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in good Physician of the Year Mary Katherine Kolbert, a Hamburg primary care physician, is Lifetime Health’s physician of the year.

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Buffalo & WNY’s Healthcare Newspaper

December 2014 • Issue 2

The Great Tonsil Massacre Year: 1920-1921• Place: Rochester • Goal: To remove tonsils of children to make them “healthier,” “stronger” and prevent them from having “mental issues” • Recommended by: Doctors, hospitals, community leaders • Result: 9,821 children had their tonsils removed.

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Nurse practitioners in Hamburg are some of the first in Buffalo area to open a medical clinic.

Beginning Jan. 1, nurse practitioners will have more freedom to work independently, thanks to new legislation signed into law by Gov. Cuomo Page 5

Should Med School Go to Three Years?

Yep, it’s not just your impression.

Prices of generic drugs are going up

Note to Parents

Playing Action Video Games Can Boost Learning

Page 9

Kids can’t stop playing video games? Just look at the bright side: A new study shows for the first time that playing action video games improves not just the skills taught in the game, but learning capabilities in general.

Page 9

The amazing benefits of pomegranates

Does the fruit warrant all the recent hype? Is it still in the limelight?

Page 12

Eat Eggs, Feel Full Eggs are one of seven foods that can make you feel full without overeating

Sure, the schools have healthier food, but are kids eating it?

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December 2014 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 1

U.S. Prices Soaring for Some Generic Drugs Supply and manufacturing problems, plus fewer companies in the market among causes

M

arket forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brandname medications.

Generics that should cost pennies per dose have undergone radical increases in price in recent years, said physician Aaron Kesselheim, author of a new commentary in the “New England Journal of Medicine,” and director of the program on regulation, therapeutics and law at Brigham and Women’s Hospital in Boston.

Example: • The widely used broad-spectrum antibiotic doxycycline has increased from 6.3 cents to $3.36 per pill.

• The long-established antidepressant drug clomipramine has increased from 22 cents to $8.32 per pill.

Supply chain and manufacturing problems have caused some of these price hikes, but Kesselheim believes that other increases have resulted from too few companies making the generic versions of these drugs.

“We take for granted that generic drugs are low-cost, but they’re only low-cost because there’s competition.

When that competition goes away, the prices rise,” said Kesselheim. “Because we leave this up to the free market, this is a risk we take on.”

In response to these increases, both the U.S. Senate and the U.S. Department of Justice have undertaken investigations into generic drug pricing.

Federal prosecutors have issued subpoenas to two generic drug makers, seeking information about possible collusion between competitors, according to a published report. At the same time, the Senate Subcommittee on Primary Health and Aging has sent letters to executives of 14 pharmaceutical companies asking for answers.

Generic drugs are a “critical part of system-wide efforts to hold down health care costs,” said Ralph Neas,

president and CEO of the Generic Pharmaceutical Association, a trade group.

Neas noted that the world’s leading health care analytics firm, IMS Institute for Healthcare Informatics, found that generics saved $209 billion in 2012, $239 billion in 2013 and almost $1.5 trillion over the recent decade. That data was compiled by the IMS Institute on behalf of the Generic Pharmaceutical Association, according to an association news release.

Hospital Noisy Alarms Project reduces “alarm fatigue” by 80 percent

T

he sound of monitor alarms in hospitals can save patients’ lives, but the frequency with which the monitors go off can also lead to “alarm fatigue,” in which caregivers become desensitized to the ubiquitous beeping.

Researchers at Cincinnati Children’s Hospital Medical Center have tackled this problem and developed a standardized, team-based approach to reducing cardiac monitor alarms. The process reduced the median number of daily cardiac alarms from 180 to 40, and increased caregiver compliance with the process from 38 percent to 95 percent.

“Cardiac monitors constitute the majority of alarms throughout the hos-

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pital,” says Christopher Dandoy, a physician in the Cancer and Blood Diseases Institute at Cincinnati Children’s and lead author of the study. “We think our approach to reducing monitor alarms can serve as a model for other hospitals throughout the country.”

The main accrediting body for healthcare organizations and programs, the Joint Commission, reported 80 alarm-related deaths between January 2009 and June 2012.

Dandoy’s study of this project was published Nov. 10 in the eFirst pages of the journal Pediatrics.

The researchers developed a standardized cardiac monitor care process on the 24-bed, pediatric bone marrow

transplant unit at Cincinnati Children’s. The project involved a process for initial ordering of monitor parameters based on age-appropriate standards, daily replacement of electrodes in a manner that was pain-free for patients, individualized daily assessment of cardiac monitor parameters and a reliable method for appropriate discontinuation of the monitors.

“With fewer false alarms, the staff can address significant alarms more promptly,” says Dandoy. “We believe the roles and responsibilities entailed in this process can be applied to most units with cardiac monitor care.”

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

Big-Name Diets All Work for a While, Review Found No eating plan stood out in terms of lasting weight loss, researchers noted

T

here are plenty of famous-name diets for weight loss, but none stands out from the pack when it comes to lasting results, a new review suggests.

Looking at a dozen clinical trials, researchers found that three big-name diets — Atkins, Weight Watchers and the Zone — were all “modestly” effective over the course of a year. In studies that compared the plans head-to-head, people lost anywhere from 4 to 10 pounds, on average.

Meanwhile, a fourth commercial diet — South Beach — was no better than traditional advice to eat a low-fat diet, the study authors said.

And in the few trials that lasted two years — all looking at Atkins or Weight Watchers — people often regained some of the pounds they lost.

“From our results, no weight-loss diet came across as a clear winner,”

said study leader Renee Atallah, a research assistant at Jewish General Hospital/McGill University in Montreal.

Atallah and her colleagues report the findings online Nov. 11 in the journal Circulation: Cardiovascular Quality & Outcomes.

A registered dietitian who was not involved in the research said he is glad more and more clinical trials are putting commercial diets to the test.

“Americans have been jumping on these diets and spending a lot of money,” said Jim White, a spokesman for the National Academy of Nutrition and Dietetics.

“We need studies like these to know whether they actually work in the long term,” White said.

As most dieters know, he noted, “keeping the weight off is the hardest part.”

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Skin Cancer Costs Soar Findings underscore importance of prevention efforts

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he cost of skin cancer treatment in the United States more than doubled between 2002 and 2011, and rose five times faster than treatments for other cancers, a new study found.

“The findings raise the alarm that not only is skin cancer a growing problem in the United States, but the costs for treating it are skyrocketing relative to other cancers,” said study lead author Gery Guy, of the division of cancer prevention and control at the federal Centers for Disease Control and Prevention.

“This also underscores the importance of skin cancer prevention efforts,” he added in an agency news release.

The analysis of national data showed that the average annual number of adults treated for skin cancer increased from 3.4 million in the years 2002-06 to 4.9 million during the years 2007-11.

At the same time, the average yearly cost of skin cancer treatment

climbed from $3.6 billion to $8.1 billion, an increase of 126 percent. During the same period, the average annual cost of treatment for all other cancers rose 25 percent.

The study findings were published online Nov. 10 in the American Journal of Preventive Medicine.

Skin cancer is the most common type of cancer in the United States, and nearly 5 million people are treated for the disease every year. Exposure to ultraviolet light in the sun’s rays is a major cause of skin cancer.

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• Wearing clothes that cover your arms and legs, a hat with a wide brim, and sunglasses that block both ultraviolet A and ultraviolet B rays.

• Using sunscreen with a sun protection factor (SPF) of 15 or higher and both UVA and UVB protection.

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 3

Healthy Lifestyle May Cut Stroke Risk in Half for Women

W

omen with a healthy diet and lifestyle may be less likely to have a stroke by more than half, according to a study published in the Oct. 8, online issue of Neurology, the medical journal of the American Academy of Neurology.

The study looked at five factors that make up a healthy lifestyle: healthy diet; moderate alcohol consumption; never smoking; physically active; and healthy body mass index (BMI).

Compared with women with none of the five healthy factors, women with all five factors had a 54-percent lower risk of stroke.

“Because the consequences of stroke are usually devastating and irreversible, prevention is of great importance,” said study author Susanna C. Larsson, PhD, of the Karolinska Instituet in Stockholm, Sweden. “These results are exciting because they indicate that a healthy diet and lifestyle can substantially reduce the risk of stroke, and these are lifestyle choices that people can make or improve.”

For the study, 31,696 Swedish women with an average age of about 60 completed a 350-item questionnaire about their diet and lifestyle. They were then followed for an average of 10 years. A healthy diet was defined as within the top 50 percent of a recommended food score measuring how often the participants ate healthy foods such as fruits, vegetables and low-fat dairy products. Moderate alcohol consumption was defined as three to nine drinks per week. Physically active was defined as walking or biking at least 40 minutes a day along with more vigorous exercise at least one hour per week. Healthy BMI was considered below 25.

Most of the women had two or three of the healthy factors.

Only 589 women had all five healthy factors, and 1,535 had none.

There were 1,554 strokes among study participants. The risk of stroke steadily decreased with each additional healthy lifestyle factor.

Women who had a healthier diet were 13 percent less likely to have a type of stroke called a cerebral infarction than those whose diet was not as healthy. Women with healthier diets had a rate of 28 strokes per 10,000 women per year compared to 43 strokes per 10,000 women per year among those with a less healthy diet.

Cerebral infarction is the most common cause of stroke, accounting for up to 80 to 85 percent of all strokes. Cerebral infarction is caused by a blockage in a blood vessel preventing blood and oxygen from getting to an area of the brain.

There was no relationship between the healthy factors and the risk of hemorrhagic stroke.

Hemorrhagic stroke, which is caused by bleeding in and around the brain, accounts for about 15 to 20 percent of all strokes.

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Meet

Your Doctor

By Chris Motola

Mary Katherine Kolbert Hamburg primary care physician chosen as physician of the year at Lifetime Health Q: I understand you received Lifetime Health’s physician of the year award this year. Can you tell uu more about it?

A: They have a recognition night every year where they nominate a physician and employee of the year.

The physician and employee with the most nominations receives the award.

This year I received the award. It’s nice because it validates the work you put in. I work in a smaller office, so even though we don’t physically interact with a lot of the rest of the Lifetime staff, they still recognize the work we do at our Hamburg office.

Q: Great. Tell us about your practice.

A: I work for Lifetime Health at the Hamburg Health Center. It’s one of Lifetime’s smaller facilities. I’m one of two physicians there, along with Dr. Golding, two nurse practitioners and a physician assistant. We’re primary care.

We’re family physicians, so we see patients ranging in age from zero to 100.

Q: What does your typical patient come to you with?

A: The bulk of my patients are between 40 and 75, but we have a pretty typical spread of patients at Hamburg.

We used to have a pediatrician on staff, but we still see young patients.

Q: Is it very different working with a younger patient than an older one?

A: There’s sometimes a difference in the amount of information you can get from the person about their symptoms and needs. For the younger patients you’re often focused on getting them all of their immunizations and basic shots. When they get older, you don’t have as much of that and tend to be more focused on managing chronic illness.

Q: How much of your practice is focused on preventive medicine?

A: That’s basically what we try to do in primary care, as well as treating chronic illness. For children, it’s the immunizations. Pap smears for women starting around 21 years, mammograms at age 40. At age 50, we recommend colonoscopies for both men and women. Depending on what we find in the first colonoscopy, we may recommend them every year after that or every 10 years. For men, between 40 and 50, like to start checking PSA (prostate-specific antigen) levels, although there’s some controversy over how beneficial that is.

and get regular exercise, but as far as what that means — for example, how much exercise — we sometimes need to do some education. Sometimes we’ll recommend that a patient with chronic illness meet with a dietitian. As far as preventive care, sometimes they won’t know that they should come in for their yearly physical. They might just be coming in when they have a cough or a complaint.

Q: With all the talk of Ebola lately, it’s been crowding out a lot of talk about the prevention of more common diseases like influenza. Who should be getting flu shots?

A: Everybody, actually. If you get a flu shot, you’re not only protecting yourself but everyone around you who may not be able to get a flu shot — for example, people with egg allergies can’t get the shot. So we actually recommend it for everyone who is able to get it, which is individuals over the age of 6 months. We especially recommend it for those with chronic illnesses. We offer sessions at all of our offices for flu shots.

Q: How safe are flu shots?

A: We do ask about allergies, including the egg allergy I mentioned. We ask about any previous reactions to flu shots or if someone in their family has had a reaction to the shot. So you wouldn’t want to give the shot to someone who had that in the past.

Q: Are any conditions more preva-

Q: Do you find your patients are pretty well aware of what they have to do to minimize their health risks?

A: Education is a large part of what we do. For the most part people do know that they should eat healthy

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

lent in the Buffalo region than elsewhere?

A: In this area, along this line of latitude, we tend to see more cases of MS. It’s not something we really have to look out for, but it is more common here than many other areas. As far as infectious diseases go, we haven’t seen abnormally high rates of flu.

Q: What got you interested in primary care?

A: I actually started out in OB/ GYN during my residency, but I went over to primary care because I really liked the preventative medicine side of it. The hope is, in doing preventative medicine, you can find things early so they don’t progress to something more.

If you find a colon polyp early, for example, that can be the end of it.

Q: What’s your view on the state of primary care in general with many medical students gravitating toward specialties?

A: It is trying. We’ve been able to cut down on paper work, but there’s still a lot of it to do. There are a lot of patients to see and not enough providers. It can be difficult because you’re not just dealing with one thing, you have to look at the whole picture.

We’re the ones who initiate specialist care and determine if you need to see a cardiologist. When you’re going to an orthopedist, they know they’re going to be looking at a broken bone.

Q: How do you maintain the breadth of knowledge necessary to keep up medical developments in multiple specialties?

A: I read a lot of medical journals and take continuing medical education courses.

Q: Do you get to know your patients well?

A: It’s interesting. I’ve been here about eight years now. At my previous practice, I was there about four or five years. That was in the inner city, so while I got to know patients, the population was always changing. That’s still somewhat the case here, but people in the community seem to get used to this office and you get to know their families and their extended families. So it’s fun in that respect.

Lifelines; Name: Mary Katherine Kolbert, M.D. Hometown: Buffalo, NY Education: University at Buffalo School of Medicine and Biomedical Sciences Affiliations: Lifetime Health Medical Group, Buffalo General Hospital Organizations: American Academy of Family Physicians, Medical Society of New York Family: Married, four children Hobbies: Basketball, baseball, gymnastics Favorite Buffalo Attraction: going sledding with her kids Favorite thing about medical school: the learning process

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By Ernst Lamothe Jr.

M

ary Cerrillo and Virginia Valenti were just having a conversation about health care when an idea struck them.

They both had extensive experience when they were working at Mercy Hospital of Buffalo and other Upstate New York facilities. The topic that continued to come up was doctor shortage and how so many patients would find the primary care physician that they needed.

“There were patients that went to urgent care to fulfill their needs because they couldn’t find doctors that would take new patients,” said Valenti, a board certified family nurse practitioner. “Sometimes it got even worse if it was a Medicare or Medicaid patient. I just knew something had to change.”

A new legislation taking effect Jan. 1 — the Nurse Practitioners Modernization Act — has been called by some as an ideal way to advance patient access to care and recognize the roles that nurse practitioners play as independent healthcare professionals.

There are 13 states that allow nurse practitioners to practice with complete independence — Alabama, Arizona, District of Columbia, Iowa, Idaho, Maine, Montana, New Hampshire, New Mexico, Oregon, Utah, Washington and Wyoming. New York is 14th.

The new law removes the requirement of a written practice agreement between an experienced nurse practitioner and a doctor as a condition of practicing on their own. Any nurse practitioner with more than 3,600 hours of practice — or two years of practice — will be able to continue extending their expertise and freedom beyond the current limitations. Previously, they had to sign a written collaborative agreement with a physician, which was as narrow or broad as the medical doctor allowed.

“As nearly one million newly insured New Yorkers are enrolled in insurance plans required by the Affordable Care Act, the new law will increase access to high-quality health care throughout New York,” said Denis Tarrant, president of the New York state’s Nurse Practitioner Association. “The new law reduces arbitrary and outdated regulatory barriers that keeps nurse practitioners from being able to fully provide care as we’ve been educated to do. As a result, New Yorkers can expect nurse practitioners to continue delivering cost-conscious, evidence-based, and culturally compe-

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Virginia Valenti (left) and Mary Cerrillo, both nurse practitioners, are opening their own medical clinic in Hamburg. “We see patients, diagnosis, can order any kinds of tests and treat them. I think a lot of people don’t recognize the wide range of things that a nurse practitioner does,” says Cerrillo. A new law in New York state gives nurse practitioners the ability to work independently from a doctor. tent health care.“ Cerrillo and Valenti are heads of Hamburg’s first nurse practitioner-owned and operated practice: Hamburg Primary Care, located at 4535 Southwestern Blvd. They have experience in adult and family medicine and have the philosophy that they diagnose and treat patients along with promoting positive health care habits through education and counseling.

Cerrillo has 33 years experience as a registered nurse and a nurse practitioner. She focused on endocrinology and internal medicine before becoming a partner with Hamburg Primary Care.

With more than 18 years of experience as a registered nurse and nurse practitioner, Valenti has worked in primary care and urgent care before becoming a partner. It is that experience which gives her even more first hand knowledge about why this new law was so necessary and overdue.

Both women applaud the law and say it will have an immediate impact in health care.

“This is going to open up the doors for more nurse practitioner offices to open,” said Cerrillo. “It will make life easier for patients who want to be seen by a doctor for a variety of issues.

I’m glad this law has now become a reality.”

In the wake of doctor storages in Upstate New York, officials believe the new law was monumental. By the year 2020, there will be a shortage of

between 100,000 to 150,000 doctors nationwide, according to the American Medical Association. New York itself is short about 1,200 doctors.

There are more than 20,000 nurse practitioners in New York. The profession began in 1965 and it took until 1988 for the career to be fully recognized.

“The shortage of primary care physicians is a real issue,” said Valenti.

“We have been in the nursing professions for a long time and we heard from the community. No one is here trying to replace doctors, but nurse practitioners are a viable option in health care and need to be recognized.”

Nurse practitioners practice in a variety of primary and speciality care settings, including ambulatory, acute, long term and primary care. They are licensed and certified by New York State Education Department to diagnose illness and physical conditions, perform therapeutic and corrective measures, order tests, perform health screenings, annual check ups and prescribe medications without direct supervision. In addition to their advanced certification by the Nursing Board, many NPs are certified by national accrediting agencies in one or more practice speciality.

“We see patients, diagnosis, can order any kinds of tests and treat them.

I think a lot of people don’t recognize the wide range of things that a nurse practitioner does,” said Cerrillo.

December 2014 •

story ideas? editor@buffalohealthnews.com

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 5

On the Record with EMR Electronic medical records are designed to improve quality of care, but some patients are not too happy, especially because of potential errors

By Catherine Miller

P

at is a tech savvy senior. She uses her computer and iPad to keep up on daily happenings. Her cell phone keeps her in contact with friends, kids and grandkids. She is not intimidated by error codes and welcomes new gadgets in her life. But she’s not sure that she’s fond of EMR. EMR — for those who are in great health and haven’t recently visited a medical provider since the onset of its generalized use — stand for electronic medical records. Simply put, EMR is a new way for health care providers to keep a patient’s medical chart — in a computerized electronic form.

Within the past few years nearly all medical providers have forgone the paper trail of the medical care for a patient and replaced it with the electronic, computer version. But this has not been met with great enthusiasm by patients who have had issues with the new system.

“I was reviewing records recently with my doctor and he mentioned my recent blood work results,” said Pat, who spoke on the condition we didn’t use her last name. “The doctor stated that my blood sugar levels were somewhat high. I thought that was odd as I had never had problems with my blood sugar. He then mentioned that the high level may be the reason for the tingling in my arm. That’s when I was concerned. I’ve never had tingling in my arm.”

The blood work results in Pat’s file weren’t hers. It was, she was told, the results of a patient with a similar name.

Chalking the event up to a one time situation, she was more than a bit upset when a similar issue occurred at yet

another doctor’s office just a short time later.

“After the second EMR record problem I spoke with some of my friends,” Pat explained, “And found out that that they have had similar issues in doctors’ offices and with billing matters.”

Some patients are finding that their test results and specialist reports either aren’t making it into their records or that the reports in their records are that of others with a similar name or date of birth.

Others are finding that the “patient responsibility” portion of a medical bill is not correct. Being senior citizens Pat and many of her friends frequent medical providers somewhat regularly, which may be the reason for their having a rather alarming number of occurrences with EMR mishaps. Another reason is that, while there has always a risk for human error when working with records, EMR is a relatively new system — and many employees in the medical offices are still becoming familiar with the system and software.

So, how does a patient verify that their records are indeed their records?

Some doctor’s offices allow you to sign up for an online service where you can view your records from your home computer. This is not always the best answer for someone that doesn’t regularly use a computer. The best course of action, suggests many medical providers, is to verify the receipt of the record at each doctors’ office during your

visit and discuss the findings. To make absolute sure the records and results are yours - verify your name and date of birth on the records, as this is the common way that doctors identify their patients. In other words — from a patient level think of E-M-R a bit differently: E: Exam results – verify that each exam and test result has been added to your file.

M: Make sure the record is yours – verify your name and date of birth on each record.

R: Review test results and specialist reports with your physician.

Ask for details. When you ask for more information than “your numbers are within range” or “there were no positive findings” you can confirm the results make sense for what you are being treated for, and it often opens up avenues of discussions on your health concerns.

Generally speaking EMR was born of necessity. With the growing use and dependence on computers there was a need to transfer a patient’s medical

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Photo exhibit at Amherst Senior Center

The photographs of Ron Palmere are now on exhibit at the Amherst Center for Senior Services through Dec. 31. The exhibit, titled “For the Birds …

And For Those Who Enjoy Them,” features dozens of framed photographs by Palmere, a retired vocation rehabilitaPage 6

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tion counselor who became passionate about photography after a birding trip to Brazil in 1994 with his wife, Diane.

He is past president and current member of the Twin Cities Camera Club.

His main interest is nature and wildlife photography.

The public is welcome to visit the center and tour the exhibit during from 8:30 a.m. – 4:30 p.m., Monday through Friday. The Amherst Center for Senior Services is located at 370 John James Audubon Pkw in Amherst, behind the Audubon Library.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

information to a platform where it could be easily adapted for use in the burgeoning technological fields by medical providers, diagnostic labs and pharmacies as well as billing offices.

While EMR seems to be the answer to the medical field’s fastest era of tech growth, the internal functions of the medical offices are working hard to keep up with the new systems and technology. During this time patients as well as providers need to be watchful to verify the completeness and accuracy of their records.

EMR has the ability to make medical records more efficient and medical treatment less costly and with time will get more user-friendly and precise as the software is streamlined and the personnel in a provider’s office become more familiarized with the systems. Until then the doctors and patients each bear a duty to verify that the patient’s medical record is accurate and complete. As they say, an ounce of prevention is worth a pound of cure — and it can be as easy as stating your name and birthdate.

Buffalo–WNY Healthcare Newspaper

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Jennifer Fecio McDougall, Catherine Miller, Jullie Halm • Advertising: Donna Kimbrell, Jasmine Maldonado, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Laura Beckwith 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.

In Good Health is Printed Locally at Buffalo NewsPress

When Your Spouse Has ADHD Divorce rate among spouses with attention deficit hyperactivity disorder is as high as 60 percent

By Deborah Jeanne Sergeant

R

earing children with attention deficit hyperactivity disorder (ADHD) can strain marital relationships; however, when one of the spouses has ADHD, the marriage may also suffer. Some studies claim that the divorce rate among couples with one or both partners with ADHD is as high as 60 percent.

“When the mind isn’t focused, it’s hard to pay attention to the spouse,” said Kathleen Calabrese, a family therapist in practice in Buffalo. “People with ADHD interrupt and get ahead of themselves in a conversation. They struggle to quietly listen while the partner is speaking. It’s very difficult to identify how they feel emotionally and what’s going on for them.”

Calabrese added that since their brains are more impulsive and reactive, it’s hard for adults with ADHD to equally contribute to the relationship and shared life.

A non-ADHD wife may feel like her ADHD husband neglects her, shirks his chores and behaves like a child for all his irresponsibility.

The ADHD husband may feel like his wife nags him each time she reminds him of his obligations.

Just honestly and openly discussing each partner’s feelings and how they can support each other goes a long ways towards harmony in a home touched by ADHD. “A partner married to someone must be educated and understand it and sit down to talk about it,” Calabrese said. “Read articles together.

Fully acknowledge that this is a real problem for this person. There’s a lot of shame for ADHD adults because they can’t manage their lives with the same level of ease as others, it undermines their confidence. That Becker-Weidman undermines their position in the relationship.”

Calabrese advises adults with ADHD to take time to spend with their spouse, get enough sleep, eat well and look into community resources that can help them cope.

A non-ADHD person is more logical, methodical and goal-oriented.

Someone with ADHD tends to think that everything is equally as important, and exhibit remarkable creativity and problem-solving skills. With that comes a lack of focus, time management and ability to cope with a stimulating environment.

Jamie DeGorge, licensed mental

Kids Obese at Young Age Often Stay That Way, Study Shows Weight at 11 a good indicator of weight at 16, researchers found

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health counselor and owner of DeGeorge Therapy Services in Orchard Park, said that ADHD “impacts their ability to work and their concentration.

The mind is never focused and organized. For someone with that problem who’s not being treated, its’ frustrating to try to get things done with them.

It causes friction and arguments. One can get on medication for it and try to improve organization skills. Make a lot of lists to get things done since that’s a major issue with that disorder.”

Instead of nagging, Arthur Becker-Weidman, PhD and owner of Center For Family Development in Williamsville, encourages the non-ADHD spouse to “reminding the person to take their medication, since they may forget or develop strategies to help them remember, like using lists or the reminders in their smart phone.

Organize the household so they can find things, like putting keys and other important things in the same place every day.”

People with ADHD also tend to “hyperfocus” on something that attracts their attention. For a child, it could be collecting toy cars for a couple months until the fascination passes and dinosaurs are the new obsession. For adults, a new love interest represents a huge object of focus.

After courtship results in marriage, the ADHD partner may shift focus to something new: work, hobbies or other people. Of course every couple phases from the honeymoon stage to everyday, mundane life, but ADHD exaggerates

that shift. The non-ADHD spouse feels ignored, even neglected, compared with how he or she felt during the dating phase of their relationship. The ADHD spouse may feel overwhelmed because there’s suddenly a lot of responsibilities and their spontaneity may not be as valued.

“If one or both don’t recognize the disorder, often you do see a lot of marital conflicts,” Becker-Weidman said. “They treat it as a marital conflict or personality flaw instead of a biologically based chemical imbalance.”

As with any couple, a scheduled date night and occasional weekends away can help the couple reconnect midst the responsibilities of married life and the added stress of coping with ADHD. It may also help to reach out to peer resources, such as support groups for adults with ADHD and groups for spouses of people with ADHD. Counseling may help couples.

Having an unbiased third party listen and offer advice can make a big difference, but professional counseling can target specific problems better and often offer better long-term solutions.

“Contact a reputable mental health provider to develop strategies for your particular situation,” Becker-Weidman said. “You have to start with a good assessment. A competent mental health provider can help them sort through any problems in their life and marriage.

Health insurance covers out-patient mental health. Just a couple sessions should help get things sorted out.”

December 2014 •

he vast majority of children who are obese at age 11 are still far too heavy at age 16, new research suggests.

Tracking nearly 4,000 children in three U.S. metropolitan areas over five years, researchers found that 83 percent of obese 10th graders had also been obese in fifth grade. Only 12 percent of kids who were obese in fifth grade transitioned to a normal weight over the following half-decade, according to the study.

“Parents sometimes think that it’s just baby fat and their kids will outgrow it, but we found a lot more constancy [of extra weight over time] than we anticipated,” said study author physician Mark Schuster, chief of general pediatrics at Boston Children’s Hospital.

“Certainly, once you’ve gained weight and become obese or overweight, it’s harder to change the habits influencing that,” he added. “But just because kids are gaining weight as they get older doesn’t mean they can’t lose weight -- they definitely can.”

The study was published online Nov. 10 and in the December print issue of the journal Pediatrics.

Obesity has more than doubled in children and quadrupled in adolescents in the past three decades, according to the U.S. Centers for Disease Control and Prevention.

About 18 percent of children aged 6 to 11 and 21 percent of adolescents aged 12 to 19 are obese, the CDC says.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Take the chill out of spending the holidays alone

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he prospect of spending the holidays alone can send a cold chill through even the most independent among us. And it’s no wonder.

All the hype for traditions that tout togetherness can leave divorced, widowed and single people feeling alone and disconnected this time of year. The “holiday blues” can take hold with a vengeance.

What to do? Decide to beat those blues with a change in attitude. Decide to make this holiday season a good one. Take advantage of this special time of year to spend some quality time with yourself, to create memorable moments with friends and family, and to help those less fortunate. Here are a few inspirational and practical tips to get you in the spirit: Slow down. Better yet, stop what you’re doing altogether. Ask yourself what the holidays really mean to you.

Rebirth? Hope? Family time? Gratitude and goodwill? Revisit your most deeply held beliefs about the season and make a conscious decision to participate in the holiday rituals that align with your values and spiritual underpinnings.

Be realistic and give yourself a break. For those who live alone, some degree of loneliness can be considered normal during the holidays. It’s a good time to remember that feelings of loneliness aren’t terminal, nor are they a “state of being” reserved for single people.

Loneliness has very little to do with being alone. It has everything to do with your state of mind. So, take

time to remind yourself that your happiness is in your hands, and that there are positive, healthy steps you can take to avoid the chill of loneliness.

Create new holiday traditions.

This is especially important if you are bemoaning the loss of irretrievable traditions of a “former life.” Consider instituting your very own “signature” traditions — whether it be a new cookie recipe or gathering of single friends at your place.

Volunteer and express gratitude. When you give of yourself, you reap two big rewards: first, you’ll develop connections with people who share your spirit of giving; and second, you’ll help those in need. Volunteering, especially at this time of year, can nurture your soul and make a meaningful difference.

If volunteering doesn’t fit into your schedule this year, there are plenty of other ways to express your gratitude and giving spirit. Consider baking some holiday goodies for your colleagues at work. Or leave a little something on a neighbor’s doorstep.

When you are doing for others and counting your blessings, you can transcend yourself and your current circumstances. The result? You might feel less lonely — more a part of the world and of this season of giving.

Be the instigator. Identify a holiday concert or event you’d like to

KIDS Corner Healthy Food? Well, Maybe Not

Y

ou can offer young children healthier food choices in the elementary school cafeteria, but will they actually put it on their trays and eat it?

Probably not, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Researchers observed 274 children in kindergarten through second grade in 10 New York City public schools as they selected from the offerings during one lunch period when a chicken-and-vegetable entrée was on the menu.

They watched to see whether each of the 6-through-8-year-olds chose a fruit, vegetable, whole grain, low-fat milk or a lean protein, taking before Page 8

•

and after photos of the trays.

They found that while 75 percent of the kids chose the lean protein (the entrée), only 58 percent chose a fruit and 59 percent chose a vegetable. And among those who put the various types of food on their trays, only 75 percent took even a single bite of the protein, while only 24 percent ate a bite of their vegetables.

“We have been thinking that if young children choose healthy food, they will eat it,” says Susan M. Gross, PhD, MPH, a research associate in the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. “But our research shows that is not necessarily so.”

attend and invite family or friends to join you. Take on the role of “social secretary” and you’ll gradually feel your holidays and social life becoming more active and interesting.

Just yesterday, I purchased two tickets to the “Christmas From Vienna” concert performed by the Vienna Boys Choir at the Eastman Theatre. I’ve yet to decide whom to invite, but that’s part of the fun! This concert is now on my calendar and I will look forward to surprising a friend with an invitation.

Seeding your future with anticipated events will give you something to look forward to during this wonderful time of year.

Decorate your home or apartment. Do it for you. It will help put you in the spirit of the season.

Hang a wreath on your door. Accent your mantel. Bring the holidays inside your home and feel its essence inside your heart.

Invite people over. It will give you an incentive to decorate, if you just don’t feel motivated to do it for yourself. No need to do anything elaborate or large. Even inviting just a few friends over for brunch or to watch a holiday special on TV can fill your day with warmth and cheer.

Send out holiday cards. Take this occasion to say “hello” and make connections. I love getting an unexpected card from a long-lost friend, and I

delight in tracking down and sending out season’s greetings to those who might be surprised to hear from me.

Sure enough, good things come from reaching out to others.

Include yourself on your gift list.

This is a good time of year to spoil yourself with a little comfort. Take time out for yourself. Snuggle up with a best-seller by the fire. Schedule a massage or pedicure. Treat yourself to that luxurious terrycloth robe you’ve had your eye on.

What’s on my gift list for Gwenn?

Experiences are what I’m after these days; I have all the “stuff” I need. I think I’ll treat myself to a solo weekend away at the Roycroft Inn in East Aurora, N. Y. It’s a charming, beautifully restored inn, steeped in the history of the arts and crafts movement.

Solo travel gives me a chance to just “be” with myself, reflect, and rejoice in life’s blessings. Why not consider a similar gift for yourself?

Let go. This is key. Let go of the notion that you need to be married or in a romantic relationship to enjoy the holidays. Life is all about personal connections, and there are plenty to be found in friends, family, neighbors, colleagues, even people you meet in passing. Reach out. Make those connections.

My warmest wishes to you this season. Have yourself a merry little Christmas, a happy Hanukkah, or a joyous Kwanzaa. Enjoy the season to the fullest. You have a choice. Choose to be with people rather than isolate.

Choose to appreciate what you have rather than focus on what you’re missing. I promise you this: Embrace even half of the tips above and, chances are, you’ll find more meaning and merriment this season. Enjoy!

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

When to Call the Doctor About a Cold or Flu Signs they need medical attention Flu and the common cold share some common symptoms. Though both often can be treated at home, more serious cases require a doctor’s care.

The American Academy of Family Physicians mentions these warning signs that you should see a doctor: • A persistent fever of higher than 102 degrees Fahrenheit that causes body aches and fatigue.

• Symptoms that persist for longer than 10 days, or symptoms that worsen instead of improve.

• Shortness of breath, difficulty breathing, or pressure or pain in the chest.

• Confusion, disorientation or fainting.

• Vomiting persistently.

• Significant sinus pain affecting the forehead or face.

• Swelling of glands in the neck or jaw.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

Note to Parents

Playing Action Video Games Can Boost Learning

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new study shows for the first time that playing action video games improves not just the skills taught in the game, but learning capabilities more generally.

“Prior research by our group and others has shown that action gamers excel at many tasks. In this new study, we show they excel because they are better learners,” said Daphne Bavelier, a research professor in brain and cognitive sciences at the University of Rochester. “And they become better learners,” she said, “by playing the fast-paced action games.”

According to Bavelier, who also holds a joint appointment at the University of Geneva, our brains keep predicting what will come next — whether when listening to a conversation, driving or even performing surgery. “In order to sharpen its prediction skills, our brains constantly build models or ‘templates,’ of the world,” she said.

“The better the template, the better the performance. And now we know playing action video games actually fosters better templates.”

Action Players vs. Non-Action Players

In the current study, published in the Proceedings of the National Academy of Sciences, Bavelier and her team first used a pattern discrimination task to compare action video game players’ visual performance with that of individuals who do not play action video games.

The action-gamers outperformed the non-action gamers. The key to the action-gamers success, the researchers

found, was that their brains used a better template for the task at hand.

Video Training

Then, the team conducted another experiment to determine if habitual players of fast-paced, action-rich video games may be endowed with better templates independently of their game play, or if the action game play lead them to have better templates.

Individuals with little video game experience were recruited and, as part of the experiment, they were asked to play video games for 50 hours over the course of nine weeks. One group played action video games such as Call of Duty. The second group played 50 hours of non-action video games, such as The Sims.

The trainees were tested on a pattern discrimination task before and after the video game “training.” The test showed that the action video games players improved their templates, compared to the control group who played the non-action video games. The authors then turned to neural modeling to investigate how action video games may foster better templates.

Measuring Learning

When the researchers gave action gamers a perceptual learning task, the team found that the action video game players were able to build and fine tune templates quicker than non-action game control participants. And they did so on the fly as they engaged in the task.

Being a better learner means de-

veloping the right templates faster and thus better performance. And playing action video games, the research team found boosts that process.

“When they began the perceptual learning task, action video gamers were indistinguishable from non-action gamers; they didn’t come to the task with a better template,” said Bavelier. “Instead, they developed better templates for the task, much, much faster showing an accelerated learning curve.”

The researchers also found that the action gamers’ improved performance is a lasting effect. When tested several months to a year later, the action-trained participants still outperformed the other participants, suggesting that they retained their ability to build better templates.

Bavelier’s team is currently investigating which characteristics in action

Healthcare in a Minute

By George W. Chapman

Healthcare job growth. The healthcare industry has done its share of hiring, contributing to the steady decline in the U.S. unemployment rate.

The sector has added an average of 26,000 jobs per month for the last six months (April thru September). This exceeds the average monthly gain from the prior 12 months (thru March of this year) by 50 percent.

Obamacare good (so far) for insurers. Commercial carriers and their industry spokespeople have been noticeably quiet when it comes to Obamacare, most likely because it’s too early to make bold statements or predictions. There is still a lot of uncertainty out there. But so far so good for the three of the nation’s largest commercial insurers. Aetna, UnitedHealth and WellPoint have seen memberships grow by hundreds of thousands through both federal and state exchanges and Medicaid expan-

sion. Insurers expect 20 percent growth in new Affordable Care Act members in 2015. Most insurers are reporting that the feared huge surge in utilization by newly insured members has not happened.

Massachusetts leads the way in transparent pricing. The birthplace of “Romneycare” has been years ahead of the rest of the country. What happens in Massachusetts should not be overlooked or marginalized, as it is the harbinger of the Affordable Care Act or “Obamacare.” Massachusetts mandated insurers must post their prices (how much they pay various providers) for certain office visits and procedures on their websites. Not all procedures are listed, but the state feels it is a start.

Consumers can now determine where to go for healthcare based on price, as this impacts what they will pay out-ofpocket, be it their deductible or co-insurance. So, a consumer may decide

to receive care at the hospital with the lowest reimbursement rate for a particular procedure as this means less out of pocket if their deductible has not been met. One of the biggest misconceptions among consumers is higher prices mean higher quality.

America’s youngest billionaire wants your blood. More than seven billion lab tests are performed in the US annually. It is a $76 billion industry. Too often, however, the cost of lab tests or the fear of having a needle stuck in you prevents many Americans from getting necessary tests. So, Elizabeth Holmes, smelling opportunity, dropped out of Stanford University to form her own company called Theranos. Instead of vials, tourniquets and needles, there is just a relatively painless pinprick of blood that goes into a container the size of a dime. Seventy lab tests can be run on just a drop of blood. Her prices for 1,000 tests are readily available on

December 2014 •

video games are key to boost players’ learning. “Games other than action video games may be able to have the same effect,” she said. “They may need to be fast paced, and require the player to divide his or her attention, and make predictions at different time scales.”

Vikranth R. Bejjanki of the University of Rochester and Princeton University, and Ruyuan Zhang of the University of Rochester are co-lead authors of the study. In addition to Bavelier and the lead authors, researchers from the University of Geneva, University of Wisconsin-Madison, and Ohio State University also contributed to the study.

The Office of Naval Research, the Swiss National Foundation, The Human Frontier Science Program, and the National Eye Institute supported the research.

the website and they are significantly lower than what hospital or commercial labs charge. Her goal is to have a Theranos Wellness Center within five miles of any American.

2015 Health Savings Accounts. For those who have an HSA, the maximum contribution for a single person has been raised $50 from $3,300 to $3,350. The maximum for a family has been raised $100 from $6,550 to $6,650. Those 55 and older are allowed to contribute an additional $1,000, called a “catchup contribution.” You must be enrolled in an eligible high deductible health plan to have an HSA.

GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York.

To reach him, email gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 9

Back to Basics: the Physical Therapy Solution to Back

By Catherine Miller

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s the baby boom bubble begins to slide into retirement years there is an increase in the age-related health issues experienced by this group consisting of 76 million Americans — not the least of which is low back pain.

Spinal stenosis, the narrowing of the spinal canal and nerve root canal, creates severe pain during simple everyday tasks such as standing and walking. Often caused by the body’s natural aging process, this pain can be debilitating, life changing and could hasten the rate at which the baby boomers enter retirement.

While your primary physician or orthopedist is the best person to recommend treatment options for low back pain issues, an increasing number of health care providers are recommending physical therapy to treat spinal stenosis pain at the root of the problem.

Bartholomew Horrigan and Bernard Ryan are two physical therapists at Ascend Physical Therapy Group in Buffalo who have seen an increase in spinal

stenosis patients, and are finding that a large percentage of these patients respond quickly and favorably to the physical therapy approach.

“Our first step is always to educate the patient about his condition and our course of treatment,” said Horrigan, “Many people, as they age, assume that their low back pain is a herniated disc, when in fact its spinal stenosis.

Although the manifestation of the pain may be similar, the causation of the issue is very different. We educate the patient as to their specific condition and then teach them ways they can work to improve their condition in our office and at home.”

Using physical therapy for spinal stenosis can aid to decrease pain as well as increase the patient’s range of motion, and alleviate numbness and weakness they may be experiencing in their lower extremities, according to Horrigan. In addition to exercise and stretching, a physical therapist will

Bartholomew Horrigan, a physical therapist with Ascend Physical Therapy Group in Buffalo, educates a patient on the causes of spinal stenosis and how physical therapy can alleviate pain. According to him, more physical therapists have been able to help those who have back pain.

often review your physical habits, such as your stance, positioning and posture and the stress that is put on various spinal areas that may be contributing to your pain. Your therapist can then work with you to design ways to change habits and relieve the pain and pressure.

Your physical therapist may use heat therapy to improve blood circulation and ice therapy to relieve pain. Cycling and limited walking are also used to promote good physical conditioning.

The overall purpose of physical therapy is to decrease pain and allow you to return to your everyday activities.

Art Pepe was recently diagnosed with spinal stenosis. At the age of 57 Pepe had recently retired from his position as a teacher and was excited at the anticipation of becoming a partner at Impress Apparel, a local photography and impression gift shop. Working an approximate 30 hours a week on his feet, Pepe began to feel the pains of his new venture in his lower back and began to show symptoms of spinal stenosis. Pepe was concerned that the pain would affect his ability to continue his new business endeavor.

“I’m very active and I began to have difficulty even walking through a large hardware store,” said Pepe, “I would need to sit down and take a break before making my way back out to my car.”

Pepe visited his doctor, was quickly diagnosed with spinal stenosis, and recommended to begin physical therapy.

“When I first visited Ascend Physical Therapy Group, Dr. Horrigan taught me about my problem and how to work to alleviate the pain. Within weeks I began to respond. Now after a couple of months of treatment I am back working in my shop, painting and fixing things. I’m on my feet more and can do the jobs I need to do to get my business up and running.”

Presently more than 65 million people suffer from low back pain and

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this number is expected to rise with the aging baby boomer population.

Back pain is the leading healthcare expenditure and costs $80 billion a year in the US for lost work time, medical cost and rehabilitation. It is the leading cause of disability for people under the age of 45, disabling 1.2 million Americans a year.

Most patients that will respond to physical therapy will do so, at least to some degree, within three weeks of treatment. While physical therapy is a great course of treatment, it’s not for everyone.

“For most patients that have minimal to moderate stenosis we have a very good success rate with physical therapy,” notes physical therapist Bernard Ryan, “We aren’t going to get everybody, but there are other treatment options out there. I think it’s important that those that are experiencing low back pain don’t just accept it. They need to realize that it could be better and they need to talk to their doctor about options.”

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

Fighting Viruses: Forget Ebola, Focus on the Flu, Experts Say

By Deborah Jeanne Sergeant

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hanks to the massive media coverage of Ebola, communicable diseases have gained center stage in public attention. But according to the Centers for Disease Control (CDC), the risk of getting Ebola in the United States is very low, even when working with West African communities in the United States.

Although the cases of common cold or influenza generally don’t grab the number of headlines that Ebola has, they can cause deadly complications and will most likely kill more than Ebola in the US this year. The CDC reports that 153 children under age 18 died of influenza in the 2013/2014 flu season, for example. Children, the elderly, and people with compromised immune systems represent three groups especially prone to lethal flu and cold complications.

Several steps can help preventing the spread of colds and flu. Help your immune system stay strong. Eating a balanced diet rich in fruits and vegetables can help your body fight off illness.

But according to the experts the single most imporatn step to take this season is to take a flu vaccine “We’re lucky to have a good supply of many types of flu vaccine,” said physician Gale R. Burstein, commissioner of health with the Erie County Department of Health. “There are many places in the community to get it.”

Two varieties are available. One protects against three strains and one that protects against four strains. If the available vaccine matches the strains of virus to which a person is exposed, effectiveness may be as high as 85 percent; otherwise, it can range from 30 to 40 percent.

Although vaccine is the most effective way to control influenza, it’s not foolproof. Vaccinated people may still get influenza, but they will experience less severity and longevity of the illness.

Burstein said that since flu vaccines are less effective for older people, it’s important for every person six months years old and older to receive vaccine for “herd immunity.”

“The more people in the community who get flu vaccine, the more the community in general is protected,” Burstein said. “Everyone six months and older should be able to get one type of flu vaccines.

“Some people could get very, very ill with the flu, like the very young and elderly people 65-plus. Also, people with abnormal immune system and those with other medical conditions that affect the heart and lungs. They should get vaccinated. Pregnant women can get very ill with influenza, especially with H1N1.”

Healthcare, child care providers, elderly caretakers and anyone with lots of public interaction should be vaccinated.

Vaccination is available in the form of a nasal spray, injection, and intra-dermal that just goes under the skin.

“If you don’t like needles and you don’t want the nose spray, that’s a great option,” Burstein said. “There is one for people who have egg allergies.”

It’s also important to wash your hands.

“That’s the best protection against viruses,” she said. “Make sure that you’re frequently washing your hands throughout the day.”

Viruses can live on many surfaces

for days. After touching a contaminated surface, you can transmit viruses to your body if you eat or touch your mouth, eyes, or nose. Before doing any of these, wash up. Use warm water and

soap, scrubbing vigorously for about 20 seconds. It takes about that long to sing “Happy Birthday” twice. Use hand sanitizer only when washing the hands isn’t possible.

Resist exposing others to viruses if you become ill.

“Stay away from people who are sick,” Burstein said. “They are teeming with the virus. If you’re ill, stay home and stay away from other people.”

Typical symptoms include fever, body aches, dry cough, and extreme fatigue.

Remain safely at home with help from HomeFirst.

More and more people on Medicaid who might otherwise be struggling to take care of themselves won’t have to because of HomeFirst.

HomeFirst, a product of Elderplan, is one of the oldest managed long-term care (MLTC) plans in the state. Our Personal Care Workers provide assistance with bathing, dressing and meals.

You can keep your own doctor, and we provide transportation to medical appointments. There is no cost to participate.

HomeFirst is an affiliate of MJHS, which was founded on the core values of compassion, dignity and respect for every culture. Those core values date back to 1907, when MJHS began a tradition of caring every minute, every day.

Call 1-866-384-3509 or visit homefirst.org

Services covered by HomeFirst are paid for by New York State Medicaid. The services not part of HomeFirst benefits continue to be covered by Medicaid and/or Medicare benefits. All services are coordinated, even those not included in the MLTCP benefit package. H3347_EPHF14288 December 2014 •

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 11

SmartBites

By Anne Palumbo

The skinny on healthy eating

The Amazing Benefits of Pomegranates

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few years ago, pomegranates and their juice became the darlings of the health-minded. Declared a superfood by some, an anti-aging food by others, this exotic fruit had us by the tongue buds. Did it warrant all the hype? I think so. Is it still in the limelight?

More than ever.

Long used for medicinal purposes in other countries, pomegranates are finally taking center stage here because they’re loaded with compounds we covet: antioxidants. Antioxidants protect our body from disease and accelerated aging by gobbling up harmful free radicals — byproducts of the oxidation process that can turn good cells bad.

Pomegranates stand out as antioxidant superstars because they boast a powerful combination of antioxidants — not just one or two. In fact, according to the U.S. Department of Agriculture, a pomegranate juice’s antioxidant activity is right up there with prunes, dark chocolate and red wine.

Like other antioxidant-rich foods, pomegranates are also the darlings of the research world. Although more studies are needed, preliminary re-

U.K. have found an anti-inflammatory compound in pomegranates that they believe may help slow the progression of Alzheimer’s and Parkinson’s diseases.

On the nutrient front, pomegranates measure up to other fruit superstars. Low in fat, cholesterol and calories (about 70 per ½ cup of seeds), this sweet and tangy fruit contains notable amounts of vitamins C and K (good for the immune system and blood clotting, respectively) and potassium (essential for muscle control and blood pressure regulation). And although one ½-cup serving of seeds contains 12 grams of sugar, the high sugar content is kept in check by the fruit’s substantial 3.5 grams of fiber.

Helpful tips

search suggests that drinking a daily (8 oz glass) of pomegranate juice may significantly slow the progress of prostate cancer in men with reoccurring prostate cancer, cut cholesterol build-up in arteries and improve blood flow to the heart. Wow! Worried about chronic inflammation? Pomegranates may be your ticket to quieting the painful and often destructive fire within. A small study at the University of Maryland Medical Center showed that pomegranate extract decreased joint tenderness in rheumatoid arthritis patients by 62 percent. What’s more, researchers in the

Select pomegranates that feel heavy for their size and have a deep color. To easily extract the seeds, cut the pomegranate in half, put each half under water, and then use your fingers to coax the seeds from the inside. The pith is light and will float to the top while the heavier seeds sink to the bottom. At room temperature, whole pomegranates last about a week (two with refrigeration). Extracted seeds last about five days in the refrigerator and three months in the freezer.

Pomegranate-Chicken Salad Adapted from the Food Network Kitchen Serves 6-8 1/2 cup mayonnaise 1/2 cup fat-free plain yogurt 1/4 cup Dijon mustard

1 clove garlic, minced 2 tablespoons lemon juice Kosher salt and freshly ground black pepper 1 rotisserie chicken, shredded 1 cup pomegranate seeds 2 tablespoons chopped fresh chives 2 stalks celery, sliced Baby arugula or other lettuce (optional) Combine the mayonnaise, yogurt, Dijon mustard, lemon juice, garlic and some salt and pepper. Taste and adjust seasonings as needed.

Add the shredded chicken, pomegranate seeds, chives and celery to a bowl.

Pour some of the dressing around the sides of the bowl and toss to combine.

Add more dressing as desired. Taste and adjust seasonings as needed.

Serve on top of arugula or lettuce, if using.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes.

She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

7 Ways to Feel Full Without Overeating

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ot feeling full after or between meals can result in overeating.

In the October issue of “Food Technology” magazine published by the Institute of Food Technologists (IFT), contributing editor Linda Milo Ohr writes about studies that show eating certain nutrients and foods may help curb appetite and keep one feeling fuller longer.

These include:

1. Protein Adding one protein to breakfast everyday could contribute to improved satiety and diet quality. Another study showed that daily consumption of a high-protein afternoon snack containing soy lead to improved appetite control, satiety and reduced unhealthy evening snacking in adolescents. Whey, soy, pea and egg protein all contribute to a

feeling of fullness.

2. Whole Grains and Fiber Substituting whole grain bread with refined wheat bread is linked to lower hunger, higher levels of fullness, and less desire to eat. Oats increased appetitecontrol hormones up to four hours after a meal, whereas rice-based foods did not.

3. Eggs Eggs are one of the densest proteins in the non-meat category. It has been shown that eating one egg with breakfast will help to reduce hunger between meal times.

4. Almonds The healthy fats in almonds decrease hunger and improve dietary vitamin E intake. People who ate 1.5 oz. of dry-roasted, lightly salted almonds every day helped satiate their hunger without increasing body weight.

5. Pulses Part of the legume family, pulses include dried peas, edible beans, lentils, and chickpeas. They are very Page 12

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high in protein and low in fat, and are proven to contribute to a feeling of fullness after consuming.

6. Saffron Extract This type of extract is shown to have a beneficial

effect on appetite, mood, and behaviors relating to snacking, which helps reduce overeating linked to habit or stress.

7. Korean Pine Nut Oil This kind of nut has high levels of healthy, all-natural fats, which are shown to release the satiety hormone, cholecystokinin.

A Third of All Food Is Wasted – and Such Loss Is on the Rise Recent reports conclude that one-third of all food grown or produced is lost each year in its journey from the farm to a consumer’s table. Robert Gravani, an expert in food technology and professor of food science at Cornell University, says developed countries are not immune to such waste, and that food waste is steadily increasing in the U.S. Gravani says: “Food waste has increased dramatically in the last several decades and it is estimated that about 20 pounds of food is wasted per person per month in the U.S.”

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

Keeping the holidays happy and healthy Trays of fresh vegetables are a colorful and healthy addition to your holiday snack table.

By Catherine Miller

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h, the holiday season — old friends gathering, family get-togethers, holiday office parties and shopping for endless hours.

Among all the hustle and bustle are buffets of food and cocktails that add merriment to the festivities and pounds to the midriff. But a season filled with joyful celebrations doesn’t have to mean regretful moments on your scale come New Year’s Day. “There are plenty of ways to stay healthy this holiday season with just a little bit of planning,” says Jennifer Turesky, registered dietitian with the Piver Center at the Women Health and Wellness Center. “When people try to avoid social gatherings because they are dieting, it just doesn’t work.

We want to be social. We just need to prepare for it.”

In addition to suggesting relaxation, proper sleep and balancing stress during the holidays to stay healthy, Turesky offers nutritional counseling and a weight management program.

She is an advocate of the “balanced plate method.” This method of balancing your plate along with your nutritional needs consists of filling half of your plate with colorful vegetables, one-fourth with lean proteins and onefourth with your starch or grain for a meal that is satisfying, healthy and filling. While the plate method is easy to control at a house party, it may be more difficult to complete at a restaurant.

“At a restaurant, ask your server to omit the starch and give you two vegetables,” Turesky says. “Most restaurants are very willing to accommodate this request. Also look for the healthy options on their menu and ask for

dressings and condiments on the side so that you can limit them.”

Chef advocates use of healthy food

Scott Steiner, a chef instructor at the Niagara Falls Culinary Institute, is dedicated to instilling young chefs with the tools they need to bring nutrition into the kitchens they will one day serve. His passion for nutrition is enlightening and with good cause.

“There is an obesity epidemic in America,” states Steiner, “the use of sugar, saturated fats and processed foods is out of control. We need to add fresh, whole foods to our diets.”

Steiner’s nutritional knowledge comes first hand. He used the nutritional insight he was teaching in class to lose 65 pounds over five years ago, and has kept the weight off simply by adjusting his eating habits. In addition to teaching culinary classes, Steiner is chairman of the local chapter of the American Culinary Foundation and uses his resources to spread the word on nutrition and healthy eating.

“The key to a satisfying meal is to prepare the food in a way that retains the greatest amount of nutrients without foregoing taste. When I make a hummus I use chicken stock to replace the oil, and I serve it with vegetables and homemade crisps made from whole wheat tortillas or blue chips found in the organic food aisle,” says Steiner. “Guacamole is another great party dip as the avocado is high in mono- and polyunsaturated fats ,which are “good fats,” and you can add garlic and other spices to increase flavor for a dip that is nutritious and delicious.”

Steiner recently challenged his

Change Traditions If many of your holiday traditions center around food, it may be time for new traditions. Instead of baking and making traditional foods, try making traditional holiday crafts with your family or friends. The crafts can then be donated or given as treasured gifts.

Organize a holiday sing-along at a local nursing home or grab sleds and head for the hills once the snow starts to fly. There are dozens of great holiday activities to incorporate into your family’s traditions as you revamp your holiday menus, so that you can enjoy a healthy, active and fit New Year. students to create sandwiches using only healthy ingredients, omitting fatty condiments and replacing them with flavor filled alternatives.

“When you omit the fat and sugar, you take out the flavor. You need to replace that flavor in order to satisfy the appetite,” Steiner explains, “Using mild banana peppers, vinegar based condiments, lemon or lime juice and tomatoes is a great way to add in healthy flavor. In class we use balsamic vinegar

Babies Born in the Winter Start Crawling Earlier Than Those Born in the Summer Study shows a seasonal effect on the pace of motor development in Israeli babies during their first year

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he season of a baby’s birth influences its motor development during its first year of life, a new study by University of Haifa researcher’s shows.

Babies born in the winter (between December and May) start crawling earlier compared to babies born in the summer (June-November).

Forty seven healthy babies with typical development patterns where divided them into two groups. The first group comprised “summer-fall” babies, 16 babies born from June to November,

and the second, “winter-spring” babies, 31 babies born from December to May. The study consisted of motor observations in the babies’ homes when they were 7 months old, and a follow-up session when they began to crawl. Parents were asked to record the stages in their babies’ development before and between the observations.

The study used the Alberta Infant Motor Scale (AIMS), an observational assessment with high reliability, to track the babies’ development. The scale relates to four positions: Prone

(on the stomach), supine (on the back), sitting, and standing. The average age at which the babies started crawling was 31 weeks. But while the babies born in the winter (who started to crawl in the summer) started to crawl at an average 30 weeks, those born in the summer (who started to crawl in the winter) began crawling at an average of 35 weeks, with no differences noted between the boys or the girls or in the initial style of crawling (belly crawling or using hands and knees).

The overall AIMS score was higher for those babies born in the winter, and the score for movement in the prone position, the scale most meaningful in connection with crawling, was significantly higher for the babies in the winter group. By contrast,

December 2014 •

to caramelize onions and it’s a great alternative.”

IHF offers online healthy recipes

The ideas for changing up your holiday menus are endless and you don’t have to be a chef to do so. When you are hosting this holiday season there is a great web tool, courtesy of Independent Health Foundation, that will add pizazz to your party while keeping it health conscious. Visit the Independent Health Foundation’s Healthy Options Program at www. healthyoptionsbuffalo.com for a listing of great recipes, including vegan cauliflower wings (a new Buffalo favorite?), pumpkin and red lentil soup, and peach and pepper salsa.

“We will be adding new recipes and holiday food ideas throughout the month,” stated Lauren Bevacqua, special project assistant for the IHF Healthy Options Program, “People can join our website, and follow us on Twitter and Instagram to keep up on all of our new healthy eating ideas.”

The IHF Healthy Option website includes a listing of some of your favorite restaurants, with a summary of healthy entrees, making sticking to your good eating habits even easier.

there was no significant difference in the scores for the supine position, sitting, or standing between the two groups. According to the researchers, the findings strengthen the assumption that there is a window of opportunity for starting to crawl and stress the effect of the season on the start of crawling.

“The difference in crawling onset of four weeks constitutes 14 percent of a 7-month-old’s life and is significant,” the researchers note.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Should Medical School Go to Three Years?

Prestigious schools such as Dartmouth have reduced their medical program from four to three years. Should schools Upstate do the same?

By Deborah Jeanne Sergeant

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he Association of American Medical Colleges estimates that by 2024, America will lack more than 90,000 physicians. Numerous factors contribute to the problem, including an influx of 32 million newly insured people seeking care because of the passage of healthcare reform, the shrinking number of new physicians entering the field and the huge number of aging baby boomers needing care as patients and retiring from practicing medicine.

One idea for reducing the shortfall and getting more physicians practicing sooner is shortening the length of medical school by a year. Supporters claim that the current four-year academic plan is passé since it was based upon recommendations a century old.

Current technology could help shorten medical school. But local medical school representatives aren’t as convinced.

At UB School of Medicine and Biomedical Sciences, physician David Milling, senior associate dean for student and academic affairs, feels confident that the four-year plan is the way to go, describing it as the best way to train future physicians. “As one of the oldest medical schools in the U.S., the UB medical school has seen the growth in medical knowledge continue unabated for more than a century. UB faculty and administrators continually reassess how this expanding knowledge can best be incorporated into the curriculum.”

UB maintains national raking in the five health sciences-medicine, nursing, dental medicine, pharmacy and public

health — and established the Behling Simulation Center.

“Throughout its history, the university has instructed students in affiliated hospitals throughout the city,” Milling said. “The UB medical school’s commitment to its hospital and research partners in Buffalo will be reinforced when the school moves downtown in 2017 to a greatly expanded and improved facility, now under construction on the Buffalo Niagara Medical Campus. That commitment, too, is wellserved by the four-year curriculum.”

Physician David R. Lambert, a senior associate dean for medical student education at the University of Rochester Medical Center, feels similarly. He noted that prestigious schools such as Dartmouth have reduced their medical program from four to three years, but stated, “I don’t see why we should go to three. There’s a need for time for the student to mature more and time to do thoughtful inquiries as to what they want to pursue in their specialty. We need to maintain a competency based curriculum.”

Some also see benefit in saving students money on tuition because with less debt, physicians could afford to see fewer patients and keep rates lower.

Lambert isn’t sure schools would keep tuition the same rate for three years as four years.

“I don’t think economics should be a motivation,” he added.

Lambert’s colleague, physician Mark Taumban, dean of the School of Medicine and Dentistry at the University of Rochester Medical Center, agrees

and said that regardless of how many years it takes, the same number of students will graduate per year. Shortening the time it takes to graduate “won’t clear up the bottleneck,” he said. “You’re not filling any new slots going from four years to three years.

We would have the same 104 students.”

Lambert acknowledged that although some institutions are adequately educating physicians in three years, one should approach the question from the perspective of time instead of outcome.

“If we think we’re producing the perfect doctor, ideally equipped to provide the highest level of care at the lowest cost and the next generation of scientists that will help cure disease and produce the workforce that will run the medical center of the future, then I’d say maybe we can do this in fewer years,” Lambert said. “But if we haven’t gotten there yet, and there are things we can do to make better physicians, educators and scientists better, what should we do?”

He believes that shortening medical school may save some money, but it won’t necessarily be the best move for

providing the quality level that patients need.

Though teaching approaches such as technology-based learning and team training during simulations help save time, Lambert said that the school must first look at “what produces the best possible physician,” he said. “Then you’ll know how many years are right and what’s the right curriculum.”

He said that most medical schools don’t make much money and cutting tuition exacerbates the problem.

“If we could do it in three years, we would,” Lambert said. “But the argument is driven not by the desire to get to a number of years, but to provide the best possible physicians we can.”

Time will tell if three-year programs become commonplace in Upstate New York.

Can Human Growth Hormone Reverse Aging?

Experts: HGH not the fountain of youth

By Deborah Jeanne Sergeant

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ou’ve likely seen ads online about human growth hormone (HGH), popularly touted to reverse the aging process. While HGH is FDA approved for certain uses, turning back the clock for middle-aged and older adults isn’t one of them. Reports of its success in doing so are anecdotal.

Physician Robert Stall, geriatrician, consultant and CEO of Stall Senior Medical in Amherst, said that he knows of no medical studies indicating HGH should be used for restoring youth.

“Because of its side effects, I don’t recommend it,” he said. “People have unrealistic expectations and want a magic pill to make them younger and feel stronger and they don’t want to do the things they need to do to make that happen.”

The pituitary gland produces HGH naturally to spur children’s and teens’ growth. It also controls functions involving metabolism. Synthetic HGH can help spur growth in children and adolescents whose growth has unnaturally stopped because of certain medPage 14

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ical conditions. Doctors also prescribe HGH for conditions such as short bowel syndrome, HGH deficiency, or muscle-wasting disease.

No evidence has shown that HGH can recapture youthful appearance and muscle mass; however, side effects of using HGH for non-prescribed purposes includes increased cholesterol, increased risk of diabetes, carpal tunnel, swelling of the arms, and legs, gynocomastia in men, and joint pain.

In addition to the risks involved in taking non-prescribed medication, people using HGH often obtain it from dubious sources such as sketchy Internet “pharmacies” and from foreign suppliers, which could compromise its integrity.

Beth Smythe, registered dietitian and representative of the New York State Dietetic Association, said that eating right is vital for feeling and looking one’s best at any age.

“Foods deliver physiological benefits such as protein for muscle repair, carbohydrates for energy and vitamins

and minerals for cell function,” she said.

For optimal benefit, she advises eating less processed foods and more whole foods. Many foods boast fortification; however, these don’t offer equal nutritional value as foods which naturally contain the same nutrients.

“For instance, omega-3 fatty acids: many foods are fortified with omega-3s, but one of the best sources is cold water fish such as salmon which is naturally high in omega-3s,” Smythe said. “They can lower your risk of heart disease.

You would have to eat a lot more of fortified foods with omega-3 fatty acids to get the same physiologic response you would get from eating salmon.”

Filling the diet with whole fruits and vegetables, whole grains, nuts, beans, low-fat dairy, and lean sources of proteins helps the body stay healthy.

The “My Plate” diagram illustrates a balanced meal comprised of one-half fruits and vegetables, one-quarter lean protein and one-quarter whole grain carbohydrates.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

Joe Fox, founder and president of Train Smart Personal Fitness in Williamsville, said that many people overlook strength training.

“If you do research on fat loss, the single most important thing you can do to increase strength, vitality and to sleep better is to improve lean muscle mass in your body,” he said.

To do so effectively and safely, he encourages people to seek a professional assessment. Working with small weights won’t yield the best results and working with weights that are too heavy or lifting improperly can result in injury.

“Aerobic training is the least effective for fat loss and muscle building,” Fox said. “It is good for general health, though.”

In general, perform a vigorous activity you enjoy doing, along with strength training 30 to 60 minutes most days of the week and to get — and stay — physically fit.

Health on a Hectic Schedule Health coach says even a few minutes here and there help people stay in shape

By Julie Halm

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aintaining a healthy lifestyle on a crammed schedule can be a daunting task. Whether your daily planner is packed tight with a demanding work schedule or a full family life, deficits of time and energy can be major hurdles to overcome.

Rachel Miller, a health coach who is certified in many things from being a holistic health coach and nutrition counselor, to being a personal trainer and physical therapist assistant, says that while it may be difficult, it is far from impossible.

Like many, Miller has struggled with her own journey to reaching health and fitness goals and losing weight. She tried many unsuccessful methods and fad diets before reaching a lifestyle that worked for her. Personalizing a regimen is one of the tips Miller gives for moving towards an overall healthy lifestyle.

Exercise is an essential component of improving overall health, and is just one of many things that can be worked into any schedule.

“I really feel that the best time to work out is the best time that works for you, whenever you can do it,” said Miller. “Even 15 minutes a day, just to start, until it becomes a habit, is good.”

She noted that those with excep-

tionally tight schedules can even split that time up into separate portions throughout the day.

How and where to exercise is another adjustable factor in the road to good health. While some people might do best with a personal trainer to increase motivation and accountability, others might not have room for the additional expense in their budget. Miller noted that having a friend to work out with, or even just talk to, can help to keep people on track.

“Find a friend and tell them what you’re doing,” she said.

Another way for those who are tight on time and money to reduce the cost of getting healthy is to find walletand watch-friendly ways to work out.

Miller suggests taking walks or jogging through your own neighborhood, and investing in less expensive tools such has hand weights, exercise balls and workout videos. These tools are accessible any time, so whether you’re trying to get in a short workout at the beginning or the end of the day, there is no added time spent commuting to a gym or fitness facility.

No matter how accessible the tools, getting into a workout routine can be difficult, and a smaller amount of time

dental care expenses is to join a dental discount network. How this works is you pay an annual membership fee — around $80 to $200 a year — in exchange for 10 to 60 percent discounts on service and treatments from participating dentists. To find a network, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists by zip code, as well as get a breakdown of the discounts offered.

Another option that’s currently available only in the southern California area is Brighter.com. They provide users free access to a network of dentists offering up to 50 percent discounts on all services.

By Jim Miller

A Guide to Finding Affordable Dental Care Dear Savvy Senior, I had dental insurance through my work for many years but lost it when I retired.

Where can retirees find affordable dental care?

Need a Dentist Dear Need, Finding affordable dental care can be challenging for seniors living on a tight budget.

Most retirees lose their dental insurance after leaving the workplace, and original Medicare does not cover cleaning, fillings or dentures. While there’s no one solution to affordable den-

Dental Schools

tal care there are a number of options that can help cut your costs. Here’s where to look.

Medicare Advantage

While original Medicare (Part A and B) and Medicare supplemental policies do not cover routine dental care, there are some Medicare Advantage (Part C) plans that do. Many of these plans, which are sold through private insurance companies, cover dental care along with eye care, hearing and prescription drugs, in addition to all of your hospital and medical insurance. If you’re eligible for Medicare, see medicare.gov/find-a-plan to look for Advantage plans in your area that covers dental care.

Dental Discounts

might mean that results don’t come rapidly. To avoid becoming discouraged, Miller suggests setting small and attainable goals.

“It takes time to put weight on and it takes time to take weight off, so find something that motivates you and really set specific goals for yourself,” she said. “Set one goal at a time, even if it’s for two or three weeks.”

Eating right is another essential component to good health and at the end of a long day, a drive-thru can look much more appealing than going home and trying to figure out what to make for dinner. To avoid this temptation, pre-planning can be extremely helpful.

Cooking meals in bulk that can be easily frozen and then thawed is one way to avoid poor dietary choices.

Miller gives grocery store tours and healthy eating classes and her blog offers suggestions for easy ways to eat healthy.

You can find more on her classes and links to her blog at reformwithrachel.healthcoach.integrativenutrition. com.

A tight schedule can often make an easy excuse for pushing health to the back burner, but with motivation, goals and pre-planning, even the most

Another way you can reduce your

Dental school clinics offer savings opportunities, too. All 65 accredited dental schools in the U.S. offer affordable care provided by dental students who are overseen by their professors.

You can expect to pay about half of what a traditional dentist would charge and still receive excellent, well-supervised care.

Another option is to check with local colleges that offer dental hygiene programs. For training purposes, many programs provide teeth cleanings by their students for a fraction of what you’d pay at a dentist’s office.

To search for nearby dental schools or dental hygiene programs visit ada. org/dentalschools.

Veterans Benefits

If you’re a veteran enrolled in the VA health care program, or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA is now offering a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost.

The VA also provides free dental

December 2014 •

overloaded of people can find a routine that includes healthy choices.

care to vets who have dental problems resulting from service. To learn more about these options, visit va.gov/dental or call 877-222-8387.

Low Income Options

If you’re low income, there are various programs and clinics that provide dental care at a reduced rate or for free.

To look for options in your area contact your state dental director (see astdd. org), or your state or local dental society (ebusiness.ada.org/mystate.aspx).

You may also be able to get discounted or free dental care at one of the federally funded HRSA health centers (findahealthcenter.hrsa.gov, 877-4644772), or at a privately funded free clinic (nafcclinics.org).

Also check with the Dental Lifeline Network (dentallifeline.org, 888-4716334) which provides free dental care for low-income elderly and disabled; Remote Area Medical (ramusa.org) which offers free health, eye and dental care to people in select locations; and Indian Health Service (ihs.gov), which provides free dental care to American Indians and Alaska Natives who are members of a federally recognized Indian tribe.

Also see toothwisdom.org, a website created by Oral Health America that will help you locate low-cost dental care.

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.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper

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Page 15

The Social Ask Security Office Column provided by the local Social Security Office

The Amherst Senior Citizens Foundation named Robert M. Chur as the 2014 Senior Community Leader and Beverly and Sidney Fish as the 2014 Senior Citizens Volunteer Award recipients. From left are Melissa Holmes, WGRZ-TV & Mistress of Ceremony, Robert M. Chur, Beverly Fish, Sidney Fish and Charles “Bud” Kopp, ASCF chairman.

Amherst Senior Citizens Honors Community Leader, Volunteer The Amherst Senior Citizens Foundation (ASCF) awarded the recipients of the 2014 Senior Community Leader and Senior Citizens Volunteer awards at its Night in Tuscany Gala Nov. 15.

The awardees: • Robert M. Chur received the organization’s Senior Community Leader Award. He was recognized as someone who, through his or her position, time and talent, has provided important leadership in promoting and developing activities, which provide a favorable climate for Amherst seniors to age within the community.

In the last 36 years Chur has played a significant role in residential health care management that includes the construction of health care facilities and development of skilled nursing, assisted living, and independent living service operations.

Chur was the founder, owner, president and CEO of Elderwood Senior Care from 1978 until July 2013 when most of the Elderwood assets were sold. He and his wife Carol still own and operate two former Elderwood facilities, which are now called Heathwood Assisted Living of Williamsville and Heathwood Assisted Living of Penfield. He now works at CCNY (Chur Companies of New York, Inc.).

• Beverly and Sidney Fish were named the recipients of the Senior Citizens Volunteer Award, which was created to honor individuals who display a passion for giving of their time, endeavoring to fulfill the needs of the community, and serving as role models by demonstrating the critical impor-

tance of individual involvement and caring. In this case, the dedication was magnified by two special people who began their volunteer journey together over 60 years ago.

The two met in their early teens, sharing common interests including a passion for helping others. They started by entertaining veterans at the VA Hospital at the age of 16. After graduating from high school and getting married, Sidney attended UB Pharmacy School and Beverly earned her degree in retailing from UB. Together they have been very active with the Northeast Kidney Foundation and the American Diabetes Foundation (ADA) where they have been team leaders for the Tour de Cure for the past 20 years. Beverly serves on the women’s board at Millard Fillmore Suburban Hospital and chairs its annual fashion show fundraiser. She helps run the gift shop at the hospital and is known for her “diaper cakes” often creating them for those in need. She also served on the supervisory committee of the Workmen’s Circle Federal Credit Union for 11 years.

Sidney mentors clients through the SCORE Program (Service Corps of Retired Executives) and has served on the committee for development of continued education for pharmacist at University at Buffalo Pharmacy School and at D’Youville College School of Pharmacy. He also conducts diabetes management training at UB, scheduled over 50 speakers for the Equality Club and serves on the new membership committee for the Forum Club.

Team at Gates Vascular Institute recognized three-star overall composite score, the highest recognition possible from the Society of Thoracic Surgeons, in three categories, including: • Isolated Aortic Valve Replacement (AVR) July 2013-June 2014• Isolated Coronary Artery Bypass Graft (CABG) July 2011-June 2014 • AVR + CABG July 2011-June 2014 “This is a tremendous accomplishment for the entire cardiac team at the Gates Vascular Institute,” said physician Hashmat Ashraf, chief of service, thoracic/cardiovascular surgery. “Their hard work, compassion and dedication to excellence have repeatedly earned this prestigious ranking, and I could not be prouder of the quality of cardiac surgery.”

There are 626 institutions that report their participant performance for Page 16

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all three categories — isolated CABG, combined CABG and AVR and isolated AVR — to the Society of Thoracic Surgeons, and only 18 of them achieved three-stars in all three categories.

“The Gates Vascular Institute cardiac surgery program has received tremendous national accolades,” said Cheryl Klass, senior vice president, operations, Kaleida Health and president, Buffalo General Medical Center.

“Recognition by the Society of Thoracic Surgeons is especially important to us as their whole purpose is to recognize and help surgeons provide the very highest quality of care. I am both personally and professionally proud of their outstanding work on behalf of our patients.”

Help Social Security Help the Homeless

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ec. 21 is National Homeless Persons’ Memorial Day. Since 1990, on or near the first day of winter and the longest night of the year, the National Coalition for the Homeless brings attention to and seeks compassion for the homeless who have died because they didn’t have a warm, safe place to sleep. Even as the recovery works its way through the entire economy, no one is immune to potentially being homeless. People in our community — colleagues and family members, military veterans, and our friends — might be too proud to ask for help. Too often, homelessness ends in tragedy.

Social Security provides services to the homeless and you can find these services at www.socialsecurity.gov/ homelessness. Those who are homeless can apply for benefits and, if they are eligible, their benefits can be deposited directly into a personal banking account, a direct express debit bank card or another electronic account. They

Q&A Q: I suspect that someone I know is collecting Social Security disability benefits when they shouldn’t be. What is the best way for me to report fraud?

A: Social Security has zero tolerance for fraud and uses many proven tactics to prevent fraud, waste and abuse. Our office of the inspector general is relentless in its pursuit of people who conceal work activity while receiving disability benefits. We investigate and seek prosecution for people who receive benefits for a child or children who aren’t under their care or who fail to notify Social Security of the death of a beneficiary and continue to receive and cash checks of the deceased. We also depend on you to help stop fraud.

Please report fraud online at http:// oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800-269-0271.

Q: I haven’t received my Social Security Statement in the mail the last few years. Will I ever get one again?

A: In September 2014, Social Security resumed mailing Social Security Statements to workers aged 25, 30, 35, 40, 45, 50, 55, and 60 who aren’t receiving Social Security benefits, and who don’t have a my Social Security account. Rather than once every five years, those over age 60 will receive a statement every year. Instead of waiting to receive a mailed statement once every five years, we encourage people to open a my Social Security account at www.socialsecurity.gov/myaccount so they can access their statement online, anytime.

IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

can also have benefits mailed to a third party or, if necessary, a representative payee can receive their funds.

Social Security also collaborates with other agencies to help the homeless. At www.socialsecurity.gov/ homelessness/collaborations.htm, you can read more about the health care for the homeless program that provides grants to a network of local public and nonprofit private organizations. Social Security also participates in the Federal Interagency Reentry Council, as well as the Projects for Assistance in Transition from Homelessness (PATH) program.

PATH helps people with serious mental health issues or people who are homeless or at risk of homelessness.

Every day, and especially on Dec. 21, remember those living without a place to call home. Homelessness is a complicated and emotional issue, but we can help our brothers and sisters — friends and family — access the safety net that Social Security provides. Visit www.socialsecurity.gov/homelessness to learn more.

Q: Why is it so important that my baby have a Social Security number?

A: Your child may need a Social Security number if you are planning to open a bank account, buy savings bonds, obtain medical coverage or apply for government services for the child. Your child will also need a Social Security number if you are going to declare him or her on your taxes. Getting a Social Security number for your newborn is voluntary, but it is a good idea to apply when your child is born. You can apply for a Social Security number for your baby when you apply for your baby’s birth certificate. The state agency that issues birth certificates will give us your child’s information and we will mail you a Social Security card with the child’s Social Security number.

Q: I am about to retire, but I still have a young child in my care. Will I receive additional benefits for the child I care for?

A: When you qualify for Social Security retirement benefits, your children may also qualify to receive benefits. Your eligible child can be your biological child, an adopted child or a stepchild. In limited circumstances, you may also get benefits for a dependent grandchild. To receive benefits, your child must be: unmarried; under the age of 18; between 18 and 19 years old and a full-time student (no higher than grade 12); or 18 or older and disabled from a condition that started before age 22. You can read more about planning for a disabled child’s care here: www. socialsecurity.gov/retire2/yourchildren.htm.

H ealth News OB-GYN now delivering at Mount St. Mary’s

Daniel Burns, an OB-GYN, has announced he is now delivering babies exclusively at Mount St. Mary’s Hospital in Lewiston. With an office at 7220 Porter Road in the Town of Niagara, Burns joins a team of OB-GYN at the Center for Women at Mount St. Mary’s that includes physicians Mark Weissman, Sharmilee Thota, Faraj Touchan, Rachel Weselak and Judy Wesolowski. All are board Burns certified by the American Board of Obstetricians and Gynecologists.

The Center for Women at Mount St. Mary’s is in the midst of a $2 million renovation.

Practice now offers mini implants for dentures Alltown Dental is now offering mini dental implants to those denture wearers who are not happy with the way their full dentures fit.

By using these type of implants to stabilize dentures, wearers will no longer need to worry about their dentures coming loose when they eat. According to Alltown, the method gives people a long term solution for a reasonable fee.

The mini dental implant process is very simple. After a small amount of dental anesthesia is placed, a mini dental implant is secured to the jaw bone by placing a pin hole in the bone and inserting the dental implant gently by hand. Next the denture is fitted with a snap that attaches to the implants and gives dentures security. After the mini dental implant placement, there is no need for denture adhesives and wearers can still remove their dentures for hygiene.

For more details and pricing, please call Alltown Dental at 716-6885046. Consultation and X-rays are always free of charge and financing options are available.

Haberstro appointed to national walking group Philip Haberstro, executive director of the Wellness Institute of Greater Buffalo & WNY, has been appointed to the planning team for America Walks!

National Walking Summit.

In 2015, the National Walking Summit will convene multiple sector allies to increase walking and make America’s communities more walkable.

In addition to his work with the Wellness Institute, Haberstro is the incoming president of the Buffalo Sunrise Rotary, member of the Explore Buffalo Strategic Plan Committee, and leader of more than 50 walks annually in Western New York.

The past years’ Wellness Institute

rograms totaled more than 10 million steps taken by participants on walks in Erie County.

America Walks, a nonprofit national organization, is building a diverse coalition to be a strong voice to advance and protect walking at Haberstro the national level serving as a coordinator, information clearinghouse, and resource provider; America Walks advances game-changing campaigns with national and local partner organizations. The mission of America Walks is to make America a great place for walking by working collaboratively to share knowledge, advance policies and implement effective campaigns to promote safe, convenient and accessible walking conditions for all.

New staff announced at Evolution Dental Science Cheektowaga-based Evolution Dental Science announced that John (Johnnie) Orfanidis, a certified dental technician, has joined the practice and will oversee all the digital aspects of Evolution Dental, the leader in digital dentistry, production.

“I am humbled that Johnnie has decided to join our team and move to WNY,” said Andy Jakson, president Orfanidis of Evolution Dental Science.

Until recently, Orfanidis worked in Boston, where he owned Orfan Dental Laboratory, a full service lab and research facility. A graduate from George Brown College in Toronto, he is also an instructor at Tufts University School of Dental Medicine. With over 30 years of experience, Orfanidis is a former research associate at Tufts University School of Dental Medicine, and lectures internationally. He is a published author and consultant to several dental product manufacturers.

Orfanidis is joined by two other returning Buffalo natives: Ken Jones, Colin Chiarmonte and Vinnie Murphy.

Murawski is the new transplant boss at ECMC Phyllis Murawski has been appointed as transplant administrator for the Regional Center of Excellence (COE) for Transplantation & Kidney Care at Erie County Medical Center (ECMC) Corporation.

“After working with the Transplant Leadership Institute to conduct a national search, Phyllis Murawski, who previously served in an interim leadership capacity since August of 2014, was identified as the strongest candidate to

Candace Johnson, CEO and Cancer Center Director at Roswell Park Cancer Institute, center, with physicians Andrew Bain, left, and Samjot Dhillon, co-chiefs of endoscopy, at the Nov. 13 ribbon-cutting for RPCI's new Endoscopy Center.

New Roswell Park Endoscopy Center is First of its Kind in Region Roswell Park Cancer Institute (RPCI) recently unveiled a new endoscopy center, a multipurpose clinical space that brings together advanced endoscopy and interventional pulmonology services into one state-of-the-art facility. The new center, designed for optimal patient safety and comfort, was built to meet increasing demand for minimally invasive endoscopic procedures used for diagnosis, staging and treatment of malignant and nonmalignant gastrointestinal and pulmonary conditions.

Endoscopic procedures use a thin, camera-equipped tube — an endoscope for gastrointestinal procedures and a bronchoscope for pulmonary procedures — to see inside the body, without surgery, resulting in less trauma, faster recovery and reduced risk for complications.

RPCI is a high-volume center for endoscopic ultrasound, performing 800 a year; and for bronchoscopic ultrasound, performing 400 a year.

In addition, RPCI is the only regional facility to offer several advanced oversee our transplant program and move it forward,” said Richard C. Cleland, president / chief operating officer and interim chief executive officer, ECMC Corporation.

Recognized for inspiring employees to succeed while working toMurawski ward unified goals, Murawski is an experienced instructor and skilled communicator who has proven to be a team builder.

“Phyllis has proven to be a strong leader and valuable asset. She worked closely with our transplant physicians and staff to assure the reopening of our Living Donor Program,” said Mary L. Hoffman, senior vice president of operations at ECMC Corporation.

December 2014 •

interventional options, such as photodynamic therapy, double-balloon enteroscopy, autofluorescence bronchoscopy, medical pleuroscopy and more. More than 90 percent of procedures are done at RPCI on an outpatient basis.

“Roswell Park’s new Endoscopy Center combines the latest technological tools with the expertise of some of the only fellowship-trained interventional pulmonologists and advanced GI endoscopists in the country,” says Candace S. Johnson, Cancer Center Director and President and CEO of RPCI. “Bringing these resources together creates a center of excellence where we can provide less-invasive procedures, a better experience and better outcomes for our patients.”

The new facility more than doubles the size of RPCI’s previous endoscopy center, which operated at full capacity. The new center boasts five larger, fully equipped treatment bays, better accommodating physician collaboration.

Murawski joined ECMC in February 2014, as assistant vice president of critical care and emergency services. She previously held transplant positions as vice president of clinical services at Unyts (2012-2014) and director of medical surgical nursing and transplant administrator at Kaleida Health (2008-2012).

Murawski earned a Master of Science degree in executive leadership and change and a Bachelor of Science in nursing from Daemen College; and an Associate of Applied Science in nursing at Erie Community College.

Murawski is a member of the WNY Organization of Nurse Executives and treasurer of American Legion Auxiliary Post 410 B. Leo Dolan.

The Gates Vascular Institute’s cardiac surgery team has again achieved a

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Page 17

Book explores odd piece of healthcare history in Upstate New York ‘The Great Tonsil Massacre’ explores an effort by the Rochester medical community in the 1920s to prevent mental illness by removing children’s tonsils

By Deborah Blackwell

W

hen Teresa (Terry) Lehr, a former archivist at Rochester General Hospital, uncovered a little piece of local history begging to be told, her fascination with historical healthcare kept her searching for more.

In her upcoming book, “The Great Tonsil Massacre,” Lehr examines a curious and rather risky public health project that occurred in Rochester between 1920-21.

The informative and somewhat humorous story describes an undertaking by community leaders to have children’s tonsils removed in an attempt to allegedly make every child in Rochester “healthier and happier.”

This endeavor was under the assumption that to not remove the tonsils could possibly give rise to a child’s mental deficiency.

Nearly 10,000 children (9,821 to be exact) had their tonsils removed between 1919 and 1921.

The 100-page novella uses fact and fiction to explore both cultural and ethical motives around removing children’s tonsils, while illustrating economic and social challenges that individual families may have faced during this peculiar effort by leaders of the city.

The story is told through the eyes of a family who must answer the many questions that parents face when considering the health and well being of their children. The decision becomes especially difficult for them, because they are bombarded by community-wide propaganda and pressure in support of the clinics.

“There were many things at RGH [Rochester General Hospital] I found fascinating, although I had never heard of them,” says Lehr. “I went to the

George Eastman House and looked at the scrapbooks, because I did not understand the thinking on how a physical thing like having tonsils could make someone mentally deficient.”

The project became one of curiosity and love for Lehr, whose extensive travels backward in time began to reveal interesting facts layer by layer.

She uses fictionalized characters in the book to uncover the various layers of this unusual story, but the settings and the historical events are based on extensive research in local archives and newspapers.

She believes that finding the answers to the many questions revealed during a public health initiative can reveal the heart of a family, an institution, and a community.

“When I am doing a research project it becomes like a compulsion.

It’s a path of discovery,” says Lehr, “I am fascinated with the questions these events raised, and some of the motives for the leadership were actually putting Rochester on the map.”

The epilogue covers the historical piece of the tonsil health project, and the use of both fictional and non-fictional elements throughout the book allowed Lehr to reconstruct the historical account, and may help the reader understand its significance. Adding fiction to a historical book is new for Lehr, who wanted to try her hand at it, as well as entice fictions readers into reading nonfiction and vice versa.

“It’s a historic story, but to get into the unreported, undocumented affects of the events on the individuals that are part of this story, I had to use fiction,” says Lehr. “Fiction was essential to it. I have tried to be as objective as possible so people can make some decisions

about whether the community leaders were right or wrong.”

Some of the information she presents prompts readers to ask, why did local medical authorities, industrialists, and businessmen want to establish and endorse affordable tonsil and adenoid clinics?

Why did no citizens seem to question the wisdom of holding a tonsil and adenoid removal clinic in the middle of winter and during a raging epidemic of diphtheria? And what might have happened within the families of children whose parents resisted this risky project?

“It’s compelling reading, with excellent descriptions, realistic dialogue, and an intriguing storyline that makes me want to read more,” says Almeta Whitis, a storyteller, writer and educator from Rochester. “The book is impeccably researched and reads like a detective mystery.”

Lehr is no stranger to writing, documenting historical fact, and sharing that with others. She spent most of her career as an educator, first teaching junior high school, then at SUNY Brockport, teaching non-fiction writing and

Teresa Lehr of Penfield, designed the cover of her book “The Great Tonsil Massacre,” using a scan of an illustration from a 1902 edition of Otto Zukerkandi’s “Atlas and Epitome of Operative Surgery.” research, English, and literature courses. She has a master’s degree in English and one in history. She also spent years writing articles, designing exhibits, and giving presentations about Rochester General Hospital’s history and how the larger community has responded to epidemics and other crises. “The Great Tonsil Massacre” is her first novella.

“The topic of inoculations, healthcare, and sickness is so current right now,” says Lehr. “And this relevant story is 100 years old.”

How to Get the Book

The Great Tonsil Massacre will be available this November on Amazon, and CreateSpace in both digital and paperback formats. For more information about Teresa Lehr’s other publications and presentations, please contact her via email: tklehr@frontier.com.

Experts:

Tonsils Should Stay In S

o what do modern health care providers think about the routine and unnecessary tonsillectomies and adenoidectomies of the past? The physicians at Buffalo ENT Specialists, LLP in Williamsville weighed in.

“Prior to the advent of antibiotics, prophylactic tonsillectomy was performed to avoid rheumatic fever and the serious and long-term cardiac consequences.

“When antibiotics became widely available and the incidence of rheumatic fever was significantly decreased, the practice of prophylactic tonsillectomy is no longer performed.

“The current indications for tonsillectomy are available through the American Academy of Otolaryngology/Head and Neck surgery.

“It is interesting to note that rheumatic fever has had periods of recurrence over the past few decades, perhaps related to patients who do meet current indications for tonsillectomy being reluctant to have it performed.”

Sue Vernna, assistant to physician Sayeed Nabi Page 18

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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • December 2014

of Ear, Nose Throat Care of NY in Williamsville, also commented.

“Unless the tonsils are chronically diseased or obstructing the throat, they should stay in. It’s a very painful surgery.

“Dr. Nabi takes a conservative approach to first treat infected tonsils with medication. Infected tonsils may require antibiotics. Back in those days when tonsils were removed preemptively, they didn’t know what else to do if there was a problem. And they didn’t understand the purpose of the tonsils. Just like they used to do bloodletting, they removed tonsils when they really didn’t have to because they didn’t know any better.

“Unless a patient is experiencing more than three infections a year and antibiotics aren’t helping, a tonsillectomy is unwarranted. I’ve been assisting Dr. Nabi for 36 years and these kinds of infections or an obstruction don’t happen overnight.”

Interviewed by Deborah Jeanne Sergeant

Decoding the Medical Professions

MD, NP, PA, LPN, DPM — with so many acronyms, some not familiar with the industry may be at loss

By Jennifer Fecio McDougall

“The RN will be here in a moment.”

“I’d like you to talk to our NP about that.”

“I think you should see a DPM for that condition.”

T

here’s a lot of information to process during a hospital stay or even a doctor visit. Sometimes, even the terms for the medical personnel who provide treatment can be confusing. What is an LPN and how is that different from an RN? How about an NP? What’s a DPM? What does MD actually mean? What does a PA do?

RN (Registered Nurse) and LPN (Licensed Practical Nurse) Many people are familiar with RN, which stands for registered nurse, but how about LPN? That one stands for licensed practical nurse.

Susan Lombardo, associate dean of the school of nursing at Trocaire College in Buffalo explains that a registered nurse has a greater degree of autonomy to care for patients in a variety of settings, including acute care units, intensive care units, and clinics.

She notes that an RN may start IVs, administer medications, change dressings and perform other duties necessary to provide the best possible care to the patient.

LPNs are not required to receive as much education as RNs, so LPNs typically work under the auspices of registered nurses, Lombardo says.

“LPNs are helpful in providing good, quality, patient-centered care to vulnerable groups,” says Lombardo.

She describes them as critical to the healthcare team and notes that their specific duties depend on where they are working. In addition to administering medications and changing dressings, LPNs may also take care of tube feedings, Lombardo says. She notes that they may also be in charge of nursing home units.

Lombardo explains that RNs and LPNs earn their nursing titles by passing New York State exams. The exams are known as boards.

PA (Physician Assistant) Tricia DiFranco considered going to medical school and becoming a doctor, but she chose to become a physician assistant instead. She explains the typical educational background for a

PA is a four-year undergraduate degree in a health or science field, followed by a masters degree in physician assistant studies.

“The physician assistant’s scope of practice is limited by the scope of practice of the supervising physician,” DiFranco explains. She is a PA at Rheumatology Consultants of Western New York in Buffalo so the scope of her practice is limited to rheumatology.

In this role, she sees patients, gives injections, participates in procedures, and diagnoses patients.

DiFranco enjoys helping the community and caring for patients, but she also appreciates the work-life balance her job provides. After helping people with their rheumatology issues, “I get to go home and focus on family life,” she explains.

NP (Nurse Practitioner) After working as a registered nurse for 16 years, Laurie Danieu Schmidt went back to school, obtained her master’s degree in nursing, and became a nurse practitioner. As an RN, she provided inpatient care for acutely ill patients, and as a nurse practitioner, she is able to diagnose and treat patients.

Today, Danieu Schmidt works in a weight loss clinic preparing patients for weight loss surgery and caring for them postoperatively. “I assist people who wish to be proactive about their health, often resolving or minimizing their risk of serious health issues, such as diabetes, hypertension, and sleep apnea,” she explains. “It is very rewarding to see their health improve after weight loss surgery,” she says.

MD (Medical Doctor) When an individual decides to go to medical school, that is the first of many decisions. What comes after that?

A specialty, such as cardiology, neurology or orthopedics? Family practitioner, geriatrician, pediatrician? Add another degree along the way?

For physician Margaret Eberl, her four years of medical school were just the beginning. She did a residency in family medicine for three years, a residency in general preventive medicine for two years, and a fellowship focusing on health disparities with the

National Institutes of Health for two years. During the residency in general preventive medicine, she earned a master’s degree in public health (MPH).

Today, Eberl provides long-term care to residents of skilled nursing facilities. She also provides care to patients in the sub-acute setting. This includes patients who are transferred to the facility after a hospital stay that may or may not have included surgery.

In this case, she often cares for patients who have had elective hip or knee replacements. “I really enjoy this work as it is satisfying to help people recover from a surgery and get back to leading active lives,” Eberl explains.

DPM (Doctor of Podiatric Medicine) Puneet Chahal is a board-certified podiatric surgeon in private practice in Olean. After earning his undergraduate degree, he went to a medical school specifically for podiatry. This means that he studied a branch of medicine specializing in the foot and ankle.

As with other branches of medicine, podiatry requires two to four years of post-graduate training after medical school.

December 2014 •

In his private practice, Chahal sees patients of all ages, ranging from children to the geriatric population. He sees patients in his office several days per week to provide care for their foot complaints. In addition, he spends a day to a day and a half per week doing foot and ankle surgery in the hospital.

He cares for a variety of issues related to the foot and ankle, including diabetic foot infections, orthopedic foot problems, and congenital pediatric deformities.

Chahal explains that it’s rewarding to help people feel better. One of the best things, he says, is when someone who hobbled into his office in severe pain “can walk out with no pain. That doesn’t always happen, but it happens enough to make it worthwhile.”

Healthcare ABCs PA, NP, RN, MD, DPM, and LPN are a few of the letters patients may find on a caregiver’s nametag. During a visit to the doctor’s office, a stop at the lab for bloodwork, or a hospital stay, patients may come across these and other combinations. Unsure what they mean? Asking, “So, what exactly do you do?” is always acceptable.

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