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in good The Mindfulness Doctor

GVhealthnews.com

April 2017 • Issue 140

priceless

Rochester’s Healthcare Newspaper

Diseases

Ronald Epstein, an URMC physician and expert in mindfulness, writes new book for people who want to learn about being present and attentive in a distracted and polarized society

That Kill Women the Most

Autism Research

What disease kills more women than any other? Breast cancer? Lung cancer? Ovarian cancer? Colorectal cancer?

Six ways to determine if the research on autism you read or hear is accurate

ALSO INSIDE 5 THINGS YOU NEED TO KNOW ABOUT MISCARRIAGE

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‘Not Tonight’

People who were married or lived together had sex 16 fewer times a year in 20102014 than in 2000-2004, according to a survey by San Diego State University. It shows married couples over the age 65 had sex 20 times a year vs. 80 times a year among people in their 20s.

Queen of Brazilian Wax

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Rochester’s Brazilian wax technician uses humor in her career, her personal life and to empower women

Cheddar Cheese

I adore cheese, most kinds, but the cheese I adore most is cheddar. And the reason my heart cheers for cheddar is because it’s a nutritional superstar, packed with protein, calcium and phosphorous. Read more in SmartBites.

­

Fat Cats, Fat Dogs You’ve guessed: More than half of dogs, cats in the Land of Plenty weigh too much, says CDC


Fat Cats, Fat Dogs

FDA: More than half of dogs, cats in the Land of Plenty weigh too much

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merica’s weight problem extends to its pets, with a majority of cats and dogs dangerously overweight, a federal government veterinarian warns. “Just as obesity has become a serious problem in people, it’s also a growing problem in pets, one that can seriously harm your pet’s health,” said veterinarian Carmela Stamper, of the U.S. Food and Drug Administration’s Center for Veterinary Medicine. About 58 percent of cats and 54 percent of dogs in the United States are overweight, according to a 2015

survey by the Association for Pet Obesity Prevention. “The diseases we see in our overweight pets are strikingly similar to those seen in overweight people,” Stamper said in an FDA news release. These include life-shortening conditions such as Type 2 diabetes, high blood pressure, osteoarthritis, heart and respiratory disease and kidney problems, she noted. So, what exactly signals obesity for Fido or Kitty? In general, 20 percent over ideal body weight is obese. And Stamper

said age, breed, body type and metabolism can help tip the scales. “In dogs, some breeds seem more inclined toward obesity than others,” Stamper said. Labs, beagles and long, low dogs such as dachshunds and basset hounds are some examples. Although America’s cats are also fattening up overall, veterinarians say no specific feline breed is prone to pudginess. Stamper outlined some ways to determine if your pet is at a healthy weight. Look at your pet from above to see if it has a definite waist.

“If not, and her back is broad and flat like a footstool, she is likely overweight,” Stamper said. Run your hands along your pet’s side. Can you easily feel the ribs, or do you have to push hard to feel them? Check your pet’s abdomen/ stomach. If you can easily grab a handful of fat, that’s a sign your pet is overweight. If you’re concerned about your pet’s weight, or want to know how to keep your pet at a healthy weight, talk to your veterinarian, Stamper said.

Caring for the Most Important People on Earth

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017


‘Yes Here.” Campaign to Raise Awareness About Local Human Trafficking

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he Rochester Regional Coalition Against Human Trafficking (RRCAHT) is launching an awareness campaign to educate the Greater Rochester Community about human trafficking in the Rochester area. Through a partnership with the Vignelli Center for Design Studies at RIT. RRCAHT introduced the Yes, Here. marketing campaign, to counter the thinking that human trafficking is not a local problem.

RIT students designed information graphics and sourced images that represent the various facets and types of human trafficking. These were combined by professors Bruce Meader and Anne Ghory-Goodman into artwork displayed on RTS buses. Buses were selected as appropriate carriers for a message about trafficking. Now the coalition is asking the public to report when buses are spotted. “We’re asking the public to keep their eyes open for the buses with our Yes, Here. message and to let us know if they see one of them and where,” said RRCAHT Chairwoman Celia McIntosh. “It’s a way to get the community to think about this issue, and to keep their eyes open — which is exactly what we want the community to do with human trafficking itself. We want people to keep their eyes open for it and to report anything suspicious to authorities.” People spotting one of the Yes, Here. buses are asked to email the whereabouts of the bus to RRCAHT1@gmail.com. Sightings and pictures will go on RRCAHT’s website.

Which Path Will You Take?

Which Path Will You Take?

Has your doctor recommended an invasive surgery for your symptomatic knee? There may be other options. If an MRI showed a bone defect - also an lesion invasive your “The RRCAHT is dedicated to Has your doctor knownrecommended as a bone marrow - insurgery the bonefor near yoursymptomatic knee, ask your eliminating human trafficking in ® knee? Theredoctor may about be other If an MRIProcedure. showed aThis bone defect - also The options. Subchondroplasty minimally-invasive our community through education, these defects biomimetic bone your substitute thatask is replaced known as asurgery bone fills marrow lesion with - inathe bone near knee, your advocacy, and networking with ® with new bone during the healing process. So...which path will you take? individuals  and organizations,” doctor about The Subchondroplasty Procedure. This minimally-invasive said McIntosh.

surgery fillsVisit thesesubchondroplasty.com defects with a biomimetic bone substitute thatabout is replaced to learn more The Subchondroplasty® Procedure

New York has the fifth highest So...which path will you take? area. call volume to the National Human with new bone during the healing process. and find a surgeon in your Trafficking Resource Center of all 50 states. On a national level, the As with every surgical procedure, there are risks and potential complications. Individual results will vary. Success depends on factors such as age, weight and criminal enterprise of trafficking activity level. Only your health care team can determine if you are healthy enough for surgery. Consult your doctor for a complete assessment of possible risks before in persons (TIP) is second only to deciding to have surgery. See the package insert on subchondroplasty.com for full information. the illegal drug trade, in terms of the speed of its growth and being among the most lucrative. TraffickAs with every surgical procedure, there are risks and potential complications. Individual results will vary. Success depends on factors such as age, weight and ers typically use multiple means activity level. Only your health care team can determine if you are healthy enough for surgery. Consult your doctor for a complete assessment of possible risks before to control their victims, suchdeciding as: to have surgery. See the package insert on subchondroplasty.com for full information. physical, psychological and emotional abuse, isolation, drug and/or alcohol dependency, and document withholding.

Visit subchondroplasty.com to learn more about The Subchondroplasty® Procedure and find a surgeon in your area.

Special Golden Years Issue

Copyright © 2016 Zimmer Knee Creations, Inc. 903.133 Rev A

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Don’t miss the next issue of In Good Health.

For further information, visit www.rrcaht.org.

Reach more close to 100,000 readers (based on 35,000 copies distributed) Call 585-421-8109

April 2017 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

April 10

Learn how to build a plant-based burger Rochester Regional Health is sponsoring a plant-based class — titled “Build a Better Burger” — to show participants how to prepare plant-based burgers made with beans, lentils, legumes and a variety of vegetables. The class will take place from 5:30 to 6:30 p.m. April 10 at 2655 Ridgeway Ave., suite 220, Rochester. Registered dietitians Sharon Spear and Joy Valvano will lead the class. Cost is $35 and includes tastings, recipes and handouts. Recipes at this class include quarter pounder beet burger, falafel veggie burger and black bean burger; tahini sauce and homemade ketchup, and sweet potato fries For more information, call 585368-6542.

April 25

Pastry chef to discuss healthy baking Pastry chef Kelly Halligan, who owns Get Cake Bakery in Rochester, will be the guest speaker at the New Fibromyalgia Support Group monthly meeting, which takes place from 6 to 8:30 p.m., April 25, at Westside YMCA, 920 Elmgrove Road in Rochester. Halligan will talk about the unique blend of specialty sweets and will stage a demonstra-

tion. According to the nonprofit, this program will be of special interest for those suffering from inflammatory disorders, gluten, or celiac. This workshop will give people new ideas and healthy options on eating baked goods again. Registration is required. Call 585-752-1562 and leave a voice mail with your details. More information, visit www.newfibrosupport. com

April 25

Doctor presents ‘There is No Incurable” lecture Physician, Daniela Dentico, meDaniela Dentico, a physician of the Medical Scientific Group (MWF) of the Bruno Groening Circle, will speak about a new path of health of body and soul during an event that will take place at 7 p.m., April 25, at Assisi Institute, 1400 N. Winton St., 14609,. Titled “There is No Incurable,” the lecture is part of a series of lectures sponsored by the group that discusses holistic and natural healing. All individuals from medical professions, those interested in holistic and natural cures, and those searching for help and healing are welcome. Admission is free. Donations are appreciated. In addition to the lecture, organizers will show the documentary “The Phenomenon of Healing” and “The Phenomenon Bruno Groening.” For more information, send an email to deborahorose333@ gmail.com, visit www.facebook.com/ BrunoGroeningCircleofFriends or go

HLAA Rochester Scholarship Program Hearing Loss Association of America Rochester Chapter is sponsoring a scholarship program for high school seniors. Started in 1996, it awards $1000 to local high school seniors who have hearing loss and are pursuing their education after graduation. Funding is made possible in part by monies raised by the annual Walk4Hearing. Financial need is not a requirement. The scholarship is a one-time award. Any 12th grader meeting the hearing loss and educational continuation criteria is invited to apply. Applications can be found at www.hlaa-rochester-ny-org or by contacting Cindy Kellner at cmkellner23@gmail.com. The application deadline is April 15.

to www.northamerica.bruno-groening.org.

April 27

Series to help seniors deal with technology Older adults who want to gain confidence using their iPad, iPhone, or Facebook can learn the basics and more through a series of classes at St. Ann’s Community at Cherry Ridge, 900 Cherry Ridge Blvd. (off Ridge Road near Five Mile Line) in Webster. The April 27 class will run from 1:30 to 3 p.m. and will discuss Facebook. Some of the topics will be about what social media is, a brief history of Facebook and how to stay connected with family and friends. Classes are taught by Daniel Jones, an independent instructor who specializes in helping older adults learn technology. To register, call 585-697-6701 or email events_cr@mystanns.com.

May 2

HLA to feature NTID prof’s Ethiopian work Hearing Loss Association of America Rochester Chapter will feature the experiences of audiologist Catherine Clark in Ethiopia at its chapter meeting Tuesday, May 2 at St. Paul’s Episcopal Church, East Avenue at Westminster Road Rochester. Clark is the volunteer audiological consultant for programs established by Global Visions Empowerment in Bahir Dar, Ethiopia. She initially traveled there in 2014 with Nazareth College students to participate in a service learning project established for deaf and hard of hearing Ethiopians, most of whom never had had a hearing test. In 2015 she established an Audiological Assessment and Intervention Center with the assistance of Global Visions Empowerment, audiology suppliers and Ethiopian partners. To date, over a hundred Ethiopians have received audiological services, including hearing aids for children and adults. The presentation will describe challenges and successes involved in creating a sustainable audiology program there. Images and products developed by the Ethiopians will be shared. Anyone interested in hearing loss is welcome to either meeting. For more information visit www. hlaa-rochester-ny.org or telephone 585 266 7890.

Help and Healing on the Spiritual Path Teachings of Bruno Gröning

Lectures by an MD : ROCHESTER : April 25, 2017 – 7-8 :30 PM Assisi Institute, 1400 N. Winton St., 14609 BUFFALO: April 26, 2017  -- 8 :30-10 PM Complete Wellness Arts & Science Center, 1515 Kensington Ave, 14215

Two documentary films shown in Buffalo/Rochester April through June : The Phenomenon Bruno Gröning and The Phenomenon of Healing For more details : www.bruno-groening-film.org www.northamerica.bruno-groening.org Page 4

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

All natural local honey Enjoy the benefits of Honey!

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April 2017

About 50 Paid Summer Internship Positions Open at Excellus Excellus BlueCross BlueShield has about 50 summer internship positions available for college students at its locations in Upstate New York. Summer internship positions include jobs in finance, sales, marketing, information technology and corporate communications. Internships are available at health plan locations in Rochester, Buffalo, Syracuse and Utica. “Our goal is to attract an internship class of students from a wide range of cultures, backgrounds and life experiences, which will help drive the innovation needed to best serve our customers,” said Joseph Searles, corporate director, diversity and workforce inclusion at Excellus BCBS. The 10-week paid internships will generally run from June 2017 through Aug. 2017. To qualify for an internship, students must be actively enrolled in a college degree program at the time of the internship. Goals of Excellus BCBS’s diversity and inclusion internship program include: •Providing professional career development opportunities for students, helping them gain hands-on experience and jump starting their careers. •Helping the company attract and retain the best talent. Students will be offered development workshops, networking opportunities and meaningful work experiences that will help them become qualified applications for future job openings. Former students have shared their experience at YouTube.com/ ExcellusBCBS. Students are encouraged to apply for internships as soon as possible. Positions will close as candidates are selected for the internships. To apply for the internships, go to excellusbcbs.com/careers   Excellus BCBS has recently received several workforce accolades.  For the third consecutive year, the Corporate Equality Index named Excellus BCBS a Best Place to Work for Lesbian, Gay, Bisexual and Transgender (LGBT ) Equality. Excellus BCBS also received a 2017 Diversity Leader Award from “Profiles in Diversity Journal.” Last year, the company was certified as a “great workplace” by the independent analysts at Great Place to Work.  The company earned this credential based on extensive ratings provided by its employees in anonymous surveys.


U.S. Suicide Rates Rising Faster Outside Cities Hanging-type deaths rose more than gun-related suicides since 1999, CDC says

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lthough the U.S. suicide rate has been rising gradually since 2000, suicides in less urban areas are outpacing those in more urban areas, according to a new federal report. “Geographic disparities in suicide rates might be associated with suicide risk factors known to be highly prevalent in less urban areas, such as limited access to mental health care, made worse by shortages in behavioral health care providers in these areas, and greater social isolation,” the researchers from the U.S. Centers for Disease Control and Prevention wrote. It’s also possible that economic pressures may have played a role, the study authors noted. The biggest increase in the suicide gap occurred beginning in 2007-2008, when the U.S. economy was experiencing a severe recession. Another possibility the researchers pointed to is the country’s opioid

About 600,000 U.S. residents died by suicide from 1999 to 2015, the CDC researchers said. The highest annual suicide rate occurred in 2015

epidemic. In the early years of the current study, opioid misuse was more common in less urban areas. About 600,000 U.S. residents died by suicide from 1999 to 2015, the CDC researchers said. The highest annual suicide rate occurred in 2015. Suicide by hanging went up notably during the study period. The report said the rate of non-firearm suicide, particularly from suffocation — which includes hanging — went up more than the increase in gun-related suicides. Men were four times more likely than women to kill themselves, the findings showed. By age, the highest suicide rates were among 35- to 64-year-olds, and people 75 and older. Whites and American Indian/ Alaska Natives had the highest rates of suicide. They also had the sharpest increases during the study period. For whites, the rate jumped from about 15 to 18 per 100,000 people. For American Indian/Alaska Natives, the suicide rate went from almost 16 up to 20 per 100,000 people. Suicide rates for blacks and Hispanics were much lower. These rates increased only modestly from 1999 to 2015, the report said. The study was published in the March 17 issue of the CDC’s Morbidity and Mortality Weekly Report.

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April 2017 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Ronald Epstein, M.D. URMC doctor, an expert in mindfulness, writes new book for people who want to learn about being present and attentive in a distracted and polarized society Q: In your new book “Attending: Medicine, Mindfulness, and Humanity,” what do you mean by “mindfulness?” A: In the context of medicine, I talk about mindful practice. That’s really an understanding of who you are, your inner life and having a personal attention to your own thoughts and feelings, to be able to practice with clarity and compassion. It’s knowing yourself. Q: What ramifications does that have for medical practice? A: So I think that being mindful means that you’re paying attention. It means that you’re curious about people and what’s happening to them. It means being able to view a situation with what I call a beginner’s mind, being able to look at a situation with new eyes. Also, you’re present and undistracted. You’re really there. Q: Does medical school prepare physicians well in this regard? A: I think our medical training is largely about learning facts and learning skills and much less about learning about ourselves. What I’ve been working on for the past 30 years is finding ways to help doctors and those who are training to be doctors to know themselves better. So if you think about it, there’s a book that came out a while ago called “The Inner Game of Tennis.” It’s not about how to have a good backhand, but how to put yourself into an effective psychological state. It’s about knowing yourself well enough to do that. Musicians do that also. It’s not just about pushing down keys, it’s about learning how to be present with an audience. You need that same skill in medicine. You need to be curious and present and treat every time you see a patient like it’s the first time. It makes you more observant, make fewer errors and make the patient feel like they’re being heard, which is very important. Q: This seems like something people struggle with in general. What makes it so difficult? A: Aside from the challenges that have existed for thousands of years as part of the human condition, we have a ton of distractions now. Even as I’m sitting here talking to you, there’s a computer in front of me, with a monitor. If I left it on, which I haven’t, then things would be flashing at me. Or an ambulance would go by. Or someone would knock on my door. Those distractions have gotten more intense over the years. The second part is the distractions that come from within. If you’ve had a very distressing occurrence early in the day — say a patient isn’t doing well — and you hold onto that all Page 6

day, it’ll color the way you treat a healthy 3 year old. So there are internal and external distractions. Q: How did you become interested in this? A: I think, for me, it was really something that started early on in childhood. I took up meditation when I was 16, so it was a long time ago. So I’ve always done this. It’s been very useful for understanding myself and how I live in the world. Other people discover this later in life and discover other ways; meditation isn’t the only one. I discovered early on that I was able to practice medicine more effectively and effortlessly when I was more in touch with my own thoughts and feelings.

Q: You’ve written some very popular articles before this. A: I’ve written quite a bit. There was one back in 1999 that outlined what mindfulness in medicine is and why it was important. In 2009, I posted about a workshop we did to help doctors be more mindful, express more empathy toward their patients and avoid burn-out. So the book is an attempt to bring it out of medical journals and into the public. Q: What are some the challenges in bringing this material to a lay audience? A: It’s a good question. It took some effort. When you write for a professional audience, you use a lot of technical language and established theories to make your point. When you’re writing for a general audience, people seem to respond more to stories. So I tried to show how doctors are mindful rather than going through a list of principles and ideas. It changes how you organize your writing. So rather than making an argument and giving an example, I start with the example and try to pull meaning out of that. It was an enjoyable experience. So it’s observations from my experience as a physician, or things I’ve observed. Q: The cliché is that scientists, and by extension physicians, are bad communicators and communi-

Ronald Epstein, a URMC family physician who also trains doctors at the UR and across the country on how to better communicate with patients, has published a new book for the general public, titled “Attending: Medicine, Mindfulness, and Humanity.” It’s based on true stories, teachings, and observations from the medical profession.

cators are bad scientists. Did they both come naturally to you? A: I’d say neither did. I had to work pretty hard at both. I think there’s an advantage to that though. When you have to work hard to learn something, you understand the path a bit better. If you’re naturally really good at something, it’s harder to explain how to be good at it. Q: Do you have more books in you? A: I like writing, so I think so. I haven’t put together what it will be about, but it will probably be about the practice of medicine. The idea right now is to explore how leadership and organizations shape how people think about and relate to their work. So actually, it might step outside of medicine now that I think about it.

Q: How does the book approach this subject? A: So the first four chapters deal with four aspects of mindfulness: attentive observation, critical curiosity, beginner’s mind and presence. The four after that deal with difficult moments in medicine like when there are difficult decisions to make, or when a patient dies or when you yourself feel exhausted and burnt out. And then finally I talk about what institutions can do to help physicians practice more effectively. So I really hope that people read it, no matter what they do, will find a way to make their own practice — not just medicine — more effective, and hopefully a happier experience.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

In the News

Lifelines Name: Ronald Epstein, M.D. Position: Professor of family medicine, psychiatry, oncology and medicine at University of Rochester School of Medicine Hometown: New Hyde Park, NY Education: Wesleyan University (undergrad); Harvard (medical) Affiliations: Strong Memorial; Highland Hospital Organizations: American Academy of Family Physicians; American Academy of Hospice and Palliative Medicine Family: Married (Deborah Fox); son (Eli); daughter (Malka) Hobbies: Harpsichord, bicycling, cross-country skiing, cooking

April 2017


‘Not Tonight’

Biggest drop in sexual activity seen for those married or living together, survey finds “Not tonight” seems to be an increasingly familiar refrain in America’s bedrooms, according to a new study that found people are having less sex than they previously did. Researchers surveyed more than 26,000 Americans, and found that adults had sex about nine fewer times a year in 2010-2014 than in 1995-1999. For married couples, the survey had even more potentially discouraging news — people who were married or lived together had sex 16 fewer times a year in 2010-2014 than in 2000-2004. “These data show a major reversal from previous decades in terms of marriage and sex,” said study author Jean Twenge, a professor of psychology at San Diego State University. “In the 1990s, married people had sex more times per year than never-married people, but by the

“Older and married people are having sex less often — especially after 2000,” Twenge said. “In a previous paper, we found that the happiness of adults over age 30 declined between 2000 and 2014. With less sex and less happiness, it’s no wonder that American adults seem deeply dissatisfied these days.”

People might be quick to blame increased working hours. Surprisingly, the study found that people who worked more hours actually had sex more often. The findings were published March 7 in the Archives of Sexual Behavior.

mid-2000s that reversed, with the never-married having more sex,” she said in a university news release. And here’is another twist: younger Americans are having less sex than their parents or grandparents did when they were younger. “Despite their reputation for hooking up, millennials and the generation after them [known as iGen or Generation Z] are actually having sex less often than their parents and grandparents did when they were young,” Twenge said. “That’s partially because fewer iGen’ers and millennials have steady partners.” The researchers also found that age is a major factor. People in their 20s have sex more than 80 times a year. By age 45, that falls to 60 times a year. And, at 65, that number is just 20 times a year. Each year after the peak of sexual frequency at 25, sexual activity decreases about 3 percent.

Healthcare in a Minute By George W. Chapman

Social media.

Social media (SM) is having more and more of an impact on consumers and their behaviors every year. 40 percent say information gleaned from SM affects how they deal with their health. 19 percent of smartphone owners have at least one health related app. 41 percent of us say SM influences our choice of providers and hospitals. 30 percent of healthcare professionals use SM for networking. When it comes to sharing health info via SM, 43 percent of us are comfortable sharing with hospitals, 47 percent with physicians, 38 percent with insurers and 32 percent with pharmacies. 60 percent of physicians report SM actually improves the quality of health in their patients.

Dementia & Sleep

46 million people worldwide suffer from some sort of dementia. In the US, 5 million people have Alzheimer’s disease. One in three seniors will die from dementia complications. Dementia costs us about $236 billion a year. Researchers at Boston University School of Medicine found that people who sleep more than nine hours on average are twice as likely to develop dementia than those who sleep less than nine hours on average.  

Telehealth

More and more insurance companies are paying for telehealth. The immediate benefits are easier access, enhanced doctor/patient communication and remote monitoring of incapacitated patients. It will take more time and experience to determine whether or not the increased utilization of physician services via telehealth is eventually outweighed by cost reductions in other areas like

inpatient care and drug utilization. A study published in Health Affairs followed three years of claims for respiratory infections. The study concluded that nine of 10 telehealth visits (for this condition) represented new or additional utilization versus visits that substituted for an in-person encounter. The authors of the study recommended insurers or even providers might want to increase patient out-of-pocket costs to prevent frivolous or unnecessary telehealth utilization and that telehealth might have more of a positive impact for those patients with traditionally undertreated conditions like diabetes and mental health.

some of the changes, but it has expressed concern about the potential decline in coverage and the negative impact on our most vulnerable populations. The American Medical Association flat out will not support the new bill. The hospital lobby says the probable increase in the uninsured will cost hospitals billions. Washington observers and healthcare policy experts believe the bill, as written, will not garner enough support in the Senate. The Congressional Budget Office still has to determine if the new bill’s numbers add up. The CBO has estimated that 15 million people could lose their insurance.

Affordable Care Act

Critics of the ACA have maintained many consumers really don’t have choices because one in three markets has only one insurance company left on the exchange. Consequently, consumers, physicians and hospitals could potentially be at the mercy of monopolistic pricing. Insurance companies maintain that mergers (resulting in less choices) will allow them to reduce costs and increase efficiencies which would benefit the consumer. The Department of Justice isn’t buying that and has blocked the mega merger of Anthem and Cigna, the second and third largest commercial insurers in the nation. Incredibly, Cigna is now suing Anthem to end the merger agreement and for damages. Anthem has countersued. The AMA has expressed its strong concern over the possibility of politically driven settlement negotiations between Anthem and the DOJ that could result in Anthem closing the deal with Cigna.

A bill to replace the ACA, called the “American Healthcare Act,” has just passed the Ways and Means committee in the Republican controlled House. The bill would: eliminate many of the taxes that support expanded Medicaid and the premium subsidies on the exchanges and replace them with consumer tax credits, provide block grants to the states for Medicaid, and discontinue the individual mandate requiring all to have insurance or pay a penalty. The bill would continue, however, the basic cornerstones of the ACA: allow children to remain on a parent’s plan until age 26, no lifetime monetary caps on illnesses, and insurers cannot deny coverage for pre-existing conditions. Rather than going through a disruptive and highly political repeal and replace process, many industry observers wonder why the changes proposed in the new bill were not simply introduced in Congress, over the last six years, as amendments to the ACA. The insurance lobby (AHIP) has expressed approval of April 2017 •

Mega merger drama

Accountable Care Organizations ACOs were established by the

ACA to cut costs and improve access and quality. More than 850 ACOs across the country care for over 28 million people. Hospitals, physicians and insurers have been collaborating the past six years. The majority of ACOs participate in shared savings programs with Medicare and commercial insurers. Industry experts are confident ACOs will survive any changes in the laws of the land.  

Obesity

In a study published in “Cell Metabolism,” researchers found that a dopamine deficit may be the major cause of physical inactivity which has often been blamed on obesity. Lab mice were divided into two groups. The first group was fed low-fat food while the second received high-fat food. The mice on the high-fat diet naturally gained more weight, but researchers noted all mice were inactive — due to low dopamine levels — to start. So weight gain itself did not lead to inactivity in these mice.  

Really?

And finally this. “Nobody knew that healthcare could be so complicated.” President Donald Trump, Feb. 27, 2017. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 7


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Being Your Own Sole Supporter Can be Taxing

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ell, tis’ the season . . . the tax season that is. This time of year always reminds me how important it is for those living alone to take responsibility for their financial health. The fear of ending up “alone and penniless” is a seemingly universal fear shared by many women (and some men) who are divorced or widowed in mid-life, either by choice or by chance. It certainly was the case for me. While shared responsibility for financial matters is becoming more common these days, it is still true that in many marriages the men pull the purse strings and manage the financial decision-making. It’s the “way it was” for many traditional couples, when the man was the primary bread winner, but it’s also the “way it is” for more progressive couples who simply want to

divide and conquer when it comes to managing household responsibilities. Problem is, once a spouse is out of the financial loop, he or she often remains uninvolved for the long haul, which can put them at a real disadvantage. Their knowledge of and self-confidence around money matters becomes very diminished. Simply put, when one spouse controls the finances, the other can be left in a vulnerable position if and when the marriage ends. I consulted with my financial adviser and together we identified a few essential steps to help those flying solo to gain control of their money and make progress toward financial autonomy: Come out from under the covers. Ignorance is not bliss when it comes to financial management. Women, and men alike, need to find the cour-

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age to get “up close and personal” with their financial circumstances. I avoided looking into my financial mirror for years until the fear of not doing anything was greater than the fear of facing reality. Fear, in my case, turned out to be a blessing in disguise — a real motivator. It prompted me to get my act together and seek help. There’s no time like the present to take charge of your money and your destiny. Find your stuff. David Bach, renowned financial expert and best-selling financial author, says it best: “Getting organized is one of the keys to financial security. It begins with finding your stuff.” Before you can plan your financial future, you need to figure out where you stand financially in the present. It starts with gathering together all your financial documents in one place. I cleared out a file drawer in my desk, purchased new hanging file folders, and started labeling the files according to the instructions in David Bach’s book titled, “Smart Women Finish Rich.” It didn’t take as long as I thought it would and I felt a great sense of accomplishment once I had everything collected together. And guess what? This simple step helped me feel in more control. Almost immediately, my fears began to lessen. Get help, if you need it. Once I had my “stuff” organized, I was in a much better position to make sense of my financial situation.

I continued to work through Bach’s book, but I found I needed more — I needed a real, live person to help me take the next step and make more progress. That’s when I engaged the help of a financial representative who helped me align my spending, saving and investing with my needs and priorities. He’s been an invaluable coach and motivator. If you are like me, you may benefit from engaging a professional. If you are more self-directed and inclined to educate yourself on money matters, there are excellent resources out there in books, magazines and on the web. Peace of mind and a sense of empowerment are the rewards for women and men who get their financial house in order. Solid information, personal discipline and good help from a trusted adviser can turn financial uncertainty into financial security. With increased self-confidence and awareness, you can better protect your future and more fully embrace the pleasures of living alone . . . with a little left over to splurge on something special just for you! Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive”, empowerment workshops for women held throughout the year in Mendon, New York. For information contact Gwenn. To speak, call (585) 624-7887 or email: gvoelckers@rochester.rr.com.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

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Get Savvy on Autism Research By Deborah Jeanne Sergeant

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ccording to the Centers for Disease Control, the prevalence of autism spectrum disorders is one in every 54 live births. If autism affects your life, you likely home in on news stories about it. Or well-meaning friends inform you about new autism research. Though widespread, autism remains little understood by the medical community. Because scientists have discovered little about what causes autism, it’s only natural for parents, grandparents, teachers and others interested in autism to seek answers from perhaps less-than-accurate sources. Consider these tips for finding accurate information on autism.

Consider only research performed by credible sources. “I make certain that the research was conducted by a reputable research team at a university or hospital, and it is written up in a reputable journal, not just on a blog or other random site,” said Rachel Rosner, director of Education & Support Services at AutismUp in Webster, and parent of a child on the autism spectrum. “Research that is conducted using grant funds from the government is a safe bet. Any research conducted by a team through the Autism Treatment Network is reputable and sound as well. If you are ever in doubt, please ask your child’s doctors and health care providers.” Take a wary look at a small, shortterm, local study. “Look at the sample size of the population,” said Lawana Jones, founder and executive director of

What is Autism?

Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. ASD is defined by a certain set of behaviors and is a ‘spectrum condition’ that affects individuals differently and to varying degrees. There is no known single cause of autism, but increased awareness and early diagnosis/intervention and access to appropriate services/ supports lead to significantly improved outcomes. Some of the behaviors associated with autism include delayed learning of language; difficulty making eye contact or holding a conversation; difficulty with executive functioning, which relates to reasoning and planning; narrow, intense interests; poor motor skills and sensory sensitivities. Again, a person on the spectrum might follow many of these behaviors or just a few, or many others besides. The diagnosis of autism spectrum disorder is applied based on analysis of all behaviors and their severity. Source: Autism Society:

Lawana Jones, founder and executive director of The Autism Council of Rochester The Autism Council of Rochester, certified autism specialist and parent of a child on the autism spectrum. “Is it a complete representation of the data? What are some of the different elements of the data, like the race and ethnicity of the subjects? Ages? Make sure it’s a broad range of ages and sample size. If they don’t have a good sample size, it should make you wonder.” Not one size fits all. Anytime you hear phrases such as “cure your child’s autism” or any type of pigeonholing such as “every child with autism responds to this” consider those red flags. “Listen, peel back the onion on the comment,” Jones said. “Where are they coming up with these blanket statements? People are people whether they have autism or they’re not on the spectrum. They have their own needs and responses. You can’t look at research and say it’s true for all individuals on the spectrum.” Beware of anecdotes Anecdotes can sound very convincing because of the emotional element and personal information they contain, but they hold the least amount of weight. It’s not that parents of autistic children purposefully lie about their experience; however, many other factors may be involved which they have not considered. Or they may cite factors that have nothing to do with their child’s autism. “Reach out to a professional,” Jones said. “Most parents whose children are newly diagnosed, it’s by a professional who’s familiar with the spectrum. “Be careful of people who say they’re experts but have no credentials. Make sure they’re certified and check the source of the certification, not just people who know people on the spectrum or have a special education degree.” Paying for products or information. Organizations selling information or products may be the least reliable sources. That doesn’t mean their ideas have no merit; however, their claims may be overinflated since they want to profit. “That is not a site they want to use as a source,” Jones said. April 2017 •

18 CONVENIENT LOCATIONS IN MONROE AND LIVINGSTON COUNTIES

Close to Where You Work or Live

Early Morning and Late Evening Hours for Your Convenience LATTIMORE PHYSICAL THERAPY NETWORK AVON PHYSICAL THERAPY 490 Collins Street Avon, NY 14414 Phone: 226-2480 Fax: 226-2494 Co-Clinical director: Jon Gerenski, DPT Co-Clinical director: Leslie Summers, PTA Owner: Mario Melidona, PT DANSVILLE PHYSICAL THERAPY 40 Village Plaza Dansville, NY 14437 Phone: 335-2456 Fax: 335-3494 Owner: Matt Marino, MS, PT

LATTIMORE OF IRONDEQUOIT PT 1299 Portland Ave Suite 10 Rochester, NY 14621 Phone: 286-9200 Fax: 286-9203 Clinical Director: Lindsey Yu, DPT, LMT LATTIMORE PHYSICAL THERAPY AND SPORTS REHABILITATION 1655 Elmwood Ave Suite 130 Rochester, NY 14620 Phone: 442-9110 Fax: 442-9049 Clinical Director: Erin Tobin, PT, DPT

LATTIMORE OF FAIRPORT PT 59 Perinton Hills Shopping Ctr Fairport, NY 14450 Phone: 385-0444 Fax: 385-0442 Clinical Director: Matthew Stoutenburg, MS, PT, CSCS

LATTIMORE PHYSICAL THERAPY (Land and/or pool based therapy) 383 White Spruce Blvd Rochester, NY 14623 Phone: 442-6067 Fax: 442-6073 Clinical Director / Owner: Andrew Chatt, DPT, OCS Owner: Cynthia Shuman, MS, PT, ATC

LATTIMORE OF GATES-CHILI PT 5 Fisher Road Rochester, NY 14624 Phone: 247-0270 Fax: 247-0294 Clinical Director: Jeff McGiven, PT

NORTH GREECE PHYSICAL THERAPY 515 Long Pond Road Rochester, NY 14612 Phone: 227-2310 Fax: 227-2312 Owner: Tim Anne, MS, PT, MLD-CDT

LATTIMORE OF GENESEO PT 4577 Morgan View Road Geneseo, NY 14454 Phone: 243-9150 Fax: 243-4814 Clinical Director: Johanna Kaufman, DPT

PIANO WORKS PHYSICAL THERAPY 349 W. Commercial St. Ste. 1275 East Rochester, NY 14445 Owner: Leah Gerenski, DPT, OCS

LATTIMORE OF GRPT 2000 Empire Blvd. Building 2 Webster, NY 14580 Phone: 671-1030 Fax: 671-1991 Clinical Director: Melissa Graham, DPT, OCS

PITTSFORD MENDON PT 20 Assembly Dr. Suite 101 PO Box 212 Mendon, NY 14506 Phone: 582-1330 Fax: 582-2537 Clinical Director: Dustin Maracle, PT, DPT, MS, SCS, COMT,CSCS

LATTIMORE OF GREATER PITTSFORD PT 40 State Street Pittsford, NY 14534 Phone: 387-7180 Fax: 387-7182 Clinical Director: Adam Ellis, DPT

RUSH HENRIETTA PT 60 Finn Road Suite C Henrietta, NY 14467 Phone: 444-0040 Fax: 444-0052 Clinical Director: Karen Shufelt, DPT, CHT

HILTON PHYSICAL THERAPY 1026 Hilton Parma Corners Rd. Suite 1, PO Box 131 Hilton, NY 14468 Owner: Matt Landon, DPT HONEOYE FALLS LIMA PT 58 North Main Street Suite 200 Honeoye Falls, NY 14472 Owner: David Monsees, MS, PT

LATTIMORE OF SPENCERPORT PT 37 N. Union Street Spencerport, NY 14559 (585)349-2860 Fax (585)349-2995 Clinical Director: Russell Manalastas, DPT, SCS, COMT, CSCS LATTIMORE OF WEBSTER PT 1130 Crosspointe Lane, Suite 6 Webster, NY 14580 Phone: 347-4990 Fax: 347-4993 Owner: Adam Frank, MS, PT

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

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SmartBites

The skinny on healthy eating

Cheers for Nutrient-Rich Cheddar

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as your relationship with dairy products soured? You’re not alone, especially when it comes to cheese. Fearing the relatively high fat, calorie and sodium content of some cheeses, many of us have curtailed our consumption of this beneficial food. I’m not one of them. For me, a life without cheese would hardly be a life worth living. Yes, I adore cheese, most kinds, but the cheese I adore most is cheddar. And the reason my heart cheers for cheddar is because it’s a nutritional superstar, packed with protein, calcium and phosphorous. A 1-ounce portion (think a pair of dice) fulfills 14 percent of our protein needs with 7 grams, 20 percent of our calcium needs, and 14 percent of phosphorous. All together, this powerful team supports our muscles, bones, teeth, tissues and immune system. I’m also a huge cheddar fan because its bold flavor helps me eat it in moderation, which is the key to eating cheese, according to the American Dietetic Association. On the fat front, cheddar serves up 9 grams of total fat per ounce, with 6 of those being saturated fat.

The American Heart Association recommends that we consume no more than 13 grams of saturated fat a day due to its propensity to raise our bad cholesterol, which may then increase our risk for heart disease and stroke. Some recent studies, however, have indicated that cheese — even in high amounts — may not raise bad cholesterol after all. While more research is clearly needed, scientists think multiple mechanisms are involved, possibly related to calcium (shown to reduce the absorption of fat during digestion), protein and a cheese’s unique nutrient matrix. Something else to cheer about: Cheddar may protect our teeth, according to a study published in General Dentistry. Research has revealed that eating cheddar at the end of a meal helps to neutralize acids that form while eating, which may then thwart cavity formation. Cheddar for dessert, anyone? Much like some other delicious foods that are good for us — nuts, avocados, peanut butter, olive oil — cheddar is no slouch when it comes to calories: a 1-ounce slice has about 115 calories. Eat a few slices at a cocktail party and you’re over 200. What

cheddar calls for then is moderation. Depending on your dietary needs, it may also call for eating some of the reduced-fat versions. A final cheer: Sodium-wise, cheddar has less salt than most cheeses per 1-ounce slice, clocking in at 174 mg. The same amount of Parmesan has 450 mg.

and set aside. Top four of the bread slices with cheese; spread with avocado mixture and top with tomato slices. Add the four remaining bread slices on top. Heat 1½ teaspoons canola oil in a large nonstick skillet over medium-high heat. Add 2 sandwiches to pan; top with another heavy skillet. Cook 3 minutes on each side or until golden; remove sandwiches from pan. Repeat procedure with remaining oil and sandwiches. PS: Celebrate: April 12 is National Grilled Cheese Sandwich Day! According to a reader’s opinion poll, grilled cheese sandwiches are among one of the top comfort foods in the United States.

Helpful tips

Grilled Cheese with Mashed Avocado and Tomato Adapted from Food.com

1 ripe peeled avocado 1 tablespoon lemon juice ½ teaspoon ground cumin ¼ teaspoon kosher salt ¼ teaspoon coarse black pepper 1 teaspoon dried basil 8 slices whole-grain bread 6 ounces cheddar cheese, sliced 1 large tomato, thinly sliced and patted dry 1 tablespoon canola oil, divided   In a small bowl, mash together avocado, lemon juice, cumin, salt, and pepper until smooth. Stir in basil

Choose sharper cheddars with stronger flavors to help monitor intake. Lactose intolerant? Aged cheeses like cheddar contain relatively low levels of lactose. Read cheese labels carefully: some reduced-fat versions contain fillers and additives that don’t suit everyone. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Bad Diets Tied to 400,000 U.S. Deaths in 2015 Adding healthy foods such as nuts, seeds, vegetables, whole grains might help prevent premature demise, researchers suggest

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nhealthy diets may have contributed to as many as 400,000 premature deaths from heart disease and strokes in 2015, a new study estimates. And, it’s not just the things you should be avoiding — such as salt and trans fats — that are contributing to these deaths. The excess deaths may also be caused by what’s missing in your diet — namely, nuts and seeds, vegetables and whole grains, the researchers said. “Cardiovascular disease is the No. 1 cause of death in the United States, killing more people in 2015 than any other cause,” said lead researcher, physician Ashkan Afshin of the University of Washington in

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Seattle. He’s an acting assistant professor of global health at the university’s Institute for Health Metrics and Evaluation. “Poor diet is the top risk factor for cardiovascular disease death and, therefore, deserves attention from decision-makers in the U.S. when setting health agendas,” Afshin said. The study results suggest that nearly half of heart disease and stroke (cardiovascular disease) deaths in the United States might be prevented with improved diets, he explained. Debates on dietary policies in the United States tend to focus on cutting out unhealthy foods and nutrients, such as trans fats, salt and

sugar-sweetened beverages. But this study shows that a large number of heart-related deaths may be due to a lack of healthy foods, Afshin reported. “This study highlights the urgent need for implementation of policies targeting these unhealthy food groups as well healthy foods, such as nuts, whole grains and vegetables,” he said. The study data came from the U.S. National Health and Nutrition Examination Survey from 1990 to 2012. The researchers also used food availability data from the Food and Agriculture Organization of the United Nations and other sources. Looking at deaths in the United

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

States from heart and blood vessel diseases for 2015, the investigators found unhealthy diet choices and lack of eating healthier foods had a part in the deaths of more than 222,000 men and over 193,000 women. The study could not, however, prove a direct cause-and-effect relationship. Low intake of nuts and seeds likely accounted for nearly 12 percent of deaths. Too few vegetables probably contributed to as many as 12 percent of the heart disease and stroke deaths. And, low intake of whole grains may have been responsible for more than 10 percent of those deaths. Too much salt likely accounted for 9 percent of deaths, Afshin said.


Women’s HEALTH

Queen of Brazilian Wax

Rochester’s Brazilian wax technician uses humor in her career, her personal life and to empower women By Amy Cavalier

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he banner hanging along the front of Mark and M.E., a salon on Mt. Hope Avenue in Rochester, boasts “Home of the 10 minute Brazilian wax.” Waxing technician Mary Elizabeth Nesser is widely known in Rochester for her efficiency. Nesser has removed hair from all sexes, races and body parts — except the inside of the nose if she can help it. She also specializes in Brazilians, which entails removing all the hair from the pubic area to the rectum. Nesser has found humor is a good way to put clients at ease during the procedure “I’m causing pain on somebody,” she said. “They’re embarrassed. It’s an uncomfortable situation and I just want to make it fun and light hearted. Since such crazy shenanigans happen on my table every day, I feel compelled to share them, but it’s also a way to help cope with the situation.” Nesser uses humor to make women feel sexy and confident in her regular column in Rochester Women’s Magazine. She’s written “The Happy Hoo-Ha” trilogy, a series of non-fiction books inspired by her career, and she updates her blog “Hose Down Your Hoo-Ha” daily with outrageous stories about everything from making a man cry for the first time to the difference between the way black women and white women deal with the pain of waxing. “White women tend to swear like truckers. Black women, on the other hand, tend to scream for Jesus,” she writes. No laughing matter Nesser’s job is not all fun and games though. Sometimes she’s the first person to notice something as minor as an inflamed follicle to something serious as serious as cancer. She’s tipped clients off to health issues including genital warts, melanoma and even a tumor. “If you have thick dense pubic hair covering your skin or thick hair covering skin on any part of the body, you might not necessarily see a mole,” she said. “You feel a bump, you think it’s a skintab or an ingrown and you dismiss it.” Physician David Gandell, a clinical professor of obstetrics and gynecology at the University of Rochester Medical Center, said shaving can cause ingrown hairs, especially for those with curly hair, as well as folliculitis — tiny pimples which can be irritating. “A razor gets micro-nicks in it when it’s used,” said Gandell. “If the

razor wasn’t thoroughly washed and dried and it nicks a person’s skin the next time they use it, it becomes a breeding ground for the bacteria that has been introduced onto it during shaving.” Nesser said she’s also spread awareness of polycystic ovarian syndrome among her clients. “I always try to keep it light but at the same token, if somebody has heavy or difficult periods or unwanted hair, they often have it, and some people need to be medicated if their levels are so high,” she said. “Also, it can be difficult to get pregnant with PCOS.” Even though there are many reasons men and women get Brazilians, the number one reason they get it done is because sex is better, Nesser said. Passion for Waxing A Buffalo native, Nesser, 51, has an undergraduate degree in sociology from the University of Rochester and a master’s degree in education from Nazareth College. She worked as an elementary school teacher for three years before earning her cosmetology license in 1993 to work fulltime at her husband Mark’s family beauty salon. Nesser had been doing nails at the salon for over 10 years when she started to explore waxing. First she tried it on herself. Then she started offering traditional bikini waxing, removing hair visible in the bikini line. Then a handful of women agreed to be her guinea pigs and allowed her to wax the entire pubic and rectal area. “I didn’t charge more,” she said. “There was no name for the service. I didn’t know the positions. I taught myself how to do it.” It was around 1996 when she got the first call for someone asking for a “Brazilian” by name ... the procedure she’d already been doing. Nesser credits the HBO series “Sex and the City” for bringing the procedure into popularity. Physician Mary Gail Mercurio, professor of dermatology, obstetrics and gynecology at the University of Rochester Medical Center, said it’s almost become a social norm in the United States to shave or wax under the arms and legs. “I think waxing is increasing in popularity because it’s so mainstream that people are comfortable going to a salon and being waxed whereas originally when the trend started, it might have been something that women felt the need to do April 2017 •

Mary Elizabeth Nesser performs about 100 Brazilian wax treatments per week out of her salon on Mt. Hope Avenue. A sign outside the building reads, “Home of the 10 minute Brazilian wax.” She drives a yellow corvette with plates that read “wax it all.” in the privacy of their own home,” said Mercurio. “Now social acceptance is to an extent that salons providing this service are abundant.” Laughing Through the Pain Nesser is not your average wax technician. She drives a yellow corvette with plates that read “wax it all.” Although she averages about 100 Brazilians a week, for Nesser, it’s not about quantity. It’s about quality. “I get offended when people request a speed wax from me,” she said. “I am very efficient. I don’t feel like I’m rushing through it and I would hate for a client to feel that way.” Nesser credits laughter and writing with helping her deal with her own pain from fibromyalgia which she’s suffered from since her mid20s. With tendinitis in various parts, arthritis and a herniated disc in her neck, she emphasizes the importance of self-care.

“I feel like my entire career at Mark & M.E. is about encouraging women to make themselves a priority, because we never do,” she said. “Even though I do everything for my family, my business and my husband, I still go to the gym. I still get massages once a month and acupuncture twice a month. Those are the things I need for Mary Elizabeth not to be crazy.” Married 30 years, Nesser and her husband Mark have three children aged 21, 24 and 25. She would love for someone to pay her to live on a beach and write or to go on Shark Tank, but until then she’ll be ripping and telling and laughing her way through each day. “You absolutely do not do Brazilian’s for the money. I have people’s rectums in my face all day. I do it for the clients because I am able to make them feel good about themselves. If I can make a woman feel sexy, then I have the best job in the world.”

Why wax? By Mary Elizabeth Nesser, Brazilian wax technician 1. Shaving causes razor bumps and ingrown hairs. 2. When shaved hair grows back, it itches and can be very irritating. 3. The pubic area isn’t a flat surface and is difficult to navigate and reach with a razor. 4. Waxing requires zero effort and lasts longer. 5. Waxing hurts temporarily. The irritation from shaving can last a lot longer. 6. Using a razor can spread bacteria and increase your risk of infection. IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Women’s HEALTH

6

Six Things You Should Know About Miscarriage By Ernst Lamothe Jr.

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or pregnant women, a miscarriage is an unexpected and emotionally devastating loss. Erin Masaba, an OB-GYN at UR Medicine’s Strong Fertility Center, understands the affects it can have on a person. Miscarriage, which is the spontaneous loss of a pregnancy in the first 20 weeks, is the most common type of pregnancy loss. About 10 to 20 percent of known pregnancies end in miscarriage, according to the Mayo Clinic. The risk of miscarriages can change with age and history. Masaba, who moved to Rochester after completing a fellowship in reproductive endocrinology and infertility at Weill Cornell Medical College, talks about the top six things women need to know about pregnancy loss. “Miscarriage is a relatively common occurrence among all childbearing women,” she said.

1.

Causes of miscarriages

About 60 percent of pregnancy losses are caused by unforeseeable, sporadic chromosomal abnormalities. Some of those causes include increased age of the mother. A woman is born with all the eggs she will ever have. However, if you are over 35 or 40 and trying to get pregnant, the chances for an egg to have a chromosomal abnormality increases. And in some small cases, a miscarriage occurs when a genetic abnormality is found in the mother or the father and passed on to the fetus. “For women over age 40, the miscarriage rate approaches 50 percent.”

2.

Abnormal Defects

Some women are born with anatomical defects in the uterus that can cause miscarriages in the early weeks of their pregnancy including a septate uterus. A uterine septum forms when the tubes that eventually become one uterus don’t fuse together properly. Having a septate uterus doesn’t affect a woman’s sexual pleasure or fertility, but it may add complications to pregnancy. “Septate uterus is correctable with surgery, but the other defects are not,” said Masaba. “Still, many women with these conditions go on to have successful pregnancies.”

3.

Aftermath of miscarriage

Many women form an attachment to their baby early on in the pregnancy, especially if they’ve been trying to conceive for some time. But after the grief, anger, depression or other emotions subside, many times parents want to know what went wrong. Physicians suggest parents to talk to an OB-GYN and perform certain tests. “When a woman comes in after a pregnancy loss, we test the mother and father for chromosomal anomalies and test the mother for anti-phospholipid syndrome,” Masaba said. “Imaging tests can detect a uterine anatomical defect.”

4.

Seeking Support

It’s important for couples to know that when a woman has recurrent losses, it is not the woman’s fault. That’s a hard

concept for women to accept because they often think they did something wrong or failed to do “everything” to ensure a healthy pregnancy. “Miscarriage is a traumatic experience. The loss of a pregnancy should be grieved and dealt with, as with any loss,” Masaba said. “Women should feel free to reach out for the support they need. It takes a lot of courage for a woman who has lost a child to try again, but their chances of having a successful pregnancy are very good.”

5.

Treatment options

About 50 percent of the time, physicians don’t identify a cause for the miscarriage. In those patients, it’s hard to hear the physicians advice to just try again. But the good news is that 60 percent of these couples will go on to a successful pregnancy. “When we can pinpoint a reason for the miscarriage, we can offer appropriate treatment for the medical condition and ongoing management of the pregnancy,” said Masaba. “For couples who have an abnormality, we can test their embryo for the presence of a problem before implanting it in the uterus.” There is the possibility that a woman will not have any eggs that make it to the stage to do genetic testing. “For these women, there is the option of using a donated egg to initiate pregnancy,” she said. “These donor eggs come from young women, so the chance of a successful pregnancy is higher.”

Erin Masaba, an OB-GYN at UR Medicine’s Strong Fertility Center

6.

Recurrent Loss

Recurrent miscarriages — the loss of three or more consecutive pregnancies before the fetus is 10 weeks old — are not as common. The American Society for Reproductive Medicine recommends that if a woman has two consecutive pregnancies, she should see her OB-GYN or fertility specialist for an examination. If a woman has had a miscarriage, the likelihood of her having another one increases. “After a first miscarriage, the risk of having a second is 15 to 20 percent. After two miscarriages, the odds of a third go up to 25 to 30 percent,” added Masaba. “Fortunately, less than 5 percent of women will have two consecutive miscarriages and only one percent will experience three consecutive pregnancy losses. For women over the age of 35 with recurrent pregnancy loss, physicians recommend genetic testing of the embryos if no other explanation is found. It’s important to note that once a woman reaches 40, it can be harder to stimulate ovaries to release a quantity of eggs needed to find a healthy one.

The Secret to a Good Sex Life Is … Affection: It’s the cuddling, whispering secrets afterwards that boost contentedness, study finds

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ouples who regularly have sex tend to be happier, and now a new study suggests one reason why: affection. The study of couples in committed relationships found what many others had shown before: Couples who had sex more often were typically happier and more content with their lives. However, much of that link seemed to be explained not by sex itself, but by couples’ general levels of affection — whether that meant cuddling or whispering sweet-nothings to each other. It all suggests that the “relationPage 12

al aspects of sexuality — and more specifically, the sharing of affection — are central in understanding why sex does good,” said lead researcher Anik Debrot. That might be good news for people who worry about things like sexual performance or having a “perfect body,” according to Debrot. Instead, they could “remember that sex is a great way to share an intimate and affectionate moment with your partner,” said Debrot, a research fellow at the University of Lausanne’s Institute of Psychology, in Switzerland. She was based at the University

of Toronto at the time of the study. The findings are based on four studies of couples in the United States and Switzerland. In each, couples were asked how often they had sex, and how often they shared affectionate “moments” or “touches.” Two studies asked participants about their typical habits, while the other two tracked them over a specific time period. Overall, the studies found, couples who were more sexually active tended to report greater satisfaction with life. They also had more “positive emotions” — both in general, and the morning after having sex.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

But in each study, affection seemed to largely account for that sex-happiness link. So does that mean sex, by encouraging affection, helps breed happiness? Or do happy people have sex more often? One of the studies suggests it may be the former: Debrot’s team found that sex predicted positive emotions the next day — whereas good feelings did not boost couples’ likelihood of having sex over the next 24 hours. The study was published in the March issue of the Personality and Social Psychology Bulletin.


Women’s

HEALTH

fuel is a nutrient. When you have a health problem, your body is talking to you. You need to learn how to listen. It is missing certain nutrients.” Skimping on protein. “I’ve been doing this over 35 years,” Pickering Picone said. “I’ve now mostly gone toward telling people to follow their blood type. I am a meat eater. I need to eat red meat at least three times a week. Most people are tired and have dark circles under their eyes because they don’t consume enough protein.”

Top Nutritional Mistakes Women Make By Deborah Jeanne Sergeant

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wo-thirds of women in the U.S. perform most of the food shopping in their household, according to Progressive Grocer, a grocery store trade periodical. That means their food selections heavily influence the nutrition of the family. If you’re the one steering the grocery cart, bone up on your nutrition knowledge and avoid these common mistakes. Buying too many packaged foods. “People want convenience,” said Marge Pickering Picone, a nutritional coach certified by the Nutritionist Institute of America, and the founder and CEO of Professional Nutrition Services of Rochester, Inc. “They should make their food. Children

have high cholesterol because they live on cereal, mac and cheese and pizza. That’s their diet. It’s convenient but it’s not healthy.”

Buying sweetened drinks. “Those liquid calories aren’t necessary,” said Amy Miller, registered dietitian with Rochester Regional Health. “People are starting to get the message about soda, but we also should talk about juice and sports drinks. They have a lot of calories without much nutrition. I recommend 8 oz. or less per day as a maximum for adults. Eating whole fruit would offer a person more nutrition. Also, most adults don’t need sports drinks unless they are dehydrated. Many people who use them when exercising drink back the calories they’ve just burned off.”

Thinking only fresh produce is good enough. “I use a lot of frozen fruits because typically they’re better than some fresh because they take the best of the crop and freeze it at peak,” Pickering Picone said. “In season, go fruit picking with your kids.”

Making impulse buys. “Meal planning is important to take an inventory of what we have in the fridge and pantry and coordinate what we need for the week and not waste food,” Miller said.

Buying into food fads. “A lot of health issues go on if you’re not balancing your food,” Pickering Picone said. “Every part of your body runs on fuel and every

Buying high-sodium foods. “Don’t overlook simpler foods like bread,” Miller said. “It can be higher in sodium than you think. People know snack foods have so-

April 2017 •

dium, but quick side dish foods that require water for preparation, like macaroni and cheese mixes or boxed potato side dishes are very high in sodium. It’s not like you should never use them, but they need to be eaten infrequently. Always caving in. “A lot of times, there’s pressure from family members to buy certain unhealthful foods,” Miller said. “It’s a tough balancing act. Allowing kids to come along to pick out fresh produce maybe one way to incorporate them into the shopping. With sweets and treats, minimize them. Healthy eating begins at the grocery store.”   Obsessing about one facet of eating right. “It’s about your overall health and overall diet,” Miller said. “Some individuals won’t eat fruits and vegetables because of pesticides. But obesity is linked to many more cancers than pesticides; we’re missing the big picture.”  Assuming small packages contain one serving. “People read labels and they don’t take in account how many servings are in a package,” said Cindy Fiege, certified herbalist, Nature’s Sunshine certified In.Form coach, and owner of Harmony Health Store, LLC in Spencerport. “An example is a box of Rice-a-Roni reads that there are 2.5 servings per box yet a lot of people will eat a whole box and not realize that they’ve consumed almost 1,000 calories of prepared Rice-aRoni, thinking that they’ve consumed only 280 calories as indicated on the box.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 13


Women’s HEALTH

Sitting the Month Chinese practice calls for moms to do nothing for a month after they deliver their baby By Deborah Jeanne Sergeant

T

raditional Chinese mothers practice “zuo yuezi” — or “sitting the month” — after delivering their babies. Whether it’s assistance from relatives at home or at a facility designed to aid new moms — and staffed with nurses and nutrition experts — these mothers take it very easy for 30 days. They eat special foods to help them recover and avoid chills to help restore their body’s balance. Beyond nursing, they literally do nothing and go nowhere for a month. While taking it this easy for a month may not be possible or advisable for many mothers, new moms should call upon whatever support they need to take care of their babies and themselves. Unfortunately, isolation from extended family and employment demands often mean that women don’t get the help and rest they may need.

“One problem with modern life is we were meant to be in small villages with family units to help new mothers and help in the process and be supportive,” said Rob Kiltz, founder and director of CNY Fertility in Rochester. “We’re herd animals and meant to be interactive.” Kiltz is a diplomate of the American Board of Obstetrics and Gynecology and board-certified in reproductive endocrinology and infertility. Kiltz said that post-partum support should do more than just ease mom’s burden, but should include help from the family. “It’s not just about ‘Let me help you do nothing’, but as a village, tribe, family and group, ‘Let’s work together for the greater good.’ Raising a child is meant to be done as a family. That’s where we get our best creativity and joy out of life.” Women’s bodies change a lot

from pre-pregnancy to pregnant to post-partum. Christi Muscato is a DONA-certified doula, birth doula trainer, Lamaz-certified educator and co-owner of Beautiful Birth Choices in Rochester. She likens the time after delivery as the “fourth trimester” because it takes a while for women’s bodies to heal and recover. Christine Kowaleski, New York state coordinator for Postpartum Support International, acknowledges that support for new moms helps them cope with the changes involved with having a baby. But once their doctors give them clearance to exercise, walking and yoga can help moms get active again. “Exercise is always good for everyone, and may be helpful in preventing baby blues,” she said. In addition to helping mothers reduce their risks for postpartum depression and develop coping mecha-

Rob Kiltz, founder and director of CNY Fertility in Rochester: “Raising a child is meant to be done as a family. That’s where we get our best creativity and joy out of life.” nisms, Postpartum Support International also helps moms network. “Using complementary medicine team with our support group has really helped our moms and they decide on their own when they’re ready to go out on their own,” Kowaleski said.

Long-term Contraceptives Offer Convenience By Deborah Jeanne Sergeant

I

nstead of remembering to take a daily oral contraceptive pill or recalling to keep contraceptives such as condoms or spermicidal inserts available, women have many other long-acting, reversible contraception (LARC) options. Once you decide you’d like to have a baby, your health care provider can remove the LARC and within a few weeks, you can become pregnant. Two popular LARCs offered today are the intrauterine device (IUD) and hormonal implants. Once inserted, women “don’t need to worry about them,” said Jane Dodds, practice manager at Women Gynecology & Childbirth Associates, PC in Brighton. “Ease of use is a big advantage.” Both IUDs and hormonal implants reduce menstrual flow significantly, a side effect many women embrace. “We’ve seen a big uptick since the ACA covers contraceptives in full,” Dodds said. Since these LARCS can cost hundreds of dollars, more women are seeking them since cost isn’t a factor, according to Dodds. Depending upon the type, IUDs provide nearly foolproof contraception for three to 10 years and don’t interfere with breastfeeding for womPage 14

en who want contraception to space their children. All IUDs are approximately the same size in the shape of a small “t,” dangling a string. Inserting the IUD doesn’t require anesthesia and most women feel one sharp cramp and it’s over. Copper-based IUDs contain no hormones and work for 10 years. At first, women may experience heavier periods; however, eventually, their cycles resume their regular intensity. Implantable progestin involves inserting the contraceptive into the upper arm to slowly release over the next three years. Faye Justicia-Linde, an OB-GYN at University at Buffalo, said that implanted progestin works well for women “who are leery of pelvic exams and placing anything in the vagina.” Women who can’t tolerate estrogen contraceptives can usually use progestin implants. They require a minor, out-patient procedure where the skin is numbed and within minutes, the implants are placed in a small incision the arm. “It’s very rare for people to have a serious side effect,” Justicia-Linde said. “An IUD could move or shift. Only once or twice a year, we have a patient who needs an IUD removed.

It takes about two minutes. It’s annoying for patients, but not serious. It’s an uncommon issue. Most women are happy with the convenience.” Justicia-Linde said that one previous IUD design was prone to complications such as infection; however, newer IUDs available have corrected those issues. “We check people first to make sure they have no infection,” Justicia-Linde said. “Once it’s there, it

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

doesn’t increase the risk of infection over one who doesn’t have an IUD.” She said that compared with the Pill, condoms, spermicidal inserts, quarterly progesterone shots and other contraceptives, the IUD and implant make it easy to prevent pregnancy. “The more the person has to remember to do, the higher the failure rate,” Justicia-Linde said.


Women’s HEALTH Shift Work May Hamper Conception

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Harvard study suggests that women who work late shifts may have problems conceiving a baby

Serving Men, Women and Children

By Deborah Jeanne Sergeant

A

study recently released by the Harvard T.H. Chan School of Public Health in Boston states that women who work second or third shift may experience a reduced ability to conceive. The disrupted sleep schedule — resting while others are awake and working when most are asleep — may be partly to blame. “Anything that disrupts the circadian rhythm throws off our hormonal and endocrine and even our immune system,” said Rob Kiltz, founder and director of CNY Fertility in Rochester. “The stress factors that go along with that and the fact that we may not be in synch with the partner, that probably doesn’t help.” Kiltz is a diplomate of the American Board of Obstetrics and Gynecology and board-certified in reproductive endocrinology and infertility. He said that circadian rhythm disruption affects ovulation dysfunction, “likely affecting the hormonal environment that supports the early embryonic environment. It could throw off the hormones that support early pregnancy.” Other work factors can reduce the woman’s ability to conceive, such as performing heavy physical labor. The study indicated that women

Tara L. Gellasch, an OB-GYN, practices at Rochester Regional Health.

working physically intense jobs had fewer eggs than women working sedentary jobs. Kiltz said that these somewhat androgenic activities release cortisol, the stress hormone. That promotes inflammatory conditions that can negatively affect how egg and sperm interact, ovulation and implantation of a fertilized egg. While exercise is healthful, strenuous, heavy activity may make having a baby tougher. In addition to physical stress, emotional stress can also inhibit conception. “This is why we recommend yoga, exercise, acupuncture, going for a walk, listening to nature and soothing music and reading a good book,” Kiltz said. “Turn off the TV news. If you do have shift work, imagine you’re able to come home, reduce the light, and change that circadian rhythm a bit to get a quiet time of rest and relaxation.” He also recommends limiting carbohydrates in the diet. Tara L. Gellasch, an OB-GYN board-certified by the American Board of Obstetrics & Gynecology with Rochester Regional Health, recommends women who want to conceive to take pre-natal vitamins, since their 400 micrograms of folic acid have been shown to reduce the risk of certain birth defects. She also recommends women considering pregnancy to get any health conditions under control and ask their doctors about the safety of any medication they take. “Additionally, overweight and obese women should consider weight loss prior to pregnancy,” Gellasch said. Obesity increases the risk of gestational diabetes, preeclampsia, and preterm birth. Overweight women also experience higher rates of cesarean sections. Tobacco cessation can also help increase fertility and decrease the risk of miscarriage and birth complications. “Quitting smoking is the best thing you can do for your health and the health of your family,” Gellasch said. “Your medical provider can discuss with you some of the options available to help you quit while you are trying to conceive.” Working with an OB-GYN and fertility expert can help women struggling to conceive to eliminate factors that decrease their likelihood of pregnancy. April 2017 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Anal Cancer There is more good that can come from the HPV vaccine

Women’s HEALTH What Disease Kills Women the Most?

By Rick Bartell

I

n the January Issue of “In Good Health” I wrote about the current campaign to get as many people as possible to get the HPV vaccine, which has been linked to the prevention of cervical cancer in women. I reported the dramatic decreases in cervical cancers that are expected over the next generation due to the vaccine. I received a wonderful email from a reader thanking “In Good Health” for highlighting this important issue but pointing out to me that cervical cancer is indeed on the decline here in the United States but unfortunately anal cancers are on the rise and the HPV vaccine could go a long way in prevented these cancers too. Upon further research, I discovered that since the 1970s the rates of people diagnosed with anal cancer has tripled in the United States. The major risk factor for this type of cancer is infection with the human papilloma virus (HPV). It is estimated that about 85 percent of all anal cancer cases are a result of HPV infection. Other risk factors for anal cancer include men having sex with men, multiple sexual partners, and cigarette smoking. The reader went on to point out to me that “screening to prevent anal cancer has been available in Rochester for 12 years, yet many health providers are unaware. Patients are particularly dismayed, and when they develop anal cancer frequently ask why they were never told of this possibility, even though they may have been diagnosed with cervical dysplasia. Anal cancer is another one of the diseases that can be prevented by the HPV vaccine. Thanks for providing exposure for a necessary vaccine.” So it seems there is an additional reason for getting those eligible for the HPV vaccine to take advantage of it. Ask your health care provider about it as well as asking about important anal cancer screenings for those at highest risk. This just might be another cancer that a future generation might consider a thing of the past.

Heart disease claims more women’s lives than any other disease, including breast cancer By Deborah Jeanne Sergeant

W

hat disease kills more women than any other? Breast cancer? Lung cancer? Ovarian cancer? Colorectal cancer? Wrong. Heart disease is the leading cause of death among American women, totaling 161,698 deaths annually, according to WomenHeart. That’s more than one-third of all deaths for women. Compared to that, only 40,861 women die every year from breast cancer. Mary McGowan, CEO of WomenHeart, The National Coalition for Women with Heart Disease (www. womenheart.org), hopes that by promoting education about heart disease risks and signs of heart attack in women, her organization can help drive down those statistics. One means is Women Heart’s National Hospital Alliance program, which aids hospitals in educating clinicians and patients. Many women don’t realize that heart attack often presents differently in women than men. “It’s important for women to understand the difference because this can be lifesaving information,” McGowan said. Men may experience sharp pain in the chest, but women may feel short of breath, pain in the arm and back, extreme fatigue and nausea. “Women tend to minimize their symptoms,” said cardiologist Joseph F. Gomez, who practices at

Geneva General Cardiology Associates. While prenatal health care may put women on the track for regular health care visits, once a child or more arrives, it’s harder for some women to stay faithful to a regular health care regimen, especially considering over-the-counter contraceptives can eliminate the need for doctor visits for prescribed contraceptives. Women can also use long-lasting contraceptives. Since they’re not seeking regular physicals, some women overlook the risk factors for heart disease, which include high blood pressure, family history, high cholesterol, diabetes, smoking and post-menopausal. “Estrogen has a degree of protection in preventing coronary artery disease,” cardiologist Gomez said. “After menopause, the risk goes up.” McGowan added that female-specific risk factors include pregnancy if the mother experiences hypertension and pre-diabetes related to the pregnancy. “The science is showing that pregnancy is a first cardio stress test for many women,” McGowan said. “These issues that develop during pregnancy can be precursors for heart disease later in life.” Healthy women who become pregnant don’t elevate their risk of heart disease during pregnancy, but all women should receive prenatal care. Patients aren’t the only ones

Rick Bartell has worked for over 23 years in the area of sexual health education. He currently acts a consult to a number of area nonprofits. You may contact him at bartellrick@ gmail.com with any questions or ideas for future columns. Page 16

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

not thinking about heart disease. WomenHeart literature states, “A 2005 American Heart Association study showed that only 8 percent of primary care physicians and 17 percent of cardiologists knew that heart disease kills more women than men.” More women need to ask for the screenings that could save their lives. These include blood pressure, cholesterol, body mass index and pulse, which can detect arrhythmia. It makes sense to get evaluated for heart disease risk since physicians can prescribe medication to protect against heart attack, according to Gomez. “You don’t want to wait until damage has been done,” Gomez said. On Feb. 3, WomenHeart is offering complementary screenings in 46 states at Burlington stores. Call store locations for more details.

Are You at Risk? By the numbers. According to WomenHeart, the following factors increase the risk of heart disease for women: • Cigarette smokers are two to four times more likely to develop heart disease than non-smokers. • 44.9 percent of women have total cholesterol of at least 200mg/dL. • 31.7 percent of women do not engage in leisure time physical activity. • 61.2 percent of Caucasian women, 81.9 percent of African-American women, and 76.3 percent of Mexican-American women are overweight or obese. • Women with diabetes have a 2.5-fold higher risk for developing cardiovascular disease (CVD) compared to women who do not have diabetes, and men with diabetes have a 2.4-hold higher risk for developing CVD compared to men who do not have diabetes; women with diabetes and CVD have a 2.2-fold higher risk of dying from CVD compared to women who do not have these two conditions; men with diabetes and CVD have a 1.7-fold increased risk of dying from CVD compared to men who do not have these two conditions.


prove their breathing. Like a physical therapy assistant, a respiratory therapist should relate well to people, record accurate information in patient charts and exhibit an ability to think creatively to help patients who struggle with completing their exercises. Many respiratory therapists work in hospitals. Genesee Community College (www.genesee.edu) offers a certificate in respiratory therapy. Median annual salary: $54,220 Projected growth: 12 percent

HEALTHCARE CAREERS

Make $45,000+ with an Associate’s Degree Great opportunities in the health industry available for people who have only a two-year degree By Deborah Jeanne Sergeant Joining the health care field doesn’t require 12 years of training to become a medical doctor. Many good-paying, satisfying positions in health care require only an associate’s degree. These careers limit the amount of debt the student acquires as they’re attending classes only two years. Plus, many community colleges and smaller, less expensive institutions offer the coursework required. In addition, students uncertain of their career path invest only two years in their education. Some of these positions also may segue into provider positions with additional education. The annual mean wage and projected growth (through 2024) statistics are according to the Bureau of Labor Statistics, specific to Rochester, Western New York, and Syracuse, respectively.

Food Services Manager The food services manager’s role includes working with dietitians, medical staff and social workers to meet patients’ dietary needs while in the hospital. It’s also a managerial role, involving working with staff that prepare and deliver meals. Food knowledge and good people skills combine in this career. Local schools offering a certificate in Food Services Management include Monroe Community College (www.monroecc. edu). Annual mean wage: $51,960 Projected growth: 5 percent Respiratory Therapist Whether from an injury of lung illness or disease, patients seek the help of a respiratory therapist to im-

Radiographers and MRI Technologist At hospitals, outpatient clinics and independent diagnostic offices, radiographers perform diagnostic tests, including X-rays and MRI techs perform MRIs. People with empathy and attention to detail can fit well in these careers. Monroe Community College (www.monroecc.edu) offers certificates in radiography. Median annual salary: (MRI) $63,460 (Radiographer) $52,580 Projected growth: 9 percent Cardiovascular Technician As its name denotes, a cardiovascular technician helps people with heart problems. Specifically, they use imaging equipment to perform diagnostic tests physicians use to diagnose heart problems. “Soft skills” and ability to follow protocols can help cardiovascular technicians succeed. They usually work in hospitals or heart centers. Rochester Institute of Technology (www.rit.edu) offers a certificate echocardiography (cardiac ultrasound). Median annual salary: $55,080 Projected growth: 24 percent Medical Sonographer Working in outpatient, hospital and physicians’ offices, the medical sonographer operates equipment used to perform diagnostic tests on organs and soft tissues. They can specialize in maternity, children, breasts or other areas. Rochester Institute of Technology (www.rit.edu) offers

a certificate in diagnostic medical sonography. Median annual salary: $68,170 Projected growth: 24 percent Dental Hygienist Dental patients often spend more time with their dental hygienist than the dentist. But they do far more than just clean teeth. They also perform patient intakes, update charts, screen for a variety of oral health issues and take X-rays. Dental hygienists need a warm personality as well as close attention to detail. Eastman Institute for Oral Health (www.urmc. rochester.edu) is one example of a local school offering dental hygienist certificates. Median annual salary: $61,210 Projected growth: 19 percent Radiation Therapist Usually working with oncologists, radiation therapists treat cancer patients in hospital and cancer clinic settings. Radiation therapists work with equipment that delivers doses of radiation, so complying with safety guidelines is extremely important. Solid science and math skills and also exceptional people skills are required for the radiation therapist, as they work with patients and families facing what’s often a life-changing diagnosis. Monroe Community College (www.monroecc.edu) offers a certificate in radiation therapy.. Median annual salary: $66,930 Projected growth: 14 percent The employee’s location, specific employer, experience, and coursework can influence the annual salary. The New York Office of College and University Evaluation website (www. nysed.gov/heds/IRPSL1.html) can help you determine the educational requirements of these professions and what New York-based institutions can help you obtain the education required to practice these careers in New York.

Excellus Survey Shows Acceptance of Telemedicine

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early five out of 10 upstate New York adults are aware of telemedicine, and 80 percent of those who have used telemedicine rated their experience as “very good” or “excellent,” according to a survey commissioned by Excellus BlueCross BlueShield. The online survey administered by the polling firm One Research contacted 2,000 Upstate New York adults, a representative sample of the region’s U.S. Census Bureau demographics. “Telemedicine services are widely and quickly being made available in the region, so we thought it was important to get a handle on levels of awareness that exist and regional responses to a broad spectrum of related questions,” said Martin Lustick, senior vice president and corporate medical officer for Excellus BlueCross BlueShield. Respondents who had health insurance were not asked to identify their insurance carrier. About one-quarter of survey respondents indicated that they plan to use telemedicine in the future, while an equal number said they did not plan to use it. About half of the respondents were undecided. Respondents who reported that

they had either used or were familiar with telemedicine were asked their first and second choice for having any future minor medical condition needs addressed. An in-person visit with their doctor ranked highest, followed by a telemedicine visit with their doctor. Use of an urgent care center, and a telemedicine visit with a provider other than their own doctor ranked third and fourth. Going to a hospital emergency room ranked last as a preference for treating minor conditions. “That initial ranking was gratifying as a finding to us,” Lustick said, “because our repeated promotions around a telemedicine option have been very clear. Ideal medical care is when a patient can see his or her doctor. We’ve said the second best choice, if available, is a telemedicine visit with their physician. A new option we’ve been suggesting is to consider a telemedicine visit with another provider for treatment of minor conditions. With time, we expect that will gain in popularity over going to an urgent care center.” Other highlights in the survey show: •Approximately one-third of Upstate New York respondents who are April 2017 •

between the ages of 18 and 44 plans to use telemedicine. Interest in using telemedicine declines with age. • Preference for in-person interaction is the main reason why respondents don’t use telemedicine. • People who use telemedicine are significantly more likely to report using it again. • On weekdays, telemedicine is mostly used during daytime hours, however weekend use is typically at night (between 6 p.m. and 6 a.m.). The survey results establish a benchmark for consumer acceptance and use of telemedicine. Excellus BCBS will conduct additional surveys to track possible changes in attitudes. View results of the Excellus BCBS survey online at http://tinyurl.com/ jecwp6b

Martin Lustick

The percentage of respondents who plan to use telemedicine varied significantly by region Western New York

20%

Finger Lakes

25%

Central New York

23%

Central New York’s Southern Tier

31%

Utica/Rome/North Country

31%

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 17


Ask St. Ann’s

8 Tips for Avoiding Falls

By Diane Kane, MD

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pring may be approaching but “fall” is always just around the corner. Falling is a serious concern for older adults who are working hard to maintain their independence in their own homes. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults, according to the Centers for Disease Control & Prevention. Reduced muscle strength, increased inactivity, more severe chronic health conditions and increased use of prescription medications are risk factors for falls among older Americans. Fall injury rates are almost seven times higher for older adults with poor health than for those with excellent health (CDC). It is important to note that falling is not a normal part of aging. Strength and balance exercises, managing your medications, having your

vision checked and making your home safer are all steps you can take to prevent a fall. First and foremost, talk to your healthcare provider about fall prevention and tell them about any falls you’ve had. Although one out of four older Americans falls each year, less than half tell their doctor. Fall prevention is a team effort. Your doctor and your loved ones want you to maintain your independence and avoid injury — be honest with them.

Simple Steps at Home Simple changes to the home environment can make a big difference — and the changes don’t need to be costly or time consuming. Here are eight ways to make your home a fall-free zone. Clear the way. Shoes, boots and the items we all stack on our stairs can become tripping hazards. Get them out of the way.

1.

Alzheimer’s Death Toll Nearly Doubles in 15 Years

2.

Pay attention to uneven surfac-

es, like the thresholds between rooms. The transition from a carpeted room to a tile or wood floor can create a ridge. In older homes, a step up or down from one room to the next can be a tripping hazard.

3.

Add handrails to help you get

up from the tub, and make sure your tub and shower have non-skid floor surfaces.

4.

Don’t let the throw rug throw you. Throw rugs and mats can

be slippery on linoleum, wood or tile floors. Place a gripper mat under them to keep them in place, or get rid of them altogether.

5.

Place night lights in your bedroom and bathrooms. If you’re getting up in the middle of the night, make sure you can see where you’re going. Wear non-skid footwear for better traction. Avoid leather-soled shoes or other footwear with

6.

flat, slippery soles.

7.

Make sure stairs are in good repair. Crumbling or decaying

stairs can be hazardous. If you don’t have railings, get them installed. Add outdoor lights at all of your doors, so you can see exactly where you’re stepping and what might be in your way. Consider motion-sensor lights that come on as you approach. Take steps like these to make your next steps sure and steady.

8.

Physician Diane Kane is chief medical officer at St. Ann’s Community. She is board-certified in internal medicine, geriatrics, hospice and palliative medicine and has been involved in senior care for 29 years. Contact her at dkane@stannscommunity.com or visit www.stannscommunity.com.

Would You Feel Safe in a Driverless Ambulance?

Vehicles would free up an extra person to care for patient, but studies find Price tag hits $259 billion a year, projected Americans have mixed views to exceed $1 trillion by 2050, report finds

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lzheimer’s disease claims nearly twice as many American lives annually as it did just 15 years ago, a new report shows. “And that’s frankly alarming,” said Keith Fargo, director of scientific programs and outreach at the Alzheimer’s Association, which produced the report. “Now, a lot of people will think it’s because we’re living longer,” he added. “And there is some truth to that. But there’s also an assumption that we should just expect to get Alzheimer’s disease as we get older. And that’s not true. “Most people do not get Alzheimer’s, even if they live into their 80s or 90s. It’s not normal. It’s not something that we should accept. We’ve definitely got to do something about it,” Fargo said. The report also found that more than 5 million American seniors aged 65 and older now live with the memory-robbing disease. That represents approximately 10 percent of all the nation’s seniors, and that number is projected to jump to nearly 14 million by 2050. In fact, nearly half a million seniors are expected to develop the disease in 2017 alone. Another 200,000 Americans under the age of 65 also struggle with Page 18

the disease, the report found. And those statistics come with a hefty price tag: It costs $259 billion a year for Alzheimer’s care. That amount is expected to reach $1.1 trillion by 2050, the report estimated. Physician Anton Porsteinsson is director of the Alzheimer’s Disease Care, Research and Education Program at the University of Rochester School of Medicine. He said the rising numbers likely reflect a number of different factors in play. “Partly, it is due to increasing numbers of older individuals, partly due to success in treating other leading causes of death, and partly due to increasing awareness that AD [Alzheimer’s] is a lethal disease,” Porsteinsson said. Among the report’s additional findings: Alzheimer’s is now the fifth leading cause of death among seniors; the sixth leading cause of fatalities among all Americans; and the only disease among the nation’s top 10 biggest killers for which there is no prevention, no way to slow progression and no cure. “And the costs are now completely out of control,” added Fargo, with the total annual cost for Alzheimer’s and dementia care in excess of a quarter trillion dollars.

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utomated, driver-free cars and trucks may be the wave of the future. But new research suggests many Americans aren’t sold on the idea of a ride in a driverless ambulance. This new technology does have one potential advantage over current emergency vehicles. Right now, a patient in an ambulance gets medical attention only from one paramedic, while the other crew member drives the vehicle. But “an automated ambulance would allow patients to get to the hospital much more quickly and smoothly while receiving care from two providers instead of one,” said study co-author Joseph Keebler. “Automation could be especially important in many regions where emergency medical services are insufficiently funded,” added Keebler, who is an assistant professor of human factors at Embry-Riddle Aeronautical University in Daytona Beach, Fla. And with prototype driverless cars and trucks already being tested, “it is likely that automated emergency response vehicles may soon be a

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

reality,” he and co-author Stephen Rice wrote in the study. But how would today’s public react to ambulances with computers instead of people in the driver’s seat? To find out, the researchers conducted online studies involving more than 1,000 U.S. adults. In one study, people were asked to imagine they had placed a 911 call and one of two scenarios followed: A conventional ambulance arrived with a driver and one attending paramedic, or a driverless ambulance arrived with two paramedics free to help the patient. That study, involving adults with an average age of 36, found most still preferred getting driven to an ER in a conventional ambulance. Fewer women than men would be willing to ride in a driverless ambulance, the study found, even if told they would receive care from two paramedics instead of one. The study was presented in March at the International Symposium on Human Factors and Ergonomics in Health Care conference in New Orleans.


LOCAL EMPLOYMENT LAWYER James D. Hartt, Esq. Attorney at Law

Hostile Work Environment? Employment Discrimination? Sexual Harassment on the Job?

By Jim Miller

How to Help Older Drivers Give Up the Car Keys Dear Savvy Senior, What tips can you recommend that can help me deal with my mom’s bad driving? At age 83, her driving abilities have declined, but I know she’s bound and determined to keep driving as long as she’s alive. Nervous Nelly Dear Nelly, There’s no doubt that giving up driving can be a tough step for many elderly seniors, as well as a difficult conversation for concerned family members. While there’s no one way to handle this sometimes touchy topic, there are a number of tips and resources that can help you evaluate and adjust your mom’s driving, and ease her out from behind the wheel when she can no longer drive safely.

Assess Her Driving

To get a clear picture of your mom’s driving abilities, your first step — if you haven’t already done so — is to take a ride with her and watch for problem areas. For example: Does she drive at inappropriate speeds, tailgate or drift between lanes? Does she have difficulty seeing, backing up or changing lanes? Does she react slowly, get confused easily or make poor driving decisions? Also, has your mom had any fender benders or tickets lately or have you noticed any dents or scrapes on her vehicle? These, too, are red flags. For more assessment tips see SeniorDriverChecklist.info. If you need help with this, consider hiring a driver rehabilitation specialist who’s trained to evaluate older drivers. This typically runs between $100 and $200. Visit AOTA. org/older-driver or ADED.net to locate a specialist in your area.

Transitioning and Talking

After your assessment, if you think it’s still safe for your mom to drive, see if she would be willing to take an older driver refresher course. These courses will show her how aging affects driving skills, and offers tips and adjustments to help ensure her safety. Taking a class may

also earn your mom a discount on her auto insurance. To locate a class, contact the local AAA (AAA.com) or AARP (AARP.org/drive, 888-2277669). Most courses cost around $20 to $30 and can be taken online or in a classroom. If, however, your assessment shows that your mom really does need to stop driving, you need to have a talk with her, but don’t overdo it. If you begin with a dramatic outburst like, “Mom, you’re going to kill someone!” you’re likely to trigger resistance. Start by simply expressing your concern for her safety. For more tips on how to talk to your mom about this, the Hartford Financial Services Group and MIT AgeLab offers a variety of resources at TheHartford.com/lifetime — click on “Publications” on the menu bar, then on the “We Need To Talk” guidebook.

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Refuses to Quit

If your mom refuses to quit, you have several options. One possible solution is to suggest a visit to her doctor who can give her a medical evaluation and, if warranted, “prescribe” that she stop driving. Older people will often listen to their doctor before they will listen to their own family. If she still refuses, contact your local Department of Motor Vehicles to see if they can help. Or, call in an attorney to discuss with your mom the potential financial and legal consequences of a crash or injury. If all else fails, you may just have to take away her keys.

What if you could choose?

5 Days or 45 Days

Alternative Transportation

Once your mom stops driving, she’s going to need other ways to get around, so help her create a list of names and phone numbers of family, friends and local transportation services that she can call on. To find out what transportation services are available in her area, contact the Rides in Sight (RidesInSight. org, 855-607-4337) and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. April 2017 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 19


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Medication Drop Drop Box Box Locations: Locations: Medication Bristol: Bristol: Town Hall Hall Town

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here are nearly 57 million people living with disabilities in the United States, according to the Census Bureau. Thirty percent of American adults help provide care for a sick or disabled family member. Caregivers provide physical and emotional support for the people in their care. It’s a demanding job with its stresses and rewards, but it can also be a labor of love. Social Security is committed to you throughout life’s journey, helping secure today and tomorrow for every American. This is especially true for people who need help managing their benefits. We work closely with caregivers through our representative payee program. A representative payee is someone who receives and oversees the Social Security or Supplemental Security Income (SSI) benefits for anyone who cannot manage their benefits. This can be a child or an adult incapable of managing their own funds. You can learn more about our representative payee program at www.socialsecurity.gov/ payee.

Q&A

Q: I applied for a Social Security card for my child at the hospital and the card came back with the first name misspelled. What should I do? A: Go to your local Social Security office or card center to ask for a corrected card. We need to see at least two original documents proving your child’s: • U.S. citizenship; and • Identity. We also must see proof of your identity, as the parent. The documents you show us must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies. To find out more, go to www.socialsecurity.gov/ssnumber. There, you can learn what documents you need, fill out and print an application, and then bring or mail the information to us. You may also want to read the publication, Social Security Numbers For Children, available at www. socialsecurity.gov/pubs. Q: I own a small business. How can I verify employees’ Social Security numbers? A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

A representative payee is usually a trusted family member or friend of the beneficiary, but when friends or family are not able to serve as representative payees, Social Security looks for qualified individuals or organizations to represent the beneficiary. You can learn about becoming a representative payee by watching our new series of videos on the duties of a representative payee at www.socialsecurity.gov/payee. It’s our hope that these videos will not only educate individuals about the roles and responsibilities of being a representative payee, but also provide further insight, broaden community awareness, and provide key resources to deal with the growing incidents of elder abuse, neglect, and financial exploitation. Caregivers are valuable and irreplaceable assets to our great nation. Please join us in celebrating them for all they do for those who cannot do for themselves.

purposes. For more information, go to www.socialsecurity.gov/employer/ssnv.htm. Q: I know that Social Security’s full retirement age is gradually rising to 67. But does this mean the “early” retirement age will also be going up by two years, from age 62 to 64? A: No. While it is true that under current law the full retirement age is gradually rising from 65 to 67, the “early” retirement age remains at 62. Keep in mind, however, that taking early retirement reduces your benefit amount. For more information about Social Security benefits, visit the website at www.socialsecurity. gov/r&m1.htm. Q: I was speaking with my sister and she told me that she receives half of her spouse’s benefit. Why am I not eligible for benefits from my spouse? A: If your spouse is eligible for Social Security benefits, you could be eligible for one-half of their benefit at your full retirement age. However, if you worked and are eligible for Social Security benefits on your own record, your own benefit may be higher than what you could be eligible for on your spouse’s record. If you have questions regarding your eligibility for benefits, please call 1-800-772-1213 (TTY 1-800325-0778) between the hours of 7 a.m. and 7 p.m. Monday through Friday.


H ealth News Diane Kane gets ‘Achievement Award’ Physician Diane Kane, chief medical officer of St. Ann’s Community, has received the 2017 Health Care Achievement Award for Senior Care from the Rochester Business Journal next month. The Health Care Achievement Awards recognize indiKane viduals whose contributions to health care have been deemed outstanding by their colleagues and patients. “During her 30-plus years working with seniors, Dr. Kane has been a role model in the long-term care industry,” said Michael E. McRae, President and CEO of St. Ann’s Community. “Her expertise is recognized by healthcare providers across the country who routinely request that she share her recipe for success.

associates,” said Thompson Health President/CEO Michael F. Stapleton Jr. “This sets us apart in our recruiting efforts and lets us know we are going above and beyond to maintain a happy and healthy workforce and to encourage work-life balance, which in turn benefits our patients and residents.” According to Becker’s, its editorial team determined the organizations included on this year’s list. At no cost, organizations were able to submit nominations and final decisions were made based on previous recognitions, awards, employee benefits, culture and workplace excellence. The editorial team also considered diversity, employee satisfaction and retention when developing the list. Thompson was chosen for several reasons, such as being named a “Leader in LGBT Healthcare Equality” by the Human Rights Campaign Foundation in 2014, 2015 and 2016. Becker’s also noted Thompson offers tuition assistance, on-site exercise classes, biometric screenings and opportunities for professional

development. Self-care initiatives including stretch breaks and adult “de-stressing” coloring sessions at lunchtime were mentioned, as well.

Cloverwood Senior Living has new director Andy Trepanier has been promoted to executive director of Cloverwood Senior Living, part of the Friendly Senior Living continuum of caring communities in Pittsford. He has served at Cloverwood in various positions for more than 10 years, most recently as the senior living community’s dining services director. Trepanier As executive director, Trepanier is responsible for the successful operation of programs and services through direct over-

“It is also a regular and common occurrence to receive praise from residents and family members regarding the care Dr. Kane gives at the bedside. We are continually impressed by her ability and desire to deliver exceptional care to her patients.”

Thompson among top places to work For the third consecutive year, UR Medicine’s Thompson Health is on the “150 Top Places to Work in Healthcare” list published by “Becker’s Hospital Review.” According to the hospital, it is the only health system in Western or Central New York to receive the distinction. This list includes U.S. hospitals, health systems, ambulatory surgical centers and home health agencies as well as other types of healthcare-specific companies “committed to fulfilling missions, creating outstanding cultures and offering competitive benefits to their employees.” Hospitals of all sizes are included, with the Cleveland Clinic, the Mayo Clinic and St. Jude Children’s Research Hospital among the larger ones. “Once again, being among the ‘150 Top Places to Work in Healthcare’ highlights our unique corporate culture and our exceptional team of

“The Friendly Senior Living and Cloverwood family is tremendously pleased that Andy has accepted this leadership opportunity,” said Glen Cooper, president and CEO of Friendly Senior Living. “Andy’s experience with our organization, his leadership skills, and the relationships he has built with both Cloverwood residents and staff are invaluable assets in his new role. I am confident that Andy will make great things happen for Cloverwood, its culture and, most important, our residents.” Trepanier, a United States Army Reserve veteran, earned a bachelor’s degree in food and beverage business management from New England Culinary Institute in Montpelier, Vt. He also attended Monroe Community College and the United States Army Culinary School in Fort Lee, Va. In addition, Trepanier holds certifications from the United States Army, National Restaurant Association and Culinary Institute of America in Hyde Park. He resides in Rochester with his wife, Jennie, and their three children.

Common Ground Health is FLHSA’s new name Finger Lakes Health Systems Agency, one of the nation’s oldest regional health planning organizations, recently announced it is now Common Ground Health. The Rochester-based nonprofit is rebranding to better reflect its mission to help our region find common ground on health issues, according to a new release.

Kane is also medical director of St. Ann’s Care Center in Webster. Board certified in geriatrics, internal medicine, and hospice/palliative care, she is passionate about caring for seniors. She is currently leading the expansion of an outpatient practice to address the needs of St. Ann’s Community residents in assisted living and independent living.

sight of Cloverwood departments. In addition, he will oversee the day-today functions of Glenmere Assisted Living to ensure compliance with applicable codes, rules and regulations.

Highland Chief of Cardiology Named GovernorElect of the American College of Cardiology J. Chad Teeters, chief of cardiology for Highland Hospital, has been elected as the next governor of the New York state delegation of the American College of Cardiology (NYACC). Teeters will serve as governor-elect until March 2018, when will serve as governor of NYACC and president of the New York Cardiological Society from 2018 until 2020. The American College of Cardiology is the largest organization of cardiologists in the world, with representation from each state and multiple international chapters. The New York delegation is the second largest in the ACC and is the oldest cardiological organization in the nation. Teeters’ duties will

April 2017 •

include serving as a resource for New York State cardiologists and acting as a surrogate to the national board, where he will also serve on the national ACC board of governors, effective immediately. Teeters joined Highland Hospital Cardiology in 2009. Additionally, he is an associate professor of clinical medicine at the University of Rochester Medical Center. He received his medical degree from the University of North Carolina at Chapel Hill and completed his residency in internal medicine at URMC, where he was chief resident. He also completed his fellowship in cardiovascular disease at URMC.

The organization was originally designated a Health Systems Agency (HSA) in 1974 by federal statute. After HSAs were phased out in the 1980s, the work of the nonprofit evolved, although the name did not — until now. Today, Common Ground Health brings together leaders from health care, education, business, government and other sectors to develop strategies for meeting the region’s health needs. From caring for the aging populations to preventing lifestyle diseases like high blood pressure and obesity, the organization works with key decision-makers to meet a growing list of fundamental needs for the Rochester region and beyond. “Many of our health problems are too large and complex for any one organization to solve alone,” said Trilby de Jung, CEO of Common Ground Health. “We provide the community table and data analysis that allow decision-makers to tackle health challenges together. That collaboration has led to improved care, costs, and outcomes for residents in

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 21


H ealth News our nine-county region.”

St. Ann’s named a topperforming nursing home St. Ann’s Care Center has been named one of the top-performing nursing homes in New York state by the NYS Department of Health’s Nursing Home Quality Initiative (NHQI). St. Ann’s Care Center provides long-term skilled nursing care on the campus of St. Ann’s Community at Cherry Ridge in Webster. It opened in 2012 and has 72 private rooms in a state-of-the-art building with a focus on person-centered care. “This is well-deserved recognition of the quality of care the staff at St. Ann’s Care Center provides our residents,” said Michael E. McRae, president and CEO of St. Ann’s Community. “In five short years, St. Ann’s Care Center has distinguished itself as exemplary among other facilities across the state, and we couldn’t be more proud.” The NHQI is an annual evaluation designed to improve the quality of care for residents in Medicaid-cer-

tified nursing facilities across New York state. It awards points for quality and performance in the areas of quality, compliance, and efficiency. Those scoring in the top quintile for the past three years, including St. Ann’s Care Center, are recognized as top-performing. St. Ann’s Community is Rochester’s leading senior housing and health services provider, with a tradition of quality care for older adults dating back to 1873. St. Ann’s offers a continuum of care that includes independent retirement living, assisted living, skilled nursing, memory care, short-term transitional care, wound healing, palliative care, and adult day programs. One of the area’s largest employers, St. Ann’s has more than 1,200 employees.

Excellus awards hospitals $22.9 million Forty Upstate New York hospitals and health centers last year earned $22.9 million in quality improvement payments from Excellus BlueCross BlueShield as part of

its performance incentive program. Since 2005, Excellus BCBS’s program has paid out more than $232 million.  “We are very pleased that our continuing collaboration with our provider partners has resulted in higher quality scores and increased value for our customers,” said Tony Vitagliano, Excellus BCBS vice president of health system performance. Eight hospitals in the Finger Lakes region participated in this program in 2016, sharing $9.6 million in quality improvement incentive payments. Participating hospitals are Clifton Springs Hospital, F.F. Thompson Hospital, Highland Hospital, Newark-Wayne Community Hospital, Nicholas H. Noyes Memorial Hospital, Rochester General Hospital, Strong Memorial Hospital and Unity Hospital. In 2016, Excellus BCBS’s hospital performance incentive program evaluated participating hospitals on more than 244 performance measures. Hospitals that received quality improvement incentive payments achieved 85 percent of all quality improvement targets. 

In addition to achieving required clinical and patient safety measures in 2016, other nationally endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement, and others. Areas targeted for 2016 improvement included: • Clinical Processes of Care — Focused on improvements in heart attack care, heart failure, pneumonia and surgical care, and other measures that may be unique to each participating hospital • Patient Safety — Centered on reductions in hospital-acquired infections, falls, pressure ulcers, readmissions,  and other adverse events or errors that affect patient care • Patient Satisfaction — Used the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which is the first national, standardized, publicly-reported survey of patients’ perspectives of hospital care.

Special Golden Years Issue Don’t miss the next issue of In Good Health. Reach more close to 100,000 readers (based on 35,000 copies distributed) Call 585-421-8109

Metro Footcare joins UR Medicine Serving Monroe and Ontario Counties in good A monthly newspaper published

Health Rochester–GV Healthcare Newspaper

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

In Good Health is published 12 times a year by Local News, Inc. © 2017 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Rick Bartell , Diane Kane (MD); Amy Cavalier • Advertising: Anne Westcott, Debra Kells, Denise Ruf • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Page 22

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

Metro Footcare, which has four podiatry practices in the Rochester area that have served patients for more than two decades, has joined UR Medicine. It has become a division of UR Medicine’sdepartment of orthopedics and rehabilitation and is now known as UR Medicine Podiatry. “We are excited to become part of UR Medicine and what this means for patients, who will continue to receive exceptional podiatric care while gaining access to the excellent orthopedic services and surgical facilities offered by UR Medicine,” said podiatrist Pearce Sloan. The practice also includes podiatrists David High, Michael Gruttadauria and Ayaz Habib. “Podiatry services are a valuable addition to UR Medicine Orthopaedics and Rehabilitation’s complement of services,” said Adolph S. Flemister, chief of orthopedics’ foot and ankle division. “This will provide patients and their referring physicians with a single source for the most advanced and comprehensive range of services concerning the foot and ankle.

April 2017


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper •

April 2017

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