Page 1

BFOHEALTH.COM

APRIL 2020 • ISSUE 66

CORONAVIRUS Getting on with our lives in this new age Special Issue

Beware of Coronavirus Scams P. 13

Autism: Why Are Incidence Rates So High RECORD NUMBER OF PEDESTRIAN DEATHS IN U.S.

Local experts discuss the dramatic increase in cases of autism in the U.S.

Study estimates 6,590 pedestrian deaths in 2019, an increase of 5% over previous years

The Amazing Benefits of Olive Oil

P. 8

­

Pot Use Among Seniors Nearly Doubled in 3 Years

P. 2


Pot Use Among U.S. Seniors Nearly Doubled in 3 Years A mericans may want to rethink the stereotype of the potloving teen: More U.S. seniors are using the drug now than ever before. The proportion of folks 65 and older who use pot stands at 4.2%, up from 2.4% in 2015, according to figures from the U.S. National Survey on Drug Use and Health. “The change from 2.4 up to 4.2, that’s a 75% increase,” said senior researcher Joseph Palamar, an associate professor of population health at New York University Langone Medical Center. “It didn’t double, but 75% is a pretty big increase, I think.” Emily Feinstein, executive vice president and chief operating officer at the Center on Addiction, reviewed the study and commented that the trend is “not surprising.” “First, older people are more likely to experience pain and other chronic conditions,” Feinstein said. “Secondly, marijuana has become increasingly available and acceptable within society. Together, these two factors are probably driving this trend.” But Palamar doesn’t think the wave of marijuana legalization sweeping the nation has prompted Grandma and Grandpa to give weed a try, either to ease aches and pains or have a pleasant evening. Rather, he thinks the proportion of aging marijuana users is increasing because more older folks are already familiar with pot.

Golden Years Special In Good Health,WNY’s Healthcare Newspaper, is publishing a special issue on seniors, titled Golden Years. Call 716-332-0640 to advertise and to reach nearly 100,000 readers.

“A lot of people who use marijuana are aging into the 65-and-older age bracket. I personally think that’s what’s driving this,” Palamar said. “Of course, there are new initiates, but I don’t think there are that many older people trying weed for the first time ever.” There still are a lot fewer seniors using pot than younger folks, Palamar added. It’s just that marijuana use overall has continued to rise in the United States, affecting nearly all groups of people. The NYU researchers analyzed responses from more than 15,000 older adults. Pot use rose more drastically among specific groups of seniors between 2015 and 2018, including: • Women (93% increase) versus men (58%), although nearly twice as many men use compared with women overall. • College-educated (114% increase) versus high school or less (17%). • Households making more than $75,000 a year (129%) or $20,000 to $49,999 (138%), compared with folks making less than $20,000 (16%) or between $50,000 and $74,999 (3%). • Married seniors (100% increase) versus singles (45%). Seniors taking up pot after smoking it back in the day are probably doing so for potential medical benefits, although the survey didn’t ask this question, Palamar said. “From what I see, I think a lot of older people are using weed more for

medical reasons rather than recreational reasons,” Palamar said. “I know someone in this age group who for never in a million years I thought would use marijuana. She eats a marijuana gummy every night to help her sleep, because she feels it helps better than anything else. I think this is becoming more common.” However, the survey showed that marijuana use increased more among seniors with one or fewer chronic health problems (96%) than those with two or more chronic conditions (29%). Palamar said his main concern regarding pot use among older adults is that marijuana has become

CALENDAR of

HEALTH EVENTS

April 7, May 12

Catholic Health holds webinar on women’s issues Pelvic and uterine health are important issues for women and can often be uncomfortable to talk about. Hundreds of thousands of females across the Unites States suffer from conditions such as pelvic organ prolapse, urinary incontinence, and endometriosis. While these conditions can vary from woman to woman, they all are treatable. Join nationally-recognized pelvic surgeon and urogynecologist, Ali Ghomi for a Facebook Live event featuring a presentation and live Q&A surrounding these common, yet often embarrassing topics: • 6 p.m., April 7: “Female Incontinence: The Latest Treatments & Solutions.” • 6 p.m., May 12: “Endometriosis Surgery: Options & Outcomes.” Call 716-447-6205 or visit chsbuf-

falo.org/events to register for any or all of the “Power of Health LIVE” sessions. Once registered, you will receive information on how to join the Facebook Live event.  Registrants will be able to ask Ghomi questions and have him answer in real-time.  

April 23

Sips, Suds & Sweets to benefit Senior Wishes program The Seventh Annual Sips, Suds & Sweets event to benefit the Senior Wishes program will take place from 6 to 9 p.m. Thursday, April 23, at Fox Run at Orchard Park. Presented by GEICO, guests will enjoy wine, beer, food and dessert samples from more than 25 local businesses while enjoying the music of the Scott Celani Trio.  A basket raffle, silent auction and Year of Dining raffle will also be featured. Advance tickets are available for $55 at www.seniorwishes.org/

more powerful over the years while their bodies have aged. “If you’re in your late 60s or 70s and you haven’t smoked weed in decades and you reinitiate weed one day, you might not know what to expect,” Palamar said. “Your body is much different in your 60s than it was when you were a teenager. You might not be able to handle it, especially considering that weed appears to be getting more potent.” Seniors whacked out of their minds on strong pot could fall and hurt themselves, or get into a car wreck, Palamar warned. The study was published Feb. 24 in JAMA Internal Medicine. events until April 22. Remaining tickets will be available at the door for $65. The event has sold out in the past two years. Senior Wishes is a local nonprofit serving Erie, Niagara, Genesee, Wyoming and Orleans counties with a mission to foster respect and appreciation for seniors by granting life enriching wishes. The program has provided customized individual experiences for over 260 qualifying seniors, as well as several group wishes to seniors in care facilities and senior residences. Additionally, “Simple Wishes for the Holidays” provides over 100 isolated seniors with a wrapped gift, card and friendly visit each Christmas. Sips, Suds & Sweets is the organization’s major fundraiser to support wish granting. Sips, Suds & Sweets is made possible through many generous sponsors, including M&T Bank, Office Max, Calspan, Fox Run at Orchard Park, BCBS of Western New York, Elderwood, The McGuire Group Health Care Facilities, West Herr Automotive and The Buffalo News. In face of the coronavirus crisis, those planning to attend the event are urged to contact Wendy Backman at 716-508-2121 or wbackman@ uchsinc.org to confirm the event is taking place.

Find Us on Facebook @ In Good Health Buffalo Page 2

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020


Changing Lives ... One Bottle at a Time Why Choose CBD BioCare:

Record Number of Pedestrian Deaths Seen in U.S.

W

alking on America’s streets is getting ever more dangerous, a new report

Why Choose CBD BioCare:

Why Choose CBD BioCare: Why Choose CBD BioCare:

Full Spectrum CBD Oil Whole Plant / CO2 Supercritical Extraction Organically Grown in the USA USA Manufactured 3rd Party Tested from Plant to Product Company Transparency

• Full Spectrum CBD Oil • Whole Plant / CO2 Supercritical Extraction • Organically Grown in the USA • USA Manufactured • 3rd Party Tested from Plant to Product • Company Transparency

Changing Lives ... One Bottle at a Time

• • • • • •

Call or Text

Changing Lives ... One Bottle at a Time Full Spectrum CBDCBD Oil Oil •• Full Spectrum Whole Plant / CO2 Supercritical Extraction •• Whole Plant / CO2 Supercritical Extraction Organically Grown in theinUSA •• Organically Grown the USA USA Manufactured •• USA Manufactured 3rd Party Tested fromfrom Plant Plant to Product •• 3rd Party Tested to Product Company Transparency •• Company Transparency

716-866-7202

or visit

CBDbyDIVA.com

the past decade, the number of all other traffic deaths increased by only 2%. shows. Overall, traffic deaths in the first Based on data from the first half of 2019 are projected to be 3.4% six months of 2019, the Governors lower than in the first half of 2018, Changing Lives One Bottle at a Time Highway Safety Association (GHSA) according to the report. Changing Lives...... One Bottle at a Time predicts there were 6,590 pedestrian A number of factors are contribdeaths that year, which would be a uting to the rise in pedestrian deaths. 5% increase over the 6,227 pedestrian Most pedestrian deaths occur on deaths in 2018. local roads, at night and away from The 2019 figure is the highest intersections, suggesting the need for number of such deaths in more than safer road crossings and making pe2424 Niagara Falls Blvd, Niagara Falls NY 30 years, according to the association. destrians and vehicles more visible, 1169 Harlem Rd, Buffalo NY “In the past 10 years, the numthe GHSA said. ber of pedestrian fatalities on our Over the past 10 years, the numnation’s roadways has increased by ber of nighttime pedestrian deaths more than 50%,” said GHSA Execuincreased by 67%, compared to a tive Director Jonathan Adkins. 16% increase in daytime pedestrian “This alarming trend signifies deaths. that we need to consider all the Dangerous driving behaviors factors involved in this rise, identify such as speeding, and distracted and the high-risk areas, allocate resources drowsy driving threaten pedestrians, where they’re needed most, and conand alcohol impairment by the driver Linda M. Blazier Nurse Practitioner tinue to work with local law enforceor pedestrian was reported in nearly ANCC Board Certified ment partners to address the chronic half of pedestrian fatalities in 2018. Direct Pay Primary Care Center driver violations that contribute to Pedestrians struck by a large pedestrian crashes,” Adkins said in SUV are twice as likely to die as those an association news release. struck by a car. Passenger cars are the Pedestrians are projected to largest category of vehicles involved account for 17% of all traffic deaths in pedestrian deaths, but pedestrian • Modern Primary Care Medicine with Homeopathic in 2019, compared to 12% in 2009, deaths over the past decade involvsupport according to the GHSA’s annual ing SUVs increased at a faster rate • Bio Identical thyroid Replacement Therapy Spotlight on Highway Safety report, (81%) than those involving passenger • Medical Marijuana Certifications released in February. cars (53%). While there’s been a significant • USDOT/CDL Driver Exams -FMCSA certified provider increase in pedestrian deaths over • Deprescribing Pharmaceuticals safely • Full body health, nutrition, vitamin and mineral evaluation erving estern ew ork • Lipo B12 weight loss shots

We are now hiring NYS-Certified PCAs and HHAs.

tĞĂƌĞŶŽǁŚŝƌŝŶŐ Call 716-274-5000 Ez^ͲĞƌƚŝĨŝĞĚWƐĂŶĚ,,Ɛ ͘ or apply at LibertyHomeCare.org/Careers WeĂůůϳϭϲͲϮϳϰͲϱϬϬϬ now have two locations!

ŽƌĂƉƉůLJĂƚ

>ŝďĞƌƚLJ,ŽŵĞĂƌĞ͘ŽƌŐͬĂƌĞĞƌƐ

Colden

tĞŶŽǁŚĂǀĞƚǁŽůŽĐĂƚŝŽŶƐ͊ Health and Wellness

ϮϰϮϰEŝĂŐĂƌĂ&ĂůůƐůǀĚ͕EŝĂŐĂƌĂ&ĂůůƐEz ϭϭϲϵ,ĂƌůĞŵZĚ͕ƵĨĨĂůŽEz

Services:

S

W

N

Y

A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region

ACCEPTING NEW PATIENTS 716-941-3117

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: editor@bfohealth.com 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, Ernst Lamothe Jr., Norb Rug, John Addyman, Jenna Schifferle 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.

www.coldenhealthandwellness.com

In Good Health — WNY’s Healthcare Newspaper April 2020 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 3


Meet

Your Doctor

By Chris Motola

Oscar R. Colegio, M.D. Roswell Park chairman of dermatology department discusses his research in finding new ways to treat skin cancer

Doctors’ Ratings Tank When Patients Are Kept Waiting: Study

T

ick-tock: A long delay in the waiting room annoys some patients so much that they give their doctors lower ratings, a new study finds. “Waiting to see the doctor is not like waiting in line for a fun ride at Disney World,” said senior author, physician Oren Gottfried, a professor of neurosurgery at Duke University School of Medicine in Durham, North Carolina. He and his colleagues analyzed 15 months of patient ratings after more than 27,000 visits to 22 spine surgeons at Duke University practices. The average clinic visit lasted about 85 minutes, the study found. Every 10-minute increase in waiting time reduced patient scores for overall visit experience and the doctor’s communication by 3%. “While a medical visit is important, it does not have the positive feedback of an amusement park ride where a two-hour wait seems worth it for even a short ride,” Gottfried said in a university news release. “This isn’t entirely surprising, but our data shows it’s something doctors need to be aware of and should manage.” The researchers took waiting room times, in-room times, electronic health record responses and patient demographics into consideration for the study. “Anytime you can improve scores by 3%, that’s big,” Gottfried said. “So if 10 minutes in the waiting room means a drop of 3%, that something that should be addressed, because it’s hard to make up for that in the actual doctor-patient visit.” The study was published online Feb. 21 in the Journal of Neurosurgery: Spine.

Page 4

Q: Can you describe your role at the Roswell Park Comprehensive Cancer Center? A: I’m the chair of the department of dermatology at Roswell Park. I’m also a professor of oncology. As far as my role goes, there are three principle activities that constitute the role. The first and foremost is helping the department to provide the best care possible to patients who have had cancer or are at a high risk of developing cancer. A little bit differently than the rest of Roswell Park, though, dermatology has a broader scope of practice. Meaning that we’ll often see individuals who have no history of cancer for skin conditions if they’re concerned about something on their skin they don’t recognize. We do that by performing skin checks and deciding whether it’s a neoplasm, a rash or even something that doesn’t even need to be treated at all. So I’m trying to optimize how we perform that role in Western New York. The second activity is actually providing care myself. My focus has been on caring for high-risk skin cancer patients. I define that as individuals who have had numerous skin cancers in that past as well as those who have conditions that put them at high risk for developing skin cancer like immuno-suppression or conditions where they’re born without a normal immune system. For patients taking drugs that suppress their immune system after, say, a transplant, their risk of getting skin cancer can go up 100 fold. And the third role is my laboratory role. My focus there is on how the immune system can be used to control the growth and spread of cancers. Q: Are we talking immunotherapy? A: It is like an immunotherapy, but what I think is interesting about the research is that where immunotherapy is harnessing the adaptive immune system and using the T-cells to attack the cancer — or even instructing dendritic cells to activate T-cells to target the cancer — the focus of our lab has been on helping the innate immune system, meaning macrophages. The reason I say it’s interesting is because unlike T-cells,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

macrophages, in large numbers, when present in the tumor, seem to feed the tumor by creating an environment that supports tumor growth. So it is an immunotherapy, but it’s almost an inverted view of immunotherapy. So we’re interested in seeing if we can target the cell and change its polarization state so it begins to control the cancer or target it for elimination. We’re also trying to figure out what it’s doing to really feed or support cancer growth. Because those downstream functions of the macrophage may be targetable themselves. Q: How do you go about doing that? A: For the macrophages, the lab is pretty much a basic science lab at this point. We’re not yet at the point of having therapeutics at present. What we have done is characterized some of the metabolic functions and figured out that if we interrupt pathways of nitrogen metabolism in macrophages [so] they can switch from being pro-tumor to anti-tumor. At this point, we’re piloting therapies in animal models of cancer, but we’re not quite at the stage where we can deliver it to humans. Q: Assuming it’s successful what advantages will it offer? A: I think the advantages are huge. At present if someone’s at high risk for developing skin cancer, they may have easily as many as 10 independent skin surgeries each year. That’s not that unusual. So the quality of life is severely impacted, and each of those skin cancers has a risk of spreading or metastasizing. So the advantage of targeting at-risk skin is to reduce the number of skin cancers that develop and keep the skin at an earlier stage of cancer development. This would reduce the number of surgeries needed and hopefully improve long-term outcomes for these high-risk patients.

Q: What’s the next milestone you’re trying to reach? A: Within the lab, we’re actively trying to figure out the mechanism by which the treatment is working. It clearly does work, but we’d like to get a better sense of how it’s working. We’ll continue to treat pre-clinical models to see whether we can consider bringing it to human trials. Q: What percentage of your patients are high risk? A: Within my practice, the vast majority of patients are high risk. We’re really focused on patients who have had solid organ transplants and stem cell transplants. In addition to that clinic, I also re-started a clinic that uses photodynamic therapy to treat at-risk skin. It’s used to target precancerous lesions, usually on the face, with the goal of reducing the number of cancers that develop. It’s an FDA-approved therapy. The way it works is, a drug is applied to the skin and allowed to incubate for about an hour. Precancerous cells take up the drug and activate it, then light leads to oxidated death of the cells that take up the drug. I think of it kind of like a Trojan horse approach. Those cells die, selectively, leaving your normal cells alone. Q: That sounds pretty useful. Is there a reason it’s not more widely adopted? A: It is used and has been approved for awhile, but it’s probably due to the equipment involved. The light source is a bit bulky, so a lot of offices may not be equipped to use it. It’s also time-consuming because you have an hour or two of incubation. We use a staggered approach to allow us to take care of a number of patients in one afternoon. Q: To what degree is the sun responsible for most of these cancers? Do you think the populace under- or over-estimates the risks? A: Sure. Sun exposure, particularly ultraviolet radiation, is carcinogenic. It’s the leading cause of the mutations that are required for the development of skin cancer. From the press I’ve read, I don’t see any of it being an overestimation, whether it’s from the sun or even worse, tanning beds, when it comes to the risk of developing cancer.

Lifelines Name: Oscar R. Colegio, M.D., Ph.D. Position: Chairman of dermatology department and a professor of oncology at Roswell Park Comprehensive Cancer Center; Education: Yale University School of Medicine (Ph.D. in cell biology in 2003 and an M.D. degree in 2004); University of Texas at Austin (bachelor’s degree in pharmacy in 1995). Internship in internal medicine and a residency in dermatology at Yale-New Haven Hospital (2004-2008) Hometown: McAllen, Texas Affiliations: Roswell Park Comprehensive Cancer Center Organizations: International Immunosuppression and Transplant Skin Cancer Collaborative; American Academy of Dermatology; Society for Investigative Dermatology Family: Wife, two sons Hobbies: Running, biking, cooking, baking


Cancer Death Rates Continue to Fall in U.S., Report Says U .S. death rates from cancer continued falling from 2001 to 2017 — dropping an average 1.5% a year, a new report shows. The annual decline was slightly larger among men (1.8%) than women (1.4%), according to the Annual Report to the Nation on the Status of Cancer. The report is prepared by the U.S. Centers for Disease Control and Prevention; the U.S. National Cancer Institute; the American Cancer Society, and the North American Association of Central Cancer Registries. “The United States continues to make significant progress in cancer prevention, early detection, and treatment,” said CDC director, physician Robert Redfield. “While we are encouraged that overall cancer death rates have decreased, there is still much more we

can do to prevent new cancers and support communities, families, and cancer survivors in this ongoing battle,” Redfield added in a CDC news release. There were decreases in all major racial/ethnic groups and among men, women, young adults, teens and children. Rates of new cancers leveled off among men and increased slightly among women from 2012 to 2016, according to the report. The researchers also found that from 2013 to 2017: • Among men, death rates fell for 11 of the 19 most common cancers. They remained stable for four cancers — including prostate — and increased for four cancers: mouth and pharynx; soft tissue including heart, brain and other nervous system, and pancreas. • Among women, death rates decreased for 14 of the 20 most common

cancers, including the three leaders — lung, breast and colon. However, death rates rose for cancers of the uterus, liver, brain and other nervous system, soft tissue including heart, and pancreas. Rates were stable for mouth and pharynx cancers. • Overall cancer death rates among children up to 14 years fell an average of 1.4% a year. Rates among 15- to 39-year-olds decreased an average of 1% a year. • Deaths from melanoma skin cancer fell more than 6% a year among men and women. • Lung cancer death rates decreased 4.8% a year among men and 3.7% a year among women. However, lung cancer remains the

leading cause of cancer death in the United States, accounting for about one-quarter of all cancer deaths. “The drops in mortality we’re seeing are real, sustained, and a strong indication of what we can do when we work to prevent and treat cancer,” said physician William Cance, chief medical and scientific officer of the American Cancer Society. “But we can and must do more, particularly to ensure everyone in the United States has access to the resources that are all too often benefiting only the most fortunate,” he said in the release. The findings were published March 12 in the journal Cancer.

last upheld the ACA over a challenge regarding premium subsidies for the indigent five years ago. Last year, a court of appeals ruled the individual mandate was unconstitutional, but did not conclude the entire law was unconstitutional. Mostly “blue” states are challenging the entire law and therefore sending the issue to the Supreme Court. Politics pervades all decision-making in Washington.  

explained in their new book titled, “Deaths of Despair and the Future of Capitalism.” Similarly, advanced countries in Europe are not experiencing this awful trend. Authors Case and Deaton point out that middle-class incomes have stagnated more in the US than other industrialized countries. Exacerbating the problem is our expensive healthcare system which impacts lower paid workers more by draining resources that could be spent on other things which would improve their lives. The “deaths of despair” among the non-college educated workers are up across all ages and races. The study found a growing number of these workers are finding it increasingly difficult to socialize or exercise because of chronic physical or mental conditions. The study found that most non-college educated Americans have decreased feelings of identity or pride with their employer. The authors believe the solutions are obvious, but will be difficult. Our medical system needs to put a higher priority on the health versus wealth of our citizens. Students who graduate from college, including technical schools, make more money and do better in life overall.

Healthcare in a Minute

By George W. Chapman

COVID-19: NYS Approves $40 Million Emergency Response Package

N

ew York state has issued a directive prohibiting any insurer, including Medicaid, from charging a member for any out-of-pocket costs related to testing for the virus or any related visits to a physician’s office or emergency department. Gov. Cuomo has also approved a $40 million emergency response package. Self-insured plans are not regulated by NYS, but they would be wise to follow suit. Most commercial carriers have indicated they will follow suit and not

charge their members. The federal government has budgeted $8.3 billion to combat the virus. (As of this writing in mid-March there is a huge shortage of testing kits.) Federal spending goes toward: removing restrictions for treatment via telemedicine; reimbursing states for the virus response and preparedness; buying drugs, masks and personal protection for healthcare workers; and funds for caregivers and communities facing the brunt of the virus.

Amazon’s Huge Influence

intelligence and IT expertise to alter the entire healthcare delivery system. Industry observers believe Amazon will have the same impact on brickand-mortar providers as it did on stores. In lieu of the dire predictions of a physician shortage, Amazon could considerably reduce the deficit with increased automation and artificial intelligence.

Just as Amazon changed the way we shop, resulting in the closure of 9,000 brick-and-mortar stores last year alone, so it is changing the way we receive medical care. It is opening primary care clinics, virtual medical services and an online pharmacy called PillPack. Amazon is working on an Alexa-based program whereby consumers can query drug interactions and side effects as well as manage their meds. Information will be updated regularly. The company is also working on clinical speech recognition whereby provider-patient conversations will automatically be documented in the medical record. This will have a significant impact on “he said, she said” conversations. Amazon has the wherewithal, size, money, supply chain, artificial

ACA in Limbo

The fate of the Affordable Care Act remains up in the air. It won’t be determined by the Supreme Court until mid-2021 or later. Consequently, the delay exacerbates and prolongs the uncertainty and anxiety for insurers, providers and enrolled consumers. The makeup of the Supreme Court has shifted since it

Experience Counts

Hospitals establish minimum volume standards (experience) for every procedure performed before granting a surgeon specific operating privileges. The bigger the hospital and medical staff, the more likely higher volume standards will be required. According to the independent hospital safety watch group “Leapfrog,” the majority of 2,100 hospitals surveyed are performing high-risk procedures with inadequate volume standards. The AHA and CMS are looking into this. In the meantime, it is perfectly acceptable for a patient to ask a physician for her or his experience with a particular procedure.    

Non-college-Educated Worker “Deaths of Despair” Up

A study conducted by Princeton economists Anne Case and Angus Deaton found that “deaths of despair” — caused by alcoholism, drug abuse, suicides, depression, obesity — are soaring among America’s non-college educated workers. Similar deaths among the college-educated workers have remained stable. The escalating death rate has occurred primarily over the past three decades. This phenomena is April 2020 •

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 5


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone and Content: Finding Your ‘True North’

I

’ve discovered that a key to living alone successfully is to determine who you really are and what you want from life. My own path to contentment took some time, some growing pains — setbacks as well as successes — and some aching losses before I found my “true north.” It hasn’t always been easy, but it’s been well worth the journey. The reward has been a life on my own filled with more peace, freedom and joy than I could have imagined. The journey began with a set of soul-searching questions to identify and clarify my beliefs, values, likes and dislikes. I was careful to focus on what matters to me and to steer clear of “shoulds” and other people’s agendas. The result? I created a list of personal principles and preferences that illuminated the way forward and shaped my future as a self-sufficient, independent women. Now, in the happy third chapter of my life, I am comfortable being me and expressing my true self. In no particular order, below are just a few examples of my insights (some profound, others practical and a few whimsical) that have inspired and guided me: • Gratitude, forgiveness, and loving kindness are life staples to embrace, practice and model on a daily basis. • Gathering with friends and family around a fire, indoors or out, enhances life. It’s warm, relaxing and hypnotic — a life essential in my book. • If I am unhappy with an aspect

of my life and choose to stick with the status quo, nothing will get better. • A stick shift is, hands-down, superior to an automatic transmission. Driving is so much more fun. It’s all I’ve ever owned. • Hardship, failure and loss can build strength and self-awareness. Taking time and turning inward can create space for reflection and renewal of the spirit. Remember: after rain there are rainbows. • An honest-to-goodness listener (not a pretend listener) melts my heart. • Music makes life better. I enjoy playing and listening to all genres of music, but I always return to the Great American Songbook. • As an introvert, solitude, nature and meditation recharge my batteries. • Letting go of old ways of thinking, of a poor self-image, or of destructive thoughts or behaviors can free us up to embrace life’s blessings. • Gardening is a great teacher. Fertile ground exists in each of us, and a little planning, caretaking and patience can produce beautiful results. • Solo travel is an adventure not to be missed. It’s good for the mind, deepens the soul and fosters confidence. • Living alone doesn’t mean being alone. We are social beings. We need each other. Relationships are the glue. Compiling my full list of insights took time and thought. For those coming out of a long relationship, de-

s d i K Corner

1 in 4 Gets Unneeded Antibiotics at Children’s Hospitals

O

ne-quarter of kids who receive antibiotics in U.S. children’s hospitals are given the drugs inappropriately, which increases the risk of antibiotic resistance, researchers say. “Antibiotic resistance is a growing danger to everyone; however, Page 6

there is limited data on children,” said study co-author, physician Jason Newland, a professor of pediatrics at Washington University in St. Louis. “Data on adults have suggested that 30%-50% of antibiotics used in hospitalized adults is inappropriate,” Newland noted in a university news

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

termining or rediscovering “who you really are” can be a daunting process. After years of focusing on the needs and desires of a spouse and family, many discover that, somewhere along the way, they have disappeared around the edges and lost their own sense of self. Rediscovering yourself and identifying those things that bring joy and meaning into your life can turn living alone into an adventure of the spirit. Once you establish your individual interests and means of self-expression, you may find that time alone and the silent moments between events no longer feels empty. Below is an exercise to help you get back in touch with your true self. These are but a few of the questions to contemplate on your road to self-discovery. Spend some time answering these 10 questions 1. Search back. What hobbies did you pursue as a child that gave you joy? What did you do particularly well or (perhaps secretly) take pride in? 2. More recently, when do you completely lose yourself in something? What activities make you feel alive and complete, as though nothing is missing? 3. What do you hold most dear? 4. How do you want to be remembered? 5. What is your biggest regret? If you could have a “do-over,” what would you do differently? 6. How would your life change (or get better) if you were a more curious person? 7. What brings tears to your eyes? 8. If you were to dedicate your

release. He said the goal of the study was to determine if antibiotics used to treat hospitalized children were “suboptimal.” That means doctors shouldn’t have prescribed any antibiotics; they could have used a more effective antibiotic; or they could have prescribed a different dose or for a shorter duration. “Health care workers must be vigilant since the inappropriate use of antibiotics is fueling dangerous drug resistance in children,» said Newland, who directs the antimicrobial stewardship program at St. Louis Children’s Hospital. About one in three patients in U.S. children’s hospitals receives one or more antibiotics, the researchers said in background notes. They analyzed data from nearly 12,000 patients at 32 U.S. children’s hospitals. The kids were prescribed one or more antibiotics to treat or prevent infections. Of those patients, 25% — or nearly 3,600 — received at least one antibiotic considered inappropriate, according to the study. The most common cases of inappropriate antibiotic use were: giving the wrong antibiotic for a particular infection (27%); prolonged antibiotic

life and resources to a particular cause or charity, what would it be? 9. What does your perfect day look like? 10. How do you want to describe yourself and your life a year from now? Then, take action After answering these questions, ask yourself how you can use these insights to influence the direction of your life. What can you do today to reconnect with a past love or pursuit, to delve more deeply into an existing interest, or to fulfill a new passion or purpose? When you identify your values and the things you love to do, and pursue them, you will feel more integrated and in touch with your true self. You’ll be spending your time immersed in pursuits that bring you personal satisfaction — pursuits that reinforce who you are and who you want to become. Those of us who live alone have the gift of abundant time to ourselves. Use it wisely. Use the time to get to know yourself all over again. With each passing day, I am confident you’ll find your internal compass, unique to you, pointing north – your true north. Gwenn Voelckers leads Alone and Content empowerment workshops for women held in Mendon and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase her book, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com. use after surgery to prevent surgical-site infections (17%); unnecessary use of antibiotics (11%); and use of broad-spectrum antibiotics when a drug that targets a specific type of bacteria could have been used (11%). Pneumonia, or lower respiratory infections, accounted for the greatest percentage of suboptimal prescriptions — 18%. The researchers also found that about half of inappropriate antibiotic use would not have been detected by current antibiotic stewardship programs designed to prevent antibiotic resistance. “Arguably, this is one of the most important findings because it helps us to identify blind spots in antimicrobial stewardship programs,” Newland said. “Antibiotics currently not targeted for review still have a significant need for oversight. The obvious solution is to expand routine reviews to include all antibiotics. Unfortunately, this is resource-intensive and may not be feasible at some hospitals,” he pointed out. The study was recently published online in the journal Clinical Infectious Diseases.


TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.

Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.

Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure

New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com

Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.

65505

WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015

April 2020 •

©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7


SmartBites

By Anne Palumbo

The skinny on healthy eating

The Amazing Benefits of Olive Oil I don’t know about you, but I was raised on vegetable oil. Pale in color and neutral in flavor, it found its way into every dish or baked good that needed oil. Once out of the nest, it’s the oil I habitually reached for when I started cooking. But then, for nutritional reasons, I switched over to canola oil. Although canola oil and vegetable oil are both plant-based oils, they differ in their fat composition: canola oil is lower in saturated fat and richer in healthy fats. These days, however, my heart and hearth belong to olive oil — primarily the extra-virgin type referred to as EVOO. Ever since I read that people tend to live longer and healthier lives in regions where olive oil is a staple part of the diet, I decided to embrace one of the world’s healthiest oils. What makes olive oil so good for you? It’s rich in two important nutrients: heart-healthy unsaturated fats and disease-thwarting antioxidants. What makes EVOO particularly good? Because it’s less refined than regular olive oil, it’s notably higher in both. According to the American Heart Association, unsaturated fats — which include monounsaturated and polyunsaturated fats — can reduce the risk of heart disease and stroke by helping to lower bad cholesterol levels in your blood. When you choose to eat healthy fats over unhealthy fats (i.e., saturated and trans fats), you are doing your body good! Olive oil is

especially high in monounsaturated fats, quite low in saturated fat, and has no trans fats. Olive oil stands apart from most oils because it boasts a unique and abundant combination of beneficial antioxidants. Antioxidants protect our body from disease and accelerated aging by gobbling up harmful free radicals — byproducts of the oxidation process that can turn good cells bad. Worried about chronic inflammation? Olive oil may be your ticket to quieting the painful and often destructive fire within. Research has shown that olive oil contains two nutrients that can fight inflammation: oleocanthal (an antioxidant) and oleic acid (an unsaturated fatty acid). Chronic inflammation is believed to be among the leading drivers of many diseases, including cancer, heart disease, Alzheimer’s, diabetes and arthritis. Like most oils, olive oil contains about 120 calories per tablespoon. While it’s one of the healthier oil choices, it’s still high in calories compared to actual vegetables. Experts recommend that we use olive oil in moderation and in place of overly processed oils and butter, not with them.

Mixed Greens with Favorite Vinaigrette 2 tablespoons red wine vinegar 2 tablespoons fresh lemon juice

Helpful tips Opt for EVOO whenever possible: it has fewer chemicals, more nutrition and a lot more flavor. Scour the label for the words “extra virgin” and “cold pressed” to get an assurance of quality. The bottle or container itself should be opaque, made of either dark glass or metal. When cooking, use EVOO, which has a low smoke point (the temperature at which the oil begins to smoke), for cold dishes, salad dressings, drizzling, and light sautéing. Use regular olive oil, which has a higher smoke point, for searing and frying. Store olive oil in a cool, dark place; best used within six months.

1/2 teaspoon salt 1/4 teaspoon coarse black pepper 1 1/2 tablespoons minced shallots (or 2 cloves garlic, minced) 2 teaspoons Dijon mustard 1/2 teaspoon sugar 1/3 cup olive oil Salad greens of choice In a small bowl, whisk everything together but the olive oil. Slowly whisk in the olive oil until well blended. Use immediately or store in the refrigerator for up to two weeks. Place the greens in a large bowl and toss with enough dressing to coat the leaves.

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 avpalumbo@aol.com.

How to Understand New Food Labels

U

nderstanding the updated nutrition facts label can help you get the most from it, according to the Academy of Nutrition and Dietetics. The U.S. Food and Drug Administration announced the update in 2016. The new labels must appear on all food items by Jan. 1, 2021. Many companies already use the updated label, which is based on the latest information about links between nutrition and chronic diseases such as obesity and heart disease. “Nutrition Facts Labels help you find out which foods are good sources of particular nutrients such as vitamin D or dietary fiber,” said registered dietitian nutritionist Lauri Wright, an academy spokeswoman. “Nutrition facts labels can help you compare similar foods so you can select those lower in salt, saturated fat, trans fat and added sugars,” she said in an academy news release. Here, Wright offers advice on using the updated label. Serving sizes have been updated to reflect what people now typically consume at one time, and the servings per container show the total Page 8

number in the entire package. When comparing foods or drinks, check the calories, nutrients and serving size to make an accurate comparison. “Consider the amount you typically eat or drink and compare it to the serving size listed on the label,” Wright said. “If what you typically eat is larger than the listed serving size, you will consume more calories, fat and other nutrients listed on the label.” The percent daily values help you gauge how a food fits into your daily eating plan, not just one meal or snack. It shows how much of a nutrient is contained in one serving and in relation to a general guide of 2,000 calories per day. “Caloric needs vary depending on a person’s sex, age, height, weight and physical activity levels,” Wright said. “Consider consulting a registered dietitian nutritionist to help you determine the number of calories your body needs.” She recommends foods in which percent daily values are 5% or lower in saturated fat, sodium and added sugars and 20% or higher in vitamins, minerals and dietary fiber.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020


Best Ways to Kill Coronavirus In Your Home Y our kitchen cabinet may already be stocked with cleaning agents that can kill coronavirus. But not all chemicals will work, and none are as gentle on your skin as commercial hand sanitizers, according to Rutgers University experts. Siobain Duffy, an associate professor of ecology with expertise in emerging viruses and microbial evolution, and Donald Schaffner, a distinguished professor and extension specialist in food science with expertise in microbial risk assessment and handwashing, offer the following tips for cleaning to kill the pathogens that cause COVID-19 and other deadly diseases. “Each disinfecting chemical has its own specific instructions, but an important general rule is that you shouldn’t immediately wipe a cleaning solution off as soon as you’ve applied it to a surface. Let it sit there long enough to kill viruses first.” General Disinfecting Guidelines • The U.S. Centers for Disease Control and Prevention recommends daily disinfection for frequently touched surfaces such as tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets and sinks. • The CDC also recommends the use of detergent or soap and water on dirty surfaces prior to disinfection. • If someone in your home is sick with flu-like symptoms, consider regularly disinfecting objects in your home since SARSCoV-2 has been shown to

survive for 16 hours on plastics. • Whatever cleaning solution you use, let it remain in contact with the surface long enough to kill viruses and other pathogens. The time needed will depend on the chemical. • Don’t use different cleaning agents at the same time. Some household chemicals, if mixed, can create dangerous and poisonous gases. Bleach • Bleach can be diluted with cold water to make an effective disinfectant against bacteria, fungi and many viruses including coronaviruses. You can typically use 1/4 cup of bleach per 1 gallon of cold water — but be sure to follow the directions on the label of your bleach. • Make dilute bleach solution as needed and use it within 24 hours, as its disinfecting ability fades with time. • Non-porous items like plastic toys can be immersed in bleach for 30 seconds. Household surfaces that won’t be damaged by bleach should get 10 or more minutes of exposure. • Bleach solutions are very hard on the skin, and should not be used as a substitute for handwashing or hand sanitizer.

tizers have a concentration of about 60% alcohol, and Lysol contains about 80%; these are all effective against coronaviruses. • Solutions of 70% alcohol should be left on surfaces for 30 seconds (including cellphones — but check the advice of the phone manufacturer to make sure you don’t void the warranty) to ensure they will kill viruses. Pure (100%) alcohol evaporates too quickly for this purpose. • Containers of 70% alcohol should be sealed to prevent evaporation. But unlike bleach solutions, they will remain potent as long as they are sealed between uses. • A 70% alcohol solution with water will be very harsh on your hands and should not be used as a substitute for handwashing and/or hand sanitizer.

Hydrogen Peroxide • Hydrogen peroxide is typically sold in concentrations of about 3%. It can be used as is, or diluted to 0.5% concentration for effective use against coronaviruses on surfaces. It should be left on surfaces for one minute before wiping.

Natural Chemicals (Vinegar or Tea Tree Oil) • Vinegar, tea tree oil and other natural products are not recommended for fighting coronaviruses. A study on influenza virus found that cleaning with a 10% solution of malt vinegar was effective, but few other studies have found vinegar to be able to kill a significant fraction of viruses or other microbes. While tea tree oil may help control the virus that causes cold sores, there is no evidence that it can kill coronaviruses.

Alcohol • Alcohol in many forms, including rubbing alcohol, can be effective for killing many pathogens. You can dilute alcohol with water (or aloe vera to make hand sanitizer) but be sure to keep an alcohol concentration of around 70% to kill coronaviruses. Many hand saniApril 2020 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 9


Major Nursing Homes in Upstate Remain on High Alert From Elderwood in WNY to Loretto in Syracuse, large nursing homes in Upstate New York impose restrictions as a way to contain the spread of COVID-19 By Ernst Lamothe Jr.

M

any nursing homes and assisted living facilities in Upstate New York have been on the forefront of battling the coronavirus and making sure their residents stay safe while also making sure the lines of communications remain strong with their loved ones. Older adults and people who have severe underlying chronic medical conditions such as heart or lung disease or diabetes are at a higher risk for developing serious complications from COVID-19. “We have issued a temporary visitor restriction to all our senior care communities,” said Julie Sheedy, chief marketing and engagement officer for Loretto in Syracuse, a comprehensive continuing healthcare organization that provides a variety of services for older adults. “For us being a nursing home facility, we have always focused on taking the

most precautions in any situation. We are always on high alert especially in this time because it is flu season and we had strict protocols in place even before the coronavirus.” Loretto is the ninth largest employer in Onondaga County and employs about 2,500 people. It serves nearly 10,000 individual annually. “The only exception we’re making when it comes to visitors is for residents who are at the end of life where we are making special arrangements,” said Sheedy. “We have stopped any community outings as well as entertainers or events coming into our facilities. We know that we care for one of the most vulnerable populations and we’re meeting daily to assess and reassess any of our protocols.” St. Ann’s Community, which is the largest senior facility provider in the Rochester area — and the sev-

enth largest nonprofit senior living provider in New York state — has assembled a core team of physicians, nurses and care providers to monitor the virus’ spread and obtain updated guidance from the Department of Health and the Centers for Disease Control (CDC). The medical team has limited all visitation that are not medical related. Jennifer Aiezza, marketing manager for St. Ann, said the organization releases regular videos, which cover a wide range of topics from visitation restriction, preparedness, resident activities and programs. In addition, it has set up an email address — covidquestions@mystanns. com — for families to also send questions. “Although large-scale events have been suspended, our staff are providing programs for small groups fewer than five residents and indi-

viduals to meet their interests and needs,” said Aiezza. “This allows residents to stay on their floors and in their households, socializing with those they ordinarily interact with. Innovation and spontaneity has already taken place; from impromptu birthday celebrations to dance parties in the dining room, we are working together to continue normalcy for our residents,” said Aiezza. St. Ann’s has also implemented a buddy program, which pairs staff with residents for daily visits. During these visits, team members will check-in on residents to talk, listen, and help connect them with their families via video-chat or another way as determined by family preferences. The team members are volunteers from across multiple functions of St. Ann’s. “With visitation being so limited, we have created opportunities for social interaction and engagement,” said Triciajean Jones, St. Ann’s director of life enrichment. “Every resident has been paired with a staff member who will visit daily and help keep in touch with family through video chat or a simple phone call. It’s a friendly visit for both residents and staff.” “So many of our residents enjoy weekly and daily visits from their loved ones, and now, due to restricted visitation, we will do everything we can to keep families connected,” added Aiezza. Based on guidance from the CDC and other health agencies regarding COVID-19, and an abundance of caution, Buffalo-based Elderwood, which operates several senior facilities throughout New York state, has issued temporary visitor restrictions at all of its senior care communities. No unnecessary visitors will be allowed into these facilities. Those individuals that must enter, including Elderwood staff, must complete a health screening prior to moving throughout the facility. Trying times Physician David Gifford, chief medical officer for the American Health Care Association and National Center for Assisted Living, understands families panicking because they are not able to visit but he believes these are trying times. “This virus is acting differently in the elderly population, those who are 80 years old and older, especially those who are living in nursing homes and assisted living. The disease for them is very dire,” said Gifford. “We are making recommendations, governors nationwide are making recommendations and the CDC is making recommendations to limit individuals coming into buildings. We know this is a difficult thing to ask but the risk of this virus being spread is very serious.”

Resources for the Coronavirus • Erie

County Department of Health, COVID-19 Information Line: 716-858-2929 Mondays through Fridays: 8 a.m. – 8 p.m. • Erie County Department of Health, COVID-19: www.erie.gov/covid19 • Erie County Department of Health, Online Case Mapping: www.erie.gov/covidmap • NYS Department of Health, Novel Coronavirus: www.health.ny.gov/diseases/communi cable/coronavirus/ • New York State Department of Health Hotline: 888-364-3065 • Centers for Disease Control and Prevention, Coronavirus: www.coronavirus.gov

Page 10

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020


Norb’s Take

Norb Rug is a writer from Lockport. He blogs at WhyWNY. home.blog.

By Norb Rug

Coronavirus: The Sky Is Falling…

S

o now we have a coronavirus pandemic. My wife Donna and I went shopping this morning to pick up a few supplies. We first went for some Tylenol. There was a big vacant space where this used to be. So we went for some lemonade mix. Looks like we weren’t going to get any of this either. Then we proceeded to the pasta aisle. This was so empty that we heard an echo from the squeaky cart wheels. So we decided to pick up some canned sauce and tomatoes to make some sauce for pasta we had at home. No luck there either. This was getting ridiculous. At least we could pick up some dried split peas and beans to make some soup. It turns out the soup was going to be very thin and bland

because it would only contain water — there were no beans in the grocery store. At that point it got fascinating to walk up and down the aisles to see what they did have. There were three jars of peanut butter and four jars of jelly on the shelves. Canned soup was MIA unless you were looking for cream of mushroom. We managed to get some mac and cheese. However, it had unicorn shaped pasta. In the canned meats aisle, there was no canned chili, corned beef hash or Spam. We did manage to throw some roast beef hash into our cart. We also picked up a can of Walmart brand spam and some canned chicken. I’d never had any of this before but at this point I thought it was food we could eat if we had to. I don’t know what we would mix with the

A lone shopper gazes down an aisle of mostly empty shelves at a local Wegmans.

chicken because the canned vegetable aisle had as much food in it as a tire store. If you like frozen Brussels sprouts, you were in luck. It seems that even during a pandemic, nobody eats Brussel sprouts. The bottled water aisle was as dry as a desert. However there was plenty of beer. Really? If my kids were going to be home, locked inside my house for a few weeks, I would stock up on beer. Finally we went to the paper aisle to pick up some toilet paper, paper towels and tissues. All the shelves there were as bare as lady Godiva. I don’t know why there is a toilet paper shortage when we don’t have any food to eat. This wouldn’t be our first panic over toilet paper. In 1973, consumers emptied store shelves for a month due to rumors, fears and a joke. At that time, Americans were concerned about decreasing supplies of gasoline, electricity and onions. A government press release that warned about a possible scarcity of toilet paper created a lot of press coverage but no panic buying until Johnny Carson, the famous late night television host, joked about it in his monolog. In the 2009 the swine flu pandemic lasted from early 2009 to late 2010. Globally, an estimated 151,700 to 575,400 people died from swine flu in the first year of the pandemic. As soon as the outbreak was announced, Mexico notified the U.S. and World Health Organization. Within a few days of the outbreak Mexico City was “effectively shut down.” The HIV/AIDS pandemic (20052012) was first found in the Congo in 1976. HIV/AIDS has proven itself to be a global pandemic that killed more than 36 million people since 1981. Right now, there are around 31 to 35 million people that are living with HIV. We had what was referred to as the Hong Kong flu pandemic in1968. The first case was reported on July 13, 1968. It took just 17 days until outbreaks of the virus showed up in Singapore and Vietnam. Within three

BlueCross BlueShield to Cover Cost of COVID-19 Testing

A

mid the growing concerns about the spread of the COVID-19 in communities across the country, BlueCross BlueShield of Western New York announced it will cover the cost of COVID-19 diagnostic tests as prescribed by doctors.  According to the insurer, by removing any cost to members, BlueCross BlueShield will pay for the appropriate diagnostic testing for fully insured employer, individual and Medicare members who meet

the Centers for Disease Control and Prevention (CDC) guidelines for testing. As part of BlueCross BlueShield’s ongoing commitment to eliminate barriers to care, the health plan does not require prior authorizations for COVID-19 testing. BlueCross BlueShield strongly recommends members to use telehealth to connect with a doctor when possible. Members can use BlueCross BlueShield’s telemedicine provider, Doctor on Demand.

Virtual visits are a safe and effective way for members to consult a doctor to receive health guidance related to COVID-19 from their homes via smart phone, tablet or computer-enabled web cam 24/7. Using telehealth as a first step may lower your risk of getting sick or exposing others to illness, according to BlueCross BlueShield. BlueCross BlueShield encourages members to use their mail order benefit to obtain a 90-day supply of their prescription medication. Members

April 2020 •

months it had spread to The Philippines, India, Australia, Europe, and the United States. While this pandemic had a relatively low mortality rate (.5%) it nevertheless resulted in the deaths of over a million people. Then there was the Asian flu pandemic from 1956-1958.The Asian flu was a pandemic outbreak that originated in China in 1956 and lasted until 1958. In its two-year spree, The Asian flu traveled from the Chinese province of Guizhou to Singapore, Hong Kong, and the United States. The World Health Organization places the final death toll at approximately 2 million deaths, 69,800 of those in the US alone. As of mid March, at least 4,226 people in all 50 states, Washington, D.C., and Puerto Rico have tested positive for coronavirus in the United States; at least 75 patients with the virus have died. Unless you have been in a coma recently I think you have heard all the things you should be doing to protect yourself like frequent hand washing and avoiding crowds, so I am not going to rehash them here. Use common sense and stay away from sick people. I have always said that the Russians, Koreans or even aliens won’t kill us off. It will be a tiny, little, unseen bug that will get us all. — Norb Rug is a writer and blogger from Lockport. You can follow his blog at WhyWNY.home.blog.

are also encouraged to refill or renew their prescription medication at retail pharmacies when 25% of their current prescription is remaining, which is consistent with the CDC recommendation to have a one-month supply of medication on hand. “We all have a shared responsibility to keep our community healthy, and we want our members to know that we’re here for them,” said physician Thomas Schenk, senior vice president and chief medical officer at BlueCross BlueShield of Western New York. “Our focus now is on slowing the spread of this illness and making sure that if a person does become seriously ill, they are able to access the care that they need in a timely way.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 11


Getting on With Your Life in the Age of Coronavirus

A

s coronavirus continues to spread across America, people in some areas are quarantined. Conferences, sporting events and travel plans are being called off, while hand sanitizer and toilet paper are flying off the shelves. Short of finding a well-stocked bunker, how can you learn to live with this new normal? An important key to living with the looming threat of this virus is flexibility, experts say. “You have to be willing to change as the situation changes, and it’s likely to keep changing for a while,” said Robin Gurwitch, a psychologist at Duke University Medical Center in Durham, North Carolina. Living with uncertainty Gurwitch said uncertainty leads to high anxiety and panic. She said that’s likely one of the reasons why people have been stockpiling things like hand sanitizer and toilet paper. During any viral outbreak, “one of the things that helps to reduce anxiety and worry is when we have a very clear and unified messaging from respected officials. Viruses arent political, they’re a public health issue,” Gurwitch explained. “What is creating more distress now is that there are really different messages out there. When that

happens, people start filling in the gaps in the messaging themselves, and they may think they’re not being told everything. That’s when you get panic buying,” she said. “Coronavirus has taken quite a bit of our sense of control. But buying supplies is something I can control. I can know that I have enough supplies. And it makes me feel like, ‘I’ve got this,’” Gurwitch said. Here are some additional steps you can take to bring back a little bit of normalcy to your life. At home Plenty of folks were caught short and don’t have a supply of hand sanitizer, but soap and water are fine. “At home, you don’t need alcohol-based sanitizer. Soap and water are also very effective,” said Chunhuei Chi, director of the Center for Global Health at Oregon State University. Chi said when you get home, wash your hands well, and clean your cellphone with alcohol, or put soap and a little water on a paper towel, clean your phone and immediately dry it. Don’t forget to clean surfaces that everyone touches often — doorknobs, toilet handles, faucets and remote controls.

Out and about Life does go on, and you’ll need to go to work, school and shopping. When you leave your home, Chi suggested carrying tissues with you. Whenever you need to open a door, grab a shopping cart or even push an elevator button, use a tissue to create a barrier between you and the object. If you have hand sanitizer — containing at least 60% alcohol — he said you can use it to disinfect your hands. “This virus is very sensitive to alcohol,” Chi said. Many stores also keep sanitizing wipes by their carts for you to clean the handle before you shop. Physician Debra Spicehandler, co-chief of infectious diseases at Northern Westchester Hospital in Mount Kisco, said it’s important to pay attention to potentially common sources of infection. “After touching pens, money, credit cards or even salt and pepper shakers, try to use hand sanitizer right away. If you can’t, don’t touch your hands to your face,” she said. And, Spicehandler said, skip handshakes altogether. Travel Travel is becoming more of a challenge. The U.S. Centers for

Disease Control and Prevention is advising people not to fly unless it’s absolutely necessary. Check the CDC website before traveling internationally. The CDC said air travel itself isn’t likely to be a problem. Physician Krystina Woods, director of infection prevention at Mount Sinai West in New York City, explained, “Planes do have filtered air. Proximity [to someone who is ill] is the thing that might be concerning, and you don›t have much control over who is sitting beside you on a plane. But you do have control over whether you wash your hands or touch your face.” If you decide to cancel a flight, policies on whether or not you can get a credit or refund vary, so check with your airline. Large events At least for the foreseeable future, it’s going to be important to check whether or not an event is still taking place. A number of large conferences and events have been delayed or canceled out of an abundance of caution. The big California music festival Coachella has been rescheduled to the fall. New York stalled its big auto show until August, and the South by Southwest Festival in Austin, Texas, was canceled. “Indoor gatherings, especially any with 1,000 or more people, should be avoided,” Chi said. Learning to live with the risk “There’s been a lot of concern, bordering on panic recently. But most people who get the virus have relatively minor illness and the majority are getting better,” Woods said. Gurwitch advised staying upto-date on the situation by checking reliable sources of information, such as the CDC. And take the steps you can to control your personal and family situation. If you do get symptoms — fever, cough, difficulty breathing — call your doctor or local emergency room to find out what to do, Spicehandler advised. The CDC also recommends calling your doctor if you find out you’ve been exposed to someone who develops COVID-19, the illness caused by coronavirus. This article was distributed by HealthDay News.

Stay Sensibly Cautious Amid COVID-19 Crisis By Deborah Jeanne Sergeant

E

very month, I interview a few dozen health professionals for articles printed in three editions of In Good Health — Buffalo/ Western New York, Rochester and Syracuse/Central New York. That has been a routine for the last several years. As the COVID-19 outbreak spread, fewer public relations professionals were available to schedule care providers for me to interview. Many of those not engaged in patient care were working from home and could not take time for interviews. By early March, it became obvious they were swamped with work, including screening patients for possible COVID-19, developing internal policies regarding the outbreak and forming public statements and Page 12

advisories. That’s a lot to add to their usual patient load. I can see why an interview wasn’t possible. A little more prudence from the public can help them use their time better so they can treat the patients who really need care. Only people exhibiting symptoms identified with COVID-19 should contact a care provider over the phone about their coronavirus concerns. The Centers for Disease Control and Prevention stated on its website that these symptoms manifest between two and 14 days following exposure: fever, cough, and shortness of breath. Severe signs that may require emergency treatment include difficulty breathing or shortness of breath; persistent pain or pressure in the chest; new confusion or inability to arouse; and bluish lips or face. Keep in mind that amid the outbreak, people still have colds, flu,

allergies and breathing issues not related to COVID-19. It wastes resources and needlessly exposes people to germs to rush to the doctor over non-COVID-19 illnesses that could be safely treated at home. People with pre-existing conditions such as a lung disease or illness or lowered immune response and older adults should remain vigilant about their health, call their provider over concerns and remain more reluctant to go out. The outbreak also reminded me about how few people seem to have more than a few days’ food and supplies at home. Since we live in an area that has had the occasional blizzard, we should know better than to let things dwindle to the point where we need to rush to the store to clear out the shelves. My grandparents lived through the Depression and rationing during

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

wartime. They always advised to keep extra groceries on hand just in case. Perhaps tight budgets, megastore convenience and busy schedules all add up to the wave of panic buying recently observed while trying to do some routine shopping. I’ve never seen entire aisles completely bare in my life. The septuagenarian checker who helped me said that she had never seen such a spectacle, either. Use common sense and follow the guidelines of the CDC and local recommendations for hygiene. Get enough rest and try to exercise and eat right. Stay home if you can. Try to think of it as extra time to nurture your family and yourself. Above all, don’t stress. That lowers your immune system’s response and doesn’t help one bit.


Coping with Coronavirus By John Addyman

I figured, I’ve got this coronavirus thing handled — no problem. Tell me I’ve got to spend some weeks at home and I’ll enjoy myself. First, my wife and I will have time to enjoy a nice late dinner out, something we don’t do nearly often enough. It’ll be like a date night for us. But wait, they closed the restaurants and taverns. OK, I thought to myself. This is the perfect opportunity to go deep on some books in the library, put a binge readfest together for myself. Then they closed the library. OK, I thought to myself. Instead of improving my mind, I’ll improve my body and set up a daily schedule at our local gym. I’ll be buff as a Greek god by summer. So they closed the gym — while we were there for its last hour of operation. I’ve closed some bars in my flaming youth, but I’ve never closed a gym. “How about a movie?” my wife suggested. Of course the movie theaters were closed. “Wait a minute,” she said, “Hello, Dolly!” is coming up soon. We have tickets!” That sounded great…but within hours, the theater canceled the production. Goodbye, Dolly. “I have a great idea,” I told my

‘In so many ways, the shape of this worldwide coronavirus tragedy gives some of us a chance we’ve never had to slow down and take on things that we left on the sidelines long ago.’ wife. “Let’s go to a school board meeting! We can show our civic pride! We can see what’s going on in our grandchildren’s schools in two school districts! We’ll social-distance ourselves from all the other two or three parents who will be there!” Then the school boards decided to have their meetings by live stream, with no members of the public allowed. We coped, but watching a school board meeting on a computer with a beer and some popcorn is really a weird experience. “What can we do to pass the time?” my wife asked. I looked at her in that old certain way and my eyebrows danced an encouraging and flirty dance on my

face. “You can forget that,” she said. “I’ll make you a to-do list…a long to-do list.” So much for dreams of conjugal bliss. “Maybe we can snoop around and find out where the black market for toilet paper is,” I suggested. My wife just looked at me. “We could rake up all the rest of the leaves in the yard and put them in big bags and sell them, just in case toilet paper disappears completely,” I suggested. My wife went back to reading her book. I decided to watch some movies and because it’s Lent, I decided “The Ten Commandments” would be a good choice…and it was until I got to the part where the Destroyer comes like a green fog in the night for the first-born of Egypt. That’s when it hit me — that’s what this coronavirus is: a secret, scary, silent, sinister and slithery thing that is lurking in the dark to capture us. Some won’t know they’ve acquired it. Some won’t survive acquiring it. And lamb’s blood on our doors won’t do much good this time around. So after some thought, my wife and I have settled on some things about these days of our lives. • First, we’re going to take walks and enjoy our village and perhaps

a stray neighbor or two we meet on the way. We’re going to watch spring bloom. For once in my life, I’m enthusiastic about cutting the grass and spending some time in the garden (doing what, I have no idea). • Second, and we talked about this when we took a ride in the car today — we’re going to enjoy studying and learning again. I’m a retired nurse, but I’m going to take a refresher course on infection control. I’m a retired biology teacher, and I want to get ahead of where my grandkids will be in the fall when they take their living environment course. I have a binocular microscope, and I’m going to study some flora and fauna. I’m going to spend some afternoons with a libretto in my hand listening to opera. • Third, we’re going to reconnect with friends on Facebook and through emails and letters. We know the time we spend putting those notes together will be appreciated and returned. • Fourth, we’re going to move ahead. We’ll fill out the census form and check our voter registration. I’ll throw out old white T-shirts and worn out but oh-so-comfortable sweatshirts and sandals. I will actually read the owner’s manual for my car. In so many ways, the shape of this worldwide coronavirus tragedy gives some of us a chance we’ve never had to slow down and take on things that we left on the sidelines long ago. In the midst of their terror, the Italians found passionate music to express their spirit. As Upstate New Yorkers, we will do no less.

Beware of Coronavirus Scams By Jim Miller

U

nfortunately, coronavirus scams are spreading nearly as fast as the virus itself, and seniors are often the most vulnerable. These con artists are setting up websites to sell bogus products, and using spoofed phone calls, emails, texts and social media posts as a ruse to take your money and get your personal information. The emails and posts may be promoting awareness and prevention tips, and fake information about cases in your community. They also may be asking you to donate to victims, offering advice on unproven treatments, or contain malicious email attachments. Here are some tips to help you keep the scammers at bay. • Click carefully: Don’t click on coronavirus-related links from sources you don’t know in an email or text message. The same goes for unfamiliar websites. When you click on an email or download a file, you could get a program on your computer that could either use your computer’s internet connection to spread malware or dig into your personal files looking for passwords and other information. • Ignore bogus product offers: Ignore online offers for coronavirus vaccinations or miracle cures. There are currently no vaccines, pills, po-

tions, lotions, lozenges, or over-thecounter products available to treat or cure coronavirus online or in stores. If you see or receive ads touting prevention, treatment, or cure claims for the coronavirus, ignore them because they’re not legitimate. • Beware of CDC spoofing: Be wary of emails, text messages or phone calls claiming to come from the Centers for Disease Control and Prevention (CDC) and/or the World Health Organization (WHO). These scams could take several forms – such as fake health agency warnings about infections in your local area, vaccine and treatment offers, medical test results, health insurance cancellation, alerts about critical supply shortages, and more. For the most up-to-date information about the coronavirus, visit CDC.gov/coronavirus. • Beware of fundraising scams: Be wary of emails or phone calls asking you to donate to a charity or crowdfunding campaign for coronavirus victims or for disease research. To verify a charity’s legitimacy use CharityNavigator.org. But, if you’re asked for donations in cash, by prepaid credit card or gift card, or by wiring money, don’t do it because it’s probably a scam. • Beware of stock scams: The U.S. Securities and Exchange Com-

mission (SEC) is warning people about phone calls and online promotions, including on social media, touting stocks of companies with products that supposedly can prevent, detect or cure coronavirus. Buy those stocks now, they say, and they will soar in price. But the con artists have already bought the stocks, which typically sell for a dollar or less. As the hype grows and the stock price increases, the con men dump the stock, saddling other investors with big losses. It’s a classic penny-stock fraud called “pump and dump.” Making matters worse: you may not be able to sell your shares if trading is suspended. When investing in any company, including companies that claim to focus on coronavirus-related products and services, carefully research the investment and keep in mind that investment scam artists

April 2020 •

often exploit the latest crisis to line their own pockets. For more tips on how to avoid getting swindled, see the Federal Communications Commission COVID-19 consumer warning and safety tips at FCC.gov/covid-scams. Jim Miller is the author of Savvy Senior column, published every issue in In Good Health.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 13


Owners of Kid to Kid Tonawanda, Michelle and Christopher Talley, in March donated $3,000 worth of baby formula.

Parents, Small Business Owners in WNY Stand United Against COVID-1919 By Jenna Schifferle

A

s anxiety around COVID-19 rises, Buffalo proves once again why it truly is the City of Good Neighbors. Supply shortages are becoming commonplace, but that hasn’t stopped parents and small business owners from rising up to support a community in need. West Seneca mom Krista Reid said being a parent changes your perspective on the coronavirus pandemic. She’s had difficulty finding wipes and diapers for her 8-month-old son, Warren. Beyond that, she lives in worry about keeping her son safe. “I think my biggest concern is bringing the virus home to my little man. What would happen if he got it? The media says that children are one of the least affected, but I still

don’t think my heart could handle it.” To pass the time at home during this pandemic, Reid has been Facetiming her sister and trying to otherwise go about life as normal indoors. She’s also making a conscious effort to help other moms, especially those who are struggling to find formula. Reid breastfeeds and has extra milk stored in her freezer. She offered to share her supply with anyone in her Facebook community. “I just want to help. I can’t imagine how stressful it would be to try to find formula in this situation when so many places are sold out.” While no one has taken Reid up on her offer yet, she plans to make a donation to Baby’s Sweet Beginnings, a breastfeeding and maternity bou-

Alcoholics Anonymous Most Effective to Beat Drinking Problems

A

lcoholics Anonymous, the worldwide fellowship of sobriety seekers, is the most effective path to abstinence, according to a comprehensive analysis conducted by a Stanford School of Medicine researcher and his collaborators. After evaluating 35 studies — involving the work of 145 scientists and the outcomes of 10,080 participants — Keith Humphreys, Ph.D., professor of psychiatry and behavioral sciences, and his fellow investigators determined that AA was nearly always found to be more effective than psychotherapy in achieving abstinence. In addition, most studies Page 14

showed that AA participation lowered health care costs. AA works because it’s based on social interaction, Humphreys said, noting that members give one another emotional support as well as practical tips to refrain from drinking. “If you want to change your behavior, find some other people who are trying to make the same change,” he said. The review will be published March 11 in Cochrane Database of Systematic Review. Although AA is well-known and used by millions around the world, mental health professionals are sometimes skeptical of its effective-

tique in Lancaster. The business is an official donation center for the New York Milk Bank, a nonprofit that “collects milk from carefully screened donors, pasteurizes it, and distributes to infants in New York State and the surrounding area,” according to its website. Beyond that, Reid also delivered a few groceries and essentials to moms and their families before PAUSE went into effect. Even small business owners are getting involved — just ask Kid to Kid Tonawanda. As an upscale resale store for children and infants, Kid to Kid has been a staple in Tonawanda for almost four years under the leadership of owners Michelle and Christopher Talley. When the pandemic first took hold, the Talleys took

ness, Humphreys said. Psychologists and psychiatrists, trained to provide cognitive behavioral therapy and motivational enhancement therapy to treat patients with alcohol-use disorder, can have a hard time admitting that the lay people who run AA groups do a better job of keeping people on the wagon. Early in his career, Humphreys said, he dismissed AA, thinking, “How dare these people do things that I have all these degrees to do?” Humphreys noted that counseling can be designed to facilitate engagement with AA — what he described as “an extended, warm handoff into the fellowship.” For the review article, Humphreys and his colleagues evaluated both AA and 12-step facilitation counseling. AA began in 1935 when two men in Akron, Ohio, were searching for a way to stay sober; they found it by forming a support group. They later developed the 12 steps, the first

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

strides to sterilize the store and have all employees wear gloves during transactions. On March 17, they closed their storefront to keep their customers and employees healthy and safe. Michelle Talley connected with several moms on Facebook and learned about the formula shortage through mom groups like Buffalo Mom Squad. Along with her husband, she decided to take action. “Social distancing is very important,” she said. “We’re not going to have anyone in our store, so we thought, what else can we do to help while we’re here painting?” So, the Talleys decided to donate approximately $3,000 worth of formula to the community. On March 21, the Kid to Kid Facebook page announced that it would leave a table of formula in front of the store on Saturday, March 21, and Sunday, March 22. People could stop by and grab a can while still practicing social distancing. “People are going through tough times, and it means a lot that we could do something small,” Michelle Talley said. Despite reservations that people might take advantage of an unmonitored table, Talley was happy to report that visitors respected the one-can guideline. To her surprise, the Facebook post even prompted additional donations from community members who wanted to aid the cause. Several people brought cans and left them on the table. “This really is the City of Good Neighbors. People want to help.” Parents and caregivers alike stopped by to grab a can and show their appreciation and gratitude. One father was able to get Neocate, a hypoallergenic formula that retails for around $50, while a grandmother was able to get a can for her daughter, a single mother faced with new financial hardships. All remaining formula from the table is being donated to Clothe Me Co-op in Kenmore, a donation-based organization that aims to clothe people in need in Western New York. Anyone interested in donating essential items like toiletries and pantry foods can contact Becky Henderson at 757-573-8660.

being accepting one’s inability to control drinking; the last, helping others sustain sobriety by becoming a sponsor of a new member. The AA model — open to all and free — has spread around the globe, and now boasts over 2 million members in 180 nations and more than 118,000 groups. Though the fellowship has been around for more than eight decades, researchers have only recently developed good methods to randomize trial participants and measure its effectiveness, Humphreys said. For the Cochrane review, the researchers found 57 studies on AA; of those, 35 passed their rigorous criteria for quality. The studies used various methods to measure AA’s effectiveness on alcohol use disorder: the length of time participants abstained from alcohol; the amount they reduced their drinking, if they continued drinking; the consequences of their drinking; and health care costs.


Autism Rates Way Up — Why? By Deborah Jeanne Sergeant

T

he prevalence of autism spectrum disorder (ASD) was about one in every 150 children in 2000. Currently, it’s about one in 59, according to the Centers for Disease Control and Prevention. So why do so many more children have a diagnosis of ASD? While some people might look at the issue and think that some outside factor is causing more children to have ASD, experts look to other reasons for the increased rate. “There are many reasons for the increase in the diagnosis, some of which are the inclusion of a broad range of phenotypes or symptoms from very mild to very complex,” said pediatrician Michelle Hartley-McAndrew, medical director at Children’s Guild Foundation Autism Spectrum Disorder Center at Oishei Children’s Outpatient Center. She said that “the increase in diagnosis of individuals with other genetic disorders such as Fragile X or Down syndrome contributes to the increase — as well as the fact that autism spectrum disorder diagnosis sometimes includes what used to be diagnosed as intellectual disability.” Increased availability of interventions has also led to a greater number of diagnoses. “More people may seek a diag-

A

nosis when it is required to obtain support and health services,” said Hartley-McAndrew, who is also a clinical associate professor of pediatrics at University at Buffalo Jacobs School of Medicine and Biomedical Sciences. “At times, there may be over diagnosis when autism symptoms are not consistent at a young age and then as the children grow up their symptoms may lessen or disappear to the point where they may no longer meet the criteria for a diagnosis of autism spectrum disorder.” As Hartley-McAndrew alluded, one of the reasons for the uptick in diagnoses is the broadening of how members of this population are described. Published by the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM), represents mental health professionals’ book of officially recognized psychiatric disorders. “They removed some subcategories,” said Tracy A. Panzarella, licensed speech-language pathologist and director of clinical services with Autism Services, Inc. in Amherst. “Now it’s ‘autism’ and varying levels under that. Many years ago, there were different labels. There was a continuum and terms like ‘high functioning’ or ‘childhood disintegrative

disorders.’” Though Panzarella doesn’t know why the terms were removed, she sees some merit in making the changes, since even under the former labels, it was all still ASD. Using “ASD” as an umbrella term is simpler, especially for children with multiple, overlapping and numerous traits difficult to label. “Over the years, the statistics have definitely changed considerably,” Panzarella said. “We’re not sure if more doctors are on the lookout for more early warning signs.” Insurance companies are covering more early intervention services because research indicates that “the more services they can get early on, the greater strides you’ll see the child make and more independence the child will have on down the road,” according to Panzarella. No definitive, objective test exists to indicate whether or not a child has autism. Instead, providers consider a child’s developmental milestones, such as fine and gross motor skills, any sensory disorders and things parents have noticed that are different about their child compared with neuro-typical children. Panzarella said that some adults on the spectrum who were previously diagnosed as having Asperger’s still prefer the term as they view it as a cultural, social distinction that better defines their experience. Thanks to greater awareness and acceptance of autism, more community agencies and resources have been made available to help parents of children with autism spectrum disorder and the community in general better understand autism. “Even 30 to 40 years ago, there wasn’t as much information as readily available,” Panzarella said. “There’s so much more information out there and it’s accessible to people so they can educate themselves.” But Panzarella isn’t sure if some other factor is increasing incidences of autism to some degree as well. “We don’t really know what causes autism,” she added.

Has Immediate Openings for the following positions Come grow with us!

• HR Benefits Specialist • IT Technician • Sr. Substance Abuse Counselor • Data Entry Clerk • Family Case Worker • Family and Community Partnership Coordinator • Family Partner • Home Visitor • Youth Services Program Coordinator • Youth Services Counselor • Teacher (Certified) • Teacher I/II/III • Nutrition Associate • Maintenance Associate • Substitute Teacher

Visit us at www.caowny.org to learn more about the requirements and to complete an online application. Erie & Niagara counties.

What is Autism?

utism is a neurologically based developmental disability that lasts throughout a person’s lifetime. It is a spectrum disorder that is characterized by social and communication challenges, sensory impairments, restricted behaviors and interests, and associated medical issues. Autism spectrum disorder (ASD) varies widely in severity and symptoms and may go unrecognized, especially in mildly affected children or when it is masked by other more prominent disabilities. Autism is not a mental illness, bad behavior, caused by vaccines, or always associated with cognitive impairment. If you see any of these signs in your child, be sure to inform your child’s pediatrician: • no babbling or pointing by age 1 • no single words by 16 months or two-word phrases by age 2 • no response to name • loss of language or social skills • poor eye contact • excessive lining up of toys or

objects • different social responsiveness than other children These behaviors have been observed in older children: • impaired ability to make friends with peers in expected ways • impaired ability to initiate or sustain conversation with others • stereotyped, repetitive, or unusual use of language • restricted patterns of interest that are abnormal in intensity or focus • inflexible adherence to specific routines or rituals • Lack of fear or danger awareness • Sudden (to you) changes in mood or demeanor • Dislike of being touched/touching too much • Not responsive to verbal and nonverbal cues • Difficulty expressing needs or WEC_ad1_5.167x6.75.indd responding to questions A developmental evaluation is required to diagnose a child with ASD. From the website of AutismUp (www. autismup.org).

WEC_ad1_5.167x6.75.indd 1

WEC_ad1_5.167x6.75.indd 1

April 2020 •

In Good Health, Western New York’s Healthcare Newspaper. Call 716-332-0640 to advertise.

WEC_ad1_5.167x6.75.indd 1

6/2/10 9:46:04 AM

1

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 15

6/2/1

6/2/10 9:46:04 AM


5

Things You Should Know About Hearing Loss

By Ernst Lamothe Jr.

H

earing is one of the five senses. It is a complex process of picking up sounds, processing it and attaching it to meaning. The ability to hear is critical to understanding the world around us and connecting us to loved ones and colleagues. Approximately 20% of Americans — around 48 million Americans of all ages — have some degree of hearing loss, according to the Centers for Disease Control and Prevention. In addition, hearing loss occurs in five out of every 1,000 newborns each year in the United States. “Oftentimes it takes people an average of seven years to seek treatment for hearing loss,” said Jill Bernstein, audiologist for Hearing Evaluation Services of Buffalo Inc. Stigma surrounding aging factors into some of the neglect, according to Bernstein. People often equate a hearing check-up to aging, so they’re reluctant to seek treatment, she said. Bernstein discusses five aspects about hearing of which people should be aware.

1.

Get a hearing screening

Hearing screening is a test to tell if people might have hearing loss. The tests are both easy and painless. Audiologists suggest that you receive regular screenings to check if your hearing is normal or near normal. People could be experiencing tinni-

that. As many as 16% of teens aged 12 to 19 have reported some hearing loss which may be caused by loud noise, according to the CDC. In addition, hearing loss can affect a child’s ability to develop communication, language and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential. “If a child doesn’t respond to sound by shifting the focus of their eyes toward the sound, or show any indication they heard a sound, they should get checked out,” said Bernstein.

3.

Jill Bernstein is an audiologist with Hearing Evaluation Services of Buffalo Inc. tus, which is a ringing in the ears and is a side effect of hearing loss. “Exposure to loud noises, medications with high doses of aspirin, medications related to cancer treatments, blood pressure medication, too much wax in the ears, and diet, are the things which exposes an individual to tinnitus,” said Bernstein.

2.

Early indication for child hearing loss

There is still a myth that hearing loss is an older adult problem. However, the trends are not supporting

Noise level matters

Various people fall victim to blasting music in their ears, but young people specifically have a tendency to perform such activity for hours at a time, which can be extremely harmful to their hearing overtime. Bernstein mentioned people can listen to 85 decibels of music for six hours without any damage to their hearing. Despite 85 decibels being high enough, many young people reach higher levels than that. Anything higher than 85 decibels is damaging. Normal conversation is about 60 decibels while a lawn mower is about 90 decibles.  “Every decibel we go up by 5, we cut our safe music time in half,” said Bernstein. She said 70-75 decibels is a comfortable, safe level to listen to music where individuals can hear the music clearly while canceling out the outside world. For those who want an effective way to listen to music, they can invest in quality headphones with noise canceling capabilities, which doesn’t require increase volumes.

4.

Hearing and health are connected.

Bernstein believes in the relationship between hearing and several

other health issues. “Any kidney disease can affect the ear because they share the same cellular structure. With high blood pressure and cholesterol, it’s all about blood flow,” she added. Bernstein said the ear has the most requirement for blood flow in the body. Because high cholesterol and blood pressure blocks blood flow, it affects the blood flow to the ear, which affects the hearing.

5.

People don’t realize how far hearing technology has come.

Hearing aids are similar to earbuds, but they’re safer, clearer and more natural. In the 21st century, there have been significant advances in hearing aid manufacturers. They have made improvements by developing hearing aids that are more effective for various types of hearing loss. That includes those specifically made for high-frequency hearing loss, along with better feedback management, noise reduction, rechargeable batteries and connectivity to Bluetooth technology. They can link their hearing aids to their phones and stream hands-free phone calls, according to Bernstein. Digital hearing aids can help convert incoming sounds so that it can be amplified to an individual’s specific needs. They also analyze the listening environment every couple of milliseconds to determine if noise reduction assistance is needed. Bernstein describes a unique, invisible device called a Lyric, which is replaced every few months by an audiologist, and it’s pushed so deeply into the ear to create the illusion of being invisible. “Audiology as an art and a science. The science tests an individual’s hearing to use it as the base of their hearing aid programming,” said Bernstein.

H ealth News MHA recognizes people who make a difference Mike Billoni of Billoni Associates in Buffalo recently received the “Courage to Come Back Award” from the Mental Health Advocates of WNY (MHA). Billoni was recognized for “his resiliency and ability to rise above his mental health Billoni challenges and share his personal experiences to help individuals who are going through similar situations,” according to a press release from MHA. He was one of several people honored during MHA’s 58h Annual Dinner and Auction in March. This was the MHA’s signature event and Page 16

biggest fundraiser of the year. Other honorees are: • Paul Hogan, executive vice president of John R. Oishei Foundation, was presented with the “Community Impact Award” for his extraordinary impact in WNY as a catalyst for change with respect to mental health issues. • Jenny Laney, director of the Child and Family Support Program at MHA of WNY, received the “Professional of the Year Award” for her dedication to helping children and families living with the challenges of mental illness. • Camalot Todd of Spectrum News Buffalo received the MHA’s “Advocacy Award” for the impact she’s made through her series #IAm1in5. The series covers in-depth mental health issues and personal stories, which help to break down the stigma of and other barriers to getting mental health treatment.  • Wayne Whitaker, a Court Appointed Special Advocate (CASA)

volunteer, was honored as “Volunteer of the Year.”

Dr. Hicks Jr. receives Weill Cornell Medical Center award Recognized for his contributions to patient care, Roswell Park Comprehensive Cancer Center’s Wesley Hicks Jr., has earned a Distinguished Alumnus Award from Weill Cornell Medical Center. Chairman Hicks of the department of head and neck, plastic and reconstructive surgery at the Buffalo cancer center, Hicks is only the third

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

alumnus to receive this award from Weill Cornell. In awarding this distinction, the school highlighted his 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.


Subscribe to By Jim Miller

How Medicare is Covering Coronavirus Dear Savvy Senior,

Is Medicare covering testing for the coronavirus? My husband and I are very nervous about this virus and would like to find out if or when we should get tested, and how Medicare manages it.

coronavirus. So, everyone in these categories need to be vigilant. Symptoms of COVID-19 include fever, cough and shortness of breath. Severe cases can lead to pneumonia, severe acute respiratory syndrome, kidney failure and death. If you develop any symptoms that are concerning, you should contact your primary-care provider by phone for guidance. If your doctor believes you need testing, he or she will instruct you on what to do. Unfortunately, there have been reports of test shortages across the country, so depending on where you live you may have to wait a few days.

Nervous Nelly

Prevention Tips

Dear Nelly,

To help you steer clear of COVID-19 the CDC recommends that you avoid close contact with anyone who is sick. Wash your hands often with soap and water for at least 20 seconds, especially after being out in public, blowing your nose, coughing or sneezing. If soap and water isn’t available, use a hand sanitizer that contains at least 60% alcohol. To the extent possible, try to avoid touching your face, nose and eyes. And avoid touching high-touch surfaces in public places, like elevator buttons, door handles, handrails, and handshaking with people. Use a tissue or your sleeve to cover your hand or finger if you must touch something. Also, clean and disinfect your home to remove germs: Practice routine cleaning of frequently touched surfaces — tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and cell phones. You should also avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick. The CDC also recommends that seniors and high-risk individuals stock up on supplies, such as extra medications and groceries. And, if there is an outbreak in your community, remain at home as much as possible. They also discourage non-essential travel. For more information on the COVID-19, visit Coronavirus.gov.

Yes! Medicare is indeed covering the cost of testing for the coronavirus, or COVID-19. But be aware that getting a test isn’t as simple as going to your local pharmacy or doctor’s office and asking for one. Here’s a breakdown of what Medicare is covering, along with how to get tested if you think you may have symptoms.

Medicare Coverage Medicare (Part B) will cover the lab test to see if you have coronavirus, but only when your doctor or other health care provider orders it. You will pay no out-of-pocket costs for these tests. In addition, Medicare also covers all medically necessary hospitalizations. This includes if you’re diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. And while there’s currently no vaccine yet to protect against COVID-19, when one becomes available next year, it too will be covered by all Medicare prescription drug plans (Part D). If you happen to get your Medicare benefits through a private Medicare Advantage plan, you will have access to these same benefits. In addition, many Advantage plans are also expanding coverage of telemedicine, which allows beneficiaries to consult with medical professionals without having to go to a doctor’s office. Check with your plan for coverage details.

When to Call Your Doctor Older adults, age 60 and older (especially those in their 70s and 80s), and people with chronic medical conditions like diabetes, heart, lung or kidney disease are at a higher risk of serious illness if they contract the

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.

Get In Good Health in the mail. In Good Health brings news items you won’t find in any other publication. Subscribe today

IN GOOD HEALTH — WNY’s HEALTHCARE NEWSPAPER Name ________________________________________ Address_______________________________________ City / State / Zip________________________________

Clip and Mail w/ your check to:

In Good Health

P.O. Box 550, Amherst, NY 14226

21.00 1 year $ 35.00 2 years

$

There are many ways to help kids who stutter... Doing nothing is not one of them! For more information...

800-992-9392 www.StutteringHelp.org

April 2020 •

www.tartamudez.org

THE

STUTTERING FOUNDATION

®

A Nonprofit Organization Since 1947—Helping Those Who Stutter

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 17


Golden Years Maria Shriver Sounds the Alarm on Women and Alzheimer’s W hy are two out of three people struck by Alzheimer’s disease

women? That’s the question that drove journalist and author Maria Shriver to start the Women’s Alzheimer’s Movement (WAM). The group is dedicated to raising awareness that women face a greater risk of Alzheimer’s disease, and aims to fund women-based research for Alzheimer’s disease. “Women’s research is way behind men’s research, and the Women’s Alzheimer’s Movement sits there pushing. Because we can’t close the knowledge gap unless we do the research. And we can’t help women on the front lines of this disease without that research,” Shriver said at a WAM luncheon in March honoring new research grant recipients. Shriver, 64, has spoken openly about her father Sargent Shriver’s battle with Alzheimer’s disease, and how it destroyed her “father’s beautiful brain.” But she soon noticed that when people shared their stories of loved ones with Alzheimer’s disease, the stories were disproportionately about women. When Shriver pressed experts on why the brain disease seemed to affect so many more women, she

was told it was because women live longer. Not one to let a potentially important story go, Shriver partnered with the Alzheimer’s Association to look closer at this connection. The result was “The Shriver Report,” which confirmed that women were, in fact, being diagnosed with Alzheimer’s disease far more often than men. And it wasn’t just a factor of women living longer. But no one knows exactly why Alzheimer’s disease ravages so many more female minds. And many women and their families still don’t realize the seriousness of the risk. A woman in her 60s faces an estimated 1 in 6 lifetime risk of developing Alzheimer’s disease. For breast cancer, the risk is one in 11, according to the Alzheimer’s Association. Therefore, research is essential, WAM says. Some of the early research projects receiving grants from WAM include: • The gut microbiome’s role in Alzheimer’s. Harvard researcher Laura Cox is exploring how the natural bacteria in the digestive system (gut microbiome) might affect the development of Alzheimer’s, and whether adding more beneficial microbes could be a way to treat Alz-

heimer’s disease in women. • Sex-based genetic analysis. Massachusetts General Hospital researchers Rudy Tanzi and Dmitry Prokopenko are mapping genetic markers based on gender and looking for genetic markers for Alzheimer’s disease on the female genome. • Sudden hormonal shifts and Alzheimer’s disease. Lisa Mosconi, from Weill Cornell Medicine, is looking at how a rapid shift in estrogen levels might impact a woman’s risk of Alzheimer’s disease. Women in the study are being treated for other conditions, but a side effect of those treatments is early menopause. Mosconi will compare the brains of women before and after these treatments to see how a sudden loss of estrogen affects the brain. • Sex-based brain differences. Using advanced imaging techniques, neuropsychologist Jessica Caldwell, from the Cleveland Clinic, is studying gender-based differences in the brain in people with memory issues and those without to gain a better understanding of what role gender plays in the brain. • Alzheimer’s prevention and sex differences. Physician Richard Isaacson, from Weill Cornell and New York-Presbyterian Hospital, has

already published research based on a WAM grant that found women and men with a family history of Alzheimer’s disease can improve their memory and thinking skills on their own with changes in lifestyle. The current grant is to help build a consortium to see if these risk reduction techniques change based on gender, and if there is a way to optimize prevention methods by gender. • Sex-based differences in severity of disease. Sarah Banks and Erin Sundermann, from the University of California, San Diego, are studying factors that may contribute to the more severe brain changes that seem to occur in women with Alzheimer’s compared to men. In particular, they will be looking at whether changes in sleep, diet and exercise are linked to greater inflammation in women with Alzheimer’s disease. Despite the significant challenges that Alzheimer’s disease presents, Shriver said she remains hopeful, encouraged by the progress that has been made since her father was diagnosed with the disease in 2003. “While we don’t have a cure, we do know so much more today about our brain health and what we can do to slow, if not prevent, Alzheimer’s disease in the future,” Shriver said.

10 Things Medicare Doesn’t Cover By Jim Miller

W

hile Medicare (Part A and B) covers a wide array of health care services after you turn 65, it doesn’t cover everything. If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance, or you enroll in a Medicare Advantage health plan, which may offer some additional benefits. Here’s a look at some commonly needed medical services that original Medicare doesn’t pay for. Most dental care: Rou1. tine dental care including checkups, cleanings, fillings, tooth

extractions and dentures are not covered by Medicare. However, some Medicare Advantage plans do cover basic dental care services. Routine vision care and eyeglasses: Medicare does not cover routine eye exams, eyeglasses and contact lenses (except following cataract surgery), but tests, treatments and surgeries for medical eye diseases like cataracts, glaucoma and macular degeneration are covered. Some Medicare Advantage plans do

2.

Page 18

offer routine vision benefits. Alternative medicine: Acupuncture, chiropractic services (except to fix subluxation of the spine), and other types of alternative or complementary care are not covered by Medicare. Prescription drugs: Medicare (Part A and B) doesn’t provide coverage for outpatient prescription drugs, but you can buy a separate Part D prescription-drug policy that does, or a Medicare Advantage plan, that covers both medical and drug costs. Cosmetic surgery: Most cosmetic procedures are not covered, however, if the surgery is due to an injury or deformity, it might pay. For example, Medicare will cover a breast prosthesis for breast cancer survivors. Hearing aids: Medicare will not pay for hearing exams or hearing aids, but may cover a hearing and balance exam if your doctor determines it’s necessary. Some Medicare Advantage plans do offer hearing benefits. Long-term care: Nursing home care and assisted living

3. 4. 5.

6.

7.

facilities are not covered by Medicare. But, Medicare will help pay up to 100 days of skilled nursing or rehabilitation care immediately following a hospital stay of three or more days. Personal home care: If you need to hire help for bathing, dressing or getting out of bed, Medicare typically won’t cover these costs either, unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning are not covered either unless you are receiving hospice care. But a few Medicare Advantage plans do offer in-home support services. Routine foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns, calluses and toenails. But they do cover medically necessary podiatrist services for foot problems like hammertoes, bunion and heel spurs, along with exams, treatments and therapeutic shoes or inserts if you have diabetic foot problems. Overseas coverage: In most cases, health care outside of the United States is not covered by Medicare except for very limited circumstances — such as on a cruise

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

8.

9.

10.

ship within six hours of a U.S. port. But, Medigap supplemental plans D, G, M and N cover 80% of emergency care abroad, and some Medicare Advantage plans cover emergency care abroad too. The best way to find out what Medicare covers is to talk to your health care provider, visit Medicare. gov/coverage and type in your test, item or service, or download the Medicare “What’s covered” app on the App Store or Google Play. And to look for Medicare Advantage plans that offer additional benefits visit Medicare.gov/plan-compare. Also keep in mind that even if Medicare covers a service or item, they don’t pay 100% of the cost. You will have to pay a monthly Part B premium (which is $135.50 for most beneficiaries) and unless you have supplemental insurance, you’ll have to pay your annual deductibles and copayments, too. However, most preventive services are covered 100% by Medicare with no copays or deductibles. Jim Miller is the author of “Savvy Senior” column published every issue in In Good Health.


Q A &

with

Aubrey Calhoun Associate executive director of Buffalo City Mission By Michael J. Billoni

New community center a “new dawn in our fight to alleviate homelessness”

A

ubrey Calhoun, who has worked at the Buffalo City Mission for 14 years and is now its associate executive director, oversees all annual giving, major donor, corporate and church development and outreach programs in line with the organization’s multimillion-dollar Next Century Capital Campaign. Calhoun is committed to ensuring every person who enters the mission has a second chance toward a new journey and stable life. Founded in 1917, the Buffalo City Mission provides preventive, emergency and transitional housing programs to thousands of people who are homeless and impoverished every year. With an annual budget of $8 million, the Buffalo City Mission has 105 employees and in 2019 served more than 1,620 individuals through its programs and services, providing more than 158,000 meals and more than 73,000 safe nights of sleep shelter for the homeless. What is the status of your new community center, the Alfiero Family Center of Hope and Promise, on the Buffalo City Mission campus? This new state-ofthe-art facility represents a new dawn in our fight to alleviate homelessness. We have tremendous momentum, but there is still work to be done. Today, approximately $13.7 million of a target $15 million has been committed through the City Mission’s Next Century Capital Campaign. The

new 75,000-sq.-ft. community center, scheduled to open this summer, is actually being built within the City Mission’s current parking lot at 100 E. Tupper St. and we have remained open throughout the construction process so the homeless can continue to receive the services they need without interruption. What are some of the new features of the community center specific for your clients and the thought behind them? The community center will provide stronger preventive services to help decrease the percentage of homelessness annually. It will also deliver more complete care to individuals who already experience homelessness. In every sense, it represents a one-stop-shop for helping those who need it most, not just for the mission’s emergency shelter guests and residents, but also for the community at large. The building is part of the City Mission’s vision of moving into the next century to provide services that help prevent and decrease homelessness in the community. It will be the lifeline for our most vulnerable neighbors, and our goal is to make sure everyone in our city has an opportunity to prosper. What is the Pick-a-Brick campaign and its goal toward the $15 million facility? Pick-a-Brick is a dynamic fundraising initiative that provides individuals and organizations with a special opportunity to contribute a lasting legacy for our new communi-

ty center. We proudly launched Picka-Brick in January with a goal to help raise the last $1 million needed to complete our Next Century Capital Campaign and open the doors to our new community center. What is the thought behind creating the Pathway to Hope and the importance of engaging community members in this initiative? The Pathway to Hope is the literal pathway in front of the Alfiero Family Center of Hope and Promise. It symbolizes the journey to hope and restoration that our new center represents for every individual impacted by homelessness. Through the “Pick-a-Brick” campaign, donors can select, purchase and personalize their own brick to be included in

this Pathway to Hope. We are asking everyone to learn how they can help by visiting pickabrick.org. What is the state of the homeless community in Erie County? The impact of homelessness is broad. According to a 2018 brief from the Homeless Alliance of Western New York, more than 5,750 people experienced homelessness in Erie County. Approximately 900 individuals are on the streets of Buffalo any given night, and 31% of people in Buffalo live below the poverty line. Of these, 77% are facing homelessness for the first time.

In Good Health,Western New York’s Healthcare Newspaper.

Call 716-332-0640 to advertise.

April 2020 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 19


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.

©2019 ECMC

Give to the place where there’s no giving up, and donate today for hope and healing in WNY. SUPPORTECMCTRAUMA.ORG

Page 20

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2020

Profile for In Good Health: WNY's Healthcare Newspaper

IGH - WNY 66 April 20  

Advertisement
Advertisement

Recommendations could not be loaded

Recommendations could not be loaded

Recommendations could not be loaded

Recommendations could not be loaded