of his proposed changes to our modalities of treatment. The seven domains are identity, connectedness, security, autonomy, meaning, growth and joy. “These seven parameters lie behind the needs of all of us, but particularly the needs of people with dementia that are so hard for us to identify. I discovered that if we set that kind of strengthbased goal of building well-being, rather than just responding to the negative symptoms we see, then we can actually create a more durable path for success,” he said. At the start of the new book, Power — who refers to himself as a “student of dementia” — writes: “I have learned that deconstructing dementia in [new] ways can lead to new insights that were not apparent with the one-dimensional view that has dominated society over the last century.” “One thing I do with my classes and lectures is I remind people that there are several things that people with dementia actually do better than us. One of them is the ability to be mindful and be in the present moment. We’ve mostly multi-tasked ourselves out of appreciating the present moment,” he said. “We pay money for classes to help us do that, when a
person with dementia can just be there. When you give up certain parts of your thinking and focus on others, you can develop certain strengths. This isn’t to sugar-coat the condition, or to suggest that there isn’t a loss, but there are also other things that we might gain and appreciate on that journey.” Fortunately, the Rochester area abounds with more resources than any other place in the state. Power cites the Eden Alternative, Lifespan, the local chapter of the Alzheimer’s Association, the University of Buffalo’s Institute for Person-Centered Care, and two Eden-registered care facilities, St. John’s and the Rochester Presbyterian Home. “New York has not been a great state where culture change has been put forward in nursing homes,” he offers, “but we do have several resources available for individuals and families who want to find out about these things.”
Cover of the first book published by Rochester geriatrician G. Allen Power. In his second book — “Dementia Beyond Disease” — he discusses different ways to improve current model of care for Alzhmeire’s patients. The book is expected to be published in July.
Doctor Gets Folksy Geriatrician connects with his artistic side By Saby Reyes-Kulkarni
hen he’s not traveling the world giving presentations and teaching courses on eldercare and dementia, local geriatrician G. Allen Power likes to indulge his inner troubadour. As a teenager in the 1960s, Power became enamored of the folk music of the day. Later, during his pre-med years at the University of Rochester, Power took half his courses at the Eastman School of Music, studying jazz composition under pianist Bill Dobbins and the late composer/conductor Rayburn Wright. Wright served as co-director and conductor of the Radio City Music Hall orchestra before founding Eastman’s jazz department in 1970. Power has made music in both styles, but he has been most publicly active under the name Allen Power as a singer/songwriter working in the classic folk tradition that made such a profound impression on him in his youth. Unsurprisingly, his work with elders informs his choice of subject matter. His albums “A Life Worth Living” (2001) and “The Healing Art” (1993) reflect heavily on Power’s experiences with nursing home residents. His songs address aging through a poignant lens, but often focus on humor, such
May 2014 •
as on lighthearted numbers like “Five Constipated Men,” “Glad Old Man,” and “Get Up and Go.” Power’s song “If You Don’t Mind” even struck a chord with the iconic folk group Peter, Paul & Mary, so much that they approached him for permission to perform the song in concert. For group member Noel Paul Stookey, the song “touched on some personal issues of self-esteem for the aged that were particularly moving.” Power’s music has caught the attention of several other musicians as well, and his song “I’ll Love You Forever” even appeared in a 1995 Discovery Channel special on families hosted by Walter Cronkite. Still, while these remain career highlights, some of Power’s most receptive audiences have been the residents of St. John’s Nursing Home, where he performed about twice a year throughout his tenure there. “Even people living with Alzheimer’s can very easily connect to songs. Neurologically speaking, the right side of the brain is not usually as affected by Alzheimer’s as the left side, where the speech and memory areas are more strong,” he said. Plus, he adds with a laugh, “it certainly beats playing a noisy bar.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Weed Use Up, Cocaine Use Down, U.S. Report Finds Review covered 2000 to 2010, so doesn’t reflect suspected increase in heroin use
mericans’ use of cocaine fell by half from 2006 to 2010, but marijuana use increased by more than 30 percent during that time, according to a new report. The spike in pot use may be due to an increase in the number of people who said they use the drug on a daily or near-daily basis, said the researchers, whose study covered drug trends from 2000 to 2010. Heroin use remained fairly stable during the decade, while methamphet-
amine use rose sharply during the first half of the decade and then fell. Americans spent $100 billion a year on cocaine, heroin, marijuana and methamphetamine — or a total of $1 trillion over the decade, the RAND Drug Policy Research Center report estimated. “Having credible estimates of the number of heavy drug users and how much they spend is critical for evaluating policies, making decisions about treatment funding and understanding
the drug revenues going to criminal organizations,” study lead author Beau Kilmer, co-director of the RAND Drug Policy Research Center, said in a RAND news release. While the overall amount spent per year on drugs remained the same from 2000 to 2010, spending patterns for certain drugs shifted. Much more was spent on cocaine than on marijuana in 2000, but that had reversed by 2010. Because the report did not examine trends after 2010, it doesn’t include
recent reported increases in heroin use, or the effects of marijuana legalization in Colorado and Washington. The report also didn’t look at the reasons behind changes in drug use and did not assess the effectiveness of drug-control strategies. The report was prepared for the White House Office of National Drug Control Policy and appears on its website.
Excellus awards to help veterans, people with disabilities and local nonprofits
n a former warehouse on Hudson Avenue in Rochester, volunteers fixed enough broken bicycles last year to help thousands of needy children and adults. R Community Bikes will now expand its free services to help a new population, thanks to a $5,000 Community Health Award from Excellus BlueCross BlueShield. Volunteers will soon be modifying bicycles for use by people with physical or developmental disabilities. “Over the course of working with volunteers with developmental disabilities, we learned that many of them were unable to ride conventional bicycles,” said Dan Lill, director, R Community Bikes. “This grant will help us meet their need for tricycles or other modified bikes.” R Community Bikes is one of seven nonprofits in the Rochester region to earn a total of $30,000 in Community Health Awards from Excellus BCBS.
The nonprofits earned funds to target chronic diseases or mental health conditions. R Community Bikes, for example, will use the funds to purchase parts needed to convert traditional bicycles into tricycles. They hope to offer the bikes to veterans with disabilities, among other groups. “Biking is an easy way for individuals to exercise, stay healthy and avoid chronic diseases,” Lill said.
Award to benefit seven organizations The winning programs hold the potential to help thousands of individuals in Monroe, Ontario, Livingston, Wayne and Seneca counties: 1 — R Community Bikes: $5,000 to modify bicycles so that up to 60 individuals with disabilities will be able to ride them. 2 — East House: $5,000 for a diabetes
prevention program with 20 individuals who suffer from severe mental illnesses. Results from the program will be shared with the local mental health community. 3 — American Lung Association of the Northeast: $5,000 to start a virtual Better Breathers Club for at least 100 individuals in Wayne and Livingston counties who suffer from chronic lung diseases, including chronic obstructive pulmonary disease (COPD). More than 7,000 individuals suffer from COPD in these counties, according to the Lung Association. 4 — Compeer Rochester: $5,000 to the CompeerCorps mentorship program to help returning military veterans readjust to living in the Rochester area. 5 — CP Rochester: $4,000 to begin a comprehensive health and wellness program for its 300 employees who support people with disabilities. 6 — Seneca County Pomona
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
Grange: $3,400 to help more than 1,000 individuals in rural communities receive health education through health screenings and risk assessments at local events in Fayette, Interlaken, Lodi, Seneca Falls and Waterloo. 7 — Clifton Springs Hospital & Clinic: $2,600 to purchase a blood pressure kiosk for the Ontario County hospital’s main lobby for use by visitors, patients and staff. Bob Gregoire of Greece is a Navy veteran and mentor in the CompeerCorps program. Three years ago, he started mentoring an Army veteran who struggled with job and housing issues. Gregoire helped his mentee find a job and housing. He accompanied his mentee to job fairs, helping him with his resume and job interviews. “Adjusting to civilian life can be stressful and full of uncertainty,” he said. “I’m thrilled that more military veterans will now be matched with mentors who’ll help them with this adjustment.”
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How to Get Help with Medicare Decisions Dear Savvy Senior, Where can I get help with my Medicare decisions? I’m approaching 65, and could use some help sorting through the different Medicare plan options that are available to me. Almost Eligible Dear Almost, The options and choices available to Medicare beneficiaries today can be overwhelming. In addition to original Medicare (Part A and B) that has been around for 49 years, you also have the option of enrolling in a Part D prescription drug plan, and a supplemental (Medigap) policy — both of which are sold by private insurance companies. Or, a Medicare Advantage plan which covers health care, prescription drugs and extra services all in one. These plans, which are also sold by private insurers, are generally available through HMOs and PPOs. To help you figure out the Medicare plans for you, there are a variety of services and tools available today depending on how much help you need. Here are several to get you started.
Free Resources A good starting point to get familiar with Medicare is the “Medicare & You” 2014 handbook that overviews the program and your options. You can read it online at medicare.gov/pubs/ pdf/10050.pdf, or you should receive a free copy in the mail one month before your 65th birthday. The Medicare website also offers a free “Plan Finder” tool at medicare. gov/find-a-plan that can help you find and compare health plans, supplemental policies and prescription drug plans in your area. Or, if you don’t have Internet access, or don’t feel confident in working through the information on your own, you can also call Medicare at 800-633-4227 and a customer service representative will do the work for you over the phone. Other free resources that can help include planprescriber.com or ehealthmedicare.com, two websites developed by eHealth Insurance that will compare Part D, Advantage and supplemental plans in your area and connect you to a licensed insurance agent.
In addition, the Medicare Rights Center (medicarerights.org) staffs a hotline at 800-333-4114 to help answer your Medicare questions. And your State Health Insurance Assistance Program (SHIP) provides free Medicare counseling in person or over the phone. To find a local SHIP counselor see shiptalk.org, or call the Eldercare Locator at 800-677-1116. And, for tips on choosing a top Medicare Advantage plan, see the HealthMetrix Research Cost Share Report at medicarenewswatch.com. This resource lists the best Advantage plans by area based on your health status.
Fee-Based Services If the free services don’t cut the mustard and you need some additional help in making your Medicare decisions, there are a handful of fee-based companies that are very helpful. One of the best is Allsup Inc. (ama. allsup.com, 866-521-7655) which offers a Medicare adviser service that takes your personal information online or over the phone, such as the prescription drugs you take and the doctors you use, and provides you customized advice on the best Medicare plans that match your needs and budget. They’ll even help you enroll in the plan(s) you select. Fees for their services range between $200 and $495 depending on how much help you need. Another option is Healthcare Navigation (healthcarenavigation.com, 877-811-8211), which charges $750 for a 90-minute comprehensive Medicare consultation.
Commission-Based Another way to get help with your Medicare enrollment is to consult an independent insurance agent. Agents typically get paid a commission to sell you a policy, although they offer plans from a number of providers. The Independent Insurance Agents and Brokers of America have a directory on their website (see independentagent.com/contactus) that lets you search for agents in your area. But keep in mind that agents typically specialize in the Medicare plans they represent, rather than all the plans in your market. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. May 2014 •
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
The Social Ask Security Office
What They Want You to Know:
Gastroenterologists By Deborah Jeanne Sergeant
he American College of Gastroenterology states on its website (www.gi.org) that the specialty focuses on “the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. It involves a detailed understanding of the normal action (physiology) of the gastrointestinal organs including the movement of material through the stomach and intestine (motility), the digestion and absorption of nutrients into the body, removal of waste from the system, and the function of the liver as a digestive organ. It includes common and important conditions such as colon polyps and cancer, hepatitis, gastroesophageal reflux (heartburn), peptic ulcer disease, colitis, gallbladder and biliary tract disease, nutritional problems, irritable bowel syndrome (IBS), and pancreatitis. In essence, all normal activity and disease of the digestive organs is part of the study of Gastroenterology.” • “Patients wonder what I’ll do to them when they come in. They fear coming into doctor’s offices because of procedures. They fear gastro because they may be in pain or uncomfortable. They need to know that most people have very little discomfort with these procedures because we use good sedation. • “The procedures are very important to undergo because oftentimes they’re used as screening tests to prevent disease. If they wait until they are ill, the treatment is much more difficult to accomplish and it’s hard to control things when they get to that point. They need to overcome their fear. • “They should disclose all their medical information to the provider so they can avoid interactions with medication or cause any type of harm because of lack of knowledge of their medical history. That way we can move forward with the procedures in a comfortable and safe manner. They can provide a list of their history or obtain it from their primary care physician who might have that for them. Something we’re going to try to do in the near
future is offer colonoscopy screening by direct access, without a pre-office evaluation. To accomplish this safely and effectively, we need that medical history to evaluate their situation. It’s called direct access. It depends upon how good the communication is between the primary and care provider. • “Don’t be scared of us. We’ve had the procedures ourselves. • “Some people say, ‘I don’t know why I’m here; I feel fine.’ That’s a misconception that you can’t have a disease if you feel fine. I hear that a lot.” Robert Helft, D.O., gastroenterologist with Clifton Springs Hospital • “The field of gastroenterology offers a variety of excellent medical therapies for various GI-related conditions. We are seeing patients take an active role in having screening colonoscopies with a resultant decrease in colon cancer rates. • “Everything from probiotics, heartburn/GERD, clostridium difficile colitis related to antibiotic use to garden variety health maintenance can be seen. • “Life is priceless and precious. I am very pleased and privileged to be a good provider to help preserve and improve our patients’ quality of life through better advances in our medical field.” Jeffrey Goldstein MD, Rochester General Health System Gastroenterology
Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.
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Column provided by the local Social Security Office
Older Americans Benefit From ‘My Social Security’
ach May, groups and organizations around the nation join in celebrating Older Americans Month. Established in 1963, Older Americans Month provides an opportunity for our nation to recognize seniors for their many contributions and share important information to help them stay healthy and active. This year’s theme is “Safe Today, Healthy Tomorrow.” Social Security has something to help keep you safe and healthy: a suite of online services. Rather than driving or taking public transportation to a local office, you can use our secure, free online services to handle much of your Social Security business. With the amount of time you save, you’ll have more time to spend with the grandkids or have time for a brisk walk around the neighborhood or local park. Before going for that walk, though, visit www.socialsecurity.gov. Whether you already receive benefits or you’re just starting to think about retirement, it’s a great time to open a “my Social Security” account. “My Social Security” is a secure online account that allows you immediate access to your personal Social Security information. During your working years, you can use “my Social Security” to view your Social Security statement to check your earnings record and see estimates of the future retirement, disability and survivor benefits you and your family may receive. Check it out at www.socialsecurity.gov/myaccount.
Q&A Q: I lost my Social Security card, but I remember my number. Do I really need a new card? A: No, probably not—but it is important to know your number. The only time you may need the Social Security card is if your employer asks for it when you get a new job. If you do decide to get a new card or your lost one turns up, don’t carry it with you. Keep it with your other important documents. Generally, you are limited to three replacement cards a year and 10 cards during your lifetime. Legal name changes and other exceptions do not count toward these limits. Keep in mind this is a free service. Learn more at www.socialsecurity.gov/ssnumber. Q: What type of information will I need to provide if I’d like to apply online for Social Security retirement benefits? A: Whether you apply for retirement benefits online, by phone or in an office, we suggest that you have the following information at hand when you do it — it will make completing
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
After you check your online Social Security statement, be sure to visit our “Retirement Estimator.” Like a “my Social Security” account, you can use it as many times as you’d like. The estimator lets you change variables, such as retirement date options and future earnings. You may discover that you’d rather wait another year or two before you retire to earn a higher benefit. To get instant, personalized estimates of your future benefits just go to www. socialsecurity.gov/estimator. Deciding when to retire is a personal choice and depends on a number of factors. To help, we suggest you read our online fact sheet, “When To Start Receiving Retirement Benefits,” available at www.socialsecurity.gov/pubs. If you’re ready to retire, the online service you’ve been waiting for is our online application for retirement benefits, which allows you to complete and submit your application in as little as 15 minutes at www.socialsecurity.gov/ retireonline. Once you complete and submit the electronic application, in most cases, that’s it—no papers to sign or documents to provide. Are you already receiving benefits? You can use “my Social Security” to immediately get your proof of benefits letter, change your address or phone number on our records, start or change your direct deposit information and check your benefit and payment information. We encourage you to take advantage of our online services and resources, freeing up more time for activities you really enjoy. Learn more at www. socialsecurity.gov.
the application easier for you. • Your birthdate, place of birth and Social Security number; • Your bank account number and your bank’s routing number, for direct deposit; • The amount of money you earned last year and this year. If you are applying for benefits in the months of September through December, you may also need to provide an estimate of what you expect to earn next year if you plan to continue working; • The name and address of your employer(s) for this year and last year; • The beginning and ending dates of any active military service you had prior to 1968; and • The name, Social Security number and date of birth of your current and any former spouses. Depending on your situation, you may need to provide additional documentation with your application. We’ll give you instructions on how to mail or bring it to us. To get started, visit our Retirement Planner at www.socialsecurity.gov/retire2.
H ealth News Penfield Place receives award from state group Penfield Place, a Hurlbut Care community and nursing home, has received recognition as a winner of the 2014 Innovative Practice Award from New York State Health Facilities Association (NYSHFA). The award is based on a special program created at Penfield Place called the Shangri-La Spa, designed to enhance the quality of life and wellbeing of residents. Shangri-La Spa was spearheaded by Nicole Fernandez, Linda Burley and Charna Kay Chambers as a quality assurance and performance improvement trial program in spring of 2013. Residents make appointments every Thursday for a therapeutic experience Chambers in a spa tub at Shangri-La with soft lighting and aromatherapy, followed by a manicure and light snacks. The goal for each resident utilizing the spa is specific to the individual. Objectives for residents range from decreasing loneliness and depression to reduction of Nersinger psychotropic drug use; acceptance of a warm and comforting bath by those residents who prefer tub baths to improvement in overall resident psychosocial well-being by being treated to the day of pampering at the “Spa.” Residents have expressed a high degree of satisfaction from their participation in the program. The spa has expanded to Tuesdays and Thursdays, and has now been adopted as a regular activities program at Penfield Place.
Event raises $13.5K for Habitat for Humanity HCR Home Care, Nazareth College Physical Therapy and Monroe Wheelchair teamed up recently to host a full-day event focused on creating rehabilitation solutions for the aging population. Topics covered at the 7th annual full-day continuing education program included respiratory system performance, assistive equipment prescription, joint arthroplasty, generational differences, wheelchair seating solutions and environmental modification. More than 175 physical and occupational therapists and aides from across New York state attended the event at Nazareth College, representing 50 different organizations. The event raised $13,500 for Flower City Habitat for Humanity’s aging in place program, which helps low-income elderly homeowners improve
their homes by adding ramps and other upgrades that aid in accessibility. Matthew Hyland, president of the New York Physical Therapy Association, delivered the keynote address on the topic of health care evolution. Other presenters included Chris Chimenti, director of therapeutic services at HCR Home Care; Jill Sparacio, occupational therapist at Sparacio Consulting Services; and Elizabeth Clark, assistant clinical professor in physical therapy, Nazareth College Physical Therapy.
Robert Cole appointed to board of Easter Seals NY Physician Robert Cole, medical director and family medicine physician at Lifetime Health Medical Group, has been appointed to the board of Easter Seals New York. In this role, Cole will work to advance Easter Seals’ message and mission in the community by helping identify needs of local residents, resources to help Easter Seals staff address them, and assisting with fundraising efforts. “I’m thrilled to be able to contribute to the important work of Easter Seals, as their mission is very much in line with what I’ve always tried to deliver throughout my medical career — namely, providing resources to people and families in need and thereby strengthening our communities,” says Cole. “Having a loved one with disabilities, I can tell you first-hand just how valuable these resources are for individuals and families.” Cole joined Lifetime Health Medical Group in 1997 and was named medical director of the Rochester region in 2010. He practices at Lifetime’s 800 Carter St. location in Rochester. Cole earned his medical degree from SUNY Health Science Center College of Medicine at Syracuse and completed his residency in family practice at Albany Medical Center, also serving as chief resident there. He is board certified in family medicine. For more than 90 years, Easter Seals New York has been offering help and hope to children and adults living with disabilities, and the families who love them. Through therapy, training, education and support services Easter Seals New York provides exceptional services to ensure that all people with special needs and veterans and their families have equal opportunities to live, learn, work and play in their communities. To learn more about Easter Seals New York, visit www.eastersealsny.org.
downtown Rochester. “Our team is excited for the opportunity to build on the success of the Rochester Marathon,’’ said Ellen Brenner-Boutillier, co-owner of YellowJacket Racing and its sister company, Fleet Feet Sports, with her husband, David J. Boutillier. “It is the only marathon with its start and finish line in downtown Rochester, bringing thousands of runners, spectators and volunteers into the city’s center. We will be applying our expertise in race production to make the race an even greater asset to the area.’’ To that end, YellowJacket Racing is committing to continue operating the marathon as a fundraiser for local charity. Groups will be able to adopt sections of the race and share in its proceeds. Details of the fundraising partnership efforts will be announced later. The Rochester Marathon is now in its tenth year. Last year, there were more than 600 finishers for the marathon, 2,000 for the half marathon and 186 relay teams.
Rochester Academy of Medicine welcomes archives dedicated to local health care history
Racing company acquires Rochester Marathon YellowJacket Racing, the premier race production and timing services company in Upstate New York, has acquired ownership of the Rochester Marathon from the Arthritis Foundation of Upstate New York. This year’s race day, which includes a marathon, marathon relay and half marathon, is set for Sept. 21. The foundation has managed the event since it was founded in 2005. It is the only marathon to start and finish in May 2014 •
With more than a century dedicat-
ed to medical education, the Rochester Academy of Medicine has enriched its portfolio of outreach programs by welcoming the Rochester Medical Museum and Archives (RMMA). RMMA collects, cares for and shares the history of institutions within the Rochester General Health System, which dates back to 1847 and highlights more than 400 cumulative years of caring for the health of the Rochester region. The collection, now located at the academy’s 1441 East Ave. campus, was previously housed at the Stromberg-Carlson complex on Humboldt Street. “East Avenue is an appropriate location for the Rochester Medical Museum and Archives — here along museum row,” says Suzanne Welch, Rochester Academy of Medicine executive director. “We are so pleased to serve as the new site of the museum’s exhibits and archival material, and we are grateful to Rochester General Health System for the opportunity to form this partnership.” The Rochester Academy of Medicine has been providing educational opportunities to the local medical community since it was founded in 1900. It moved to its current site, the former home of Carolyn and Edmund Lyon, after the landmark was donated to the academy in 1939. Until the latter stages of the 20th century, the facility served as a resource center that provided members access to a comprehensive
Thomas Hildebrandt elected chairman of Excellus The board of directors for the parent company of Excellus BlueCross BlueShield has elected A. Thomas Hildebrandt of Rochester as its chairman. The board also elected four new members from throughout Upstate New York. The Lifetime Healthcare Companies is a family of companies that provides health insurance coverage to 1.84 million people across 39 counties of New York state, as well as medical care, hospice care and long-term care coverage. The Lifetime Healthcare Companies Hildebrandt had revenue of about $6.9 billion in 2013 and employs 6,000 people in Upstate New York. Hildebrandt is special assistant to the president and CEO of Hillside Family of Agencies and the president of Hillside Children’s Foundation and has been a member of The Lifetime Healthcare Companies board of directors since 2010. “As the largest nonprofit health insurer in the state and a provider of health care services through our affiliated companies, our company focuses primarily on Upstate New
York,” said Christopher Booth, chief executive officer. “It’s important for our board to have strong representation from the communities we serve. Tom Hildebrandt has excellent business acumen and a long record of community involvement in the Rochester area.” Hildebrandt’s community activities include serving as president of The Country Club of Rochester, chairman of the Rochester Philharmonic Orchestra Fund, Inc. and vice president of the Davenport-Hatch Foundation. He has served as chairman of the board for the Genesee Country Museum and the Rochester Philharmonic Orchestra and retired from a distinguished career as a certified public accountant for Deloitte & Touche and Ernst & Young LLP. The board also elected four new members: James Norman, president and CEO of Action for a Better Community Inc., Rochester. Judith Sweet, co-founder and president of Strategic Financial Services, Utica. David Young Jr., business manager for the International Brotherhood of Electrical Workers, Local Union 86, and president of the Rochester Building and Construction Trade Council. David Nasca, president and CEO of Evans Bancorp Inc. and Evans Bank NA of Buffalo.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
collection of medical journals. RMMA assumes 5,000 square feet of space at the site, including gallery space in the academy’s former library. “One thing that is wonderful to me is the number of curatorial opportunities that exist in this house alongside the history of the Rochester Academy of Medicine,” explains Kathleen Briton, RMMA director and curator. “Becoming part of this facility really helps to reinforce our identity as an historical society.” RMMA’s collection consists of archival documents, photographs, costumes, material culture objects, and a series of oral interviews. All items relate to the history of Rochester General Hospital, the former Genesee Hospital, their associated schools of nursing, Newark-Wayne Community Hospital, and close to 20 other organizations whose roots trace back to Rochester General Health System or one of its affiliates. “There is a tremendous amount of history and many great stories related to these institutions, so it’s important this history has a safe place to live and be available to share,” Briton says. “The health care history in this area provides a great lens for looking at Rochester. It really is reflective of who we are as a community.” “When people come to the museum, they will also get to come inside the academy, which in itself is an historic site,” Welch adds. “We’re very happy about that, and I think the Rochester community will be happy too.”
Michael E. McRae assumes role as St. Ann’s Community president and CEO Michael E. McRae, who until recently served as executive vice president and chief operating officer at St. Ann’s Community, became the organization’s president and CEO April 7. He is now the third person to hold the title of CEO in 50 years and succeeds Betty Mullin-DiProsa, who served in that position for 17 years. St. Ann’s Community is one of Rochester’s largest private employers with more than 1,200 employees, Mullin-DiProsa and provides a wide range of services and care levels McRae joined St. Ann’s in 2010 as senior vice president and administrator. He was elected to succeed Mullin-DiProsa after a unanimous vote by the organization’s board of directors in July last year. “Having worked in health care for 27 years, this is an incredible privilege, and I’m honored to step into this role and lead an organization with such an
exceptional history and passion for care and service,” McRae said. “I’m looking forward to continuing the great reputation of St. Ann’s Community, which is founded on the quality of care that we provide, caring for ‘the most important people on earth.’” As the new president and CEO, McRae will look to expand on Mullin-DiProsa’s efforts to lead the $80 million senior living community. “I look forward to joining in the dedication and enthusiasm of our employees, board members and the community,” McRae said. “Together, we can continue carrying forward and building upon the tremendous progress and innovations of St. Ann’s Community, as we continue our legacy of caring for Rochester Seniors.” McRae holds a McRae master’s degree in human services administration from Buffalo State College and a bachelor’s degree in gerontology from University at Buffalo, and is a licensed New York state administrator. McRae is a board member of Visiting Nurse Association and the Sea Gate Alliance.
RGH names president for Clifton Springs Hospital & Clinic and Newark-Wayne Community Hospital Rob Cercek, currently vice president of operations for Rochester General Hospital, has recently become regional president of operations for two hospitals in the Finger Lakes: Newark-Wayne Community Hospital (NWCH), an RGHS affiliate since 1997; and Clifton Springs Hospital & Clinic, when that facility becomes a full RGHS affiliate later this year. Since joining RGHS in 2008, Cercek has led the development of the strategic expansion of services to rural areas outside of greater Rochester. Those responsibilities have included a lead role in the current affiliation processes that will lead to Clifton Springs Hospital & Clinic and Batavia’s United Memorial Medical Center joining RGHS later this year. In his current role, Cercek leads over 2,000 staff members across all service lines. “Rob’s track record of success in managing complex operational change and clinical integration across our system, as well as his team-oriented approach to leadership, makes him uniquely qualified for this vital new executive role,” said Mark C. Clement, president and CEO of RGHS. “Under his leadership, we can effectively transform Newark-Wayne and Clifton
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
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Springs into growing and complementary campuses providing fully integrated health care in the Finger Lakes.” Cercek has more than 20 years of experience in health care administration, including leadership roles with various organizations in Colorado and Ohio. Immediately prior to joining RGHS he was director of operations for Diversified Radiology of Colorado, PC. He is a fellow in the American College of Healthcare Executives, and earned a master’s degree in health care administration from Central Michigan University. As president of Newark-Wayne Community Hospital, Cercek will succeed Mark Klyczek, who has led the hospital since 2011 and guided NWCH to its current position as a regional leader in quality and patient satisfaction. Klyczek is taking on a new system-wide leadership role, with responsibility over the RGHS oncology, pharmacy and respiratory therapy service lines. At Clifton Springs, physician and interim president and CEO Lew Zulick will transition into a senior clinical leadership role.
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HANYS’ survey finds increased need for primary care physicians New York state’s physician shortage continues, with a significant need for primary care physicians, according to a new report by the Healthcare Association of New York State (HANYS), “Doctor Shortage: Outpatient and Primary Care Need Growing.” HANYS’ 2013 physician advocacy survey of hospitals and health systems found a need for 1,026 physicians statewide, excluding New York City, 26 percent of which are primary care physicians. As the Affordable Care Act assigns hospitals and health systems to create healthier communities with an emphasis on preventive care, 63 percent of respondents said their primary care capacity did not meet patient need. Ninety-seven percent indicated primary care sites as part of their systems: 76 percent have off-site extension clinics; 55 percent have off-site hospital-owned ambulatory care practices; and 60 percent have on-site ambulatory care practices. Seventy percent of respondents indicated that recruitment of primary care physicians was very difficult. Looking to non-physician clinicians to fill that void, many members said they were also having difficulty recruiting both nurse practitioners and physician assistants. “As our hospitals and health systems across New York state transition to population health management, they are met with a significant need for primary care doctors to fill these critical roles,” said HANYS President Dennis Whalen. HANYS recommends the following: • Telemedicine reform: HANYS has been successful in changing the requirement for duplicate credentialing of health care professionals, eliminating that burden for many rural hospitals seeking to provide telemedicine services, and will continue to push for insurance companies to cover telemedicine. • Expand the highly successful DANY and Primary Care Services Corps funding. • Develop opportunities for rural and small city residencies, as well as initiatives to encourage students to practice primary care.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Into the Great Wide Open Rochester resident Marty Robinson is one of 18 hikers in the United States being sponsored by the Thru-Hike Syndicate as he attempts to complete the Appalachian Trail By Amy Cavalier
ach year, just about 2,000 people attempt a thru-hike of the nearly 2,200 mile Appalachian Trail. Less than 20 percent make it, said Chris Miller, director of sales for Vasque and founder of the Thru-Hike Syndicate. “It’s tough on multiple elements, from the physicality of the trail to the mental aspect,” he said. “Staying engaged in an endurance event for that period of time, it takes a special person.” Marty Robinson, 33, of Rochester set out on his attempt to complete the journey in late April. Robinson is one of 18 hikers selected from 250 hikers in the United States to be sponsored by the Thru-Hike Syndicate, a partnership between Vasque, which produces hiking boots and trail running shoes, Osprey Packs, NEMO Equipment, Leki, which produces trekking poles, and Darn Tough socks. As a result, he’s received over $2,000 of free gear and additional support from these companies alike “We felt by providing them with the best equipment, we could better their chances of completing the hike and do it in a way that we want them to be as comfy and hopefully successful in their efforts,” said Miller. Growing up in the Watertown area, as a teenager, he spent many days hiking area waterfalls or into the Adirondacks. In high school, nature took a
Marty Robinson, 33, of Rochester, ready for his biggest challenge: hike the 2,200-mile Appalachian Trail.
backseat to sports. After he graduated from General Brown High School in Dexter, N.Y., Robinson said he got back in touch with nature. His desire for knowledge and love of discovery led him to travel, follow live music festivals and to study, mingled with camping/hiking trips in between. “On some of the private properties, we could just roam the grounds, pulling 30-plus miles of walking in a day,” he said. “Backcountry bushwhacking, making your own trail; I’ve walked miles down crystal clear creeks up to my knees and come across owls and hawks sitting 10 feet away, amazing!” In 2007, a little more than a year after graduating from Jefferson Community college, Robinson was diagnosed as having schizoaffective disorder. He spent the next few years working to manage his mental illness with the help of professionals. That’s when the idea came about to try to hike the Appalachian Trail for the first time. In May of 2012, Robinson attempted a partial hike of the Appalachian Trail starting with the state of Massachusetts with a friend. They embarked on their journey on May 1st. It lasted one week. “It was a complete failure,” he said. His hopes of completing the trail were dashed by a late-winter storm which covered the entire east coast to the midwest with two weeks straight of rain. It wasn’t a complete wash though. “As much preparation time as I put into it and as much as I learned from people who had completed it or messed up, it was one small state to learn a whole lot in,” he said.
To support Marty Robinson’s attempt to thru-hike the Appalachian Trail, visit www.gofundme.com/6asaoc. In hindsight, Robinson said, “I was not nearly conditioned enough to be up for the challenge.” Robinson relocated to Rochester in the summer of 2013, ending the year accomplishing something he’d always wanted: visiting New York City. “Being there in the heart of it all, going out on my own and dominating 70 blocks of Manhattan...I did it, enjoyed it and it was a different feeling than a few years back when the schizoaffective symptoms were so debilitating,” he said. “It still exists but I’ve been able to conquer that with a more positive outlook.” He returned from New York City more determined than ever to attempt the Appalachian trail again, joining Monroe County CrossFit to build up his endurance and strength. He casually mentioned the idea of hiking the AT to friend Sam Fitchette, 28, who put the wheels in motion for the sponsorship. Fitchette said he emailed about 50 companies. Of the few that responded, Robinson received word that he h––ad been selected out of 250 applicants to be sponsored by the Thru-Hike Syndicate. Fitchette will be assisting Robinson’s hike, following his travels and providing him with supplies as needed. He has been studying gazetteers to identify forest service roads, seasonal access and logging routes so that he
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • May 2014
can meeting Robinson as close to the trail, allowing him to keep a light load. “I’m there to support Marty in whatever way I can, be it moral support or if he needs me to meet him at a certain spot and hike in to give him a pack so he can switch out,” said Fichette. “Maybe grab him a pizza or hamburger to keep his spirits up.” Miller got the idea for the Thru-Hike Syndicate while attending Trail Days in Damascus, Va., which is the 500 mile marker for AT thru-hikers venturing south to north. “When you get a chance to meet with and interact with hikers, they’re an interesting breed,” he said. “I recognized that these are every bit athletes as much as those racing triathlons or competing in any other endurance event.” The Thru-Hike Syndicate aims to increasing brand visibility on the trail, create a team atmosphere among hikers and a positive energy to support hikers. Most importantly though, said Miller, is helping connect hikers through social media and providing them a platform to share their journeys, challenges and hurdles in hopes of inspiring others to get outdoors. “I definitely recognize that a thru-hike is probably going to just remain a dream for most people, but if we can get people out, even if it’s in their neighborhood park for a small hike, then that’s a mission accomplished for us,” Miller said. “We want to get more people out there to experience how beautiful it is and to see how important that natural resource is for all of us.” According to the Outdoors Industry Association, Americans spend $640 billion annually on gear, travel and services relating to the outdoors. That’s 25 percent larger than the pharmaceutical industry in the United States, said Miller. “With those types of numbers, with that type of economic impact, we know we have the attention of the government and you are seeing more states that are really engaging outdoors tourism as a viable portion of their livelihood,” said Miller. The hope is to broaden the Thru-Hike Syndicate sponsorship program in 2015 to include the Pacific Coast Trail and to include other trails that endurance hikers may be looking to complete. Robinson said the sponsorship has been extremely helpful. It’s caused him to raise his expectations and strive for a speed record. He’s got his sights on Jennifer Pharr Davis’ time, the first woman to hold the overall record – hiking 2,181 miles in 46 days, 11 hours and 27 minutes. Whether he completes his hike in record time or not, Robinson said this could be one of the biggest opportunities of his life.” “To accomplish the speed record, to be an Ambassador and to complete a hike that only 20 percent of the people who try it can do, my mission will be accomplished either way when I complete the thru-hike.”