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JUNE 2020 • ISSUE 178

Patients Wanted Drastic reduction in patient population, layoffs, limited sources of revenue. How hospitals are managing one of the worst crises in the industry and what they are doing to recover from it. Page. 13

Tired of COVID-19? Here’s one more thing to worry about this summer: disease-carrying ticks Dr. David DiLoreto is the new director of the Flaum Eye Institute. He wants to make it a top destination for those who need eye care

Fitness in the Finger Lakes Forget COVID-19. New free hiking challenge offers incentives for people to get active on the trails this summer. P. 11

Why You Should Eat Snapper This Summer? P. 11

Baby Boom After Pandemic Lockdowns? P. 2

Baby Boom After Pandemic Lockdowns? Maybe Not


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In Good Health, Rochester’s Healthcare Newspaper

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

t’s happened before: Couples stuck at home during blizzards, hurricanes or other natural disasters enjoy some “alone time” — and a baby boom follows. But a new survey from researchers at the University of Florence in Italy suggests the same probably won’t unfold during the COVID-19 pandemic. Why? “What we found the main reasons that led people to not wanting to conceive included worries related to future economic difficulties and consequences on pregnancy,” said study author Elisabetta Micelli, from the university’s Assisted Reproduction Technologies Center. The researchers conducted nearly 1,500 online interviews and found that nearly 82% of those surveyed said they didn’t plan to conceive during the coronavirus pandemic. The survey was conducted in the third week of the lockdown in Italy and included men and women in a stable heterosexual relationship for at least one year. The findings were published May 7 in the Journal of Psychosomatic Obstetrics and Gynecology. Of the 268 participants who said that, prior to the pandemic, they had plans to have a child, more than one-third abandoned their intentions when the pandemic struck. The main reasons were worries about future economic struggles (58%) and any potential consequences on pregnancy (58%) from the new coronavirus. Even though almost half of those who responded to the survey had not lost their jobs or income, “the fear of imminent and future economic instabilities led those who were searching for a pregnancy to stop their intention in 58% of cases,” Micelli said in a journal news release. Interestingly, 140 (11.5%) of the participants — mostly women — expressed a new desire for parenthood during quarantine, with the main reasons being “the will for change” (50%) and “the need for positivity” (40%). But only six of the 140 (4.3%) actually tried to get pregnant during the lockdown. “Again, fear of consequences on pregnancy in addition to the economic impact on families are probably the reasons why almost the whole group of couples who unexpectedly started to express a desire for parenthood during quarantine did not translate this dream into a concrete attempt,” said study co-author Gianmartin Cito, a specialist training in urology. The study also asked participants about their levels of sexual activity and found that two-thirds of those who didn’t express a wish to conceive before or during the pandemic reported no decrease in sex. The same was true for 60% of people already trying to conceive. It’s “unknown whether these findings will result in a substantial modification of birth rate in the near future,” the authors concluded.

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Page 3

By the Numbers, COVID-19 Was Never ‘Like the Flu’


n the early days of the coronavirus pandemic, President Donald Trump announced that Americans need not worry because the new coronavirus was “like a flu.” Now, 1.4 million cases and more than 84,000 COVID-19 deaths later (as of May 17), a new report finds the comparison was never valid. “Public officials continue to draw comparisons between seasonal influenza and SARS-CoV-2 mortality, often in an attempt to minimize the effects of the unfolding pandemic,” wrote physicians Jeremy Faust, of Harvard Medical School, and Carlos del Rio, of Emory University School of Medicine in Atlanta. But those comparisons are “apples and oranges,” the physicians reported in an article published May 14 in the journal JAMA Internal Medicine. That’s because the numbers comparing COVID-19 and flu just don’t match up. For example, the U.S. Centers for Disease Control and Prevention produces an annual tally of deaths caused by flu. During the 2018-2019

flu season — by all accounts a moderate one — 34,200 Americans are thought to have died from complications linked to the flu. In more severe flu seasons, that number can go higher — the 2017-2018 season was linked to more than 61,000 deaths, for example. However, Faust and del Rio noted that confirming that flu caused a patient’s death (and not some other underlying condition) is often tough, so the CDC long ago issued their numbers as “calculated estimates” — not actual death counts as verified by death certificates. An annual number for verified flu deaths also exists, however, and it’s much smaller than the calculated estimates. Between 2013 and 2019, “the number of counted influenza deaths was between 3,448 and 15,620 yearly,” the report authors noted. Conversely, COVID-19 deaths occurring in 2020 have all been counted, not estimated. That means that by May 14, the more than 84,000 deaths from coronavirus are already about 5.5 times

higher than the highest annual death count for the flu over the past seven years. Those ratios widen even further when deaths are looked at on a weekly basis. “Statistics on counted deaths suggest that the number of COVID-19 deaths from the week ending April 21 was 9.5-fold to 44.1fold greater than the peak week of counted influenza deaths during the past seven influenza seasons in the U.S.,” Faust and del Rio said. Finally, there’s simply no comparison between flu and COVID-19 when it comes to what medical staff are experiencing on the frontlines. “In some hot zones of the pan-

demic … ventilators have been in short supply and many hospitals have been stretched beyond their limits,” the two experts noted. This overwhelming demand on hospitals, “has not happened before in the U.S. even in the worst of influenza seasons.” Finally, they said, the actual death count of COVID-19 may be even higher than current estimates, because “indirect” deaths linked to the pandemic aren’t factored in. Those include deaths that occurred because people with other, often fatal conditions couldn’t get the help they needed as health care systems became overwhelmed by COVID-19.

and group psychotherapy that are delivered in temporary expansion locations, including the patient’s home. Normally, patients would be required to receive these services at the community clinic.  

‘CMS is allowing physicians, licensed in a particular state, to bill for telehealth services provided to their patients who may live across state lines.’

Healthcare in a Minute

By George W. Chapman

CARES Act Expands Beneficiary Coverage for COVID-19, Gives Providers Flexibility


n late April, the Centers for Medicare & Medicaid Services (CMS) issued radical changes to combat the COVID-19 pandemic. The Coronavirus Aid, Relief, and Economic Security Act expands beneficiary coverage for the virus and gives providers greater flexibility in delivering care. Some of the important provisions are summarized below. It should be noted that CMS rules pertain to Medicare and Medicaid beneficiaries. However, most commercial carriers tend to mimic CMS especially during this pandemic. If you are covered by a commercial plan, to be sure about coverage, contact them first.


You do not need a written order from your treating physician to get tested for the virus. An order (it does not have to be written) from any qualified healthcare practitioner authorized to do so under state law will be accepted. Pharmacies can do testing if enrolled with CMS as a lab. Beneficiaries can now be tested in so called “parking lot” sites operated by qualified entities such as hospitals, community health centers, pharmacies, etc. CMS will pay for the services related to the virus in full. The beneficiary will not be responsible for any deductible or co-pay.   

Inpatient facilities

Hospitals are allowed to temporarily increase their number of beds to accommodate COVID-19 patients. Inpatient psychiatric and rehab facilities may admit COVID-19 patients to relieve the pressure on hospitals. CMS has made it easier for inter-facility transfers. Page 4


Advanced practitioners (nurse practitioners, physician assistants, clinical nurse specialists) can provide home health care without physician certification. APs can order the services, establish care plans and certify that the patient is eligible for home care. Teaching hospitals are allowed to send available residents to other affiliated or non-affiliated hospitals to help out. Physical and occupational therapists can delegate routine maintenance services to their qualified assistants. During the COVID-19 emergency, hospitals and ambulatory surgery centers will not have to periodically reappraise staff privileges. This allows them to keep providers whose privileges would normally be expiring. It also allows them to temporarily bring retired physicians back.

Mental health delivery

CMS will allow and pay for individual psychotherapy, education


These temporary changes will most likely have the most profound and enduring impact on the delivery of care far beyond the pandemic. Up until the pandemic, telehealth was used sporadically and traditional face to face encounters were preferred. Red tape and low payment discouraged both physicians and patients from using telehealth. CMS and commercial carriers have long feared the easy use of telehealth would merely increase utilization without any real impact on outcome. As the pandemic lingers, both consumers and providers are adapting to telehealth. Most likely, some of these temporary changes below will become permanent. Physical, occupational and speech therapists can provide services via telehealth. Hospitals may provide and bill, as the originating site, for telehealth services provided to registered outpatient in their home. The patient’s home becomes an extension of the hospital’s outpatient department. Services provide remotely include counseling, education and therapy. Telehealth may be provided by audio only (telephone) versus audio and visual. Medicare is now covering some services when provided as audio only — this includes behavioral and patient education services. CMS has (finally) increased payments to providers for telephone encounters to match payments for traditional office visits.

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

This is retroactive to March 1. CMS has promised to add to the list of approved telehealth services and to accelerate the approval process on a “sub-regulatory” basis. (As providers and consumers adapt, I think it will be very difficult for CMS to go backwards on telehealth once the pandemic subsides.) CMS is now paying rural clinics and federally qualified community health centers for providing telehealth services.      CMS is allowing physicians, licensed in a particular state, to bill for telehealth services provided to their patients who may live across state lines. 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

Venturing Out? Guard Yourself Against Disease-Carrying Ticks The latest? Asian long-horned tick is expanding its range and has moved into New York state, says expert


s pandemic-related restrictions ease and people return to parks and other outdoor spaces, remember to protect yourself against another threat — ticks. “With our latest mild winter, ticks have been active in much of the region on warmer days all winter long,” said Jody Gangloff-Kaufmann, an entomologist at Cornell University in Ithaca, who said it’s too soon to predict population trends for 2020. She added that it is clear, however, that ticks are expanding their geographic range and moving into colder regions. That’s why it’s important to know how to recognize them, take preventive steps and do a tick check each time you venture out. “Although ticks aren’t everywhere, they can be anywhere so be aware of your surroundings,” Gangloff-Kaufmann said in a news release. Though no notable change in distribution or density has been reported in the past year, there is one exception, according to Laura Harrington, director of the U.S. Centers for Disease Control and Prevention Northeast Regional Center for Excellence in Vector-Borne Diseases at Cornell. Harrington said the Asian longhorned tick is expanding its range and has moved into New York state. “So far, it hasn’t been found infected with human pathogens, but it does transmit a hemorrhagic viral disease in Asia,” Harrington said. The bacterial infection that causes Lyme disease is the most important tick-borne illness in the United States, with an estimated 200,000 to 300,000 cases reported each year, she said. “The blacklegged tick or ‘deer tick’ is the vector of Lyme disease in most of the U.S.,” Harrington said. It also transmits other disease-causing organisms, including agents that cause babesiosis, anaplasmosis and Powassan disease. These ticks are most common in forested areas and shaded trail edges where there are lots of fallen leaves and shrubs, she said.

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Female deer tick on hairy human skin. It can transmit Lyme disease. As such, you need to take steps to protect yourself when you’re headed outdoors. Harrington recommends wearing repellent, light-colored clothing and tucking pants into your socks. “You can also treat your clothing with permethrin or purchase permethrin-treated clothing,” she said. But don’t stop with those steps. It’s important to check yourself for ticks often. “For Lyme disease, time is on your side,” Harrington said. “It usually takes 24 to 48 hours after the tick has attached and started feeding before it can transmit Lyme bacteria. For some other pathogens, like Powassan virus, transmission can happen quickly, so check yourself periodically for attached ticks even when you are still outside.” Here’s how: Look for ticks all over your body, including on your back, neck and hairline. If you find one, use sharp tweezers to remove it, grasping the tick as close to the skin as possible, then pulling. Once you are back inside, remove your clothing and place it in a hot dryer for at least 20 minutes, if possible. If that’s impractical, place clothing in a sealed garbage bag and do it later, Harrington said. “This is also a good time to take a shower and perform a tick check,” Harrington said.

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. © 2020 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Mike Costanza, Ernst Lamothe Jr., Kyra Mancine, Christine Green, Adrianne Mann, Karen Bonomo, Tricianjean Jones • 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.

June 2020 •

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Page 5


Your Doctor

By Chris Motola

David A. DiLoreto, M.D.

New director of the Flaum Eye Institute talks about cutting edge research done locally, wants to make eye institute top destination for those who need eye care You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details:

Thompson Honors Seven Staff Members The Service Excellence Team (SET) at UR Medicine Thompson Health recently announced the second-quarter recipients of the health system’s Service Excellence Awards. All seven recipients work at the health system’s F.F. Thompson Hospital in Canandaigua: • Caitlin Bonanni of Shortsville, registered nurse, 3West medical-surgical unit; • Darci Camacho of Newark, patient care technician, 3West medical-surgical unit; • Ashlee Hill of Canandaigua, registered nurse, hospital float pool; • Mary Long of Geneva, registered nurse, hospital float pool; • Tonya Moon of Macedon, patient care technician, 3West medical-surgical unit; • Gina Smith of Canandaigua, registered nurse, radiology administration: • Kate Sprague of Naples, clinical service technician, lab. Created in 2014, the Service Excellence Award acknowledges Thompson associates who consistently deliver exceptional service. They are selected each quarter by the SET, which reviews system leaders’ submissions of compliments from patients, families and coworkers. Each recipient of the Service Excellence Award is given points to be used on Thompson’s online shopping site, and is featured in CEO presentations, as well as on Thompson’s intranet site.

Page 6

Q: Tell us a little bit about the Flaum Eye Institute. A: When [former director] Steve Feldon got here in 2001, he started a more academic eye department. Then, by 2005, it was officially named the Flaum Eye Institute, which brought together both researchers and clinicians to drive the science and clinical work forward and manage very specialized cases. That’s what we’ve been doing for the last several years. So, when I took over [on Dec. 16], I wanted to create a space where we could take care of everyone without having to refer them to the Cleveland Clinic or Johns Hopkins. So that’s my major goal right now — recruiting those super-subspecialists on ocular oncology, ocular genetics and other very distinct diseases so we can become not just a destination for Upstate New York, but the whole nation. Q: What kinds of conditions are we talking about? A: We deal with everything here from eye glasses and contact lens to extremely difficult ocular injuries like retinal detachment. Retina surgery, glaucoma, pediatrics, cataract surgery, we have the whole spectrum of services. Q: What impact has the pandemic had on the Flaum Eye Institute, particularly the restrictions on elective procedures? A: Depending on the subspecialty, some things like cataract surgery are considered more elective while things like glaucoma or retina surgery are considered more emergent. But overall our volume is down quite a bit. Now that they’ve announced the reopening of elective surgery and exams, we’ve been ramping up slowly and have developed a plan to address the COVID-necessitated restrictions of distancing and taking care of not just patient-distancing, but staff as well. We created what we call a “parking lot waiting system.”

tient per room, and that’s their room until they’re done. I don’t know how familiar you are with ophthalmology, but there’s a lot of testing involved. So normally we would bring a patient in for testing, then send them back to the waiting room; there was a lot of shuffling around involved. So, we stopped all that. When a patient is completely done with their room, that room is completely wiped down and sanitized. We have all the precautions possible that we could have in place to protect or patients, physicians and staff. Q: Have these measures helped you identify any processes that you’d want to change permanently? A: It’s really interesting. With all the bad stuff that’s going on, we’re still trying to learn what we can from it. And what we’re learning is how to be really efficient and understand what we really need to run a practice. We were working on that before this started, but it really forces your hand. How many staff and people do you need? How are you using the patients’ time and the physicians’ time? So, usually a physician will schedule a patient based on what they need and, as you know when you go to the doctor, it leaves the patient waiting around a lot. So, when you’re scheduling around the patient, they’re actually a lot happier. They come in, they go home and things are a lot more efficient. We never thought it could be done, that we could see as many patients as we could the other way, but it looks like if you have proper things in place, you still may be able to do this. What could come out

Q: Can you elaborate more on this “parking lot waiting system”? A: Much like what you’ve seen in many retail places these days, they’ll call a number to check from, they’ll be screened and check in from their car, and be called up when their appointment is ready. That limits the number of people in the eye wing of the hospital. For people who take a taxi or get dropped off, there’s enough space for them to wait safely in the waiting room. Everybody’s offered a mask if they don’t have one. Staff wears masks as well as eye-shields or goggles. One pa-

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

of this is all those jokes about waiting for your doctor may die away. Q: You’re doing some work with genetic therapies for ocular issues. Can you tell us a little about that? A: We do a number of things. We do clinical trials where we’re testing various drugs and procedures. And then we’re imagining studies where we look at the cellular level of how diseases change the eye, and what can be done. The earlier you can detect a change and the earlier you intervene, the more vision you’re going to be able to save. So being able to image at the cellular level, you can see how the disease effects these things and how drugs affect the process. We’re also doing stem cell transplantation. Not in humans right now, but it’s experimental in animals, where we’re trying to use stem cells to replenish damaged retinas. We’re also using optogenetics, which is transforming cells in the retina that don’t normally capture light by injecting certain genes into the eye into light-sensing cells. When you have degenerative eye disease, you lose your photo-receptive cells, but you’re left with other cells that are still connected to your optic nerve and your brain. By injecting a vector into the eye that would imprint this new machinery into the cells that are already there, you can turn a ganglion cell into a photo-receptor cell. So those are some of the things we’re still working on. It’s still experimental. Q: On the more mundane side, are there any interesting advances in vision correction coming down the pipe? A: Yeah, we have our refractive center that Scott MacRae runs. He does custom refractive surgery. He’s one of the leaders in the nation as far as using a laser to change the shape of the cornea to create better vision. In the past you’d call it Lasik, but there are now all kinds of different laser procedures a physician can use to help a patient see better. We’re looking at an experimental technology where we’re using a laser to try to change the shape of the cornea that Krystel Huxlin is working on. This is where you selectively burn spots within the corneal tissue with small, microbursts of energy. So instead of shaving the surface of the cornea, you’re going inside the tissue itself and creating little spots that change the shape of the cornea.

Lifelines Name: David A. DiLoreto, M.D., Ph.D. Hometown: Tacoma, Washington Position: Chairman of ophthalmology at the University of Rochester School of Medicine and Dentistry; director of the Flaum Eye Institute Education: University of Rochester School of Medicine (Ph.D. and M.D.) Training: Residency at University of Southern California School of Medicine; internship Highland Hospital of Rochester; fellowship at Wilmer Eye Institute — Johns Hopkins Hospital Organizations: American Academy of Ophthalmology; American Society of Retina Specialists; New York Ophthalmology Society Family: Wife (Zoe Williams, neuroophthalmologist at Flaum Eye Institute); two children Hobbies: Tennis

URMC, RRH Collaborate to Test Experimental Coronavirus Vaccine

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he University of Rochester Medical Center (URMC) and Rochester Regional Health (RRH) are investigating a new potential coronavirus vaccine developed by Pfizer and BioNTech.  “COVID-19 is a highly infectious and deadly disease and there is a tremendous urgency to develop a vaccine that will help us fight this global pandemic,” said physician Edward Walsh, a professor in the URMC department of medicine (infectious diseases) and member of the infectious diseases unit at Rochester General Hospital. “While the scientific and medical community are moving at an unprecedented speed to advance vaccine candidates, it is critical that this effort be conducted in a rigorous manner that evaluates the safety and efficacy of potential vaccines. This new clinical trial is the first step in that process.”  Walsh and physician Ann R. Falsey, co-director of the URMC vaccine and treatment evaluation unit and a member of the infectious disease at Rochester General Hospital, are leading the Rochester arm of the study. The randomized placebo-controlled clinical trial will recruit 90 individuals in the Rochester area aged 18 to 85 who have not been infected with COVID-19 and will evaluate the safety, tolerability and immunogenicity of up to four variations of the vaccine. Pfizer contracted with URMC to conduct the clinical trial in Rochester and the recruitment of study volunteers and testing of the vaccine will occur at Rochester General Hospital. The study is the only active COVID-19 vaccine clinical trial

in Upstate New York. In March, Pfizer partnered with BioNTech, a German biotech company that has created a platform to rapidly develop vaccines for coronavirus and other emerging viral diseases. While there are approximately 100 potential COVID-19 vaccines in various stages of development, the Pfizer/BioNTech experimental vaccine is one of only seven that have advanced to human clinical trials worldwide. Rochester is one of four sites in the U.S. that will be conducting early stage studies of the vaccine, which began in clinical trials in Germany in late April. Traditionally, effective vaccines against viruses like hepatitis A and B and influenza contain protein components of the virus called antigens to stimulate the immune system to produce antibodies and immune cells that provide protection from infection. The Pfizer/BioNTech vaccines will utilize a relatively new genetic engineering method to stimulate the immune system to produce a protective response to the new coronavirus. The vaccines are composed of short sequences of the virus RNA, known as messenger RNA (mRNA), which provide precise instructions to the recipients own cells to produce the virus antigens. While experimental vaccines against cancer and bird flu have used a similar mRNA strategy, there are currently no approved RNA vaccines for humans. Individuals interested in learning more about volunteering for the study should call 585 922-5944 or email

Trillium Health Opens COVID-19 Testing to Walk-Ins


rillium Health has been offering since May 11 COVID-19 testing on a walk-in basis at its 259 Monroe Ave. facility. While appointments are no longer required, they are still preferred; patients can reserve a time by calling Trillium’s COVID-19 Hotline at 585-545-7292. Who should get tested? • Community members who have symptoms of COVID-19 or who have had close contact with a person with symptoms of COVID-19 • Healthcare workers • Essential workers • At least 16 years old How do you make an appointment? • Walk-ins are welcome. • Or, save time and call ahead to Trillium’s COVID-19 Hotline at 585-545-7292. The hotline is staffed Monday – Friday, 8:30 a.m. – 4 p.m. Callers will speak with a registered

nurse to schedule an appointment. Where do I go for testing? • Testing is at Trillium Health’s main location at 259 Monroe Ave. in downtown Rochester. • The COVID-19 testing check-in is under a white tent on the southeast side of the building. Please do not enter the building for testing. Greeters in the parking lot will help provide directions from the entrances on Monroe Avenue and Alexander Street. Trillium Health is a community-based health center whose mission is to promote health equity by providing affordable health care for people of all backgrounds, regardless of income, sexual identity, race, or ethnicity. The goal of the COVID-19 testing initiative is to connect area residents to care. For more information, please visit June 2020 •

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Gardening Blooms While We Shelter-in-place


ave you been to a gardening center or nursery lately? Vegetable seeds are in short supply, if not sold out altogether. People are revisiting the basics during this coronavirus lockdown. Many are returning to gardening — especially vegetable gardening — given slim pickings at the super market. As a vegetable gardener for years, I see this as a precious silver lining in this otherwise trying time. And June is the perfect time for folks to dig in, get their hands dirty and grow their own vegetables at home. It’s also a good time to reflect the many life lessons that gardening offers to those who live alone. It has taught me the value of planning, preparation, patience and pleasure — four essential “P’s” for a bountiful garden and ... a bountiful life. Fertile ground exists in each of us, and a little tending can produce beautiful results. Here’s what I have learned: • Plan. Realizing the garden of your dreams begins in your imagination, followed by careful planning. Diagram your garden and it will help you avoid planting onions on top of potatoes or mistaking basil for a

weed. Likewise, envisioning your life goals and committing them to writing can help you flourish and grow. • Cultivate. Good, cultivated soil promotes healthy, deep roots. When you add fertilizer to your garden you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows. You can’t go wrong with nutritious food, a walk in nature, a good book, soothing music, or saying “yes” to a new adventure that’s been tugging at your heart. • Plant. So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage. And remember: We reap what we sow, so follow your dreams. Plant a tomato and you get a tomato; plant a dandelion and you get a dandelion. Seed your future with healthy choices that promote well-being. • Weed. We all need room to breathe and space in which to blossom. It holds true for your garden and your life. Gardening is all about consistent caretaking. Slack off, even

s d i K Corner

Kids’ ER Visits for Mental Health Problems Soared Over 10 Years


hildren treated in America’s emergency rooms for mental health disorders jumped 60% over a recent decade, a new study finds. Between 2007 and 2016, visits for self-harm like suicidal thoughts and cutting soared 329% and treatment for drug abuse rose 159%, according to the study led by Charmaine Lo, from Nationwide Children›s Hospital in Columbus, Ohio. “This is happening in all emerPage 8

gency departments all across the country and in kids of all ages,” said Lo. “And regardless of whether it’s a children’s hospital or a general hospital, and whether or not they’re in an urban location or in a rural location.” Lo thinks that social media has put a lot more pressure on children. “Children, particularly teenagers, are feeling that. Also, there’s a lot more awareness of mental health, and children know that there are resources in

‘June is the perfect time for folks to dig in, get their hands dirty and grow their own vegetables at home. It’s also a good time to reflect the many life lessons that gardening offers to those who live alone.’ for a few days, and all things unwelcome show up and take root. Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil your fun. When you pull out the bad, you can more easily focus on the good in your life. • Prune. When weeding is not enough, a major pruning may be in order. A job, relationship, or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.” • Mulch. Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch. Mulch offers a blanket of protection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. We

place for them to seek help and get help,” she said. The coronavirus pandemic is only going to make things worse, experts say. “Although this study was conducted prior to the onset of the COVID-19 pandemic, the increase in social isolation and household stressors caused by the pandemic are likely to further worsen children’s mental health” said physician Jennifer Hoffmann from the emergency medicine division at the Lurie Children’s Hospital of Chicago. A study from China showed that children affected by the COVID-19 pandemic had more symptoms of anxiety and depression, Hoffmann said. The study researchers worry that emergency departments aren’t equipped to handle mental health problems in children, especially small hospitals in rural areas. “Preparation could be as simple as a screening training program for the nurses and doctors, because you don’t have to be a psychologist to take care of these kids, you just need to recognize whether they’re dangerous to themselves or others,” said study co-author physician Rachel Stanley, division chief of emergency medicine at Nationwide. “Those tools are currently available through various agencies, although they aren’t being used by most of the places that are taking care

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

can learn a lot from mulching. • Wait. We all know that “good things come to those who wait.” Enjoy the gradual unfolding of a garlic scape, a lettuce leaf, an idea, or a friendship. When you exercise patience, life can be savored and more deeply appreciated. • Each year, I look to my garden to remind myself that growth takes time. • Enjoy. Before you know it, your labor of love and patience will pay off. Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives. So get busy, then step back and take a good look. There’s nothing quite as satisfying as admiring what you’ve accomplished. It’s reason to celebrate! By osmosis, gardening has taught me how to take better care of myself. I have absorbed its rich messages and learned how to nurture my inner garden and growth as a woman on her own. I encourage you to grab a spade and join me. Beauty, growth, and an energizing sense of renewal can be yours, season after season after season. 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, or visit

of these kids,” Stanley said. For the study, Lo and her colleagues analyzed data for children aged 5 to 17 from Nationwide’s emergency department databases. The researchers found that, while the number of children seen in the emergency rooms remained stable between 2007 and 2016, visits for mental health problems increased dramatically. Visits for alcohol problems actually fell 39%, while overall drug use visits grew substantially. This bears more investigation, the researchers said, given the opioid epidemic still raging in the United States. The types of mental health problems reviewed included adjustment and anxiety disorders; attention-deficit, conduct, and disruptive behavior disorders; impulse control and mood disorders; and psychotic disorders like schizophrenia. One in five U.S. children has a mental health disorder, according to background notes. Children with mental health disorders make up about 2% to 5% of all pediatric ER visits nationally, and this number is increasing. Until now, few studies have looked at where these kids go in an emergency, Lo and colleagues said. The report was published online May 11 in the journal Pediatrics.

Men’s Health

New Test May Help Determine Prostate Cancer Risk How effective is the urine test for prostate cancer? It’s been available for about a year now. Is it working? By Deborah Jeanne Sergeant


fter receiving a diagnosis of prostate cancer, men and their healthcare providers have many decisions to make together. Prostate cancer treatment can result in urinary incontinence and impotence, and since many prostate cancers are slow-growing, a man may be a good candidate for active surveillance, depending upon many factors such as comorbidities, age and ethnicity. Other than periodic check-ups to ensure the cancer isn’t growing, he may not require further treatment. Historically, testing has involved tests such as a prostate specific antigen (PSA) blood test, digital rectal exam and biopsies to determine if their cancer is growing. Understandably, prostate cancer patients don’t like the invasive tests. About a year ago, researchers in the UK announced testing of a prostate urine risk (PUR) test that may help test risk of their cancer becoming more aggressive. The trial included 500 men, most of whom had prostate cancer. It was able to detect men who are up to eight times

less likely to need radical treatment within five years. “It’s an interesting test,” said Tom Frye, urologist with University of Rochester Medical Center. “I think it needs more study on it. It was a fairly small number of patients. “They are able to potentially group men’s cancer based on the different results they got. They can show some discerning features between low-risk and high-risk groups. That’s the Holy Grail of all of this.” A blood or urine test is much less invasive than biopsy. The PSA blood test also gives false results — both negative and positive — so something more accurate that could prevent the need for a biopsy would benefit patients. “Tests like this would probably be much more appealing to men if they became good enough that they didn’t need a biopsy or rectal exam,” Frye said. “They’re not there yet. These things will continue to be refined over time.” Frye encourages men with prostate cancer to discuss all the options available. He said that a problem with the PSA blood test is that it’s not specific to prostate cancer as any number of health factors could ele-

vate a man’s PSA without reflecting the presence of cancer or the aggressiveness of an existing cancer. “A few years ago, the US Preventive Task Force gave PSA testing a grade D for benefit and that it should be done away with,” Frye said. A year after, the organization updated the grade to a C after reviewing their data; however, Frye thinks that the test can offer some benefits and should be part of the discussion between doctors and patients. Prostate MRI is being used more than ever with diagnosed men. “Biopsies can be painful and lead to infection,” Frye said. “It could indicate insignificant cancers. Prostate MRI can help risk-stratify. If we see there’s something there, I know exactly where to biopsy. It’s like a woman getting a mammogram. If there’s something suspicious, they biopsy that area. It’s crazy that for decades, we put a needle into a prostate and hoped to hit cancer.” He can use MRI to focus radiation therapy on that focal point instead of treating the entire prostate. A newer tool in the urologist’s toolbox is the 4Kscore blood test, which tests a few molecular variations of the PSA and uses a formula

including biopsy history, age and other factors to give a number indicating risk. “None of these things will say ‘Yes, there’s cancer’ or ‘No, there’s not,’” Frye said. “Only a biopsy will tell that 100%. If that comes back high, I’d say, we may need to biopsy you.” John DeBerry, III, MD, a board-certified urologist practicing in Buffalo, is also interested in the PUR test. “I think that it might be very useful, but it will depend upon different studies looking at it in a wider cross section of patients,” DeBerry said. He is also making use of MRI to “hone in on the higher risk cancer,” he said. “We have a higher yield of clinically significant cancer present and we can repeat MRI imaging for monitoring.” Health insurance typically covers annual prostate MRI for patients with a negative biopsy and elevated PSA or those diagnosed with cancer and are on active surveillance. “It doesn’t usually cover a screening MRI for someone with an elevated PSA but no biopsy,” DeBerry said.

The most important person on earth? My Dad. He’s wiped your tears. Supported your dreams. And helped shape the person you’ve become. At St. Ann’s Community, we understand the special place a parent holds in your heart. That’s why we offer a full range of senior services designed to make your mom or dad feel like what they’ve always been – the most important people on earth.

Caring for the Most Important People on Earth | 585.697.6000

June 2020 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Best Summer Produce for Diabetics Doctor: ‘[Diabetes] can be basically reversed with a healthy lifestyle’ By Deborah Jeanne Sergeant


ummer produce season is in full swing; it’s a great time to eat plenty local, fresh foods available at pick-your-own farms, farm stands and markets, and possibly at a home garden. These foods can be helpful for diabetics in improving their blood sugar levels because of their low glycemic index status, among other benefits. “[Diabetes] can be basically reversed with a healthy lifestyle,” says physician Az Tahir, who practices holistic medicine in Rochester. He says that in addition to exercise and stress reduction — both essential for a healthy lifestyle — eating plenty of produce “is part of the protocol for helping reverse effects of diabetes.” The glyAzTahir cemic index is based on a food’s carbohydrate content and how it affects blood glucose levels after a meal. According to Diabetes Self-Management (www., “a glycemic index of 55 or lower is con-

sidered low, a glycemic index from 56 to 69 is considered intermediate, and a glycemic index of 70 or higher is considered high.” Most vegetables and fruits are within the range of 0 to 55. The person’s age, gender, weight, number of active minutes per week and general health affect the ideal glycemic load that their diet can bear, as well as how the produce is prepared. In general, the lower the glycemic index, the better. That’s why incorporating produce makes sense. For their volume, many fruits and vegetables are low in carbohyCarrera drates. They are also rich in vitamins, minerals and naturally-occurring compounds that improve health in many ways. “Spring and summer are when a lot of the non-starchy vegetables are in season,” said Heather Carrera, who has a doctorate in clinical nutrition and works in the office of Lesley James, MD in Pittsford. “Summer is the easiest time because all the stuff in season is lower on the glycemic

index scale.” She said that peaches, plums, berries and tomatoes are all low on the glycemic index, and tomatoes also offer lycopene, which is good for heart health. Carrera warned that tropical fruits, like mangoes, are higher in sugar, as are watermelons. The portion size also makes a difference in glycemic load per meal. “If you eat a large amount, it can be a problem, but watermelon is high in lycopene,” Carrera said. She listed artichoke, asparagus and cucumbers as good veggie choices since they’re low on the glycemic index. Green or wax beans, Brussels sprouts, broccoli, celery, onions, mushrooms, greens, lettuce, peppers, okra, zucchini, and cabbage represent other good choices, according to Diabetes Self-Management. Carrera said that the produce diabetics should limit include parsnips, potatoes, winter squash and sweet corn. “Corn, being a grain, is very

Restless Leg Syndrome is Treatable By Deborah Jeanne Sergeant


re your legs keeping you up at night? Restless leg syndrome may be the culprit. The central nervous system causes the condition, which typically manifests at bedtime — but not while someone’s asleep. Physician Jacob Dominik, who serves as medical director at Sleep Insights in Rochester, said many people think restless leg syndrome awakens them at night when their legs’ movements awaken them; however, that’s periodic limb movements, a separate but often coexisting condition. “Restless leg syndrome symptoms are felt by patients when they’re awake in the evening before bed,” he said. He added that symptoms may appear in the legs or other areas of the body and feel like an ache, itch, wiggle or tingle that cannot be relieved until the patient moves. Ignoring it only allows it to build. As patients stop moving, the Dominik Page 10

symptom returns. Periodic limb movement involves involuntary and repeated movement of the limbs during sleep, which can cause patients to awaken. The movement occurs at least four times consecutively between five and 90 seconds. Since lack of movement is important to start sleeping, restless leg syndrome can prevent sleep. Periodic limb movements disrupt sleep. Though some people experience restless leg syndrome as a minor nuisance, some find it so bothersome that they seek treatment. It may have a genetic component. Other sleep issues, like sleep apnea, worsen restless leg syndrome. “We first address any underlying sleep disorders,” Dominik said, referring to different ways to treat the condition. Medication such as antihistamines and antidepressants can contribute to sleep issues. Dominik also looks at iron levels, since low iron has been linked with restless leg syndrome. Dominik explained that low levels of dopamine in the brain seems to affect restless leg syndrome and iron is thought to synthesize dopamine.

“What’s important is we look at ferritin, a measure of iron stores in the body,” Dominik said. “It’s important to note that the level of ferritin you want for iron is different than what you want for leg symptoms. Someone might go to a doctor for unrelated reasons and be told their iron levels are fine.” The level of iron stored in the body should be up to three times the amount tested in the blood. Patients found deficient are advised to take iron supplements, which take about three months to improve their levels. “You shouldn’t just take it without having it checked as you can have an overload,” Dominik said. Restless leg syndrome sometimes appears — and, if pre-existing, worsens — with pregnancy, since pregnancy may deplete the body’s iron stores. Changes in the diet may help improve restless leg syndrome. Heather Carrera, doctor of clinical nutrition at the office of Lesley James, MD in Pittsford, recommends checking magnesium and folate levels, as well. “Magnesium is a mild muscle relaxant,” Carrera said. “Avocados are high in magnesium and potassi-

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

starchy,” Carrera said. “If you’re diabetic, it’s not a good idea.” That doesn’t mean that fall produce is entirely off-limits. “When I work with clients, if they’re starting out with high levels of glucose, I have them for the short-term avoid starchy vegetables and then integrate them in small amounts,” Carrera said. “There’s no widespread recommendations.” Though beets are a starchy root vegetable, she likes to keep them in patients’ diets since they contain a compound that opens up constricted blood vessels. That effect is helpful for patients who have high blood pressure. Dietary recommendations can vary depending up on many health, age and co-existing condition factors. Any food can be part of a healthful diet, though diabetics need to be especially careful about balancing what they eat and how they exercise under the guidance of their healthcare providers.

um, which can be out of balance and influence muscle twitching. Dark chocolate and legumes are high in magnesium. Folate is found in whole grains and dark, leafy green vegetables like kale, spinach, broccoli, eggs, avocado and lentils.” It can also help if patients use good “sleep hygiene” such as keeping the bedroom dark and quiet, avoiding caffeine and engaging in a relaxing activity before bedtime. Light exercise may help; however heavy exercise right before bed can worsen restless leg syndrome. Physician Az Tahir, who practices holistic health in Rochester, recommends a bath with Epsom salts and lavender oil for relaxation. “Have massage before you go to sleep,” he also said. “Chamomile tea is very good and lavender oil in a diffuser.” He has also suggested noise machines to help create a restful environment. Sleep specialists may also prescribe medication that increases dopamine or helps calm the nervous system. “It’s a condition that’s very treatable,” Dominik said. “Some just think it’s a nuisance or made up by pharmaceutical companies, but it’s a real condition with a neuro-biological basis. When people are questioned about the impact on quality of life, it is like people with multiple sclerosis. It’s readily and easily treatable.”


By Anne Palumbo

The skinny on healthy eating

Red Snapper Pops with Healthy Benefits


ere’s a quarantine surprise: More people are cooking seafood, especially now that certain meat products are becoming harder to find. Here’s a surprise of a different nature: Snapper, a popular white fish with a firm texture and a distinctive sweet, nutty flavor, has a nutritional profile that’s bound to intrigue. To begin, snapper is an excellent source of lean, high-quality protein, with an average serving delivering about 40% of our daily needs. What makes snapper’s protein particularly attractive is that, unlike, say, a comparable serving of ground beef, it’s much lower in fat, calories and sodium. What’s more, it has an admirable water footprint: snapper, 0 gallons; one hamburger, 450-600

gallons. We need protein to build and repair tissues, regulate hormones and increase feelings of fullness. Snapper is a vitamin B12 superstar. This high-priority vitamin helps to produce red blood cells and DNA, keep nerves healthy, promote bone health and synthesize serotonin — the “happiness” chemical. Many studies support that vitamin B12 may boost energy, slow mental decline and improve moods. Since many older people suffer from a B12 deficiency — whether through diet or poor absorption — it’s good to know that seafood is a great source of this essential B vitamin. Another nutritious hook? An average serving of snapper contains 50% of our daily needs for selenium. A powerful antioxidant that helps

prevent cell damage, selenium is required for the thyroid gland to work properly and plays an important role in the health of our immune system. This flavorful fish is also a good source of omega-3s — healthy fats that have been linked to a lower risk of many life-threatening conditions. According to experts at the Cleveland Clinic, omega-3s have been shown to increase levels of good cholesterol and reduce blood clots, blood pressure, and inflammation. While all fish, including snapper, contain some cholesterol, they can still be part of a heart-healthy diet. The good news is, it’s the saturated fat in food that raises blood cholesterol levels, not so much the dietary cholesterol, and snapper is super low in saturated fat. It’s also relatively low in cholesterol: an average serving of snapper, 37 mg of cholesterol; an average serving of shrimp, 190 mg. As for its mercury levels, snapper is a “good choice” to eat once a week, according to the FDA. This advice is particularly helpful for women who are pregnant, breastfeeding mothers, and young children.

Grilled Red Snapper with Black Beans Serves 4

1 teaspoon olive oil 2 red snapper fillets (halved) 1 teaspoon paprika 1/4 teaspoon cayenne (optional) 1 teaspoon salt 1/2 teaspoon garlic powder 1 teaspoon dried thyme 1 teaspoon dried oregano 1/2 teaspoon coarse black pepper 15 oz. can black beans, rinsed and drained 3 tablespoons chopped red onion 1 garlic clove, minced 1 tablespoon olive oil 2 teaspoons red wine vinegar 1 teaspoon Dijon mustard 1/2 teaspoon salt 1/4 teaspoon coarse black pepper

Fitness in the Finger Lakes New free hiking challenge offers incentives for people to get active on the trails this summer By Kyra Mancine


o encourage hiking on the more than 1,000 miles of trails across New York state this season, the Finger Lakes Trail Conference (FLT) has launched the FLT50 Challenge. FLT is a nonprofit based in Mount Morris, Livingston County. Walk, run or hike a total of 50 miles on FLT’s expansive trail system and you’ll receive a patch, certificate and sticker and be entered into monthly drawings for prizes. For you hiking overachievers out there, if you up your mileage to 50 miles for three months over the course of the year, you can earn a hat. Tag your progress on social media and you might even be highlighted on the FLT’s website and social media sites. “So many people have discovered the benefits of hiking and walking and being outdoors during this crisis — it’s been one of the few things we can still do,” said Chris-

ty Post, director of marketing and communications at FLT. “And I think that’s been great for people — and for families — especially now that the weather is getting nice. I know my kids and I are getting out more together, and I see a lot more people and families out on the trails than I used to.” If you’re concerned about maintaining social distancing outside, this is the perfect pursuit. “Activities that allow physical distancing will be the new normal for most of the summer, and trails give people the space they need to be safe,” said Post. “Our hope is that this challenge brings people and families together for healthy activity — with appropriate social distance — and brings us all together virtually with shared pictures and adventures on the trails.” Open to all ages, participation in the FLT50 is easy. Simply pick a June 2020 •

FLT trail, complete your miles and submit your tally once you’re finished. Largely built and maintained by volunteers, FLT’s numerous trails run from the Pennsylvania-New York border in Allegany State Park to the Long Path in the Catskill Forest Preserve and includes branch trails to Niagara Falls, the Genesee River valley, the Great Eastern Trail south of Corning, the central Finger Lakes and the Syracuse region. Founded in 1962, FLT’s mission is “to build,

Helpful tips

Snapper fillets are readily available fresh and frozen. Fresh fish should be cooked the day it is purchased; however, it will keep for two days in the refrigerator if properly wrapped. Although it’s best to eat snapper the day it’s prepared, any leftovers will last three to four days in the refrigerator. Using a “grill pan” facilitates cooking snapper on the grill. Lightly coat both sides of snapper with olive oil. Mix together the paprika, cayenne, salt, garlic powder, thyme, oregano and black pepper. Sprinkle over each side of the red snapper. Set aside. Before grilling, coat your grates with a high-heat cooking oil, such as canola oil (spray or a paper towel coated with oil will work). Do the same if using a grill pan. Preheat the grill to high heat for 10-15 minutes. While grill is preheating, combine the beans, onion, garlic, olive oil, vinegar, mustard, salt and pepper in a medium saucepan. Cook, uncovered, over low heat for 10 minutes, stirring occasionally. Remove from heat and cover. Grill the snapper about 5 to 6 minutes on each side or until the fish reaches an internal temperature of 145 F. Serve topped with black bean mixture. (No grill? Heat 2 tablespoons canola oil in a large skillet over medium-high heat. Place snapper fillets in skillet and cook about 5 minutes on each side.)

Anne Palumbo is a lifestyle colum-

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

protect, enhance, and promote a continuous footpath across New York State. Forever!” Organizers say this is the perfect opportunity to get outdoors. They cite a RunRepeat study of over 12,000 people from 139 countries showing that during March people who normally exercised once or twice a week increased exercise frequency by 88%. Even moderate athletes who normally exercised three times a week increased their frequency by 38%. “This challenge came at exactly the right moment,” according to one FLT50 challenge participant. “We’d found ourselves moping about the house, putting on pounds and full of self-pity for backpacking trips canceled. I had no idea such incredible, sweeping vistas were less than 15 miles from home. I felt entirely transformed. I can’t wait to get out there again and rack up those miles!” You can start the challenge at any time, and miles must be completed and submitted by the end of 2020. If you want to join the FLT50 challenge, visit for more details, including maps and a mileage tracker you can download.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 11


mily Kathleen Eberhart had the numbers 1, 2 and 3 mounted on her wall. When she wanted a moment of calm she’d sit on the end of her bed, look at the numbers and count her breaths. Breathe in 1, 2, 3... Exhale 1, 2, 3... Her grandchildren watched and learned. She taught them simple meditation techniques like imagining themselves surrounded by a soothing and loving white light. One of those grandchildren, Melanie Macdonald of Brockport, took these lessons into her life’s work. “My grandmother was a meditator. She didn’t necessarily have formal practice with the grandchildren, but we spent an awful lot of time with her when we were kids. She taught me about mindfulness before it was cool and before it was a big thing.” That was back in the 1970s and 1980s. Today Macdonald applies those lessons to her life, her work and in her home. After Macdonald had her first Melanie Macdonald in her classroom in Brockport. child in 2001, she picked up a yoga DVD to help her get in shape. But soon her yoga practice became about more than just toning up. It became about connecting mind and body, joining breath to movement and maintaining a formal meditation practice. Soon another child came along and Macdonald taught both kids simple yoga poses and mindfulness lessons. In 2009 she became a registered yoga teacher after training with Francois Raoult, the director of Open Sky Yoga in Rochester who has been teaching yoga since 1975. That same year she did an intensive course of study with instructor and founder of the Radiant Child yoga teacher training program Shakta Khalsa and became a “Radiant Child” certified children’s yoga teacher. It wasn’t long before she By Christine Green began teaching yoga to adults and children at local studios, various children’s programs, and at area colleges.  deep breathing practices, and other “My first goal was to make sure mindfulness techniques. After lunch that it was scientifically based. So, she chose a “bell master” to be in [the students] researched the brain From Studio to Classroom charge of ringing her Tibetan singing and we researched the effects of yoga bowl. and meditation on the brain. We did At the time, Macdonald worked “The kids would say something yoga poses and we talked about how a day job at a local staffing company. nice about that person that they they help certain parts of the body.” But she wanted to devote her life to liked. And then that person rings the Krisher, the social worker at the yoga, meditation and mindfulness bowl. And I did it in summer school, school, and her colleagues were imfor children.  too. It was a really big hit. And every- pressed with Macdonald’s approach. She decided she wanted to be a body would take three breaths and “Her whole focus was paying teacher and worked diligently to get then we would start our afternoons.” attention to the emotional needs of her bachelor’s and master’s degree She also taught the students our kids first and foremost, so that in teaching in 2009. As soon as she gratitude meditations and they kept they can be able to learn and retain completed her studies, she took a job gratitude journals. She walked them the academic information. She did at Eugenio María de Hostos Charter through progressive relaxations and training with our staff to help staff School in Rochester teaching math demonstrated how a calm mind can understand the impact of trauma and English to elementary special help a person be more relaxed and and how it affects the brain and how education students. happier. some of the classroom behaviors Erin Krisher, the social worker and struggles you might see with at Eugenio María de Hostos High students can be directly related back School, said that the K-12 students at Sewing a SEAM of Calm to that. Learning skills through yoga their schools are deeply affected by and mindfulness is going to help trauma. Teachers and students from prethese kids in the classroom.” “We have an urban population vious years sought Macdonald out The SEAM classroom was a sucwho are extremely traumatized. Most to help them relax and refocus after cess, but Macdonald decided to take of them don’t come to school necestense situations would arise at home a teaching position closer to home sarily ready to learn, because they’ve or in class. Her room became a spelast year. She now teaches second had all sorts of situations where who cial place for anyone in her building grade special education students at knows if they slept the night before to take a break and find a moment of Barclay Elementary School in Brockor had food or what was going on be- peace. tween family members or happened Administrators at Eugenio María port. “We wish she was still here with on the walk to school.” de Hostos took notice and the next us,” said Krisher. “But we underRight away, Macdonald started year Macdonald started a special using meditation and mindfulness high school class called SEAM: Social stand she has to share her wealth in other ways in other places.”  techniques to help her students. “We Emotional Academic Mindfulness. Macdonald works with Denise worked a lot on reducing anxiety and She combined New York state’s recNowaczyk who has been using varibringing back focus.” ommended social emotional learning ous mindfulness techniques with her She then moved to fifth and sixth benchmarks with mindfulness and grade classrooms where she incorpo- English language arts to create a new students for several years. Together they have a partnership based on rated a morning community circle, learning experience.

Bringing Meditation, Mindfulness to Local School Kids

Teacher focuses on both academic success and emotional wellbeing of students, incorporating meditation and mindfulness practices during classes

Page 12

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

teaching students both academic success and emotional wellbeing. Macdonald incorporated her Tibetan singing bowl and the “bell master” practice into the students’ after lunch mindfulness practice. Nowaczyk said that practicing breathing and mindfulness after lunch has helped students in a number of ways. “The kids have gained a lot of awareness firstly, and then secondly, I think the kids have begun to take on ownership of it and really are invested in this time that they have.” she noted. “They’re coming out of the lunch room, which is the craziest place in their life, and then the bell master rings a bell again and we do the quiet breathing until we don’t hear the sound anymore. And then we get up and we start our afternoon.”

Mindfulness for the Next Generation What does Macdonald like best about her work with children? “When you see somebody about to freak out and they turn to their breath instead, that’s the most rewarding part. Because it’s not about me at all. It’s about them. For them to understand that they have some sort of ability to regulate their own emotions, to see that in action, it’s gold.” Macdonald met with Rochester Mayor Lovely Warren in early March to talk about ways they can work together to bring trauma-informed mindfulness to families around the city. She also teaches at Beyond Yoga in Brockport and presented talks on mindfulness at the Western New York School Counselors Consortium in 2019 and 2020. She has taught yoga and mindfulness at SUNY Brockport in two different professors’ classes since 2013.

Melanie Macdonald’s Tenets 1 Breathe, breathe, breathe! Practice breathing especially in non-stressful situations, so that when stress happens your body is already prepared to use the breath as a tool for calming. Set aside a time to practice taking three deep breaths before heading out for school or work, when you first walk in the door at home, and right before bed. 2. Help kids get in touch with their bodies. When they are feeling happy, ask them to notice where they feel emotions in the body (sad, angry, excited). Naming and feeling emotions help kids learn to self-regulate and understand the connection between mind and body.    3. Gratitude! Instead of asking kids how their day was, ask them to think of one thing that happened in their day that they are grateful for. Tell them one thing that happened in your day that you are grateful for. Fostering positive thoughts is a habit that requires practice.    4. Take a walk in nature! Reconnecting with the natural world is a wonderful way to foster a sense of calm within yourself and your kids. Let your kids guide the way! Draw a picture of your favorite part of the walk afterwards.

Where have all sick patients gone? The good news for the hospitals is that they are coming back... very slowly.

Patients Wanted By Deborah Jeanne Sergeant


hile healthcare providers caring for COVID-19 patients have been busy throughout the pandemic, providers in other areas of hospitals, such as numerous surgeons and related personnel, had been on furlough. The only surgeries permitted at most hospitals during the pandemic were life- or limb-saving procedures or those that are time-dependent for positive outcomes. As a result, hospitals have lost considerable revenue. How much they have lost? According to a report released in May by the American Hospital Association, hospitals will have lost an estimated $202.6 billion nationwide from March 1 through June 30, an average of $50.7 billion monthly from direct and indirect effects of COVID-19. While the related costs include expenses for COVID-19 hospitalizations, additional personal protective equipment and extra support for some hospital employees, a large portion of that loss is from canceled and delayed elective surgery. Ambulatory surgical centers have also experienced losses. “As you can imagine, if you stop what you do that generates income, it creates problems,” said Carla Stebbins, director of Institute of Health Sciences and Technology program at Rochester Institute of Technology. “Healthcare still lives on direct billing for procedures and when those aren’t done, there’s no layaway plan. You don’t put deposits down. It creates cashflow issues and income problems like for any business. In healthcare, a lot of the cost related

to it are the people. When you don’t have money coming in, it’s a difficult situation to make payroll.” Stebbins said that shifting personnel, such as nurses going from the surgical team to an acute care team, isn’t as easy as some might think because of specialization in nursing. As a result, hospitals’ typical personnel shortages were exacerbated during the worst part of the pandemic. Stebbins said that colleagues planned reopening for elective surgery by working out options that could safely make an in-patient surgery an out-patient surgery to reduce the number of patients using hospital space and resources — especially since if the number of COVID-19 patients surges again, those beds will be needed. “There’s no question that the operating room is the heart and soul of a hospital or surgical center,” said physician Pasquale Iannoli who serves as chairman of the department of surgery at Unity Hospital. “It’s true that the financial health of an organization can be tied to its surgical volumes.” Iannoli, who also practices at Westside Surgical Associates in Rochester, said that hospitals have a backlog of cases and surgeons are looking at patients’ cases to prioritize who’s first in line based upon medical needs as outlined by organizations such as The American College of Surgeons. “Patients are being scheduled and operated upon and our hospital systems are working with state regulators and the Department of Health,” Iannoli said. “The period of June 2020 •

waiting is impacted by the outcome if they wait.” For hospitals and surgical centers, their economic survival may depend upon efficiently scheduling patients to both to meet their healthcare needs and also to generate much-needed income. “Surgery is the economic engine of a hospital,” said Dorothy Urschel, doctor of nursing practice who heads the nurse practitioner program at Daemen College and serves as chief operating officer at Columbia Memorial near Albany. “We had to close some surgery sites and primary care sites.” She calls the current situation ironic that hospitals must care for the sickest patients while they had to furlough some staff. “Most hospitals look at their cash positioning and evaluate ‘How do we work together to make sure we’re financially healthy at the end of all this?’” Urschel said. Early in the outbreak, she didn’t think surgical units would have to be shut down, as even during a bad flu season, surgeries continue. Urschel said that she felt “shock” as state and federal orders suspended elective surgery. One big key is getting elective surgery patients back to the hospital for care. Many still feel concern over social distancing, especially in a medical setting. “We’re working with the community at large and developing a ‘marketing campaign’ to make sure they understand it’s a safe place to come back to,” Urschel said. “We need to make sure that we present

ourselves as a hospital they trust. What we’re looking at is COVID awareness, preparing the patients and staff and the community at large and each patient issue to still deliver a high quality of care.” Urschel also believes that it’s a good time for hospital administration to evaluate how they can improve their organizations and look at how they can manage resources better, grow and increase revenue. University of Rochester released a statement April 15 which said, “We have experienced significant lost revenue from suspending non-essential medical procedures in order to build capacity in our hospitals for an anticipated surge in COVID-19 patients. Similarly, we have incurred expenses to prepare to care for our patients through telemedicine and to prepare our faculty and students for online learning. We have refunded room and board fees for undergraduates who left campus in March, but continue to provide housing, food, and support for students who had to remain on campus…We cannot predict when clinical revenue from our healthcare system will return to the levels we experienced prior to the pandemic. The financial implications of this situation have been significant, and we don’t yet know how long these will last.” On April 28, Thompson Health and other UR Medicine facilities began performing semi-urgent and elective procedures again. In an April 30 press release, UR Medicine Thompson Health President/CEO Michael F. Stapleton, Jr., stated that “those with chronic conditions — who may have been putting off care since the onset of the pandemic — are especially encouraged to not delay care any further because their conditions could very well worsen without it.” Facilities related to Rochester Regional Health and Finger Lakes Health also resumed elective surgeries by the end of April.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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COVID Effects on the Food Supply Chain Bottleneck responsible for recent shortage of milk, meat at the grocery stores By Deborah Jeanne Sergeant


uring the peak of COVID-19 panic buying, many stores’ supply of milk, meat and produce dwindled. Meanwhile, dairy farmers dumped milk and other farms experienced surpluses of their own. The paradox left many consumers scratching their heads — and some feeling ire toward farmers. Why don’t stores have enough while farmers have too much? The answer lies in unprecedented bottlenecks in the food supply chain. “It is a confusing time for a consumer to go into a grocery store and see an empty shelf and farmers are on TV having to dispose of their milk,” said Steve Ammerman New York Farm Bureau public affairs manager. “It doesn’t have anything to do with the farm side of things but the distribution methods.” It’s illegal for dairies to sell raw

milk directly to the public, so consumers can’t simply drive to a nearby dairy to fill a pitcher. The only exception is farms licensed to sell raw milk; however, only a handful of producers statewide possess the hard-to-obtain license. The cost of building a licensed bottling facility is too high for any dairy still reeling from four years of prices below the cost of production. Farms with creameries must also market and distribute their milk, enterprises for which farmers may not be prepared. Farms without their own bottling facilities sell to cooperatives throughout the state. The milk cooperatives decide how much they need for the processing plants, where milk is pasteurized, homogenized and bottled. Ammerman said that because milk normally headed for the food service industry — institutions and restaurants — wasn’t needed during

quarantine, farmers had a surplus. “Those plants are designed for those types of customers and couldn’t easily pivot and change their processing and package to sell to the grocery store,” Ammerman said. “In turn, there wasn’t a place for all the milk to go and some farmers were directed by their milk cooperative or the plants that they couldn’t pick up the milk.” Since most farms cannot store, process or bottle their milk, they were often forced to dispose of it at a loss. While many school districts still offered school lunches for those in need, the number of children receiving a school lunch was lower than those who would normally eat lunch at school. Colleges also sent home resident students. Though restaurants could still operate through take-out, diners didn’t need beverages, as they had those at home. All chefs needed was the milk necessary for cooking. All of these factors reduced demand for farms supplying these industries. Rerouting that milk to stores may seem like an easy way to keep supplies high — after all, students are someplace drinking milk — but infrastructure complicated the possible solution. Store coolers are designed for quarts, half gallons and gallons, not the students’ pints and the food service industry’s bulk containers. “There are so many variables that have to fall into line like packaging, storage and transportation,” Ammerman said. Panic buying contributed to a dearth of milk. It may seem sensible that stores could order more cartons and jugs of milk once a shortage seemed imminent; however, stores may not have sufficient storage space for it.

Produce and meat supply also affected Stores’ produce departments have become a little picked over. Restaurant closures mean more cooking at home; however, interruptions in deliveries hampered stores’ ability to stock. Local produce seasons began only in mid-May with asparagus and any farms using greenhouses for greens. But pick-your-own operations and farm stands began their seasons with social distancing precautions.

Why Some Products Vanished from the Shelves


ona Golub, vice president of public relations and consumer services for Price Chopper, said that the statewide chain had experienced a few categories of food that ran low during the early part of the pandemic, such as canned vegetables, dried pasta, baking supplies and Golub

Page 14

canned soup; however, that was likely because of panic buying and also because of unanticipated shifts in the market and weather. “Soup generally falls off by the time we get to March,” she said. “When kids are home more, more meals are made at home and the weather stays cool, then soup is popular.” The surge in baking — typically a popular activity during the fall and winter — also abruptly lowered supplies in that aisle as consumers quarantined at home wanted homemade treats and familiar rituals. “We’ve been resourceful rela-

tive to maintaining the food supply, calling upon a vast network of distribution and tapping into the food service supply chain,” Golub said. For example, purchasing bulk meat that would have gone into the restaurant market and repackaging it in consumer-friendly sizes enabled Price Chopper to keep up its stock closer to normal levels. As of mid-May, Golub said that Price Chopper’s stock still wasn’t at 100% of what it normally carries, but Golub said part of the reason is that manufacturers are focused on making more of their core products.

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

Meat shortages existed largely because of temporary shut-downs of meat processing plants and transportation issues, not a lack of cows, chickens and pigs. Tapping local farms may seem an easy way to get some meat; however, farmers selling off the farm must sell only whole, halved and quartered animals. A quarter of a beef steer costs around $700 and would supply a family of four with beef for a year. Many families lack freezer space for that much meat or else they must arrange to pool their money with other families and divide the meat they purchase together. The only legal way for farms to sell smaller amounts to a single buyer — such as just a few packages of ground chuck and a couple ribeye steaks — is to have the meat processed by a USDA-certified processor. “In New York state, we don’t have major slaughterhouses,” Ammerman said. “A lot of our beef and dairy cows go to Pennsylvania.” Ammerman said that he has heard anecdotes of meat processors both in New York and outside the state as being booked. Despite consumer demand, they have reached capacity. At Rugenstein Family Farm in Canandaigua, co-owners Mike and Amy Pyra raise around 20 beef cattle and six pigs. The farm sells quarters and halves through its “freezer meat” side and retail cuts. “We put a steer in the freezer four week ago and sold it out,” Amy Pyra said in early May. “We wish we had more to go in the freezer.” Since it takes at least 12 months to raise a steer to the right size to butcher, the meat industry isn’t one that can readily scale to meet consumers’ needs. Pyra said that social isolation at processing plants diminished their workforce and hampered producers from getting their meat to buyers. “There’s plenty of beef to go to the packers, but they can’t process at the same capacity,” she said. She said that only four USDA processors operate within a reasonable driving distance from the farm. Her farm uses one in Gasport in Niagara County. Pyra is thankful that her farm had reservations at the facility for specific animals; otherwise, they likely would have to wait for months. Despite the struggles for producers and consumers, Prya said that she sees a few positives by the COVID shake-up to the food supply chain. “It is making people think about buying local,” Pyra said. “It helps them know where their food comes from.” The crisis has also prodded her to think more about a long-term goal she has held: opening a farm store instead of selling by appointment from a freezer on the farm. “People have to have faith in our food system that farmers are still working hard,” Ammerman said. “It’s a supply system still trying to settle and maneuver to adjust to the reality. “Even though farmers have to go through a lot right now, many are donating to food banks. That’s been very positive and comforting to see, but it’s not a surprise. Farmers jump in and help their neighbors.”


Losing ‘COVID-15’ After Quarantine By Deborah Jeanne Sergeant


he “freshman 15” weight gain experienced by many college students shares some similar origins of the “COVID-15” pounds packed on during quarantine: mindless stress eating, availability of food, boredom, poor food choices and lack of exercise opportunities. Plus, those who are working at home had little positive peer pressure. At the office, others would notice that second or third doughnut. Also absent at home are the lunch-

time walking group, buying a healthful lunch at a nearby eatery and hitting the gym on the way home. While working at home, it’s easier to binge on unhealthful convenience foods and stressful news updates. Familiar movies in the evening — instead of workout videos — offer comfort. Despite the ease of gaining weight, it’s possible to shed unwanted pounds. Physician Az Tahir, who prac-

tices holistic medicine in Rochester, said that it helps to incorporate more movement into each day — and not just during a formal workout time. “Exercise should be part of a lifestyle,” he said. Exercise and stretching can help combat the weight-gain effects of stress. Tahir said he walks for half an hour before breakfast and half an hour before dinner to burn calories, boost his alertness and aid in digestion. He also recommends substituting not-so-healthful cravings for healthful activities, such as reaching for the yoga mat instead of a cookie for a mid-afternoon lift and to reduce stress. “When you’re at home or at work, every hour, do a yoga stretch, relax your back or neck,” Tahir said. “Many yoga stresses are very good. Just do it for two or three minutes. That will prevent back problems when working. You feel like a new person.” He also advises to watch portion control, both with food and also with beverages. “You should have something with zero calories as a filler, such as water,” he said. “You can drink it as much as you can. Drink half of your weight in ounces every day. Unsweetened tea, you can drink as much as you can. Apple cider vinegar has zero calories. You can take it as much as you can, as it has many benefits for losing weight and more than 100 other benefits.”

Jessica Kouzan, SNAP-Ed community nutritionist for Cornell Cooperative Extension Monroe County, said that it’s important to plan a healthful grocery list to keep stocked up on healthful foods for meals and snacks. “If it’s in the house, I’ll eat it,” she said. Instead, it’s important to “create a plan for meals you’ll make and try to stick to it.” Emphasizing whole grains, fresh and frozen fruits and vegetables, and lean sources of protein makes a big difference in weight loss and overall health compared with eating so many convenience foods. Kouzan also said that portion size matters. “Start with a smaller plate of food,” she said. “If you’re still hungry, go back and get more. If you have a plateful of food, you may feel you need to finish it.” She confessed that pasta represents her “comfort food” that’s easy for her to overeat; however, beginning with a small portion and eating a side salad and roasted or sautéed vegetables helps her fill up on healthful foods while still enjoying her beloved pasta. “Try to find foods higher in fiber can be really important,” Kouzan said. “Fiber gives us that fullness feeling. If you eat fruits, vegetables and whole grains, you won’t be hungry again within 20 minutes.”

Delivering Home Care Even More Challenging During the COVID-19 Crisis By Adrianne Mann and Karen Bonomo


roviding home health care is challenging work on a typical day, as clinical staff work diligently to keep patients safe and healthy in a home environment they do not completely control. The home care reality comes even more into focus during the coronavirus pandemic, where home health care workers are the front line in fighting this crisis. The challenge of home care workers has largely gone unnoticed. At HCR Home Care, a leading provider of home health care services in Rochester and across New York state, our enhanced infection-control protocols help keep both patients and staff safe. Based on guidance from the Centers for Disease Control and Prevention, the New York State Department of Health and the Visiting Nurse Associations of America manual, the clinical staff protocols include: • Washing hands with soap and warm water prior to each patient contact • Cleaning and disinfecting all areas of equipment after each use • Ensuring clinicians are always stocked with soap, hand sanitizer, paper towels, gloves and other personal protective equipment • Practicing proper disposal of medical waste • Utilizing dedicated personal

protection equipment for the care of COVID-19-possible patients • Self screening of staff members Clinical staff screen all patients during the initial referral process and prior to each home visit. We also are tracking patients who are either awaiting COVID-19 test results, have tested positive or have recovered from the illness. Staff receive alerts containing guidance for all patients prior to all home visits. Clinical workers now must factor in much more time to provide care to a patient. Besides the additional time to sanitize their hands and equipment and screen a patient, there are the time-consuming tasks of setting up a station with all the personal protective equipment a mask, eye protection, a gown, etc. putting it on outside the home, and then removing it in a patient’s driveway after the visit. Putting on and removing PPE is all the more difficult during poor weather conditions. HCR nurse Eduardo Diaz Rodriguez recently learned this firsthand during a patient visit on a blustery, snowy day in western New York. “It was very stressful to try to put on the PPE and then take it off while it was windy and snowing,” he said. “When working in a hospital, you can simply put the gown and gloves in the trash when you are done seeing a patient. During June 2020 •

a home care visit, you have to put it in a container in your car and take it with you until you can safely dispose of it.” The role of home health care is expanding during the crisis, as it provides an opportunity to help prevent rehospitalizations among COVID-19 patients and lessen the enormous burden on the hospitals. Research shows people recover faster at home. In-home care staff can monitor COVID-19 patients closely and provide education and support. Our home health aides are referring patients to telehealth appointments, when necessary, and monitoring patients’ temperature and oxygen levels. In addition to in-home visits, clinical staff is making phone calls in between appointments to provide emotional support. Home health care workers are committed to providing the best possible care to patients. While their work is much more challenging during the COVID-19 crisis, their commitment is that much stronger.

Adrianne Mann is executive director of HCR Home Care’s Certified Home Health Agency (CHHA), and Karen Bonomo is executive director of HCR’s LHCSA/ administrator/outreach.

Adrianne Mann

Karen Bonomo

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 15


Life-Saving Organ Transplants Plummet During COVID-19 Crisis


he coronavirus pandemic has affected all areas of medical care, and a new study finds it has delayed potentially life-saving organ transplants. Across the United States, transplants from deceased donors dropped 51% from early March to early April, amid the COVID-19 outbreak, the researchers found. In France, meanwhile, those procedures plummeted 91%. Experts said the findings, published online May 11 in The Lancet, come as no surprise. The figures, they said, largely reflect efforts to protect patients, and to deal with the diversion of hospital resources to COVID-19. Much of the decrease was in kidney transplants, partly because they are the most common organ transplant. But it’s also because people with advanced kidney disease can be maintained on dialysis while they await a donor organ, explained physician David Klassen, chief medical officer for the United Network for Organ Sharing (UNOS). So there is generally less urgency around a kidney transplant, compared to a heart, liver or lung transplant, Klassen said. UNOS is a nonprofit that man-

ages the U.S. organ transplantation system. The new findings are based on its data, but it did not conduct the study. “Transplants in the U.S. have not shut down,” Klassen said. “But, clearly, we want to do them as safely as possible.” Physician Peter Reese, an associate professor of medicine at the University of Pennsylvania in Philadelphia, was part of the study team. “The good news is, we’ve carried on through the worst of COVID-19,” he said. However, Reese added, while some transplants can be delayed, patients on waiting lists for donor organs undoubtedly missed out on opportunities. “The tragedy is, there were deceased-donor organs that patients did not receive, and that we’ll never get back,” he said. Right now, more than 112,000 Americans are on the waitlist for a donor organ, according to UNOS. More than 94,000 of them need a kidney. And while kidney patients can receive dialysis, it doesn’t always buy the time they need: Each year, around 9,000 patients on the waitlist either die or have to be removed from the queue due to worsening health.

Pandemic Lockdown

Increases Child Abuse Risk


unkering down during the coronavirus pandemic has stressed families and raised the risk for child abuse, Penn State researchers report. “We’re very worried about children becoming more seriously injured over longer periods of time before they can get treatment,” said physician Lori Frasier, chief of the division of child abuse pediatrics at

Penn State Children’s Hospital. Data from ChildLine, part of the Pennsylvania child protective services program, show 30% to 50% fewer reports of child abuse from the three weeks before state-mandated COVID-19 restrictions to the first three weeks after closures. Yet that’s different from what Frasier found. “Most reports to ChildLine are

When COVID-19 hit the United States, most transplants from living donors — which can be rescheduled — were put on temporary hold. One reason was to protect donors from possible exposure to the virus in the hospital, Klassen said. Transplant patients also require many hospital resources, including intensive care beds. If a living donor is involved, that means two patients for each procedure. And at the start of the outbreak, U.S. transplant centers did not know whether every city was going to “look like New York,” said physician Stephen Pastan, medical director of the kidney and pancreas transplant program at Emory University in Atlanta. “Hospitals were preparing for the worst,” said Pastan, who is also

a board member of the National Kidney Foundation. “At Emory,” he noted, “we took a cautious approach and closed our kidney program.” It also took time, nationally, for testing protocols to be put in place. Transplant recipients need to be tested for coronavirus infection, Pastan said, to ensure they don’t bring it into the hospital. Meanwhile, organ procurement organizations started testing donors for the virus, according to the American Society of Transplantation. Now, Pastan said, “programs are slowly ramping up again.” The current study, which looked at data through April 10, does not capture more recent trends. According to Klassen, of UNOS, there has been no indication of further declines in U.S. transplants.

made by mandated reporters — teachers, doctors and psychologists, daycare providers — those who work with children,” Frasier said in a Penn State news release. “As children remain isolated in their homes with their families, they lack that safety net of mandated reporters who are obligated under the law to report their reasonable suspicion that child abuse has occurred,” she said. Without reporting by outside observers, a significant risk for serious trauma to an abused child is likely, she explained. “A bruise seen by a mandated reporter can lead to intervention that

stops the abuse before it escalates,” Frasier said. The damage can be long-term, said Brian Allen, director of mental health services at the Penn State Center for the Protection of Children. “Child abuse can have a very pervasive effect on various developmental aspects for the child,” Allen said. “If we don’t catch the abuse early, it can greatly impede a child’s ability to regulate emotions, behaviors and social skills. Post-traumatic stress can negatively affect academic potential and achievement as well,” he said.

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


Things You Need to Know About Cataracts By Ernst Lamothe Jr.


ll of your five senses matter. The deterioration of any of them can greatly decrease quality of life. When it comes to vision, there are a variety of issues that may present themselves — blurriness, difficulty distinguishing distant and nearby objects, blind spots and fading of colors, among others. Different eye conditions affect vision in unique ways. Almost 12 million people aged 40 years and older in the United States have vision impairment, according to the Centers for Disease Control and Prevention. “We rely on vision for reading, driving, experiencing the aesthetic wonders of our world and just functioning in our everyday lives,” said Christian Klein, ophthalmologist with UR Medicine’s Flaum Eye Institute in Rochester. “We often take our vision for granted until we start having problems. However, we shouldn’t neglect our eye health because it is strongly tied to our quality of life.” As we get older, an issue that often comes to the forefront is cataracts. The risk of cataract increases with each decade of life. Typically, evidence of early cataracts begins in our 50s but this varies among individuals. According to the National Eye Institute, by age 75, half of white Americans have cataracts. By age 80, 70% of whites have cataracts compared with 53% of African Americans and 61% of Hispanic Americans. Klein answers about five questions about cataracts.


What is a cataract? A cataract is a progressive clouding of the normally clear lens of your eye. This

is usually a very slow process, taking decades before the cataract becomes truly symptomatic. Some medical conditions or medications can accelerate the progression of cataracts. For people who have cataracts, seeing through a cloudy lens is a bit like looking through a frosty or foggedup window. Cataracts form in the lens which is behind your iris; the colored part of your eyes. “When the natural lens of the eye begins turning into a cataract, the lens will evolve from clear, to yellow, to yellow-brownish to brown in advanced cases. It can take decades to get to the point where it is affecting your vision and gradually things no longer look clear,” said Klein.


What can be done? When your natural lens becomes less transparent with age, this is called a cataract. When a patient’s vision becomes cloudy, blurry or one experiences a lot of glare when driving at night, this may be an indication of advancing cataracts and patients should seek an evaluation from an eye care specialist. An estimated 61 million adults in the United States are at high risk for serious vision loss, but only half visited an eye doctor in the previous 12 months, according to the Centers for Disease Control and Prevention. Klein likes to talk with his patients and discuss their goals and routines for their lives before they go forward to the next steps. “It’s essential to speak with your doctor because we need to understand your visual needs and hobbies. A cataract surgery is not necessary until one’s quality of life begins to suffer. This is often mani-

fest as difficulty driving, especially at night, trouble with reading, watching television or distinguishing colors,” said Klein


What does cataract surgery look like Cataract surgery is performed by an ophthalmologist as an outpatient surgery. Patients don’t have to stay overnight at the hospital and it has become one of the most common and successful surgeries in the U.S. “The surgery is performed with moderate anesthesia where the patient is in a relaxed state. The procedure can take anywhere from five to 30 minutes for a routine case depending on the experience of the surgeon. More complicated cases can take longer. The cloudy lens is removed and a new lens is implanted,” said Klein. “The United States success rate is 98% to 99%.”


What is the recovery time Klein believes patients should review precautions that their doctors suggest during the first few weeks to avoid any issues or complications. The patient’s physician often prescribes antibiotic and anti-inflammatory eye drops to aid in healing and recovery during the first several weeks. The patient is seen several times after surgery to ensure that they are progressing well. “Most people completely heal between three to four weeks but sometimes it can take a little longer. Everyone heals at their own rate. Still most people will be healed by that timeline,” said Klein. “Some of the first symptoms you might feel is a scratchy feeling or light sensitivity, but that will subside after a few days

Christian Klein, ophthalmologist with UR Medicine’s Flaum Eye Institute in Rochester. or weeks.”


What can you do to maintain eye health? Klein said because people can start having cataracts even as early as their 40s, that is why it is essential to have regular eye visits as well as protect your eyes early on. To protect your eyes from harmful solar radiation, you should wear sunglasses that block 100 percent UV rays whenever you are outdoors in daylight. The World Health Organization estimates up to 20 percent of cataracts may be caused by overexposure to UV radiation. “If you feel something is happening with your vision, we want you to come in as soon as possible,” said Klein. “Even a healthy person can experience some eye problems. It doesn’t always happen when you are older.”

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Q A & with

Ann Marie Cook

Lifespan’s president and CEO Serving older adults (including distributing robot pets), despite COVID-19 Interview by Mike Costanza


ifespan of Greater Rochester has long served older adults, their families and their caregivers in the 10 counties it covers. All have been able to turn to the nonprofit for help dealing with the challenges, and partaking of the joys, that the years can bring. COVID-19 forced the agency to alter some of its services and programs, but Lifespan intends to get back on track as soon as possible. In Good Health spoke to Ann Marie Cook, Lifespan’s president and CEO in mid May. Q. In a nutshell, what is Lifespan’s mission? A. Lifespan helps older adults and family caregivers access services and get information and training on various topics, but essentially helps older adults take on, we say, both the challenges and opportunities of


longer life. Q. Gov. Andrew Cuomo’s New York State on PAUSE executive order forced all nonessential businesses to close as of March 22. How did that order, and the threat of the virus, affect Lifespan’s work? A. We fall under services for older adults, which all are considered an essential service. The disease impacts older adults so we’ve taken this very, very seriously. We’ve had to curtail some services — so much we do is in the home, and a lot of that has been curtailed. But we’ve also have had to develop new services during this COVID-19 outbreak. Q. About half of Lifespan’s 155 employees are working from home, and the 300 volunteers who usually donate their time to your agency each day haven’t

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been able to come in. Are your offices still open to the public? A. We’re not closed, but we don’t accept people to walk into the agency anymore. Q. Does Lifespan still do home visits or provide other in-person services for older adults? A. We didn’t feel comfortable going into older adults’ homes until we understood what kind of protective equipment we needed and what they needed. Most of that work was curtailed dramatically. We are doing home visits to some clients who we feel may be at risk. Q. What are some of the new services that you’re providing? We are delivering food to people who cannot get out. Food delivery, prescription delivery. We’re also delivering masks to people, so that when they do go out — though we’re not encouraging that — they at least have the appropriate protective wear on their faces. One of the other services we started was kind of a daily check-in call. We have some of our volunteers calling out to older adults who live alone, and the loneliness and the isolation has been getting to people. That has been heartbreaking. The other thing is we hear a lot from families who have a loved one in a nursing home, and are trying to get advice about what they can do to have more access to their loved one. Those have been heartbreaking calls, because they’re used to seeing their loved ones. Their family member might have dementia, so they don’t understand why the family’s not coming in. The hard part for the staff is listening to the concerns of folks, and not having a lot of options in which we can help them. We have also been sending out information to our clients on a regular basis. We’re helping people get answers, in terms of the stimulus money. It has been difficult to get all the information, but we’re trying to do that for people. Q. You also mentioned something called a “robot pet.” What is that? A. I’ve had it sitting on my lap. It looks like a real pet — a cat or a dog. It does move a little bit so you feel movement. If you touch it, it purrs or does a little bark. We got a shipment

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

of the pets from the State Office for Aging [New York State Office for the Aging], and we’ve distributed those pets to older adults who are living at home alone. I can’t begin to tell you how much of a difference it’s made in peoples’ lives. For individuals who were used to having a pet, and unfortunately can’t do all of the work of a pet now, this has been a great comfort. Q. How are you safeguarding Lifespan employees who are working onsite? A. We are taking every measure possible to make sure that the staff is safe. Those that are working in the office have to wear a mask. Some have been tested — we’re essential workers that can be tested. We’re also practicing maximum social distancing. We have “one-way streets” [corridors] now, so people don’t face each other when they walk. We’ve stopped in-person meetings and education programs and trainings, and moved to a webinar format. We have deep-cleaned the agency, and clean it every night. Q. The threat of COVID-19 has receded enough that some businesses and organizations in the Finger Lakes region can qualify to begin reopening. What are your plans for reopening? A. We’re calling it not a reopen plan — because were not closed — but a “transition-back to-normal-plan.” We have a lot more staff coming back into the office to do our work. We will figure out a date at which we can also welcome back volunteers. Those kinds of details we’re going to decide after June 1st. First, we’re going to get all of our staff back here. Q. When do you hope to have all of your staff back onsite? A. We’re hoping by June 1. A slow transition for a couple of weeks, and then we’ll figure out when we can bring back in volunteers. Also, when we’ll be able to unlock the doors, because we’ll have enough safeguards back in place to welcome older adults back in the building. Q. When might your clients be able to enter your offices again? A. It will be sometime in June. I don’t believe it will be June 1.

By Jim Miller

What Older Diabetics Should Know About Coronavirus

Experts in Hearing and Balance Care.

Dear Savvy Senior, My husband and I are both in our late 60s and have diabetes. We would like to find out if our diabetes increases our risk of getting the coronavirus. Concerned Diabetics

Dear Concerned, Currently, there’s not enough data to show that people with diabetes are more likely to get COVID-19, the disease caused by the coronavirus, than the general population. But the problem for diabetics is, if you do happen to contract the virus, your chance of developing serious complications are much higher. This is especially true if your diabetes isn’t well-controlled. Here’s what you should know.

Diabetic Risks Health data is showing that about 25% of people who go to the hospital with severe COVID-19 infections have diabetes. One reason is that high blood sugar weakens the immune system and makes it less able to fight off infections. Your risk of severe coronavirus infection is even higher if you also have another condition, like heart or lung disease. If you do get COVID-19, the infection could also put you at greater risk for diabetes complications like diabetic ketoacidosis (DKA), which happens when high levels of acids called ketones build up in your blood. Some people who catch the new coronavirus have a dangerous bodywide response to it, called sepsis. To treat sepsis, doctors need to manage your body’s fluid and electrolyte levels. DKA causes you to lose electrolytes, which can make sepsis harder to control.

How to Avoid COVID-19 The best way to avoid getting sick is to stay home as much as you can. If you have to go out, keep at least 6 feet away from other people. And every time you come back from the supermarket, pharmacy or another public place, wash your hands with warm water and soap for at least 20 seconds. Also wash your hands before you give yourself a finger stick or insulin shot. Clean each site first with soap and water or rubbing alcohol. To protect you, everyone in your

Trust your Hearing and Balance Care to our Doctors of Audiology. We have over 40 years of experience in fitting and dispensing the latest in hearing aid technology with devices to fit every lifestyle and budget. house should wash their hands often, especially before they cook for the family. Don’t share any utensils or other personal items. And if anyone in your house is sick, they should stay in their own room, as far as possible from you. The CDC also recommends that you stock up on medications and diabetes testing supplies to last for at least a month. The same goes for grocery supplies and other household necessities. Also know that Medicare is now covering the cost of telehealth visits, so if you have questions for your doctor, you can ask by video chat or phone instead of going into the office.

If You Get Sick The most common symptoms of COVID-19 are a dry cough, fever or shortness of breath. If you develop any symptoms that are concerning, call your doctor about getting tested. If you find that you have contracted COVID-19, the first level of care is to stay home and check your blood sugar more often than usual and check your ketones too. COVID-19 can reduce your appetite and cause you to eat less, which could affect your levels. You also need more fluids than usual when you’re sick, so keep water close by, and drink it often. You should also know that many over-the-counter medicines that relieve virus symptoms like fever or cough can affect your blood sugar levels one way or the other. So, before you take anything check with your doctor. And be aware that if you start experiencing severe shortness of breath, high levels of ketones or DKA symptoms like severe weakness, body aches, vomiting or belly pain, you need to see your doctor or get to an emergency room right away.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 19

Ask St. Ann’s

Ask The Social

Security Office

From the Social Security District Office

Social Security’s Online Services Are Ready for Business

Valuing Seniors and the Mark They Make in Our Community By Triciajean Jones


ontributing one’s time, talent and life experience to benefit others is an act of kindness that never gets old. Whether living independently or in a senior living community, seniors enrich our lives and strengthen our community in so many ways. In honor of Older Americans Month, the life enrichment team at St. Ann’s Community invites us to recognize and nurture these contributions. n Offer to listen. With age comes a deeper understanding and perspective on life, making seniors among the wisest people in our society. When someone needs to talk about life’s ups and downs and the emotions that arise, you can offer sage wisdom and model patience and empathy that younger people often can’t yet provide. n Share your story. Your life story is more engaging to others than you may realize. Why not share memories from your childhood or assemble a photo album of important moments in your life? During their time apart from family and friends, residents at St. Ann’s Community are busy writing down their life stories to send to loved ones. Whether created by hand or with the help of online video and photo services, sharing your stories will build and strengthen your bonds with each other. n Sow seeds of hope. Everyone needs reassurance, especially in uncertain times. Use social media to share your words of wisdom. Visit St. Ann’s Community on Facebook and Instagram to see photos and messages from its residents for inspiration! n Celebrate life. Focusing on what’s right in the world is difficult right now, but a well-lived life offers many reasons for celebration. St. Ann’s Community uses video technology to celebrate birthdays and bring family and friends together, even if they live across the country. Annual community-wide celebrations will continue, too, including the Centenarian Salute to honor the community’s oldest residents, and Project Page 20

Glory Home to thank residents and staff who served in the armed forces. n Volunteer. Senior living communities and senior centers would welcome your involvement in their social and recreational programs. Opportunities that match you with an elder who shares your interests nurture more meaningful connections. Volunteers at St. Ann’s visit residents, provide musical entertainment, assist with events, tend bar for happy hour, and so much more. Abilities change over time, so when it’s time to transition to a senior living community, choose one that nurtures resident engagement. Many of the volunteers at St. Ann’s Community are also residents. They tend to the community in many ways, including staffing the gift shop and cafe, reading to others and planting gardens to beautify their surroundings and bring hope to their neighbors. Others participate in intergenerational school programs, bake cookies for local fire departments, and knit hats for the needy in Rochester. Now more than ever, we need the wisdom of our elders to help us learn from the past and fuel hope for the future. Enriched and supported by their love and guidance, we’ll be able to meet whatever comes our way with confidence. Triciajean Jones is the director of life enrichment at St. Ann’s Community in Rochester. Contact her at tjones@ or 585-697-6687or visit www. To volunteer, contact Maureen Murphy, manager of volunteer services, at 585-697-6523 or


uring this time when our physical offices are closed to the public, you may wonder, “How can I get help from Social Security without visiting an office?” You can find the answer at www., which links you to some of our most popular online services. You can apply for retirement and disability benefits, appeal a decision and do much more. Our newest My Social Security feature, Advance Designation, enables you to identify up to three people, in priority order, who you would like to serve as your potential representative payee in the event you ever need help managing your benefits. We have updated our Frequently Asked Questions at faq.ssa. gov/en-us/Topic/article/KA-10039 to answer questions you may have about Advance Designation. You can also apply for Medicare online in less than 10 minutes with no forms to sign and often no required documentation. We’ll process your application and contact you if we need more information.


Q: If I receive Supplemental Security Income (SSI) disability benefits, what is the effect on my benefits if I work? A: In most cases, your return to work would reduce your benefit amount. Unlike Social Security disability, there is no “trial work period” for people who get SSI disability benefits. If your only income besides SSI is from your work, you can earn up to $ 1651 in a month (in 2020) before we stop your payments. Reporting wages each month helps us pay the correct amount of SSI. Timely reporting may also prevent you from owing us money or may allow us to pay a higher amount. We have several publications about SSI, including Reporting Your Wages When You Receive Supplemental Security Income, available at pubs. Note that there are other work incentives that can help you return to work when you receive SSI. You can read about them in What You Need To Know When You Get Supplemental Security Income (SSI), also available at pubs. For more information, visit our website at Q: Will my eligibility for the Extra Help with Medicare prescription drug

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

Visit medicare to 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. We’ve organized our Online Services webpage into four popular categories for easy navigation: • Review Your Information. You can access your secure, personal information and earnings history to make sure everything is correct. You can even print statements with ease. • Apply for Benefits. You can apply for retirement, disability, and Medicare benefits without having to visit a field office. • Manage Your Account. You can change your direct deposit information and your address online. • Find Help and Answers. We’ve answered your most frequently asked questions, and provided links to publications and other informational websites. Let your family and friends know they can do much of their business with us online at

plan costs be reviewed and, if so, how often? A: If you get the Extra Help, Social Security may contact you to review your status. This reassessment will ensure you remain eligible for Extra Help and receive all the benefits you deserve. Annually, usually at the end of August, we may send you a form to complete: Social Security Administration Review of Your Eligibility for Extra Help. You will have 30 days to complete and return this form. Any necessary adjustments to the Extra Help will be effective in January of the following year. Go to for more information. Q: I went back to work after retiring, but now the company I work for is downsizing. I’ll be receiving unemployment benefits in a few weeks. Will this affect my retirement benefits? A: When it comes to retirement benefits, Social Security does not count unemployment as earnings, so your retirement benefits will not be affected. However, any income you receive from Social Security may reduce your unemployment benefits. Contact your state unemployment office for information on how your state applies the reduction to your unemployment compensation.

H ealth News Local nonprofits get awards from Excellus BCBS Ten nonprofit Rochester area organizations are receiving Excellus BlueCross BlueShield’s Community Health Awards to help provide people with better access to food, health care, and assistance. Each of the organizations will receive up to $4,000 to help fund programs that include improved infant care, increased access to food pantries and health care services for low-income and uninsured people. Excellus BCBS is donating almost $124,000 to 35 nonprofits across Upstate New York with this round of its Community Health Award program. “Especially during this pandemic, our health plan’s focus is on helping address the economic and social conditions influencing the health of our community,” said Christopher C. Booth, president and CEO of Excellus BlueCross BlueShield. “These grants demonstrate our corporate commitment to supporting community organizations that share our mission as a nonprofit health plan,” Organizations are selected based on the proposed program’s scope of need, goals and the number of people expected to benefit from it. The nonprofit organizations in the Finger Lakes region chosen to receive Excellus BCBS Community Health Awards are:   • Asbury First United Methodist Church, to support the UR Well Clinic, an outreach program within the University of Rochester School of Medicine and Dentistry that offers free acute health care to uninsured and underserved adults. • Cameron Community Ministries, Inc., to host a family nurse practitioner to conduct wellness checkups and health education for adults at its wellness center. • Catholic Charities of Livingston County, for its Help*Works program

that provides emergency services to people living in poverty (including utility help, rent assistance, infant needs such as diapers and formula, furniture, food, gasoline voucher for employment needs). • Dimitri House, Inc., to benefit its Emergency Food Cupboard and Drop-In Lunch program; providing healthy food and beverages to community members who are experiencing the effects of poverty, including those who are homeless. • Hope Lutheran Church, for its Center for Hope Community Care Center that houses a permanent food pantry, medical services, job coaching and financial mentorship to provide hope and help to an underserved, low income population. • Junior League of Rochester, Inc., for the Junior League of Rochester Diaper Bank (JLRDB), to provide diapers and diapering supplies to partnership organizations and social workers in Monroe and surrounding counties. • Legal Assistance of Western New York, Inc., to help fund a Women, Infants, and Children (WIC) help specialist. The WIC Outreach program embeds a help specialist in Wayne and Seneca counties to link pregnant, breastfeeding, and postpartum women, and infants and children, with vital nutrition and education support. • St. Peter’s Kitchen, Inc., for pantry assistance that will provide clients and their families increased access to nutritious foods. • Villa of Hope, to support Hope Place, a peer support program for adults experiencing difficulties with resiliency, recovery and wellness. The program offers linkages and referrals to support services ranging from health care coordination, to employment assistance, food pantry, clothing and personal needs and transportation services.  • Willow Domestic Violence Center of Greater Rochester, to support the Client Transportation Fund, pro-

viding transportation for victims of domestic violence residing in Willow’s emergency shelter with access to health care and other community services that are necessary to help them lead healthy, violence free lives. “These awards complement our existing grants and sponsorships to agencies that work to enhance the quality of life and health of our Upstate New York communities,” said Holly Snow, community investments and partnerships director for Excellus BlueCross BlueShield.   Excellus BlueCross BlueShield has been serving Upstate New Yorkers for more than 80 years. In that time, the company has supported hundreds of programs that help residents in our community live healthier and more secure lives through access to high-quality, affordable health care.

Child Care Council promotes Rose Shufelt Child Care Council Inc. has promoted Rose Shufelt to director of its new health and social emotional child wellness department. In her new role, Shufelt provides training, coaching and mentoring to child care providers and oversees the health care consultants, special needs coordinator and infant and early childhood mental health consultants for Monroe, Livingston and Wayne counties. With more than 30 years of experience in the child care field, Shufelt previously served as an infant toddler specialist at the council as well as an elementary school teacher, as a toddler and preschool teacher and as a program director of

a child care center. Shufelt is a Master Cadre Pyramid trainer and leadership coach, and she holds New York state credentials as an early learning trainer and as a training and technical assistance professional coach. She is a resident of Greece. Child Care Council also announced a new grief consultation program within the health and social emotional child wellness department. Access to services that specialize in early childhood grief is rare. The Council now offers a grief support specialist to assist child care providers who have staff, children and families who experience grief. Providers interested in more information can contact Claire Haggerty, health care consultant, at 585-654-4732.

St. Ann’s named a ‘Rochester Top Workplace’ St. Ann’s Community announced it has been named a 2020 Rochester Top Workplace. St. Ann’s is included in a short list of companies from the Rochester area to make the Top Workplace list, which is organized and published annually by the Rochester Democrat & Chronicle. Selection is based solely on employee feedback gathered through an anonymous third-party survey administered by Energage, an employee engagement company. The survey measures several aspects of workplace culture. “We are humbled and honored to be named a 2020 Rochester Top Workplace,” said Michael E. McRae, President and CEO of St. Ann’s Community. “We are so grateful for the dedication of our employees who are caring for the most important people on earth and we thank them for all they do.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 21

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


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Nothing to do but enjoy your life. You’re one of the most important people on earth. You deserve a care-free retirement at St. Ann’s Community at Cherry Ridge. Instead of home maintenance, you can focus on today’s exciting group activity, outing or dining option. Maybe you’ll just enjoy quiet time for yourself in spacious, beautifully maintained surroundings with 24-hour security. Choosing Cherry Ridge means you can live the lifestyle you’ve always wanted and having priority access to on-site assisted living, memory care, and skilled nursing if you ever need it. • Luxury 1- and 2- Bedroom Apartments • Charming 2- Bedroom Cottage Homes • 41 Wooded Acres

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Page 24

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

Profile for In Good Health: Rochester's Healthcare Newspaper

IGH Rochester #178 June 20  

IGH Rochester #178 June 20  


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