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in good Meet Your Doctor

Cardiologist George E. Matthews talks about his new home at UBMD and why he challenges medical students to look at medicine critically

STRUGGLING WITH DIZZINESS

September 2016 • Issue 23

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MEDICAL ERROR A new study shows that medical errors are the third leading cause of death in the U.S. Officials from several Upstate New York explain how they confront, contain the Page 12 element of human error

Randy Atlas of Tonawanda struggled so much from dizziness (and had such a difficult time getting the right diagnosis) that he created a support group to help others

Want to Raise a Puppy? Guide Dog Organizations Need Help

Donating Old Hearing Aids, Eyeglasses and Mobility Equipment

Heads Up: Concussions Can Endanger High School Athletes Page 14

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See this month’s Savvy Senior column

Average American 15 Pounds Heavier Than 20 Years Ago

Grapes

Nothing heralds the start of fall in Upstate New York quite like grapes­. Find out why you should eat them Inside

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What Americans Fear the Most The biggest fear many Americans have is blindness. Losing vision would be as bad or worse than losing hearing, memory, speech or a limb, survey finds Inside


Average American 15 Pounds Heavier Than 20 Years Ago Growing wider but not taller, research shows. Men’s average weight now at 196 pounds; women, at 169

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here’s no doubt about it: Americans are getting heavier and heavier. But new U.S. estimates may still come as a shock — since the late 1980s and early 1990s, the average American has put on 15 or more additional pounds without getting any taller. Even 11-year-old kids aren’t immune from this weight plague, the study found. Girls are more than seven pounds heavier even though their height is the same. Boys gained an inch in height, but also packed on an additional 13.5 pounds compared to two decades ago. When looked at by race, blacks gained the most on average. Black women added 22 pounds despite staying the same average height. Black men grew about one-fifth of an inch, but added 18 pounds, the study found. “We are not doing nearly enough to control and reverse the obesity epidemic and doing far too much to propagate it. This is another notice of that sad fact,” said physician David Katz. He directs the Yale University Prevention Research Center and is president of the American College of Lifestyle Medicine. The new statistics were released

Aug. 3 in a report from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics. The statistics for 2011-2014 are based on an analysis of a sample of 19,151 people who underwent medical examinations and were interviewed at home. According to the report, the average weight of men in the United States rose from 181 pounds to 196 pounds between 1988-1994 and 20112014. Their average height remained the same at about 5 feet, 9 inches. The average woman, meanwhile, expanded from 152 pounds to 169 pounds while her height remained steady at just under 5 feet, 4 inches. How big of a deal are these weight gains? “A 15- to 16-pound weight gain is fairly significant and typically would be consistent with a couple of points increase in body mass index,” said Anthony Comuzzie. He’s an obesity researcher and scientist with the department of genetics at the Texas Biomedical Research Institute in San Antonio. Body mass index, or BMI, is a rough estimate of a person’s body fat using height and weight

measurements. The BMI classifies people into several categories, such as normal, overweight and obese. “From a practical point,” Comuzzie said, the average weight gain “means that someone who was on the high end of normal weight would have likely moved into the overweight category, and those at the high end of the overweight category would have likely moved into the obese category.” This matters because “we know that increasing BMI is a good indicator of overall risk for a variety of diseases, including heart disease and diabetes,” he said. The reasons behind the increase in weight are complex, according to Comuzzie. In part, he suggested, it’s related to trends toward less exercise and more access to food that’s rich in calories.

But “at the end of the day, it is still fairly basic physics: If energy consumed is greater than energy expended, then there will be a gain in weight,” he said.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

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Blindness Biggest Fear for Many Americans

Losing vision would be as bad or worse than losing hearing, memory, speech or a limb, survey finds

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lindness is what many Americans fear most, a new survey shows. “These findings underscore the importance of good eyesight to most and that having good vision is key to one’s overall sense of well-being,” said lead researcher Adrienne Scott and colleagues. Scott is an assistant professor of opthalmology at Johns Hopkins University School of Medicine in Baltimore. “The consistency of these findings among the varying ethnic/ racial groups underscores the importance of educating the public on eye health and mobilizing public support for vision research,” the researchers added in a news release. The nationwide online poll, commissioned by the nonprofit

health research group known as Research!America, found that 88 percent of more than 2,000 respondents considered good vision vital to overall health. And 47 percent said losing their sight would have the most effect on their day-to-day life. Overall, respondents ranked losing vision as equal to or worse than losing hearing, memory, speech or a limb. The top concerns associated with vision loss were quality of life and loss of independence. Close to two-thirds of the respondents said they wear glasses. But respondents’ awareness of eye diseases varied widely. Sixty-six percent were aware of cataracts; 63 percent, glaucoma; 50 percent, macular degeneration; and 37 percent, diabetic retinopathy. Onequarter of the respondents were not aware of any eye conditions. While 76 percent and 58 percent, respectively, knew that too much sunlight and family history were potential risk factors for vision loss, only half were aware that smoking puts eyesight at risk. The study was published online Aug. 4 in the journal JAMA Ophthalmology.

Drowsy Driving Causes 1 in 5 Fatal Crashes: Report

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early 84 million sleepdeprived Americans take to the roads every day. And, drowsy driving was a factor in crashes that claimed about 5,000 lives last year, a new report shows. Traffic deaths rose almost 8 percent in the United States in 2015. Drowsy driving is estimated to cause up to 20 percent of all road fatalities, but the extent of the problem is not fully known, according to experts. The threat posed by tired drivers prompted the U.S. National Highway Traffic Safety Administration (NHTSA) to expand its definition of impaired driving to include not only drunk, drugged and distracted, but also drowsy driving. The annual cost to society of

fatigue-related crashes that cause injury or death is $109 billion, according to a Governors Highway Safety Association (GHSA) report. Some drivers are at greater risk for drowsy driving. “Teens and young adults are involved in more than half of all drowsy driving crashes annually,” Adkins said. “People who work nights or long or irregular shifts are also more likely to get behind the wheel when they are too tired to drive, along with the estimated 40 million Americans who suffer from a sleep disorder.” Americans need to change how they view sleep, according to report author Pam Fischer.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Amherst Center For Senior celebrates National Senior Center Month Aging isn’t what it used to be and neither are today’s senior centers. With a growing focus on wellness, life-time learning, and volunteerism, senior centers are modernizing to meet new needs. So, when it comes

to finding tools for staying healthy and involved or finding information about benefits, senior centers are the place to start. This September, during National Senior Center Month, the Amherst Center for Senior Services invites the community to take part in its programs and to find out more about its services. New members who join during the month of September will be entered into a drawing to win a prize. The Amherst Center for Senior Services is highlighting this year’s theme “Celebrate Find Balance at Your Center: Purpose, Fitness, Friendship & Learning” with many activities and events including:

Special Events

Sept. 21: Matter of balance exercise class at 1 p.m. Sept. 26 to 30: Active aging week Sept. 27: Senior week fun day includes: free donuts and coffee from 10 a.m. to noon; photo booth from 11 a.m. to noon; balance & coordination games at 12:30 p.m.; cotton candy, popcorn & snow cones from 12 noonto 2 p.m. Sept. 28: National health and fitness day at 11 a.m.

Fall Classes

Over 95 classes to choose from fall prevention, yoga, tai chi and weight resistance classes 
 • Nutrition Lunch Program is served every week day at noon and requires reservations by calling 636-3059. A confidential, voluntary donation of $3 per person is suggested by the Erie County Department of Senior Services. • Community Volunteer Fair It is set for Oct. 5 from 4:30 to 6:30 pm. Ideal for adults or seniors looking to enhance their life by helping others. To learn more about the Amherst Center for Senior Services, call 716636-3055 or visit www.amherst.ny.us and click on “Senior Services.” The Center is located at 370 John James Audubon Parkway in Amherst.

New pajamas and books being collected The Amherst Senior Center is once again collecting new, unused pajamas (sizes infant to 17 years old) and new children’s books for its pajama program. The collection runs from Sept. 1 through Oct. 31. All items collected will be delivered to the Buffalo chapter of the pajama program, which will distribute the items through agencies such as Cornerstone Manor, Baker Victory Services, Child and Family Services and the Salvation Army. The pajama program benefits area children that are living with their families below the poverty level, in desperate need of food, clothing and shelter and others are waiting to be adopted.  For more information about The Pajama Program, visit www. pajamaprogram.org. The Amherst Center for Senior Services is located at 370 John James Audubon Parkway in Amherst, behind the library. Page 4

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016


Pay Gaps Persist for Female Doctors Across the U.S.: Study Medicare reimbursement review finds male specialists earning more

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emale doctors in the United States make much less than their male colleagues, a new study finds. Researchers examined more than 3 million Medicare reimbursement claims received by doctors in 13 medical specialties in 2012. Overall, female doctors got $34,126 less than male doctors, the investigators found. After the researchers adjusted for working hours, productivity and years of experience, they found that female doctors were reimbursed $18,677 less than their male colleagues. The study found that the largest gender gaps

were in nephrology ($16,689) and rheumatology ($15,405). The narrowest gaps were in hematology ($10,115), critical care ($4,360) and medical oncology ($3,971). The study was published online Aug. 15 in the Postgraduate Medical Journal. Tejas Desai of the division of nephrology at WG (Bill) Hefner VA Medical Center in Salisbury, N.C., and colleagues said their study does not explain why female doctors get paid less than males. But, they noted in a journal news release, the findings show that “the commonly held theories of why monetary disparities exist need to be revisited.”

Healthcare in a Minute By George W. Chapman

Hospital rankings released

After months of delay due to concerns about the methodology used, the Centers for Medicare and Medicaid Services (CMS) released the results of its hospital quality rankings. 4,600 hospitals received from one to five stars based on 64 quality measures like post-surgical infection rates, average waiting time in the emergency department, readmission to the hospital after a heart attack, use of CT and MRIs, complications after hip surgery, etc. Only 102 hospitals (2 percent) earned five stars. 934 (20 percent) earned four stars. 1,770 (38 percent) earned three stars. 723 (16 percent) earned two stars. 133 (3 percent) earned one star. 937 hospitals (20 percent) received no ranking due to insufficient data. NYS had the most one-star hospitals with 35 of the 133. Thirty three of those 35 were downstate. Faxton-St. Luke in Utica and SUNY Health Science Center in Syracuse were the two Upstate hospitals getting a single star. Many believe the rankings were biased against teaching hospitals, which typically treat more trauma, transfers from other hospitals and the more complex cases. Go to www.cms.gov and look for “CMS Hospital Compare” online to check a hospital’s ranking.

Cancer survivors increasing

The number of cancer survivors will increase by 11 million over the next two decades, according to the National Cancer Institute. Its numbers will increase from the current 15 million to over 26 million. Almost 75 percent of the survivors will be over 65 by 2040.

Text messaging your physician

CMS is working on guidelines for text messaging. The availability of better and secure text messaging technology caused CMS to reconsider its ban on text messaging which has been in force since 2011. Various studies indicate text messaging can accelerate care, boost communications between patients and their providers and streamline patient activity. A recent study of women diagnosed with breast cancer found a much higher level of satisfaction with both treatment plans and their decision making among women who used some means of electronic communication with their physician.

Healthcare to be 20 % of GDP

According to Office of the Actuary under CMS, healthcare expenditures will grow 5.8 percent a year between now and 2025. That is about 1.3 percent faster than the rest of the economy, which could make healthcare 20 percent of the gross domestic product — or GDP — by 2025. We spent $3.2 trillion last year on healthcare. The Affordable Care Act has been credited with keeping annual increase to “moderate levels” compared to the 8 percent growth rate in the two decades prior to the ACA. Price inflation accounted for less than 1 percent of the increase in expenditures. We continue to spend far more per capita or percentage of GDP, than any other country.

Curbing fraud

Penalties will soon double. The minimum penalty for each false claim submitted to CMS will double from the current $5,500 to nearly

$11,000. The maximum penalty per false claim would increase to over $21,000. There are typically thousands of false claims in a particular case meaning penalties reach into the million and sometimes billions. Whistleblowers receive a cut of the monies recovered. Many feel the higher penalties may invoke the constitutionality of the fines as a defense. The eighth amendment prohibits excessive fines. However, most cases are settled on damages or the government’s actual losses versus penalties.

Trump’s plan

Republicans have tried to repeal the ACA nearly 50 times. Donald Trump has vowed to repeal it if elected. According to the nonpartisan Center for Health and Economy, Trump’s plan would upend most of the recent reforms under the ACA. Eighteen million Americans would lose their insurance due to elimination of tax credits and Medicaid expansion. Premiums would decrease across all plan categories (bronze, silver, platinum) by removing actuarial rating and deductible restrictions and the individual mandate. Medical productivity would increase 2 percent due to a shift from employersponsored plans to individual plans. More cost sharing would result in a more price-conscious consumer. Provider access would increase 11 percent based on the assumption that new low-benefit, low-premium catastrophic plans would offer a wider network of providers. The federal deficit would decrease $583 billion over the next decade due to provisions directly related

September 2016 •

to removing the standard benefit packages under the ACA.

Feds to Increase value of primary care

In a continuing effort to make primary care more appealing to medical students and to reward those already practicing, Medicare will increase payments for internal medicine, family medicine, OB-GYN, pediatrics, geriatrics and mental health by $900 million next year. Most of the increase will come at the expense of specialists. Commercial insurers tend to follow Medicare’s lead on how physicians and hospitals are paid.

Random health facts

Lack of exercise causes as many deaths as smoking. Eating out regularly at restaurants doubles your risk of obesity. Laughing 100 times equals 15 minutes of exercising on a stationary bike. 30 percent of cancer can be prevented by avoiding tobacco, limiting alcohol and exercising. Averaging less than seven hours of sleep a night reduced your life expectancy. Just one soda a day increases your chances of Type 2 diabetes by 22 percent. George W. Chapman is a healthcare consultant who works with hospitals and medical groups. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ gwchapmanconsulting. com.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Cancer Now leading killer in 12 European nations, surpassing heart disease

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ancer has overtaken heart disease and stroke as the leading cause of death in 12 European countries, a new study reports. However, cardiovascular disease (heart disease and stroke) is still the leading cause of death worldwide, killing more than 17 million people a year, according to the study. In the 53 countries defined as the European region by the World Health Organization, heart disease killed more than 4 million people in 2016. Those deaths accounted for 45 percent of all deaths in those nations. Cancer accounted for less than half the number of deaths from heart disease in Europe as a whole, researchers said. However, success in preventing and treating heart disease seems to have led to large declines in heart disease deaths in a number of countries. Cancer now kills more men than heart disease in these 12 countries: Belgium, Denmark, France, Israel, Italy, Luxembourg, the Netherlands, Norway, Portugal, Slovenia, Spain and the United Kingdom, the study showed. The study also found that cancer now kills more women than heart disease in Denmark and Israel. Findings from the study were published Aug. 15 in the European Heart Journal. “These figures highlight the wide inequalities between European countries in deaths from [heart disease and stroke],” said study leader Nick Townsend in a journal news release. He is a senior researcher at the British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention at the University of Oxford in England. The countries where cancer caused more death than heart disease were all found in Western Europe, he noted, adding that nine of them were members of the European Union before 2004. In contrast, the highest numbers of deaths from heart disease and stroke still tend to be seen in Eastern European countries, Townsend said. “Although we have seen progress across Europe in the prevention and treatment of [heart disease and stroke], leading to decreases in mortality from it, it is clear that such progress is not consistent across the continent,” he said.

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Meet

Your Doctor

By Chris Motola

George E. Matthews, M.D. Cardiologist talks about his new home at UBMD and why he challenges medical students to look at medicine critically Q: What path led you to your current role? A: I’ve always been interested in cardiovascular disease, being that it’s been the No. 1 cause of death and illness in our country. So I saw it as the biggest opportunity to impact people’s lives. The treatment, the variety of therapies developed over the past 20 or 30 years have provided an ability to improve the health of individuals and the population at large. In terms of joining UBMB, the group I was a part of [Buffalo Cardiology & Pulmonary Associates] dissolved, so when I was exploring opportunities, I saw that UBMB offered not only the ability to practice, but the opportunity to teach the next generation of physicians. Q: How does being in proximity to medical research help your practice? A: I have access to individuals working on research, clinical trials, cutting-edge technologies, which I can apply to cases I see. Clinical trials allow us to meld the clinical aspect of the business with the research. Q: Can you give an example of this in action? A: I should add that not only are these technologies available here, but so are the individuals trained to use them. So even if I don’t necessarily perform a particular procedure, my colleagues do. We’re talking about people who specialize in very

particular niches, so if I need an interventionist, I can easily refer. We’ve got a number of treatments for arrhythmias and pulmonary heart disease. So those are just a couple of examples of what I have at my disposal at UBMD. Q: Cardiology seems like it’s at the forefront of medical advances. How hard is it to keep up? A: There’s been a sea change so far as technology goes, but with that goes knowing which technologies are most appropriate for a particular individual. The educational resources we have are of paramount importance for maintaining that knowledge base. Our area in Buffalo is particularly fortunate in having the resources to able to bring optimal therapies to bear based on the individual’s needs. So it’s the concept of personalized medicine that’s really important these days rather than a one-size-fits-all approach. Q: You’re also an assistant professor at University at Buffalo. How do you prepare the next generation of physicians to be ready for a rapidly changing medical landscape? A: The most important thing is having an open mind and questioning principles, not accepting them as dogma without some critical evaluation. If there’s one thing I hope to impart to students, residents and fellows, it’s that everything should be questioned. Not necessarily in terms of criticizing, but in terms of asking if this is the way we do things now, can we do them better? Are there other ways to approach the problem? Is this the best treatment? The landscape for how we take care of a variety of populations is changing, so the students, residents, fellows and trainees are going to have to ask themselves what do they do and can they do it better. So they will have to keep up and keep reviewing.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

Q: Do you find it’s at odds with our more test-focused culture? How do you teach critical thinking within a medical context? A: The important thing for them to realize is the education they receive in medical school is just the beginning. That it’s a foundation to build upon, which you then use as a basis for your critical thinking. When they’re examining a patient, which is really the biggest test you can take, it’s figuring out what the best measure is, what’s affecting them and how to treat it. So it’s a lot of listening, learning and then applying. Q: Is there anything new and important people should know about keeping their hearts working well? A: Often we focus on the technology but, while it’s important and crucial, the most important elements are preventive. For every individual we treat with surgery, it would have a greater impact by far to educate adolescents, children and young adults. Dietary modifications are important. Obesity is an epidemic that we’ll be seeing the negative effects of going forward. Curbing tobacco use. Encouraging exercise. These things all have a huge impact. It’s unlikely that we have enough people to address all the cardiovascular problems that’s needed, but we certainly have enough people capable of educating about preventive care. You get a force multiplier on preventive care that’s much higher than what one individual can do. Preventive health is probably where a lot of the future of cardiology lies. Q: On that note, what does a successful lifestyle intervention tend to look like? A: It’s a matter of helping them realize the benefit. We try to show that, if they modify their diet, improve their cholesterol, do cardio. It’s education, but education with a purpose that helps them appreciate the effects of it rather than leaving it abstract. It’s showing the difference between living very much in the moment and taking a longer view of their health and happiness, to live not only a longer life, but one with substantially less impairment.

Lifelines Name: George E. Matthews, M.D. He is a cardiologist with more than 30 years’ experience. The primary focus of his patient care is the diagnosis, treatment and prevention of coronary artery disease, arrhythmias, valvular heart disease, lipid abnormalities, heart failure and hypertension Position: Cardiologist with UBMD Internal Medicine, assistant professor of medicine at Jacobs School of Medicine and Biomedical Sciences, UB. Formerly with in private practice at Buffalo Cardiology and Pulmonary Associates, PC (1984-2016) Hometown: Brooklyn, NY Education: medical degree, Cornell University Medical College (1979); bachelor’s degree in biology, Brown University (1975) Affiliations: Kaleida Health Awards: Best Doctors in America – 2005-2008; America’s Top Doctor, 2012-2015 Organizations: American College of Cardiology; American Heart Association Family: Married, one son Hobbies: Exercise


After spending three years on a waiting list, Paul Bloser of Rochester is finally set to receive a new kidney Oct. 1. The kidney will be donated by his sister, Susan Boyd, who was recently medically cleared as a donor. “I’ll believe [the surgery is] happening when they’re actually putting the mask on,” he says.

Finally a Kidney, After a Three-Year Wait Rochester Paul Bloser scheduled to undergo kidney transplant, after a long wait By Katie Coleman

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ack in March I wrote an article for In Good Health on Paul Bloser, a Rochester resident living with chronic kidney disease (CKD) who was anxiously waiting

to receive a kidney transplant for almost three years. His story really touched my heart and humbled me; here is a man who is overcoming so much, staying

active and hopeful, and volunteering his time with the National Kidney Foundation to help other people living with CKD. Paul recently reached out to me with great news. After struggling through failed surgery attempts, difficulties coordinating with his local hospital, and spending three days a week at dialysis treatments, Paul’s sister, Susan Boyd, has finally been medically cleared as a successful kidney donor for Paul. The surgery is set for October. He opted to have his surgery at Carolina Medical Center in Charlotte, N.C. “We found out a few weeks ago and the ball just started rolling,” Paul said. “I’m relieved, nervous, excited and humbled. People around me have been amazing with support, and that’s been a key factor.” Paul is on the board of the National Kidney Foundation serving Upstate and WNY, dedicated to the awareness, prevention and treatment of CKD for healthcare professionals, patients and their families. “Kidney disease changes a person’s life instantly,” said Ellen Scalzo, executive director for the National Kidney Foundation serving Upstate and Western New York. “It’s a terrible disease and our efforts every day are focused on raising awareness about the risks and providing extensive education to patients, and the healthcare professionals who treat them. We’ve found that many people diagnosed with kidney disease struggle every day with what they should and shouldn’t eat.” Paul has worked really hard to help the NKF partner with Palmer’s Food Services Inc., located at 900 Jefferson Road in Rochester, to launch the new patient nutrition education program to teach those challenged by kidney disease how to plan and prepare kidney-friendly diets. Classes are already taking place and will continue on a quarterly basis at Palmer’s high-tech kitchen. (Those interested in signing up should call Elissa Rowley at 585-598-3963 ext. 373.)

“This program is the first of its kind in the nation,” Paul said. “The NKF wants to get this going nationwide. I’m excited to help people going through the same struggle as me. It’s been a long road. I’ve already attempted surgery twice for transplants, and they didn’t go through. I’ll believe it’s happening when they’re actually putting the mask on.” The NKF reports that 233,480 adults in Upstate and WNY are living with CKD, and 1.4 million more adults are at risk due to high blood pressure, diabetes or a family history of CKD. Over 4,000 people in these areas are receiving life-sustaining dialysis treatments, costing $251 million annually, according to NKF. Early detection can help prevent kidney failure.

Kidney Walk Scheduled for Oct. 1 The National Kidney Foundation serving Upstate and WNY invites the public to join the kidney aalk fundraiser event, which will take place at 5 p.m. Saturday, Oct. 1, at Frontier Field in Rochester. It will be a fun, carnival-themed walk with a goal to raise $70,000 for NKF locally supporting programs, research, education and patient care. Register at KidneyWalk.org. To reach the local National Kidney Foundation chapter call 585-598-3963 or email infoupny@kidney. org. Information on the NKF for patients, families, and healthcare providers can be found at www.kidney.org.

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Maria Corigliano, M.D. FACOG Ellen Sterman, M.D. Theresa Rush, M.D. Robin Hoebel, M.D., FACOG Rebecca Sorley-Mastrodomenico, M.D. Jane Dimopoulos, M.D. FACOG Ndey Diallo, M.D. Cheryl Haslinger, N.P. Kristen Anastasi, N.P. Lisa Wallenfels, N.P. Angela Roche, N.P. Katie Schmidt, N.P.

1360 North Forest Road, Suite 102 Williamsville, NY 14221 Phone: 716-639-4034 • Fax: 716-929-8940 www.audubonwomens.com

September 2016 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Forging a New Life on Your Own. Need Some help?

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or some women, living alone in mid-life is a welcome change, especially if they are coming out of an unhappy marriage. Being alone can offer a respite from the stress and heartache of a relationship gone bad. But for many others, the change is not welcome, and the prospect of living alone can appear on the horizon as a daunting challenge. The ending of my own marriage years ago fell into the latter category; it was not a welcome change. But it was a change nonetheless and one I had no choice but to accept and ultimately to embrace. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to organize and offer workshops to support other women in the similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a threepart workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for over 10 years now,

and often get questions from “In Good Health” readers about what the workshop covers and how it is organized. In this month’s column, I am pleased to answer the most frequently asked questions: Q. What is the purpose of the workshop and what do you cover? A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self, socialize in a couples’ world, and otherwise embrace what may be a once-ina-lifetime opportunity to create a wonderful and rewarding life on your own. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel

KIDS Corner 2 Kids an Hour Hurt in Strollers, Infant Carriers About one-third of these were more serious injuries, study finds

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lthough strollers and child carriers may look safe, two children are injured in these kid-movers every hour in the United States, a new study says. “While these products are used safely by families every day, when injuries do occur they can be quite serious,” study author Kristi Roberts, research associate in the Center for Injury Research and Policy at Nationwide Children’s Hospital, said in a hospital news release. Her team reviewed federal government data from 1990 to 2010. During that time, nearly 361,000 Page 8

children aged 5 years and younger were treated in hospital ERs for injuries that occurred while in a stroller or carrier. That works out to an average of two an hour, the researchers said. “The majority of injuries we saw were head injuries, which is scary considering the fact that traumatic brain injuries (TBIs) and concussions in young children may have long term consequences on cognitive development,” Roberts said. The most common cause of injuries was falling. Falling accounted for 67 percent of stroller

better about yourself — more selfassured and resourceful — life on your own or with a special someone can be richer and more satisfying. Getting good at living alone takes practice. There’s no magic pill and it doesn’t happen overnight. But it can happen, and good things can result. Q. Who attends the workshop? A. Most, but not all, of the women who attend the workshop are between the ages of 40 and 70, and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist or their congregation. Q. I’m still grieving the loss of my marriage/spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women feel more whole and complete on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I am not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hits and misses, I found my way and now thoroughly enjoy the freedom and independence that comes with living alone.

injuries and 63 percent of carrier injuries, the study found. Tipping over was another common cause of injuries. About 29 percent of carrier injuries and 16 percent of stroller injuries were the result of tipping over. The most commonly injured parts of the body were the head and face. Many of those injuries were soft tissue injuries, such as bumps and bruises, the study found. About one third of carrier injuries and one-quarter of stroller injuries were more serious, causing traumatic brain injuries or concussions, the study said. The researchers also found that stroller-related TBIs/concussions doubled during the study period, and carrier-related TBI/concussions tripled. Seven percent of children with a carrier-related injury and 2 percent of those with a stroller-related injury

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

My time-tested experience, resources, and tried-and-true tips and techniques have inspired and helped many workshop participants. My workshop has been the jumpstart they needed to reclaim their lives. Q. How large are the workshops? A. Ideally, I like to have eight women in each workshop, although, on occasion, I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon, near Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester. rr.com, and we’ll schedule a time 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 about her workshops or to invite Gwenn to speak, call 585-624-7887, or email gvoelckers@rochester.rr.com.

were hospitalized, meaning an average of one child a day was hospitalized with such injuries. TBIs/concussions accounted for two-thirds or more of those hospitalizations. “By taking a few simple steps — like making sure your child is buckled up every time he is in his stroller or carrier — and being aware of things that can cause these products to tip over, [you] can help prevent many of these injuries,” Roberts said. The study was published online Aug. 17 in the journal Academic


Hot Yoga, Anyone? By Tim Fenster

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ot yoga class at of Evolation Yoga Buffalo. The classes typically involve 26 poses and two breathing exercises, performed over the span of 90 minutes in a room heated to 90 or 105 degrees. Dave Drost is the owner of Evolation Yoga Buffalo. Unlike traditional yoga, Bikram yoga takes place in heated rooms where temperature can reach up to 105 degrees Though us northerners claim to love a warm summer, the truth is we

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generally avoid heat like the plague. We fill our windows with box fans and air conditioners; we install pools in our backyards to have a place to cool off; we crack the car windows and bemoan the time it takes for the car AC to kick in. But David Drost, owner of Evolation Yoga Buffalo, says that in the right conditions, there are benefits to facing the heat. And it seems more people are starting to agree. Hot yoga, more commonly

emember the “crackberry addicts” with their noses buried in the cell phone screens, oblivious to the world around them? Pokemon GO is the latest example of cell phone distraction. With a near-addictive quality, the game has swept the nation and captured the attention of game enthusiasts of all ages. While its blending gaming with real life recreation helps foster more social interaction among gamers and necessitates physical activity to participate, Pokemon GO bears some risks as well. Distracted walking and driving provide an obvious example as gamers are too busy watching their screen to watch where they’re going. Elizabeth Carey, public affairs manager for AAA Western and Central New York, said that her organization took the growing phenomenon so seriously that they issued a press release about Pokemon GO after the game became available. “It gets people up and off the couch and that’s fun, but you should never try to play behind the wheel,” Carey said. She personally witnessed someone apparently trying to play the game while driving who nearly hit her vehicle. Carey also cautions pedestrians to keep their eyes on the real world to avoid walking into traffic. “Gamers are vulnerable while playing the game,” Carey said. “Pay attention to your surroundings. Always pay attention, whether in a busy place or an isolated place.” The National Highway Traffic Safety Administration attributes 3,000 annual deaths in the US to distracted driving, which includes cell phone use of any kind. “If you look away two seconds, you double your crash risk,” Carey said. The NHTSA also states that when driving 55 miles per hour a person not looking at the road travels the length of a football field as if blindfolded. They say that distraction plays a role in nearly 6 out of 10 moderate-to-severe teen crashes. Sam Dalfonso, president and driving instructor at Buffalo Driving Schools, Inc. in

known as Bikram yoga, is becoming more popular both locally and across the country. Within the last five years, two new Bikram yoga studios have opened in the Buffalo area, Bikram Yoga Hamburg and Bikram Yoga Williamsville. The classes typically involve 26 poses and two breathing exercises, performed over the span of 90 minutes in a room that is heated to 90 or 105 degrees. Drost, who was the first in the

Catch ‘Em All Carefully Pokemon Go causes safety concerns

By Deborah Jeanne Sergeant

September 2016 •

Buffalo area to offer hot yoga, says that the practice has two main benefits over traditional (room temperature) Hatha yoga. The first comes from sweating — increased Dave Drost is the perspiration owner of Evolation Yoga helps the body remove Buffalo. toxins, cleans pores and improves blood circulation. “Most people in our culture these days tend to frown upon perspiration. Without proper perspiration, the human animal gets very ill,” Drost said. “It fosters that cleansing of the body.” The second benefit, he says, is that it encourages people to breathe deeply during periods of intense heat. He pointed out that people tend to slouch and breathe shallowly when it’s hot out. “That’s what my body needs me to do,” Drost said. “It forces us, challenges us to breathe deeply, and find a way to use our body to its maximum capacity.” Bikram yoga, a style that is so popular that it’s become synonymous with hot yoga, was founded by yoga teacher Bikram Choudhury in the ‘70s.

Buffalo, said that even at lower speeds, cars cover much more ground than many people realize. He uses a formula of dividing the car’s speed, then adding the answer to the original number. For instance, for a car traveling 40 mph, divide that by 2 to get 20. Add the 40 to 20 and you get 60. That’s nearly how many feet per second your car travels. “Obviously, it’s very unsafe,” Dalfonso said. Most people look at their phones for at least five seconds to check them. “You’ve driven almost 300 feet without knowing where you’re going,” Dalfonso said. “A lot of changes can happen in that time span.” Drivers should put their phones away while behind the wheel. Malachi Fisher, coordinator of trauma injury prevention and educational outreach for Women & Children’s Hospital of Buffalo, hasn’t treated any patients because of a Pokemon GO incident, but said he has heard of mishaps. “You have to keep your head up,” he said. “With this game, the Pokemon are all in congested spots. You’ll have a group of people looking down at their phones and not paying attention.” Pedestrians should watch both for immediate peril, such as that signpost or curb, and the possibility of danger, such as traveling through an unfamiliar neighborhood. Some players wander off and get lost while wrapped up in a game. While GPS could ordinarily guide you home, the game is hard on battery life since employs GPS to function. You may realize you’re lost just as your battery dies. Instead, keep tabs on your phone’s power supply or use a portable charger. In the thrill of finding a Pokemon, don’t stray from public property. “Sometimes, it lists places where you shouldn’t go,” Fisher said. “There have been trespassing complaints. Don’t go on private property.” Especially at night, a homeowner may not understand your intentions and could think you’re a prowler. Don’t assume other players want to meet you. Though you both may share enjoyment of the game, approach carefully.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Suffering From Dizziness By Jana Eisenberg

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andy Atlas was experiencing dizziness so debilitating that he could neither work nor drive; he ended up in bed for eight months. “I traveled to different cities, seeing neurologists who specialized in dizziness,” the Tonawanda resident recollects. “Each gave a different diagnosis.” Then he found treatment for his condition right here in Buffalo. Atlans now runs a support group — dizzygroup.org — to help other people. At one point, Atlas was experiencing dizziness so debilitating that he couldn’t work or drive; he ended up in bed for eight months. He is among the millions of adults who experience dizziness and vestibular disorders. The various causes and symptoms make these disorders difficult to diagnose and, as a result, they are not always treated properly. The Vestibular Disorder Association says that patients see on average four or five doctors before being diagnosed. And even then, it’s not always correct. This was Randy Atlas’ experience. “I traveled to different cities, seeing neurologists who specialized in dizziness,” the Tonawanda resident recollects. “Each gave a different diagnosis. One of the most common disorders is benign paroxysmal positional vertigo (BPPV), which is related to the inner ear. And that was one diagnosis I was given. I was also told that I was imagining it, or that I was ‘malingering’; that I didn’t want to work…I would have given anything to work and drive again. “Finally, in 2014, Dr. Lixin Zhang, a neurologist and director of the Dent Institute’s Dizziness and Balance Center, suggested that my problem was more related to the brain, not ears. He prescribed a medication that is normally used for seizure patients,” adds Atlas. “After he and his colleague Dr. Capote explained it, it made sense.” Patients have also found that physical therapy can work to recondition and retrain the brain — in the absence of medication or surgery to “fix it,” says physician Susan Bennett. Bennett, who holds appointments in University at Buffalo’s department of neurology, rehabilitation medicine and communicative disorders, is active in the American Physical Therapy Association. She is also a physical therapist at Susan E. Bennett PT & Associates. The first thing she does when meeting a new patient is a comprehensive examination to determine the cause of the Page 10

Randy Atlas was experiencing dizziness so debilitating that he could neither work nor drive; he ended up in bed for eight months. “I traveled to different cities, seeing neurologists who specialized in dizziness,” the Tonawanda resident says. “Each gave a different diagnosis.” Then he found treatment for his condition right here in Buffalo. Atlas now runs a support group — dizzygroup.org — to help other people. dizziness. “The most important thing in diagnosing these disorders is listening to the patient and taking a really good patient history. Also, therapists need to know anatomy and pathology,” she attests. “The most common type of dizziness is based in the inner ear — if someone is lying down and they roll over, they’ll experience a sudden burst of true room-spinning dizziness” she says. “It can be short-lasting, and be accompanied by nausea…” “The second most common

is ‘vestibular neuritis;’ it’s an infection of the cranial nerve VIII [vestibulocochlear], which affects balance,” says Bennett. “This can be a nemesis — it can come on suddenly, and patients can’t get comfortable. It can be present 24/7. Patients often have to try and stay as still as possible; sometimes they’ll think they’re having a stroke.” “BPPV is positionally provoked,” adds Bennett. “Sometimes both vestibular and

What’s Randy Atlas’ Diagnosis Again? When we asked the Tonawanda resident to be specific about his diagnosis, it took him an email to explain his condition. Here’s what he says: “I have been diagnosed with several conditions: 1) Persistent Postural — Perceptual Dizziness — with an anxiety component

2) Chronic Subjective Dizziness (very similar to the above) 3) Migraine-Associated Dizziness (a.k.a. Vestibular Migraine) — mine is without headaches, but with visual disturbances The above are all brain-related / central nervous system conditions. 4) Cervicogenic dizziness (possibly).”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

cochlear can be involved. The third most common disorder that we see is Meniere’s disease. That’s when the fluid — endolymph — that circulates through the vestibular canals and balance apparatus is blocked. The fluid accumulation increases pressure, which pushes on hair cells, which causes sudden attacks of disequilibrium.” Randy Atlas found physical therapy helpful. “The goal it is to train your brain to get used to situations that make you dizzy,” he describes. “Eye and balance exercises are also helpful.” Bennett describes this way: “We have balance retraining programs for peripheral neuropathy and vestibular neuritis — with peripheral, patients can’t tell where their feet are, and with vestibular, they can’t tell where their head is in space. It’s conceptual retraining, where people learn to use vision to override and compensate for dysfunction coming from elsewhere.” Patients start out sitting, and making small, controlled head and eye motions. They progress to larger motions and more demanding postures, such as standing while holding on, standing with a wide base, standing with a smaller base, etc. “Every patient who follows the program responds, and has been able to get back to ‘quality of life’ and activity,” attests Bennett. Atlas started a monthly support group [dizzygroup.org], so people — and friends or caregivers — can come together in an understanding environment. “I decided to start the group as I was recovering,” says Atlas. “I wanted to see who else was going through similar situations. We share feelings and coping strategies, and get new information from guest speakers. “We try to keep it positive, which is very important; we can also vent. People feel comfortable sharing things they may not be able to elsewhere. Family and friends may not understand. Having a dizziness problem can negatively affect your life and your family, like it did to me.” “Walking is part of my physical therapy,” says Atlas. “It’s good to get out of the house, to feel more steadiness, focus in the distance. Feeling grounded is the best thing; knowing that the floor is not moving, that the room isn’t turning. Once you realize that, it helps. Now I can do more, play with my daughter, walk her to school and drive her home. I couldn’t dream of doing that before.” “I wish we didn’t have to have a support group. But people still have these problems, and it helps convey that there’s hope,” says Atlas. “If I could improve from rock bottom, others can too.”


SmartBites The skinny on healthy eating

Good-For-You Grapes Burst with Benefits

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lthough grapes are available year-round, nothing heralds the start of fall in Upstate New York quite like grapes. From our grape festivals to our grape stomping to our roadside grape pies, everything is all about the grape. As a child, I liked grapes for their taste; as an adult, I like grapes for their taste, their thirst-quenching qualities — and most

importantly — their bountiful health benefits. To begin, grapes of all colors — red, green and dark purple — contain an impressive variety of antioxidants known as polyphenols. Antioxidants promote health and longevity by neutralizing damaging free radicals that have been linked to a host of health conditions and chronic diseases. Eating a variety of grapes may be especially good for hearts. Human studies have shown that grapes may promote relaxation of blood vessels, which helps to maintain healthy blood flow and reduce heart stress. Animal studies have demonstrated that grapes may

lower blood pressure and reduce inflammation. Controlling inflammation is particularly important in lowering our risk for atherosclerosis and other lifethreatening diseases, such as cancer. Dark red and purple grapes have high concentrations of resveratrol, a widely researched polyphenol that might be responsible for the cardiovascular benefits of red wine. Exactly how resveratrol might do this is still a mystery, but some researchers suggest that it reduces bad cholesterol, thwarts damage to blood vessels and prevents blood clots. Bring on the merlot, please! And while grapes do contain more sugar than a lot of fruits, eating colorful, nutrient-rich fruits is crucial to a healthy diet. A 2013 study published in the British Medical Journal, in fact, found that people who ate at least two servings each week of certain whole fruits — particularly grapes, blueberries, and apples — reduced their risk for Type 2 diabetes by as much as 23 percent in comparison to those who ate less than one serving per month. Low in fat, sodium, cholesterol and calories (only 100 per cup), grapes are also an excellent source of vitamins C and K. Immune-boosting vitamin C helps the body maintain healthy tissues and heal wounds, while bone-building vitamin K aids in proper blood clotting.

Helpful tips Select firm, plump grapes that are even in color and firmly attached to the stem. Don’t wash grapes when you return home, but do refrigerate them in the bag they came in. Rinse before eating in a colander under

cold water.

Orzo-Grape Salad with Feta and Mint Adapted from EatingWell 1 cup orzo, preferably wholewheat 2 tablespoons extra-virgin olive oil 2 tablespoons lemon juice 1/4 teaspoon salt 1/4 teaspoon freshly ground pepper 2 cups quartered or halved seedless red and green grapes 1/2 cup crumbled feta cheese 1/4 cup chopped fresh mint 1 to 2 garlic cloves, minced 2 tablespoons finely chopped red onion (optional) Bring a large saucepan of water to a boil. Add orzo and cook until just tender, about eight minutes. Drain in a colander and rinse with cold water until cool. Meanwhile, whisk oil, lemon juice, salt and pepper in a large bowl. Add grapes, feta, mint, onion and the orzo; toss to combine. 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.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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istakes happen everywhere. But when they occur in a hospital, the consequences can be fatal. Mary Brennan-Taylor understands that fact. Seven years ago during the Fourth of July weekend her mother was admitted to a hospital, according to Brennan-Taylor, an adjunct professor of family medicine at Jacobs Schools of Medicine and Biomedical Sciences, UB, a volunteer faculty appointment. As an 88-year-old woman, Alice Brennan maintained her activeness, vibrancy, independence and spontaneity. She went into the hospital for a common medical problem that was not life threatening. She died six weeks later from multiple hospital-acquired infections and from polypharmacy, the use of numerous medications. For those past seven years Brennan-Taylor traded in her pain for progress, her anger for providing answers and teaching medical students about the issue. “I’m a human being so I am not going to pretend like I wasn’t absolutely enraged about what happened to my mother,” said Brennan-Taylor. “She was experiencing leg pain and a little gout and her story ends in death and that should never have happened. Her death certificate said her cause of death was sepsis and you know that is preventable. But I wasn’t interested in demonizing a particular doctor or hospital, but helping to fix a dysfunctional system.” Brennan-Taylor didn’t want to mention the name of the hospital. She said that is her policy to never mention the hospital or the name of the doctor because her cause is bigger than that. The case is not isolated. The Centers for Disease Control recently compiled the most common causes of deaths in the United States — and medical error landed as No. 3 on the list. Medical error is defined as an unintended act of omission, a wrong plan of action or a deviation from the process that caused the patient harm. Many of these medical errors are due to human miscalculations such as diagnosis mistakes, poor judgment or inadequate skills. Yet the term medical error is never included on a death certificate. More than 250,000 people die in the U.S. yearly because of medical care gone wrong, which is just behind heart disease and cancer, according to the study. It’s an issue is calling for change and more transparency.

Teaching new generations The personal aspect of a patient’s story was something powerful added to the curriculum. While medical students understood that doctors are going to make mistakes over a lifetime, it was essential they comprehend the serious consequences of each misjudgment. “Speaking with the third-year medical residents, this is an opportunity to talk to them about the real dangers of medical error. This has to be an issue that we take seriously from the CEO in the board room to the cleaning staff,” said Brennan-Taylor. “In a hospital, you have to care about every detail.” She believes patients need to be the captains of their own medical treatments and learn about their own Page 12

Mary Brennan-Taylor, an adjunct professor of family medicine at Jacobs Schools of Medicine and Biomedical Sciences, UB, said her mother was admitted to a hospital for a common medical problem, but died because of medical error days later. “She was experiencing leg pain and a little gout and her story ends in death and that should never have happened.

Medical Errors: A Hidden Killer

Study says medical errors are the third leading cause of U.S. deaths. How Upstate hospitals confront, contain the element of human error By Ernst Lamothe, Jr medical connections “There are so many questions that I wish I would have asked and so many face-to-face meetings that I should have had with the medical team,” said Brennan-Taylor. “But I am here to not dwell on the past as much as help others learn. It’s always painful when a family member dies and there is something that could have been done about it.” However, knowing how they died can be an important element in a person’s closer.

Checking on individual doctors David Norris is the CEO and founder of MD Insider, an organization based in Santa Monica, Calif., that analyzes doctor performance using intricate comparison data. “As healthcare consumers, we should know what procedures our physicians have done and how efficient and effective they were before

we select them as our doctors,” he said during a phone interview. “We may know a lot of information about a particular hospital, but not about the surgeons and other doctors who are at that hospital. Norris’ passion for transparency began with a personal story. About 20 years ago, he went to a hospital for knee surgery. It seemingly went well because he came in the morning and was able to leave in the afternoon. Then three days later, the knee began to swell three times its size. “They had to pull out fluid and then they told me I had a staph infection,” added Norris. “That put me back in the hospital for another three weeks and they had to re-do my surgery and inject me with antibiotics. They never gave me more information. I thought I went to a good doctor, but apparently not.” Several Buffalo hospitals were contacted for this story but declined to offer any comments.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

In the Rochester area, physician Robert J. Panzer, chief quality officer and associate vice president at University of Rochester Medical Center, said his health system is taking an active role in examining medical error for the safety of their patients. The center, he said, conducts annual quality and safety surveys among physicians and all clinical teams. They use the findings to identify specific actions to take. “We take a system-wide, comprehensive approach to quality and safety, with everyone in our organization trained and engaged to promote patient safety and the best possible outcomes,” Panzer said. “Our leadership conducts weekly, monthly and quarterly reviews of our quality performance to identify and address areas for improvement. At Upstate University Hospital, part of SUNY Upstate in Syracuse, Hans Cassagnol, chief quality officer, said “if you look at the industry as a whole, one of the biggest challenges is the rate at which people get blood clots in the hospital setting,” Cassagnol said. “We tend to put patients in bed when they’re sick. That can increase the chances of them getting a blood clot. We really should prophylaxis everybody when they come into the hospital unless there is a contraindication.” Cassagnol said medical errors have been an issue in American medicine for a long time, but the health industry is finally taking a harder look at what can be done to help prevent them. He said Upstate University Hospital is taking several measures to limit any potential errors.

Coding issues The annual list of the most common causes of death system in the United States is created using death certificates filled out by physicians, funeral directors, medical examiners and coroners. When someone dies, the process begins with assigning them an International Classification of Disease code for cause of death. Because medical error doesn’t have its own code class, it cannot be entered as a reason for death. “The problem of people dying from poor medical care is not known,” said Martin Makary, surgical director at John Hopkins University School of Medicine in Baltimore, who helped write the CDC study about medical errors with physician Michael Daniel. “We spend a lot of money on heart disease and cancer, but we don’t discuss nationwide medical care. This is a problem that is likely not just in the United States, but throughout the world.” Medical researchers who worked on the CDC study recommend strategies to reduce death from medical care. They consist of three steps: making errors more visible when they occur so their effects can be intercepted; having remedies at hand to rescue patients; and making errors less frequent by following principles that take human limitations into account. An example would be putting a place in the death certificate where doctors could write whether a preventable complication contributed to the death. However, that would also make the physician liable and the medical community may not be interested in setting a precedent that might later lead to a greater number of lawsuits.


Meet Your Provider Audubon Women’s Medical Associates, PC OB-GYN team is committed to treating women through all stages of life

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udubon Women’s was founded by physicians Maria Corigliano and Ellen Sterman in 1993. Both physicians continue to practice fulltime at Audubon Women’s with their co-owners, physicians Theresa Rush and Robin Hoebel, who joined the group in 1994 and Rebecca SorleyMastrodomenico, who joined the group in 1996. In addition to the five physician owners, Dr. Jane Dimopoulos, joined Audubon in 2014. The practice is now welcoming a new physician, Ndey Diallo, who is starting in September. All physicians at Audubon are board certified in OB-GYN. Drs. Corigliano, Rush, Sorley-Mastrodomenico, Dimopoulos and Diallo specialize in obstetrics and gynecology. Drs. Sterman and Hoebel practice gynecology only. All physicians perform minimally invasive surgery, including hysterectomies and tubal ligations. Audubon Women’s also has five nurse practitioners: Cheryl Haslinger, Kristen Anastasi, Lisa Wallenfels, Angela Roche and Katie Schmidt who are all certified in women’s health and

Maria Corigliano

Ellen Sterman

Rebecca SorleyMastrodomenico

practice both obstetrics and gynecology. Audubon is committed to providing the highest quality care to its patients. Over the 23 years since Audubon was founded, it has continued to grow and expand services to ensure that all of its patients’ needs are met. Patients at Audubon Women’s have access to on-site sonography, which is offered every day of the week, including Saturdays; a mental health counselor who specializes in women’s issues; as well as a health and nutrition coach. Audubon is committed to treating women through all stages of life. Patients can be seen as

Robin Hoebel

Theresa Rush

young as 12 years old by a provider who will orient teenagers to GYN care and address highrisk behaviors. What can patients expect when they come to Audubon Women’s Medical Associates, PC? A warm and friendly staff of receptionists, medical assistants, nurses and providers. Audubon has a family friendly atmosphere, which is apparent by the family, children and pet pictures which line the hallways throughout the office. All pictures have been submitted by staff and providers and are updated frequently.

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Heads Up: Concussions Can Endanger High School Athletes Experts: Play safe, protect your head, identify when the problem arises By Deborah Jeanne Sergeant

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hile participating in school sports promotes teamwork skills, fitness and healthy self-image, student athletes can sustain serious, even lifelong injuries or die because of concussions. Emergency personnel treat more than 170,000 school-aged children and teens annually for traumatic brain injuries, which include concussions related to recreation or sports, according to the Centers for Disease Control. Before your children don their uniforms, consider how you can help lower their risk. “Prevention is the hardest part,” said Renee Reynolds, pediatric neurosurgeon with Kaleida Health at Women & Children’s Hospital of Buffalo. But recognizing and ensuring recovery from concussion can help prevent further damage. There’s no “safe” sport, so pulling your children out of football, lacrosse, hockey and soccer won’t eliminate the chance of sustaining a concussion. However, those sports do tend to see the highest rates of concussions. Any type of sport in which a participant falls, is shaken, or receives a blow to the head can cause a concussion. One that surprises many parents is cheerleading. Though not a contact sport, the activity places participants high in the air where a fall or missed catch can be disastrous. “Clinically, we see the most complications from women’s soccer,” Reynolds said. “We’re not quite sure why. It may have to do with different bodily structure like musculature in the upper body and neck. Any sport is a risk.” Concussions can cause shortterm symptoms, including headache, confusion, loss of consciousness, Page 14

nausea, vision disturbance, lack of memory about the incident, slurred speech and dizziness. Secondary concussions can cause more serious consequences, including lifelong brain damage or death. The key to preventing serious concussion injury lies in protection, playing safely and identifying concussion. Ensure your children have and use any protective gear appropriate for the activity every time they participate, including practices at home at school. Explain why the equipment is important. Though teens tend to think nothing bad will happen to them, statistically, it may. “The symptoms can be subtle at first,” Reynolds said. “It takes a qualified person. Many high school athletes may not recognize it themselves.” Visit your children’s school during a practice to see how safety equipment and rules are enforced.

Coaches and other players should not encourage rough play, though the CDC states that rough or illegal play contribute to about 25 percent of concussion incidences. Many school coaches teach football players to keep their heads up, not down, when tackling to reduce the risk. The school’s athletic department should also maintain a concussion awareness program, which includes removing athletes from play who may have suffered a concussion. They should follow a return to play protocol that includes a physician’s examination and clearance. “Any potential symptom of a concussion should be taken seriously and they should report that to the parents, trainer, or coach so the adult can remove the child from play before they sustain another head injury,” said John Leddy, director of the Concussion Management Clinic at University Buffalo. “The

Physician John Leddy, director of the Concussion Management Clinic at University Buffalo. “You can’t prevent all concussions, but you can identify them and get them checked and make sure they’re fully recovered before playing again,” he says.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

worst thing that can happen is that a student gets hit, has symptoms and they just choose to ignore symptoms and get hit again.” Leddy also serves as a clinical professor of orthopedics at the Jacobs School of Medicine and Biomedical Sciences and physician with UBMD Orthopaedics and Sports Medicine. Telling athletes to “shake it off” and return to play endangers their health and, possibly their lives. Although it’s rare, athletes have died from secondary concussions. It’s not worth the risk. “You can’t prevent all concussions, but you can identify them and get them checked and make sure they’re fully Renee Reynolds is a recovered pediatric neurosurgeon before with Kaleida Health. playing again,” Leddy said. For more information about preventing concussion injuries, visit http://www.cdc.gov/headsup/ index.html.

7 Ways to Avoid Serious Injury From School Sports • Good nutrition and proper hydration are key. • It’s important to stretch, warm up and cool down for practices and games or competitions. • Practice and use proper techniques for your sport, such as tackling in football; tumbling in gymnastics; and running, jumping and landing in basketball and track events. • Always wear all recommended safety equipment, and be sure it fits properly. • Cheerleaders and gymnasts should train only in properly equipped facilities with recommended safety equipment, including quality tumbling mats. • Basketball players and trackand-field athletes shouldn’t push themselves too hard because doing so increases the risk for overuse injuries. • Remember that rest is an important part of the training cycle. From physician Jennifer Beck, specialist in pediatric sports medicine at the University of California, Los Angeles Medical Center.


Intervention Radiology

Guiding Medicine from Diagnostics to Treatment

Field has dramatically expanded the role it plays in treatments, diagnosis By Deborah Jeanne Sergeant

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any people become familiar with radiology through a diagnostic such as X-ray or sonogram. But the field has grown dramatically in the past several years to make the radiologist a vital part of treating diseases and disorders from head to toe. One example is interventional radiology, which can enable minimally invasive procedures. “This new realm with interventional radiology is essentially a different route to treat relatively aggressive diseases,” Linda Kerwin, dean of health professions at Trocaire College. “We can perform surgery in almost every organ.” For example, instead of creating an incision in the neck to clear the carotid artery, threading instruments through a nick in the skin to clear the lesion is less painful and expensive. Patients experience much shorter recovery and a reduced risk for infection. Kerwin also referenced abdominal aneurism. “Depending on the size, we can enter a vessel in your groin,” she said. “We can do a repair considerably less invasive than a huge abdominal incision with pain medicine.” Medical imaging can also help guide a catheter to administer radiation to tumors in organs and bones to target the malignant cells while leaving healthy ones intact. “They’ve been most successful with kidney cancer,” Kerwin said. “Liver cancer in the past has been extremely hard to treat. We can enter the system and be more precise in

A vascular interventional radiologist, Azher Iqbal offers a variety of treatments. He recently opened Buffalo Vascular Center in Lancaster, a full clinical practice, because of the growth in vascular-based treatments.

fighting a malignancy. “Neurovascular-wise, we’re going farther into the brain to treat malignancies that before were considered inoperable.” Vertebrae repair offers another example. For an elderly patient, a fractured vertebrae begins a sharp physical decline as mobility is minimized. “Those who get spine fractures get put on bed rest for 12 weeks with narcotics,” said physician Azher Iqbal with Vascular Interventional Associates in Lancaster. “They can get constipation, pneumonia and their bones get weaker because of the bed rest.”

Staying laid up so long can also lead to lack of social interaction and further deconditioning. But thanks to radiology, physicians can perform a vertibroplasty, a procedure that involves injecting cement to stabilized the fractured bone through a 1/8-in. incision. “It stabilizes the bone and they’re pain-free in two hours and go home the same day,” Iqbal said. For elderly patients unable to tolerate general anesthesia and invasive surgery, the procedure has proven life-changing. A vascular interventional radiologist, Iqbal offers a variety of treatments. He recently opened

For People with Skin Problems, Phototherapy Has Made a Difference By Tim Fenster

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n an effort to provide expanded and more convenient treatment for children suffering from skin disorders, the department of pediatric dermatology at Women & Children’s Hospital of Buffalo is significantly extending its hours for phototherapy treatment. Phototherapy is a safe and effective ultraviolet light therapy that is used to reduce the inflammation caused by skin disorders such as eczema, psoriasis and vitiligo, among others. It is especially helpful for those with severe skin disorders that require stronger therapy treatments than creams and ointments, and is safer than strong systemic medications. “It’s a great treatment for people who can’t control their skin disorders with creams alone,” said physician Ilene Rothman, chief of pediatric dermatology at WCHOB. However, in order to be effective, the treatments must be administered

two to three times a week over a period of three months to one year, though some conditions can be treated much faster. The duration of the treatment has presented a barrier to some families who are working or in school when the therapies are available. Rothman said their hope is that by expanding treatment hours, they will be able to reach more children, and eventually, adults as well. “The problem with phototherapy is people have to come in for treatments regularly,” Rothman said. “It’s an inconvenience for people who can’t come in during school or during the day.” Rothman added that the treatment itself is fast and pain-free. Patients enter a booth with banks of ultraviolet lights on the walls, and remain there for no more than a few minutes, sometimes less than one. The treatment utilizes narrowband ultraviolet B, which is considered the safest and more

effective form of ultraviolet treatment. “We use only the part of the light spectrum that is effective for treating skin, and filter out the parts that burn the skin,” Physician Ilene Rothman Rothman, chief of said. “You can get pediatric dermatology a little at WCHOB. redness, but no direct links to skin cancer have been found from narrow-band ultraviolet B.” Rothman added that narrowband ultraviolet is far safer than the lights that are typically used in tanning beds, which of course are

September 2016 •

Buffalo Vascular Center in Lancaster, a full clinical practice, because of the growth in vascular-based treatments. His new center focuses on reducing amputation rates by using interventional radiology to restore blood flow to limbs endangered by non-healing ulcers. The outpatient procedures enable patients to return home after two hours. Iqbal said that using interventional radiology can help prevent hysterectomy. Treating uterine fibroids used to mean hysterectomy; however, radiologists can use an artery in the leg or groin to embolize the blood vessels and shrink the fibroids until they become asymptomatic. Patients can return home the same day instead of the lengthy hospital stay caused by hysterectomy. Plus, patients avoid the risk of adhesions and scar tissue associated with abdominal surgery. “It’s an option not generally offered because most physicians are not aware of it,” Iqbal said. “It’s an excellent treatment for women who don’t want to undergo major abdominal surgery.” Correcting varicose veins is another procedure Iqbal offers. Previously, patients’ only choice for the painful condition was what Iqbal “stripping out the veins.” Instead, ablation of the main veins of the leg, guided by medical imaging, can greatly decrease pain in the legs and improve the appearance, too. Patients can return home after the hour-long procedure instead of experiencing a prolonged hospital stay. Although radiology’s minimally invasive procedures won’t replace general surgery, for some conditions, it can reduce recovery time while providing the same or even better results. For many of these procedures, a little sedation and a numbing medication is all patients need instead of general anesthesia. Using imaging can help reduce the length of hospital stays and turn some procedures into outpatient treatments.

associated with an increased risk of skin cancer, including melanoma. “That’s why we advocate that people don’t go to tanning beds for skin disorders,” she said. For patients like Erik Betancourt, Jr., 8, phototherapy has made all the difference. Erik was born with atopic eczema, and was diagnosed with the condition at 6 months old. His mother, Karlisha, said he suffered for years from near constant inflamed and itchy skin. Erik was entered into WCHOB’s phototherapy program at the beginning of last year, and soon saw positive results. “He doesn’t scratch anymore. It’s made a big difference,” she said. Karlisha added that WCHOB has been flexible, made her son comfortable during treatments and have been with them ever since his birth. “This has been a process for us, and they’ve been with us every step of the way,” she said. WCHOB’s phototherapy program will be able to accept more adult patients in January 2017, after the program is relocated to the Conventus Medical Office Building near the corner of Main and High streets in Buffalo.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Men’sHealth Early Prostate Cancer Diagnoses Continue to Fall in U.S.: Study Decline follows recommendation against routine screening, but experts not sure if trend is good or bad

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iagnoses of early prostate cancer continue to decline in the United States, following the U.S. Preventive Services Task Force recommendation against routine screening for the disease, researchers report. The screening involves a blood test that identifies levels of PSA (prostate specific antigen), a protein produced by the prostate gland. That test can determine when cancer exists, but it often wrongly identifies nonexistent cancer. These “false positive” results can cause anxiety and lead to unnecessary followup tests. Because of this, the task force issued a draft recommendation against routine screening in 2011 and a final guideline in 2012. Since then, diagnoses of early prostate cancer in American men aged 50 and older dropped by 19 percent between 2011 and 2012 and by another 6 percent the following year, said lead researcher Ahmedin Jemal. He is a physician and vice president of the American Cancer Society’s surveillance and health services research program.

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But while many men may have been spared unnecessary anguish, less frequent screening may have a downside. Some experts worry more men will develop potentially fatal prostate cancer as a result. “Prostate cancer is a slowgrowing tumor, so it takes time. We may see it over the next three to five years,” Jemal said. There is a balance in the task force recommendation, said Anthony D’Amico, chief of genitourinary radiation oncology at Brigham and Women’s Hospital and the Dana Farber Cancer Institute, in Boston. “Some men who should not be treated are not being diagnosed, but that also means some men who should be treated are either losing the chance for cure or presenting later and needing to undergo more treatment and more side effects for a possible cure,” he said. “The answer to this dilemma will come with personalized medicine based on risk-based screening — screening men preferentially in good health and at high risk,” D’Amico added.

Paul Morgan, founder of Western New Yorkers Against Conversion Therapy (in blue) leading a recent parade against conversion therapy. To the right of him is Lorri Johnson, who is an LGBT activist from Jamestown.

Local Group Condemns ‘Conversion Therapy’

Controversial practice was initially included in the Republican National Committee’s proposed platform By Tim Fenster

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hen the 2016 Republican National Committee’s proposed platform was released in July, national attention was immediately drawn to a line that explicitly defended a controversial practice that’s commonly known as conversion therapy. The practice often involves aversion treatments, psychoanalysis, masturbatory reconditioning and sometimes prayer in an effort to change an LGBTQ person’s sexual orientation. There is no standard approach to conversion therapy, because it has been discredited by practically every major medical group, including the World Health Organization, American Medical Association and American Psychiatric Association. “The almost unanimous consensus among medical organizations in the U.S. and across the world is that [conversion therapy] is ineffective at best and harmful at worst,” said Paul Morgan, founder of Western New Yorkers Against Conversion Therapy. Religious and social conservatives argue that individuals should be free to try and abstain from the homosexual lifestyle. They also say parents should be able to decide whether such therapy is right for their children. (It should be noted that while the final RNC platform does not mention conversion therapy explicitly, it does advocate for a parent’s right to “determine the proposed medical treatment and therapy for their minor children.”) But a growing body of evidence shows that conversion therapy can be harmful to young people, and several states, including California and New Jersey, have banned the practice for minors. “If that change [in sexual orientation] doesn’t come about,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

they’re dealt an enormous psychological blow,” Morgan said. “When you inflict that on children, the effects are magnified.” In the case of Long Island native Mathew Shurka, participation in conversion therapy caused years of confusion, frustration, alienation from family members, depression and eventually, suicidal thoughts. Shurka explained that he entered a conversion therapy program after admitting to his father, at age 16, that he had been with boys (as well as girls) and had a crush on a fellow male student. At his father’s behest, Shurka met with a conversion therapist who told him that his homosexual feelings were caused by some trauma in his past. Although Shurka had never experienced any sort of real trauma to that point in his otherwise normal upbringing, he believed the therapist. “I was told that because all my urges were a response to my trauma, I would never experience true love,” he said. Before long, Shurka was committed to becoming straight. He masturbated to heterosexual-oriented pornography. He slept with as many girls as possible. He spent all his time with men, trying to act traditionally masculine, and avoided any kind of platonic communication with women. This even meant not talking to his sisters and his mother, which, of course, caused tension at home. “All my training, it was all based on stereotypes,” he said. By the time Shurka enrolled in college, it became increasingly clear that his efforts weren’t working. All the time he was spending around men only increased his homosexual feelings. And while he was still

Continued on page 18


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Donating Old Hearing Aids, Eyeglasses and Mobility Equipment Dear Savvy Senior,

Where are some good places to donate old hearing aids, eyeglasses and mobility equipment? My uncle passed away a few months ago and left behind a bunch of useful aids that could surely help someone else.

Searching Nephew

Dear Searching,

Donating old, unused assistive living aids or medical equipment is a great way to help those in need who can’t afford it, and in most cases its tax deductible too. Here are some good places to check into.

Hearing Aids

There are several national nonprofit service organizations that offer hearing aid recycling programs. Hearing aids that are donated are usually refurbished and either redistributed to those in need or resold with the proceeds going to buy new hearing aids for people who can’t afford them. One of the most popular places to donate old hearing aids, as well as hearing aid parts or other assistive listening devices is the Starkey Hearing Foundation “Hear Now” recycling program (starkeyhearingfoundation.org, 800-3288602), which collects around 60,000 hearing aids a year. Hearing aids and other listening devices should be sent to: Starkey Hearing Foundation, ATTN: Hearing Aid Recycling, 6700 Washington Ave. S., Eden Prairie, MN 55344. Some other good nonprofits to donate to are the Lions Club Hearing Aid Recycling Program (go to lionsclubs.org and search for: HARP), and Hearing Charities of America (hearingaiddonations.org, 816-3338300), which is founded by Sertoma, a civic service organization dedicated to hearing health. Or, if you’re interested in donating locally, contact your Hearing Loss Association of America state or local chapter (see hearingloss. org for contact information). They can refer you to state agencies or community service programs that also accept hearing aids.

Eyeglasses

One of the best places to donate old eyeglasses is to the Lions Club Recycle for Sight program. They

collect nearly 30 million pairs of glasses each year and distribute them to people in need in developing countries. To donate, look for a Lion’s Club glasses donation drop-off box in your community. You can often find them at libraries, community centers, churches, schools and many local eye doctor offices or call your local Lions Club for drop-off locations. See directory.lionsclubs.org for contact information. New Eyes (www.new-eyes. org/recycle) is another nonprofit organization that collects unused eyeglasses and distributes them abroad to people in need.

Medical Equipment

If you have old wheelchairs, walker, canes, shower chairs or other durable medical equipment, there are many foundations and organizations that would love to receive them. For example, Goodwill and Salvation Army stores are popular donation destinations, as are foundations like the ALS Association (alsa.org) and Muscular Dystrophy Association (mda.org), which accept donations at local chapters. There are also state agencies and local nonprofit organizations that accept medical equipment donations and redistribute them to people in need. To find what’s available in your area, contact your state assistive technologies program for a referral. See ataporg.org/programs for contact information. Or, if you’re interested in selling your uncles old medical equipment, you have options here too, including craigslist.com, recycledmedical.com and usedhme.com, which are all free sites that let you list what you want to sell online.

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With 4.5 million dog bites occuring annually in the US, parents with young kids are advised to be careful before bringing a dog in their home

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Going on Vacation? A week’s vacation may leave many adults with a heavier midsection — extra weight that can hang around even six weeks post-vacation.

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Online Breast Milk There has been an explosion of websites that buy and sell breast milk and traffic in those sites has continued to rise. Transactions have more than doubled in the past three years. And it’s not just moms buying it. But how Page 14 safe is buying breast milk online?

One Year, No Domestic Line Infections Violence

Beloved Buffalo Sabres broadcaster and throat cancer survivor Rick Jeanneret helping promote Relay to Life. See inside

The Revenge of Bedbugs They’ve grown thicker skin, which helps protect against pesticides and may explain why population is growing worldwide, scientists suggest

Living Alone: Create Your Own Perfect Day!

A Former Ballet Dancer Making a Difference Dancer Cynthia Pegado has performed in Belgium, Switzerland and Portugal. Now she is devoted to helping patients with Parkinson’s disease in Buffalo

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Why You Should Fall for Mangoes

NYS Hospital Mergers Driving Up Prices A study by the conservative think tank, the Manhattan Institute, concludes that the 100-plus hospital mergers in NYS have served to only increase costs and decrease competition with no perceptible increase in quality. See “Health in a Minute” on page 5

Q&A with Christopher Kerr, M.D.

Mangoes, the world’s most popular fruit (who knew?), bring a wealth of powerful nutrients.

One in four women has been the victim of severe physical violence by an intimate partner, while one in seven men have experienced the same. Why this is still a problem and how local groups are trying to tackle it

5

Autism: Are Girls Being Overlooked for Screening?

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Farrell family from Tonawanda with their newborn at the Women & Children’s Hospital of Buffalo’s NICU. The unit recently celebrated one year without any central line infections.

The Surprising Benefits of Portobellos

Hospice Buffalo chief medical director talks about the end-of-life experience and why we have the thoughts we do when we’re in final hours May 2016 •

Page 3

Reasons to Do Aquatic Therapy

Page 1

Tai Chi Could Be a Healthy Move for Your Heart

Tai chi and other traditional Chinese exercises might reduce depression, improve quality of life for heart patients

Q&A with Carlos A. Santos, M.D.

This mushroom possesses such a unique and vast array of nutrients, it’s hard to know where to begin.

Founder and managing partner of OB-GYN Associates of Western NY talks about growing a single-specialty group focused on women’s health April 2016 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Don’t forget that donations to nonprofits are tax-deductible, so when you drop off your donated items, be sure to ask for a receipt for your tax records. Or, if you’re mailing it in or are using one of the Lions Club drop-off boxes, you’ll need to include a note requesting a letter of acknowledgement of the donation. Your note should include your name and a brief description of what you donated, along with a self-addressed stamped envelope. 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.

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Prepare for Your Disability Interview: Tips From Social Security

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Bill to ban controversial ‘conversion therapy’ is stalled in the state senate

hen a person becomes disabled, it can be a very stressful time in their life. There are many questions and unknowns when you have to transition out of the workforce due to medical issues. While an employer may offer short or long-term disability, most people faced with a disability will file for benefits with Social Security. If you’re facing life with a disability and don’t know where to start, we encourage you to visit our website at www.socialsecurity. gov/disabilityssi. You can apply for benefits on our website; it’s the most convenient way. Additionally, you can contact us at 1-800-772-1213 (TTY 1-800-325-0778) or visit your local office if you wish to apply for disability benefits. When applying for benefits, you should be prepared to answer a number of questions including: When your conditions became disabling: • Dates you last worked; • The names, addresses, phone numbers, and dates of visits to your

doctors; • The names of medications that you take and medical tests you’ve had; and • Marital information. In addition, if you plan on applying for Supplemental Security Income (SSI) disability payments, for people with low income who haven’t paid enough in Social Security taxes to be covered, we will ask you questions about: • Your current living arrangement, including who lives there and household expenses; • All sources of income for you and your spouse, if applicable; and • The amount of your resources, including bank account balances, vehicles, and other investments. You can view our disability starter kit at www.socialsecurity.gov/ disability/disability_starter_kits.htm. Remember, we are there when you might be faced with one of the hardest obstacles of your life. Social Security helps secure today and tomorrow with critical benefits for people with severe disabilities, not just during retirement. Learn more at www.socialsecurity.gov.

Continued from page 16 trying to be intimate with women, he was no longer functioning in bed. By then Shurka was seeing a different therapist (he saw four over five years), and this one responded to his supposed erectile dysfunction by prescribing him Viagra. “This on so many levels is a violation of what a therapist should do,” Shurka said. But the continuation of heteronormative behavior only left Shurka totally demoralized. He had been in these programs for about three years now, he had been trying as hard as he could, and yet he didn’t feel any more “normal.” Like others, Shurka grew increasingly depressed, and over the next two years, he contemplated ending his life. “All I could think of was how much is wrong with me,” he said. Finally, at 21 years old, Shurka left conversion therapy. Two years later he came out, and at age 24, he began advocating for banning conversion therapy for minors. Shurka, 28, is now an LGBT rights spokesperson and an adviser member of the Born Perfect Campaign. He pushed for Gov. Andrew Cuomo’s February 2016 executive order that barred insurance coverage of conversion therapy for minors — a move that both he and Morgan hailed as an important step Page 18

in the right direction. “Anyone concerned with the welfare of children owes the governor a debt of gratitude,” Morgan said. But both agree it isn’t enough. LGBT rights groups are pushing for a ban on conversion therapy for minors at both the state and federal level, but have encountered opposition from Republican lawmakers. A 2014 bill to ban the practice for children passed the New York State Assembly, which has a Democratic majority, but stalled in the Republican-led Senate. It has yet to be taken up for a vote. In the meantime, Morgan and Shurka will continue to try and raise awareness of the psychological harm that conversion therapy can do to young people. As Shurka himself learned, growing up as an LGBT person is difficult enough; but with parents who don’t support your sexual orientation, this time can be a nightmare. “If the parents are supportive of their child, it makes such a difference,” Shurka said.

Letter to the Editor Mistaken Identity Dear Editor, I enjoyed reading your July 2016 issue of In Good Health. There were a number of informative articles I enjoyed. Being originally from the Central New York area myself, I was pleased to read the article, “Mistaken Identity,” by Aaron Gifford, as transgender services are greatly needed. However, while the article mentioned that this comprehensive care is unusual which seems true, I did want to point out that Evergreen Health Services in Buffalo is well-known to provide comprehensive medical and mental health services to this population as well. Additionally, a well-kept “secret” at Erie County Medical Center is our outpatient OCD Specialty Clinic, which provides specialized treatment for Obsessive Compulsive Disorder, by specially

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

trained psychotherapists (like myself) and psychiatrists. The treatment of OCD is unlike other mental health disorders, in that it requires a different behavioral approach rather than a cognitive/ stress-reduction approach. If you are interested in learning more about our services, we welcome inquiry. My colleague, Ellen Metzger, LCSWR, is the coordinator. Thanks again for a great publication!  

Shirley Mazourek, LCSW-R ECMC Outpatient Behavioral Health


Health News Genetic counselor joins Windsong Health Medical

Laura Fisher, a certified genetic counselor, has joined Windsong Radiology Group’s affiliate, Windsong Health Medical Alliance, PLLC. A news release states that the addition strengthens the nationally accredited Windsong Breast Care Program, a first of its kind collaborative program in Fisher WNY, designed to assist newly diagnosed breast cancer patients through coordinated care and ultimately improved outcomes. Fisher received a Master of Science degree in genetic counseling from Boston University and has most recently provided genetic counseling at Women and Children’s Hospital of Buffalo. “We are incredibly fortunate to have Laura join us,” said physician Thomas Summers, president of Windsong Radiology Group, PC. “She is enthusiastic about her new role with Windsong and the breast care program. She is a dedicated

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and intelligent counselor committed to offering a compassionate, informative environment for patients seeking genetic counseling,” The field of genetic counseling is on the rise and counselors like Fisher have become essential to healthcare. According to the National Society of Genetic Counselors, the field has grown 75 percent since 2006. As healthcare moves in the direction of personalized medicine, counselors will be vital to the care of patients, according to Summers. Genetic counselors know all too well that cancer gene testing does not provide a simple “yes” or “no” answer to the question of whether individuals will get cancer. Fisher will help patients understand how results of genetic testing may impact their health, mental and emotional well-being. “With genetic testing for inherited cancer predisposition becoming more widely available and increasingly complex, it is my goal to provide patients with the counseling and education needed to help them make informed decisions,” said Fisher.

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community-based organizations have come together to create the “Quality Living to the End of Life” coalition. The mission of the “Quality Living to the End of Life” coalition is to encourage Western New York residents and their loved ones to consider, discuss and document their values and choices and to facilitate processes within the medical community that ensure that those values and choices are honored.   The coalition is comprised of Western New York hospital systems, Roswell Park Cancer Institute, the Performing Provider Systems (DSRIP’s Community Partners of WNY and Millennium Collaborative Care), the three health insurance payers, HEALTHeLINK, and leaders from academia and community based organizations.  The coalition is led by the P² Collaborative, which has been asked to spearhead the effort as a neutral convener. John Craik, P²’s executive director, said that when he was named for the position a year ago, a number of health leaders indicated that the creation of a coalition such as this was a priority for Western New York.   “Effective January of 2016 doctors could bill Medicare for having the important conversations with patients about how they want to plan for the end of their lives,

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but just changing the billing codes hasn’t been enough to really drive changes. We’re hoping to change that by giving doctors and other healthcare professionals realistic and pragmatic tools, tips and guidance on how to do this crucial work with patients,” said Craik. On Sept. 17, the coalition will host a half-day training on having meaningful discussions for healthcare professionals.  The training will be an interactive affair that will include role-playing activities, speakers and a panel discussion with family, professional, academic, work flow and legal issues addressed. Visit www.p2wny.org for more information.

BC BS announces Medicaid alliance BlueCross BlueShield of Western New York recently announced an alliance with Amerigroup Partnership Plan to help administer and manage the company’s Medicaid managed care programs. BlueCross BlueShield recently notified the New York State Department of Health (DOH) of the agreement and its intention to continue to serve its current 26,000 Medicaid members. Pending approval from DOH, BlueCross BlueShield will begin to enroll new members in the coming months and anticipates the full transition of management services to Amerigroup by the end of 2016. BlueCross BlueShield members do not need to make any changes as a result of this agreement. Additional information and updates will be provided to BlueCross BlueShield Medicaid members, health care providers and all other critical stakeholders in the coming months. The agreement is limited to BlueCross BlueShield’s statesponsored programs and does not impact any other lines of business, nor reflect any broader long-term strategy. “We have a long history of supporting our Medicaid members, which is core to our mission as a community-based, not-for-profit health plan,” said Dave Anderson, president and CEO, BlueCross BlueShield of Western New York. “Amerigroup’s experience and expertise will allow us to remain in Medicaid long term, and continue to deliver access to high-quality health care.” Amerigroup’s parent company serves more than six million Medicaid members nationwide through its subsidiaries, including 460,000 Medicaid members in downstate New York through Empire HealthPlus. It maintains similar alliances with several partners across the country who participate or desire to participate in Medicaid programs.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Want to Raise a Puppy?

Guide Dog Organizations Need Help Puppy raisers needed to provide the first training for dogs that will serve as guide dogs By Deborah Jeanne Sergeant

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uiding Eyes for the Blind, an organization that trains service animals, estimates that about 2 percent of people in the U.S. with visual impairment use guide dogs, amounting to about 10,000 guide dogs. Numerous regional and national organizations train guide dogs, but before dogs qualify for guide dog training, they need a foster home. That’s where puppy raisers come in. Everyday people may be good candidates for providing a potential guide dog’s first home. Most organizations don’t enforce many parameters about a puppy raiser’s age, occupation or marital status; however, a few traits help make a puppy raising experience successful. Beverly Underwood, founder and president of Canine Helpers for the Handicapped, Inc. in Lockport, said that patience, time and, “ideally, previous dog experience” along with a caring environment represents traits of a good puppy raiser. “Puppy raisers are the key to whether the puppy will be successful or not,” she added. Her organization raises about 20 to 40 dogs annually, all of which are rescue animals, except for the occasional donation from breeders. “A good candidate is someone who loves dogs and wants to make a difference in the life of an individual who’s visually impaired or has a special need in addition to being visually impaired,” said Mary Ellen Pratt, Erie County regional coordinator for Guiding Eyes for the Blind. Without plenty of adult help, children likely cannot raise a puppy themselves, but many families enjoy raising guide dog candidates together. Puppy raisers should have plenty of time to spend with a puppy. People who travel for work frequently to places where puppies can’t go, or spend numerous hours away from home may not be ideal puppy raisers. Retirees, at-home parents, small business owners, and those with accommodating workplaces possess the flexibility to tend to day-to-day puppy care, attend training meetings and take the puppy to plenty of places for socialization. Puppy raisers must keep in mind the long-term goal for their new Page 20

Paula Weronski of Gowanda, puppy raiser for Guiding Eyes for the Blind, holds her new puppy, Pat. Photos Courtesy Guiding Eyes for the Blind.

Pat is the puppy who is going through training in Gowanda. At about 18 months of age, the dog is usually ready for further training as a guide dog if it passes muster.

charge: placement as a guide dog. That means following the directions of the guide dog organization, such as teaching good manners, enforcing housebreaking and preparing to return the dog. “The things a pet dog is allowed to do — we have to think beyond that,” Pratt said. “Close your eyes and imagine laying out your briefcase and shoes. If one was missing, a blind person would have a really hard time.” At about 18 months of age, the dog is usually ready for further training as a guide dog if it passes muster. Depending upon the organization, dogs that don’t “pass” guide dog training may be passed along to a different branch of their organization or to a different service organization for another type of service. Some return the animals first to the puppy raiser for optional

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • September 2016

adoption, and, if refused, to another good home. Guide dog training organizations source dogs through breeding, rescue and/or donation. The animals are expected to learn good manners and balance obedience with the moxie to contradict their handlers if that’s what it takes to guide them away from danger. Linda Damato, director of the puppy program for Guiding Eyes for the Blind in Yorktown Heights, NY, said that the organization has about 440 puppies in foster homes. Guiding Eyes serves the area from Ohio eastward and from Maine to North Carolina. Though it’s a lot of work to socialize and care for a puppy, she said that “most of the puppy raisers say when they hand in the dog that they get out of it more than they give. There’s a connection with the community they build.” Since 2007, Lynn Fox has raised around seven dogs for Guiding Eyes for the Blind. It started as a means to have a dog with a short-term commitment for her 10-year-old’s sake. Ironically, she still raises dogs for Guiding Eyes for the Blind as a service project. She and her husband, Jamie, and their three daughters attended weekly lessons to learn how to work with the puppy. “It’s a very emotional time when you hand over the dog, but it’s bigger than that,” Fox said. Understanding the difference a dog makes in the life of its recipient helps tremendously. Fox’s flexible schedule has made puppy raising easier to fit into her life. “It’s a great commitment,” Fox said. “You have to incorporate this puppy into your life, not just as a hobby you can stop or start.” Cindy White, a retiree in Buffalo, has raised puppies for Canine Helpers for about 10 years. “I like working with dogs and give them basic obedience for when they’re in public,” White said. It’s important for puppy raisers to only train within the parameters of the organization to avoid confusion later. She takes her charges everywhere she can to expose them to innumerable sights, sounds and smells. “What’s most important is to help them become well-balanced dogs, since you won’t know where they will go,” White said.

Buffalo wny igh 23 sept 16 final