IGH Rochester #157 September 2018

PRICELESS

Meet Your Doctor URMC pediatrician Stephen Cook: Want to reduce child obesity? Get the parents to lose weight as well

Clinical Trials There are more than 100,000 clinical trials conducted in the U.S. every year. Some websites can help find the right one

GVHEALTHNEWS.COM

SEPTEMBER 2018 • ISSUE 157

Special Needs Issue Starts on page 16

It’s A Match

Syracuse-area man gets new kidney at Strong Hospital — from his wife

Dan Lill started the group that would later become R Community Bikes. It repairs and distributes 2,000 bicycles to dozens of community organizations, needy families and individuals with disabilities in Rochester every year.

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Tips to Increase Male Longevity

Page 8

Heads Up on Head Lice

Back to school means a higher incidence of lice. See what’s the latest in treating the problem

Don’t just survive on your own ... THRIVE! Reed it in Live Alone & Thrive

Making a Difference, Two Wheels at a Time

Why You Should Eat Pears

Besides how refreshing and delicious a crisp pear can be, pears are a super source of fiber and a goldmine of phytonutrients

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You’re Not Alone Half of Americans are trying to slim down

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Exercise Really Can Chase Away the Blues … to a Point E

xercise is good for your mental health, as long as you don’t overdo it, researchers say.

An analysis of data from 1.2 million people in the United States found they reported 3.4 days a month of poor mental health on average.

But those who were physically active had 1.5 fewer “down” days a month than those who were not active.

Being active for 45 minutes three to five times a week was associated with the biggest benefit.

Exercise had the greatest impact on people with diagnosed depression, the findings suggested. In this group, those who exercised had 3.75 fewer days of poor mental health a month than those who were inactive — 7.1 days versus 10.9 days.

“Depression is the leading cause of disability worldwide, and there is an urgent need to find ways to improve mental health through population health campaigns,” said study author Adam Chekroud. She is an assistant professor of psychiatry at Yale University.

The study included 75 types of physical activity — from sports and exercise, to childcare, housework and lawn mowing.

Team sports, cycling, aerobics and going to the gym were associat-

ed with the largest reductions in poor mental health days, possibly because they reduce social withdrawal and isolation, the study authors noted.

People who were active three to five times a week had better mental health than those who exercised more or less, according to the study published Aug. 8 in The Lancet Psychiatry.

Thirty to 60 minutes of physical activity was associated with the biggest reduction in down days (about 2.1 fewer days each month). But exercising more than three hours a day appeared to be worse for mental health than not exercising at all, the researchers said.

The associations seen in the study don’t prove a cause-and-effect relationship, however.

“Previously, people have believed that the more exercise you do, the better your mental health, but our study suggests that this is not the case,” Chekroud said in a journal news release. Exercising more than 23 times a month or for more than 90 minutes at a pop was linked to poorer mental health, the researchers said.

The links appeared to be universal.

“Exercise is associated with a lower mental health burden across

people no matter their age, race, gender, household income and education level,” Chekroud said. “Excitingly, the specifics of the regimen like the type, duration and frequency

— played an important role in this association.”

Researchers hope to use the information to personalize exercise recommendations.

AMERICANS WALK 5,000 STEPS A DAY ONLY HALF THE RECOMMENDED AMOUNT Let’s get stepping! ExcellusBCBS.com/LiveFearlessNation Page 2

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

Jewish Senior Life’s Physician House Calls program brings a team of skilled, compassionate healthcare professionals and a wide range of services—directly to your home.

Our doctor provides one-on-one primary care, medical assessments, and coordination of care with other home health services. The Physician House Calls team will work with you to develop a comprehensive care plan that will give you and your family peace of mind.

This program is available to individuals 65 years and older.

“Dr. Baratta is wonderful. I feel comfortable when she is here; she’s so welcoming and makes me smile.”

Call (585) 244-5993 or visit jslphysicianhousecalls.org A service of Jewish Senior Life

– Lily, Physician House Calls patient since 2010

2021 Winton Road S., Rochester, NY 14618

PRIMARY CARE • HEALTH ASSESSMENTS • CARE COORDINATION • MEDICATION REVIEW September 2018 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Sept. 11

Hearing loss group holds meeting in Rochester

Hearing Loss Association of America Rochester Chapter invites anyone interested in hearing loss to any or all of several events on Tuesday, Sept. 11. All programs are held at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. (Enter only through Westminster Road door.)

• 10 a.m. Hearing Other People’s Experiences (HOPE) meets in the church vestry room. Prospective or new hearing aid users can share their experiences, questions, and hearing loss journeys in an informal round table discussion facilitated by retired audiologist and current hearing aid user Joseph Kozelsky.

• 11 a.m. to 1 p.m. Parish hall.

Program begins at noon. “Audiology in Zambia” with audiologist John J. McNamara. One sole audiologist serves the 15 million inhabitants of Zambia, formerly Rhodesia, located in Southern Africa. McNamara, owner of Ontario Hearing Centers, participates in Entheos, an organization focusing on humanitarian services locally and in Third World countries with a philosophy of “giving back.”

McNamara has worked with the hearing impaired population for over 35 years • 7 to 9 p.m. Parish hall Program begins at 8 p.m. “Approach to Tinnitus and Dizziness” with physician Paul Dutcher. Tinnitus is the perception of sound when no actual external sound is present. According to the America Tinnitus Association, an estimated 50 million Americans suffer from some form of it. Dutcher, associated with the Rochester HLAA

chapter since its inception, explains tinnitus and its management. He will also present his approach to dizziness.

He has been on the faculty at University of Rochester Medicine since 1983, having obtained his internship and residency here with a fellowship in otology and neurotology at the House Ear Clinic in Los Angeles. Many HLAA members are or have been his patients.

All HLAA programs are free.

Anyone interested in hearing loss is welcome. For more information, view the organization’s website at hearinglossrochester.org or phone 585-266-7890. Those needing a sign language interpreter for an evening meeting should contact Linda Siple at 585-788-6744 a week in advance.

Please note, this phone is only for those needing an interpreter.

Sept. 13

Divorce 101 presentation in Henrietta

Neutral Ground Support Organization, a nonprofit peer support group for people who are divorced, widowed, separated or ending a significant relationship, will host speaker B.J. Mann who will discuss the topic Divorce 101. Mann has been a divorce and family mediator for more than 17 years. She brings more than 30 years of prior business, mentoring, coaching and community leadership to her practice of mediation. She is also the past president of the Rochester Association of Family Mediators.

During the event, which takes place from 7 to 9 p.m. at Henrietta UCC, 1400 Lehigh Station Road, Henrietta, Mann will give an overview on how to get a divorce in New

York state and highlight the changes to the tax laws as well as clarify issues of child support, alimony and parenting, among other issues.

After her remarks there will be time for questions and brief discussion.

Mann’s new book: “A Better Not Bitter Divorce” will also be available as a resource.

This event is open to the public.

A donation is requested for all attending: $5 from the public, $4 from Neutral Ground members.

Neutral Ground meets from 6:30 to 9 p.m. every Thursday at Henrietta UCC, 1400 Lehigh Station Road, Henrietta. For more information, visit https://NeutralGroundSupport.org.

Sept. 15

Washington, D.C., doctor to speak at vegan event

The public is invited to attend the September meeting of the Rochester Area Vegan Society to hear physician Milton Mills speak on “Having the Courage of Our Convictions: Lessons for the Vegan/Vegetarian Movement Drawn from the Bible and the Struggle for Civil Rights.”

Mills is an intensivist (critical care and ICU) physician in the Washington, D.C., area, and is associate director of preventive medicine with Physicians Committee for Responsible Medicine.

The event will start with a potluck dinner at 5:30 p.m. Sept. 16 at Brighton Town Park Lodge, 777 Westfall Road, followed by the program at 7 p.m.

Please bring a dish with enough to serve a crowd, and a serving utensil; also bring a place setting for your own dinner. We can help non-vegetarians or others uncertain about how

to make or bring a vegan dish; please call 585-234-8750 for help.

A $3 guest fee for non-members will be charged.

For more information, call 585234-8750 or visit rochesterveg.org.

Oct. 5

Workshop for women who live alone

Do you live alone? Is it a challenge for you?

Alone and Content: How to Survive and Thrive on Your Own, is a one-day workshop offered for divorced or widowed women who want to rediscover joy and contentment, and to gain the know-how to forge a meaningful life on their own.

You’ll meet others in similar circumstances and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world.

The workshop takes place at House Content Bed & Breakfast in Mendon from 9:30 a.m. to 4 p.m., Friday, Oct. 5. Breakfast snacks/coffee/ tea and a delicious healthy lunch will be provided. The workshop fee of $165 includes interactive discussion, empowerment exercises and helpful resources you can trust.

Gwenn Voelckers, who writes the column “Live Alone and Thrive,” published monthly in In Good Health, leads the workshop. Voelcker recently wrote the book “Alone and Content — Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For registration and more information, send an email to gvoelckers@rochester.rr.com or visit www.aloneandcontent.com.

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Rochester New York’s Healthcare Newspaper

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Author of Live Alone & Thrive Column In this workshop led by Gwenn Voelckers - a woman who's "been there" - you'll discover how to think differently about living alone, overcome loneliness,reconnect with your true self, and socialize in a couples' world. $165 fee covers engaging, interactive discussions, empowerment exercises, and trusted resources.

To register, call (585) 624-788 or email gvoelckers@rochester.rr.com Page 4

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

What is Sleep Apnea?

Sleep Apnea is the temporary stoppage of breathing during sleep. There are three types of apnea: obstructive, central and mixed; of the three, obstructive is the most common. People with untreated sleep apnea stop breathing repeatedly during the night, maybe hundreds of times.

Sleep Disorder Symptoms

Most Americans Support Gene Editing for Babies to Treat Diseases, Poll Finds

T

he idea of using gene-editing technology to tweak a baby’s DNA before birth has been the topic of fierce debate for years. But now, most Americans say using this technology on embryos would be acceptable under certain circumstances, according to a new poll.

The poll, from the Pew Research Center, found that 76 percent of Americans say that altering an unborn baby’s genetic characteristics in order to treat a serious disease the baby would have at birth is an appropriate use of gene-editing technology.

In addition, 60 percent of Americans support the use of gene-editing technology in unborn babies to reduce the child’s risk of developing a serious disease over his or her lifetime, the poll found.

However, only 19 percent of Americans say it would be appropriate to use the technology to make a baby more intelligent; the vast majority of Americans, 80 percent, say this would be taking the technology too far.

Once the realm of science fiction, gene editing for babies is getting closer to becoming a reality thanks to the development of the gene-splicing technology known as CRISPR, which allows scientists to precisely cut and insert pieces of DNA. In 2017, U.S. scientists announced that they had used CRISPR to edit genes in human embryos to correct a mutation that causes a heart defect. (The embryos were discarded, and they did not progress far in development.)

Still, there are many safety and

ethical issues surrounding editing human genomes that have yet to be explored. Currently, the U.S. Food and Drug Administration doesn’t allow clinical trials that involve editing the germ line, or making genetic changes that can be inherited.

It’s likely that the development of gene editing will involve testing the technologies on human embryos (as the 2017 study did), but most Americans are averse to this idea: The Pew poll found that 65 percent of Americans say that if gene-editing development requires testing on human embryos, it would be taking the technology too far. (Only 33 percent of Americans say that it would be appropriate to test on human embryos to develop gene-editing technologies.)

The poll also found that Americans who are highly religious differ in their acceptance of gene editing compared with those who are less religious. For example, among the highly religious, 46 percent say it would be appropriate to use gene editing to reduce a baby’s risk of disease later in life, while 53 percent say this would be taking the technology too far. Among the less religious, 73 percent say using gene editing to reduce a baby’s risk of disease later in life would be appropriate, while only 27 percent say this would be taking the technology too far.

The survey is based on interviews with a nationally representative sample of more than 2,500 U.S. adults, conducted from April 23 to May 6.

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, Amy Cavalier, Payne Horning, Carrie Buckert, Ernst Lamothe Jr. • 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.

September 2018 •

If you experience any of the following symptoms, you may suffer from a sleep disorder: • Daytime fatigue • Morning drowsiness • Insomnia • Gasping for breath in the middle of the night • Snoring

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585-425-1018 www.star-physicaltherapy.com 790 Ayrault Rd. Fairport, NY 14450 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 5

Meet

Your Doctor

By Chris Motola

Stephen Cook, M.D. URMC pediatrician: Want to reduce child obesity? Get the parents to lose weight as well Q: You recently received a $3.1 million as part of a multi-site effort to study childhood obesity. What’s this study hoping to achieve?

A: This is a contract funded by the Patient-Centered Outcomes Research Institute, PCORI. They’re kind of like a federal funding agency, though they’re not the National Institutes of Health. Their charge has been to take research findings and testing their implementation. You’ll hear about a study that showed, say, a 20 percent reduction in cholesterol. It was performed in a clinical setting, but it’s still not a real world implementation. There are lots of steps to support the people in the studies; some are paid to attend. This is meant to take an evidence-based behavioral approach to obesity, embed in primary care and apply it in a real world setting.

Q: I understand it’s focusing on broader family behaviors. I take it there’s more to this than “eat better, move more?”

A: It’s a behavioral intervention targeting kids between 6 and 16. The key is that we’re having them partner with their parents. It’s not the child alone. So it’s not just the parent taking the kid to a session. The parent gets specific behaviors to change not just for the child, but themselves. So we track both the parents and the children. The research in controlled settings found that parents typically exhibited between 15 to 20 pounds of weight loss, and their own weight loss was a strong predictor for whether their children lost weight.

There aren’t any studies that have shown this kind of halo effect on the adult side. The only other interventions that have shown a beneficial effect to the children was a relationship between bariatric surgery patients and their children, specifically mothers who undergo it showing a beneficial effect on their sons, and more than their daughters.

But there are other lifestyle interventions for adults that don’t show this kind of halo effect. There’s no evidence that children benefit from their mother’s diabetes intervention, or even that her spouse does.

So we like the fact that we’re getting a two-for-one.

And we’re also tracking the effects on siblings and partners.

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Q: That’s really wild that it was so specific in the case of that bariatric surgery study. Mothers and sons, but not mothers and daughters?

A: There was a study out of Pennsylvania that looked at data from their electronic records. The strongest effect was on women and their sons. I believe it was significant for the daughters as well, just not as much.

Q: With your project, is the intervention more effective on young children or teenagers?

A: We’re looking at kids up through 16, but when they start getting around 11 or 12 the effect of the parent isn’t as great since the children have a lot more independence, are hanging out with their parents less. There have been studies in preschool age where the parent is responsible for 99 percent of the intervention and the kids are just there.

So we’re trying to strike a balance. As we get into the older teens, we want the parent involved, but it’ll be in more of a supporting role.

Q: What behaviors have the biggest effect?

A: It’s dependent on the family. Our coaches assess the family dynamic. Meal planning and identifying healthy foods.

Edu-

cation is important, since many foods that aren’t healthy are labeled as healthy. We use a stoplight approach, where we categorize foods as red, yellow, green. You can have all the green foods as much as you want, the yellow and red less often. Getting families to go from not planning meals to planning meals is a big lifestyle change and takes some education. We also look at things like stress eating, mild mental health problems if they’re present. We talk about appropriate amounts of screen time and mindfulness; whether someone is watching TV and suddenly a bag of chips or half gallon of ice cream is gone. Sleep patterns, sleep routines.

Q: Seems like we’ve been struggling to get a handle on the obesity epidemic for a while. What changed in the mid-’70s that put us on the road to being so overweight?

A: The problem is that a variety of things changed. Modern conveniences keep coming into our lives, fast food, convenience stores, food subsidies. We subsidize corn and soy more than we do fresh fruits and vegetables. There are also biological factors like gut bacteria and the effects of antibiotics. We’re noticing that there’s a relationship between heavy antibiotic use in the first two years of life and rates of obesity.

There are chemicals in our food supplies that affect hormones. And, honestly, just stress. Adverse childhood experiences, abuse, poverty, they don’t just affect your mood, they affect your biology. It may affect how you store and burn calories. If you’re constantly in a state of fight or flight, it alters your metabolism.

Some might say, given all of these factors, it’s amazing obesity isn’t even more of a factor than it is today.

Q: Is the project underway now?

A: It officially began Aug. 1. We are actually spending the first year setting up our team and engaging stakeholders. We’re taking our intervention and curriculum and taking it out to primary care doctors and asking what they’d need to make it work. We’re going out to families

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

In the News The a $3.1 million funds that URMC has received to study childhood obesity is part of a $13.9 million study, funded by the Patient-Centered Outcomes Research Institute (PCORI). It encourages overweight parents to attempt to lose weight themselves in addition to assisting with their child’s nutrition and physical activity goals.

In previous smaller studies, this approach has reduced obesity in children and has seen parents lose an average of 15 to 20 pounds. and getting their opinions since this is meant to be intensive. Does it need to be delivered in person? Could it be done with an app and limited guidance? So we’re looking about how to roll this out in the real world. That’s really important, because obesity is a stigmatized condition.

Q: Is social weight stigma a useful tool or an obstacle to fighting obesity?

A: It’s a huge barrier. If bullying and nagging worked, we wouldn’t have this problem since we have no shortage of those behaviors. It undermines people. Graduate students applying for PhD programs are evaluated different if they’re obese.

Even in preschool, obese children are often treated differently. There’s a lot of literature showing that we have biases that associate obesity with poor moral fiber, laziness, lack of will, but the truth is there’s a lot of biology in this that isn’t within the individual’s control.

Q: The biggest challenge with behavioral changes seems to be that willpower and attention span are finite resources. How do you keep patients engaged?

A: They are. We have this constantly distracting society and that’s a huge barrier. So breaking people out of routines is a big piece of this.

And we also need to identify barriers and issues as they arise. There’s some literature showing that women who apply to bariatric surgery, some 25 percent of them, have experienced sexual assault at some point in their life. The concept of “adverse childhood experiences” actually comes from adult obesity literature. It’s stuff beyond their control and can’t be solved by just telling them to count calories and walk more.

Lifelines Name: Stephen Cook, M.D. Position: Associate professor of pediatrics and internal medicine Hometown: Rochester Education: SUNY at Buffalo School of Medicine & Biomedical Sciences Medicine, medical degree; University of Rochester School of Medicine & Dentistry, Master of Public Health (MPH) degree; post-doctoral training and residency, plus fellowship at University of Rochester Medical Center Affiliations: Golisano Children’s Hospital; University of Rochester Organizations: American Academy of Pediatrics; American Heart Association; the Obesity Society Certifications: American Board of Internal Medicine; American Board of Pediatrics Family: Wife, three kids, one dog Hobbies: Time with family, yard work

- Hippocrates

Follow us on social media: @roclifemed

Contact us now to learn how you can prevent and reverse chronic diseases such as: • Heart Disease • Type 2 Diabetes • Obesity • High Blood Pressure • Elevated Cholesterol and more!

At the Rochester Lifestyle Medicine Institute (RLMI), we use evidence-based Lifestyle Medicine and Plant-Based Nutrition programs to empower patients to take charge of their health. We offer various programs and courses such as: • 2-week Jumpstart Program - Lose weight, improve vitals and feel great in 15 days • 6-week Nutrition Course - Learn how to embrace a Whole-Food Plant-Based Diet (Physicians can receive professional credit.)

• 18-week Complete Health Improvement Program - For Long Term Health with Guidance!

Free CHIP Information Sessions 9/20/18 and 9/27/18 at 6:30 pm

Call: 585-484-1254 Email: info@roclifemed.com Visit: roclifemed.com/events

Lifestyle as Medicine Lecture Series - Begins 9/24/2018 Ian Cramer (Rochester’s Plant-Based Cyclist), spreads the message that diet and lifestyle dramatically affect individual health as well as the health of the planet. His topic will be “Overfed & Undernourished.”

Matt Ruscigno, MPH, RDN, an LA-based Registered Dietician, endurance athlete, and long-time vegan, examines the relationship between Plant-Based nutrition and physical fitness.

Natalie P. Santiago, MD, FAAP, a Chicago-based, board-certified pediatrician, helps children and their families transform to vibrant health with a nutritious, delicious Plant-Based diet.

“Dr. Veggie” Ted Barnett, MD

Healthcare in a Minute

By George W. Chapman

Investments Show Telehealth Growing — and It’s Here to Stay

I

f insurance companies are investing in or partnering with telehealth companies, then you know telehealth or virtual medicine has arrived. Historically, physicians have been somewhat reluctant to embrace telehealth primarily because of low reimbursement. However several factors are contributing to a change of heart including an aging and less mobile population, consumer preference, improved IT security, the continuing shortage of physicians and value or outcome-based reimbursement from Medicare, Medicaid and commercial carriers. CIGNA and

Health Care Service Corporation just invested $50 million with telehealth company MDLive, and Anthem has invested $365 million in Samsung and American Well telehealth companies to make virtual visits available on Galaxy mobile phones. Insurance companies are lowering copays and fees for telehealth/virtual visits to cut into expensive and often unnecessary visits to urgent care centers and emergency rooms. They are focused on providing their members with choice, personalization and affordability.

Senior bankruptcy Three percent of seniors will file for bankruptcy this year, and it is a steadily increasing percentage of all bankruptcies. There are several factors for this: more people are retiring from companies that no longer provide pensions, credit card debt, bad investments, lack of planning and an unforeseen calamity. But the looming reason behind most senior bankruptcies is medical debt. Medicare covers 80 percent of physician claims and some drug costs. A chronic condition, serious illness, accident and out-ofpocket drug expenses can easily wipe out hard-earned savings.

Focus on patients As the industry transitions to value/outcome based payments, hospitals and physicians are transitioning from being “treatment-centric” entities to “patient centric” entities.

Their focus is on attracting, engaging, managing and retaining patients. In order for this to succeed, as patients, we must bear more responsibility for our care. Providers are implementing strategies to make it easier for us to stay in touch, be informed and be

proactive versus passive in our care.

Patient portals, wearable devices, telehealth, patient education programs, specifically targeted information sent directly to your phone, navigators and digital apps are all there to strengthen the relationship.

In addition to a patient focus, healthcare systems must eliminate wasteful practices, many of which were driven by fee-for-service or volume incentives, and rely more on data and analytics to manage their patients and their bottom lines.

Fewer docs feel overworked According to a recent survey of 3,700 physicians sponsored by two large MD staffing agencies, fewer physicians feel overworked or are considering retiring early compared to just two years ago. While the survey is somewhat heartening, physician burnout is still a serious issue.

• 56 percent of respondents said they feel overworked; • 55 percent say they have less free time than when they first started practicing; • 48 percent of physicians said they spend less time with patients September 2018 •

now than when they first started; • 74 percent of the physicians responding said they recognize the signs of burnout in their colleagues; • 40 percent said burnout effects their job satisfaction and family life; • Only 17 percent of physicians suffering burnout have sought help.

The study did not attribute the slight “improvement” in results to anything. One reason for the improvement could be that physicians are getting used to and less frustrated with electronic medical records.

Many physicians report spending several hours after work and on weekends keeping their records up.

Market consolidation Bigger is better, especially at the negotiating table. In order to get the upper hand at the negotiating table, hospitals are merging with other hospitals while insurers are merging with other insurers. In order to preserve competition and protect consumers from monopolistic pricing, the Department of Justice must approve and then monitor all mergers.

While the common justification for both hospital and insurance mergers is cost reduction, it hasn’t always been the case. The DOJ has split apart mergers when the larger hospital or insurer proceeded to take advantage of their newfound clout in the market and raised prices. According to the Commonwealth Fund, 90 percent of metropolitan statistical areas (MSAs) are either “highly” or “super” concentrated provider (hospital) markets and that 54 percent of MSAs were highly concentrated insurance markets. Provider concentration was higher than insurance concentration in 58 percent of MSAs. Premiums have increased and provider choices have decreased across the board for most Americans, not just those covered by the ACA.

Millennial caregivers A recent article in the Wall Street Journal presented an alarming trend.

As the US population grows older, accelerated by aging baby boomers,

the age of the average care giver grows younger. An estimated 6.2 million millennials account for 24 percent of unpaid caregivers, averaging 21 hours a week caring for an elderly parent or relative. One-third of millennials are caring for someone with dementia. By 2050, it is estimated that potential caregivers will increase by only 13 percent while those requiring their care will increase by 160 percent. The places a tremendous personal and financial burden on younger generations who are building careers and starting families.

Short-term health plans Under the Affordable Care Act, short-term plans were limited to just three months. They were offered primarily to bridge the time one had to wait until the next open enrollment period. The Trump administration has recently finalized a rule allowing insurers to offer short-term plans covering 12 months and then renewable for two more years. These purported “affordable plans” do not have to cover pre-existing conditions or the essential health benefits that were the hallmarks of the ACA. So buyer beware. According to HHS Secretary Alex Azar, “Under the ACA, Americans have seen insurance premiums rise and choices dwindle.”

The problem with that statement is health insurance premiums have risen and choices have dwindled for all Americans. Just ask any employer that pays for most of the premium.

The ACA is simply a microcosm of the entire health insurance industry.

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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Page 7

Making a Difference, Two Wheels at a Time R Community Bikes gives away over 2,000 bicycles to dozens of community organizations and families in need every year. It has given away 28,000 bikes since it started in 2008

By Amy Cavalier

I

t all began when Dan Lill offered to fix a flat tire while volunteering his time to serve lunch in a soup kitchen. From that good deed sprouted a weekly bike clinic at St. Joseph’s House of Hospitality.

As more volunteers began collecting and distributing bikes to those in need in Rochester, the group merged with another nonprofit that had a warehouse, which later folded.

In 2008, R Community Bikes (RCB) was officially formed.

The goal of the area nonprofit is to make transportation more accessible for those in need. Owning a bicycle allows people to get to places that are too far to walk or not accessible with public transportation, among other benefits, according to RCB Executive Director Dan Lill.

“It gives kids the opportunity to take a break from screen time and play,” said Lill. “It can help adults save money on public transportation and even improve their health without realizing it.”

Nearly 100 steady volunteers dedicate 18,000 hours repairing and distributing 2,000 bicycles to dozens of community organizations, needy families and individuals with disabilities in Rochester every year.

In addition, volunteers perform nearly 3,000 repairs for individuals, many of whom depend on a bicycle as their main source of transportation.

Jim Morris, vice president for the Catholic Family Center (CFC), said R Community Bikes has helped his agency outfit with bicycles many refugee children resettling in the area.

“To a kid who has spent their life hemmed in by walls or barbed wire, where you were lucky to get the bare necessities for life, to come here and be given a bike to call your own is a gift beyond expectation, a gift of freedom akin to a magic carpet,” Morris said. “R Community Bikes might seem like just a couple thousand small acts of kindness, but what this operation gives to that individual is often immeasurable.”

Have bike, will travel Morris said R Community Bikes has been a tremendous advocate for providing many individuals in Rochester with a means of transportation — everyone from kids in CFC’s child welfare programs to refugee families and folks coming out of homeless shelters.

“Transportation is a huge obstacle to so many of Rochester’s most vulnerable populations,” he said.

“Mobility allows for options and economic opportunity. Having a bicycle provides people with a lifeline so they can get to work, school, their doctor.”

R Community Bikes runs a repair clinic every Tuesday at the Westside Farmers Market in southwest RochPage 8

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How to Support R Community Bikes

Members of a refugee family getting their bikes through R Community Bike. Photo provided. ester.

“It is always a joy to see people come to the market and line up to wait for bike repairs,” Market Manager Jackie Farrell said. “They know that repairs are first-come, firstserved, so they want to be first in line. If R Community Bikes were not at our market, our number of shoppers would go down drastically.”

A large percentage of our city residents do not have access to a motorized vehicle, said Farrell.

“Providing them with a bike, and keeping it in good repair, is essential for their transportation,” she said.

“People can ride together on bikes, forming new friendships. Bikes are good equalizers — no judgment about your financial status, where you live or who your friends are.”

Volunteers make the wheels go around In addition to serving as the executive director, Lill is a RCB board member and bike mechanic.

“There’s something new every day, from teaching a teen how to ride without training wheels to learning the life stories of our volunteers and customers,” said Lill.

Gene McCabe, 70, began volunteering with R Community Bikes after retiring as a psychologist for 40 years.

“There is considerable satisfaction in providing a meaningful service to less privileged individuals,” said McCabe. “Working with the customers is the most rewarding aspect of this work. They are extremely grateful and appreciative of the service and the generosity of the all-volunteer staff.”

Lill said R Community Bikes’

growth has been in response to the community’s needs. The demand is so large, the agency has outgrown its 6,000-sq.-ft. warehouse and needs to find a larger facility.

“We have daily bike repair clinics in the community throughout the summer time so that we can meet the needs of a folks in other parts of the city,” he said. “None of this was planned. We just responded to the need.”

• Volunteer to help with everything from clerical work and record keeping to mechanics, dismantling bikes, repairing tubes, organizing parts and maintaining their headquarters.

• Donate a bike, tools or money to cover expenses such as spare parts.

• Purchase a bike — R Community Bikes sells higher quality new, like-new and gently used adult bikes running anywhere from $100 to $150 with some high-end models going for more.

All bikes are tuned and adjusted before being sold.

• Bike giveaways — take place twice a week at RCB’s headquarters located at 226 Hudson Ave. in Rochester.

• Free bike repairs are available several days of the week at a number of locations.

• Learn more with the Rochester Minimalists during a tour of R Community Bikes, followed by a question and answer session at 6 p.m., Wednesday, Oct. 10.

Visit https://rcommunitybikes.org for RCB’s hours of operation and more information on the services they offer.

Part of a group of volunteers who dedicate 18,000 hours repairing and distributing 2,000 bicycles to dozens of community organizations, needy families and individuals with disabilities in Rochester every year. In addition, volunteers perform nearly 3,000 repairs for individuals, many of whom depend on a bicycle as their main source of transportation. Photo provided.

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

It’s A Match Syracuse-area man gets new kidney at Strong Hospital — from his wife

By Payne Horning

I

t was a conversation the Paquettes hoped they would never have. In June of 2017, the couple sat down with a team of doctors at Strong Memorial Hospital to discuss their options for a kidney transplant. Jeff’s only kidney was diseased, and he was in need of a replacement.

As they were talking about the process of putting Jeff on the waiting list and how long it could take to find a match, his wife Marlene volunteered hers.

“We hadn’t even discussed it,” Marlene said. “I just knew that I was going to try.”

Offering her kidney turned out to be the easy part, Marlene says, the difficulty was what followed.

Marlene had to go through a series of tests, including bloodwork and scans, to ensure she was in good health.

She was. Then, there were more tests to ensure the two were a match.

They were. And then she had to stay completely healthy leading up to the procedure. Even a cold could postpone it indefinitely, which was easier said than done for an operation that was scheduled in February.

Marlene says it may have just been a coincidence that she and Jeff were a match, but she believes it was much more.

“I just think I had it in me that we would,” She said. “They ask you many times why are you doing this.

And I just said I always thought there was another reason we were together, deep down. There’s a reason that we met. Maybe this was meant for me to be his donor down the road.”

Marlene says she was not surprised they were a match, but Jeff was that she even offered to begin with.

“I couldn’t believe she wanted to donate to me,” Jeff said. “I was very humbled and emotional at the time to think she would do that for me.”

Fortunately, the operation, which took place in February, was successful and Jeff’s body has thus far not rejected the new kidney. But Marlene says the work is not finished.

Both have regular checkups and must stay on top of their potassium intake, as well as drink at least three liters of water a day. It’s little sacrifice, Marlene says, for her husband of

The Paquettes: When Jeff Paquette of Mexico, Oswego County, found out he would need to have a kidney transplant, his wife Marlene didn’t hesitate. She decided to donate one of hers.

36 years.

To honor her selflessness, Jeff nominated his wife for the New York State Senate’s Women of Distinction Award.

“I felt she deserved to be recognized,” Jeff said. “There aren’t many people who are living donors. She is a hero for that in my book.”

In addition to that award, Marlene won a New York State Gift of Life Medal of Honor. Marlene says she appreciates the recognition, but that’s not why she did it. Love pushed her, she says, despite the many opportunities she was given to opt out.

“You can literally back out up until the time they knock you out,” Marlene said. “And they said, ‘Are you sure you want to do this?’ And I said ‘Yep, I’m ready let’s go.’ My

sister looked at me and said, ‘I can’t believe how calm you are.’ I go, ‘I’m not really calm, I’m just ready. We’ve been talking about this and now the day is here, let’s do it.’”

The kidney transplant changed the Paquettes’ lives in more than one way. It took their relationship to a whole other level, as Marlene puts it.

The couple has since become advocates for those in need of organ donations, and those who have gone through the process. Jeff shares his experiences and tips online with people who are about to undergo the operation. And the two recently participated in the Rochester River Run, a 5K walk/run event to raise awareness and funds for those who await, undergo and recover from transplant surgery.

       .

A place where family and iends are always welcome. Where medical staff is as respectful and compassionate as they are skilled. And where our patients receive the absolute best end-of-life care and support. To schedule a visit, call Holly, our Admissions Nurse, at (585)697-6308.

S. A’ C  P A.  R, NY  ./

September 2018 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Don’t just survive on your own ... THRIVE! Here are six success strategies for living alone and finding contentment

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o you live alone? If so, here’s a follow-up question for you: Are you just surviving or are you thriving? There’s a huge difference, of course.

Merriam-Webster defines surviving as “continuing to exist.” Thriving means “to grow and develop well and vigorously.”

Fear of change or the unknown can keep you stuck in survival mode.

Or perhaps it’s lethargy or out of habit that you find yourself just putting one foot in front of the other to make it through your day.

That was the case for me after my divorce, until I got tired of the same ol’ same ol’ and wanted to get more out of life. I wanted to experience more, to feel more and to connect more with others. I wanted to find meaning and purpose in my life.

Is there something bigger and better out there for you? Inspired

by the word “THRIVE,” here are six success strategies for living alone and finding contentment.

Think differently Your beliefs determine the life you have. If you don’t like the results you are getting in your life, take a look at changing the beliefs that are producing those results.

You have a choice.

Choose to focus on your strengths, your gifts, and this unique opportunity to define what you want out of life and then to create a life that is consistent with your goals and values.

Help yourself When you live alone, you need to become your own “nudge,” your own motivator and cheerleader.

Setting goals is a wonderful and very effective way to give your life direction and purpose.

Goals can put passion into

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everyday existence. Goals should be written down; expressed in positive, affirming language; assigned a deadline; be achievable; and reviewed regularly.

Rediscover and reconnect A key to living alone successfully is to determine who you are and what you really want for your life. No “shoulds” or other people’s agendas.

Identify those things that fully engrossed you as a child or that today completely consume you — those things that make you feel whole, as though nothing is missing.

These are your “loves” and they reveal your true self. When you live your life consistent with these loves, you’ll feel less alone, more energized and alive.

Invest in your future On your own or with help, there’s no time like now to find out where you stand financially and where you want and need to go. Start today to align your spending with your values, to “find your stuff,” and to create a plan to protect your future.

Peace of mind and a sense of empowerment are the rewards for those who come out from under the covers, ask for help if they need it, and get their financial house in order.

Vow to banish negative thinking Negative thinking can get in the way of your goal to feel better and to have the life you want. Take deliberate action when negativity creeps into conscious thought: (1)

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just turn it off, or (2) give yourself a limited amount of time to dwell on a negative thought and then move on, or (3) replace a negative thought with a positive one or (4) repeat a personal and positive affirmation.

Letting go of old ways of thinking, of a negative self image, of anger, of regret or any self-limiting thought or behavior will free you up to embrace your new life and the possibility of feeling whole and complete on your own.

Embrace the possibilities You have an opportunity in front of you — an opportunity that many people never have the chance to experience. Today you can, perhaps for the first time ever, fashion a life that reflects your dreams, your style, and your true self.

It can be a precious gift — this time of rediscovery and renewal. Embrace it. When that happens, living alone becomes secondary to living fully. Surviving becomes thriving!

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Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon.

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

School Prep Includes Planning Allergy, Asthma Management

A

llergies and asthma can make the start of the new school year a challenge for kids who aren’t prepared to deal with flareups, an allergist warns.

“Every age group is different in how much they can handle when it comes to protecting themselves from flare-ups due to allergies and asthma while at school, as well as severe allergic reactions from food allergies,” said physician Bradley Chipps. He is president of the American College of Allergy, Asthma and Immunology (ACAAI).

“But every student wants to feel good and be free from their triggers when they’re away from home,” he added in an ACAAI news release.

Here are tips from the organization that can help: Page 10

•

• Children from pre-kindergarten to fourth grade. These young students need their parents to speak on their behalf. Talk with your child’s teachers before school starts to inform them of your child’s allergies and the kind of reaction they might have to allergens in the classroom.

Meet with the school nurse and administrators to create a health plan for your child. Also, tour the classroom to identify possible allergy triggers, such as wall-to-wall carpeting or a class pet.

• Children in grades 5 to 8. At this age, children can likely speak up for themselves about possible allergens in the classroom, cafeteria or other areas of the school. But when you fill out your child’s school

registration, be sure to note if they have allergies or asthma, need to carry medications or need to avoid certain foods.

All states allow students to carry and use medications for asthma and severe allergic reactions. Your child should know how to use these medications in an emergency.

• High school students. Teens probably know how to handle their allergy and asthma medications, but they may be too self-conscious to carry or use them.

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

Parents of high school students should encourage them to regard self-care as a “next step” in their journey toward independence.

• Going off to college? Young adults will have to assume much more responsibility for managing their allergy or asthma. For example, he or she might need to contact school administrators to discuss necessary arrangements for dorm living and meals. Students who will be living far from home may have to find a new allergist and pharmacy.

7

Tips to Increase Male Longevity

Men’s Health

Men in New York (and in the U.S.) live shorter lives than women. Here are some suggestions to extend their life expectancy

T

on cancer prevention. One out of nine men are diagnosed 1.“Work

with prostate cancer and that can impact men’s health because of chronic morbidity and coping with the disease aftermath.

Healthy weight and diet are important for cancer prevention. A few anti-inflammatory things can help, like improving vitamin D and vitamin E levels. Eat enough eggs, fish and fortified foods like milk. Relatively safe exposure to sunlight helps with D. Lypocene-rich foods like tomatoes, watermelon and apricots show good association with improving men’s health and suppressing things that stimulate cancer growth.

“Omega-3 fatty acids show variable evidence at this point in reducing risk of heart disease and prostate cancer. There’s low relative risk in taking it.

“Try to see what you can do to improve mental health. Many articles talk about the rise of depression and suicide, and not necessarily only men. Mental health for men is

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Boxers vs. Briefs and Your Chances of Becoming a Dad

A

ttention guys: Your tightywhities may not be doing your sperm any favors.

Men who wear tight-fitting briefs have sperm counts that suffer in comparison to men who wear boxers, according to results from the largest study to date on the controversial topic.

“Men who wore tighter underwear had lower sperm counts than men who wore the most loose underwear,” said senior researcher, physician Jorge Chavarro, an associate professor of medicine with the Harvard T.H. Chan School of Public Health in Boston. “This was reflected both in sperm concentration as well as in total sperm count.”

Men who wore boxer shorts had 25 percent higher sperm concentration than those who wore briefs, researchers found.

They also had 17 percent higher sperm count and 33 percent more swimming sperm in a single ejaculate.

However, Chavarro noted that the average sperm count across all types of underwear was well within

normal levels.

“Even though individual men in this study could have had sperm levels that were low, on average these men were fairly normal,” Chavarro said.

“For most men, it’s probably a nonissue,” he concluded. “Men who may benefit the most are men who’ve been trying a while and continue to struggle getting their partners pregnant.”

A number of smallscale studies previously have linked tighter underwear to lower sperm counts, Chavarro said. This study has the largest sample size yet, including 656 male partners of couples seeking treatment at the fertility center of Massachusetts General Hospital in Boston.

The theory is that higher temperatures caused by body-hugging underwear interferes with the testicles’ ability to produce sperm, a September 2018 •

arthritis, improves cardiovascular health and wellness and decreases cancer risk.

Some foods have high anti-inflammatory and anti-oxidant properties. Some foods are the opposite. Eat in a way that will promote a healthy lifestyle.”

• Joanne Wu, an integrative and holistic medicine and rehabilitation physician who specializes in wellness, teaches yoga.

5.

must strive to practice 6.ing“We good self-care and make livlonger and happier a bigger

By Deborah Jeanne Sergeant he average New York male has a life expectancy of 77.92 years, according to www.worldlifeexpectancy.com, compared with 82.79 for women. It’s understandable that men’s life expectancy tends to be shorter than women’s. Many male-dominated occupations such as commercial fishing, forestry, farming, construction and electric line workers tend to be high-risk occupations.

Men also tend to engage in riskier hobbies at higher rates than women and riskier behavior in general, such as performing stunts, smoking and using illicit drugs. Men don’t tent to maintain regular doctor visits and ask about health screenings.

Men can take a few steps to increase their potential for a long, healthy life. Two local doctors offer suggestion for a longer and healthy life

“Maintain a good weight through 4. exercise and nutrition, as it’s good for health. It decreases risk of

or equal issue in our lives more than risky ‘male-associated’ behaviors like smoking and drinking.

“Also, we can learn to reach out for support when stressed and depressed so we don’t feel the only way out is a painful and shame based suicide. In some ways the [life expectancy] gap may be closing, and this is optimistic, yet we still cannot ignore the many issues men encounter regarding their physical, emotional and psychological health.

Health is not just about longevity as defined by World Health Organization. Health is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity.”

• Robert Giambrone, emergency physician at Rochester Regional Health and a certified life and success coach.

7.

still very under-served. Men need to be more open about it, to talk with loved ones and with primary care providers. Depression affects sleep and ability to function at work and their ability to feel motivated to eat well and exercise. The mind-body connection is very, very strong. If we don’t correlate mental health with physical health, we’re not whole. process called spermatogenesis.

“We know that spermatogenesis is very, very sensitive to temperature,” Chavarro said. “Even relatively small changes in temperature by choosing a type of underwear that would bring the scrotum closer to the abdomen could, in theory, have an effect on spermatogenesis.”

Men in the study were between 18 and 56 years old. Each provided a semen and blood sample, and answered a questionnaire that asked about the type of underwear they most often wore during the preceding three months.

Among them, 53 percent wore boxer shorts.

The rest wore tighter underwear.

Researchers also found that men who wore boxers had 14 percent lower levels of follicle-stimulating hormone (FSH).

FSH promotes sperm production. Higher levels in men who didn’t wear boxers could be evidence of the body trying to compensate for the challenge to sperm production wrought by tight underwear, Chavarro said.

However, those efforts aren’t enough.

“Even though they have higher FSH levels, these men still have lower sperm count. Were it not for the higher FSH levels, their sperm count would probably be even lower,”

Chavarro said. “There seems some compensation, but this compensation is not sufficient to bring them back to sperm counts of men who wear looser-fitting underwear.”

Although this study adds new information in the ongoing battle of boxers versus briefs, there are a few important caveats, said Dr. Jennifer Kawwass, medical director of IVF and third party reproduction at the Emory Reproductive Center in Atlanta.

“It is very important to recognize that the study does not prove a causal relationship between briefs and infertility, but rather an association between briefs and a lower, though still normal, sperm count that may or may not be a cause of infertility,” she said.

So don’t run out and buy a pack of boxers because you’re worried about your sperm counts, Kawwass added.

“This study does not necessarily suggest that men should alter their clothing preferences and tendencies; the study was conducted among men in an infertility clinic and the results may not be generalizable to men in the general population,” she said. “Additionally, the differences in hormone and semen analysis parameters were not different enough to be identified as the primary cause of infertility.”

The study was published Aug. 8 in the journal Human Reproduction.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Number of Opioid-Addicted Women Giving Birth Quadruples

T

he number of pregnant women addicted to opioids as they give birth has more than quadrupled since 1999, a disturbing new report shows.

In 2014, for every 1,000 hospital deliveries, 6.5 were mothers who arrived at the hospital with opioid use disorder, up from 1.5 per 1,000 in 1999, the U.S. Centers for Disease Control and Prevention researchers found.

This increase is likely linked to America’s ongoing opioid epidemic, said study co-author Jean Ko, an epidemiologist with the CDC’s division of reproductive health.

“With the opioid overdose epidemic, it’s natural to see increases in opioid use disorder among the general population,” Ko said. “Our data tell us that women presenting for labor and delivery are no different.”

Opioid use during pregnancy has been tied to maternal death during delivery, stillbirth and preterm birth, the CDC researchers noted.

Even babies born healthy might have to go through opioid withdrawal, a condition known as neonatal abstinence syndrome (NAS).

Babies with NAS can experience tremors, convulsions, seizures, difficulty feeding, breathing problems, fever, diarrhea and trouble sleeping, according to the March of Dimes.

The CDC study used data from the Agency for Healthcare Research and Quality, focusing on 28 states with at least three years of data available for analysis.

Between 1999 and 2014, all 28 states saw significant increases in opioid-addicted pregnant women entering labor.

Vermont and West Virginia had the most cases of opioid-affected pregnancies in 2014. Vermont had 48.6 cases for every 1,000 deliveries; West Virginia had 32.1 cases per 1,000. On the low end, Nebraska had 1.2 cases per 1,000 and the District of Columbia had 0.7 per 1,000.

The average annual rate increases were highest in Maine, New Mexico, Vermont and West Virginia. Those states all had growth of more than 2.5 cases per 1,000 each year -- six times higher than the national average of 0.4 cases per 1,000.

The states with the lowest increases were California and Hawaii, with fewer than 0.1 new cases per 1,000 each year.

Page 12

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Men’s Health

New Dads Can Get the Baby Blues, Too

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ostpartum depression isn’t limited to moms.

Rates of depression among new fathers are similar to those among new mothers, and more needs to be done to help these men, two psychologists say.

“Recent research has shown that roughly 10 percent of new dads experience postpartum depression, and up to 18 percent have some type of anxiety disorder,” said Dan Singley, of the Center for Men’s Excellence in San Diego.

“Unfortunately, few psychologists receive focused training regarding identifying, assessing or treating common men’s issues in the period from conception to a year or so post-childbirth,” Singley said in a news release from the American Psychological Association.

Men tend not to seek mental health services during this period, so theres a lack of scholarly attention to this vulnerable group, Singley added.

Singley’s work on male postpartum depression was scheduled for presentation Thursday at the annual meeting of the American Psychological Association in San Francisco.

Sara Rosenquist is also addressing dads’ postpartum depression at the meeting at the same time.

“The predominant narrative has attributed these experiences to hormonal changes and fluctuations specifically related to pregnancy and birthing,” said Rosenquist, of the Center for Sexual and Reproductive Health Psychology in Cary, N.C. “It is highly unlikely that the hormonal disruptions of pregnancy and birthing would explain the whole picture if fathers and adoptive

parents all experience postpartum depression at the same rates,” added Rosenquist.

Factors that could trigger anxiety and the “baby blues” in new fathers include sleep deprivation, exhaustion, time away from work, gender role conflict and concerns about being a good parent, the psychologists said.

New and expectant fathers should be screened for signs of depression, Rosenquist and Singley believe.

However, identifying depression in men can be a challenge because

New Opioid PSAs Local professionals say new campaign to curb use of opioids won’t work

By Deborah Jeanne Sergeant

R

emember the public service announcements (PSAs) from the Partnership for a Drug-Free America in the 1980s depicting an egg in a hot pan to show “your brain on drugs” as it fried?

New PSAs released by Office of National Drug Control Policy (ONDCP) to address the opioid crisis, the Truth Initiative and the Ad Council, also discuss drug abuse in a dramatic fashion. Based on true stories, they show people purposefully hurting themselves to obtain more prescription pain medication. For example, smashing a hand with a hammer or driving a car into a dumpster.

Though the spots warn “opioid addiction can happen after just five days,” area experts contest the effectiveness of the new PSAs, which debuted on TV and social media in June.

“The people who need to hear it aren’t necessarily the ones watch-

ing,” said Peter Navratil , a licensed clinical social worker who practices at Tree of Hope Counseling in Rochester.

While Navratil does think that the new PSAs raise awareness, he’s not sure that the message they contain clearly connects the dots between how some people start taking opioids, as prescription medication after surgery, which eventually leads to medicating for feelings of depression and hopelessness. And, as the PSAs purport, inflicting significant self-harm to obtain more medication.

“For most people caught up in this, their compassion toward themselves has disappeared,” Navratil said. “They’re self-loathing. They’re disgusted with themselves. They’re not paying attention to themselves and they won’t see, ‘This is very harmful; I shouldn’t do this.’ PSAs only make sense for us in the thinking world. If you’re in the midst of

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

they can have different symptoms than women, Rosenquist said.

“Women are more likely to report feelings of sadness and frequent crying, whereas men are more likely to feel irritable and socially disconnected,” she said.

One thing that can help men avoid postpartum depression is support from friends, Singley said.

“Fathers who maintain solid social support networks experience a buffer from the conflicts and demands associated with parenting,” he said. addiction, this stuff doesn’t grab you.

It’s an attempt, but I don’t know how to measure how successful they are.”

Navratil wants more attention on different options for pain management. Patients have the right to ask for other, non-addictive means to manage pain than opioid medication when they’re injured or about to undergo surgery.

While the PSAs do grab attention, Nancy McQueen Mooney, licensed mental health counselor with a private practice in Brighton, isn’t sure the message is effective.

“A lot of times, these are written by people who don’t have chemical abuse in their background,” she said.

Mooney also has a master’s in education and counsels in the Brighton School District. “Addicts will go to any end to get what they want,” she added. “Their love affair is with a drug. They won’t care what they have to do to get it.”

She thinks that people who aren’t addicted to drugs may not readily identify with the extreme examples of self-harm depicted in the videos.

Mooney wants more parents to begin the dialogue about drug abuse sooner, so children understand that taking illicit drugs or abusing prescription drugs leads to damaged health and possible death. Enlisting the help of an objective third party, such as another trusted adult the child respects, can also help influence behavior.

SmartBites

whisk in oil. Season dressing to taste with salt and pepper.

Toss greens in large bowl with enough dressing to coat. Divide greens among six plates. Top with pear slices, dividing equally. Sprinkle with cheese and walnuts. Drizzle lightly with remaining dressing and serve.

The skinny on healthy eating

Pears: A Sweet Treat You Should Eat

W

hy reach for a pear? Besides how refreshing and delicious a crisp pear can be, pears are a super source of fiber and a goldmine of phytonutrients — those beneficial compounds found in plants that are thought to have health-protecting qualities.

One medium pear — with its skin on — boasts nearly 6 grams of fiber, which, for many, is about a quarter of our daily needs. Conveniently, pears deliver both soluble and insoluble fiber. Pears’ soluble fiber — pectin — helps regulate blood glucose levels and lower cholesterol, while pears’ insoluble fiber promotes regularity. A well-run system improves bowel-related health problems, like constipation, hemorrhoids and diverticulitis.

Adequate intake of fiber is a long-established factor in reducing our risk of both heart disease and Type 2 diabetes; and in the case of pears, this benefit may be even more pronounced due to the helpful combination of both kinds of fiber.

Like most fruits and vegetables, pears come packed with important

phytonutrients that help to quell inflammation and mop up cell-damaging free radicals. Many experts believe that the work of these naturally occurring compounds may thwart the development of certain cancers and other life-threatening diseases.

Nicely low in calories — about 100 per medium pear — pears can help with weight maintenance and loss. In fact, studies support that the more fresh fruit and vegetables someone eats, the less likely they are to gain weight. Modest calories notwithstanding, a pear’s high fiber and water content may also contribute to weight control, as both nutrients help us to feel fuller longer.

Although pears contain natural sugars in the form of fructose, they have a low glycemic index (GI), according to the American Diabetic Association. The GI is a scale from one to 100 that ranks how foods affect blood sugar. Because of their impressively high fiber content, pears unleash sugar into the bloodstream slowly, providing us with a steady stream of energy.

What other nutrients do pears

Helpful Tips

bring to the table? Pears are a good source of immune-boosting vitamin C, bone-building vitamin K, and energy-producing copper.

Pear, Walnut and Gorgonzola Salad Adapted from Bon Appetit-Serves 6

3 tablespoons fresh lemon juice 1 tablespoon Dijon mustard 1 tablespoon minced shallot 1 teaspoon dried thyme 1/3 cup olive oil salt and pepper to taste 5-6 cups of mixed greens 2-3 medium, ripe pears: halved, cored, thinly sliced lengthwise 1 cup crumbled Gorgonzola 1 cup walnuts, toasted, coarsely chopped

If you want a ripe pear to eat immediately, press a finger gently into the top of the pear where the stem joins the fruit. If it yields to pressure, the fruit is ripe. A ripe pear will last in the fridge about three to five days. If you want to eat the pear in a few days, the top should be hard. Hard pears, stored at room temperature, will ripen in a few days. You can speed things up by placing the pears in a paper bag with a ripe banana or apple.

Whenever possible, eat the nutrient-rich skin. If you eat canned pears, choose versions packed in 100 percent fruit juice (versus sugary syrup).

Anne Palumbo is a lifestyle colum-

nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Whisk first four ingredients in small bowl to blend. Gradually

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Page 13

5

Things to Know About Sleep

By Ernst Lamothe Jr.

A

good night’s sleep is sometimes referred to as one of the best free medicines a person can get. And too often the general public is suffering from a lack of it.

“Rest is something that can be vital in restoring and strengthening your immune system,” said physician Alice Hoagland, director of the Insomnia Clinic at the Unity Sleep Disorder Center. “People who suffer from excessive tiredness start to feel emotionally, psychologically and physically different. People have experienced increases in blood pressure, mood disorders and depression because of lack of sleep.”

Hoagland offers five tips to good sleeping.

1.

Get regular sleep

Even though as adults we don’t always like routine, going to bed at the same time each day has significant benefits. Going to bed and waking up at the same time every day will actually help you sleep better at night. Your body has a circadian rhythm that requires sleeping at a regular time. Sporadic sleeping patterns disrupts that pattern and can cause problems throughout the week.

“I know people don’t like to hear

this but you should consider going to bed during the weekend at the same time you go to sleep during the weekday,” said Hoagland. “Your body and brain have a rhythm, and when that rhythm constantly fluctuates, then that will lead to problems sleeping.”

2.

Stay away from caffeine

There are people who say they can drink coffee and caffeinated drinks at night and still sleep well.

They are the chosen few. However for most adults, it’s not a good idea to have coffee or your favorite soft drink right before bed. The most obvious effect of the stimulant is that it can make it hard for you to fall asleep. One study found that caffeine can delay the timing of your body clock, according to the National Sleep Foundation.

“We really do recommend that you stay away from caffeine as far away from your bedtime as possible,” said Hoagland. “It will disrupt your system and either keep you from sleeping or cause you to wake up more randomly during the night.”

3.

Eliminate or reduce technology at night

Technology isn’t always our friends. You carry it around with you

everywhere you go all day — smart phones, tablets, you name it. Too often, we not only take it to bed, but we stare at the screen for hours and then expect to get a good night’s sleep when we are done. To have a good night’s sleep we have to put all of that down. “This is something we see a lot with millenials who are driven by technology,” said Hoagland. “Technology has this addictive quality and a disruption pattern that most people don’t know. The light from the cellphone has an effect on your brain that can prevent it from sleeping.”

4.

Environment is key

Sometimes your surroundings may lead to bad sleep.

Your social environment whether it is the lightness of the room or what’s on your bed makes a difference.

“Two years ago, I told a patient to take a picture of their bedroom and bring it to me. They did and what you saw was piles of clothes everywhere, things in disorder and just chaos. There was even a person who was in a queen size bed and had a laptop and a printer on the other side just in case she ever wanted to wake up and do work,” said Hoagland. “You can find out a lot about a person by how their bedroom looks.”

Hoagland’s advice: Get the place where you sleep in good shape.

Alice Hoagland, director of the Insomnia Clinic at the Unity Sleep Disorder Center: “The light from the cellphone has an effect on your brain that can prevent it from sleeping.”

5.

Relaxation can make all the difference

Peacefulness on your way to bed should be a consistent goal. Hoagland recommends something relaxing like yoga or meditation to ease your way into sleep. “When your body is in a relaxing state, it helps your mind become just as relaxed.

That will trigger a calming effect that will make it easier to sleep,” she said.

“Even doing relaxing, non-strenuous exercising is something we recommend.”

How to Find the Right Clinical Trial There are more than 100,000 clinical trials conducted in the U.S. every year. Some websites can help find the right one

By Jim Miller

E

ach year, hundreds of thousands of Americans participate in clinical trials in hopes of gaining access to the latest, and possibly greatest, but not-yet-on-the market treatments for all types of illnesses. But, you need to be aware that clinical trials can vary greatly in what they’re designed to do, so be careful to choose one that can actually benefit you. Here’s what you should know along with some tips for locating one.

Clinical Trials

A clinical trial is the scientific term for a test or research study of a drug, device or medical procedure using people. These trials — sponsored by drug companies, doctors, hospitals and the federal government — are conducted to learn whether a new treatment is safe and if it works.

But keep in mind that these new treatments are also unproven, so there may be risks too.

Also be aware that all clinical trials have certain eligibility criteria Page 14

•

(age, gender, health status, etc.) that you must meet in order to be accepted. And before taking part in a trial, you’ll be asked to sign an informed consent agreement. You can also leave a study at any time.

Find a Trial Every year, there are more than 100,000 clinical trials conducted in the U.S. You can find them by asking your doctor who may be monitoring trials in his or her specialty. Or, you can look for them on your own at ClinicalTrials.gov. This website, sponsored by the National Institutes of Health, contains a comprehensive database of federally and privately supported clinical studies in the U.S. and abroad on a wide range of diseases and conditions, including information about each trial’s purpose, who may participate, locations, and phone numbers for more details.

If you want some help finding the right trial, try ResearchMatch. org, a web-based resource created by Vanderbilt University that connects

willing patients with researchers of clinical trial. Or, use the Center for Information and Study on Clinical Research Participation at CISCRP.org.

This is a nonprofit organization that will take your information online or over the phone and do a thorough clinical trials search for you, and mail or email you the results within a week or two. Call 877-633-4376 for assistance.

Those with dementia and their caregivers can also locate clinical trials at the Alzheimer’s Association TrialMatch at TrialMatch.alz.org.

Things to Know Before deciding to participate in a trial, you need to first discuss it with your doctor to make sure it is appropriate for you. Then, schedule an appointment with the study’s medical team and ask lots of questions, such as: • What’s the purpose of the study and can it improve my condi-

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

tion?

• What are the risks?

• What kinds of tests and treatments does the study involve, and how often and where they are performed?

• Is the experimental treatment in the study being compared with a standard treatment or a placebo?

• Who’s paying for the study?

Will I have any costs, and if so, will my insurance plan or Medicare cover the rest?

• What if something goes wrong during or after the trial and I need extra medical care? Who pays?

For more information on clinical trials visit the National Institute on Aging (nia.nih.gov/health/clinical-trials), which has many informative articles including one on “questions to ask before participating in a clinical trial.”

Jim Miller is the author of Savvy Senior, a column published monthly in In Good Health.

Can Arthritic Dogs (and Their Owners) Benefit From Stem Cell Injections?

I

f dogs with arthritis can gain benefit from stem cell injections, maybe people can, too.

That’s the opinion of an Italian veterinarian who oversaw the stem cell procedures in 130 arthritic dogs.

“For at least six months, the results are very satisfactory and promising. The lack of any complications in the dog should be taken into account when considering this treatment in other species, including man,” said lead investigator Offer Zeira, of Tavazzano con Villavesco.

Osteoarthritis is the most common form of arthritis in dogs and humans, affecting millions of people worldwide. It occurs when cartilage on the ends of bones wears down

with age, resulting in pain, discomfort and reduced mobility.

In this study, stem cells were gathered from fat tissue in each dog and injected back into the same dog at the site of the arthritic joint. The dog was able to go home the same day as the procedure.

The researchers found improvements in 78 percent of the dogs after one month and in 88 percent of them after six months. There were no major complications.

The study was published recently in the journal Stem Cells Translational Medicine.

“The procedure is a simple, time-sparing, cost-effective, minimally invasive, one-step procedure and

eliminates the need for complex and time-intensive cell culture processing,” Zeira said in a journal news release.

The findings of animal studies usually aren’t replicable in humans.

But Anthony Atala, journal editor-in-chief, was enthusiastic.

“These results are certainly promising, because the therapy appears to be safe, feasible and minimally invasive,” Atala said. “This study underscores the need to now transition this technology to human clinical trials.”

Veterinary hospitals in Italy, Sweden, Israel and the United Kingdom participated in the study.

County, and in Pennsylvania, Arkansas, North Carolina, Virginia and West Virginia.

The ticks were found feeding on horses, dogs, deer, a calf, a sheep and an opossum. They do feed on humans, but experts say you can protect

yourself by following the same measures to guard against domestic ticks, such as using repellents and checking for ticks after walking through woods or tall grass, the newspaper reported.

The Asian longhorned tick.

New Tick Species Spreading in U.S.

T

he first new tick species to appear in the United States in 50 years is spreading rapidly in the East and has been confirmed in seven states and the suburbs of New York City.

In it’s home range, the Asian long-horned tick carries a virus that kills 15 percent of its victims, but it is considered a greater threat to livestock than to humans, The New York Times reported recently.

U.S. public health experts say they are concerned, but not alarmed,

by the presence of the long-horned tick, which is known in Australia as the bush tick and in New Zealand as the cattle tick.

The ticks can reproduce rapidly and suck so much blood from a young animal that it dies, the Times reported.

In the United States, the first long-horned tick was found last summer in western New Jersey. Since then, they’ve been found in Bergen, Essex and Middlesex counties in that state, in New York’s Westchester

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

Special Needs

More Families Willing to Adopt Special Needs Kids

By Deborah Jeanne Sergeant

I

t may seem like children with special needs would wait longer for a permanent home; however, according to Michael Hill, associate director at Adoption Star, Inc., an increasing number of potential adopting families express interest in adopting a special needs child.

Hill said that the 2012 adoptive placements comprised of 73 percent healthy newborns, 15 percent at-risk for developing special needs, and 12 percent born with special needs.

In 2017, the agency placed 63 percent healthy newborns, 26 percent at risk for developing special needs and 11 percent born with special needs.

He explained that in general, the agency has a larger pool of children who have or may potentially have special needs, in part because of the opioid epidemic exposing babies to drugs in the womb and causing them to be form addicted to opioids.

The agency has also made mandatory an adoptive parent training weekend.

“Part of that is sharing a lot of information about kids at risk for special needs or who have special needs,” Hill said. “Because everyone has to come for classes, we can talk all about situations where a pregnant woman has pre-identified issues and that may affect the child. We can share uniform, consistent information on parenting a special needs

child. Being able to educate people on the topic makes families more open to adopting a special needs child.”

While that’s good news for the agency and children they serve, Hill wants more families to understand the differences between general adoption and special needs adoption.

Adoption Star is based in Amherst, Western New York, but places kids statewide.

“Particularly over the course of the last five years, we’re finding at our agencies there are more and more prospective adoptive families who are willing to adopt a special needs child or one who potentially will have special needs,” Hill said.

The agency’s Shining Star program offers financial assistance to help cover special needs adoption costs so adoptive families can allocate more funds toward their new child’s needs.

Some may need early intervention services, specific medical care or additional assistance for home health or childcare.

The Family Star program helps link adoptive parents to the resources that can help them meet their child’s needs, providing information, referrals and support groups for parents.

New York state also provides regional permanency resource centers.

These state-funded centers provide post-adoption support services,

which include respite care, support groups, medical care, and, as needed, referrals.

Hill encourages prospective adoptive parents to do their own research on the children they may parent, both into the child’s medical records and history as provided by the adoption agency, and how these can affect the child’s development.

“It’s important to collect and review that information,” Hill said.

“Go into parenting with eyes wide open, regardless of whether you’re adopting or it’s your biological child.

Pre-natal records and medical history of the biological family help you understand the potential challenges that may exist.”

Hill said that some pediatricians can help prospective parents review the records and understand their implications. Sites such as March of Dimes (www.marchofdimes.org), Mayo Clinic (www.mayoclinic.org), and the American Academy of Pediatrics (www.aap.org) may also help.

Understanding the child’s history is important as “these are things they deal with their entire lives,” said Laura P. Glasner, licensed clinical social worker with Jewish Family Service of Rochester.

“That’s normal processing the facts of their adoption, whether they have special needs or not.”

She also thinks that prospective parents should get as much informa-

tion in advance as possible.

“They may have been considered to have special needs because of emotional and behavioral disturbances,” Glasner said. “It is important to understand the traumatic experiences the child has had and how trauma impacts development on all levels: physical, cognitive, emotional and behavioral.”

She added that many times, behavioral problems are misdiagnosed and are actually caused by trauma.

That’s why parents need to do their own research and tirelessly advocate for their children to receive the resources they need for education, health, or rehabilitation.

“Our society isn’t dedicated to making sure those needs are provided,” Glasner said.

That’s why it’s helpful to seek support groups of other parents who are going through similar experiences.

Despite the challenges in special needs adoption, Glasner said that it’s a wonderful way to build a family.

“Children thrive in loving families.

Children who have many, many obstacles either developmentally or physically or emotionally, when they’re in an unconditionally loving, supportive family, they thrive. I’ve seen this over and over again.”

like check-ups and cleanings. This way, we can keep their good oral hygiene.”

Since many of these patients depend upon others for their at-home dental care, educating caregivers represents part of the program.

“Dental care isn’t really taught to people who work in a group home,” Planerova said. “It’s surprising that sometimes caregivers say, ‘Oh, now I know how to do it.’ There’s a definite need for additional education for this population.”

Her team acclimates patients unfamiliar with dental care by starting with the easiest procedure, such as cleaning. During each visit, providers use a behavior management plan.

“If it isn’t working, we use some oral medication or use nitrous oxide if that didn’t work,” Planerova said.

“If none of those work, we use general anesthesia.”

Caregivers or parents are allowed in the oversized rooms to provide more comfort and to give providers clues as to what will help.

The rooms are specially designed with no equipment attached to the dental chair so providers can treat patients in their own wheelchair, including x-rays, if that’s easier for

the patients.

Even the paint color-dark greenwas chosen with the idea of creating a soothing, low stimulation environment, which also includes dimmer lighting.

“A visit goes very slowly,” Planerova said. “At the next visit, it can go much faster. They know we’re not there to harm them or push them to do something that’s not pleasant.

We need to have a legal guardian to agree to this procedure.”

About 5 percent of the patients are from the community; the remaining 95 percent are medically complex or have some sort of special needs.

Planerova said that dental schools don’t educate much about special needs patients.

In addition to special exam rooms, the office also features a quiet waiting room, which may appeal to patients on the autism spectrum. The front desk personnel can see them from a window. The office also plans the flow of work so that patients don’t have to wait long.

“This population has the same dental needs as anyone else,” Planerova said.

Few Providers Offer ‘Special Needs’ Dentistry

By Deborah Jeanne Sergeant

F

ew people relish a visit to the dentist. For patients with physical, intellectual or emotional disabilities, professional oral health care can become even more difficult.

A few providers in the area offer “special needs” dentistry to ensure they receive proper care.

Oliver Cabrera, dentist with Greece Family Dentistry and Implantology in Rochester, said that the most important “tool” at his office is “a heart for special needs.” He said, “We have a servant’s heart to help parents because many times, they and their child have nowhere else to go after they try several offices.”

Their “equipment” includes taking more time, developing a special plan for them, discovering their triggers and working with parents to find ways to improve the whole experience.

“We do in-office anywhere from using medication, nitrous oxide, to IV sedation,” Cabrera.

If needed for safety, he can provide treatment at a hospital to a patient under general anesthesia.

“It’s a relationship,” Cabrera said. “Many times the parent knows what we should try.”

For example, some autistic Page 16

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patients enjoy the feeling of pressure on their bodies, Cabrera said. So, using the office’s lead apron — even if not doing dental X-rays — provides a comfort measure without restraining Dentist Oliver Cabrera them.

Adela Planerova, dentist and director of dental services at UR Medicine’s Complex Care Center, said that some of her special needs patients live a two- or three-hour drive away — or more.

“There is low access to care,” Planerova said. “We are not known well enough that everyone will know we provide this care.”

Open three years, the Complex Care Center has had 7,000 visits and seen 1,500 unique patients.

“Many patients are screened only every three years and they have general anesthesia,” Planerova said.

“Our goal is to make a dental home for them so they can come every six months for regular dental visits

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

Special Needs

Reversing Autism with a Cancer Drug

R

esearchers may have found a promising new treatment for a genetic form of autism. Using experimental cancer drugs, scientists reversed the condition in mice.

According to the most recent estimates, one in 59 children in the United States have an autism spectrum disorder (ASD).

Over 7 percent of these cases have been tied to chromosomal defects, suggesting that many of the impairments in social communication, movement, sensory perception and behavior that characterize the syndrome are down to genes.

Specifically, some people with ASD are missing a piece of their chromosome 16.

Known as 16p11.2 deletion syndrome, this chromosomal defect often leads to neurodevelopmental disability and language skills impairment.

Now, researchers may have found a way to reverse this genetic form of ASD. Scientists led by Riccardo Brambilla — a professor at Cardiff University in the United Kingdom — used experimental drugs that were initially developed to treat cancer to restore normal brain function in mice with ASD-like symptoms.

The findings are now published in The Journal of Neuroscience.

“The human 16p11.2 microdeletion,” explains Brambilla, one of the most common gene copy number variations 56 linked to autism.”

But the mechanisms that link the chromosomal defect with the neurodevelopmental condition are poorly understood. So, the team designed a mouse model of this chromosomal deficit to examine its pathophysiology.

The mice that had the defect displayed a series of behavioral and molecular abnormalities. These included hyperactivity, dysfunctions in their maternal behavior, and problems with their olfactory perception.

Moreover, the researchers found that mice with 16p11.2 deletion also had higher levels of a protein called ERK2.

ERK2 has been recently emerging as a target in cancer therapy, explain the researchers. This prompted the scientists to test the effect of experimental cancer drugs on mice with 16p11.2 deletion.

The drugs stopped ERK2 from reaching the rodents’ brains, which reversed the ASD-like behavioral, neurological, and sensory symptoms in the mice.

“Importantly,” the authors write, “we show that treatment with a novel ERK pathway inhibitor during a critical period of brain development rescues the molecular, anatomical, and behavioral deficits in the 16p11.2 deletion mice.”

“By limiting the function of the protein that appears to cause autism symptoms in people with the chromosome 16 defect,” explains Prof.

Brambilla, “the trial drug not only provided symptomatic relief when administered to adult mice, but also prevented genetically predisposed mice from being born with the form of ASD.” This occurred as a result of administering the experimental drugs to the mother during gestation. The researcher explains what this means for humans.

“While it wouldn’t be feasible to treat pregnant women who have been screened for the genetic abnormality, it could be possible, in principle, to permanently reverse the disorder by treating a child as early as possible after birth.”

“In the case of adults with the condition, ongoing medication would probably be required to treat symptoms,” he adds.

In the future, the scientists hope to replicate the findings and ultimately test the drugs in clinical trials for people with ASD.

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Page 17

Special Needs

AutismUp Educates, Informs Group formed in 2004 to help parents of children with autism

By Deborah Jeanne Sergeant

R

achel Rosner doesn’t want to see any other parents of autistic children go through what she did in 2004 when her son received a diagnosis of autism. Little information existed to help parents know what to expect, how to help their children succeed and where to find resources.

Four moms of autistic children began meeting for coffee to share what they had learned. That’s how AutismUp, an independent, Webster-based organization, stared in 2004.

Though Rosner’s son is now an adult, she still serves as AutismUp’s director of education and support services and continues to promote the needs of families touched by autism. At present, about one in 59 people has autism.

About 2,500 families are affiliated with AutismUp. The organization employs 20 part-timers and three full-time people. Most have children with autism.

“That’s why it works,” Rosner said. “We know what we want and need because we live it 24 hours a day. That doesn’t mean professionals don’t have a solid understanding, though.”

AutismUp’s children’s programs are available to the general public

Page 18

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“because they’re fun,” Rosner said.

“We have participants in our programs who don’t have an autism diagnosis, but what we offer works for what they need. If we have a program that looks like it would be helpful, come one, come all.”

Many times, a sibling of an autistic child tags along and later invites a friend. Rosner said that the experience benefits both autistic and non-autistic children.

The organization often brings in professionals to speak to families.

AutismUp also provides information, workshops and referrals, in addition to a helpline for referrals.

AutismUp also maintains a closed Facebook group for families. It boasts 950-plus members.

“People can share what they’ve tried,” Rosner said. “It’s a virtual presence, even when you feel alone, you’re not. Someone’s always awake 24 hours a day. It’s a wonderful support we provide.”

AutismUp has developed a team of family navigators who can work with families at no cost to help them understand and access the resources available in the community.

“They coach parents through everything so they can make decisions that suit their family and child,” Rosner said. “We were the first site in the country to have a parent navigator.”

A parent navigator works from the medical facility at Golisano Children’s Hospital. Others work inhouse and still more work at various sites in the community.

“We want to get as many partnerships as we can,” Rosner said.

“We don’t want families to have to go looking. We want navigators in every pocket of the community as members in that community.”

Rosner said that the overall goals of AutismUp are to “prepare our kids for the world and prepare the world for our kids,” which summarizes both the programming that supports families and also the educational/training outreaches. The latter includes businesses who want their employees to serve all members of the community. These companies are proactive, not reactive.

Rosner said that she trains staff of other organizations about how to respond when a visitor “has a meltdown,” so that staff know how to best help the guest and the family.

Or if an autistic child cannot tolerate waiting, it helps if staff can talk with other customers in line so they understand why one family cuts to the front.

Rosner also trains school bus drivers, law enforcement and first responders.

The navigation is free and training and programs are fee-based, but Rosner will not turn away people for financial reasons.

The Golisano Autism Center, opening fall 2019, represents a partnership among AutismUp, CT

Rochester and Al Sigl Center.

“The idea is it’s a one-stop shop for everything that’s not medical,” Rosner said.

The location will offer a pre-K program, housing support and all of AutismUp’s support programs.

For more information, call AutismUp’s helpline at 1-866-autism-4 and visit http://autismup.org.

All in the Language likes the impersonal, business-like So...is it “person-first” lanconnotation of the term. guage or what?

“They are helping people live For a couple decades, profestheir lives,” she said. “’People’ sionals working with people with or ‘individuals’ is friendly and it disabilities have described those they serve with the person first and doesn’t sound like they’re getting checked out at the grocery store” the disability second. Although compared with “client” in this AutismUp doesn’t have an official context. policy on the matter, Rosner has Beth Rapke, behavior intervennoticed a boomerang to “identity tion specialist at The Arc of Monfirst” language.

“It’s not our place to tell people roe, said that based on her experience, “they don’t like person-first how they would like to be referred language. They would like to be to,” Rosner said. “Lots of people referred to not as ‘autistic’ but as like to say, ‘a person with autism’ ‘autistic people.’” and others like to refer to themShe said that the change origiselves as ‘autistic’. I use both internates in the thought changeably when Examples of person-first that autism isn’t a writing in an language: sickness that needs official capacity.”

• “person with autism” healing.

She said • “individual challenged by a “It’s another that her son calls developmental disability” population within a himself and prediverse community, fers to be called Examples of identity-first like Hispanic people “autistic” as an language: or deaf people,” identifier because • “autistic person” Rapke said. “That’s autism makes • “developmental disabled what we need to achim who he is. person” cept them as. They Without autism, say, ‘We’re autistics’ “he wouldn’t because they do not want to be have the same point of view or cured and are offended by people strengths,” Rosner said. who put money into research to Though every person is an ‘wipe them out.’ individual, those served by Au“They taught me how to run tismUp may share similar life experiences and challenges as well. this organization and to focus on their interests, then their strengths Identifying with others can feel and if you put an emphasis on empowering. those, you may not deal with their The term “client” used to be challenges.” widely used to describe individuals served by an organization such as AutismUp; however, Rosner dis-

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

Special Needs

Is Autism on the Rise or Are We Better at Catching It? Latest CDC autism figures from April show 15 percent rise

T

he latest analysis published by the Centers for Disease Control and Prevention concludes that autism might be more prevalent than previously estimated. They are now calling for more effort to be made toward early detection.

Autism spectrum disorders (ASD) are conditions that affect development. They impact the ways a person interacts with other people and alter how they perceive the world.

And, though every case is different, the most common symptoms include delayed speech development, trouble interacting with peers and repetitive behaviors.

As for prevalence, in 2016, the Centers for Disease Control and Prevention (CDC) estimated that it affected one in 68 children — about 1.5 percent of all children. However, as of April this year, they updated this estimate.

The revision comes off the back of the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network. This tracking system follows more than 325,000 8-year-old children, which accounts

for around 8 percent of all 8-yearolds in the United States.

The ADDM assesses the young participants for any characteristics of ASD. It is the largest network of its type and the only one that also follows the health and education of each child.

The data come from 11 communities in Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. The new results were published in April.

According to the analysis, in 2014, one in 59 children — or 1.7 percent — had ASD. That represents a 15 percent rise from two years ago.

Also, boys were four times more likely to receive a diagnosis than girls.

Why has the figure changed?

There are many potential ways to explain why the percentage of children with ASD may have risen. For instance, improvements in the identification of ASD in minority populations could be part of the answer.

Although, ASD is still more likely to be diagnosed in white children than Hispanic or black children.

Physician Stuart Shapira, an as-

sociate director for science at CDC’s National Center on Birth Defects and Developmental Disabilities, explains: “Autism prevalence among black and Hispanic children is approaching that of white children. The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities and increased efforts to have all children screened for autism so they can get the services they need.”

Improving diagnostic services in minority communities is vital; the earlier ASD is caught, the more successful interventions tend to be.

If children are put in contact with support services at an early age, they are more likely to reach their full potential.

Interestingly, autism rates across the 11 communities varied. Five regions had similar levels (1.3–1.4 percent), but the highest rate was seen in the New Jersey community, which hit one in 34 (2.9 percent).

The researchers believe that this disparity might be due to differences in the way that autism is documented and diagnosed in different areas.

After the 2016 results were published, many concluded that the rise in ASD had paused. Now, some believe that this may not be the case.

The take-home message from these findings is that diagnosis needs to occur earlier. For instance, they found that fewer than half of children who identified as having ASD received their diagnosis before they were 4.

Also, although 85 percent of children with ASD had medical notes outlining concerns about their development by the age of 3, only 42 percent of them had received a developmental evaluation.

“Parents can track their child’s development and act early if there is a concern,” explains Shapira.

“Healthcare providers can acknowledge and help parents act on those concerns.”

“And those who work with or on behalf of children can join forces to ensure that all children with autism get identified and connected to the services they need as early as possible,” he adds. “Together, we can improve a child’s future.”

The Arc Monroe: More Than 60 Years of Service

By Deborah Jeanne Sergeant

M

ost people in the Rochester region have at least heard of The Arc Monroe. Providing services for people with intellectual or developmental disabilities and their families for more than 60 years has helped The Arc grow its reputation in the communities it serves, including the 1,700 participants in its various programs across 40 locations.

The Arc’s offerings range from residential services to day services to an Article 16 clinic, “which is like a full-service clinic with speech therapy, counseling, physical therapy, and almost a doctor’s clinic,” said Beth Rapke, behavior intervention specialist at The Arc’s Article 16 clinic.

The Arc also provides community habilitation services, community behavior management and family support services.

Rapke has worked for The Arc since 1995, except for a five-year hiatus for having her children.

Rapke said that the role of The Arc is to support, not change or “cure” those they serve.

“Anyone with any kind of challenge needs their needs supported,” Rapke said. “If they need extra support in communicating or making friends or repetitious behaviors they’d like to manage, we can help

them. We’re not saying they need to be a different person, but we support how they can function as they are, being the best person they need to be.”

The Arc emphasizes community integration — a far cry from when The Arc was founded, when many people The Arc now serves were considered by many as belonging in institutional settings.

Rapke said that people living in the group homes Rapke can participate in activities they may enjoy, such as attending a Red Wings game, shopping or attending concerts. About 800 people work for The Arc. In addition, “there’s a great amount of volunteer work done,” Rapke said.

“There are activities that get the people we serve in the community and teach functional skills so they might be involved in vocational activities or money-earning jobs,” she added. “I’ve had many employers say they’re their best employees.

September 2018 •

They’re very loyal and once they learn a task, they have it. There are so many local industries that have been wonderful supporters of our people.”

The Arc’s six points of emphasis for the staff and those they serve are empathy, integrity, camaraderie, excellence, integrity and perseverance.

“As an agency, we’re looking toward all those points to move us forward in the same direction,” Rapke said. “We strive toward that as our goals.”

She also hopes more members of the community understand the abilities of the population The Arc serves.

“They don’t know how wonderful they are as people,” Rapke said. “They have all the same goals, dreams and aspirations everyone does.”

The Arc operates 31 residential homes, two businesses (Arc Works and Arc Deli) and eight day services.

Recent initiatives of The Arc include Project SEARCH job training program hosted at URMC with Monroe 2-Orleans BOCES, ACCES-VR, Finger Lakes DDSO, and Strong Center for Developmental Disabilities.

The Arc also began LifePrep Naz, a four-year collegiate experience that partners with Victor School District and Nazareth College and ROC Your Flight, a partnership with TSA and the Greater Rochester International Airport, which aids in preparing individuals for flying.

The Culinary Career Prep represents another newer program. It fosters pre-vocational and vocational skills at the ArcDeli on Lyell Avenue.

The Arc receives funding in part from the New York State Office for People with Developmental Disabilities and Adult Career and Continuing Education Services-Vocational Rehabilitation (ACCES-VR).

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

•

Page 19

Back to School:

Heads Up on Head Lice

By Deborah Jeanne Sergeant

A

bout 6 million to 12 million head lice infestations occur annually among US children 3 to 11 years of age, according to the Centers For Disease Control and Prevention.

“Head lice are not a health hazard, a sign of uncleanliness or a vector for disease,” states the National Institutes for Health on its website.

Upon their child’s diagnosis of head lice — usually at school or the pediatrician’s office — many parents head to the drugstore to buy an overthe-counter remedy, some of which contain pesticide; others contain dimethicone, a silicone-based product that smothers the lice and prevents them from managing water.

But they have other choices.

Marnie Murray co-owns Naughty Nits in Pittsford, a national company which operates locations in Western and Central New York as well.

“The pesticides are designed to kill the bugs, but not the eggs,” Murray said. “The resistance rate is high after 40 years. ‘Super lice’ are resistant to permethrin-based treatments.”

Stronger preparations are available by prescription. But Naughty Nits uses a different method. Instead

of killing with chemicals, the company uses AirAlle FDA-approved medical device that dehydrates the lice and eggs. With a 30-minute treatment, followed by a 30-minute combout, the person should be lice-free.

“It’s a silver bullet,” Murray said.

“It’s relaxing, stress free and chemical free but deadly to lice and eggs. It has a specifically designed, one-use tip.”

She said that the device has more than 500,000 uses worldwide without incident. Naughty Nits doesn’t take insurance; however, Murray said some people have submitted their itemized receipts with mixed results.

“People think they can use the blow dryer, but that can burn the scalp,” Murray said. “AirAlle is similar to a blow dryer, but it’s gentle. It has a similar sensation but it’s different technology.”

She reassures parents that they don’t have to go crazy cleaning their home; however, items that have come into direct contact with their child’s head should be cleaned with hot water. Items that can’t be cleaned with hot water may be sealed in a plastic bag for two weeks to kill the lice.

“People are always looking for ways to make sense of their world and they want to know where it’s

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Lice treatment at Naughty Nits in Pittsford. With a 30-minute treatment, followed by a 30-minute comb-out, the person should be lice-free, according to the owners. coming from,” Murray said. “She was at a softball tournament and they were sharing helmets. They spend a lot of time being angry at a friend, cleaning like crazy and the whole time, it came from the babysitter. By the time you figure it out, it’s been six to eight weeks and you’ve already spread it.”

She has parents fill out a form that asks what they’ve already tried.

Home remedies include kerosene — which is very dangerous and should not be tried — olive oil, Listerine, Coca-Cola and mayonnaise. Murray said those folk remedies don’t work.

Others rely on pesticide-based treatments.

“They spend about $200 usually and multiple people have it in their household,” Murray said. “What they don’t realize is, time is money.

If they try things that don’t work, they’ll be missing school and work.

Naughty Nit’s most expensive treatment is $169. The facility also offers an “express” treatment for $119 and a DIY topical treatment that’s less.

The company also sells a line of organic preventive items that contain tea tree, rosemary, mint, citronella and eucalyptus which Murray said ward off bugs to prevent re-infestation after a bout of lice.

“They have 93 percent efficacy in clinical trials,” she said. “When you’ve had head lice they leave pheromones on your head that’s very difficult to get off that’s imperceptible to humans. You have to have something in your hair that’s a different scent to mask that.”

Don’t share Physician Joanne Wu, board-certified in integrative and holistic medicine lives in Rochester and Buffalo. She recommends oil of tea

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

tree, lavender and eucalyptus used in a carrier oil for both treating and preventing head lice. A few small studies seem to indicate at least a measure of efficacy in essential oils, she said.

“The important thing is don’t share implements,” she said. “Any materials that come in contact with the child’s head should be cleaned.”

All household members and those in close contact should be checked for head lice, too.

Lice? Doctor Recommends OTC Permethrin Physician Bridget Messina, who works at the division of general pediatrics, UBMD Pediatrics & Oishei Children’s Hospital, said that the main treatment her children’s hospital uses is approved in children older than 2 months: permethrin.

“It’s made from a natural chrysanthemum extract, though it’s synthetic,” she said.

Lower concentration permethrin is available over the counter.

Messina said that permethrin has low toxicity, though some children may be a little sensitive.

She’s not convinced hot air treatments are effective.

“One study was done fairly recently that showed an effect, but it wasn’t blinded,” she said. “The people knew they were getting the treatment. It leaves way for some interpretation bias. The study wasn’t big enough to say whether it works or not.”

She thinks that the combing performed after the hot air treatment is what’s working.

Making Your Story Count Common Ground Health is asking for everyone’s health story to help shape policies, programs, and care in the region

By Colleen M. Farrell

A

n older farmer in Wayne County and a young mom in Rochester may not seem to have much in common other than they each have diabetes.

But dig a little deeper and it becomes apparent that both have trouble affording test strips, causing them difficulty in man emphysema aging their condition.

The more than 1 million people spread across Rochester’s nine-county region share a lot of similarities and notable differences when it comes to their individual health.

There is already data available on some of it. Within the next few months, there will be more, thanks to a survey conducted by Common Ground Health.

For example, recent analysis shows that opioid overdoses have increased across all populations, that African-Americans struggle with higher rates of heart disease compared to other groups, and that early death rates are as high in rural areas as they are in poorer urban neighborhoods.

Community health planners are trying to find out the “why” behind impediments to healthy living through a new survey.

“We’re really trying to understand: why are people having certain challenges with Solomon their health?” said Marc Solomon, a senior research associate at Common Ground Health, a nonprofit regional health planning agency.

The idea for the survey was

borne out of the agency’s health equity work, which looks at what racial and ethnic disparities exist in the region to ensure disadvantaged and underserved groups are represented in community health planning.

“We know disparities exist, but what we really wanted to do is understand what are the barriers people face to staying healthy and managing conditions when they’re not as healthy as they’d like to be,” Solomon said.

The questions are open-ended.

So, if respondents indicate they have hypertension, they are also asked if they feel like they are managing the condition well and what resources and factors help or hinder their care.

Barriers may include lack of access to healthy food or transportation issues and inadequate childcare, making visits to the doctor a challenge. Resources could include taking advantage of local farm stands, being on a bus line, or telemedicine.

The architects of “My Health Story” hope to hear from a wide swath of people across socioeconomic, racial, ethnic, age, and gender lines.

“The broader of a response we can get from the population in all our counties, the more likely we are to be able to find those areas where small investments may have much bigger outcomes,” said physician Thomas Mahoney, chief medical officer for Common Ground Health.

Mahoney explained how something as simple as providing air conditioners to patients with asthma or emphysema could alleviate some of their breathing problems, helping them avoid respiratory distress that sends them to the hospital. That ends up not only being bad for their overall health but also costs them, their insurance companies, and the public a lot more.

“As an agency, we have a lot of interest in where policy can take these things,” he said. “The hope is that we can end up putting the investments into the places where it’s going to have the most significant impact.”

The survey, available at Mahoney www.commongroundhealth.org, can be taken on a computer or smartphone. In addition, representatives from Common Ground Health have been attending events this summer in the community to reach people. The survey is also available at area public libraries, as well.

Responses are being collected through Labor Day, Sept. 3. Solomon expects it will take a few months to comb through the data, after which it will be publicized and used to shape future health planning decisions.

“We’re excited about it because I think it’s a really nice complement to a lot of statistics and secondary data sources we have around prevalence of disease and health care,” he said.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Here’s What Makes Seniors Feel and Act Younger

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pair of new studies points toward two potential paths to the fountain of youth.

When older adults feel more control of their lives and get more exercise, they feel younger — and that improves their thinking, overall quality of life and longevity, the studies say.

One study included 116 older adults (aged 60 to 90) and 106 younger adults (aged 18 to 36). For nine days, the participants kept track of how much control they felt they had each day and how old they felt.

Among the older adults, there was a significant link between perceived level of control and how old they felt, according to the findings presented at a recent meeting of the American Psychological Association, in San Francisco.

“Shaping the daily environment in ways that allow older adults to exercise more control could be a helpful strategy for maintaining a youthful spirit and overall well-being,” study presenter Jennifer Bellingtier said in an APA news release.

She is a postdoctoral researcher at Friedrich Schiller University of Jena in Germany.

“Some interventions could be formal, such as a regular meeting with a therapist to discuss ways to take control in situations where individuals can directly influence events,

and how to respond to situations that they cannot control,” Bellingtier said.

“Smartphone apps could be developed to deliver daily messages with suggestions for ways to enhance control that day and improve a person’s overall feeling of control,” she added.

The second study, also presented at the APA meeting, found that increasing physical activity can help adults feel younger.

It included 59 adults, aged 35 to 69, whose daily step counts were tracked. After five weeks, those with greater increases in their step counts felt younger.

“Our results suggest that promoting a more active lifestyle may result in a more youthful subjective age,” study presenter Matthew Hughes said in the news release.

Hughes is a postdoctoral scientist at the Adult Cognition Lab at the University of North Carolina, Greensboro.

“As this was part of a pilot study, our sample size was small,” he noted.

“While the results suggest that walking may contribute to feeling younger, further research with a larger sample in a more controlled setting is needed to confirm.»

Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.

men to have aimed for weight loss (56 percent versus 42 percent), the findings showed.

Income made a difference as well, with wealthier men and women significantly more likely to say they tried to slim down.

Besides turning to exercise and veggies, survey respondents also

commonly said they’d cut down on junk food and fast food, and tried to limit sugar. Many said they “drank a lot of water.” The vast majority of people who tried to lose weight said they’d used at least two tactics.

The report was published July 12 in the CDC’s NCHS Data Brief.

You’re Not Alone: Half of Americans Trying to Slim Down

I

n a country where four out of 10 adults are obese, it’s probably good news that half of U.S. adults say they’ve recently tried to shed some pounds.

They did this most often through exercise, cutting calories and eating their fruits and veggies, according to a new government survey that tracked Americans’ weight-loss attempts between 2013 and 2016.

Overall, 49 percent of respondents said they’d tried to lose weight in the past year — including two-thirds of those who were obese.

As of 2016, almost 40 percent of American adults were obese, according to researchers with the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).

So it’s important to know how many Americans are trying to lose weight — and how they’re doing it, said Kirsten Herrick, a senior research fellow with the NCHS who worked on the study.

There were some positive signs, said a registered dietitian who wasn’t involved in the research.

The most common weight-loss Page 22

•

methods were exercise and eating less — each reported by 63 percent of people aiming to shed pounds.

And half said they were eating more fruits, vegetables and salads.

“The good news is that people seem to recognize that weight loss is about changing habits, not quick-fix diets,” said Connie Diekman, director of university nutrition at Washington University in St. Louis.

Sustainable diet changes are critical, Diekman said. That includes cutting sugary, fat-laden junk food, and replacing it with plenty of fruits, vegetables, fiber-rich grains and other healthful whole foods.

Regular exercise can improve your overall health, and may aid in weight loss, Diekman noted. But, she said, people need to make lasting changes in how they eat, rather than try fad diets.

The report was based on a nationally representative sample of Americans aged 20 and older.

Many people said they’d tried to lose weight in the past year, though the figures varied among different groups.

Women were more likely than

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

By Jim Miller

How Medicare Covers Diabetes How well does Medicare cover diabetes? I’m 66 years old and was recently told by my doctor that I have pre-diabetes. If it progresses to full-fledged diabetes what can I expect from Medicare?

Recently Retired Dear Recently, Medicare actually provides a wide range of coverage to help beneficiaries who have diabetes, as well as those who are at risk of getting it — but they don’t cover everything.

Here’s a breakdown of what Medicare covers when it comes to diabetes services and supplies along with some other tips that can help you save.

Screenings — If you have pre-diabetes or some other health conditions that put you at risk of getting diabetes — such as high blood pressure, high cholesterol and triglycerides, are overweight, or have a family history of diabetes — Medicare Part B (medical insurance) will pay 100 percent of the cost of up to two diabetes screenings every year.

Doctor’s services — If you’re a Medicare beneficiary, Medicare will pay 80 percent of the cost of all doctor’s office visits that are related to diabetes. You are responsible for paying the remaining 20 percent after you’ve met this year’s $183 (for 2018) Part B deductible.

Prevention program — Just launched in April, the Medicare Diabetes Prevention Program provides lifestyle change programs offered by health professionals to help you prevent diabetes. This is available for free to all Part B beneficiaries who have pre-diabetes.

Self-management — If you have diabetes, Medicare covers 80 percent of the cost of self-management training to teach you how to successfully manage your diabetes.

Supplies and medications — Medicare Part B covers 80 percent of the cost of glucose monitors, test strips (100 per month if you use insulin, or 33 per month if you don’t), lancets, external insulin pumps and insulin (if you use a pump), after you’ve met your deductible.

If, however, you inject insulin with a syringe, Medicare’s Part D prescription drug benefit will help pay your insulin costs and the supplies needed to inject it — if you have a plan. Part D plans also cover most

other diabetic medications too. You’ll need to check your plan for coverage details.

Nutrition therapy — Medicare will pick up the entire tab for medical nutrition therapy, which teaches you how to adjust your diet so you can better manage your condition. You’ll need a doctor’s referral to get this service.

Foot care — Since foot problems are common among diabetics, Medicare covers 80 percent of foot exams every six months for diabetics with diabetes-related nerve damage. They will also help pay for therapeutic shoes or inserts as long as your podiatrist prescribes them.

Eye exams — Because diabetes increases the risks of getting glaucoma and diabetic retinopathy, 80 percent of dilated medical eye exams are covered each year, but eye refractions for glasses are not.

For more information, see “Medicare’s Coverage of Diabetes Supplies & Services” online booklet at Medicare.gov/Pubs/pdf/11022-Medicare-Diabetes-Coverage.pdf.

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Other Insurance If you have a Medicare supplemental (Medigap) policy, it may pay some of the costs that Medicare doesn’t cover. Call your plan’s benefits administrator for more information.

Or, if you’re in a Medicare Advantage plan (like an HMO or PPO), your plan must give you at least the same diabetes coverage as original Medicare does, but it may have different rules. You’ll need to check your policy for details.

Financial Assistance If you’re income is low, and you can’t afford your Medicare out-ofpocket costs, you may be able to get help through Medicare Savings Programs. To find out if you qualify or to apply, contact your state Medicaid program.

Also, find out if you are eligible for “Extra Help” which helps Medicare Part D beneficiaries with their medication expenses. Visit SSA.gov/ prescriptionhelp or call Social Security (800-772-1213) to learn more.

Age 3:

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

Age 19:

Dad patiently taught me how to drive a stick shift.

Dad walked me down the aisle.

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

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 23

Ask St. Ann’s

Ask The Social

By Carrie Buckert, LPN

What is Memory Care?

D

o you worry about leaving a loved one living with Alzheimer’s or dementia home alone? Maybe it’s time to consider memory care.

Similar to assisted living, memory care is for people living with memory impairments who can still do many activities of daily life but need 24-hour supervision. Memory care centers provide a higher staff-to-resident ratio and innovative support to help residents maintain as much independence as possible.

Many senior living communities offer memory care apartments in a comfortable, safe and secure environment, such as Rainier Grove Memory Care Center at St. Ann’s Community at Cherry Ridge in Webster.

Helping memory care residents feel at home is a top priority. At Rainier Grove we complete an “I Care Plan” with residents and their families upon their arrival. This helps us understand the resident’s history, interests, achievements and what motivates them. Knowing even the smallest of details helps staff create a family environment that promotes choice, celebrates accomplishments and reinforces the familiar for residents.

The Essentials

Before choosing a memory care center, talk to the direct-care staff about the hands-on care provided and how a typical day unfolds. Essential items to listen for include: • Safety: A secure environment with alarms allows residents to move about safely and alerts staff to wandering.

• Family-style environment: Familiar routines promote a calm and relaxed atmosphere and help reduce anxiety and confusion. For example, at Rainier Grove we serve family-style meals and staff often share meals with residents. Baking in the community kitchen fills the air with the aromas of home.

• Interactions: Daily opportunities for socialization and engagement are signs of a caring environment.

Take a tour when there’s an activity in progress to see if the center’s

promotional message matches its actions.

• Person-centered and holistic: Staff should support the accommodations outlined in residents’ individual care plans. Programs and activities should address residents’ social, emotional, spiritual, physical, and intellectual wellness.

• Family access and inclusion: You should be welcome to participate in activities with your loved one.

Look for a facility with around-theclock access so you can visit any time your schedule allows.

• Experienced staff: All direct-care staff should specialize in Alzheimer’s and dementia care. The team should maintain residents’ dignity and promote their optimal levels of cognitive, physical, and functional ability.

• Communication: Staff should communicate regularly with local and out-of-town family members and provide daily interaction updates.

• Continuum of care: Dementia is a progressive disease. Consider a center that offers priority access to skilled nursing care on the same campus, should your loved one progress past the scope of memory care.

Making the move Memory care is a compassionate bridge between home and a skilled nursing facility for your loved one.

To receive the support and peace of mind you need, maybe it’s time to make the move.

Carrie Buckert, licensed practical nurse, is the dementia service manager at Rainier Grove Memory Care Center, located on the campus of St. Ann’s Community at Cherry Ridge in Webster. Contact her at cbuckert@mystanns.com or 585-6976720, or visit www.stannscommunity. com.

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Security Office

From the Social Security District Office

Medicare, Explained

S

ocial Security and Medicare have a few things in common.

Both programs help safeguard millions of Americans as well as improve the quality of life for our family and friends. Although both programs are household names, many people may not be familiar with the details of Medicare.

Medicare is our country’s health insurance program for people aged 65 or older. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have original Medicare coverage, you can buy a Medicare supplement policy (called Medigap) from a private insurance company to cover some of the costs that Medicare does not.

Medicare has four parts: • Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay). Part A also pays for some home health care and hospice care.

• Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.

• Medicare Part C (Medicare Advantage) includes all benefits and

Q&A

services covered under Part A and Part B. Some plans include Medicare prescription drug coverage (Medicare Part D) and other extra benefits and services.

• Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs.

Some people with limited resources and income may also be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan. The Extra Help is estimated to be worth about $4,900 per year. You must meet the resources and income requirement.

Medicare’s different parts are further explained in our publication at www.socialsecurity.gov/pubs/ EN-05-10043.pdf.

If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from the state. States offer programs for people eligible for or entitled to Medicare who have low income.

Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance.

To qualify, you must have Medicare Part A and have limited income and resources.

You can learn more about Medicare, including how to apply for Medicare and get a replacement Medicare card, at www.socialsecurity.gov/benefits/medicare.

it online at: www.socialsecurity.gov/ forms/ssa-1372.pdf.

Q: How much will I receive if I qualify for Supplemental Security Income (SSI) benefits?

A: The amount of your SSI benefit depends on where you live and how much income you have.

The maximum SSI payment varies nationwide. For 2018, the maximum federal SSI payment for an eligible individual is $750 a month and $1,125 a month for an eligible couple.

However, many states add money to the basic payment. For more information, go to www.socialsecurity. gov/ssi.

Q: How can I get proof of my benefits to apply for a loan?

A: If you need proof you get Social Security benefits, Supplemental Security Income (SSI) and/or Medicare, you can request a benefit verification letter online through your personal my Social Security account at www.socialsecurity.gov/myaccount. This letter is sometimes called a “budget letter,” a “benefits letter,” a “proof of income letter,” or a “proof of award letter.” You even can select the information you want included in your online benefit verification letter.

Q: My child, who gets Social Security, will be attending his last year of high school in the fall. He turns 19 in a few months. Do I need to fill out a form for his benefits to continue?

A: Yes. You should receive a form, SSA-1372-BK, in the mail about three months before your son’s birthday. Your son needs to complete the form and take it to his school’s office for certification. Then, you need to return page two and the certified page three back to Social Security for processing. If you can’t find the form we mailed to you, you can find

Q: I’m reaching my full retirement age and thinking about retiring early next year. When is the best time of year to apply for Social Security benefits?

A: You can apply as early as four months before when you want your monthly benefits to begin. To apply, just go to www.socialsecurity. gov/applytoretire. Applying online for retirement benefits from the convenience of your home or office is secure and can take as little as 15 minutes. It’s so easy.

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

H ealth News Thompson recognized for stroke care UR Medicine Thompson Hospital recently received the American Heart Association/American Stroke Association’s Get With The Guidelines-Stroke Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.

Thompson a New York state-designated stroke center earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most upto-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, and experience other care transition interventions.

“Thompson is dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get With The Guidelines-Stroke

Daniel Mendelson, who became the first palliative care physician at Highland in 2000.

Ching has been the associate director of the Highland Hospital palliative care program since 2012 and is physician chairwoman of the Highland Hospital ethics committee.

She also serves as the medical director for Serenity House Hospice/Comfort Care Home in Ching Victor. She received her medical degree from the University of Rochester School of Medicine and Dentistry where she also completed her residency in internal medicine.

“Dr. Ching has been critical to our program, which was one of the first in the nation to achieve advanced certification in palliative care by the Joint Commission.” said Mendelson, founder of Highland Hospital’s palliative care program.

“Her experiences at Highland and outstanding accomplishments as a clinician, teacher and administrator make her incredibly well qualified to carry through our program’s mission of caring and supporting patients at all stages of illness, including the end of their lives.”

Mendelson will remain part of the program as he focuses on grow-

initiative,” said Clinical Quality Improvement Coordinator/Stroke Coordinator Jen Yancey. “The tools and resources provided help us track and measure our success in meeting evidenced-based clinical guidelines developed to improve patient outcomes.”

Physician Eric E. Smith, national chairman of the Get With The Guidelines Steering Committee and an associate professor of neurology at the University of Calgary in Alberta, Canada, said research has shown hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative often see fewer readmissions and lower mortality rates.

According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

Highland has new palliative care program director Physician Chin-Lin Ching has been appointed director of the Highland Hospital Palliative Care Consult Service. Ching succeeds physician

ing Highland’s ambulatory palliative care practice in addition to his responsibilities as associate chief of medicine for Highland Hospital.

Highland plans nearly all private rooms for patients Nearly all Highland Hospital patients will benefit from private rooms, through a modernization plan announced recently. Providing patients with private rooms will further Highland Hospital’s ongoing efforts to improve patient care, help reduce the risk of infections and offer more adequate, therapeutic space during recovery, according to a hospital press release.

Part of the hospital’s master facility plan, the modernization project would add four levels to the hospital’s southeast wing, elevating the wing from its current three to seven floors total, the same floor count as the hospital’s east and west towers.

Design of the structure has not yet begun.

Under its current license, Highland has 261 patient care beds: 218 beds are on medical/surgical units with 124 beds in semi-private rooms (57 percent) and 94 beds in private rooms (43 percent). The remaining 43 beds are on maternity and intensive care units and are all private rooms.

The four new levels would add 60 private patient-care rooms, result-

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Harry Bowker of Manchester, left, served as master of ceremonies for the June 9 Rose Walk, which raised more than $20,000 for the cardiac rehabilitation program offered at UR Medicine Thompson Hospital in Canandaigua. On the right is exercise physiologist Joshua Featherly. He is among those who work with program participants.

Rose Walk Proceeds Top $20,000 The 22nd annual Rose Walk raised more than $20,000 in net proceeds for the cardiac rehabilitation program at UR Medicine Thompson Health, bringing the total amount raised by this event over the years to more than $287,000.

Held June 9 at Sonnenberg Gardens & Mansion State Historic Park in Canandaigua, the event

attracted community members of all ages drawn to the cause of assisting patients of the Fralick Cardiac Rehabilitation and Fitness Center at Thompson Hospital. The center helps patients regain and maintain their physical health and sense of well-being following a cardiac event.

Presenting sponsor was Finger Lakes Cardiology Associates.

ing in 214 medical/surgical beds in private rooms. The project will allow Highland to shift patients currently in semi-private rooms to private patient care rooms.

The hospital is applying to the city of Rochester to rezone the facility as a planned development district (PDD) to allow the project to move forward.

“It is imperative that we continue to modernize our facility to provide the highest-quality patient- and family-centered care, now and into the future,” said Cindy Becker, vice president and COO of Highland Hospital. “Central to this modernization project is the transition to private rooms, which will offer numerous benefits to patients from the reduced risk of hospital-acquired infections, to the positive therapeutic impact of more privacy and less noise during recovery.”

Local scientists present research at Alzheimer’s event Members of the Alzheimer’s Association Rochester & Finger Lakes chapter’s med-sci committee Carol Podgorski, Ph.D., and physician Anton Porteinsson were among seven

scientists from University of Rochester who presented their research at The Alzheimer’s Association International Conference (AAIC) recently.

Held in Chicago, more than 5,200 scientists from 65 countries attended the event. It’s considered the world’s largest dementia research forum.

“It certainly has been an exciting week here at AAIC 2018 in Chicago.

We are inspired by new research developments demonstrating what we can do to reduce our risk of mild cognitive impairment. The future of dementia prevention could be in treating the whole person with a combination of drugs and modifiable lifestyle changes,” said Teresa Galbier, president/CEO of the Alzheimer’s Association, Rochester & Finger Lakes Region.

Podgorski — who is also an honorary board member of the Alzheimer’s Association, Rochester & Finger Lakes Region — presented her study on family therapy in dementia care. Porteinsson, UR Medicine’s director of AD-Care, reported the results of his team’s S-Citad clinical trial that sought to find an effective combination of non-pharmacologic and pharmacologic approaches to treating agitation in Alzheimer’s disease.

Living in Areas with Less Sun May Increase Your Risk of OCD

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iving at higher latitudes, where there is also less sunlight, could result in a higher prevalence rate of obsessive compulsive disorder (OCD), according to new research from Binghamton University, State University of New York.

“The results of this project are exciting because they provide additional evidence for a new way of thinking about OCD,” said Meredith Coles, professor of psychology at Binghamton University. “Specifically, they show that living in areas with more sunlight is related to lower rates of OCD.” To compile their data, Coles and her research team read through many papers that addressed OCD prevalence rates in certain places and then recorded the latitudes of each location.

Individuals with OCD commonly report not being able to fall asleep until later than desired. Often times, they will then sleep in very late in order to compensate for that lost sleep, thus adopting a delayed sleep-wake pattern that may have adverse effects on their symptoms.

“This delayed sleep-wake pattern may reduce exposure to morning light, thereby potentially contributing to a misalignment between our internal biology and the external light-dark cycle,” said Coles. “People who live in areas with less sunlight may have less opportunities to synchronize their circadian clock, leading to increased OCD symptoms.”

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This misalignment is more prevalent at higher latitudes — areas where there is reduced exposure to sunlight — which places people living in these locations at an increased risk for the development and worsening of OCD symptoms. These areas subsequently exhibit higher lifetime prevalence rates of the disorder than areas at lower latitudes.

While it is too soon to implement any specific treatment plans based on this new information, future studies are in the works to test a variety of treatment methods that address sleep and circadian rhythm disruptions.

“First, we are looking at relations between sleep timing and OCD symptoms repeatedly over time in order to begin to think about causal relationships,” said Coles. “Second, we are measuring circadian rhythms directly by measuring levels of melatonin and having people wear watches that track their activity and rest periods. Finally, we are conducting research to better understand how sleep timing and OCD are related.”

Additionally, the team of researchers hopes that further study exploring exposure to morning light could help develop new treatment recommendations that would benefit individuals with OCD. The paper, “Obsessive Compulsive Disorder Prevalence Increases With Latitude,” was recently published in the Journal of Obsessive-Compulsive and Related Disorders.

Officials from Rochester Regional Health and TeamHealth during the opening of the Brighton immediate care location.

Rochester Regional Health Opens Urgent Care Facility in Brighton On Aug. 1, Rochester Regional Health Immediate Care started seeing patients at a new facility in Brighton. Located in the heart of the 12 Corners neighborhood, this is the eighth Rochester Regional Health Immediate Care location.

This immediate care center (sometimes referred to as “urgent care centers”) is one of six locations operated through a joint venture between Rochester Regional Health and TeamHealth, a leading clinician services organization.

“We are excited to bring expert care and personal service to Brighton,” said physician Janet Williams, medical director of Rochester Regional Health Immediate Care.

“You never know when you’ll need immediate care, so we offer evening and weekend hours and accept a wide variety of insurances to help

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

make sure you can get the care you need, when and where you need it.”

The Brighton location is at 1881 Monroe Avenue in 12 Corners.

Like all Rochester Regional Health Immediate Care locations, patients can expect quick, quality treatment in an hour or less with access to Rochester Regional’s network of hospitals, specialists and primary care physicians if they need it.

In 2017, Rochester Regional Health Immediate Care was voted “Best Urgent Care Center” by readers of the Rochester Business Journal. Rochester Regional Health Immediate Care provides urgent care services 365 days a year in Greece, North Greece, Henrietta, Penfield, Webster, Irondequoit, the Wilson Center near Rochester General Hospital and, now, Brighton.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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