5 THINGS YOU SHOULD KNOW ABOUT IT Physician Nadia Kousar, infectious disease specialist at Rochester Regional Health, explains the basics of the virus that has killed more than 2,000 so far
DIABETES BREAKTHROUGH Buffalo endocrinologist Kathleen E. Bethin talks about breakthrough drug that improves the lives of kids with diabetes
MARCH 2020 • ISSUE 65
SHOULD YOU SKIP BREAKFAST? Celebrity TV doctor Mehmet Oz recently said people should skip breakfast. Should you heed his advice? Do we really need the ‘most important’ meal? P. 13
2 million lost health coverage or access in Trump’s first year
PARKINSON’S How to detect the disease and what to do when you’re diagnosed
‘Spring Forward’ Brings Surge in Fatal Car Crashes
Yes, there’s something new in the air in WNY — hatchets P. 11
Little Lentils Dish Up Big Benefits P.12
Visits to Pediatricians on the Decline P.8
Life Expectancy in U.S. Up Again First increase after four years of decline
fter four years of declines, life expectancy in the United States increased in 2018, health officials reported in February. The jump in longevity comes as deaths from opioid overdoses dropped for the first time in 28 years, as did deaths from six of the 10 leading causes. The new data could be a glimmer of good news for Americans’ health, with recent declines in average lifespans initially casting doubt on progress made over the past decades. “The three-year trend in life expectancy for the total population either decreasing or remaining steady has stopped, with the increase in life expectancy in 2018,” said lead researcher Kenneth Kochanek, from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). “The decrease in mortality from unintentional injuries in 2018 is a reverse from the 2014-to-2017 trend,” he added. “From 2014 to 2017, the increase in deaths from unintentional injuries contributed the most to the decrease in life expectancy, with decreases in cancer mortality offsetting this change in life expectancy,” Kochanek said. Between 2010 and 2014, life expectancy increased from 78.7 years to
78.9 years, then fell between 2014 and 2017 from 78.9 years to 78.6 years. But in 2018, it went back to 78.7 years, which is still below the peak of 78.9 years in 2014, Kochanek said. The 10 leading causes of death in the United States are heart disease, stroke, chronic respiratory disease, Alzheimer’s disease, diabetes, flu, kidney disease, suicide, cancer and accidents. Between 2017 and 2018, decreases in deaths from cancer and unintentional injuries contributed the most to the increase in life expectancy, with increases in mortalityfrom influenza and pneumonia offsetting the change in life expectancy, Kochanek added. According to Dr. Howard Koh, a professor at Harvard T.H. Chan School of Public Health in Boston, “After years of plateauing and declining U.S. life expectancy, this one-year uptick is certainly welcome news.” But more detailed evaluation over time is needed to judge whether declining trends are truly being reversed, he said. Another expert agreed that the increase in life expectancy was welcome news, but must be taken with a grain of salt. “It’s good news U.S. life expec-
tancy increased for one year, interrupting its fall over the past three years, but the overall picture remains bleak,” said Steven Woolf, director emeritus and senior advisor at the Center on Society and Health at Virginia Commonwealth University School of Medicine, in Richmond. For many years, life expectancy in other wealthy nations has been higher than in the United States, and their life expectancy rates have been climbing, Woolf said. The increase in life expectancy between 2017 and 2018 is statistically significant, but time will tell whether it holds, he added. A similar increase occurred between 2013 and 2014 before falling the following year. Other findings in the report include: • Among the 10 leading causes of death, only deaths from suicide and flu-related pneumonia rose. • More than half the increase in life expectancy in 2018 was from fewer deaths from cancer and accidents. • Drug overdose deaths dropped 4% from 2017 to 2018, from about 70,200 in 2017 to nearly 67,400 in 2018. The majority of drug overdose deaths (90%) were unintentional. • Drug overdose deaths in 2018 dropped in 14 states and the District of Columbia. Across the country, the overdose death rate was 20.7 per 100,000 in 2018 and 21.7 in 2017. • The rate of drug overdose deaths from drugs such as fentanyl, fentanyl analogs and tramadol rose 10% from 2017 to 2018. • Between 2012 and 2018, the rate of drug overdose deaths from cocaine more than tripled, and from drugs such as methamphetamine increased five times. Koh pointed out that, “while
Between 2017 and 2018, decreases in deaths from cancer and unintentional injuries contributed the most to the increase in life expectancy the overall decline in drug overdose deaths is notable and must continue, rising mortality from synthetic opioids — as well as from cocaine and methamphetamine - represent the next disturbing wave of the nation’s ongoing substance use challenge.” Woolf added that it’s good news that the rate of fatal drug overdoses has decreased. “But this, too, should be put in perspective,” he said. “It’s still higher than it was in 2016 and alarmingly higher than it’s been in the past two decades.” The report was published Jan. 30 in the CDC’s NCHS Data Brief.
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‘Spring Forward’ Brings Surge in Fatal Car Crashes
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Daylight saving time begins Sunday, March 8
atal car accidents in the United States spike by 6% during the workweek following the “spring forward” to daylight saving time, resulting in about 28 additional deaths each year, according to new University of Colorado Boulder research. The study, published in February in the journal Current Biology, also found that the farther west a person lives in his or her time zone, the higher their risk of a deadly crash that week. “Our study provides additional, rigorous evidence that the switch to daylight saving time in spring leads to negative health and safety impacts,” said senior author Céline Vetter, assistant professor of integrative physiology. “These effects on fatal traffic accidents are real, and these deaths can be prevented.” The findings come at a time when numerous states, including Oregon, Washington, California and Florida, are considering doing away with the switch entirely amid mounting research showing spikes in heart attacks, strokes, workplace injuries and other problems in the days following the time change. For the study — the largest and most detailed to date to assess the relationship between the time change and fatal motor vehicle accidents — the researchers analyzed 732,835 accidents recorded through the U.S. Fatality Analysis Reporting System from 1996 to 2017. They excluded Arizona and Indiana, where daylight
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saving time was not consistently observed. Stimulating Social, Educational After controlling for factors like and recreational activities year, season and day of the week, they found a consistent rise in fatal Medication management accidents in the week following Access to 24-hour personal the spring time change. Notably, care assistance that spike moved in 2007, when the Energy Policy Act extended daylight Affordable memory care saving time to begin on the second Sunday of March instead of the first Changing Lives One Bottle at a Time Changing Lives...... One Bottle at a Time Sunday in April. Now offering respite & enhanced assisted “Prior to 2007, we saw the risk increase in April, and when daylight saving time moved to March, so did the risk increase,” said Vetter. “That 410 Mill St. - Williamsville,NY 14221 gave us even more confidence that the risk increase we observe is indeed attributable to the daylight saving time switch, and not something else.” With the arrival March 8 of daylight saving time, clocks shift forward by one hour, and many people will miss out on sleep and drive to work in darkness — both factors that can contribute to crashes.
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1 in 5 Insured Hit with Surprise Bills for Surgery
ou scheduled your surgery and made sure both your doctor and hospital are in your insurer’s approved network of providers. Everything went without a hitch — until a whopper of a bill showed up in the mail for “out-ofnetwork” care during your operation. The average out-of-network surprise bill tops $2,000, a new study finds. And about 20% of patients who had surgery using a doctor and hospital considered in-network for their insurance got a surprise bill. So, what gives? In some cases, surprise bills are for medical imaging during surgery or for assistants that patients didn’t even know would be involved. “In this study, we narrowed it
down to those cases where patients did as well as they could checking to make sure the surgeon and hospital were in-network, and still one in five got an out-of-network bill,” said the study’s lead author, physician Karan Chhabra of the University of Michigan Institute for Healthcare Policy and Innovation in Ann Arbor. He said 37% of the surprise bills came from out-of-network surgical assistants. Another 37% came from anesthesiologists. The average outof-network surgical assistant bill was more than $3,600; anesthesiologist bills topped $1,200. The findings were published Feb. 11 in the Journal of the American Medical Association.
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In Good Health — WNY’s Healthcare Newspaper
March 2020 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
In the News
By Chris Motola
Kathleen E. Bethin, MD Buffalo endocrinologist talks about breakthrough drug that improves the lives of kids with diabetes
Fresh Donor Egg Better Than Frozen for IVF: Study
resh donated eggs appear to be better for in-vitro fertilization (IVF) than frozen ones, a new study suggests. Donor eggs provide the best chance of success for many women undergoing IVF, according to the authors. But it wasn’t clear whether using fresh or frozen donor eggs in IVF improves the chances of success, so a team from the University of Colorado and Duke University analyzed nearly 30,000 IVF cycles using donor eggs over three years. Fresh eggs had a much higher likelihood of implantation and birth than frozen eggs, the study found. Compared to frozen eggs, fresh eggs were associated with a 25% better chance of live birth and a 10% higher odds for good outcomes. Fresh eggs were also associated with a 37% higher chance of multiple births. The authors said that supports the increasing practice of transferring a single embryo during IVF to help avoid multiple births and the complications they often cause to mother and child, according to the authors of the study. The findings were published Feb. 6 in the journal Obstetrics & Gynecology. “We can now confidently say that choosing to utilize fresh donor eggs along with transferring a single embryo instead of multiple embryos will provide the best chances for a healthy mother and a healthy baby,” senior author, physician Alex Polotsky, said in a University of Colorado news release. He’s chief of the division of reproductive endocrinology at the university’s School of Medicine in Aurora. Between 1% and 2% of all births in the United States occur through IVF, and more than 24,000 U.S. women use donated eggs each year, according to the U.S. Centers for Disease Control and Prevention.
Q: What kinds of hormonal issues do you treat in children? A: About half of our patients have Type 1 diabetes, the other half have a mixed bag of hormone problems, including thyroid disease, growth issues — parents who are concerned about how short their kids are , hypopituitarism, which is an under active pituitary gland, and differences in timing of puberty, which is the failure to produce when children start making more sex hormones. About 10% of our patients with diabetes have Type 2 diabetes. Q: You’ve been working in trials with a fast-acting insulin drug Fiasp (insulin aspart injection) that seems well-suited for juvenile patients. Can you tell us more about it? A: Yes. It’s basically an ultra fast-acting insulin, but they’ve added an ingredient that causes it to be absorbed quicker so that it is approved to be used up to 20 minutes after you start eating. Q: What does that mean? A: For children, that’s great, because younger kids especially don’t know what they’re going to eat. Insulin is most effective before you start eating. If you give, say, a 2-yearold with diabetes their insulin, they quickly learn that if they don’t eat the healthy food, mom and dad will bring out the candy so they don’t go low with their blood sugar. So, it works closer to how human insulin works in people without diabetes. Basically, people without diabetes start thinking about food and their pancreas starts secreting insulin. Q: Does that mean you have some control over the amount of insulin you have in your system? A: Not really. Your body does it without any prompting from your conscious
brain. I don’t think anyone knows what the signal is that causes your pancreas to start shooting out insulin, but studies have shown that your pancreas starts preparing for that meal. Q: What are some of the results of the study as far as outcomes go. Are the children healthier? A: Well, there’s no long-term data on it as of yet. We participated in the trial and the patients who ended up on the drug loved it. The onset is much quicker, but it’s also turned off much quicker. Potentially you can have fewer lows after eating. We didn’t see any differences in the clinical trial. What we saw was that Fiasp given after meals was just as effective as fast-acting insulin aspart (Novolog) given before meals. So the aim of the study wasn’t to show that anything was better, it was to show it was at least equivalent, and that’s what the study showed. Our patients who have been on insulin really like it, but it hasn’t been on the market long enough for us to have any longterm data. It was approved for adults in 2017 and just approved for kids in December 2019. Q: Type 1, of course, is something you have for life. Is Type 2 reversible when it appears in children? A: It can be, but Type 2 in kids is much more aggressive than it is in adults. Sometimes we can’t tell the difference between types at diagnosis, so the Type 2 kids get put on insulin. If their numbers get better, we try to wean them off insulin, but a lot of them we can’t get off insulin. We do have some patients who started eating healthier and exercising more. They were able to stay off the insulin, but most of them aren’t perfect, they’re just under control without insulin. So, it’s not completely reversible but can get signifi-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
Physician Kathleen E. Bethin, of the University at Buffalo, led the local arm of a clinical trial that spanned 17 countries and involved more than 700 children worldwide (five from Buffalo) that resulted in the FDA approval of the drug Fiasp (insulin aspart injection, which means a fast-acting insulin) for children with diabetes mellitus. The drug, manufactured by Novo Nordisk and approved for children in December, was already available for adult use since 2017. Physician Lucy D. Mastrandrea, associate professor and division chief, endocrinology/diabetes in the department of pediatrics at UB and medical director of the Diabetes Center, was co-investigator in the trial. cantly better in some of the children. Q: What kinds of interventions are possible? A: In the mid-90s data came out showing that the lower the hemoglobin A1C, which we measure every three to four months in people with diabetes, the less likely you were to have complications. We now know it’s more than just the hemoglobin A1C, it’s also the variability of your blood sugars. So, we know the closer we can get blood sugars to normal, the less likely we are to have complications. We are trying to get their numbers better using different tools like continuous glucose monitors , which tell you what your glucose is doing every five minutes without having to poke your finger. A lot of parents really love this. I would also say that most of our patients end up going on insulin pumps, which allows us to do finer dosing than we could with injections. It’s still very challenging because some parents give too much responsibility to their children, and with teenagers, parents just don’t have as much control. The teens’ frontal cortex isn’t fully developed yet, so they don’t see long-term consequences as easily as adults, and they sometimes don’t take care of their diabetes because they want to be like everybody else. So, it’s challenging during that time.
Lifelines Name: Kathleen E. Bethin, M.D., Ph.D. Position: Clinical professor in the department of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at UB, and a physician with UBMD Pediatrics and the Diabetes Center at UBMD Pediatrics and Oishei Children’s Hospital (OCH) Hometown: Buffalo Education: University at Buffalo; Washington University (St. Louis) Affiliations: Oishei Children’s Hospital; Olean General Hospital Organizations: American Academy of Pediatrics; Pediatric Endocrine Society; American Diabetes Association; The Endocrine Society Family: Single Hobbies: Reading, cooking, walking her dog
2 Million Lost Health Coverage or Access in Trump’s First Year
wo million more Americans didn’t seek health care from late 2016 through 2017 because they couldn’t afford it or lacked insurance, new research shows. The analysis of data from 2011 through 2017 also found that health care coverage and access improved with implementation of the Affordable Care Act (ACA), but reversed after President Donald Trump and congressional Republicans began working to dismantle it, according to Boston University researchers. “While we found the ACA isn’t unraveling, there are real consequences to some of the policies that have been put in place,” said lead author Kevin Griffith, a doctoral candidate in the School of Public Health. “We see that you have these policy changes that are affecting millions of people’s ability to get insurance, and millions of people forgoing care
because they can›t afford it.” For the study, Griffith and his team analyzed federal data on 18- to 64-year-olds. The investigators found that uninsurance rates dropped 7.1 percentage points between 2013 and 2016, then rose 1.2 percentage points during 2017, Trump’s first year in office. Rates of adults who did not seek care due to costs reflected similar trends. The 2017 reversals had the greatest impact on low-income residents of 14 states that didn’t expand Medicaid under the ACA. In those states, which are mainly in the South, decreases in insurance coverage and health care access were four to five times higher than in states that expanded Medicaid. The study also found that from 2013 to 2016, the gap in health care access between higher- and lower-in-
come Americans narrowed by about 8.5 percentage points in expansion and nonexpansion states. But between the fourth quarter of 2016 and the fourth quarter of 2017, that gap widened by 2.6 percentage points in nonexpansion states (a relative increase of 11%). It continued to decrease by another 1 percentage point in expansion states (a relative decrease of 8%). The study appears in the February issue of the journal Health Affairs. “Medicaid expansion seemed to be a really great way for states to insulate themselves from some of
the damage of these federal policies,” Griffith said in a university news release. “For states considering Medicaid expansion, this shows that it’s a good way to take care of your residents, even regardless of what’s going on in Congress.” He said the reversals revealed by the study are worrisome. “We had this narrowing of disparities in access and coverage, but that’s reversing,” Griffith said. “Since 2017, the split between white and black, between rich and poor, urban and rural, renters and homeowners — all of these disparities are getting wider again. That’s concerning.”
The corona virus, so named for its crown-like spikes, is unknown so its spread causes alarm. On top of it all, infectious disease experts (ID docs) are a dying breed. There has been a 40% decrease in medical students enrolling in ID training programs or residencies between 2009 and 2017. Infectious disease is one of just two subspecialties where not all residency slots are filled. Telemedicine can help by transmitting increasingly rare and valuable expertise to physicians working in even the remotest areas. Telemedicine also allows physicians to treat patients remotely, keeping them from coming into emergency facilities and offices and infecting provider staffs and other patients.
prices is a form of “socialism.” The rather timid bipartisan bill would authorize CMS to negotiate just 25 prices the first year, then ramp up to more over 10 years. Drug prices remain totally unchecked while CMS literally sets prices and fees for physicians and hospitals.
Healthcare in a Minute
By George W. Chapman
MD Association Endorses Universal Coverage
he American College of Physicians — with about 160,000 members — joins the ranks of physician organizations to endorse some sort of universal coverage or single payer healthcare system. Historically, most physician groups have resisted any form of increased government involvement. Several factors contribute to this gradual about-face. Millions of patients still struggle with paying their medical bills, including those with insurance. Medical debt is the No. 1 reason for personal bankruptcies. Over the past 30 years, commercial insurance carriers have gradually lowered their payments to physicians to Medicare levels. Consequently, there is less support for multiple payers and more for a single payer if fees are about the same. More and more Americans are not covered by employer sponsored insurance. The
percentage of Americans covered by some sort of federal program now exceeds 50%: Medicare, Medicaid, VA and military, federal employees, Bureau of Indian Affairs and the Affordable Care Act. The aging of America means Medicare is the fastest growing insurance plan. Dealing with multiple insurance plans is a cost and bureaucratic nightmare for physicians and their staff. A single payer would significantly lower practice overhead. According to a study in the Annals of Internal Medicine, a single payer system would reduce administrative costs by $600 billion annually. Finally, increasingly, younger physicians and recent grads prefer employment with larger health systems vs. private practice. Consequently, they are less resistant to government intervention if it guarantees access and affordability.
Easing MD Shortage
“certified,” but they do not have licenses. They operate under the license of a supervising physician. Nurse practitioners have their own license and many states allow them to practice independently from physicians. “Nurse practitioner” is a master’s degree. Both APs have seen rapid growth over the past decade.
Physician assistants (PAs) and nurse practitioners (NPs) are both considered to be advanced practitioners (APs). Both of these professionals are helping to mitigate the increasing shortage of physicians, especially in primary care. The likelihood of being seen by an AP in any setting (private practice, urgent care or clinic) increases every year. There are approximately 125,000 PAs and 270,000 NPs in addition to about 950,000 active/practicing physicians. (PAs have only existed since 1967.) This year, PA schools will be required to offer a master’s degree. PAs must complete 100 hours of continuing education every two years. PAs are
The Coronavirus Vs. the Flu
With the coronavirus grabbing the headlines, we forget how pervasive and deadly influenza can be. Five to 20% of us (or 16 million to 66 million of us) will contract the flu every year. About 200,000 of us will be hospitalized every year with the flu on average, costing $10 billion a year.
There is typically no charge when you approve or request the transfer of your record from one provider to another. Up until recently, when you requested a copy of your record be sent to a third party, like a law firm, the provider could charge you, but not more than an imposed cap of $6.50 regardless of the record format, like digital or paper. In January, a federal judge eliminated the cap on what you could be charged as arbitrary and capricious. Healthcare lawyers are challenging the ruling.
Out-of-network providers and insurance companies have been feuding over how to settle surprise billing. Currently, the consumer is stuck with paying the difference between what the out-of-network provider charges and what their insurance company thinks is reasonable. Congress’ Ways and Means Committee has suggested a two-step process to resolve the dilemma. First, the provider and the patient’s insurance company have 30 days to resolve the dispute between themselves. If they can’t, step two involves a third-party mediator. The vast majority of surprise billing emanates from a visit to an emergency room. The bill proposes giving patients an “advance explanation of benefits” including a cost estimate of what they will owe out of pocket which is alright in non-emergent situations. However, the Emergency Medical Treatment and Active Labor Act (EMTALA) requires hospitals to treat patients regardless of their ability to pay.
In his State of the Union address, President Trump once again called for legislation to bring drug prices under control. The House bipartisan bill authorizing Centers for Medicare & Medicaid Services (CMS) to negotiate drug prices on behalf of the 165 million people covered by Medicare and Medicaid remains stalled in the Senate. Sen. Chuck Grassley, a Republican, spearheaded the bipartisan bill. Opponents of the bill have argued that negotiating
George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at email@example.com.
Request for Copy of Your Record
Drug Price “Uncontrol”
March 2020 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Things You Should Know About Coronavirus By Ernst Lamothe Jr.
ith the new strain of coronavirus — COVID-19 — hitting more than 2,000 in death toll and tens of thousands affected worldwide, much is still unknown by the general public about how the epidemic has spread. The COVID-19 is thought to have originated in 2019 at a market in Wuhan, China, and has spread throughout mainland China and a number of other countries. As of mid-February, confirmed cases are more than 70,000 in countries that include China, Japan, Singapore, Thailand, South Korea, Malaysia, Tawaiian, Australia, Germany, Vietnam, France, the United Kingdom and United States. According to the Centers for Disease Control and Prevention, human coronaviruses are common throughout the world. However, the 2019nCoV virus is a public health concern because of the many unknown factors and the fact that there is more than just one form of the virus. Physician John A. Sellick, professor of medicine in the division of infectious diseases at University at Buffalo, talks about five things you need to know about the virus.
There are multiple coronaviruses
The various coronaviruses can infect people and make them sick. Some human coronaviruses — not the new strain — were identified many years ago. Human coronaviruses commonly cause mild to moderate illness in people worldwide. “It is a very common group of viruses that affect humans and have existed before in epidemics such as SARS and Middle East Respiratory Syndrome Coronavirus,” said Sellick. “There are viruses that have affected animals and when they start affecting humans because our bodies don’t have the same immunity, these new viruses can have serious outcomes. That is why it is called the novel coronavirus because it is new.”
Coronaviruses are most commonly passed from person to person
Most often the virus is spread from person to person among close contacts about six feet away. It occurs mainly through respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. “This is why we tell people that you should use the same common practices you have when you have a cold. You cover your mouth because you can spread large droplets to other people,” said Sellick. “It is those microscopic viruses that you can also spread through your fingers if you are infected when you rub your eyes and it can go through your ducts that go through your nasal passages.”
Coronavirus is less than a threat in the U.S. than the flu
Flu vaccines are updated to better match viruses expected to be circulating in the United States. The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children and people with certain health conditions, are at high risk of serious flu complications. “Influenza has a higher mortality rate and we have to make sure we don’t ignore the seriousness of it just because everyone is talking about the coronavirus,” said Sellick. ”Last year the flu virus was affecting people all the way through the summer.”
to Hubei province, where Wuhan is the capital and where the population has been hit hardest by the virus. The government has already spent $4.5 billion to handle the outbreak. “I believe people have been calmer in the United States than when they hear about outbreaks happening worldwide. I think people have done a good job educating themselves on the situation and understand that the number of cases in the United States is minimal,” said Sellick. “What is still unknown is if the measures that China enacted to quarantine people so that it wouldn’t spread worked or not.”
There is no vaccine
There are no approved drugs or vaccines to specifically treat or prevent 2019-nCoV infection or disease. Medical experts do offer some suggestions, which include washing hands often with soap and water for at least 20 seconds. If soap and water are not available, experts advise the use of an alcohol-based hand sanitizer. “The virus is fairly small and its genetic code has already been created so we will not be able to make a vaccine for it for a couple of years,”
People should remain calm in the United States
The Chinese government has mobilized many resources for containment and treatment. They have sent more than 10,000 medical workers, including military doctors,
Physician John A. Sellick, professor of medicine in the division of infectious diseases at University at Buffalo. said Sellick. “So that means there is no vaccine that can help currently with this outbreak which is why the death toll and affected numbers are growing rapidly.”
Bats, Snakes May Be the Source of New Coronavirus A study published Jan. 30 in The Lancet, finds strong evidence that bats are where the infection actually originated. According to study authors, the infection could still have been passed to humans through an intermediary animal. A previous study theorized that it went through snakes before being passed on to humans. “Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans,”
wrote the study authors. Bats have an unfortunate history of passing potentially deadly pathogens to human hosts. A 2017 article in Nature explains how virologists identified a single population of horseshoe bats harboring virus strains with all the genetic building blocks of the SARS virus that jumped to humans in 2002. That worldwide outbreak killed almost 800 people. Research published in Emerging Infectious Diseases confirms that many African bats are also reservoirs of the incredibly dangerous Ebola virus. Source: www.healthline.com
Perry’s Ice Cream Lends Support to Parkinson’s Foundation
he Parkinson’s Foundation recently received a nearly $4,000 donation from Perry’s Ice Cream. The monies were raised through the company’s Community Returns, a program that engages employees in a variety of raffles, games and product sales over a sixmonth period, which helps to accrue the funds that comprise the donation. Rob Alexander, a truck driver with Perry’s, suggested the Parkinson’s Foundation be selected as a beneficiary of the program. The funds will support programming for the Parkinson’s community as well as ongoing research. Perry’s has long committed itself to giving back to the community. The Community Returns program has allowed them to support many local organizations working within our Page 6
region. The organizations supported are all chosen from names that are submitted for consideration by employees. “By doing it this way, we are not only supporting great organizations, but we are also supporting causes that are important to our workers,” said sales administrator Jayne Perry, a member of the Community Returns committee. The donation will help to fund efforts by the Parkinson’s Foundation, like the annual Educational Symposium in April, a Care Partner Summit in May and ongoing research into effective treatments and, ultimately, a cure for this chronic, progressive neurodegenerative disease, said Chris Jamele, development director for the Parkinson’s Foundation New York and New Jersey Chapter.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
March 2020 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
On Your Own: See the Glass as Half Full! “Every one of us has been given a great gift: the cup of life. It is half full and half empty. We choose which half to focus on, at every moment.” - Marc Allen, triathlon coach Seeing the glass as half full rather than half empty is all about focusing on what’s positive in our lives, regardless of what comes our way. It’s about being thankful, appreciative and grateful. It’s about concentrating on our strengths rather than our weaknesses. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass as half full can make a big difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative; we can open our eyes to possibilities or begrudge what life has offered up. So, how do you view the cup of life? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I’ve had the pleasure to meet in my workshops or public speaking engagements. Do you find yourself identifying with one perspective over another? NOT BEING MARRIED – Half empty “Something must be wrong with me. All my friends are married, and
here I am alone and miserable.” – Half full “Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I’ve always wanted to travel and try new things, and now I have that opportunity — to create a life that’s rewarding and full of new people and experiences that bring me joy. And, who knows? I may meet a special someone along the way.” DECISION MAKING – Half empty “Are you kidding? I don’t know enough to buy a house or a car. Those are the big decisions my spouse used to make. I wouldn’t know where to begin.” – Half full “Finally, I am making all my own decisions! No one is around to second-guess my choices. I just purchased my first car all on my own: a 2020 Subaru Outback. I did the research and was completely prepared when I went to the dealership. My color choice? Autumn green metallic. I love it!” IN A CRISIS – Half empty “I’m no good in a crisis. I go to pieces. When I hear bad news, I’m embarrassed to admit that sometimes I long to be taken care of and protected. Living alone makes all this worse. There’s no one to turn to.” – Half full
s d i K Corner
Visits to Pediatricians on the Decline
ommercially insured children in the U.S. are seeing pediatricians less often than they did a decade ago, according to a new analysis led by a pediatricianscientist at the University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh. But whether that’s good or bad is unclear, the researchers say in the study, published in January in JAMA Pediatrics. “There’s something big going on here that we need to be paying attention to,” said lead author, physician Page 8
Kristin Ray, assistant professor of pediatrics in Pitt’s School of Medicine. “The trend is likely a combination of both positive and negative changes. For example, if families avoid bringing their kids in because of worry about high co-pays and deductibles, that’s very concerning. But if this is the result of better preventive care keeping kids healthier or perhaps more physician offices providing advice over the phone to support parents caring for kids at home when they’ve got minor colds or stomach bugs, that’s a good thing.”
“Being alone in a crisis isn’t the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family together. I learned I could take care of myself and others, too.” DATING – Half empty “I can’t imagine re-entering the dating scene. What could anyone possibly see in me at this age, with my graying hair, expanding waistline and grandchildren?” – Half full “I believe that warm friendships, even romance, can happen at any age. I’m now remarried. We met in a grief support group and the rest is history. Next year, we are celebrating our fifth anniversary.” FINANCES – Half empty “My spouse took care of all the finances — the bills, the taxes, everything! I feel helpless and, honestly, I fear dying alone and penniless.” – Half full “I knew it wouldn’t be easy, but I knew I could do it. Getting help with my finances was one of the first things I did after my divorce. I picked up the phone and asked for help, did my homework, and now enjoy peace of mind. I’m very proud of myself.” COOKING FOR ONE – Half empty “Why would I go to any lengths to create a special meal for just myself? It hardly seems worth it. I can fill up on chips and salsa and call it a night.” – Half full “Creating a pleasant ‘table for one’ makes me feel good about myself. It means I’m nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a simple home-cooked meal, a sense of serenity comes over me. I feel at home with my own good Ray and her colleagues examined insurance claims data from 2008 through 2016 for children 17 years old and younger. The data came from a large commercial health plan that covers millions of children across all 50 states with a range of benefit options. In that time span, primary care visits for any reason decreased by 14%. Preventive care, or “well child” visits, increased by nearly 10%. This change occurred during the years when the Affordable Care Act eliminated co-pays for such visits. But that increase was eclipsed by a much larger decrease in problem-based visits for things such as illness or injury, with these visits declining by 24%. Among problem-based visits, decreases were seen for all types of diagnoses, except for psychiatric and behavioral health visits, which increased by 42%. “This means that children and their families are visiting their pediatrician less throughout the year, presumably resulting in fewer opportunities for the pediatrician to connect with families on preventive care and healthy behaviors, like vaccinations and good nutrition,” said Ray, also a pediatrician and director of health system improvements at UPMC Chil-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
company.” DISCOVERING YOUR TRUE SELF – Half empty “I’m a creature of habit, too old to re-invent myself. And, what’s the point anyway? There’s no one to share my life with. – Half full “It’s never too late. Today, I have an opportunity to fashion a life that reflects my dreams, my style, my true self. Just recently, I signed up for dancing lessons, a lifelong dream of mine. My niece is also coming into her own, and I love being a role model for her. TIME ALONE – Half empty “Living alone is for the birds! I just want to stay in bed and pull the covers up over my head. – Half full “Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities and new relationships. Used wisely, the time can be an adventure in self-discovery and reveal opportunities for personal growth, spiritual awakening, and quiet fulfillment.” If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what new journeys and joy await those who focus on gratitude and embrace the wisdom of seeing the glass half full.
Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase her book, or invite her to speak, call 585-624-7887, email firstname.lastname@example.org, or visit www.aloneandcontent.com. dren’s Community Pediatrics. “The question is: Why? We don’t have the definitive answer, but our data give us some clues.” One possible explanation is that children are getting care elsewhere. Visits to urgent care, retail clinics and telemedicine consults for problem-based care increased during the study period. But that increase accounted for only about half of the decrease in visits to primary care pediatricians. Higher out-of-pocket costs probably also explain why some parents aren’t taking their children to the pediatrician for medical concerns, Ray said. During the time period studied, out-of-pocket costs for problem-based visits increased 42%, while inflation-adjusted median household income rose by only 5%. Previous studies have found that even $1-$10 increases in copayments are associated with fewer visits. Other factors also could be at play, the research team noted. With more parents working, some may find it difficult to bring children in for care. And there may be less need for some visits. Vaccination has dramatically reduced rates of ear infections and hospitalizations.
Allison Davis, mother of two boys and art teacher in Buffalo, said she is happy with Whole30 diet. “After three weeks of Whole30, my energy and mood were more even and it did give me a healthier relationship with food.”
Whole30 Diet: Is It For you? Process involves weaning out foods that disagree with body By Katie Coleman
ou may have heard of the Whole30 diet, which intends to change your relationship with food in 30 days via cutting out “trigger” foods to see how they affect your body when reintroducing them at the end of 30 days. Following this diet, you must eliminate added sugar, alcohol, grains, legumes, dairy, baked goods and junk food — and anything containing carrageenan, monosodium glutamate or added sulfites from your diet. Instead, you eat food including unprocessed meat, seafood, eggs, veggies and fruits, nuts and seeds. Allison Davis, mother of two boys and art teacher in Buffalo, was looking for a healthier relationship with food and a body, mind and spirit reset. She learned about Whole30 from a friend and decided to give it a try. “I was ready to work on my physical self as I realized body, mind and spirit are all strongly connected,” said Davis. “After three weeks of Whole30, my energy and mood were more even and it did give me a healthier relationship with food.
As I added foods back in, I learned what doesn’t work for me. Gluten hit the hardest. My whole stomach would knot up in pain when I started adding it back in.” In order to be successful, Davis said being prepared and organized was key. That means having meals planned and food chopped up and ready for use in the fridge. Think about your day and make sure you bring food with you if necessary. Although Whole30 did not lead to permanent diet changes for Davis, she does eat certain foods in more moderation now. “One of the benefits of the diet is that you learn how food affects your body and makes you feel,” Davis said. Although Whole30 is popular, it ranked 33 out of the 35 diets that were judged by a panel of 25 experts organized by the U.S. News and World Report’s 2020 ranking of best diets.
The report by U.S. News & World Report analyzed balance, maintainability, palatability, fam-
ily friendliness, sustainability and healthfulness. The Mediterranean diet was ranked first for the third year in a row, falling within the accepted range of protein, carbs, fat and other nutrient intake and offering a host of health benefits: weight loss, heart/brain health, cancer and diabetes prevention and control. “By following the Mediterranean Diet, you could also keep that weight off while avoiding chronic disease,” according to the U.S. News & World Report. Although it is not a scripted diet and varies from region to region, the Mediterranean diet pyramid serves as a guideline, emphasizing fruits, veggies, whole grains, nuts, legumes, olive oil, herbs and spices; fish and seafood, poultry, eggs, cheese and yogurt. Ranked second place, tying with the Mediterranean diet for best overall diet, is the DASH diet, which stands for dietary approaches to stop hypertension. It emphasizes foods including fruits, veggies, whole grains, lean protein and low fat dairy. “The DASH diet is balanced and can be followed long-term,” the U.S.
News & World Report said. The Whole 30 diet was ranked lower for unsustainable, highly restrictive and lacking in certain nutrients. Other cons of the diet listed were that only the highly committed and organized could follow the diet. The Keto diet, which has also gained considerable popularity, was ranked 34 out of 35. The diet includes slashing carbs and filling up on fats. Some of the foods recommended in the diet are chicken thighs, grass-fed beef, fatty fish like salmon, pork shoulder and bacon, and leafy greens. One of the main reasons it was ranked so low is the diet recommends carb intake that is lower than what’s recommended by government guidelines. Jenna Guadagna, registered dietitian and media representative in Western New York for the New York State Academy of Nutrition and Dietetics, said before trying Whole30, it’s important to know that restricting whole food groups increases the risk of vitamin and mineral deficiencies. “Restricting specifically grains and legumes reduces fiber intake and B vitamins,” Guadagna said. When asked about the benefits of Whole30, her response was to cite the intake of more whole foods and reducing the intake of empty calories and highly processed foods. She also encouraged cooking at home, avoiding alcohol, tobacco and added sugars. “If someone has a medical condition and they are trying to figure out what foods they can and can’t tolerate, they should not try Whole30 on their own,” Guadagna said. “They should consult their doctor and a registered dietician to help them through a science-based elimination diet.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Addiction The Talk: Discussing Drugs with Your Kids By Deborah Jeanne Sergeant
o parents want to see their children use drugs, yet many parents don’t know what to say to their children about drugs. Or they assume that the school program suffices or maybe hope that if they yell at their children about drugs, their children won’t try drugs. All of these strategies are a big gamble. Physician Gale R. Burstein, who serves as commissioner of health with Erie County Department of Health, believes parents can play an essential role in keeping their kids away from drugs. “It’s very important that parents start talking with their kids about all risky behaviors that can lead to poor health outcomes at an early age,” Burstein said. She advises open and honest conversation that comes from a viewpoint of love and concern — not yelling, blaming, accusing or threatening, since scaring children curtails learning about the topic. Burstein said that parents shouldn’t focus on “The Talk” about drugs — a long lecture performed one time at a certain age — but they should instead organically discuss drugs in short, age-appropriate sessions throughout childhood. “There are messages that are age appropriate from a young age,” she
said. “They should understand you do not want them to misuse prescriptions or alcohol or illicit drugs.” Whether it’s a news story, billboard or movie, parents can ask their children what they think about what they see. By elementary school, children could learn about the differences between medicine and illicit drugs and why prescriptions should be taken only as prescribed and by who’s on the prescription. In addition to drug talks, children also need to learn problem solving for lasting solutions so they won’t feel the need to turn to drugs to solve problems or deal with stress. “Kids who are well connected to their parents and know their parents don’t want them to use drugs have a much lower risk of using drugs,” Burstein said. “Repeat those messages. They can change as the child ages.” Around the pre-teen years, young people need to feel they can talk with their parents about anything without judgment or a harsh response. They need to feel that their parents will simply listen without rushing in to fix or teach all the time. “It’s good that you help your child develop a plan if they’re offered things by their friends,” Burstein said. “Help them plan to say no or
Despite Drop, Overdose Still Poses Serious Threat By Deborah Jeanne Sergeant
etween 2018 and 2019, death because of drug overdose in New York has decreased by 4.6%, from 2,386 to 2,276, according to the most recent, non-finalized statistics from the Centers for Disease Control and Prevention; however, any death from drug overdose is one too many. While prompt medical attention can sometimes reduce the chances of fatality from use of opioids and other substances, that medical care doesn’t always happen, especially when young people are involved. Fear of their parents’ response or legal repercussions may cause teens and young adults to not seek medical help in some cases. Some may hope their friend will sleep off the effects or fear that by helping, they will reveal to their parents their drug use. “Hopefully, parents will be supportive of their children who are struggling with any type of substance use disorder,” said Gale R. Burstein, Page 10
commissioner of health at the Erie County Department of Health. “It’s a chronic disease of the brain. There are changes in the brain where individuals cannot control their using despite knowledge that it will cause them harm. There are new pathways established in the brain.” Some may fear their parents’ response over their friend’s possible death in part because of previous experience with run-ins with their parents. Parents can help reduce this effect by responding in a more measured fashion when their children break the rules. Good Samaritan laws protect both the patient and the person who sought medical attention. A study in Washington State indicates that 88% of people surveyed who use opioids would feel more likely to call 911 in case of an overdose because of the law. Most teens feel invincible, as if terrible things won’t happen to them
have an exit plan. They can text you any time to come get them and they won’t be in trouble.” Also at the pre-teen age, it’s time to establish rules with consequences, long before something happens. Sourav Sengupta, Ph.D. at University at Buffalo’s department of psychiatry, said that by the teen years, it’s time to have more frank discussions about the consequences of drug use. “The language there is important. ‘Sometimes people make choices to put things into their bodies to make them feel a different way. This isn’t always a good idea. What have you heard about this?’” he suggested as an idea of what to say. Substance abuse education at school can provide a springboard to conversation and to answer any questions they have. Sengupta also stressed the importance of a solid relationship with teens so parents can seek any help they may need. “Stay in touch with the teen,” he said. “Teens aren’t particularly open to ‘How was your day?’ That process is still required to keep the ground fertile for when you need to talk.” Teens who experiment with
drugs often have different reasons for their behavior than their parents may think. Sengupta said it could include, “‘It’s so stressful at school. I have three hours of homework at night after school. When I smoke weed, I can calm myself down.’ Or, ‘All the girls at school make fun of me for what I look like so I smoke some in the morning so I can get to school.’ Sometimes, it’s ‘We went over to Jimmy’s house and I puffed and I passed.’ It is a social norm and there’s some peer pressure. Try to address the underlying issue.” For this reason, it’s also important to lead by example. If you rush for a glass of wine every evening after work, it signals teens that using a mood-altering substance can help them relax, too. If you have used drugs in the past, use your experience to indicate the negative effects of using drugs. “You can try to have a conversation about, ‘You’re right, I did those things and I experienced challenges, but I don’t want to you to have to go through that,’” Sengupta said. If you suffered no lasting effects, express how lucky you were and that others aren’t so fortunate.
or their friends such as dying from a drug overdose. Doing nothing seems like the right answer to some teens since it’s really difficult for them to believe that another young person could die. Some teens don’t recognize the signs of when a friend is in trouble with substance abuse and in need of emergency help. Joshua Lynch, clinical assistant professor of emergency medicine and a physician with UBMD Emergency Medicine and a member of the Erie County Opiate Epidemic Task Force, is the founder of Buffalo MATTERS, a program that provides medication-assisted treatment to opioid use disorder patients. Lynch provided the following signs of overdose: • Meth and Cocaine — can be alert, awake, and excited; may experience injuries or heart attacks while on the drugs. • Alcohol, opioids, anxiety medication and other benzodiazapines — decreased level of consciousness, increased sleepiness, lower respiratory rates, low blood pressure, lower oxygen, breathing problems, possible vomiting. • Opioids — pinpoint pupils, nodding off to sleep while sitting up, unconscious. “If you suspect overdose from opioids like Vicodin, heroin or Fentanyl give the patient Narcan (naloxone) and call 911,” Lynch said. Narcan is available over-thecounter at pharmacies and will not harm people who are misdiagnosed as overdosing on opioids; however, patients who have taken other drugs
may need different treatment. Lynch warned, “having someone take Narcan and waiting for them to wake up isn’t a substitute for calling 911.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
By the Numbers
According to the Centers for Disease Control and Prevention’s most recent statistics: • 70,237 drug overdose deaths occurred in the United States in 2017. • The age-adjusted rate of overdose deaths increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). • Opioids—mainly synthetic opioids (other than methadone) — are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths). • In 2017, the states with the highest rates of death due to drug overdose were West Virginia (57.8 per 100,000), Ohio (46.3 per 100,000), Pennsylvania (44.3 per 100,000), the District of Columbia (44.0 per 100,000), and Kentucky (37.2 per 100,000). • States with statistically significant increases in drug overdose death rates from 2016 to 2017 included Alabama, Arizona, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland, Michigan, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, West Virginia, and Wisconsin.
Photo courtesy of Hatchets and Hops.
The Latest Trend in Buffalo? Hatchet Throwing Activities Yes, there’s something in the air —hatchets By Catherine Miller
ust when you think you’ve tried all the activities that the bustling Buffalo area has to offer, hatchet throwing comes to Western New York. Similar to darts — but on steroids — brandishing hatchets has been around for centuries, but is only now becoming a social sporting sensation. Originally used as pre-historic tools and later medieval weapons, axes and hatchets have made their way to the modern-day social circuit and is a great group activity for all ages. The social hatchet-throwing craze initiated in Canada and is now an international sport. And it’s not just for the barrel-chested men donning red plaid. “We’ve held bachelor and bachelorette parties, wedding day groom prep-parties, and everything from 21st to 60th birthday parties,” explains Alec Siskar, outside events coordinator for Hatchets and Hops, located on Main Street in downtown Buffalo. “We get people of all dif-
ferent backgrounds,” he says. “This tends to be a great team building environment as you do not need much strength or technique to have a great time.” At Hatchets and Hops, a seasoned instructor is assigned to each group and you are given a lesson prior to throwing your first hatchet. You are informed on the proper approach in holding and raising your hatchet, when to release it and how to correct your stance and pitch. Your instructor will stay with your group for the duration of your practice period, and will rotate your hatchet wielding allies round robin style until the final tournament. The throwing areas are bays set up with two large wooden targets, similar to hanging out in a small bowling alley or batting cage. “This is a great experience for a date night or group of friends,” said Sarah Signorelli, marketing manager at Hatchets and Hops, “People think they need a large group but as few as two people can book a time slot. We will group people together to make things more fun and often find that
people make new friends by the end of the night.” So, why hang out throwing hatchets, you ask? Well, aside from having a great time socially (and yes, Hatchets and Hops does serve beer, wine and food if you are in the mood), it is great exercise. Instead of sitting around with friends you are up and moving which gets your blood flowing. Hatchet throwing is great for your core, lats, shoulders and legs. Think of the stress you release as you repeatedly lift and hurl a weighted hatchet up and over your shoulders toward a large wooden board 12 feet away. The hatchet is between one and two pounds, and after an hour or so, you can feel the stress release from your shoulder area, as well as your mind. While Hatchets and Hops is for the 21 and over crowd, Western New York has an option for those teens looking for a fun new alternative to staring at video games. Buffalo Battleground, located on
March 2020 •
Niagara Falls Boulevard in Tonawanda has a starting age of 13 in their hatchet-throwing bays. If you have children beneath that age there is an arcade and laser tag area for the kiddies to enjoy while mom, dad and older teens heave a few hatchets. Buffalo also boasts the AxeWagon, a mobile van that can transport hatchet-throwing activities right to your wedding reception or bat mitzvah to make for a memorable event. Americans may have moved on from their days of lumberjacks working the frontier, but that’s no reason to bury the hatchet. hatchet throwing is a social, stress relieving activity that can be a great date night, team-building event or fun family outing. Check out the websites for Hatchets and Hops, the Axe Wagon or Buffalo Battle Ground for more information on what they have to offer. Keep an eye out. I’ve heard there are more hatchet-throwing venues coming to the current Buffalo frontier in the near future.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
The skinny on healthy eating
Little Lentils Dish Up Big Benefits A small but mighty member of the legume family, lentils have so much going for them it’s hard to know where to begin. Nutritionally dense and loaded with wide-ranging health benefits, lentils are considered by many to be a “superfood.” Lentils are remarkable high in fiber — both soluble and insoluble — with one cooked cup providing around 16 grams of this cholesterol-lowering nutrient. According to the American Heart Association, the average American adult needs about 25 grams of fiber a day to reap its benefits. On average, however, American adults eat only 10 to 15 grams of fiber a day. Why bump up your fiber intake? Multiple studies have confirmed that eating lots of fiber can reduce your risk of dying from heart disease, cancer, stroke, and Type 2 diabetes. Lentils’ impressive amounts of folate and magnesium also contribute to heart health. Folate helps lower levels of homocysteine, an amino acid that when elevated can lead to hardening of the arteries and blood clots, while magnesium helps maintain a steady heartbeat and normal blood pressure. Heart benefits notwithstanding, folate is critical for preventing neural tube defects in newborns. Seeking to increase your intake of plant-based protein? Look to lentils, the bean that delivers the second most protein per cup (soybeans take
top honors): a whopping 18 grams. A building block of bones, muscles and skin, this powerhouse nutrient can also be a dieter’s best friend, as its slower digestion helps to curb snacking, and its metabolic boost (protein takes the most energy to digest) can be a bona fide calorie-burner. Similar to other beans, lentils are packed with antioxidants — those magical compounds that can help prevent a host of age-related maladies, from heart disease to cancer to Alzheimer’s. Lentils’ antioxidants do a body good by helping to reduce inflammation, lower blood pressure and fight free radical damage. A versatile bean that cooks in a
By Anne Palumbo jiff, lentils are naturally low in fat, sodium, cholesterol and calories: only 230 per cooked cup. This ancient legume — nearly 10,000 years old — is also a good source of manganese, phosphorous and iron.
Adapted from Cuisineathome.com 2 tablespoons olive oil 2 cups sliced white or cremini mushrooms (or more) 1 cup chopped onion 3 cloves garlic, minced 1 cup each sliced carrot and celery 2 teaspoons Italian seasoning 1/4 teaspoon red pepper flakes 1 tablespoon tomato paste 2-3/4 cups low-sodium broth: vegetable or chicken 1 can diced tomatoes (14.5 oz.) 3/4 cups lentils 1/4 cup 2% milk 1 teaspoon balsamic vinegar salt and pepper to taste 8 to 10 oz. pasta of choice shredded Parmesan
Helpful tips Store dry lentils in an airtight container in a cool, dry place for up to a year (can be stored longer, but taste may deteriorate). Cooked lentils will last about a week in refrigerator or up to six months in freezer. Canned lentils have a similar nutritional profile to dry lentils, but may be slightly higher in calories and sodium. Check label and be sure to rinse well before using.
Heat oil in a large saucepan or skillet over medium heat. Add the onion and garlic and sauté until onions become soft, about eight minutes. Add the celery, carrots, mushrooms, Italian seasoning, and pepper flakes; gently heat, partially covered until softened, about 10 minutes, stirring occasionally. Stir in tomato paste; cook two minutes. Add broth, tomatoes, and lentils; simmer, partially covered, until lentils are tender, 45-50 minutes, stirring occasionally. Meanwhile, cook pasta in a pot of boiling salted water according to package directions; drain. Stir milk and vinegar into bolognese; season with salt and coarse black pepper. Serve bolognese over pasta; top with Parmesan.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at email@example.com.
One Egg Per Day Is Heart-Healthy, After All I t’s no yolk: Americans for decades have gotten dietary whiplash from the back-and-forth science on whether eggs are good for them. But a major new study will have many egg-lovers relieved: You can enjoy an egg a day without having to worry about your heart. “Moderate egg intake, which is about one egg per day in most people, does not increase the risk of cardiovascular disease or mortality even if people have a history of cardiovascular disease or diabetes,” said study lead author Mahshid Dehghan. She’s an investigator at the Population Health Research Institute (PHRI) of McMaster University in Hamilton, Canada. The study, which analyzed data on more than 177,000 people, was funded by various provincial government health agencies in Ontario, and nonprofit groups focused on heart health. It received no funding from the egg industry. Dehghan’s group poured over data from three large, long-term international studies, all conducted at the PHRI. The three studies involved people with various income Page 12
levels living in 50 countries on six continents, so the results are widely applicable, the researchers said. Most of the people in the studies had one or fewer eggs a day, suggesting that this level of consumption is safe, Dehghan said. “Also, no association was found between egg intake and blood cholesterol, its components or other risk factors,” she said in a McMaster news release. “These results are robust and widely applicable to both healthy individuals and those with vascular disease.” Eggs are an inexpensive source of essential nutrients, but some nutritional guidelines have advised that people should limit intake to fewer than three eggs a week, due to concerns they increase the risk of heart disease. But as study principal investigator Salim Yusuf pointed out, prior studies about eggs and health have yielded conflicting findings. “This is because most of these studies were relatively small or moderate in size and did not include individuals from a large number of countries,” Yusuf said in the news release. He directs the PHRI.
Two U.S. experts in nutrition and heart health agreed that maybe it›s time — again — to give eggs a break. “The case of eggs causing heart disease has been cracked — Humpty Dumpty can remain on the wall,” said physician Guy Mintz, who directs cardiovascular health at the Sandra Atlas Bass Heart Hospital in Manhasset, Long Island. “This very large study has clearly demonstrated that people can have one egg a day without any
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
cardiovascular consequences.” Mintz believes eggs are a good source of many nutrients, and he stressed that no deleterious effect was seen, even in people who already had heart disease or were taking medications. The study was published recently in the American Journal of Clinical Nutrition.
Should You Skip Breakfast? Celebrity TV doctor Mehmet Oz recently said people should skip breakfast. Do we really need the ‘most important’ meal? By Deborah Jeanne Sergeant
elebrity doctor Mehmet Oz recently said that people should skip breakfast. That seems to fly in the face of the ageold adage that breakfast is the most important meal of the day and the means to jumpstart the metabolism, but Oz explained that most people respond to society cues to eat, whether they need the calories or not. Oz explained that eating later in the evening causes the hormones to make the body crave calories — primarily carbohydrates — first thing in the morning. Stopping eating around 7 p.m. resets the hormones so that by 7 the following morning, the body has been fasting 12 hours and it doesn’t feel hungry right away. He added that the data comes from animal research and anecdotal input from professional athletes. Oz’s advice seems to correlate with emerging research on intermittent fasting, which advocates for eating only during eight hours of the day and abstaining from food for the rest of the 24-hour period. Oz believes that skipping breakfast can help people not only maintain healthful weight, but also perform better both physically and mentally, and even age more slowly. He also believes that it’s an easy way for people to lose weight and maintain healthful weight, since it doesn’t involve counting calories or
points, severe food restrictions or continual efforts (although eating a generally healthful diet of moderate calories is still a good idea). Even when eating the same number of calories over an eight-hour period compared with an 18-hour period, people tend to lose weight, according to Oz. Also as part of his System 20 eating plan, adherents are permitted a cheat day so their bodies don’t get in a rut — and they can enjoy an occasional breakfast out. Or, instead of skipping breakfast, they can skip dinner that evening to maintain the eight hours of eating. Debbie Wolfe, a home and lifestyle writer based in the metro Atlanta area, posted in February on She Finds, “if you think skipping breakfast will help you lose weight faster you may be making a big mistake.” She bases this on the low blood glucose levels people have after not eating for 12 hours since their previous evening’s dinner. “When you wake up, your glycogen stores are low,” Wolfe wrote. “Glycogen is the glucose that has been stored in your muscle and liver tissues and is released slowly so your blood sugar levels are stable overnight. When you skip breakfast in order to fast, all of the energy from the glycogen stores is used up, your body starts to break down fat to produce energy. You may lose weight
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with this method, but you can also experience reduced energy levels and fatigue.” She added that eating breakfast can add a nutritious boost to the day, improve energy levels and metabolism and prevent poor food choices later. Dennis Lesniak, doctor of chiropractic, has a master’s in clinical nutrition and bachelor’s in exercise science. He works at Quarter Deck Athletics-CrossFit QDA in Buffalo and sees some merit in skipping breakfast for some people. “When we work with our nutrition clients with a lot of different dietary strategies, we need to find something to help them be successful,” Lesniak said. “If you eat breakfast every day and it’s something you enjoy and feels good with you, keep at it. If you hate eating breakfast and you’re only making bad choices like [eating] a muffin, pancakes, waffles or cereal, skipping it might help you make better choices.” He believes that it’s all about cumulative nutrition strategies throughout the day. But for people who want to lose weight, it’s essential that they can maintain their weight loss strategy long-term. Mary Jo Parker, registered dietitian with Nutrition and Counseling Services in Buffalo, believes that Dr. Oz is oversimplifying the case for intermittent fasting by saying that since animal research shows some positive metabolic change while fasting, “there is insufficient evidence that the same occurs with humans,” Parker said. “What we know is that if people fast for a prolonged period of time, they may have weight loss results, but most researchers attribute this to eating less in a 24-hour period
versus any significant metabolic change.” While she acknowledged that anecdotal evidence shows some people seem to benefit from intermittent fasting, it cannot be called a one-sizefits all weight loss solution. Instead, she wants people to focus more on reducing intake of processed foods and to emphasize eating more whole foods, natural fiber, healthy fats and a plant-based diet. “This is the healthiest way to eat and I think it will catch on more,” Parker said. Laura M. Anderson, Ph.D., assistant professor and licensed psychologist and director of the PULSE Healthy Weight Research Team at University at Buffalo, said she used to strictly adhere to calories in versus calories out for weight loss; however, she said that if intermittent fasting helps individuals and they can stick with it, it can be a helpful tool for weight loss. “Many on intermittent eating say that it’s like their brain is reset,” she said. “They say all the organs are more in synch.” Overall, people should try to eat a healthy diet and stop when they’re full. “Roast veggies, make your own foods, eat things that don’t have so many ingredients,” Anderson said. “It all boils down to no diet ever. You want it sustainable forever to prevent weight regain.” Though not a big fan of breakfast cereal, Anderson said that anyone who wants to eat breakfast should. She suggests foods that contain protein, along with a little healthful fat and produce, such as Greek yogurt with fruit and nuts.
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Careers in Healthcare
Career: Dental Laboratory Technician Field is growing ‘much faster than average, compared with all other careers,’ according to the Bureau of Labor Statistics By Deborah Jeanne Sergeant
ith an annual mean wage of $44, 620 to $76,440 statewide (Bureau of Labor Statistics, May 2017; no Buffalo-specific data available) and no education requirements, the dental lab tech career offers generous remuneration. Few other positions related to healthcare pay so well with so few education requirements. Lab techs may make and repair orthodontic devices or dental prosthesis like dentures and bridges or crowns. These devices are all custom equipment specially made according to the patient’s forms and the specifications from the doctor. Dental lab techs don’t interact with patients; however, their relationships with doctors require a level of customer service and interpersonal skills. Dental lab techs must pay careful attention to detail and understand why these details will play a large role in the patient’s satisfaction with their experience with their dental professional. Dental lab techs are very employable. “I don’t think the need will ever stop,” said Jessica Grange, human resources assistant with Great Lakes
Dental Technologies in Tonawanda. “We have 275 employees and we’re always hiring for this position.” Great Lakes trains new hires inhouse. Grange said that even people without any experience have hope for advancement into areas with greater skill and responsibility. “We pay for further education if someone had a true interest in the career,” Grange said. Peter DeMarco, dentist and department head for Erie Community College’s two-year dental laboratory technology program, said that with the certification and education, “you tend to make more money.” The program has no prerequisites but a high school diploma; however, “you need excellent manual dexterity and good color perception.” Students learn to make complete dentures, removable partial dentures, crowns, bridges and orthodontic appliances. “It’s a great career choice,” DeMarco said. “The biggest problem in getting students in is that few students know it’s a career.” Of course, additional schooling would only help a dental tech to advance in the career; however many
Dental lab techs may make and repair orthodontic devices or dental prosthesis like dentures and bridges or crowns. Mean wage for the profession is $46,240 in Rochester. It doesn’t require extensive schooling. employers provide on-the-job training. A few community colleges in the region like Monroe Community College and Erie Community College offer two-year courses. Graduates can then become certified in dental lab technology. Although not a required credential in New York, the certification is nationally recognized. Some states may have their own qualifications. With this kind of experience and education, people may work at orthodontic labs, dental labs, doctor’s offices and larger dental and orthodontic offices. Brian D. Willison, certified dental technician, is on faculty at UB School of Dental Medicine, department of oprthodontics, and also trains at Great Lakes Dental Technologies in Tonawanda. “It can be a good career if you choose to run the ladder,” Willison said. “If you look at orthodontics, there’s a variety of devices and depending on what company you join, there’s chances of advancement.” For Willison, the work is reward-
U.S. Birth Weights Drop Due to Rise in Cesarean Births, Inductions
Average length of a pregnancy has declined from 40 weeks to 39
.S. birth weights have fallen significantly in recent decades due to soaring rates of cesarean deliveries and inductions which have shortened the average pregnancy by about a week, new Colorado University at Boulder research shows. “Our data indicate that there has been a dramatic shift in birth timing in this country, it is resulting in birthweight decline, and it is almost entirely due to changes in obstetric practices,” said Ryan Masters, a social demographer with the Institute of Behavioral Science and senior author of the study published January 29 in the journal Demography. Previous research has shown that, after decades of rising, birth weights began to fall in 1990, a trend that has puzzled scientists and alarmed public health officials well aware of the long-term adverse health effects that can arise from low birthweight. Page 14
Masters and lead author Andrea Tilstra, a Ph.D. candidate in the CU Boulder department of sociology, set out to pinpoint what’s driving the trend, using records from the National Vital Statistics System. They analyzed more than 23 million single births to healthy mothers from 1990 to 2013, using demographic techniques to plot: birthweight; week at which each birth occurred; and whether the baby was born via vaginal delivery, induced vaginal delivery, cesarean delivery, or induction and cesarean. Then they ran a simulation to see what would have happened if cesarean and induction rates hadn’t increased. “We found that the decline in birth weight would not have happened if it were not for the rapid increase in these obstetric interventions,” said Tilstra. “In fact, birth weights would have gone up.”
Medical interventions on rise Among the study population, the incidence of cesarean deliveries grew from 25% in 1990 to 31.2% in 2013, with rates rising fastest among healthy women in weeks 37 to 39. Labor induction more than doubled from 12% of deliveries to 29%. Meanwhile, the average length of pregnancy decreased from 40 weeks to 39 weeks, and overall births became increasingly concentrated between 37 and 39 weeks, with far fewer stretching into 42.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
ing because “you’re helping people and making beautiful smiles and improving oral health as well as the digestive system. It all works together. You’re helping people and making them look good.” He added with a chuckle, “You start noticing people’s teeth more working in this field.” The industry has become more dependent upon technology as an increasing number of dental and orthodontic offices are using computerized scans rather than physical molds to help dental techs create the devices they need. While 3-D printers can create some dental devices like tray aligners, they don’t take the place of dental lab techs. The printers also require skilled technicians to operate them, so their presence in the industry doesn’t mean fewer jobs. In fact, the Bureau of Labor Statistics predicts an increase in the demand for dental lab techs to increase by 11% between 2018 and 2028, rated as “much faster than average, compared with all other careers.
About 18% of births in 2013 would have happened later, via a vaginal delivery that was not induced, had they occurred in 1990. That matters, the researchers note, because a fetus can put on significant weight in the final weeks of pregnancy. Over the 23 years, the average weight of a baby born in the United States declined 67 grams (about 2.4 oz). Had rates of interventions stayed level, the average birth weight would have risen by 12 grams. “By intervening in the pregnancy instead of allowing it to reach its natural finality we are shifting when birth happens, and that can have public health consequences,” said Tilstra, noting that low birth weight has been linked to poorer long-term health and lower educational attainment.
New Medication for Migraines By Deborah Jeanne Sergeant
f you suffer from migraine headaches, a new medication recently approved by the FDA may offer help. Ubrelvy (ubrogepant) tablets are indicated for treatment migraine with or without aura, a visual effect concurring with many migraines. Unlike preventive migraine medication, patients prescribed to take ubrogepant can take it upon onset of a migraine as needed. Ubrogepant represents the first drug in the class of oral calcitonin gene-related peptide receptor antagonists that the FDA has approved for treating acute migraine. The FDA announced ubrogepant’s approval
Dec. 23. Physician Melissa Rayhill is a neurologist with UBMD Neurology, who specializes in patients suffering from headaches, migraines and post-traumatic headaches. She said that other medications in the same class as ubrogepant are in current development. “There are additional new classes of medications that have been recently approved for the treatment of migraine in the last two years including lasmiditan — the first of the new ‘ditan’ class for symptomatic attack management — and CGRP monoclonal antibodies for migraine prevention [erenumab, fremanezumab, and
galcanezumab],” she said. While it seems there’s a lot of migraine medication available for people with migraine, Rayhill said that offering more options benefits patients. “Not all patients respond to treatments in the same way, so having a new class of medication available to our patients is a big deal,” Rayhill said. “We need better treatments for the millions of patients suffering with migraine in this country alone.” She said that ubrogepant blocks the activity of pain-transmitting protein. When a patient feels a migraine coming on, taking the medication decreases the inflammatory response caused by the protein. That can stop the migraine. People who take certain other medications metabolized by the liver should avoid taking ubrogepant, as well as those with liver disease and women who are pregnant or breastfeeding. Participants in two randomized, controlled trials reported nausea, drowsiness, and dry mouth as the most common side effects. Dashrath Dulal, pharmacist at Alexander Pharmacy in Rochester, said that this class of medication is becoming popular as a class since its mechanism is different. Many other migraine medications constrict blood vessels, which can contribute to higher risk of stroke and heart attack, unlike the oral calcitonin class. Though Dulal hasn’t seen demand at his pharmacy for the medication yet since it is so new, he said, “It will be interesting to see how people will respond to it. It may be something for people who have no other choices may try it. It’s something that’s an alternative for people. Something like this might be a good try for them.” Having many options available can provide better therapies for people who cannot tolerate or do not
Migraine at Glance
According to the Migraine Research Foundation based New York City, migraine affects 39 million men, women and children in the U.S. and 1 billion worldwide. • Migraine is the third most prevalent illness in the world. • Nearly one in four U.S. households includes someone with migraine. • Twelve percent of the population — including children — suffers from migraine. • Eighteen percent of American women, 6% of men, and 10% of children experience migraines. • Migraine is most common between the ages of 18 and 44. • Migraine tends to run in families. About 90% of migraine sufferers have a family history of migraine. • Migraine is the 6th most disabling illness in the world. • Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks. wish to experience unwanted side effects of their migraine medication.
Machine Could Expand Pool of Livers for Donation
esearchers report they have developed a machine that can repair injured livers and keep them alive outside the body for up to a week. They said the machine could one day increase the number of livers available for transplant and save the lives of many people with severe liver diseases or cancer. Until now, it was only possible to store livers safely outside the body for a few hours. But this new technology — a complex perfusion system that delivers blood to the injured livers — can extend safe outside-the-body storage of livers to up to seven days and offers a wide range of possibilities, including repair of liver injury, cleaning of fat deposits in the liver, and even regeneration of partial livers, according to the researchers from the University of Zurich in Switzerland. Injured livers from dead donors aren’t suitable for transplantation, but the study authors said this machine may restore these organs to full
function after several days. “The success of this unique perfusion system— developed over a four-year period by a group of surgeons, biologists and engineers — paves the way for many new applications in transplantation and cancer medicine helping patients with no liver grafts available,” researcher Pierre-Alain Clavien said in a university news release. He is chairman of the department of visceral and transplants at University Hospital of Zurich. An initial study of the technology showed that six out of 10 poor-quality human livers that were refused for transplantation by all centers in Europe recovered to full function within one week of perfusion on the machine. The next step will be to use such organs for transplantation. The research was published Jan. 13 in the journal Nature Biotechnology.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Routine Care Vital With Braces By Deborah Jeanne Sergeant
f you or your child has just been fitted with braces, it may seem like your orthodontist has all the bases covered as you visit every eight weeks or so. Although orthodontists are general dentists with additional training in orthodontia, you still need to see your general dentist for routine cleanings just as before braces. “It’s important to see your dentist every six months for a cleaning and exam,” said Amy Richter, owner and orthodontist at Amy Richter Orthodontics in Buffalo. Although orthodontists take the time to give the teeth a good cleaning before applying braces, the general dentist maintains the oral hygiene through visits every six months, or more often as prescribed. Most orthodontists don’t do general or routine cleaning as a general dentist does. Richter said that before braces are applied, the patient should already have a good understanding of home care and good dental health and then ramp it up while their braces are in place. “Flossing changes when you have braces because you need to use a floss threader or pick to fit under
the wire and between the teeth,” Richter said. “You need to floss to prevent cavities and for the health of the gums. You can use a power toothbrush or a manual, but you should brush for at least two minutes.” Some power toothbrushes have a built-in timer. Establishing good home care is even more important while wearing braces because the brackets and wires make brushing and flossing more difficult. It also somewhat disrupts the natural movement of saliva through the mouth. Richter said that patients need to angle the bristles under the wires and brackets and along the gum line — an area often overlooked. It takes more time to brush and to use a floss threader to get between teeth and clean the gum line; however, that’s the key to achieving the best results and maintaining oral hygiene with braces. “We give patients the ‘little Christmas tree’ brushes for getting under the wire,” Richter said. “Some like an oral irrigator to clean food out prior to brushing.” Fluoride treatments can also prevent cavities for patients facing the
cleaning challenges of braces. “Braces don’t cause cavities, but what happens is it’s an obstacle to brush around and a trap to collect food against your teeth,” Richter said. Because of that obstruction, proper home care and regular dental visits are especially important. “A lot of people are surprised that even though they come to our office very eight weeks that they do still need to keep up with their appointments with their general dentists,” said Carolyn Schlageter, registered dental assistant. Schlageter is also the treatment and financial coordinator at Get It Straight in Pittsford, Macedon and Greece. She said her office works closely with the general dentist’s office to help patients take care of their smile and show patients videos on dental care with braces so they
Dry Mouth: Important Health Clue by Deborah Jeanne Sergeant
f you find that your mouth often feels parched, it’s not a symptom you should ignore, unless it’s only when you’re nervous. When it persists as a regular problem, dry mouth, called xerostomia in the medical world, can indicate a number of important health concerns. Instead of constantly reaching for lozenges, hard candy or a drink, you should see a healthcare provider. It’s not just an inconvenience. “It can cause issues with a higher rate of decay,” said Amy Richter, orthodontist and owner of Amy Richter Orthodontics in Buffalo. “Saliva has some cleaning action. If you don’t brush after a meal, your saliva can rinse away food particles and if you have a dry mouth, that can be a problem.” Richter said that age, certain medications and some medical conditions can cause dry mouth. “It can have many, many causes,” said Az Tahir, a medical doctor who practices holistic medicine in Rochester. He said that dry mouth could be a localized problem from a blocked salivary gland in the mouth, or a systemic issue such as Sjogren’s syndrome, which can also cause dry eyes. Sjogren’s is an autoimmune disease that often accompanies other autoimmune conditions such as lupus, Hashimoto’s disease and rheumatoid arthritis. Beyond the chance of association Page 16
with other conditions and the annoyance of feeling like your tongue is sticking to the roof of your mouth, dry mouth can cause dental health issues as well, such as increased plaque, tooth decay, gingivitis, mouth sores, thrush, cracked and dry lips, and, because saliva helps initiate the breakdown of food, digestive issues and nutrition problems. Paul Emile Rossouw is doctor of dental science, Ph.D., and chairman of the orthodontics and dentofacial orthopedics department at Eastman Institute for Oral Health, which is part of the University of Rochester Medical Center. Rossouw said that drying out the mouth can hasten the gingivitis process, since saliva helps wash away food debris and neutralize acid in the mouth. Sometimes, dry mouth isn’t a local or systemic condition but is caused by an external injury that damages the salivary glands or a mechanical issue. “That’s why one should want good lip seal,” Rossouw said. “Many things can create incompetent lips. Any kind of habit like sucking the thumb, genetics, and crowding with the teeth, which can make it difficult to close the lips. Aging can also be a cause.” Drinking more water and using mouthwash made to combat dry mouth can help, as can addressing any sleep apnea issues. Sleep apnea causes the lower jaw to drop open, which dries the mouth during sleep.
Chemotherapy and radiation as a cancer treatment can cause dry mouth. Patients undergoing these treatments should ask about ways to keep more comfortable. Some medications can cause dry mouth, like some antihistamines, anti-hypertensive drugs, and antidepressants, so it’s a good idea to
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
learn the techniques of brushing and flossing. Each employee in the clinical area at Get It Straight is a licensed dental hygienist so they can keep a close watch on their patients’ hygiene, even though they don’t offer traditional dental prophylaxis. According to Schlageter, one of the misunderstandings that people sometimes make is that they think the white marks on their teeth after braces come off are caused by the braces. “It’s not. It’s decalcification,” she said. “That’s caused by not brushing properly.” Decalcification can lead to tooth decay, so it’s vital to properly care for teeth as the orthodontic team directs. As another means to protect teeth, Get It Straight recommends a prescription fluoride toothpaste twice a day.
bring this up during a visit with a healthcare provider, as an alternative medication or treatment option may be available. Dry mouth should also be addressed at a dental visit, since the dentist and hygienist can look for any signs of gingivitis and make recommendations on strategies to mitigate and prevent dry mouth. Using alcohol, tobacco products, or illicit drugs also contribute to dry mouth, so quitting use of these can help restore better moisture to the mouth.
Tips for Beautiful, Healthy Skin
Want that airbrushed look without a photo filter? Follow these tips from three area experts By Deborah Jeanne Sergeant
ips from Lori Ullman, dermatologist with University at Buffalo: n “Sleep is important for generally healthy skin. When you sleep, your body repairs itself. Lack of sleep causes distress to our bodies. n “The single most contributing factor to keeping your skin beautiful is protecting it from the sun’s harmful rays. Solar radiation is the biggest factor. When we chronically expose the skin, we get break down of collagen, the elastic fibers in the skin. It gives strength and elasticity. It results in rough, dry, irregular pigmentation, caused by dilated blood vessels. The real approach is for use of year-round sun protection. UV-B tends to be more active 10 a.m. to 4 p.m. in April through October. But UV-A is the same in January as July. It’s active as long as you don’t have to turn on artificial light. Use SPF of 30 or higher. I also recommend that chemical-free sun screens or sun blocks containing a physical sunscreen like zinc or titanium dioxide rather than chemical sun screens. Recent studies show the chemicals are absorbed in larger amounts than we previously thought
and there are studies underway to study the potential affects. The physical sun blocks are micronized now so it’s not the old sunscreen where you look as white as a ghost. n hats, sunglass, and clothing. Standard cotton is SPF 5. If you’re looking for sun protective clothing, purchase clothes that are rated as sun protective. Their fibers are more tightly woven. If it gets wet, change. Apply every two to three hours. Your own oils slough them off. Apply in the morning and afternoon and when you get out of the water. n “Don’t smoke. The nicotine causes restriction of blood vessels, which decreases blood flow to the skin. Oxygen delivery is decreased, as is essential nutrient delivery, which contributes to premature aging. Unrelated to sun exposure. It contributes to breakdown of collagen and elastic fibers. It leads to sagging and coarse wrinkling. That lack of oxygen and nutrients leads to skin discoloration. Removing to this one factor will improve skin health. n “Use gentle cleaners and avoid exfoliants and scrubs, which
lead to inflammation. Use oil-free products. ‘Less is more’ is my motto. the products with fewer ingredients tend to be gentle and often have a good safety profile. Beautiful skin is healthy skin.”
ips from Nananamibia Duffy, dermatologist with Rochester Regional Health: n “Cleanse twice daily. Wash sweat off immediately after exercising so bacteria and yeast do not sit on the skin. n “Use sunscreen.
n “Use a retinoid [prescription] or retinol daily to help stimulate cell turnover and boost collagen production. n “If you are in your late 20s and beyond, consider a regular skin maintenance procedure like a no-downtime resurfacing laser — Clear and Brilliant is my favorite — which can be performed as often as every month to help maintain the skin integrity and get that glow back.”
Answers for Adult Acne
By Deborah Jeanne Sergeant
hether you have been breaking out since your teen years or acne has returned after a hiatus, adult acne can cause embarrassment and frustration. Fortunately, you have a few options for mitigating its effects. It’s important to understand what causes adult acne. It’s more complex than you may think. “It is a multi-factorial disorder that involves the hair follicle and sebaceous gland,” said Lori Ullman, dermatologist with University at Buffalo. “It peaks in adolescence and 35% of women and 25% of women in their 40s still suffer from acne. Some of those women had acne as adolescents and it continues. Genetics play a role. The number of pustules and size and activity of sebaceous glands are genetics. It runs in families. The severity and duration into adulthood. does run in families.” Hormones appear to influence acne. Some women experience outbreaks related to their menstrual cycles and accompanying hormone shifts, as do women with polycystic ovary syndrome, which is hormonal in nature. “We often work with an endocrinologist,” Ullman said. Stress hormones can also play a role, as increases in cortisol can worsen acne. It’s easy to forget that the skin is an organ of the body. Lifestyle factors such as poor diet definitely affect the skin.
A generation ago, chocolate and greasy foods were commonly identified as causing acne. While there’s more to curbing outbreaks than banning these foods, the notion holds some truth. Ullman said some people have linked adult acne to processed foods and dairy. “Excessive intake of sugar and excessive iodine can worsen the problem,” said Mary Jo Parker, registered dietitian with Nutrition and Counseling Services in Buffalo. Instead, she advises focusing on produce, whole foods and limited processed foods. In addition to eating a healthful diet, the health of the gut itself can influence acne. Heather Carrera, a doctor of clinical nutrition in Pittsford, near Rochester, said that gut health is highly linked to skin conditions. “Acne is a good indication that the cells of the gut lining have spaces between them. If it’s leaky, undigested food particles can enter the blood stream. It shows up as skin condition,” she said. Washing the face twice a day and removing make-up with a gentle cleaner before bed is essential, as it can otherwise clog pores and worsen acne. If regular at-home care isn’t working, seeing a dermatologist can help diagnose acne and suggest treatments and lifestyle changes that can help. While zealous cleaning may
seem a good idea, Ullman advised against it. “That makes it worse,” she said. “Stay away from irritants and scrubs. Use gentle cleansers like Cetaphil or Aquanil. Stay away from anything that has oil in it. Look for something that’s oil free rather than noncomedogenic. Noncomedogenic means it doesn’t cause acne in the lab.” For those with mild acne, overthe-counter products containing alphahydroxy may help remove the dead skin cells that trap the oil and debris causing acne, but Ullman
March 2020 •
warned that those products do increase sensitivity to the sun. “You want to make the proper diagnosis with acne,” she added. “Sometimes, it can be confused with rosacea, which also has its onset in adulthood and often in middle age. It also manifests with pustules but more in the central part of the face. The bumps are fairly similar looking and aren’t blackheads and whiteheads.” Talking with a dermatologist can help form an effective treatment plan.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
CrossFit: Hardcore Workout or Hard-to-Avoid Injury? By Deborah Jeanne Sergeant
f you don’t do high-intensity functional training (HIFT) such as at CrossFit, you likely know someone who does. HIFT workouts have become very popular. Flipping over tractor tires, hauling cement blocks and jumping on top of a stack of wooden blocks is far different from exercise regimens like spinning and running — and that’s the point. HIFT-style classes offer high intensity functional training that constantly change and challenge every area of the body and aspect of fitness: strength, endurance, balance and flexibility. They’re also designed to create camaraderie. Instead of slogging solo on bikes or plodding side by side on treadmills, HIFT classes encourage a teamwork environment as members of the gym cheer and encourage each other to complete the same workout with a few modifications as needed. Anecdotal reports of injury and
even a few lawsuits have tarnished the reputation of CrossFit and other HIFT-style classes. In late 2018, a study published in the Orthopaedic Journal of Sports Medicine looked at injury rates of participants in HIFT (specifically CrossFit, as it’s the most popular and identifiable HIFT class). The study surveyed 3,049 CrossFit participants between 2013 and 2017. More than 30% reported injury because of CrossFit in the past 12 months, including shoulders (39%), back (36%), knees (15%), elbows (12%) and wrists (11%). That meant an injury rate of 0.27% per 1,000 hours of participation. The study concluded that CrossFit “is relatively safe compared with more traditional training modalities.” But the caveat is that those new to CrossFit (less than a year) and who train fewer than three workouts weekly are at greater risk, which may
indicate that their lack of fitness and conditioning contributed to their likelihood of injury. “A lot of physical therapists and chiropractors see people with CrossFit injury,” said Dennis Lesniak, doctor of chiropractic. He has a master’s in clinical nutrition and bachelor’s in exercise science. He works at Quarter Deck Athletics-CrossFit QDA in Buffalo. He thinks that the high participation rate skews the statistics. For example, someone who plays tennis three times a month doesn’t participate as often as someone who trains at CrossFit five or six days a week. Lesniak also said that some people may attribute their injury to “CrossFit” who are mimicking a Workout of Day (WOD) at home. CrossFit gyms post their WOD online, but at home, there’s no coach to guide them in how to perform movements safely. Also, the gym offers scaling options for people who have limitations. “That may not be on the website,” Lesniak said. “If someone said, ‘Let’s play football’ it’s not going to be the Super Bowl. What you see online isn’t what 99.9% of the CrossFit population is doing.” He also added that “every exercise program has some degree of risk.” Especially for those who are out of shape, Lesniak encourages consulting with a health care provider and proceeding under the guidance of a trained professional to ensure gradual progress in intensity, appropriate warm-up and stretching and that each movement is performed safely. “Most CrossFit gyms have an introductory process, like an on-ramp class or one-on-one,” Lesniak said. “It’s a way to screen participants. The challenge comes when people want to move faster or move heavier weights. We have to help them keep their egos in check.” Knowledge of each client is key to safe and effective workouts. That’s why careful screening and making expectations clear is vital. “We talk about very clear communication,” Lesniak said. “We talk about soreness from exercise or pain.
I don’t care if you’re sore. Sore is fine. I care if you’re in pain. If the athlete doesn’t feel right, we scale the movement so they’re not in pain. “ He encourages people to make sure they know their own capabilities and that they don’t push past that point and allow injury. “Everybody and every exercise is so complex and different,” said Laura M. Anderson, Ph.D., assistant professor and licensed psychologist and director of the PULSE Healthy Weight Research Team at University at Buffalo. “Always consult with your healthcare team whether your doctor, personal trainer, and others. Even if it’s walking, you may need to talk with your healthcare team.” She said that selecting a form of exercise that’s sustainable for the long run is important for increasing the chances of maintaining good health. “Make sure you enjoy it, have access to it and you’re willing to put these together,” Anderson said. She views camaraderie as a factor that can help some people stick with an activity, but it can also push some participants toward injury. “Knowing your own limits is so key,” Anderson said. “Listen to your body instead of the peer pressure. That’s the double-edged sword of the peer environment. Don’t push too far.” She also said it’s important to keep in mind a back-up activity in case something happens to prevent participation in the favored activity. The practice of Kim Fenter, doctor of naturopathic medicine at Audubon Women’s Medical Associates, P.C. in Williamsville, is geared toward nutrition, weight loss and healthful lifestyle. “I ask my clients to exercise but in most cases the exercise choice is based on a client by client health history and their current level of activity,” she said. “My client’s likes or dislikes have a lot to do with the sustainability of an active lifestyle. If you have someone who doesn’t like going to the gym and enrolling in classes, the likelihood of their sustainable active lifestyle or success is compromised from the start.”
Antioxidant Use During Chemotherapy Risky for Breast Cancer Patients
reast cancer patients who take the dietary supplements known as antioxidants, as well as iron, vitamin B12, and omega-3 fatty acids, during chemotherapy may be at increased risk of disease recurrence and death, according to new study results appearing in the “Journal of Clinical Oncology.” Led by researchers at the SWOG Cancer Research Network, a cancer clinical trials network funded by the National Cancer Institute (NCI) through the National Institutes of Health, the study confirms previous medical guidance advising cautious use of any supplements, other than a multivitamin, for cancer patients undergoing chemotherapy. A small but growing body of research in the last 20 years shows that, despite their cancer-fighting reputation, antioxidants such as vitamin E, beta-carotene and selenium can actually increase risk of some Page 18
cancers, cause some cancers to return after treatment or interfere with the effects of chemotherapy. As part of the nation’s oldest and largest publicly-funded cancer research network, SWOG has conducted some of this work. Its landmark Selenium and Vitamin E Cancer Prevention Trial (SELECT) showed that vitamin E supplementation increases the risk of prostate cancer in healthy men. What’s unique about the new study, led by Christine B. Ambrosone, Ph.D., of Roswell Park Comprehensive Cancer Center, is that it is the first investigation of the effects of supplement use during breast cancer treatment, and only the second to investigate the effects of supplement use during any kind of cancer treatment. The first was conducted by physician Charles Fuchs, the director of Yale Cancer Center, who found that vitamin C may be helpful for people undergoing chemotherapy
treatment for colorectal cancer. “Although this is an observational study and the number of users of supplements was fairly small, the results are compelling,” said Ambrosone, chairwoman of the department of cancer prevention and control at Roswell Park. “Patients using any antioxidant before and during chemotherapy had an increased risk of their breast cancer returning and, to a lesser degree, had an increased risk of death. Vitamin B12, iron, and omega-3 fatty acid use was also associated with poorer outcomes.” Here’s what researchers found: • Patients who reported taking any antioxidant — vitamins A, C, E and carotenoids and Coenyzme Q10 — were 41% more likely to have their breast cancer return when they took the supplements both before and during chemotherapy treatment • Patients had a similar, but weaker, increased risk of death when
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
taking those antioxidants • Patients taking vitamin B12, iron, and omega-3 fatty acid supplements were at significantly greater risk of breast cancer recurrence and death • Patients taking multivitamins showed no signs of poorer or better outcomes after chemotherapy . Ambrosone cautions that her study results are not definitive enough to influence how doctors treat cancer patients. To do that, she notes, the research community would need to run a larger, randomized trial testing groups who do and do not take supplements to get a clear and strong connection. However, she said the results do support the current cautious approach to supplement use for people undergoing chemotherapy.
A Night of Hope for
By Jim Miller
How to Detect Friday, April 24th 2020 Hotel Buffalo, Parkinson’s Disease Millennium 2040 Walden Ave, Buffalo 6pm-9pm
Dear Savvy Senior,
What are the early warning signs of Parkinson’s disease? I was just diagnosed with it after noticing hand tremors for nearly a year, but looking back, I’m wondering if I missed any other early warning signs. Tremoring Tom
Dear Tom, The holy grail in any progressive disease is to find it early enough to start effective treatment before irreversible damage has occurred. But recognizing the early warning signs of Parkinson’s disease is challenging because they’re usually subtle and can be easily overlooked, dismissed or even misdiagnosed. Parkinson’s disease, which afflicts around 1 million Americans, is a degenerative disorder that occurs when the brain’s dopamine-producing neurons die or become impaired. This happens in the part of the brain that controls movement, which can cause tremors (or shaking), stiffness, and difficulty with walking, balance and coordination. The symptoms usually begin gradually and get worse over time, and the progression of symptoms is often different from one person to another. Some people with Parkinson’s become severely disabled, while others may experience only minor motor disruptions. While the cause of Parkinson’s disease is unknow, scientists believe genetics and environmental factors (exposure to certain toxins) play a key role. Most people with Parkinson’s first develop the disease around age 60 or older, and men are more likely to develop it than are women.
Early Warning Signs
Parkinson’s disease is difficult to diagnose because there’s no definitive test to confirm it. Doctors, usually neurologists, will do an examination and evaluate a combination of warning signs, but symptoms can vary greatly by patient which often leads to confusion and misdiagnosis. That said, here are some of the key signs and symptoms everyone should know. • Trouble sleeping: Thrashing around in bed or acting out dreams — kicking or punching — when asleep. This is a REM sleep behavior
disorder and one of the strongest and earliest pre-diagnostic symptoms of Parkinson’s disease. • Loss of smell: Not being able to smell certain foods very well like bananas, dill pickles or licorice. This too is one of the earliest symptoms. • Constipation: Problems with digestion and bowel movements are a big problem for people with Parkinson’s, and an early sign that can occur up to 20 years before this disease is diagnosed. • Changes in handwriting: Writing may become harder to do, and your handwriting may appear much smaller than it has in the past. • Tremors: Slight shaking or tremor in your finger, thumb, hand or chin. The tremor usually happens at rest, and when you move the extremity it may disappear. This is the most common and recognizable outward sign of Parkinson’s disease, but by the time tremors start, the brain has already lost more than half of its dopamine-producing cells. • Slowed movement: Over time, Parkinson’s disease can slow movements, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag your feet as you try to walk. • Speech changes: Speaking softly, quickly, slurring or hesitating before talking. Your speech may be more of a monotone rather than with the usual inflections. • Loss of automatic movements: Decreased ability to perform unconscious movements, like blinking, smiling or swinging your arms when you walk. • Impaired posture and balance: Stooping, leaning or slouching when you stand, and/or balance problems can all be a sign of Parkinson’s.
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Currently, there is no known cure for Parkinson’s disease, but there are a variety of medications that can provide relief from the symptoms. In some later cases, surgery may be advised. Other treatments include lifestyle modifications, like getting more rest and exercise. For more information, visit the Parkinson’s Foundation at Parkinson. org.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
There are many ways to help kids who stutter... Doing nothing is not one of them! For more information...
March 2020 •
A Nonprofit Organization Since 1947—Helping Those Who Stutter
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Ask The Social
From the Social Security District Office
Apply Online for Medicare Even If You’re Not Ready to Retire
Hiker to Face Challenges of Parkinson’s and Appalachian Trail Great Valley resident trains for grueling, sixmonth hike
Western New York man is training for the walk of his life. Great Valley resident Dan Schoenthal is expected to leave in April to attempt a thru-hike along the Appalachian Trail. Completing — or even attempting — the more than 2,000-mile hike through 14 states is monumental for anyone. Schoenthal, however, has Parkinson’s disease, elevating the difficulty of this endeavor exponentially. He hopes to cover the route from Georgia to Maine in six months, using the effort to raise awareness about the disease along with funding for the Parkinson’s Foundation. To train for the trail, Schoenthal has been hiking the hills and countryside of Cattaraugus County lugging a weighted backpack. Despite his Parkinson’s disease (PD), Schoenthal is fit at 55 years of age. He spent 25 years as a union pipe fitter along with serving 18 years in the Air Force and Reserves. He believes it was contaminated water at California’s McClellan Air Force Base that triggered the onset of his PD. He was diagnosed in 2015, but he felt the symptoms before then. “Looking back, I’m sure that I had symptoms eight to 10 years before the neurologist in Olean mentioned Parkinson’s disease,” he said. Page 20
Schoenthal is an outdoorsman, so he is not intimidated by the challenges posed by the hike. The symptoms and demands of PD are another matter. Parkinson’s is a chronic, progressive neurodegenerative disease without a cure. It affects the brain signals that control the muscles, so a person diagnosed will move more slowly. Balance, posture and flexibility can all be affected, as pain, sleep issues and cognitive acuity can become challenges later in the progression. PD symptoms are controlled by an array of medications, which is one of the real challenges Schoenthal faces. Keeping those medications in supply along the trail and being sure to take them properly are primary concerns. Through-hikers often ship food and equipment to stops ahead along the trail. This is one method that could keep medications on hand. “Dan and I spoke a bit about how this might work. I’m not sure what the final plan will be, but if we can help, we certainly want to,” said Chris Jamele, development director for the Parkinson’s Foundation New York & New Jersey Chapter. Jamele is planning to report Schoenthal’s progress on the foundation’s local chapter website — parkinson.org/NYNJ — and other social media.
id you know that you can apply online for Medicare, even if you are not ready to retire? We can help you make an informed decision about when to apply for benefits based on your individual and family circumstances. Applying online can take less than 10 minutes. There are no forms to sign and usually no required documentation. We’ll process your application and contact you if we need more information. Visit www.socialsecurity.gov/ benefits/medicare to begin. There, you can apply for Medicare and find other important information. If you’re eligible for Medicare at age 65, your initial enrollment period begins three months before your 65th birthday and ends three months after that birthday.
Q&A Q: My same-sex partner and I recently married. Will we qualify for Social Security benefits? A: You may be eligible to apply for Social Security benefits. Many factors affect your eligibility for benefits, including how long you worked and your age. Social Security is now processing more claims in which entitlement or eligibility is affected by a same-sex relationship. We encourage you to apply for benefits right away, even if you aren’t sure you’re eligible. Applying now will protect you against the loss of any potential benefits. You can apply safely and securely at www.socialsecurity. gov/applyonline. Learn more about Social Security for same-sex couples by visiting www.socialsecurity.gov/ same-sexcouples. Q: I am receiving Social Security retirement benefits and I recently went back to work. Do I have to pay Social Security (FICA) taxes on my income? A: Yes. By law, your employer must withhold FICA taxes from your paycheck. Although you are retired, you do receive credit for those new earnings. Each year Social Security automatically credits the new earnings and, if your new earnings are higher than in any earlier year used to calculate your current benefit, your monthly benefit could increase. For more information, visit www. socialsecurity.gov or call us at 1-800772-1213 (TTY 1-800-325-0778).
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
Some Medicare beneficiaries may qualify for Extra Help with their Medicare prescription drug plan costs. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia. For more information on Extra Help, read www.socialsecurity.gov/pubs/EN05-10525.pdf. You may also be interested in reading these publications: • “Apply Online for Medicare — Even if You Are Not Ready to Retire” www.socialsecurity.gov/pubs/EN05-10530.pdf. • “When to Start Receiving Retirement Benefits” www.socialsecurity.gov/pubs/EN-05-10147.pdf. Helping a friend or family member with this information can improve the quality of their life. Share these resources with someone you love today.
Q: What is the benefit amount a spouse may be entitled to receive? A: If you are eligible for both your own retirement benefit and for benefits as a spouse, we will always pay you benefits based on your record first. If your benefit as a spouse is higher than your retirement benefit, you will receive a combination of benefits equaling the higher spouse’s benefits. A spouse generally receives one-half of the retired worker’s full benefit unless the spouse begins collecting benefits before full retirement age. If the spouse begins collecting benefits before full retirement age, the amount of the spouse’s benefit is reduced by a percentage based on the number of months before he or she reaches full retirement age. For example, based on the full retirement age of 66, if a spouse begins collecting benefits: • At age 65, the benefit amount would be about 46 percent of the retired worker’s full benefit; • At age 64, it would be about 42 percent; • At age 63, 37.5 percent; and • At age 62, 35 percent. However, if a spouse is taking care of a child who is either under age 16 or disabled and receives Social Security benefits on the same record, a spouse will get full benefits, regardless of age. Learn more by reading our Retirement publication at www. socialsecurity.gov/pubs/10035.html.
H ealth News Julie Snyder wins “Top Women in PR” Award
UBMD Internal Medicine has new CCO
Julie. R Snyder, senior vice president, chief marketing and communications officer for BlueCross BlueShield of Western New York, has been recognized as one of the Top Women in Public Relations by PRNEWS as a 2019 honoree. Recognized for representing one of the most trusted brands in health care — BlueCross BlueShield of Western New York — Snyder’s award recognizes how she dedicates her time and talents to make the biggest impact for her company, her Julie R. Snyder colleagues and her community. PRNEWS serves the communications industry at all levels, including corporations, agencies and nonprofits. It annually selects and honors highly influential women who have made advances for their organizations in crisis management, brand reputation, content creation and more. Among many other accomplishments throughout her career are leading a best-in-class corporate giving program, including developing and launching BlueCross BlueShield’s Blue Fund, a health focused grant program; launching the region’s first health care thought leadership podcast; developing award- winning partnerships with the National Safety Council and Canalside Buffalo; and most recently co-founding BlueCross BlueShield’s Women’s Leadership Circle, a proactive approach to bring forward development opportunities for women at all levels of the Buffalo-based health plan. Snyder is a member of the company’s executive leadership team and also serves as chief of staff to BlueCross BlueShield of Western New York’s President and CEO David W. Anderson. A marketing and communications executive with nearly two decades of experience in the health care industry, Snyder is also actively involved as a board member for the Buffalo Olmsted Parks Conservancy; Buffalo Therapeutic Riding Center; and Medaille College. Snyder has been a Junior League of Buffalo member for more than 30 years, receiving the league’s Susan Reid Green Russell Award in 2016 for leadership and organizational skills as well as commitment and involvement in the community. Snyder earned a bachelor’s degree in public communication from American University in Washington, D.C. Snyder previously served as executive director for the Sisters Hospital Foundation and as director of communications for the Buffalo Niagara Partnership.
Sanjay Chadha has recently joined UBMD Internal Medicine as its new chief operating officer. He most recently held the position of senior vice president of service line operations at Niagara Falls Memorial Medical Center (NFMMC), where he had worked since 2010. Chadha has previousSanjay Chadha ly managed service lines in primary care and specialty services, including practice transformation for primary care. He has also managed other inpatient and outpatient operations, including hospitalist programs. Chadha has extensive experience in graduate medical education as well, having served as the designated institutional officer for the family medicine program at NFMMC. “Sanjay was highly recommended to us, and it was immediately apparent when we met that he has exactly the right background and experience to transform our operations in UBMD Internal Medicine,” said physician Anne Curtis, UBMD Internal Medicine president and chief executive officer. Chadha worked for Kaleida Health prior to NFMMC in the roles of vice president of business operations and vice president of ambulatory care and business development. Prior to Kaleida, he worked at ECMC as the vice president of ambulatory and transplant services, as well as assistant director of specialty clinical services. His experience with UBMD’s healthcare partners and his broad knowledge of inpatient and outpatient operations put him in an ideal position to develop a plan for growth and clinical collaboration with Great Lakes Health, according to a press release. Chadha earned a master’s degree in business administration and is a graduate of the Harvard Business School’s executive managing healthcare delivery program. He is a Leadership Buffalo graduate and received the “40 Under 40” award from Business First in 2004.
ECMC receives $10 million for new trauma and emergency facility Erie County Medical Center (ECMC) Corporation has recently been awarded $10 million from the New York State Department of Health’s Statewide Health Care Facility Transformation Program (SHCFTP) for the institution’s future Key Bank Trauma and Emergency Department.
The state program is designed to “improve patient care through the development of high-quality medical facilities and programs serving the inpatient, primary care, mental health, substance use disorder and long-term care needs of communities throughout the State.” ECMC broke ground on the $55 million facility in June 2018 and it is expected to be completed in May 2020. A combination of public funding, private funding, and hospital equity and financing is being utilized to complete the project. The facility is the designated mass casualty trauma center for Western New York. It nearly doubles facility square footage to 54,000 sq. ft.and will increase treatment space from 36 to 54 stations including four dedicated trauma rooms, two behavioral health safe rooms, two isolation rooms, and four medical resuscitation rooms. It features intradepartmental imaging consisting of two CT rooms and two X-ray rooms, direct access from the hospital’s rooftop helipad, and a care initiation zone to support an enhanced triage model of care. “ECMC is deeply appreciative to Gov. Cuomo, his administration and the NYS Department of Health for this very important funding, which will support the dedicated clinicians who everyday save lives in our Key Bank Trauma and Emergency Department and, of course, the tens of thousands of patients they serve annually,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “We are also very thankful for the strong support ECMC received from the members of our Western New York state legislative delegation, especially NYS Assembly Majority Leader Crystal Peoples-Stokes and NYS Sen. Tim Kennedy. They made this critically important funding a priority of the delegation and they advocated tirelessly for ECMC. Our Great Lakes Health partners at Kaleida Health and the University at Buffalo were equally important in reinforcing ECMC’s need for this level of funding to support our lifesaving care for all Western New Yorkers.”
Buffalo City Mission to raise $1M for new community center The Buffalo City Mission announced the launch of its Pick-aBrick Campaign, a dynamic fundraising initiative that will provide community individuals and organizations with a special opportunity to make a lasting legacy gift that will build a “Pathway to Hope” for the next century, leading to the completion of the organization’s new community center, the Alfiero Family Center of Hope and Promise. Through the Pick-a-Brick Campaign, donors can select and personalize their own brick that will be used to pave the Pathway to Hope, in front of the new community center. Gift levels include a Hope Brick (4 by 8 inches) for $400, and a Promise
March 2020 •
Brick (8 by 8 inches) for $750. Each purchased brick will be personalized and placed along the pathway to memorialize the generosity of the giving community. The City Mission has set a goal to raise over $1 million by the end of April 2020. “The Pick-a-Brick Campaign is a way for our community to make personalized and permanent contributions in our shared mission to help every neighbor in need,” said Stuart Harper, CEO and executive director of the Buffalo City Mission. “We are in the final stretch to complete our new community center this year, and — in every sense -— this campaign represents the power of coming together to help change lives for the poor and homeless in our city.” “On any given night, over 900 men, women and children are homeless and on the streets of Buffalo,” said Harper. “Through the final stages of our Next Century Capital Campaign, this Pick-a-Brick opportunity will help us to cross the finish line strong. The time to make a lasting impact together is now.”
Roswell Park head & neck cancer chairman honored Physician Wesley Hicks Jr., chairman of the department of head and neck, plastic and reconstructive surgery at Roswell Park Comprehensive Cancer Center, has recently earned a Distinguished Alumnus Award from Weill Cornell Medical Center for his contributions to patient care. Hicks is only the third alumnus to receive this award from Weill Cornell. In awarding this distinction, the school highlighted Hicks’ leadership, dedication to education and impactful research. His research focuses include tissue engineering, wound healing and the mechanisms involved in wound repair. Hicks, who has co-authored more than 200 journal publications, has been on staff at Roswell Park since 1991, serving as chairman of his department since 2011. Hicks earned his medical degree from the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. He completed residencies at Manhattan Eye, Ear & Throat Hospital, The New York Hospital-Cornell Medical Center (now NewYork-Presbyterian Hospital) and Memorial Sloan Kettering Cancer Center.
Roswell Park designated as a ‘Cancer Center of Excellence’ Roswell Park Comprehensive Cancer Center has been designated as an Optum Cancer Center of Excellence (COE) for its pediatric and adult population. Optum and its Clinical Sciences Institute — a group of more than 100 practicing clinicians from across the country — develops the COE networks through a rigorous evaluation process.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
H ealth News An industry leader in health and wellness, the company has provided evaluations for over two decades. Roswell Park is one of 37 cancer centers of excellence, and the only such designated center in Western and Upstate New York. COE’s are vetted annually to ensure they meet quality thresholds such as involvement in clinical research, quality of patient support and outcomes as well as patient satisfaction survey results. Optum has consistently recognized Roswell Park and its quality of care for a number of years. “Continued recognition by Optum is an incredible testament to our commitment of providing the highest standards of care to everyone who comes through our doors,” said physician Boris Kuvshinoff II, chief medical officer at Roswell Park. “It is a designation that assures patients they are in the right place for their cancer treatment.” Roswell Park is also an Optum center of excellence for both adult and pediatric blood and marrow transplantation (BMT) and has received the designation each year since 2005.
Patient-centered care earns Roswell Park designation Providing another view into the center’s high standards of care, Roswell Park Comprehensive Cancer Center has earned full accreditation from the Commission on Cancer (CoC), a quality program of the American College of Surgeons. The hospital has been reaccredited for three years. The CoC gives recognition to cancer centers that provide multidisciplinary, patient-centered cancer care. Hospitals are also required to maintain registries through the National Cancer Database, which looks at types of cancer and patient outcomes. Roswell Park has maintained CoC accreditation since 1931, making it one of the longest-accredited such programs. Reviewers noted the center’s expansion of comprehensive services and growth in patient volumes and clinical trial participation, commending the center for “delivering high quality care to all cancer survivors” and expanding services to fit all patient populations. “In addition to our designation as a National Cancer Institute Comprehensive Cancer Center, we are proud of our long-standing CoC accreditation. The CoC standards complement NCI designation through the CoC quality measurement program, cancer registry, and complementary standards including recognition of our outstanding survivorship care program,” said physician Stephen Edge, vice president of healthcare outcomes and policy. “This distinction highlights the work Roswell Park is doing to define best practices that improve care for cancer patients everywhere.”
ECMC’s New Main Entrance, Russell J. Salvatore Atrium, Opens
rie County Medical Center Corporation (ECMCC) recently celebrated the opening of the institution’s new main entrance, which is now known as the Russell J. Salvatore Atrium. Three years ago on Valentine’s Day, Buffalo restaurateur/ philanthropist Russel J. Salvatore announced that he was committing $1 million to ECMC’s capital campaign. Thanks to his early support of that effort, ECMC has raised nearly $15 million from private sources for the capital campaign, which includes the building of a new state-of-the-art trauma and emergency department, as well as other capital improvements at the hospital, including the new main entrance. In July 2014, Salvatore donated $500,000 that led to the opening of the Russell J. Salvatore Orthopaedic Unit in 2015 on the sixth floor of ECMC. He had also previously in 2012 donated $250,000 to upgrade televisions in patient rooms throughout the hospital. “I believe in ECMC’s mission and I am proud to support their lifesaving services for the residents of Western New York,” Salvatore said. “I have experienced firsthand the high level of quality care that the ECMC staff provide to their patients, at every level throughout the hospital. Their culture of caring is second to none and I wanted to reinforce my admiration for their healthcare excellence by supporting them for the capital campaign and in other earlier hospital improvement projects. I am particularly honored that the hospital’s new entrance will be known as the Russell J. Salvatore Atrium.” ECMCC Board Chairman Jonathan A. Dandes said, “On behalf of my fellow board of directors at ECMCC, we are truly grateful for Russell Salvatore’s longstanding support and generosity to ECMC.
Attending the ECMC event are, from left, Russell J. Salvatore, restaurateur / philanthropist; Kathleen “Kathy” C. Hochul, Lieutenant Governor of New York state; Jonathan A. Dandes, ECMC Corporation’s chairman of the board ; and Thomas J. Quatroche Jr., PhD, president & CEO, ECMC Corporation. In the early stages of our capital campaign, he made a commitment of $1 million that absolutely spurred subsequent donations that have had a significantly beneficial impact now and for the future of ECMC.” ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. said, “ECMC is truly fortunate to have such a steadfast supporter and friend in Russell Salvatore. Over the years, Russell has repeatedly demon-
strated his love and admiration for our ECMC family and our dedicated caregivers in turn have always been deeply thankful for his unwavering support. Thanks to Russell, we have literally transformed ECMC’s ‘front door’, providing a warm and welcoming environment for patients, their families and visitors.”
Russell J. Salvatore Atrium at a Glance
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020
• 50 feet high glass and aluminum curtain wall system • Stone accent panels on the interior and exterior walls • Custom chandelier with 75 suspended LED light stems • Modern in wall recessed LED light strip accent wall • Marble chip terrazzo flooring • Custom formed oval reception desk • Continuous atrium clearstory skylight • Covered carport for drop off
/ pick-up • Open seating and gathering areas • Large full glass enclosed vestibule • New escalators & elevator to 1st floor • Total area: 4,000 square feet • Construction management: Gilbane Building Company • Architectural Services: Clark Patterson Lee
Q A &
John D. Craik
Executive director of Population Health Collaborative By Michael J. Billoni
ohn D. Craik is the executive director of Population Health Collaborative, a nonprofit that creates connections for Western New York health. PHC, a regional population health collaborative that connects diverse groups of people to align resources and expertise, has a staff of six full-time professionals and an annual budget of approximately $1.5 million. Q. What is the art of collaboration for the Population Health Collaborative? A. We recognize that WNY is very rich in resources, and although we have an abundance of programs, energy and talent, we do not have community players aligned in a systematic or strategic way. Our collaborative role is to get the diverse partners and influencers to work together in a way that is more impactful, but we embrace a humility-based approach where we do not assume that we know more than anyone else. Our collaborative approach is based on curiosity and a recognition that people know more about their own resources, assets and challenges than we do, and our role is to be the neutral convener who aligns the assets we already. Q. What is the current state of health in the Buffalo-Niagara region? A. In a word, dismal. According to the Robert Wood Johnson Foundation County Health Rankings, WNY is the least healthy region of New York state. We have excellent public health leaders and healthcare facilities, but we have a culture that encourages unhealthy eating, a sedentary lifestyle and smoking rates that
exceed the New York state average. The life expectancy in WNY is lower than the state average, particularly the African-American community in Buffalo — members of this community die approximately 12 years early. These factors are overwhelmingly driven by preventable chronic disease. Q. What is the economic impact of poor health in WNY and how is that determined? A. Health policy experts are able to tell us how much chronic diseases cost businesses and based on the prevalence of chronic diseases like cardiovascular disease, COPD, obesity, diabetes and related conditions, WNY business loses $1.2 billion in preventable or avoidable healthcare costs and $1.3 billion in lost productivity due to these diseases. These figures only include privately ensured employees, and if you factor in Medicaid and Medicare the costs to WNY is closer to $3 billion per year. Q. What are the plans for PHC for the $273,000 Livewell WNY grant? A. We recognize there are hundreds of programs and organizations that can help us reduce the prevalence of chronic disease, but they are not necessarily aware of or supportive of each other. We need to take a more systemic look at the resources we have and line them up so that we start to move the needle. The grant we just received will help us reach out directly to members of the community who will give us their voices and perspectives on what works, what doesn’t work, what resources
John Craik: “The current state of health in the Buffalo-Niagara region? ‘Dismal’” and assets we have and what we need to improve health in our region. Q. What are PHC’s goals for 2020? A. We are taking a long-term approach and aligning programs, changing systems, and overall changing the culture of WNY will take decades. For the coming year the pivotal work will revolve in devising plans that are evidence-based, but that will also be effective in the
specific communities where we need to implement them. We also need to develop the relationships and the level of trust so that sectors, people and organizations that have not worked well together in the past can start to engage and align in the near future. It’s herding cats, but smart cats and the end game is worth it. For more information, visit www. pophealthwny.org.
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A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 2020 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: firstname.lastname@example.org Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Michael J. Billoni, Katie Coleman, Catherine Miller • Advertising: Anne Westcott, Amy Gagliano Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Niet No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
ECMC-18108-InGoodHealth_January_Ad | TRIM: 9.75” x 13.75” | No Bleed | CMYK
If ECMC wasn’t there, we wouldn’t be here. In the face of the worst accidents and traumas, ECMC has always been on the front line of our community’s most critical injuries. As Western New York’s only Level 1 Adult Trauma and Emergency Department, we know firsthand the level of dedication and excellence ECMC’s caregivers bring to every patient they serve. For too long, these doctors, nurses, and support staff have provided lifesaving care in a cramped, outdated facility designed for far fewer patients than the over 70,000 individuals who are treated there annually. But with a new, state-of-the-art Trauma and Emergency Department opening in spring 2020, more lives can be saved, more families can celebrate their loved ones, and more stories of hope and healing can be shared throughout our region.
Give to the place where there’s no giving up, and donate today for hope and healing in WNY. SUPPORTECMCTRAUMA.ORG
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • March 2020