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Meet Your Doctor UB psychologist Jeffrey M. Lackner: Behavioral treatment of irritable bowel syndrome provides significant relief across a wide range of IBS symptoms


JUNE 2018 • ISSUE 44

Is Complementary Medicine For You? About one-third of Americans use complementary or “integrative” medicine, according to the most recent statistics offered by the National Institutes of Health. But is it right for you? Page 15


More than 20 percent of New York state high school students use e-cigarettes — one brand, JUUL, which looks like a USB flash drive, accounts for more than half of the users

ALSO INSIDE n Cancer: Can Complementary Medicine Help? n Is Integrative Medicine Right for You? n Benefits Extend Beyond Wellness: Mayo Clinic

Cancer & Food 5 Things You Need to Know About it. We spoke with pediatric oncologist Kara Kelly, director for hematologyoncology at the John R. Oishei Children’s Hospital.

New Shingles Vaccine New shingles vaccine approved by the FDA is believed to be 97 percent effective in people under 69 and 90 percent effective in those 70 and older

Fun on the Water! This summer, don’t just take advantage of all there is to do near the water…get out there on the water! Page 8

ALSO INSIDE: Kids of Youngest, Oldest Moms at Risk of Developmental Issues

Boost Vitamin C with Sugar Snap Peas A cross between snow peas and regular green peas, sugar snap peas have a lot going for them.

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Already in Town This season, illnesses tied to ticks, mosquitoes are soaring. CDC says incidence of ticks tripled from 2004 to 2016. PS: There are 35 varieties of mosquitos in Erie County region

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arts, has found the experience to be a welcoming way to meet local individuals while learning new, challenging skills.

Buffalo Takes Flight: Aerialists Prepare Showcase Performances By Jennifer Aline Graham


p! Aerial Fitness has made a name for itself over the last year and now will host its first showcase where students and instructors will perform using apparatuses such as aerial silks, lyra, trapeze and aerial hammock.

Where Fitness, Flying and Confidence Collide The aerial and circus arts culture is often rare or unheard of in many cities, but Western New York has fully embraced this unique type

of exercise. Up! Aerial Fitness is a studio that has not only brought more of this culture, as well as other cirque-related workouts, to the greater Buffalo area, but has also brought a sense of positive self-worth and confidence to the many students who now call this little studio their second home. “It’s an opportunity for an adult to feel like a kid again,” said Ashley Acevedo, a mother and aerial silks student at Up! Aerial Fitness. Acevedo, like many students new to circus

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Those who attend classes have not only seen an improvement in their aerial skills, but also in their confidence level during their time spent at Up! Aerial Fitness, the studio owner said. The studio promotes a positive sense of self along with the large assortment of classes available, and those who partake in classes often leave feeling uplifted and mentally strengthened. Since many students, and instructors,\ have gained this newfound sense of confidence, they are diligently preparing performances for the first-ever Up! aerial showcase. Performers of all ages and abilities will showcase their skills using apparatuses such as the aerial silks, aerial hammock, lyra and trapeze.

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The Showcase Will Highlight Local Talent

Up! Aerial Fitness Showcase

New patients welcome716.961.6948

Practicing their aerial skills at Up! Aerial Fitness in Buffalo. Students and instructors will perform their first show June 16.

A Cozy Studio Set in a Historic Building The brightly colored space opened last summer and since its arrival has brought positivity, passion and, of course, a healthier sense of self to those who have walked through the historic doors. The studio is tucked away in the basement of historic School 56 on West Delavan Avenue in Buffalo, and the bright colors and comfortable setting brings a comfortable environment to all who partake. “Up! Aerial Fitness offers fitness and circus-style training courses that target the whole body and pesky core muscles as participants literally learn how to fly,” said Kim Eichorn, the owner, manager and lead instructor. Eichorn has seven years aerial experience and studied at The Philadelphia School of Circus Arts as well as Aerial Arts of Rochester — the “sister studio” to Up! Aerial Fitness. “There are so many different classes to attend that you never get bored. Everyone supports and cheers each other on to reach that next goal,” Eichorn said. The studio has many workouts available, including session classes, utilizing apparatuses such as

aerial silks, aerial hammock, lyra (aerial hoop), trapeze and the studio will soon be introducing the aerial swinging pole to the mix. Since many adults live busy lives and cannot commit to weekly, scheduled classes, Up! offers walk-in classes such as bungee dance, aerial yoga, fly barre trapeze as well as many more. The studio also hosts a range of kids, classes as well as group parties for both children and adults.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018 IGH_Urology_Ad_June.indd 1

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Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Sources: WedMed.com, fnic.nal.usda.gov, and helpguide.org.

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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) 。

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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U.S. Illnesses Tied to Ticks, Mosquitoes Are Soaring


iseases transmitted by biting insects — ticks and mosquitoes in particular — have more than tripled in the United States over the past decade, a new federal government report shows. These pests caused more than 96,000 cases of illness in 2016, up from roughly 27,388 in 2004 and part of a continuing increase in insectborne diseases, CDC researchers said. “Zika, West Nile, Lyme and chikungunya — a growing list of diseases caused by the bite of an infected mosquito, tick or flea — have confronted the U.S. in recent years, making a lot of people sick. And we don’t know what will threaten Americans next,” CDC director, physician Robert Redfield, said in a statement. Several factors are likely behind the increase, researchers said. Mosquitoes and ticks are increasing in number and moving

into new areas, carrying with them the diseases they transmit through their bite, the report said. For example, Aedes aegypti — the mosquito most responsible for transmitting Zika — has now expanded its range into as many as

38 states, the report found. Overseas travel also is contributing to the increase, with travelers picking up insect-borne illnesses in other lands and bringing them back to the United States. Further, nine new germs spread

What You Need to Know About Bug Bites

by mosquitoes and ticks have been discovered or introduced since 2004, seven of those in ticks alone. “The data show that we’re seeing a steady increase and spread of tick-borne diseases, and an accelerating trend of mosquito-borne diseases introduced from other parts of the world,” physician Lyle Petersen, director of the division of vector-borne diseases in the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said in a statement. Tick-borne diseases are mainly found in the eastern continental United States and areas along the Pacific coast, the researchers said. West Nile virus, the major mosquito-borne disease in the continental United States, can be found widely distributed across the country. Dengue, chikungunya and Zika viruses were almost exclusively transmitted in Puerto Rico, American Samoa and the U.S. Virgin Islands. Though rare, plague was the most common disease resulting from the bite of an infected flea. The findings were published May 1 by the CDC as a Vital Signs report.

Erie County expert: There are as many as 35 varieties of mosquitos in the region but only a few have been found to carry disease By Julie Halm


hile Buffalo and its surrounding communities may be of the urban and suburban ilk, residents are still exposed to a number of insects with problematic bites as spring turns to summer. Mosquitos, black and deer flies, bees and ticks are some common antagonists in the area, but there are several steps people can take in order to protect themselves. According to Alexandra Murr, nurse manager at Degraff Memorial Hospital, ticks can be found just about anywhere, including the backyards of homes in the city. The insects seek out warm places such as the armpit, groin or scalp. “They’re programmed to find somewhere dark and hidden to hide out so you don’t find them,” added Gail Burstein, Erie County Commissioner of Health. According to Murr, for those planning an outdoor excursion in any area that might have ticks, some steps to prevent tick bites include wearing long sleeves and pants, tucking pants into socks and wearing light colored clothing so that the small bugs are easier to spot. When the weather is too hot for long sleeves, Burstein suggests bug spray with between 20 and 25 percent deet, which is safe for children as well, although parents should consult their pediatricians. Those who have been outdoors should also perform thorough checks of themselves and children and pets should also be inspected by an adult. While these measures can help to Page 4

prevent a bite, there are several steps to take in the event that a bite has already occurred. A pair of tweezers can be used to remove the bug and should be placed as close to the base of the tick’s head as possible, according to Murr. A rocking motion should then be used to avoid creating separate pieces and leaving the head or mouth of the bug in the skin. The area should then be cleaned thoroughly with soap and water and treated with a triple antibiotic. Murr also advised putting the bug in a jar in case there are issues later on. One such potential issue is Lyme disease. The most well-known symptom of Lyme disease is the bullseye rash, but according to Health Commissioner Burstein, identifying the illness is not quite that simple. The rash typically develops as a small, red blotch at the site of the bite and then grows and becomes a bullseye. Burstein noted, however, that only about 75 percent of Lyme disease patients will develop that symptom and that the rash can also develop in other places. Other symptoms can include fever, chills, headaches, fatigue, muscle and joint aches and pains and can develop between three and 30 days following the bite. If detected early, a simple antibiotic will treat the issue, but if left unchecked, Lyme disease can become much more serious. “If people are not treated, they can get late-stage Lyme disease,” said Burstein. “They can get a stiff

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

Used tires potentially store stagnant water which become breeding ground for mosquitoes. neck, more rashes, arthritis with severe joint pain and swelling, you can see visible swelling in the joints, people can develop paralysis in one side of their face. They might have intermittent pain in their joints and bones and muscles, it can develop irregular heartbeats and palpitations. People can become dizzy and short of breath, they can have severe central nervous system inflammation where their spinal cord or brain can become inflamed causing unconsciousness and coma and short term memory loss.” Ticks are not the only pesky pest found in this area. Mosquitos can be both annoying and dangerous if infected with West Nile virus. According to Peter Tripi, senior public health sanitarian and supervisor of the vector control program for the Erie County Health Department, there are as many as 35 varieties of mosquitos in the county but only a few of them have been found to carry the virus. While residents can try to prevent individual bites, the first step is to minimize mosquitos’ favorite breeding ground — standing water. According to Tripi, stagnant swimming pools, ornamental ponds, clogged gutters and anywhere with standing water greater than a quarter of an inch can be problematic. The problem can escalate much

quicker than some might assume. Even one tire with standing water inside can produce thousands of mosquitos. “One swimming pool in a neighborhood can infest a whole neighborhood,” he said. The token swelling and itchiness caused by a mosquito bite is an allergic reaction to the chemicals that are being put into contact with the skin, according to Burstein, and can be treated with an antihistamine. West Nile virus will occasionally present with a different and more severe set of symptoms, however. Roughly eight out of 10 people infected will never develop symptoms, according to the CDC. “About one in 150 people who are infected develop a severe illness affecting the central nervous system such as encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes that surround the brain and spinal cord,” reads CDC’s website. In the mid-ground, some people will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea or rash. There is no treatment for West Nile virus, although treatment of particular symptoms can be administered in severe cases.

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U.S. Motorcycle Deaths Dropped 6 Percent Last Year


otorcycles are still deadlier than cars, but there’s some good news: Nearly 6 percent fewer bikers died on U.S. roads last year than in 2016, a new report says. Preliminary data indicate that there were 4,990 motorcyclist fatalities in the United States in 2017 — which is 296 fewer than the year before, according to the Governors Highway Safety Association (GHSA). But even with that reduction, motorcyclists account for a disproportionate amount of all traffic deaths. Deaths per mile traveled are 28 times higher among motorcyclists than among people in passenger vehicles, the report noted. “Motorcyclist fatality numbers have fluctuated from year to year over the past decade,” said report author Tara Casanova Powell. “While we are cautiously optimistic about this projection, we really need to see a sustained trend downward toward eventually eliminating motorcyclist fatalities altogether,” she said in a GHSA news release. Last year, motorcyclist deaths fell in 30 states, remained the same in two states and rose in 18 states, according to the report. In 2016, one-quarter of motorcy-

clists who died had a blood alcohol level over the legal limit, the highest percentage of any vehicle type. Data suggest that trend continued in 2017. Several states had an increase in distracted riding-related motorcycle deaths in recent years. And one state (Virginia) had more than double the number of such deaths between 2016 and 2017. Motorcyclists are aging, and riders over age 40 now account for the largest share of motorcyclist deaths nationwide, the findings showed. The average age of motorcyclists killed in 2016 was 43. And in onethird of states, the majority of 2017 motorcyclist crashes involved older riders. A particularly active hurricane season in 2017 may have led to fewer motorcycle riders on the roadways, Powell pointed out. But, she added, “clearly, we can’t — and shouldn’t — rely on bad weather to prevent motorcyclist deaths.” Recently, some states have considered ignition interlocks as a way to reduce alcohol-impaired riding. These prevent a motorcycle from starting if alcohol is detected on the rider’s breath.

Serving Western New York A monthly newspaper published by Local News, Inc. Distribution: 32,500 copies throughout more than 1,500 high traffic locations in the region In Good Health is published 12 times a year by Local News, Inc. © 2018 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

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Julie Halm, Kyra Mancine, Ernst Lamothe Jr., Julie Halm Advertising: Anne Westcott, Amy Gagliano Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler

For more information, Call Michele:


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.buffalo.edu June 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Your Doctor

By Chris Motola

Jeffrey M. Lackner, PsyD UB psychologist: Behavioral treatment of irritable bowel syndrome provides significant relief across a wide range of IBS symptoms

Could Time in a Sauna Lower Stroke Risk?


lder adults who like to bask in the heat of a sauna may be less likely to suffer a stroke, a new study suggests. The study, of more than 1,600 Finnish adults, found that those who hit the sauna at least four times a week were about 60 percent less likely to suffer a stroke over the next 15 years versus people who had only one weekly sauna session. Finland is the birthplace of the traditional sauna which involves sitting in a room filled with dry heat at temperatures that top 160 degrees Fahrenheit. Sauna bathing is ingrained in the Finnish culture, and most people do it at least weekly, according to the researchers on the new study. So it’s not clear whether the results would extend to other types of heat therapy from steam rooms to hot tubs that are more common in other countries, said lead researcher Setor Kunutsor. But the findings do build on evidence that traditional saunas benefit people’s cardiovascular health, said Kunutsor, a research fellow at the University of Bristol in England. Past studies have found that frequent sauna users have lower rates of heart disease and dementia, compared to infrequent users. There’s also evidence the sessions lower people’s blood pressure, and make the blood vessels less stiff and more responsive to blood flow. It’s those effects, said Kunutsor, that might explain the lower stroke risk seen in this study. The findings are based on 1,628 adults who were between the ages of 53 and 74 at the outset. None had a history of stroke. The findings were published online May 2 in Neurology.

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Q: You’ve been researching a very unusual way to treat irritable bowel syndrome (IBS). A: We’ve been working on developing treatments for IBS for the last 20 years. It’s funded by the National Institutes of Health. IBS is one of the most common gastrointestinal disorders and is a major source of quality of life impairments. And that quality of life impairment is aggravated by the lack of satisfactory dietary and medical treatments. As we’ve gotten to know more about how the brain and gut interact, we’ve learned that the brain not only can be a source of symptoms, but we can actually teach patients to gain control over and reducing their symptoms. The challenge has always been the accessibility of these treatments. There aren’t a lot of people who provide what’s called cognitive behavioral therapy for 10 to 20 weeks. In another study we found a very brief, home-based treatment was effective. We wanted to see if those results stood up with a larger group of patients. The results were very promising. Q: What is IBS, exactly, symptoms notwithstanding? A: I’m not sure we really know exactly what’s going on. It seems to be a problem with the way the brain and the gut communicate. When they’re working in tandem, patients don’t complain of symptoms, but if there’s any alteration of the brain-gut axis, it can influence some of the physical properties that underlay IBS, like motility and intestinal secretion. Q: What do these techniques look like? A: The strategies we focus on emphasize teaching skills that help patients process information

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

more effectively. And that can include worry control, flexible problem solving, muscle relaxation training, being able to monitor their symptoms and staying ahead of flare-ups. And those are pretty effective at dampening the extent to which stress interrupts the brain-gut interaction. Q: Are there problem foods, or is it more a matter of how what you eat makes you feel? A: Our view is that there are a number of factors that can affect the way the brain and gut communicate. Hormonal factors are one. Diet is another. Stress is another. Diet is not really a big part of our treatment because when our work began there wasn’t a definitive diet that worked. There’ve been a lot of diets tried since, but I’m not sure we can teach them anything new in that area that they haven’t already tried. Q: Are most IBS patients good candidates for this treatment? A: Our response rate was about 50 – 60 percent, with those patients experiencing a significant reduction in symptoms. I think the people we see have fairly severe symptoms. If people are looking for a cure or fix from a medical point of view, they’d be disappointed with a behavioral approach, but the truth is they’d probably be disappointed with a dietary or medical approach because there’s no cure or fix to be had. I think the type of treatment we have provides significant relief across a wide range of IBS symptoms, unlike medications which are very specific to patients with specific types of bowel problems. Q: Do you think this is indicative of their being a strong behavioral component to other chronic conditions?

In the News Psychologist Jeffrey Lackner, associate professor in the department of medicine at UB, is renowned for his research into innovative treatments for irritable bowel syndrome. In 2008 Lackner received $8.5 million from the National Institutes of Health (NIH) to conduct a seven-year, multisite clinical trial of a program he developed. The program concluded in 2016. The trial was the largest to date and one of the largest behavioral trials funded by the NIH. Results showed that one-third of patients with IBS who undergo the treatment achieve significant relief within four weeks. A: I think the more we learn about the complexity of these pain disorders, I think therapeutic benefit of behavioral treatments will be more apparent. And I don’t mean in terms of coping with having a disease, but in getting to the core aspects of the illness itself. Q: Do you think it’s fair to call these diseases at least partially psychosomatic, or is that too loaded a term? A: Psychosomatic seems to suggest that it’s a physical manifestation of a psychiatric problem. IBS is a real medical problem that is more complicated than just saying it’s in their head. Q: How much monitoring do patients need? A: We saw these people only for four hours. Most of the treatment was done at home. Our follow-up data suggests that people in our treatments were able to retain their gains long after treatment, so people seem to be able to sustain it. Q: As a researcher, how do you get this knowledge into the hands of patient-facing medical doctors and professionals? A: I think you do it one patient at a time. I think you try to work with them and emphasize that our approach is to round things out, not to compete with physicians and dietitians. What we’re trying to do is target a mechanism that is beyond their reach. Q: Where do you see this research headed from here? A: The next big step forward would probably be to make it a more portable treatment. I think that could come in the form of a digital platform or an app that could help people who don’t live near a research center studying this.

Lifelines Name: Jeffrey M. Lackner, PsyD Position: Director of Behavioral Medicine Clinic at University of Buffalo Hometown: Denver, Colo. Education: Emory University; Rutgers University; College of William and Mary Affiliations: University of Buffalo Jacobs School of Medicine and Biomedical Sciences Family: Wife, two children Hobbies: Music, reading, photography, travel

ECMCC Expands Substance Abuse Treatment Services Multiple initiatives implemented to support people contending with substance abuse


s substance abuse continues to damage individuals, families and the broader community, particularly through elevated alcohol- and opioid-related tragedies, Erie County Medical Center Corporation (ECMCC) has developed and implemented a variety of initiatives that support ongoing efforts of local nonprofit organizations dedicated to combating the effects of the crisis, as well as expanding existing and creating new substance abuse treatment programs on the ECMC healthcare campus. “ECMC’s emergency department receives a majority of the opioid overdose patients in the region, and is the only emergency department to offer specialized services for trauma, psychiatric emergencies and acute substance abuse detoxification,”

said ECMC Corporation President and CEO Thomas J. Quatroche Jr. “Building on those established programs and expanding our collaboration with outside dedicated organizations who are experienced and well-positioned to enhance these critically important services, we are committed to leveraging our core strengths to make a lasting difference in the lives of everyone affected by substance abuse.” ECMC’s efforts include: • Have collaborated with the following organizations to improve access to detoxification services: Save the Michaels, Seneca Nation, Sprout Health, VA Medical Center and BC/BS-HHS-City of Buffalo first responders • ECMC chemical dependency and emergency department

leadership collaborated on the development and implementation of sensitivity training for ECMC’s emergency department and inpatient chemical dependency staff to better serve patients presenting with substance abuse-related conditions. • Expanded ECMC’s existing inpatient chemical dependency by 10 beds. • Worked with WNIL’s Addict to Addict program to implement peer support in the emergency department. The peers meet with patients and their families to support their treatment decisions and provide education regarding community resources/support for their substance abuse issues. • Collaborated with Horizon Health Services to apply for a NYS OASAS Open Access Grant, which, if successful, will have ECMC provide enhanced chemical dependency coverage and oversight in its emergency department to ensure continuous, uninterrupted emergency intervention during the off-hours each week and on weekends when the communitybased Open Access Center is not accessible.

“ECMC has a strong legacy of caring and supporting patients experiencing substance abuse from opening an alcoholism clinic in downtown Buffalo in 1973 and in 1975 running the only Methadone detox program in Erie County,” said ECMC Corporation Senior Vice President for Nursing Karen Ziemianski. “Building on that strong legacy and working with our committed partners, ECMC is dedicated to helping those struggling with substance abuse and improving their lives.” Within ECMC’s Center of Excellence in Behavioral Health, ECMC offers individuals and families the most comprehensive alcohol and drug addiction rehab services available in Western New York, with inpatient and outpatient programs to support patients with their needed level of care. Currently, ECMC operates a 28-bed medically managed chemical dependency detoxification (withdrawal and stabilization) inpatient program for patients dependent on both drugs and alcohol.

times faster than inflation in just the last five years. Both President Trump and HHS Secretary Azar have vowed to bring drug prices down. Physicians with computers The paper record is virtually dead. A computer in the exam room, either hand held or on a stand, is as evident as an exam table. Computers are part of everyday life. Ironically, healthcare has historically been well behind other industries when it comes to computers. So, that all being said, just what does the average patient think of providers using computers in the exam room? The University of Texas conducted a study to find out. Participants were asked to watch two videos with exactly the same script. In one video, the physician used a computer. In another video, the physician used a notepad. Seventy-one percent of participants preferred the physician without the computer and ranked him higher on communication and professionalism. Realizing the computer is here to stay, researchers believe strategies that mitigate the perceived negativity of computers in the exam room are imperative to effective communication between provider and patient. Hopefully as providers become more familiar with their electronic medical records, their “art of eye contact,” while inconspicuously using their computer, should improve.     NPs and PAs Just as computers and electronic records are now generally accepted integral parts of healthcare, so too are advanced practice clinicians better known as nurse practitioners and physician assistants. There are now about 375,000 active NPs and PAs as compared to about 950,000 active physicians. The anticipated physician shortage would certainly be worse without the 375,000 advanced practice clinicians. By now, most of us have come into contact with a NP or PA in the course of our care. Initially used primarily for follow up care, to the care provided by a physician,

NPs and PAs now see new patients and provide acute care. In many instances, a NP or PA is the only provider on duty at many practices. Value-based care reimbursement and financial incentives for team-based care have further stimulated the use of NPs/PAs in both primary and specialty care settings.   Veterans care In response to recent criticism of the care provided by the VA system, the “VA Mission Act of 2018” has been introduced to Congress. It allows vets to seek care from private, non-VA providers in the general community. A caveat is the veterans, VA-based provider must agree that private care in the community is the best interest of the veteran. Timely access to care would be a critical consideration for the ultimate approval to go elsewhere. If the veteran is denied approval to receive care elsewhere, there is a clinical appeals process. 

Healthcare in a Minute

By George W. Chapman

Medicare: More Than $59 Billion Lost to Fraud


he lead article in the current AARP Bulletin explains Medicare fraud. Last year, Medicare spent $591 billion on claims. Medicare covers about 58 million senior and disabled Americans so that works out to $10,000 per enrollee. (11,000 to 12,000 people a day become eligible for Medicare.) According to Medicare, 10 percent of the $591 billion was lost to fraud which comes to about $1,000 a year per enrollee. However, many experts in the field believe the amount of fraud could actually be more. Commercial carriers like BlueCross BlueShield, Aetna, Cigna, United, etc., all investigate suspicious claims before paying them. Medicare pays claims and investigates after paying them. Crooks have opened

phony pharmacies or medical equipment stores, submitted phony claims using stolen social security numbers, made millions and closed down before Medicare got wise. The federal government spends a lot of money chasing fraud. The key is to prevent it in the first place. A major change is the current discontinuation of social security numbers for Medicare identification. All enrollees will have a personal ID number this year. The format will look like this: 1GJ5 HB5 LR72. Another change is the enrollment of Medicare members into Advantage plans that are run by commercial carriers. Finally, Medicare recipients can help fight fraud by reviewing their bills and reporting any service or item items not received. The Medicare fraud hotline is 800-633-4227.

DNA sequencing he medical community agrees that sequencing will help them pinpoint your treatment. In 2015, President Obama introduced the Precision Medicine Initiative and Cancer Moonshot projects as a way to get individually tailored treatment plans. While most insurers still consider DNA sequencing as “experimental,” which is their way of saying they won’t pay for it, the tide is turning. The Geisinger Health System, based in Pennsylvania, recently announced it will make DNA testing a routine part of preventive care, just like mammograms, colonoscopies and cholesterol tests. The “forecasting” provided by DNA testing allows physicians to provide active versus reactive treatment. Geisinger expects 10 percent to 15 percent of their patients will benefit from the testing. While most industry experts see the benefits of DNA testing, they are

concerned about privacy and the use of the results, which will predict the diseases a person is prone to, by life and health insurance companies.


Uninsured rate up The number of uninsured Americans is heading in the wrong direction, according to a Commonwealth fund survey. The number of uninsured has increased to 15.5 percent as of March 2018. That is up from 12.7 percent in 2016 and is expected to increase further, primarily due to the gutting of the Affordable Care Act and particularly due to the repeal of the individual mandate. Premiums for those seeking insurance on the exchange will increase as younger and healthier people drop coverage. Drug prices continue to be virtually uncontrolled and add significantly to everyone’s premium increases, not just those on the exchange. According to a congressional report, drug prices have risen 10

June 2018 •

Rural healthcare CMS has recently vowed to take into consideration how their proposed policies and payments might, inadvertently, negatively impact rural-based physicians and hospitals. Sixty million of us live in rural areas which have higher rates of poverty and under-insurance as well as larger gaps in the delivery systems versus urban areas. CMS plans to increase its rates for telemedicine and make it easier for rural providers to bill for them. 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

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drive its growth so long ago. There are also relaxing cruises that tour the Buffalo River, Harbor and Canalside. There’s no better way to experience one of the wonders of the world — Niagara Falls — than being up close and personal on the Maid of the Mist boat tour. You’ll enjoy amazing views and the thundering roar of 600,000 gallons of water falling right before your eyes — it’ll be the ride of your lifetime.

estern New York summers might be short, but we certainly know how to make the most of those lazy, hazy crazy days by boating, sailing, swimming, touring, fishing and, yes, even biking on the many waterways that frame our region — including two Great Lakes and the mighty Niagara River. If Paddling’s Your Pleasure… If you’d like to enjoy a slightly different view of the Queen City, either on your own or in a group, try kayaking or stand-up paddleboarding. There are plenty of places where you can rent everything you’ll need, including Buffalo Harbor Kayak; Elevator Alley Kayak or Silo City Paddling Co, and they’re both great ways to leisurely explore the beautiful city from the water. Come Sail Away! Have you ever driven along Interstate 190 and noticed the colorful sailboats dotting the water … and wished you were out on one? Well, you can be! There are many ways to enjoy sailing in Western New York. Never sailed? Take lessons through Buffalo Harbor Sailing Club’s Discover Buffalo Sailing program or through Seven Seas Sailing Center. “Sailing is more than just fun in the sun,” says Diana Augspurger, past commodore of Buffalo Harbor Sailing Club. “It’s the ultimate stress release that will lift you from your everyday world. Everyone who has a love of water should try sailing at least once. To feel the strength of the wind as the boat glides through the water without the use of a motor is exhilarating.” Want someone else to do the navigating while you relax and enjoy? Charter a boat through Seven Seas or Make Sail Time. Let’s Go Cruisin’ Looking for a different way to celebrate a birthday, anniversary or other special occasion? Cruise options abound, including the 56-foot long, 31-inch wide MoondanceCat catamaran, which can accommodate up to 75 for group charters and includes wet bar, enclosed seating and dining area, sound system and plenty of space to tan. On the Spirit of Buffalo, a classic 73-foot topsail schooner, you can enjoy day, evening and sunset sails, along with special events, such as children’s pirate Page 8

Biking…On The Water? Yes, definitely! Water Bikes of Buffalo offers unique ways to experience our waterways: via water bikes, adult pedal boats and children’s paddleboats as well as stand up pedal boards. If you want to pedal, party and float, try Buffalo CycleBoats, the area’s only humanpowered cycle boat. Or take a relaxing tour around Buffalo’s Inner Harbor on a Hawaiian style tiki hut through Buffalo Tiki Tours, which offers a variety of cruise options (including onboard weddings). And here’s a great way to enjoy the natural beauty of Delaware Park: rent a quaint wooden rowboat and paddle around serene Hoyt Lake.

Fun on the Water! This summer, don’t just take advantage of all there is to do near the water…get out there on the water! By Nancy Cardillo cruises, craft beer cruises, educational excursions and Wine in the Wind. You can also book this beauty for private charters. Buffalo Harbor Cruises has been sailing the local seas for more than 40 years, offering sightseeing cruises, party cruises, corporate events and private charters aboard the Miss Buffalo II on routes that include the Buffalo River; Outer Harbor; Lake Erie; Niagara River and the Black Rock Lock and Canal. The Grand Lady is the area’s only dinner cruise

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

vessel, and boasts both public and private cruises. Enjoy a lazy lunch and sightseeing cruise or an evening happy hour and dinner cruise. It’s also available for private charters. For a unique cultural experience, cruise through history on any one of a number of boat tours offered May to October. Buffalo River History Tours offers narrated tours that tell the story of the Erie Canal and Buffalo’s history as the largest grain port in the world as you gaze at the magnificent structures that helped

Angling For a Good Time Fishing is an extremely popular sport here in Buffalo. Whether it’s smallmouth bass, walleye, muskellunge, trout or salmon, our waterways are thriving with opportunities to cast your line and enjoy a relaxing experience. Go out in your own boat, or take a charter through Jim Hanley’s Fishing Charters, Niagara River Fishing Charters, Lake Erie Fishing Charters or Sparky’s Fishing Adventures. Want the Boating Without the Hassle? Here’s a great way to enjoy the benefits of boating without the hassle and expense: join Buffalo Boat Share. Members enjoy a seasonal recreational boating experience for far less than the cost of normal ownership. It’s “everything you love about boating, without the hassles!” And, last but not least, there’s the Queen City Bike Ferry. OK, its main purpose is to shuttle bicyclists and pedestrians between Buffalo’s inner and outer harbor, but still…it’s a watercraft that gives you access to such attractions as Wilkeson Pointe Park; Times Beach Nature Preserve, the Chinamen’s Lighthouse and more.

Juuling: E-cigs Craze Hooks More Kids By Deborah Jeanne Sergeant


ou’d surely notice the tell-tale odor of cigarette smoke on your child if he or she were lighting up. But e-cigarettes make nicotine addiction stealthy. E-cigarettes use water vapor as the means to deliver nicotine. Their use is skyrocketing among young people. According to the Campaign for Tobacco Free Kids, 20.6 percent of New York state high school students use e-cigarettes, compared with 4.3 percent who smoke. While it may appear e-cigarettes offer a harmless, smoke-free diversion, Daniel Stapleton, public health director for Niagara County, said that nicotine “affects the developing brain and the damage it does is incredible. Substances in e-cigarettes cause cancer and very serious lung diseases. Heavy metals like lead, nickel and tin are in the Stapleton aerosol vapor.” Physician Leslie J. Kohman said, “The American Cancer Society strongly recommends that every effort be made to prevent the initiation of e-cigarettes by youth.” Kohman serves on the board of directors of the Eastern Division Board of the American Cancer Society. Kohman She’s also a thoracic surgeon specializing in

thoracic oncology at Upstate Medical University in Syracuse. Ironically — and, many experts believe, inappropriately — marketed as an alternative for established smokers or cessation aid, e-cigarettes contribute to youth picking up smoking combustible cigarettes, according to a 2018 report by the National Academies of Science, Engineering and Medicine. “I think they’re being marketed to young people,” said physician Gale R. Burstein, commissioner of health for the Erie County Department of Health. “Some look like a flash drive. Young people are attracted to electronics. It’s visually appealing.” She refers to the design of one brand, JUUL, which appears to be a sleek, cylindrical USB flash drive and even charges Burstein in a USB port. JUUL’s replaceable cartridges, which contain the nicotine “juice” come with flavors adolescents like, such as mango, fruit medley and crème brulee. So many children use that brand that the slang term “Juuling” was coined to describe the habit. JUUL products comprise half the e-cigarette market. Burstein views e-cigarettes as a natural stepping stone to combustible cigarettes. In a statement on the company website, JUUL Labs CEO Kevin Burns said that the company is “committed to deterring young people, as well as adults who do not currently smoke, from using our products. We cannot be more

emphatic on this point: No young person or non-nicotine user should ever try JUUL.” Despite the statement, the fad of Juuling has become widespread enough that schools have developed policies about e-cigarettes because of the potential for harm. “No one should smoke cigarettes, and every effort should be made to get smokers off all forms of tobacco and to prevent everyone, especially youth, from starting to use any tobacco product,” Kohman said. “Smokers are strongly advised to use proven cessation methods, such as prescription medications and counseling, to quit smoking.” Though likely less harmful than combustible cigarettes, little is known about the full extent of the harm caused by e-cigarettes. JUUL’s website states that their product “contains chemicals known to the state of California to cause cancer and birth defects or other reproductive harm” according to California Proposition 65. Mike Seilback, vice president of advocacy and communications at the American Lung Association New York in Albany, wants the federal government to find out exactly what the products contain. Many brands of e-cigarette cartridges, for example, are imported from China and have no oversight as to what is in the chemical cocktail that produces the flavor. JUUL’s website states that some components of their products are domestic and some are imported. “The FDA still hasn’t regulated these products in a way that we know exactly what is in these products,” Seilback said. “We know that when some of these products over the entire market were labtested, ones claiming to be nicotine free weren’t.” He isn’t sure if that was

intentional or lab errors; however, he said that “inhaling anything into your lungs, say anything of something mixed in a lab thousands of miles away, isn’t the safest thing to do.” Seilback believes that the Juuling trend has reversed decades of work to make tobacco use unappealing to young people. “We now see teens proudly declaring they are JUUL users,” Seilback said. “They might hide it from their parents, but it’s gotten to the point where it’s cool to their peers in identifying with these products. “We’re alarmed we might see a generation of youth who are addicted to tobacco products without realizing the long-term effects.” Physician Bridget Messina serves as clinical assistant professor of pediatrics, University at Buffalo. She is also an attending physician, division of general pediatrics at UBMD Pediatrics and Oishei Children’s Hospital. She said that non-nicotine e-cigarettes, legal to sell to those younger than 18 in New York, still contain chemicals that may harm the lungs. “We think in the pediatric community that they’re marketing to the middle school population,” she said. “They’ve been banned in some countries, but not in the US. They should not be sold to any children under 18.” Parents should talk with their children about the dangers of e-cigarettes, especially since no longterm studies indicate that e-cigarettes are any safer than combustible cigarettes.





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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

What My Garden Has Taught Me


ardening season has finally arrived, as witnessed by the abundance of daffodils, forsythia and gorgeous flowering trees. June is the perfect time for us to dig in and get our hands dirty! And it’s a good time to reflect the many life lessons that gardening offers to those who live alone. It has taught me the value of planning, preparation, patience, and pleasure — four essential “P’s” for a bountiful garden and ... a bountiful life. Fertile ground exists in each of us, and a little tending can produce beautiful results. Here’s what I have learned: n Plan. Realizing the garden of your dreams begins in your imagination, followed by careful planning. Diagram your garden and it will help you avoid planting bulbs on top of bulbs or mistaking a poppy for a weed. Likewise, envisioning your life

goals and committing them to writing can help you flourish and grow. n Cultivate. Good, cultivated soil promotes healthy, deep roots. When you add fertilizer to your garden you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows. You can’t go wrong with good, nutritious food; a walk in nature; a good book; soothing music; or saying “yes” to a new adventure that’s been tugging at your heart. n Plant. So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage. And remember: We reap what we sow, so follow your dreams. Plant a rose and you get a rose; plant a dandelion and you get a dandelion. Seed your future with healthy choic-

es that promote well-being. n Weed. We all need room to breathe and positive space in which to blossom. It holds true for your garden and your life. Gardening is all about consistent caretaking. Slack off, even for a few days, and all things unwelcome show up and take root. Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil your fun. When you pull out the bad, you can more easily focus on the good in your life. n Prune. When weeding is not enough, a major pruning may be just what the arborist ordered. A job, relationship or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.” n Mulch. Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch. Mulch offers a blanket of protection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. We can learn a lot from mulching. n Wait. We all know that “good things come to those who wait” and it’s not just what comes out of the Heinz ketchup bottle. When you exercise patience, go slowly, and enjoy the gradual unfolding of a flower, an idea, or a friendship, your life can be savored and more deeply appreciated.

s d i K Corner

Kids of Youngest, Oldest Moms at Risk of Developmental Issues: Study


hildren with the youngest and oldest mothers may be at increased risk for developmental vulnerabilities, a new study reports. Researchers analyzed data from nearly 100,000 children and found that overall, 21 percent of them had at least one developmental vulnerability at age 5. The rate was highest (40 percent) among those born to mothers age 15 and younger. It then steadily decreased to the lowest rate (17 percent) among children born to mothers aged 30 to 35, and then rose to 24 percent among children born to mothers aged 35 to 45. Social and economic disadvantages accounted for at least half the increased risk of developmental vulnerabilities among children born to Page 10

young mothers, according to the authors of the study, published recently in the journal PLOS Medicine. “To our knowledge, this study is the largest scale evidence internationally on the relationship between maternal age at childbirth across the whole distribution of maternal ages and early childhood development,” Kathleen Falster, of the University of New South Wales in Sydney, Australia, and colleagues wrote. “Further research to better understand the mechanisms that underlie the elevated risk of developmental vulnerability … may inform policies and interventions to promote positive child development across the population,” the researchers added in a journal news release.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

Each year, I look to my garden to remind me that growth takes time. n Enjoy. Before you know it, your labor of love and patience will pay off. Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives. So get busy, then step back and take a good look. There’s nothing quite as satisfying as admiring what you’ve accomplished. It’s reason to celebrate! By osmosis, gardening has taught me how to take better care of myself. I have absorbed its rich messages and learned how to nurture my inner garden and growth as a women on her own. I encourage you to grab a spade and join me. Beauty, growth, and an energizing sense of renewal can be yours, season after season after season.

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to invite her to speak, or to purchase her new book, call 585-624-7887, email her at gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.


The skinny on healthy eating

Boost Vitamin C with Sugar Snap Peas


cross between snow peas and regular green peas, sugar snap peas have a lot going for them. One, the entire pea is edible, including the pod. Two, they’re a fantastic source of vitamins, minerals and other nutrients that promote good health. And three, they’re low in calories (only 40 per one-cup raw), deliciously crunchy and a terrific vehicle for hummus and vegetable dip. One of the most notable health benefits of sugar snaps is their high vitamin C content: one cup boasts nearly 100 percent of our daily needs. This workhorse vitamin speeds wound healing, boosts immunity and aids in the production of collagen. A powerful antioxidant, vitamin C also helps to neutralize free radicals — unstable atoms that can damage cells, causing illness, aging and premature wrinkling. During the summer, vitamin C is especially important for heat regulation. According to research, vitamin C helps to prevent serious

low amount of sugar. Non-starchy vegetables like sugar snaps keep blood sugar in check and can actually aid in the prevention of diabetes.

Sugar Snap Peas and Noodles with Ginger-Sesame Sauce

problems caused by excessive heat — such as heat stroke and heat rashes — by keeping sweat glands in good working condition. Sugar snaps are surprisingly good for bones, as they boast decent levels of four important nutrients that contribute to normal bone growth and overall bone health: vitamins A and K and the minerals manganese and iron. Beset by osteopenia now, I’m always on the lookout for foods that will fortify my bones and prevent osteoporosis later. Hearts benefit from this tasty pea, too. From its low fat content to its cholesterol-clearing fiber to its folate (a B vitamin that may reduce the risk of heart disease and stroke by nearly 20 percent), sugar snaps may keep our tickers tocking longer. Are sugar snaps full of sugar and bad for diabetics and others watching their sugar intake? No! According to the American Diabetic Association, we should snap up this non-starchy vegetable with its complex carbs, low glycemic index and relatively

Helpful tips

Look for pods that are bright green and crisp (when broken in half, they should make a snapping sound). They can be refrigerated for two to three days, but will be sweetest if cooked or eaten raw as soon as possible after purchase. Do not wash until ready to use.

Adapted from Cookie and Kate 8 ounces soba noodles or spaghetti noodles of choice 3 cups sugar snap peas, trimmed and cut diagonally in half 2 cups frozen edamame 3 large carrots, peeled and julienned 1 medium red pepper, chopped 2 tablespoons minced shallots (optional) ½ cup chopped fresh cilantro Ginger-Sesame Sauce ¼ cup reduced-sodium soy sauce 2 tablespoons extra-virgin olive oil 1 small lime, juiced 2 teaspoons sesame oil 2 teaspoons honey or agave nectar 1 clove garlic, minced 2 teaspoons freshly grated ginger 1 teaspoon Sriracha or pinch of red pepper flakes (optional)

Bring a big pot of water to boiling. Add the soba noodles and cook for five minutes. In the last 20 seconds of cooking, add the sugar snap peas. Drain and rinse the noodle-pea mixture in cool water. Drain again. Prepare edamame according to package directions. Drain. Place the noodles and peas in a large bowl. Add the carrots, pepper, edamame, and shallots. Whisk together the dressing ingredients and add to the noodle mixture. Top the salad with cilantro and serve.

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.

Snack Your Way to Your Eating Nuts Linked to Lower Odds of Having AFib Summer Weight



ealthy snacking throughout the day can help you maintain your ideal weight, or even drop a few pounds in time for swimsuit season. “When you snack on the right foods, you tend to consume fewer calories throughout the day,” said Patricia Salzer, a registered dietitian and health and workplace wellness consultant at Excellus BlueCross BlueShield. “You’ll feel fuller longer and be less likely to overeat or reach for unhealthy foods.” In addition to looking good at the beach, individuals who stay at a healthy weight reduce their risk of heart disease, stroke, Type 2 diabetes, high blood pressure, osteoarthritis, and some forms of cancer, Salzer said. Rather than snacking on cookies or chips, Salzer recommends having a handful of raw almonds. She divides a day’s serving (about 23 almonds) into snack size bags and leaves them in key locations such as her desk, purse and the beverage cup holder in her car. Another healthy snack idea is to pair a small amount of cheese with whole grain crackers. The protein in the cheese will keep you from feeling hungry, Salzer said. The Centers for Disease Control

and Prevention offers the following healthy snacking tips: n Try three cups of air-popped popcorn instead of oil-popped popcorn. You’ll consume 73 fewer calories. n Avoid the vending machine. Pack an eight-ounce, nonfat, no sugar added yogurt. That’s 82 fewer calories compared to a package of six peanut butter crackers. n Consider packing vegetable sticks and fresh fruit, “nature’s fast food,” Salzer said. n Substitute a sugary 12-ounce can of soda with a bottle of carbonated water for 136 fewer calories. n Instead of chocolate sandwich cookies or other sweet snacks, eat a bowl of berries or a juicy peach. For fresh fruit ideas that will help you manage your weight, visit fruitsandveggiesmorematters.org.

n a large study, Swedish researchers found that eating nuts three or more times a week was associated with an 18 percent lower chance of having AFib. It also helped cut the odds of heart failure. “Even a small increase in nut consumption may have large potential to lead to a reduction in incidence of atrial fibrillation and heart failure in this population,” the study said. Lead research Susanna C. Larsson, PhD, of the Karolinska Institutet in Stockholm, Sweden, said nuts are rich sources of unsaturated fatty acids, protein, fiber, minerals, vitamin E, folate, and other chemicals. Previous studies have suggested that eating nuts may have antioxidant and anti-inflammatory effects, and can improve blood cholesterol, help blood vessels work better, and prevent weight gain. The researchers analyzed data from two Swedish studies in which 61,364 people had completed a questionnaire about their eating habits and were followed for 17 years. People who ate nuts tended to be better educated and to have healthier lifestyles than those who didn’t. They were less likely to smoke or to have a history of high blood pressure. They weighed less, got more exercise,

June 2018 •

drank more alcohol, and ate more fruits and vegetables. Each extra portion of nuts eaten during the week was associated with a 4 percent decrease in the chance of having AFib. Researchers also saw less heart failure with people who ate moderate (but not high) amounts of nuts. The researchers say this might be related to higher weight gain with more consumption. The researchers say they cannot rule out that the links are due to things they didn’t account for, such as income and occupation, because these were not known. But they say the strength of the study lies in its large size and the large number of heart disease cases reported.

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For People with Diabetes, New App Provides Nearly Instant Feedback Independent Health encouraging diabetic members to download Brook, an app that links users to real time experts and personal data You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org

WE’RE HIRING! Trillium Health is growing, and we’re looking for candidates like YOU! Currently recruiting: Community Health Specialist Consumer Relations Specialist Licensed Practical Nurse (LPN) Registered Nurse (RN) and more! To view these positions and others, visit trilliumhealth.org!

Page 12

By Jana Eisenberg


new software application, the Brook Personal Diabetes Assistant, fits perfectly with the age we’re living in—while embracing personal responsibility, it folds in elements of technology and ever-improving artificial intelligence to make people’s lives better. Brook is a free smart phone application available for both iPhone and Android. It combines easily accessible, interactive digital technology with intelligence from both data-analysis and real people (registered dietitians and certified diabetes educators) to provide personalized feedback and guidance to its users: people living with diabetes. The Brook app is promoted as simple to use and innovative in its responsiveness. Among many other features, it stores and displays a user’s diabetes data, like blood glucose readings, medications, food and activity, with the option to download and print out. Brook can also connect other devices, like fitness trackers, to provide insight into strategies for maintaining healthy and safe glucose levels. Wonder what yogurt to buy while you’re at the store? Text your question to Brook, and you’re likely to get an answer before you get to the checkout. The app even analyzes your data and translates it into tips and suggestions. The app is working so well that Western New York health plan Independent Health has partnered with Brook, and is encouraging their diabetic members to use it. Part of the motivation for both patient and health plan is that when diabetes patients are able to sustain healthier levels, they need less medication, saving everyone money. Of course, Brook does not replace advice, guidance and education that users receive from their doctor, health care team and diabetes management classes; rather it complements that information by helping people better manage their diabetes on a day-to-day basis. Brook CEO Oren Nissim is both an executive in the company and a daily user of the app to help with his Type 2 diabetes. “Everyone is trying to be healthier; when you have a chronic condition, it becomes harder to figure out the right choices,” Nissim said. “Brook helps me with solutions between doctor visits.” As far as who’s using it, and what technological skills and equipment are needed, Nissim said that it’s as easy as texting, which most of

The Brook app is promoted as simple to use and innovative in its responsiveness. Among many other features, it stores and displays a user’s diabetes data, like blood glucose readings, medications, food and activity, with the option to download and print out. us already do. And, while Brook has users well into their 80s, the median user age is around 60. “Brook has made everything incredibly simple,” he said. “There are many easy ways to get your data into the app. We want to make our users happy. Like most consumers, they want something that’s easy to use and gives good results.” As a person living with diabetes, Betsy Manning began using Brook over a year ago; her experience echoes Nissim’s hopes for the app. Manning, 54, an Independent Health member who lives in South Buffalo, is now committed to the app and said it has noticeably helped to improve her health, her awareness and feelings of well-being. “I was in the hospital after a car accident, and I got an email from Independent Health about the app,” recalled Manning. “I thought, what the heck, I’d try it. Before I started using it, of course I tested my blood sugar…but knew that I should be testing it more. Once I started using Brook, it helped me to sit down and see what I eat; I’ve learned what good carbs are and know which to stay away from.” “Brook checks in with me at least once a week. I can schedule a one-onone with a real dietitian if I want, or

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

text my question and I get an answer usually within 10 minutes,” she said. “They’re very encouraging and supportive. And when you get good numbers, that makes you want to keep doing what you’re doing.” Nissim acknowledges that it can be frustrating to try and maintain healthier habits. Brook, he said, can provide “lightbulb” moments that help people realize their goals are achievable. “Brook provides consistent help when people need it,” said Nissim. “It might be ‘What do I eat for dinner,’ or ‘I’m tired of doing this.’ We deal with all of it, even human behavior, 24/7. Blood sugar a little high? Take a 10- to 15-minute walk and have a drink of water. It will go down.” Brook even texts users acknowledging data-based patterns, like, “I’ve noticed that you’ve been sleeping well, how is your blood sugar doing?” These can help a person understand that even little things can make an impact. That impact been great for diabetes patients who are successful Brook users. “Starting to use the app made me realize that I have to take care of myself,” Betsy Manning said. “I don’t want to die from something that can be taken care of.”

Complementary MEDICINE Is Integrative Medicine Right for You?


ny approach that differs from conventional — or Western — medicine is typically considered complementary and alternative, or CAM. But these practices have

become much more mainstream, leading to growth in the health care approach called integrative medicine, which draws on traditional and non-traditional systems tailored to each individual’s needs.


The U.S. National Institutes of Health agency that reports on CAM therapies has even changed its name to the National Center for Complementary and Integrative Health, to better reflect this shift in philosophy. Getting familiar with integrative health will help you decide if it’s the approach you want. Integrative medicine focuses on your well-being and considers all aspects of your health: physical, emotional, mental, social, spiritual and environmental. It draws on whatever medical approaches — traditional or alternative — will serve you best. Integrative medicine centers are now part of many leading institutions across the United States, such as the University of Arizona, Duke, Scripps, Vanderbilt and the University of California, San Francisco. Board certification for practitioners from the American Board of Integrative Medicine was introduced in 2014. These advances

have made it easier to find integrative doctors and medical centers. Key Tenets of Integrative Medicine:

• Creating a partnership between patient and practitioner. • Using conventional and alternative methods as needed, and less-invasive yet effective interventions when possible. • Focusing on prevention and promoting good health as well as treating illnesses. • Training practitioners to be models of health and healing. Prevention is a hallmark of integrative care because it’s easier, less expensive and better for people to avoid an illness rather than have to treat and manage one. Integrative medicine also recognizes that physical illnesses can affect you emotionally and vice versa, so all aspects of your wellbeing are addressed.

Can Complementary Medicine Help? Experts say a number of therapies can help in the treatment of cancer and its side effects By Deborah Jeanne Sergeant


ll any patient with cancer wants is healing and to reduce side effects during and after treatment. An increasing number of patients consider and turn to complementary medicine. Physician Sanford Levy, who practices integrative medicine in Buffalo, said that some cancer patients come to his practice for improving their health overall — and thus improve their chances of beating cancer with traditional care. Still others come to him after conventional care can no longer offer them help and they’re facing hospice care. “They want to live longer and better,” he said. “I have options, but how often it will make a difference for those hospice-bound patients is few and far between.” He thinks many more cancer patients are turning to complementary medicine and that’s why more Western practitioners are integrating various modalities into their practices. “Focusing on coping with conventional treatment is the biggest area where the two are being blended together,” Levy said. Gaining support for the journey through cancer draws patients to Invision Health in Williamsville, according to Linda Ann Taylor, board certified adult nurse practitioner at Invision Health.

“They want help in getting through traditional treatments,” she said. “Others have a huge history of cancer and are worried could they have that risk down the road, so we have tests we can do.” While no one can guarantee they can prevent cancer, maintaining vitamin D levels, eating right, exercising and reducing any controllable factors may help reduce risk. “It’s about making better choices to make your body healthier,” Taylor said. Rob Jones, board member of Buffalo Wellness, also serves as executive director of the Breast Cancer Network of WNY. He said that many people at risk for cancer or who have a diagnosis want to find things they can control. “When they’re in treatment and being told what to do when to do it and what to take, they lose control. With complementary care, they can pick and choose.” He also sees benefits to patients’ general wellness by improving mood and bolstering their baseline health. “Many classes like yoga and tai chi can provide camaraderie, so that gives them a sense of community,” Jones said. Physician Joanne Wu is a certified yoga instructor and integrative wellness coach, board certified in rehabilitation medicine

and holistic medicine, specializing in wellness. She sees clients in Buffalo and other lcoations. She’s part of the integrative oncology program of Wilmot Cancer Center, affiliated with the University of Rochester Medical Center in Rochester. “Patients’ bodies are changing so rapidly,” Wu said. “They need a lot of support.” Since treatments like chemotherapy and radiation kill healthy and malignant cells, they take a toll on patients’ bodies. Wu said that using complementary modalities helps mitigate these effects. “Co-morbidity like depression,

June 2018 •

anxiety, nerve damage that increase falls are common side effects not well managed with the traditional model,” Wu said. Acupuncture often helps control pain. Yoga, as another example, reduces stress, depression and anxiety, while improving sleep. Every cancer patient should discuss any complementary medicine treatment before attempting it to ensure it will augment and not hinder the traditional Western treatment they’re undergoing. Their complementary practitioner should also know about the Western treatment they receive.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 13

Complementary MEDICINE Benefits of Integrative Medicine Extend Beyond Wellness: Mayo Clinic


ntegrative medicine has become an increasingly popular way to enhance treatment for health concerns. At Mayo Clinic, two forms of integrative medicine acupuncture and massage have already helped numerous patients. In a review of several case studies in Explore, Mayo Clinic researchers examined the potential role of integrative medicine as a therapeutic and diagnostic benefit when combined with a patient’s treatment plan. A massage therapist’s ability to have hands-on contact with a patient and potential for seeing patients for multiple sessions not only can relieve symptoms, but also aid diagnostic detection. Such was the case in a study where Mayo Clinic researchers observed a patient who underwent a partial small bowel resection and was being followed up with massage for persistent pain. The massage therapist detected tenderness upon palpating an area and alerted the patient’s care team. Subsequently, the team found an intestinal leak and infection in the abdominal cavity. “We have done over two dozen studies on massage and acupuncture


showing the benefits that both treatments have on patients. Skilled practitioners of integrative medicine are able to be a member of the care team and contribute their expertise, while also delivering care directly to patients,” says physician Brent Bauer, director of research for Mayo Clinic’s

integrative medicine program, who is the lead author. Acupuncture is another treatment that has been widely noted for its role in helping with chronic pain management. “Our experience with patients at Mayo Clinic confirms that we see a tremendous number

of patients for which acupuncture is a central part in their pain management strategy,” says Bauer. Along with pain relief, acupuncture also can play an important role in assessing underlying health issues. Another case study focusing on acupuncture treatment at Mayo Clinic revealed that a mass was identified on a patient who initially was referred for acute upper-back pain. The acupuncturist noted a small mass in the muscle and brought it to the attention of the primary doctor. Subsequently, an ultrasound of the area was ordered, which showed that the mass was positive for sarcoma. As these case studies show, bringing acupuncture and massage into the clinical setting can have benefits that extend beyond therapeutic wellness. Acupuncturists and massage therapists can bring another level of healing and a second set of eyes to a patient’s overall treatment plan. As Bauer notes, “That is the definition of integrative medicine in a nutshell — combining the best of both worlds to optimize health and healing for our patients.”

Things You Need to Know About Cancer & Food

By Ernst Lamothe Jr.


ood is fuel for your body. And just like in cars, if you put the wrong fuel inside, something unfortunate is likely to occur. Bad eating habits can lead to an array of medical outcomes, including cancer. What you decide to consume for breakfast, lunch, dinner and snacking can have a detrimental outcome on your quality of life. Cancer risk reduction starts with a healthy diet. “The importance of eating a balanced diet is twofold,” said pediatric oncologist Kara Kelly, who teaches pediatrics in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. “For one, you want to get the synergy of the combination of nutrients, particularly from the more plant-based foods. The second is that these same foods are low in calories and therefore reduce the risk of excess fat and weight gain.” Kelly —— who also serves as program director for pediatric hematology/oncology at the John R. Oishei Children’s Hospital of Buffalo, offers five connections between food and cancer.


What you eat, if done in a balanced way, can help to prevent cancer. What has been shown to be important is a diet that’s balanced in vegetables, fruits, whole grains, beans and other plant foods, Kelly said. It’s the synergy of all these Page 14

foods in combination that is associated with reduction cancer risk rather than a single nutrient from the foods. “For patients with cancer, it can help reduce the side effects of treatment,” said Kelly. “But there’s no single food that prevents cancer. You can’t take vitamin C or selenium or any other single nutrient and prevent cancer.”


Make your calories count, and that’s about what you eat as well as what you don’t eat. Fill your plate more than twothirds full with plant-based foods — veggies, fruits, whole grains, beans — and limit your intake of processed foods and fast food and foods high in saturated fat. “We often recommend that you eat a rainbow of colors,” said Kelly, who is co-author of “Integrative Strategies for Cancer Patients: A Practical Resource for Managing the Side Effects of Cancer Therapy.” “The more intensely colored foods and vegetables tend to be richer in antioxidants.” Antioxidants are important because they help to reduce some of the risk of damage to DNA, which is associated with cancer progression. Kelly led a study few years ago, where researchers looked at the foods people were consuming. “Based on questionnaires we got back about the foods kids with cancer were eating,

the only fruits and vegetables on the list of most frequently consumed foods were French fries and orange juice. “There wasn’t what we would consider to be a healthy fruit or vegetable on the top 10 list,” she added. “We generally emphasize, not just for cancer patients but for everybody — vegetables, fruits and fiber.” She suggests opting for cereals based on oats, barley and bran rather than some of the sugar-sweetened cereals. In addition, use breads with whole grain, stone-ground flour or sourdough rather than breads with white flour. Kelly also suggests reducing the amount of potatoes and white rice.


A healthy and balanced diet is important not just for prevention but also for improving tolerance to chemotherapy among patients with cancer. In a study Kelly conducted looking at nutrition status in children with leukemia, she found that it really wasn’t a single nutrient that protected the patients, but a diet rich in antioxidants reduced their risk of developing infection and other toxicities from the treatment.


It’s not just about food; you’ve got to move too. Exercise is free medication. Almost every health ailment can

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

Pediatric oncologist Kara Kelly is the program director for hematologyoncology at the John R. Oishei Children’s Hospital. either be linked to not exercising or can be improved because of it. “Staying active is a great way to make sure you’re reaping the benefits of your healthy choices when it comes to the food you eat,” said Kelly.


Getting the whole family behind healthy eating is really important. And no one should view healthy eating as a diet; it’s not about calorie restriction, it’s about better choices. “Cooking together as a family can be a great way to do this,” said Kelly, “Even if you start with baby steps, like committing to eating right for one day a week, you can really make a difference and start on a path to eating better and feeling better.”

Complementary MEDICINE

Complementary Medicine Becoming Mainstream One third of Americans report using some form of complementary medicine By Deborah Jeanne Sergeant


bout one-third of Americans use complementary or “integrative” medicine, according to the most recent statistics offered by the National Institutes of Health. Complementary medicine describes using evidence-based practices to support health in conjunction with — but not replacing — Western health. “Alternative health” tends to describe modalities replacing Western health care. Many complementary medicine methods have ancient roots. Their recent growth in popularity represents a desire for more natural ways of supporting good health, according to physician Joanne Wu, a certified yoga instructor and integrative wellness coach, boardcertified in rehabilitation medicine and holistic medicine, who practices in Buffalo and other Upstate New York locations. Wu said that many patients have become turned off from rising costs and the side effects of Western medicine’s surgery and medication. “Invasive treatments have a lot of long-lasting, irreversible side effects,” Wu said. “People want to use everything that’s natural that will help them in the long run.” The holistic approach of complementary medicine, which addresses the person’s overall health rather than only reducing symptoms, appeals to many patients because it seems more personable and addresses the cause of the problems. Wu sees modalities that promote the mind/body connection as among the most popular, including yoga, tai chi, qi gong and mindfulness. “These reduce stress and pain and have been proven to improve outcomes,” she said. Natural approaches include eating a balanced diet of whole foods and using supplements and herbs. Wu cautioned that one drawback of supplements and herbs is the lack of regulation on the products, so

consumers must ensure they seek high-quality items. Les Moore, doctor of naturopathic medicine, certified herbalist and licensed acupuncturist, directs the Center for Special Medicine in Pittsford, near Rochester. He has served as president of the New York Association of Naturopathic Physicians and cofounded the White House Health, Tourism, and Recreation Task Force on Obesity. “In the past, the two paths were separated, Western and complementary medicine,” he said. “Now, more are sharing information on either path you choose to go or if you choose both paths.” Western primary care physicians Moore should know the modalities their patients choose and complementary medicine practitioners should know about any prescriptions and procedures in their clients’ care. It’s up to patients to ensure everyone knows what’s going on. Although more cooperation has made coordinating care easier, insurance coverage would make complementary care more accessible to all patients. Moore said that complementary care’s emphasis on preventing health issues and taking the least invasive method possible makes it generally less expensive and less time consuming than many conventional therapies. Physician Sanvord Levy practices integrative medicine in Buffalo. He believes that some of the growth of complementary medicine could be attributed to the internet. “In the clinical practice I have, 80 percent of my new patients are

putting down on the intake they learned about me through the internet,” Levy said. He thinks that the remaining 20 percent of his patients are comprised of referrals from doctors and chiropractors. “For decades, complementary medicine has been a movement that’s a consumer driven movement; they want options,” Levy said. “In many cases, mainstream medicine is realizing, based Levy on consumer demand, they need to learn something about this.” Like many other complementary medicine practitioners, Levy often treats cases difficult for Western medicine to address, such as chronic fatigue syndrome and fibromyalgia. Or, conditions such as hypothyroidism and adrenal dysfunction for which patients want different approaches than they say they can achieve with Western medicine. The holistic approach at Invision Health attracts many patients, according to Linda Ann Taylor, board-certified adult nurse practitioner at the Williamsvillebased office. “Functional, holistic medicine treats the whole individual,” she said. She believes that complementary medicine is expanding as more people want to live healthier, not just address symptoms as they crop up. The 90-minute initial exams represent just one way in which the

June 2018 •

approach differs from practices that offer only Western medicine. “We look at the whole person,” Taylor said. “Do they have trouble with their job, kids? How’s their stress? How’s their digestion? Do they have a thyroid problem no one’s uncovered yet? Adrenal problems? We’re trying to get people back into balance.” The practice offers specialties including primary care, neurology, rheumatology, acupuncture and more modalities. Rob Jones board member of Buffalo Wellness Center in Lancaster, has observed an increase of acceptance among Western medicine primary care providers. “Doctors are learning how to integrate non-traditional cares to support the care they give,” Jones said. “And patients turn to complementary medicine because they want to find things they can control. It allows them to pick and choose. They also want wellness. “It’s about being in good health to begin with and using preventative measures. “ At University Buffalo Neurosurgery, complementary medicine has a “synergistic effect on our patients” according to Andrea Privitera, certified holistic health coach. She helps patients understand how diet and movement effect their health. The center encourages antiinflammatory, whole, clean foods to support good health. The center also offers Pilates and yoga. Privitera said that looking at every aspect of patient health helps improve outcomes. For some patients, making many lifestyle changes to improve their health “is kind of overwhelming,” Privitera said. “I try to make it as underwhelming as possible.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 15

A child plays with toys at The Ronald McDonald House Family Lounge on the fifth floor of Oishei Children’s Hospital.

Lounge at Oishei Children’s Hospital Offers Respite The Ronald McDonald House Family Lounge, which opened at the hospital in November, offers a cozy space for parents and families By Jenna Schifferle


hen you exit the elevator to the fifth floor, just past the Winter Garden and chapel, you’ll find a quiet room amidst a bustling hospital. At the door, a ride-on toy waits across from a pair of striped socks in oversized red shoes. A kitchenette lines the right wall inside, and to the left, orange and blue flames leap upward. The heating element is disabled, but somehow you can still feel the warmth of the fireplace against the low lighting. On the back wall, a strawberry red couch sits beneath an assortment of pictures: kids playing, families smiling in front of a West Ferry house. They form a circle around four bold letters: RMHC. In the middle of it all, a small child stares with wonder at all the treasures the room has to offer. She pulls a puzzle off a shelf and begins to play as the

hospital buzzes around her. Ronald McDonald House Charities has been a staple in communities across the nation for decades. The local Ronald McDonald House on West Ferry Street in Buffalo has helped families of children undergoing medical treatment since 1983. By providing meals and a place to stay, the facility strives to take away the hassle of everyday life so families can focus on helping their child heal. Since its launch, it has expanded to include beds for 40 people, three suites with private bathrooms, a downstairs playroom, a laundry room, and transportation to and from the hospital. Now, the Ronald McDonald House of WNY has brought that same hospitality to the John R. Oishei Children’s Hospital.

Sally Vincent, the executive director of the Ronald McDonald House of WNY and Marianne Hoover, the hospital programs manager The Ronald McDonald House Family Lounge opened Nov. 13, 2017, thanks to a collaborative effort between Kaleida Health, the RMHC board of directors, and numerous architects, engineers and staff members. The concept is simple: a cozy space where parents and family members can grab a cup of coffee and take a moment. Some people come to relax, while others just want to grab a snack or bagel after a long day. Sally Vincent, the executive director of the Ronald McDonald House of WNY and Marianne Hoover, the hospital programs manager, were key players behind the launch of the family lounge. “We thought this was a great way to be able to help people from around the corner be able to have a quiet respite away from their child’s bedside, within steps of their child’s bed, within Children’s Hospital,” Vincent said. According to a 2015 research study published in the Journal of Health Organization and Management, over 90 percent of hospital administrators surveyed agree that having an affiliation with Ronald McDonald House Charities helps to reduce parental stress and improve the quality and quantity of sleep for caregivers. This has always been the main goal of the organization, and providing familycentered care is at the center of its mission. Whether at the hospital or the house, they are committed to helping others. Vincent said that there is one main difference between the two locations, despite the bond of hospitality. While the local Ronald

McDonald House serves as a resource for families traveling to Western New York for care, the family lounge directly supports the community of which they are a part. “We knew we could help many families that had to travel a distance to Buffalo for specialized care, but we wanted to help everyone: the people around the corner and our neighbors in Western New York — the ones who didn’t necessarily need to use the Ronald McDonald House,” Vincent said. Felicia Kostecky, the marketing and communications manager for the Ronald McDonald House of WNY, said they would never be able to achieve their mission without the outpouring of support from the community. They rely on donations and volunteers to operate their services. “It’s just amazing how the community comes together and stands behind these different projects and expansions. That’s the really cool thing with the Family Lounge — it [is] our chance to give back to our neighbors … in their time of need; in their time of crisis,” Kostecky said. When the family lounge first opened, Hoover had recruited 15 volunteers, which was enough to support a schedule of Monday through Friday. In a few short months, the number has nearly tripled, and the lounge is now open seven days per week. But Hoover said they are always on the lookout for more volunteers to manage the room and support upcoming projects. Starting on May 1, the Family Lounge introduced a new Happy Wheels Cart to their program. The cart has been donated by Fisher-Price in East Aurora, and it will allow the Family Lounge to mobilize its efforts within the hospital. Volunteers will deliver coffee, snacks, and toys door to door to provide comfort to families when they need it most. Kostecky, Hoover, and Vincent agree that the volunteers and sponsors who provide their time, talent, and treasures are what make initiatives like the Ronald McDonald House Family Lounge possible. Anyone interested in getting involved — whether it be by volunteering at the Family Lounge, cooking a meal for the House, or donating resources — can reach out to Marianne Hoover at mhoover@ rmhcwny.org or visit http:// rmhcwny.org/banner/volunteers/ . “It’s inspiring to see the resilience of these children and the positive attitude from day to day … it’s all about the moment, particularly for the children, and helping them to forget,” Vincent said.

Gardening Isn’t Just for Adults


till having a hard time getting your kids to eat fruits and veggies? Studies show one solution is to grow your own. Kids get excited as they watch a garden yield fresh foods and are more motivated to eat what they helped grow. It gives kids a good understanding of what it takes to get vegetables to the dinner table and teaches them about healthy food choices. Gardening is also a great way to take a break

Page 16

from all the technology, and get into extra exercise and enjoy being outdoors. Whether you have a small patio bucket or can allocate square footage in your backyard, start your planning now. It’s important to know which growing zone you are in, so use online resources to determine your right climate zone and planting times. To get kids interested, the Arizona Farm Bureau suggests

looking through colorful seed catalogs together and letting them help pick out choices. But you don’t need to bore them with every planning detail. Keep their responsibilities age appropriate. Older children can be more involved in the planning and design of the garden, harvesting and even preserving some of the yield. Younger children can help with planting seeds, weeding and watering, but try and get them their

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

own age-appropriate tools and gloves that fit them, according to the farm bureau. Little ones will enjoy their tasks more with gloves and tools sized for small hands. You should also give the kids their own space and vegetables so they have a sense of ownership with a gardening space all their own, within Mom’s and Dad’s larger plot.

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By Jim Miller

New Shingles Vaccine Provides Better Protection for Seniors Dear Savvy Senior, A good friend of mine got a bad case of shingles last year and has been urging me to get vaccinated. Should I?

Suspicious Susan Dear Susan, Yes! If you’re 50 or older, there’s a new shingles vaccine on the market that’s far superior to the older vaccine, so now is a great time to get inoculated. Here’s what you should know. Shingles, also known as herpes zoster, is a burning, blistering, often excruciating skin rash that affects around 1 million Americans each year. The same virus that causes chickenpox causes shingles. What happens is the chickenpox virus that most people get as kids never leaves the body. It hides in the nerve cells near the spinal cord and, for some people, emerges later in the form of shingles. In the U.S., almost one out of every three people will develop shingles during their lifetime. While anyone who’s had chickenpox can get shingles, it most commonly occurs in people over age 50, along with people who have weakened immune systems. But you can’t catch shingles from someone else. Early signs of the disease include pain, itching or tingling before a blistering rash appears several days later, and can last up to four weeks. The rash typically occurs on one side of the body, often as a band of blisters that extends from the middle of your back around to the breastbone. It can also appear above an eye or on the side of the face or neck. In addition to the rash, about 20 to 25 percent of those who get shingles go on to develop severe nerve pain (postherpetic neuralgia, or PHN) that can last for months or even years. And in rare cases, shingles can also cause strokes, encephalitis, spinal cord damage and vision loss. New Shingles Vaccine The Food and Drug Administration recently approved a new vaccine for shingles called Shingrix (see Shingrix.com), which provides much better protection than the older

New vaccine is 97 percent effective in preventing shingles in people 50 to 69 years old, and 91 percent effective in those 70 and older, says manufacturer

vaccine, Zostavax. Manufactured by GlaxoSmithKline, Shingrix is 97 percent effective in preventing shingles in people 50 to 69 years old, and 91 percent effective in those 70 and older. By comparison, Zostavax is 70 percent effective in your 50s; 64 percent effective in your 60s; 41 percent effective in your 70s; and 18 percent effective in your 80s. Shingrix is also better than Zostavax in preventing nerve pain that continues after a shingles rash has cleared — about 90 percent effective versus 65 percent effective. Because of this enhanced protection, the Center for Disease Control and Prevention recommends that everyone age 50 and older, receive the Shingrix vaccine, which is given in two doses, two to six months apart. Even if you’ve already had shingles, you still need these vaccinations because reoccurring cases are possible. The CDC also recommends that anyone previously vaccinated with Zostavax be revaccinated with Shingrix. You should also know that Shingrix can cause some adverse side effects for some people, including muscle pain, fatigue, headache, fever and upset stomach. Shingrix, which costs around $280 for both doses, is (or will soon be) covered by insurance including Medicare Part D prescription drug plans, but be aware that the shingles vaccines are not always well covered. So before getting vaccinated, call your plan to find out if it’s covered, and if so, which pharmacies and doctors in your area you should use to insure the best coverage. Or, if you don’t have health insurance or you’re experiencing medical or financial hardship, you might qualify for GlaxoSmithKline’s patient assistance program, which provides free vaccinations to those who are eligible. For details, go to GSKforyou.com. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Ask The Social

Security Office

From the Social Security District Office

Three Ways Your Social Security Payment Can Grow After Retirement


ou made the choice and now you are happily retired. You filed online for your Social Security benefits. They arrive each month in the correct amount exactly as expected. But did you ever wonder if your Social Security check could increase? Once you begin receiving benefits, there are three common ways benefit checks can increase: a cost of living adjustment (COLA); additional work; or an adjustment at full retirement age if you received reduced benefits and exceeded the earnings limit. The COLA is the most commonly known increase for Social Security payments. We annually announce a COLA, and there’s usually an increase in the Social Security and Supplemental Security Income (SSI) benefit amount people receive each month. By law, federal benefit rates increase when the cost of living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W). More than 66 million Americans saw a 2 percent increase in their Social Security and SSI benefits in 2018. For more information on the 2018 COLA, visit www.socialsecurity. gov/cola. Social Security uses your highest


Q: What is the maximum Social Security retirement benefit? A: The maximum benefit depends on the age you retire. For example, if you retire at full retirement age in 2018, your maximum monthly benefit would be $2,788. However, if you retire at age 62 in 2018, your maximum monthly benefit would be only $2,158. If you retire at age 70 in 2018, your maximum monthly benefit would be $3,698. To get a better idea of what your benefit might be, visit our online Retirement Estimator at www.socialsecurity.gov/retire/ estimator.html. Q: If I receive Supplemental Security Income (SSI) disability benefits, what is the effect on my benefits if I work? A: In most cases, your return to work would reduce your benefit amount. Unlike Social Security disability, there is no “trial work period” for people who get SSI disability benefits. If your only income besides SSI is from your work, you can earn up to $1,585 in a month (in 2018) before we stop your payments. RePage 18

35 years of earnings to figure your benefit amount when you sign up for benefits. If you work after you begin receiving benefits, your additional earnings may increase your payment. If you had fewer than 35 years of earnings when we figured your benefit, you will replace a zero earnings year with new earnings. If you had 35 years or more, we will check to see if your new year of earnings is higher than the lowest of the 35 years (after considering indexing). We check additional earnings each year you work while receiving Social Security. If an increase is due, we send a notice and pay a one-time check for the increase and your continuing payment will be higher. Maybe you chose to receive reduced Social Security retirement benefits while continuing to work. You made the choice to take benefits early, but at a reduced rate. If you exceeded the allowable earnings limit and had some of your benefits withheld, we will adjust your benefit once you reach full retirement age. We will refigure your payment to credit you for any months you did not receive payments. Your monthly benefit will increase based on the crediting months you receive. You can find additional information about working and your benefit at www.socialsecurity.gov/pubs/EN-05-10077.pdf.

porting wages each month helps us pay the correct amount of SSI. Timely reporting may also prevent you from owing us money or may allow us to pay a higher amount. We have several publications about SSI, including Reporting Your Wages When You Receive Supplemental Security Income, available at www.socialsecurity.gov/ pubs. Note that there are other work incentives that can help you return to work when you receive SSI. You can read about them in What You Need To Know When You Get Supplemental Security Income (SSI), also available at www.socialsecurity.gov/ pubs. For more information, visit our website at www.socialsecurity.gov. Q: I prefer reading by audio book. Does Social Security have audio publications? A: Yes, we do. You can find them at www.socialsecurity.gov/pubs. Some of the publications available include What You Can Do Online, How Social Security Can Help You When a Family Member Dies, Apply Online for Social Security Benefits, and Your Social Security Card and Number. You can listen now at www. socialsecurity.gov/pubs.

Health News Keith Lukasik appointed ECMC’s chief strategist officer

Keith Lukasik has joined ECMC Corporation as chief strategy officer. He will provide the planning discipline and business/ market insight to shape ECMC’s strategic direction to ensure the viability of and to further ECMC’s Lukasik mission, according to a company press release. He will also lead many of ECMC’s strategic initiatives with partners at Kaleida Health, the University at Buffalo, community hospitals and local providers and payers. Lukasik has worked extensively with academic medical centers, integrated health systems and community hospitals on a wide array of strategic planning and partnership initiatives. Prior to joining ECMC, he spent six years leading client engagements at the Chartis Group, a strategic advisory and analytics firm dedicated to serving healthcare organizations nationwide.  Lukasik holds a Master of Business Administration degree with distinction from the Kellogg School of Management at Northwestern University. He graduated cum laude with a Bachelor of Science in engineering, with a concentration in bioengineering, from the University of Pennsylvania.  Lukasik lives in the Parkside neighborhood of Buffalo with his wife and children.  He is currently the board chairman of the Neighborhood Health Center, a four-site federally qualified health center in the Buffalo area.   

Schofield Residence gets top ratings from Medicare

Schofield Residence, Ken-Ton’s independent nonprofit long-term care organization is a five stars out of five stars nursing home on Medicare. gov. Medicare assigns the overall star rating based on a nursing home’s performance on three measures: health inspections, quality measures and staffing. “We’re so pleased to be recognized with this top rating,” said Olivia Rozycki, administrator of Schofield Residence. “Our staff works very hard and was also awarded five out of five stars for quality measures. This is much above the average for New York state and national averages.” Each year, more than 300 individuals, aged 50 and up, come to Schofield to use its rehab services, according to a press release. In addition, Schofield’s certified and licensed home health teams offer a comprehensive array of skilled services as well as personal care as-

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

sistance in the home to more than 250 patients in Erie and Niagara counties.

Cheryl Nosek: Nurse of Distinction in Education

Cheryl Nosek, professor and chairwoman of nursing at Daemen College, has been named the 2018 Nurse of Distinction in Education by The Buffalo News and the Professional Nurses Association of Western New York. Her award is among other Nurses of Distinction honorNosek ees recognized in celebration of National Nurses Week from May 6 to 12. “We extend our sincerest congratulations to Dr. Nosek for this richly deserved honor,” said Michael Brogan, vice president for academic affairs and dean of the college. “Her exemplary leadership and dedication to the advancement of nursing education has contributed to the career and professional success of countless Daemen nursing students.” Nosek’s award will officially be presented at a ceremony on June 5 in Salvatore’s Italian Gardens. Award winners will each receive a plaque, $500 toward furthering their education at a professional conference of their choice, and a one-year Professional Nurses Association membership. The awards honor RNs who have made outstanding contributions to the nursing profession, demonstrate leadership that provides a role model to inspire other nurses to improve, and participates in activities that foster a positive public image of nursing as a profession. With more than 40 years of experience in the nursing profession, Nosek has taught for more than three decades in nursing education at the undergraduate and graduate levels. She assumed the leadership role as chairwoman of nursing at Daemen in 2016, having previously served as director of undergraduate nursing programs. During her 16-year tenure at Daemen, Nosek, a Lancaster resident, earned a doctor of nursing science and a master’s degree in community mental health nursing, both from the University at Buffalo, and a bachelor’s degree in nursing from SUNY Albany.

Surgeon Jon L. Dusse joins Eye Care & Vision Associates

Jon L. Dusse has recently joined Eye Care & Vision Associates (ECVA) as eye physician and surgeon. With more than 23 years’ experience in comprehensive eye care in Western New York, Dusse specializes in diabetic eye care, cataract surgery and oculoplastics. A native of Syracuse, and current

H ealth News Eggertsville, resident, Dusse received his bachelor’s degree in biomedical engineering and chemistry from Vanderbilt University School of Engineering (cum laude), his master’s degree in biology from Syracuse University (magna cum laude) and his medical degree from the University at Buffalo School of Medicine and Biomedical Sciences, where he completed his residency in ophthalmology. Dusse also completed a residency in Dusse ophthalmology at the Brookdale Hospital Medical Center in Brooklyn, and a pre-residency fellowship in the departments of ophthalmology and anatomy at Children’s Hospital of Buffalo. Dusse, who is a member of the Buffalo Ophthalmological Society, previously practiced through Buffalo Medical Group, P.C. and the Wettlaufer Eye Clinic. Eye Care & Vision Associates (ECVA) is a full service ophthalmology group practice with offices in Elmwood Village, Orchard Park, Niagara Falls and Williamsville.

In Good Health has new senior advertising rep Angela Rosa, a Buffalo resident and a seasoned advertising sales representative, has recently joined Local News, Inc., the publisher of In Good Health — Western New York’s Healthcare Newspaper. She will be in charge of selling ads for the newspaper and help develop new products. Rosa has more than 15 years experience in advertising sales. Among other places, she worked for the Metro Group / Community Newspapers of WNY and RW Publications. “I’m very excited to embark on this new project,” she said. “In Good Health is a great publication — it’s the only healthcare newspaper in Western New York. It has great stories and is widely distributed. It really fills a gap in the market.” If you have Rosa any questions, or would like to place an ad, please contact her at 716-247-9255.

ECMC Trauma Center receives national verification

Following a recent on-site survey, ECMC has been verified as a Level 1trauma center by the verification review committee, an ad hoc committee of the committee on trauma (cot) of the american College of Surgeons. According to a news release, this

achievement recognizes ECMC’s dedication to providing optimal care for injured patients. Established by the American College of Surgeons in 1987, the COT’s consultation/verification program for hospitals promotes the development of trauma centers in which participants provide not only the hospital resources necessary for trauma care, but also the entire spectrum of care to address the needs of all injured patients. This spectrum encompasses the prehospital phase through the rehabilitation process. Verified trauma centers must meet the essential criteria that ensure trauma care capability and institutional performance, as outlined by the American College of Revised Surgeons’ Committee on Trauma in its current “Resources for Optimal Care of the Injured Patient” manual. “On behalf of the trauma program at ECMC and the department of surgery, I would like to recognize the daily contributions made by members of our trauma team that have resulted in verification of ECMC as an adult Level 1 trauma center,” said physician William Flynn, chief of service, ECMC department of surgery. “Their tireless dedication ensures that the people of Western New York continue to receive the highest quality trauma care.”

ECMC Foundation event breaks attendance record

Erie County Medical Center (ECMC) Corporation and the ECMC Foundation recently presented Springfest 2018, the largest nonprofit gala in Western New York, which drew more than 1,750 guests — the largest gathering in the event’s history — from the business, medical, and ECMC communities for an evening of entertainment, fine dining and celebration.  The annual event raised the highest gross in its history: over $1 million, which will benefit life-saving medical services at ECMC.  Presented by Pegula Sports and Entertainment, this year’s Springfest Gala May 12 honored the distinguished service of physician Mark J. Anders, director of orthopedic Anders trauma, center for orthopedic care at ECMC and clinical associate professor, Universi ty at Buffalo, Jacobs School of Medicine and Biomedical Sciences; and registered nurse Sandra Lauer, director at Continuum of Care, Supportive Care and Palliative Medicine at Lauer ECMC.   

Independent Health Recognized by J.D. Power


ndependent Health is the second highest ranked health insurance plan for member satisfaction in the New York region, according to J.D. Power’s 2018 U.S. Member Health Plan Study. Conducted through an online survey across 22 market-based regions, this annual syndicated study examines the experience of a typical health plan member and is designed to provide health insurance plans with information that will add focus and clarity to the factors contributing to the member experience. This marks the ninth consecutive year Independent Health has been recognized by J.D. Power. From 2010 through 2013 and then again in 2016, Independent Health received the award from J.D. Power for ranking highest for member satisfaction in the New York region. In 2014, 2015 and 2017, Independent Health was the second highest ranked plan for member satisfaction in the New York region. “The consistent, objective, third-party recognition we receive

“ECMC’s Springfest Gala celebrated the contributions of our two honorees, as well as the dedicated service of the thousands of caregivers that make ECMC so special,” said Jonathan Dandes, board of directors chairman at ECMC Foundation. “Over the past 100 years, ECMC has been home to extraordinarily talented physicians, nurses and support staff and this year’s honorees exemplify that tradition of healthcare excellence.” 

Mercy earns ‘Advanced Comprehensive Stroke’ reaccreditation

Mercy Hospital of Buffalo was recently reaccredited as an “advanced comprehensive stroke center” by The Joint Commission. Presented in conjunction with the American Heart Association and American Stroke Association, the advanced certification for comprehensive stroke center accreditation is the highest stroke center designation offered by The Joint Commission, the nation’s leading healthcare accrediting body. Mercy received the initial Joint Commission’s comprehensive stroke center designation in 2013 and was among the first in New York state to

June 2018 •

in the annual J.D. Power Study reflects our unwavering commitment to helping our members understand their coverage so they can take charge of their health,” said physician Michael W. Cropp, president and chief executive officer, Independent Health. “Our excellent service, as well as our innovative benefits and efforts to provide better coordinated care through strong partnerships with providers, continues to help set Independent Health apart from other health plans.” Independent Health also received 5 Power Circles in the Power Circle Ratings for the J.D. Power 2018 Member Health Plan Study. This rating indicates consumers rated Independent Health “among the best” of all health plans included in the region. Independent Health’s overall score was 767, up 20 points from last year, and 59 points above the regional average score of 708. Independent Health’s score was also sixth highest in the nation. The study by J.D. Power surveys commercial health plan members (excluding Medicare and Medicaid programs) and then ranks members’ experiences in six categories: customer service; coverage and benefits; cost; provider choice; information and communication; and claims processing. This year’s study is based on the responses of 33,342 members in 163 health plans throughout the United States. The comprehensive health plan rankings for all 22 U.S. regions are available online at www. jdpower.com/pr-id/2018061 .

achieve that level of certification. The hospital and its stroke team recently completed a rigorous and successful recertification evaluation by the Joint Commission. “This is the highest bar there is to achieve in stroke care,” said physician Lee Guterman, medical director of neurosciences for Catholic Health. “This advanced certification is a voluntary process that represents our hospitals’ commitment to deliver the highest quality, most advanced care to all patients affected by stroke.” The Joint Commission developed the advanced certification for comprehensive stroke centers designation, to recognize the significant differences in resources, staff, training and technology that are necessary for the treatment of complex stroke cases. Hospitals that earn this distinction are responsible for setting the national agenda in advanced specialized stroke care. As part of this designation, comprehensive stroke centers like mercy hospital, are required to have 24/7 availability of specially trained physicians and medical personnel, advanced imaging capabilities and specially equipped operating facilities to diagnose and treat the most complex stroke cases.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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By acting today, we can heal tomorrow’s traumas.

Nicholas Ball, Trauma Patient

Karen Beckman-Pilcher, RN, Clinical Nurse Specialist of Emergency Services

Amy Terpening, Traumatic Brain Injury Survivor

Michael Manka Jr., MD, Chief of Emergency Medicine

Donna Oddo, Nursing Care Coordinator Emergency Department

As Western New York’s only Level 1 Adult Trauma Center, the future of healthcare at ECMC is clear. With a steady rise in patient volume, we know that more of our neighbors will depend on our lifesaving trauma and emergency care more than ever before. And with your support, they’ll receive it in a new facility with state-of-the-art technology, more space and privacy, and designed for better experiences and outcomes for patients and their families.

The difference between healthcare and true care


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©2018 ECMC

Learn how you can give to save lives in the most critical situations at SupportECMCtrauma.org

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • June 2018

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WNY IGH #44 JUNE 2018  


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