in good Meet Your Doctor
ECMC physician John K. Crane says a bad byproduct of opioid crisis is more people getting infectious diseases
Physician Assistants Why is this one of the hottest careers in medical field today? The mean wage in WNY is $100,510
February 2018 • Issue 40
WNY’s Healthcare Newspaper
Sex After 90?
Can older adults enjoy sexual intimacy? Read what several experts have to say about it.
Also in this “Golden Years” special edition: • Buffalo woman turns 105 • Too many meds = increased health risks. What to do about it? • Mediterranean diet a recipe for strength in old age • Trying to get in shape? Get a trainer
Healthy Tips for 2018 Help with ED
Heard the Latest on Yoga?
In news that will delight men who’ve had difficulties in the bedroom, two generic versions of the erectile dysfunction drug Viagra hit the market in December.
Off-beat ways to perform yoga — with goats, on horses, in the air — have become a huge trend, thanks, in part, to a new generation of yogis
Pickleball craze sweeping the nation now serving up all-ages fun in Western New York
Dark Chocolate Don’t feel guilty about eating dark chocolate, says SmartBites writer. There are tons of good things going for it.
Food & Meds Foods and medications can interact, reducing the medications’ effectiveness or increasing the risk of harmful side effects. Find out what you should not eat if you’re taking certain medications.
An apple a day will keep the doctor away, but a glass of apple juice might not, says physician Roy Buchinsky as he encourages people eat fruit, not drink it.
better with everyday hassles. Remind yourself that from challenges, come opportunities.
6. Healthy Tips for 2018 Tips to help maximize your chances of a long, strong and resilient life
“If the food is white, it’s probably not right.” Avoid processed white carbohydrates such as white bread, bagels, rice, pasta and pizza. Replace with whole-grain products such as whole-grain bread, brown rice — or try pasta made from quinoa or brown rice.
“Don’t drink your fruit when you can eat your fruit.” Fruit in its natural form is healthiest. It is filled with fiber and antioxidants with their inherent benefits. When fruit is liquefied, you lose much of the fiber and increase the concentrated sugar load on your body. An apple a day will keep the doctor away, but a glass
of apple juice might not.
“Sitting is the new smoking.” Increase your daily physical activity by moving more every day. Aim for 10,000 steps per day — no ifs, ands or buts. “Don’t skimp on sleep.” Aim for seven to eight hours per day. This will allow you to function at your best and ward off many illnesses that are associated with sleep deprivation.
“Maintain a gratitude attitude every day.” Looking at life with a positive attitude can help you deal
“Don’t sweat the small stuff.” Don’t get upset over minutia in life and focus on the big-ticket items: health, family, work, religion.
“Avoid toxins such as tobacco, excess alcohol and BPA.” Take care of the environment and the environment will take care of you.
“Prevention is the best intervention.” Vaccinations might not be foolproof, but they are very powerful in preventing common illnesses such as influenza, pneumonia, HPV, hepatitis, shingles, diphtheria, etc. Remember these ‘bugs’ are devilishly clever.
“Control the controllable.” So much energy is spent worrying about
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
things that are out of our control. If you focus predominantly on items that are actually within your control, you will be able use your energy productively.
. “Take your work seriously, but don’t take yourself too seriously.” As the inimitable Charlie Chaplin said, “A day without laughter is a day wasted.” Source: Physician Roy Buchinsky, director of wellness at University Hospitals Cleveland Medical Center and the Robert and Susan Hurwitz Master Clinician in Wellness.
TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
Be Heart Smart A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-6993552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
©WellCare 2015 NA_03_15_WC February 2018 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Breast Cancer Network to host nutritional seminar The Breast Cancer Network of WNY (BCN) will present a seminar for breast cancer patients and survivors at 6:30 p.m., Wednesday, Feb. 7. The seminar, titled “Nutrition for Breast Cancer Survivors,” will be presented by noted nutritionist Sarah Thompson DiPaolo of WNY Nutrition at the offices of the Breast Cancer Network, 3297 Walden Ave.
in Depew. Registration is available online at www.bcnwny.org or by calling 716-706-0060. The free seminar is the final installment of BCN’s year-long series designed for breast cancer survivors. Funded by a grant received from the New York State Department of Health, the programs have focused on wellness activities and integrative therapies that can be used to complement traditional health care practices. BCN Executive Director Rob Jones said, “For breast cancer patients, so much of their time is
A flight of kombucha samples at Bootleg Bucha features flavors including Cucumber Lime Mint and Apple Spice.
It’s All About Kombucha Tea Some claim trendy kombucha can offer a cure to a variety of conditions — from sweaty feet and thinning hair to cataracts and even AIDS By Julie Halm––
n 2015, kombucha brewing had yet to be regulated in New York state. The fermented tea drink had begun gaining popularity nationwide and Jeff Empric, Heather Lucas and Todd Salansky believed in the health benefits of the beverage. The trio decided to begin brewing and Bootleg Bucha was born. The beverage has been known by a number of somewhat outlandish names throughout the years — including “The elixir of life” — and some fans claim that it has extraordinary health benefits, Page 4
including the ability to battle cancer. A quick internet search of the refreshment will turn up proponents who espouse the belief that the drink — the origins of which are not entirely clear but are commonly believed to be hundreds, if not thousands of years in the past — can cure everything from sweaty feet and thinning hair to cataracts and even AIDS. These claims, however, lack the support of scientific evidence, according to the National Center for Complementary and Integrative
spent with doctors and getting treatments. They aren’t always aware of complementary care and the different ways available for them to take more control of their lives.” By presenting information on topics such as nutrition, meditation, yoga, integrative medicine, chiropractic care, and genetics, Jones feels that the seminars met that need. “The overall response has been very positive and we are in the process of putting together similar programs for the upcoming year.” Jones also cited collaborations with local providers and speakers as a direct benefit of the programs.
Doctors to discuss menopause and heart health Catholic Health is sponsoring a community dinner program titled Health. That being said, the fizzy drink that seems to be one of the trendiest health foods on the market is far from being without merit. While it may not be the beverage to cure all that ails, the brewing process imbues it with characteristics that may well be linked to improved gut health. In order to create the drink, a symbiotic culture of bacteria and yeast, or SCOBY, is added to the mixture of tea, sugar and water and left to ferment for between two and four weeks. Before opening Bootleg Bucha, both Empric and Salansky suffered from intestinal issues and say that their gut health was greatly improved by kombucha. That may be because the result of the fermentation process is that the beverage is infused with probiotics. According to the Mayo Clinic, there is evidence to suggest that probiotics might help treat diarrhea, irritable bowel syndrome, speed the treatment of certain intestinal infections, prevent or reduce the severity of colds and flu and ease allergic disorders such as eczema and hay fever. “It’s the good bacteria that balances your gut, helps you process your food, gain the nutrients you need and keep your gut in check,” said Empric. “There’s a huge mind-gut connection,” added Lucas. “Your brain can’t be healthy if your gut isn’t healthy.” Kombucha also provides an alternative path to probiotic intake for those who are dairy-free, as yogurt is one of the most common sources. Whether or not you’re headed to the cooler to even out your stomach, kombucha certainly serves as a healthier alternative to many other drinks on the shelf. At Bootleg Bocha, all-natural flavoring is used for the variety of flavors from Apple Spice to Butterfly Pea Tea with Lemon Lavender. The brewery is also largely organic and plans to be entirely organic by 2018. Sugar is used but in moderation, according to the business owners. “Sugar is needed for the fermentation process and in the weeks that it’s fermenting, a lot of that sugar will ferment out,” said Lucas. “We don’t add any additional
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
“Menopause and Heart Health: What Women Need to Know” from 5:30 to 7:30, Feb. 8, at the Millennium Hotel, 2040 Walden Ave. in Buffalo. Registration begins at 5 p.m. Join women’s health specialist, physician Jodi Ball and interventional cardiologist Eram Chaudhry for an informative look at menopause and heart disease. In addition to answering all participants questions, they’ll explain what symptoms women should look for, and what they can do to take charge of your heart health. “Menopause and Heart Health: What Women Need to Know” is open to the public. Catholic Health invites area residents to attend one free dinner program each year. Admission for each additional program is $20 and includes dinner. Space is limited and reservations are required by calling Catholic Health’sHealthConnection at 716447-6205.
Tom Brady bottles kombucha for distribution at Bootleg Bucha.
sugar. All we add is fruit juices and herbs.” According to Salansky, an 8 ounce glass of Bootleg’s kombucha will average between 5 and 8 grams of sugar, compared to an 8 ounce full-flavor pop, which averages between 25 and 30 grams. Additionally, the drink is free of chemical additives and preservatives which pervade many grocery store shelves. “It started in, I’d say, the late ‘50s or early ‘60s when you started getting away from a lot of the farm-to-table foods and shifting to the FDA safe food stream, and the instant way to do it was chemicals,” said Empric. “It’s on the food and it’s in the food to prevent bacteria growth, so it’s going to alter your gut bacteria.” For Empric, the benefit is in the move back to basics. “There can be a fear of not having a preservative,” he said. “It’s a mindset change, but this is the way food was always made.” Bootleg Bucha is located at 1250 Niagara St. For more information, visit their website at http:// bootlegbucha.com.
Raw Meat Not the Safest Choice for Your Dog … or You W hile your dog or cat might love the taste of raw meat, a steady diet of it might be a bad idea, a new study warns. Raw meat diets for pets have become increasingly popular, but there is no evidence that they are healthier than typical pet foods, the researchers said. In fact, some studies have reported that raw meat diets may pose a threat to pets and their owners due to the potential presence of bacteria and parasites. To learn more about these risks, the Dutch researchers analyzed 35 commercial frozen raw meat diet products for pets that are widely available in the Netherlands. E. coli bacteria was
found in eight products (23 percent), listeria bacteria was discovered in 15 products (43 percent) and salmonella was detected in seven products (20 percent). Eight products contained Sarcocystes parasites and two products (6 percent) contained Toxoplasma gondii parasites. The two types of Sarcocystesparasites found in the products do not affect people but pose a risk to farm animals. T. gondii can cause disease in people, the researchers said. The study was published Jan. 11 in the journal Vet Record. “Cats and dogs that eat raw meat diets are also more likely to
become infected with antibioticresistant bacteria than animals on conventional diets, which could pose a serious risk to both animal health and public health,” lead researcher Paul Overgaauw, from Utrecht University, and colleagues said in a journal news release.
Pet owners should be informed about the risks of feeding their pets raw meat diet products. They should be educated about proper handling of the products and personal hygiene measures, and the products should include warnings and handling instructions, the investigators said.
Healthcare in a Minute By George W. Chapman Hospital Ratings CMS has released its 2017 star ratings for US hospitals. CMS is constantly tweaking the rankings to make them more meaningful for both hospitals and consumers. More than 3,700 hospitals were ranked from one star to five stars. The rankings break down as: one star, 7 percent; two stars, 21 percent; three stars, 32 percent; four stars, 31 percent; and 5 stars, 9 percent. The number of five-star hospitals tripled to 337 from just 102 in 2016. You can get the star rating for any hospital at www. medicare.gov/hospitalcompare. Enter either the zip code or name of the hospital. ACA Individual Mandate The Affordable Care Act has not been “repealed” with the recent removal of the individual mandate requiring all citizens to have health insurance or else pay a penalty. The individual mandate made insurance premiums more affordable for all ages by including younger and healthier people in the risk pool. With the termination of the individual mandate, many younger and/or healthier people will stop buying insurance, thereby leaving the risk pool with a higher mix of older and/or less healthy members. All insurance premiums, not just those sold on the exchange, will be negatively impacted. The Congressional Budget Office estimates that the removal of the individual mandate will: increase the uninsured by 13 million, increase premiums by at least 10 percent and reduce the federal deficit by $338 billion over the next 10 years. (The deficit decreases because the government will be subsidizing fewer premiums.) Despite the removal of the individual mandate, at the last count, 8.8 million people
enrolled for insurance on the federal exchange, down slightly (4 percent) from 9.2 million at the end of 2016. The number of additional people insured by the ACA through expanded Medicaid is around 15 million. Women Physicians For the first time in history, the number of women entering medical school has exceeded the number of men. According to the Association of American Medical Colleges or AAMC, 51 percent of incoming students are women, which is a culmination of the slight trend over the past few years. This class of medical students is also more diverse: 13 percent African American, 15 percent Latino. However, despite these encouraging numbers, the number of overall applicants to medical schools was the lowest in 15 years fueling the concern about a physician shortage. The AAMC continues to lobby congress to authorize Medicare to pay for more residency slots. Congress has not increased the number of US residency slots since the mid-’90s. Millennial Point of View Currently, there is an equal number of millennials and baby boomers. At 75 million people apiece, they are the two largest segments of the US population. This is significant for both political and economic reasons. The highest uninsured rate is in the 26 to 34 age cohort. (Parents can cover their children up to 26.) This uninsured rate is sure to increase with the removal of the individual mandate. One can’t blame millennials for going without insurance. The world today is far different for millennials than it was “back in the day” for boomers. In 1980, when boomers were still young, 80 percent of insurance was paid by employers. Today, employers
pick up an average 50 percent of the premium. Consequently, a lot of millennials can’t afford insurance, let alone the high deductibles and copays that are part of today’s insurance policies. Many figure the deductibles (out of pocket) attached to today’s premiums are so high, insurance won’t even kick in. Millennials are just one catastrophic event from bankruptcy. On average, millennials have more medical debt than older boomers who have enjoyed better coverage for most of their lives. The actuarial problem is clear: by not purchasing insurance, younger and healthier people are not diluting the risk pool. If health insurance is not to be mandatory, there has to be a solution/incentive for millennials. MD Job Creation Always overlooked in discussions about the cost and effectiveness of care is the number of jobs created by physicians. According to a study by the American Medical Association, physicians are responsible for 12.6 million jobs, generating about $2.3 trillion in economic activity. The study measured the impact of 737,000 physicians based on four economic indicators: employment, wages and benefits, and state and local taxes. Every dollar from physician services supports another $2.64 in other business activity. The American Hospital Association claims it supports one in nine jobs. Osteopathic Physicians The number of osteopathic physicians (DO vs. MD) is increasing rapidly. There has been a 68 percent increase in their numbers in the last 10 years. There are now more than 108,000 practicing DOs in the US or about one in seven physicians. Osteopaths are fully licensed physicians and practice in every
February 2018 •
specialty. They emphasize treating the whole person with a focus on prevention. They receive special training in the musculoskeletal system which is comprised of nerves, muscles and bones. More than half of DOs are in primary care. Currently, about 25 percent of all medical students are enrolled in a college of osteopathic medicine. MDs are technically “allopathic” physicians. Be a Better Patient in 2018 1. Understand how your insurance works. It’s your responsibility, not your providers’. Four in 10 of us don’t understand our benefits or what the policy pays. 2. Be an active partner in your care. Busy providers prefer an involved and responsible patient vs. an uninvolved and passive patient. Don’t be afraid to ask questions. 3. Be compliant. Once you have agreed upon an approach to your care, stick with the game plan. 4. Keep your own records. You do for everything else. 5. Review your bill. If it confuses you, call the office. 6. Take advantage of preventive care. Most insurances will pay for it. 7. Never be afraid to get a second opinion. Your physician will not be offended. 8. Don’t be a “no show.” If you can’t make an appointment, be sure to call at least 24 hours ahead to reschedule. Considering the lead time to get an appointment, it is an expensive waste to have the slot go unused. 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 email@example.com.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Join us on Tuesday February 6th
St. Paul’s Episcopal Church East Avenue & Westminster Road, Rochester, NY 14607 - Free parking is available at the George Eastman Museum
Support Session: H.O.P.E., (Hearing other peoples' experiences) 10:00-11:00am
* Note new time Prospective or new hearing aid users can share their experiences, questions, and hearing loss journeys in an informal session. James Feuerstein, PhD, Professor of Audiology in the Nazareth College Dept. of Communication Sciences and Disorders, will be monitoring the discussion this month.
Daytime meeting 11:00am-1:00pm Program begins at noon Untreated hearing loss and Alzheimer's Disease: Is there a connection? Anton Porsteinsson, MD, an internationally known expert on dementia, will update us on current concepts in Alzheimer's Disease. As a geriatric psychiatrist, he has devoted his career to the care and study of individuals with memory disorders. A Professor of Psychiatry at the U of R, Dr. Porsteinsson is widely recognized for his clinical research and considered one of the leading experts in the treatment of Alzheimer's Disease and other dementias.
For more info visit hearinglossrochester.org or call 585.266.7890
A hearing loop and captions will be used
By Chris Motola
John K. Crane, M.D. Byproduct of opioid crisis: more people getting infectious diseases, says ECMC physician Q: What kind of patients do you see? A: I’m in the division of infectious diseases. I do all my inpatient care at Erie County Medical Center. On the outpatient side, I also work at the Erie County TB Clinic. Q: You mentioned a trend you are concerned about: how the opioid epidemic is increasing the risks of certain infectious diseases? A: These are infections people acquire when they graduate from oral opiates to intravenous drug use. Q: Are we mainly talking about blood-borne pathogens? A: It includes blood-borne pathogens like HIV, hepatitis C and hepatitis B. Acquiring those pathogens doesn’t just come from IV drugs, but the sharing of dirty needles. Q: So, these are largely the same concerns we had at the end of the last century with heroin and HIV? A: Right. We’ve known for decades that the sharing of needles promotes all kinds of nasty infections, especially those three viral infections. Q: Do we still have mitigation programs for that, like needle exchanges? A: In New York we have needle exchanges in most of our larger cities, but even if you don’t have a program near you, you can get clean needles and syringes from your corner drug store. There’s no reason that addicts should have to reuse old, dirty needles. Q: What’s stopping addicts from using those? A: They may have really bad cravings and in a hurry, particularly if you’re in a house with other IV drug users. You may just grab one that’s lying around, shoot up and now you have HIV. And of course, some of those diseases can then be transmitted sexually. So even if you never use IV drugs but your partner does, you could catch HIV
from them. Q: Are the rates rising? A: We’ve already noticed an increase in the rate of new cases of hepatitis C and HIV over the last year. Q: Are there other risks of infectious diseases? A: Yes. Using clean needles does not prevent IV drug users from developing nasty bacterial infections. These don’t come from someone else’s body, but rather from your own skin. So, when you inject, especially in an environment of poor hygiene, you can inject all kinds of nasty bacteria into your body and develop all kinds of complications like injection-site abscesses and bloodstream infections. Q: So, most of the risks that come with any small puncture wound? A: Yeah, from having a break in your skin. In this case, however, you also have the risk of injecting any bacteria that might be in the drugs themselves. When you buy from the dealer, you’re not buying a sterile product. It has bacteria in it. Most of the time it’s not in high volume, or especially dangerous, but once in a while you can have a batch that’s contaminated with pathogenic bacteria. Then if you inject it into yourself, you can inject those dangerous pathogens into yourself. The low oxygen in an abscess is an environment where Clostridium botulinum can grow; you can give yourself botulism. Q: Other than quitting, how can they avoid that? A: In addition to using clean needles, they need to get alcohol wipes to clean the injection site. You can’t really tell if there’s anything in the drug, though, without laboratory testing. Q: As for encouraging cessation, what can you do as a pathologist? A: When we end up seeing these people, they’re
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
usually in a really bad state. Sometimes it’s serious enough to be a teachable moment for IV drug users. We have OK infrastructure for referring them to drug treatment centers, but the problem is that most inpatient drug treatment centers around the country are full. There’s a waiting list for residential treatment, which is what a lot of people need in the beginning. If you can’t go into inpatient rehab, you can do outpatient therapy, but if you have a serious problem with opiates, it’s difficult to keep an abstinence commitment. Methadone is usually best for people who are heavy users. Suboxone can be used for lighter users who haven’t been using that long. Q: I wanted to touch on this year’s flu season. What happened? A: We’re in the middle of a bad one. New York state just sent out an influenza surveillance report. It looks like we’re in for a bad year. Q: And the flu shot isn’t that effective this year? A: It’s not a great match with the most common circulating strain this year. The main strain circulating right now in influenza A, type H3N2. It seems to be a pretty aggressive strain capable of causing pretty bad symptoms. It’s not being considered a pandemic yet — the CDC would have to make that declaration. It just looks like a bad regular flu season. The flu shot still helps even if it’s not 100 percent effective. If you do come down with H3N2, the severity of your illness will likely be less. We consider a vaccine a failure if you have any detectable symptoms, but that doesn’t take into account that you were only in bed two days with a fever of 101 rather than five days with a fever of 105. But it’s still considered a vaccine failure. Q: Any advice beyond the vaccine? A: Washing of hands. If you’re sick with flu, try to isolate yourself socially. Alcohol-based hand sanitizer works on flu. Practice respiratory etiquette: cover your mouth when you cough. Sneeze into a tissue if you can. And wash your hands after you cough and sneeze if you can.
Lifelines Name: John K. Crane, M.D. Position: Attending physician and chief of the infectious disease section at Erie County Medical Center; professor of medicine; adjunct professor of micro and immunology, and pharmacology and toxicology, Jacobs School of Medicine & Biomedical Sciences, State University of New York at Buffalo Hometown: Westfield, NY Education: Fellowship, infectious diseases, University of Virginia (1990); residency, medicine, University of Rochester, Strong Memorial Hospital (1987); medical degree from University of Virginia (1984); PhD, pharmacology, University of Virginia (1983) Affiliations: ECMC Organizations: Infectious Diseases Society of America; American Society for Microbiology Volunteer work: Volunteer physician at Good Neighbors Health Center, a free clinic for the underserved on Jefferson Avenue in Buffalo Family: Married, four adult children Hobbies: Running, cross-country skiing, hiking, backpacking, canoeing
Working Out in Cold Weather Experts recommend plenty of ways to get active in wintertime By Deborah Jeanne Sergeant
he weather may be frightful, but don’t let this winter “go to waist.” Area experts recommend plenty of ways to get active and stay fit. Tips from physician Joanne Wu, board-certified integrative and holistic medicine and rehabilitation doctor: • “I’m a big outdoorsy person, so I always coach people about getting outside. If it is a nice day, I tell people to ski, take hikes and snowshoe. • “Ice skating is somewhat accessible. • “Curling is something I talk with people about. Some are shy about it, but it’s a winter sport. You don’t have to be out in the elements — you can do it in an indoor ice skating rink — but it is a winter sport and it gets people active and together. • “But if there’s a blizzard, you can stay active without going out. Indoors, try new things I don’t normally do when the weather is nice. Look up things exciting things
like maybe rock climbing or indoor volleyball that are one-off of what you’d normally do. • “Try indoor leagues for soccer.” Tips from Mary Shaw, active older adult coordinator at Ken-Ton Family YMCA in Kenmore: • “Indoor cycling is a really great cardiovascular workout. The music is very motivating. It’s a super way to maintain fitness, especially for people who ride in warmer months — but even for those who don’t. • “Try a treadmill or indoor track. Join a gym where you have access to that equipment or where you can do strength training with free weights. Or you can try any group classes or aquatics classes. Getting out of the house where you’re seeing other people you know can make a huge difference with seasonal affective disorder when we’re stuck in the house in the winter. • “If you prefer things at home, there’s a wealth of DVDs to purchase to workout with or YouTube videos. • “If you don’t mind being in the
outdoors, cross-country or downhill skiing or snowshoeing is great cardiovascular exercise.” Tips from Andy Cowan, fitness director and certified personal trainer at LeRoy Physical Therapy and Village Fitness in LeRoy, Macedon and Batavia: • “Join a fitness facility. That way you’re inside. • “Join a fitness class that keeps you interested and motivated. • “We do a few different ‘boot camps’ like a cardio boot camp and a strength boot camp. People at first seem intimidated, but there’s times where you can choose your weights like a 5-pound weight instead of a 10. Or you can reduce the amount of reps. You can push yourself a little without overdoing it. Boot camps can be motivating as you see someone around your age doing or lifting more.” Tips from Joe Fox, certified personal trainer and founder and owner of Train Smart, Buffalo: • “It’s important to try to get out in winter, as long as you have
the right outerwear. If the weather is really, really bad, maybe go to the mall and walk laps. • “You may need to do short workouts where you do them at home with little equipment in little space. These can make a huge difference. • “When it’s really cold out, try racquetball, indoor tennis or get to a gym and do some walking or wall climbing. I’m not a huge fan of stationary cardio equipment, but elliptical or treadmills are better than nothing.
Cold Hands or Toes? You May Have Raynaud’s Up to 10 percent of the population experience extreme sensitivity to cold, according to organization By Kyra Mancine
s winter weather rushes in, we often we feel the chill in our fingers and in our toes. People pass this off as a sign of the season. However, for some, it can be a symptom of a more serious condition known as Raynaud’s. Raynaud’s is a little known, yet relatively common disorder that causes poor blood flow to the hands and the feet as a result of dropping temperatures. People with this condition experience “attacks” when the smaller arteries that supply blood flow are disrupted. These vasospasms (narrowing of the blood vessels) result in fingers and toes turning white or blue as blood flow is lost. This is accompanied by pain and numbness, often described as a throbbing, tingling or burning feeling. After an attack, skin color changes to red (or becomes blotchy) and, eventually, back to normal. Attacks can last for a few minutes to much longer. The disorder impacts fingers more than toes, women more than men, and is more common in colder climates. Primary vs. Secondary
If you have primary Raynaud’s disease, you experience attacks described as above, but do not have underlying medical issues. This is the more common disorder. Secondary Raynaud’s disease is less
common and can be the result of an underlying medical condition, such as lupus, scleroderma or rheumatoid arthritis — even frostbite. Workers who work with vibrating power tools can also develop Raynaud’s. There is no cure for the disorder, although for secondary Raynaud’s, doctors can prescribe calcium blockers that help alleviate some of the symptoms. This type of medication is often prescribed for people with high blood pressure. The most severe Raynaud’s cases, while relatively rare, can result in skin sores or gangrene. However, according to the National Heart, Lung and Blood Institute, a majority of people who have Raynaud’s will not suffer from long-term tissue damage or disability. Preventing an attack If you have Raynaud’s, prevention of attacks is key. Stock up on hand warmers (hint – Dollar Stores have the best deal on them), get one of those pillows you can microwave and place on your hands, wear layers to keep the rest of your body warm, get into dry clothes as soon as possible after any outdoor activity where you might get wet (skiing, snow shoeing, ice skating, etc) and try to keep your stress level low. Mittens are recommended instead of gloves, as they trap air and can keep you warmer. You need to be very mindful of
People suffering from Raynaud’s disorder usually have the skin color of their hands and fingers changed to red during colder weather. weather conditions and attire when you have this chronic condition. In winter, the cold and damp can exacerbate symptoms, although attacks can happen all year. Air conditioning can also be a trigger. Prevention is possible, but you need to be proactive.
8) Use cold-allergy over-thecounter medications with caution — they have been known to contribute to attacks 9) Educate your friends, family and coworkers on your disorder. People can dismiss what they don’t understand. Help spread the word!
9 tips to try 1) Keep your overall body warm. Cold impacts Raynaud’s sufferers more than other people. You may have to wear layers/coats/sweaters during times when others will not have to dress in a similar fashion. 2) Use hand warmers — these portable heat generators make a big difference! 3) Have mittens or gloves to wear when needed. This can include when you shop in the grocery store or pump gas. Reaching into a cold freezer or handling a gas pump can cause an immediate flare up for some people. 4) Cut back or quit smoking — it can exacerbate symptoms 5) Eliminate or limit caffeine, as this can be a trigger 6) Limit exposure to the elements as much as you can 7) Practice mindfulness and stress reduction techniques
During an Attack If you do have an attack, there are things you can do, such as: 1) Running your hands under warm (not hot) water to help bring them back to normal 2) Move your arms in a windmill type motion (to increase circulation) 3) Go to a quiet area out of the cold, slow your breathing and try to remain calm
February 2018 •
If you think you may have Raynaud’s, consult your doctor to find out more and determine a treatment appropriate for your circumstances. Don’t be afraid to seek help. People often minimize this condition, not understanding the pain and severe nature of the affliction. For more information, resources and support, visit the Raynaud’s Association website: www.raynauds. org.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
New Book Announcement: ‘Alone and Content’ Dear Readers,
s d i K Corner
US Childhood Mortality Rates Lag Behind Other Wealthy Nations Leading causes of death are prematurity and injuries
n a new study of childhood mortality rates between 1961 and 2010 in the United States and 19 economically similar countries, researchers report that while there’s been overall improvement among all the countries, the U.S. has been slowest to improve. Researchers found that childhood mortality in the U.S. has been higher than all other peer Page 8
nations since the 1980s; over the 50year study period, the U.S.’s “lagging improvement” has amounted to more than 600,000 excess deaths. A report of the findings, published Jan. 8 in Health Affairs, highlights when and why the U.S. performance started falling behind peer countries, and calls for continued funding of federal, state and local programs that have proven to save children’s lives.
Teresa Jackson Live Alone and Thrive Workshop Participant
“For anyone who has
wondered, ‘Will I ever that This can come with independence. collection of essays offers hope be happy again?’, Alone and encouragement fortake those searching But, don’t my word for gentle it. and Content’s for answers. Here, you’ll find practical wisdom and practical and inspirational advice forBJ overcoming Here’s what Mann, highly insights will light a loneliness, rediscovering your true self, and coming into founder your own with confidence, new and hopeful way respected of BJ Mann curiosity, and a renewed love for life. forward.” Mediation Services, had to say about The thoughtful counsel in this book will Sally Ward help you develop a new, stronger sense of the book: “As a divorce mediator self and experience the freedom that comes Professional alone and content. (for with 17being years) I have seen Certified thousands Coach, PCC, CPCC of clients yearn forVoelckers a guide toandhelp Gwenn is the founder facilitator of Live Alone and Thrive empowerment workshops for women, a newspaper columnist, and sought-after speaker. After her them move from sadness to hope. divorce, she overcame loneliness and loss to create a life of fulfillment and joy on her own. Today, she is dedicated Gwenn’s gentle nudges and positive to helping others embrace their independence and feel “at home” with themselves. Gwenn lives with her dog, suggestions are being Scout,a in blueprint an 1830s English cottagefor in upstate New York, she operates House Content Bed & Breakfast. your best self where and loving your own www.aloneandcontent.com company. The book provides the key for thriving not just surviving, for living not just healing.” With the right attitude, you can turn the life you are living into the life you want. Possibilities can open up. When that happens, living alone becomes secondary to living fully! SELF-HELP USA $11.95 CAN $14.95
Cover design: Rebecca Nolen Author photograph: Amanda Kinton Photography
Writing this book has been a labor of love. And gratitude. First, I’m grateful to my “workshop women,” those resilient women who have attended my Live Alone and Thrive workshops and generously shared their stories, struggles and triumphs. Their courage touched me deeply and inspired not only the essays in my book, but my ongoing commitment to helping women live alone with confidence, peace, and joy. Next, my heartfelt thanks go to Wagner Dotto, publisher and editor of “In Good Health” and “55 PLUS” magazine. He invited me to become a contributing columnist over a decade ago and has been my biggest fan ever since. This book would not exist were it not for Wagner’s foresight and support. All my best, Gwenn
Among the leading causes of death for the most recent decade, the researchers say, were premature births and Sudden Infant Death Syndrome (SIDS). Children in the U.S. were three times more likely to die from prematurity at birth and more than twice as likely to die from SIDS. The two leading causes of death for those 15 to 19 years old in the U.S. during the same time period were motor vehicle accidents and assaults by firearm. Teenagers were twice as likely to die from motor vehicle accidents and 82 times more likely to die from gun homicide in the U.S. than in other wealthy nations. “Overall child mortality in wealthy countries, including the U.S., is improving, but the progress our country has made is considerably slower than progress elsewhere,” says physician Ashish Thakrar,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
I’m delighted to announce the publication of my book “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” The book is a collection of essays I handpicked and adapted from the series of monthly columns I have written for “In Good Health” over the past decade. Now, all in one place, my collection of essays is available for those who live alone after losing a spouse or partner through divorce, death or other life circumstance. Many often wonder, “Will I ever be happy again?” As a divorced woman, I know how painful it can be to find yourself living alone, especially after a long relationship has ended. I also know it’s possible to reclaim your life, to determine who you really are and to turn living alone into an adventure of selfdiscovery and personal growth at any age. My book opens with a “How Content Are You?” quiz, followed by a simple scorecard designed to help readers assess their level of happiness and satisfaction with life. While not scientific, this quiz
and scorecard can provide a helpful baseline for moving forward on the road to contentment. After the quiz is taken, readers can then pick and choose from over 25 essays full of thought-provoking and practical advice. The essays are organized into six chapters: • Coming into Your Own • Overcoming Challenges • Designing a Home Sweet Home • Surviving the Holidays and Special Occasions • Exploring Relationships and Romance • Spreading Your Wings Each essay is followed by two compelling questions, under the heading, “What You Can Do Today.” These questions are designed to inspire action and motivate readers to take healthy steps toward creating a life of fulfillment and joy on their own. While the book is intended for women, men can also benefit from my experience and helpful advice. It’s my hope that those who pick up my book will find encouragement, inspiration and even a few laughs within its pages. Ideally, “Alone and Content” will awaken readers to new ways of thinking about living alone and to the pride, pleasure and power
You’re not alone. Gwenn Voelckers has been there—and so have hundreds of women who’ve attended her Live Alone and Thrive workshops to move forward after a divorce, death, or other painful separation.
“This book is a gift for those who live alone!”
Alone & Content: Inspiring, Empowering Essay to Help Divorced Women Feel Whole and Complete on Their Own
Live Alone & Thrive
re you wrestling with the end of a relationship? Does the thought of creating a full and intentional life on your own seem impossible?
Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own
“This book is a gift for those who live alone!” Teresa Jackson, Live Alone and Thrive workshop participant. To Purchase The Book Alone and Content is available for purchase in both paperback and Kindle on Amazon.com and can be ordered through Barnes and Noble. You can also find the book on Gwenn’s website:
Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops, book, or to invite Gwenn to speak, call 585-624-7887, email firstname.lastname@example.org, or visit www.aloneandcontent.com.
an internal medicine resident at The Johns Hopkins Hospital and a lead author of the study. He adds: “Now is not the time to defund the programs that support our children’s health.” Thakrar notes that while the U.S. spends more per capita on health care for children than other wealthy nations, it has poorer outcomes than many. In 2013, the United Nations Children’s Fund ranked the U.S. 25th in a list of 29 developed countries for overall child health and safety.
New Generation of PAs: “Highly Employable” Field for physician assistants growing “much faster than average,” according to NYS Dept. of Labor. The mean wage in WNY is $100,510 By Deborah Jeanne Sergeant
he physician assistant (PA) has become one of the most lucrative and employable position is health care. PAs provide direct care to patients in conjunction with a physician and can focus on a medical specialty. Most schools in New York offer a five-year program that is an accelerated bachelor’s and master’s degree, which is followed by required certification. The 2016 Statistical Profile of Certified Physician Assistants, a report by the National Commission on Certification of Physician Assistants, states that more than 115,000 certified PAs work nationwide, an increase of 44 percent in the previous four years. According to the Department of Labor’s most recent statistics (May 2016), the Buffalo/Cheektowaga/ Niagara Falls area employs 1.0 PA per 1,000 people. Their mean wage is $100,510. The average mean wage statewide is $107,030. The Department of Labor predicts 37 percent increase in employment change between 2016 and 2026, cited as “much faster than average” growth. “There is a great outlook for PAs in all arenas,” said Katherine Sumner, physician assistant and adjunct instructor at Bryant & Stratton College and student director-at-large for the Western New York Physician
Assistant Association. “Our PA grads are highly employable. There is a huge need as older physician are retiring and cutting back and relying on a mid-level provider. It’s a really good field if you’re ready to take on the challenge and grow.” It only makes sense that the need for care providers has increased. With the jump in insured patients thanks to the Affordable Care Act and the decrease in providers as baby boomer physicians retire, demand for care providers has steadily risen. Many physicians use “physician extenders”— physician assistants and nurse practitioners — to help meet their patients’ needs. Sumner speaks enthusiastically about her chosen career path at Limestone Primary Care in Williamsville. “It’s very, very rewarding,” she said. “I am able to build rapport with patients and learn about their families during their pregnancy and watch the children grow up, knowing the patients and their parents.” The physician assistant also has room for advancement through specializing, thanks to fellowships, residencies and on-the-job training. With that experience, Sumner said that PAs “definitely have a lot of room for advancement into leadership roles such as in organizations, supervisory or specializing.”
Greg Shutts serves as chairman and professor of Physician Assistant Studies at Daemen College.
Physician assistant Katherine Sumner, director at-large for the Western New York Physician Assistant Association.
PAs practice in every surgical and medical care setting. A few examples include emergency medicine, cardiac care, general surgery, obstetrics, psychiatry, and neurosurgery. Beyond the patient care setting, PAs may also find roles in administration of a health care facility or as faculty. Gregg Shutts serves as chairman and professor of Physician Assistant Studies at Daemen College in Amherst. Daemen maintains 99 percent employment rate for PA graduates within six months of passing their board. Shutts said that in addition to good math and science skills, PA candidates should possess interpersonal communication skills. “They need to be able to communicate bi-directionally with families and with the supervising physician,” Shutts said. “Critical thinking, problem solving, flexible in
various situations is important.” Any previous medical experience, such as working as an emergency medical technician or paramedic, may also help the candidate become familiar with medical settings and give a small taste of a few of the tasks PAs do daily. “It’s a really good idea to be in the workforce and recognize the trials of being in healthcare to see what physicians and PAs do,” Shutts said. “Do you like interaction with patients and the other members of the team before you embark on this rigorous program? “Many apply because they like to help people, but we want them to sit back and think how they will help the patient. Getting experience tells them, ‘This is what I want to do and I understand what the challenges will be.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
The skinny on healthy eating
Lots to Love about Dark Chocolate B efore I became aware of dark chocolate’s nutritious ways, I used to feel a tad guilty whenever I indulged, fearing that I was consuming empty calories (and a lot of them). But I haven’t felt that way in years and here’s why: Dark chocolate is chock-full of health benefits. Let’s start with dark chocolate’s most noteworthy health perk: Its super-high concentration of antioxidants. We want to include antioxidants in our diets because they gobble up cell-damaging free radicals (present in all of us), which are unstable molecules that may contribute to heart disease, cancer, Alzheimer’s and other age-related diseases that shorten lives. What’s more, the particular kinds of antioxidants found in chocolate — flavonoids and polyphenols — may boost heart health, by improving blood flow, lowering blood pressure and reducing bad cholesterol. Another health perk to behold? Dark chocolate is surprisingly full of nutrients. A 1-ounce portion serves up 3 grams of fiber (as much as a banana!) and is rich in iron, copper and manganese. Current research shows that fiber may lower blood pressure, improve blood cholesterol
levels and reduce the “inflammation” now attributed to cardiovascular disease. Iron, copper and manganese all play a role in energy production and overall good health. Dark chocolate is a bona fide brain booster and mood elevator, as it triggers the release of endorphins and serotonin — neurotransmitters that make us feel up and good. A study published in the Journal of Nutrition showed that participants over age 70 who reported regularly consuming chocolate scored higher on cognitive performance tests. Fortunately — because dark chocolate runs high in fat and calories — only 1 ounce (about 150 calories; 10 grams of fat) is needed to achieve health benefits. On average, a few truffles or 3 squares of a 3.5-ounce bar are equal to about 1 ounce. More sweet news: Chocolate, like nuts, induce satiety, so a little goes a long way in helping us feel fuller longer. Not all chocolate is created equal, so choose your chocolate wisely. Most nutritionists recommend minimally processed dark chocolate with at least 70 percent cocoa content or higher to reap the aforementioned benefits. While milk and white chocolate are delicious, they have
fewer antioxidants and nutrients, scant fiber and nearly twice as much sugar.
Double-Chocolate Black Bean Brownies 1 (15-ounce) can of black beans, rinsed and drained 3 eggs 3 tablespoons vegetable oil ½ cup unsweetened 100% cocoa powder ¼ teaspoon salt ¼ teaspoon baking powder 1 teaspoon vanilla extract 2/3 cup white sugar (or less, if prefer) ½ cup semi-sweet or bittersweet chocolate morsels ½ cup chopped nuts (optional)
Preheat oven to 350 degrees. Lightly oil or coat an 8-inch baking pan with nonstick cooking spray. Combine the black beans, eggs, oil, cocoa powder, salt, baking powder, vanilla extract, and sugar in a blender or food processor. Blend until smooth. Gently stir in chocolate morsels. Add ½ cup of chopped nuts if you like. Pour the batter into the
f the prescription label says “take with meals,” does it matter what you eat? It depends on the medication. Many meds should be taken with food — any food — to increase their absorption and reduce the risk of side effects. But some foods and medications can interact, reducing the medications’ effectiveness or increasing the risk of harmful side effects. To stay safe, you should always talk to your doctor or pharmacist to learn the ins and outs of your prescriptions, along with what foods and beverages to avoid while you’re on it. In the meantime, here are some foods you should stay away from for some commonly prescribed drugs. n Cholesterol Medications: If you take a certain statin drug to control high cholesterol like Lipitor, Zocor, Altoprev, Mevacor or generics atorvastatin, simvastatin or lovastatin, you should avoid grapefruit and grapefruit juice. Grapefruit can raise the level of the drug in your bloodstream and increase the risk of side effects, especially leg pain. n Blood Pressure Medicine: If you take an ACE inhibitor drug like Capoten, Vasotec, Monopril, Zestril and others to lower your blood pressure, you should limit foods that contain potassium like bananas, oranges, tomatoes, spinach and other leafy greens, sweet potatoes, and salt substitutes that contain potassium. ACE inhibitors raise the body’s potassium levels. Eating too many potassium-rich foods while taking an ACE inhibitor can cause an irregular Page 10
Don’t Eat This if You’re Taking That By Jim Miller heartbeat and heart palpitations. n Blood Thinning Medications: If you are taking Coumadin, Jantoven, or the generic warfarin, you should limit kale and other greens, including broccoli, cabbage, spinach, and brussels sprouts that contain vitamin K. These foods can block the effects of these blood-thinning medications, putting you at risk for developing blood clots. You also need to watch out for garlic, ginger, vitamin E and fish oil supplements because, they can increase these medications bloodthinning abilities, putting you at risk for excessive bleeding.
prepared pan and sprinkle with 2-3 tablespoons more of the chips you are using. Bake 28 to 30 minutes, or until the edges start to pull away from the sides of the pan and a toothpick comes out clean. Let cool at least 15 minutes before cutting and removing from the pan.
n Antidepressants: If you take a monoamine oxidase inhibitor (MAOI) antidepressant like Marplan, Nardil, Emsam, Parnate, or generic isocarboxazid, phenelzine, selegiline or tranylcypromine, avoid aged cheeses, chocolate, cured meats and alcoholic drinks. These contain tyramine, which can raise blood pressure. Normally, the body controls tyramine levels with an enzyme called monoamine oxidase, but the MAOI antidepressant block that enzyme. n Thyroid Medications: If you take a medication for hypothyroidism
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
Store chocolate in an airtight container in a cool, dark place. Ideally, it shouldn’t be stored in the refrigerator, as chocolate is a magnet for odors and more likely to discolor (or “bloom” with a whitish coating) from the fridge’s moisture. Bloom doesn’t affect flavor, but it does affect how appealing chocolate looks. If refrigeration is a must, however, first wrap your chocolate tightly, then seal it in an airtight container. When stored properly, solid dark chocolate keeps for two years; filled chocolates, such as truffles, keep for three to four months, sometimes longer.
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 email@example.com.
like Synthroid, Levoxyl, Levothroid or generic levothyroxine, you should avoid eating tofu and walnuts, and drinking soymilk. All these can prevent your body from absorbing this medicine. n Anti-Anxiety Medications: If you take medication for anxiety like Xanax, Klonopin, Valium, Ativan, or generic alprazolam, clonazepam, diazepam or lorazepam, you should avoid alcohol. These medications act as sedatives, binding with the brain’s natural tranquilizers to calm you down. But when you mix these drugs with alcohol, the side effects intensify, and can cause you to feel lightheaded, sleepy and forgetful. n Antibiotics: If you’re taking an antibiotic like Sumycin, Dynacin, Monodox, or generic tetracycline, doxycycline or minocycline, you should avoid dairy — milk, yogurt and cheese and calcium supplements and fortified foods — for a couple hours before and after taking the medicine. Calcium in dairy products binds to the antibiotic and prevents your body from absorbing it, making it ineffective. To find more dietary guidance on the drugs you take, see reliable health sites like MedlinePlus.gov or MayoClinic.org, or consider the excellent new AARP book “Don’t Eat This If You’re Taking That: The Hidden Risks of Mixing Food and Medicine” available at Amazon.com and BN.com for $13.
Jim Miller is the author of the Savvy Senior column, published in In Good Health every issue.
Diet’s Role in Heart Disease
• “Check labels. Just because it says ‘whole grain’ doesn’t mean it’s good for you. Look for whole oats or grains as the first ingredients. • “Practice portion control. Don’t stop eating your favorite foods, but make sure you’re eating a reasonable portion.”
By Deborah Jeanne Sergeant
our fork can influence your risk of heart disease. While genetics also affect your chances, diet represents one factor you can control. Here’s what some area experts recommend: Tips from physician Priyanka Patnaik, medical director with UBMD Family Medicine at UBMD Outpatient Center at Conventus. • “Heart disease happens because of an accumulation of fat in the arteries. It comes from diet, mainly. Too much saturated fat, like those available in animal products, are taken in by some of the cells that guard our arteries. There’s also inflammation associated with it. It can cause a blockage of the arteries. • “Control calories overall. In the old days, people used to be involved in agricultural labor and were physically active and burning a lot of calories. If we’re not burning a lot of calories, they all get stored in the body as fat and cause heart disease. All the foods we eat, no matter what kind, if we eat excess in the calories we burn, we’ll gain weight. • “Eat less processed foods and sodium. People think only of added
salt, but processed deli meats — like cold cuts — are full of salt. • “Try cooking green vegetables or meat by baking or grilling, not frying.” Tips from Becky O’Connor, Eat Smart NY project manager for Western New York with Cornell Cooperative Extension Erie County. • “We look to the USDA My Plate to start. It shows how we can make our diet really healthy. • “Make half your plate fruits and vegetables. They have a lot of vitamins and minerals to reduce high blood pressure, keep blood vessels in good shape, and they’re full of fiber, which keeps you full longer. They also help reduce inflammation. • “Make half your grains whole grains. • “Eat a variety of lean protein and have fish and non-animal sources in there. • “Drink low-fat or no-fat dairy. • “Processed foods and those high in fat, salt and sugar we should avoid. That’s hard for a lot of people. • “Even small changes can make a difference, whether adding vegetables to a pasta sauce or
choosing an apple instead of chips from the vending machine. It all adds up in the long run. • “For protein choices, reduce intake of red meat. Choose lean protein no matter what. Choose lean red meat, and if you’re eating poultry, make sure there’s no skin on it. How you prepare it makes a big difference. Choose protein options that are baked, grilled or roasted, not fried. • “You should vary your protein routine. Eat fish one time a week, maybe a meatless Monday. It’s good for your heart and your wallet. Replace some red meat with some beans, such as in tacos. Or swap ground turkey for ground beef in tacos or chili. • “I’m a big advocate of whole grains, which are shown to reduce risk for heart disease. They taste a lot better now than they used to. Overlooked whole grains include brown rice, whole grain pasta, or try to make it half and half if you don’t like the taste. Cereals are a good place to look.
In general, foods with more processing tend to contain fewer nutrients and more sodium, fat and calories. “Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review” by Dariush Mozaffarian, published by the American Heart Association, states: “Evidenceinformed dietary priorities include increased fruits, non-starchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (eg., sodiumpreserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. “More investigation is needed on the cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. “Little evidence to date supports the cardiometabolic relevance of other popular priorities: eg, local, organic, grass-fed, farmed/wild, or non–genetically modified.” For tips on portion and other aspects of healthful eating, visit www.myplate.gov.
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Heard the Latest on Yoga? Off the mat: Offbeat ways to perform yoga has become a huge trend
Good News, Guys: Viagra Prices Start to Tumble In news that will delight men who’ve had difficulties in the bedroom, two generic versions of the erectile dysfunction drug Viagra hit the market in December. One of the new generics is made by Teva Pharmaceuticals, and the other by Greenstone, a subsidiary of Pfizer, the company that manufactures Viagra. The generic versions of the little blue pill (sildenafil) are cheaper than brand-name Viagra for most men. And more generic versions are expected this year, which could drive prices even lower. Viagra came on the market in 1998 as the first drug to treat impotence. Cialis (tadalafil) and Levitra (vardenafil) are two other erectile dysfunction medications. They work by relaxing muscle cells in the penis, which allows for greater blood flow, according to the Urology Care Foundation. Pfizer says the current wholesale cost for a 50 milligram or 100 milligram Viagra is $61.54 a pill. Greenstone will sell the generic version for between $30 and $35 a pill. However, both of those figures represent the price the drug maker charges. A number of variables affect the final cost a consumer pays, such as mark-ups from pharmacy benefit managers or pharmacies, and insurance coverage and co-pays. “Cost has been a tremendous issue for patients. Many patients have been unable to obtain the medication since insurance companies don’t pay for it and out-of-pocket costs are astronomical,” said physician Aaron Katz, chairman of urology at NYU Winthrop Hospital in Mineola. “The hope is that [the introduction of generics] will reduce the cost, and patients will have greater access to Viagra, which has been an important medication for healthy men with erectile dysfunction,” Katz added. Generic versions “will be of real benefit to the majority of men,” he said. “The brand erectile dysfunction drugs are often not covered by commercial payers [insurance companies], or are covered but with substantial co-pays and restrictions on the number of pills covered per month,” he said. For older men on Medicare, he said the brand-name drugs can cost as much as $50 for one pill. The doctor said this has led many men in the United States to buy erectile dysfunction drugs online or in Canada. Page 12
By Deborah Jeanne Sergeant
oga: would you do it on a boat? Would you do it with a goat? Today’s yoga scene sounds like it took a page from Dr. Seuss’ “Green Eggs and Ham.” But yogis are practicing on boats, with goats — and in hammocks, on horseback and with a lap full of puppies or kittens. Offbeat ways to perform yoga has become a huge trend, thanks, in part, to a new generation of yogis looking for a fun, quirky way to enjoy an ancient practice. “Some are fusing other forms of exercise, like hooping or Pilates to the yoga program,” said Joanne Wu, an integrative and holistic medicine and rehabilitation physician who practices in Buffalo and also teaches yoga. “Others are a brand new form of movement. It makes it more fun and keeps people challenged. For yoga practitioners, it helps remain mindful of their exercise program while trying something new.” Wu teaches aerial yoga, which uses silk fabric and hammocks as props to help students perform circus-like movements; pi-yo, which merges Pilates and yoga; barre yoga, a mix of ballet and yoga; acrobatic yoga, where a partner aids in achieving poses; and SUP yoga, which uses a stand-up paddleboard on the water. Though some purists may balk, “There are definitely ways to make yoga fun and lighthearted, but maintain the mind/body connection that makes yoga what it is,” Wu said. “I’ve worked on blending different exercises with a yoga core. People want to stay active and still learn new things while keeping old traditions. They want something a little different incorporated into their program. “Alternative yoga is helpful for a yogi who wants to stay grounded with mat practice, but expand their horizons and meet more people in the community.” For example, SUP yoga may draw paddleboard enthusiasts who have never tried yoga. Deanna DeSimone, certified precision nutrition coach with UBMD Orthopaedics & Sports Medicine, part of the yoUBwell nutrition program, has experienced aerial yoga and found it quite different in some aspects from mat-based yoga. “You can get into different positions you couldn’t on a mat,” DeSimone said. “It works on different muscles, as you’re climbing up and down the rope.” DeSimone She likes the novel aspects of “alternative” forms of yoga, such as practicing outdoors or trying different poses. That’s what typically draws many experienced yogis as well as newbies to unusual forms of yoga. Erica Cope, owner and certified
Aerial yoga is one alternative ways to practice yoga. It’s increasingly more popular in the area.
Mallory Wisniewski is a certified yoga instructor who teaches yoga in Syracuse. She is also one of the area instructors who leads goat yoga classes. “It’s beautiful how friendly the animals are,” Wisniewski says.
yoga teacher at Buffalo Aerial Dance, teaches aerial yoga and many participants say they enjoy doing poses in the hammock for its novelty. But for those with certain kinds of back issues, the device can take the weight off their spines to make inverted poses more accessible to them compared with standard matbased yoga.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
DeSimone said that participants can join an aerial yoga class as a beginner or advanced student, as she offers options to keep the class more or less challenging for each person. Of course, participants should ask their doctors before engaging in any type of exercise, including yoga of any sort, especially if they have pre-existing conditions.
Pickleball Anyone? Pickleball craze sweeping the nation now serving up all-ages fun in Western New York By Daniel Meyer
thletes of all ages, shapes and sizes are embracing what has recently been recognized by physical fitness experts as the country’s fastest growing sport. Locally, more than 1,000 players hit courts across Western New York for an activity that offers a relatively new exercise option, especially during the cold winter months. A game that can be played competitively or as a leisurely way to have fun while still breaking a sweat, pickleball is a combination of tennis, badminton and ping-pong. Using oversized paddles and a small ball similar to a traditional wiffle ball, games are played on a badminton-sized court. Utilizing a low standing net that makes it easy for people of all ages and abilities to compete, the ball must bounce at least once on each side before volleying can begin. There is major interest in pickleball among senior citizens, especially because it is a sport featured in the Senior Olympics and is a major draw for many “snowbirds” who play locally during the summer months and continue playing wherever they live during the winter, including Florida, South Carolina and Arizona. But the rapid, high-energy style of play is also attractive to younger people, with teenagers and people in their 20s, 30s and 40s playing on indoor and outdoor courts throughout the Buffalo region. “It’s fast, it’s fun and it’s a very social game, which is what attracts people of all ages,” said Jason Santerre, the pickleball ambassador for this region on behalf of the United States of America Pickleball Association and the co-founder of Buffalo Pickleball, a local organization dedicated to growing the sport’s popularity in Western New York. “The popularity is skyrocketing here and is growing dramatically with the younger crowd. In fact, a lot of younger competitive tennis players are making the conversion and playing pickleball more often, if not exclusively.” Local pickleball leagues, some of which are competitive and others that feature casual play, are based throughout Western New York, including weekly action in the city of Buffalo, the Northtowns and the Southtowns. Courts are now used in prominent locations that include Buffalo RiverWorks, Larkin Square, the Boys & Girls Club of Orchard Park, Ellicott Creek Park in Tonawanda and Firemen’s Park in West Seneca. Frequent players cite the excitement level of each point, the less strenuous toll on the body when compared to tennis and the social aspect as some of the reasons pickleball has become their new favorite pastime. “It is never boring and it gives us a really good workout,” says Paul
Licata, who plays three to four days a week. “I’m 62 years old and it is a very fun sport for me. I enjoy the competition. I plan to play this for years to come.” Mark Melewski, who works for the Town of Hamburg Department of Recreation, Youth and Senior Services and supervises weekly pickleball action, is impressed with how much the sport has been embraced locally. “The thing is people who play it really love it,” said Melewski. “It’s great for coordination, testing your reflexes and the concentration aspect of it is something they really enjoy. Our players show up every week, no matter what the weather is outside. It’s an impressive level of commitment. Some of our players go on vacation or live somewhere warmer during the winter but they keep playing wherever they go.” The ability to play year-round makes pickleball especially attractive to those who do travel, whether it is for a vacation or to spend time at a winter residence. “I now play four times a week up here after I picked it up five years ago while in Florida,” said Jack Hoerner, a 72-year-old resident of Orchard Park. “I really enjoy the strategy involved. I’ve noticed it’s catching on with younger people. It’s fun to compete, get some quality exercise, see familiar faces and meet new people.” Men and women compete, with some local players preferring to play mixed doubles, which often leads to rousing games with intense action. “It’s a really great activity that’s not that demanding on your body,” said Jeanine Hillman. “I’m 60 years old and what I like is it’s a great way to meet people and establish some wonderful friendships. You work up a sweat. I look forward to playing every time I step on the court. My snowbird friends love to play when they go on vacation. I just started playing last year and now I’m hooked.” The future for pickleball locally is bright, with Santerre pointing out there are more than 300 dedicated pickleball courts at approximately 60 locations throughout Western New York. In addition, more corporate events are using a pickleball theme because the sport is considered an effective team-building event for employees to bond outside of the office. “We host the New York State Pickleball Tournament and that brings over 200 players to town,” said Santerre. “It’s an incredible social experience that provides fitness while having fun. We are seeing more children playing pickleball in gym class. It is a physical game with a unique mental aspect that helps keep people moving.” For more information about pickleball, including a listing of local facilities that offer indoor play, visit www.buffalopickleball.com.
Group of people play pickleball at Buffalo RiverWorks in Buffalo. The sport has grown in popularity nationwide. In the Buffalo area, more than 1,000 people play on a regular basis.
Men and women who live in the Southtowns gather every Sunday to play pickleball in the gymnasium at the Town of Hamburg Senior Center.
Pickleball can be a family-oriented activity enjoyed by people of all ages. Pictured from left are Kyle Gray, Peter Gray and Kevin Gray. February 2018 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Golden Years Too Many Meds = Increased Health Risks Experts warn about the dangers of polypharmacy By Deborah Jeanne Sergeant
he older patients become, the more likely they need prescription medication. According to the AARP, people 45 and older on average take four prescriptions daily. While needed medications improve length and quality of life, taking too many unnecessary prescriptions can have the opposite effect. Physycian Joanne Wu, boardcertified integrative and holistic medicine and rehabilitation doctor, specializes in wellness and sees clients in Buffalo and other areas in Upstate. She believes that one reason that some older adults take unnecessary medications is that their care providers lack to time to comb through their patients’ medical records and discuss their health goals. Many also don’t re-evaluate how well medication is working. “We’re striving for better cholesterol, diabetes and blood pressure numbers, which prevent mortality in the long run, but if you’re taking three to four drugs and the numbers are not well-controlled, at some point, the primary care team may need to sit down and review it,” Wu said. The patient’s physicians may not realize all the medication taken. At this age and stage, many patients see numerous specialists who may not always communicate with each other. Despite the prevalence of electronic medical records, the systems don’t usually transfer data between them.
By law, they also require signed paperwork from patients to transfer data. Older patients also seldom selfadvocate. “A lot of older adults don’t have the medical literacy to understand that a drug may cause harm,” Wu said. “It takes a strong primary care team and support for that older adult so they can understand they have a choice in the matter as to whether they take that drug or not. “If people take time to talk about those goals with the family and patient, we’d probably cut down on polypharmacy.” Wu added that some older adults taking over-thecounter drugs, herbs and supplements don’t realize the potential for negative drug interactions. Older Patnaik adults who travel or spend winters South use different providers and pharmacies, making it more difficult to keep track of what they’re taking. For elderly adults, taking multiple medication may become difficult — and more dangerous — because of cognitive impairment. Physician Priyanka Patnaik serves as medical director with UBMD Family Medicine at UBMD Outpatient Center at Conventus. She
is also an assistant professor in the department of family medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. She said that younger patients may well tolerate medication that a middle-aged or older person may not. As the body ages, it’s less capable of efficiently processing and metabolizing medication. “The body itself is changing physiologically,” she explained. “The type of side effects they didn’t see when they were younger become evident. Their body fat distribution is different. They may eat less. As a result, they may need their dose adjusted because otherwise, they can experience side effects such as an unstable gait or feeling confused.” Some patients may take medication to counteract a side effect of another medication; however, if the side effect is that bothersome,
Patnaik said that patients need to ask about alternatives that could help mitigate the original problem. Patnaik advises patients to bring every prescription bottle, over-thecounter medication and supplement to every visit with every provider, even if the medication wasn’t prescribed by that provider. “That is one of the most important suggestions that patients should follow,” Patnaik said. “A lot of times, patients are going to multiple physicians and they don’t advise their primary care provider about what they’re taking from other providers.” She encourages patients to regularly assess their medication with their providers, since one’s health and body change constantly. “It’s always a good thing to ask questions about side effects and be aware of what possibly can happen,” Patnaik said.
Mediterranean Diet a Recipe for Strength in Old Age
Mediterranean diet may make seniors less likely to become frail and help them maintain their health and independence, new research suggests. Frailty — characterized by weak muscle strength, weight loss and low energy — is common among seniors. Frail seniors are at increased risk for falls, fractures, hospitalization, disability, dementia, nursing home placement and premature death. It’s believed that nutrition may play a role in frailty, so researchers reviewed data from four studies to determine if a healthy diet might reduce the risk for frailty. The studies included nearly 5,800 older adults in France, Spain, Italy and China. They found that following a Mediterranean diet appears to be beneficial. That diet is high in fruits, vegetables, whole grains, legumes Page 14
and nuts. The findings were published online Jan. 11 in the Journal of the American Geriatrics Society. “We found the evidence was very consistent that older people who follow a Mediterranean diet had a lower risk of becoming frail,” said researcher Kate Walters, from the University College London. “People who followed a Mediterranean diet the most were overall less than half as likely to become frail over a nearly four-year period compared with those who followed it the least,” she said in a journal news release. However, it’s unclear whether people who followed a Mediterranean diet had other factors that may have helped prevent frailty. And the study did not prove that a Mediterranean diet actually caused
Mediterranean-style food includes fish, vegetables, herbs, chickpeas, olives and cheese, among other products. frailty risk to drop, just that there was an association. “While the studies we included adjusted for many of the major factors that could be associated — for example, their age, gender, social class, smoking, alcohol, how much they exercised, and how many health conditions they had — there may be
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
other factors that were not measured and we could not account for,” Walters said. “We now need large studies that look at whether increasing how much you follow a Mediterranean diet will reduce your risk of becoming frail,” she concluded.
Golden Years Buffalo Resident Celebrates 105 Years Mary Pecoraro has no major medical issues to date except she can no longer hear By Katie Coleman
elebrating 105 years of life was certainly a huge milestone for Buffalo native Mary Pecoraro, who marked her Dec. 23 birthday surrounded by loving family and friends. “Mary had a really fantastic time. They did a really nice job. She had her hair done and my sister, Lucille, bought her a new outfit,” said Pecoraro’s son, George, 72, who has always been very close with his mom and loves to joke around with her. Mary Pecoraro, who lives at HighPointe on Michigan, a nursing home in Buffalo, has lived through major U.S historical events including the Great Depression, World War I and II, prohibition, the sinking of the Titanic, the Civil Rights Movement, the women’s suffrage movement and the assassination of John F. Kennedy. On her 101st birthday she received congratulatory letters from
Barack and Michelle Obama, as well as Pope Francis. Pecoraro has no major medical issues to date except she can no longer hear. She’s still very socially engaged and enjoys coffee with other residents, reading the newspaper and going for daily assisted walks. She has a brightness to her that defies her age, and although she can’t hear, she offered up many smiles during my interview and even invited me to come back to visit. “I never thought I’d get to see my mom turn 105,” said George Pecoraro. “She has always been very loved by the people around her. We live day-to-day with her, and moving forward I’d like to celebrate another birthday… I’m wondering if she’ll outlive me.” George Pecoraro says he has dodged a few health bullets, having survived cancer and open-heart
George Pecoraro, 72, and his mother, Mary, during her celebration of her 105th year. surgery. He said his mother’s health history has been much stronger than his, and any health conditions that run in their family bypassed her. So what can be credited to her longevity? “It’s all about love,” George Pecoraro said. “We’re a very close family. She’s always had very strong bonds. Even at HighPointe, people love her and she loves them. Her life has always consisted of love.” As the family story goes, Mary Pecoraro was actually conceived on her parents’ way over from Sicily, Italy, on the boat they took to the U.S. Her father was one of the original stonemasons in the city of Buffalo, and her mother was a housewife caring for their nine children. Pecoraro spent much of her
Getting in Shape? Get a Trainer W By Deborah Jeanne Sergeant
alking laps, playing a sport or following an exercise video can help you improve your health. But dropping pounds and gaining muscle is harder now than ever before. Especially if you’re mid-life and looking to get in shape, consulting with a personal trainer may help you improve your chances of achieving your fitness goals. Here’s why, according to a few local experts.
• “Working with someone who can guide them is safer and is more enjoyable so they’re stick with it. • “I’d say to someone middle aged or older looking at starting an exercise program, that’s fantastic but they should make sure they can safely do so. They should be seen by their primary care provider to see if they can safely do this. Their primary may give a thumbs up or thumbs down.” — Physician Michael S. Freitas, a primary care sports medicine physician, at UBMD Orthopaedics & Sports Medicine, and associate professor, Jacobs School of Medicine and Biomedical Sciences, UB. • “The vast majority of personal trainers don’t understand the science of movement. Finding a good personal trainer is every bit as hard as finding a good mechanic or financial adviser. It would probably be helpful to look for a facility that has functional medicine and physical therapy with sports medicine or someone that is functional movement system certified.
• “Be very wary of crossfit. the injury rates are through the roof. any physical therapist will tell you that they get a lot of clients through it. i’m sure there are some crossfit people who understand movement, but we see a lot of clients who are hurt doing it crossfit. • “Many, many people buy workout CDs and videos, watch stuff on YouTube and use apps. The vast majority is really, really bad stuff that will hurt people over a period of time. It’s terrible. • “The certifications won’t guarantee you’ll stay injury-free, but it increases the likelihood. • “Multiple physical therapists referring the same trainer also helps. Movement is medicine but if you don’t understand movement, don’t prescribe it. A lot of trainers don’t understand movement and they hurt a lot of people.” Joe Fox, certified personal trainer, certified functional movement systems professional, and president and founder at Train Smart, Williamsville. • “The motivation of that relationship will keep the person coming back to the facility or wherever they’re training. The relationship between the trainer and Fox
the health seeker is significant. • “The personal trainer can make modifications in relation to injuries they’ve had or osteoarthritis or joint issues. They have professional knowledge the person might not have on their own. • “The personal trainer has knowledge of equipment, proper alignment which is significant as we age and it’s more important to be aware of this to avoid injury to bones, joints. Personal training is an excellent avenue. — Mary Shaw, active older adult coordinator for Ken-Ton Family YMCA in Kenmore. • “Hiring a personal trainer helps big time. Clients learn the proper way to do things if they haven’t worked out in a while or never. • “Motivation is a big reason to hire a personal trainer. • “For a lot of people, scheduling an appointment ‘forces’ them to come in. • “Paying for something--as opposed to going for walks or working out at home-motivates people to use what they’ve paid for. • “Personal trainers help their clients progress toward goals. For example, I find a lot of people working out every day use the same weight for the same exercises. It’s beneficial for a while, but eventually, they stagnate in their progress. I had a couple people who’d used the same weights for the past six months. It had gotten easier, but they hadn’t
February 2018 •
life helping care for her siblings until her 30s when she met the love of her life, her husband Russell. She was a homemaker to her two children, George and Lucille, and loved to cook. “She learned from my grandmother. During Christmas season all of her sisters would get together and cook all day. Believe me, you ate all day, and you had to eat because they’d stand over you and watch you,” George Pecoraro said. Russell died at 67 years old from heart failure and to this day remains Mary’s one true love. Mary Pecoraro’s sister, Josephine, who is 92 years old, was Mary’s caretaker until she joined the HighPointe community.
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(716) 860-7546 www.gcopefitness.com CoachGCope@gmail.com increased the weight. • “It can get you revamped to feel good about yourself. If you stay active, you look and feel better as you age. Being able to go up and down stairs is beneficial. By doing strength training, it helps you stay stronger. Personal trainers can help people do that.” — Andy Cowan, fitness director, certified personal trainer at LeRoy Physical Therapy and Village Fitness with locations in Cowan Macedon, LeRoy and Batavia .
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Sex After 90? By Deborah Jeanne Sergeant
an older adults enjoy sexual intimacy? Local experts say yes. “Nothing should really inhibit them,” said physician Tova Ablove, who practices at UBMD ObstetricsGynecology. She called problems with intimacy as “usually fixable” and that most problems are surmountable, even for women who experience difficulty because of previous vaginal surgeries or anatomic problems. “Many people remain sexually active well into their 80s and 90s and beyond,” said physician Pebble Kranz, who operates the Rochester Center for Sexual Wellness. “Humans need physical intimacy, touch and pleasure from cradle to grave.”
Kranz said that the risk of heart attack from sex are very small. But for some older adults, issues with mobility, pain and desire increase with age. Despite these problems, “there is clear evidence that as people mature they become less anxious and bothered by these issues,” Kranz said. “Vibrant older adults figure out how to keep their erotic selves alive by continuing to nurture their sexuality.” While they may not experience sex in the same way as when they were younger, many older adults can enjoy their time together. Vaginal atrophy represents a common issue for older women, as age or lack of use can make intimacy difficult, but taking more time and
using an over-the-counter lubrication can remedy the problem. When physical problems make sex hard, people should talk with a doctor, who may counsel on various physical issues. Medication, for example, can inhibit satisfying intimacy. Doctors can also discuss ways to combat these problems. “If you feel like you’ve hit a dead end with your primary care doctor, urologist, gynecologist, oncologist or other medical provider, then you may want to seek out the help of a sexual medicine specialist,” Kranz said. “Most medical problems should not get in the way of satisfying sex. “While one does need to respect one’s physical limitations, there are very few medical issues that get in the way of enjoying some kind of physical intimacy.” Non-medical issues can create barriers to intimacy, such as sex drive. “There’s a decrease in desire for some people,” said Tova Ablove of UBMD Obstetrics-Gynecology. “One may want more sex than the other. One is completely done and the other is not done.” She advises patients to take time with their mate during lovemaking and to keep communicating so it’s mutually enjoyable time together. Older adults who have lost a spouse through death or divorce may feel finding someone new is daunting, especially for people who had been married for decades. “Luckily for women, most have their desire fall off,” Ablove said. They say, ‘Do I miss it? Yes. But I’m not staying up at night worrying about it.’” Older people who are interested in intimacy won’t experience unwanted pregnancy; however, they have same risk of sexually transmitted disease as a sexually
Social Security Options for Divorced Spouses
s a divorced spouse, you can collect Social Security retirement benefits on the earnings record of your ex-husband or ex-wife, if your ex is at least age 62, was married to you at least 10 years, and you are not now married and not eligible for a higher benefit based on your own earnings record. In order for you to collect, your ex must also be at least 62 and eligible for Social Security benefits. But your ex does not have to be receiving them for you to collect divorced spouse’s benefits, as long as you have been divorced at least two years. Even if your ex is remarried, it won’t affect your right to divorcee benefits, nor will it affect your ex’s retirement benefits or his current spouse’s benefits.
Security benefit, or less if they take benefits before their full retirement age — which is 66 if you were born between 1943 and 1954. To find out your full retirement age and see how much your benefits will be reduced by taking them early see SSA.gov/ planners/retire/retirechart.html. Keep in mind though, that if you qualify for benefits based on your own work history, you’ll receive the larger of the two benefits. You cannot receive benefits on both your record, and your ex’s work record too. To find out how much your retirement benefits will be, see your Social Security statement at SSA. gov/myaccount. And to get an estimate of your ex’s benefits, call Social Security at 800-772-1213. You’ll need his Social Security number to get it.
A divorced spouse can receive up to 50 percent of their ex’s full Social
You also need to know that if your ex-spouse dies, and you were
married for 10 or more years, you become eligible for divorced survivor benefits, which is worth up to 100 percent of what your ex-spouse was due. Survivor’s benefits are available to divorced spouses as early as age 60 (50 if you’re disabled). But if you remarry before 60 you become ineligible unless the marriage ends. Remarrying after age 60 will not affect your eligibility. Also note that if you are receiving divorced spouses’ benefits when your ex-spouse dies, you will automatically be switched over to the higher paying survivor benefit.
Being divorced also offers a switching strategy that can help boost your benefits if you were born on or before Jan. 1, 1954. Here’s how it works. If you worked and are eligible for benefits on your
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
active person of any age. Using condoms provide a measure of protection against many sexually transmitted diseases; however, the only foolproof way to avoid them is to only engage in sex in a mutually monogamous relationship with someone who does not have any infections.
Study: 10% of People 85-plus Still Do It According to “Older Adults and Sexual Health: A Guide for Aging Services Providers,” a study published by ACRIA last year, many older adults are engaging in intimacy. The New York Citybased organization promotes HIV research and education. ACRIA is a leading international HIV/AIDS research, education, and prevention organization based in New York City. Their survey indicates that 75 percent of those between the ages of 57 and 64 state that they’re sexually active. Of those between 65 and 74, more than half engage in sex. Over one-quarter of people 75 to 85 do. For those over 85, the number drops to 10 percent for women and remains at 25 percent for men, according to data compiled by Dr. David Lee, a researcher from Manchester University’s School of Social Sciences, and professor Josie Tetley, from the English Longitudinal Study of Ageing, which was published in February 2017. Perhaps indicative of America’s tendency towards ageism and youth obsession, little data exists from American sources on intimacy for people 85-plus. own earnings record, you could file a “restricted application” with Social Security at age 66 to collect a divorced spousal benefit, which is half of what your ex gets. Then, once you reach 70, you stop receiving the ex-spousal benefit and switch to your own benefit, which will be 32 percent higher than it would have been at your full retirement age. Unfortunately, as a result of the Bipartisan Budget Act of 2015, this option is not available if your birthday is Jan. 2, 1954 or later. Divorced widows (and widowers) also have switching options regardless of your birthday. If, for example, you are currently collecting Social Security retirement benefits on your own record, and your ex-spouse dies, you can switch to survivor’s benefits if the payment is larger. Or, if you’re collecting survivor’s benefits, you can switch to your own retirement benefits – between 62 and 70 – if it offers a larger payment. For more information visit SSA. gov/planners/retire/divspouse. html, or call 800-772-1213
Jim Miller is the author of Savvy Senior column, which is published every issue in In Good Health.
The Olear Team
Senior Real Estate Specialists
By Jim Miller
What To Do When a Loved One Dies
Dear Savvy Senior,
This may seem like a strange question, but can you tell me what steps need to be taken after a loved one dies? My 80-year-old father has a terminal illness, and I would like to find out what I will need to do when he passes.
Only Daughter Dear Only,
facilitate the transport of the body. If he dies at home without hospice care, call 911, and have in hand his DNR document. Without one, paramedics will generally start emergency procedures and, except where permitted to pronounce death, take the person to an emergency room for a doctor to make the declaration. If no autopsy is needed, you will need to call the funeral home, mortuary or crematorium to pick up the body. If your dad is an organ or tissue donor, contact the funeral home or the county coroner immediately.
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Within a Few Days If funeral plans were not prearranged, you’ll need to make arrangements and prepare an obituary. If your dad was in the military or belonged to a fraternal or religious group, you should contact those organizations too, because they may have burial benefits or conduct funeral services.
Before Death Occurs
Up to 10 Days After Death
There are several tasks you can do now while your father is still living, that will make things a lot easier and less hectic for you after he dies. For starters, find out where your dad keeps all his important papers like his will (also make sure it’s updated), birth certificate, marriage and divorce certificates, Social Security information, life-insurance policies, military discharge papers, financial documents, and keys to a safe deposit box or home safe. Also, if your dad doesn’t have an advanced directive, help him make one (see CaringInfo.org for free state-specific forms and instructions). An advanced directive includes a living will that specifies his endof-life medical treatments, and appoints a health-care proxy to make medical decisions if he becomes incapacitated. In addition, you may also want to get a do-not-resuscitate (DNR) order, which will tell health care professionals not to perform CPR when your dad’s heart or breathing stops. Your dad’s doctor can help you with this. You should also pre-arrange his funeral and burial or cremation.
To wind down your dad’s financial affairs, you’ll need to get multiple copies of his death certificate. These are typically provided by the funeral home. If you’re the executor of your dad’s estate, take his will to the appropriate county or city office to have it accepted for probate. And open a bank account for your dad’s estate to pay bills, including taxes, funeral costs, etc. You also need to contact your dad’s estate attorney if he has one; tax preparer to see if estate or final income taxes should be filed; financial adviser for information on financial holdings; life insurance agent to get claim forms; his bank to locate and close accounts; and Social Security (800-772-1213) and other agencies that provided benefits to stop payments and, if applicable, ask about survivor benefits. You should also cancel his credit cards and, if relevant, stop household services like utilities, mail, etc. For more information on the duties of an executor, a great resource is “The Executor’s Guide: Settling A Loved One’s Estate or Trust” available at Nolo.com for $32.
Once your father dies, you’ll need to get a legal pronouncement of death. If no doctor is present, you’ll need to contact someone to do this. So, if your dad dies at home under hospice care, call the hospice nurse, who can declare his death and help
Anne Kader, SRES, CRP
Licensed Assoc. Real Estate Broker Certified Relocation Specialist Certified Buyer Representative Seniors Real Estate Specialist
I’m sorry about your father’s situation but this is a great question many families inquire about when a loved one’s death becomes imminent. Here’s a run-down of some things you can do now, and after his death, that can help keep a sad event from becoming even more painful.
Immediately After Death
Sally Ball Conover, SRES, CBR
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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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Stephen Hawking Turns 76: How Has He Lived So Long With ALS?
enowned physicist Stephen Hawking turned 76 Jan. 8, an age well beyond what he was expected to reach when he was diagnosed with the incurable neurological disease amyotrophic lateral sclerosis (ALS) more than 50 years ago. Hawking was 21 years old when he was diagnosed with ALS in 1963, and he was given just two years to live. The disease causes the progressive degeneration and death of the nerve cells that control voluntary muscle movements, such as chewing, walking, talking and breathing, according to the National Institute of Neurological Disorders and Stroke (NINDS). But how has Hawking lived so long with a disease that is typically fatal after just a few years? In fact, no one knows for certain why Hawking has survived so long with ALS, which is also known as Lou Gehrig’s disease. But researchers do know that the progression of the disease varies depending on the person. Although the average life expectancy after a diagnosis of ALS is about three years, about 20 percent of people live five years after their diagnosis, 10 percent live 10 years after their diagnosis and 5 percent live 20 years or more, according to The ALS Association. One factor that likely plays a role in patients’ survival time is genetics; scientists have identified over 20 different genes involved in ALS, said physician Anthony Geraci, director of the Neuromuscular Center at Northwell Health’s Neuroscience Institute in Manhasset, New York, who is not involved in Hawking’s care. “ALS is probably 20 or more different diseases when one considers the genetic underpinnings,” Geraci said. Some of these genetic differences appear to affect various aspects of the disease, including survival. For instance, a gene called SOD1, which is linked with a type of ALS that runs in families, is associated with a more rapid course of the disease, said Geraci. Studies have also found that being diagnosed with ALS at
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Stephen Hawking turned 76 in January. Few people suffering from ALS live more than 20 years. a younger age is linked with a longer survival time. (Hawking was relatively young when he was diagnosed with ALS; the disease is most commonly diagnosed in people ages 55 to 75, according to the NINDS.) The Food and Drug Administration has approved two drugs to treat ALS, called riluzole (Rilutek) and edaravone (Radicava). Each of these drugs can prolog survival by about six months, but the drugs likely don’t account for an exceptional survival time like the one Hawking has experienced, Geraci said. Early symptoms of ALS can include muscle weakness or slurred speech, and eventually, the disease can cause people to lose the ability to move, speak, eat or breathe on their own, according to the Mayo Clinic. People with ALS typically die from respiratory failure, which occurs when the nerve cells controlling the breathing muscles stop working or from malnutrition and dehydration, which can occur when the muscles that control swallowing deteriorate. Original article appeared in www.livescience.com.
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In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 • P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: email@example.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Julie Halm, Kyra Mancine, Danel Meyer, Katie Coleman 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.
The Social Ask Security Office iming is everything, and the arrival time of your monthly payment from Social Security can be key to keeping your financial house in order. As you budget to pay your bills and save for future needs, keep in mind that your monthly retirement or disability benefit will be paid at the same time each month. To see your next payment date, create or log on to your my Social Security online account at www.socialsecurity.gov/ myaccount and go to the “Benefits & Payments” section. In general, here’s how we assign payment dates: • If you were born on the first through the tenth of the month, you’ll be paid on the second Wednesday of the month; • If you were born on the 11th through the 20th of the month, you’ll be paid on the third Wednesday of the month; and • If you were born after the 20th of the month, you’ll be paid on the fourth Wednesday of the month. There are exceptions. For example, children and spouses who receive benefits based on someone else’s work record will be paid on the
Q: What is the average Social Security retirement payment that a person receives each month? A: The average monthly Social Security benefit for a retired worker in 2018 is $1,404 (up from $1,360 in 2017). The average monthly Social Security benefit for a disabled worker in 2018 is $1,197 (up from $1,171 in 2017). As a reminder, eligibility for retirement benefits still requires 40 credits (usually about 10 years of work). The Social Security Act details how the COLA is calculated. You can read more about the COLA at www. socialsecurity.gov/cola. Q: Can I refuse to give my Social Security number to a private business? A: Yes, you can refuse to disclose your Social Security number, and you should be careful about giving out your number. But, be aware, the person requesting your number can refuse services if you don’t give it. Businesses, banks, schools, private agencies, etc., are free to request someone’s number and use it for any purpose that doesn’t violate a federal or state law. To learn more about your Social Security number, visit www.socialsecurity.gov/ssnumber. Q: How do I report a lost Social Security card? A: You do not have to report a lost Social Security card. In fact,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2018
same day as the primary beneficiary. For others, we may issue your payments on the third of each month. Among other reasons, we do this if: • You filed for benefits before May 1, 1997; • You also receive a Supplemental Security Income (SSI) payment; • Your Medicare premiums are paid for by the state where you live; or • You live in a foreign country. Individuals who receive SSI payments due to disability, age, or blindness receive those payments on the first of each month. If your payment date falls on a federal holiday or weekend, you can expect to receive that month’s payment on the weekday immediately prior. You can see a current schedule for Social Security and SSI benefit payments in an easy-to-read calendar at www.ssa.gov/pubs/EN-05-100312018.pdf. Social Security is with you through life’s journey, helping you to secure today and tomorrow through important financial benefits, information, and planning tools. To learn more, please visit www. socialsecurity.gov.
reporting a lost or stolen card to Social Security will not prevent misuse of your Social Security number. You should let us know if someone is using your number to work call 1-800-772-1213; TTY 1-800325-0778. If you think someone is using your number, there are several other actions you should take: • Contact the Federal Trade Commission online at www.ftc.gov/ bcdp/edu/microsites/idtheft or call 1-877-ID-THEFT (1-877-438-4338); • File an online complaint with the Internet Crime Complaint Center at www.ic3.gov; • Contact the IRS Identity Protection Specialized Unit by calling 1-800-908-4490, Monday – Friday, 8 a.m. – 8 p.m.; and • Monitor your credit report. Q: My brother had an accident at work last year and is now receiving Social Security disability benefits. His wife and son also receive benefits. Before his accident, he helped support another daughter by a woman he never married. Is the second child entitled to benefits? A: The child may qualify for Social Security benefits even though your brother wasn’t married to the second child’s mother. The child’s caretaker should file an application on her behalf. For more information, visit us online at www.socialsecurity. gov.
Health News ECMCC Sees Record Number of Patients in 2017
Peter D. DeRose joins Inspire Dental Group
Inspire Dental Group, a multispecialty dental practice with offices in Amherst, West Seneca and downtown Buffalo, announces the addition of Peter D. DeRose to the practice. DeRose practices general dentistry and specializes in pain management relating to TMJ and associated conditions. A Buffalo native, DeRose began his career by practicing dentistry with his father at DeRose Dental on Franklin Street in downtown Buffalo. He took over the practice in 2000 and maintained the office until joining Inspire Dental Jan 2. “Dr. DeRose is very well respected in the industry and the community,” says Inspire Dental managing partner, Ron Sadler. “His philosophy of maintaining a tradition of comfort, concern and care for patients while utilizing the newest advances in technology and up-todate procedures fits perfectly with our philosophy at Inspire Dental. We are thrilled to welcome Dr. DeRose and his patients to the practice.” DeRose received his bachelor’s degree from Trinity College, his Doctor of Dental Surgery degree from State University of New York at Buffalo, School of Dental Medicine and his Master of Business Administration degree from Canisius College. He is a member of the American Dental Association, the New York State Dental Association, the Eighth District Dental Association and the Academy of General Dentistry. DeRose has been contracted as an expert in TMJ injuries and issues. He is certified in occlusion and TMJ disorders from the Piper Education and Research Center and the Dawson Center for Advanced Dental Study. In addition, he has had extensive postgraduate training in comprehensive smile design and esthetic dentistry. He resides in the city of Buffalo.
Erie County Medical Center Corporation (ECMCC) treated a record number of patients in 2017, according to a news release issued by the hospital. For the first time, inpatient hospital visits exceeded 19,000. Inpatient surgeries were up 9.7 percent and total surgeries increased by 1.3 percent over 2016; growth occurred in orthopedic surgeries (3 percent), kidney transplants (8 percent) and neurological surgeries (19.6 percent). Additional growth occurred in the hospital’s outpatient clinics, including primary care (2 percent), neurology (3.7 percent), urology (2.5 percent), cardiology (5.4 percent) and the Center for Occupational and Environmental Medicine (5.1 percent). ECMC also saw an increase in the acuity, or level of illness in patients, with an increase of 14,155 patients admitted through the emergency department and an acute case mix index of 1.85 (an indicator of patient’s severity). In addition to this the volume of operations, ECMC’s Terrace View Long-Term Care facility in May earned a four-star rating for overall quality from the federal Centers for Medicare and Medicaid Services (CMS). “While 2016 was a record-setting year for ECMC, 2017 built on that success and continued our growth and high patient volumes,” said ECMCC President and CEO Thomas J. Quatroche Jr., Ph.D. “More and more a hospital of choice for the residents of our region, as confirmed by such strong activity in areas such as orthopedics, transplants and neurology, ECMC maintains our high quality standards as the region’s only level 1 adult trauma center and strengthening our collaborative partnership with both Kaleida Health and the University at Buffalo. Quatroche said that what sets ECMC apart is the over 3,000 caregivers who make the hospital special and successful. “Their care and compassion for every patient who seeks our care is second to none, which is reinforced by our consistently high patient experience scores. Now in our 100th year of delivering healthcare services from our Grider Street campus, ECMC is proud to maintain the high level of excellence first established here in the early years of the 20th Century.”
Tried to Quit But Still Smoking? Help’s On the Way
hen it comes to kicking the smoking habit, if at first you don’t succeed, try, try again, the U.S. Food and Drug Administration says. To help encourage adult smokers to quit, the FDA is launching a new public education campaign called “Every Try Counts.” It will target smokers aged 25 to 54 who’ve tried to quit smoking in the past year but haven’t been successful. The campaign will feature messages of support that highlight the health benefits of quitting smoking. The Every Try Counts campaign begins in January in 35 markets nationwide and will include print, digital, radio and billboard ads. The FDA plans to focus its ads in and around retail locations, such as gas stations and convenience stores places that not only sell cigarettes but are favorite targets of cigarette advertising. As part of the campaign, the FDA has teamed up with the U.S. National Cancer Institute to create a website that will provide resources and tools to help smokers quit. “Cigarette smoking remains the leading cause of preventable disease and death in the U.S.,” physician Jerome Adams, the U.S. Surgeon General, said in an FDA news release. “Sustained and comprehensive efforts, including the FDA’s Every Try Counts campaign, are critical to encouraging more Americans to quit smoking and preventing the harms associated with cigarette use.” FDA Commissioner Scott Gottlieb said the new campaign
“encourages smokers to rethink their next pack of cigarettes at the most critical of places — the point of sale.” Gottlieb pointed out that “tobacco companies have long used advertisements at convenience stores and gas stations to promote their products, and we plan to use that same space to embolden smokers to quit instead.” Cigarette smoking causes about 480,000 deaths in the United States each year. Despite declining smoking rates among adults, 15 percent of American adults (36.5 million) were cigarette smokers in 2015. Of those, more than 22 million said they’d like to quit, according to the FDA. However, though more than 55 percent of adult smokers tried to quit in 2015, the agency said that only about 7 percent were successful. Mitch Zeller directs the FDA’s Center for Tobacco Products. “Tobacco advertising in retail environments can generate a strong urge to smoke, prompting a relapse among those attempting to quit,” he said in the news release. “This campaign offers smokers motivational messages in those environments with the intention to build confidence and instill the belief within each smoker that they are ready to try quitting again,” Zeller explained. “We want smokers to feel good about each attempt to quit because it is getting them closer to one day leading a healthier life free from cigarettes, reducing their risk of tobacco-related death and disease,” he added.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
Celebrating a Century of True Care In our 100 years of taking care of Western New York, much has changed within the world, the community, and even within our own walls at ECMC. But even as we prepare for our next century of delivering true care for patients and families, we know the most important thing—compassionate care for everyone who turns to us—hasn’t. And never will.
ECMC-RET-16302 Ad_In_Good_Health_9_75 x 13_75_M.indd 1 Page 20 • January IN GOOD HEALTH – Buffalo & WNY’s
Healthcare Newspaper • February 2018
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