in good GVhealthnews.com
March 2018 • Issue 151
Ted Barnett, an interventional radiologist known as Dr. Veggie, is a strong proponent of lifestyle medicine and plant-based nutrition
• “I Survived Prostate Cancer” • Reasons to See a Urologist • Men Less Likely to Seek Treatment for Depression • Pain Meds May Affect Sperm Count • Risks and Signs of Testicular Cancer p.14
Cardiac Arrest Patients CPR, not ‘scoop and run,’ should be priority. Buffalo doctor says twice as many survive, thanks to a new protocol
ACUPUNCTURE Find out why so many people are seeking treatment through this ancient Chinese medical practice
Sleepy Drivers May Be Causing More Crashes ThanThought
Rochester’s Healthcare Newspaper
Things You Need to Know About Overmedication
ALSO INSIDE: Number of Men in Nursing Schools Steadily Growing p.11
Taking the Plunge
The Advantages of Aquatic Therapy
Yogurt: Greek vs. Regular Which one is better for you? The answer may surprise you. SmartBites. p. 12
Dog Bites Men are nearly twice as likely to have been bitten as women, according to the study. p 2
Dog Bites More Common for Anxious People Also: Men are nearly twice as likely to have been bitten as women, according to the study
aybe there’s some truth in the long-standing belief that dogs can sense fear in a
human. According to a new British study, anxious people may be at increased risk for dog bites. The finding came from a survey of nearly 700 people in northern England, done by researchers from the University of Liverpool. As part of the study, participants were asked if they were ever bitten by a dog, whether they knew the dog that bit them, and the severity of the bites. They also took a 10-item personality test. The more emotionally stable and less neurotic the participants were, the less likely they were to have been bitten by a dog, the study found. As a person’s emotional stability score increased by a single point, between one and seven, their likelihood of having been bitten fell by 23 percent. “Dog bite prevention schemes may also need to target particular behaviors around dogs by different
victim personality types,” wrote the authors led by Carri Westgarth, from university’s Institute of Infection and Global Health. Overall, one in four participants had been bitten by a dog. Men were nearly twice as likely to have been bitten as women. More than half of the participants — 55 percent — had been bitten by a
dog they didn’t know. Also, people who owned several dogs were three times more likely to have been bitten than those who didn’t own dogs. Dogs’ characteristics — sex, age and breed — were not taken into account. The study only found an association between human personality traits and frequency of dog bites. The study results were published
online in the Journal of Epidemiology and Community Health. “It is essential that previously assumed risk factors are reassessed as this study has revealed that prior beliefs — such as bites typically being from familiar dogs — are contested,” the study authors said in a journal news release.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
March 2018 •
10/24/2017• IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
10:40:29 AM3 Page
Plant-based nutrition course offered
For more information on the events, or to register, visit http://son. rochester.edu/openhouse/.
Rochester Lifestyle Medicine Institute will offer a six-week plantbased nutrition course for the 15th time beginning on Monday, March 5, at the Monroe County Medical Society. The course will take place from 6:15 to 8:30 pm. on six successive Mondays The course, “A Plant-Based Diet: Eating for Happiness and Health,” begins with a review of the history and politics behind our current dietary recommendations and ends with a discussion of scientific “reductionism” and its relevance to the current state of our healthcare system. In between are discussions of the protein myth, supplements and the relationships between lifestyle factors and chronic disease — including heart disease, cancer, and diabetes. All profits will go to the Rochester Lifestyle Medicine Institute. For more information and to register, call 585-484-1254 or email info@RocLifeMed.com.
Prostate cancer support meeting
March 6, 8
March 11 thru June 10
The University of Rochester School of Nursing will host two informational open houses from 5 to 7 p.m. March 6 and 8. The March 6 event will highlight the RN to BS and care management education programs and registered nurse first assistant and legal nurse consultant courses. For a detailed list of UR School of Nursing programs, visit http://son.rochester.edu/academics. The March 8 event will focus on the school’s master’s and doctoral programs, which includes six nurse practitioner specialties (adult-gerontology acute care, adult-gerontology primary care, family, family psychiatric mental health, pediatric, pediatric/neonatal), clinical nurse leader, health care organization management and leadership, nursing education, MS-PhD, PhD, and DNP programs. Both events will be held at Helen Wood Hall, 255 Crittenden Blvd., Rochester.
Bruno Groening and Healing on the Spiritual Path.” This presentation is about a free, natural way of healing as taught by Bruno Groening (19061959). According to a news release, Groening led thousands of people to complete healing from “incurable” conditions. Today, the Bruno Groening Circle of Friends (BGCOF), a worldwide nonprofit organization, has been bringing these teachings to people the world over. Physicians who are members of the Medical Scientific Group (MWF), a part of the BGCOF, document and verify these healings, according to a news release. “A compilation of more than 200 (of thousands) of these healing reports can be found on the website under the link “Healings,” reads the news release. The event will take place always
U of R School of Nursing to host open houses
Us Too Rochester, a regional chapter of Us TOO International, an independent 501(c)(3) nonprofit organization founded by prostate cancer survivors for survivors, will hold a meeting from 7 to 9 p.m., March 8, at Jewish Community Center, 1200 Edgewood Ave, Rochester. The regular monthly support group meetings give men and caregivers, an opportunity to discuss relevant issues faced in the treatment of prostate cancer. UsTOO provides educational seminars and open discussion meetings, where men share concerns, treatments and stories. Spouses and partners are encouraged to attend. No RSVP is required. For more information on Us TOO contact Mark and Peg Richardson, Us TOO chapter leaders @email@example.com
Vegan group to hear from D.C. physician, educator The public is invited to attend the March meeting of the Rochester Area Vegan Society, which will feature physician Milton Mills and health educator Roberta Schiff. Their topic is titled “What the Bible/ Torah Teaches About a Plant-Based Diet and Animal Rights.” Mills is an intensivist (critical care/ICU) physician in the Washington, D.C. area, and is associate director of preventive medicine at Physicians Committee for Responsible Medicine, a nonprofit research and advocacy organization based in Washington, D.C., which promotes a vegan diet, preventive medicine, and alternatives to animal research. Schiff is a health educator and nutrition counselor who coordinates educational outreach activities for the Hudson Valley Vegans. The event will take place starting with a vegan potluck dinner at 5:30 p.m., March 18 at Brighton Town Park Lodge, 777 Westfall Road. The program will start at 7 p.m. For more information, all 585234-8750 or visit rochesterveg.org.
Groening Circle of Friends March 22 sponsors presentations ‘Living with Hearing Loss’ The Rochester Community of the Bruno Groening Circle of Friends presentation at Chapel will sponsor an event titled “An Introduction to the Teachings of Oaks
Thompson Grant Applications Due April 15 All local nonprofit organizations whose programs improve the health and wellness of the community within the service area of UR Medicine Thompson Health are encouraged to apply by April 15 for Mary Clark Thompson Community Health Grants offered by the F.F. Thompson Foundation. Mary Clark Thompson’s spirit of community-minded philanthropy was the motivation behind the creation of the Community Health Grants, which are under new guidelines with applications accept-
at 2:30 p.m. March 11, April 8, May 6 and June 10 at Penfield Library, 1985 Baird Road, Penfield. For information, contact Bob Brown at 585-248-0690 (mrbrown16@ rochester.rr.com), Luc Watelet at 585-737-6848 (lucwatelet@gmail. com) or Nanci DeLeo at 585-703-6695 (firstname.lastname@example.org).
ed annually on April 15 instead of twice a year. These grants enable the foundation to invest directly in projects and organizations benefiting the health of the community. Grants awarded through a competitive application process range from $500 to $2,500. For complete applicant guidelines and to apply, visit www. ThompsonHealth.com/MCTGrants. For more information, call the Foundation at 585-396-6155.
A presentation on living a full life despite hearing loss will take place from 2 to 3:30 p.m., Thursday, March 22 at St. Ann’s Community at Chapel Oaks. “Vibrant Living with Hearing Loss” will help participants: recognize signs of hearing loss, address the issue and its challenges, overcome anxiety and isolation and learn tips, options, and solutions. It will be led by Michelle Gross of the Hearing Loss Association of America, the nation’s foremost advocacy organization for people with hearing loss. The event is free and open to the public. Reserve a space by calling 585-697-6606. St. Ann’s Community at Chapel Oaks is located at 1550 Portland Ave., Irondequoit, directly behind St. Ann’s Home.
Is a cochlear implant a possibility in your future? A representative from Advanced Bionics, a manufacturer of cochlear implant based in California, will headline the April 3 meeting sponsored by Hearing Loss Association of America Rochester Chapter. It will take place at 1:30 p.m., April 3, at the Parish Hall of St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester. Jane Ledingham, Northeast
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
region consumer specialist with Advanced Bionics cochlear implants, will introduce the company’s device and support services. Ledington will present background of Advanced Bionics and its partnership with Phonak; advancements in AB technology; the importance of hearing with two ears; connectivity; rehabilitation resources and support services. Advanced Bionics is one of three cochlear implant manufacturers in the U.S. In 2009 AB joined Phonak as part of the Sonova Group. Cochlear implants are implantable devices which directly stimulate the auditory nerve. When hearing loss becomes too profound for hearing aids to manage, cochlear implants can be an option enabling patients from toddlers to seniors to hear. For more information, visit the company website advancedbionics. com. For any questions about the meeting, email hearinglossrochester. org or contact Janet McKenna at email@example.com.
Free mammogram screenings in Rochester The Cancer Services Program of Monroe County is offering free mammogram screening from 8 a.m. to noon, April 7, at Borg & Ide Imaging at Clinton Crossing, 995 Senator Keating Blvd., building E, suite 100, in Rochester. If you are 40 years or older, have a family history, or have concerns about your risk, you should take advantage of these free screening event. According to the organization, breast cancer is the most common cancer found in women, but mammogram screenings can save lives since they can find breast cancer in the earliest stages when it is most treatable. To schedule a mammogram, call 585-224-3070 or visit www. GetScreenedRochester.org for more information. The event is funded by the New York State Department of Health, Bureau of Cancer Prevention & Control.
Event to benefit pancreatic cancer research To honor the memory of family members and friends who lost their lives to pancreatic cancer, the family of Cheryl Marrese of Rochester is sponsoring Luau for Lustgarten for Pancreatic Cancer Research, an event that will raise funds for the Lustgarten Foundation, a nonprofit organization that helps find a cure for pancreatic cancer. The event, which includes dinner, music, prizes, auctions and raffles, will take place from 5 to 11 p.m., April 21, at St. John Fisher’s Ralph Wilson Athletic Center, 3690 East Ave., Rochester. According to the Marrese family, the Lustgarten Foundation was chosen because 100 percent of the money it gets goes to fund research. The family has raised $116,000 during the eight years it has sponsored the event. Tickets for the event cost $45 per person and must be purchased by April 11 by calling 585-225-3088 or going to www.lustgarten.org/luau2018.
Specializing in consistent, effective, one-on-one care. Founded in 1982, we are now one of the largest private physical therapy practices in the Greater Rochester area.
Sleepy Drivers May Be Causing More Crashes Than Thought Accidents involving sleepy drivers about eight times higher than current federal estimates
river fatigue causes many more car accidents in the United States than previously estimated, a new report suggests. The finding comes from an analysis of several months’ worth of video recordings taken of nearly 3,600 Americans while they were driving. During that time, participating drivers were involved in 700 accidents. All participants’ vehicles had been outfitted with a dash-cam video recorder. That allowed researchers to analyze each driver’s face in the minutes right before crashing. The researchers also had video of the road scene in front of the drivers. Together, the footage suggested that the percentage of accidents involving sleepy drivers was about eight times higher than current federal estimates. The finding was highlighted in a report released recently by the AAA Foundation for Traffic Safety. The foundation describes the investigation into drowsy driving as the most in-depth of its kind to date. “Driver drowsiness is a notoriously difficult problem to quantify because it typically doesn’t leave behind evidence that a police officer can observe after the fact when investigating a crash — in contrast to alcohol, for example,” said Brian Tefft, a senior research associate with the foundation in Washington, D.C. “Thus, we expected that our study would find that the problem was substantially bigger than the official statistics from the U.S. DOT [Department of Transportation] suggest,” he said. “But we were still surprised by just how many crashes
we found to involve driver drowsiness in our study.” The study found that “approximately 10 percent of all motor vehicle crashes involve driver drowsiness,” Tefft said. The U.S. Centers for Disease Control and Prevention estimates that about one-third of American drivers aren’t getting the minimum seven hours of daily sleep that experts recommend. A recent AAA survey found that nearly three in 10 drivers said that in the past month they’d been so exhausted while driving that they weren’t able to keep their eyes open at some point. To identify driver fatigue during car crashes, the researchers examined video taken during the one-to-three minute period preceding each accident. They then tallied the amount of time each driver’s eyes were closed in that timeframe. Drivers were deemed to have been “drowsy” if their eyes stayed closed for more than 12 percent of the time. The study team concluded that current federal estimates — which link 1 to 2 percent of all car crashes to driver fatigue woefully underestimate the dimension of the drivingwhile-tired problem. “Our previous research has shown that a driver’s risk of crashing increases significantly when they don’t get at least seven hours of sleep, and climbs to levels similar to the crash risk of a drunk driver after missing more than two to three hours of sleep over a 24-hour period,” Tefft said.
Serving Monroe and Ontario Counties in good A monthly newspaper published
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In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Kyra Mancine, Marcia Spoto (PT), Christine Green, Mike Costanza, Ernst Lamothe Jr., Kim Petrone (MD) • Advertising: Anne Westcott, Denise Ruf • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
March 2018 •
MORE THAN PHYSICAL THERAPY COMMON
CONDITIONS TREATED Post-surgical rehabilitation Fibromyalgia Low back pain Osteo-arthritis Sport injuries Sprains & Strains
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By Chris Motola
Ted D. Barnett, M.D. Interventional radiologist — known as Dr. Veggie — a strong proponent of lifestyle medicine and plant-based nutrition Q: How did you get the nickname Dr. Veggie? A: Many years back, when everything was dial-up modems and AOL, I had to pick a screen name, and I went with Dr. Veggie. Then every time something new came along, I grabbed the name. So I’m Dr. Veggie on Twitter, although I’ve never really used it. It kind of became my thing.
You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org
Q: How long have you been on a vegan diet? A: When we made the change back in 1991, I was chief of radiology at Thompson Hospital in Canandaigua. I think “vegan” has an interesting connotation and can kind of scare people away. Perhaps it’s just the history of it, but it’s kind of the “v-word.” We kind of made the change as a family after we read Dean Ornish’s book on reversing heart disease. He’s kind of a pioneer in this field. He was the first person who not only demonstrated that you could use diet and lifestyle to reverse heart disease, but that you could reverse heart disease at all. Q: I’m not sure it’s conventional wisdom even now. A: When I was in medical school, I had this image in my head of plaques being made of concrete, that they weren’t going anywhere. But in fact that’s not true. Plaques can improve and some can even go away completely. Drug companies will tell you they can do that with medications, but it turns out you can do that with lifestyle changes. Diet is the most important thing, but also physical activity, getting enough sleep. It’s returning the locus of control back to the patient. We’re looking at giving patients the tools.
Q: I’ve heard differing descriptions of what plaque is over the years. How would you describe it? A: Think of it as inflammation. Young plaques are kind of like pimples under the wall of the artery. Basically it’s the body reacting to an inflammatory process. We think we know what the cause is — processed foods, diets high in animal products — but honestly it’s not that important. What we can do is look around the world at blue zones, these are regions with high life expectancies, and what their common denominators are. They all have diets that are very high in plant matter, especially lots of greens. They also tend to have great social support and get a lot of physical activity, not necessarily from working out, but just generally active. Lots of walking and hills. Low stress life. Q: You’re recommending a diet based off Caldwell Esselstyn’s work. What does that look like? A: Esselstyn spring-boarded off the work of Dr. Ornish. He’s a doctor with the Cleveland Clinic. He’s been getting rapid results through diet changes. The Esselstyn diet is basically unprocessed food, no oil, no high-fat plant foods. No nuts, no avocados, no coconut. We don’t necessarily recommend that last part about high-fat plants, we recommend that you do have some nuts in your diet. We still don’t recommend oil, though. So, no olive oil, no canola oil. They’re not as bad for you as other oils, but there’s no evidence that they’re helpful, and they may be harmful. Q: When you say quick results through diet, how quickly are we talking? A: Doug Schmidt, one of our facilitators, put together a whole food plantbased jumpstart for schools in the Finger Lakes and 1,300 teachers and administrators signed up for this. It started January 8th and went on for 10 days. And it had amazing
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
results. We had people whose cholesterol and blood sugars drop tremendously. All these things we think of as chronic illnesses can actually clear pretty quickly once people just stop abusing their bodies. It’s very hopeful. We have over 400 million Type 2 diabetics in the world. It’s a huge problem in China and India as well. Q: Is that a new development? A: Over the last couple decades as the Western industrialized diet has spread around the world. So it disputes the idea that Americans are somehow genetically predisposed toward diabetes. For kids born after 2000, we’re predicting one-in-three will end up diabetic. Q: Given that we’re honing in on diet as the cause, why are the rates of diabetes and other diseases still increasing rather than plateauing? Is our diet still getting worse? A: That’s a great question. I think there’s more junk and empty calories available and in larger packages. Chips, soda, cookies, pizza. And inactivity. The soda companies will tell you it’s just inactivity because they want to sell more soda. Activity is good, but the big change is how much junk they’re getting. But kids are getting less activity now than they used to. Our electronic devices are seductive, but are they actually making us happier? Q: How do you think this approach compares to medication? A: I see a lot of optimism. Not to be a downer, but people who get a diabetes diagnosis are often looking at a long, dark tunnel. They’re told it’s a chronic disease, it’s never going to go away. First they want you to try diet, which won’t be effective very long, then oral medication, which won’t work forever, then insulin. It’s the leading cause of renal failure, blindness, amputation, peripheral neuropathy — you’re predicted to have a lifetime of misery. But we have an exit door, and that’s a whole food, plant-based diet and exercise. These things don’t have to be inevitable. Do you know how much of our health care dollars are spent on chronic illnesses related to lifestyle? Q: The majority, I believe. A: Yeah. It turns out to be around 85 percent. Look, I love procedures. That’s how I make my living. It’s very satisfying; we get very fast results. And sometimes it’s the best treatment, but most of the time people on my table got there through lifestyle choices they don’t realize are as harmful as they are.
Name: Ted D. Barnett, M.D. Position: Attending diagnostic and interventional radiologist, Unity Hospital; partner at Borg & Ide Imaging, P.C.; co-coordinator Rochester Area Vegan Society, Rochester; CEO and Medical Director of Lifestyle Medicine Hometown: Westport, Conn. Education: Yale University; Tufts School of Medicine Affiliations: Unity Hospital; Rochester Lifestyle Medicine Organizations: American College of Lifestyle Medicine, Society of Interventional Radiology, American College of Radiology Family: Wife, two daughters, one son Hobbies: Bird watching, photography
CPR, Not ‘Scoop and Run,’ Should be Priority with Cardiac Arrest Patients Buffalo doctor says twice as many survive, thanks to a new protocol
change in protocol for treating out-of-hospital cardiac arrest patients in Western New York has yielded striking results: twice as many patients now survive. The change was implemented by physicians from the department of emergency medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo who serve as medical directors at American Medical Response (AMR), which provides ambulance service to the city of Buffalo and surrounding communities. “When a patient collapses from cardiac arrest in the community, the chance they will survive is low to begin with,” said physician Brian Clemency, associate professor of emergency medicine in the Jacobs School, medical director at AMR and a physician with UBMD Emergency Medicine. “But their chances get even worse if emergency medical services (EMS) providers automatically try to take the patient to the hospital, rather than maximizing their care on scene.” Instead of immediately transporting the patient to the hospital, often at high speeds in an ambulance, a procedure known as “scoop and run,” the physicians found that patients are more likely to survive when first responders stay on the scene to focus on high-quality cardiac pulmonary resuscitation (CPR) and defibrillation. With this change, first implemented in April, the UB physicians have seen the number of patients who eventually were discharged from the hospital with favorable neurologic function increase from 1.3 per month to 3 per month. AMR has tracked this progress through a national database that links ambulance care with outcomes from local hospitals. Eric Dievendorf, clinical manager at AMR, said, “We
are thrilled with the results of our new program. Measurable gains like these inspire caregiver buy-in, which will continue to drive favorable patient outcomes.” He and his colleagues are now working with local EMS providers to promote treating cardiac arrest in the field instead of rushing patients to the hospital, where they are often pronounced dead. He also intends to launch a public information campaign that promotes CPR training among bystanders. “Taking the patient to the hospital right away robs precious time when that patient could have been getting CPR,” Clemency said. “The message we’ve learned for EMTs is: ‘Stay on the scene. Wherever we find you is where we’ll work on you.’”
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record your stride. The water level is kept below the shoulder level of the shortest person, so you won’t even get your hair wet. There is also a TV at eye level to watch. “There are a variety of ailments that draw people to participate in pool programs,” said Barb Cacia, wellness coordinator at Pieters Life Center. “They range from pre-and post-surgery replacements to chronic pain of all sorts. This type of exercise is very beneficial for people who want to reduce the limitations aging has on the body.” Cacia said that “for those with injuries or pain, the warm water relaxes muscles and improves range of motion, opening the joint and preventing more arthritic bone formation. At the same time, the muscles are working against the resistance of the water; therefore, strength will improve.” In contrast, non-water therapy and workouts can prove too strenuous and discourage patients from continuing the treatment, she said. “The warmth of the water is so comforting,” Cacia said. “It reduces stress and, in turn, people are more likely to return to the exercise program. Once the participants meet others whose goals are similar, friendships develop, and now you have a total wellness program!”
quatic therapy can help rehabilitate, relieve pain and improve mobility, strength and coordination for a variety of conditions. The buoyancy of the water, combined with soothing, warmer water temperatures and gentle, low impact exercises (done with or without equipment), makes it one part of an overall treatment plan for individuals with orthopedic issues or other injuries. You don’t even need to know how to swim to participate.
The treatment Most sessions include resistant exercises done in a therapeutic pool heated to 85 degrees Fahrenheit or above. Some pools have lifts, so the patient won’t have to walk down steps to enter or exit the pool. In select locations, an underwater treadmill is available. During the course of the session, which can range from 30 to 60 minutes, individuals complete a variety of movements intended to improve balance, strength, range of motion, endurance and coordination. Because of the resistance of the water, you can get a better workout in a shorter period of time, without the risk of injury. All you need prior to your session is a swimsuit and, in some cases, goggles or water shoes. “We see people for aquatic therapy to treat any number of conditions, including low back pain or pain in the ankle, knee or hips,” said Gregory VanGorden, assistant clinic coordinator at Brockport’s Agapé Physical Therapy. “We also offer fitness packages in which clients can come do individual aquatic exercises and water walking.” Van Gorden said aquatic therapy is great for reducing stress on the joints and allowing individuals with arthritis, obesity or lower extremity conditions to exercise. Agape’s rehabilitation pool has enough space for three people and also includes an underwater treadmill. Two of its other locations offer underwater treadmills with a one-person private exercise chamber — the Hydro Track in Gates and the AquaFit in Webster.
How to get started In most cases, individuals are referred by their doctor for these programs and evaluated by a licensed therapist who customizes a treatment plan. This plan can also include land-based exercises. Typical-
Getting in a water workout in the HydroWorx pool at The Pieters Life Center in Henrietta. Aquatic therapy offers a number of advantages for patients with orthopedics issues or other injuries.
Water Wellness: The Advantages of Aquatic Therapy By Kyra Mancine ly, the physical therapist will screen potential candidates and recommend a course of therapy appropriate for their needs. Insurance often covers the therapy, but always check with your provider before you begin any course of treatment.
A pool with a treadmill floor The Pieters Life Center in Henrietta is another option for aquatic
therapy. It offers a state-of-the art HydroWorx 2000 pool for aqua therapy. The pool is not meant for swimming laps — it’s too small for that. You don’t even have to climb into the pool — it rises up and lowers down with you. The treadmill floor moves up to 8.5 mph, and there’s a bar that lowers down in front of you for stability. They can also turn on the jets to create greater resistance. Three underwater cameras
Where It’s Available There are several places in the region that offer aquatic therapy, including the following businesses Agapé Physical Therapy 92 W. Avenue, Brockport 880 Elmgrove Road, suite 2, Rochester 1075 Ridge Road, Webster • Metro Center YMCA (program via Strong Health) 444 E. Main St., Rochester • Physical Therapy at Ridgeway 2655 Ridgeway Ave., auite 320, Rochester Pieters Family Life Center (Heritage Christian Services) 1025 Commons Way, Rochester Star Physical Therapy 790 Ayrault Road, Fairport Summit Physical & Occupational Therapy Center 99 MedTech Drive, suite 104, Batavia University Orthopedic Associates 2064 Fairport Nine Mile Point Road, Penfield
Why You Should Consider Aquatic Therapy By Marcia Spoto, PT
quatic therapy can be simply described as a treatment approach that utilizes the special properties of water to enhance the health benefits of a treatment program. A licensed physical therapist or physical therapist assistant directs aquatic physical therapy sessions. People who have musculoskeletal pain must work to restore their movement function. For many, landbased exercise can be difficult. The water environment, which allows the body to be more buoyant, makes it much easier and more comfortable to exercise because it decreases the effects of gravity. If you add a heated pool environment, movement is even Page 8
easier. Therapeutic pools are generally kept at between 92° and 96° F. At this temperature, circulation is improved and aching joints and muscles are more relaxed. Another benefit of water is that it provides resistance to muscles when they contract against it. This allows the muscles to strengthen throughout their range of movement, while removing the stress of full weight bearing. Water also provides stability to improve balance and prevent or assist with fear of falling. Aquatic therapy can be very helpful to a variety of conditions, including joint pain, any form of arthritis such as osteoarthritis and
rheumatoid arthritis, back pain, fibromyalgia, orthopedic injuries such as sprains and strains, following joint replacement, general deconditioning, and chronic stroke. Aquatic physical therapy entails the provision of one-on-one treatment to better monitor and provide feedback on prescribed exercises designed to speed healing and return patients to their normal function. In some cases, aquatic therapy is used in conjunction with land-based therapy. Specific goals of treatment are improving flexibility, increasing muscle strength and endurance, enhancing aerobic capacity, promoting coordination and balance, and assisting
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
gait. This form of therapy can make a tremendous difference in the road to recovery for many patients. Marcia Spoto is a physical therapist and certified as orthopedic specialist by the American Board of Physical Therapy Specialties. She teaches at Nazareth College in Rochester and is the owner of STAR Physical Therapy in Fairport. Visit www.starphysicaltherapy.com.
Brain Training to Promote Health FamilyDementia Dementia Caregivers Brain Training totoPromote Health in Family Dementia Caregivers Caregivers Brain Training Promote Health in in Family
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Healthcare in a Minute By George W. Chapman
Buffet, Bezos to Get Into the Health Insurance Business
arren Buffett, CEO and chairman of Berkshire Hathaway, has long purported that U.S. healthcare costs are the underlying reason why U.S.-based firms find it difficult to compete globally. Businesses in other countries spend less than half on healthcare as their U.S. competitors. Buffett is teaming up with Jeff Bezos, CEO of Amazon, and Jamie Dimon, CEO of JP Morgan Chase, to develop a system of care for their combined 1 million employees that is “free from profit-making incentives.” The headquarters and management team are to be announced. The mere threat of this alliance caused healthcare stocks (United Healthcare, Anthem, Aetna, Humana, etc.) to drop. Industry observers have noted, however, that there already is a nonprofit system in place. It’s called Medicare.
Federal Budget Passed On Feb. 9, Congress finally passed, and the president signed into law, a two-year $400 billion budget. Among the healthcare related items are: $6 billion to fight the opioid epidemic and treat mental illness; $2 billion for National Institute of Health research; $90 billion for disaster relief; accelerates the closing of the infamous “doughnut dole” in Medicare Part D (drug) coverage; delays funding cuts to disproportionate share (more Medicaid and indigent care than average) hospitals; continues funding of the National Health Service Corps; expands the VA Choice program which allows vets to seek care from the private sector; repeals the Independent Payment Advisory Board which used to make seemingly arbitrary budget cuts to Medicare; continued community health center funding. Uninsured Rate Up It should come as no surprise that the number of uninsured Americans increased, by an estimated 3.2 million people, to 12.2 percent of the US population in 2017. That’s up from the record low of 10.9 percent
in 2016. However, 12.1 percent is far better than the 18 percent uninsured rate before the ACA went into effect. The individual mandate repeal takes effect in 2019. The CBO estimates that repeal will cause 13 million people to drop health insurance over the next decade. Cost of US Healthcare It’s well established that we spend almost twice as much on healthcare, $10,000 per capita, as any other industrialized nation. In 2016, we spent $3.3 trillion, which was 18 percent of our GDP. Interestingly, several studies have shown we actually use about the same amount of healthcare as other countries. The major cost culprit is price. We simply pay a lot more for care than most countries. Neither population growth nor aging can account for the fact that we pay far more. A study by the Institute for Health Metrics and Evaluation in Seattle, published in the Journal of the American Medical Association (JAMA), found that 63 percent of the increase in spending from 1996 to 2013 was due to the combination of more being done for patients during office visits/hospital stays and inflated prices. U.S. hospiMarch 2018 •
tal prices are 60 percent higher than those in Europe. Another report, from the Healthcare Cost Institute, found that spending per person reached an all-time high in 2016 in employer-sponsored plans despite lower utilization. According to the report, increasing prices were the major factor in rising costs. Between 2012 and 2016 drug prices increased 25 percent and hospital prices increased 24 percent. Aetna/CVS The much ballyhooed, potentially game changing merger of the insurance and pharmacy giants, is facing another hurdle. Aetna shareholders filed a class action complaint alleging that a document filed with the SEC contains incomplete and misleading information to win over Aetna shareholders. The Aetna shareholders believe the price offered by CVS is unfair and inadequate. Opioid Crisis A large bipartisan group from the House of Representatives has made fighting the crisis a top priority. They are focused on getting a package of eight new bills passed and signed by Trump. Among the eight bills are: directing funds for substance abuse centers to rural areas; requiring states with federal health grants to track written scripts and what pharmacists dispense; forcing all Medicare Part D scripts to be electronically transmitted to curb pharmacy shopping; and stopping illegal trafficking of opioids. In his state of the union address, Trump noted that 174 people a day die from an opioid overdose and that he is committed to fighting the epidemic. To date, there has been little funding to fight the battle. Killer Air Pollution was responsible for over six million global deaths in 2016. That is 12 percent of all global deaths that year. While not officially listed
as the “cause of death,” pollution is strongly linked to lung cancer and emphysema, according to the Institute for Health Metrics and Evaluation. Two thirds of the six million deaths are due to outdoor or ambient pollution, which is caused by vehicles, coal fired plants and steel mills. Deaths per 100,000 due to ambient pollution are highest in central Africa, India, China and Pakistan. Team-Approach to Care A physician can no longer do it alone. Several factors, including the pending physician shortage, uncertainly in Washington, increased regulations and moving target reimbursement methodologies, have made it all but impossible for physicians to effectively keep up. According to research by the AMA itself, consumers prefer coordinated healthcare that is delivered by a physician-led team. The key is the physician is responsible for providing a safe and effective way of delivering and managing your care. Well-trained staff should be able to handle several of the chores traditionally handled by the physician including: data gathering and recording taking vitals and history information, and patient education. The team approach allows each member to perform at the maximum level of their training, be they medical assistant, LPN, RN, care coordinator, PA or NP. Many visits may not even require a physician. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at email@example.com.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Making New Friends: It’s Never Too Late
uestion from a reader: I’ve been divorced for about a year now, and struggle with loneliness. I miss the friends we shared as a couple, but I’m just not comfortable socializing with couples anymore. I’m 56, and it feels awkward to try to make friends at my age. Any advice for me? Answer from Gwenn: It’s unfortunate, but what you are experiencing often happens in the aftermath of a separation or divorce, especially if it was acrimonious. Friends’ loyalties can be split and, just as you feel uncomfortable relating to your former “couple” friends, some couples feel uncomfortable relating to a now-single friend. So how do you meet new people and cultivate friendships as an adult? Here are a few tips: n First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll attract. Positive people appreciate and gravitate to other healthy,
positive people. n Do what you enjoy doing. You won’t make friends sitting alone at home. Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, taking a cooking class, joining a book club, or any number of activities that are fun and interesting. You’ll meet people who enjoy similar pursuits. Friendships can follow. n Consider a support group. It’s not uncommon for new friendships to be born out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.” n Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood meetings, work events, etc. is one of the
easiest ways to make new friends. You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending an invitation to someone you meet. It could be a cup of coffee, quick bite to eat or a short walk. n Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone. Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own. n Rekindle relationships with old friends. Sometimes the friendships you made when you were single drift away after you get married. That’s not unusual. New priorities take over and focusing on married life requires time and attention. But now, when you’re looking to find new friendships, consider reconnecting with old friends. They were an important part of your life at one point, and may still have lots to offer. Pick up the phone. n Give a “singles” event a try. Many divorced or widowed men and women find fun and friendship in community activities organized just for singles. It could be a hike, bike ride, dinner club or dance. These opportunities can be found online in community calendars or in your local newspaper. n Volunteer or join a cause. Supporting an organization or cause you believe in will put you in conProudlyWelcomes tact with people working toward a common goal. Community gardens, ProudlyWelcomes
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political parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place. n Join an online community of people who share your interests. Social networking sites can be a safe and satisfying way to meet people. One popular site is www.meetup.com, which helps people meet others nearby who share their interests. Meetup allows members to find and join groups unified by a common interest, such as nature, photography, hiking, books, movies, health, pets, careers, hobbies, you name it! Good friendships can make life better. The company of someone who makes you laugh, who provides a shoulder to lean on, and who is just plain fun to hang out with can provide a welcome boost to your health and happiness. So, if you feel your social network is too small, remember you can always meet interesting people, make new friends, and nurture existing ones. It’s never too late.
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Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon, N.Y. For information about her workshops, book, or to invite Gwenn to speak, call 585-624-7887, email firstname.lastname@example.org, or visit www.aloneandcontent.com.
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Number of Men in Nursing Schools in Rochester Steadily Growing A profession once dominated by females is gradually getting more diverse, despite a lingering gender bias among patients and health care administrators By Deborah Jeanne Sergeant
icture a nurse. Did an image of a kindly-faced woman in white or scrubs come to mind? Decades-long female dominance in nursing has contributed to the gender stereotype of women nurses. While women still outnumber men in nursing, more men have joined the ranks at schools such as University of Rochester Medical Center School of Nursing where in 2013 only 12 percent of the students were male compare to 18 percent in 2017. The faculty also reflects those statistics — it increased from 15.4 percent males to 18.5 percent over the same time period. David Goede, doctorate nurse practitioner and lead APP (advanced practice provider) manager for cardiovascular service line at URMC, remembered that back in 1985 when he earned his associate’s degree in nursing, men represented only 2 percent of nurses. “I had often encountered the question as why I chose nursing as a career,” he said. “As I contemplated this question, the next question that was usually asked is, ‘Are you working on becoming a doctor?’ I have always had difficulty trying to understand the basis of these questions. Do we ever ask female physicians why they chose to be a physician and not a nurse? To me, these comments exemplify bias of career choices based on gender.” Goede also serves as acute care nurse practitioner, cardiac surgical service at Strong Memorial Hospital; assistant professor of clinical nursing at University of Rochester School of Nursing; and regional director Region 2, Nurse Practitioner Association of New York State. He said that men in nursing is not new. Males cared for individuals’ health care needs throughout history. During the 1300s, most care provided by non-family members were provided by male monks through monasteries, he said. And during the Crimean War, men worked within the hospital setting alongside women providing direct care, until they were called into battle. Goede believes that the origins of female dominance in nursing stems from how nurses initially received their education. Once formal education became standard for nurses, they were trained at schools with dormitories. Since men weren’t allowed to stay in the dormitories, they faced difficulties in entering nursing school. “It wasn’t until the education of nurses moved from strictly controlled dormitory-style education into an academic setting that allowed male students to
attend,” Goede said. Mary Maher serves as associate professor and department of nursing chairwoman, coordinator of Nursing Global Studies and director of the public health program in nursing at Nazareth College. She sees many opportunities for men in nursing. “In an economy where we’re seeing a large shift in the workforce, where we have a growth spurt in health care, it’s an issue of job security,” she said. She said that it’s also a respected career with a high degree of satisfaction. David “Grant” Hewitt, nurse practitioner and instructor of nursing at Monroe Community College, said that in 2008 at MCC 5.7 percent of fall nursing students were men. In 2017, the percentage climbed to 26 percent. Hewitt said that men can leverage their usually greater strength for the tasks nurses face, such as moving patients. “Men also tend to go into high stress nursing situations, like the ICU or the ER,” Hewitt said. “Maybe it’s adrenaline; they like it.” Like women, men also have opportunities to seek further education to obtain supervisory roles, work in education or, in the case of nurse
March 2018 •
practitioners with more than 3,600 hours of clinical experience, practice without a collaborative agreement with a physician. Hewitt said that men get hired for management roles in nursing “much faster” than women. They also receive better pay, on average. He said that it’s not uncommon for patients to call male nurses “doctor” because they feel sure that nurses are female. Or to insist that they do not want a male nurse helping them. Sometimes, Hewitt kindly asks if they would feel the same way about a male doctor. Hewitt said that despite lingering gender bias among patients and health care facility administration, he wants more high schools to promote nursing as a good career option for all students. “This is a great job,” he said. “Nursing isn’t female anymore. You’ll always have a job, so there’s great job security. I think that’s part of the reason it’s changing.”
David Goede, a nurse practitioner at URMC, remembers when he earned his associate’s degree in nursing in 1985, men represented only 2 percent of student nurses. The percentage now is 18 percent.
Head Injuries Hit 1 in 14 Kids, CDC Reports
iven the news of the devastating effects of head injuries among professional football players, parents may wonder if their mini athletes are at risk, too. Some very well might be, new research suggests. About 7 percent of children 3 to 17 years old have experienced a head injury, according to U.S. health officials. The findings are part of a report on children’s head injuries released Feb. 9 by the U.S. Centers for Disease Control and Prevention. More boys (8 percent) than girls (6 percent) have had a significant head injury, according to the data. And the older kids are, the more likely they are to have had such an injury. Nearly 12 percent of 15- to 17-year-olds have had a significant head injury, the report showed. This “suggests that as more children and teens engage in sports and other activities, the risk for a head injury also goes up,” said Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City. The good news, he said, is that most children with a concussion improve within two weeks. It’s not yet known if there are long-term effects from these injuries. The CDC report included data from a nationally representative survey completed in 2016. Parents were asked if their children had ever had a concussion or other significant head injury. One new cause of head injuries and one that’s largely preventable is a fall caused by distracted walking. “Kids just aren’t paying attention to what’s in front of them,” Glatter said. “They’re looking at their phones and walking into light poles, windows and doorways.” The CDC report found that white children and kids with parents who have more than a high school education are the most likely to sustain a head injury. Klamar said that’s probably because those kids have more access to sports.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
The skinny on healthy eating
The Lowdown on Nutrient-Rich Yogurt
Is Greek yogurt better than the regular one?
s Greek yogurt better for you than regular yogurt? Based on all the press it’s received lately, along with its takeover of the dairy aisle, you might automatically think “yes.” I know I did. While indeed Greek yogurt has certain benefits that surpass those of regular yogurt, its nutritional profile is not necessarily better. It all depends on your dietary needs. Since one of my dietary needs is protein, Greek yogurt is better for me. On average, Greek yogurt contains nearly twice as much protein as regular yogurt. One cup of FAGE nonfat Greek yogurt, in fact, provides a whopping 22 grams. Why is the 60-plus me (who is no longer in a growth spurt or running three miles a day) concerned about getting enough protein? According to research, boosting your protein intake or at least getting an adequate supply helps combat the natural loss of muscle mass and strength that occurs with aging. Greek yogurt, however, is not necessarily better than regular yogurt for my friend who suffers from osteoporosis and seeks calcium. The
cially helpful for those who have lactose intolerance. And fewer carbs and sugar hold huge appeal for those looking to lose or maintain weight. Both Greek and regular yogurts boast the Holy Grail of stomach health: probiotics, aka the “good” bacteria that promote a healthy gut and boost immune health. Eating yogurt with probiotics helps improve digestion and potentially ease conditions like constipation, inflammatory bowel disease and diarrhea. Doctors often suggest eating yogurt while taking antibiotics (which can
Avocado Hummus with Yogurt Adapted from FAGE recipes
straining process that creates Greek yogurt — and gives it its thicker, richer texture — unfortunately removes some calcium. On average, regular yogurt provides 30 percent to 40 percent of the daily recommendation, compared to Greek’s 20 percent to 25 percent. Concerned about carbs and sugar? Lactose? If so, Greek yogurt might be the better choice for you, since the straining process to remove whey reduces all three. Less lactose, the sugar in dairy products that can sometimes upset stomachs, is espe-
2 garlic cloves ½ jalapeno (optional), seeded 2-3 tablespoons fresh cilantro (or 2 teaspoons dried) 15.5 oz. can chickpeas, drained and rinsed 2 avocados, peeled and cubed ½ cup plain, low-fat yogurt: Greek or regular 2 limes, juiced Salt and coarse ground pepper, to taste ½ teaspoon cumin 3 tablespoons extra virgin olive oil Place garlic, jalapeno and cilantro in food processor; pulse to mince. Add chickpeas and pulse for about 2 minutes. Add remaining ingredients and blend until smooth. Serve with toast, tortilla or pita chips, or cut-up veggies.
cause “bad” bacteria to flourish) to help reduce the side affects of this treatment. Both yogurts are rich in vitamin B-12, an essential nutrient for nerve and brain function and for forming red bloods cells and DNA. This all-important vitamin also helps prevent a type of anemia that makes people tired and weak. One cup of plain, nonfat yogurt provides about half of our daily needs. What’s more, the B-12 in dairy products, such as yogurt, tends to be more readily absorbed by the body.
Helpful Tips Read yogurt nutrition labels carefully (some have more sugar than you may expect) and look for the words “contains active cultures” to assure the brand you choose has probiotics in it. Use caution when cooking with yogurt, since prolonged high temperatures can kill the beneficial bacteria. Fruit-flavored yogurts tend to be higher in sugar, so opt for plain yogurt and add your own fruit
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at email@example.com.
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Meet Your Provider Ashton Place Senior Living ‘We want our residents to feel independent and to help them enrich their lives during their golden years.’
shton Place is a family-owned and operated senior living community located in Clifton Springs. We have proudly served the community and the surrounding area since 1998. Our friendly staff provides a variety of services for every stage of retirement, allowing our residents to age in place. We offer a range of programs, including an option for seniors who simply want to avoid the common hassles of home ownership, all the way up to our assistive program with more supportive services for daily living, such as medication management. All of our rentals include meal options, housekeeping services, all utilities (including cable and Wi-Fi), personal emergency response pendants, and more. What is aging in place? At Ashton Place, aging in place
means that as your needs change, we change with you. As our residents increase their services, they do not move to another apartment, wing or area of the building. Our residents can simply increase their services, as needed, from the comfort of their apartment. This is very important to us and the resident, as it allows them to truly settle into their apartment home. What kinds of activities do you offer? We pride ourselves on our diverse and exciting programs and activities that create an active, energetic environment. Our most popular activities include exercise classes daily, volleyball weekly, ecumenical and communion services, Betty Crocker baking hour, weekly bingo, and our shopping trips — twice a week. Our residents have a variety of interests and our activities depart-
More than 50 years of experience in senior living: members of the Christiano family, who own and operate Ashton Place Senior Living. From left are wife Debbie, marketing; Dennis, owne; and son Kevin, executive director. ment ensures there is something for everyone. What sets Ashton Place apart from other senior living communities? What sets us apart from other communities is our skilled, dedicated staff and ownership. Our owners, the Christiano family, have over 50 years of experience in senior living. Owner, Dennis Christiano, began working
for his father’s senior living community as a young boy and has passed the tradition on to his son, Kevin, our executive director. The family commitment does not stop there. Dennis’ wife, Debbie, also works on property in the marketing department. The sense of family spills over into every aspect of living at Ashton Place and we feel it is something you notice the moment you walk through our doors.
Ashton Place 190 Ashton Court, Clifton Springs, NY 14432
Web: www.ashtonplaceny.com • Phone: 315-462-3140 • Email: firstname.lastname@example.org March 2018 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
‘I Survived Prostate Cancer’ A survivor’s story By Deborah Jeanne Sergeant
ark Richardson of Pittsford is a veteran, RIT grad and Kodak retiree. He’s also a prostate cancer survivor. The month he retired, August 2015, he received the diagnosis of prostate cancer after a biopsy. The pathology of the prostate indicated that he had stage three cancer, with stage four being the worst. He and his wife Peggy talked over their options. “I have a very supportive wife that stood by my side and helped me make important decisions about my treatment,” Richardson said. His wife had already been researching prostate cancer, as she had suspected something was wrong. Within an hour of diagnosis, while still at the office, the couple decided to go with prostatectomy — surgical removal of the prostate. With slower growing prostate cancer, some men can take a waitand-see approach with periodic testing of the prostate specific antigen (PSA) in the blood to keep tabs on whether or not the cancer was growing and spreading. “Most urologists just give risks and benefits of treatments and they said, ‘Here’s a book, take it home and read it, and come back in two weeks,’” Richardson recalled. “We looked at each other and we didn’t have to think about treatments. We made the decision for surgery for removal.” During the laparoscopy surgery
six weeks later, Richardson experienced less bleeding than typical prostatectomy, but he did run into a small snag. He had volunteered to join a study looking at the outcomes of prostatectomy patients who don’t receive antibiotics. Richardson ended up with a urinary tract infection (UTI) and fever that he said caused him to spend a night in the hospital. “Except for the UTI, surgery went very, very well,” Richardson said. During the surgery, the doctor looked for cancer cells in the margin of the prostate. If it’s a negative margin, the cancer is contained within the prostate. If it’s not, the doctors assumes that cancer cells lurk nearby. Richardson had a positive margin in the fatty tissue outside the prostate. As a follow-up to surgery, he received external beam radiation therapy to further eradicate any existing prostate cancer cells. He could have chosen to wait and see if the PSA rose; however, he felt that radiation would eliminate the chances that the cells would grow. He had to wait a little while, however. As a side effect of surgery, Richardson experienced urinary incontinence which he had to resolve before radiation could start. He hadn’t fully realized urinary incontinence was one of the post-surgical side effects. If he didn’t wait, the radiation could damage his bladder and urethra and likely cause that level of incontinence to persist for the
Reasons to See a Urologist When should you see a urologist? Area urologists weigh in. By Deborah Jeanne Sergeant Jeanne O’Brien, professor of urology and male infertility at URMC Urology: • “Infertility. For men, being unable to conceive for six months to a year is a reason to see a urologist. One-third of cases of infertility involve the male partner. Another third is women and the remaining third is mixed or unknown. Often, men who are coming to see me for infertility, it’s their first doctor visit since their last pediatrician visit. • “Patients should come in to voice issues like testicular masses, lumps, and bumps. • “See us about things like the inability to urinate.” Physician Teresa Danforth, UBMD Urology, Buffalo: Page 14
• “Blood in the urine. • “Urinary tract infections. • “Kidney stones. • “Urinary incontinence. • “Vasectomy.” Physician Kent Chevli, president of Western NY Urology Associates, Buffalo: • “Urology is a very broad and diverse field. We take care of men, women and children and the elderly. It covers the entire gamut. • “There is a specialty of pediatric urology. For adolescent or older, generally, urology manages them. • The conditions involve the bladder, kidney, prostate, including many forms of cancer. Urologists diagnose 25 percent of all cancers, more than any other field. Prostate,
rest of his life. “Having incontinence was a major shock,” he said. “The book said some men have two to three days and then there’s no dripping. I went three months. But I’m glad it was only three months. Some might need a pad for a few weeks; some go a few years.” He confessed that during the six weeks between diagnosis and surgery, he didn’t perform the recommended Kegel exercises to strengthen the pelvic floor, which can help reduce incontinence. “I was exercising every day and felt my pelvic floor muscles were fairly exercised,” Richardson said. “That was a shock, even though the doctor said, ‘You’ll probably have some urinary incontinence. I shut down after hearing ‘cancer.’” At first, he used six pads daily, which gradually decreased over the next three months until he needed none at all. He underwent radiation for seven straight weeks, five days a week, which he said is standard. Each session lasted about 15 minutes. “After that, I went home,” Richardson said. “The side effects of radiation include fatigue, which affected me, and others include rashes, red spots on the skin, urinary incontinence, bowel issues and stomach issues. Luckily for me, it was only fatigue. I took a one- to three- hour nap each day. It took about a year for the fatigue to go away.” bladder and kidney cancers are all diagnosed by urologists and they’re in the top 10 of all cancers for prevalence. No other field covers three of the top ten. Urologists are almost always cancer doctors as part of our training. • “We also take care of kidney stones, troubles urinating for men and women, including bladder control problems or inability to urinate. • “We take care of fertility problems in men. • “We want to see men about their kidney pain or flank pain.” Physician JC Trussell, associate professor of urology at Upstate University Hospital: • “Weak erections. • “Curved erection (Peyronie’s disease). • “Slow urine stream or post void dribbling. • “Blood in the urine or ejaculation. • “Leakage of urine with coughing or standing. • “Birth control (vasectomy is safer and fails less than a tubal ligation). • “If a dad or brother has a history of prostate cancer.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
Mark Richardson of Pittsford Every six months, he visits a specialist: an oncologist alternating with a urologist, to monitor for any recurrence. So far, he remains in remission. “The past two-and-a-half years have been a real challenge for me, but I have a very positive attitude,” Richardson said. He advises other men with a prostate cancer diagnosis — and their spouses and caregivers — to join a support group for prostate cancer, such as Us TOO or Gilda’s Club. At the meetings, patients and families can learn about their treatment options and what to expect. “I’m very, very satisfied with my treatment,” Richardson said. “I wish I’d never had it, but one out of six men my age are diagnosed and I happened to be one of those men. I had surgery and I’m glad I did. “Between diet, exercise and support from my wife, Peggy, those things helped me maintain a positive attitude.” Richardson leads a local chapter of Us TOO. For more information on the local chapter, email ustoorochesterny@ gmail.com or visit www.facebook. com/ustoorochester or www.sites. google.com/site/ustoorochesterny. The national site is at www.ustoo. org. Urology: Not Just for Men According to Urology Care Foundation: “Urology is a part of health care that deals with diseases of the male and female urinary tract (kidneys, ureters, bladder and urethra). It also deals with the male organs that are able to make babies (penis, testes, scrotum, prostate, etc.). Since health problems in these body parts can happen to everyone, urologic health is important. “Urology is known as a surgical specialty. Besides surgery, a urologist is a doctor with wisdom of internal medicine, pediatrics, gynecology and other parts of health care. This is because a urologist encounters a wide range of clinical problems. The scope of urology is big and the American Urological Association has named seven subspecialty parts: • Pediatric Urology (children’s urology) • Urologic Oncology (urologic cancers) • Renal (kidney) Transplant • Male Infertility • Calculi (urinary tract stones) • Female Urology • Neurourology (nervous system control of genitourinary organs)”
Men Less Likely to Seek Treatment for Depression By Deborah Jeanne Sergeant
he lifetime prevalence of major depression is 20 to 26 percent for women and 8 to 12 for men. But those numbers may be skewed by a few factors, according to the Journal of the American Medical Association. Anne Graham, licensed mental health counselor in private practice in Rochester, believes that more women seek help for depression than men. “Women are just wired to be more verbal,” she said. Culture also plays a role, as men are conditioned to remain quiet about feelings and not express feelings in healthy ways. Instead, turning to “self medication” such as alcohol and drugs, or relieving stress through angry outbursts or irresponsible behavior represents unhealthy ways men cope. “Generally, I feel men have less awareness of their emotions,” Graham said. “They maybe can’t name how they feel. I have a chart that lists 60 or 70 emotions. It’s not that unusual to find a guy who says, ‘I don’t know how I feel.’” Unfortunately, many men don’t see primary providers very often and when they do, they typically don’t receive screening for depression, according to Todd Kennedy, licensed master of social work in private practice in Rochester. “Primary care providers carve
out 15 minutes of time for each patient and mental health is about the last thing on their mind,” Kennedy said. “It’s usually initiated by the patient.” He said that oftentimes when patients bring it up, they receive a questionnaire to fill out and receive a separate, unexpected co-pay for asking. When men do contact mental health providers, it’s usually because of a crisis, such as a DUI conviction, infidelity or divorce, Kennedy added. Kennedy said that logistics may hamper men from seeking mental health help. Many entry-level insurance plans don’t cover long-term mental health treatment. Providers included in these plans and mental health clinics that accept a sliding scale fee typically have a two-to three-month waiting list and provide care only from 9 to 5. Many men feel reluctant to take time off from work for therapy, both because they need the money and because they fear the stigma of needing mental health help. “It’s a challenge, depending upon the environment you work in,” Kennedy said. “Be as open and honest as possible. Shame is a barrier for people in a lot of ways. Overcome that by saying, ‘I’m dealing with personal issues I’m getting help with.’ “Use qualities of strength toward being vulnerable. It’s not very strong to lie about something.”
But Kennedy urges people to take mental health seriously. “Recognize that depression can be a deadly disease,” he said. Kennedy isn’t just referring to suicide risk, which increases with untreated depression, but other health implications. Eric Schantz, licensed mental health counselor in private practice in Pittsford, said that he treats many men in professions with high responsibility and high risk of depression, Schantz such as doctors, first responders, fire fighters and law enforcement officers. “In those fields, people will seek help, but it’s overall less common because there’s an incredible stigma,” Schantz said. “It’s seen as a sign of weakness. I’ve been told over and over that they don’t dare talk about mental health issues to their supervisor. They will immediately become a target. They’re afraid they’ll lose their jobs.” Schantz thinks that untreated depression resulting in suicide contributes to the lower life expectancy of men in certain professions. He said that the rate of completed suicide among first responders and medical personnel is twice that of other fields. “I know of first responders who travel miles out of the way and pay out of pocket so no one at their workplace will know about their mental health treatment,” Schantz said. Fortunately, mental health treatments provide real help for people struggling with depression. Dan Rosen, a licensed clinical social worker in private practice in Rochester, said that cognitive behavior therapy and mindfulness represent just a few of the psychotherapy techniques that therapists can use
Pain Meds May Affect Sperm Count By Deborah Jeanne Sergeant
ant to be a dad? Consider cutting back on ibuprofen. A recently released study in the journal Proceedings of the National Academy of Sciences indicates that over-the-counter pain relievers aspirin, acetaminophen (branded as Tylenol) and ibuprofen, (branded as Motrin and Advil), may hamper fertility. French and Danish researchers found that the ubiquitous painkillers disrupted participants’ testosterone levels, affecting their ability to produce normal levels of sperm. Low sperm count, also known as oligospermia, represents a common reason for male infertility. Male fertility matters. Male issues account for about one-third of infertility cases, women’s issues cause another third and the remaining third have unknown or a combination of causes. It may not be as simple as blam-
ing over-the-counter pain medication. “When anyone takes pain medication, it’s because they have inflammatory pain,” said physician Rosalind Hayes, with Rochester Fertility Care. “It’s hard to separate the underlying pain from medication. Inflammation is bad for everything in our bodies.” Men can improve their sperm count through many other means, too. Hayes advises men to stop smoking cigarettes, drinking excessive alcohol and using marijuana or other illicit drugs, including anabolic steroids. Some prescription medication may interfere with sperm count, so men should consult with their care providers. “There’s a long list of medication for treating all manner of diseases that can affect a man’s sperm,” Hayes March 2018 •
said. Chemical exposure, such as herbicides used in agriculture, may affect sperm count, too. Men should also seek treatment for any sexually transmitted diseases, manage stress, lose weight, and control blood pressure and any other illnesses such as diabetes. Jeanne O’Brien, professor of urology and male infertility at URMC Urology, said that many men come to the office after trying to conceive for about eight months to a year. Many previously assumed it’s only a female issue; however, once that’s been ruled out, they want to see what they can do to improve their chances of fatherhood. “All the things for normal health overall are important for reproductive health overall,” O’Brien said. She encourages men to eat a well-balanced diet and take a
with the goal of helping people develop their own healthy coping mechanisms. “The lifelong chance of having a depressive episode is close to 40 percent,” Rosen said. “It’s common and nothing to be Rosen ashamed of.” He encourages people to treat their depression. In addition to a low emotional state, “depression raises the risk for cardiovascular disease, erectile dysfunction and overall poor health,” he said. Websites such as that of Psychology Today (www.psychologytoday.com) or Good Therapy (www. goodthearpy.org) can help people find a therapist with whom they feel comfortable. From the website of Depression and Bipolar Support Alliance (http://www.dbsalliance.org): Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older, in a given year. (Archives of General Psychiatry, 2005 Jun; 62(6): 617-27) While major depressive disorder can develop at any age, the median age at onset is 32. (U.S. Census Bureau Population Estimates by Demographic Characteristics, 2005) People with depression are four times as likely to develop a heart attack than those without a history of the illness. After a heart attack, they are at a significantly increased risk of death or second heart attack. (National Institute of Mental Health, 1998) multi-vitamin supplement, along with omega-3 and vitamin D. “Many men from ages 20 to 40 don’t usually get enough dark, leafy green vegetables,” O’Brien said. Using hot tubs, excessive bike riding, long-term laptop use (if the laptop is supported in the lap) or other means of increasing heat in the groin can lower sperm counts. If these healthful interventions don’t work after a few months, patients may consider correcting varicose veins in the scrotum. These contribute to extra warmth in the groin that inhibit sperm and O’Brien said they are responsible for 75 percent of secondary infertility. “Repair of those is associated with a huge improvement in fertility,” O’Brien said. Medication may also improve sperm count for some men. Of the men who can be helped by these interventions, “many men do very, very well,” O’Brien said. “There are a lot of things we find on the evaluation that they’re not aware they had and they wouldn’t have known otherwise. It’s a good way of informing them.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Risks and Signs of Testicular Cancer By Deborah Jeanne Sergeant
stimates for testicular cancer are approximately 9,310 new cases diagnosed and 400 deaths, according to the American Cancer Society. About one out of every 250 men will develop testicular cancer at some point during their lifetime. Unlike many cancers, it strikes mostly young and middle-aged men at an average of age 33. Only 6 percent of cases are in children and teenagers and men over age 55 comprise only 8 percent. Also uncommon is its high likelihood of successful treatment. As with most cancers, early detection and treatment improves the chances of good outcome. “Sometimes a low sperm count can be a first sign of testicular cancer,” said Jeanne O’Brien, professor of urology and male infertility for URMC Urology. “Men with testicular cancer have lower sperm count. They
often come to a fertility expert who finds a mass.” Some men may notice a painful lump in the testicle or a lump in the abdomen while showering or dressing. “Most know it’s been there for moths before they come in,” said physician Edward M. Messing, professor of urology, as well as oncology and pathology at University of Rochester School of Medicine and Dentistry. “Most related it to unrelated scrotal trauma, like getting hit during athletics.” Rarely, pain in the scrotum could indicate testicular cancer. Messing estimated that one third of cancers are caught once metastatic. But despite its spreading, “it’s one of the few cancers where there’s a very high probability of cure, even when far advanced,” Messing said. “It can
be in the 90 percent level.” The reason is that testicular cancer is very sensitive to chemotherapy, even in the advanced stage; however, the severity and cost of treatment increases if the disease has advanced. Messing said most doctors recommend removal of the diseased testicle, as European doctors have attempted testicle-sparing approaches with little success. Sparing the testicle increases the chances of the cancer spreading to the lymph nodes. “Usually, it’s so big by the time you’ve found it, it has replaced the testicle,” Messing said. Although men can still father children with one testicle, the chemotherapy may cause infertility, and it can affect the nerves that cause semen to ejaculate (although erections still occur). Risk factors include a non-de-
scended testicle at birth, a factor for one out of 1,000 boys. Messing said that the testicle that had not descended is at exceptionally higher risk than in other patients and even the normal testicle has an elevated risk. Caucasian ancestry is also a risk factor. A man with a previous testicular cancer has a higher risk in developing cancer in the remaining testicle, which is why banking sperm is a good idea for men who still hope to father children after treatment for testicular cancer. “Before starting treatment, we can have them bank their sperm so when they’re done with treatment, they won’t regret not banking the sperm,” O’Brien said. “For the two to three newly diagnosed patients I see a year, I will always offer the option to bank their sperm. We have a reproductive endocrinologist who runs the lab.” Both Messing and O’Brien recommend monthly self exams. “It’s similar to women and breast exams,” O’Brien said. “In the shower, use a warm, soapy hand once a month to feel any lumps, bumps or things that don’t belong. You can find anything abnormal.” But more exams isn’t necessarily better. O’Brien said it can lower the threshold for what feels abnormal.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
A Trusted Form of Treatment for Many Ancient Chinese medical practice that involves placing hair-fine needles at specific anatomical points along the surface of the body By Christine Green Sandra Bordeau of Brockport has struggled with depression for many years. In the beginning, she sought help from a variety of medical practitioners yet she experienced little to no improvement. “I tried everything available and nothing was working,” she said. But then she discovered acupuncture and the tide turned. Regular treatments helped her feel better emotionally and her overall health improved as well. That was 20 years ago, and today she still gets regular acupuncture treatments to help with her depression as well as other medical issues. 2,000 Years of Success Acupuncture is an ancient Chinese medical practice that involves placing hair-fine needles at specific anatomical points along the surface of the body. Stimulating these points can trigger a physiological response that promotes healing and relieves pain. Practitioner John Crawford of Natural Health Chiropractic & Acupuncture in Rochester explains how acupuncture works by describing its effects on the body’s qi (pronounced “chee”) or essential life force. “There are meridians where the qi flows in the body. Needling of the places where the meridians hit the surface of the body bring attention and energy to those areas, in the form of blood, oxygen, hormones, etc. So when you impart a stimulus, such as rubbing [acupressure] or a needle [acupuncture] you’re telling the body we want energy to go to and flow better through here.” Patrick Boswell of A New Life Acupuncture in Spencerport also points out that acupuncture affects-
the chain of fascial fibers that covers the body’s muscles and organs. The gentle stimulation of the fascia induces a stretch reflex that can help the body release pain and encourage healing. Western scientists are still trying to figure out the exact medical changes that take place when a patient receives acupuncture, but it is clear that for people worldwide, acupuncture is a trusted form of treatment for a variety of medical issues. Acupuncturists can treat almost any medical concern brought to them. In 2003 The World Health Organization published a list of over 100 conditions that can be treated with acupuncture, including everything from muscle pain, migraines, and gastrointestinal problems to insomnia, infertility and depression. How Acupuncture Can Help Many acupuncturists are general practitioners that treat patients with different medical problems, but some have a particular specialty. Boswell sees patients with diverse complaints, but he specializes in women’s health. He says he is the only acupuncturist in Rochester with inpatient credentials at Strong and Highland hospitals on their labor and delivery floors. Acupuncture can help women in labor with pain, labor induction, difficulty pushing or failure to progress. Boswell can even use acupuncture to help a breech baby move into the proper head down position before birth. Derek Barclay of Pivot Acupuncture in Bergen and Rochester treats several conditions like Boswell, but combines his background as a physical therapist with his acupuncture training to help people with ortho-
Lainey and Derek Barclay of Pivot Acupuncture, which operates in Bergen and Rochester. In addition to being an acupuncturist, Derek has a background in physical therapy. “A combo of PT and acupuncture is much more effective than one alone,” he says. March 2018 •
pedic issues. “A combo of PT and acupuncture is much more effective than one alone,” said Barclay. Crawford is also a chiropractor and will sometimes use a combination of chiropractic treatments along with acupuncture to address a patient’s problem. Ellen Comisar of Rochester suffers with back pain. Crawford recommended that she combine chiropractic adjustments with acupuncture and massage “I think the combination has helped reduce overall achiness, even as I have added weight-bearing workouts to my schedule,” Comisar said. What to Expect Acupuncturists use sterile onetime use needles, but first time acupuncture patients shouldn’t worry about pain. Lainey Barclay, also of Pivot Acupuncture, notes that acupuncture “is not without sensation,” but it should not be unpleasant, distressing or painful. “They’ll feel the pin prick but it should not be lingering or be uncomfortable,” said Crawford. In fact, most people fall asleep during treatment and experience a deep relaxation. First timers should wear comfortable clothes and be prepared to discuss their medical history with the practitioner as well have a brief physical exam. After the initial intake is over and they fill out necessary paperwork, the needling will begin. Patients then relax in the treatment
room for a short period of time with the needles in place. It is best to plan to be at the office for at least an hour. Acupuncture treatment “is a process” says Lainey Barclay, so be prepared to come back for follow up treatments as it can take several appointments [anywhere from three to six] before a significant change in your condition can be felt. Embracing Eastern Medicine Lainey Barclay knows about this process not just as a provider but also as a patient herself. She became interested in acupuncture and traditional Chinese medicine after struggling with gastrointestinal problems and health concerns that failed to respond to Western medical treatment. She said a “combination of Chinese herbs and acupuncture cleared up my problem.” Her return to health was so profound that she decided to become an acupuncturist and herbalist. Barclay, Comisar, Bordeau and countless others have experienced relief from pain and illness as a result of acupuncture, and, for Bordeau, it’s a treatment option that will have her coming back time and time again especially because of its low risks. “One of the biggest things I like about Eastern medicine is the lack of side effects,” Bordeau said. “I have ended up in the ER twice in the last few years with adverse effects from Western medicine but the worst I have ever gotten from acupuncture is a little bruising.”
Patrick Boswell of A New Life Acupuncture in Spencerport. He said that acupuncture can help women in labor with pain, labor induction, difficulty pushing or failure to progress. IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Things You Need to Know About Overmedication By Ernst Lamothe Jr.
hile the topic of opioids continues to be on the front of the news, America has another drug epidemic: the overmedication of seniors, or polypharmacy. Researchers estimate that 25 percent of people aged 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79, according to the Kaiser Health Network. Doctors say it is common to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders. “The problem can lead to unwanted side effects, additional health problems, excessive health care costs and, in some cases, unnecessary death,” said physician Stephen Ryan, medical director of ElderONE, an all-inclusive care for the elderly, which is part of Rochester Regional Health. Ryan gives five important tips that could prevent overmedication of seniors.
Have your medication list with you
Because seniors often take multiple medications, it can be difficult to remember the name, dosage and function. The more information your provider has, the more accurately they can pinpoint any potential adverse effects “As a geriatric doctor, I see overuse all the time,” said Ryan. “Medication just becomes something that people just rely on without thinking about all the factors that go into their
body once they take it.” Ryan also suggests seniors keep a list of when they take the medication as well. It can be useful and help prevent overlapping use, while also making sure to consistently update your list with any new medication.
Take your medication bottles to the pharmacy.
A 2015 National Institute of Health report found that the share of Americans of all ages who regularly took at least five prescription drugs nearly doubled between 2000 and 2012, from 8 percent to 15 percent. Another way to keep track and monitor medication is bringing the bottles to the pharmacy especially if you were just prescribed new medication. “There are medications that can sound the same but have dramatically different dosages and functions. There can be so much confusion and that is when large problems can begin,” said Ryan, who is also the senior medical director for geriatric medicine at Rochester Regional Health. “Bringing in not only your list, but the actual bottles that show the dosage can be helpful to the doctor or pharmacist when you ask followup questions.”
Know the side effect profile of your medications
We have gotten so used to hearing the long list of side effects for medication in commercials that it becomes background noise to the visuals that are playing. It may not be
that big of a deal when you are only taking one medication. But with multiple, it can cause life-altering issues. “You need to know all the side effects of the drugs you are taking,” added Ryan. “We have seniors who are taking nine medications and some side effects trigger problems that were supposed to be solved by other medication.”
Ask before taking
Just because you can pick up a medication without a doctor’s prescription doesn’t mean you should. It’s easy to pick up aspirin, ibuprofen, and other medications without having to speak with a pharmacist. However, simply making your own decision has led to massive health ailments for seniors. “If you are not careful, some of these medications you take can affect kidney and liver function among other things,” said Ryan. “It may interfere with medication you are already taking, or the dosage may be higher than you should be taking considering your other medications. We have a culture of taking medication as a country, which is another issue that we should deal with at some point. But seniors especially just can’t pick up whatever they want at a drug store.” There could be a concern about combing various medication. It isn’t something that you should be deciding on your own. If you are taking something and are worried about the effects of the new medications, you must speak directly to your doctor or pharmacist. “Don’t be afraid to call some-
Physician Stephen Ryan, medical director of ElderONE, an all-inclusive care for the elderly, which is part of Rochester Regional Health. one if you have a question because sometimes asking questions too late can have disastrous consequences,” said Ryan.
Minimize the number of providers and pharmacists
Keeping the number of doctors and pharmacies to a minimum is better for you and better for the providers who must coordinate care. The more doctors you or your love ones see, the more likely you can have an adverse drug reaction. “Even though we have decreased issues with this because of electronic records, it still helps if you are not seeing too many providers,” added Ryan.
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An App for Loss — of Pounds Highland Hospital introduces app that helps those who undergo bariatric surgery keep their health (and weight) in check By Mike Costanza
or those who undergo bariatric surgery, the procedure is just one step on the journey toward dropping the pounds — and keeping them off. “It’s vitally important to watch your food intake,” says Piera Carubia, a registered dietitian with the Bariatric Surgery Center at Highland Hospital. “If you’re not paying attention on a daily basis to what you’re eating, you’re not going to be able to make significant lifestyle changes not only to maintain the weight loss after surgery, but also to help prevent other problems and diseases.” Baritastic, a weight loss app that the center’s patients are allowed to access for free, can help them maintain healthy lifestyles for life. Obesity, characterized by a body mass index of 30 or more, has grown to be a huge problem in the U.S. As of 2014, one in three American adults was obese, according to the National Health and Nutrition Examination Survey. Though many shed excess pounds through a healthier diet, exercise and other lifestyle changes, others who struggle with their weight might use bariatric surgery to begin attacking the problem. “It reduces the size of the stomach,” Carubia explains. “You’re using a small stomach as a tool to help you feel that fullness faster, leading you to eat less food.” Patients of the Bariatric Surgery Center must undergo physical and psychological examinations before coming in for surgery. “Ultrasound on your gall bladder, testing your hemoglobin A1c to make sure you’re not diabetic — these are standards everyone has to check, and there’s multiples of them,” Carubia says. “In addition to that, many people have additional health complications. They would then have to get other checks.” Individual counseling is also part of the program. “We work on behavior and lifestyle changes in these sessions, and we give them goals,” Carubia says. “We’re a very structured program.” In addition, patients must attend a nutritional program geared toward healthy eating and keep a food journal. They note what they eat, how much they consume and other facts. Altogether, preparation for bariatric surgery takes about six months. Patients begin seeing the operation’s effects quickly.
“They’ll lose most of their weight in the first year,” Carubia explains. “After that, their job is to maintain that weight loss.” Tracking nutrition, exercise, inches lost Following surgery, the Bariatric Surgery Center’s staff will sit down with patients for follow-up appointments. Patients are also encouraged to continue food journaling, and practicing other lifestyle changes that could help them become or remain healthier. There’s even a support group, Monarch Monthly, to which those who have undergone the procedure can come with their families and friends. As attractive as the idea of losing weight can be for bariatric surgery patients, the steps to take to prepare for the operation, to lose weight after it is completed and to keep those pounds off requires a great deal of attention. “A lot of people get very confused, because there’s so many checks and balances in the program to do,” Carubia says. “It can be very overwhelming.” Baritastic is designed to help patients avoid that confusion. “It’s essentially an app for bariatric patients to track everything pre-and-post-operatively from nutrition to exercise to inches lost to taking photos of their progress etc.,” says Dan Abeling, president of Texas-based NBL Media LLC, which created the app. The overall purpose of Baritastic is to better educate bariatric surgery patients. “Your diet guidelines are in there, discharge instructions are typically in there, best practices, calendar of support groups etc.”
Vivian Roseto of Gates had a bariatric surgery in May. She says she began accessing the Baritastic app right after surgery. Users like Roseto are able to more easily share information with their dietitians, access the program’s meal plans, and receive notifications of upcoming support events. Abeling explains. “We also have a checklist section where your program can set up a checklist for you to follow so you can get to surgery.” The checklists can be customized to fit the needs of individual patients. A patient who has suffered kidney damage, for example, would have to check off the obtaining of clearance from a nephrologist before undergoing surgery. Baritastic also allows patients to note their attendance of the nutritional program, when and how much they have exercised, and the other tasks that comprise a healthy weight loss regime. Best of all, they can write their food journals on their phones, and give the surgical center’s dietitians access to them. “Say, they had a question about something they ate,” Carubia says. “We can go in and access that data.” With that in hand, dietitians are more able to give patients the guidance and encouragement they need. Baritastic can also remind patients to take vitamins and supplements, and to attend upcoming support group meetings. “Best thing I ever did”
Smartphone showing the Baritastic app. March 2018 •
By 2017, Vivian Roseto had had enough of coping with her situation. “I battled my weight since I was in high school,” the 53-year-old Gates resident says. “I was just getting older, and tired of it.” Moreover, the dental office manager was beginning to feel the physical effects of having a BMI of
51. Both her right knee and her back ached very badly, especially when she was at her second job in a florist’s shop. “It was very hard to stand all day,” she says.” In early May, Roseto underwent a vertical sleeve gastrectomy. The surgery removed a large part of her stomach, leaving her with a banana-shaped organ. Since then, she has dropped 105 pounds, giving her a BMI of about 32. “It’s the best thing I ever did,” Roseto says. Roseto began accessing the Baritastic app on her Samsung Galaxy S4 Smartphone right after undergoing surgery. “You walk right after surgery — they get you up,” Roseto explains. “From day one, I calculated how long I walked.” Nowadays, Roseto tries to head to the gym three times a week, where she mounts the elliptical machine and lifts weights. She closely monitors her activities and diet, and uses the Baritastic app to note when she exercises and what she consumes on her phone. “It’s just a great way for me to… keep track of my calories, how many liquids I’m having, what types of foods I’m having,” Roseto says. By early February, her BMI had dropped to 32.8. Though Roseto plans to continue her exercise and dietary regimens, she isn’t concerned about losing more weight. “If I stay like this, I’m happy,” she says. “If I lose some more, I’m happy.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Ask St. Ann’s
What is Hospice Care and What Does it Offer Patients and Families?
hen patients are terminally ill and treatment to cure their illness is no longer an option, families may decide that hospice care is the right choice. Hospice care focuses on controlling pain, providing comfort and managing symptoms. It helps patients maintain their dignity while completing their life in comfort and peace. Senior living communities with a continuum of care, such as St. Ann’s Community, offer hospice care in partnership with licensed hospice and palliative care agencies. Care is provided at the patient’s home, which may be in independent living, assisted living or skilled nursing. You may also want to consider independent comfort care homes, staffed mainly by volunteers and home-based hospice agencies. Patients with a prognosis of six months or less may receive compassionate end-of-life care at The Leo Center for Caring on St. Ann’s Irondequoit campus. The Leo Center provides skilled nursing with a comfort care approach for those who are terminally ill. (For more information about the Leo Center, call 585-6976311 or visit www.stannscommunity. com.)
Quality of life matters
Ask The Social
By Kim Petrone, MD
The hospice or comfort care option you choose should ensure that your loved one’s quality of life, comfort, and dignity are paramount. A good start is making sure the option you’re considering offers patients a private room with an in-room private bath. The quality and availability of care is also a crucial factor. Having medical professionals on site and on call is important, ensuring the patient receives optimal care throughout their stay. Ask what the medical team consists of (e.g., doctor, nurse practitioner, medical social worker, dietitian) and whether they are accessible 24/7. Does the facility provide pastoral care and counseling services? Specially trained staff in these areas can
recognize the changing needs of patients and can support the emotional and spiritual needs of both patient and family.
Helping families feel at home
Does the hospice option you’re considering allow around-the-clock visitation for families? This removes barriers to visiting and makes it easier for families to balance everyday obligations with their desire to spend time with their loved one. Quality accommodations are also essential. Comfortable sitting areas and kitchens that are always open encourage families to come together, and quiet spaces allow for reflection and prayer. Many places, including the Leo Center, also offer food service and private accommodations so family members can stay overnight and enjoy the comforts and conveniences of home.
The gift of time
Be sure to take a tour of the hospice care options you’re considering. Get a feel for the atmosphere, the accommodations, the services and the staff. Then choose the one that’s the right fit for your loved one and family. While no one knows precisely when a loved one will pass, securing compassionate end-of-life care gives families a wonderful gift: quality time together to say goodbye. Kim Petrone is medical director of St. Ann’s Community and the Rochester General Wound Healing Center at St. Ann’s. She is board-certified in internal medicine and geriatrics. Contact her at kpetrone@ mystanns.com or 585-922-HEAL (4325), or visit www.stannscommunity.com.
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From the Social Security District Office
Your Contributions Help Millions
eeing taxes taken out of your paycheck can be confusing when you get your first paycheck. But understanding how important your contribution is can help. Your taxes are helping millions of Americans — wounded warriors, the chronically ill and people with disabilities — as well as protecting you and your family for life. You can take pride in knowing you’re making an important impact with each paycheck. By law, employers must withhold Social Security taxes from a worker’s paycheck. While often referred to as “Social Security taxes” on an employee’s pay statement, sometimes the deduction is labeled as “FICA” which stands for Federal Insurance Contributions Act, a reference to the original Social Security Act. In some cases, you will see “OASDI” which stands for Old Age, Survivors, and Disability Insurance. The taxes you pay now translate to a lifetime of protection — for retirement in old age or in the event of disability. And if you die, your family (or future family) may be able to receive survivors benefits based on your work as well. Because you may be a long way from retirement, you might have a tough time seeing the value of benefit payments that could be many decades in the future. But keep in mind that the Social Security taxes
you’re paying can provide valuable disability or survivors benefits now in the event the unexpected happens. Studies show that of today’s 20 year olds, about one in four will become disabled, and about one in eight will die before reaching retirement. If you’d like to learn a little more about Social Security and exactly what you’re building up for yourself by paying Social Security taxes, take a look at our online booklet, How You Earn Credits, at www.socialsecurity.gov/pubs/10072.html. If you have a friend who lost a parent when they were a child, they probably got Social Security survivors benefits. Social Security helps by providing income for the families of workers who die. In fact, 98 of every 100 children could get benefits if a working parent dies. And Social Security pays more benefits to children than any other federal program. You can learn more at www.ssa.gov/benefits/survivors/. Do you prefer videos to reading? Check out the webinar, “Social Security 101: What’s in it for me?” The webinar explains what you need to know about Social Security. You can find it at www.socialsecurity.gov/ multimedia/webinars/social_security_101.html as well as on YouTube at www.youtube.com/watch?v=5hkLaBiavqQ. Social Security is with you through life’s journey. You can learn more at www.socialsecurity.gov.
Q: Can I delay my retirement benefits and receive benefits as a spouse only? How does that work? A: It depends on your date of birth. If you were born on or before Jan. 1, 1954, and your spouse is receiving Social Security benefits, you can apply for retirement benefits on your spouse’s record as long as you are at your full retirement age. You then will earn delayed retirement credits up to age 70, as long as you do not collect benefits on your own work record. Later, when you do begin receiving benefits on your own record, those payments could very well be higher than they would have been otherwise. If your spouse is also full retirement age and does not receive benefits, your spouse will have
to apply for benefits and request the payments be suspended. Then you can receive benefits on your spouse’s Social Security record. If you were born on or after Jan. 1, 1954, and you wish to receive benefits, you must file for all benefits for which you are eligible. The Social Security Administration will determine the benefits you are eligible for and pay you accordingly. For individuals born on or after Jan. 2, 1954, there is no longer an option to select which benefit you would like to receive, even beyond your full retirement age. Widows are an exception, as they can choose to take their deceased spouse’s benefit without filing for their own. For more information, please visit www.socialsecurity.gov.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
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CALL By Jim Miller
Three Ways to Cut Hearing Aid Costs Dear Savvy Senior, I’ve heard that hearing aids will soon be available over-the-counter and will be much cheaper than they currently are. What can you tell me about this? My husband desperately needs hearing aids but we simply can’t afford them.
Searching Spouse Dear Searching, Unfortunately, for many years the high cost of hearing aids has kept millions of Americans with hearing loss from getting hearing aids because they can’t afford them. Hearing aids — typically sold through audiologists’ offices — are expensive, usually ranging between $1,000 and $4,000 per ear, and are not typically covered by private insurance or traditional Medicare. But there’s good news on the horizon. Last summer President Trump signed the Over-the-Counter Hearing Aid Act of 2017 into law. This will allow people with mild to moderate hearing loss to buy hearing aids without consulting an audiologist, and the devices could sell for between $250 and $300 at drugstores and other retailers. The only problem is that it will be a couple more years before these OTC hearing aids are available to consumers. So in the meantime, here are some tips that can help you find some affordable options.
Check Your Insurance
While most private health insurance companies do not cover hearing aids, there are some that do. For example, Aetna members can purchase aids at a discount through certain suppliers, and United Healthcare offers hearing aids to their beneficiaries through HealthInnovations for $799 to $999 each. You should also know that some federal workers, as well as residents of Arkansas, Connecticut, New Hampshire, and Rhode Island can get their hearing aids covered by health insurance, as can eligible veterans through the Department of Veterans Affairs. Or, if your husband is a Medicare recipient, about half of all Medicare Advantage plans offer at least partial coverage or discounts on hearing exams and devices. So, be sure you check your husband’s insurance coverage to see if it offers any type of
A new law will allow people with mild to moderate hearing loss to buy hearing aids without consulting an audiologist, and the devices could sell for $250 to $300 at drugstores. Problem is, these OTC hearing aids will only be available to consumers in about two years.
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hearing aid benefit.
To help you save money, consider shopping at Costco, which offers no-cost screenings at certain locations, as well as very competitive prices. Hearing aids at Costco range between $500 and $1,500 each. You can also shop online at websites like EmbraceHearing.com and Audicus. com, which can save you up to $2,000 per pair. Then visit a local specialist to make any necessary adjustments. Another option worth a look is over-the-counter personal sound amplification products (or PSAPs). Unlike hearing aids, the Food and Drug Administration does not regulate PSAPs. And PSAP manufacturers are not allowed to call these products hearing aids or claim that they help hearing. But these devices are very effective for people with mild to moderate hearing impairment, and typically cost between $350 and $450 each. To find a wide variety of PSAPs see assistive listening sites like Harris Communications (HarrisComm.com, or call 866-476-9579).
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Look For Assistance
If your income is low, there is a number of national, state and independent groups that can help you pay for hearing aids or offer discounts. To find them, visit the American Speech-Language-Hearing Association website at ASHA.org/ public/coverage/audfundingresources. Or, call the National Institute on Deafness and Other Communication Disorders at 800-241-1044, and ask them to mail you their list of financial resources for hearing aids.
Despite my being camera shy, Dad loved taking my picture.
Dad patiently taught me how to drive a stick shift.
Dad walked me down the aisle. 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. March 2018 •
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
H ealth News Thompson recognized for maternity care Excellus BlueCross BlueShield has once again recognized UR Medicine Thompson Hospital with a Blue Distinction Center+ for Maternity Care designation as part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated hospitals that show expertise in delivering improved patient safety and better health outcomes, based on objective measures that were developed with input from the medical community. Nearly four million babies are born in the U.S. annually, making childbirth the most common cause of hospitalization, and cesarean sections the most common operating room procedures, according to National Centers for Health Statistics and the Agency for Health care Research & Quality. Reducing early elective delivery is an area of focus for the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. According to Health Affairs, elective inductions result in more cesarean deliveries and a longer maternal hospitalization. The Blue Distinction Centers+ for Maternity Care program evaluates hospitals on quality measures for vaginal and cesarean delivery. To receive a Blue Distinction Centers+ for Maternity Care designation, a hospital must also demonstrate cost-efficiency. Thompson was first designated a Blue Distinction Center+ for maternity care in 2016. “This designation from Excellus represents an objective assessment of the obstetric care provided to our community. It reflects the competence and expertise of the providers and nursing staff who care for mothers and babies. It also illustrates the overall commitment of the organization in supporting safe
Women’s Health. Special Issue Don’t miss the next issue of In Good Health Please call to advertise Page 22
and cost-effective care. It assures our community that they can expect to receive the highest quality care at Thompson,” said Deborah Jones, director of obstetrics.
MVP adds online psychiatry services MVP Health Care has added psychiatry visits to myVisitNow, a telemedicine service offering online health care visits to MVP members through a mobile device or computer and web cam anytime, anywhere in the U.S. The ability to access a psychiatrist through MVP’s telemedicine benefit extends services beyond those already offered by physicians, behavioral health therapists, nutritionists, lactation consultants, and other health providers since the health insurer launched myVisitNow Jan. 1, 2017. “We believe offering additional psychiatry services in this manner will help expand member access to behavioral health treatment,” said physician Judith Feld, MVP’s vice president of behavioral health. “Many members are not able to seek treatment otherwise, as a result of the limited availability of in-person appointments, transportation issues or a reluctance to seek help in an office setting due to a perceived stigma that has been attached to seeking this kind of health care. We know behavioral health care can improve an individual’s overall health and quality of life and reduce the need for emergency room visits, urgent care visits or hospital admissions.” The online psychiatric visit includes an initial evaluation of the member to determine a diagnosis
and often results in recommendations for care that may also include a referral to a therapist. This service might also result in the member being given a prescription when needed but does not include prescribing controlled substances. “This initial evaluation can support a patient’s primary care provider in developing a treatment plan that addresses both the member’s medical and behavioral health care needs,” said Feld. “MVP is committed to improving the overall health of our communities and ensuring that our members have access to the best possible health care in the most appropriate setting for them is an important part of our approach,” said MVP President and CEO Denise Gonick. “If talking to a psychiatrist from home enables members to get the help they need, that’s what we want to enable them to do. We’re providing value that can’t be measured in dollars.”
Thompson celebrates five associates The Service Excellence Team (SET) at UR Medicine’s Thompson Health recently announced the first quarter recipients of the health system’s Service Excellence Awards: Greg LaDow of Victor: radiology technologist, diagnostic imaging; Kris Michalko of Canandaigua: clinical coordinator, ultrasound; Celeste Orton of Geneva: patient care tech, 3 West; Beverly Owens of Farmington: cashier, business office; and Teresa Trank of Dundee: registered nurse, radiology administration. The Service Excellence Award acknowledges Thompson associates
who consistently deliver exceptional service. They are selected each quarter by the SET, which reviews system leaders’ submissions of compliments from patients, families and coworkers.
Thompson Hospital has new ED medical director Physician Matthew E. Osborne of Pittsford is the new Emergency Department medical director for UR Medicine Thompson Hospital. Osborne, an attending physician in the emergency department since 2009, served as a lieutenant and flight surgeon with the medical corps of the U.S. Navy, and later as a lieutenant commander with the medical corps of the U.S. Navy Reserve. He received his medical degree from Georgetown University School of Medicine and held an internship at the National Naval Medical Center in Bethesda, Md., before completing his three-year emergency medicine residency at Strong Memorial Hospital in Rochester. He is a diplomate with the American Board of Emergency Medicine. Prior to joining Thompson, he worked for two years in the emergency center at Unity Hospital in Rochester. “We have been fortunate to have Dr. Osborne as a part of our emergency department team for more than eight years now and are excited to now have him at the helm,” said Thompson Health President/CEO Michael F. Stapleton Jr. “With his exceptional clinical skills, patient focus and proven leadership abilities, we are confident he will ensure excellence in emergency care for our patients and their families.”
Health Foundation President & CEO to Step Down John Urban, who has served as president and CEO of the Greater Rochester Health Foundation since its creation in 2006, will step down July 31. “The timing is right,” Urban said. “The board of directors has adopted a new strategy that will increase its focus on all dimensions of children’s development. This creates an ideal moment to shift leadership and enable a highly experienced professional to implement this strategy early in the process.” The board of directors plans to conduct a nationwide search for a replacement, according to a news release. “The impact the Health Foundation has been able to achieve over the past decade reflects the commitment John has brought to the organization, our grantees and community health overall,” said Dennis Richardson, board chairman, Greater Rochester Health Foundation. “John’s vision, business acumen, and commitment to evidence-based programming have been a powerful combination, enabling us to help create real change across the Greater Rochester region.”
During Urban’s tenure, the Health Foundation has invested in projects and programs that have had a measurable impact on a variety of critical health issues, including: improved management of blood pressure across the region; community-wide improvement of the acute treatment of strokes and more effective aftercare for those at risk for repeat incidents; and expansion of telemedicine, among others. Urban began his career in psychiatric and mental health, including time as deputy commissioner for administration and finance with the New York State Office of Mental Health. He moved to Rochester from Albany in 1984 to become president and CEO of Preferred Care, where he served for 21 years. It was during Urban’s time at Preferred Care that Bill Clinton recognized Rochester in a 1992 presidential campaign speech for its innovative approach to keeping health care costs low and quality of care high. With 2005 revenue of $775 million, the health plan was an attractive merger target. The independent Greater Rochester Health Foundation was formed when MVP Health Plan acquired Pre-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018
ferred Care. The value of Preferred Care was returned to the community through its $232 million purchase price, creating a foundation dedicated to improving the health of the greater Rochester community. Urban was named the Health Foundation’s first CEO in 2006.
Does hearing loss have you singing the blues? Don’t let it keep you from enjoying life! Join us for
Vibrant Living with Hearing Loss Thursday, March 22 at 2:00pm St. Ann’s Community at Chapel Oaks 1150 Portland Ave., Irondequoit
You’ll learn about: · Recognizing hearing loss · Taking charge · Overcoming anxiety and isolation · Tips, options, and solutions Free and open to the public. Refreshments will be served.
Presented by Michelle Gross
Reserve your space by calling (585) 697-6606.
of the Hearing Loss Association of America
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March 2018 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
It’s like being on a cruise, but without those tiny cabins. When you think about a cruise you think about great dining, entertainment, the pool, having all your needs met. Well that’s what it’s like living at Chapel Oaks. You have a beautiful apartment but it’s up to you how much or how little time you spend there. There are community areas where you can gather with friends, take a class, read a book or do nothing at all. Actually, the only thing you need to do is enjoy life.
Caring for the Most Important People on Earth To schedule a tour of St. Ann’s Community at Chapel Oaks call Al Brumagin at (585) 697-6606.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2018