IGH Rochester #175 March 20 by In Good Health: Rochester's Healthcare Newspaper

PRICELESS

5 THINGS YOU SHOULD KNOW ABOUT IT Physician Nadia Kousar, infectious disease specialist at Rochester Regional Health, explains the basics of the virus that has killed more than 2,000 so far

GERIATRICS Robert McCann, Highland Hospital chief of medicine and long-time geriatrician, reflects on nearly 35 years of practice

GVHEALTHNEWS.COM

MARCH 2019 • ISSUE 175

SHOULD YOU SKIP BREAKFAST? Celebrity TV doctor Mehmet Oz recently said people should skip breakfast. Should you heed his advice? Do we really need the ‘most important’ meal? P. 15

Top Health Innovations Screening remains crucial for effective cancer treatment. We look at five common types of cancer

PARKINSON’S

Healthcare is always changing as new research and discoveries lead to changes that improve care. Area experts discuss what they see as the top innovations in development now or coming very soon. P. 22

How to detect the disease and what to do when you’re diagnosed

‘Spring Forward’ Brings Surge in Fatal Car Crashes

Little Lentils Dish Up Big Benefits

‘Spring Forward’ Brings Surge in Fatal Car Crashes

P. 14

P. 4

Dramatic Increase in Flu Cases in NYS

he number of confirmed flu cases in New York state has increased dramatically compared to the same time last year, according to a review of health tracking data by Excellus BlueCross BlueShield. As of Feb. 1, the Department of Health confirmed 89,597 cases of flu statewide, 54,554 more cases than at this time last year. This flu season has been especially difficult for children. More than 50% of all confirmed cases have been among children 17 and younger. Upstate New York is also being hit hard by flu. During the week of Feb. 1, there were 4,844 confirmed flu cases, with the Utica-Rome and North Country region experiencing the most cases this week: • Western New York: 1,033 flu cases • Rochester/Finger Lakes: 913 flu cases • Central New York: 779 flu cases • Central New York’s Southern Tier: 745 flu cases • Utica/Rome/North Country: 1,374 flu cases “We’ve confirmed an increase in flu activity week-over-week in Upstate New York, so we may not yet have reached the peak of this flu season,” said physician Stephen Cohen, senior vice president and corporate medical director at Excellus BCBS in early February. “I can’t stress enough that it’s not too late to get the

Confirmed Flu Cases in NYS

Activity during the week ending Feb. 1, 2020 Source: NYS Department of Health. Chart by Excellus BlueCross BlueShield. flu vaccine.” Studies support the effectiveness of the flu vaccine in preventing flu, and in reducing the severity of illness in vaccinated people who get sick. With few exceptions, the Centers for Disease Control and Prevention recommends that everyone six months old and older gets vaccinated. Only about one in three Upstate

New York adults gets the flu vaccine. Cohen said there is a social responsibility to getting vaccinated. “Someone carrying the flu virus can spread it to unsuspecting people up to about six feet away, mainly by expelling microscopic droplets into the air when talking, coughing, or sneezing,” Cohen said. For young children, the elder-

ly, and people with compromised immune systems, the flu virus can be deadly. Last year’s flu, and complications from flu, killed 34,200 people in the United States, according to the federal CDC.

Nothing to do but enjoy your life. As one of the most important people on earth, your only retirement concern should be choosing today’s exciting activity, outing or dining option. Or enjoying quiet time in spacious, beautifully maintained surroundings with 24-hour security. St. Ann’s Community at Cherry Ridge offers you a wide range of options to live the lifestyle you’ve always wanted and the peace of mind knowing you have access to on-site assisted living, memory care, and skilled nursing if you ever need it. 1- and 2- Bedroom Apartments • 2- Bedroom Cottages • 41 Wooded Acres

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

home is where the help is. Living Well Companion Care provides nonmedical services to make living in your own home feel manageable again. We can support you with daily routines, transportation, housekeeping and more. Companions undergo comprehensive background screenings and we only hire those we would trust to care for our own loved ones. Now hiring in and serving eastern Monroe and Ontario counties. Call us at (585) 248-5021 or visit livingwellcompanioncare.org to learn more or to apply to be a Companion.

I look forward to the time with my Companion. She keeps me on track and motivated to stay independent. Peter, client

COMPANION CARE • HOUSEKEEPING RESPITE & 24 HOUR CARE A service of Jewish Senior Life March 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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‘Spring Forward’ Brings Surge in Fatal Car Crashes Daylight saving time begins Sunday, March 8

atal car accidents in the United States spike by 6% during the workweek following the “spring forward” to daylight saving time, resulting in about 28 additional deaths each year, according to new University of Colorado Boulder research. The study, published in February in the journal Current Biology, also found that the farther west a person lives in his or her time zone, the higher their risk of a deadly crash that week. “Our study provides additional, rigorous evidence that the switch to daylight saving time in spring leads to negative health and safety impacts,” said senior author Céline Vetter, assistant professor of integrative physiology. “These effects on fatal traffic accidents are real, and these deaths can be prevented.” The findings come at a time when numerous states, including Oregon, Washington, California and Florida, are considering doing away with the switch entirely amid mounting research showing spikes in heart attacks, strokes, workplace injuries and other problems in the days following the time change. For the study — the largest and most detailed to date to assess the relationship between the time change and fatal motor vehicle accidents — the researchers analyzed 732,835 accidents recorded through the U.S. Fatality Analysis Reporting System from 1996 to 2017. They excluded Arizona and Indiana, where daylight

saving time was not consistently observed. After controlling for factors like year, season and day of the week, they found a consistent rise in fatal accidents in the week following the spring time change. Notably, that spike moved in 2007, when the Energy Policy Act extended daylight saving time to begin on the second Sunday of March instead of the first Sunday in April. “Prior to 2007, we saw the risk increase in April, and when daylight saving time moved to March, so did the risk increase,” said Vetter. “That gave us even more confidence that the risk increase we observe is indeed attributable to the daylight saving time switch, and not something else.” With the arrival March 8 of daylight saving time, clocks shift forward by one hour, and many people will miss out on sleep and drive to work in darkness — both factors that can contribute to crashes.

1 in 5 Insured Hit with Surprise Bills for Surgery

Y NewROC Nursing and Rehabilitation Center provides skilled nursing and residential health care services to all.

“Caring for those who need us the most!”

ou scheduled your surgery and made sure both your doctor and hospital are in your insurer’s approved network of providers. Everything went without a hitch — until a whopper of a bill showed up in the mail for “out-of-network” care during your operation. The average out-of-network surprise bill tops $2,000, a new study finds. And about 20% of patients who had surgery using a doctor and hospital considered in-network for their insurance got a surprise bill. So, what gives? In some cases, surprise bills are for medical imaging during surgery or for assistants that patients didn’t even know would be involved. “In this study, we narrowed it

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

down to those cases where patients did as well as they could checking to make sure the surgeon and hospital were in-network, and still one in five got an out-of-network bill,” said the study’s lead author, physician Karan Chhabra of the University of Michigan Institute for Healthcare Policy and Innovation in Ann Arbor. He said 37% of the surprise bills came from out-of-network surgical assistants. Another 37% came from anesthesiologists. The average outof-network surgical assistant bill was more than $3,600; anesthesiologist bills topped $1,200. The findings were published Feb. 11 in the Journal of the American Medical Association.

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“The medical staff has made this therapy device ‘one of our go to’ tools when treating sprains, strains, and other muscular skeletal conditions. I am confident in saying that the LiteCure laser helped us get our players back on the court faster. It also helped us keep injured players in action through some painful conditions.” – Ed Lacerte, MEd., PT, SCS, L/ATC, CSC S Head Athletic Trainer for the Boston Celtics®

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“The Deep Tissue Laser treatments I received dramatically helped my recovery. Not only did it help reduce the swelling, the pain relief I experienced was nothing short of miraculous. My orthopedic doctor was amazed with the results.” – John M. “All the players love the laser. The treatment times are fast and the results are obvious. The laser is instrumental in getting players back on the field earlier than expected after severe injury. We have used low level lasers in the past, the big difference with LiteCure lasers is the faster treatment times and consistent positive outcomes.” – George Poulis, MA, ATC, LAT Head Athletic Trainer for the Toronto Blue Jays®

Lasers have made a remarkable contribution toward healthcare, allowing practitioners to treat a variety of conditions with the speed of light. As a noninvasive tool, the laser is particularly effective for the efficient treatment of soft tissue injuries, sprains and strains, and a variety of other ailments and pain. A key component to the new laser is its depth of penetration. Remember the old adage, “If you can’t reach it, you can’t treat it.” See figure A below.

“I was treated for spinal stenosis L3-5, sciatica, and an old injury at S1. Surgery not possible. Am now able to stand and walk like a normal person. Had laser therapy and spinal decompression. Very grateful.” – Leslie

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Figure B Actual MRI image of the lumbar spine @ L5-S1 Disc bulge depicting associated pain and inflammation

FIGURE A

If You Can’t Reach It, You Can’t Treat It! If you suffer with sciatica, back pain and neck pain and it hasn’t gone away despite numerous treatments ask yourself: – WHY hasn’t the pain gone away? – WHY have all the treatments failed? – WHAT can be done? The answer is actually very simple… Seek out a team of EXPERTS that are capable of evaluating and treating ALL FOUR COMPONENTS of sciatica, back pain and neck pain SIMULTANEOUSLY (muscular, neurological, skeletal, and inflammation).

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When you work with a TEAM that is SIMULTANEOUSLY treating all FOUR COMPONENTS you maximize your chances of completely eliminating your pain and avoiding the dangers and permanent changes that occur with risky and invasive surgeries. Our clinic is an INTEGRATED clinic that specializes in offering COMPREHENSIVE and SIMULTANEOUS treatment for sciatica, back pain and neck pain. Our TEAM of doctors are specialists and experts who work TOGETHER from EVERY angle to ensure maximum recovery in as little time as possible. Not treating ALL potential components of the problem SIMULTANEOUSLY is the MOST CRITICAL and most common mistake made. Typically there are FOUR individual components of sciatica, back pain and neck pain that contribute to the overall problem. Those FOUR components are: 1. Skeletal 2. Neurological 3. Inflammatory 4. Muscular The problem with most treatment approaches is that the treatment will focus on just one or two of the components while COMPLETELY IGNORING the others. The failure of some doctors to look at the big picture and treat ALL OF THE COMPONENTS SIMULTANEOUSLY results in patients suffering LONGER, treatments costing MORE MONEY, and in many cases will result in patients getting UNNECESSARY SURGERY. DC-SPAD0221113734_1

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REAL PEOPLE, REAL RESULTS:

“The treatments with deep tissue laser allowed me to return to work much more quickly than anyone had expected, considering the pain I was in. During the treatments, all I felt was a warming sensation as the laser was moved across the injured area where all my pain was. After just three short treatments, my pain was almost totally gone.” – Jason B. “I feel confident that the LiteCure laser has provided relief to our players through some painful conditions and has been integral in the rehabilitation process after injury. In addition, I believe it has accelerated the recovery time to several injuries that would have normally kept our players off the ice.” – Tim Macre, ATC, CSC S Head Athletic Trainer for the Buffalo Sabres®

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March 2020 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare PAID ADVERTISING PAID Newspaper ADVERTISING

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CALENDAR of

WHY SPEND ANOTHER SNOWY WINTER COOPED UP OR STRANDED?

HEALTH EVENTS

March 11

We hold the key to affordable living!

April 18

Lunch meeting to discuss Elder Justice to hold Parkinson’s disease seminar for seniors

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Parkinson’s disease is very often misunderstood. Who knew there were symptoms beyond tremors? And what about exercise, does that help? Nearly 1 million people in the United States are living with this disease. The Parkinson’s Foundation NY/NJ branch makes life better for people with Parkinson’s disease by improving care and advancing research toward a cure. A “Lunch and Learn” program will help people who suffer from Parkinson, their family and friends, to understand common misconceptions, what to be aware of and other important facts related to Parkinson’s. The event will take place from 12:30 – l:30 p.m. March 11 for a light lunch with Nancy Nealon, licensed master of social work and community program manager from the Parkinson’s Foundation NY/NJ branch. Seating is limited. For reservation and information, contact Debbie Vandewall at 585-225-7210 or dvandewall@elderwood.com by March 9.

3.5% UNINSURED RATE 35% LOWER

THAN THE NEW YORK STATE AVERAGE

61% LOWER

THAN THE NATIONAL AVERAGE

The Elder Justice Committee of Metro Justice will co-host a seminar titled “Cost of Advancing Age: Financial, Emotional, Social.” It will take place 10:30 a.m. to 12:30 p.m. Saturday, April 18, at Camp Eastman, Rotary Cabin, 1558 Lakeshore Blvd. in Irondequoit. Elder Justice is a group of seniors that works to ensure that elders in the community are able to live their lives with dignity. Among the topics to be discussed will include power of attorney, transition from personal and financial independence, home care concerns, dealing with cognitive decline, continuum of care, choosing a long term care facility and Medicaid The event is presented in collaboration with Irondequoit Recreation Department, Irondequoit Rotary Club and Alzheimer’s Association. For more information, contact Marydel Wypych at mdwypych@aol. com.

Upstate New York’s 2018 uninsured rate is among the lowest ever recorded. According to recently released numbers from the U.S. Census Bureau, the uninsured rate in upstate New York was just 3.5 percent in 2018, compared with a New York state uninsured rate of 5.4 percent and a national rate of 8.9 percent. Low health-care costs are a key factor in upstate New York’s low uninsured rate.

For private insurance, Rochester and Syracuse are ranked as having among the lowest health care spending rates among 306 hospital referral regions across the country.* Upstate New York has a proud history of affordable, high-quality health care. It’s the result of regional partnerships and a commitment to nonprofit health care. It helps make our community a great place to live and work.

*Source: “The Experts Were Wrong About the Best Places for Better and Cheaper Health Care.” The New York Times, December 15, 2015 A nonprofit independent licensee of the Blue Cross Blue Shield Association

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

2 Million Lost Health Coverage or Access in Trump’s First Year

wo million more Americans didn’t seek health care from late 2016 through 2017 because they couldn’t afford it or lacked insurance, new research shows. The analysis of data from 2011 through 2017 also found that health care coverage and access improved with implementation of the Affordable Care Act (ACA), but reversed after President Donald Trump and congressional Republicans began working to dismantle it, according to Boston University researchers. “While we found the ACA isn’t unraveling, there are real consequences to some of the policies that have been put in place,” said lead author Kevin Griffith, a doctoral candidate in the School of Public Health. “We see that you have these policy changes that are affecting millions of people’s ability to get insurance, and millions of people forgoing care

because they can’t afford it.” For the study, Griffith and his team analyzed federal data on 18- to 64-year-olds. The investigators found that uninsurance rates dropped 7.1 percentage points between 2013 and 2016, then rose 1.2 percentage points during 2017, Trump’s first year in office. Rates of adults who did not seek care due to costs reflected similar trends. The 2017 reversals had the greatest impact on low-income residents of 14 states that didn’t expand Medicaid under the ACA. In those states, which are mainly in the South, decreases in insurance coverage and health care access were four to five times higher than in states that expanded Medicaid. The study also found that from 2013 to 2016, the gap in health care access between higher- and lower-in-

come Americans narrowed by about 8.5 percentage points in expansion and nonexpansion states. But between the fourth quarter of 2016 and the fourth quarter of 2017, that gap widened by 2.6 percentage points in nonexpansion states (a relative increase of 11%). It continued to decrease by another 1 percentage point in expansion states (a relative decrease of 8%). The study appears in the February issue of the journal Health Affairs. “Medicaid expansion seemed to be a really great way for states to insulate themselves from some of

the damage of these federal policies,” Griffith said in a university news release. “For states considering Medicaid expansion, this shows that it’s a good way to take care of your residents, even regardless of what’s going on in Congress.” He said the reversals revealed by the study are worrisome. “We had this narrowing of disparities in access and coverage, but that’s reversing,” Griffith said. “Since 2017, the split between white and black, between rich and poor, urban and rural, renters and homeowners — all of these disparities are getting wider again. That’s concerning.”

The corona virus, so named for its crown-like spikes, is unknown so its spread causes alarm. On top of it all, infectious disease experts (ID docs) are a dying breed. There has been a 40% decrease in medical students enrolling in ID training programs or residencies between 2009 and 2017. Infectious disease is one of just two subspecialties where not all residency slots are filled. Telemedicine can help by transmitting increasingly rare and valuable expertise to physicians working in even the remotest areas. Telemedicine also allows physicians to treat patients remotely, keeping them from coming into emergency facilities and offices and infecting provider staffs and other patients.

rather timid bipartisan bill would authorize CMS to negotiate just 25 prices the first year, then ramp up to more over 10 years. Drug prices remain totally unchecked while CMS literally sets prices and fees for physicians and hospitals.

Healthcare in a Minute

By George W. Chapman

MD Association Endorses Universal Coverage

he American College of Physicians — with about 160,000 members — joins the ranks of physician organizations to endorse some sort of universal coverage or single payer healthcare system. Historically, most physician groups have resisted any form of increased government involvement. Several factors contribute to this gradual about-face. Millions of patients still struggle with paying their medical bills, including those with insurance. Medical debt is the No. 1 reason for personal bankruptcies. Over the past 30 years, commercial insurance carriers have gradually lowered their payments to physicians to Medicare levels. Consequently, there is less support for multiple payers and more for a single payer if fees are about the same. More and more Americans are not covered by employer sponsored insurance. The

percentage of Americans covered by some sort of federal program now exceeds 50%: Medicare, Medicaid, VA and military, federal employees, Bureau of Indian Affairs and the Affordable Care Act. The aging of America means Medicare is the fastest growing insurance plan. Dealing with multiple insurance plans is a cost and bureaucratic nightmare for physicians and their staff. A single payer would significantly lower practice overhead. According to a study in the Annals of Internal Medicine, a single payer system would reduce administrative costs by $600 billion annually. Finally, increasingly, younger physicians and recent grads prefer employment with larger health systems vs. private practice. Consequently, they are less resistant to government intervention if it guarantees access and affordability.

Easing MD Shortage

“certified,” but they do not have licenses. They operate under the license of a supervising physician. Nurse practitioners have their own license and many states allow them to practice independently from physicians. “Nurse practitioner” is a master’s degree. Both APs have seen rapid growth over the past decade.

Physician assistants (PAs) and nurse practitioners (NPs) are both considered to be advanced practitioners (APs). Both of these professionals are helping to mitigate the increasing shortage of physicians, especially in primary care. The likelihood of being seen by an AP in any setting (private practice, urgent care or clinic) increases every year. There are approximately 125,000 PAs and 270,000 NPs in addition to about 950,000 active/practicing physicians. (PAs have only existed since 1967.) This year, PA schools will be required to offer a master’s degree. PAs must complete 100 hours of continuing education every two years. PAs are

The Coronavirus Vs. the Flu

With the coronavirus grabbing the headlines, we forget how pervasive and deadly influenza can be. Five to 20% of us (or 16 million to 66 million of us) will contract the flu every year. About 200,000 of us will be hospitalized every year with the flu on average, costing $10 billion a year. March 2020 •

Surprise Billing

There is typically no charge when you approve or request the transfer of your record from one provider to another. Up until recently, when you requested a copy of your record be sent to a third party, like a law firm, the provider could charge you, but not more than an imposed cap of $6.50 regardless of the record format, like digital or paper. In January, a federal judge eliminated the cap on what you could be charged as arbitrary and capricious. Healthcare lawyers are challenging the ruling.

Out-of-network providers and insurance companies have been feuding over how to settle surprise billing. Currently, the consumer is stuck with paying the difference between what the out-of-network provider charges and what their insurance company thinks is reasonable. Congress’ Ways and Means Committee has suggested a two-step process to resolve the dilemma. First, the provider and the patient’s insurance company have 30 days to resolve the dispute between themselves. If they can’t, step two involves a third-party mediator. The vast majority of surprise billing emanates from a visit to an emergency room. The bill proposes giving patients an “advance explanation of benefits” including a cost estimate of what they will owe out of pocket which is alright in non-emergent situations. However, the Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to treat patients regardless of their ability to pay.

In his State of the Union address, President Trump once again called for legislation to bring drug prices under control. The House bipartisan bill authorizing Centers for Medicare & Medicaid Services (CMS) to negotiate drug prices on behalf of the 165 million people covered by Medicare and Medicaid remains stalled in the Senate. Sen. Chuck Grassley, a Republican, spearheaded the bipartisan bill. Opponents of the bill have argued that negotiating prices is a form of “socialism.” The

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.

Request for Copy of Your Record

Drug Price “Uncontrol”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Robert M. McCann, M.D.

Highland Hospital chief of medicine and longtime geriatrician reflects on nearly 35 years of practice in the Rochester area Q: You’ve been a geriatrician for quite some time. A: Longer than I’d even like to admit. Q: How has the specialty changed since you started? A: I started off as an emergency room doctor and worked for about three years at Park Ridge Hospital, which is now Unity, part of Rochester Regional Health. One of the things that struck me was elderly people coming into the emergency room on multiple medications from multiple people, some of them dying, and no one really addressing the big picture with them. So, when I had an opportunity to go back to Rochester General and start programs in geriatrics, it was a big interest to me. Q: Was it at that point you changed directions in your career? A: Geriatrics was just taking off in the country. I helped start the inde-

pendent living for senior’s program, which is now called ElderONE. We were one of the demonstration projects for a model called PACE [Program of All-Inclusive Care of the Elderly]. And that had been a very successful program in San Francisco in the Chinatown area. It showed that under a capitated payment system from Medicare and Medicaid they were able to deliver good care to people and keep them out of the hospital, and actually save money. We were one of 12 demonstration projects to see if it could be replicated in a non-Asian community. We showed that it could be. I ended up testifying with the head of Medicare in front of the House Ways and Means Committee as PACE got added on as a provider of medical care along with hospitals and nursing homes. At that time in Rochester, we hadn’t built new nursing home beds in about 10 years. People were piling up in the hospital. So this program

of keeping people out of the hospital was very timely, because Rochester General was looking for innovative ways to address that issue. I did that for about 10 years and really enjoyed that. Then an opportunity came up to come over to Highland Hospital. Q: What kind of impact have you had at Highland? A: I was full-time faculty with the University of Rochester when I was at Rochester General, and I continue-after I started working at Highland. Highland wasn’t doing well at the time and really wanted to build up their programs. So, I took that on. We developed programs there and out in the community. We started an acute care unit for the elderly. Over time I was able to recruit a lot of geriatrics faculty. The division continued to grow. I’ve been at Highland for 21 years now. I always felt that if you could make a hospital safer for the elderly, you make it safer for everyone. Q: Can you mention some of the things you have worked on at Highland? A: There’s a canary in the coal mine adage about how older people who are frail are more likely to suffer from things that go wrong in the hospital than people with a lot of functional reserve. So that’s been one of the big things I’ve worked on. We’ve been able to develop a world-famous hip fracture program and really improve their quality of care and one-year mortality, and improve the expenses to the hospital by not doing unnecessary things. It’s been a great model that we’ve helped 30 or 40 other places around the country emulate. And my faculty has gone to many other countries to help them replicate this program. It’s been a gold standard for coordinated, home-managed care in a hospital setting. About six years ago I got involved with helping to start Accountable Health Partners, which is the network for the medical center which involves eight hospitals and about 2,500 doctors. That’s been very different than my geriatric activities, but I’ve really enjoyed them, but I think we’re doing very good things that improve the quality and cost of care. Q: When you’re talking about making the hospital safer for the elderly, what are we talking about? A: We want to make sure we pay attention to activity, that we get them out of bed. That we don’t have unnecessary IVs, catheters, oxygen, things that keep them tied up. We keep them moving. When they’re uncomfortable with medicines, we take a look at them and eliminate ones that are unnecessary. We make sure that if they’re near the end of their life, that we have meaningful conversations with them about what appropriate goals of care are so that we don’t give them things that harm their quality of life. Some of the more basic things we do include hand washing, stopping the spread of infectious illness. We started the HELP program (Hospitalized Elder Life Program) where we have volunteers who engage elderly people in the hospital and talk to them. It’s been a national program that reduces delirium and confusion for elderly people in the hospital. It’s really been a multidisciplinary approach to making sure we understand what someone’s needs are, what their mobility is, what their cognitive function

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

is like and making sure their hospital stay isn’t harmful. Q: A common issue that comes up when I talk to geriatricians lately is deprescribing. How has it factored into your own strategies? A: I think this is something that every geriatrician has been interested in since they’re started practicing. Sometimes older people have multiple medications prescribed to them by multiple specialists and, all of a sudden, they’re on 20 medicines. It’s hard to be compliant when you’re on that many medications, and you can’t even calculate what the drug interactions might be when you’re on that many medications. You take a look at symptoms people are having, try to figure out which medications they need the most and which medicines may be causing some of the symptoms they’re having. What we don’t like to do is prescribe medications to deal with the side effects of other medications. So, if you have constipation as a side effect, we try to find ways to get rid of the medication that’s causing it. Q: Do we have, generally speaking, reasonable expectations where the health of the elderly is concerned? A: I think that’s very individual. You really need to talk to people to understand their quality of life. In geriatrics, we pay a lot of attention to patients’ functional status. Are they able to pay their bills, go shopping, talk on the phone and things like that. Measuring their functional status gives us a sense of what their functional reserve is, and that helps you gauge how they will do with surgeries or even taking medications. We help set expectations based on their wishes, values and their functional status. One size doesn’t fit all. Q: What aspects are within our control when it comes to quality of life later in life? A: When you talk to people, meaningful interpersonal relationships almost always comes up. So that’s dependent upon cognitive function. Functional status is kind of interesting, because people say, “I can’t imagine life in a wheelchair or a walker,” but in practice people using them see them as a way to stay independent. It can be a walker that helps you stay independent. But a lot of it is being meaningfully socially engaged. I know people who are very independent who are miserable and people with lower functional status with a good quality of life.

Lifelines Name: Robert M. McCann, M.D., MACP Position: Chief of Medicine at Highland Hospital; CEO of Accountable Health Partners; professor of medicine at University of Rochester School of Medicine & Dentistry Hometown: Buffalo Education: SUNY Upstate; Concordia University Affiliations: Highland Hospital; Strong Memorial Hospital Organizations: American College of Physicians; American Geriatric Society; Royal College of Physicians of Edinburgh Family: Wife; three children Hobbies: Golfing, fishing, outdoor activities, going to his children’s sporting events

Experiencing Vision Loss?

Life Expectancy in U.S. Up Again

First increase after four years of decline

fter four years of declines, life expectancy in the United States increased in 2018, health officials reported in February. The jump in longevity comes as deaths from opioid overdoses dropped for the first time in 28 years, as did deaths from six of the 10 leading causes. The new data could be a glimmer of good news for Americans’ health, with recent declines in average lifespans initially casting doubt on progress made over the past decades. “The three-year trend in life expectancy for the total population either decreasing or remaining steady has stopped, with the increase in life expectancy in 2018,” said lead researcher Kenneth Kochanek, from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). “The decrease in mortality from unintentional injuries in 2018 is a reverse from the 2014-to-2017 trend,” he added. “From 2014 to 2017, the increase in deaths from unintentional injuries contributed the most to the decrease in life expectancy, with decreases in cancer mortality offsetting this change in life expectancy,” Kochanek said. Between 2010 and 2014, life expectancy increased from 78.7 years to 78.9 years, then fell between 2014 and 2017 from 78.9 years to 78.6 years. But in 2018, it went back to 78.7 years, which is still below the peak of 78.9 years in 2014, Kochanek said. The 10 leading causes of death in the United States are heart disease, stroke, chronic respiratory disease, Alzheimer’s disease, diabetes, flu, kidney disease, suicide, cancer and accidents. Between 2017 and 2018, decreases in deaths from cancer and unintentional injuries contributed the most to the increase in life expectancy, with increases in mortality from influenza and pneumonia offsetting the change in life expectancy, Kochanek added. According to Dr. Howard Koh, a professor at Harvard T.H. Chan School of Public Health in Boston, “After years of plateauing and declining U.S. life expectancy, this one-year uptick is certainly welcome news.” But more detailed evaluation over time is needed to judge whether declining trends are truly being reversed, he said. Another expert agreed that the

increase in life expectancy was welcome news, but must be taken with a grain of salt. “It’s good news U.S. life expectancy increased for one year, interrupting its fall over the past three years, but the overall picture remains bleak,” said Steven Woolf, director emeritus and senior adviser at the Center on Society and Health at Virginia Commonwealth University School of Medicine, in Richmond. For many years, life expectancy in other wealthy nations has been higher than in the United States, and their life expectancy rates have been climbing, Woolf said. The increase in life expectancy between 2017 and 2018 is statistically significant, but time will tell whether it holds, he added. A similar increase occurred between 2013 and 2014 before falling the following year. Other findings in the report include: • Among the 10 leading causes of death, only deaths from suicide and flu-related pneumonia rose. • More than half the increase in life expectancy in 2018 was from fewer deaths from cancer and accidents. • Drug overdose deaths dropped 4% from 2017 to 2018, from about 70,200 in 2017 to nearly 67,400 in 2018. The majority of drug overdose deaths (90%) were unintentional. • Drug overdose deaths in 2018 dropped in 14 states and the District of Columbia. Across the country, the overdose death rate was 20.7 per 100,000 in 2018 and 21.7 in 2017. • The rate of drug overdose deaths from drugs such as fentanyl, fentanyl analogs and tramadol rose 10% from 2017 to 2018. • Between 2012 and 2018, the rate of drug overdose deaths from cocaine more than tripled, and from drugs such as methamphetamine increased five times. Koh pointed out that, “while the overall decline in drug overdose deaths is notable and must continue, rising mortality from synthetic opioids — as well as from cocaine and methamphetamine – represent the next disturbing wave of the nation›s ongoing substance use challenge.” Woolf added that it’s good news that the rate of fatal drug overdoses has decreased. “But this, too, should be put in perspective,” he said. “It’s still higher than it was in 2016 and alarmingly higher than it’s been in the past two decades.” The report was published Jan. 30 in the CDC’s NCHS Data Brief. March 2020 •

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Live Alone & Thrive

Dr. Patrick Solan Dr. Aaron Rickles

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

On Your Own: See the Glass as Half Full! “Every one of us has been given a great gift: the cup of life. It is half full and half empty. We choose which half to focus on, at every moment.” - Marc Allen, triathlon coach Seeing the glass as half full rather than half empty is all about focusing on what’s positive in our lives, regardless of what comes our way. It’s about being thankful, appreciative and grateful. It’s about concentrating on our strengths rather than our weaknesses. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass as half full can make a big difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative; we can open our eyes to possibilities or begrudge what life has offered up. So, how do you view the cup of life? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I’ve had the pleasure to meet in my workshops or public speaking engagements. Do you find yourself identifying with one perspective over another? NOT BEING MARRIED – Half empty “Something must be wrong with me. All my friends are married, and here I am alone and miserable.” – Half full “Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I’ve always wanted to travel and try new things, and now I have that opportunity — to create a life that’s rePage 10

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warding and full of new people and experiences that bring me joy. And, who knows? I may meet a special someone along the way.” DECISION MAKING – Half empty “Are you kidding? I don’t know enough to buy a house or a car. Those are the big decisions my spouse used to make. I wouldn’t know where to begin.” – Half full “Finally, I am making all my own decisions! No one is around to second-guess my choices. I just purchased my first car all on my own: a 2020 Subaru Outback. I did the research and was completely prepared when I went to the dealership. My color choice? Autumn green metallic. I love it!” IN A CRISIS – Half empty “I’m no good in a crisis. I go to pieces. When I hear bad news, I’m embarrassed to admit that sometimes I long to be taken care of and protected. Living alone makes all this worse. There’s no one to turn to.” – Half full “Being alone in a crisis isn’t the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family together. I learned I could take care of myself and others, too.” DATING – Half empty “I can’t imagine re-entering the dating scene. What could anyone

possibly see in me at this age, with my graying hair, expanding waistline and grandchildren?” – Half full “I believe that warm friendships, even romance, can happen at any age. I’m now remarried. We met in a grief support group and the rest is history. Next year, we are celebrating our fifth anniversary.” FINANCES – Half empty “My spouse took care of all the finances — the bills, the taxes, everything! I feel helpless and, honestly, I fear dying alone and penniless.” – Half full “I knew it wouldn’t be easy, but I knew I could do it. Getting help with my finances was one of the first things I did after my divorce. I picked up the phone and asked for help, did my homework, and now enjoy peace of mind. I’m very proud of myself.” COOKING FOR ONE – Half empty “Why would I go to any lengths to create a special meal for just myself? It hardly seems worth it. I can fill up on chips and salsa and call it a night.” – Half full “Creating a pleasant ‘table for one’ makes me feel good about myself. It means I’m nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a simple home-cooked meal, a sense of serenity comes over me. I feel at home with my own good company.” DISCOVERING YOUR TRUE SELF – Half empty

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

“I’m a creature of habit, too old to re-invent myself. And, what’s the point anyway? There’s no one to share my life with. – Half full “It’s never too late. Today, I have an opportunity to fashion a life that reflects my dreams, my style, my true self. Just recently, I signed up for dancing lessons, a lifelong dream of mine. My niece is also coming into her own, and I love being a role model for her. TIME ALONE – Half empty “Living alone is for the birds! I just want to stay in bed and pull the covers up over my head. – Half full “Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities and new relationships. Used wisely, the time can be an adventure in self-discovery and reveal opportunities for personal growth, spiritual awakening, and quiet fulfillment.” If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what new journeys and joy await those who focus on gratitude and embrace the wisdom of seeing the glass half full.

Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase her book, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.

C-A-N-C-E-R Screening remains crucial for effective cancer treatment By Todd Etshman

arly detection of cancer through a screening process is still essential for effective cancer treatment and for the patient’s chances of survival, several local experts say. People in a group at high risk of cancer need to have more frequent screening and must begin screening at an earlier age. Common highrisk factors include age, race, family history and the results of previous screenings above normal range. Women tend to be better at getting screened for cancer than men for a variety of reasons, says Jean Joseph, chairman of the department of urology at the University of Rochester Medical Center. “Men don’t go to the doctor until there’s a problem,” he says. For some men, prostate and colon cancer screening involve areas of the body that are taboo. It’s a mistake that can cost lives. “What you don’t know can kill you,” Joseph says. Here’s a look at commonly used screens for leading types of cancer:

better than no screen at all.

Breast Cancer A non-invasive breast X-ray or mammogram is recommended for women beginning at age 40 to screen for breast cancer. However, Holly Anderson, president and executive director of the Breast Cancer Coalition of Rochester, wants people to know it’s not perfect or as conclusive as other types of cancer screening. “Breast cancer is an extremely complicated disease that continues to take the lives of over 41,000 women in our country every year,” she says. That figure includes women who had annual mammograms and caught the cancer early. Early detection offers the best chance of survival but the biology of the tumor is also a major factor. Mammogram results can be misleading. A small tumor caught early can still be lethal and a large tumor may not be life threatening, Anderson explains. Other forms of imaging, regular self examination and physician examination can help identify breast cancer and determine treatment.

Skin Cancer Skin cancer is the most common cancer in the U.S. today, accounting for more incidents of cancer than every other cancer combined. Fortunately, it is also one that is relatively easy to monitor and detect. A Rochester based company, Visual DX, developed the Aysa app that allows people to photograph a skin lesion and have it analyzed before a dermatologist even sees it. Soon, patients will be able to send that picture directly to a dermatologist, says Nana Duffy, lead physician for dermatology at Rochester Regional Health. “Artificial intelligence can only help us”, she says. Modern technology and the Aysa App don’t eliminate the need for a full body physical check by a dermatologist for skin cancer Duffy explains. As my sibling recently found out, skin cancer isn’t confined to the face, shoulders, arms or places you can see. The full body check entails looking at every area of skin from head to toe. Light skin with freckles, melanoma and multiple memorable sunburns put patients at higher risk, Duffy says. The only thing better than the physician’s eye is a non-invasive tool called a dermatoscope that allows dermatologists to look through skin lesions and get a magnified view to help determine skin cancer. “The best thing to do is prevent it or catch it very early so it doesn’t end up costing people their lives or the medical system millions of dollars,” Duffy says.

men is prostate cancer. “It remains a very common cancer that affects men from all walks of life,” says Joseph. The PSA blood test to detect the presence of a protein in the blood stream that only the prostate makes remains one of the two principal ways to screen for prostate cancer. “It [the protein] tends to be made when there is activity in the prostate that could be cancerous,” Joseph explains. Age, family history and African American men are factors that put people in a higher risk group for prostate cancer. Since not all prostate cancer shows up on the PSA, a manual check of the prostate through the rectum by a physician also needs to be done no matter how squeamish men are about it, says Joseph. The prostate cancer rate has decreased a bit in recent times but Joseph says prostate cancer awareness and screening must improve for more significant gains.

Prostate Cancer

Colon Cancer

Outside of skin cancer, the most common cause of cancer death in

Lung Cancer

Marino

Joseph

“Colon cancer is preventable and you need to get screened for it,” says March 2020 •

Nead Danielle Marino, a gastroenterologist and associate professor of medicine at URMC. “We are definitely making progress. The incidents of colon cancer have gone down. A colonoscopy is the best way to screen because we find pre-cancerous polyps and remove them at the same time so we can prevent cancer,” she says. Finding polyps and removing them interrupts the colon cancer sequence, says gastroenterologist Jeffrey Goldstein of the Digestive Center of Western New York. A colonoscopy is still recommended at age 50 but if colon cancer is in the family history it should be done as early as age 30. “People are much better about getting screened today but we can still do better,” he says. Colon cancer is still the second leading cause of cancer death in men and women. Early colon cancer detection is crucial to treatment. Colonoscopies are now done in high definition so doctors can see even better than before. Other screen tests that only examine fecal matter do not eliminate the need for a colonoscopy but doctors say they are

Lung cancer is the third most common type of cancer and has one of the highest mortality rates, says Michael Nead, associate professor of medicine at URMC. Lung cancer may already be established within the body by the time screening is done and the screening merely confirms that cancer is present. Screening for lung cancer is done by capturing a low dose radiation image called a CT scan. “Unfortunately, we are screening only a small fraction of the people who need to be screened. There are people out there with lung cancer that haven’t been screened, If the cancer is found in early stage, the survival rate is high but one of the problems with lung cancer is by the time most people develop symptoms it’s usually late stage,” Nead says. Age and tobacco history are high-risk factors but non smokers still constitute 15% of all lung cancers. Far and away the best thing anyone can do to improve their life and lifespan is to quit smoking, Nead says. More time and testing is needed to determine if there is a correlation between vaping, marijuana smoke and lung cancer. “Vaping causes other lung injuries and is not as innocuous as was first thought,” says Nead, who advises against smoking of any kind.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Tips for Beautiful, Healthy Skin Want that airbrushed look without a photo filter? Follow these tips from three area experts By Deborah Jeanne Sergeant

ips from Nananamibia Duffy, dermatologist with Rochester Regional Health: n “Cleanse twice daily. Wash sweat off immediately after exercising so bacteria and yeast do not sit on the skin. n “Use sunscreen. n “Use a retinoid [prescription] or retinol daily to help stimulate cell turnover and boost collagen production. n “If you are in your late 20s and beyond, consider a regular skin maintenance procedure like a no-downtime resurfacing laser — Clear and Brilliant is my favorite — which can be performed as often as every month to help maintain the skin integrity and get that glow back.”

ips from Lori Ullman, dermatologist with University at Buffalo: n “Sleep is important for generally healthy skin. When you sleep, your body repairs itself. Lack of sleep causes distress to our bodies. n “The single most contributing factor to keeping your skin beautiful is protecting it from the sun’s harmful rays. Solar radiation is the biggest factor. When we chronically expose

you get out of the water. n “Don’t smoke. The nicotine causes restriction of blood vessels, which decreases blood flow to the skin. Oxygen delivery is decreased, as is essential nutrient delivery, which contributes to premature aging unrelated to sun exposure. It contributes to breakdown of collagen and elastic fibers. It leads to sagging and coarse wrinkling. That lack of oxygen and nutrients leads to skin discoloration. Removing to this one factor will improve skin health. n “Use gentle cleaners and avoid exfoliants and scrubs, which lead to inflammation. Use oil-free products. ‘Less is more’ is my motto. the products with fewer ingredients tend to be gentle and often have a good safety profile. Beautiful skin is healthy skin.”

ips from Heather Carrera, doctor of clinical nutrition who works in the office Lesley James, MD in Pittsford: n “It’s definitely going to be different for every individual. n “Drink water for sure. If you’re not hydrated, wrinkles will be more prominent. n “Eat healthy fats in your diet. It’s really affected by the fat. Fish oil,

avocados and nuts help skin appear more supple. n “When it’s more of a unique situation, food sensitivity can be a big issue. Determine if you have a food sensitivity and keep that food out of your diet. Definitely look for food sensitivities or to alcohol, caffeine. n “Alcohol can cause skin conditions and acne. n “If you just switched products, it may be external. If it’s the same products, look what you’re putting into your body. That’s usually the cause for adults. n “There’s the role of toxins in the environment. Our liver is our major detoxification organ. If we’re taking in too many or we’re not able to get them out, that can cause skin conditions. The more research we do about chemicals in our environment, we can rule out the role toxins play.”

Answers for Adult Acne

hether you have been breaking out since your teen years or acne has returned after a hiatus, adult acne can cause embarrassment and frustration. Fortunately, you have a few options for mitigating its effects. It’s important to understand what causes adult acne. It’s more complex than you may think. “Adult acne can be due to a number of different causes,” said Nananamibia Duffy, dermatologist with Rochester Regional Health. She mentioned a genetic predisposition to acne could be one cause, for example. “Hormonal changes, new medications — especially lithium, steroids and testosterone — stress and having a genetic tendency are all triggers for adult acne,” Duffy added. “Speaking with a board-certified dermatologist about your acne is a good way to try to get to the root cause of the acne.” Mara Weinstein, an UR Medicine dermatologist, blames hormones as the most common cause. “Women in their late 30s and beyond can develop acne along the chin and jaw line which is also considered to be in the distribution of a man’s beard due to increased androgens,” Weinstein said. Some women experience acne outbreaks related to their menstrual cycles and accompanying hormone shifts, as do women with polycystic Page 12

the skin, we get break down of collagen, the elastic fibers in the skin. It gives strength and elasticity. It results in rough, dry, irregular pigmentation, caused by dilated blood vessels. The real approach is for use of year-round sun protection. UVB tends to be more active 10 a.m. to 4 p.m. in April through October. But UVA is the same in January as July. It’s active as long as you don’t have to turn on artificial light. Use SPF of 30 or higher. I also recommend that chemical-free sun screens or sun blocks containing a physical sunscreen like zinc or titanium dioxide rather than chemical sun screens. Recent studies show the chemicals are absorbed in larger amounts than we previously thought and there are studies underway to study the potential affects. The physical sun blocks are micronized now so it’s not the old sunscreen where you look as white as a ghost. n “Wear sun protective clothing like hats, sunglass, and clothing. Standard cotton is SPF 5. If you’re looking for sun protective clothing, purchase clothes that are rated as sun protective. Their fibers are more tightly woven. If it gets wet, change. Apply every two to three hours. Your own oils slough them off. Apply in the morning and afternoon and when

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ovary syndrome, which is hormonal in nature. Stress hormones can also play a role, as increases in cortisol can worsen acne. “Oftentimes, stress is also compounded with a poor diet, lack of sleep, dehydration and little exercise, so it’s important to maintain a balanced lifestyle which includes a healthy diet with everything in moderation, exercise and mental wellness,” Weinstein said. It’s easy to forget that the skin is an organ of the body. Poor habits such as those definitely affect the skin. A generation ago, chocolate and greasy foods were commonly identified as causing acne. While there’s more to curbing outbreaks than banning these foods, the notion holds some truth. “We do have some evidence-based research that supports the fact that chocolate and foods with a high glycemic index — [refined sugars] — can worsen acne,” Weinstein said. “Sugary foods increase the inflammation in your body and so, limiting them can help to reduce acne and other inflammatory conditions.” In addition to eating a healthful diet with limited processed foods, the health of the gut itself can influence acne. Heather Carrera, doctor of clinical nutrition who works in the office Lesley James, MD in Pittsford,

said that gut health is “highly linked to skin conditions. Acne is a good indication that the cells of the gut lining have spaces between them. If it’s leaky, undigested food particles can enter the blood stream. It shows up as skin condition.” Washing the face twice a day and removing make-up with a gentle cleaner before bed is essential, as it can otherwise clog pores and worsen acne. If regular at-home care isn’t working, seeing a dermatologist can help diagnose acne and suggest treatments and lifestyle changes that can help. “In general, hormonal acne can

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

require oral medications that combat the increase in androgens,” Weinstein said. “There are also topical medicines that will help as well, containing ingredients like salicylic acid, benzoyl peroxide and retinoids.” A course of antibiotics may be warranted. Weinstein warns that popping pimples at home only lengthens recovery and may lead to scarring. But dermatologists can offer a cortisone injection to resolve a painful cyst within 24 to 48 hours. “Chemical peels and light therapy are also great ways to control acne and prevent scarring,” she added.

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Things You Should Know About Coronavirus By Ernst Lamothe Jr.

ith the new strain of coronavirus — COVID-19 — hitting more than 2,000 in death toll and tens of thousands affected worldwide, much is still unknown by the general public about how the epidemic has spread. It was first identified in 2019 in the city of Wuhan, Hubei Province, China. Since then, the virus has been identified in multiple other countries, including in the U.S. According to the Centers for Disease Control and Prevention, human coronaviruses are common throughout the world. However, the COVID-19 virus is a public health concern because of the many unknown factors and the fact that there is more than just one form of the virus. Physician Nadia Kousar, infectious disease specialist at Rochester Regional Health for Newark-Wayne Community Hospital and Clifton Springs Hospital and Clinic, discusses five important facts about the virus.

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There are multiple coronavirus

The various coronaviruses can infect people and make them sick. Some human coronaviruses — not the new strain — were identified many years ago and some have been identified recently. Human coronaviruses commonly cause mild to moderate illness in people worldwide. Middle East Respiratory Syndrome Coronavirus was first reported in 2012 in Saudi Arabia and has since caused illness in people in more than 25 other countries, including the United States, according to the CDC. Most people reported to have MERSCoV infection developed severe acute respiratory illness, including fever, cough, and shortness of breath. “The [novel] coronavirus that you are hearing about now is new and there is a lot of information that people don’t know or make assumptions,” said Kousar. “That is why it is important for people to understand all the aspects of this virus.”

Coronaviruses are most commonly passed from person to person

Most often the virus is spread from person to person, which happens among close contacts about six feet away. It occurs mainly through respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. Confirmed cases are more than 70,000 in countries that include China, Japan, Singapore, Thailand, South Korea, Malaysia, Taiwan, Australia, Germany, Vietnam, France, the United Kingdom and United States. “People who have either been to mainland China or have been in contact with those who have traveled around that region are the highest susceptible people for contracting the virus,” said Kousar.

Coronavirus is less than a threat in the U.S. than the flu

Flu vaccines are updated to better match viruses expected to be circulating in the United States. The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions, are at high risk of serious flu complications. “People sometimes don’t take influenza as seriously as they should,” said Kousar. “We continuously have a large number of cases of people who have contracted the flu or have been hospitalized. It is far greater a threat than the coronavirus so far in the United States.”

The symptoms are similar to flu

The severity of the new coronavirus symptoms can range from very mild to severe, even death. Although March 2020 •

understanding of this disease continues to grow, most people with severe illness have been of an older age or had other significant existing medical conditions. “It can take the form of having shortness of breath, fever or a cough,” said Kousar.

No vaccines yet

Thomas said there are no approved drugs or vaccines to specifically treat or prevent COVID-19 infection or disease. Medical experts do offer some suggestions which include washing hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer. Kousar suggests avoiding touching your eyes, nose and mouth with unwashed hands, avoiding close contact with people who are sick and staying home when you are not feeling well. Also, some of the same habits discussed when you have a cold such as covering your cough or sneeze with a tissue, then throwing the tissue in the trash and cleaning and disinfecting frequently touched objects and surfaces. “Because as we talked about

Physician Nadia Kousar, infectious disease specialist at Rochester Regional Health for Newark-Wayne Community Hospital and Clifton Springs Hospital and Clinic. before it is called novel because it is new there is no current vaccine or expectation that a vaccine will be ready for what is currently going on in China,” said Kousar. “There are people likely working on a vaccine but it will take time.”

Bats, Snakes May Be the Source of New Coronavirus A study published Jan. 30 in The Lancet, finds strong evidence that bats are where the infection actually originated. According to study authors, the infection could still have been passed to humans through an intermediary animal. A previous study theorized that it went through snakes before being passed on to humans. “Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans,”

wrote the study authors. Bats have an unfortunate history of passing potentially deadly pathogens to human hosts. A 2017 article in Nature explains how virologists identified a single population of horseshoe bats harboring virus strains with all the genetic building blocks of the SARS virus that jumped to humans in 2002. That worldwide outbreak killed almost 800 people. Research published in Emerging Infectious Diseases confirms that many African bats are also reservoirs of the incredibly dangerous Ebola virus. Source: www.healthline.com

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

SmartBites

By Anne Palumbo

The skinny on healthy eating

Little Lentils Dish Up Big Benefits A small but mighty member of the legume family, lentils have so much going for them it’s hard to know where to begin. Nutritionally dense and loaded with wide-ranging health benefits, lentils are considered by many to be a “superfood.” Lentils are remarkable high in fiber — both soluble and insoluble — with one cooked cup providing around 16 grams of this cholesterol-lowering nutrient. According to the American Heart Association, the average American adult needs about 25 grams of fiber a day to reap its benefits. On average, however, American adults eat only 10 to 15 grams of fiber a day. Why bump up your fiber intake? Multiple studies have confirmed that eating lots of fiber can reduce your risk of dying from heart disease, cancer, stroke, and Type 2 diabetes. Lentils’ impressive amounts of folate and magnesium also contribute to heart health. Folate helps lower levels of homocysteine, an amino acid that when elevated can lead to hardening of the arteries and blood clots, while magnesium helps maintain a steady heartbeat and normal blood pressure. Heart benefits notwithstanding, folate is critical for preventing neural tube defects in newborns. Seeking to increase your intake of plant-based protein? Look to lentils, the bean that delivers the second most protein per cup (soybeans take

top honors): a whopping 18 grams. A building block of bones, muscles and skin, this powerhouse nutrient can also be a dieter’s best friend, as its slower digestion helps to curb snacking, and its metabolic boost (protein takes the most energy to digest) can be a bona fide calorie-burner. Similar to other beans, lentils are packed with antioxidants — those magical compounds that can help prevent a host of age-related maladies, from heart disease to cancer to Alzheimer’s. Lentils’ antioxidants do a body good by helping to reduce inflammation, lower blood pressure and fight free radical damage. A versatile bean that cooks in a

Physician Deborah Rib, a local OB-GYN, helps refugees with background in health get training, jobs

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Medicare for All

A recent survey of 10,000 people shows a divided opinion: 30% are in support of the proposal made by some presidential candidates while 28% oppose it

Weighty Issues

GVHEALTHNEWS.COM

SEPTEMBER 2019 • ISSUE 169

Back to School n This is usually challenging time for those within the autism spectrum. Find out why n Medical groups recommend that middle and high schools should start 8:30 a.m. or later. See why n Seven myths about children’s eyes n Asthma, allergies: New school year can bring major ﬂare-ups n Starts on p. 11

Fair Food

Mother, daughter discuss healthy weight journey

Aging Eyes

CBD OIL

Droopy eyelids, dry eyes, floaters, cataracts and ocular migraines are just some of the eye problems we may have to deal with as we age. We talk to local experts about what to do

Please Give Me My Zuchini Find out why SmartBites’ columnist is elated when zucchini season rolls around. “It’s as nutritious as it is delicious,” she says P. 19

Are Too Many Kids Prescribed Antihistamines?

Physician Lisa Smith was elected the new president of Monroe County Medical Society. She wants to reduce administrative burden for doctors, among other goals. See interview on page 6

Things You Need to Know About Skin Cancer Prevention

Want to Relax? Try ‘Floating’

Bodymind Float Center in Rochester takes relaxation to whole new level

Women’s Health by Decade Main issues women should pay attention to as they age

GENERICS Recent news stories raise questions about effectiveness and safety of generic drugs sold in the U.S. One problem: Most of these drugs are manufactured in China and India, where oversight is not as stringent as in the U.S. or other countries. See story on page 24

Free personal fitness challenge on the Erie Canal encourages families to get active. Page 8

GVHEALTHNEWS.COM

Vaccination 5 things you need to know about it, according to pediatrician Larry Denk. Page 12

Do’s & Don’ts • Lemons • Strawberries • Oranges • Limes • Pink and red grapefruit As terrific as blueberries are considered, blackberries were actually the next fruit on the list,

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Story on p. 12

followed by white grapefruit. Now this isn’t to say that blueberries, which many studies rank very high for antioxidants and other healthful compounds, shouldn’t be on your shopping list along with raspberries. Eating fruits in a rainbow of colors gets you the widest variety of nutrients and phyto-nutrients — those hard-to-duplicate compounds that go beyond vitamins and minerals. It’s also important to pay attention to a fruit’s ripeness. Studies show that ripe fruits, including all berries, offer more antioxidants than fruits that are not quite ready. Based on that criteria, strawberries topped the list, followed by black raspberries, blackberries and red raspberries in that order. Remember that fruits have more calories than vegetables, so watch your portion sizes. P. 23

Story on p. 15

Heat oil in a large saucepan or skillet over medium heat. Add the onion and garlic and sauté until onions become soft, about eight minutes. Add the celery, carrots, mushrooms, Italian seasoning, and pepper flakes; gently heat, partially covered until softened, about 10 minutes, stirring occasionally. Stir in tomato paste; cook two minutes. Add broth, tomatoes, and lentils; simmer, partially covered, until lentils are tender, 45-50 minutes, stirring occasionally. Meanwhile, cook pasta in a pot of boiling salted water according to package directions; drain. Stir milk and vinegar into bolognese; season with salt and coarse black pepper. Serve bolognese over pasta; top with Parmesan.

Name ________________________________________

The Top 5 Fruits to Add to Your Diet

The top 5 nutrient-dense fruits

shredded Parmesan

JULY 2019 • ISSUE 167

Summer Fitness for Women

Researchers have looked at the most nutrient-dense fruits and vegetables to see which provided meaningful amounts of B vitamins including thiamin, riboflavin, niacin, folate, B6 and B12, vitamins C and K, iron, fiber and protein. Most of the top spots on their ranked list of powerhouse fruits — those most strongly associated with reducing the risk of chronic diseases — were various citrus fruits with one popular berry mixed in.

2 tablespoons olive oil 2 cups sliced white or cremini mushrooms (or more) 1 cup chopped onion 3 cloves garlic, minced 1 cup each sliced carrot and celery 2 teaspoons Italian seasoning 1/4 teaspoon red pepper flakes 1 tablespoon tomato paste 2-3/4 cups low-sodium broth: vegetable or chicken 1 can diced tomatoes (14.5 oz.) 3/4 cups lentils 1/4 cup 2% milk 1 teaspoon balsamic vinegar salt and pepper to taste 8 to 10 oz. pasta of choice

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Are You Up for the Canalway Challenge? PRICELESS

What’s the go-to type of potato the author of column SmartBites reaches for? Yes, baby red potatoes. Find out why. Page 14

P. 10

Can Italian sausage be part of a healthy diet?

•

AUGUST 2019 • ISSUE 168

Baby Red Potatoes

Drugs such as Benadryl provide little benefit to kids with cold

New President

GVHEALTHNEWS.COM

Fried dough, funnel cakes, corn dogs, deep fried cookies — should you resist to all these temptations? We’ve asked the experts about eating those delicious treats

Excessive Video Game Playing Now Considered a Disorder P. 23

A new study shows that a person taking the medicinal cannabis derivative cannabidiol (CBD) won’t fail a drug test for marijuana

Page 14

An OB-GYN in Clifton Springs

Adapted from Cuisineathome.com

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.

PRICELESS

The Clifton Springs area has historically been underserved when it comes to OB-GYN services. New physician, Ahmad Awada, wants to change that

Lentil Bolognese

Store dry lentils in an airtight container in a cool, dry place for up to a year (can be stored longer, but taste may deteriorate). Cooked lentils will last about a week in refrigerator or up to six months in freezer. Canned lentils have a similar nutritional profile to dry lentils, but may be slightly higher in calories and sodium. Check label and be sure to rinse well before using.

Anne Palumbo is a lifestyle colum-

PRICELESS

Helping the Educated Refugee

jiff, lentils are naturally low in fat, sodium, cholesterol and calories: only 230 per cooked cup. This ancient legume — nearly 10,000 years old — is also a good source of manganese, phosphorous and iron.

Helpful tips

1,000,000

Number of new sexually transmitted infections cases every day among people aged 15-49 years, according to the World Health Organization.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

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Should You Skip Breakfast? Celebrity TV doctor Mehmet Oz recently said people should skip breakfast. Do we really need the ‘most important’ meal? By Deborah Jeanne Sergeant

elebrity doctor Mehmet Oz recently said that people should skip breakfast. That seems to fly in the face of the age-old adage that breakfast is the most important meal of the day and the means to jumpstart the metabolism, but Oz explained that most people respond to society cues to eat, whether they need the calories or not. Oz explained that eating later in the evening causes the hormones to make the body crave calories — primarily carbohydrates — first thing in the morning. Stopping eating around 7 p.m. resets the hormones so that by 7 the following morning, the body has been fasting 12 hours and it doesn’t feel hungry right away. He added that the data comes from animal research and anecdotal input from professional athletes. Oz’s advice seems to correlate with emerging research on intermittent fasting, which advocates for eating only during eight hours of the day and abstaining from food for the rest of the 24-hour period. Oz believes that skipping breakfast can help people not only maintain healthful weight, but also perform better both physically and mentally, and even age more slowly. He also believes that it’s an easy way for people to lose weight and maintain healthful weight, since it doesn’t involve counting calories or points, severe food restrictions or continual efforts (although eating a generally healthful diet of moderate calories is still a good idea). Even when eating the same number of calories over an eight-hour period compared with an 18-hour period, people tend to lose weight, according to Oz. Also as part of his System 20 eating plan, adherents are permitted a cheat day so their bodies don’t get in a rut — and they can enjoy an occasional breakfast out. Or, instead of skipping breakfast, they can skip dinner that evening to maintain the eight hours of eating. Debbie Wolfe, a home and lifestyle writer based in the metro Atlanta area, posted in February on She Finds, “if you think skipping breakfast will help you lose weight faster you may be making a big mistake.” She bases this on the low blood glucose levels people have after not

eating for 12 hours since their previous evening’s dinner. “When you wake up, your glycogen stores are low,” Wolfe wrote. “Glycogen is the glucose that has been stored in your muscle and liver tissues and is released slowly so your blood sugar levels are stable overnight. When you skip breakfast in order to fast, all of the energy from the glycogen stores is used up, your body starts to break down fat to produce energy. You may lose weight with this method, but you can also experience reduced energy levels and fatigue.” She added that eating breakfast can add a nutritious boost to the day, improve energy levels and metabolism and prevent poor food choices later. Az Tahir, MD, practicing holistic medicine in Rochester, sees merit in intermittent fasting. “It has been shown to help people lose weight and prevent and treat diabetes,” Tahir said. “It causes blood pressure and blood glucose markers to go down.” He likes the simplicity of fasting while still drinking water or tea, since it’s easy for people to understand and follow. Tahir said that after two or three days, people fasting for 18 hours per day don’t feel hunger anymore. Heather Carrera, doctor of clinical nutrition who works in the office Lesley James, MD in Pittsford, does see merit in forcing the body to rely upon stored glucose, but believes that skipping breakfast may benefit some, but not all. “I think that intermittent fasting has a lot of health benefits,” she said. “There’s a subset of people who may not benefit who have adrenal fatigue and stressful situations. They may not be able to tolerate fasting. They should eat within an hour of waking up. It’s not a one-size-fits-all.” For those who do eat breakfast, it shouldn’t be a nutrient-void, sugary cereal or pastry. Carrera encourages things like a protein such as eggs with a little healthful fat or a smoothie with a quality protein powder. Any grains should be whole grains. “Oatmeal can be a good option if they’re whole or steel cut oats with a little nut butter,” she added. March 2020 •

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Serving Monroe and Ontario Counties A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Christine Green, Mike Costanza, Katie DeTar, Todd Etshman, Molly Pow • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Nancy Nitz 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.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

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or over 14 years, the Greater Rochester Health Foundation (GRHF) has been a leader in the fight to improve the health of those living in the nine-county region that it serves. Based in Rochester, the nonprofit has 13 employees and a current budget of $11.3 million. Of that total, $8.9 million will be dispensed in grants to the organizations and agencies that serve the area’s residents. In mid-January, GRHF announced the adoption of a new mission. GRHF President and CEO Matt Kuhlenbeck, who just finished his first year on the job, recently sat down with In Good Health to talk about that change. Q. What was GRHF’s original mission? A. The mission before the change was to improve the health status of residents of the Greater Rochester community, including those whose unique healthcare needs have not been met because of race, ethnicity or income. Q. How is GRHF’s new mission different? A. Our new mission is to pursue and invest in solutions that build a

healthier region where all people can thrive. The new mission statement really focused on creating a situation where all people can thrive, recognizing that some people already are and that there are several groups that aren’t. Our purpose is to really meet the needs of the community, and meet the community where they are in their health journey. Q. Who isn’t thriving, in terms of health? A. We have pockets of deep poverty, childhood poverty in addition to adult poverty. We have different degrees of access to healthcare service, depending on where you live. Certain neighborhoods, counties, portions of communities where the life expectancy is dramatically different than other areas of our community where people are doing incredibly well. Rochester is also one of the most segregated communities in the nation. People are starting at different places and have different levels of assets, and they have different supports around them. Q. How did that influence GRHF’s decision to change its mission? A. As we looked at our original

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

mission, and reflected on the work that we’ve been doing, a lot of the focus around race, poverty and income really wasn’t becoming a central part of our work. We knew that we couldn’t achieve change while looking at that wide a swath of the individuals, and so we really felt that we needed to be more explicit with who we’re trying to work with and where we’re trying to affect change. Q. In general terms, how might those views influence GRHF’s policies and actions? A. We’re taking a broad understanding of health, recognizing that only 20% of what impacts somebody’s health actually happens in a healthcare setting, and that 80% is the result of a variety of different neighborhood conditions, systems and policies that create inequities. It’s everything from where you live, to where you play, to where you work that influences your health outcome, not just your interactions with a healthcare provider. How do we work with those who are not in a position where they feel they are thriving, and how do we elevate them to where they feel they are? Q. Can you point out an example of how this might work? A. One area that we spent considerable time with over the last 10 years was with the El Camino Neighborhood in north central Rochester. We worked with the Ibero-American Action League to help community residents and community leaders develop their journey on what they felt a healthy community looked like. For them, a healthy community had green space — parks and trails. They also focused on not just healthcare, but “How do we have a safe neighborhood? How do we make sure that the sidewalks are taken care of, and we have spaces where our children can play?” We worked with them to really bring their vision to life, and invested a total of $1.5 million in the project. Q. What was the result? A. Now, there’s greenspace, parks, the El Camino Trail. More recently, they announced that they’re building La Marketa, a large community gathering space that will be in that same neighborhood. That’s actually being funded through the city of Rochester, and others. Q. What did your organization learn from that project? A. These efforts were isolated and they were pockets — it wasn’t part of our general overall operating principle. As we looked at where we had successes, and where we really felt we were really truly fulfilling our mission, we identified those projects such as this one, and decided that we really needed to do that more, and holistically, across all of our programming. We also realized that the community’s voice is a critical part of creating a solution. Q. Can you point to a project that GRHF is working on now that is in line with its new mission? A. It’s called “Healthy Futures.” It is an effort that is focused on improving health outcomes for children zero through 8 years old. We are working with a variety of stakeholders across the region, from the Healthi Kids network to the Greater Rochester Parents Leadership Training Institute with a focus on we support children who are in that zero-to-8 space, as well as their families, to improve their health outcomes.

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Dental Care

Routine Care Vital With Braces By Deborah Jeanne Sergeant

f you or your child has just been fitted with braces, it may seem like your orthodontist has all the bases covered as you visit every eight weeks or so. Although orthodontist are general dentists with additional training in orthodontia, you still need to see your general dentist for routine cleanings just as before braces. “The general dentist plays an important role in this,” said Paul Emile Rossouw, doctor of dental science, Ph.D., and chairman of the orthodontics and dentofacial orthopedics department at Eastman Institute for Oral Health, which is part of the University of Rochester Medical Center. “The basic things start with the general practitioner because that’s whom the patient will see through his life.” Although orthodontists take the time to give the teeth a good cleaning before applying braces, the general dentist maintains the oral hygiene through visits every six months, or more often as prescribed. Most orthodontists don’t go general or do routine cleaning as a general dentist

does. Rossouw said that before braces are applied, the patient should already have a good understanding of home care and good dental health. “If a patient has gingivitis, we don’t start orthodontic treatment until that is at a good level,” Rossouw said. “Very often, we refer patients back to their general dentist to do good prophylaxis, learn how to brush and floss effectively and use a fluoride rinse. Those are the magic things: brushing, flossing, something with fluoride in the mouthwash.” Other tools like an electric toothbrush or water pick may help, too. Establishing good home care is even more important while wearing braces because the brackets and wires make brushing and flossing more difficult. It also somewhat disrupts the natural movement of saliva through the mouth. “Having something in your mouth makes it less self cleansing,” Rossouw said. “Braces are an obstruction. One needs to learn to do it well so when braces are on there, it’s

the same process.” It takes more time to brush and to use a floss threader to get between teeth and clean the gum line; however, that’s the key to achieving the best results and maintaining oral hygiene with braces. “A lot of people are surprised that even though they come to our office very eight weeks that they do still need to keep up with their appointments with their general dentists,” said Carolyn Schlageter, registered dental assistant. Schlageter is also the treatment and financial coordinator at Get It Straight in Pittsford, Macedon and Greece. She said her office works closely with the general dentist’s office to help patients take care of their smile and show patients videos on dental care with braces so they learn the techniques of brushing and

Dry Mouth: Important Health Clue by Deborah Jeanne Sergeant

f you find that your mouth often feels parched, it’s not a symptom you should ignore, unless it’s only when you’re nervous. When it persists as a regular problem, dry mouth, called xerostomia in the medical world, can indicate a number of important health concerns. Instead of constantly reaching for lozenges, hard candy or a drink, you should see a healthcare provider. “It can have many, many causes,” said physician Az Tahir, who practices holistic medicine in Rochester. He said that dry mouth could be a localized problem from a blocked salivary gland in the mouth or a systemic issue such as Sjogren’s syndrome, which can also cause dry eyes. Sjogren’s is an autoimmune dis-

ease that often accompanies other autoimmune conditions such as lupus, Hashimoto’s disease and rheumatoid arthritis. Beyond the chance of association with other conditions and the annoyance of feeling like your tongue is sticking to the roof of your mouth, dry mouth can cause dental health issues as well, such as increased plaque, tooth decay, gingivitis, mouth sores, thrush, cracked and dry lips and, because saliva helps initiate the breakdown of food, digestive issues and nutrition problems. Paul Emile Rossouw is a doctor of dental science, Ph.D., and chairman of the orthodontics and dentofacial orthopedics department at Eastman Institute for Oral Health, which is part of the University of Rochester March 2020 •

Medical Center. Rossouw said that drying out the mouth can hasten the gingivitis process, since saliva helps wash away food debris and neutralize acid in the mouth. Sometimes, dry mouth isn’t a local or systemic condition but is caused by an external injury that damages the salivary glands or a mechanical issue. “That’s why one should want good lip seal,” Rossouw said. “Many things can create incompetent lips. Any kind of habit like sucking the thumb, genetics and crowding with the teeth, which can make it difficult to close the lips. Aging can also be a cause.” Drinking more water and using mouthwash made to combat dry mouth can help, as can addressing

flossing. Each employee in the clinical area at Get It Straight is a licensed dental hygienist so they can keep a close watch on their patients’ hygiene, even though they don’t offer traditional dental prophylaxis. According to Schlageter, one of the misunderstandings that people sometimes make is that they think the white marks on their teeth after braces come off are caused by the braces. “It’s not. It’s decalcification,” she said. “That’s caused by not brushing properly.” Decalcification can lead to tooth decay, so it’s vital to properly care for teeth as the orthodontic team directs. As another means to protect teeth, Get It Straight recommends a prescription fluoride toothpaste twice a day.

any sleep apnea issues. Sleep apnea causes the lower jaw to drop open, which dries the mouth during sleep. Chemotherapy and radiation as a cancer treatment can cause dry mouth. Patients undergoing these treatments should ask about ways to keep more comfortable. Some medications can cause dry mouth, like some antihistamines, anti-hypertensive drugs, and antidepressants, so it’s a good idea to bring this up during a visit with a healthcare provider, as an alternative medication or treatment option may be available. Dry mouth should also be addressed at a dental visit, since the dentist and hygienist can look for any signs of gingivitis and make recommendations on strategies to mitigate and prevent dry mouth. Using alcohol, tobacco products, or illicit drugs also contribute to dry mouth, so quitting use of these can help restore better moisture to the mouth.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

New Approach to Pelvic Health Addresses Formerly Taboo Concerns By Katie DeTar

ncontinence. Pain. Constipation. Often considered taboo in society, these health issues affect women and men, and can drastically reduce their quality of life. Specially trained pelvic floor physical therapists are bringing new treatments, hope and healing to patients of all ages. Jennifer Morin is a physical therapist at Specialty Physical Therapy in Brighton, specializing in pelvic health and orthopedics. She is one of a few pelvic floor physical therapists practicing in Western New York, but her approach is unique. “The treatment used to be focused so much on kegels, doing hundreds of repetitions,” said Morin. “For most people that means I’m going to squeeze my muscles as hard as I can and I’m going to do it while parked at a stoplight. But what we know from research and clinical experience is that it doesn’t always fix the issue.” Kegels is a term for a series of exercises involving the squeeze and release of the muscles of the pelvic floor. For many years, kegels were the prescribed therapy for urinary incontinence and other pelvic health issues. “What that was neglecting was teaching people how to use their muscles in the moment, and how

Jennifer Morin is a physical therapist at Specialty Physical Therapy in Brighton, specializing in pelvic health and orthopedics. to respond to different motions and forces that come on our body,” said Morin. “It’s not just about your pelvic floor, it’s about how your pelvic floor is intertwined with your breath and the rest of the core.” Activities including running, picking up and carrying children, and pushing and pulling heavy objects are all dependent on the proper functioning of the pelvic floor — the bowl of muscles in the base of the

pelvis. These muscles provide stability and support to the pelvic bones, help to control bladder and bowel function, and play a role in sexual activity. An often-overlooked aspect of proper pelvic floor functioning is muscle tension and tightness. Sometimes patients are dealing with incontinence and pain because of over-tight muscles, and the old prescription of hundreds of kegels will not heal those symptoms. “You can have dysfunction not just because it’s weak, but because there is tightness and lack of flexibility in the muscle,” said Morin. “So we’re working on range of motion and flexibility first, then we work on strength.” A typical exam with Morin is focused on making the patient comfortable and at ease discussing what can be embarrassing health concerns. Women of all ages, including pregnant and postpartum women, as well as men — sometimes while undergoing prostate cancer treatment — start with an initial, fully-clothed assessment. An ultrasound machine is used to gauge the general functionality of the muscles. Future visits often include an internal exam, essential for properly assessing the pelvic floor muscles and diagnosing any harmful muscle tension or pressure points.

Treatment plans then vary in length, and include exercises, in-office manual therapy to stretch muscles and mobilize soft tissue, and home strengthening and stretching regimens. Morin is also bringing her unique, whole-body wellness physical therapy approach to an online audience. Through her web business, Core Capacity Physical Therapy, she’s teaching online classes and seminars. “The online platform is a good way to get information to more people who may not have access to this,” says Morin. “And with how busy people are and the cost of insurance, I wanted to give people an option to get accurate information in the comfort of their own home.” The telemedicine-style treatment does not replace a physical exam, but offers basic, quality information to get a treatment plan started. Morin can then recommend a follow-up appointment in her office, or connect a patient with a practitioner in their home area. Physical therapy with a professional trained in pelvic floor health is a great, non-invasive alternative to surgery or medications, she said. Tools learned in treatment will further correct and relieve pain, incontinence, and discomfort. As with any medical condition, talk with your doctor and determine the best course of action for your body. “The hope is that people learn how to properly use their pelvic floor,” said Morin. “It’s really nice to see the sparkle in patients when they can get back to doing what they love to do.”

Meet Your Provider

Grasta’s Beauty and Wig Studio Store carries the largest collection of wigs in Western New York. It serves cancer patients and those with hair loss Q: When and why did you open Grastas Beauty and Wig Studio?

A: From 1942 to 1984 my mother Lucille K. Russo owned the LuRue’s Beauty Shop in Rochester. At the age of 14 I was helping my mom. I strived and managed to open my own business in 1973 in another Rochester neighborhood. I worked very hard and walked many blocks and handed papers at everyone’s door telling them about Grasta’s Beauty & Wig Studio. I followed up with many phone calls and invites until I was able to generate a new and loyal clientele. There is much pride between my mother and I in our accomplishments in the field of cosmetology. I was mentored by her and the daughter of a wig supplier. After 13 years I opened a second location in 1985 at 409 Parma Center Road and closed the first one in 2017. I’ve also been able to help many people who are shut-ins or cancer patients. When a client walks out of

Grasta’s Beauty and Wig Studio they will be proud to be wearing a Grasta wig, and no one will ever notice they are wearing a wig!

wigs. Everything is done on a oneon-one basis. No walk-ins allowed to ensure privacy and making clients feel beautiful inside and out.

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Q: Would health insurance cover any of the costs associated with the wigs or hairpieces?

A: We serve any and all clientele. Whether you’re experiencing hair loss or you’re a cancer patient or someone had a tragic accident — everyone deserves the respect and confidential treatment that only a private appointment can accomplish. The wig shop is open by individual appointment only to ensure a personalized experience every time.

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A: Yes, we do accept insurance. Contact your insurance company to see if and how much would be covered, and if prior approval is required.

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Sharon Grasta: “I do this with my whole heart and soul. I just love this work and it is my life. It’s my calling.” Q: Is there any financial assistance for veterans?

A: Yes! Ask me about this. You pay first and the form I supply to you gets turned in to Champ VA Benefits for a one-time reimbursement for retirees and spouse.

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409 Parma Center Rd, Hilton • 585-392-7823 • www.GrastaBeautyAndWigStudio.com

Monday thru Friday by appointment only. No walk-ins!

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

CrossFit: Hardcore Workout or Hard-to-Avoid Injury? By Deborah Jeanne Sergeant

f you don’t do high-intensity functional training (HIFT) such as at CrossFit, you likely know someone who does. HIFT workouts have become very popular. Flipping over tractor tires, hauling cement blocks and jumping on top of a stack of wooden blocks is far different from exercise regimens like spinning and running — and that’s the point. HIFT-style classes offer high intensity functional training that constantly change and challenge every area of the body and aspect of fitness: strength, endurance, balance and flexibility. They’re also designed to create camaraderie. Instead of slogging solo on bikes or plodding side by side on treadmills, HIFT classes encourage a teamwork environment as members of the gym cheer and

encourage each other to complete the same workout with a few modifications as needed. Anecdotal reports of injury and even a few lawsuits have tarnished the reputation of CrossFit and other HIFT-style classes. In late 2018, a study published in the Orthopaedic Journal of Sports Medicine looked at injury rates of participants in HIFT (specifically CrossFit, as it’s the most popular and identifiable HIFT class). The study surveyed 3,049 CrossFit participants between 2013 and 2017. More than 30% reported injury because of CrossFit in the past 12 months, including shoulders (39%), back (36%), knees (15%), elbows (12%) and wrists (11%). That meant an injury rate of 0.27% per 1,000

hours of participation. The study concluded that CrossFit “is relatively safe compared with more traditional training modalities.” But the caveat is that those new to CrossFit (less than a year) and who train fewer than three workouts weekly are at greater risk. Physician Az Tahir, who practices holistic medicine in Rochester, acknowledged that “there’s a lot of benefits to exercise.” He added that the improvements in physical and mental strength and functional health are well documented; however, the “extreme” nature of HIFT exercise concerns him. “The heavy exercise can cause muscle damage,” Tahir said. “It can also cause joint and other tissues tendon damage and lead to some unnecessary surgeries and unnecessary damage that’s lifelong. These injuries can also cause imbalance in the body. If one part is injured, the other parts of the body have to compensate, like limping on one leg because the other one is injured.” Especially for those who are out of shape, Tahir encourages consulting with a health care provider and proceeding under the guidance of a trained professional to ensure gradual progress in intensity, appropriate warm-up and stretching and that each movement is performed safely. Knowledge of each client is key to safe and effective workouts, according to Elizabeth Corbett-Renner, physical therapist and physician assistant at Excellence in Physical Therapy in Rochester. “There has to be emphasis on body mechanics and how clients should do things and knowledge of clients’ prior activity level and body conditioning,” she said. “Keep

in mind the risk of throwing tires and running on pavement carrying weights without proper footwear. Yes, I’ve seen CrossFit injuries.” She encourages people to make sure they know their own capabilities and that they don’t push past that point and allow injury. “Everyone can’t do the same activity,” Corbett-Renner said. “People must have knowledge of prior activity and specific body makeup and risk of injury.” Even under the same branding umbrella, gyms will vary based upon the background of the trainers and owners. At CrossFit Rochester in Pittsford, Joe Celso, a Level 4 CrossFit certified coach, said that the “mechanics are sound and safe. What should be happening at CrossFit gyms and every gym is the trainers should be paying attention to you. They should be keeping an eye on you making sure you’re in the right spot.” He wants participants to push themselves with intensity, but doing so intelligently so they get results and stay safe. “Get a free trial at a gym you’re considering,” Celso said. “I would. That’s doing due diligence when you’re paying for something. I would go visit all of them. Which one works? Where do I like the people?” CrossFit owners must have a CrossFit Level 1 certification, but Celso warned that doesn’t mean the gym owner is good at operating a gym and training members. “It’s what you make of the information provided,” he said. “There are plenty of people out there who passed a test but that doesn’t mean they’re good at coaching or sharing what they know.”

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Addiction The Talk: Discussing Drugs with Your Kids By Deborah Jeanne Sergeant

o parents want to see their children use drugs, yet many parents don’t know what to say to their children about drugs. Or they assume that the school program suffices or maybe hope that if they yell at their children about drugs, their children won’t try drugs. All of these strategies are a big gamble. Christy Richards, a registered nurse and public health educator with Ontario County Public Health, believes parents can play an essential role in keeping their kids away from drugs. “Conversations are one of the single most important tools when talking about protecting your kids,” Richards said. “It’s protection from lifelong addiction.” She advises open and honest conversation that comes from a viewpoint of love and concern — not yelling, blaming, accusing or threatening, since scaring children curtails learning about the topic. Richards said that parents shouldn’t focus on “The Talk” about drugs — a long lecture performed one time at a certain age — but they should instead organically discuss drugs in short, age-appropriate sessions throughout childhood. “There’s teachable moments all the time,” Richards said. Whether it’s a news story, movie

or TV show, parents can ask their children what they think about what they see. Richards said that even preschool aged children can learn that a vitamin is not candy but something that they should only take when a parent provides it. That introduces the idea that medication isn’t for recreation but is taken only by those who need it. Richards said that talking about drugs should be part of talks about maintaining good health, just like eating right and staying physically active. By elementary school, children could learn about the differences between medicine and illicit drugs and why prescriptions should be taken only as prescribed and by who’s on the prescription. In addition to drug talks, children also need to learn problem solving for lasting solutions so they won’t feel the need to turn to drugs to solve problems or deal with stress. “Teach them when they’re young that if they’re in an uncomfortable place, they need to leave,” Richards said. “They should follow their gut and figure out how to get out. When they’re older, they can get out of situation at a party. Otherwise, they may not want to ruffle any feathers.” Around the pre-teen years, young people need to feel they can

Despite Drop, Overdose Still Poses Serious Threat By Deborah Jeanne Sergeant

etween 2018 and 2019, death because of drug overdose in New York has decreased by 4.6%, from 2,386 to 2,276, according to the most recent, non-finalized statistics from the Centers for Disease Control and Prevention; however, any death from drug overdose is one too many. While prompt medical attention can sometimes reduce the chances of fatality from use of opioids and other substances, that medical care doesn’t always happen, especially when young people are involved. Fear of their parents’ response or legal repercussions may cause teens and young adults to not seek medical

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help in some cases. Some may hope their friend will sleep off the effects. “Hopefully, their first choice would be to call 911 even over their fear of their mother,” said Christy Richards, a registered nurse and public health educator with Ontario County Public Health in Canandaigua. She said that they may fear their parents’ response over their friend’s possible death in part because of previous experience with run-ins with their parents. Parents can help reduce this effect by responding in a more measured fashion when their children break the rules.

talk with their parents about anything without judgment or a harsh response. They need to feel that their parents will simply listen without rushing in to fix or teach all the time. Any children who have experienced trauma of any sort should have the opportunity to receive mental healthcare as needed. Richards said that issues such as these can manifest later as a greater susceptibility to drug use. At the pre-teen age, Richards said that it’s also time to establish rules with consequences, long before something happens.

Ask thought-provoking questions When having a more formal discussion like this, Jennie Militello, manager of Evelyn Brandon Chemical Dependency, said that the time and place can be significant. “Pick a time when you will have your teens’ undivided attention and when there is sufficient time to talk through whatever comes up. Pick a place “From a young age, how do you react to your children?” Richards said. “I know my kids will make mistakes and aren’t perfect. I’m not perfect. They need to know they can talk with us about anything at anytime. I want my face to be the first face that pops into their mind when they’re stuck. They should call me when they’re in trouble. “Parents should be consistent and not freak out when they come home and tell you things.” Good Samaritan laws protect both the patient and the person who sought medical attention. A study in Washington State indicates that 88% of people surveyed who use opioids would feel more likely to call 911 in case of an overdose because of the law. Most teens feel invincible, as if terrible things won’t happen to them or their friends such as dying from a drug overdose. Doing nothing seems like the right answer to some teens since it’s really difficult for them to believe that another young person could die. Some teens don’t recognize the signs of when a friend is in trouble with substance abuse and in need of emergency help. Jennie Militello, manager of Evelyn Brandon Chemical Dependency in Rochester, listed the overdose symptoms for the following substances: • Alcohol: disorientation, difficulty remaining awake, seizures, vomiting, slow or irregular breathing, clammy skin, bluish skin color. • Narcotics: clammy skin, bluish skin color, convulsions, lethargy, hallucinations, shallow breathing, coma.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

where distractions are limited.” Some like to do so during a car drive, where there’s no ability to escape, yet you don’t have to look eye to eye. Militello wants parents to prepare with information and details on the negative effects — both longterm and short-term — of different substances. “Ask thought-provoking questions,” she added. “Any questions that will assist your teen with looking to their own choices and consequences related to these choices will be helpful. “ It’s also important to lead by example. If you rush for a glass of wine every evening after work, it signals teens that using a mood-altering substance can help them relax, too. If you have used drugs in the past, use your experience to indicate the negative effects of using drugs. If you suffered no lasting effects, express how lucky you were and that others aren’t so fortunate.

By the Numbers According to the Centers for Disease Control and Prevention’s most recent statistics: • 70,237 drug overdose deaths occurred in the United States in 2017. • The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). • Opioids—mainly synthetic opioids (other than methadone) — are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths). • In 2017, the states with the highest rates of death due to drug overdose were West Virginia (57.8 per 100,000), Ohio (46.3 per 100,000), Pennsylvania (44.3 per 100,000), the District of Columbia (44.0 per 100,000), and Kentucky (37.2 per 100,000). • States with statistically significant increases in drug overdose death rates from 2016 to 2017 included Alabama, Arizona, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, West Virginia, and Wisconsin. • Marijuana: paranoia, anxiety, rapid heart rate with high blood pressure, fatigue, psychosis.

Churchville Woman Follows Own Advice to Deal with Bell’s Palsy Shortly after publishing a self-help book, she was diagnosed with a neurological condition: ‘My own book helped me cope with yet another experience and trauma,’ she says By Christine Green

ast summer Lori Bruton of Churchville was enjoying a much-needed lunch break at a local coffee shop when her life changed dramatically. She suddenly felt odd, unwell and woozy. “I had a ringing in my right ear, became very dizzy, and felt my face tingling. It was scary. I thought I may be having a stroke.” She knew she couldn’t return to work and that the ER was probably where she should head instead. She drove to the closest emergency room hoping that she hadn’t just had a stroke. Physicians concluded that she was suffering from a virus. They sent her home with instructions to see her family doctor the next day. “The next morning, I woke up, looked in the mirror, and was devastated to see my face disfigured and droopy. My speech was slurred. I had trouble closing my eye. I drooled when I ate or drank. “ Bruton had just experienced the acute onset of Bell’s Palsy.

What is Bell’s Palsy? The National Institute of Neurological Disorders and Stroke defines Bell’s Palsy as “a form of temporary facial paralysis resulting from damage or trauma to the facial nerves.” The seventh cranial nerve runs along the side of the jaw and controls facial expression and other important functions. When something irritates or damages this nerve, messages from the brain to the facial muscles are disrupted resulting in the syndrome known as Bell’s Palsy. The onset of Bell’s Palsy is often sudden and usually only affects one side of the face. It can cause a variety of symptoms, including weakness or paralysis of the facial muscles, dropping of the eyelid and mouth, ringing in the ear and dizziness. Physician Martha David is a family practitioner at Rochester Regional Health in Brockport. She noted that Bell’s Palsy is not very common. “It’s relatively rare. Out of all the patients I’ve had I’ve only seen two cases.” The condition can occur because of a virus or other infection or trauma to the face. In some cases, there is no clear explanation of the cause but pregnant women and those with certain conditions such as high blood pressure are slightly more prone to Bell’s Palsy. Bruton believes that, for her, stress played a major part in her condition. “I definitely know stress was the breaking point and brought on the Bell’s Palsy attack.” Just a few weeks before her attack she started a new, and very intense job doing office work for a lo-

cal corporation. The new job coupled with some other health issues and personal challenges at home was a recipe for extreme stress. After her ER visit, Bruton followed up with her personal physician. She was given a course of antiviral medication as well as steroids to help ease her symptoms. Unfortunately, she didn’t feel that they helped much and now, months later, she still suffers some of the symptoms of Bell’s Palsy. Most people make a full recovery after a Bell’s Palsy attack, though it can take up to six months or more, depending on individual cases, to see improvement. “I lost my smile,” said Bruton. “That was very sad. It happened on July 31st. It is Jan 28th now, and I am better though not fully recovered yet. I believe my full symmetrical smile and all muscles and nerves are healed completely and forever and that will show in the natural soon.”

The Emotional Toll of Facial Paralysis The physical symptoms associated with Bell’s Palsy are only the tip of the iceberg for those who have been afflicted. Researchers at OSU College of Liberal Arts have found that people who suffer acquired facial paralysis experience higher rates of depression and anxiety. Bruton said she felt alone and scared after she learned she was dealing with Bell’s Palsy. But she wasn’t going to get beaten down, especially since she had recently published a self-help book called “Hole To Whole: Journey To Hope And Transformation.” The book tells Bruton’s story of healing and her journey to wellness after a series of setbacks earlier in life. “My own book helped me cope with yet another experience and trauma. And I’m like, all right, you know what? Let me listen to myself. If I’m not applying this, then how do I expect anybody else to?” She said a positive mindset coupled with a dedication to her Christian faith was the best way for her to overcome the sadness that threatened to overcome her as she healed physically from Bell’s Palsy. Bruton’s son, Joseph Bruton of Greece, was impressed with his mom’s bright outlook. “I think she had about, maybe a couple hours’ worth of grieving or a low. For most people it would probably be five days. But with her it was a couple of hours then she’s like, ‘You know what, it’s part of my story.’” He acknowledged that his mother has had setbacks but they have never completely stopped her from March 2020 •

Lori Bruton of Churchville holds her self-help book, “Hole To Whole: Journey To Hope And Transformation.” After she was diagnosed with Bell’s Palsy — a condition that cause weakness or paralysis of the facial muscles, dropping of the eyelid and mouth, ringing in the ear and dizziness — she said she decided to follow the lessons she discussed in her book.

growing and becoming a happier, more well-rounded person. “She keeps getting knocked down and keeps walking forward and still has an amazing amount of hope,” he said about his mom’s life. Bruton advised anyone experiencing a similar diagnosis to adjust their mindset in order to get through the tough days. “You may think, ‘Oh my gosh, no, I’m really ugly.’ I mean I felt disfigured, like kind of a freak or something. So, I thought, no, no, that’s wrong thoughts. I’d say take your thoughts captive. Think about what you’re thinking about. Even though this happened, it’s not who you are, it’s just something you’re going through.”

Tips Physician Martha David said that anyone experiencing symptoms like Bruton’s should go to the emergency room. Since attacks of Bell’s Palsy can come on quickly and can mimic a stroke, proper medical care is needed as soon as possible. Those suffering Bell’s Palsy or other forms of facial paralysis can find further resources at the Facial Paralysis & Bell’s Palsy Foundation (facialparalysisfoundation.org) and the National Institute of Neurological Disorders and Stroke (www.ninds. nih.gov). To learn more about Lori Bruton, her journey with Bell’s Palsy, and her book, visit loribruton.com

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Top Health Innovations Healthcare is always changing as new research and discoveries lead to changes that improve care. Here’s what area experts see as the top innovations in development now or coming very soon. By Deborah Jeanne Sergeant

• “One exciting thing is stem cell studies. It’s amazing the conditions that were not treatable before. Research is going on in diabetes, spinal cord injuries, dementia and ALS. Tendon and joint injuries won’t need as many surgeries because of stem cells. • “Gene therapy is still experimental but it’s amazing. Retinitis pigmentosa — there’s no treatment for that. Usually, people go blind in two to three years’ time. Now the patient is able to see. It’s very expensive. It’s amazing and has quite a future. • “With genetic diagnosis, people can prevent things from even happening. Diagnosis in the future will be very deep. We’ll be able to do mitochondrial diagnosis and know what’s happening in the cells. • “The power to the patient is going to be even bigger. They’ll have more knowledge on new conditions and how they can stay healthy through technology. They can find out their sleep at night and other health statistics through things like the Apple watch. You can see your blood pressure and blood sugar levels 24 hours. More and more things will be coming up. People will be able to diagnose conditions very,

very early. • “Reversing diseases is growing. Diabetes, cholesterol and hypertension, now, with individualized food prepping, we can reverse diabetes, lower cholesterol without medication and diminish medication. • “There will be vaccines for not only infections but also cancer, Type 1 diabetes and other diseases. • “Artificial intelligence has many potential uses coming up. Many hospitals are using this so the patient can communicate with the nurse through Alexa;“ Tell the nurse I have pain.’ There’s a lot of potential.”

Az Tahir, MD, practicing holistic medicine in Rochester

• “A lot of the apps we continue to be developed. The iPhone can do an EKG reading. Other apps will take pictures of food and it makes it simpler and simpler to follow a plan and be successful. But it will make it easier to be lazy and put things off. As everything continues to evolve, it creates new challenges. We use a lot of different tracking software to pay attention to how many classes they come to. It can show how much time

they slept and exercised and moved. There’s a lot of opportunity for people to home in on what they need to do for success.”

Dennis Lesniak, doctor of chiropractic, master’s in clinical nutrition, bachelor’s in exercise science at Quarter Deck Athletics-CrossFit, Buffalo

• “Precision medicine where we see diagnostics, molecular genomics and personalize therapeutics. Much of the way we categorize disease states are on location or appearance. A glandular cancer you call it based on where you find it. We’re starting to call it on its molecular characteristics. A glandular cancer in the breast might be associated with the colon. You can more quickly develop medication. If this glandular cancer had a certain enzyme that the chemo therapeutic was targeting, a drug using the same mechanism might be able to target it better. It has the same underlying mechanism. • “Liquid biopsy, where you take blood. If you find circulating cancer cells before they form a mass, it might be easier to treat if limited to a small area in an organ and in

the bloodstream. Once you know the enzyme that’s characteristic of that cancer, you can tailor the therapeutic to it to cause less toxicity to the patient and more targeted therapy. • “It’s hoped that every cancer patient has a genetic profile done and as drugs become available, we’d be able to treat it. • “Artificial intelligence software packages are using to determine if someone is having a stroke. You can use technology to level the playing field. Maybe in the future we’ll need fewer specialists because you’ll need less knowledge. You’ll need operational knowledge and the backup of AI with the diagnosis. Technology is leveraged to level the playing field. A general practitioner in the middle of nowhere can use AI. What’s the latest literature? It doesn’t have to even be something complex, but a certain bacteria causing ear infections and the AI can show trends moving in the trend of where that patient is.”

Robert Corona, MD, board-certified in neuropathology and pathology and general informatics at Upstate Medical University

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Dear Savvy Senior,

What are the early warning signs of Parkinson’s disease? I was just diagnosed with it after noticing hand tremors for nearly a year, but looking back, I’m wondering if I missed any other early warning signs. Tremoring Tom

Dear Tom, The holy grail in any progressive disease is to find it early enough to start effective treatment before irreversible damage has occurred. But recognizing the early warning signs of Parkinson’s disease is challenging because they’re usually subtle and can be easily overlooked, dismissed or even misdiagnosed. Parkinson’s disease, which afflicts around 1 million Americans, is a degenerative disorder that occurs when the brain’s dopamine-producing neurons die or become impaired. This happens in the part of the brain that controls movement, which can cause tremors (or shaking), stiffness, and difficulty with walking, balance and coordination. The symptoms usually begin gradually and get worse over time, and the progression of symptoms is often different from one person to another. Some people with Parkinson’s become severely disabled, while others may experience only minor motor disruptions. While the cause of Parkinson’s disease is unknow, scientists believe genetics and environmental factors (exposure to certain toxins) play a key role. Most people with Parkinson’s first develop the disease around age 60 or older, and men are more likely to develop it than are women.

Early Warning Signs

Parkinson’s disease is difficult to diagnose because there’s no definitive test to confirm it. Doctors, usually neurologists, will do an examination and evaluate a combination of warning signs, but symptoms can vary greatly by patient which often leads to confusion and misdiagnosis. That said, here are some of the key signs and symptoms everyone should know. • Trouble sleeping: Thrashing around in bed or acting out dreams — kicking or punching — when asleep. This is a REM sleep behavior

disorder and one of the strongest and earliest pre-diagnostic symptoms of Parkinson’s disease. • Loss of smell: Not being able to smell certain foods very well like bananas, dill pickles or licorice. This too is one of the earliest symptoms. • Constipation: Problems with digestion and bowel movements are a big problem for people with Parkinson’s, and an early sign that can occur up to 20 years before this disease is diagnosed. • Changes in handwriting: Writing may become harder to do, and your handwriting may appear much smaller than it has in the past. • Tremors: Slight shaking or tremor in your finger, thumb, hand or chin. The tremor usually happens at rest, and when you move the extremity it may disappear. This is the most common and recognizable outward sign of Parkinson’s disease, but by the time tremors start, the brain has already lost more than half of its dopamine-producing cells. • Slowed movement: Over time, Parkinson’s disease can slow movements, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk. • Speech changes: Speaking softly, quickly, slurring or hesitating before talking. Your speech may be more of a monotone rather than with the usual inflections. • Loss of automatic movements: Decreased ability to perform unconscious movements, like blinking, smiling or swinging your arms when you walk. • Impaired posture and balance: Stooping, leaning or slouching when you stand, and/or balance problems can all be a sign of Parkinson’s.

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Currently, there is no known cure for Parkinson’s disease, but there are a variety of medications that can provide relief from the symptoms. In some later cases, surgery may be advised. Other treatments include lifestyle modifications, like getting more rest and exercise. For more information, visit the Parkinson’s Foundation at Parkinson. org.

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. March 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 23

Ask St. Ann’s

When Is Music Therapeutic for Seniors?

Board-certified music therapists:

They complete rigorous coursework in the sciences, music and psychology, community internships and continuing education through their careers to earn their credentials.

Daily interactions:

Music therapists observe and assess elders daily, including their emotional well-being, physical health, social functioning, communication abilities and cognitive skills, based on musical responses. They adjust their treatments accordingly.

Interdisciplinary care:

Assessments and recommendations from music therapists inform the multidisciplinary care team working toward a resident’s healthcare goals. They often co-treat with social work, occupational-, physical-, speech-, and recreational therapists, too.

Timely & safe:

To ensure a secure and productive session, therapists stay alert to any changes in a senior›s body movements, voice, breathing and eye contact. If the person becomes easily overstimulated, distressed or anxious at the onset of music based stimuli — as some elders living with dementia do — the therapist would recommend another form of care.

Community:

Music is an opportunity for people to come together, socialize and feel a sense of belonging. St. Page 24

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Security Office

From the Social Security District Office

Apply Online for Medicare Even If You’re Not Ready to Retire

By Molly Pow

split second is all it takes for a song to get you moving to the groove and feeling happier. Listening to music turns on your brain’s auditory, physical and emotional centers, but how do you get the therapeutic benefits of music to last, especially for seniors? Board-certified music therapists get the job done by actively applying research-based supportive science to the creative, emotional, and energizing experiences of music. Whether provided one-on-one or in a group setting, music therapy nurtures a senior’s growth and abilities, regardless of the elder’s talents. It also enhances their selfworth, self-esteem and relationships. For example, therapists at St. Ann’s Home never miss an opportunity to integrate things like memory recall exercises into weekly group therapy sessions for residents to share stories and reminisce. Senior living communities use music therapy as a safe and costeffective alternative to promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication and support physical rehabilitation. Pharmaceutical interventions often decrease, too. Whether you’re considering a high-quality music therapy program at an eldercare facility or in the community, here’s what to look for:

Ask The Social D

Ann’s Community offers a variety of social, spiritual, and self-care opportunities for residents and families, including support groups, adaptive handbell choir, cabarets and music-based intergenerational activities.

On a final note Long after other healthcare treatments end, music therapy goes on to provide comfort to elders in end-of-life care. Therapists at St. Ann’s also support families during that time by providing them with ceremonial planning support, muchneeded respite breaks, and support groups. Music therapy is not a one-hitwonder. Instead, it’s an intentional process that, over time, brings about and sustains change. All it takes is patience, a positive attitude, and a board-certified music therapist. If you or a loved one live at home and think music therapy could improve quality of life, some music therapists will make house calls. Look for a board-certified independent provider, contact a local college or university with a music therapy program, or visit: www. musictherapy.org to learn more.

Molly Pow is a board-certified music therapist at St. Ann’s Community and holds a Master of Science degree in creative arts therapy. She serves as the internship director and clinical supervisor for the music therapy internship program that brings college students to St. Ann’s Community. Contact her at mpow@mystanns.com or 585-6976818 or visit www.stannscommunity.com

id you know that you can apply online for Medicare, even if you are not ready to retire? We can help you make an informed decision about when to apply for benefits based on your individual and family circumstances. Applying online can take less than 10 minutes. There are no forms to sign and usually no required documentation. We’ll process your application and contact you if we need more information. Visit www.socialsecurity.gov/ benefits/medicare to begin. There, you can apply for Medicare and find other important information. If you’re eligible for Medicare at age 65, your initial enrollment period begins three months before your 65th birthday and ends three months after that birthday. Some Medicare beneficiaries

Q&A Q: My same-sex partner and I recently married. Will we qualify for Social Security benefits? A: You may be eligible to apply for Social Security benefits. Many factors affect your eligibility for benefits, including how long you worked and your age. Social Security is now processing more claims in which entitlement or eligibility is affected by a same-sex relationship. We encourage you to apply for benefits right away, even if you aren’t sure you’re eligible. Applying now will protect you against the loss of any potential benefits. You can apply safely and securely at www.socialsecurity. gov/applyonline. Learn more about Social Security for same-sex couples by visiting www.socialsecurity.gov/ same-sexcouples. Q: I am receiving Social Security retirement benefits and I recently went back to work. Do I have to pay Social Security (FICA) taxes on my income? A: Yes. By law, your employer must withhold FICA taxes from your paycheck. Although you are retired, you do receive credit for those new earnings. Each year Social Security automatically credits the new earnings and, if your new earnings are higher than in any earlier year used to calculate your current benefit, your monthly benefit could increase. For more information, visit www. socialsecurity.gov or call us at 1-800772-1213 (TTY 1-800-325-0778).

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

may qualify for Extra Help with their Medicare prescription drug plan costs. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia. For more information on Extra Help, read www.socialsecurity.gov/pubs/EN05-10525.pdf. You may also be interested in reading these publications: • “Apply Online for Medicare — Even if You Are Not Ready to Retire” www.socialsecurity.gov/pubs/EN05-10530.pdf. • “When to Start Receiving Retirement Benefits” www.socialsecurity.gov/pubs/EN-05-10147.pdf. Helping a friend or family member with this information can improve the quality of their life. Share these resources with someone you love today.

Q: What is the benefit amount a spouse may be entitled to receive? A: If you are eligible for both your own retirement benefit and for benefits as a spouse, we will always pay you benefits based on your record first. If your benefit as a spouse is higher than your retirement benefit, you will receive a combination of benefits equaling the higher spouse’s benefits. A spouse generally receives one-half of the retired worker’s full benefit unless the spouse begins collecting benefits before full retirement age. If the spouse begins collecting benefits before full retirement age, the amount of the spouse’s benefit is reduced by a percentage based on the number of months before he or she reaches full retirement age. For example, based on the full retirement age of 66, if a spouse begins collecting benefits: • At age 65, the benefit amount would be about 46 percent of the retired worker’s full benefit; • At age 64, it would be about 42 percent; • At age 63, 37.5 percent; and • At age 62, 35 percent. However, if a spouse is taking care of a child who is either under age 16 or disabled and receives Social Security benefits on the same record, a spouse will get full benefits, regardless of age. Learn more by reading our Retirement publication at www. socialsecurity.gov/pubs/10035.html.

H ealth News Pierce named director of pharmacy for Thompson Deirdre (Dede) Pierce of Canandaigua has accepted the role of director of pharmacy services for UR Medicine Thompson Health. “Dede has been an integral player in the inpatient setting here at Thompson since 2014. She has represented the pharmacy on several key initiatives, not the least of which resulted in two Willoughby Patient Safety Award recognitions,” said Executive Vice President/COO Kurt Koczent. Koczent noted that until 2018, Pierce served dually as an assistant professor of pharmacy practice/ administration at St. John Fisher College, where she received the Faculty Student Advisor of the Year award and a Faculty Preceptor of the Year nomination. She previously worked as the clinical pharmacy manager at St. Joseph’s Hospital Health Center in Syracuse. “Board-certified in both pharmacotherapy and geriatric pharmacy, Dede brings a depth of pharmacy practice that I am sure will lead us into the next decade of pharmacy innovation here at Thompson,” Koczent said.

Rochester Regional investing more in Geneva Healthcare is about to get a little more convenient for residents of Geneva and its surrounding communities. Rochester Regional Health (RRH) recently announced a major expansion of its campus at 875 Pre-Emption Road, set to open in May. “For most patients, the majority of their healthcare is delivered in the office and outpatient settings,” said physician Art Equinozzi, assistant medical director of Finger Lakes Medical Associates,part of Rochester Regional Health. “The destination campus at Pre-Emption Road makes accessing high-quality, safe care easy for our patients.” Already home to RRH Finger Lakes Medical Associates, RRH Finger Lakes Bone & Joint, and the region’s only open MRI, the campus will be transformed into a destination, one-stop facility with additional services and programs being added this spring. “This is the kind of convenient access to care that patients deserve,” said Mark Ryan, primary care physician and medical director of Rochester Regional Health’s Finger Lakes Medical Associates. By May, the following Rochester Regional Health services will be added to the campus: primary care general surgery, vascular surgery, endocrinology, allergy and rheumatology and nutrition counseling. Later this year, Rochester Region-

al will be adding specialty services, including neurosurgery, gastroenterology and urgent care, making RRH at Pre-Emption Road a convenient, one-stop destination medical campus for residents of the region. “Rochester Regional continues to invest in the communities of the Finger Lakes Region,” said Rochester Regional Health Eastern Region President Dustin Riccio, a physician. “The new Marshall Birthing Unit at Newark Wayne Hospital, the construction of Clifton Springs Medical Village and now, a destination medical campus at 875 Pre-Emption Road, are just a few of the ways we have raised the level of care available in the region.” “Rochester Regional Health has been enhancing the health and wellness of Geneva and the region for more than 50 years,’ said physician Bridgette Wiefling, senior vice president of the Rochester Regional Health Primary Care Institute. “Our significant investment in the development of our newest destination campus at 875 Pre-Emption Road, delivers on our commitment to deliver the best possible care in the most convenient setting for our patients.”

HCR Home Care promotes six executives HCR Home Care, a leading provider of home health care services across New York state, recently announced the promotions of six company executives. • Andrew Bascom has been promoted to chief operating officer, having previously served as senior vice president. Bascom now directs and manages all lines of business operations, including the certified agency, licensed agency and care management. He also oversees IT and is responsible for managing the

infrastructure and application support across HCR’s footprint. He lives in the Wayne County town of Walworth. • Suzanne Turchetti has been promoted to chief administrative officer, after previously serving as vice president of administration. In this new role, Turchetti now oversees all non-clinical administrative operations, including human resources, contracts, corporate compliance and communications/public relations. She lives in Irondequoit. • Karen Bonomo has been promoted to executive director of LHCSA (licensed home care services agency) / administrator/ outreach, after previously serving as director of patient services licensed agency. In this new role, Bonomo develops and implements strategies aimed at promoting the organization’s mission, creates business plans, and ensures adherence of the organization’s daily activities and longterm strategies and legal guidelines. Karen Bonomo is a resident of Hilton. • Rui Ventura has been promoted to executive director of patient care coordination and care management. Formerly senior director of HCR Care Management, Ventura is responsible for leading and overseeing care management services, clinical intake and

Rochester General, Unity Named Two of Healthgrades 2020 America’s Best Hospitals Rochester General Hospital among top 50; Unity Hospital

ochester Regional Health announced Rochester General Hospital achieved the Healthgrades 2020 America’s 50 Best Hospitals Award and Unity Hospital achieved Healthgrades 2020 America’s 250 Best Hospitals Award. The distinctions place Rochester General Hospital in the top 1% and Unity Hospital in the top 5% of nearly 4,500 hospitals assessed nationwide for its consistent, yearover-year superior clinical perforMarch 2020 •

mance as measured by Healthgrades, the leading resource that connects consumers, physicians and health systems. “This achievement is a reflection of the tireless work our entire staff does each day to ensure we deliver the high quality of care our patients deserve,” said physician Kevin Casey, president of Rochester General. “We want to thank our patients and their families for putting their trust and confidence in us to take care of them in their time of need.”

patient services coordination, as well as strategic involvement in business planning to optimize organizational performance and meet growth initiatives. Rui Ventura resides in Pittsford. • Laura Bartolotti has been promoted to director of administrative operations and communications, having previously served as procurement manager. Bartolotti is responsible for both internal and external communications, as well as marketing collateral, public relations, procurement, property management and the customer care center across HCR’s footprint. She lives in Honeoye Falls. • Michael Kamm has been promoted to IT director. Previously serving as IT operations manager/ network administrator, Kamm now is responsible for overseeing operation of network and server systems, for managing the infrastructure portion of the IT Help Desk and its staff, and for identifying and recommending new technology solutions. He lives in Holley.

Advertise with In Good Health — Rochester’s Healthcare Newspaper to reach nearly 100,000 readers in the region. For information, please email editor@GVhealthnews.com “Unity Hospital is so fortunate to have such a dedicated, compassionate and talented team that embraces the responsibility of caring for our community and continuously strives to provide the best possible health care experience,” said Unity Hospital President Doug Stewart. From 2016 through 2018, patients treated in hospitals achieving the Healthgrades America’s 50 Best Hospitals and 250 Best Hospitals Award had, on average, a 27.1% and 26.6% lower risk of dying than if they were treated in hospitals that did not receive the awards as measured across 19 rated conditions and procedures for which mortality is the outcome, according to anews release issued by Rochester Regional Health.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020

Healthiest & Unhealthiest Cities in America Rochester ranks 48th healthiest city in the U.S. while Buffalo is 90th. Syracuse is not included in the survey. San Francisco tops the list

ith health care costs rising and U.S. life expectancy declining for three consecutive years, the personal-finance website WalletHub recently released its report on 2020’s Healthiest & Unhealthiest Cities in America as well as accompanying videos. To identify the places where health is a priority, WalletHub compared more than 170 of the largest U.S. cities across 43 key metrics. The data set ranges from cost of medical visit to fruit and vegetable consumption to fitness clubs per capita. The two Upstate New York cities included were Buffalo, who ranked as 90th healthiest, and Rochester, which was placed as 48th in the ranking.

Healthiest Cities 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 48. 90.

San Francisco Seattle San Diego Portland Washington, DC New York City Denver Irvine, California Scottsdale, Arizona Chicago Rochester Buffalo

Unhealthiest Cities 165. 166. 167. 168. 169. 170. 171. 172. 173. 174.

Detroit Fort Smith, Arizona Augusta, Georgia Huntington, West Virginia Montgomery, Alabama Memphis, Tennessee Shreveport, Louisiana Gulfport, Mississippi Laredo, Texas Brownsville, Texas

Key Stats • Overland Park, Kansas, has the lowest share of physically unhealthy adults, 7.60%, which is 2.5 times lower than in Detroit, the city with the highest at 19.20%. • Laredo, Texas, has the lowest cost per doctor’s visit, $58.33, which is 3.3 times less expensive than in Boston, the city with the highest at $191.62. • Portland, Maine, has the lowest share of adults eating fruit less than once daily, 28.20%, which is 1.8 times lower than in Gulfport, Mississippi, the city with the highest at 51.80%. • Amarillo, Texas, has the lowest average monthly cost for a fitness-club membership, $10.17, which is 8.1 times less expensive than in San Francisco, the city with the highest at $82.83. To view the full report and your city’s rank, please visit: https:// wallethub.com/edu/healthiest-cities/31072/

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FINANCES Getting into retirement with credit card debt can pose challenge to boomers HOBBIES Members of Finger Lakes Photography Guild look for the perfect angle AGING Does the term ‘senior’ bother you? How about ‘elderly’? MUSIC The New Horizons Clarinet Choir gathers people from all walks of life DEDICATION Dottie Haelen celebrates 60 years working at Highland Hospital COVER • Attorney, supporter of the arts, women’s rights advocate Sharon Stiller talks about what keeps her going COMMITMENT The Welker family: three generations of firefighters BOOKS Four small suburban independent bookstores buck the trend and stay active AIRPLANES Austin Wadsworth’s love of war airplanes leads to creation of National Warplane Museum in Geneseo

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2020