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in good Adolescence Gynecologist OB-GYN Robin Hoebel, who practices inWilliamsville, gives up being obstetrician to focus on pediatric and adolescent gynecology. She talks about her decision

Healthy Holiday Eats A little pre-planning can go a long way to keeping the scale in check. Also: 12 tips that will help those who live alone; how to stay mentally healthy

Kevin Guest House Home to more than 1,200 guests who come to Buffalo for medical treatment, officials are raising money to open a fourth building

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December 2017 •  Issue 38

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Is there anything that aspirin doesn’t treat? It has been used to prevent heart attack, relieve headaches, pain and many other conditions. 12 things you need to know about it. Page 4

Embracing WNY Winters

Many fun outdoor activities happening in in the Western New York during this winter. Just get out and get ready to enjoy

Oh, pistachios ‘Along with almonds, walnuts, cashews and other nuts, pistachios play an important role in our weekly diet — perhaps even a starring role.’

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Savings Lives The introduction of self-driving cars would save perhaps hundreds of thousands of lives over a 15- to 30-year period, according to a new study


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Want to Avoid Catching a Cold or the Flu? Simply Wash Your Hands ‘Hand washing can be a game changer to prevent common respiratory viruses,’ says Erie County Health Commissioner Gale Burstein By Deborah Jeanne Sergeant

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he best way to reduce your risk of catching a cold or influenza doesn’t cost a thing and is something you already know how to do: hand washing. “It can make a huge difference,” said physician Gale Burstein, commissioner of the Erie County Department of Health in Buffalo. “Most people become ill through first exposure of viruses and bacteria from their hands. Washing their hands is a great way to prevent contact with bacteria or viruses in the area.” Unfortunately, people don’t do it as often as they should, according to Burstein. Viruses aren’t just spread when a sick person sneezes. She said that many viruses survive on surfaces such as tables, door knobs and utensils for more than 24 hours. In places where many people touch these surfaces, they’re likely crawling with bacteria that can make others sick. “Hand washing can be a

game changer to prevent common respiratory viruses,” Burstein said. “Wash as often as possible, especially before eating and drinking because you’ll know you’ll come in contact with your face and possibly infect yourself.” Since most people pick up a cold or case of the flu by transferring the germs from their hands to their eyes, nose or mouth, it’s important to avoid touching the face while in public. Burstein suggests washing the hands after coming home and before coming in contact with a vulnerable person such as a baby or elderly person. She said that proper hand washing means using warm water and soap, vigorous rubbing and scrubbing the fronts and backs of the hands, between the fingers and under the fingernails. It should take about 20 seconds. She covers the handle with a dry

paper towel or her jacket or shirt to avoid contaminating her hands by touching the handle. Oxana Khinkis, a registered nurse who works as infection preventionist at VA Medical Center in Buffalo, said hand sanitizer can also help prevent spread of communicable illnesses. “An alcohol-based hand sanitizer is the preferred method for cleaning your hands when they are not visibly dirty because it is more effective at killing potentially deadly germs on hands than soap, requires less time, is more accessible than hand washing sinks, produces reduced bacterial counts on hands and improves skin condition with less irritation and dryness than soap and water,” Khinkis said. She recommends products with

60 to 95 percent alcohol as most effective. But she added that hand sanitizer is “not appropriate for use when hands are visibly dirty or contaminated with proteinaceous materials.” So if you’re cutting up chicken, lather up and wash afterwards. Living in a germ-free bubble isn’t advisable — or possible. Balancing cleanliness with sensibility, such as avoiding people known to be sick and staying home when sick, can help reduce the spread of illness. In addition, managing stress, eating a balanced diet and exercising all help support overall health, including a healthy immune system, which can also help the body fight off colds and flu.

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Aspirin: The Magic Pill Americans Love Their ER

About half of Americans get health care in ER

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hen Americans need medical care, almost one in two people choose the emergency room, a new study reveals. “I was stunned by the results. This really helps us better understand health care in this country,” said physician David Marcozzi. He is an associate professor in the University of Maryland’s department of emergency medicine. “This research underscores the fact that emergency departments are critical to our nation’s health care delivery system,” Marcozzi said in a university news release. “Patients seek care in emergency departments for many reasons. The data might suggest that emergency care provides the type of care that individuals actually want or need, 24 hours a day,” he added. The analysis of data from several national sources showed that there were more than 3.5 billion emergency department visits, outpatient visits, and hospital admissions during the 1996 to 2010 study period. U.S. emergency department visits increased by nearly 44 percent over the 14-year period, the findings showed. Outpatient cases accounted for nearly 38 percent of visits, and inpatient care accounted for almost 15 percent of visits. In 2010, there were nearly 130 million emergency department visits, compared with almost 101 million outpatient visits and nearly 39 million inpatient visits, according to the report. Black Americans were much more likely to seek emergency department care than other racial/ ethnic groups. In 2010, black people used the emergency department almost 54 percent of the time. The rate was even higher for black people in cities, at 59 percent, the researchers said. The study also found that Medicare and Medicaid patients were more likely to use the emergency department. Certain areas of the country also appeared to have a fondness for the emergency room. Rates of emergency department use were much higher in the South and West — 54 percent and 56 percent, respectively — than in the Northeast (39 percent). The findings suggest that increasing use of emergency departments by vulnerable groups may be due to inequality in access to health care, the study authors noted in the news release. The study was published online recently in the International Journal of Health Services.

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Among other things, people use it to prevent heart attack, to fight headaches, relieve pain — a new study now shows it also reduces the risk of liver cancer for certain patients By Deborah Jeanne Sergeant

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our medicine cabinet likely holds a pill that reduces cancer risk, risk of heart attack, and acute damage during a heart attack. It also relieves aches and pains. Is there anything aspirin can’t do? The humble white pill seems to live up to Bayer’s claims that it’s a “wonder drug” on many levels. Recent research from Taiwan indicates that taking a low dose of aspirin daily may reduce risk of liver cancer for certain patients. Presented at The Liver Meeting hosted by the American Association for the Study of Liver Diseases in October, the research indicates that daily aspirin therapy appears to significantly reduce risk of liver cancer that’s related to hepatitis B. Current therapies, such as antiviral medicine, reduce liver cancer risk; however, the therapy is not appropriate for many hepatitis B virus patients. Prescribing aspirin could provide a more widely tolerated and inexpensive treatment. The Taiwan researchers reviewed data from patients seen between 1998 and 2012 as the basis for their study. They compared 1,553 patients receiving daily aspirin for a minimum of 90 days with 6,212 patients who never did. The cases of liver cancer in the treated group proved markedly lower than the control group in five years. Further clinical research will be needed to confirm the initial findings. Kirsten Moysich, PhD, distinguished professor of oncology, departments of cancer prevention and control and immunology at Roswell Park Cancer Institute, led a study on the effects of aspirin in cancer patients, “Aspirin and Acetaminophen Use and the Risk of Cervical Cancer.” “Compared to nonusers, frequent aspirin use was associated with decreased odds of cervical cancer,” the study results stated. “A slightly larger association was observed with frequent, long-term use of aspirin. Acetaminophen use was not associated with the risk of cervical cancer.” The research suggested that “frequent and long-term use of aspirin is associated with decreased odds of cervical cancer.” The study included patients with cervical cancer and controls — women suspected of having but not ultimately diagnosed with a neoplasm. Patients taking aspirin at least once weekly for more than six months, up to daily tablets for more than five years, experienced a 47 to 54 percent reduced risk of cervical cancer. The study further stated, “These findings warrant further investigation in a larger sample size to characterize better the subset of frequent, long-term users, with better-defined dosing regimens, and information on HPV status,

screening practices, and cervical cancer histology.” While the research appears promising, Moysich advises women to obtain regular Pap smears, “which is the most effective way to detect cervical lesions before they are even cancerous,” she said. “There is strong evidence that regular aspirin use protects against cardiovascular disease and colon cancer,” she added. “There is growing evidence that regular aspirin use protects against breast cancer, endometrial cancer, lung cancer and head and neck cancer; however, individuals should consult with their physician to determine if an aspirin regimen is right for them.” William M. Healy, a Williamsville-based physician who offers personalized medical care throughout Western New York through MDVIP, said that research indicates daily aspirin may reduce the risk of colorectal cancer. “If you read guidelines, it takes five to 10 years before you have benefit from taking daily aspirin,” Healy added. Patients beginning at age 50 would receive benefit by age 60. “For breast cancer and cervical cancer, it didn’t show a benefit,” Healy said. For decades, aspirin has been used to reduce heart attack risk. Healy said that he recommends an aspirin a day — usually 81 mg. — if a patient has experienced a heart attack and is not contraindicated. “If they have lots of risk factors, it may be worth taking aspirin daily to prevent a heart attack,” Healy said. Risk factors may include high blood pressure, family history of heart problems and diabetes. Taking an aspirin acts as a sort of first aid for heart attack. People experiencing a heart attack can also experience less heart damage by taking aspirin. Many times during a heart attack, small bits of plaque in an artery break loose and partially clog the blood vessel. Platelets signal the blood to clot. The clot can completely block the rest of the artery. A dose of 325 mg. of uncoated aspirin helps protect the heart from damage by inhibiting those platelets from forming clots, thus buying time for physicians to physically clear the blockage or use clot-busting drugs. How the patient takes aspirin makes a difference. Swallowing an aspirin whole slows its benefit, since it needs more time to enter the blood stream. Chewing the aspirin takes less time-only five minutes-to begin

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

providing benefit, compared with 12 minutes for swallowed aspirin. Patients should discuss their health concerns with their health care provider before taking daily aspirin or making any other changes with medication.

12 Things You Need to Know About Aspirin In “12 Things You Should Know About Aspirin” (US News & World Report: Oct. 28, 2017), writer Sarah Baldauf listed a few of aspirin’s emerging benefits and a few caveats, summarized below: Aspirin can: 1) Cut pre-eclampsia risk during pregnancy. 2) Reduce risk of developing colorectal cancers. 3) Lower a woman’s risk of breast cancer.  4) Throw off test results for prostate cancer.  5) Offer some protection against Alzheimer’s disease.  6) Help prevent strokes—unless you also take ibuprofen 7) Prevent asthma in middleaged women.  8) Protect against Parkinson’s disease.  9) Provide zero protection against heart attacks in people with diabetes.  10) Offer no protection to sufferers of heart attack or stroke who are “aspirin resistant.”  11) Cause stomach troubles such as gastrointestinal bleeding and stomach ulcers—particularly with long-term use of the drug. 12) Be less effective in women. 


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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Robin Hoebel, M.D. Doctor Burnout: A Big Health Threat in U.S. Study: One in five doctors intends to reduce work hours in the next year

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omplaining of burnout and job dissatisfaction, many U.S. doctors plan to reduce their work hours or leave medicine altogether, a new study reveals. “Our findings have profound implications for health care organizations,” according to the researchers from the American Medical Association (AMA), the Mayo Clinic and Stanford University. The study found that about one in five doctors intends to reduce work hours in the next year. And about one in 50 intends to leave medicine for a different career within the next two years. The demands of electronic health records were among the challenges leading to job dissatisfaction. If only 30 percent of those doctors follow through on their plans to leave medicine, that would mean a loss of nearly 4,800 doctors. That’s about the same as losing the graduating classes of 19 U.S. medical schools in each of the next two years, the researchers explained. Replacing physicians is expensive for institutions. One recent analysis estimated the cost at $800,000 or more per doctor. “In addition, turnover is disruptive to patients, staff and organizational culture,” the study authors wrote. “An energized, engaged, and resilient physician workforce is essential to achieving national health goals,” said physician David Barbe, president of the American Medical Association. “Yet burnout is more common among physicians than other U.S. workers, and that gap is increasing as mounting obstacles to patients’ care contribute to emotional fatigue, depersonalization and loss of enthusiasm among physicians,” Barbe said in an AMA news release. “The AMA is urging Congress, hospitals, and health plans to recognize the coming crisis as an early warning sign of health system dysfunction. America’s physicians are the canary in the coal mine,” he noted. Nearly 6,700 physicians across all specialties participated in the 2014 survey. The results were published Nov. 1 in the journal Mayo Clinic Proceedings.

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OB-GYN gives up being obstetrician to focus on pediatric and adolescent gynecology Q: I understand you’ve been focusing your practice more on adolescent gynecology as of late? A: I’d always had an interest in pediatric and adolescent gynecology. And since I gave up obstetrics last year, I’ve been able to spend a bit more time focusing on that. I joined the North American Society of Pediatric and Adolescent Gynecology to brush up on some of the current information that was out there and make it a special interest of mine. Q: What are some of the unique traits of adolescent gynecology? A: Well, the adolescents, of course, are super sensitive about talking about it. Sometimes they have a good rapport with their pediatrician, but sometimes they have things they don’t want to go into — whether it’s a menstrual problem, contraception or something going on in the pelvic region. And they sometimes get things that are more age specific. They tend to get somewhat different infections. So, it’s figuring out to handle them best and in the context of their family. Q: What approach do you take to communicating with teenage girls more effectively? A: I think the staff is a huge part of it because patients have to feel like they’re OK to come here the moment they walk in the door. Having a great staff

that will greet them and treat them well is important. We also try to be mindful of things that adolescents are sensitive about, like being weighed. We try to be sensitive about how and where we ask questions, and find out what they hope to get out of the visit before they even enter the room. When I go in, I try to start gradually and see what their needs are — slowly and gently. Q: You mentioned the parental aspect. How do you deal with a patient who has adult medical needs and questions but is still socially a minor? A: If they’re under 18, they sign a consent regarding whether you have permission to speak to their guardian or not. The patients who are over 18 are welcome to bring whoever they want in the room with them, but we won’t be seeking anyone else out unless they ask us to. Otherwise it depends on the scenario. Sometimes the patients are here because their guardian wants them to be. Other times the patient wants to come, but doesn’t want anyone else to know they’re coming. It depends on the situation, and you take it from there.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

Q: We don’t necessarily do a consistently good job educating teenagers about their reproductive health. How do you deal with the, presumably, very

different levels of patient knowledge? A: Sometimes they get a bit in school, sometimes they get a bit at home. Families often aren’t sure when they should bring them in for the first time. Generally, I say I like to see them at least once before they graduate from high school. After that, they’re more independent, whether they stay in their family’s home or not. I always say I like to see them before 18, but if they’re having problems or are being sexually active [they can come sooner]. But if they don’t need me, I don’t absolutely have to see them until they’re close to that 18 mark. Q: What are some of the benefits for a teenage girl to see an OB-GYN early? A: I don’t encourage them to become sexually active, but if I see them before that I can let them know how to protect their female parts if they become sexually active. So I go into that even if it’s not relevant at the moment. If they are sexually active, I give them contraceptive options. For other patients, if they’re having trouble with their periods, I can give them some ideas about how to alleviate their symptoms. Q: If you could pinpoint an ideal age for patients to have their first gynecological appointment, what would it be? A: Probably 16, maybe 17. Unless something comes up before then. Q: Do you miss the obstetric aspect of your practice? A: Yes and no. I did OB for 26 years and I loved it, but the decision was really for my family life. It’s easier for me and my family if I’m home at night. It also made sense for me to not be limited by my call schedule for weekends and holidays since I need to be within 30 minutes of the hospital. As my kids became bigger, their worlds became bigger, so I wanted to be available for them when they were available. I just felt like it was time for me to rein in my schedule. Q: Do you think work-life balance is something the medical profession in general should take more seriously, or should it be left mostly to the individual physicians to find something that works for them? A: I think it’s definitely evolved over the years, and I think it’s also figuring out what works for you. I evolved my schedule a little bit at a time over the years. But it’s always going to be a balancing act. For me, this ultimately made sense. So, I miss obstetrics, but I don’t miss being on call.

Lifelines

Name: Robin Hoebel, M.D. Position: Obstetrician-gynecologist at Audubon Women’s Medical Associates, PC in Williamsville Hometown: Buffalo, NY Education: University of Buffalo Medical Affiliations: Millard Fillmore Suburban Hospital Organizations: Buffalo OB/GYN Society; American College of OB/GYNs; American Board of OB/GYNs Family: Married, four kids, two dogs Hobbies: Hiking, biking, skiing, outdoor activities


U.S. Preemie Birth Rates Rise 2 Years in a Row U.S. preterm birth rate is among the worst of highly developed nations, says expert

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fter nearly a decade of decline, the preterm birth rate in the United States has risen for the second year in a row, the March of Dimes reports. And racial and ethnic disparities are driving the increase, the group added. The premature birth rate rose from 9.63 percent in 2015 to 9.8 percent in 2016, and the number of preterm births increased by 8,000, according to the group’s new report. The premature birth rate was 9.57 percent in 2014, according to the March of Dimes. “The U.S. preterm birth rate is among the worst of highly developed nations,” said Stacey Stewart, president of the March of Dimes. “This report card is a public wakeup call, an urgent call to action on the health of our nation’s moms and babies.” Compared to white women, black women are 49 percent more likely to deliver preterm. For American Indian/Alaska Native women, the number is 18 percent. “Moms and babies face a higher

risk of preterm birth based on race and zip code,” Stewart said in a March of Dimes news release. A baby born before 37 weeks of pregnancy is considered premature. A full-term birth is around 40 weeks. Each year, more than 380,000 babies are born preterm in the United States, putting them at increased risk of death before their first birthday, lifelong disabilities and chronic health conditions. Preterm birth is the leading cause of infant death in the United States, the organization says. And preterm birth is associated with more than $26 billion annually in avoidable medical and societal costs, according to the National Academy of Medicine. “We must address the social and environmental factors that impact health,” said Paul Jarris, chief medical officer of the March of Dimes. “Only by improving the broader social context for health will we be able to level the playing field for mothers and babies in every community.”

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Nancy Cardillo, Julie Halm, Catherine Miller, J’Leise Sosa, MD, Kimberly Blaker Advertising: Anne Westcott (716-332-0640.) Tina LaMancusa (716-946-2970) 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.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Kevin Guest House: Expanding to Provide for Those in Need Home to more than 1,200 guests who come to Buffalo for medical treatment, officials are raising money to open a fourth building By Nancy Cardillo

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evin Guest House opened in 1972 as America’s first independent healthcare hospitality house, serving patients of Roswell Park Cancer Institute and their families, and setting the standard for compassionate guest care. Today, the house is part of a campus comprised of beautifully restored buildings in the heart of the Buffalo Niagara Medical Campus and serves more than 1,200 guests annually from all over the country and around the world. Kevin Guest House has embarked on an ambitious $3 million campaign to open the fourth building on its campus, the Russell J. Salvatore Hospitality House. This 1888 home has been renovated and designed to plan for the future and better serve the next generation of guests. Executive Director Lynsey Zimdahl Weaver was hired in 2014 and tasked with overseeing the expansion. Formerly with the Roswell Park Alliance Foundation, Weaver helped raised millions there through various fundraising projects including the Ride For Roswell and the PaintBox Project. IGH: How did Kevin Guest House get its start and its name? LZW: Pennsylvanians Claudia and Cyril Garvey brought their son Kevin to Roswell Park Cancer Institute in the early 1970s for treatment of leukemia. They became aware of the many families who had also traveled to Western New York for treatment but were unable to find affordable lodging; some even sleeping in their cars. Shortly before Kevin’s death in 1972 at age 13, the Garveys purchased property at 782 and 788 Ellicott St., formed a 501(c) (3) nonprofit organization and, with the help of Roswell and volunteers, renovated the house. Kevin Guest House welcomed its first guest on July 26, 1972. IGH: What is the mission of Kevin Guest House? LZW: Our mission is to provide an affordable, comfortable and supportive home away from home for patients and their families who are traveling for medical care. IGH: What services does Kevin Guest House offer? LZW: Primarily, we provide short-term lodging for those with family being treated at nearby medical facilities. We also provide meals, a peaceful place to rest and recover and a place to be with others who understand what you are going through because they, too, are going through something similar. We also partner with area hospitals to provide support groups, spiritual sessions and bible study. We know our guests are staying with us during some of the most difficult times of their lives, so we want to make them comfortable, to mimic ‘home’ so they Page 8

convenience and comfort. Healthcare is expensive enough, but when you add hotel and meal costs, it can really be a hardship for some families. We ask for $25 per person per night, but won’t ever turn away anyone because they can’t afford to stay with us. Then there’s our proximity to the many medical facilities. Roswell Park actually has data showing that when bone marrow patients stay at Kevin Guest House, they have higher success rates than patients who travel back and forth, because it’s much more convenient to be across the street than driving several hours, so they’re more likely to keep their appointments. Finally, Kevin Guest House feels more like home than a hotel, and gives guests a chance to rest their head, focus on their health and not worry about additional finances. IGH: How large is your staff? LZW: We currently have six fulltime and five weekend temporary staff members who rotate each week, plus dozens of volunteers.

The Kevin Guest House has accommodated more than 1,200 guests per year who come to Buffalo for medical treatment. Officials are raising $3 million to open a fourth building on its campus, the Russell J. Salvatore Hospitality House, located at 766 Ellicott St. in Buffalo. The building is under renovation. Photos courtesy of Kevin Guest House. experience as much normalcy as possible. IGH: What is the campus comprised of? LZW: Right now we have three completed buildings and one under construction. The main house, named the Garvey Family & Friends House, is a grand Victorian built in 1867. It can host up to 20 guests in 10 rooms and is also home to our resident manager. Large families and bone marrow transplant patients typically stay in our yellow brick transplant recovery building, which features two spacious apartments. We converted the original garage/ carriage house into two transplant recovery apartments, one of which is handicapped accessible. We also have a beautiful healing garden in the backyard for our guests to enjoy IGH: And the new Russell J. Salvatore Hospitality House? LZW: Thanks to many generous donations, including a $500,000 donation from Russell Salvatore, we were able to purchase the Victorian home next door and are in the process of restoring and renovating it. When it opens early in 2018 it will house two transplant recovery apartments and four large family suites and will double the number of guests we can serve each year, to 2,400. IGH: What necessitated the need to expand the campus? LZW: Demand. Right now we turn away approximately 400 families annually either because we are at capacity or not fully handicapped accessible. The new

12,000-square-foot hospitality house will have, in addition to the suites and apartments, an elevator, a commercial laundry room, a family living space and a multi-purpose room where guests can work while away Weaver from home. IGH: Has the expansion of the medical campus created more demand for you? LZW: Absolutely, and we expect it to increase even more with the recent opening of the Oishei Children’s Hospital, which was recently approved to be the only hospital in Buffalo that performs pediatric bone marrow transplants, in conjunction with Roswell. We now welcome patients from any hospital — and we are the only such facility in Buffalo to do so — of any age, being treated for any disease. While approximately 50-60 percent of our guests still come from Roswell, we now are seeing more guests coming from Kaleida, ECMC, Buffalo General, Gates Vascular Institute and Sisters Hospital, as well as regional facilities. We hear from staff members all the time that they send people to us first because it feels so much like home. IGH: What’s the advantage of staying at Kevin Guest House over a hotel? LZW: It’s a combination of cost,

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

IGH: How can the community help? LZW: There are many ways to support Kevin Guest House. We still need to raise approximately $550,000 to meet our expansion fund goal, so donations are always appreciated and can be made via our website (https://kevinguesthouse. com/give/). Companies can host or sponsor events or initiate team fundraising or volunteer as a group to cook a dinner for guests or help with a special project. We always need volunteers to check in guests, give tours, clean and prepare rooms, do gardening tasks and cook meals. (NOTE: those interested in volunteering can visit https:// kevinguesthouse.com/volunteers/ or email info@kevinguesthouse.org for more information.) IGH: What is your dream for the future of Kevin Guest House? LZW: I am always asking myself what I would do if something happened to one of my loved ones. Our hope is to continue to expand to serve more people, more families so we do not ever have to turn anyone away. IGH: What is the one thing you’d like people to know about Kevin Guest House? LZW: It’s all about being the City of Good Neighbors, thinking about those going through one of the most difficult times in their lives and paying it forward for someone by providing dignity and comfort for those wanting to be near their loved ones. We don’t want to see a grandmother sleeping in her car with a sick grandchild because she can’t afford a place to stay.

Poinsettia Flower Sale

Support Kevin Guest House this holiday season! Purchase beautiful poinsettias for your home or office. Dec. 5-14 at Roswell Park Cancer Institute; Buffalo General Medical Center; John R. Oishei Children’s Hospital; ECMC, Ellicott Square Building and the Larkin Building. Days and times vary by location. Visit https:// kevinguesthouse.com/events/ flowers/ for more information.


Getting Self-Driving Cars on the Road Soon Might Save Lives

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he sooner driverless cars make their way onto American roadways, the sooner thousands of lives will be saved each year, a new report suggests. For that reason, the RAND Corporation research team that did the analysis is cautioning against delaying the introduction of driverless cars — which they call “highly automated vehicles” (HAVs) — under any misplaced premise that current technology might be somewhat less than “perfectly” safe. “We were surprised by the magnitude of life savings by the introduction of HAVs,” said Nidhi Kalra. She is senior information scientist and director of RAND’s San Francisco office. The RAND report, released online early November, warns of the cost of forgoing somewhat safer self-driving cars in favor of waiting for hugely safer cars that might take many more years to develop. The safety record would improve even more by getting self-driving

cars on the roadways “so that technology that was only just better than humans when introduced could become much better, much faster,” Kalra said. Specifically, the introduction of self-driving cars that are just 10 percent safer than cars driven by humans would save perhaps hundreds of thousands of lives over a 15- to 30-year period. Those are lives that would otherwise be lost if such cars were kept off the road in anticipation of ones that are as much as 75 to 90 percent safer than human drivers, the researchers said. At issue is the fact that driverless cars will probably never be perfectly safe, experts acknowledge. Weather, traffic and cyber security issues are vulnerabilities that will endure, even if risks currently linked to human error get reduced or eliminated. But when considering when to actually launch self-driving cars on U.S. roads, the question remains: How safe is safe enough? “Nearly perfect autonomous

vehicles may be extremely difficult to achieve without widespread deployment,” Groves said. “Fortunately, the industry and observers are quite confident that autonomous vehicles that are safer on average than humans can be achieved through current development procedures.” Still, “it may be a very long time before these vehicles can operate in all possible conditions at a performance that is many times better than human drivers,” he

stressed. “And yet, they may offer huge benefits in some conditions, even when the improvement over human drivers is modest.” That’s because human driving can be deeply flawed, undermined by a variety of factors such as fatigue, distraction and drunk driving. The U.S. National Highway Traffic Safety Administration says that more than 90 percent of car crashes are the result of driver-related errors.

Healthcare in a Minute By George W. Chapman

Insurance Market Dominance

Critics of the Affordable Care Act have been quick to point out that insurance choices on the exchanges in several markets are limited to only one carrier or at least a dominant carrier. But lack of choice is not limited to the exchanges. The exchanges merely reflect what is going on across the country: commercial insurance is becoming increasingly concentrated in many markets which can be bad for employers, consumers and providers. Carriers have been quick to abandon markets where they have less than a 10 percent market share, leaving even more market share for the already dominant insurer. Physicians are particularly cognizant of the increasing concentration and dominance of certain carriers in their respective markets. According to a survey by the American Medical Association, last year 43 percent of metropolitan markets had a single carrier with over 50 percent market share. It was 40 percent in 2014. Overall, 69 percent of metro markets experienced a “significant absence of health insurer competition” resulting in a “highly concentrated” rating based on federal guidelines used to assess competition. To maintain competition and reduce the risk of monopolies, federal judges have prevented the proposed mergers of Aetna-Humana and AnthemCigna. To counter, America’s Health Insurance Plans (AHIP) point out that increased hospital mergers also threaten market competition. The FTC and Department of Justice remain wary of all mergers, purportedly for improved services and cost reductions, that end up increasing prices in a market.

Uninsured Number Goes Up

According to the GallupSharecare Well-Being Index survey, the number of uninsured increased to 12.3 percent in the third quarter of 2017 after an all-time low of 10.9 percent at the end of last year. Considering the uncertainty and confusion caused by Washington, this comes as no surprise considering the cost sharing reduction payments (subsidies) and the individual mandate have been threatened; the enrollment period was cut in half; and outreach and advertising budgets were slashed. Open enrollment for 2018 ends Dec. 15.  

Confidence in Congress Low

In a recent poll of its members, the Medical Group Management Association (MGMA) revealed that 89 percent of over 1,500 respondents said they had “low confidence” in their politician’s ability to solve the nation’s healthcare problems. Ten percent expressed moderate confidence, leaving just 1 percent with high confidence. Instability, uncertainty and lack of vision were cited as reasons for low confidence.

Patient Non-compliance Costly

Most physicians rank “patient non-compliance” as a major contributor to poor outcomes. An article that appeared in the New England Journal of Medicine estimated the cost of non-compliance was $100 billion a year….over 10 years ago. Non-compliance is especially high in patients being treated for HIV, high blood pressure, mental health disorders and childhood illnesses. Not taking

medications as prescribed is also considered non-compliant behavior leading to poor outcomes. Behavioral economics in medicine has not come up with any easy answers for improving patient compliance. Increasing out-of-pocket payments, high deductibles and copays, could be a contributing factor to patient non-compliance.

Opioid Scam

One hundred forty people a day are dying from opioid overdoses. As if that isn’t bad enough, there are unscrupulous providers trying to enrich themselves at the expense, if not the life, of others. A 74-yearold physician and two of his staff were arrested in NYC for writing thousands of medically unnecessary prescriptions for oxycodone and fentanyl thereby flooding the local community with the highly addictive opioids. The physician charged $200 to $300 cash for a “patient visit” resulting in over $2 million. The “patients” then sold the drugs to a local dealer who then sold the drugs on the streets.

Genetic Testing Closer

It is becoming cheaper and simpler all the time. Right now it costs about $100 on average. Mail order tests like “23andMe” and “Color Genomics” are practically mainstream. Experts think these tests will cost almost nothing in a few years and will be paid for by all insurances. The results of the genetic testing will help physicians to be more targeted or precise when ordering treatment plans for problems like cancer and high risk pregnancies. Patients determined to be at risk for diseases like cancer can

December 2017 •

be treated preventively which would save payers millions over the long run.

Merger Mania

Not to be outdone by insurance company and hospital mergers, CVS Health (the pharmacy benefits management company, not the drug stores) has offered to buy mega insurance company Aetna for $70 billion. CVS Health would pay for Aetna with cash and stocks. CVS Health figures once they own an insurance company with its 52 million members, it will be able to negotiate lower prices for drugs. Nurse Shortage A survey of over 3,300 nurses conducted by a national recruiting firm revealed 36 percent of respondents plan to retire in a year. Other surveys show 73 percent of baby boomer nurses plan to retire in the next three years. The Bureau of Labor Statistics predicts nursing jobs will increase 15 percent from now until 2026. The healthcare industry will be hard pressed to replace all the experience and institutional knowledge that will retire with the baby boomer nurses. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ gwchapmanconsulting. com.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Surviving the Holidays: 12 Tempting Tips

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hether you celebrate Christmas, Hanukkah, Kwanzaa or the winter solstice, the holidays can be anything but merry if you are newly divorced or widowed. I know I dreaded the month of December after my divorce. That was until I made a deliberate decision to fight the Bah Humbugs and instead embrace good tidings and joy. Inspired by the holiday favorite, “The Twelve Days of Christmas,” I offer the following 12 tips to help those who live alone rediscover some meaning and merriment this time of year. Slow down. Better yet, stop what you’re doing altogether. Take a few moments to ask yourself what the holidays really mean to you. Rebirth? Hope? Peace and love? Generosity and goodwill? Revisit your most deeply held beliefs about the season and make a conscious decision to participate in the holiday rituals that align with your values and spiritual underpinnings.

1.

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2.

Be realistic and give yourself a break. For those who live alone, some degree of loneliness can be considered normal during the holidays. It’s a good time to remember that feelings of loneliness aren’t terminal, nor are they a “state of being” reserved for single people. Loneliness has very little to do with being alone. It has everything to do with your state of mind. Now’s a good time to remind yourself that your happiness is in your hands, and that there are positive, healthy steps you can take to avoid the chill of loneliness. Create new holiday traditions, especially if you’re bemoaning the loss of irretrievable traditions of a “past life.” Consider instituting your very own signature tradition of helping others. When you give of yourself, you reap two big rewards: First, you’ll develop connections with people who share your spirit of giving and second, you’ll nurture your soul. Volunteering, especially this time of year, can be as fulfilling as it is uplifting.

3.

4.

On that note, if volunteering doesn’t fit into your schedule, bake some holiday goodies for your colleagues at work or leave a little something on a neighbor’s doorstep. When you are thinking about and doing for others, you get outside yourself and feel less lonely — more a part of the world and of this season of giving. Be the instigator. Identify a holiday concert or event you’d like to attend and invite family or friends to join you. Take on the role of social secretary and you’ll gradually feel your holidays and social life becoming more active and interesting. Decorate your home or apartment. Do it for you. It will help put you in the spirit of the season. Hang a wreath on your door. Accent your mantel. Bring the holidays inside your home and you’ll feel its essence inside your heart. Invite people over. It will give you an incentive to decorate, if you don’t feel motivated to do it for yourself. No need to plan a party or go overboard. Just having a few friends over for brunch or to watch a holiday special on TV can lift your spirits (and theirs). Send holiday cards. Take this occasion to say “hello” and make connections. I love getting an unexpected card from a long-lost friend, and I delight in tracking down and sending out season’s greetings to those who might be surprised to hear from me. Sure enough, good things come from reaching out to others. I encourage you to address a few envelopes this season.

5. 6.

7. 8.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

9.

Include yourself on your gift list and spoil yourself with comfort. Read a best-seller by the fire. Schedule a massage. Treat yourself to that luxurious bathrobe you’ve admired for weeks. Welcome children into your home. Children add a wonderful dimension to the holidays. Host a cookie party or otherwise put yourself with children. Their silliness, curiosity and wonder will add to your joy this season. Let go of the notion that you need to be married or in a romantic relationship to enjoy the holidays. Life is all about personal connections, and there are plenty to be found in friends, neighbors, colleagues, even people you meet in passing. No final tip. No “drummers drumming.” Just my warmest wishes to all of you who live alone. Have yourself a merry little “whatever” and enjoy the season to the fullest. You have a choice. Choose to be with people rather than isolate. Choose to appreciate what you have rather than focus on what you’re missing. I promise you this: Embrace even half of the tips above and you will find more joy this season. Cheers!

10. 11. 12.

Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon. For information or to contact Voelckers, call 585-624-7887 or email: gvoelckers@rochester.rr.com.


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s d i K Corner

What Really Works to Fight a Stubborn Cough?

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f you’re looking for a cough remedy this cold season, you might be out of luck. Nothing has been proven to work that well, according to a new report from the American College of Chest Physicians (ACCP). After reviewing clinical trials testing everything from cough syrups to zinc, an ACCP panel came to some less-than-positive conclusions: Overthe-counter medicines — including cold and cough products and antiinflammatory painkillers — cannot be recommended. Nor is there evidence supporting most home remedies — though, the group says, honey is worth a shot for kids.

Every season, most people probably battle at least one coldinduced cough, said report author, physician Mark Malesker. And they apparently want relief. In 2015, Americans spent more than $9.5 billion on over-the-counter cold/ cough/allergy remedies, according to the report. “But if you look at the evidence, it really doesn’t support using those products,” said Malesker, a professor at Creighton University in Omaha. Unfortunately, he said, there have been no big advances made since 2006 — the last time the chest physicians issued guidelines on treating cold-related cough. So what do you do when a

hacking cough keeps you up all night? A couple of studies have found that honey may bring some relief to children age 1 and up. (Honey should not, however, be given to babies younger than 1 year, the physicians’ group says.) There was also “weak evidence” that zinc lozenges might help ease adults’ coughing — but it wasn’t enough to recommend them, according to the report. Plus, it says, zinc can have side effects, including a bad taste in the mouth, stomach cramps and vomiting. What about storied home remedies, like Grandma’s chicken soup or neti pots for nasal irrigation? There’s no strong evidence for them, either, the review found. On the other hand, Malesker said, if your favorite tea or soup makes you feel better, use it. “It’s very frustrating that we haven’t found a good way to address this,” said David Beuther, a pulmonologist at National Jewish Health, a Denver hospital that specializes in respiratory diseases. A simple cold-related cough is generally something healthy people can wait out but it can be miserable, Beuther pointed out. And while a quick fix might be tempting, simply slowing down could help, Beuther said. “Sometimes you just need to take a day off and let yourself rest,” he

When It Pays to Quit, More People Stop Smoking

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inancial rewards and personalized support can improve a smoker’s chances of quitting, a new study finds. “Our results show that a successful intervention to help [lowincome] individuals quit smoking should be multifaceted and focus on both assisting with resources and, when possible, providing financial incentives,” said lead author, physician Karen Lasser. She’s a general internist at Boston Medical Center and an associate professor of

medicine at Boston University School of Medicine. In the study of more than 350 adults, one group of smokers was provided a “patient navigator” to help them get prescriptions for nicotine replacement products and referrals for counseling. They were also offered a monetary reward ($250) if they quit within six months. They received an additional $500 if they were not smoking after 12 months. Those who did not quit within

six months were given a second chance to earn $250 if they quit within 12 months. A control group of smokers was only given information about resources to help them quit smoking. After six months, nearly 10 percent in the intervention group had quit smoking, compared with less than 1 percent in the control group. After 12 months, researchers found 12 percent of the intervention group had stopped smoking, compared with 2 percent who only received

December 2017 •

noted. Beuther also recommended that people drink enough water to stay hydrated — which may help break up any thick mucus that is causing the cough.

information about quitting. “Most of the participants who quit smoking utilized patient navigation, but it’s unclear whether navigation alone would achieve the rates of smoking cessation we observed,” Lasser said in a medical center news release. She and her colleagues said older smokers, women and nonwhites were most likely to benefit from the personal support and payments. The study was published Oct. 30 in the journal JAMA Internal Medicine.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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SmartBites

Helpful Tips

The skinny on healthy eating

Pistachios Do a Heart Good

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very December, my husband and I get a gift tin of roasted pistachios from my aunt. No surprise, they’re gone in a day, what with the way we swarm and crack and devour the tasty kernels. Not too long ago, Auntie’s tin would have provided our pistachio fix for the year. But these days, December isn’t the only month we eat pistachios. Along with almonds, walnuts, cashews and other nuts, pistachios play an important role in our weekly diet — perhaps even a starring role. We frequently reach for pistachios because they’re so good for hearts. Numerous studies have shown that pistachios in particular can help reduce bad cholesterol and that the omega-3 fatty acids present in pistachios can help lower blood pressure and protect against abnormal heartbeat. What’s more, pistachios are rich in L-arginine, an essential amino acid that makes arteries more flexible and less susceptible to blood clots. On top of everything, pistachios contain

a decent amount of cholesterollowering fiber. If you’re worried that pistachios — and their high fat and calorie content — are bad news for health and weight, it’s time to refresh your thinking. Most of pistachios’ fat is good-for-you unsaturated fat; and, relative to other nuts, pistachios have fewer calories than most (about 160 per 50 kernels). According to a Harvard study, in fact, frequent nut eaters were less likely to gain weight. “Nuts are high in protein and fiber, which delays absorption and decreases hunger,” said physician Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health. Compared with other nuts, pistachios boast a roster of nutrients and are an especially good source of protein, vitamin B6, copper and manganese. And while pistachios may not pack the antioxidant punch of walnuts or pecans, they do dish out two antioxidants—lutein and zeaxanthin—that promote eye health.

Pistachio-Crusted Chicken Breasts with Zesty Yogurt Sauce

Serves 4

¾ cup shelled pistachios ¼ cup whole-wheat breadcrumbs (suggest panko) 1 teaspoon garlic powder ½ teaspoon paprika ½ teaspoon ground cumin ¼ teaspoon cayenne pepper (optional) ½ teaspoon kosher salt ¼ teaspoon coarse black pepper 2 large boneless, skinless chicken breasts (sliced in half, horizontally) ½ cup plain Greek yogurt 1 tablespoon fresh lemon juice 1 teaspoon lemon zest 1 tablespoon olive oil 1 clove garlic, minced ½ teaspoon ground coriander salt and pepper to taste ¼ cup chopped, roasted pistachios Preheat oven to 400 degrees F. Lightly oil baking sheet (if using a baking rack, line sheet with foil and then lightly oil rack). Finely grind nuts in food processor. Add

Monitoring your weight? Sodium intake? Opt for unsalted pistachios in their shells (studies show you’ll eat less). When buying in bulk, look for pistachios that have their shells opened at one end and an intact kernel (the greener the kernel, the fresher the nut). And take a whiff: If they smell off, they’re probably rancid. Pistachios will last longer when stored in a cool, dark, dry place. They can also be stored in the fridge for up to 6 months or the freezer for up to a year. breadcrumbs and all the spices up to the chicken breasts and blend, using on/off turns. Transfer mixture to a plate. Coat chicken with nut mixture (lightly pressing mixture into chicken), and place on prepared baking sheet or rack. Bake until cooked through, about 20 minutes. Let rest for 10 minutes, then slice into thin strips (if desired). While chicken is cooking, whisk together remaining ingredients for yogurt sauce; season with salt and pepper. Serve chicken on a bed of fresh or sautéed greens; drizzle with sauce; garnish with chopped pistachios.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Want to Avoid Salt? Turn Up the Spice

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f your taste buds lean toward spicy, you might be doing your heart a favor, new research suggests. Spicy foods may increase salt sensitivity, thereby dampening the desire to consume heart-harming salty food, researchers in China say. “High salt intake increases blood pressure and contributes to cardiovascular disease,” said study author Zhiming Zhu, a physician. “Thus, reducing salt intake is very important for health. “We find that the enjoyment of spicy foods significantly reduced individual salt preference, daily salt intake and blood pressure,” he added. Zhu is director of Daping Hospital’s Center for Hypertension and Metabolic Diseases at Third Military Medical University in Chongqing. The research team conducted a mouse study alongside a human trial of more than 600 Chinese adults. Both correlated blood pressure levels with intake of spicy and salty dishes. Foods like chili that dial up the heat essentially change the way the brain interprets salt, or sodium, intake, explained Zhu. As spice consumption goes up, the result is a notably reduced craving for salt, according to his study. Page 12

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

The World Health Organization (WHO) has identified salt reduction as the “key dietary target” in a push to cut the risk of dying from noncommunicable illnesses by 2025. Zhu and his associates pointed out that people in most of the world routinely take in far more than the WHO’s recommended limit of 5 grams of dietary salt a day. The American Heart Association advises consuming no more than a single teaspoon of salt — about 2,300 milligrams of sodium — a day. In the United States, three-quarters of all sodium consumption comes from processed and packaged foods and/ or restaurant meals. For the new study, the researchers assessed participants’ preferences for salty and spicy flavors, and linked those tendencies to blood pressure levels. The biggest consumers of spicy food were found to consume about 2.5 fewer grams of salt daily, compared to those with the blandest palates. The spice lovers also had systolic (upper) and diastolic (bottom) blood pressure levels that were 8 mm Hg and 5 mm Hg lower, respectively, on average, the findings showed. The findings were released online Oct. 31 in the journal Hypertension.


Healthy Holiday Eats By Catherine Miller

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s spirits rise during the holiday season, so can glucose and cholesterol levels. With so many gatherings throughout the month being snack-centric, it’s difficult to watch our nutritional intake. But a little pre-planning can go a long way to keeping the scale in check. Yes, it’s time to socialize, and festive food and drink make the season more fun. Taking time at home to eat a salad or protein-packed small meal before your get-together can mean fewer calories consumed at the party. Once there, head toward the veggies and away from the fat-saturated dips and sugar-based goodies. Offer to bring a dish and lean toward lean foods — that way you know there will be something healthy at the table. You don’t have to go as basic as a veggie tray (although if you do, there are plenty of ways to turn red and green pepper strips, tomatoes and cukes into an adorable tree shape). Think outside the box — literally. Most boxed crackers are loaded with sodium and fats. Wander your produce aisle for inspiration. Try slices of cucumber topped with hummus and sliced tomatoes for a finger sized snack. Missing your dips? Try a layered bean dip using fat-free refried beans mixed with cumin and cayenne pepper, layered

with tomatoes, shredded lettuce, and fat-free sour cream. You nix most of the calories and fat of the ground meat-based versions of this party favorite. Cut your favorite soft taco shells into strips and pop in the oven for ten minutes to make your own dippers. You’ll never miss the sodium laden bagged chips. Sweets. No, we won’t ask you to give them up. After all, what is the holidays without holiday treats? But a little planning can keep your treats as good for you as they taste. Kathleen Cunningham, owner of KupKates Bakery, has found numerous ways to “lighten up” her baking when her clients ask her to. “Many times I minimize the amount of sugar a recipe calls for,” says Cunningham, who has been in the baking business for nearly a decade, “While you can’t change the ratio of most dry ingredients, you can alter the sugar amount with little change to the texture and taste.” Another suggestion is to replace the sugar with unsweetened applesauce, allowing the natural sweetness of the apples to reinvent your baked goods into wholesome goodness. Simply swap even amounts of applesauce with the sugar. You may need to limit any liquid that you are adding to the recipe. When you really want to limit your holiday snacks, simply make

Making a smaller portion sized cupcake keeps calories at bay — and still allows for a bit of holiday indulgence. them smaller. “I believe in portion control,” Cunningham says. “At KupKates you won’t find an oversized cupcake or muffin. You will find a perfect sized cupcake, beautifully decorated.” Consider bringing muffins to a party as an alternative to cupcakes. Many recipes are made without sugar, using molasses or honey as a sweetener. Cunningham uses Bob’s Red Mill wheat bran along with a recipe that is printed right on the bag – altering it just a bit to make it her own, and adding local blueberries for

a touch of homegrown flavor. Pastry hearts are an easy alternative to cookies. There is no sugar in the dough and the icing can be colored in bright festive colors – or simply dust with cinnamon for an elegant delight. My mother’s goto healthy dessert was angel food cake topped with fresh strawberries. Sliced strawberries can be mixed with a bit of water and honey for fresh natural flavor. Wherever you end up this holiday season – just a bit of planning is all you need to keep your holidays healthy and your bathroom scale in check.

Under the Mistletoe: Physical Contact Can Have Many Benefits By Julie Halm

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nyone who has experienced a warm hug at a holiday gathering or a kiss beneath the mistletoe on a snowy evening can tell you simply, it just feels nice. But that feeling is more than just a fleeting sensation, it is an important part of the human experience with very serious benefits. According to Rene A. Jones, a licensed marriage and family therapist as well as a certified sex therapist, the continuum of physical intimacy covers a broad spectrum. The starting point, however, is that any physical touch is only healthy when it is consensual, no matter how benign it may seem. “To me, I define physical intimacy as anything that you would do with a kid; hugging, hand holding and cuddling,” she said. “Sexual intimacy is that physical touch with another level of innuendo, so kissing on the neck petting and moving into more sexual acts. They may be on the same continuum, but there’s a

definite line between basic physical intimacy and sexual intimacy.” Physical intimacy brings immediate bodily relaxation and can give participants a sense of connection, as well as a sense of value. “Emotionally, we just tend to feel more content or happy,” said Jones. Sexual intimacy brings an added sense of being desired and physical contact across the board can help release mood-boosting endorphins. Touch is not only important for emotional satisfaction, it can be as critical for early development as physical nutrition. According to the American Psychological Association, a study which was begun in 2000 examining children who had been living in government institutions since birth with minimal physical contact or

nurturing showed that this deficit had profoundly negative impacts on those children. “Institutionalized children had delays in cognitive function, motor development and language. They showed deficits in socio-emotional behaviors and experienced more psychiatric disorders. They also showed changes in the patterns of electrical activity in their brains, as measured by EEG (electroencephalogram),” according to an AAP article written by Kristen Weir. The same study showed that children who had been neglected had physically smaller brains with less grey and white matter. For those who lack someone around the holidays with whom they are physically close, the situation is not nearly as dire, but a deficit of physical touch can be difficult to deal with. Jones suggests that those who are able can reap many of the same benefits of basic physical

December 2017 •

Rene A. Jones

contact with another person by becoming a pet owner. Additionally, certain inanimate objects can provide a boost of comfort. “If you have something soothing to touch, that can be beneficial. So most people have a soothing material that’s calming or relaxing for them. It might be a silky blanket or an afghan from when they were a kid,” she said. “A body pillow can also create some of those similar feelings.” The holidays often offer the opportunity to be close to those who we love or to snuggle up on a cold winter night, and both, it turns out can be a very beneficial gift.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Stay Mentally Healthy This Season By Deborah Jeanne Sergeant

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at right. Exercise. Get medical check-ups. All of these may help you maintain better physical health. But what about mental health? Of course, genetics affect health, but by good selfcare, you can reduce your risk of experience issues. Try these tips from local experts:

you or are you doing it to others around you? If so, you may need to be mindful of that and protect yourself against that. And be careful that you’re not the one doing it to people around you, like when you come in from a bad day at work and emotionally dump on everyone else. That can alienate you from others.”

From Susan Varney, licensed psychoanalyst, Elmwood Village Psychotherapy, Buffalo: • “Engage in reflection, mindfulness and taking the time to reflect before you act. • “Avoid acting out on unprocessed emotion. That creates an emotional burden in the future. • “Watch the breathing. A lot of people carry a lot of stress and anxiety which makes them breathe shallowly. It signals the body that a fight or flight response is required. Breathing deeply signals everything is okay and I can proceed as usual. • “People carry stress in various parts of the body such as digestive or headaches. Look for signals of stress throughout the body. Think of how you can help relieve it. Often, that’s when people come in for treatment because their bodies express these symptoms. They need to put into words things that are lodging in the body so the symptoms can be alleviated. • “Be aware of how you are being impacted and how you impact others at an emotional level. Are people unloading their anxiety on

From Nicole Urdang, licensed mental health counselor, holistic psychotherapist in Buffalo: • “Keep a written journal or an audio journal. An audio journal is easy to keep if you download a free recording app. Many people don’t like listening to the sound of their own voice, but it can be very healing in time to hear your voice say things you wish people would: caring, loving, supporting words. Many studies show that people who keep a journal feel better than people who don’t. • “Get enough sleep. • “Get outside every day if possible. • “Do something that feels loving and nurturing for yourself, like yoga, meditation, tai chi or other forms of exercise. It can be anything you find calming and rejuvenating, like listening to music. • “Give yourself permission to feel all your feelings, especially the ones you don’t like. Feel all your feelings because we have them for a reason. • “Be gentle with yourself

Holiday Season Not a Joyous Time for Some Official at Hospice Buffalo Bereavement says agency sees spike during holiday season By Julie Halm The holiday season can be a difficult time for those who have lost loved ones, whether recently or in years past. For those coping with grief, there are numerous resources ranging from bereavement support groups to individualized counseling. Whether people are more likely to seek those resources during the yuletide is a topic which is up for debate among local professionals.

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Mary Beth Giesler, bereavement coordinator for Hospice Buffalo Bereavement, says that her agency sees a spike in program attendees around the holidays. “For most of them that come, it’s the first holiday without a loved one and every first is difficult for them,” she said. “If a loved one isn’t there, there is this sense of, ‘what do we do?’” Nicole S. Urdang, a holistic psychotherapist in the Buffalo area, says she does not believe that a greater number of people seek out support

when you don’t feel good about something. Listen to your intuition. All the things we think we must or should do intrude upon what we intuitively know is good for us. It might be better to skip the social engagement and go to bed early. Or skip a social event with children and do something calm with them. • “Slow down. We’re a society in a hurry. If you slow down, you’ll already feel calmer. One thing you can do that will create more calm is turn off the ping sounds on your phone or computer. Otherwise, you’ll be trained like a Pavlovian dog to respond. You’ll be anxious for the next one. • “If you always tell the truth, you’d have fewer problems in relationships. By telling the truth and being more honest, you’re more congruent in yourself and more cohesive. You’re more relaxed.

• “It’s a great thing, but be careful that you’re not forcing yourself to be grateful when you’re upset and use gratitude to repress a negative feeling. It’s not going to clean sweep negativity. Then you feel worse because you’re not feeling grateful but you were really angry about something and no amount of gratitude will make that go away. • “Have a creative outlet. Urdang Any and all creativity is incredibly nurturing to our spirit, a real break from other demands.”

Grief and the Holidays

when that passing, ideally, is due to old age. Complicated grief tends to be the result of the loss of someone with whom a person had a difficult relationship. “Complicated grief is when you had a traumatic or difficult relationship and they died and you have all these mixed feelings,” she said. “So clearly complicated grief creates a lot more issues. According to Urdang, that grief can take much longer to abate and trigger post-traumatic stress around the holiday season. Urdang notes that the onset of this type of stress is not a disorder, but rather an understandable reaction to experiencing trauma. What experts across the board agree on is that experiencing sadness in the wake of a loss is perfectly all right, and that there are many healthy ways to deal with that grief. “We really just kind of try to tell them that each person grieves differently; no two people are the same,” said Giesler. “Give yourself a cosmic permission slip to feel whatever you’re feeling. I’m not saying act on it, but feel it. We have feelings for good reasons,” said Urdang. “The next thing is to allow yourself some catharsis, if you think it would be helpful. If you want to watch a sad movie and let yourself cry, do it.”

Those seeking support services at this time of year can attend a program titled “Grief and the Holidays” from 2 to 3 p.m. Thursday, Dec. 14, at the Hospice Education Center, 225 Como Park Blvd., Cheektowaga. A variety of free resources and advice on grief and other topics can also be found at www. holisticdivorcecounseling.com. resources to cope with grief during the holidays because of societal normalization of grief at this time of year. “People have read enough magazine and newspaper articles to know that if it’s Christmastime and they feel down, they’re not alone. People normalize their grief and they think it’s understandable that they’re triggered” she said. “The biggest surge is in the spring, because people think that in the spring while everything is growing and budding, they should be happy.” According to Urdang, the two primary types of grief can be broken down into the categories; simple and complicated. Simple grief tends to arise when we lose someone we love and had a good relationship with and

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017


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ost laymen don’t know that a perfusionist is the person who operates heart and lung equipment and monitors patient vitals during major surgery or while they await healing or major organ transplant. Though not a well-known title, the position is hard to fill, like many health care specialties. “People with technical and advanced degrees are more and more difficult to recruit,” said Doug Braun, owner of Braun Recruitment, Inc. in East Aurora. “In general, health care recruiting has become more and more difficult. “You’re not getting them out of college but recruiting them from their current role. It’s been a challenge. There are a lot more openings than I have people.” Braun believes that part of the reason for the growing need for advanced health care workers is the aging baby boomer population. Along with other health issues, heart and lung issues need surgical intervention and thus would require perfusionists. SUNY Upstate in Syracuse offers the only training for perfusion in the state, except for in Long Island. According to Bruce Searles, an associate professor and chairman of the department of cardiovascular perfusion at SUNY Upstate, only 16 schools nationwide teach profusion and they produce 120 graduates per year. At Upstate, about 70 people apply for the six to seven openings for new perfusion students each year. “Employers have quite a shortage,” Searles said. “All of our graduates in this program get jobs, many before they graduate.” He attributed the shortage to the number of retiring perfusionists,

rather than a lack of interest in the career path. Although enlarging the program at SUNY Upstate and other schools may seem an easy solution, Searles said that the school focuses on quality rather than quantity. “It’s discouraging to me as a program director to hear people say, ‘We’ll hire any graduate and train them,’” Searles said. “An issue with such a young field is we went from no training to on-the-job formalized training to the curriculum we have now. Some busy heart centers have schools and have been around a long time, but there are big cracks in the process. “The career as a whole is just over 50 years old. Some remember being trained in the hospital by their surgeon.” SUNY’s 21-month program requires a bachelor’s degree, though not necessarily in medicine (though that certainly helps). “We’ve even had people with a bachelor’s in English,” Searles said, “but a background in nursing, anatomy or biology is best. We cast a wide net and sort out the net later.” The applicants’ personality type matters also. Searles said that those who can remain calm and pay attention to details over a long period of time perform better. He likens it to the same skills as required for flying a plane, along with monitoring lots of technical and physiological data. After completing the coursework successfully, students sit for two certification examinations offered by the American Board of Cardiovascular Perfusion, offered every six months online at testing centers. Those who pass both tests are credentialed as a “certified clinical perfusionis.”

Starting salary locally is about $80,000. Those who are on-call or work in more urban areas can make about $100,000 within a few years. “Their employment is a matter of life or death,” Searles said. “You have to be ready for emergency. Be prepared every day for the most unlikely event. It can be stressful, but with proper training and experience, you have confidence to know whatever goes wrong, you can solve it.” He compared the risks to that of driving a car. Many things can go wrong on a serious level, but most of the time, it doesn’t, and the proper precautions reduce the risk. In addition to managing job related stress, perfusionists must also feel comfortable with a varied schedule. Emergencies can pop up at any time, requiring a level of flexibility from perfusionists. A scheduled eight-hour shift can change to a 16-hour shift with little notice. “If you really want a predictable life, knowing you’ll punch out at 3:30 every single Thursday for 25 years, this is not the right job,” Searles said. Despite the stress and scheduling demands, Searles said that the work is “extremely satisfying.” Though he spends plenty of time at the college, he also maintains his skills and credentials in the OR. “I never have to wonder if what I did that day was important,” Searles said. “All cardiac patients consider they might not wake up. I make sure they do wake up. Sometimes the work is easy, sometimes it’s hard but it really matters to the patient. They come in sick but go home with a better quality of life.”

December 2017 •

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Stricken with Strep Here’s a primer on dealing with serious illness By Jennifer McDougall

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ore throats are nothing to worry about, right? It depends. Tabitha McNamara, a clinical nursing instructor at Trocaire College, said a sore throat could be a symptom of strep throat. “The symptoms of strep throat can vary. They can include a sore throat, fever, cough, and white spots or swelling on the tonsils or the back of the throat,” she explained. However, she noted symptoms can also be a little different. “Some people get flu-like symptoms, including a fever, upset stomach, and vomiting — and people don’t associate that with strep, so they don’t think that’s what it is,” she said. McNamara said strep throat is diagnosed through visual assessment and a throat culture, after a sample is collected via a throat swab. She said rapid strep tests aren’t always as accurate, but they can be a good initial indicator. If the results indicate strep is present, it’s treated with antibiotics; amoxicillin is the most common choice. “If left untreated, strep can lead to rheumatic fever in children, and that’s more severe because it can lead to heart valve disorders,” McNamara said. She said it can cause the same problems in adults, and she warned that untreated strep can also lead to necrotizing fasciitis, also known as flesh-eating bacteria. Finally, McNamara offered a fact that may be news to many people, but may be helpful in determining why certain people seem to get strep repeatedly. “Some people can be carriers of strep, which means they carry it all the time, but they have no symptoms or issues. If someone in the family keeps getting strep, it can help to determine if anyone in the household is a carrier of it,” she explained.

Not just a sore throat Jennifer Blankenship has experience dealing with strep throat. All three of her children have had it, and all three ended up having their tonsils out as a result. She emphasized, as McNamara did, that strep throat may not be just a sore throat. “Ours always presented first with a high fever, vomiting, and then

lack of appetite. They didn’t even always complain of throat pain, at least not for the first few days,” she said. As a voice of experience with strep, she offered advice for people who may be new to it. “Be aggressive with it, and find a specialist if it comes back. Ask questions, and don’t be afraid to advocate for your child,” she urged. For Blankenship, this meant working very closely with her children’s pediatrician and otolaryngologist, also known as an ear, nose, and throat specialist. She also added a caution about how tricky the symptoms can be. “The first couple of times, I think we missed the early signs and chalked it up to a bug, which can be a regular occurrence when kids are in school or daycare,” she said. She recommended taking notes during medical appointments because it helps to be able to refer back to them if strep comes back.

Feeling ‘awful’ Although many people think of strep throat as a childhood illness, Suzanne Hebert is proof it can strike adults, as well. She had strep throat as a child, but it came back with a vengeance after she had children. Each time she got it, she had a sore throat and a fever, but she also had swelling in her throat and white spots in her mouth. It kept her home from work and interfered with her daily life. “The frequency of it bothered me, and every time it came back, I knew how awful I was going to feel,” she said. When she was 68 years old, her doctor recommended that she have her tonsils out. Hebert followed up by seeing an ENT for a second opinion. Hebert had her tonsils out, and she hasn’t had strep throat since. She said people should give the issue serious consideration if a doctor recommends removing the tonsils. “It gets harder as you get older, so if you’re going to do it, it’s better to do it sooner rather than later,” she said. She noted some people seem to be prone to strep throat. “It’s important to watch out for it and be aware of the patterns, so you can get treatment right away when it comes back,” she said.

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Technology Helps People with Visual Impairment By Deborah Jeanne Sergeant

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n addition to reading Braille documents, people with visual impairment have many technological choices for accessing written words, from apps and software that read aloud text online to scanners that can read menus, signs and more. Rachel Colegrove, occupational therapist with Western New York Center for the Visually Impaired in Buffalo, said that many of her clients, especially those in their 20s and 30s, find definite advantage using printto-speech technology. “Apps are cheaper and more accessible because the person has it on their phone instead of having another device,” said Colegrove. Voice-activated devices, e-books and other technology intended for commuters or convenience often work well for people with visual impairment without purchasing specialty devices. But Colegrove said that people who aren’t tech savvy about smartphones and their apps may find using them challenging. “A lot of our clientele is older,” Colegrove said. “A younger person who has recently become visually impaired or has grown up with the cell phone is more used to working with phones.” For Ann K. Parsons, owner of Portal Tutoring in Rochester, the ability to hear information beyond audiobooks — things like menus, signs and postal mail — makes life easier. But access to more books is important, too. Parsons is visually impaired. When she was growing up, she owned very few books, since she had to either obtain Braille books or obtain a reader to help. “I’ve spent my whole life hearing books read aloud and now people who are sighted are enjoying them as well,” Parsons said. Since apps like these are common on smartphones, it makes accessibility ubiquitous. The number of audio book titles now on CD or stored on thumb drives makes it much easier to get audible materials. But more recent innovations have helped make more written words accessible.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

Parsons mentioned Be My Eyes. It’s a free app on the iOS (the Android version is coming) that connects people with sight to those who need help in seeing. Using a real-time video chat, volunteers read whatever is put in front of the screen. Users find it helpful for sorting through cans in the pantry, reading websites that screen readers can’t, or finding a dropped object. The app selects volunteers only during their daytime hours; however, users may use it whenever they would like for as long as they would like at no charge. Parsons said that KNFB Reader is quite popular on the Android and iOS platforms. Users take a picture with a smartphone and it reads text aloud. Parsons uses that herself, and also uses a traditional reader on her computer that works with a scanner. Parsons thinks that electronic Braille readers will continue to advance. These readers create Braille text of what’s on the screen by raising and lowering pins electronically. Chelsea Hale, teacher for the visually impaired and orientation and mobility instructor with the New York State Association for the Educations and Rehabilitation of the Blind and Visually Impaired (NYSAER) in Darien Center, said that JAWS screen reading software is pretty popular. While technology helps in some ways, it can have its drawbacks. Recent developments in web design feature graphics-heavy sites that require users to scroll down before they find text. Sites designed like this make it more difficult for people to navigate with screen readers. Displaying important information such as phone numbers and names in a graphic usually makes it impossible for a screen reader to relate that information verbally. National Federation of the Blind states that 2.3 percent of the US population is visually impaired. That amounts to 387,900 New Yorkers. Businesses that make it hard to read text through screen readers miss a sizable market share that will only grow as the baby boomers age and experience age-related vision loss.


Helping Young People to Take Control of Their Sexual Health Four steps they need to take to stay safe By J’Leise Sosa, MD

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orty-six percent of American high-schoolers have had sexual intercourse and one in four teens has a sexually transmitted disease — or STD. For the third year in a row, sexually transmitted infection (or STI) rates have risen in the US. About 20 million new diagnoses of sexually transmitted infections were made in 2016 and young people account for a disproportionate number of these infections, the most common in this cohort being HPV. Half of STI diagnoses occur in young men and women 15 to 24 years old. This occurs even though young people make up only 25 percent of the sexually experienced population. The reason for high infection rates in young people despite being a relatively small percentage of the population could lie in the wide knowledge gap on STIs, how they are spread, their symptoms and how to get tested. Closing that knowledge gap is an important step in empowering young people to take control of their sexual health. Though most STIs can be easily treated, they can affect a person’s health for the rest of their life. STIs can lead to a web of other health issues. Having one STD can increase the risk of getting another STD. For example, trichomonas

infection can increase the risk of HIV infection; the human papilloma virus (HPV) can lead to penile cancer, cervical cancer and anal cancer; herpes infection can lead to a lifetime of recurring sores; hepatitis B could lead to liver cancer. Though the rate of new infections appears to be equal in both young women and young men, young women tend the bear a greater burden of the health implications of STIs. Gonorrhea or chlamydia infection can lead to scarring in the fallopian tubes making it difficult or impossible to get pregnant in the future. These infections can also cause pelvic inflammatory disease which can lead to chronic pelvic pain and could require surgery to address complications. STI infection in pregnancy can cause preterm birth and low birth weight infants.  A young person who is having sex needs to be thinking about STIs. Being safe is crucial in reducing risk. The only way to avoid a sexually transmitted disease is to avoid sex whether it is oral, anal or vaginal. When one chooses to become sexually active, the following are methods to stay safe:   Get tested…regularly. Anyone under 25 years old should be screened for gonorrhea and chlamydia each year. You should also be offered HIV testing. Men who have sex with men should be tested

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more often — every three to six months. Ask your doctor to be tested at your annual visits. If you are ever concerned about an infection, get tested ASAP.   Get vaccinated…early. The CDC recommends that the HPV vaccine be given to 11-12-year-old boys and girls. If started before becoming sexually active, it can significantly reduce the risk of cervical cancer, penile cancer, anal cancer, and genital warts. It can still be effective even after starting sexual activity and can be given up to the age of 26.  Use condoms…every time. Yes, it could be a bore but unless you can be 100 percent sure that your partner is monogamous, condom use could save you from a lifetime of anxiety, doctors’ visits and medical problems related to STIs. Talk… to your partner. A discussion about STIs and a plan to reduce risk should be had with every potential sex partner. Some important things to note: Men often do not show signs of STIs. They therefore are more likely to transmit an infection without even knowing it. A lack of symptoms does not necessarily mean a lack of infection. See No. 1 above — get tested. Also, men are not routinely checked for some STIs. For example, there is no test to screen men for the HPV virus. The HPV vaccine

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J’Leise Sosa is therefore very important in reducing risk. As a gynecologist, I often see women who test positive for trichomonas but tell me their partners had negative STI testing. These men have undiagnosed trichomonas because it is not routinely included in the male STI panel. It is important for men to ask specifically for trichomonas testing and for women to ask their partners about this.  Taking control of one’s sexual health is imperative.  In Buffalo, the Erie County Department of Health, Planned Parenthood, Kaleida Health Family Planning Center, and Evergreen Health all provide free or low cost STI testing. To find another STI clinic, go to: gettested.cdc.gov. J’Leise Sosa is an OB-GYN providing services through General Physician, P.C. Women’s Health in Buffalo and East Aurora.

Better Waiting Areas for Those in the Autism Spectrum A visit to dentist or doctor can heighten anxiety among children on the autism spectrum. Better space design can be the solution By Deborah Jeanne Sergeant

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urability and appeal likely comprise the top two factors when designing a public waiting area. A television, bright overhead lights, patterned upholstery, air freshener and people chatting may appeal to most people. To some children on the autism spectrum, however, the same waiting room may pose a problem. It would seem too bright, too loud and too chaotic. The over-stimulating room can heighten any anxiety children may already feel because of the doctor’s visit. Providing a low-sensory space or making a few modifications can help more patients feel at ease. If you’re a health care provider wanting to accommodate patients with autism, dedicate a separate room to provide a low-stimuli space. If that’s not possible, part of the waiting area separated by a half wall, a moveable cubicle wall or child’s play tent place may help carve out

some space. “The parents are very appreciative,” said Tracy Panzarella, director of clinical services at Autism Services, Inc. in Amherst. Placement is important. Panzarella said that it’s best to create the space away from the noise and bustle of the main waiting area, such as on the opposite side of where patients check-in and away from the television. She also advises using soft lighting, not harsh, overhead fluorescent lighting. If possible, lighting with a dimmer switch is helpful. Panzarella also recommends darker and more neutral colors throughout the space: floors, walls, ceilings and furnishings. Minimize patterns in all aspects of the decor. Wood furnishing is sensory-friendly, but select dark painted furniture that doesn’t let the wood grain show through.

Don’t paint sprawling murals or hang numerous pictures. Just one piece of art per wall suffices. Choose a soothing nature scene, for example, or abstract art with curves and spirals instead of jagged shapes. Include carpeting, soft seating and curtains to help absorb sound. Consider sound-absorbing architectural features like ceiling tiles. Keep the television in the main area turned down. Skip artificial air fresheners and harsh-smelling chemicals. Opt for natural cleaners and live plants. Provide a few simple toys and books but store them in a covered, opaque bin to reduce visual clutter. “Activity panels, where there are different textures of fabric, toys that make different sounds and things like small manipulatives and puzzles are nice, along with different books to look at,” Panzarella said. Natalie LeVan, supervisor of occupational therapy at The Center

December 2017 •

for Learning at Aspire of Western New York, suggested beanbag chairs or other seating that’s more inviting to cuddling. “Compression vests or blankets can have a calming effect,” she said. “A beanbag chair mimics that.” Overall, making the waiting room quieter-both visually and audibly-can help some patients on the spectrum remain calmer if they ordinarily feel overwhelmed by that kind of stimuli. “Many of these kids tend to be distractible if there’s too much to see or hear,” LeVan said. “Some hear the lights buzzing, the heater blowing and people walking outside the window. Simplify the environment. Having the TV remote available is helpful.” Most of these changes provide a more tranquil waiting area for any patient, but can make the space more welcoming to a patient on the autism spectrum.

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Rotary Rink at Fountain Plaza, which is managed by Buffalo Place. Photos courtesy of Buffalo Place, Inc.

Embracing WNY Winters Winter in Western New York? Bring it ON! By Nancy Cardillo

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a know what? Winters in Buffalo can be long, dark, cold and depressing. Let’s face facts: we get a lot of snow around here in our winter months. In fact, according to the National Weather Service, Western New York averages about 85 inches of the white stuff each season, with the highest amounts typically falling in January and February. That’s good enough reason to hunker down on the couch under Grandma’s afghan, binge watch all those TV shows you’ve been meaning to get to and…gain weight, get depressed and pretty much lose contact with the outside world, right? Wrong! While there certainly are those who prefer to take down the Christmas tree, undeck the halls and then hibernate like a bear for three or four months, most Western New Yorkers embrace the cold and the snow, finding ways to enjoy themselves as Old Man Winter sets up residence. After all, we are a hardy bunch. And, as proof, there are just as many fun outdoor activities happening in our backyard during the winter as there are during the good, er…warm seasons. Love the idea of strapping on some thin boards, grabbing a couple

skinny poles and racing down a mountain at, like, 65 miles an hour? There are plenty of places nearby to enjoy downhill skiing, such as Kissing Bridge; Holiday Valley; Holimont or Peek’n Peak, all of which fire up the snow machines as soon as the temperatures drop. A full day on the slopes can be exhilarating, especially when you’re with good friends. Ever skied in the evening when there’s a full moon? It’s like skiing on the moon! And if you’re really feeling adventurous, these places also offer great snowboarding trails. If the idea of zooming down a mountain doesn’t appeal to you, there’s always cross-country skiing. Here, you rely on your own power to move through snow-covered trails. It’s great exercise and also gives you a much better opportunity to enjoy the beauty that is nature in the winter. Most ski resorts also offer cross-country skiing, but you can also just grab your skis (or rent some) and head to any of Erie County’s parks, such as Chestnut Ridge; Delaware Park; Sprague Brook or Como Lake. Never tried cross-country skiing? Buffalo Nordic Ski Club offers clinics, lessons and workshops. They say if you can walk,

‘Winter: time to hunker down on the couch under grandma’s afghan, bingewatch all those TV shows you’ve been meaning to get to and…gain weight, get depressed and pretty much lose contact with the outside world, right? Wrong!’ you can snowshoe. After all, snowshoeing has been around for thousands of years, and is a great way to move quickly through deep snow. Snowshoeing has become very popular in our area — it’s a great form of exercise (you’ll be surprised at how quickly you warm up!) and it’s the perfect way to relax and enjoy your surroundings as you work those muscles. There are plenty of designated trails to explore, including Tifft Nature Preserve; the Erie County Forest; Beaver Meadow and Bond Lake Park. Most will rent you snowshoes, too.

Yodeler Lodge at Holiday Valley. Photo provided Page 18

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

Who doesn’t remember those great snow days of youth, when schools shut down and sledding (or tubing) was at its best! And while any decent snow-covered hill will do, you can also relive your childhood at Akron Falls Park; Beaver Island State Park; Holiday Valley or the infamous sledding hill at Chestnut Ridge Park. Here’s another great (and less costly) way to celebrate winter: ice skating. Again, no shortage of options here, both indoors and outdoors! Buy or rent some skates and head to Rotary Rink, Riverworks or the Ice at Canalside in downtown Buffalo, the Healthy Zone Rink in East Aurora or the Erie County Parks. If you’d rather skate in indoor comfort, check out the Northtown Center in Amherst, HarborCenter in downtown Buffalo or the North Buffalo Ice Rinks. One of the hottest winter activities these days is ice biking. Yep, that’s right. Biking. In the winter. On ice. It’s a great way to still enjoy the ice if you’re not so steady on ice skates. You can rent ice bikes exclusively at Canalside, and pedal and steer your way around the ice to your heart’s delight, with the city skyline and waterfront as your backdrops. And, speaking of pedaling… how about taking a pedal tour of Buffalo this winter? Buffalo Pedal Tours offers special winter discounts through March. The pedaling will keep you and your friends warm (as will the stops at some of the city’s favorite taverns) as you see Buffalo from a unique vantage point. How about an icy alternative to shuffleboard? Curling has also seen a bump in popularity here in Western New York. So much so that Buffalo Curling Club has moved into the former Buffalo China Factory to offer the area’s only indoor curling facility. They’ll teach you how to play (hint: are you good with a broom?), rent you whatever equipment you need and ensure a few hours of friendly competition on the ice. But you don’t necessarily need expensive equipment or advance planning and you don’t need to travel far to embrace our winters. Simply taking a walk around your neighborhood during a soft snowfall or heading down to the marina to look for snowy owls can be very enjoyable. The bottom line is: Buffalo enjoys four seasons and each one including winter! Has something special to offer. Don’t miss it!

Downtown Buffalo. Photo courtesy of Buffalo Place, Inc.


How to Make Achievable New Year Resolutions By Kimberly Blaker “Year’s end is neither an end nor a beginning but a going on, with all the wisdom that experience can instill in us.” Hal Borland The New Year is a great time to take inventory, set goals and take charge of your life. But if you’re like most, making resolutions is much easier than keeping them. Rather than focus on the idea of a new beginning, which can lead to disappointment at the first slip, keep in mind that self-improvement is an ongoing endeavor. Setbacks are not failure; they bring wisdom and insight for future success. Before making a split decision as to this year’s resolutions, make a list of goals and changes you’d like to make. Then review your list, and cross off any you do not feel truly devoted to. Whether you resolve to spend more time with your family, quit smoking or lose weight, you’re more likely to succeed if you feel a strong personal commitment rather than ‘I should.’ One reason people don’t keep resolutions they make is the resolutions are often made to silence the pestering of a loved one. If you decide to quit smoking to get your husband off your back, you’re less likely to succeed. If you decide to quit smoking to feel healthier and

be able to enjoy physical activity without being winded, you’re more likely to experience success. Choose one or perhaps two of the resolutions on your list to which you feel most committed. Then choose one or two you feel confident you can do with ease. These last couple can be used as positive reinforcement for the more challenging first choices. The next step is to make a clear plan for adhering to your resolutions. Put each resolution in writing and detail the steps to achieve them. If your resolution requires a routine or schedule such as an exercise routine, a new diet, or steps toward completing your education, then create a goal chart, a detailed plan, and a checklist to track your progress. Also, post notes in strategic places such as the refrigerator, bathroom mirror, or steering wheel as reminders of your resolutions with tips on how to overcome temptation. Make certain your family understands the importance of your resolutions. Family support and their positive reinforcement can be most helpful. If your resolution is something your family has been nagging you about, ask for their encouragement but explain that pressure and pestering, particularly during setbacks, could undermine

your resolve. Determine how each family member can help you to achieve your goal perhaps by taking on additional household chores or through affirmations of your continued success. Adjust your environment to enable success. If eating healthier is your goal, don’t fill the cupboards with junk food for other family members. Find healthy snacks they’re willing to substitute. If you’re trying to quit smoking, avoid people, places, and things that remind or tempt you, at least until you have it well under control. Don’t go it alone. If you have a friend with a similar resolution, make a pact. Work together to create a plan, and then make a point to check in with each other regularly for encouragement, praise, and support. If you resolve to get more exercise,

do it together. Having a commitment and someone to accompany you will go a long way in helping you to succeed. Finally, reward yourself, not just once you’ve achieved your goal, but periodically for your success so far. Small, periodic rewards can be motivation enough to keep you strong when you’re ready to throw in the towel. Remember, whatever New Year resolutions you choose, success awaits you if you resolve to never give up trying. Kimberly Blaker, of Michigan, is a freelance lifestyle writer. Her articles have appeared in more than 250 newspapers, women’s and parenting magazines, and other publications throughout the U.S. 

Avoid Chapped Skin Cream and ointment-type products work better to keep skin from cracking because of the cold weather, according to local experts. By Deborah Jeanne Sergeant

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t’s chapped skin time. But you don’t have to endure flaky, red, irritated skin this winter. Local experts offer a few tips for avoiding chapped skin. Moisturizing with the right products can make all the difference. Elise DeLuke, dermatologist with DeLuke Dermatology in Amherst, prefers CeraVe, Neutrogena Norwegian Formula hand cream, and O’Keefe’s Working Hands. For the lips, it’s Aquaphor or Vaseline. Moisturizing the lips is especially important for women who wear lipstick frequently, as these cosmetics can dry the lips. In addition to using quality moisturizers — early and often — DeLuke recommends using a humidifier to help improve Turowski skin condition and prevent chapping. “People get dry skin because

there’s no humidity in the air,” she said. “Drink plenty of water, too.” Try a vitamin E supplement to help support healthy skin. Cream and ointment-type products work better than using standard lotion, but lotion is lighter and better for using on the face, according to Jonathan Turoski, nurse practitioner with Neiman Dermatology in Williamsville. “If you use products on the face that are too heavy, you can have acne,” he said. Applying products before bed and after hand washing helps restore Deluke moisture; however, people who wash and use hand sanitizer often, such as those in health care and food service, will need to remain vigilant with moisturizing. Fragrant or deodorant soaps can further dry and irritate chapped

skin; milder soap causes less drying. Turoski says Dove, Aveno or Ivory soaps are a few examples of milder products. Long, hot showers can also dry skin. Though cold showers are hardly welcome in winter, moisturizing afterward can mitigate its effect. Colleen Vaccaro, physician assistant to dermatologist Lynn Amareante in Williamsville and North Tonawanda, tells patients to take shorter showers instead of baths, which further dry the skin. Vaccaro “For a child, get the bathroom warm with a small heater away from the tub or run hot water to get steam in the bathroom, but don’t have the water too hot,” Vaccaro said. “The hotter the water and longer we’re in it, the more it pulls moisture from the skin.” She added that for peeling and

December 2017 •

Cream and ointment-type products work better to keep skin from cracking because of the cold weather.

cracking skin, prescription strength steroid creams can help. Some people apply heavy moisturizer and then don gloves before bed; however, if the gloves cause their hands to sweat in the night, that can aggravate skin problems, so use lightweight cotton gloves. These are available in the skin care aisle. Plan ahead for housework. Most household cleaners can dry out hands, as can dishwashing, so wear latex gloves and moisturize afterwards. If gloves can’t be worn, using milder, more natural cleaners can also help prevent drying. Keeping skin covered while outdoors aids in retaining moisture in the skin, so don gloves each outing no matter how brief and wear a scarf around the face for prolonged exposure, such as for a day of sledding.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Shingles: To Vaccinate or Not?

The Social Ask Security Office

For experts, it’s a no brainer. If you had chickenpox as a child and are over 50, you should get the vaccine By Deborah Jeanne Sergeant

Y

ou faithfully receive your flu vaccination every fall, but have you thought about shingles? If you’re like most people who had chickenpox as a child, you have a risk of developing shingles once you hit your 50s or 60s. That’s why physicians such as Elise DeLuke, dermatologist with DeLuke Dermatology in Amherst, recommend that adults age 50 and older who have had chickenpox receive shingles vaccine. “Some people who think they didn’t have chickenpox did have it and they’re not aware of it,” DeLuke said. Also known as herpes zoster, shingles occurs when the dormant virus that causes chickenpox reactivates in the body later in life. About one-third of the population that has had chickenpox later develops DeLuke shingles. “If it is on the face near the eye, it should be taken care of by an ophthalmologist,” DeLuke said. “It can cause serious problems. It can get inside of the mouth. It’s more painful but it’s not as dangerous as the eye.” People at higher risk for shingles have experienced chickenpox and have a depressed immune system because of stress, injury, medication or unrelated disease. DeLuke added that the only contraindications to the shingles vaccine are allergies to one or more of the components of the vaccine, usually gelatin or neomycin. The other contraindications are conditions or medication that suppress the immune system, such as chemotherapy drugs. The vaccine reduces patients’ risk of developing shingles by 50 percent or more. Vaccination can also help prevent the spread of illness to others who are not or cannot be vaccinated, such as yet-unvaccinated babies, who can develop chickenpox from an adult’s case of shingles. Local reaction at the injection site is the most common side effect. Some insurance plans cover shingles vaccination. Shingles starts out with a sensation of burning, pain or tingling in an area of the body, sometimes as a band, but only on one side of the body. Within two days, infectious lesions form (once they form a crust, the patient isn’t contagious). Topical preparations can reduce pain at the site, while oral anti-viral Page 20

medication can help reduce the duration. “If you get shingles, get medication within the first 72 hours,” DeLuke said. “If you do get the medication, it decreases the length and severity and likelihood of persistent pain.” Called post-herpetic neuralgia, these lifelong flare-ups occur in the same place manifesting lesions. About 20 percent of patients experience post-herpetic neuralgia. Some describe it as burning, stinging, shooting pain in the skin that Mele-Delgado any slight contact sets off, such as clothing brushing against the skin. “Oftentimes, you can expect someone will feel numbness and tingling post-infection,” said Melissa Mele-Delgado, board-certified with a doctor of nursing practice degree, who works at Neiman Dermatology in Williamsville. “For most, it dissipates. Post-herpetic neuralgia can last for years. Some have to go on medication. I had a patient with her entire left arm covered with countless lesions. She has pain in her thumb so bad she says she wishes she could cut it off.” Anyone approaching 50 should discuss shingles vaccination with a primary care provider.

From the Social Security District Office

A

Is It Medicare Or Medicaid?

lot of people have a difficult time understanding the difference between Medicare and Medicaid. Both programs begin with the letter “M.” They’re both health insurance programs run by the government. People often ask questions about what Medicare and Medicaid are, what services they cover, and who administers the programs.

Medicare

Let’s start with Medicare. Medicare is the national healthcare program for those aged 65 or older and the disabled. You pay for some Medicare expenses by paying the Medicare tax while you work. The Centers for Medicare & Medicaid Services is the agency in charge of both Medicare and Medicaid, but you sign up for Medicare A (hospital) and Medicare B (medical) through Social Security. You can apply for Medicare online from the convenience of your home at the link on our website: www.socialsecurity.gov/medicare/. If you’re already receiving Social Security retirement benefits when you reach age 65 or are in the 25th month of receiving disability checks, we will enroll you automatically. Medicare Part C (Medicare Advantage) and Part D (prescription drug) plans are available for purchase in the insurance marketplace. Social Security administers a program called Extra Help to help people with low income and low resources pay for premiums, co-pays, and co-insurance costs for

Q&A

Q: My daughter is 19 years old. In her senior year of high school, she had an accident that paralyzed her. It doesn’t look like she will be able to work in the near future, and since she has never worked she hasn’t paid Social Security taxes. Can Social Security still help her? A: Your daughter may qualify for Supplemental Security Income (SSI) benefits. SSI is a needs-based program paid for by general revenue taxes and run by Social Security. It helps provide monetary support to people who are disabled and who have not paid enough in Social Security taxes to qualify for Social Security disability benefits. To qualify for SSI, a person must be disabled, and have limited resources and income. For more information, visit our website and check out our publication, You May Be Able To Get SSI, at www.socialsecurity.gov/pubs.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

Part D plans. You can find out more about Extra Help and file for it at www.socialsecurity.gov/medicare/ prescriptionhelp. Each year, The Centers for Medicare & Medicaid Services publishes Medicare and You available online at its website at www.medicare.gov/medicare-andyou/medicare-and-you.html. This publication is a user’s manual for Medicare.

Medicaid

Each state runs their own Medicaid program under guidance from the Centers for Medicare & Medicaid Services. Medicaid offers care for the most vulnerable among us. While it does not require paying taxes while working, it does have guidelines about how much income and resources you can have to qualify. Medicaid provides coverage for older people, people with disabilities, and some families with children. Each state has its own eligibility rules and decides which services to cover. The names of the Medicaid program may vary from state to state. You can read about each state’s Medicaid program at www.medicaid.gov/medicaid/ by-state/by-state.html. You can find each state’s Medicaid contact information at www.medicaid.gov/ about-us/contact-us/contact-statepage.html. Medicare and Medicaid are two of the major insurance programs that provide healthcare to the American public. Understanding each program, as well as how the two programs differ, can help you and those you care about find the right healthcare program.

Q: I usually get my benefit payment on the third of the month. But what if the third falls on a Saturday, Sunday, or holiday? Will my payment be late? A: Just the opposite. Your payment should arrive early. For example, if you usually get your payment on the third of a month, but it falls on a Saturday, we will make payments on the Friday prior to the due date. Find more information about the payment schedule for 2017 at www.socialsecurity.gov/pubs/ calendar.htm. Any time you don’t receive a payment, be sure to wait three days before calling to report it missing. To ensure that your benefits are going to the right place, create a my Social Security account. There, you can verify and update payment information without visiting your local office. Please visit www. socialsecurity.gov/myaccount to create your account.


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Assistance Dogs Provide Help and Love Dear Savvy Senior: What can you tell me about assistance dogs for people with disabilities? My sister, who’s 58, has multiple sclerosis and I’m wondering if an assistance dog could help make her life a little easier.

Inquiring Sister Dear Inquiring, For people with disabilities and even medical conditions, assistance dogs can be fantastic help, not to mention they provide great companionship and an invaluable sense of security. Here’s what you and your sister should know. While most people are familiar with guide dogs that help people who are blind or visually impaired, there are also a variety of assistance dogs trained to help people with physical disabilities, hearing loss and various medical conditions. Unlike most pets, assistance dogs are highly trained canine specialists — often golden and labrador retrievers, and German shepherds — that know approximately 40 to 50 commands, are amazingly wellbehaved and calm, and are permitted to go anywhere the public is allowed. Here’s a breakdown of the different types of assistance dogs and what they can help with.

Service dogs

These dogs are specially trained to help people with physical disabilities due to multiple sclerosis, spinal cord injuries, Parkinson’s disease, chronic arthritis and many other disabling conditions. They help by performing tasks their owner cannot do or has trouble doing, like carrying or retrieving items, picking up dropped items, opening and closing doors, turning lights on and off, assisting with dressing and undressing, helping with balance, household chores and more.

Guide dogs

For the blind and visually impaired, guide dogs help their owner get around safely by avoiding obstacles, stopping at curbs and steps, negotiating traffic and more.

Hearing dogs

For those who are deaf or hearing impaired, hearing dogs can alert their owner to specific

sounds such as ringing telephones, doorbells, alarm clocks, microwave or oven timers, smoke alarms, approaching sirens, crying babies or when someone calls out their name.

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Seizure alert/response dogs

For people with epilepsy or other seizure disorders, these dogs can recognize the signs that their owner is going to have a seizure, and provide them with advance

warning, so he or she can get to a safe place or take medication to prevent the seizure or lessen its severity. They are also trained to retrieve medications and use a pre-programmed phone to call for help. These dogs can also be trained to help people with diabetes, panic attacks and various other conditions.

Finding a Dog

If your sister is interested in getting a service dog, contact some assistance dog training programs. To find them, Assistance Dogs International provides a listing of around 65 U.S. programs on its website, which you can access at AssistanceDogsInternational.org. After you locate a few, you’ll need to either visit the website or call them to find out the types of training dogs they offer, the areas they serve, if they have a waiting list, and what upfront costs will be involved. Some groups offer dogs for free, some ask for donations and some charge thousands of dollars. To get an assistance dog, your sister will need to show proof of her disability, which her physician can provide, and she’ll have to complete an application and go through an interview process. She will also need to go and stay at the training facility for a week or two so she can get familiar with her dog and get training on how to handle it. It’s also important to understand that assistance dogs are not for everybody. They require time, money, and care that your sister or some other friend or family member must be able and willing to provide. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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App to Help Treat Substance Abuse Approved by FDA

T

he U.S. Food and Drug Administration has approved its first mobile app to help treat substance abuse, the agency said in a recent news release. The Reset application is designed to help treat abuse of alcohol, cocaine, marijuana and stimulant medications. But the app is not intended for opioid dependence, the FDA said. The newly-approved app delivers behavioral therapy that’s designed to “increase abstinence from substance abuse and increase [participation] in outpatient therapy programs,” the FDA said. “This is an example of how innovative digital technologies

can help provide patients access to additional tools during their treatment,” said Carlos Peña, director of the FDA’s Division of Neurological and Physical Medicine Devices. The agency said it reviewed a 12-week clinical study involving nearly 400 people. Among those who used the app, 40.3 percent abstained from further alcohol, cocaine, marijuana or stimulant use, compared with 17.6 percent among those who did not use the app. Approval of the app was given to Pear Therapeutics, based in Boston and San Francisco.

Online @ www.bfohealth.com/

December 2017 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Health News Catholic Health Home Care recognized among best Catholic Health Home Care Services has received two national recognitions for top-ranked quality and patient satisfaction. “Our patients are at the center of everything we do, and our dedicated associates are committed to that philosophy, so when you combine those two elements day-in and day-out, people take notice,” said Joyce Markiewicz, Catholic Health executive vice president and president & CEO of Home & Community Based Care. “We are certainly honored to be ranked among the best in the country for home care.” DecisionHealth recently named Catholic Health’s McAuley Seton Home Care a 2017 HomeCare Elite Top 100 Performer. The 2017 HomeCare Elite is the compilation of the most successful home care providers in the United States. Now in its 12th year, this review names the top 25 percent of home care agencies from more than 9,000 nationwide, based on a number of performance measures. Special recognition is given to agencies like McAuley Seton that finish in top 100. Additionally, Strategic Healthcare Programs (SHP) of Santa Barbara, Calif., awarded Catholic Health Home Care services its SHPBest Superior Performer Award. Theannual SHPBest program was created to acknowledge home health agencies that consistently provide high quality care based on Medicare’s Home Health Consumer Assessment of Healthcare Providers & Systems (HHCAHPS) survey, which measures patient experience. With the largest HHCAHPS benchmark in the nation, SHP is in a unique position to identify and recognize organizations that have made patient satisfaction a priority and have been rewarded for their efforts with high marks on the HHCAHPS survey. SHPBest™ award recipients are determined by ranking the overall score for all SHP HHCAHPS clients. Providers that rank in the top 20 percent receive the Superior Performer award.  

VNA of WNY ranked among top 5 percent nationally The Visiting Nursing Association of Western New York (VNA) has been named to the Top 500 of the 2017 HomeCare Elite, a recognition of the top-performing home health agencies in the United States.  “VNA’s national ranking is humbling and very rewarding,” said Judy Baumgartner, president of the VNA. “Our team consistently strives for excellence. This recognition is a testament to the focus and emphasis the VNA places on leading with Page 22

CARE and the provision of high quality patient care.” HomeCare Elite agencies are determined by an analysis of performance measures in quality outcomes, best practices implementation, patient experience (HHCAHPS), quality improvement and consistency and financial health. In order to be considered, an agency must be Medicare-certified and have data for at least three outcomes in Home Health Compare.  Over 9,000 home care agencies are considered nationally and the analysis is based on review of Centers for Medicare and Medicaid Services (CMS) publicly reported data. The VNA was awarded Top 500 designation, representing the Top 5 percent of agencies nationally.  The VNA is the largest certified home health agency in Western New York. They provide care for more than 26,000 patients annually, performing more than 500,000 home visits. The agency is ranked among the top home health care agencies in the nation, according to data from Strategic Healthcare Partners and CMS.  Founded in 1885, the VNA was the first visiting nursing organization in the country. Since then, they have become one of the oldest charities in the nation and remain the largest home health agency in the Western New York region.  The VNA offers a full range of services including pediatric and adult skilled nursing and therapies, chronic disease management, home infusion therapy, mental health care, obstetrical services, telehealth, personal care, as well as personal response systems.  The VNA, a Kaleida Health affiliate, currently provides services to residents in ten Western New York counties including Erie, Niagara, Orleans, Genesee, Chautauqua, Cattaraugus, Allegany, Wyoming, Livingston and Steuben. 

ECMC Emergency Department gets grant from foundation Erie County Medical Center (ECMC) Corporation has received $250,000 grant for the hospital’s future trauma center / emergency department from The Margaret L. Wendt Foundation. The grant was reviewed and authorized through The Margaret L. Wendt Foundation trustees Robert J. Kresse, Thomas D. Lunt and Janet L. Day.  The foundation is a private, grant-making entity, established in 1956 and dedicated to charitable and public-service purposes in the Western New York area. During her lifetime, Margaret L. Wendt participated in a number of community activities but her greatest contribution to Buffalo and the Western New York Area was her vision that saw a major lifetime gift and ultimately her family fortune becoming a major social and cultural force.  “We are very pleased and

thankful to The Margaret L. Wendt Foundation for this very generous grant,” said Jonathan Dandes, chairman at ECMC Foundation. “I thank the foundation trustees for their support of ECMC’s future trauma center / emergency department. This gift will make a major impact on our efforts to generate further support for this vitally important project.”  ECMC Corporation President and CEO Thomas J. Quatroche Jr., said, “This significant donation highlights the critical role ECMC plays in the overall health and safety of our community and underscores the recognition and confidence that The Margaret L. Wendt Foundation has in the thousands of ECMC

caregivers for the life-saving work they perform each day for the residents of our community.” Erie County Medical Center Corporation plans to relocate its existing trauma center / emergency department into a newly-constructed ground floor facility on its Grider Street health campus. As the region’s busiest and only Level 1 adult trauma center and emergency department, which serves 1.5 million residents of the eight counties of Western New York, it is imperative to expand to meet current and future demands for appropriate trauma and emergency care, according to hospital sources. The trauma center / emergency department serves

Haitian rehab therapists Wilfred Macena (left) and Cedieu Fortilus (second from left) observe an auto accident patient exercising at ECMC as D’Youville College physical therapy department chairwoman Lynn Rivers (right) and ECMC rehab acute care supervisor and physical therapist Kevin Jenney (second from right) instruct the Haitian visitors in one of many training sessions held during their multi-week visit for intensive therapeutic instruction. 

Haitian Rehab Clinicians Undergo Training by D’Youville, ECMC Clinical Rehab Specialists Erie County Medical Center (ECMC) Corporation recently hosted two Haitian rehabilitation clinicians who have been undergoing intensive rehabilitation therapy training through D’Youville College since Oct. 9. The clinicians coordinated training sessions at School 84 on the ECMC health campus and at ECMC’s department of rehabilitation medicine. Cedieu Fortilus, a rehab technician, manages a rehabilitation clinic in his native Haiti. His patient case mix includes pediatrics, people with orthopedic and back problems, stroke, and amputations. Wilfrid Macena was a welder in Haiti before being injured by the 2010 earthquake, after which he lost his right leg due to the injury and

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

subsequent infection. Macena has since been trained in prosthetics and orthotics in Haiti. Both Haitian clinicians have been participating in intensive training in several areas. D’Youville and ECMC Physical Therapy (PT) and Occupational Therapy (OT) faculty, alumni and current students offered educational sessions in splinting, pediatrics, back care, body mechanics, and more. The visit and training was coordinated through the Haiti Rehab Project founded by Ginger Oliver, a physical therapist from the Utica, who was inspired to help the Haitians after the devastating 2010 earthquake. 


patients for trauma, emergency psychiatric conditions via ECMC’s Comprehensive Psychiatric Emergency Program and traditional medical conditions and is best suited of any of the region’s emergency departments to handle mass casualty, disaster-related circumstances. The new emergency department will contain greater efficiencies in patient flow and staff workflow thereby enabling the department’s medical services team to achieve high quality standards and outcomes. The customized layout of the space will better align with physicians’ and staff’s work flow while creating a more patient-oriented space containing larger rooms to accommodate patients’ families and the medical services team.

Independent Health Medicare plans get high ranking The Centers for Medicare & Medicaid Services (CMS) recently released its Star Ratings for Medicare Advantage and Prescription Drug plans. This annual rating was created as a way for Medicare beneficiaries and CMS to assess the overall quality and service of Medicare Advantage plans throughout the country. All of Independent Health’s Medicare Advantage plans again received a 4.5 out of 5 Star Rating from CMS. The Star Ratings are determined based on a combination of access to care and preventive services, as well as customer service and member satisfaction. Independent Health’s Medicare Advantage HMO plan has received a 4.5 Star Rating every year since 2011, and its Medicare Advantage PPO plan received a 4.5 Star Rating for the past three consecutive years. “As the leading Medicare Advantage plan in this region with nearly 80,000 members, we take great pride in the fact that all of our Medicare Advantage plans are again 4.5 Star Rated, which further underscores the consistency of the quality and value of our plans,” said Nora McGuire, chief marketing officer, at Independent Health. “Health coverage is a serious decision you make once a year. And unlike purchasing auto or homeowner insurance, which you hope not to have to use, health insurance is much more personal and used more frequently. As such, it’s important for Medicare beneficiaries to choose a plan based on its consistent performance for customer service, ease of use and coverage,” said McGuire. “We understand how important it is to choose the right plan because it’s such an individual, personal decision,” said McGuire. “That’s why Independent Health commits so much time and energy in making sure we have enough dedicated RedShirts who can provide the support and help through our exclusive RedShirt Benefit Review. Our nine Medicare Information Centers are located throughout Western New York as a convenient resource to help people get the answers they need when they need it.”

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U.S. Hospitals Still Prescribe Too Many Antibiotics: Study About 20 percent of U.S. hospital patients who receive antibiotics experience side effects from the drugs, researchers report. The new study included nearly 1,500 hospitalized adults who were prescribed antibiotics. The findings revealed that onefifth of those who experienced antibiotic-related side effects didn't require the drugs in the first place. The results add to growing evidence that antibiotics are overused, according to the Johns Hopkins Hospital researchers. "Too often, clinicians prescribe antibiotics even if they have a low suspicion for a bacterial infection, thinking that even if antibiotics may not be necessary, they are probably not harmful. But that is not always the case," said physician Pranita Tamma. She is director of the hospital's Pediatric Antimicrobial Stewardship Program. Antibiotics can cause real harm and doctors should always consider if they are necessary, Tamma said. "If the patient develops an antibiotic-associated adverse reaction, even though that is, of course, unfortunate, we should be able to take some comfort in knowing that at least the antibiotic was truly necessary," Tamma said in a Johns Hopkins news release. Tamma is also an assistant professor of pediatrics at Johns Hopkins School of Medicine in Baltimore. Patients in the study were hospitalized for reasons ranging from trauma to chronic disease. All received at least 24 hours of antibiotic treatment. Overall, 20 percent had one or more antibiotic-related side effects within a month of leaving the hospital. The most common were digestive upsets (42 percent), kidney problems (24 percent), and blood problems (15 percent), the findings showed. For every additional 10 days of antibiotic treatment, the risk of side effects rose by 3 percent, the investigators found. Over 90 days, 4 percent of study patients developed a bacterial diarrhea called Clostridium difficile, which can be severe. In addition, 6 percent developed infections that were potentially drug-resistant. The study was published this summer in the journal JAMA Internal Medicine.

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Online @ www.bfohealth.com/ December 2017 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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The choice to give is a life and death decision.

Dr. Jennifer Pugh Associate Chief of Service, Emergency Medicine

As Associate Chief of Service in ECMC’s emergency department, Dr. Jennifer Pugh is on the front line of critical cases. Each year, she and her team care for over 70,000 patients in a facility built for just 45,000. From double the square footage to new technology, our new Trauma Center and Emergency Department will bring our dedicated caregivers the resources they need for even more medical miracles.

The difference between healthcare and true care

TM

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2017

©2017 ECMC

Be a part of lifesaving care at SupportECMCtrauma.org.

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