IGH Rochester 156 August 18

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Meet Your Doctor Head of the Wound Healing Center at St. Ann’s, physician Kim Petrone discusses the multifaceted approach to wound care

Daith Piercing Can it reduce migraine pain? Some say yes, but what do experts say?

Alzheimer’s Vs. Dementia What’s the difference between the two? INSIDE: SPECIAL ‘GOLDEN YEARS’ ISSUE

Pharmacy Technician Career accepts high school graduates with no experience. The annual mean wage in the Rochester area is $32,240


AUGUST 2018 • ISSUE 156

Smart Phone Addiction

Experts say overuse of mobile devices can be called an addiction and can be harmful. Are you a smartphone addict? See our test on page 8

A Creek Runs Through It Sulfur Creek in Clifton Springs has helped attract a number of people to The Springs Integrative Medicine Center & Spa. They say they seek relaxation and healing. We went there to check. Page 12

What Should Your Children Do If They’re Bullied at School?

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Cherry Tomatoes Like all tomatoes, cherry tomatoes often make superfood lists. Find out why you should eat more of them

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Bike Accidents 25 U.S. kids treated in ERs every hour for bike injuries Page 5

More Evidence That Supplements Won’t Help Your Heart


here’s another study suggesting that the vitamin and mineral supplements bought by millions of Americans do nothing to stave off heart disease. This time, the finding stems from an analysis of 18 studies conducted between 1970 and 2016. Each one looked at how vitamins and mineral supplements — which are not reviewed by the U.S. Food and Drug Administration for either safety or effectiveness — affect heart health. After tracking more than 2 million participants for an average of 12 years, the studies came up with a clear conclusion: they don’t. Still, “people tend to prefer a quick and easy solution, such as taking a pill, rather than the more effortful method to prevent cardiovascular disease,” said study author, physician Joonseok Kim. “Simply put, multivitamins and mineral supplements do not improve cardiovascular health outcomes, so [they] should not be taken for that purpose, added Kim. Hes an assistant professor of medicine at the University of Alabama at Birminghams division of cardiovascular disease. The Council for Responsible Nutrition, a trade association representing supplement makers, stressed that

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the products are meant as nutritional aids only, not as a means of preventing or treating illness. “CRN stresses that multivitamins fill nutrient gaps in our less-than-perfect diets and support a host of other physiological functions,” senior vice president Duffy MacKay said in a statement. “They are not intended to serve as magic bullets for the prevention of serious diseases.” In the study, Kim and his colleagues reported that after accounting for both smoking histories and physical activity habits, they saw no evidence that taking a multivitamin or mineral supplements lowers the risk for dying from heart disease, experiencing a stroke, or dying from a stroke. The lack of any apparent heart health benefit was seen across the board, regardless of age or gender. Physician Gregg Fonarow helps direct the UCLA Preventive Cardiology Program in Los Angeles. He noted that upwards of 100 million American men and women take vitamins or supplements “frequently based on the misguided belief that doing so can improve their heart and vascular health.” The largely unregulated supplement industry is doing a booming

business, with a projected value of $278 billion by 2024, Kim’s team noted. This, despite the fact that prior studies have “consistently demonstrated no benefit” from supplements when it comes to heart health, Fonarow said. In fact, both Kim and Fonarow believe supplements may actually do harm. How? According to Kim, placing one’s faith in supplements “could deviate the public from following measures that are proven to be beneficial for cardiovascular health.” By way of example, he pointed out that while 50 percent of the American public consumes dietary supplements, just 13 percent meet federal recommendations for fruit and vegetable consumption. “We know that fruit and vegeta-

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

ble intake improves cardiovascular health,” Kim said. Fonarow concurred, adding that “the false belief that these supplements are providing some level of protection distracts from adopting approaches that actually lower cardiovascular risk.” “The evidence-based, guideline-recommended approaches to reduce the risk of fatal and non-fatal cardiovascular disease include maintaining a healthy blood pressure, cholesterol levels, body weight, not smoking, and engaging in daily physical activity,” Fonarow added. “There are also widely available and inexpensive once daily cardiovascular protective medications such as statins that, in eligible individuals, can safely and effectively lower risk,” he said.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Finger Lakes Wildlife EXPO &Finger FAIR Lakes Wildlife


Benefiting Bridges For Brain Injury Finger Lakes Wildlife

Benefiting Bridges For Brain Injury

Benefiting Benefiting Bridges Bridges For For Brain Brain Injury Injur y

Share Your Health Story Residents’ survey answers will help improve the region’s health

Y Canandaigua Civic Center Saturday, August 18TH, 2018

10am - 5pm Canandaigua Civic Center Canandaigua Civic Center TH Saturday, Tickets: AugustIn 18Advance ,Saturday, 2018- $6August 18TH, 2018 each. Purchase online at www.flwildlifeexpo.com, 10am 5pm Featuring Celebrity10am & - 5pm Canandaigua National Bank: Main Street

Zoologist, Jarod Miller

& Lakeshore Offices. At The Door - $8 Canandaigua Civic Center Tickets:-In$25 Advance - $6 each. Purchase each. Special Offer Family 4-Pack. In Advance $6 each. Purchase Activities Offered: Wildlife Presentations online at www.flwildlifeexpo.com, Saturday, August 18TH, 2018 Featuring Celebrity & throughout theCanandaigua day, “Birds of Prey”, online at www.flwildlifeexpo.com, Wild Wings • Hawk Creek National Bank: Main Street Featuring Celebrity & Zoologist, Jarod Miller Petting Zoo, Alpacas, Chainsaw Carving 10am - 5pm Wowee • Wildlife Rockstars Canandaigua National Bank: & Main StreetOffices. At The Door - $8 Lakeshore Other Wildlife Tickets: Presenters to include:

• Hidden Valley Zoologist, Jarod Miller

Artist, Magicians, Face Painting, Artisans, Animal each. -Special Offer -&$25 Family 4-Pack. & Lakeshore Offices. At The Door $8Games Children’s Activities, Adventures • Braddocks Bay OtherExhibitors, Wildlife - $6 each. Purchase. online at www.flwildlifeexpo. and MORE! Tickets: In Advance Raffles, Prizes and MUCH MORE! Activities Offered: Wildlife Presentations

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Canandaigua Civic Center

each. SpecialtoOffer - $25 Family 4-Pack. Presenters include:

TH com, Canandaigua National Bank: Main Street Lakeshore throughout the& day, ofOffices. Prey”, At Saturday, August 18 , “Birds 2018 Wild Wings • Hawk Creek Activities Offered: Wildlife Presentations Please visit www.flwildlifeexpo.com or call The Door - $8 each. Special Offer $25 Family 4-Pack. Activities Offered: Petting Zoo, Alpacas, Chainsaw Carving Wowee • Wildlife Rockstars (585) 396-0070 for more information. throughout the day, “Birds of Prey”, 10am - 5pmArtist, Magicians, Face Painting, Artisans, Wildlife•Presentations Hidden Valley Animal Petting Zoo, Alpacas, Chainsaw Carving Children’s Games & Activities, Adventures Braddocks throughout the •day, “Birds Bay of Prey”,Exhibitors, Petting Zoo, Alpacas, Chainsaw The Steele andMagicians, MORE!Face Raffles, Prizes andExhibitors, MUCH Family MORE! Artist,Artist, Magicians, Artisans, Carving Face Painting, Artisans, Children’s Tickets: InPainting, Advance - $6 each. Purchase Exhibitors, Children’s Games &and Activities, Games & Activities, Raffles, Prizes MUCH MORE! online at www.flwildlifeexpo.com,

Wild Wings • Hawk Creek Wowee • Wildlife Rockstars • Hidden Valley Animal Adventures • Braddocks Bay Please visit www.flwildlifeexpo.com or call and MORE! Celebrity Raffles, Prizes and MUCH MORE! Featuring & visit Please www.flwildlifeexpo.com or call Bernadette Mahle Licensed R E Associate Broker

(585) 396-0070 for more information. Canandaigua National Bank: Main Street Zoologist, Jarod Miller (585) 396-0070 for more information. & Lakeshore Offices. Please visit www.flwildlifeexpo.com or At callThe Door - $8 The Steele (585) 396-0070 for more information. Family each. Special Offer - $25 Family 4-Pack. Other Wildlife Activities Offered: Wildlife Presentations Presenters to include: Bernadette Mahle The Steele throughout Licensed R E the day, “Birds of Prey”, Wild Wings • Hawk Creek Family Associate Broker Petting Zoo, Alpacas, Chainsaw Carving Wowee • Wildlife Rockstars Artist, Magicians, Face Painting, Artisans, • Hidden Valley Animal Exhibitors, Children’s Games & Activities, Adventures • Braddocks Bay and MORE! Raffles, Prizes and MUCH MORE! Bernadette Mahle Licensed R E Associate Broker

Advertise your events on he pages of In Good Health — Please visit www.flwildlifeexpo.com or call (585)Rochester’s 396-0070 for more information. Healthcare Newspaper. The Steele Bernadette Mahle Licensed R E Associate Broker


• 585-421-8109 • Editor@GVhealthnews.com

our personal health story can help improve lives. That’s the message that county health departments and Common Ground Health are sharing with residents in Rochester and the Finger Lakes. “We are asking residents to answer questions about their experience with health through a 15 to 20 minute online survey at MyHealthStory2018.com,” explained Trilby de Jung, chief executive officer of Common Ground Health, the region’s health research and planning organization. “These stories will help identify health-related needs and reveal where programs and policies can make our communities healthier.” Monroe County Commissioner of Public Health Michael Mendoza added: “To impact disparities in health, we must have reliable and current local data on the many factors that are contributing to the gaps. To reduce health disparities, this important information will better assure that we’re on the right path.” Through recent analysis of health care data, Common Ground Health identified numerous troubling trends in chronic illness and early death in our region. For example, analysts discovered that early death rates are as high in some rural communities as they are in poorer urban neighborhoods, that African Americans struggle with dramatically higher rates of heart disease than other groups and that opioid overdose rates have soared among all populations.

“To better understand what is driving these and other issues, we need to hear directly from residents about what helps and what stands in the way of living long and healthy lives in our region,” de Jung said. The results will be incorporated into a series of studies focused on health equity in the Finger Lakes region and help county health departments develop strategies for addressing public health priorities. The survey asks about a wide range of topics from access to medical and dental care to perceptions of personal safety and satisfaction with work. To capture each individual’s unique story, several questions are open-ended with an opportunity for unstructured feedback. “For the findings to be meaningful, we need to gather health stories from as many residents as possible,” says de Jung. “Please tell us your story through the survey and share the link with friends and colleagues.” The survey is available in English at MyHealthStory2018.com and in Spanish at MiHistoriadeSalud2018. com. Participants can complete the survey anonymously, or enter their name and email for a chance to win a $500 gift card to a local supermarket or gas station. Participation is limited to residents of the following Finger Lakes counties: Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates. Submitted by Common Ground Health

Saturday August 18 It’s a Walk in the Park! Online Registration Now Open. Start Your Team Today!

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

at Cherry Ridge

25 U.S. Kids Treated in ERs Every Hour for Bike Injuries


ore than 2.2 million American children a year — or about 25 an hour — were treated in emergency departments for bicycle-related injuries over a 10year period, a new study finds. “The good news is that the rate of injury declined over the course of the study. Still, far too many children are being seriously hurt on their bikes,” said lead author Lara McKenzie. She’s principal investigator at the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. “The best place to start is with a well-fitted helmet. The study found that children who were not wearing a helmet when they were injured were more likely to suffer traumatic brain injuries and to be hospitalized,” McKenzie said in a hospital news release. Parents should look for a helmet with a sticker showing it is certified by the U.S. Consumer Product Safety Commission. McKenzie said it’s a good idea to let children help with the shopping so they can pick a hel-

met they like and will want to wear. Proper fit is important. The helmet straps should form a “V” around the ears. The chin strap should be snug, but children should be able to fully open their mouths. A space about the width of two fingers between the eyebrows and the edge of the helmet will ensure it’s protecting the front of the head but not blocking their view, McKenzie said. “Once they have a fitted helmet, parents should also make sure their kids have the proper education before they pedal away, especially if they are going to be riding in the street,” McKenzie advised. She noted that injuries involving motor vehicles more than doubled the odds of a traumatic brain injury and more than quadrupled the odds of hospitalization. Children should use bike paths where available. But experts say local officials need to make roads safer for cyclists through “Share the Road” initiatives, dedicated bike lanes and bicycle education programs.

Serving Monroe and Ontario Counties in good A monthly newspaper published

Health Rochester–GV Healthcare Newspaper

by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations.

In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Colleen M. Farrell, Mike Costanza, Jennifer Aline Graham, Heather. Wyffels, Kali Spoto Larue • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

August 2018 •


Series Final Show!

AUGUST 23 LES FEMMES BY NIK Female vocal group compliments of Nik & The Nice Guys

Food for purchase starting at 5:00pm Music: 6:30pm-8:00pm Bring your lawn chairs and enjoy this great free outdoor concert. Call 697-6700 for details and rainy day information. St. Ann’s Community at Cherry Ridge,

first-class senior living in the heart of Webster!

CherryRidgeCommunity.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Webster & Greece Locations Evenings & Saturdays available


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

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Your Doctor

By Chris Motola

Kim K. Petrone, M.D. Head of the Wound Healing Center at St. Ann’s discusses the multifaceted approach to wound care Q: Wound care tends to conjure up images of bandages, ointments, and maybe stitches, but I’m guessing there’s a lot more than that at Rochester General Wound Healing Center. A: Wound centers are kind of a national phenomenon that entered the market fairly recently, maybe 10 to 15 years. Ours opened in 2014. We see people with chronic wounds. The body is amazingly resilient, so most people who stub their toe or get a scratch heal with little to no medical intervention. A wound center is geared toward people who have very serious wounds and usually some underlying comorbidities that make it difficult for that wound to heal. Q: What are some of those issues? A: Many of our patients are either older in age and have a host of medical problems that affect their healing, or they have advanced diabetes, or people who have issues from swelling due to previous blood clots or obesity. And people who just have poor circulation and develop problems due to poor blood flow, particularly to their legs. So we try to come up with comprehensive plans to heal those wounds. Q: What do those plans entail? A: Our initial goal is always to heal those wounds, but they may have such profound disease or such complicated wounds that our goal becomes more about keeping it from growing and keeping it from getting infected. So there’s an individual goal set for every patient. The approach is multifaceted. There are some major, general things that affect healing, like nutrition. If someone isn’t eating enough protein or getting the right vitamins, we can give them advice or refer them to a dietitian. Some wounds are affected by

pressure and positioning. So we’ll look at how to offload wounds using cushions, devices and compression gear. Some wounds are due to poor blood flow, so sometimes we’re working with vascular surgery or vascular cardiology on how to improve blood flow if that’s possible. Some people need infection control, so we may need an antibiotic. Some people need weight reduction. Q: How does obesity affect wounds? A: Say you’re obese and have very swollen legs from obesity. We can heal the wound by using compression bandages on your legs, but if you don’t lose weight, as soon as you remove those compression bandages the legs will swell back up again. Q: Is the tearing literally due to swelling A: When your blood has to return to the heart, it has to pump against gravity. If the person is particularly obese, the veins can dilate and it can become harder to pump the blood. So sometimes you’ll see people with varicose veins. But over time you can get seepage into the legs, causing them to swell and become discolored. The skin can stretch to such an extent that the skin can actually crack open or blister. The legs can end up weeping fluid. So we have to get the swelling down, which we can do through diuretics, but the main way we do it is through compression bandaging. So we do a lot of types of compression bandaging to decrease the swelling and allow the skin to heal. But if you don’t address the causes, then it can come back once you remove the compression.

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

Q: What effect does diabetes have? A: Poorly controlled diabetes is the enemy of wound healing. So we work with patients to set reasonable goals for their diabetes, medicine compliance, education and referrals to specialist. The mainstay of the wound is treating the underlying causes of the wound, not the dressing.

Q: And older patients? A: With the older patients we see a lot of pressure ulcers. The older patients may not be as mobile, or they may have a fracture after a fall and not be able to walk normally. They also tend to be working on gaining weight for a host of reasons. We see people with bad blood flow to their legs who are older. Peripheral arterial disease goes hand-in-hand with atherosclerosis, which we all develop to varying degrees as we age. So we see those issues in our older population. Q: When you can completely heal the wound, what factors are in play? A: Good nutrition, good blood flow, good diabetic care, dressings that keep the wound not wet, not dry, but moist. Antibiotic care if necessary. Those are the main things. We do have some advanced therapies as well like artificial skins. Sometimes we have to remove necrotic tissue to promote healing. Most of our patients do heal their wound, but it can take some time. It typically takes a few months, so it’s not fast by the standards people are probably used to. Q: Artificial skins? A: It’s probably a misnomer, but there are a number of products on the market that can help with granulation. Granulation is the sort of tissue that grows into a wound to help it close. Some of them have skin cells embedded in them, some don’t. We call them biologics, because they have some element of either collagen, which is what the body needs to lay down to heal a wound, or they have some other factor in them that helps promote healing. Q: How does wound care fit into your broader practice? A: I think the reason I got into wound care was because in an older, frail population wounds are fairly common. The skin is the largest organ, so if all of your other organs are taking damage over time, it’s no surprise that your skin is, too. So working with that population in a nursing home, I would find people with serious-looking wounds. I didn’t think my training had equipped me to deal with some of these wounds. So I was very lucky to have a nurse who was skilled at wound care. Together, we decided to improve the way we handled wounds at St. Ann’s. That took us about five years to do. We honed our protocol and formulary. As we did that, we realized there was an opportunity to provide care to elderly living in the community, as well as younger patients who need comprehensive wound care. We were able to partner with Rochester Regional and open the center.

Lifelines Name: Kim K. Petrone, M.D. Position: Medical director of St. Ann’s Home, medical director of Rochester General Wound Healing Center Hometown: Henrietta Education: University of Rochester School of Medicine (medical degree); Duke University, bachelor’s degree in psychology Affiliations: Rochester Regional Health Organizations: American Geriatric Society, American Medical Directors’ Association, Undersea and Hyperbaric Medical Society Family: Husband (Steve), son (Cooper) Hobbies: Reading, swimming, gardening

U.S. News Ranks Best Children’s Hospitals


or the fifth year in a row, Boston Children’s Hospital is the No. 1 children’s hospital in the U.S., according to latest rankings by U.S. News & World Report. Ten hospitals earned a place on the magazine’s 2018-2019 honor roll of children’s hospitals, with a few changes from last year. Taking the No. 2 spot this year is Cincinnati Children’s Hospital Medical Center, up from No. 3 in last year’s ranking, while Children’s Hospital of Philadelphia drops to No. 3 this year, down from No. 2 last year. Texas Children’s Hospital, Houston, remains in the No. 4 spot. Children’s National Medical Center in Washington, DC, made the biggest jump, going from No. 9 to No. 5 on the honor roll. Children’s Hospital of Colorado is a newcomer to the top 10 this year, taking the No. 9 spot from Children’s

Hospital of Pittsburgh of UPMC, which dropped out of the top 10 this year. Ann and Robert H. Lurie Children’s Hospital of Chicago dropped from No. 7 to No. 10. Here is the complete list:

1 – Boston Children’s Hospital 2 – Cincinnati Children’s Hospital

Medical Center 3 – Children’s Hospital of Philadelphia 4 – Texas Children’s Hospital, Houston 5 – Children’s National Medical Center, Washington, DC 6 – Children’s Hospital Los Angeles 7 – Nationwide Children’s Hospital, Columbus, OH 8 – Johns Hopkins Children’s Center, Baltimore 9 – Children’s Hospital Colorado,

Aurora 10 – Ann and Robert H. Lurie Children’s Hospital of Chicago Each year, U.S. News & World Report ranks the top 10 children’s hospitals for each of 10 specialties: cancer, cardiology & heart surgery, diabetes & endocrinology, gastroenterology & GI surgery, neonatology, nephrology, neurology & neurosurgery, orthopedics, pulmonology, and urology. The top children’s hospitals in the 10 specialties are as follows: n Cancer: Cincinnati Children’s Hospital Medical Center n Cardiology & heart surgery: Texas Children’s Hospital n Diabetes & endocrinology: Children’s Hospital of Philadelphia n Gastroenterology & GI surgery: Cincinnati Children’s Hospital Medical Center n Neonatology: Children’s National Medical Center n Nephrology: Boston Children’s Hospital n Neurology & neurosurgery: Boston Children’s Hospital n Orthopedics: Boston Children’s

Hospital n Pulmonology: Texas Children’s Hospital n Urology: Children’s Hospital of Philadelphia “Having a child who is born with or develops a serious illness is one of the most difficult situations a parent can face,” Ben Harder, chief of health analysis at U.S. News & World Report, says in a news release. “Our best children’s hospitals rankings are designed with parents and young patients in mind. By having access to the most comprehensive data available to supplement guidance from their pediatrician, families are able to make better-informed decisions about where to seek high quality care for their children,” Harder says. For this year’s rankings, U.S. News & World Report analyzed data from 189 pediatric centers, of which 86 were ranked among the top 50 in at least one specialty. RTI International, a research and consulting firm based in North Carolina, collected the data and analyzed the results with assistance from more than 100 medical directors, pediatric specialists, and other experts.

Healthcare in a Minute By George W. Chapman

Oops! The Doctor Is Out-ofNetwork. You Pay the Bill Now


here are the bills you receive unexpectedly from “out-of-network” providers. The best example is when you go to your participating “in-network” hospital emergency room only to find that the physicians working in the ER are, unbeknownst to you, out of network. So you must pay the difference between their charge and what your insurance company typically pays for in network physicians. This can also happen with anesthesia bills. The trusting consumer logically believes if their hospital is “in-network,” so would

be the physicians who work there. The Harvard Global Institute thinks this is absurd and let a Senate committee know it, arguing it’s unethical if not illegal. It’s asking Congress to do something about it. Way back in 2011, a NYS study revealed patients paid an average $3,800 to out-of-network emergency room physicians. This would not be a problem in the first place if hospital CEOs either refused to do business with out-of-network physicians or at least paid for the difference since the patient is rarely informed in advance.

ACA 2018 Thanks to market uncertainty and the end of the individual mandate to have insurance, enrollment is going down. No one is surprised. A total of 11.8 million people signed up for coverage to begin 2018, but 1.1 million decided not to pay the premium. That left 10.7 million participants as of February 2018. Industry experts believe the number will drop further throughout the year as the current federal administration continues to undermine/sabotage the law, wanting to end the federal exchanges by 2020. Since the feds have yet to come up with a viable alternative for people seeking adequate health insurance coverage, many states will take on the charge.

by 9 percent. This is already the second time this year Pfizer has raised prices. Industry experts say this is another example of a drug manufacturer protecting profits from being negatively impacted by potential government intervention and the increasing bargaining power of pharmacy benefit managers that purchase drugs on behalf of huge health plans with millions of members. While PBMs “brag” they negotiated a 25 percent discount, that is only after drug manufactures raised their prices by double digits. No one really knows what the actual price of any drug is anymore. While the White House has basically paid lip service to controlling the exorbitant prices of drugs in the US, the American Association of Insurance Plans (AHIP) is taking matters into its own hands. They have promoted Matt Eyles to be their CEO. Before joining the AHIP three years ago as an analyst, Eyles

Big Pharma Pfizer recently raised the price of 40 drugs, (including cancer pills, blood pressure pills and pain pills),

August 2018 •

worked as a lobbyist for the pharmaceutical industry. He now sits on the other side of the fence. He wants to make drug pricing a primary focus as drugs account for almost 30 percent of what an insurance plan pays out in claims. Over the years, out-of-pocket costs for consumers for drugs have increased substantially. Lobbyists Control Washington… …and even when it comes to mother’s milk. At the recent convocation of the World Health Assembly in Geneva, Switzerland, US representatives, caving to pressure from baby formula manufacturers, refused to endorse a simple resolution promoting a mother’s natural milk as the healthiest choice for babies. The US threatened to sanction or withdraw military protection from any country that attempted to introduce the resolution. OB-GYN Shortage According to a recent study by Doximity, a social network for physicians, the predicted shortage of OB-GYNs has already hit several large metropolitan areas, including Las Vegas, Los Angeles, Miami and Orlando. These cities also tend to have higher-than-average numbers of women in child bearing years. The shortage is being exacerbated by over worked physicians retiring earlier from the delivery component of their practices to focus on more schedule-friendly gynecology. Certified nurse midwives could be a partial solution but physicians and hospitals still typically oppose that solution. CNMs are more prevalent in other countries. Currently, 60 percent of OB-GYNs are women and the percentage of male OB-GYNs drops every year. Cost of Care in the US. We outspend every developed country in the world…. by far. All agree it costs way too much and something needs to be done before

healthcare bankrupts the US. It is now 20 percent of our GDP. With so many vested interests (Big Pharma, insurance companies, hospitals, device manufacturers and even baby formula producers), experts don’t have many solutions. On average, our utilization of healthcare is on par with other developed countries. We just spend two to three times more for services than they do. Ashish Jha, MD, director of the Harvard Global Health Institute, resignedly said, “There is nobody I know that has all the answers, and what we need is a lot more experimentation.” Other countries have shown they can provide similar quality for far less. Until we address lobbying in Congress, real change in our costs will not be brought about by continued “experimentation” which unfortunately ignores the elephant in the room. Googled health problems. Here are the most “googled” health problems by selected states. (Draw your own conclusions.) New York: breast cancer. Minnesota: hemorrhoids. Missouri: ADHD. Nebraska: anorexia. South Dakota: insomnia. Utah: Hashimoto’s disease (basically inflamed thyroid). Vermont: opioid addiction. West Virginia: porn addiction. Yes, porn addiction. Connecticut: “quarter” (not mid) life crisis. Iowa: binge drinking. And finally….California, Colorado, Georgia, Illinois, Pennsylvania: syphilis.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Addiction or Harmless Pastime? How bad is the excessive use of smartphones and other devices? A therapist plans to start a group for people addicted to digital device use By Deborah Jeanne Sergeant


emember when car phones were a novelty business tool? Now it seems like everyone over 5 totes a smartphone or tablet everywhere and uses it constantly. That impression isn’t far from the truth. eMarketer, a market research company based in New York City, released a study in 2016 stating that mobile device users spend more than

four hours a day on their devices — tablets and smartphones. The study did not distinguish between leisure use and business use; however, four hours a day is a lot of time regardless of why. Robert Valenti, Ph.D., treats children and adolescents at his practice in Fairport. He said that young and old manifest overuse of mobile devices.

“The parents have a problem, too, but don’t seem to do a lot about it but restrict their kids’ use of it,” he said. “It’s more of an addiction.” Like other addictive behaviors, such as gambling, using mobile devices provides positive reinforcement to reward their use. It differs from an obsession, which is fixating on something that’s irrational. “With an addiction, it’s some-

thing that is exciting the pleasure centers of the brain like a drug and people do become addicted to it,” Valenti said. Timothy William Logsdon, licensed mental health counselor and owner of Inner Quest Counseling in Amherst, agrees that overuse of mobile devices can be called an addiction. “Brain studies show that the same circuits that are altered with drug and alcohol addiction are also altered with process addiction, things like gambling, food, video games, internet and smartphones.” What makes it difficult to understand is that plenty of people use devices for extended periods of time without becoming addicted. The difference lies in the reasons for and the consequences of their use. Logsdon said that the issue has become so widespread that he plans to start a group in Amherst for people addicted to digital device use. He said that he has talked with a school counselor about working with children, but was told that both the parents and students remain in denial about the extent of their use. “They’re at a game and the kids are on the phone until the ball drops and the parents are on their phones the whole game,” Logsdon said. Mobile devices have progressed from novelty to necessity, displacing the need for other means of entertainment, communication, information, and accomplishing an ever-widening array of tasks. Since devices can do more, people become more reliant upon them. Logsdon recommends that people who recognize they may be addicted to try to exercise “digital hygiene” to reduce use. For example, turning off alerts and ringers during meals, family time and overnight. “If you scale back and fail and try again, that is a sign of an addiction,” Logsdon said. “You may need a professional, self-help group or someone who’s been through the same thing.”

You Are A Smartphone Addict When…


sychguides.com offers the following self-assessment for smartphone addiction. This self-assessment is not meant to officially diagnose you with cell phone addiction. If you are concerned about your problematic behaviors, speak to your doctor or mental health professional about possible treatment. 1 Do you find yourself spending more time on your smartphone than you realize? 2 Do you find yourself mindlessly passing time on a regular basis by staring at your smartphone even though there might be better or more productive things to do? 3 Do you seem to lose track of time when on your cell phone? 4 Do you find yourself spending more time texting, tweeting or emailing as opposed to talking to real-time people? 5 Has the amount of time you spend on your cell phone been increasing? 6 Do you secretly wish you could be a little less wired or connected to your cell phone? 7 Do you sleep with your smartPage 8

phone on or under your pillow or next to your bed regularly? 8 Do you find yourself viewing and answering texts, tweets, and emails at all hours of the day and night, even when it means interrupting other things you are doing? 9 Do you text, email, tweet, or surf the internet while driving or doing other similar activities that require your focused attention and concentration? 10 Do you feel your use of your cell phone actually decreases your productivity at times? 11 Do you feel reluctant to be without your smartphone, even for a short time? 12 When you leave the house, you ALWAYS have your smartphone with you and you feel ill-at-ease or uncomfortable when you accidentally leave your smartphone in the car or at home, or you have no service, or it is broken? 13 When you eat meals, is your cell phone always part of the table place setting? 14 When your phone rings, beeps, buzzes, do you feel an intense urge to check for texts, tweets, or

emails, updates, etc.? 15 Do you find yourself mindlessly checking your phone many

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

times a day even when you know there is likely nothing new or important to see?

3 of 4 Black Americans Have High Blood Pressure by 55


startling 75 percent of black people in the United States develop high blood pressure by the age of 55, a new study finds. That’s a far higher rate than seen among either white men (55 percent) or white women (40 percent), the researchers said. “We started to see differences between blacks and whites by age 30,” said lead researcher S. Justin Thomas. “We need to start focusing on preventing hypertension [high blood pressure], particularly in blacks, at an early age,” he added. Thomas is an assistant professor at the University of Alabama at Birmingham’s department of psychiatry. It isn’t known why black Americans are more prone to high blood pressure at an earlier age than white Americans, Thomas said. But he speculated that a combination of lifestyle and genetics may explain why. Thomas said preventing high blood pressure needs to start with getting kids to develop healthy habits. “I don’t think you can start too early,” he said. “It should start at elementary school. If kids are told

frequently that this is important, they will adopt it.” High blood pressure can lead to serious health problems over time, the researchers noted. For the study, Thomas and his colleagues collected data on nearly 3,900 young adults who were part of a heart disease risk study. The participants were enrolled in the study when they were 18 to 30 years old, and they didn’t have high blood pressure at the time. Excess weight was the biggest risk factor for developing high blood pressure, regardless of sex or race, the researchers found. Blacks and whites who kept to a DASH (Dietary Approaches to Stop Hypertension) diet were able to lower their risk for high blood pressure, the study findings showed. The DASH diet is rich in fruits, vegetables, whole grains, low-fat or fat-free dairy, fish, poultry, beans, seeds and nuts, and low in red meat and salt. The report was published online July 11 in the Journal of the American Heart Association.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Tis the Travel Season: Be it Near or Far — Go It Alone


t’s that time of year — the travel season — and I’m already contemplating an August adventure with just “me, myself and I.” It might be a weekend away for a change of pace or a slightly longer excursion to clear my head and broaden my horizons. I look forward to my solo summer retreats, and always return home feeling rejuvenated and ready to take on what’s next. If you’ve never traveled alone, I highly recommend it. Time with yourself on the road is ripe with opportunities for self-discovery and growth. And it can be great fun! Here are a few good reasons to pack your bags and head out on your own: nYou call the shots. When you travel alone, you are free to see and do whatever tickles your fancy. Your decisions and itinerary are your own. And when that’s the case, you are reminded of who you are, what you enjoy doing the most and what you

like least. When you travel with others, their interests may not always align with yours, and precious time can be consumed with the inevitable negotiations that come with trying to satisfy everyone’s needs and desires. Travel alone, and you’ll discover the joy of listening to and following your own heart. n You meet new people more easily. I’ve discovered this time and time again. On my own, I’m more inclined to strike up a conversation with other travelers and “locals.” As a result, I’ve met so many nice, interesting and helpful people. And I often come away with great ideas and tips on new things to do, places to visit and restaurants to try. When traveling with friends and family, we have a natural tendency to stay focused on each other and may, therefore, lose the chance to meet people we might otherwise have met and enjoyed.

n You can release your adventurous spirit. On your own (with no one watching), you may be willing to try some things outside your comfort zone — take a balloon ride, soar on a zip line, join a “for singles only” biking tour or swim with dolphins. While not exactly a thrill seeker, I have sampled some pretty exotic food, wrestled Old Paint into submission on a horse trail in Costa Rica, repelled down a Colorado cliff, and white-knuckled it in a white-water raft. n Likewise, you can find some heavenly time to yourself. As a solo traveler, the opportunity for a tranquil, soul-soothing retreat is within your grasp. This is a little more up my alley, and I welcome the chance to spend as much quiet time — “me time” — as I wish. Solo trips afford this guilt-free opportunity. Want to sleep in until noon, sip tea with a good book all afternoon in a Paris cafe, enjoy a spa day or take a peaceful hike by yourself ? Go for it, because you can. n You learn a new language faster. Je peux en témoigner! (I can vouch for that!). When traveling alone in France, I was forced to make sense of the language. It was either that or go hungry. Without a traveling companion to help with translation, I was on my own. While I am far from fluent in French, I can now express simple greetings, ask for directions, and order a croque-monsieur — a popular French hot ham and cheese sandwich. Want to learn a language more

quickly? Travel alone. Here’s a tip: Download a language translation app or tool. There are many excellent (and free) options available. Check ‘em out! n You build your confidence and sense of independence. Even a small jaunt can boost your self-confidence. All the decisions are yours, including your budget. You decide how to get where you’re going, where to stay, and how much to spend on transportation, food, accommodations, and things to do. In no time, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend some time alone. The experience will challenge your limits, creativity, and coping ability — all of which will help you become a stronger person and grow as a traveler. So, I hope you’ll consider a little solo travel this month. Set out on an adventure with a spring in your step and anticipation for all the hidden treasures you’ll discover. Be it near or far . . . go it alone!

with team sports. In fact, “the odds of reporting a concussion increased significantly with the number of sports teams on which students played,” the researchers said. “It’s simply a matter of increasing the risk for collisions and contact, along with added risk of falls related to contact,” said Glatter, who was not involved with the new research. He stressed that a concussion can have lifelong effects as tragically illustrated in cases of late-life mental illness among retired National Football League players. That might be

especially true for injuries sustained by teens, Glatter said. “Because children’s brains are rapidly developing, they are more vulnerable to the effects of blunt trauma, with neurological symptoms presenting in a delayed fashion as they age,” he explained. Repeat concussions might be especially harmful, Glatter added. The study was published in the June 22 issue of the CDC journal Morbidity and Mortality Weekly Report.

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon. To purchase her new book “Alone and Content” visit Amazon.com. For information about her upcoming workshops or to invite her to speak, visit aloneandcontent.com, call 585-624-7887, or email gvoelckers@ rochester.rr.com.

s d i K Corner

2.5 Million U.S. High School Students Had a Concussion in Past Year


he damaging effects of a concussion are well-known, and new research finds the injuries are common among U.S. high school students. In a representative survey of nearly 15,000 kids in grades 9 through 12, just over 15 percent — equal to 2.5 million American youths — said they had suffered at least one concussion over the prior year. The survey was conducted in 2017, and echoes results from prior surveys, according to researchers led by Lara DePadilla of the U.S. Centers for Disease Control and Prevention. What’s more, 6 percent of respondents “reported two or more concussions” over the past 12 months, and 2 percent said they’d experienced four or more of the head injuries. And the new figures — based on anonymous interviews with high schoolers — may be undercounting Page 10

concussion frequency. “Underreporting of concussions among athletes remains an important issue,” DePadilla’s group noted. In another study, 40 percent of high school students who believed they had suffered a concussion said that “their coach was unaware of their symptoms,” the CDC researchers said. One emergency physician agreed that too many concussions go unreported. “The public needs to understand that you don’t have to lose consciousness to have a concussion. In fact, body impacts that transmit force to the head and neck can also result in concussive symptoms,” said physician Robert Glatter, who works in the ER at Lenox Hill Hospital in New York City. In the CDC study, boys were more prone to concussion than girls, and the injuries were highly linked

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

Study Shows 35% Decline in Opioid Prescriptions Filled in NYS


rom 2013 to 2017, New York state had a steeper decline in the number of opioid prescriptions filled by commercially insured Blue Cross Blue Shield members than the nation as a whole, according to a national report highlighted today by Excellus BlueCross BlueShield. Excellus BCBS highlighted the following New York state findings from a national Blue Cross Blue Shield Association report, “The Opioid Epidemic in America: An Update.” The report studied the pharmacy and medical claims of more than 41 million BCBS commercially insured members, including those in New York state. • From 2013-2017, New York state had a greater decline in the number of opioid prescriptions filled (35 percent) than the nation as a whole (29 percent). • In 2017, the opioid prescription rate (total number of opioid prescriptions filled per 1,000 members) in New York state was third-lowest among all states included in the study. Last year, 230 opioid prescriptions were filled per 1,000 members in New York state, versus 394 per 1,000 members nationwide. • In 2017, 71 percent of BCBS members in New York state filled their first opioid prescription within the dose and duration guidelines set by the Centers for Disease Control and Prevention. • In 2017, the rate of opioid use

disorder diagnoses was lower in (metropolitan statistical area data) New York state (5.0 diagnoses per 1,000 Percent members) than the Opioid prescriptions per 1,000 BCBS members 2013 2017 change nation (5.9 diagnoses per 1,000 members). Albany-Schenectady-Troy 392 257 -34% “Today’s report Binghamton 390 248 -36% by our national association is helpful Buffalo-Niagara Falls 371 233 -37% in measuring the progress made Elmira 457 291 -36% in addressing the Glens Falls 409 305 -25% opioid crisis,” said physician Martin Jamestown 361 288 -20% Lustick, Excellus BCBS corporate New York-Northern New Jersey-Long Island 357 222 -38% medical director. “New York state Rochester 363 245 -33% health care providers are making great Syracuse 376 252 -33% strides in promoting the safe and approUtica-Rome 376 251 -33% priate prescription of New York state 354 230 -35% opioids.” Lustick credits National 558 394 -29% the decline in the number of opioid Source: BlueCross BlueShield Association. prescriptions filled Confidential — Do Not Distribute in New York state in 4 ing requirement that helps enforce part to new prescripreport shows that state efforts have tion requirements passed by the state the state restrictions. The health plan helped to reduce the number of opialso has been working to address in 2016. oid prescriptions filled,” said Lustick. the crisis by providing individuals Those requirements restricted For more information regarding the initial fill rates of opioid prescrip- diagnosed with opioid use disorder the BCBS study from The Health of access to various treatment options. tions to be within CDC-recommendAmerica Report series, visit www. “While all areas of the country still ed guidelines. bcbs.com/the-health-of-america/ have a long way to go in improvEffective July 1, Excellus BCBS reports/the-opioid-epidemic-amerialso implemented an opioid prescrib- ing how opioids are prescribed, the ca-update.

Opioid Prescription Rates 2013-2017

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 11

Sulfur Creek, which runs through Clifton Springs, helped lead physician Henry Foster to found what came to be known as the Clifton Springs Sanitarium in 1850.

Enjoying the Mineral Baths at The Springs By Mike Costanza


or Michael Borys, The Springs Integrative Medicine Center & Spa is just the place to dissolve his tension, aches and pains in a hot mineral bath. “The bath is, like, the greatest thing ever,” the Seneca Falls resident says. Though The Springs provides a variety of therapeutic services — from acupuncture to massage therapy — mineral baths are central to the spa’s healing efforts. Mineral baths, a form of hydrotherapy, have long been used to treat a diverse set of illnesses and conditions, including arthritis, psoriasis and depression. While the content of mineral baths varies with their water sources, in most cases sulfur appears to be the most important component. The presence of that element in Sulfur Creek, which runs through Clifton Springs, helped lead physician Henry Foster to found what came to be known as the Clifton Springs Sanitarium in 1850. The facility offered spiritual counseling, homeopathic and massage therapies, treatments with herbal medicines, conventional western therapies and forms of the “water cure,” along with other types of care. Guests from all over the world came to the sanitarium, which eventually became part of what is now Clifton Springs Hospital & Clinic. A shift away from natural remedies led the Ontario County hospital to close the baths back in the 1950s. A renewed interest in Foster’s therapeutic modalities led the Clifton Springs Hospital & Clinic to open The Springs in 2000. Nowadays, folks come to the spa, which is located in part of the hospital, from near and far. There, they can undergo a host of treatments, including hydrotheraPage 12

vate soak, the individual can rinse down with tap water, towel off and dress. Relaxing music plays throughout the experience. Borys has a Chiari malformation, a structural defect at the base of the rear of his skull that can’t be detected by the naked eye. He also has a cyst on his spine, scoliosis — a curvature of the spine — and a degenerative disk disorder that affects the left side of his back. Though the 40-year-old has had a shunt installed to drain the cyst, further surgery won’t help — and he’s in constant pain. “I have pins and needles in my fingers, and down my leg,” Borys says. At the same time, his work as an emergency dispatcher for Seneca County has left Borys with post-traumatic stress disorder. Acupuncture, sometimes coupled with mineral baths, helps Borys cope with his conditions. As many as two times every three weeks or so, he heads to The Springs to place himself under Sarratori’s care. When his acupuncture treatment also involves a soak, she positions her needles on his upper body. “I often will use ear points on him, and upper points, and then have him soak right in the bath with the actual needles,” Sarratori says. The acupuncture reduces his pain, and the bath reduces his tension. “It relaxes everything — relaxes the muscles,” Borys says. Nicole Rogers brings her son to The Springs once a week, on average. Six-year-old Landon Rogers suffers from inflammatory linear verrucous epidermal nevus, (ILVEN) a rare skin disease. “It’s just, like, an overgrowth of skin cells…usually, on one side of your body,” the Canandaigua resident says. The growths, patches or plaques of skin that can become red, itchy and inflamed, appear on Landon’s left side, behind his left knee, and on other parts of his body. Laser therapy and steroid creams can reduce them, but there’s no real cure for ILVEN. Soaking at The Springs does seem to reduce the thickness of the growths. “It definitely appeared better,” Nicole Rogers says. A writer’s experience

Spacious bath tubes at The Springs Integrative Medicine Center & Spa. Some choose the baths for relaxation, some for healing. py, acupuncture and aroma therapy, those based upon Ayurvedic medicine and traditional Chinese medicine, and other forms of integrative therapy. The Springs refers to those it cares for as “patients” or “clients,” depending upon the services they seek, and offers over 16 water-based treatments alone. The taking of a mineral bath, or “soak,” involves a kind of ritual. First, a staff member fills a spacious tub in a private room with filtered spring water. “They put in a half-a-million-dollar system which is meant to make sure that there’s no impurities, but also keeping the sulfur and minerals that we want to keep,” says acupuncturist Mary Sarratori.

And, it’s hot — usually, 103 degrees — though the temperature might be reduced for patients for whom excessive heat could pose a problem. Those who have heart ailments or conditions, for example, might suffer if quickly immersed in water that is too hot. The staff member might then add such natural substances to the bathwater as Himalayan salts, Dead Sea mineral mud, sage or essential oils. Once that’s done, the guest is usually left alone to step into the water. “We do have some elderly patients that do have trouble getting into and out of tubs,” Sarratori says. “We have a lift for those patients — they sometimes wear, like, a bathing suit.” After a relaxing 20-minute pri-

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

You need not have such conditions to enjoy a good soak, as this writer found. At the behest of In Good Health’s publisher, I doffed my clothes and settled into a tub at The Springs for a Himalayan mineral bath. The tub was fit for my rather large frame, the water smelled of cinnamon — no scent of sulfur here — and I floated, feeling the waves move with me as relaxing music played. The 20 minutes went by all too fast, and I stepped out, feeling thoroughly relaxed. The Springs emphasizes the treatment value of its mineral baths. Though such measures appear to be seen as acceptable forms of medical care in other parts of the world, American physicians as a group do not share that view. An online hunt for medical research concerning the effectiveness of mineral baths did not uncover any that were conducted in the US — but, those studies might be out there somewhere. According to one news report, studies conducted in Israel have suggested that a form of water-based therapy can help treat some types of arthritis.

Pharmacy Technician: Promising Career in Healthcare Career accepts high school graduates with no experience. The annual mean wage in the Rochester area is $32,240 By Deborah Jeanne Sergeant


he outlook for the career of pharmacy technician is bright for the next several years, according to the Bureau of Labor Statistics (BLS). The BLS forecasts job growth for pharmacy technicians at about 12 percent between 2012 and 2026, which is faster than average for all other job titles. The pay is good, considering that it’s a career that accepts high school graduates with no experience and offers on-the-job training. The annual mean wage in the Rochester area is $32,240, a rate comparable to the $34,940 annual mean wage for pharmacy techs working in the New York City metropolitan area. The BLS also states that in the Rochester area, 1,180 people work as pharmacy technicians. Their work locations vary much more widely than the white-coated professional behind your local drugstore counter. They can work in general and surgical hospital settings, independent doctor’s offices, industrial settings, drug stores and general food store locations. The latter two categories may involve more personal contact with patients. Pharmacy techs working in

industrial settings tend to make more money, but may require education and/or experience. The growth in the pharmacy tech career is partly because of the growing population of aging baby boomers and their increasing need for medication. Pharmacy technicians are also working in ways they hadn’t previously, according to Claire Schum, doctorate of pharmacy and inpatient pharmacy operations manager at University of Rochester Medical Center. “We just opened a human donor milk lab, and they’re also involved with the medication reconciliation process when patients come to the ER,” Schum said. “They may have a lot of medications and the techs work with patients to make sure home medication is ordered to make sure it’s an accurate amount.” Although previous experience isn’t required, Schum said it’s helpful, as are good math skills, attention to detail, and an associate’s or bachelor’s degree. Pharmacy technicians must pass a pharmacy technician board exam

within a year of beginning employment with UR Medicine. It’s not a state requirement — some employers don’t require it — but Schum said that legislation is underway that would require it statewide. Instead of formal classes, wouldbe pharmacy techs can also study textbooks on the subject and then take the exam, but Schum said without pharmacy experience, “it might be difficult.” Pharmacy techs can look forward to several career opportunities by cross training to become supervisors or work in a variety of ways as specialists. “If they’ve been here awhile, they

can specialize in robotics, training, team lead, information analyst or milk lab specialist,” Schum said. The milk lab handles donated human breast milk. The advanced pharmacy technician positions offer “an opportunity to take more of a leadership role,” Schum said. “There are a lot of things they can move into.” Schum said that many people enjoy working as a pharmacy tech because they’re involved with patient care and making a difference in their lives, though not directly in contact with patient care. “Helping patients can be very satisfying,” she said.

Pharmacy Tech: Some Students May Go to School Free The federally funded Health Profession Opportunity Grant (www.acf.hhs.gov/ofa/programs/ hpog) works in affiliation with area educators to offer free classes to financially eligible and qualified people interested in pharmacy tech-

nician and other health professions. Students who complete the course and pass the board examination can begin working at up to $17 per hour, depending upon the employer.

Practice Debuts New Version of CyberKnife to Fight Cancer Hematology-Oncology Associates adopts new version of equipment it says is even more precise and effective in the fight against certain cancers


fter 10 years of impressive clinical outcomes, remarkable pain relief and new hope for cancer patients, Hematology-Oncology Associates of Central New York (HOA) recently replaced its original CyberKnife with an updated, even more precise, faster and effective version known as the CyberKnife M6 Series. The new CyberKnife (CK) remains the only FDA-approved completely robotic stereotactic radiosurgery system available in the world that targets and destroys previously inaccessible tumors. The new CK delivers dose with sub-millimeter accuracy, even to moving targets. The radiation dose adjusts automatically in real-time to respiration and other changes in tumor position. It has anatomy-specific tracking and treatment delivery solutions for brain, spine, lung and prostate.

“In addition to being a proven and effective alternative to surgery or conventional radiation for many types of cancer, patient throughput advancements, reduced treatment times and greater efficiency is also seen with this updated model,” said physician Tracy E. Alpert, board-certified radiation oncologist, partner and director of the radiation oncology program at HOA. Sub-millimeter accuracy means effective treatment with less harm to healthy tissue and long term negative effects. The CyberKnife continues to demonstrate the efficacy and longterm success of treating cancers, according to Alpert. “It has become a standard option for prostate cancer treatment,” the physician said. Compared to conventional radiation/IMRT, CyberKnife has a fiveday treatment regime instead of a 45-day treatment regime for prostate August 2018 •

The new CyberKnife M6 Series installed at Hematology Oncology Associates. cancer. This not only saves patients time and anxiety, it cuts down on copays and the overall costs of treating prostate cancer. In addition, over 9 years of data shows profiles on sparing healthy tissues, namely rectum and bladder, to be better than IMRT when the CyberKnife was used for prostate treatment. Collaboration with physicians of other specialties, such as neurosurgery, thoracic surgery, urology, GI, ENT, and general surgery continues at HOA. Specialists maintain their relationship with their patients by

being involved in the planning of this procedure. Multidisciplinary teams of physicians and clinical staff also review cases and discuss treatment options and the management of care. Alpert said HOA is privileged to provide this cutting-edge treatment option to patients. “It provides opportunities in cancer care that do not exist at any other facility in Central New York,” she said. Hematology-Oncology Associates is also the only cancer practice in Central New York certified for quality by ASCO, The American Society of Clinical Oncology.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 13

able pains, they will continue their workout regimen all while pushing through any exhaustion they may feel just to make sure they see their favorite band play at the harbor. Whether someone is having a pregnancy many women envy or one many people dread, one thing is for sure in the summer: Summertime means preparation for a pregnant mama. Stay Hydrated

Summertime Survival with Baby on Board Between heat waves, lower energy and the excitement of bringing new life into the world, summertime can be tricky emotionally and physically for mamas-to-be By Jennifer Aline Graham


ummer brings forward diverse emotions during pregnancy. Women who are constantly active busy bodies may feel dragged back due to intense heat, unexpected aches or simply because their summer clothes don’t fit the way they used to. If they are women who once enjoyed summer festivals where alcohol and late-night performances were focal points, the pure exhaustion

from pregnancy (and the inability to have a few drinks) may be all they need to feel a bit disheartened. On the other hand, some women feel great during the entirety of their pregnancy. They may fully embrace their growing belly by wearing every bikini top they can get their hands on (all while lathering themselves in sunscreen before walking out the door, of course). If they are not impacted by swollen ankles or unbear-

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Wear Comfortable Clothes When you’re pregnant, sweating isn’t always due to the summer heat. Hot flashes come and go continuously during a pregnancy and continue on during the postpartum days while those hormones are still very active and moving. The US National Library of Medicine states, “35 percent of women reported hot flashes during pregnancy and 29 percent reported hot flashes after delivery. Higher depressive symptoms were associated with hot flashes during pregnancy.” Since this is true for many, many


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Physical Activity is Important Pregnant women may want to spend as much time as they can in the sunshine during the hot summer months. However, those long walks outside may not be as safe when there is a little one growing inside of them. Being outside is a beloved activity in Western New York during the summertime and provides mamas-to-be with a variety of unique exercise opportunities. “Physical activity during a healthy, low-risk pregnancy benefits a woman’s overall health and most exercises are safe to continue,” said Victoria Hoeltke, a registered dietician who works for Women, Infants, and Children (WIC). “You can consult with your health care provider to determine a routine that works best for you.” If mom is feeling dehydrated, exhausted or a little uneasy from heat or excess sun exposure, alternatives should be looked into. This doesn’t mean ending physical activity altogether. if it is a normal part of a woman’s life – it just means adjusting that routine. And when you’re a mom-to-be, adjusting routine is already a day-today occurrence.

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While months ago people were complaining about snow-covered driveways or how many sweaters they’d have to wear at once outside, the tables have turned — as they do every year. Those wintery complaints have been replaced by the upkeep of air conditioning units, searching for friends with pools and the toll the summer heat takes on a mama-to-be. Even though you may look at the calendar and think the summer is almost over, it most definitely is not. The heat can continue well through September into October and when you are pregnant, heat can be debilitating and dangerous. “It is so important to keep your body hydrated during these hot summer months,” said registered nurse Elizabeth Carraba. “Most providers will recommend 2 to 2.5 liters of water per day and using an app on your phone can be helpful to keep track of your water intake throughout the day.”

women, it’s important not only to pay attention to your body, but also pay attention to what you’re putting on your body. While some moms-to-be want to wear whatever the latest summer fashion is, when the heat index is high it’s important to make one thing the primary focus: comfort. Baggy dresses or maxi skirts instead of jeans provide expectant women with less constricting clothing choices. Since dresses and skirts are not staple items for all pregnant women, Target, Old Navy, and Burlington have budget-friendly options for maternity shorts and tank tops that allow moms to look and feel comfortable when the sun is pounding down. If the sun is truly that intense, the best choice may be to simply stay out of it — for both the mom and baby’s health and safety.

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


The skinny on healthy eating

Why Cherry Tomatoes Are So Good for You


herry tomatoes, like all tomatoes, often make superfood lists, a designation that cheers my heart, my eyes, my skin and my constant worry about cancer. Since my husband and I eat a lot of cherry tomatoes, it’s great to know that this portable superfood can do more than just help us meet our nutritional needs — it can also help us achieve better health, prevent chronic disease, keep aging at bay and improve the way we feel. Cherry tomatoes are antioxidant superstars, boasting impressive amounts of the particular vitamins (A and C) and phytochemicals (lycopene) that protect us from cancer and other debilitating diseases by preventing the growth of harmful free radicals. Although free radicals are produced naturally in the body, lifestyle factors — such as exposure to pesticides, smoking, alcohol and fried foods — can accelerate their production. Many experts agree that eating a diet rich in fruits and vegetables can make a healthy difference.

These little globes of goodness are also a decent source of potassium, providing nearly as much potassium as a medium banana. Eating more potassium-rich foods lowers blood pressure, decreases the risk of stroke, reduces the formation of kidney stones, and supports bone and muscle strength. What’s more, cherry tomatoes are really good for eyes, thanks to their unique mix of nutrients — from vitamin A that retinas depend on to function to the nutrients lutein and zeaxanthin that protect eyes from harmful ultraviolet rays. One study showed that people who ate foods rich in zeaxanthin may be half as likely to get cataracts, while another study showed that increased consumption of lutein and zeaxanthin may slow the progression of macular degeneration. Remarkably low in calories for such a nutrient-dense food, waistline-friendly cherry tomatoes are also low in sodium, fat and cholesterol.

Helpful tips Choose cherry tomatoes with firm, bright skins and a fresh tomato-y scent. Store them at room temperature, out of direct sunlight, for best flavor and to avoid the mealy texture that can result from refrigeration. If, however, your tomatoes are ripe and you won’t be eating them in the next few days, you might want to store in the refrigerator to keep them from spoiling quickly. Before eating refrigerated tomatoes, put them out at room temperature for at least an hour.

Cherry Tomato and Avocado Salad 4 cups cherry tomatoes, halved 2 avocados, diced 1 medium carrot, shredded ½ red onion, diced (optional) 1 jalapeno pepper, minced (optional) 1 lime, juiced 1 clove garlic, minced 1½ tablespoons olive oil Salt and pepper to taste 2-3 tablespoons minced fresh basil or cilantro ½ cup chopped, toasted walnuts Place tomatoes, avocados, carrot, onion, and jalapeno into a medium

salad bowl. In a small bowl, whisk lime juice, garlic, olive oil, and salt and pepper until blended; stir in herbs. Pour over tomato mixture and gently toss. Top with toasted walnuts and serve immediately.

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Page 15

Daith Piercing: Can It Reduce Migraine Pain? By Deborah Jeanne Sergeant


ost people obtain body piercings because they like the style; however, a few seek a specific piercing because it’s believed to help reduce the symptoms of migraine headaches. Anecdotally, piercing the daith (some pronounce it to rhyme with “goth”; others rhyme it with “faith”) is said to lessen the pain, nausea, light sensitivity and other migraine symptoms. Those who use it claim that piercing the ear in its innermost fold of cartilage just above the ear canal turns off migraine pain in a similar way to acupuncture. Marc McDade, a doctor of chiropractic practicing in Rochester, said that many migraines “find their root in the upper neck. The brain stem initiates the migraine sequence.” Though he has heard of acupuncture as helpful for migraine sufferers, he hasn’t heard of any research on daith piercings. Research into daith piercings would likely be difficult because so many different factors can affect migraine headaches. Steven Sadlon, doctor of chiropractic, licensed acupuncturist and owner of Chiropractic Health and Acupuncture in Rochester, said that body piercings interrupt meridian flow. “In acupuncture, we use specific pathways,” he said. “When you puncture that point in the ear, you put the body into override and that point can never really be turned off. It may stop working and create problems. I don’t think daith piercing is a good idea in the long term.” Although he said that some people seem to find relief through daith piercing, other factors involved can make the piercing ineffective for many people.

“Even in Western medicine, migraines are broken up into 11 categories and 20 in Chinese medicine,” Sadlon said. “You have to give people an exam and diagnosis before starting treatment to get to the root of the problem.” He added that many people feel frustrated waiting weeks for their medical doctor to see them and want to try something different, such as daith piercing, when they can’t get relief. People performing the piercing most likely have no training in treating migraines or in acupuncture. Desiree Sale, licensed acupuncturist at NeuroloQi Acupuncture in Rochester, said that acupuncture treatment for migraines varies by what’s causing them, so stating that one piercing can solve all migraines oversimplifies the issue. “There’s no one point — certainly Sale not in the ear — to treat migraines, just routine types of headaches,” Sale said. “I’d go over the signs and symptoms before I’d do treatment. There are several maps of ear acupuncture. With the map I use, I don’t use that point on the ear.” She tends to initially stay away from the ear until she knows how patients respond to other acupuncture points. Some people respond poorly to acupuncture on the ear. Sale said that for the past several years, more and more clients have asked about daith piercing for migraine relief. One person tried it; however, she said it did nothing for her migraines.


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Before obtaining a daith piercing, it’s also important to realize how different it is from standard earlobe piercing. Many shopping mall jewelry stores perform only lobe piercing because of its low rate of infection and other complications but refuse to pierce cartilage because it’s more complicated--and painful. People seeking a daith piercing must go to a stand-alone piercing business. The daith piercing is tricky to keep clean because for many people,


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their hair touches the piercing more often and because it’s tucked into the innermost crease of the ear. The position also makes turning the piercing stud difficult. Should the daith piercing not help reduce migraine pain, the earring may be removed to allow the piercing to close; however, it will likely leave a scar. Before undertaking a daith piercing, discuss the possibility of complications with a health care provider.

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Daith piercing involves the innermost fold of ear cartilage. Some believe it can prevent migraine. Photo by Deborah Jeanne Sergeant.

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Geneva: North St. Pharmacy Police Station

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

Golden Years

Some seniors don’t have a normal thirst mechanism and don’t recognize when they’re dehydrated, according to physician Daniel Ari Mendelson of U of R. That’s why they need to make sure they drink enough water.

Excessive Heat Poses Risks for Older Adults By Deborah Jeanne Sergeant


or most people, extremely hot weather is a bit of a nuisance and fodder for light conversation. For elderly people, hot weather can be deadly. According to the U.S. Environmental Protection Agency, “since 1999, people aged 65-plus have been

several times more likely to die from heat-related cardiovascular disease than the general population.” Heat exhaustion, which can include heavy sweating, pale and clammy skin, body temperature between 100 and 104 degrees, and dizziness, can progress into heat

Geriatric Syndromes Require Special Care As we age, we become more likely to develop several co-occurring health problems that feed each other. These are called ‘geriatric syndromes’ By Deborah Jeanne Sergeant


ach individual’s health differs; however, “geriatric syndromes” describe a group of health concerns experienced by many older adults that often have multiple causes and involve different bodily parts and systems. These can include incontinence, sleep issues, cognitive issues, falls, osteoporosis and weight loss/frailty. For an older adult, incontinence could contribute to sleep issues and falls. Or weight loss and frailty from poor eating is often linked to osteoporosis, which would worsen the effect of a fall and lead to further frailty after a hip fracture. Stephen Ryan is a geriatrician practicing at Elder One with privileges at Rochester Regional Health.

He compared the interplay among geriatric syndromes to that of conditions such as high blood pressure and diabetes. “The effects are worse together than either separately,” Ryan said. Ryan said that a general practitioner or internist may not connect the syndromes as causal or even relational, but view them as separate conditions. Treating them as such may reduce the overall effectiveness of the care provided to the patient. It can also contribute to secondary issues as more medications bring more side effects. Of course, geriatricians are trained to recognize the relationships among various geriatric syndromes and the issues involved. However, August 2018 •

stroke, a life-threatening state in which patients manifest flushed, hot skin; less sweating because of dehydration; disorientation or fainting; rapid respiration; and high or low blood pressure. So why are older adults more prone to heat exhaustion and heat stroke? “One major issue is they don’t have a normal thirst mechanism and don’t recognize when they’re dehydrated,” said physician Daniel Ari Mendelson. “They should pay attention to how much they drink and if their urine is dark.” That’s one sign of dehydration. Mendelson is a William and Sheila Konar Family professor of geriatrics, palliative medicine, and person-centered care with the division of geriatrics, department of medicine, University of Rochester, School of Medicine & Dentistry. He also serves as associate chief of medicine at Highland Hospital. Mendelson said that sensitivity to heat worsens the more dehydrated the person becomes; that’s why sufficient hydration represents the first step in combating heatstroke. Some older adults take diuretic medication and should discuss with their doctors about adjusting the dose during hot weather. Mendelson advises older adults to set hydration goals with their care provider. “Once they get into heatstroke or heat exhaustion, it becomes a vicious cycle,” Mendelson said. Drinking caffeinated beverages like cola, tea or coffee or drinking alcohol tend to further dehydrate people since they are diuretics. Water hydrates best. For people who don’t

like the taste of water, adding slices of lemon or cucumber can flavor it. “Have a water bottle with you at all times,” Mendelson said. “Go to the movies, a restaurant or coffee shop, especially from 11 a.m. to 2 or even until about 4 or 5 p.m. on the hottest days. At least get out of the heat of the day.” Libraries, churches, senior centers and shopping malls are also usually air conditioned. People who need an air conditioner but cannot afford one may be eligible to receive up to $800 in help purchasing and installing a unit through the HEAP cooling assistance benefit through Aug. 31 or until funding runs out. Visit http://otda. ny.gov/programs/heap/contacts to find your county’s contacts. Physician Az Tahir practices holistic integrative medicine at Campanella Wellness in Rochester. He said that for seniors who don’t have or don’t want an air conditioner, an “Indian air conditioner” can help. Wring out a wet cloth and hang it in front of a fan so it can blow cooled air. “Use wet towels to keep the skin and head cool,” he said. “Keep your legs in cool water with Epsom salts in it. It helps keep the body cool. You can take more frequent showers.” Avoid outdoor activity during the hot part of the day.” For example, garden very early in the morning or closer to sunset or consider hiring temporary help for weeding, pruning and mowing. Exercise in an air conditioned environment or go swimming. Many communities open their school pools for free recreational use.

not every senior can see a geriatrician. “From my perspective and that of most of the national leadership groups, there will never be enough geriatricians to handle people who have more than one geriatric issue,” Ryan said. “The goal should be to improve the care of the majority of those who receive care from internists and general practitioners.” With more of them looking for measurable symptoms like falls and osteoporosis, non-geriatricians can help patients prevent more complicated medical issues and, as needed, refer patients to geriatricians for more complex cases, where conservative measures seem less effective, according to Ryan. Physician Az Tahir practices holistic integrative medicine at Campanella Wellness in Rochester. He believes that family members and caregivers should understand the concept of geriatric syndromes as well. For example, many different factors can influTahir ence an older person to fall. Tahir listed cataracts, muscle weakness and slower reaction time. He added that the outcome of falls can also relate to many other health concerns, such as broken bones because of osteoporosis, bedsores and further frailty. “Falls are major cause of frac-

tures and mortality and morbidity in old people,” Tahir said. “It’s important to prevent falls.” Treating the patient can involve many aspects of care, too, such as reducing environmental hazards, balance improvement programs, eye exams, and bone density testing. While some of these issues may be part of the normal aging process, geriatric syndromes aren’t, according to physician Daniel Ari Mendelson, William and Sheila Konar Family professor of geriatrics, palliative medicine, and person-centered xare in the division of geriatrics, department of medicine, University of Rochester School of Medicine & Dentistry and associate chief of Medicine, Highland Hospital. “They often can be prevented or managed,” Mendelson said. “Sometimes older adults and doctors not familiar with geriatric syndromes assume things are happening because of aging are unchangeable.” While doctors can’t manage and mitigate every aspect of a patient health — especially if the patient manifests complex, inter-related health issues — Mendelson wants more providers to improve quality of patient life in general. “If you have two or three syndromes but only one impacts quality of life, you should focus on what’s important them,” he said. “Experience in geriatric syndromes and the interplay of normal aging and person-centered care defines good geriatric care.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 17

Golden Years

Hidden Problem: Mental Health Problems Among Seniors Mental issues affecting senior population is largely overlooked By Deborah Jeanne Sergeant


ore than 15 percent of adults aged 60 and older experience mental health disorders, according to the World Health Organization. Many of those don’t receive proper treatment for conditions such as depression and anxiety. “Depression is both under-diagnosed and undertreated in primary care settings,” the World Health Organization states on its website. “Symptoms are often overlooked and untreated because they co-occur with other problems encountered by older adults.” Locally, that rings true as well. “Anxiety and depression are very overlooked in older adults,” said physician Az Tahir, who practices holistic integrative medicine at Campanella Wellness in Rochester. He said as an example, depression and dementia can be very overlapping and both misdiagnosed and some older adults don’t express their mental state accurately — and few are asked about it by their health care providers. “We find many times that patients will look OK, but when we do questionnaires on depression, we find that depression is present,”

Tahir said. “Treating the depression and giving medication, their life gets better.” Mental health issues are different from temporary adjustment to aging. For example, the American Psychiatric Association states that depression’s symptoms last two weeks or longer. An occasional feeling of sadness or grief from loss is different. “There is a difference between consequences of natural aging and a problem that needs to be addressed,” said physician Daniel Ari Mendelson. Mendelson is a William and Sheila Konar Family professor of geriatrics, palliative medicine, and person-centered care with the division of geriatrics, department of medicine, University of Rochester, School of Medicine & Dentistry. He also serves as associate chief of medicine at Highland Hospital. Young people experience depression, anxiety and other mental health issues, yet their age isn’t blamed for their conditions. But older adults may be more prone to mental health issues because of their life stage and the life changes that often come at that stage. Many older adults possess fewer

Making the Most of Your Doctor’s Visit By Jim Miller


tudies have shown that patients who help their doctors by providing important health information and preparing themselves for appointments tend to get better care than patients who don’t. Here are some simple things we can all do to help maximize our next visit to the doctor. Before Appointments Gathering your health informaPage 18

tion and getting organized before your appointment are the key steps to ensuring a productive meeting with your doctor. This is especially important if you’re seeing multiple doctors or are meeting with a new physician. Specifically, you need to: Get your test results — If you’re seeing a new doctor for the first time, make sure he or she has copies of your latest X-ray, MRI or any other

resources that support good mental health, such as a network of nearby loved ones, the ability to exercise vigorously, overall good physical health, and purposeful, engaging activity. Life changes — such as retirement, loss of peers to death and relocation, encroaching physical limitations, and age-related physical issues — all affect mental health. Mendelson added that people with lifelong mental health issues may find that the medication that worked well in their 40s and 50s isn’t working as well as it used to, since the body’s ability to metabolize medication decreases with age. Stephen Stephen Ryan, a geriatrician practicing at Elder One with privileges at Rochester Regional Health, encourages older adults and their care providers to review medication. “The metabolism and brain are different as we age,” Ryan said. “How would we measure that we’ve reached a goal since we’ve started test or lab results you’ve recently had, including reports from other doctors that you’ve seen. In most cases, you’ll need to do the leg work yourself which may only require a phone call to your previous doctor asking them to send it, or you may need to go pick it up and take it yourself. List your medications — Make a list of all the medications you’re taking including prescription and overthe-counter drugs, supplements and herbs, along with the dosages and take it with you to your appointment. Or, just put all your pill bottles in a bag so you can take them with you. Know your health history — Being able to talk to your doctor about any previous medical problems and procedures, even if they’re not the reason you are going to the doctor this time, can make an office visit much more efficient. Write it down if it’s complicated. Genetics matter too, so knowing your family’s health history can also be helpful. Prepare a list of questions — Make a written list of the top three or four issues you want to discuss with your doctor. Since most appointments last around 15 to 20 minutes, this can help you stay on track and ensure you address your most pressing concerns first. If you’re in for a diagnostic visit, you should prepare a detailed description of your symptoms.

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

the medication? It can get complex. Having a defined goal can really help with a lot of problems, including mental health issues in older adults.” He advises older patients to bring along a trusted friend or family member to serve as a “second pair of ears” during visits and to ensure all the right questions are asked and answered regarding the patient’s health concerns. Christine Peck, licensed master social worker and director at Eldersource Care Coordination and co-director at Community Care Connections at Lifespan of Greater Rochester, said that more general practitioners need to screen for mental health issues, especially in older adults. “Depression, especially, is sometimes undiagnosed and misdiagnosed in older adults because feeling sad isn’t always the primary symptom they’re reporting to their health care provider,” Peck said. Less obvious symptoms of depression could include fatigue, sluggishness and lack of interest and motivation. “If what someone’s feeling starts to interfere with daily life and functioning, we try to send the message to older adults it’s not something you have to accept and attribute it to regular aging,” Peck said. She recommends working through a primary care provider, since some older adults may resist visiting a mental health professional. A physical could lead to mental health screening if a caregiver comes along and discusses the mental health issues the patient experiences.

During Appointments The best advice when you meet with your doctor is to speak up and get to the point. So right away, concisely explain why you’re there. Don’t wait to be asked. Be direct, honest and as specific when recounting your symptoms or expressing your concerns. Many patients are reluctant or embarrassed to talk about their symptoms, which makes the doctor’s job a lot harder to do. It’s also a good idea to bring along a family member or friend to your appointment. They can help you ask questions, listen to what the doctor is telling you and give you support. Also consider taking some notes or ask the doctor if you can record the session for later review. If you don’t understand what the doctor is telling you, ask him or her to explain it in simple terms so you can understand. And if you run out of time and don’t get your questions answered, ask if you can follow up by phone or email, make another appointment, or seek help from the doctor’s nurse. For more information, the National Institute on Aging offers an excellent booklet called “Talking With Your Doctor: A Guide for Older People” that can help you prepare for an appointment and become a more informed patient. To get a free copy mailed to you, call 800-222-2225 or visit order.nia.nih.gov. Jim Miller is the author of Savvy Senior, a column published every issue in this newspaper.

Golden Years

Aerobic Exercise Key for Brain Health By Deborah Jeanne Sergeant

Alzheimer’s Vs. Dementia: What’s the Difference? By Jim Miller


any people use the words “Alzheimer’s disease” and “dementia” interchangeably, but they are not the same thing. In fact, you can have a form of dementia that is completely unrelated to Alzheimer’s disease. Here’s what you should know. Dementia versus Alzheimer’s Dementia is a general term for a set of symptoms that includes memory loss, impaired communication skills, a decline in reasoning and changes in behavior. It most commonly strikes elderly people and used to be referred to as senility. Alzheimer’s disease is a specific illness that is the most common cause of dementia. Though many diseases can cause dementia, Alzheimer’s — which affects 5.7 million Americans today — accounts for 60 percent to 80 percent of dementia cases, which is why you often hear the terms used interchangeably. But there are many other conditions that can cause symptoms of dementia like vascular dementia, which is the second most common cause, accounting for about 10 percent of dementia cases. Vascular dementia is caused by a stroke or poor blood flow to the brain. Other degenerative disorders that can cause dementia include Lewy body dementia, Parkinson’s disease, Frontotemporal dementia, Creutzfeldt-Jakob disease, Chronic Traumatic Encephalopathy (CTE), Huntington’s disease and Korsakoff Syndrome. Some patients may also have more than one form of dementia known as mixed dementia. Dementia is caused by damage

to brain cells, but the symptoms can vary depending on the cause. In the case of Alzheimer’s disease, protein fragments or plaques that accumulate in the space between nerve cells and twisted tangles of another protein that build up inside cells cause the damage. In Alzheimer’s disease, dementia gets progressively worse to the point where patients cannot carry out daily activities and cannot speak, respond to their environment, swallow or walk. Although some treatments may temporarily ease symptoms, the downward progression of disease continues and it is not curable. But some forms of dementia are reversible, which is why it’s important to be evaluated by a physician early on. Vitamin deficiencies, thyroid problems, brain tumors, depression, excessive alcohol use, medication side effects and certain infectious diseases can cause reversible forms of dementia. Another treatable form of dementia is a condition known as normal pressure hydrocephalus, which is caused by a buildup of cerebrospinal fluid in the brain that can be relieved by surgically implanting a shunt to drain off excess fluid. This type of dementia is often preceded or accompanied by difficulty walking and incontinence. To learn more about the different types of dementia, including the symptoms, risks, causes and treatments visit the Alzheimer’s Association at ALZ.org/dementia. Jim Miller is the author of Savvy Senior, a column published every issue in this newspaper.


erobic exercise may offer protection from cognitive decline. In 2017, researchers at the University of Southern California in Los Angeles published a report concluding that about one-third of Alzheimer’s disease cases could be prevented through changes in habits — including exercise. A small study by the Center for Ageing and Health at the University of Gothenburg in Sweden has shown that up to a 90 percent reduction in dementia could be associated with fitness regimens begun by women in their 50s, who were followed for the next 44 years. Very few of the fittest women experienced dementia. The benefit lessened for women who were active, but not as fit. Although any activity is better than no activity, an occasional stroll to the mailbox or quietly puttering in the garden won’t do it. To achieve this positive effect, the World Health Organization recommends that people 65 and older to participate in at least 150 minutes of moderate to 75 minutes of intense activity every week. You may not dream of achieving a buff beach body, but staying fit may benefit the brain. Other studies indicate that starting younger in life offers the most benefit, but “it’s never too late to start,” said Cathy James, co-chairwoman of the New York State Alzheimer’s Association Coalition. “Sometimes we think of high impact, but even moderate exercise may help us lower our risk for things like Alzheimer’s disease and it can contribute to brain health.” If the exercise involves learning and retaining skills, such as taking a James martial arts class, that may offer more benefits, as would exercise that’s social in nature, such as participating on a sports team. Involving music could also

Walk Briskly to a Longer Life Y ou might want to pick up the pace when you head out for a stroll, suggests a new study that found that doing so may lengthen your life. In fact, compared with a slow pace, walking at an average pace appeared to reduce the risk of dying early 20 percent, while a faster pace seemed to cut the risk by 24 percent, the researchers said. “A fast pace is generally five to seven kilometres [three to four miles] per hour, but it really depends on a walker’s fitness levels; an alternative indicator is to walk at a pace that

makes you slightly out of breath or sweaty when sustained, said researcher Emmanuel Stamatakis. Hes from the University of Sydneys Charles Perkins Center and School of Public Health, in Australia. The researchers also found that people seemed to cut their risk of dying early from heart disease by 24 percent by walking at an average pace and 21 percent by walking at a fast pace, compared with walking at a slow pace. Moreover, the benefit of brisk walking was particularly pronounced among older adults. August 2018 •

Those 60 or over who walked at an average pace had a 46 percent reduction in risk of early death from heart disease, and fast-paced walkers had a 53 percent reduction, the report suggested. But the researchers did not prove a cause-and-effect relationship between walking pace and premature death risk, just that there was an association. For the study, Stamatakis and colleagues analyzed death records and linked them with the results of 11 surveys in England and Scotland between 1994 and 2008. In those

promote more brain activity while in motion, such as a dance class. “The overall pattern is very encouraging that aerobic activity is a means of reducing risk of cognitive impairment down the line or at least delaying its onset.” said physician Jennifer Muniak at UR Medicine division of geriatrics. “It’s very difficult to study lifestyle interventions in general, so we can’t definitively point to the extent of the benefit or exact mechanisms as of yet. “But in general, the evidence as a whole is very encouraging, and is a reminder that through lifestyle interventions we do have some control over how we age.” Muniak encourages younger people to start the habit of exercise earlier in life, rather than waiting. But older adults can still benefit from exercise, including improving overall health, possibly reducing the need for certain kinds of Muniak medication (with doctor approval), and supporting brain health. “It’s truly never too late when it comes to initiating positive lifestyle changes,” Muniak said. “While we should be working closely with children and young adults to encourage good lifestyle habits from the start, older adults can see immediate as well as long lasting benefits when they increase physical activity and improve nutrition.” Though exercise offers numerous benefits to body and mind, it can’t guarantee lifelong cognitive health. Genetics, nutrition, social engagement and advanced age all represent other risk factors for cognitive decline. Before undertaking any change in nutrition or exercise, consult with a health care provider. A personal trainer may offer helpful advice for exercising safely and effectively.

surveys, people reported their walking pace. The researchers adjusted these findings for factors such as the amount and intensity of all physical activity, age, sex and body mass index (a measurement based on height and weight). “While sex and body mass index did not appear to influence outcomes, walking at an average or fast pace was associated with a significantly reduced risk of all-cause mortality and cardiovascular disease. There was no evidence to suggest pace had a significant influence on cancer mortality, however, Stamatakis said in a university news release. The report was published June 1 in the British Journal of Sports Medicine.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 19

Ask St. Ann’s

By Heather Wyffels

What is Recreation Therapy?


ecreation therapy gives seniors daily opportunities to participate in meaningful activities that promote: • mental health • physical well-being • cognitive function • autonomy •sense of joy and connectedness Almost any leisure activity can qualify as recreation therapy, but it’s not just fun and games. Each activity must include attainable and measurable goals. Bingo, for example, is a fun and popular game but it also addresses cognitive abilities, hand/ eye coordination, concentration and fine motor skills. Playing cards and casino-style games exercises decision-making skills, promotes socialization, and provides sensory stimulation.

A Professional Approach New York state mandates all senior living communities to provide recreation therapy and adhere to state standards. A large organization such as St. Ann’s Community, for example, employs full-time recreation therapists — known as life enrichment advocates — who work with residents across the continuum of care, from independent living to skilled nursing. Our life enrichment advocates are professionals with a four-year college degree in recreation therapy or a related field. Some also have National Council for Therapeutic Recreation Certification, an advanced credential.

Part of the Family Recreation therapists develop unique, personal relationships with residents and their families. This helps them plan activities that reflect residents’ interests and hobbies. At St. Ann’s, for example, we’re working with our residents to plan a fashion show, an idea they came up with. We’ve also helped a resident plan a St. Joseph’s table for the neighbors on her floor, an activity based on her love of food and her Catholic faith. Due to the nature of their work and because they provide a different kind of care, recreation therapists often have very close relationships with residents and family members and are trusted as if they are part of the family. This is especially helpful when working with residents who need extra encouragement to join activities and embrace their potential.

What To Look For Here are some other features to look for when touring a senior living

community: • Variety: Euchre games, art projects, exercise classes and gardening are among the activities residents look forward to at St. Ann’s Community. They also attend sporting events, movies, picnics, concerts and lunch trips. • Accommodations: A good recreation therapy program provides adaptive technology and specialized equipment to ensure that everyone can participate regardless of physical ability. • Connections: Group activities provide a sense of belonging and give residents the opportunity to be social, get to know others, and develop friendships. • Autonomy: Sometimes “nothing” is the right answer when asked, “What do you want to do today?” Seniors have the right to assert their independence and pass on activities every now and then.

Clinical Detectives In addition to creating engaging activities for seniors, recreation therapists often detect little changes in a person before they become significant. As a result, they can alert the resident’s care team to potential health issues that can be addressed early. Recreation therapists often co-treat with physical, occupational, speech, and music therapists to help seniors stay healthy and achieve clinical goals.

A Family Affair Recreation therapists encourage families to participate in activities with their loved ones. It’s an easy way to bring joy to your loved one’s day and to support their well-being. It’s also an opportunity to raise any concerns about your loved one’s level of engagement or changes in behavior. Senior living communities should be places where people continue to grow. Across the continuum of care, recreation therapy helps residents stay active and blossom in their senior years. Heather Wyffels, is life enrichment coordinator at St. Ann’s Community, a senior community offering a full continuum of care in Rochester. Contact her at hwyffels@ MyStAnns.com or visit www. stannscommunity. com.


Don’t miss the next issue of In Good Health. Reach close to 100,000 readers (based on 33,500 copies distributed) Call 585-342-1182

Page 20

Ask The Social

Security Office

From the Social Security District Office

Working While Disabled: Social Security Can Help


hile it may be best known for retirement, Social Security is also here to help you get back to work if you are disabled. For millions of people, work isn’t just a source of income, it’s a vital part of who they are — it gives them purpose and pride — it’s a connection to community. If you’re getting Social Security disability benefits, we have good news for you. Social Security’s work incentives and Ticket to Work programs can help you if you’re interested in working. Special rules make it possible for people receiving Social Security disability benefits or Supplemental Security Income (SSI) to work and still receive monthly payments. The Ticket to Work program may help you if you’d like to work. You can receive: • Free vocational rehabilitation; • Training; • Job referrals; and • Other employment support. You can read more about working while collecting disability bene-


Q: My daughter just joined a nonprofit charity and is helping victims of natural disasters. She gets a salary. We were wondering if she has to pay Social Security tax. A: Yes, people who work for nonprofits and who receive a salary must pay Social Security tax just like everyone else. It is commendable that she is helping people in need. But the fact is that she is also a wage-earner. Those wages and the Social Security tax she pays on them will offer her financial relief in the future, when it comes time to apply for Social Security. So she is really helping herself, too. For more information, visit our electronic publication, How You Earn Credits at www.socialsecurity.gov/ pubs. Q: A few years ago, I lost my Social Security card. Now my credit report shows that someone might be using my Social Security number. I’m afraid they might ruin my credit. What should I do? A: Identity theft and fraud are serious problems, not just for you, but for the financial integrity of our agency. It also puts our national security at risk if someone dangerous is using your number to obtain other forms of identification. It’s against the law to use someone else’s Social Security number, give false information when applying for a number or alter, buy or sell Social Security cards. Keep in mind, you should never carry your Social Security card with you.

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

fits at www.socialsecurity.gov/work. Work incentives include: • Continued cash benefits for a time while you work; • Continued Medicare or Medicaid while you work; and • Help with education, training, and rehabilitation to start a new line of work. If you’re receiving Social Security disability benefits or SSI, let us know right away when you start or stop working, or if any other change occurs that could affect your benefits. If you returned to work, but you can’t continue working because of your medical condition, your benefits can start again — you may not have to file a new application. You can read more about the Ticket to Work program in the publication titled “Working While Disabled: How We Can Help” at www.socialsecurity.gov/pubs/EN05-10095.pdf. Part of securing today and tomorrow is giving you the tools to create a fulfilling life. Getting back to work might be part of that. We’re here with a ticket to a secure tomorrow. If you think someone is using your Social Security number fraudulently, you should report it to the Federal Trade Commission (FTC) right away. You can report it at www.idtheft. gov or you can call FTC’s hotline at 1-877-IDTHEFT (1-877-438-4261) TTY: (1-866-653-4261). Q: I served in the military, and I’ll receive a military pension when I retire. Will that affect my Social Security benefits? A: You can get both Social Security retirement benefits and military retirement at the same time. Generally, we don’t reduce your Social Security benefits because of your military benefits. When you’re ready to apply for Social Security retirement benefits, go to www.socialsecurity.gov/ applyonline. This is the fastest and easiest way to apply. For your convenience, you can always save your progress during your application and complete it later. And thank you for your military service! Q: I’ve decided I want to retire. Now what do I do? A: The fastest and easiest way to apply for retirement benefits is to go to www.socialsecurity.gov/onlineservices. Use our online application to apply for Social Security retirement or spouses benefits. To do so, you must: • Be at least 61 years and 9 months old; • Want to start your benefits in the next four months; and • Live in the United States or one of its commonwealths or territories.

“Today, I Saw My Grandson Walk.” Miniature Telescope glasses for Macular Degeneration and other Low Vision Conditions Now Available

By Jim Miller

Simple Gadgets That Can Help Older Drivers Dear Savvy Senior, Are there any specific auto gadgets you can recommend that can help senior drivers? Both of my parents are in their 80s and still pretty good drivers, but due to arthritis and age they’re very stiff, which causes them some driving problems.

Researching Daughter Dear Researching, To help keep senior drivers safe and prolong their driving years, there’s a plethora of inexpensive, aftermarket vehicle adaptions you can purchase that can easily be added to your parent’s vehicles to help with many different needs. Here are some good options. Entry and Exit Aids To help arthritic/mobility challenged seniors with getting into and out of their vehicle, there are a variety of portable support handles you can buy, like the “Emson Car Cane Portable Handle” ($12), which inserts into the U-shaped striker plate on the doorframe. And the “Standers CarCaddie” ($13) nylon support handle that hooks around the top of the door window frame. Another useful product is the “DMI Deluxe Swivel Seat Cushion” ($22), which is a round portable cushion that turns 360 degrees to help drivers and passengers rotate their body into and out of their vehicle. Enhanced Rear Vision To help seniors with limited upper body range of motion, which makes looking over their shoulder to back-up or merge into traffic difficult, there are special mirrors you can add as well as back-up cameras. For starters, to widen rear visibility, eliminate blind spots and even help with parallel parking, get an oversized rear view mirror like the “Allview Rearview Mirror” ($50) that clips on to the existing mirror. You should also purchase some “Ampper Blind Spot Mirrors” ($7.50), which are 2-inch adjustable convex mirrors that stick to the corner of the side view mirrors. Another helpful device is the “Auto-vox M1W Wireless Backup Camera Kit” ($110). This comes with a night vision camera that attaches

to the rear license plate, and a small monitor that mounts to the dash or windshield. When the vehicle is in reverse, it sends live images wirelessly to the monitor so you can see what’s behind you. Seat Belt Extenders To make buckling up a little easier, there are a variety of seat belt extension products offered by Seat Belt Extender Pros like the “Seat Belt Grabber Handle” ($8), which is a rubber extension handle that attaches to the seat belt strap to make it easier to reach. And the “7-inch Rigid Seat Belt Extender” ($20) that fits into the seat belt buckle receiver to add a few inches of length, making them easier to fasten. Gripping Devices If your parents have hand arthritis that makes gripping the steering wheel, turning the ignition key or twisting open the gas cap difficult or painful, consider these products. The “SEG Direct Steering Wheel Cover” ($15) that fits over the steering wheel to make it larger and easier to grip. The “Ableware Hole-In-One Key Holder” ($9), which is a small plastic handle that attaches to the car key to provide additional leverage to turn the key in the ignition or door. And for help at the pump, the “Gas Cap & Oil Cap Opener by Gascapoff” ($12) is a long handled device that works like a wrench to loosen and tighten the gas cap. All of these products can be found online at Amazon.com. Just type the product name in the search bar to find them.

Imagine the heartbreak for someone who gradually loses the ability to see her grandchildren, husband, and the people who mean the most to her. Now imagine her joy when she can see them again. Dr. George Kornfeld, optometrist, member of the International Academy of Low Vision Specialists (IALVS), is using miniaturized telescopes which are mounted in glasses to help people who have reduced vision see better. Dr. Kornfeld is using this groundbreaking optical technology to make this dream a reality for patients with age related macular degeneration (AMD), the leading cause of blindness in older Americans.

To learn more about how miniature telescope glasses could help you or someone you care about or to schedule an evaluation, call Dr. Kornfeld today! You can also visit www.KornfeldLowVision.com

Call Today!

George Kornfeld, OD

866-446-2050 member

Safety and Security To help ensure your parents safety, and provide you and them peace of mind, they should also consider an in-car medical alert system like “splitsecnd.” Offered through Bay Alarm Medical (BayAlarmMedical. com, $30/month), his small device plugs into the vehicle’s cigarette lighter to provide 24/7 roadside and emergency assistance at the push of a button, automatic crash detection and response, and GPS vehicle location and monitoring capabilities.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. August 2018 •

Age 3:

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

Age 19:

Age 16:

Dad patiently taught me how to drive a stick shift.

Dad walked me down the aisle.

Age 64:

So happy to be there for Dad as he moved to his own new apartment!

With maintenance free living in one of our spacious apartments, you'll find you have even more time to enjoy life's special moments.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 21

Golden Years

Lending an Ear and Giving a Voice Ombudsman program, driven by volunteers, helps those in long-term health care facilities.

By Colleen M. Farrell


hen Laura Humphreys introduces herself, not everyone is sure who she is at first or what she does. Humphreys, a volunteer with New York’s Long-Term Care Ombudsman Program, drops the “ombudsman” from her title and, instead, offers up “patient advocate.” The Honeoye Falls woman helps residents of long-term care facilities, like nursing homes and assisted living centers, understand their rights and how to exercise them. Helping residents become empowered is rewarding work, she said. “It’s the kind of volunteer work that can be terribly satisfying and challenging on an almost professional level,” Humphreys said. The federally mandated ombudsman program is administered by each state. Fifteen agencies in New York offer ombudsman programs; locally, the agency is Lifespan of Greater Rochester. The aim of the program is to empower, educate and inform nearly 13,000 patients in the more than 140 facilities spread across nine counties: Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Wayne, Wyoming and Yates. “Not many people know about it I think because people don’t want to think about aging and they think about it in an unhealthy way or a crisis way,” said Alana Russell, Lifespan’s ombudsman program director. She is one of five staff members who follow up on issues or concerns raised by residents or their loved ones. Whether an issue is brought up directly by a resident or his or her loved one, Russell, one of her co-workers, or a volunteer ombudsman always start by talking to the patient. Sometimes, what is perceived by a loved one to be an issue is not perceived that way by the resident, Russell said. Matters range from food offerings to quality of care to response time after ringing the call bell — and everything in between. The ombudsman serves as a neutral third party. Volunteer support is critical because of the volume of patients. “We’re really dependent on volunteers,” Russell said. “They are the eyes and ears and heart and soul of the program.” Ideal candidates possess communication, mediation, and problem-solving skills, Russell said. Ombudsmen have to maintain boundaries, confidentiality and impartiality. If someone has had an upsetting or traumatic situation related to the long-term care setting, being an ombudsman is likely not a good fit, Russell said. Some issues exceed the scope of Page 22

Alana Russell, left, director of Lifespan’s ombudsman program, regularly meets with volunteers like Laura Humphreys. Volunteers serve as patient advocates for residents in long-term care facilities. the program. When that happens, Russell or her co-workers refer the resident to the appropriate person or agency. “We’re not the resident’s individual case manager or social worker,” she said. “We have to be aware of our lane.” Those interested in volunteering go through a prescreening process and then shadow an established volunteer to get a feel for the role. They participate in a five-day training curriculum developed by the state, followed by more shadowing. Russell and her co-workers match up volunteers with facilities based on proximity and setting in an effort to personalize placement. They meet with the facility’s administrators to explain their role. Ombudsmen get to know the staff, residents, and their loved ones. Ideally, Lifespan would place one at every facility. Currently, 74 people volunteer as ombudsmen. Many are retirees, although anyone over the age of 18 is welcome. Humphreys, who has been serving in this role for 14 years, said her work is done “behind the scenes.”

She said it’s important to stagger visits — going at different times and days — to make sure she can be available to as many residents and families as possible. It also helps staff get to know her and she, them. “It’s all about personality,” Russell said. “Some of the residents will just start talking about everything.” Others need time. Being visible gives residents and their loved ones some faith and trust in the process and a chance to build some rapport. But Russell is quick to add that ombudsmen are not there to check up on staff. “Most facilities are welcome and great collaborators. We are not here to get you in trouble,” she said. With training, guidance, and support from Lifespan, as well as peer mentoring and other ongoing training, volunteers are given tools to be successful, Humphreys said. Between doing paperwork and visiting the facility, volunteers typically spend about two to four hours a week in their role. Lifespan asks for a year-long commitment, although life events like vacations are taken into

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

consideration. Some ombudsmen end up exceeding the year-long commitment. Several volunteers have been with the program for five, 10, even 15 years. “It says a lot to me about the rewards that they’re getting out of the role,” Russell said. Humphreys has been volunteering for 14 years. She approached Lifespan looking for a volunteer opportunity and a new challenge. She said being an ombudsman has been a good fit. “It’s never boring because just when you think you have seen it all, something else comes up,” Humphreys said. “There’s always something to be learned.”

Want to Volunteer? Lifespan has a dedicated line for those who are interested in becoming ombudsmen or receiving ombudsmen services. Call 585-244-8400 Ext. 114.

Golden Years

1 in 9 U.S. Adults Over 45 Reports Memory Problems


of dementia, and what public health half of those people also said they f you’re middle-aged and you officials should start addressing had limitations performing daily think you’re losing your memory, now,” said Matthew Baumgart, tasks. you’re not alone, a new U.S. govsenior director of public policy at Among those aged 45 and older ernment report shows. the Alzheimer’s Association. who were living alone, 14 percent In fact, one in nine Americans “This issue is not going away said they were suffering from deaged 45 and older say they are expe— we are continuing on a path of a clines in mental function. Among riencing thinking declines. those suffering from a chronic According to the U.S. Centers for huge problem in the United States, and unless we do something, it’s disease, 15 percent reported some Disease Control and Prevention, nonot going to be reversed,” said cognitive decline, the report showed. ticing a decline in your mental abiliThe researchers also found that a ties (“cognitive decline”) is one of the Baumgart. The CDC researchers also found greater percentage of people aged 75 earliest signs of impending Alzheithat more than half of those reportand older reported cognitive decline mer’s disease or dementia. ing cognitive decline have difficulty than those aged 45 to 74. “Symptoms of confudoing everyday things like cooking, Moreover, only 45 percent of sion and memory loss are not a cleaning or taking medications. those who said they had memory normal part of aging,” said lead Baumgart stressed that many or other mental issues had spoken researcher Christopher Taylor, a CDC people who experience memory about their condition with a doctor, epidemiologist. “Adults with confulapses will not go on to develop Alzthe findings showed. sion or memory loss should talk to heimer’s disease or dementia. This is unfortunate because some a health care professional who can “But many will,” he said. “It’s memory problems are reversible, evaluate their symptoms and discuss a warning sign that something isn’t Baumgart said. In addition, there are possible treatments, management right.” things you can do if you have memoof other co-occurring chronic health For the study, the researchers ry problems even if they may not be conditions, advance care planning, used data from the 2015 and 2016 reversible. and caregiving needs.» Behavioral Risk Factor Surveillance “But if you don’t talk to a health One Alzheimer’s expert noted System surveys. care professional about those memthe findings point to an even larger Newspaper-internet ad for: Improving Well-Being for Older Adult Family Dementia Caregivers (RSRB The investigators found that 11 #60901)ory problems in the early stages, issue. percent of people aged 45 and older you’re missing a key window of “This survey is an indicator reported having mental decline, and opportunity,” Baumgart said. of the future problem and burden

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(585)-284-3455 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 23

Back to School What Should Your Children Do If They’re Bullied at School? By Deborah Jeanne Sergeant


o your children know what to do when they’re bullied at school? While no victims are to blame for experiencing bullying, their response at times can help diffuse some “entry level” bullying from escalating further. Peter Navratil, licensed clinical social worker practicing at Tree of Hope Counseling in Rochester, said that a foundation of trust and communication can help children who are bullied get help as needed. “They should feel comfortable reaching out to teachers and their parents about what’s going on,” Navratil said. “For kids who are experiencing bullying, if they don’t have a support system, it can feel very isolating and demeaning.” Many children feel ashamed about bullying or fear retribution if they ask adults for help. Trusted adults who take their experience seriously can help them develop strategies for dealing with bullying. “Kids who feel good about themselves have a way of shrug-

ging it off,” Navratil said. “As soon as there’s no benefit to the bully, it tends to disappear. Kids have to have enough self-esteem —what I like to call ‘self-compassion’ — to let it roll off of their backs.” Children who have a niche where they shine brightly — academics, sports, clubs or other activity — can become “bully-proof,” according to Navratil because they feel good about themselves and can ignore bully taunts. Nancy McQueen Mooney has a master’s in education and works as a school counselor in the Brighton School District. She is also a counselor in private practice in Brighton. She encourages parents to help bullied children to find something they love to do at school or after school activity. “That can help so much,” McQueen said. This strategy can help children develop better social skills and discover how they want to stand out in a positive way. She said that bullies often target

children who will respond dramatically. She coaches children that instead of an emotional response, they should come back with a statement that diffuses the situation and even practice them in front of a mirror. “Maybe be a little feisty, like saying, ‘I don’t remember asking your opinion’ to a put-down,” McQueen said. Humor can also deflate bullying attempts. She also teaches children mindfulness to help them calm down and not let bullying bother them. That strips away the bully’s emotional power over the victim. It may help bullied children to realize why some kids bully others. Sometimes, it’s because they’ve been bullied themselves and want to gain

control in a social setting instead of feeling like they can be victimized again. By diffusing the situation and offering friendship, some bullying victims can make a friend. Trusted adults can also help children differentiate between verbal digs and bullying that can quickly turn dangerous. McQueen advises children to let an adult know right away if they don’t feel safe. It’s also important to not return bullying for bullying. “Then it’s this vicious circle,” McQueen said. “That will never help at all. Not all bullied kids do that, but those who do are desperate and don’t know what to do.” She works with parents and the students involved to resolve bullying issues among students. Pediatricians and therapists may also help.

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

You’ve Made It: Welcome to Age 66! Big question now: Should you apply for full retirement with the Social Security ot wait? See ‘Financial Health’ column inside


Things to Know About ‘Nightmare Bacteria’ By Ernst Lamothe Jr.

Researchers identified more than 200 cases of “nightmare” bacteria with new or rare antibiotic-resistance genes in the U.S.


uperbugs so powerful they are resistant to antibiotics have become a reality in the United States. Known as “nightmare bacteria,” the Centers for Disease Control and Prevention recently found 221 antibiotic resistance genes. The agency detected 11 percent of people carried those genes even though they carried no symptoms. Antibiotic-resistant germs kill more than 23,000 Americans each year and that figure could be going up. “Superbugs are a major problem and a grave threat to public health,” said Emil Lesho, infectious diseases physician and the healthcare epidemiologist for Rochester Regional Health. “This is a crisis that people should be aware of and worry about.” Here are five things Lesho wants people to understand about the issue.


The “nightmare bacteria” are real and the problem they cause is growing. By 2050, healthcare research and various agencies predict antibiotic resistance genes could be the cause of 10 million deaths per year worldwide. Bacteria evolve, mutate and acquire genetic traits that make them impervious to antibiotics. These genetic resistance-causing traits can then easily spread to other bacteria, even to very different types and species of bacteria. And once it spreads, it can be very difficult to control. Imagine a world where 700,000 United States citizens die each year because of the “nightmare bacteria” situation; the equivalent of killing off everyone in a city like Denver or Seattle.

“It is one of the greatest health threats we are dealing with,” said Lesho. “This is something that is happening all over the world. We could be headed into a post-antibiotic world where common infections can kill.”


What is the cause of the resistance? Experts say many of the ‘superbugs’ we see today were unheard of or very rare 10 to 15 years ago. But why? One reason lies in the medical and agricultural communities. Overuse and misuse of antibiotics are some of the ways people have developed an antibiotic resistance. While taking antibiotics can take care of infection and make the healing process go quicker, it has also led to doctors prescribing it for longer periods of time than needed. It has also been prescribed for conditions where antibiotics are not effective such as viral infections of the throat, ears and lungs. “We have healthcare providers who are over-prescribing and having their patients take antibiotics for two weeks or more, when a few days will do,” said Lesho. “The susceptible bacteria are evolving through natural selection and increasing.” Lesho believes the medical and agricultural communities should step up and be the first line of defense to stem the crisis of escalating antibiotic resistance. “The CDC and other agencies and organizations are educating the public and physicians about the importance of using antibiotics wisely,” he said. “Physicians must take the lead in being good stewards and intervening. Whether that is in hospitals or nursing homes,

The Role of Physical Therapy in Integrative Healthcare By Marcia Spoto PT, DC, OCS


ntegrative health can be considered simply as the combination of traditional and alternative healthcare approaches in addressing the health needs of the individual. It represents an evolution in the way society views contemporary health practice. Under the older paradigm, “complementary and alternative medicine” (CAM) was something outside of medicine, optional for some people, but lacking a scientific basis. So what has changed? For one thing, the science has changed. In fact, the National Institute of Health (NIH)

has sponsored research on CAM through its former National Center for Complementary and Alternative Medicine (NCCAM). Through this research, they have been able to help the public sort among the options and provide evidence either in support, or not in support, of specific CAM therapies. This effort recognizes that a significant majority of Americans are utilizing CAM interventions, and that optimal application of these therapies occurs when they are combined with traditional approaches to care. Thus, this division of NIH has recently become the Center for Complementary and IntegraAugust 2018 •

we need people to be healthcare champions and be responsible about the prescribing antibiotics.”


Opioids Opioids has become a nationwide crisis. Opioids are a class of drugs that include the illicit drug heroin as well as prescription pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl and others. The issue is that patients who are addicted to opioids often develop severe, life threatening infections that require weeks or months of antibiotic treatment. This puts continuous pressure on the bacteria to develop resistance. “People who have opioids addiction often suffer from severe infections and those type of infections are often long-term, and recurring” said Lesho.

Emil Lesho, infectious diseases physician and the healthcare epidemiologist for Rochester Regional Health. “We have healthcare providers who are overprescribing and having their patients take antibiotics for two weeks or more, when a few days will do,” he says. of time and not used for growth promotion in agriculture.

Look at our food One of the most common causes of infections in humans and animals are known as E. coli. In China, a super-E. coli has developed because of the widespread use of a certain type of antibiotic in agriculture to promote faster growth of animals. The genetic trait causing superbug or “nightmare bacteria” easily spreads from one species to another. These bacteria can also get into the environment through animal and human stool and may spread to produce that is irrigated with contaminated water. “When you are discussing our food and our water, those are two elements that we need to survive,” said Lesho. “These bacteria and their genetic traits have been found in our food, water and sewage. Antibiotics should only be taken when needed and for a short period



tive Health (NCCIH). Much more information can be found on their website: https://nccih.nih.gov/. So how does physical therapy fit in with integrative health? It could be argued that physical therapists have been practicing integrative health since the beginning of the profession in the early part of the 20th century. Many types of alternative or complimentary therapies, such as joint manipulation, relaxation exercise, and various movement disciplines (i.e. yoga, Pilates), are utilized by physical therapists along with more traditional forms of therapy such as patient education and conventional exercise. Physical therapists employ multiple types of therapies to treat musculoskeletal or nervous system conditions. The specific combination of therapies is determined by many factors, and physical therapists consider the whole patient in planning the most appropriate care.

This is important because a foundational principle of integrative health is that it is holistic and patient-centered. More people are choosing conservative approaches, like physical therapy, for musculoskeletal pain problems, and this parallels the growing interest in integrative health.

Globally spreading Population displacement is at record levels from wars and regional conflicts. As a result, many of these countries lost their stable public health institutions. “Sanitation was disrupted. You had mosquito-borne illness in climates that really foster disease,” said Lesho. “You had drinking water that was scarce and other factors that cause spreading of antibiotic bacteria problems. There are so many reasons why this has grown to the forefront of the medical community.” “A crucial part of healthcare are antibiotics,” said Lesho. “Look at many of the major healthcare developments in the 20th century. You couldn’t do most of those without antibiotics, including elective surgery, joint replacement, transplants or chemotherapy.”

Marcia Spoto is a physical therapist and owner of STAR Physical Therapy in Fairport. She holds a Doctorate of Physical Therapy degree and she is certified as a clinical specialist in Orthopedic Physical Therapy (OCS). For more information, visit www. star-physicaltherapy.com or call 585-425-1018.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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H ealth News Schneiter to lead Thompson’s corporate communications Mary Schneiter of Canandaigua is the new director of corporate communications for UR Medicine Thompson Health. A graduate of Niagara University with a bachelor’s degree in commerce and marketing, Schneiter was most recently a communications manager Schneiter for Constellation Brands, Inc., where she developed and executed strategic communication programs for the Victor-based Fortune 500 company. Prior to her tenure at Constellation Brands, she worked at Hobart and William Smith Colleges in Geneva, serving as the associate director of annual giving and parent relations, as well as assistant director of internships. Her background also includes marketing-related work in the nonprofit sector with the Smith Opera House/Smith Center for the Arts in Geneva; a city of Geneva-funded tourism development grant; and various committee and community board seats. At Thompson, Schneiter oversees marketing and public relations, internal communications, and all digital efforts. Her department also includes the health system’s physician and community liaison function, with oversight of physician outreach and community wellness education and events.

Highland Hospital nurse honored with national award Valerie Aarne, clinical nurse manager in the Highland Hospital medical imaging department, has received a 2018 Honorary Award from the American Nursing Association (ANA). Aarne is one of only 10 nurses in the country to be honored with the Aarne award this year, according to a hospital press release. The ANA Honorary Nursing Practice Award celebrates the achievements of nurses who have proven to be exemplary leaders and advocates. Recipients are highly accomplished registered nurse leaders who are directly involved in patient care. They are recognized by peers for their contribution to the advancement of nursing through their strength of character, commitment, and competence. Aarne has been the clinical manager in the medical imaging department at Highland Hospital since 2011. Along with her duties at Highland, she is also on the New Page 26

York State Board for Nursing, the American Journal of Interventional Radiology editorial board and the International Advisory Board for the Nurse Education Today Journal. Aarne is a skilled writer and has contributed to dozens of nursing journals over the years. She has also written several award-winning books on nursing, including “Facts for the Radiology Nurse” and “Fast Facts for the Triage Nurse.” “It takes great compassion and commitment to be a strong nurse leader,” said Melissa Derleth, chief nursing officer of Highland Hospital. “Valerie displays those values on a daily basis with her patients, their families, and her colleagues at Highland. We are so proud to have such a dedicated and talented individual as part of our team.”

Thompson Health honors three professionals The Service Excellence Team (SET) at UR Medicine’s Thompson Health recently announced the second-quarter recipients of the health system’s Service Excellence Awards. The recipients are: • John Goodman of Canandaigua, MRI technician, MRI; • Renee Martinez of Farmington, nuclear medicine technician, nuclear medicine; and • Sierra Schaubert of Rushville, sonographer, ultrasound 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.

Dentist joins Comella Orthodontics in Victor Dentist Xiomara Restrepo has recently joined Comella Orthodontics in its Victor location. “It’s a pleasure to have her join the practice and add more days to our Victor location to accommodate the busy schedules of our patients,” said dentist Brandon Comella, the practice’s principal. “She is fluent in Spanish, is very Restrepo friendly, and is extremely skilled in the practice of orthodontics.” Restrepo was born and raised in Colombia where she received her dental degree as class Valedictorian in 2001 from Universidad del Valle. She worked as general dentist in Colombia for five years before moving to Rochester in 2005 to continue with her education with fellowships on temporomandibular disorders, advanced education in general dentistry, general practice residency and certificate in orthodontist at Eastman Institute for Oral Health, University of Rochester. Restrepo still enjoys being part of the UR as a faculty clinical instructor

in the orthodontic department. She loves to travel, scuba dive, paddle board, ski, hike, cook and spend time with friends and family. She has a 9-year old son (Jacob) and a French bulldog, Manolo. In addition to Victor, Comella Orthodontics sees patients at its Brighton location.

Thompson’s James Taylor receives national recognition UR Medicine Thompson Health Nutrition Services Director James Taylor recently received a Top 10 Il luminating Excellence Finalist Award from Premier, Inc., a healthcare improvement company encompassing approximately 3,900 U.S. hospitals and more than 150,000 other healthcare organizations. Taylor Presented on June 20 in Nashville, Tenn., during Premier’s annual Breakthrough Conference, this award recognizes an outstanding food service professional for improvements in operations, participation in Premier activities, professional/community activities and personal achievements. “It is always great to have the opportunity to be recognized for the effort, time and diligence put forth in order to assist in the mission and goals that we have as an organization. We are able to achieve these outlined goals through the dedication of our team,” Taylor said. “ While I am proud to receive this award of recognition of accomplishment, my team members are the individuals who make this happen daily. I merely provide the vision. They are the true shining stars,” Taylor, a resident of Rush who joined Thompson Health in December 2016 after working as an assistant unit manager/nutritionist at The Col-

lege at Brockport, was nominated by US Foods. US Foods is a leading food service distributor and partner of the Rochester-based Pandion Optimization Alliance, a group purchasing organization (GPO) and supply chain management company that works with Thompson Health.

Highland’s palliative care program recertified Highland Hospital’s palliative care program has received advanced recertification from the Joint Commission, the nation’s main accrediting body in health care. This is the third recertification for the program. Highland first received Joint Commission advanced certification for palliative care in 2012 and recertification in 2014, 2016, and 2018. Palliative care focuses on alleviating suffering and providing symptom-relieving care and support during all stages of illness, including end of life. “This program is one of the reasons Highland is such an incredible place to come for quality, patient-centered care,” said physician Daniel Mendelson, founder of the Palliative Care Consult Service. “Our palliative care program assures that patients and their families have the resources of a large hospital in the setting of a comfortable community hospital during the toughest time in their lives.” The recertification is a result of a rigorous site visit from a Joint Commission surveyor. The decision is based on standards of care, clinical practice guidelines, and performance measurement activities. Palliative care programs that successfully demonstrate compliance are awarded a two-year certification. Highland’s core palliative care team consists of five physicians, a nurse practitioner, and a physician assistant. The extended team includes pastoral services, social work, nursing, and hospice. The program completes more than 500 palliative care inpatient consults a year.

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Experts say overuse of mobile devices can be called an addiction and can be harmful. Are you a smartphone addict? See our test on page 8

A Creek Runs Through It Sulfur Creek in Clifton Springs has helped attract a number of people to The Springs Integrative Medicine Center & Spa. They say they seek relaxation and healing. We went there to check. Page 12

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Cherry Tomatoes Like all tomatoes, cherry tomatoes often make superfood lists. Find out why you should eat more of them

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We finally got our pool. We waited our whole lives, but with all that was going on we just never had the time. Now we do—and time for a lot more. Like cooking and fitness classes, relaxing dinners, and just enjoying our time together. Best part: it all happens right here at Chapel Oaks.

Come see our indoor pool and much more! Schedule a tour today: (585) 697-6606 St. Ann’s Community at Chapel Oaks, Irondequoit Page 28

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