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Meet Your Doctor Raul Vazquez: Visionary doctor and founder of GBUAHN heavily focuses on quality care and social aspects of health while keeping an eye costs

Trim Healthy Mama

Is this new diet for you? Local experts weigh in


JULY 2018 • ISSUE 45

Summer Care • Swim Safely: One-fifth of those who drown are children aged 14 and younger. Find out what you can do to push the statistics down • Sunscreen: Understanding all the lingo • Mosquito Bites: Natural ways to keep mosquitos from biting you

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Sun’s Out, Fun’s Out Pregnancy & Pot Smoking

WNY offers plentiful outdoor activities. Find out what some of the options are Page 16

Growing number of women smoke pot during pregnancy. Local experts weigh in

Sitting: the New ‘Smoking’ See what studies say about the harmful effects caused by too much sitting

Visitors of all ages enjoy the trails at Reinstein Woods Nature Preserve in Depew.

Crack a Crab for Lean Protein and More


Worse for Women?

Gloriously low in fat and calories, crab is an excellent lean protein source. See SmartBites inside

The statistics are startling: 26 percent of adults aged 30 to 70 have sleep apnea. But are women more affected than men?

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ECMC Farmers’ Market at Grider Underway Recent opening marks 10 years of farmers’ market at ECMC


rie County Medical Center (ECMC) Corporation and ECMC Foundation recently opened the Farmers’ Market at Grider for the 10th season.  The Farmers’ Market at Grider is a community resource providing access to healthy food and promoting healthy lifestyles in the 14215 zip code area of Buffalo. The goal is to improve the health and eating habits of residents in the neighborhood and the hospital community by bringing fresh produce and other healthy goods to this section of the city. Most vendors accept EBT/ SNAP benefits. The market includes free youth outreach programs, food demonstrations, and gardening

classes.   The Farmers’ Market at Grider is located at 351 Grider St. across from ECMC and is now open from 10 a.m. to 2 p.m. each Friday through Aug. 31; The Farmers’ Market at Grider is sponsored by M&T Bank.  Market partners include: the American Heritage Food Co-Op, Field & Fork Network, Double Up Food Bucks, WBLK 93.7 FM, UnitedHealthcare Community Plan, and Cornell University Cooperative Extension.  Interested vendors are invited to contact ECMC director of community relations Kelly Showard at 716-8984737.    

Saturday August 18 It’s a Walk in the Park! Online Registration Now Open. Start Your Team Today! Save $10: Register online. Want another $5 off? Use promo code: igh

Free PSA testing on site (uninsured men, age 50+ or 40+ if family history). Provided by UR Medicine Labs & UR Medicine Urology. Page 2

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

EAT WELL Partner with Your Provider

Eat Right Pack more nutrition into your day with a colorful main dish. Try to eat a rainbow of fruits and vegetables with every meal – the brighter the better. Consider flavor, texture and color. •



Sweet vegetables

For adults over 50, the benefits of healthy eating include increased mental acuteness, resistance to illness and disease, higher energy levels, faster recuperation times and better management of chronic health problems. Take action by consulting your doctor.

Feel Better When you choose a variety of colorful fruits and veggies, whole grains and lean proteins you’ll feel vibrant and healthy, inside and out. It’s all connected – when your body feels good you... •

Feel better

Sharpen the mind

Live longer and stronger

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

Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Sources:,, and

Y0070_NA029063_WCM_ADF_ENG CMS Accepted 05242015


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) 。

©WellCare 2015 NA_03_15_WC July 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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July 7

Eating Nuts Linked to Lower Odds of Having AFib


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 antiinflammatory 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, 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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Strike Out Breast Cancer to benefit local survivors, research The Breast Cancer Network of WNY (BCN), in collaboration with the Buffalo Bisons, Amherst Federal Credit Union, and WNY Imaging Group, will present its 2nd Annual “Strike Out Breast Cancer” event July 7. This family-friendly event includes a two-hour pre-game party downtown at Cathedral Park, a short breast cancer awareness walk to Coca-Cola Field, and admission to that evening’s Buffalo Bisons baseball game. Everything starts with the pregame party at 3 p.m., which will feature food, entertainment, kids zone, photos, and contests for best T-shirts and best dancers. Tickets are $30 for adults and $10 for kids 12 and under. Breast cancer patients and survivors are free. Proceeds from Strike Out Breast Cancer will benefit the support and education programming of the Breast Cancer Network and also its metastatic breast cancer research fund. “As an independent nonprofit organization, we depend on fundraising and the generosity of our community to fund the important work we do. Strike Out Breast Cancer is not just a fundraising activity, even more importantly, it gives us the opportunity to let people know what BCN is and how we help all people in Western New York who have been impacted by breast cancer. Plus we are raising funds for metastatic research, which is so important to finding a cure”

said BCN Executive Director Rob Jones. Metastatic breast cancer is the Stage IV disease that causes over 40,000 deaths in the United States each year. BCN has created a restricted fund that donates specifically to metastatic breast cancer research and that fund will benefit from this event. Strike Out Breast Cancer tickets are available online at www.bcnwny. org or at the BCN offices at 3297 Walden Ave. in Depew.

July 14, Aug. 11, 25

‘Let’s Go Walk’ program to offer guided walks in downtown Niagara Falls Cornell Cooperative Extension of Niagara County and Population Health Collaborative are offering a free summer walking program for the residents of Niagara Falls called “Let’s Go Walk!” The kickoff date to the bimonthly program was June 9. Four more events are scheduled this summer: July 14, July 28, Aug. 11 and Aug. 25. All events start at 10 a.m. at Power City Eatery on Third Street, Niagara Falls. Community members of all ages are invited to join together for free, family-friendly, guided walks to promote health and wellness. The walking routes, which feature sites in downtown Niagara Falls, are approximately 30 minutes long and are designed for all fitness levels. Each walk will finish with fun activities at the Power City Eatery. To receive updates or find notifica-

tions on the upcoming walk schedule, follow the Facebook page: “Let’s Go Walk – Niagara Falls, NY.” For questions, contact Megan Dumpleton from the Population Health Collaborative at 716-923-6577 or or contact Marla Guarino from Cornell Cooperative Extension of Niagara at 299-0905 ext. 275.​

Aug. 9

Kidney Walk has special meaning for transplant recipient

The 2018 Kidney Walk & 5K will take place Aug. 19 at the Outer Harbor, raising funds for the Kidney Foundation of WNY. The Buffalo-based nonprofit raises awareness of kidney disease, offers kidney health screening and supports patients. For information on the Kidney Walk & 5K, visit walk or call 716- 512-7918. Paul Musialowski of Buffalo will be there to celebrate his own medical journey and support the kidney health of others. He was diagnosed with polycystic kidney disease in his early 30s. Polycystic kidney disease (PKD) is an inherited disorder. It causes clusters of cysts to develop within the kidneys, damaging their ability to filter toxins from blood.  Musialowski was on the transplant list at Erie County Medical Center for about a year and a half until his successful transplant last Oct. 9. “People need to recognize the high-quality facility we have here in ECMC. My experience has been very positive from surgery, to recovery to clinic,” said Musialowski. ‘’You hear about heart disease and cancer, and justifiably so. However, many people suffer with kidney disease and need help and support as well,” Musialowski said. “Until you go through it, you don’t know what it is like.”

Fitness in the Parks Independent Health and YMCA Buffalo Niagara present Fitness in the Parks for seventh consecutive year


ndependent Health and YMCA Buffalo Niagara are teaming up for the seventh consecutive year to offer Fitness in the Parks, free outdoor community exercise classes throughout Western New York. The outdoor classes, which started May 31 will run until Aug. 25. “Independent Health is excited to partner with YMCA Buffalo Niagara again this summer to offer Fitness in the Parks. It’s a great way to get outside and get in a workout,” said Frank Sava, spokesperson for Independent Health. “Independent Health is committed to the health and wellness of Western New Yorkers. By offering Fitness in the Parks, we’re aiming to make a healthy lifestyle more accessible to the public by bringing exercise classes to the communities in which people live and work.” The free outdoor fitness classes include boot camp, cardio dance,

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

cardio kickboxing, Pilates, yoga, PiYo, Zumba, two new kids fitness classes, and more. Each class is 60 minutes and is taught by YMCAcertified instructors. In all, nearly 500 classes will take place at 23 parks and locations throughout Western New York this summer. Due to the popularity of Fitness in the Parks and to continue to meet the needs of the community, Independent Health added five new locations for 2018; DeVeaux Woods State Park in Niagara Falls, YMCA Eggert Road Program Center in Orchard Park, Losson Park in Cheektowaga, town of Carroll Park in Jamestown, and the William-

Emslie Family YMCA in Buffalo. Classes will again be held in Amherst, Buffalo, Clarence, Jamestown, Lancaster, Lockport, Olcott, Orchard Park and Tonawanda. Also returning will be the very popular class at New Era Field every Monday at 6 p.m. There is no advanced sign up required to participate in any of the classes. People can simply show up to the location of their choice at the day and time listed on the class schedule. A complete list of Fitness in the Parks locations, times and dates for giveaways visit www.

Free, weekly exercise classes will be held throughout Western New York including new locations in Niagara Falls, Cheektowaga and Buffalo’s east side

Yoga by Kathy Zawadzki

NEW! Yoga for 55+ - Offered by the West Seneca Community Education Program. This course helps to improve balance, posture, breathing, self-esteem, and flexibility. Systematic relaxation at the end of each class.

8 Weeks; Tuesdays July 10th - August 28th Bring mat (if you have one) To register contact West Seneca C.E.P at 716-677-3107 NEW! Chair Yoga!

Never Ignore Depression

This course is great for anyone recovering from a surgery, illness, has arthritis or other chronic pain illness, or cannot get on the floor.

Walk ins welcomed Thursdays 11am-12noon

4184 Seneca Street Suite 204, West Seneca, NY 14224 (across from Queen of Heaven Church) For more info contact Kathy Z. at

716-903-5020 |

Judy’s Pair-A-Dice Tours

Women more affected (26 percent) compared men (12 percent)


tudies show that depression is underreported. People aren’t getting the help they need, sometimes because they don’t know the warning signs or where to turn, or are embarrassed because of the stigma that can still surround mental health issues. But the numbers are too great to ignore. Up to 26 percent of U.S. women and up to 12 percent of men will experience major depression at some point in their lives. In any given year, that’s 16 million American adults. As many as one in 33 children and one in eight teens also struggle with depression — that’s 9 percent of kids aged 12 to 17 in any given year. And new research suggests these numbers may be even higher. It’s important to recognize signs of depression in yourself or a loved one, including a child, and to get help from a doctor.

Signs of depression: • Persistent sadness, anxiety or an “empty” feeling • Hopelessness, guilt, worthlessness, helplessness • Loss of interest in hobbies and favorite activities • A lack of energy and persistent fatigue • Difficulty concentrating, remembering, making decisions • Difficulty sleeping, early morning awakening or oversleeping


July and Aug Line Up

• Appetite and/or weight chang-

• Restlessness or irritability • Physical symptoms including pain • Thoughts of death or contemplating suicide Take immediate action if you or a loved one is having suicidal thoughts. If you’re thinking of harming yourself or attempting suicide: • Call 911 or go to the nearest hospital emergency room. • Call the toll-free 24-hour National Suicide Prevention Lifeline at 1-800-273-8255. • Ask a family member or friend to help you make these calls or take you to the hospital. The stigma around depression exists, in part, because it’s poorly understood. However, one study found that once people are educated about it that it’s an illness and not something those affected bring on themselves — they are more likely to change their thinking and accept that depression can and should be treated. Family members of someone going through depression should become educated about the disease because they make up an important part of the depressed person’s support network and can help prevent a recurrence.

July 5 - Allegany Casino July 9 - Presque Isle Casino July 12 - DelLago Casino July 16 - Double Header Allegany & Presque July 23-26 - Dover Downs Delaware 4 days Aug 1 - Allegany Casino Aug 13 - Double Header Allegany& Presque Aug 16 - St Jacobs Flea Market and quaint shops Aug 22 - DelLago Casino Aug 27-28 - Tioga Downs overnight with stop at DelLago Aug 27 - Presque Isle Casino

Call 716-568-2222 or book on line at Judy’s Pair-A-Dice Tours - PO Box 377 East Amherst NY 14051

Health care for women... in every stage of life. Focusing on your health and well-being in a warm, welcoming environment for women of all ages, backgrounds and needs across Western New York.

Source: HealthDay News

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 & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Julie Halm, Catherine Miller, Katie Coleman • Advertising: Anne Westcott, Amy Gagliano Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Williamsville 705 Maple Rd., Ste. 300 Buffalo 520 Delaware Ave. East Aurora 268 Main St. Elma 2701 Transit Rd. #134

• OB/GYN services • Adolescent and Teen Wellness • Gynecologic Surgeries • Contraception • Menopausal Issues • Bladder and Urinary Conditions Did You Know... you can see any of our providers at any location?

Orchard Park 240 Red Tail Rd. #5&6

Your electronic records follow you to each appointment, no matter which location you choose, and allow us to focus on your care.

Snyder 2072 Kensington Ave.

New patients welcome. Call 716.656.4077

Accepting most insurance carriers LGBT Friendly

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

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6/15/18 9:21 AM


Your Doctor

By Chris Motola

Raul Vazquez, M.D. Visionary doctor and founder of GBUAHN heavily focuses on quality care and social aspects of health while keeping an eye costs Q: We wanted to talk about your work with Medicaid patients over the years. A: We run what’s called G-Health Enterprises. We created so many groups over the years that it started to almost sound like they were competing with each other, so we put them all under one umbrella, G Health Enterprises. I started out in 1996 opening a private family practice in the inner city, Urban Family Practice. During that time we did great work and, in 2003, built a facility. I’ve been trying to address the social aspects of health since 1996. Transportation, housing, food, those things often interfere with patient care. We built the facility in 2003 to have patients be able to get more services like urgent care, some surgeries, X-rays on site, things we hadn’t been able to do prior to that.

Q: How did the Affordable Care Act (ACA) affect your organizations? A: Along came the ACA and developed these dollars that would go to this idea called health homes. Nobody really knew what these health homes were at the time. They felt that if we were able to do case management of these individuals who were costing the state a lot of money, it would lead to a lot of improvement. We were selected as one of the initial 35 health homes in the state in 2012. The goal was to look at individuals with two or

Q: How did you connect with other physicians? A: From there I identified eight physicians who were kind of safety net physicians in the area and organized them around 2008, 2009. We formed an independent practice association, Buffalo United, and that practice association was a corporate platform under which we could work together. Whenever you have doctors working together on something, there are a lot of legal regulations that can get you into trouble.

three chronic diseases, who often have substance abuse issues. They’re the 20 percent that accounts for 80 percent of the hospital costs. New York state has about 6 million people of Medicaid who are costing the state almost $60 billion a year. So we began the health home which became the Greater Buffalo United Accountable Healthcare Network (GBUAHN). Q: I understand you took a slightly different approach than some of the other health homes. A: So GBUAHN grew, and we developed a nice model oriented around primary care. A lot of the other health homes in the state tended to be more behavior-focused. In terms of size, we ended up being the largest health home in the state outside of New York City. The health homes, to be clear, aren’t locations, they’re a virtual model. So you’re providing these care coordination models in people’s homes or just helping them navigate through the systems. So a lot of this is happening out in the field. We were able to play around in that arena. It took us about a year to stabilize the population. ER visits climbed in that first year, but after that they dropped as we got our patients the help they needed and helped educate them and guide them through this system. We went to the National Committee of Quality Insurance to show them what we were doing differently. They were impressed with what we were doing and gave us the accreditation. We’re only ones in the state with that accreditation and one of only 45 in the country. Q: How has it evolved from there? A: So we evolved, care coordination was good, practices are good, informatics are good, but I knew that the long-term vision for this model was to become an accountable care organization (ACO). So back in 2016, we applied to become an ACO in New York state and became the first Medicaid commercial ACO. It gives you legal protection to form some structures with doctors, as long as you’re cutting costs, improving quality of care and patients are satisfied. Those are the three goals you have to meet. Q: What kinds of protections does it offer? A: Before this, if we had four or five doctors trying to do the right thing and tried to refer patients within their group and

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

making sure the services got done, sometimes that service was overutilized, especially in the Medicaid space. It kind of abused and killed the system. So Congressman [Peter] Stark came out with a ruling against that and made it illegal. But you can avoid that with an ACO, as long as you’re meeting those criteria. We’re a value-based organization not focused on volume of patients, but the quality of care. We partnered with an insurance company where we’re able to share data and look out for the best interests of the patients. It’s a true partnership, not just an insurance company deciding patient care. In our first year, last year, we ended up saving $571,000 that went back to the providers doing the work. All our organizations work together, though, they don’t compete against one another. Q: Where do you plan to go from here? A: We’re looking to develop, with the help of the insurance company, into a managed care franchise. The important thing is that doctors run this and own it. If you’re treating a patient, you have information about what that patient needs. If you’re an administrator just looking at costs … I like to say “the eyes can only see what the mind knows.” We got really good at patient management and getting a 360 view of patient care, finding out where over-utilization is, avoidable ER trips, pharmacy costs, super-utilizers. So we had a great platform for figuring out where the problems are. Q: Do you recommend physicians become more business savvy? A: You do want doctors to be able to focus on patient care, but I think eventually we can do both. Just knowing what drug alternatives are available saved us $7.2 million without having a negative effect on outcomes. I think people are more engaged when it’s their own skin in the game, and more interested in making things work. I used to run grocery stores. You sell milk at cost, you don’t make money on it, but it brings people into the store. It’s a loss leader. We’re not going to make money on everything that we do, but it’ll be beneficial to the business in the long run. Patient transportation is a big one we’re looking at now. Also housing for homeless individuals who are costing a lot money. How do we not just ignore these people, but engage in empathy, not just sympathy. The benefit will outweigh the investment.

Lifelines Name: Raul Vazquez, M.D. Board-certified and is a fellow of the American Academy of Family Physicians Position: President and CEO of G-Health Enterprises, Urban Family Practice, the Greater Buffalo United Accountable Healthcare Network (GBUAHN), the Greater Buffalo United Accountable Healthcare Organization Hometown: Bronx, NY Education: Fordham University; SUNY Buffalo Medical Affiliations: Kaleida, ECMC Organizations: Minority Health Council; Upstate New York Transplant Services Family: Wife; two sons, two daughters Hobbies: Information technology

Cancer Care Twice as Costly in U.S. Versus Canada


hat a difference a border makes, when it comes to the cost of cancer care. Common chemotherapy for advanced colorectal cancer costs twice as much in Washington state as it does a short walk across the Canadian border into British Columbia, researchers report. A month’s worth of chemotherapy cost $12,345 on the U.S. side of

the border versus $6,195 just over the line into Canada, according to findings presented recently at the annual meeting of the American Society of Clinical Oncology (ASCO), in Chicago. What’s more, the extra money Americans paid didn’t buy them any more time on Earth. Average survival was roughly similar on either side of the border.

“You don’t necessarily see that patients in Canada are faring much worse, or worse at all, which is sometimes the impression that we have in this country — that our outcomes are far better than in places with single-payer health care,” said principal investigator Veena Shankaran. She is a colorectal oncologist and associate member with the Fred Hutchinson Cancer Research Center in Seattle. For their study, Shankaran and her colleagues compared treatment and insurance claims data from western Washington and British Columbia — two regions that abut at the U.S. - Canadian border. The researchers specifically looked at chemotherapy which treatments were chosen, how often people underwent chemo, and how they

fared, Shankaran said. The analysis included 1,622 patients with metastatic colorectal cancer in Canada and 575 in the United States. Patients in British Columbia tended to be older than those in western Washington, 66 years versus 60 years old, but otherwise were very similar demographically. Overall, more Washington state residents received chemo than patients in British Columbia 79 percent versus 68 percent. The researchers said this might be because the American patients were younger on average. There were slight differences in the type of chemotherapy used between the countries, but “clinical trials have really shown these regimens are comparable in terms of efficacy,” Shankaran said. This was borne out by the survival rates, which were about the same for both regions. Average overall survival for people receiving chemo was 21.4 months in Washington and 22.1 months in British Columbia. Among patients who did not receive chemo, median survival was 5.4 months and 6.3 months, respectively. The big difference boiled down to the cost of chemotherapy treatment. Both leading types of chemotherapy cost more in the United States than in Canada, Shankaran said.

Healthcare in a Minute By George W. Chapman

Right to Try: New Law May Help Patients — to a Certain Point


ecently signed as law, the Right to Try legislation allows patients with life threatening conditions to “request” medicines that have not yet received final approval by the Food and Drug Administration (FDA). The patient must have exhausted approved

treatment options and be unable to participate in clinical trials. Unfortunately, the law does not require drug manufacturers to honor such requests. The law also does not require insurers to pay for the requested drugs. Historically, insurers have refused to pay for experimental treatment.

DRIVe The U.S Department of Health and Human Services recently introduced the Division of Research, Innovation and Research and Ventures (DRIVe). The new initiative will accelerate innovations that address systematic health concerns by funding innovation, through grants and venture capital investment, that address systematic health concerns. The focus is to save lives lost to aberrations in our healthcare system like sepsis, which is a life-threatening complication caused by infection.   ACA 2019 Uncertainty and confusion are the bane of any business, particularly insurance. The recent termination of the individual mandate, in conjunction with the persistent rumors regarding removing the pre-existing conditions and another attempt to repeal the Affordable Care Act, will cause premiums to increase by as much as $1,000 on the exchanges next year. Meanwhile, President

Trump is promising lower premiums and better coverage. Physicians and hospitals remain vigilant, as repealing and replacing the ACA will most likely result in loss of insurance by millions, resulting in bad debts. New Jersey became the second state to enact its own individual mandate, effective January 2019. Massachusetts has had an individual mandate, even before the ACA.   Power Trio The much ballyhooed triumvirate of JP Morgan Chase, Amazon and Berkshire Hathaway has announced the hiring of their CEO to oversee the healthcare partnership. They were expected to release the name of the CEO by the end of June. The three companies feel they can do a better job than traditional insurers have done for their 1.5 million employees. Skeptics believe the trio has no idea what they are getting into which, ironically, speaks to how bad things are in healthcare. Two of the nation’s top five insurers voiced their

concerns. Not being totally naïve, the trio is allowing things to develop over 20 years. Despite some nasty phone calls, JP Morgan CEO Jamie Dimon said “we’re going to take a crack at it.”   Colon cancer About 270,000 people a year die of colon cancer. It is the second deadliest cancer behind lung cancer which kills about 800,000 a year. The American Cancer Society just released new guidelines recommending that routine screening begin at 45 years old. (It used to be 50 years old.) You should discuss this with your primary care physician. Most insurers should pay for the diagnostic/ preventive colonoscopy. If you have a history in your family, your physician might recommend screenings even sooner than 45. With proper screening, this cancer is nearly 100 percent avoidable. Even stage 1 colon cancer has a 80-90 percent survival rate.  Medicare 2026 The Medicare board of trustees reports the inpatient trust fund could be depleted in just eight years (2026). The recent tax cut has accelerated the depletion of the fund by three years. Now is the time for the federal government to negotiate drug prices. Otherwise, the “solution” will most likely be a combination of: increased Medicare premiums to seniors, increased deductibles and coinsurance, decreased benefits and payments to providers.   United/AARP scheme A class action lawsuit has accused the two organizations — United/AARP — of an illegal rebating

July 2018 •

or scheme. United is the country’s largest Medigap carrier. Medigap insurance covers what Medicare does not, like certain procedures and any out-of-pocket responsibilities. According to the complaint, in exchange for AARP sponsoring United’s Medigap policy, United rebates almost 5 percent of the premiums received from beneficiaries to AARP, which then uses those rebates to pay for the monthly collective group plan premium in order to bind coverage. In 2016, AARP earned nearly $600 million in royalty payments from United across all insurance products. Anxiety up The American Psychiatric Association released a poll that, not surprisingly, indicates we are all more anxious. While millennials have the highest levels of anxiety across all age cohorts, baby boomers had the largest increase in anxiety levels. More women than men admit they are more anxious. Health, safety, finances, relationships and politics are the top stressors. The APA recommends regular exercise, relaxation, healthy eating and more time with family and friends to reduce stress and anxiety. 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

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Is Sitting the New ‘Smoking’? Mayo Clinic study: Standing desks good for long-term health By Katie Coleman


ew research from the Mayo Clinic finds that opting for a stand-sit workstation can help to burn calories and lose weight over the long term. Studies have reported that on average, adults in the United States sit for at least seven hours a day. The study, which was published in the European Journal of Preventive Cardiology, examined whether standing versus sitting for six hours a day burned more calories. Researchers discovered that standing burned 0.15 calories per minute more than sitting. According to the Mayo Clinic, chronic, long-term sitting can lead to obesity, increased blood pressure, high blood sugar, abnormal cholesterol levels, the risk of cardiovascular disease and cancer. “Sitting is the new smoking” is a phrase coined by James Levine of the Mayo Clinic’s Division of Endocrinology, Diabetes, Metabolism, and Nutrition. He has been studying the harmful effects caused by too much sitting through research funded by the National Institute of Health, and developed the science of non-exercise activity thermogenesis, which represents components of human daily energy expenditure and how they correlate to physical fitness and obesity. Standing all day is not a recommended solution and can cause harmful effects, but by reducing sitting time with standing has been shown to increase long-term health. I put in a request myself at work, Brady Corporation in Williamsville, where I answer calls and sit at a

desk. A car accident I was in two years ago resulted in chronic pain whether I’m sitting or standing, and my chiropractor, Elizabeth Lyons of Amherst Chiropractic, recommended I might try a standing desk to alleviate some of those symptoms. Significant differences “Being able to stand for periods of time during the work day allows for lengthening of muscles, better circulation and improved nerve flow,” Lyons said. “When our bodies sit for a long time, muscles and joints fatigue due to lack of stretching, and lower back spinal discs have increased compression. This can cause pressure on the nerves and overall circulation is slowed.” With my new desk, I can switch back and forth throughout the day, and with more motion and variation it helps manage those painful symptoms. My coworker, Thomas Stevens, 63, inside sales representative, uses a standing desk he initially requested due to shoulder problems that developed. Now, a year since getting his desk, the benefits have been better overall health and quality of life. “I try to split it up evenly — an hour up and an hour down — basement to penthouse,” Stevens said about a typical eight-hour shift. “It’s a great option to have during the work day. It helps your stress levels and it’s refreshing to stand up and stretch. Many co-workers are in their 20s. I hope they can see the advantages of these desks.

Thomas Stevens, 63, at his sit-stand workstation in Williamsville where he’s experienced the benefits. “It’s a great option to have during the workday. It helps your stress levels and it’s refreshing to stand up and stretch.” Employers need to see the rewards they will get.” To stay healthy, Stevens weight trains at the gym three days a week and takes frequent walks with his dog. “I try to stay active to make up for this sedentary job,” he said. More research on the effects of a sit-stand workstation was published in the scientific journal Human Factors titled, “Effect of Standing or Walking at a Workstation on Cognitive Function.”

“Research indicates that sitstand workstations may be a viable solution to reducing the incidence of obesity and chronic health conditions in an increasing sedentary workplace,” the article stated. “Sit-stand workstations have been shown to reduce musculoskeletal complaints, improve the overall mood of workers, promote faster metabolism of blood glucose following a meal, and lead to greater movement in the workplace.”

New York Expands Electronic Patient Care Alerts Service Statewide


he New York eHealth Collaborative (NYeC) recently announced the expansion of patient care alerts across the state’s eight regional health information exchanges through the Statewide Health Information Network for New York (SHIN-NY). The statewide expansion of this service further enhances the SHIN-NY’s patient care coordination capabilities and creates an integral resource in improving health and care delivery, including reducing hospital readmissions, throughout the state.  The SHIN-NY connects New York’s eight regional networks, or qualified entities, that allow participating healthcare professionals, with patient consent, to quickly access and securely exchange electronic health Page 8

information statewide. Alerts allow participating SHIN-NY providers and care team members who have treating relationships to receive real-time updates about their patients. For example, a subscribing provider can receive an admittance, discharge, transfer alert if their patient enters or is discharged from a hospital. This promotes timelier interventions and improved planning for a patient’s care at home or at another facility. Alerts are a core service offered free of charge to SHIN-NY participants. Prior to the expansion of the service, healthcare professionals could only subscribe to and receive alerts from other participating healthcare professionals within their qualified entity’s region. Now, alerts will be

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

more comprehensive, as the status of patients across regions will be available regardless of where in the state a patient receives care. “By providing doctors access to their patients’ medical records across great distances, the SHIN-NY ensures continuity of care throughout New York State,” said New York State Health Commissioner Howard Zucker. “Under Gov. Cuomo’s leadership, we are continuing to improve healthcare while reducing costs, making New York a healthier place for everyone.” “Electronic patient alerts to healthcare providers when their patients are admitted to or discharged from a New York state hospital is an important addition to the state’s SHIN-NY capabilities, which will

improve patient care,” said Senator Kemp Hannon, chairman of the Senate Standing Committee on Health. The eight qualified entities that are connected by and comprise the SHIN-NY include Bronx RHIO, HealtheConnections, HEALTHeLINK, Healthix, HealthlinkNY,Hixny, NYCIG, and Rochester RHIO. The SHIN-NY connects virtually all the state’s hospitals and more than 80,000 healthcare professionals, enabling collaboration and coordination of care that improves patient outcomes, reduces unnecessary and avoidable tests and procedures, and lowers costs. To learn more about the SHINNY, visit

Summer Care

Swim Safely One-fifth of those who drown are children aged 14 and younger: CDC By Deborah Jeanne Sergeant


bout 3,536 people drown accidentally in non-boating related accidents in the US annually, plus around 300 people die in boating-related incidences — one-fifth of those are children aged 14 and younger, according to figures from the Centers for Disease Control and Prevention. In addition, for each child who dies from drowning, another five children receive emergency care for non-fatal submersion injuries. These can cause long-term disabilities such as memory problems, learning disabilities and permanent loss of basic functioning. Physician Gale R. Burstein, commissioner of health for Erie County Department of Health, said that parents can take steps to reduce their children’s risk of drowning and submersion injuries. “Talk about the dangers of water

Who’s Most Likely to Drown?

• Males. Almost 80 percent of people who drown are male. • Ages 1 to 4. Children of this age range have the highest drowning rate. Drowning is the second-leading cause of unintentional injury-related death behind motor vehicle crashes. • Minorities. Between 1999 and 2010, the unintentional drowning rate for African Americans was significantly higher than that of whites across all ages with the greatest disparity among children 5 to 18 years old using swimming pool being 5.5 higher than the same aged whites. Source: Centers for Disease Control and Prevention (CDC) with children and make sure they never swim alone,” Burstein said. “Especially with young children,

Natural Prevention of Insect-Borne Diseases By Deborah Jeanne Sergeant


he Centers for Disease Control and Prevent (CDC) stated in May that insect-borne disease increased from 27,000 in 2004 to 96,000 in 2016 — and that’s only reported cases. These diseases include Lyme disease, West Nile virus and newcomer Heartland virus, which has recently appeared in the U.S. While using insect repellant containing DEET (N,N-diethylmeta-toluamide) can help prevent bites that could be infectious, some people don’t want to repeatedly expose themselves to the chemicals in repellants because of its toxicity, especially when used frequently. A few other strategies can help prevent bites. Joanne Wu is an integrative and holistic medicine and rehabilitation physician who specializes in wellness. She recommends using citronella, eucalyptus or tea tree oil. “Add a couple drops to 1 teaspoon of a carrier oil,” she said. “It’s a natural repellent. Consider using astringents like witch hazel mixed with oils to spray.” Planting lavender around the yard and tossing a sprig of thyme in the fire on a chilly evening can also

ward off mosquitoes. Why do these work? “It’s about masking your scent so it’s not attractive,” Wu said. She added that seeking a good quality oil is important for maximum effectiveness. Kristen MacNeil, owner of Hamburg Essential Oils, adds lemongrass to the list. If one oil doesn’t work well, try another. “I had used lavender for years, but it stopped being as effective for me,” she said. “Things within your body or diet may change things.” She also likes lemon eucalyptus, which isn’t a combination of lemon and eucalyptus, but is its own type of oil. “It’s shown in studies to be as effective as DEET,” MacNeil said. “But it does wear off more than DEET.” Always well diluted in a carrier oil, try clove, lemongrass, rosemary, cedar, catnip (if you don’t have cats), geranium or mint oils as well. Although some people have success rubbing the above plants on the skin, the essential oils provide a more concentrated source of the properties that repel insects and they’re easier to apply in liquid form.

they need supervision.” It’s easy to think that someone else at the pool party is watching the children when actually no one is. Parents should understand the differences between the hazards inherent to swimming pools and other bodies of water, which can have rip currents, undertows and debris that can pull swimmers under. “Always have adequate supervision by an adult,” said physician Bridget Messina, clinical assistant professor of pediatrics with University at Buffalo and attending physician, division of general pediatrics at UBMD Pediatrics & Oishei Children’s Hospital. “If a child can’t swim or swim in the depth they’re in, the adult should always be in arm’s reach,” Messina said. She added that toddlers and very young children can drown in less than two inches of water, so they need supervision even in small wading pools. To improve children’s swimming ability, Jay Bonafede, spokesman for the American Red Cross Western and Central New York regions, advises families to make sure everyone in the family learns to swim and swims only in designated areas under the watch of lifeguards and with a swim buddy. Swimmers should follow the rules at all times, such as no horseplay at the pool and no swimming further than the boundary at the lake. “A lot of Red Cross tips are very basic and commonsense and we like to make them catchy, something people will remember,” Bonafede said. Don’t forget to use physical barrier strategies such as wearing long sleeves and pants when walking in woods or gardening, she said. Also, tuck pants into socks and check for ticks before coming indoors. Light-colored fabrics help make ticks easier to see. Tightly woven material is tougher for the insects to penetrate. In general, try to avoid areas with high grass and brushing through undergrowth and branches. That’s where insects like to live and wait for hosts. If you choose a product containing DEET, select one with 15 percent or lower concentration of DEET to minimize exposure while still providing repellant. Don’t apply repellant indoors to minimize inhalation. Use only as directed on exposed skin. Use flea and tick prevention measures on pets and check any pets that go outdoors. Ask your veterinarian before using essential oils with pets because cats and dogs can have serious reactions to them. Eliminate sources of standing water, which is where mosquitoes like to lay eggs. Keep your yard mowed and bushes trimmed. Mosquitoes aren’t as active midmorning through early evening, so plan to perform yard work or engage in outdoor activities during those times. Check your window screens and around window air conditioners for holes and gaps.

July 2018 •

One of these is “Sit, stay and throw; don’t go” to help someone who’s struggling to keep above water. Instead of jumping in the water, sit down to stay balanced and throw a lifeline. Securing home swimming pools is also vital to promoting water safety — and, in some municipalities, part of local ordinance. “If you own a pool, make sure you have a fence around the entire area,” Bonafede said. “Make sure it’s tall Bonafede enough and the gate is locked so your child and no neighbor’s child stumbles in.” Keep in mind that a child determined to explore the pool area may use chairs or other items to climb over the fence. Remove these from outside the pool area. For above-ground pools, removing the ladder and locking it up elsewhere can add an additional measure of safety. Pool covers cannot prevent children from drowning. If a child is missing, check the pool first. Don’t rely upon novelty flotation devices for water safety. Choose only Coast Guard-approved devices, but never leave children unattended while swimming for even a moment. Visit or call 800-RED-CROSS for information on Red Cross courses.

Health Tip: Understanding Sunscreen Lingo


here may be no easy answer unless you understand sunscreen lingo, the American Academy of Dermatology says. A recent study in JAMA Dermatology found that fewer than half of people asked at a dermatology clinic understood the meaning of “broad spectrum” or “SPF.” The academy offers this primer about sunscreen lingo: • “Broad spectrum” sunscreen means it can protect you from the sun’s UVA and UVB rays. This will help prevent skin cancer, early skin aging and sunburn. • Sunburn protection factor (SPF) determines how well sunscreen protects from sun damage. SPF of 15 filters 93 percent of UVB rays, while 30 SPF filters 97 percent of those rays. • No sunscreen is entirely waterproof, but some are waterresistant. The product is considered water resistant if it stays on wet skin for 40 to 80 minutes. • Sunscreen should be reapplied every two hours, even if your skin stays dry. • A chemical sunscreen absorbs the sun’s rays, while a physical sunscreen protects you by deflecting the sun’s rays.

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

Living Alone Can Be Simply Beautiful!


ne of the beauties (and benefits) of getting older is that I’ve gained enough selfknowledge and confidence to figure out what really matters to me and what really doesn’t. This is especially helpful when making decisions about how best to simplify my life. Now that summer’s long, warm days have arrived, I’m finally finding time for cleaning, clearing, and getting rid of all those things that clutter my conscience and physical world. With great anticipation, I look forward to shedding outdated clothing, timeworn routines, and unhealthy habits. I am ready to clean up my act and de-clutter my life. Care to join me? Here are some tips: n List your priorities. Write them down. Knowing what really matters will help you decide where to start first. One of my priorities is to live in the present. Holding onto that gorgeous, skimpy dress I wore in my 30s for old-times’ sake is not doing me any good. In fact, it only serves to clog

my closet. Off it goes to Volunteers of America. n Start small. De-cluttering our lives can be daunting. I always begin by cleaning up one “corner” at a time. Today, it’s my desk. More specifically my desktop. I’ve gathered all the many documents, bank statements, Post-it note reminders, cards, etc. into one big pile. Later today, I’ll sort it out and discard probably 90 percent of it, in favor of making space and time for the things that need attention. n Purge your email in-basket. My “digital” life can be as overwhelming as my real life. How did I get on so many automated email lists? Oh, I remember now ... I made a fatal decision and purchased a pair of shoes online. That will do it! This morning, I spent worthwhile time unsubscribing to unsolicited email newsletters and shopping site promotions. n Clear your counter. Clear not just your clutter, but your counter. Nothing sinks my spirits faster than

walking into to my kitchen and finding the counter covered with old newspapers, unopened mail, yesterday’s coffee cup and more. Ugh. I feel so much better and in control when I come downstairs in the morning to a clean and organized kitchen counter. n Purchase help. This is so not “me.” I’m a do-it-yourselfer. But lately, I’ve made an investment in favor of efficiency and in keeping with my priorities. While I like to iron my own clothes (I find it peaceful and satisfying), I have found myself getting way, way behind. Shirts were piling up, and all my untended laundry was causing me stress! So I bit the bullet and decided to invest in pressing services offered by my local dry cleaner. It’s cheaper than full dry cleaning and I feel on top of things again. n Reduce your choices. This has made a big and positive difference in my life. One tiny example: Like most women, I have makeup samples galore and have been reluctant to throw anything out. But, I’ve changed my ways. I’ve discarded (or donated) many of the free makeup samples I’ve accumulated over the years and now only have my “go to” products within easy reach — one cleanser, one moisturizer, one mascara, one eye shadow, etc. How easy is that? My morning routine is simplified, and my bathroom counter is now easier on the eyes. • Carry around less stuff. Many of us

would do well to lighten our loads. I used to live in a “what if?” world: What if my car slides off the road and into a ditch? What if I needed to leave my house in a hurry to help a friend? What if TripAdvisor alerted me to an incredible discounted flight to Paris? Well, you get the idea. My oversized purse and car used to be filled with boundless “just in case” provisions — a change of clothes, back-up makeup, spare boots, a hair dryer ... you name it. But, no more. I’ve simplified my life. Now, I only carry basic necessities and my AAA card. Life is much simpler now that I’ve lightened my load. • Stay vigilant. Clutter can sneak up on you. Before you know it, your desk, your inbox, your counter, car, and conscience can fill up with unwanted, unnecessary stuff. Routinely ask yourself: Will this stuff make my life simpler or more complicated? Does it bring me joy? If the answer is no, think twice, and consider making changes in favor of your priorities. It’s as simple as that. 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, or visit

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The skinny on healthy eating

Crack a Crab for Lean Protein and More


ome people see crab the same way they do white pants: a summertime fancy to be enjoyed from Memorial Day to Labor Day. Me? I fancy the crustacean all year long because it’s simply too nutritious and too delicious to do otherwise. Gloriously low in fat and calories, crab is an excellent lean protein source. A 3-oz. cooked serving (about ¾ cup) has only 90 calories, 1 gram of fat, scant carbs, and 20 grams of complete protein. Slow-to-digest protein keeps us sated longer, is essential for building and repairing tissue, and is also an important building block of bones, muscles, cartilage, skin and blood. Eating too little protein, in fact, can make us feel sluggish, irritable, and weak. What’s more, not consuming enough protein can make the struggle to lose weight even harder. Crab rocks with a wide variety of vitamins and minerals — from iron to zinc, niacin to selenium — but it’s biggest claim to nutrient fame is its vitamin B12 content: nearly 150 percent of our daily needs in an average serving. Vitamin B12 lies at the core of our body’s ability to make DNA for new cells, form healthy red blood cells, maintain sound nerves, and turn the food we eat into energy. Furthermore, vitamin B12 may help

protect against brain volume loss in the elderly, according to researchers from the University of Oxford. Looking to boost your hearthealthy omega-3s? Much like other shellfish, crabs deliver. While no omega-3 superstar (like salmon), an average serving of crab has about 400 mg, which many deem an adequate daily amount for most. A diet rich in omega-3s may help to prevent heart disease and stroke, lower inflammation, and improve cognitive function. Because crabs come from the salty sea, they do have sodium, from around 300 to 900 mg per 3-oz. serving, depending upon which kind of crab you eat (Alaskan King has the most; Blue, the least). Since too much sodium can increase your risk of stroke, high blood pressure and heart disease, you’ll want to monitor your intake and skip the extra salt and salty butter. Crabs also serve up about 60 mg of cholesterol per 3-oz. portion, which may or may not concern you. Although my cholesterol runs high, I’m less concerned about dietary cholesterol these days because numerous studies — including one from the Harvard T.H. Chan School of Public Health — claim that, for many, the biggest influence on blood cholesterol is the mix of fats and carbohydrates in your diet, not the amount of cholesterol in your food.

Helpful Tips

When buying fresh, choose crabs that feel heavy for their size, move when you touch them, smell briny-fresh, and look bright and clean. Cooked crab in the shell should smell fresh, with no trace of “fishy” odor. Crab meat sold outside the shell is available fresh-cooked, frozen, and canned. It’s best to cook and eat live crabs the same day they are purchased. Fresh-cooked crabmeat will keep for two days, refrigerated. Canned crab is often imported from Asia and tends to have more sodium than fresh and frozen crab.

Crab Cakes with Spicy Rémoulade

Adapted from Cooking Light; serves 4

Crab cakes:

2/3 cup panko (Japanese breadcrumbs), divided 1 tablespoon minced fresh flat-leaf parsley (or 1 teaspoon dried) 2 tablespoons finely chopped green onions (or 2 garlic cloves, minced) ½ Fresno pepper, seeded, finely chopped (optional) 2 tablespoons canola-based mayonnaise 2 teaspoons fresh lemon juice 1 teaspoon Dijon mustard ½ teaspoon Old Bay seasoning ½ teaspoon Worchestershire sauce 1/8 teaspoon kosher salt 1/8 teaspoon coarse black pepper 1 large egg, lightly beaten 8 ounces lump crabmeat, picked over 1 tablespoon olive or canola oil


½ cup canola-based mayonnaise 1 ½ tablespoons chopped shallots 2-3 teaspoons Dijon mustard

2-3 teaspoons fresh lemon juice 1/8 teaspoon kosher salt 1/8 teaspoon coarse black pepper Combine 1/3 cup panko and next 11 ingredients (through egg) in a large bowl, stirring well. Add crab; stir gently just until combined. Shape crab mixture into 4 equal balls. Gently flatten balls to form 4 (4-inch) patties. Refrigerate for 30 minutes. Place remaining 1/3 cup panko in a shallow dish. Coat cakes with panko. Heat a large nonstick skillet over medium-high heat. Add oil to pan; swirl to coat. Add patties; cook 3 minutes on each side or until golden. Serve with lemon wedges or spicy rémoulade.To prepare rémoulade, whisk ingredients together in a small bowl.

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

Another Reason to Dislike Winter: Higher Risk of Heart Attack


aybe there’s a good reason you dislike cold weather: The risk of death from a heart attack is higher in the winter than in the summer, a new study says. Researchers at Leeds General Infirmary in England examined data from more than 4,000 patients treated for heart attack over four years. They found the risk of dying within 30 days of a severe heart attack was nearly 50 percent higher in the coldest months (November to April) than in the warmest months — 28 percent versus 20 percent. That was true even though the overall number of heart attacks was the same in the coldest and warmest months. It’s not clear from the study if the

results would apply in other parts of the United Kingdom or elsewhere in the world. Still, “there is no physical reason why a heart attack, even the most severe, should be more deadly in winter than in summer, so we must do further research to find the cause of this difference and remedy it,” said study leader Arvindra Krishnamurthy. Potential explanations could include longer time to treatment, prolonged hospitalization and delays to discharge, and increased prevalence of winter-associated infections. In the sickest patients, these infections could be potentially lethal, Krishnamurthy noted in a British Heart Foundation news release.

The preliminary research was presented in June at the British Cardiovascular Society Conference, in Manchester, England. Another heart specialist said it’s vital to find out why there are these apparent differences. “You obviously can’t choose when you have a major heart attack, but it shouldn’t have such an impact on your chances of surviving,”

July 2018 •

said Metin Avkiran, associate medical director at the British Heart Foundation. “Although we’ve made huge strides in the last 50 years, we must urgently fund more research to continue to drive down the number of heart attacks and ensure more people can live full lives even after a heart attack,” Avkiran said.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 11

Sons Will (left) and Dan (right) have provided support to their dad, Keith Rohleder, center, through their dad’s clinical trial process. “When we heard about the clinical trial, I was ready to go right off the bat,” the father said.

Ultimate Test Clinical trials: When are they viable option for cancer patients? By Katie Coleman


linical trials can be a viable treatment option for cancer patients from the start of their diagnosis. However, many patients and their loved ones don’t always know about them, how they work and what resources are available to help select the best treatment — whether that’s standard treatment or a clinical. The Leukemia & Lymphoma Society, which funds blood cancer research, provides education, financial resources and treatment access for blood cancer patients, broadcasts an educational webinar titled, “Clinical trials for blood cancers — How can participating in a clinical trial help me?” to explain clinical trials and questions you need to ask before selecting a treatment option for blood cancer patients. Keith Rohleder, a former Buffalo resident with a rare and aggressive form of blood cancer — blastic plasmacytoid dendritic cell neoplasm — recently completed a clinical trial and is among the panel of speakers that participated in the webinar to help spread awareness and share his personal story. BPDCN decreases red and white blood cells and platelet counts in the body and can evolve to the bone marrow and spleen. Symptoms are widespread, making the disease hard Page 12

to diagnose, and include skin lesions, enlarged lymph nodes, fatigue, and stomach pain. There is no established treatment or cure, and that is why Rohleder’s most viable option was the clinical trial SL-401, a biological targeted therapy that has shown antitumor effects. “When we heard about the clinical trial, I was ready to go right off the bat,” Rohleder said. “I was in phase three of the clinical trial. It’s been sent to the Federal Drug Administration and is supposed to be approved in 2018.” Rohleder learned about the trial after Tricia Rohleder, his wife and advocate, called The Leukemia & Lymphoma Society’s Clinical Trial Support Center. Its staff is a team of nurses that specializes in blood cancers and assists patients and their loved ones throughout the clinical trial process. Director Alissa Gentile has guided the Rohleders with information on BPDCN, clinical trial options for BPDCN, which had the highest potential for success, and referred Rohleder to the BPDCN Center at The Dana Farber Cancer Institute in Boston, Mass. Rohleder is now working through the aftermath and side effects of his treatment. When he was first diagnosed, he was given 12 to 22 months to live, and he has surpassed

that at 24 months to date. “If we would have gone with standard treatment, there’s a really good possibility Keith would either be gone or they may have just bought him another year to live,” Tricia Rohleder said. “It just didn’t make sense to choose a standard treatment option.” Parlaying medical discoveries

Clinical trials usually start with a scientific discovery that leads to a new or improved treatment option through research and drug development by doctors. After the drug or improved treatment is developed, pre-patient clinical studies are conducted and are submitted as a proposal to the FDA for review. If the FDA approves the process of studying the particular drug in a clinical trial, then the four phases of a clinical trial are outlined and doctors can begin administering to participating patients. BPDCN Center Director John Leonard, associate dean for clinical research at Weill Cornell Medicine and New York-Presbyterian Hospital, administered Rohleder’s treatment and also participated in the webinar to explain the entire clinical trial process. “There’s a great deal of review before any drug or compound makes

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

it to a patient in a clinical trial,” Leonard said. “Initially, there’s a scientific discovery that leads to a group of researchers saying, ‘Perhaps if we target this gene, pathway or molecule we can affect the disease.’ A drug, chemical or compound is developed and studied in a laboratory, and after a number of pre-clinical studies, the investigators assemble a package of information and submit it to the FDA. Once the FDA reviews the information, they may approve the process of studying the drug in a carefully designed clinical trial.” According to Leonard, it’s important to know which phase of a clinical trial you would be entering and what that means before deciding to participate. “When I talk to patients about clinical trials, I really want them to understand the goal of the trial, phase of the trial, and what we already know about the drug. It’s important you learn about all your treatment options — standard treatments and those that might be available in clinical trials — and ask questions until you have all the answers,” Leonard said. Here is a breakdown of clinical trial phases: — Phase I: Researchers administer an experimental drug or treatment for the first time to a small number of people. Its safety, dosage range and side effects are evaluated. — Phase II: The experimental drug or treatment is given to a larger pool of people to see if it is effective and to continue evaluating its safety. — Phase III: The drug or treatment is given to a large number of people. Research confirms its effectiveness, side effects, its safety requirements and they compare it to commonly used treatments. — Phase IV: Post-treatment studies are conducted after the FDA approves the new drug or treatment, and additional information on the drug’s risks, benefits, and best practices is collected. With such careful monitoring throughout the process of Rohleder’s SL-401 treatment, he experienced a high level of care that, according to Leonard, is typically seen in clinical trials. “There’s data that suggests the care provided as part of a clinical trial is actually better than what you receive in routine care, and that’s not because routine care is bad,” he said. “It’s because the extra layers of monitoring, of personnel keeping tabs on everything, and the safety measures built into it lead to more people involved in one’s care and therefore closer observation.” The Rohleders recommend that following a cancer diagnosis, patients and their caregivers find an advocate they can trust as soon as possible to help them navigate the entire process. “I’m very happy I had an advocate, my wife,” Rohleder said. “There’s so many times when you need an advocate due to the fact that you’re on this pharmaceutical or that pharmaceutical, or they need to know about billing. Having an advocate relieves some of the stress for the patient.” To view The Leukemia & Lymphoma Society’s webinar, go to

Women’s Health

Is Smoking Pot While Pregnant Safe For The Baby?

It’s difficult to tease out the data because of so much variability. It’s a challenging thing to study.” She added that it doesn’t appear that marijuana affects intelligence, but that there’s a correlation with behavioral differences and a greater likelihood of substance abuse later in life. “We don’t really know the absolute effects on a developing brain,” Barnabei said. “A lot of people don’t think that far ahead in the midst of a pregnancy.” She said that most patients who smoke marijuana quit once they learn they’re pregnant. Marijuana isn’t as addictive as tobacco, alcohol or “hard” drugs, so quitting doesn’t challenge patients much. It’s more about education. That’s why organizations like Niagara County Department of Health are working to help women understand that marijuana can have negative effects on their babies. Theresa McCabe is the public health educator for the environmental

health division of the Niagara County Department of Health. She said that the American College of Obstetrics and Gynecology (ACOG) recommends pregnant women avoiding using drugs, including hallucinogenic drugs. Marijuana contains tetrahydrocannabinol (THC), which causes its hallucinogenic effects. “It can affect the respiratory and nervous system,” McCabe said, among other effects. ACOG states that maternal marijuana use is associated with children experiencing lower test scores, visual problem solving ability, visual motor coordination and disruptive behavior. Marijuana is more potent than ever. Today’s marijuana can be as high as 37 percent THC, compared with the 1 to 3 percent average in the 1970s. Since it’s sold illegally and non-regulated for recreational use in New York, users have no idea what’s really in the marijuana they purchase. Using a non-incendiary “vape” device to get high can also bring additional problems, since they expose the mother and subsequently the baby to nickel, lead and formaldehyde. Little research exists on the effects of vaping marijuana during pregnancy because of the relative novelty of vaping and the ethics behind exposing babies to its known harmful effects. McCabe encourages moms to ask their doctors for resources to help them stop using drugs and to address underlying issues if they use them to self-medicate for other issues. “After the baby is born, any use of marijuana or opiates can cause withdrawal,” McCabe said. “Babies may go to a special nursery and CPS [Child Protective Services] may be involved. The baby will need to be monitored for neurological withdrawal.” Some mothers may believe that light use of marijuana is okay; however McCabe said that “even occasional is not recommended.” “We try to encourage them to stop and refer them to ancillary services,” McCabe said.

that it may have to do with the way certain foods affect hormones. “Refined carbs are one of the main culprits for insulin resistance,” Dunneram said. “A high level of circulating insulin could interfere with sex hormone activity and boost estrogen levels, both of which might increase the number of menstrual cycles and deplete egg supply faster, thus causing an earlier menopause.” But the researchers cautioned that the study does not prove cause and effect, and that prior research has linked earlier menopause to both a higher and lower risk of developing a wide range of diseases. “As such, we cannot really recommend women to consume these specific foods to influence their onset of natural menopause,” Dunneram said. For the study, the researchers surveyed a group of English, Scottish and Welsh women to establish their nutritional patterns with respect to 217 specific foods. All of the women were aged 40 to 65, and none were

told to alter their eating patterns. About 14,000 women were tracked for four years post-survey, during which just over 900 experienced natural menopause. On average, menopause began at 51. But for every additional daily intake of a standard portion of refined carbs, menopause onset began about 1.5 years earlier, the findings showed. By the same token, every additional daily portion of oily fish and legumes was linked to a delay in menopause of roughly three years. Higher daily intake of both vitamin B6 and zinc was similarly linked to delayed menopause. The findings were published online April 30 in the Journal of Epidemiology & Community Health.

By Deborah Jeanne Sergeant


espite years of hearing the message that substance abuse during pregnancy can harm babies, the number of women smoking marijuana while pregnant is increasing, according to a December 2017 article in Journal of the American Medical Association. “Marijuana is the most commonly used illicit drug during pregnancy, and its use is increasing,” wrote the article’s author, Kelly C. Young-Wolff, Ph.D., of Kaiser Permanente Northern California. “From 2002 to 2014, the prevalence of self-reported, pastmonth marijuana use among U.S. adult pregnant women increased from 2.4 percent to 3.9 percent. In aggregated 2002-2012 data, 14.6 percent of U.S. pregnant adolescents reported past-month use. However, studies are limited to self-reported surveys and likely underestimate use due to social desirability bias and underreporting, leaving the scope of the problem unclear.” The study included 279,457 pregnant women in California. Exact figures on how many pregnant women smoke marijuana are difficult to obtain, since admitting pot smoking may attract unwanted attention from law enforcement and, for mothers, child protective services.

Several factors play into the uptick in marijuana use among pregnant women, according to the article. Marijuana isn’t viewed as a “bad” drug, especially in light of its increasing legalization. Eight states have legalized recreational marijuana and many more, including New York, have legalized it only for different levels of medical use. Natural approaches to health have been increasing in popularity. Some people turn to marijuana to combat pain, nausea, depression and anxiety instead of prescription medication or other remedies. Some of these symptoms are often associated with pregnancy. Physician Vanessa Barnabei, PhD., serves as president and CEO of UBMD Obstetrics-Gynecology and chairwoman of the department of obstetrics and gynecology at Jacobs School of Medicine & Biomedical Sciences. “There are data that suggest that especially in heavier marijuana smokers, rate of miscarriage and stillbirth is higher,” Barnabei said. “When you look at data from National Institutes of Health or Centers for Disease Control and Prevention, some suggest longer term development abnormalities from moms who smoked marijuana.

What Foods Can Hasten or Delay Menopause? Study shows certain foods can delay menopause up to three years


hat women eat might determine when they enter menopause, new research suggests. After tracking more than 35,000 British women for four years, investigators found that menopause tended to start earlier among those whose diets were heavy in refined carbs. In contrast, menopause tended to begin later among those who consumed a lot of fish and legumes. “In particular, a higher consumption of oily fish was found to delay the timing of natural menopause by approximately three years, and fresh

legumes — such as peas and green beans — was linked to a later menopause by around a year,” said study author Yashvee Dunneram. “On the other hand, a higher consumption of refined carbohydrates — such as pasta and rice — hastened the onset of menopause by 1.5 years,” said Dunneram. She is a postgraduate researcher with the nutritional epidemiology group in the school of food science and nutrition at the University of Leeds, in England. The reason for the link remains unclear. But Dunneram speculated

July 2018 •

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Women’s Health

Mixed Martial Arts Appealing to Growing Number of Women Get defensive about your workout By Catherine Miller


razilian jiujitsu. Martial fusion. Therien jiujitsu. You may be intrigued to know that each of these variations of mixed martial arts packs in an abundance of health benefits. While many folks think of mixed martial arts classes as a men’s only world — and jiu jitsu and karate classes as something only teens are interested in — more women are taking an array of MMA classes for a change of pace in their fitness regimen and for the extensive health benefits they provide. Increased mobility along with improved flexibility and cardiovascular health are just a few of the MMA benefits. With workouts that amp up your ability to defend yourself in a world where such needs are ever growing, these classes help to lower your blood pressure and heart rate. You can improve mental concentration and relieve stress, which makes martial arts classes pretty much the perfect exercise option for men and women of all ages. Sensei Michael Downs is the owner of the Defensive Arts Dojo in Hamburg. He has over 37 years of experience in martial arts. Having obtained his black belt in 1988, he is a chiropractor by trade but allots more space to his martial arts classes at his Camp Road location than to chiropractic care, and with good reason. His dojo studio offers over two dozen varieties of martial arts classes for all ages and experiences and will intrigue even the most fastidious fitness buff. “Some people only want health benefits, so I suggest the martial fusion class, which works great for weight loss and still gives a martial arts component,” Downs said.

“The Brazilian jiujitsu is a mix of everything self-defense requires — kicking, punching, and throwing, often from a ground defense.” In the martial fusion class, attendees will work in pairs and as a group as instructors stress cardio exercise. Expect to partake in anything from burpees and sprints, to glove boxing and kicks. The interval training can be varied in intensity to fit any fitness level, from beginning to expert. Once you get hooked on this class, you can add the “warrior fitness” class that branches off the martial fusion class, but kicks it up a notch — literally — with more extensive legwork and striking maneuvers. Equal playing field

In the Brazilian jiujitsu class, students use leverage and form to teach that a smaller, weaker person can successfully defend against a larger, stronger assailant. This class focuses more on actual defensive strategy. Much of the class is onthe-ground defense and has become a popular form of defensive art. A similar option, Therien jiujitsu, is a mix of everything that self-defense requires. Classes include kicking, punching, throwing, ground defense, and multiple attacker training. Expect to learn how to use joint manipulation and pressure points to ward off would-be assailants. In addition to these specialized classes, Hamburg’s Defensive Arts Dojo offers a core group of karate and fundamental MMA classes. Many of the classes overlap in training despite their unique concepts. This helps participants become familiar with the defensive

More and more women in Western New York are taking an array of MMA classes for a change of pace in their fitness regimen concepts in a variety of scenarios and builds on the person’s reaction ability and timing confidence. Moira Prister has taken MMA classes for nearly two decades. Originally from the Rochester area, Prister moved to the Western New York area two years ago, primarily to relocate closer to the Hamburg Defensive Arts Dojo. “Nothing else compares to this dojo,” said Prister, who regularly attends a variety of classes, including the martial fusion class. “This place has a great variety of classes, great staff teaching the classes, and the people that come here are like family.” April West agrees. While she is the resident massage therapist at the facility, she is often found taking many of the MMA classes or working out on the heavy bags. Jeff Przepasniak was a member

of the Defensive Arts Dojo years ago and made his way back after over a decade-long absence when he found his traditional gym wasn’t suiting his needs in variation of classes. MMA is growing in popularity because of the range of classes available, diversity of movements that aid in the overall fitness of each participant, and the mere fact that as you are learn to defend yourself, you are also building strength and coordination. “Martial arts has the advantage of having cardiovascular, muscular, and flexibility training all in one movement. It is the total package,” Downs said. “Martial arts is my way of life in every way — through personal protection, health and wellness, and friendships I have fostered along the way. It allows me the ability to help others. It will always have a role in my life.”

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Trim Healthy Mama. Is This Diet For You? Local experts praise new diet method By Deborah Jeanne Sergeant


f you’ve spent any time on social media lately, you’ve likely heard of Trim Healthy Mama (www. from the book “Trim Healthy Mama Plan” by Pearl Barrett and Serene Allison. Also known as THM, it’s an eating plan that offers both pros and cons, according to area health experts. Not just for mamas, the eating plan basically involves nixing white flour, white sugar, unhealthful fats and artificial sweeteners; never eating carbohydrates and fat sources in the same meal; and eating every three hours. Those following the plan also choose as most of their carbohydrate intake fruit, Burch vegetables or, occasionally, low glycemic index bread, such as sourdough bread. Erin Burch, registered dietitian in practice in Buffalo as Erin Burch Nutrition, PLLC, said that the emphasis on fruits and vegetables makes THM overall pretty healthful. “The plan is geared directly toward regulating blood sugar, which prevents fat storage and

reduces inflammation, and can help with weight loss,” she said. “The plan encourages protein at each meal, which is a recommendation I make with almost all of my clients. Protein helps with blood sugar control, metabolism boosting and satiety.” She also likes its emphasis on moderation and mindful eating; however, labeling food as “good” or “bad” can lead to poor eating habits. Any food eaten in moderation can be part of an overall healthful diet, she said. Physician Priyanka Patnaik provides outpatient primary care service at Conventus Family Medicine. She’s also a clinical assistant professor at UB Family Medicine at Jefferson. She doesn’t recommend diets, as shortterm and yo-yo dieting can lead to weight gain, as individuals return to the old habits that caused weight gain. “Some have succeeded with this as it curbs extra calories,” Patnaik said.

Is Sleep Apnea Worse for Women? Studies Say “Yes”


he statistics are startling. According to the American Academy of Sleep Medicine, 26 percent of adults aged 30 to 70 have sleep apnea. Left untreated, its sleep-disturbing effects can lead to life-threatening cardiovascular problems, including high blood pressure, chronic heart failure, atrial fibrillation and stroke. And for women, the impact can be even more severe. Studies led by UCLA School of Nursing professor Paul Macey have repeatedly shown that there are significant differences between the impacts of sleep apnea on men and women. While men are more likely to have sleep apnea, women with sleep apnea have a higher degree of brain injury. “Because women report different symptoms, they tend to be misdiagnosed,” Macey said. “Early detection and treatment is the best way to protect against damage to the brain and other organs.”

In his most recent study, Macey and colleagues examined medical records and brain scans of a group of patients who were diagnosed with sleep apnea and a group without sleep apnea. Macey found several apparent connections between thinning of the brain’s cerebral cortex and apnea symptoms. The researchers also found distinct changes in brain structures and cognitive symptoms that differed between men and women. For example, in the frontal lobe, which controls cognitive skills and motor function, more regions appear thinner in women with apnea than men or in the group of patients without sleep apnea. That difference might explain the impact on memory and other mental processes among women with the disorder, the researcher said. The study continues to illustrate the significant clinical differences between men and women with sleep apnea, and points to the need for different treatment approaches to

“It is a low-carbohydrate diet and increases vegetables. It cuts down on the number of calories.” But she added that the rigidity of the plan, such as not consuming fats and carbohydrates in the same meal, may be difficult to follow. “By not eating it together, it’s a less balanced Patnaik diet,” Patnaik said. “The only reason it’s working for weight loss is you are getting energy through the fat. The protein and fat in the diet give satiety so people feel less hungry.” Patnaik also doesn’t think people can continue eating THM for a long time. Instead, she recommends cutting out sweetened beverages and juice, controlling portion sizes and making better food choices. “Be consistent in lifestyle changes,” she said. “Make changes that will work for you. Not everyone likes salad. Some might like soup and cooked vegetables. As long as there’s a calorie deficit, they will lose weight. At the end of the day, it’s how much you burn.” D.J. Mazzoni, nutritionist at UBMD Orthopaedics & Sports Medicine in Cheektowaga, said he has never heard of avoiding carbs and fat at the same meal as a means of weight loss. “Eating them together helps slow down the digestion process as you feel full

longer,” Mazzoni said. “I don’t see the science in separating fat and carbs.” Many THM recipes listed online are dessert recipes, or ones geared to replace now-forbidden foods. Since they’re trying to improve dishes that include things like white flour, they often call for more obscure and expensive ingredients. “It can be difficult if people can’t find those ingredients,” Mazzoni said. “The diet deals with a lot of food preparation. We’re used to spending less time on preparing food.” Mazzoni does like the aspect of THM that requires eating every three hours, since that helps keep prevent becoming so hungry that the person makes poor food choices or overeats later. The healthful aspects of THM sound familiar to Allyson Odachowski, registered dietitian with Custom Dietetics in Buffalo. “It’s a healthy eating message packaged in a different way,” she said. “A lot of other diets recommend the same things. Those are the positives. I don’t think those points are unique to this plan.” Odachowski doesn’t like that THM limits grains, as many of these with high fiber are healthful and contain B vitamins, for example. “Anytime you limit your foods, you limit your nutrient profile,” Odachowski said. “All food has some benefit, but you should only cut something out if you have to, like with allergies. “Eating should be enjoyable and fun. You should go to the party and have something to eat.” She explained that diet plans tend to provide a template and followers are either good and “on plan” or bad and “off plan” instead of learning and adopting lifestyle habits of eating and exercise that support good health.

address these varied symptoms. The higher degree of brain injury in women may underlie their more common cognitive problems compared with men, while thinning associated with both men and women who have sleep apnea may be behind the disordered breathing seen between both,

the researchers said. It is not clear whether these physical brain changes precede the sleep apnea disorder, or worsen sleep apnea’s symptoms as the disorder progresses. Each study “is like uncovering another piece of what might be going on,” Macey says.

July 2018 •

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Sun’s Out, Fun’s Out: WNY Offers Plentiful Outdoor Activities By Julie Halm


he summer months are fleeting in the Buffalo region, but they provide residents the opportunity to get out and be active in a variety of locations and in a plethora of ways. From hiking to kayaking to simply watching a sunset in a scenic spot, Western New York has a great deal to offer. Reinstein Woods At Reinstein Woods Nature Preserve, located at 93 Honorine Drive, Depew, visitors can exercise their bodies while also exercising their minds. According to Meaghan BoiceGreen, director of the Reinstein Woods Environmental Education Center, the nature preserve offers something different than most typical parks. “A lot of it comes down to management,” she said. “We manage this property to maximize the number of types of plants and animals that live here so we can utilize them for education and entertainment.” According to Boice-Green, this allows visitors to really appreciate the natural habitat while searching for all kinds of wildlife. This searching takes place in many ways, from the casual to the organized. Backpacks with curated scavenger hunts and games for young visitors are available for use and soon a massive group effort to log the natural residents of the preserve will be under way. A 24-hour long event known as the Bio Blitz will take place beginning at 4 p.m. Friday, Aug. 24. “We try to identify as many types of things that are living here as possible,” said Boice-Green. Groups are broken up into specific areas such as birds, bats or even fungi, but those who wish to participate need not be experts nor commit a full 24 hours to the cause. Boice-Green also noted that the event typically concludes with a summary where all visitors can learn about the range of plants and animals which were identified in the preserve. Registration will soon be open for those who wish to participate in the Bio Blitz. Reinstein Woods also features a lily pond, a nearly three-mile long walking loop suitable for people of all physical abilities, summer camp programs and other attractions. The preserve also offers a motorized scooter to those who have limited mobility so that they can also enjoy the outdoors. A scooter can be borrowed free of charge, Monday through Friday during operating hours. For more information on programs and hours, visit Fort Niagara State Park For those seeking an outdoor Page 16

experience with a historic twist, Fort Niagara State Park and its neighbor, Old Fort Niagara, can be an enticing offering. The state park, which is separate from the actual historical building, offers multiple trails for walking and biking. The “Measured Walk” around the park is just shy of 2.3 miles and the “Beach Trail” is a bit less of a commitment at approximately one mile. According to Angelina Presutti, park aid, the trails are wide, flat and appropriate for everyone from the serious athlete to the casual stroller. For those looking to get a workout on the water, the park also boasts a boat launch that is popular among kayakers. Those looking to stay a bit less dry have plentiful options as well. “One of our main attractions is the pool,” said Presutti. “It has two water slides, a kiddie pool, a sprinkler system and then the main pool.” More than 20 soccer fields are also open for public use when organized leagues are not using them. After a long and active day, visitors can relax with quite the view. “If you come to the beach area, there’s a very good view of Toronto when it’s sunny enough, and a lot of people like to come and just watch the sun set,” said Presutti. The fort borders the state park, but requires a separate admission fee. For more information on the park, visit parks/175/details.aspx. Ellicott Creek Park The Erie County Parks, Recreation and Forestry Department manages nearly two dozen parks throughout Western New York which feature hiking trails, biking trails, fishing, kite flying, disc golf, playgrounds, kayaking, soccer fields, tennis courts, horseback riding trails and more. The system covers a whopping 11,000 acres of land. For the nature enthusiast, Ellicott Creek Park, located at 1 Ellicott Creek Drive, Tonawanda, is a great place to visit. According to the Erie County Parks, Recreation and Forestry Department, visitors will find a variety of creatures from water to land to sky. Frogs, turtles and salamanders can be spotted by the water which is home to more than a half a dozen varieties of fish. Hawks, ducks, geese and woodpeckers are frequent flyers in the park and white-tailed deer, rabbits, foxes and several species of squirrel are just some of the mammals that visitors might spot. According to Daniel Rizzo, commissioner of Parks, Recreation and Forestry for Erie County, a partnership with Buffalo Niagara Waterkeeper has resulted in a 550-foot long living shoreline, which attracts all kinds of wildlife. These animals, paired with scenic grounds and the creek all make for a wonderful spot for budding pho-

A sign welcomes visitors to Fort Niagara State Park.

Visitors of all ages enjoy the trails at Reinstein Woods Nature Preserve in Depew. tographers to get outdoors and capture some beautiful scenes. For the athletically-inclined, the park features a soccer field, tennis courts, a disc golf course and even a cricket pitch, which is an uncommon find around the area. Those looking to enjoy the outdoors and spend some healthy, quality time with their four-legged friends can also visit the Ellicott Island Bark Park. “It’s the biggest dog park in the area,” said Rizzo. “It’s almost like Disney World for dogs.” The Eternal Flame At Chestnut Ridge Park, the Eternal Flame is a unique local attraction. A roughly 1.25 mile hike will bring visitors to the flame and its accompanying waterfall. According to Rizzo, the hike is not overly difficult, but requires proper footwear — shoes such as sandals or flip flops should be avoided. He also cautioned that hikers should always remain on the marked trail. For those looking to explore the parks system, especially with their little ones, the Junior Park Ranger program provides an excellent opportunity. The self-guided program is open to people of all ages and begins

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

One of the backpacks available for use by young visitors to Reinstein Woods Nature Preserve. with picking up a Erie County Park System Passport. Participants then visit a total of nine parks as designated by the program and locate codes posted in that park and complete two additional written activities. “It’s a great way to get out and explore our parks and get a little exercise,” said Rizzo. For a full list on parks in Erie County and details about what they each feature, visit parks/index.php?q=parks.

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How to Make a Living Will Dear Savvy Senior, What’s the best way to go about making a living will? I recently retired and would like to start getting my affairs in order, just in case.

Approaching 70 Dear Approaching, Preparing a living will now is a smart decision that gives you say in how you want to be treated at the end of your life. Here’s what you should know, along with some resources to help you create one. Advance Directive To adequately spell out your wishes regarding your end-of-life medical treatment you need two legal documents: A “living will” which tells your doctor what kind of care you want to receive if you become incapacitated, and a “health care power of attorney” (or health care proxy), which names a person you authorize to make medical decisions on your behalf if you become unable to. These two documents are known as an “advance directive,” and will only be utilized if you are too ill to make medical decisions yourself. You can also change or update it whenever you please. Do-It-Yourself It isn’t necessary to hire a lawyer to complete an advance directive. There are free or low-cost resources available today to help you write your advance directive, and it takes only a few minutes from start to finish. One that’s completely free to use is Caring Connections, a resource created by the National Hospice and Palliative Care Organization. They provide state-specific advance directive forms with instructions on their website ( that you can download and print for free. Or you can call 800-658-8898 and they will mail them to you and answer any questions you may have. Or, for only $5, an even better tool is the Five Wishes living will. Created by Aging with Dignity, a nonprofit advocacy organization, Five Wishes is a simple do-it-yourself document that covers all facets of an

advance directive that will help you create a more detailed customized document. It is legally valid in 42 states and the District of Columbia. To learn more or to receive a copy, visit or call 888-594-7437.

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Want Legal Help If you would rather use a lawyer, look for one who specializes in estate planning and health care-related matters. The National Academy of Elder Law Attorneys (NAELA. org) and the National Association of Estate Planners and Councils ( websites have directories to help you find someone. Costs will vary depending on the state you reside in, but you can expect to pay somewhere between $200 and $500 to get one made.


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Tell Your Family To insure your final wishes are followed, be sure you tell your family members, health care proxy and doctor so they all know what you want. You should also provide copies of your advance directive to everyone involved to help prevent stress and arguments later. For convenience, there are even resources like and that will let you and your family members store your advance directive online, so you can have immediate access to them when you need them.

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.

Sat 7/7 9-12 Sat 7/28 9-12


Do Not Resuscitate You should also consider including a do-not-resuscitate order (DNR) as part of your advance directive, since advance directives do little to protect you from unwanted emergency care like CPR. Doctors and hospitals in all states accept them. To create a DNR, ask your doctor to fill out a state appropriate form and sign it. Another tool you should know about that will complement your advance directive is the Physician Orders for Life-Sustaining Treatment (POLST). Currently endorsed in 22 states with 24 more in some phase of development, a POLST translates your end-of-life wishes into medical orders to be honored by your doctors. To learn more or set one up, see


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Ask The Social

Security Office

From the Social Security District Office

Monitoring Your Earnings Record Can Really Pay Off


ou work hard for your money. You’re saving and planning for a secure retirement. Now you need to make sure you’re going to get all the money you deserve. Regularly reviewing your Social Security earnings record can really pay off, especially when every dollar counts in retirement. If an employer did not properly report just one year of your work earnings to us, your future benefit payments from Social Security could be close to $100 per month less than they should be. Over the course of a lifetime, that could cost you tens of thousands of dollars in retirement or other benefits to which you are entitled. Sooner is definitely better when it comes to identifying and reporting problems with your earnings record. As time passes, you may no longer have easy access to past tax documents, and some employers may no longer be in business or able to provide past payroll information. It’s ultimately the responsibility of your employers — past and present — to provide accurate earnings information to Social Security so you get credit for the contributions you’ve made through payroll taxes. But you can inform us of any errors or omissions. You’re the only person who can look at your lifetime earnings record and verify that it’s complete and correct.

So, what’s the easiest and most efficient way to validate your earnings record? n Visit myaccount to set up or sign in to your own my Social Security account; n Under the “My Home” tab, select “Earnings Record” to view your online Social Security Statement and taxed Social Security earnings; n Carefully review each year of listed earnings and use your own records, such as W-2s and tax returns, to confirm them; n Keep in mind that earnings from this year and last year may not be listed yet; and n Notify us right away if you spot errors by calling 1-800-772-1213. More detailed instructions on how to correct your Social Security earnings record can be found at Securing today and tomorrow requires accuracy and diligence on our part and yours. You’ll be counting on Social Security when you reach retirement age. Make sure you’re getting every dollar you’ve earned. You can access us any time at www.

Health News Fallis appointed VP for behavioral services at ECMC Susan Fallis has recently been appointed to the position of vice president of behavioral health services at Erie County Medical Center Corporation. In this role, she will oversee the service delivery for behavioral health and chemical dependency services.  Fallis will provide leadership to the comprehensive psychiatric emergency program (CPEP), the inpatient behavioral health units, Fallis and the chemical dependency units, as well as the outpatient behavioral health and chemical dependency clinics and services all part of the Regional Center of Excellence for Behavioral Health at ECMC.   Fallis has been in her current role as assistant vice resident of behavioral health since January 2017. During her tenure at that position, the department has continued to enhance and refine its delivery of services.   She began her career as an oncology nurse and has worked in various positions within the office of mental health, including nurse manager, assistant director of nursing and chief nurse officer.   Fallis holds an associates degree in applied science from Trocaire College, a Bachelor of Science degree in nursing from Daemen College, and a Master of Science in nursing from D’Youville College. She is board-certified as a nurse executiveadvanced level from the American Nurses Credentialing Center.  

Cynthia Bass now in charge of diversity at ECMC 5945 Vinecroft Drive Clarence Center, NY 14032 (716) 741-7741

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Cynthia R. Bass has been appointed director of the office of diversity and inclusion at Erie County Medical Center (ECMC) Corporation. Reporting directly to the office of the president and CEO and working closely with other executive leaders, Bass will develop and implement a strategic plan that prioritizes and communicates the importance of diversity in a community-based, safety Bass net hospital setting; serve as a resource to incorporate diversity and inclusion into ECMC practices, programs, policies and procedures; collaborate with all levels of management and executive

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

leadership to develop diversity and inclusion competencies; and representing the hospital at community events.   Bass joined Erie County Medical Center in 2011 as a benefits analyst in the human resources department, where she served as the central liaison and administrator of benefits programs for the more than 3,400 employees of ECMC Corp.  In 2015, she expanded her role through a promotion to the position of human resources business partner.  During her tenure, she developed relationship management strategies to resolve complex employee relations issues in the nursing and behavioral health departments.  While serving in this role, she came to understand the need for diversity and inclusion initiatives to be embedded into the culture of ECMC, while also becoming more involved in strategic initiatives.   “The internal organizational knowledge and development of key relationships that Cindy has refined over the last seven years will serve her well in her current position as she seeks to strengthen diversity and inclusion as part of our unique ECMC culture,” said   ECMC Corporation President and CEO Thomas J. Quatroche Jr. “Cindy will ensure that as the changes that shape our healthcare delivery systems continue to evolve, so too will ECMC to best meet the needs of our patients and staff, and provide career opportunities for the members of the community we serve.”    Bass earned a Bachelor of Science degree in human resources (2002) followed by a Master of Business Administration from Medaille College.  In June of 2018, she completed a fellowship for certification in diversity management (CDM) from the Institute for Diversity in Health Management, an affiliate of the American Hospital Association.  

Brooks-TLC opens inpatient chemical dependency treatment unit Brooks-TLC Hospital System, Inc. has announced the opening of its 20-bed inpatient chemical dependency unit at the Lake Shore Health Care Center in Irving. The creation of an inpatient unit expands the existing outpatient substance abuse disorder treatment program, and is part of an overall plan for the Brooks-TLC service offering at the TLC campus. According to the Chautauqua County Department of Health and Human Services, there have been close to 200 drug-related or drug overdose deaths in Chautauqua County since 2015. In addition, rates of death and emergency room visits for opioid overdoses are higher in Chautauqua County than the New York state average as reported in 2014-2016 (NYSDOH, New York State- County Opioid Quarterly Report for Counties outside NYC Published October 2016). Designed with the principles of

H ealth News patient-centeredness in mind, the brand new facility features private rooms with attached half baths for every patient, extra wide corridors, a large common space/family area, and workout room. Programming includes medication assisted treatment, trauma informed care, individualized treatment planning, and provider collaboration. Transportation is available. Admissions information is available by calling 716-951-7948.

Kaleida Health and Eastern Niagara Team Complete Grossi Park Renovations

$1.5 million behavioral health clinic opens in Gowanda Zoar Valley Clinic, a facility that offers outpatient behavioral health services for adults, children and adolescents through the Office of Mental Health’s Buffalo Psychiatric Center and Western New York Children’s Psychiatric Center, has recently opened in downtown Gowanda. An open house and ribbon cutting ceremony was held June 6 to introduce the community to the services now available at the site at 49 S. Water St. Office of Mental Health Commissioner Ann Sullivan joined clinic staff, advocates and stakeholders to officially open the new facility. “The new, updated Zoar Valley Clinic is a spacious, modern facility in a more convenient location for the individuals and families we serve in Western New York,” Commissioner Sullivan said. “The clinic offers a wide range of community-based behavioral health services to provide the comprehensive care that’s needed in Southern Erie County and the Southern Tier communities surrounding the village of Gowanda.” Construction of the new $1.5 million building for the Zoar Valley Clinic started in the spring/summer of 2016. The 9,500 square foot stateof-the-art facility is easily accessible

Individuals from Kaleida Health and Eastern Niagara Hospital (ENH) put the finishing touches on Grossi Memorial Park on Saturday June 11.


group of approximately 75 individuals from Kaleida Health’s DeGraff Memorial

and Millard Fillmore Suburban along with affiliate Eastern Niagara Hospital joined forces June 11 to

by public transportation and is a short walk from the village’s main street. The new facility boasts twice the treatment space than that of its former location outside the village where the clinic had been temporarily operating since 2014. The new location houses Buffalo Psychiatric Center’s traditional clinic services, as well as its family care program, which provides residential support. A community mobile integration team, which serves southern

Erie, Cattaraugus and Chautauqua counties with comprehensive mobile behavioral health services, is located at the site along with a Health Homecare Management team, offering additional support and linkage to community services. The Western New York Children’s Psychiatric Center is now able to expand its services to the Gowanda community, addressing what has been an unmet need for child and adolescent services throughout the

revitalize Grossi Memorial Park in Lockport. The group, in conjunction local businesses, volunteered their time and acquired materials and tools to bring life and a fresh look to the park. The two-phase project was an idea brought forward by individuals at the two Kaleida Health facilities to welcome Eastern Niagara and the Lockport community to the Kaleida Health family. The initial work was done in time for the Marine Corps Memorial Day service held at the park May 21. Additional clean up, landscaping and painting to the basketball court, restrooms, bike racks, playground and picnic pavilion were completed June 11. The park’s entrance sign was expected to be ready by the end of June. “This was a great team effort between the sites and our vendor partners,” said Maralyn Militello, chief quality officer for DeGraff and Millard Fillmore Suburban Hospital and project lead for the park renovations. “It was nice to work on a community project like this that we could collaborate across facilities to complete the work, have fun and get to know each other as well.” area. “This beautiful new facility demonstrates our commitment to serving the people of Gowanda and the surrounding rural communities. We are providing a full range of quality community-based behavioral health services in a setting that promotes recovery and well-being,” said Beatrix Souza, Psy.D., executive director of the Buffalo Psychiatric Center.

ECMC ED Breakground Takes Place Erie County Medical Center (ECMC) Corporation June 1 broke ground for the hospital’s future $55 million trauma center and emergency department, which will double the size of the existing 40-year old facility and feature state-of-the-art technology and

equipment. Originally opened in 1978 to accommodate 35,000-40,000 patients annually, the current facility has reached patient levels of nearly 70,000 for both 2017 and 2016, and patient volumes are expected to reach over 75,000 annually by 2024. The project is expected to be complet-

ed by the first quarter of 2020.   ECMC Corporation Board Chairman Jonathan A. Dandes, said, “Through careful planning, working closely with the emergency department frontline staff — physicians, nurses and support personnel — we have developed what will

July 2018 •

be widely regarded as the ‘gold standard’ for emergency and critical care services. We are very thankful for the strong community support we have received to date for this project that has resulted in nearly $10 million raised to date from private sources for the new facility.”  

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

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IGH WNY 45 July 2018  

IGH WNY 45 July 2018