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Meet Your Doctor Cardiologist talks about how technology, education and research have helped reduce number of acute heart events

ALL ALONE ON THANKSGIVING Live Alone and Thrive columnist spending her first Thanksgiving alone. She discusses her plans


Live a Longer, Healthier Life Geriatrician offers 10 essential tips for those who want to live a longer, healthier life. See article on page 17

CBD Oil 101 World’s Largest Disco Marks 25 Years of Fundraising Next: Camp Good Days and Special Times event on Nov. 24 Photo courtesy of Michael DeMaria Photography

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Find out why more people are using cannabidiol (CBD) oil

Is Sitting the New Smoking?

We talk to local experts about it

Kumquats Anyone? If you don’t know what a kumquat is, you’re not alone. It’s in season now and it provides a tremendous amounnt of nutrients, See SmartBites inside Page 15


Confused? Check a list of free online resources that will help you understand your options. Savvy Senior.

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C-Section Rates Have Nearly Doubled Since 2000: Study


he number of women delivering babies via cesarean section has nearly doubled worldwide since 2000, to about 21 percent, new research shows. That’s significantly higher than the 10 percent to 15 percent considered medically necessary, researchers said. When complications develop, C-sections can save the lives of mothers and their babies. But the surgery is not risk-free and has been linked to difficulties with future births. “The large increases in C-section use — mostly in richer settings for nonmedical purposes — are concerning because of the associated risks for women and children,” said physician Marleen Temmerman, lead author of three studies published Oct. 11 in The Lancet. Temmerman is a professor of obstetrics and gynecology at Aga Khan University in Nairobi, Kenya. Worldwide, C-sections rose nearly 4 percent a year between 2000 and 2015, the study found. That translates to 16 million of the 132 million live births in 2000 and 30 million of the 141 million live births in 2015. The fastest rise (6 percent) took place in South Asia, where researchers said C-section deliveries were underused in 2000 but overused 15 years later. C-sections were also overused in

the United States, Canada, Western Europe, Latin America and the Caribbean, where rates rose about 2 percent a year over the study period of 2000 to 2015. In North America alone, C-section births rose from about 24 percent to 32 percent during that time span, the study found. Fifteen nations, including Mexico and Cuba, had C-section rates that topped 40 percent. Some women choose an elective cesarean delivery because it allows them to skip the pain and uncertain timing of natural labor. A C-section is medically necessary when complications develop such as bleeding, high blood pressure or the baby is in an abnormal position in the womb, endangering mother or child. But the procedure is unavailable to many women in low-income countries and overused in many middle- and high-income countries, the researchers found. Six out of 10 nations do too many C-sections and a quarter perform too few, the study found. Moreover, wide differences exist between rich and poor, public and private sectors, and between regions, the researchers said. “In cases where complications do occur, C-sections save lives, and we must increase accessibility in poorer regions, making C-sections universally available, but we should not overuse them,” Temmerman said in a journal news release. KH-CCRET-18294_GLCC_PrintAds / half page horizontal / live: 10.25”w x 6.75”h / no bleed / pub: In Good Health


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

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Nov. 3

BCN symposium to focus on breast cancer treatment

The Breast Cancer Network of WNY (BCN) will present its 25th Annual Breast Cancer Education Day on Saturday, Nov. 3 at Grapevine Banquets in Depew. Titled “New Developments in Breast Cancer Research and Treatment,” the program will be emceed by Gina Browning from the SPCA and include presentations on breast cancer research, radiology, genetic testing, and survivor emotional support. The program starts at 8:30 a.m. and includes a luncheon and several vendors. Cost is $30 pre-sale, $35 at the door. BCN’s Annual Education Day has been a staple of the network’s offering of educational programming designed for breast cancer survivors and patients. BCN also conducts twice-monthly educational seminars at its facility in Depew and several other locations throughout the Buffalo area.

The Breast Cancer Network of WNY, founded in 1988, is dedicated to the education, support and advocacy for all breast cancer patients and survivors of WNY. This volunteerdriven organization, located at 3297 Walden Ave. in Depew, also presents a full schedule of support groups, restorative health classes, and outreach for breast cancer survivors and newly diagnosed patients. BCN is a local organization and keeps 100 percent of all donations it receives in Western New York. For further information or to register for BCN’s Education Day, visit online at or call the BCN offices at 716-706-0060.

Nov. 15

Catholic Health seminar to focus on wound treatment

Open wounds, ulcers, and “weeping” legs can be a source of pain, anxiety and embarrassment, affecting your health and overall quality of life. Diabetes, obesity, radiation therapy, and surgery can also lead to open wounds that are difficult

Photo courtesy of Michael Demaria.

Retro for a Reason As it turns 25 years, World’s Largest Disco holds another fundraising event — for Camp Good Days and Special Times

to heal, but help is available. Catholic Health is sponsoring a community dinner program, “Treatment Options for Hard-to-Heal Wounds” from 5:30 to 7:30 p.m., on Thursday, Nov 15, at The Grapevine, 333 Dick Road, Depew. Registration begins at 5 p.m. Join local wound care expert, physician Lee Ruotsi, medical director of Catholic Health’s Advanced Wound Healing Centers, for an interactive discussion on the care and treatment of difficult wounds. He’ll discuss ways to prevent wounds from developing or worsening, when to see a specialist, and the latest treatment options available for hard-to-heal wounds, including hyperbaric medicine.  “Treatment Options for Hard-toHeal Wounds” is open to the public. Space is limited and reservations are required. For more information, call 716-447-6205 or visit events.

St. Francis Park offers free events for seniors

St. Francis Park, a senior facility located at 5229 S. Park Ave. in Hamburg, is hosting a series of community events in November. These events are free and open to the public. Reservations are required and light refreshments will be served. To make a reservation, call 649-1205. n Estate Planning: from 1 to 2:30 p.m., Nov. 5.   because of so many generous individuals and special events such as the World’s Largest Disco.” Camp Good Days and Special Times, Inc. is a nonprofit organization dedicated to improving the quality of life for children, adults and families whose lives have been touched by cancer and other life challenges. In 2018 alone, the National Cancer Institute reported that “an estimated 1,735,350 new cases of cancer will be diagnosed in the United States and 609,640 people will die from the disease.” With this reality hitting home to so many local families, partaking in an event like the World’s Largest Disco doesn’t only mean a powerful message is being shared. It also means every cent being spent is going to a local family facing this illness. “It is one of the most popular events in Western New York because of its uniqueness, its fine attention to detail, and pure fun,” said Lisa Booz of the Camp Good Days and Special Times Buffalo office. Each year, there are improvements to ensure guests are given the best experience to keep them coming back as part of their Thanksgiving tradition. Much needed support

By Jennifer Aline Graham


ights, platform shoes and big hair. What else would be expected on the largest dance floor in New York state? Voted as “The Greatest Event on Earth” by, the World’s Largest Disco started as a small idea in hopes of raising money and awareness to support beneficial charities, all while having fun, of course. Not only did the idea turn into an event heard about all over the country, it also became a major contributor to a local organization Page 4

helping families touched by cancer. The 25th version of the World’s Largest Disco begins at 9 p.m. Nov. 24 at the Buffalo Convention Center and concludes at 1 a.m. Nov. 25. “Not only is it the greatest party in the world, but all proceeds help to send some very special children to Camp Good Days and Special Times,” said Wendy Mervis, executive director of Camp Good Days and Special Times. “All of our program and services are free of charge to the participants and this is only possible

Chairman of the World’s Largest Disco, Dave Pietrowski, has been involved since the event was revived in 1994. The fundraiser has been an important part of his life not only because of the surprise celebrities in the photo booth or ‘70s musical guest, but because of the message it holds. Without Camp Good Days and Special Times and the other organizations that have been involved over the years, it wouldn’t be the purposeful, life-changing event it has

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

Join elder law and estate planning attorney Laurie Menzies as she discusses how to make a plan and preserve your assets. Topics include understanding the state of your finances, available programs and government benefits, necessary legal documents (will, healthcare proxy and power of attorney), and identifying family or friends who can help you navigate through this process. n Tea in the Park: from 2 to 3:30 p.m., Nov. 14.  For seniors who no longer want the burden of home ownership, see how living at St. Francis Park can enable you to sit back and enjoy life. Join us for light refreshments, a casual presentation and a tour of this unique senior living community.   n Living Life to the Fullest: Adaptive Equipment and Home Safety Tips: from 1 to 2:30 p.m., Nov 26. Staying independent in your home can become increasingly difficult as you age. Join Darcie Bittner, occupational therapist at Catholic Health, as she discusses modifications you can make to live safely and independently. n Outsmart the Scammers: from 1 to 2:30 p.m., Nov 28. Incidents of fraud are on the rise as scammers’ tactics become more complex. Sonja Jensen-Schell, financial adviser with Edward Jones, will discuss how to spot fraud, what to do if you or a loved one is targeted, and what you can do to protect yourself. 

become. “We have donated over $5,000,000 to charity since we started throwing the party in 1994,” explains Pietrowski. “The group that puts it on is 100 percent volunteer. This year’s charity is, again, Camp Good Days and Special Times.” The event originally started in 1979 and was later revived in 1994. Pietrowski said the event is unique not only because of its history and size, but because “95 percent of the guests come dressed like it is 1979.” Musicians originally showcased were Gloria Gaynor and The Tramps, and many other era-based guests continued to make appearances such as Barry Williams (Greg Brady) and Chris Knight (Peter Brady) of “The Brady Bunch” fame. Every year, more musical and celebrity guests surprise a crowd of 7,000. “It seriously is the greatest people-watching event you will ever attend,” Pietrowski said. “People are laughing, smiling, and singing along to the music all night. Some of the outfits belong on a reality show. For many years, there were more limos rented on the night of the event than any other night of the year – including New Year’s Eve.” General admission tickets are priced at $77.50. However, tickets sell quickly because so many Western New Yorkers want to experience the biggest party of the year. Even if the tickets do sell out before you are able to purchase one, donations to Camp Good Days and Special Times are always welcome. “Put your platform shoes on and dance the night away with 7,000 of your closest disco friends,” Mervis said. For more information, visit

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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10/22/18 9:45 AM


Your Doctor

By Chris Motola

David M. Zlotnick, M.D. Cardiologist talks about how technology, education and research have helped reduce number of acute heart events Q: What does your practice cover? A: I’m a cardiologist with subspecialty training in interventional cardiology as well as endovascular medicine. I do have an ambulatory cardiology practice, but the procedural work is done in a hospital-based setting. Q: What’s your typical patient profile? A: I treat a wide range of patients, from patients with coronary artery disease, patients with structural heart disease, to patients with peripheral arterial disease. Q: Interventional cardiology seems to have had some of the most striking gains in efficacy over the last couple decades. What’s been key to helping patients avoid heart attacks or, if they have one, to survive one? A: I think it’s a combination of many things. One of those is education and research. We have a better understanding of the disease process. And that’s education not only of cardiologists, but other providers and first responders, and setting up these regional networks and triage centers where patients are expedited and treated and brought to centers of excellence where they can be administered life-saving treatment. But in addition to that, I think it’s also the advancement in technology over the last 20 years. We’re also trying to make it more readily available. Q: What are some of the biggest game-changers, technology-wise? A: The more minimally invasive techniques, like radial approach for cardiac catheterization as well as the second and third generation stents are also helping to improve outcomes. And from a procedural standpoint, better detection and our regional EMS networks and algorithms which got our patients to tertiary care centers where procedures can be performed and expedited. Q: I know the first generation of stents had some problems. What’s changed with the newer generation that’s improved their functionality? A: The scaffold has gone from thicker to thinner. The medications on the drug-eluting stents were

changed to different drugs. And the re-stenosis rates have improved thanks to those two changes. Q: Tell us a bit about the research you’re involved in. A: My research interests are in the area of pulmonary embolism. I’m the medical director of the pulmonary embolism response team for Buffalo General Medical Center. So we’re looking at different treatment modalities for acute pulmonary embolism. Q: For our readers, pulmonary embolism is … A: A pulmonary embolism is an acute blood clot that’s gone to the lungs. Q: Is that related to a heart attack? A: No, it’s a different process. Blood clots usually start in the legs, then migrate to the lungs. As a consequence, these patients can develop right-side heart dysfunction and other issues. So the research we’re doing is to look at different treatments to deal with these types of blood clots and to look at the outcomes for patients who are hospitalized with pulmonary emboli. I’ve also been involved in clinical research trials looking at different stents and different durations of medical therapy after receiving medical stents. And I’m also an active participant in the multidisciplinary valve program studies and a part of the TAVR trials. That’s transcatheter aortic valve replacement.

Q: Are these usually congenital defects? A: Yes, most of these are congenital conditions that can then lead to other issues down the road like stroke or right-side heart failure. If those occur, that’s an indication to close these connections. Q: Is that simply a matter of stitching the hole up? A: We have devices. There are two devices on the market that are used to close the connection between the left and right atrium. It’s basically an overnight, minimally invasive procedure with a catheter-based approach. Q: As far as early intervention goes, what should friends, relatives or anyone near someone having a heart attack do to maximize their chance of survival — beyond the obvious 911 call. A: I think the most important thing is that, if they’re having an acute cardiac event, is to call for emergency assistance. It’s an interesting question you’re asking. So it’s alerting emergency services and staying with that person until emergency services arrive. There are people in the community with training in basic life support, but getting them to the proper facilities is the most important thing. Q: What is peripheral arterial disease? A: Those are patients who have developed plaque build-up in the

Q: And that’s a minimally invasive procedure? A: Yes, it’s minimally invasive. Q: When you’re talking about structural heart disease, what does that include? A: The conditions I treat are part of the TAVR program so, in layman’s terms, we’re talking about a hole in the heart.

In the News Physician David Zlotnick is part of a team at Gates Vascular Institute that recently celebrated its 1000th transcatheter aortic valve replacement (TAVR) procedure. TAVR is a minimally invasive procedure to replace stenotic aortic valves that no longer function effectively. It is a milestone for Gates Vascular given that less than 30 sites in the US have achieved this goal. This procedure was formally reserved for only high-risk patients but is now available to those with a lower risk. Treatment and care surrounding the TAVR procedure is performed by a multidisciplinary heart team led by physician Vijay Iyer. In addition to Zlotnick, the following physicians are part of the team: Janerio Aldridge, Hashmat Ashraf, Kinan Dalal, Gary Grosner and William Morris — all with Great Lakes Cardiovascular and Kaleida Health.

arteries to their arms, kidney arteries, leg arteries. The first line of defense is risk factor modification, like smoking, diabetes, hypertension. So we want to get active smokers to quit and get diabetes and blood pressure under control, and get a modified exercise program going. If there are limiting symptoms affecting their daily lifestyle, then we might consider revascularization, the opening of the blockages.


Name: David M. Zlotnick, M.D. Position: Interventional cardiologist with Great Lakes Cardiovascular, a General Physician, PC practice; assistant professor of medicine at the University at Buffalo; Hometown: Liverpool, NY Education: SUNY Upstate Medical University; University of Rochester Medical Center. Postdoctoral training: chief resident, internal medicine, Dartmouth-Hitchcock Medical Center; fellowship in cardiovascular disease and interventional cardiology at DartmouthHitchcock Medical Center; advanced fellowship in interventional cardiology/ assistant staff at Ochsner Medical Center, New Orleans Affiliations: Buffalo General Medical Center Organizations: American College of Cardiology; American Registry for Diagnostic Medical Sonography Family: Wife, two sons Hobbies: Golfing, traveling, dining

In Good Health, Buffalo’s Healthcare Newspaper Read it in print, online at In 2019, make In Good Health your advertising choice Page 6

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

One-Third of ‘GlutenFree’ Restaurant Foods in U.S. Are Not: Study


f you’re gluten-sensitive, watch out: One-third of the “gluten-free” foods sold in U.S. restaurants actually contain trace levels of the substance, new research suggests. The finding will be of particular concern to the 1 percent of Americans with the autoimmune disorder known as celiac disease. For them, even a minuscule amount of gluten — a protein in wheat and other grains — can damage the intestinal lining. “As awareness of celiac disease and the gluten-free diet have increased in recent years, restaurants have sought to offer selections that are compatible with these restrictions,” said study author Benjamin Lebwohl, a physician. “But some

establishments do a better job than others at preventing cross-contamination.” And some gluten-free foods were riskier than others. For example, more than half of all purportedly gluten-free pastas and pizzas had gluten, according to the study. Why? “The fact that gluten was so often found in pizza suggests that sharing an oven with gluten-containing pizza is a prime setting for cross-contamination,” explained Lebwohl, of Columbia University’s Celiac Disease Center. “Gluten-free pasta can be contaminated if prepared in a pot of water that was used to prepare gluten-containing pasta.” Although the U.S. Food and Drug Administration regulates packaged foods with gluten-free

labeling, there’s no federal oversight of gluten-free claims in restaurants, said Lebwohl. For the study, more than 800 investigators set out to assess the true gluten content of dishes listed as gluten-free on menus. Armed with portable gluten sensors, they tested for gluten levels that met or exceeded 20 parts per million, the standard cutoff for any gluten-free claim. Based on more than 5,600 gluten tests over 18 months, the investigators determined that 27 percent of gluten-free breakfast meals actually contained gluten. At dinner time, this figure hit 34 percent. The rise could reflect a steady increase in gluten contamination risk as the day

unfolds, the researchers said. The concerns extend beyond the celiac community alone. “There are also people who don’t have celiac disease but have symptoms triggered by gluten,” Lebwohl said. People with this problem — non-celiac gluten sensitivity — rely on gluten-free labeling and safe food preparation practices for prevention of uncomfortable symptoms, he noted. These can include constipation, bloating and nausea. “These results underscore the need for education in food preparation at restaurants, and the need for diners to inquire about these precautions,” Lebwohl said.

Healthcare in a Minute By George W. Chapman

Commercial Insurance Premiums Up Again


ore than 150 million people are on commercial insurance through their employer. Despite the elimination of some ACA taxes, premiums are still on the rise well ahead of inflation. Family premiums  Went up an average of 5 percent to about $19,600 and individual premiums went up an average 3 percent to almost $7,000, according to the Kaiser Family Foundation. Worker wage increases and inflation are both at 2.5 percent this year. In the last

10 years, premiums have increased twice as fast as worker earnings and three time as fast as inflation. To exacerbate things for consumers, outof-pocket deductibles have increased eight times faster than their earnings. Employers seemingly “take back” wage increases via increases in employee copays and deductibles. Some of the recent increase in premiums is due to younger people going without insurance (making risk pool older) once the mandate to have insurance was terminated.

Hospital Inspectors The Centers for Medicare and Medicaid Services (CMS) relies on independent inspectors or accrediting organizations (AOs) to ensure public and private hospital quality and safety. A Wall Street Journal investigation found that some hospitals, despite a history of ongoing problems, still kept their “accredited” status, which allows them to receive payments from CMS. Consequently, CMS is improving its oversight of these AOs. CMS has redesigned the inspection process AOs must follow and will begin posting the AO performance data and findings to Congress. CMS will also select hospitals at random to and compare the CMS audit to that of the AO. The plan is to release more detail like complaints and out of compliance data versus just the overall accreditation status of a hospital. It is still illegal for CMS to disclose actual hospital surveys performed by the AOs.

star scale. This year, two thirds of the VA hospitals (96 of 146) showed improvement. The current rankings are: Albany 3+, Bath 5+, Buffalo 4+, Canandaigua 4+ and Syracuse 3. The + indicates noticeable improvement since the last audit.   Accessing Your Records You are entitled to a complete copy of your medical record, digital if you want,  per the Health Information Portability and Accountability Act (HIPAA) of 1996. Providers are allowed to charge a “reasonable fee,” typically a fixed rate or per page rate. Usually, it is not a problem requesting and receiving a copy of your record from your physician. You have a relationship with your physician(s) and the cost to copy the record is not prohibitive because it might be just several pages in length. According to a study conducted by the Yale University School of Medicine, obtaining your record from a hospital is more of a challenge. Researchers, posing as patients, called the top 83 hospitals in the US and asked about procuring a copy of their record. One

Upstate VA Hospital Ratings The VA performs its own audits and ranks its hospitals on a five

hospital actually told the “patient” that it would be a HIPAA violation to release a copy in any event. Several hospitals said that sending the record via email was “insecure” and therefore a violation. That is not true. You are entitled to receive a copy of your record in any format as long as it is readily producible in that format. Many of the hospitals in the study didn’t even have a process for delivering the record in digital format, although required to do so by law. Many hospitals said they could only send paper copies and would charge per page. In most cases, the expense would be prohibitive as a 200-page hospital record is not atypical. However, in their defense, there are still storage units filled with boxes of paper records and accessing and copying your record is time and labor intensive. The study concluded that while patients should know they are entitled to digital copy by law, they have to understand hospitals are still transitioning to the digital age.    Medicare Premiums Level There are about 60 million people covered by Medicare. Ten thousand baby boomers (65+) are signing up for Medicare every day. It is projected there will be almost 80 million seniors on Medicare by 2030.  Medicare premiums went up an average of just 1 percent a year under Obama and continue to creep up today well below commercial premium increases. How is that possible? Skeptics have attributed this low increase phenomenon as a fluke or result of the last recession. The thought was seniors couldn’t afford the 20 percent copay so didn’t seek as much care. That has never been proven. Vanderbilt University economist Melinda Buntin has studied Medicare for years and has raised some eyebrows as she reveals her findings. The Affordable Care Act, not the recession, had way more to do with leveling/steadying Medicare premiums over the last 10 years. There was a “perfect storm” of provider incentives to control

November 2018 •

costs and how care was delivered. She found that Medicare and Medicaid got much better at managing dual eligibles (over 65 and poor). Value-based payments and payment bundling were effective at controlling costs without decreasing the quality of care. The dismantling of the ACA will have a negative impact and the expectation is Medicare premiums will soon increase by more than 1 percent annually.   Drug Pricing Under Control?   In what could be a sign of the times, drug manufacturer Gilead is dropping the list price of its generic Hep C drug “Harvoni.”  As reported in the Wall Street Journal recently, the list price for the eight-week treatment plan was dropped from a staggering $63,000 to a staggering $24,000.  This is “progress.” Traditionally, drug manufacturers have marked up prices in anticipation of giving discounts to pharmacy benefit managers (PBMs). The  good news for consumers is that many plans require you to pay your share based on the absurd list price versus the discounted price obtained by PBMs.  Trump Signs Spending Bill  The 2019 federal fiscal year began Oct. 1. Related to healthcare, the budget increased funding for: the DHHS and NIH, the opioid epidemic, increased access to addiction treatment, slowing the flow of illegal drugs into the US, and for states to monitor prescriptions.  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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Weekday Mornings Are No Longer Peak Times for Sudden Cardiac Arrest


eart experts have long believed that weekday mornings and especially Mondays were the danger zones for unexpected deaths from sudden cardiac arrests. But a new CedarsSinai study shows those peak times have disappeared and now, sudden cardiac arrests are more likely to happen on any day at any time. “While there are likely several reasons to explain why more cardiac arrests happen outside of previously identified peak times, stress is likely a major factor,” said physician  Sumeet Chugh, professor of medicine and associate director of the Smidt Heart Institute at Cedars-Sinai. “We now live in a fast-paced, ‘always on’ era that causes increased psycho-social stress and possibly, an increase in the likelihood of sudden cardiac arrest,” said Chugh, the primary investigator on the study, published in the peer-reviewed journal Heart Rhythm.    Chugh’s team of investigators analyzed data from the community-based Oregon Sudden Unexpected Death Study between 2004 to 2014. All reported cases were based on emergency medical service reports containing detailed information regarding the cause of the cardiac arrest.   Key findings include: • Of the 1,535 patients who died from sudden cardiac arrest, only 13.9 percent died in the early morning hours between 6 and 10 a.m. • There was no evidence that more sudden cardiac arrests occurred on Mondays. • Aside from stress, other contributing factors may be a shift in how high-risk patients are being treated, as well as inadequacies in how past studies have measured time of death caused by sudden cardiac arrest (such as using time of death found on a death certificate versus time of death when sudden cardiac arrest actually occurred).  Although “sudden cardiac arrest” and “heart attack” often are used interchangeably, the terms are not synonymous. Unlike heart attacks (myocardial infarctions), which are typically caused by clogged coronary arteries reducing blood flow to the heart muscle, sudden cardiac arrest is the result of defective electrical activity of the heart. Patients may have little or no warning, and the disorder usually causes instantaneous death. Sudden cardiac arrest accounts for approximately 300,000 deaths each year in the U.S.

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A rock designed by Sweet Buffalo Rocks, a nonprofit organization in Buffalo that produces painted rocks to brighten the days of people who come in contact with them.

Little Rocks Carry Weighty Message By Julie Halm


he idea behind Sweet Buffalo Rocks is simple — decorate a rock with a sweet message or beautiful image and hide it so when someone finds it, their day gets a bit brighter. When Kimberly LaRussa founded the organization after hearing about a similar group in her hometown in Florida, she would simply go to the park with her son to hide rocks. “Everyone thought I was cuckoo,” she said, laughing. The action was simple but the message she was sending her young son was something she felt carried a lot of weight. “It’s just so important that we all teach our kids and our future leaders about caring about one another,” she said. “We all just need to find ways to give back. You don’t have to paint rocks to do something nice, just do something for someone else.” Apparently, LaRussa is not alone in that belief. The community of people looking to brighten up Buffalo has grown to a whopping 32,000 people on Facebook alone, and the

goals have grown as well. This summer, LaRussa officially made Sweet Buffalo Rocks a nonprofit organization so that she could help people who need a bit of a lift. Since its inception, the organization has gotten involved with Oishei Children’s Hospital, raised funds for individual children battling cancer and financially assisted the family of a 25-yearold woman who died of leukemia, including her two young children. For LaRussa, bringing joy is a broad spectrum project and she’s always open to hearing about those who deserve a hand. “Maybe a kid is having a difficult time and just wants a puppy and we can sponsor that puppy’s adoption fee,” she said. The recommendations for those who need a hand come mostly through word of mouth and organizations throughout Western New York are getting on board with Sweet Buffalo Rocks’ altruistic aims. Sweet Buffalo Rocks had a large interactive display at the Erie County

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

Fair and she has been in contact with the Buffalo Police and plenty of businesses and festivals looking to help hold an event or host the group. Recently, the Buffalo Chapter of the Awesome Foundation awarded Sweet Buffalo Rocks a $1,000 grant which assisted with bringing the rocks, a plaque and a party to the little ones at Oishei Children’s Hospital. The Awesome Foundation describes itself simply as “a global community advancing the interest of awesome in the universe, $1000 at a time.” Trustees — simply residents of a particular community — contribute their own money to fund the ideas deemed to be awesome. They and LaRussa share the basic endgame of making Buffalo a happier place. LaRussa wears many other hats, including being a mom and a writer and running Sweet Buffalo Rocks can be a demanding task, particularly as the group grows and expands so rapidly. That burden is one that she bears happily, however. “I just feel like it’s my calling. I’ve never felt so strongly about something in my life. When it comes to something that you feel God has brought you here for, there’s a reason this has been put on my plate,” she said. “I feel like I have a purpose now and that’s to show people we can all do something great for one another and it doesn’t have to cost a lot of money and it doesn’t have to be something huge to make a huge difference in someone’s life. I feel like I need to give back and do something for other people because I feel so blessed.” And LaRussa has no intention of stopping or even slowing down. “This is going to be huge one day. It’s not going to stop,” she said. “If I talk to you in five years, this is really going to be something. I can’t imagine how many kids and families will be impacted in Western New York.” To learn more, visit www. sweetbuffalorocks.

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broader range of medical services for women will be available downtown, now that UBMD Obstetrics & Gynecology is instituting a new office-based gynecologic procedure access (OBGA) program at its downtown office. The program is funded by a $15,000 grant from the Garman Family Foundation administered by the Community Foundation for Greater Buffalo. Located in the Conventus building on the Buffalo Niagara Medical Campus, UBMD Obstetrics & Gynecology (OBGYN) will use the grant to purchase equipment that will allow the practice to perform procedures that until now have only been available in suburban locations or hospital settings. The practice will use the grant to purchase a bladder scanner, cystoscope and hysteroscope equipment, as well as an additional exam table. This enables the practice to enhance its diagnostic and treatment offerings to patients. The new equipment will allow the physicians to see inside the bladder, identify abnormal bleeding, and collect and remove abnormal or cancerous cells that may have been identified during pap smears. “Our primary aim is to improve the health and well-being of women in Western New York by diminishing access barriers to quality gynecological care in downtown Buffalo,” said physician Tova S. Ablove, program founder and urogynecologist with UBMD OBGYN. “There are very few providers offering in-office gynecologic procedures to patients in downtown Buffalo, and our patients have limited financial resources and often cannot afford the out-of-pocket costs

of in-hospital procedures, which often have large copays.” Ablove, an associate professor at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, said that patient care can be compromised when these necessary procedures are not performed because of the financial, social and health constraints patients face. “Making this technology available in our downtown office will increase the chances these necessary procedures take place,” Ablove continued. “Many of our patients lack transportation, have multiple dependents, or need to be accompanied by a family member to appointments, which also makes it more difficult to coordinate appointments.” The in-office procedures in Buffalo will be more efficient, easier to schedule, and are less expensive, reducing the healthcare burden on patients. Physician Vanessa Barnabei, president of UBMD OBGYN, and chairwoman of the department of obstetrics and gynecology in the Jacobs School, said there are also emotional benefits to patients. “Young adults and those with pelvic health concerns (concerns related to the bladder, vagina, uterus and rectum) will be able to have testing and diagnosis onsite without needing to travel or see someone else. As this can be a sensitive topic to many women, having these tests done with the same physicians and staff they already know can help ease some of the associated anxiety.” UBMD OBGYN has two locations, the office at Conventus and one on Wehrle Drive. Patients from both locations will have access to these in-office tests and procedures.

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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, Ernst Lamothe Jr., Jenna Schifferle, Jana Eisenberg, Daniel Meyer Advertising: Anne Westcott, Amy Gagliano, Angela Rosa, Jennifer Aline Graham 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.

November 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 9

Building a Stronger Community One Family at a Time Community Concern of Western New York offers behavioral health, senior care management programs to residents in the Southtowns By Daniel Meyer


y emphasizing its ongoing commitment to providing important mental health services to residents in the Southtowns, Community Concern of Western New York, Inc. continues to be one of the top providers of behavioral health and senior are management services in the region. A nonprofit social service agency that was founded in 1971, CommuBartone nity Concern offers services specifically designed to improve the overall quality of those for clients who present social or emotional distress. Its acquisition last fall of the former Hamburg Counseling Services, Inc. helped to ensure that residents in the southern portion of Erie Count would have increased access to much needed mental health services. “We’ve been working pretty aggressively to help meet the needs of those in our population who have

unmet mental health needs,” says Executive Director Jerry Bartone. “What we have been able to develop is an expanded scope and scale of evidence-based behavioral health services by utilizing the site in the village of Hamburg and using that in conjunction with our facility in the town of Evans. It’s been a challenge at times to coordinate everything, but the end result is an expansion of our mental health counseling for teenagers and reaching out to vulnerable senior citizens by communicating with their family members and caregivers.” Community Concern’s mental health clinic serves approximately 1,600 people annually. Utilizing the specific skill sets of a staff that includes clinical social workers, certified mental health counselors, a psychiatrist, a psychologist and other support staff, Community Concern provides treatment for existing clients and continues to introduce its services to other residents of the Southtowns. “We do tremendous work, but funding is always a challenge as a not-for-profit social service agency,” says Bartone. “There is definitely a need for what we do and it is why

Study: Even Light Drinking Increases Risk of Death At any age, daily drinkers 20 percent more likely to die prematurely than less-frequent drinkers


rinking a daily glass of wine for health reasons may not be so healthy after all, suggests a new study from Washington University School of Medicine in St. Louis. Page 10

Analyzing data from more than 400,000 people aged 18 to 85, the researchers found that consuming one to two drinks four or more times per week — an amount deemed healthy

we work so hard to assist individuals, couples and families in need.” A wide spectrum of disorders are identified and treated at Community Concern’s two locations, including marriage counseling, depression, anxiety disorder and acute mental illnesses. Its senior care management program assists people age 60 and above to maintain the highest level of independence possible, with elder care specialists helping senior citizens who hope to continue to live on their own. “We receive referrals from a variety of difGunia ferent places,” says Project Coordinator Jennifer Gunia. “We represent a link between the clients and the services that we offer. We work with each client and their families to get answers to questions they may have about health insurance coverage, Social Security benefits, home care housing assistance and much more. Sometimes it

by current guidelines — increases the risk of premature death by 20 percent, compared with drinking three times a week or less. The increased risk of death was consistent across age groups. The study is published online Oct. 3 in the journal “Alcoholism: Clinical & Experimental Research.” “It used to seem like having one or two drinks per day was no big deal, and there even have been some studies suggesting it can improve health,” said first author, physician  Sarah M. Hartz, an assistant professor of psychiatry. “But now we know that even the lightest daily drinkers have an increased mortality risk.” Although some earlier studies have linked light drinking to improvements in cardiovascular health, Hartz said the new study shows that those potential gains are outweighed by other risks. Her team evaluated heart disease risk and cancer risk and found that although in some cases, drinking alcohol may reduce risk of heart-related problems, daily drinking increased cancer risk and, as a result, mortality risk. “Consuming one or two drinks about four days per week seemed to protect against cardiovascular disease, but drinking every day eliminated those benefits,” she said. “With regard to cancer risk, any drinking at all was detrimental.” The new study comes on the heels of research published in The Lancet, which reviewed data from more than 700 studies around the world and concluded that the safest

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

is just knowing where to turn or who to call for information that can at times be confusing or quite overwhelming. We are here to help.” The senior care management service is something Bartone and his staff are passionate about. “The mission of that program is to keep frail and vulnerable senior citizens in their homes,” says Bartone. “Preventing nursing home placement is always the goal. Many of the senior citizens of our community need help and for some of them navigating the system is a nightmare.” “I can’t stress enough that contacting us can help solve some simple problems and help to start the process of resolving some more complex challenges that someone may be facing,” says Gunia. “Just give us a call. Don’t be afraid to pick up the phone to ask a question.” Community Concern welcomes volunteers who can provide home visits, run errands and handle other tasks for senior citizens who are seeking assistance. Information on how to become a volunteer can be found by visiting or by calling 716-947-5025. The importance of having these services offered and being easily accessible in the community for anyone who needs them cannot be understated,” says Bartone. “We are very proud of our two facilities and our staff, who have the experience and knowledge to help identify who could greatly benefit from specialized care for people having social, emotional or mental health problems that hinder their day-to-day lives and ability to function.”

level of drinking is none. But that study looked at all types of drinking — from light alcohol consumption to binge drinking. The Washington University team analysis focused on light drinkers: those who consumed only one or two drinks a day. The Washington University study focused on two large groups of people in the United States: 340,668 participants, aged 18-85, in the National Health Interview Survey, and another 93,653 individuals, aged 4060 who were treated as outpatients at Veterans Administration clinics. “A 20 percent increase in risk of death is a much bigger deal in older people who already are at higher risk,” Hartz explained. “Relatively few people die in their 20s, so a 20 percent increase in mortality is small but still significant. As people age, their risk of death from any cause also increases, so a 20 percent risk increase at age 75 translates into many more deaths than it does at age 25.” She predicted that as medicine becomes more personalized, some doctors may recommend that people with family histories of heart problems have a drink from time to time, but in families with a history of cancer, physicians may recommend abstinence. “If you tailor medical recommendations to an individual person, there may be situations under which you would think that occasional drinking potentially could be helpful,” she said. “But overall, I do think people should no longer consider a glass of wine a day to somehow be healthy.”

Readers’ Feedback Here are some comments we have received in the last month from new readers of In Good Health — Buffalo’s Healthcare Newspaper. “I have read your newspaper for almost six months, finding them in my doctor’s office and test locations. The health information is priceless. Not everywhere do you find this type of information in print. Just want to say thank you for what you do for our WNY community.” Earl Frampton, Eden “In Good Health is easy to read. It covers day to day issues.” Jo Ann Smith, East Amherst

“Recent report about supplements. Also, I enjoyed the story comparing Alzheimer’s and dementia. Very good information.” Ernestine Vickers, Buffalo “All articles pertaining to my interests and health.” Margo Maute, Hamburg “Lots of good health news.” The Mieth Family, Buffalo

“Love the articles. It’s all about diseases, how food affects your health and types of exercises that help your health.” Maria Cubero, Buffalo

“I often read the column SmartBites” and information on Medicare, articles for older adults, women’s health, mental health.” Rose Puluirenti, Gowanda

“Assorted information on all types of health issues.” Donald C. Puccio, Lancaster

“Informative. Good job!”

“Mostly articles on heart health and senior-related healthcare. I like all of it.” Sharon Murphy, Buffalo

“Articles about senior health and ideas how to maintain good habits and prevention medicine. Great paper.” Judith Reece, Cheektowaga

Love everything in the paper!” Hacker L&M & Family, Clarence Center “A nice variety of well-written articles. Keep up the good work.” Richard Rosche, Orchard Park “Valuable health info for seniors.” James Majchrzak, Kenmore “Very informative.” Christine Krauzowicz, Lackawanna

“The info inside this magazine has made me a big fan of learning about new and upcoming healthcare development. Thank you. Great work!” Michael Somerfeld, Cheektowaga “Articles of weight loss and clean eating.” Angela Jones, Niagara Falls



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Healthy Sleeping

Director of the Sleep and Wellness Centers of WNY talks about healthy sleeping

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Thank You November 2018 •

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 11

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone on Thanksgiving? We’re in This Together


or the first time in 64 years, I will be celebrating Thanksgiving alone. My parents have passed on and my sister Anne, who has taken up the mantle in their absence, will be leaving town to enjoy Thanksgiving with her husband’s family down south. Unfortunately, I won’t be able to join them. I’ll be on my own. If you, as I am, are facing Thanksgiving alone for the first time, you may be anticipating a lonely and depressing fourth Thursday of November. But, it doesn’t have to be so. Whether you’re divorced, widowed or simply fending for yourself on Thanksgiving, this family-centered holiday can be an opportunity for personal growth, gratitude and self-expression. Personally, I’m taking my own best advice to heart. Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year. n Be thankful — What better time to feel and experience gratitude. Consider making a list of all the things you are thankful for this year: Your health? Your children? Those good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved

pet? Or perhaps even this opportunity in your life to learn and grow? n Take the long view — While you may be alone this year, it doesn’t mean you’ll be dining solo on leftover stuffing for the rest of your life. This one day doesn’t dictate your destiny. Who knows what the future holds? Over the next year, you may meet someone special or achieve a measure of inner peace and confidence that enables you to enjoy a holiday on your own or with your “family of friends.” n Do good — Brightening the holiday for those less fortunate can be a worthwhile and satisfying way to spend the day. Shelters and food kitchens often welcome volunteers, but — truth is — many of these agencies fill up fast with regular volunteers. You may need to plan ahead and be creative. As an alternative, you might consider participating in a local Turkey Trot, most of which benefit charities. You could burn off a few calories for a good cause or participate as a volunteer. They often need extra hands to register and cheer on runners of all ages. Instead of serving supper at the shelter, you could be serving up smiles at the finish line. n Throw your own little “Friendsgiving” for fellow single or separated persons —

s d i K Corner

Many Parents Fail to Recognize That Their Children Are Overweight


or some kids, a few extra treats in moderation during the upcoming holiday season is harmless. But for others who indulge year-round and get little exercise, extra holiday indulgences only add to weight gain and the prevalence of childhood obesity in the United States. The problem, say researchers at University of Michigan C.S. Mott Children’s Hospital, is that large numbers of parents fail to recognize that their children are overweight or obese, and therefore may be less inclined to modify their children’s Page 12

diet and activity levels. According to a 2017 report by the C.S. Mott Children’s Hospital National Poll on Children’s Health, more than 40 percent of parents with obese children aged 6 to 11 describe their child not as obese, but as “about the right weight.” In fact, the report finds only 13 percent of parents with obese children aged 6 to 11 rate their child as being very overweight, compared with 31 percent of parents with obese children aged 12 to 17. And, less than 10 percent of parents with obese children aged 6 to 11 say they are

Have some fun! It doesn’t have to be elaborate or even planned far in advance. Sometimes last-minute dinner invitations can turn into the best, most memorable get-togethers. Chances are you know others who may be alone this Thanksgiving. Extend a warm invitation and ask people to bring a holiday side-dish to pass. This gives everyone a chance to make a meaningful (and delicious!) contribution. n Beware of “euphoric recall” — When you are feeling lonely, it can be easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the bickering, bad blood and woozy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing. n Rent a movie and indulge in a tasty guilty pleasure — Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart. Or find a newer movie, such as “About Time,” and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love pumpkin pie ice cream this time of year! n Pick up the phone — The difference between isolation and engagement can be as simple as dialing a seven or 10-digit phone number. My experience happily tells me that most everyone welcomes a call and warm wishes on Thanksgiving. Your invitation to go for a walk or see a matinee while the turkey is in the oven may be seen as a nice diversion and chance to get out of the house. Don’t hesitate to make a call. n Decorate your home inside and out — Do it for you. It may help put you in the spirit of the holiday. This past

weekend, I recreated my annual stacked-pumpkin display for my front porch. It gives me a warm feeling every time I pull up to the house. Create harvest accents for your home to help kindle the essence of Thanksgiving in your heart. n Write “thank you” notes — Now here’s an idea that’s so obvious it often gets overlooked on Thanksgiving. “Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, PhD, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship. Who wouldn’t love to receive a card on the day after Thanksgiving that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).” In preparation for this kind gesture, purchase cards and stamps in advance. So, there you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can be thankful you got out of bed, rose to the occasion, and enjoyed your Thanksgiving.

“very concerned” about their child’s weight. While most parents agree childhood obesity is a major health issue, many underestimate their own children’s weight and fail to take corrective steps to manage weight gain. Without intervention, childhood obesity can take a hefty toll on a person’s life-long health. “It is critical to address obesity in the childhood years — at home, and in schools and other community settings,” said physician Matthew M. Davis, director of the national poll on children’s health. “But in order to address childhood obesity at home, parents must first recognize that a child is not at a healthy weight for their height. Parents also must be concerned enough to want to do something about their children’s obesity.” One of the greatest challenges for parents is that children’s obesity may not be easy to judge subjectively, he says. Obesity is based on a child’s body mass index, or BMI. When a

child’s BMI is at or higher than the 95th percentile for children who are the same age and gender, the child is obese. For example, a 6-year-old boy who is average height (3’9 1/2’’) would be considered obese if he weighs 55 lbs. or more. Based on results from the latest report from the National Poll on Children’s Health, Davis says parents may under-estimate their children’s weight, or over-estimate their children’s height. Parent-reported height and weight for the poll indicate that 15 percent of children aged 6 to 11, and 10 percent of children aged 12 to 17, are obese. Overall, 25 percent of children in 2007 were reported as being either obese or overweight. These parent-reported estimates, however, fall short of previous data on childhood obesity and overweight obtained through national studies. The studies — in which children’s height and weight were measured in person — found that 35 percent of U.S. children aged 6 to 17 are obese or overweight

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

Gwenn Voelckers leads “Live Alone and Thrive” empowerment workshops for women in Mendon, Monroe County, and is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about workshops, to purchase a book or invite Voelckers to speak, call 585-624-7887, email, or visit

Sitting, the New Smoking How to stop sitting on your health: Undoing the damaging effects of sitting By Jenna Schifferle


n the ever-increasing digital age, screen time is becoming more prominent in our free time. For many of us, screen time has also become a fundamental part of our jobs. Along with this comes more hours spent parked in a chair and less time spent standing and moving around. Sitting has become the new smoking. According to the Bureau of Labor Statistics, the average civilian job in 2016 required a person to sit for 39 percent of their day. This figure soared above average for software developers, bus drivers, and accountants who were required to sit for 81 percent to 90 percent of their workday. Add time spent sitting behind the wheel or catching up on a favorite show, and it can quickly overshadow physical activity. So, what exactly happens to the body when we sit for too long? A review of studies published in the journal Annals of Internal Medicine in 2015 found people who sit for an excessive amount of time are at an 18 percent higher risk of developing cardiovascular disease. The same study found these people were at a 13 to 14 percent higher risk of developing cancer and had a 91 percent increase in their risk for developing Type 2 diabetes. Sitting for a prolonged period of time isn’t just bad for your physical health, but it’s also bad for your mental health. A study published by UCLA in April showed a correlation between being sedentary and thinning in the areas of the brain associated with memory in middle age and elderly people. A different case study published in the journal Mental Health and Physical Activity showed an increase in mental health conditions such as anxiety and depression

for individuals who sit for most of their day. Graig Shapiro, a sports medicine chiropractor in Williamsville, said in addition to some of these more severe risks, sitting is also going to make you prone to experiencing more back, neck, and shoulder pain, while also leading to conditions like carpal tunnel, sciatica, and tension headaches. Get proactive The evidence is overwhelming, but for many of us, sitting for prolonged periods of time is unavoidable. The good news is by being

aware of the risks, we can actively work to counteract these negative effects and stay vigilant about our health. It starts with getting moving. “If you’re in one spot for a long period of time, then basically, you’re doing damage in the long run. The body’s made to move, and you need to be doing that,” Shapiro said. Experts vary on the exact amount of time you should be moving, but standing up and moving a little every hour can make a huge difference in the long run. The more you move, the less damaging the effects of sitting.

In addition, Shapiro recommends three key items to people who work a desk job: regular exercise, stretching, and foam rolling. These are focal points not just after you start experiencing problems. “The biggest thing is getting people to be proactive and starting to do things before it becomes a problem. We tend to be very reactive in this country. We tend to see when a problem starts. That’s when people want to do stretches, when really, you should be doing that before things happen, to prevent it,” he said. Shapiro tells his patients they should “sprinkle” stretches and activities into their daily routine to break up their time, whether it means doing a stretch every hour or every few hours. The goal, he said, is to get into the habit of keeping things moving. While every body is different, there are two easy in-office stretches that you can do while at your desk, Shapiro said. One of these is a seated figure-four stretch, where you cross your leg over your knee and gently push down while pulling up on your foot and leaning forward slightly. The other is a couch stretch, where you put your foot on a chair and roll into a lunge position. It is important to keep your back straight as you do so. For more information, you can consult a wellness expert. For those of us who can’t get away for more than a minute, it might require a bit of out-of-office work. Shapiro said some of the top areas to focus on are properly doing squats, working on your pectoral strength, and stretching your hip flexors. Shapiro emphasized, however, that before beginning any stretching or workout routine, it’s critical to consult with a doctor or specialist. Doing exercises incorrectly can lead to injury, and chiropractors or physical therapists can guide you and help you do them safely and effectively. If you find yourself sitting for hours every day, don’t be afraid to talk to your primary doctor for guidance or a referral. They can get you on track to a healthier lifestyle.

Graig Shapiro, a sports medicine chiropractor in Williamsville: “If you’re in one spot for a long period of time, then basically, you’re doing damage in the long run. The body’s made to move, and you need to be doing that,” he says.

November 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 13

CBD Oil 101

More people are using cannabidiol (CBD) oil for chronic pain, inflammation, anxiety, depression


n light of the opioid epidemic, many people want an alternative means to manage chronic pain without side effects and risk of dependency. Others want pain relief for conditions difficult for typical pain medication to manage. Cannabidiol (CBD) oil may provide help. One of the more than 100 cannabinoids inherent to cannabis sativa (cannabis or hemp), CBD oil is said to support the health of people who suffer from pain, inflammation, anxiety and depression without the “high” or lethargic effects typical of tetrahydrocannabinol (THC). “A lot of people think they have to get on medical cannabis for pain relief,” said Erik Adamczyk, founder and owner of The Kokoro Way in Clarence. “It gives psychological effects. CBD is the active ingredient in cannabis that offers anti-inflammatory effects. This comes from hemp.” The Kokoro Way sells hemp-related gifts and supplements from locations in Tonawanda, Clarence and East Aurora. Though in the same plant family as marijuana, hemp contains such a minute percentage of THC that it doesn’t cause the psychotropic effects of marijuana. Adamczyk said that many people come to his shop seeking relief from anxiety and depression and pain issues. He hires a nurse practitioner to meet with patients at the store to discuss, among other topics,

how hemp can support good health. Adamczyk sources CBD oil items from vetted companies, he said, mostly located in California and Colorado. Though it’s legal to grow industrial hemp in approved pilot programs in New York, it’s not widespread. The producers supplying The Kokoro Way stores provide third party certificates of authenticity from independent labs, plus he has additional labs test all the products.

“I have lab testing available for people to see at all my locations and they’re going up on my website soon, too,” he said. While the FDA has not approved CBD oil as prescription medication (which, in New York, may include medical marijuana), it is considered a supplement, like vitamin C. The Kokoro Way carries CBD in a variety of formats, including topical preparations, capsules, gummies, beverages and edible drops. For someone taking moderate servings daily, CBD costs about $40 to $100 for a 30-day supply. Physician Laszlo Mechtler, medical director at DENT Neurologic Institute and DENT Cannabis Clinic, listed many other possible uses for CBD where it could help, including anxiety and PTSD, Crohn’s disease, irritable bowel syndrome, and neurodegenerative disorders. So far, the scientific studies on CBD oil have been small. “Dent is very actively looking at the many neurologic diseases that CBD oil has the potential to help treat,” Mechtler said. “We typically use CBD in conjunction with THC through the New York state medical marijuana program, but CBD alone may be useful in treating numerous diseases such as anxiety, depression, post-traumatic stress disorder, or epilepsy. “It has even been shown to reduce spasticity in neurodegenerative diseases such as MS, Huntington’s, and Parkinson’s.”

Upstate Doctor Skeptical of CBD Oils’ Effectiveness


hysician Brian Johnson, director of the addiction medicine program at Upstate Medical University in Syracuse, remains skeptical about the efficacy of CBD oil. “Here’s the problem,” he said. “There are no studies, no FDA trials, on its effectiveness for pain. There are lots of other things that are active treatments like exercise and physical therapy.” He added after reviewing the medical literature and research on CBD oil, no one seems to knows how cannabinoids work to relieve pain. Anecdotally, some people taking it say it helps; others say it doesn’t. He’s also concerned about the long-term effect CBD oil seems to have on pain receptors. “We’re starting to see people using cannabinoids who have taken them long-term who are really pain sensitive,” Johnson said. “It’s treacherous. It ratchets up your pain. It might help your arthritis and then you notice the arthritis as you know it is getting worse and worse.” He thinks that CBD oil could affect the pain drivers in your brain to intensify the pain. “If you have pain, taking this is not the best idea,” Johnson said.

You’re Not Alone: Half of Americans Trying to Slim Down


n a country where four out of 10 adults are obese, it’s probably good news that half of U.S. adults say they’ve recently tried to shed some pounds. They did this most often through exercise, cutting calories and eating their fruits and veggies, according to a new government survey that tracked Americans’ weight-loss attempts between 2013 and 2016. Overall, 49 percent of respondents said they’d tried to lose weight in the past year — including two-thirds of those who were obese. As of 2016, almost 40 percent of American adults were obese, according to researchers with the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). So it’s important to know how many Americans are trying to lose weight — and how they’re doing it, said Kirsten Herrick, a senior Page 14

research fellow with the NCHS who worked on the study. There were some positive signs, said a registered dietitian who wasn’t involved in the research. The most common weight-loss methods were exercise and eating less — each reported by 63 percent of people aiming to shed pounds. And half said they were eating more fruits, vegetables and salads. “The good news is that people seem to recognize that weight loss is about changing habits, not quick-fix diets,” said Connie Diekman, director of university nutrition at Washington University in St. Louis. Sustainable diet changes are critical, Diekman said. That includes cutting sugary, fat-laden junk food, and replacing it with plenty of fruits, vegetables, fiber-rich grains and other healthful whole foods. Regular exercise can improve your overall health, and may aid in weight loss, Diekman noted. But,

she said, people need to make lasting changes in how they eat, rather than try fad diets. The report was based on a nationally representative sample of Americans aged 20 and older. Many people said they’d tried to lose weight in the past year, though the figures varied among different groups. Women were more likely than men to have aimed for weight loss (56 percent versus 42 percent), the findings showed.

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

Income made a difference as well, with wealthier men and women significantly more likely to say they tried to slim down. Besides turning to exercise and veggies, survey respondents also commonly said they’d cut down on junk food and fast food, and tried to limit sugar. Many said they “drank a lot of water.” The vast majority of people who tried to lose weight said they’d used at least two tactics. The report was published July 12 in the CDC’s NCHS Data Brief.


The skinny on healthy eating

Little Kumquats Big on Vitamin C and Fiber


hat’s a kumquat? If that question popped into your head, you’re not alone. My husband thought it was a root vegetable. My friend thought it was related to a mango. It’s neither. The size and shape of a large grape, the kumquat is like a baby orange in reverse, with a sweet (edible!) skin and a tart pulp. And right around now, they’re available in major grocery stores. With winter looming — and all the sniffles and sore throats that seem to accompany this season — I’m always on the lookout for ready sources of vitamin C, especially portable ones. Kumquats certainly check that box! Just five small kumquats provide nearly 75 percent of our daily needs. Because vitamin C plays such a vital role in keeping us healthy — from boosting our immune system to producing collagen to limiting the damaging effects of harmful free radicals — it’s no stranger to healthrelated studies. Ongoing research, for example, has demonstrated that while vitamin C can’t prevent the common cold or upper respiratory infections, it may slightly reduce symptoms. Some studies have suggested that

vitamin C from food can reduce the risk of certain cancers. Still others have found that high dietary intake of vitamin C has been associated with lower risk of heart disease. My takeaway? Consuming the proper amount of this multi-tasking vitamin should be a daily priority. Five bite-sized kumquats also deliver a big dose of fiber — nearly 7 grams of both soluble and insoluble fiber. Insoluble fiber promotes regularity, while soluble fiber helps lower glucose levels and ferry cholesterol out. Both kinds contribute to better health and longevity by helping to reduce the risk of developing such conditions as heart disease, diabetes, diverticulitis and constipation. The edible peel of kumquats serves up beneficial plant compounds with antioxidant, anti-inflammatory and cholesterollowering properties. Research suggests that these compounds may help protect against heart disease, cancer, diabetes and weight gain. On the topic of weight, nutritious kumquats are a dream snack: the high water and fiber content makes them filling, the calories are relatively low (around 10 calories each), and they’re super easy to carry around.

Kumquats, Dates, and Shaved Parmesan Salad Adapted from New York Times, Amanda Hesser 6 kumquats 4 big handfuls baby arugula (or greens of choice) 1/2 cup flat-leaf parsley leaves 2-3 dates, pitted and diced 1/4 cup shredded Parmesan cheese 1 clove garlic, minced 1 tablespoon lemon juice 2 tablespoons extra-virgin olive oil Kosher salt and freshly ground black pepper, to taste.

Helpful tips

Select kumquats that are firm, smooth and bright orange, with the stem attached. Pass by any that are green or have soft spots. Store them at room temperature for 3-4 days, and inside the refrigerator for up to three weeks. Whole kumquats taste best if they are gently squeezed before being eaten. Kumquat and cranberry compote (recipe at Epicurious. com) tastes great with turkey!

Anne Palumbo is a lifestyle colum-

Slice the kumquats into thin rounds, discarding the seeds. Combine the arugula, parsley, dates, kumquats and Parmesan in a large bowl. Whisk together the garlic, lemon juice and olive oil; season with salt and pepper. Pour over the salad and toss. Serves 4.

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

team tracked data from in-person government surveys conducted with thousands of U.S. adults between 2013 and 2016. People were asked to recall what they’d eaten in the past 24 hours. The report found that Americans tend to taper off fast foods as they age. While about 45 percent of people in their 20s and 30s said they’d eaten fast food over the prior day, that number dropped to just under 38 percent for people in their 40s and 50s, and about 24 percent for people aged 60 and older, the study found.

Blacks were more likely to have eaten fast food on a given day than whites (roughly 42 percent vs. 38 percent, respectively), while 35.5 percent of Hispanics and 31 percent of Asian-Americans did so. Men tended to eat more fast food than women, Fryar’s group said. Black men were the most avid consumers of fast food — almost 42 percent had eaten the fare over the past day, the report found. The new report was published Oct. 3 as an National Center for Health Statistics Data Brief.

What Did Americans Eat Today? A Third Would Say Fast Food Research shows 37 percent of adults ate fast food at least once over the past 24 hours


mericans’ love affair with fast food continues, with one in every three adults chowing down on the fare on any given day. That’s the finding from a new report from the U.S. Centers for Disease Control and Prevention. When asked by researchers, 37 percent of adults said they’d eaten fast food at least once over the past 24 hours. There was one surprise: Bucking the notion that poorer Americans favor fast food the most, the report found that intake actually rose with income. For example, while about 32 percent of lower-income folks ate fast food daily, more than 36 percent of middle-income consumers had fast food on a given day, as did 42 percent of those with higher incomes, the report found. Whatever your income bracket, fast food probably isn’t doing your health any favors. That’s because it “has been associated with increased intake of calories, fat and sodium,”

the CDC team said. All that adds up to widening waistlines and hardening arteries, one nutritionist warned. “Most fast food is not good for our bodies,” said Liz Weinandy, a registered dietitian at Ohio State University’s Wexner Medical Center. “The more of it we eat, the more likely we are to be overweight or obese and have increased risk for several diseases like Type 2 diabetes, heart disease and metabolic syndrome when talking to patients,” she said. Too often, though, Americans ignore the danger. “When we see news clips of a shark swimming near a beach, it scares us into not going near that beach,” Weinandy said. But “what we should be scared of is double cheeseburgers, french fries and large amounts of sugary beverages.” The new report was led by Cheryl Fryar of the CDC’s National Center for Health Statistics. Her

November 2018 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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What is GERD? Dietary changes and even surgery are indicated to treat this condition — also known as the ‘silent reflux’ By Deborah Jeanne Sergeant


astroesophageal reflux disease (GERD) causes acid and food in the stomach to go back into the esophagus. That happens when the lower esophageal sphincter opens when it shouldn’t. Patients suffer pain, sore throat and heartburn severe enough that the sensation even reaches the mouth. “If someone has chest pain as their chief complaint, they should rule out cardiac issues as the first thing,” said physician Kenneth Eckhert, a surgical partner at Surgical Associates of Western New York in West Seneca. Atypical heartburn, called “silent reflux,” can cause sinusitis, cough and chest discomfort. Beyond the uncomfortable symptoms, ongoing exposure to acid can cause lasting damage and even cancer. “If it’s an acute problem, they may get screened,” Eckhert said. “If it goes on for days or weeks, they look into the cause. A lot of symptoms can mimic each other. A lot of these workups overlap.” Endoscopy Eckhert can lead to a diagnosis and then treatment options. For people who have a high acid load, medication can help control it. Lower potency acid reducers are available over-the-counter and high-

er potency by prescription. Proton pump inhibitors are another type of medication prescribed to hamper the final step of acid production in the stomach. Long-term side effects from that medication can include decreased calcium absorption, diarrhea, abdominal pain and headache. Other interventions can help. “Years ago only the most severe cases would be surgical,” Eckhert said. “The new procedures are driving people to seek surgical intervention sooner. The main focus is to recreate the junction between the esophagus and the stomach. That’s what’s failing and causing the reflux.” The newest procedures boast an 85 percent success rate, where patients no longer experience symptoms and don’t need medication either. “These are long-term successful solutions for patients with severe reflux and those who want to come off medical management,” Eckert said. For less severe cases, Mary Jo Parker, registered dietitian with Nutrition & Counseling Services in Williamsville, encourages patients to try dietary adjustments for relief. Foods to limit include acidic items like citrus, tomatoes and sauce, and coffee. Spicy foods like hot peppers and sauces can also irritate the system. High fat foods like fried foods, many kinds of nuts, nut butters, added fats and fatty meats can also prove bothersome, as can mint, garlic and onions, caffeine, carbonSupport and Healing For Every Stage of Your Life | 716.335.7000

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ated beverages, wine and sometimes other types of alcohol. “Those are the basic recommendations,” Parker said. “Some people can tolerate some of the above foods in moderation. Some people have idiosyncratic reactions to other foods or ingredients as well, but these are the common offenders.” Parker In addition to dietary changes, Allyson Odachowski, registered dietitian with Custom Dietetics in Buffalo, advises patients with GERD to make lifestyle changes. “Small, frequent meals are tolerated better than a few large meals,” Odachowski said. She also advises overweight people to trim down, as carrying too much weight can worsen GERD. Wearing looser clothing and quitting smoking can also help reduce the

effects. Eating meals slowly may also help. “Sit down and eat,” she said. “Don’t eat on the fly. We need an environment that supports digestion.” Odachowski wants patients to wait three hours after eating before lying down. She also said that raising the head of the bed nine inches can keep acid where it belongs. “Beyond the common foods that irritate foods with GERD, each person has to figure out and explore what else can irritate them with food by logging and noticing how they feel between meals,” Odachowski said. To generally improve digestion, she wants people to eat more probiotic foods, including kimchi, kombucha, yogurt, kefir, and fermented pickles and other vegetables. “Having good bacteria — probiotics — helps keep the whole system working the way it’s supposed to. This is a piece of it most people miss. We don’t eat a lot of foods that are good sources of probiotics. A probiotic supplement can help.”

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Tips to Live a Longer, Healthier Life

By Susan Friedman, MD

Special for In Good Health, Buffalo’s Healthcare Newspaper


he best estimates are that only about a third of health is determined by our genes. That is great news! It means that you can do a lot to increase not only how long you live, but how well you live. Some diseases have a strong genetic component, but many of the most common chronic conditions can be significantly impacted by lifestyle. Here is a Top 10 list for living a long, healthy and happy life.


Move it or lose it — Sedentary behavior increases the risk of both chronic disease and death. On the other hand, regular activity and exercise have many benefits, including better strength and better mood. Many chronic diseases, like diabetes, high blood pressure and heart disease (to name a few) can be controlled by exercising. What kind? How much? That could easily be the topic of several other articles, but you can learn more at paguidelines/guidelines/. And it’s not too late to start. One study looked at people who were in their 60s and did not have chronic disease when the study started. Eight years later, those who became active were three times as likely to avoid chronic disease, functional decline and depression as those who remained inactive. And even studies on much older and more frail people have shown that exercise improves health and function.


Eat more vegetables — Your grandmother was right. Many studies have found that eating a diet that focuses on plant sources, and avoids processed foods, reduces your risk of heart disease, certain cancers and dementia. Inflammation is the common pathway for a lot of our common chronic diseases, and eating more unprocessed plant-based foods can reduce inflammation. Adding more vegetables, fruits, beans, whole grains, and nuts to your diet can open up many possibilities for a culinary adventure. Why not try out a new recipe — and invite some friends to try it with you!


Nurture your relationships — In good times and in bad, we tend to do better when we have support from friends, family and community. According to an analysis of the Established Populations for the Epidemiological Study of the Elderly, fewer ties with spouse, close friends and relatives, church and other groups, increases mortality — substantially. The five-year mortality was two to three times higher in those with no ties when compared to those with all four types of ties. Don’t smoke — The connections between tobacco use and poor health are well known. Smoking is a risk factor for heart disease, stroke, lung disease and many cancers. Smoking not only impacts the individual, but those around him or her.



Sleep well — Many things can impact getting a restful night’s sleep, including demands of work, social and family responsibilities, medical conditions and sleep disorders. Sleep requirements vary, and sleep patterns change with age, but most people do best on seven to eight hours of sleep a night. Unfortunately, many people do not get this and, according to a recent National Health and Nutrition Examination Survey, more than onethird of individuals reported sleeping less than seven hours per night on weekdays or workday nights. Chronic sleep deprivation can lead to cognitive deficits, increased risk for accidents, poor immune defenses, and chronic diseases such as high blood pressure and heart disease.


Manage stress — As George Burns once said, “If you ask what is the single most important key to longevity, I would have to say it is avoiding worry, stress and tension. And if you didn’t ask me, I’d still have to say it.“ People who are faced with multiple stressors are at higher risk of developing illness. Often, these stresses cannot be avoided; what you can adjust is how you respond

to them. Some things to consider are, first, recognizing when you are stressed, and then limiting other, more avoidable stressors, talking with friends or family, or meditating.


Keep learning — Both formal and informal education play a role in healthy aging. Estimates are that a college education can delay the impact of aging by nearly a decade, so that individuals with a college education reach levels of disability and death about 10 years after those with less education. Cognitively stimulating occupations can help preserve cognition. Some studies have shown an association between cognitively stimulating leisure activities, like chess, bridge and doing crossword puzzles, with maintaining cognitive function, but results are mixed, and more work needs to be done to establish causal relationships.


Maintain a healthy weight — Being either overweight or underweight is associated with higher risk of mortality. The rate of obesity has increased substantially over the past two decades. The 2014 edition of the American Health Rankings reported that 29.5 percent of US adults were obese, a 7 percent increase from 2013. Obesity increases the risk of chronic illness and disability.


Embrace change — There is a saying that “change is the only constant in life.” A person who is 100 years old today has seen an amazing number of changes in their lifetime. Two world

November 2018 •

wars. The introduction of antibiotics. The first moon landing. Cell phones and the internet. And that is just scratching the surface. People who age well are people who can adapt to changes as they occur.


See your primary care provider regularly — Your primary care provider can help you maintain health in several ways. First, they can provide guidance for prevention of disease, through interventions like vaccines and falls prevention. Second, they can detect disease early, to provide curative treatment. Third, they can guide management of chronic disease, to slow its progression and limit loss of function that may develop as a consequence. And finally, they can provide education on health promotion, so that a healthy lifestyle can limit risk in the first place. By following some or all of these suggestions, there is a good chance that you can live a longer, healthier, and more enjoyable life. So grab a friend, and plan to make a change today!

Physician Susan Friedman holds a Master of Public Health degree and is an associate professor of medicine at the University of Rochester School of Medicine and Dentistry. She is a geriatrics hospitalist at Highland Hospital.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Golden Years

Fiber May Delay Cognitive Decline By Deborah Jeanne Sergeant


eed another reason to eat a fiber-rich diet? It may be associated with delaying onset of dementia. A study recently published in the journal Frontiers in Immunology states that fiber may set off the production of a short-chain fatty acid rich in anti-inflammatory properties that could defer cognitive decline. Reducing inflammation in the brain by eating a high fiber diet made the old mice in the study identical to young mice in regard to their inflammation markers. Rodney Johnson and Stephanie M. Matter with University of Illinois at Urbana-Champaign wrote the study. “Fiber can influence inflammation in the entire body,” said Mary Jo Parker, registered dietitian at Nutrition & Counseling Services in Williamsville. She added that fermentable fiber ramps up production of short chain fatty acids. These appear to help the digestive system generate anti-inflammatory and anti-cancer effects throughout the body. “It looks promising for brain health and diminishing the effects of aging, but we must be cautious when reading conclusions based upon animal studies,” Parker said. “We can’t automatically assume it can be extrapolated to humans. More research needs to be done but that’s how we start inquiries and further our hypotheses. It’s a good beginning.” Of course, further study will help researchers better understand the correlation and learn if the same holds true for humans. But in the meantime, eating more fiber can ben-

efit health in many ways. “We have known for a long time that fiber produces a healthy digestive tract,” Parker said. “It adds bulk to the diet to help reduce constipation and support regularity. It increases water content of stool making it easier to pass and decreases transit time of waste in the colon.” Among a high fiber diet’s benefits, Parker also listed decreased levels of serum lipids, lowered blood glucose, a healthy immune system and promotion of healthy weight.

Getting more fiber

So how can you get more fiber in


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meatballs instead or bread crumbs, or use whole wheat crumbs. • “High fiber cereals with fruit and nuts/seeds can be a good way to start the day. Of course salads and whole grain bowls can incorporate all of the above. • “Fibers that confer all of these health benefits are naturally-occurring: found in whole foods. The fiber added to foods, although they could be from natural sources [such as inulin or chicory root, polydextrose] have been shown to have laxation effects, but haven’t been shown to offer the additional health benefits of the fiber naturally found in the foods mentioned fruits, vegetables (including legumes an especially great source of fiber), whole grains, and nuts/seeds.” Physician Joanne Wu, an experienced yoga teacher, medical doctor, health coach and wellness expert who sees clients in Buffalo, said “Excellent sources include berries, nuts, beans, whole grains, oats, and leafy greens.”

Some food with high fiber content. “Fiber can influence inflammation in the entire body,” says Mary Jo Parker, registered dietitian at Nutrition & Counseling Services in Williamsville.

Choosing a Continuing-Care Retirement Community

f you want your next move to be your final one, an all-inclusive retirement community — also known as a continuing-care retirement community (or CCRC) — is a great option to consider, but they aren’t cheap. CCRCs are different from other types of senior housing because they provide all levels of housing, services and care in one convenient location. While they vary greatly in appearance and services, most CCRCs offer apartments or sometimes single-family homes for active independent seniors. In addition, they also offer onsite assisted living for seniors who require help with basic living tasks like bathing, dressing or going to the bathroom, and nursing home care for residents when their health declines. CCRCs also provide a bevy of

your diet? Parker has a few suggestions: • “Fruits, vegetables, legumes, nuts, seeds and whole grains are the sources, along with soluble fiber supplements like psyllium (Metamucil) and Citrucel, and others. • “It’s best to consume it throughout the day to get sufficient fiber in. Adding nuts and seeds can help a lot: For example, flaxseed and flaxseed meal can be added to hot and cold cereals, yogurt, baked goods. • “Chia sees are a good thickening agent and can be used in smoothies, puddings, and baked goods. Of course, you can add these to smoothies and shakes, along with fruits and veggies. • “Adding nuts and seeds to any meal or snack adds fiber without adding more volume, which can help to get more in. • “You can get lots of veggies in when they are cooked down or pureed and added to soups, stews, and casseroles, or sauces. You can use oatmeal or oat bran in meat loaf and

resort-style amenities and services that include community dining halls, exercise facilities, housekeeping and transportation, as well as many social and recreational activities. But be aware that all these services come at a hefty price. Most communities have entry fees that range from the low to mid-six figures, plus ongoing monthly fees that can range from around $2,000 to over $4,000 depending on the facility, services and the contract option you choose. With more than 2,000 CCRCs in operation throughout the U.S, finding a facility that fits your lifestyle, needs and budget will require some legwork. Here are some steps that can help you proceed. • Make a list: Start by calling the Office for the Aging (call 800677-1116 for contact information) in

the area you want to live for a list of CCRCs, or search websites like • Call the facilities: Once you’ve located a few, call them to find out if they have any vacancies, what they charge and if they provide the types of services you want or need. • Take a tour: Many CCRCs encourage potential residents to stay overnight and have a few meals in their dining hall. During your visit, notice the upkeep of the facility and talk to the current residents to see how they like living there. Also, check out the assisted living and nursing facilities, and find out how decisions are made to move residents from one level of care to another. To checkup on a facility, call the state long-term-care ombudsman (see who can tell you if the assisted living and nursing care services within the CCRC have had any complaints or other problems. You can also use Medicare’s nursing home compare tool at • Review contracts and fees:

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

Most CCRCs offer three types of contracts: Life-care, or Type A contracts, which have the highest entry fee but covers all levels of long-term care as needed; Type B, or modified contracts that have lower entry fees but limits long-term care services in the initial fee; and Type C, or feefor-service contracts, which offer the lowest entrance fees but requires you to pay extra for long-term care if you need it. You also need to find out what yearly price increases you can expect? How much of your entry fee is refundable to you if you move or die? And what happens if you outlive your financial resources? • Research the CCRC: Find out who owns the facility and get a copy of their most recently audited financial statement and review it, along with the copy of the contract with your lawyer or financial adviser. Also get their occupancy rate. Unless it’s a newer community filling up, occupancy below 85 percent can be a red flag that the facility is having financial or management problems.

Golden Years

Exercise Intensity Matters By Deborah Jeanne Sergeant


hile a casual stroll down the block is better than doing nothing (and may represent a good, first step toward improved fitness and weight loss for some people), low-intensity exercise for short periods isn’t going to exactly torch calories. Low-intensity for two hours also won’t fit into many busy schedules. But super high intensity won’t help as much with weight loss as hitting the “sweet spot” of 65 percent or so of the maximum heart rate, according to Terrence Whiteside, owner of Steel Mill Gym, Inc. in Buffalo. “Your body will use the fat, not the glycogen, that it has stored,” he said. To figure that ideal heart rate, Subtract your age from 220. Sixty-five to 75 percent of that figure represents the target heart rate. To figure the heart rate, find a pulse point such as the wrist or side of the neck and count the heartbeats for 15 seconds. Multiply by four to have the heart rate. Wearing a heart rate monitor can make it easier to keep on track. Joe Fox, certified functional strength coach and certified personal

trainer with Train Smart in Buffalo, said that losing fat relies upon five components: using very heavy weight and/or intensity; taking only short rests between each sets; spending more high time under tension (the amount of time that you’re “under the load” such as holding a pose for five seconds instead of one); and explosiveness, which means working as hard as possible as quickly as possible. One easy rule to see if you’re working intensely enough is that “you’re probably not going to be able to carry on a conversation,” Fox said. “Unfortunately, all the things proven for fat loss correlate with highest risk for injury. That’s why it’s so important to really implement movement science so the form and technique. You want to be intense but not hurt yourself at the same time.” High intensity interval training can help. Fox referenced a study from McMaster University in Canada that showed performing 12 sets of sprints that lasted for 90 seconds followed by a brief rest (about 30 total minutes of exercise) burned 450 percent more subcutaneous fat than running for 90 minutes.

“The after-burn is elevated 38 hours post-workout by doing the sprints with rest,” Fox said. Nearly any activity can be made into a high intensity interval training activity, such as bicycle riding or weight lifting by following the pattern of burst, rest, burst and sustaining that for 30 minutes. Fox likes to take walks where he sprints 50 yards five to ten times during the walk. “It will dramatically increase the intensity and amount of calories I’m going to be burning,” he said. Resistance training could include lifting free weights, using resistance bands or working out on weight machines at a level that challenges the user without compromising safe, proper form.

“There’s a principle from Craig Liebenson, a sports medicine professional, that the hardest thing, you do well,” Fox said. “I look at it as you can find the highest activity that you do well. It’s different for Fox each person.” It’s more about quality movement — doing the activity properly — to produce a safe and effective workout than the quantity of workout time.

Work in Strength Training

Simple steps can help seniors build more muscle strength By Deborah Jeanne Sergeant


f you don’t feel as strong as you used to, it’s time to do something about it. Many people find that as they grow older, they’re less able to perform tasks they once did. As the decades pass, muscle mass naturally diminishes as inactivity pairs with dipping hormones. But you don’t have to surrender. “You can build muscle all your life,” said Terrence Whiteside, owner of Steel Mill Gym, Inc. in Buffalo. “You’ll be stronger in every situation. Core strength can help keep your back from hurting and keep your body functioning properly. There’s endless reasons. It helps you sleep better. Strength training is phenomenal.” Meeting with a personal trainer in a gym can make it easier to understand how to move correctly during strength building and what to do. For some people, lack of transportation, bad weather, traveling or a busy schedule may make it difficult to go to the gym regularly. When it’s not possible to get to the gym, following a strength training DVD, using resistance bands and performing weight-bearing exercise can help build muscle. Jamie Critelli directs group training and teaches yoga at Dr. Derek Health and Wellness in East Amherst and group fitness at Crunch Fitness

in Buffalo. She’s a big believer in functional strength — doing exercises that relate to everyday activities to keep muscles strong. “Just moving your body weight is the number one thing,” said Critelli. “If you’re at home, grab a chair or counter, do some balance postures.” That could include balancing on one leg, squatting over a chair, standing push-ups from a countertop or other stable surface, or planks. “Use different inclines for pushups to increase upper body strength,” said Critelli. “Depending upon which level you’re at, when your toes are on the floor and you have your hands on a couch, that creates less intensity. You’re not pushing up as much body weight. Then try a chair that’s lower. Then you go to a low stool or the floor. You could put your knees down. Then you can progress from there.” She also encourages older adults to use elastic bands for home workouts. “Those are an incredible tool to enhance your workout,” Critelli said. She also said that household items can form weights as strength increases, filling a jug with more and more water can mimic the effect of a kettle bell. Richard Derwald, 81, and a fitness trainer with Erie County Senior Services, in East Amherst, likes to

recommend chair-based exercise for people who struggle with balance and standing exercise. He said that physical therapists tell knee surgery rehab patients to use latex resistance exercise bands to help strengthen their legs during recovery. “They’re probably the best investment anyone interested in their health, wellness and fitness could make,” Derwald said. Resistance exercise bands come in several levels of resistance, so anyone just beginning should use a band of light resistance. Derwald said to place the band between the heel and sole. Bring the leg back toward the body and then extend the leg, all while keeping the arms still. Repeat with the other leg. Derwald said to strengthen the muscles in the front and back of the upper leg, abdominals and lower back, sit on a chair, grasp the seat with both hands, hold a child’s ball firmly between the feet and ankles, inhale while slowly raising the feet. Hold the ball about four inches from the floor, then slowly lower, exhaling through the mouth. Of course, it’s important to receive clearance from a medical doctor before engaging in exercise, especially for anyone with known health issues.

November 2018 •

Richard Derwald is a fitness trainer with Erie County Senior Services, in East Amherst. He recommends chair-based exercise for people who struggle with balance and standing exercise.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 19

Golden Years

Holiday Open House: Nov 30 from 1 to 3pm Come see our beautifully decorated “home for the holidays” — our traditions can be yours.

First User-Fitted Hearing Aid Approved

Christmas Fundraiser Luncheon to benefit ASPIRE, Thurs, Dec 13th at 12 noon. Admission fee is a unwrapped toy for a child. Entertainment by Serendipity Swing - A Little big Band



he first hearing aid that doesn’t require the assistance of an audiologist or other health care provider has been approved by the U.S. Food and Drug Administration. The Bose Hearing Aid is a userfitted device for people aged 18 and older with mild-to-moderate hearing loss, the agency said in a news release. “Today’s marketing authorization provides certain patients with access to a new hearing aid that provides them with direct control over the fit and functionality of the device,” said Malvina Eydelman, director of the FDA’s Division of Ophthalmic, and Ear, Nose and Throat Devices. Some 37.5 million adults in the United States report having hearing

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It’s Not Just for Kids: Even Adults Appear to Benefit from a Regular Bedtime


ufficient sleep has been proven to help keep the body healthy and the mind sharp. But it’s not just an issue of logging at least seven hours of Z’s. A new study on sleep patterns suggests that a regular bedtime and wake time are just as important for heart and metabolic health among older adults. In a study of 1,978 older adults publishing Sept. 21 in the journal Scientific Reports, researchers at Duke Health and the Duke Clinical Research Institute found people with irregular sleep patterns weighed more, had higher blood sugar, higher blood pressure and a higher projected risk of having a heart attack or stroke within 10 years than those who slept and woke at the same times every day.  Irregular sleepers were also more likely to report depression and stress than regular sleepers, both of which are tied to heart health. African-Americans had the most irregular sleep patterns compared to participants who were white,

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loss of some degree, the FDA said. Common risk factors include aging, exposure to loud noises and certain medical conditions. The Bose device was evaluated in clinical studies involving 125 people. When participants self-fitted the device and used a cellphone app to program and make adjustments to the device settings, they “generally preferred those hearing aid settings over … professionally-selected settings,” the FDA said. While users may fit, program and control the device on their own, some state laws require that hearing aids be obtained from a licensed dispenser, the agency said. Bose Corp. is based in Framingham, Mass.



Chinese-American or Hispanic, the data showed. The findings show an association — not a cause-and-effect relationship — between sleep regularity and heart and metabolic health.  “From our study, we can’t conclude that sleep irregularity results in health risks, or whether health conditions affect sleep,” said Jessica Lunsford-Avery, Ph.D., an assistant professor in psychiatry and behavioral sciences and the study’s lead author. “Perhaps all of these things are impacting each other.” Still, the data suggest tracking sleep regularity could help identify people at risk of disease, and where health disparities may impact specific groups, such as African Americans. “Heart disease and diabetes are extremely common in the United States, are extremely costly and also are leading causes of death in this country,” she said. “To the extent we can predict individuals at risk for these diseases, we may be able to prevent or delay their onset.”

Signs You May Have Alzheimer’s

early 50 million people worldwide are living with Alzheimer’s disease and other forms of dementia, the Alzheimer’s Association says. The association lists 10 warnings signs of Alzheimer’s:

tasks. Confusion over time or place. Trouble understanding spatial or visual images. Sudden problems with speaking.

1. Memory lapses that affect

able to retrace steps. Poor judgment. Withdrawal from social activities. Changes in mood and personality.

everyday life. Challenges in planning and solving routine problems. Difficulty completing familiar

2. 3.

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

4. 5.

6. 7. Misplacing things, and not being 8. 9. 10.

Call 716-603-6851 When you pick up the phone, so do I!!

Sean Kelly

Local Medicare Professional Turning 65?, New to Medicare?, Questions about Medicare? Call 716-603-6851

When you pick up the phone, So Do I!

By Jim Miller

Free Resources That Can Help with Your Medicare Decisions Dear Savvy Senior, I’m considering making changes in my Medicare coverage during the open-enrollment period. Can you recommend any free resources that can help with my choices?

Swapping Senior Dear Swapping, There are a number of good resources you can turn to that can help you choose Medicare coverage that better suits your needs, that’s completely free to use. Each year during Medicare’s open enrollment — Oct. 15 through Dec. 7 — all Medicare beneficiaries can change their coverage without penalty. Doing so, given that insurers are constantly tweaking their plans and offerings, could help lower your premiums or give you access to better care. Any changes you make to your coverage will take effect Jan. 1, 2019. Important Tools To get help with your Medicare decisions, a good starting point is to get re-familiar with the primary parts — traditional Medicare, Medicare Advantage, supplemental (Medigap) policies and prescription-drug coverage — Medicare publishes an excellent guide called “Medicare & You” that you can access at Medicare. gov/medicare-and-you. If you are already enrolled in Medicare Advantage or a Medicare Part D prescription-drug plan, it’s very important that you read and understand your “Annual Notice of Changes” and “Evidence of Coverage,” which should have arrived in the mail in September. These documents explain how your existing coverage will change in 2019 and how much you’ll pay for that coverage. Your next step is to go Medicare’s online “Plan Finder” tool at Here you can enter some basic information — your Medicare number and prescription drugs (name and dosage) — and it will produce a list of possible healthcare plans in your area, the costs involved, drug coverage and customer-satisfaction ratings. Or, if you don’t have internet access, or don’t feel confident in working through the information on your own, you can also call Medicare at 800-633-4227 and a customer service representative will do the work for you over the phone. Free Advice If you want personalized help with a Medicare specialist, contact

the Medicare Rights Center or your State Health Insurance Assistance Program. The Medicare Rights Center is a nonprofit group ( that offers a national helpline (800-333-4114) where staff members answer questions about Medicare, and can help you choose coverage, at no charge. And your State Health Insurance Assistance Program (SHIP), which may go by a different name in your state, provides free one-onone counseling in person or over the phone to beneficiaries, as well as family members or caregivers. SHIPs are federally-funded programs that are not connected to any insurance company or health plan. To find a SHIP counselor in your area, see or call the Eldercare Locator at 800-677-1116. Another good resource, if you’re interested in choosing a new Medicare Advantage plan, is the HealthMetrix Research Cost Share Report at This free website lists the best Advantage plans by area based on your health status. Also, several Offices for the Aging in the area offer free seminars that help seniors select the best plans. Those seminars are unbiased and not affiliated with any health insurance plan. Agent Assistance Another way to get free assistance with your Medicare Advantage, prescription drug or Medigap plans is to use an agent or broker who specializes in Medicare-related insurance in your state. These people get paid a commission to sell you a policy from the insurance providers they represent. There are federal rules and state laws governing agents or brokers who sell Medicare plans, which include things like barring them from showing up uninvited at your house to pitch a plan or trying to lure you with a cash offer. They also cannot legally charge you a fee to process your enrollment. It’s also important to understand that commission-based agents and brokers will present only the Medicare plans they represent, rather than all the plans in your market. So, you may miss out on some plans that could benefit you.

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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. November 2018 •

OPEN HOUSE Sat 11/3 10-12 Sat 11/17 10-12



Holiday Special Issue

Don’t miss the December issue of In Good Health. All about food, gifts, diet, mental health IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 21

Top Dental Care Products for Seniors F or seniors who suffer from arthritis or have other hand weaknesses, an electric toothbrush is a great solution to keep your teeth clean. At the push of a button, an electric toothbrush will do everything but shake, rattle and roll to do the cleaning for you, and most come with a wide handle and rubberized grip that make them easier and more comfortable to hold on to.

• Extra features: Most higher-priced electric brushes come with various settings such as sensitive (gentler cleaning) or massage (gum stimulation), a charge-level display and more. There are even “smart” toothbrushes on the market that connect to a smartphone or tablet via Bluetooth to track brushing habits. What extra features do you want or need?

How to Choose

Top Electric Toothbrushes

With dozens of different electric toothbrushes on the market today, here are several key points you’ll need to consider, to help you choose: • Cost: The cost of electric toothbrushes will range from $15 up to around $300. How much are you willing to spend? • Brushing action: Brush heads tend to be either “spinning” (they rotate very fast in one direction, then the other, and bristles may pulsate in and out) or “sonic” (they vibrate side to side). Both methods are effective and a matter of personal preference. • Electric versus battery: Choose a brush with a built-in rechargeable battery and an electric charging station. They’re much more convenient and cost effective than toothbrushes that use replaceable batteries. • Brushing timer: Since most dentists recommend brushing for two minutes (and most adults brush less than 60 seconds), get a power toothbrush with a built-in timer. Some brushes will even split the two minutes onto four 30-second intervals and will notify you when it’s time to switch to a different quadrant of your mouth.

While there are many makes and models of electric toothbrushes to choose from, two of the best-selling, top-rated products to consider are the Oral B Pro 1000 (spinning brush head) and the Philips Sonicare 2 Series (vibrating brush head). Both are simple, very effective at removing plaque, and reasonably priced — around $50. They also both offer two-minute timers, rechargeable batteries and a range of brush heads to meet your needs. To learn more about these electric toothbrushes and a wide variety of other options, visit OralB. com and And for more information on choosing an electric toothbrush, visit best-electric-toothbrush. Easier Flossing Products If flossing is difficult too, a good alternative to traditional string floss is floss picks. These are disposable plastic-handle tools that have floss threaded onto them, which makes them easier to hold and use. DenTek, Oral-B and others sell packages for a few dollars, or check out the Reach Access Flosser, which comes with a toothbrush-like handle for a better reach. Some other flossing devices to consider that are easy on the hands include: The WaterPik power flosser ($7), which gently vibrates to dislodge embedded food particles between your teeth; Philips Sonicare AirFloss water flossers ($50 or $90) that uses burst of water or mouthwash to and clean in-between your teeth; and WaterPik Water Flossers ($50 to $130), which use high-pressured pulsating water to remove food particles and plaque and will stimulate your gums in the process. All of these dental care products can also be found at your local pharmacy or retailer that sells personal care items or online.

Ask The Social

Security Office

From the Social Security District Office

Do You Think Your Income-Related Medicare Premium Is Incorrect?


edicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure. If you’re a Medicare beneficiary who has been informed that you must pay more for your Medicare Part B or Medicare prescription drug coverage premium because of your income, and you disagree with the decision that you need to pay a higher premium amount, you may request an appeal. The fastest and easiest way to file an appeal of your decision is by visiting You can file online and provide documents electronically to support your appeal. You can also file an appeal online even if you live outside of the United States. You may also request an appeal in writing by completing a Request for Reconsideration (Form SSA-561-U2) at If you don’t have access to the internet, you can request a copy of the form by calling us at 1-800-772-1213 (TTY 1-800-325-0778).


Q: Are Social Security numbers reassigned after a person dies? A: No. We do not reassign Social Security numbers. In all, we have assigned more than 460 million Social Security numbers. Each year we assign about 5.5 million new numbers. There are over one billion combinations of the nine-digit Social Security number. As a result, the current system has enough new numbers to last for several more generations. Q: Is it true I can save about $4,900 per year if I qualify for Social Security’s “Extra Help” with the Medicare prescription drug program? A: Yes. If your income and resources meet the requirements, you can save nearly $4,900 in prescription costs each year. Resource limits for 2018 are $14,100 (or $28,150 if you are married and living with your spouse). Income limits are $18,210 (or $24,690 if you are married and living with your spouse). If your income or resources are just a bit higher, you might be eligible for some help with prescription drug costs. To learn more, visit prescriptionhelp. Q: My spouse died recently and my neighbor said my children and I might be eligible for survivors benefits. Don’t I have to be retirement age to receive benefits? A: No. As a survivor, you can receive

Page 22

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

Learn more by reading our publication “Medicare Premiums: Rules for Higher-Income Beneficiaries” at Know someone who hasn’t signed up for Medicare yet? They can use our online Medicare application if they: • Are at least 64 years and 9 months old; • Want to sign up for Medicare but do not currently have any Medicare coverage; • Do not want to start receiving Social Security benefits at this time; and • Are not currently receiving Social Security retirement, disability, or survivors benefits. Remind them that they should sign up for Medicare three months before reaching age 65, even if they are not ready to start receiving retirement benefits. They can opt out of beginning to receive retirement benefits now once they are in the online application. Then they can apply online for retirement benefits later. You can learn all you need to know at benefits/medicare and easily share these resources with family and friends.

benefits at any age if you are caring for a child who is receiving Social Security benefits and who is under age 16. Your children are eligible for survivors benefits through Social Security up to age 19 if they are unmarried and attending elementary or secondary school full time. Keep in mind that you are still subject to the annual earnings limit if you are working. If you are not caring for minor children, you would need to wait until age 60 (age 50 if disabled) to collect survivors benefits. For more information about survivors benefits, read our publication “Survivors Benefits” at pubs. Q: I got married and I need to change my name in Social Security’s records. What do I do? A: If you change your name due to marriage, or for any other reason, you’ll need to report the change and get a corrected Social Security card with your new name. You will need to fill out form SS-5. You can get a copy of this form by visiting www. or by calling our toll-free number 1-800-7721213 (TTY 1-800-325-0778). You’ll also need to provide the original marriage certificate showing your new and old names. You can mail or take the documentation to your local Social Security office. In some cases, we may need other forms of documentation as well. For more information, visit

H ealth News Roswell appoints codirector of liver and pancreas tumor center Physician Roderich Schwarz has been appointed as the new codirector of the liver and pancreas tumor center at Roswell Park Comprehensive Cancer Center. He will also serve as a professor of oncology in the department of surgical Schwarz oncology. Prior to this, he worked as a surgeon and the medical director of the Goshen Center for Cancer Care in Goshen, Ind. He also held a position at Indiana University School of Medicine as a professor of surgery. Schwarz comes to Roswell Park with more than 30 years of experience in treating gastrointestinal cancers. He specializes in treating cancer of the biliary tract, stomach, pancreas and liver. Throughout his career, he’s served as the principal or co-investigator in more than 50 clinical trials. He has also received numerous research grants to study gastrointestinal cancers. “A cancer diagnosis is a tremendous challenge for anyone. Within a single day, it can turn someone’s world upside down. I’m grateful that I’ll be able to help patients at Roswell Park as a surgeon and oncologist as part of a multidisciplinary team,” Schwarz said. As a board-certified surgeon, Schwarz has received numerous awards and recognitions, including being elected four times as a member of the “Best Doctors in America” database. In 2017, he was elected as a “top oncologist” by the International Association of Oncologists. “We’re excited to welcome Dr. Schwarz to Roswell Park. He’s a leading expert in treating complex gastrointestinal cancers. His commitment to helping patients have a better quality of life is what Roswell Park is all about,” said Candace S. Johnson, Rowell Park’s president and CEO. Schwarz holds a medical and doctoral degree from the Medical School of Hannover in Hannover, Germany. He served his residency at the University of Pittsburgh School of


Meet Your Doctor Trillium Health chief medical officer Rob Biernbaum talks about the stigma against HIV patients and the agency’s effort to help those with substance abuse disorders




Live a Long, Healthy Life Highland Hospital geriatrician Susan Friedman offers 10 tips for those who want to live a longer and healthier life. See article on page 20

Live Alone and Thrive columnist spending her first Thanksgiving alone. She discusses her plans

CBD Oil 101

Safer Roads

Find out why more people are using cannabidiol (CBD) oil

Dentist Visits

Campaign in Rochester aims at reducing number of injuries and deaths involving motor vehicles and bicyclists/ pedestrians

Study released by Excellus BlueCross BlueShield shows nearly 30 percent of adults in region skip annual regular visits

Health Coach Should you hire one? They are great, by they come at a price

Kumquats Anyone? If you don’t know what kumquat is, you’re not alone. It’s in season now and the it brings tremendous amounnt of nutritients See SmartBites inside

Page 15

Confused? Check a list of free online resources that will help you understand your option. Savvy Senior. Page XX

Page 8

Medicine, and completed a surgical oncology fellowship at Memorial Sloan Kettering Cancer Center. In addition to having more than 150 peer-reviewed publications, Schwarz has authored numerous editorials, letters and textbook chapters.

Professionals join ECMC leadership team

Erie County Medical Center (ECMC) Corporation officials recently announced two appointments to its executive leadership team.   • Pamela Lee has been appointed as senior vice president of operations. She holds a Master of Business Administration and a Master of Nursing Administration from the University of Illinois in Chicago. She also holds a Bachelor of Lee Science in Nursing from the University of Iowa. Most recently, Lee has served as the chief operating officer of Ozarks Medical Center in West Plains, Mo. During her career, she has served in several executive positions that have focused in operations, patient safety, and quality.    • Joseph T. Giglia II has been appointed to the position of chief human resources officer. He holds a Juris Doctor degree from Widener University School of Law based in Harrisburg, Pa. He holds a Bachelor of Science in Giglia criminal justice from the State University of New York at Brockport. Most recently, Giglia II served as vice president of human resources and general counsel at the Buffalo News. Prior to that, he served as vice president of legal and operations, corporate human resources for Catholic Health in Buffalo.  Giglia has been a resident of Buffalo and Western New York for many years.   

ECMC Terrace View LTCF ranked No. 1

The Centers for Medicare & Medicaid Services (CMS) has ranked ECMC’s Terrace View Long-Term Care Facility No. 1 in its skilled nursing facilities value-based purchasing (VBP) program out of 15,421 skilled nursing facilities nationwide. The VBP program focuses on better outcomes and rewards skilled nursing facilities with incentive payments for the quality of care they provide to people with Medicare, in particular reducing hospital readmissions and improving quality indicators scores. The program moves CMS toward paying providers based on the quality, rather than the quantity, of care they deliver to patients. The Protecting Access to Medicare Act of 2014 started the skilled nursing facilities VBP program and requires CMS, among other things, to furnish value-based incentive payments to SNFs for services; develop a methodology for assessing performance scores; adopt performance standards on a quality measure that includes achievement and improvement; and rank SNFs based on their performance from low to high. The highest ranked facilities will receive the highest payments, and the lowest ranked 40 percent of facilities will receive payments that are less than what they otherwise would have received without the program. Funding for the program came from CMS, by withholding 2 percent of SNF Medicare payments starting Oct. 1. Because of its No. 1 ranking, Terrace View will receive a 1.64 percent increase in its Medicare Rates. The system measured Terrace View on its individual performance, as well as in comparison to all other SNF facilities in the nation. The program based the performance score by measuring improvements from 2015 to 2017. “Terrace View has always provided high quality care to some of the most vulnerable in our community,” said Thomas J. Quatroche Jr., PhD, president and CEO at ECMC Corporation. “It is a special place with special people who truly care for its residents. This ranking affirms this quality of care, and also rewards Terrace View financially to provide more resources for the great work they do every day.” Anthony DePinto, administrator for Terrace View, said, “Over the past three years, the staff at Terrace View has worked very hard to improve

our CMS star ranking and all other aspects of care. The VBP program criteria paralleled that improvement. We were expecting good scores; however, to be ranked #1 is truly sensational.”

Roswell’s doctor honored by Susan G. Komen Upstate New York

Physician Ellis Levine, the chief of breast medicine at Roswell Park Comprehensive Cancer Center, received the Susan G. Komen Upstate New York Hope Award Oct. 6. The award is given annually to a breast health or breast cancer professional Levine who works toward improving the lives of breast cancer survivors or conducts research to find cures. “I am overjoyed to hear the news, but not at all surprised. All the patients we share adore Dr. Levine for his exceptional care,” says physician Kazuaki Takabe, clinical chief of breast surgery, Alfiero Foundation Endowed chairman in breast oncology and professor of oncology at Roswell Park. “Dr. Levine has been the central pillar in our efforts on clinical trials. The Hope Award is a very well-deserved honor for him.” Physician Marc Ernstoff, the Katherine Anne Gioia chairman of medicine and senior vice president for clinical investigation, adds, “Dr. Levine has led our breast cancer program and has worked in Western New York for the past 30 years toward improving the treatment and care of women with breast cancer. We are forever grateful for his expertise, thoroughness and compassion.” In addition to treating patients and being an expert in breast oncology, Levine is also pursuing more than 30 clinical trials. Many are focused on new treatments or therapies for patients with breast cancer or metastatic disease. Levine, who is board-certified in medical oncology and internal medicine, has been on staff at Roswell Park since 1993. A graduate of the University of Pittsburgh School of Medicine, he completed both residency and a fellowship at the University of Minnesota. He has been named to the America’s Top Doctors list annually since 2005.


716-332-0640 EDITOR@BFOHEALTH.COM November 2018 •


Meet Your Doctor Trillium Health chief medical officer Rob Biernbaum talks about the stigma against HIV patients and the agency’s effort to help those with substance abuse disorders




Live a Long, Healthy Life Highland Hospital geriatrician Susan Friedman offers 10 tips for those who want to live a longer and healthier life. See article on page 20

Live Alone and Thrive columnist spending her first Thanksgiving alone. She discusses her plans

CBD Oil 101

Safer Roads

Find out why more people are using cannabidiol (CBD) oil

Dentist Visits

Campaign in Rochester aims at reducing number of injuries and deaths involving motor vehicles and bicyclists/ pedestrians

Study released by Excellus BlueCross BlueShield shows nearly 30 percent of adults in region skip annual regular visits

Health Coach Should you hire one? They are great, by they come at a price

Kumquats Anyone? If you don’t know what

Confused? Check a list of free online resources that will help you understand your option. Savvy Senior. Page XX

kumquat is, you’re not alone. It’s in season now and the it brings tremendous amounnt of nutritients See SmartBites inside

Page 15

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

Page 8

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Western N.Y.'s In Good Health Newspaper! November 2018 Edition


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