in good Meet Your Doctor
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April 2017 • Issue 30
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Buffalo & WNY’s Healthcare Newspaper
Diseases
UB physician, Robert S. Miletich, is studying brain scans from 16,000 patients as a way to advance nuclear medicine techniques to better diagnose brain diseases, including Alzheimer’s, autism and Parkinson’s
That Kill Women the Most
Autism Research
What disease kills more women than any other? Breast cancer? Lung cancer? Ovarian cancer? Colorectal cancer?
Six ways to determine if the research on autism you read or hear is accurate
ALSO INSIDE 5 THINGS YOU NEED TO KNOW ABOUT MISCARRIAGE
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ECMC to Break Ground on New ER From Spreadsheets to Smoothies
Leaders at Erie County Medical Center plan to start construction of a new ER facility over the summer. It’s expected to be complete by 2019. The ER at ECMC is the busiest in Western New York. page 7
Jill Chiacchia goes from corporate world to career of food, facts and fitness
Career: Make $45,000+ with an Associate’s Degree
Cheddar Cheese
I adore cheese, most kinds, but the cheese I adore most is cheddar. And the reason my heart cheers for cheddar is because it’s a nutritional superstar, packed with protein, calcium and phosphorous. Read more in SmartBites.
Fat Cats, Fat Dogs You’ve guessed: More than half of dogs, cats in the Land of Plenty weigh too much, says CDC
Fat Cats, Fat Dogs
FDA: More than half of dogs, cats in the Land of Plenty weigh too much
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merica’s weight problem extends to its pets, with a majority of cats and dogs dangerously overweight, a federal government veterinarian warns. “Just as obesity has become a serious problem in people, it’s also a growing problem in pets, one that can seriously harm your pet’s health,” said veterinarian Carmela Stamper, of the U.S. Food and Drug Administration’s Center for Veterinary Medicine. About 58 percent of cats and 54 percent of dogs in the United States
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are overweight, according to a 2015 survey by the Association for Pet Obesity Prevention. “The diseases we see in our overweight pets are strikingly similar to those seen in overweight people,” Stamper said in an FDA news release. These include life-shortening conditions such as Type 2 diabetes, high blood pressure, osteoarthritis, heart and respiratory disease and kidney problems, she noted. So, what exactly signals obesity for Fido or Kitty? In general, 20 percent over ideal
body weight is obese. And Stamper said age, breed, body type and metabolism can help tip the scales. “In dogs, some breeds seem more inclined toward obesity than others,” Stamper said. Labs, beagles and long, low dogs such as dachshunds and basset hounds are some examples. Although America’s cats are also fattening up overall, veterinarians say no specific feline breed is prone to pudginess. Stamper outlined some ways to determine if your pet is at a healthy weight. Look at your pet from above
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
to see if it has a definite waist. “If not, and her back is broad and flat like a footstool, she is likely overweight,” Stamper said. Run your hands along your pet’s side. Can you easily feel the ribs, or do you have to push hard to feel them? Check your pet’s abdomen/ stomach. If you can easily grab a handful of fat, that’s a sign your pet is overweight. If you’re concerned about your pet’s weight, or want to know how to keep your pet at a healthy weight, talk to your veterinarian, Stamper said.
MUST SEE
AT LEAST ONCE in YOUR LIFETIME
Connecting Heaven and Earth ALL-NEW SHOW WITH LIVE ORCHESTRA
“A gift for this planet.” - Georgian veteran journalist Helena Apkhadze
“
I’ve reviewed about 4,000 SHOWS. None can compare to what I saw tonight.” —Richard Connema, renowned Broadway critic
“Absolutely the NO.1 SHOW in the world. ... No other company of any style can match this!”
“5,000 Years of Chinese music and dance in one night !”
—Kenn Wells, former lead dancer of the English National Ballet
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“Demonstrating the highest realm in arts.”
“Awe-Inspiring Sensation!”
—Chi Cao, lead actor in Mao’s Last Dancer
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“Absolutely the greatest of the great!
“A MUST-SEE!”
It must be experienced.”
— Broadway world
—Christine Walevska, “goddess of the cello”, watched Shen Yun 5 times
“The highest and the best of what humans can produce.” — Oleva Brown-Klahn, singer and musician
“The 8th wonder of the world. People have no idea what they're missing until they come here and see the show.” —Joe Heard, former White House photographer, watched Shen Yun 6 times
ORDER TODAY! TICKETS SOLD OUT IN MANY CITIES ACROSS THE COUNTRY. MAY 5–6
Shea’s Buffalo Theatre 646 Main St., Buffalo, NY 14202
May 5, Fri 7:30pm May 6, Sat 2:00pm May 6, Sat 7:30pm
Tickets ShenYun.com/Buffalo Hotline: 877-519-0905 Ticketmaster: 800-745-3000 E-mail: Buffalo.SY@gmail.com April 2017 •
Prices: $73 - $153
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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CALENDAR of
Help and Healing on the Spiritual Path Teachings of Bruno Gröning
HEALTH EVENTS
Lectures by an MD : ROCHESTER : April 25, 2017 – 7-8 :30 PM Assisi Institute, 1400 N. Winton St., 14609 BUFFALO: April 26, 2017 -- 8 :30-10 PM
April 25
Complete Wellness Arts & Science Center, 1515 Kensington Ave, 14215
Series to offer seniors latest in travel trends
Two documentary films shown in Buffalo/Rochester April through June : The Phenomenon Bruno Gröning and The Phenomenon of Healing For more details : www.bruno-groening-film.org www.northamerica.bruno-groening.org
Change Two Lives... Yours and a Child’s
Become a Foster Parent Today
Visit us at berkshirefarm.org or call (716) 862-4212 to learn how you can be a hero in a child’s life D’YOUVILLE STUDENT VETERANS ASSOCIATION PRESENTS
LAPS FOR LIMBS 2017 WNY LAPS FOR LIMBS COMMUNITY EVENT
APRIL 27-30 FRONT PARK 121 PORTER AVE • BUFFALO, NEW YORK • 14201
JOIN US
WALK, RUN, OR ROLL TO BENEFIT CHILDREN AND VETERANS WITH AMPUTATIONS IN WESTERN NEW YORK PRE-REGISTRATION IS AVALIBLE ONLINE AT LAPSFORLIMBS.ORG
OPENING CEREMONY SUNDAY, APRIL 30 • 08:30
FEATURING AMERICAN VETERANS TRAVELING TRIBUTE VIETNAM WALL OPENING CEREMONY APRIL 27 • 12:00
GRIT ‘N’ WIT OBSTACLE COURSE APRIL 29 & 30 10:00 - 17:00
INTERESTED IN PARTICIPATING? REGISTER, VOLUNTEER OR DONATE AT
LAPSFORLIMBS.ORG
Asbury Pointe Retirement Community has once again teamed up with AAA Western and Central New York to offer a program geared toward seniors on the go who want to know about the latest in travel trends and opportunities. The fourpart “Savvy Senior Travel Series” begins in April and runs through January, and is free and open to the public. AAA’s top travel experts and travel industry vendors will be on hand to talk about everything from cruises, land tours, handy travelrelated items to traveling solo and more. The first event in the series, “Alaska, Land of the Midnight Sun” will take place on from 10 to 11:30 a.m., April 25, in the Asbury Pointe Theatre Room, 50 Stahl Road in Getzville. Seating is limited and reservations are recommended. Those interested should call 716-8107500. The additional sessions will take place on July 25, Oct. 10 and Jan. 25, 2018. Light refreshments will be served. Tours of Asbury Pointe apartments will be offered after each session.
April 26
Doctor presents ‘There is No Incurable” lecture Daniela Dentico, a physician of the Medical Scientific Group (MWF) of the Bruno Groening Circle, will speak about a new path of health of body and soul during an event that will take place at 7 p.m., April 26, at Complete Wellness Arts & Science Center, 1515 Kensington Ave., Buffalo. Titled “There is No Incurable,” the lecture is part of a series of lectures sponsored by the group that discusses holistic and natural healing. All individuals from medical professions, those interested in holistic and natural cures, and those searching for help and healing are welcome. Admission is free. Donations are appreciated. In addition to the lecture, organizers will show the documentary “The Phenomenon of Healing” and “The Phenomenon Bruno Groening.” For more information, send an email to deborahorose333@gmail. com, visit www.facebook.com/ BrunoGroeningCircleofFriends or go to www.northamerica.brunogroening.org.
April 27 thru April 30
WNY Laps for Limbs to benefit local amputees The D’Youville Student Veterans Association is planning the Sixth Annual WNY Laps for Limbs event designed to raise awareness and monetary assistance for amputees and their families. Participants sign up to run, Page 4
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
walk or roll as many laps as possible during a specified time slot. Each participant recruits sponsors, either per lap or for a flat donation. All funds raised will be shared equally between two recipients: Camp No Limits, which is a camp specifically designed to serve children with amputations, and the Amputee Treatment Center, owned and operated by a Vietnam veteran, which serves WNY amputees and veterans. The four-day weekend event will kick off at noon March 27 at Front Park,121 Porter Ave., Buffalo, and will conclude at 2 p.m. April 30. Vendors, food trucks and other special activities will also take place. The event will feature the following activities: The Traveling Vietnam Wall, Grit & Wit Obstacle Course, and Laps for Limbs. Since the inception of the D’Youville Veteran Affairs Office in 2009, the college has consistently ranked in the top five veteran friendly colleges. D’Youville currently serves more than 650 veteran-and military-aligned students. According to Military Times, it is “Best for Vets College 2017.” For more information, call D’Youville Student Veterans Association at 716-829–7582 or email veterans@dyc.edu. To register, visit lapsforlimbs.org.
April 29
Clarence basket raffle to help Meal on Wheels The Clarence Senior Center will sponsor a basket raffle that will feature more than 150 baskets. A portion of the proceeds will supportMeals on Wheels of Clarence / Newstead and Rural Transit Service. The event will take place from 11 a.m. to 3 p.m. at the center, 4600 Thompson Road in Clarence. Admission is free and drawing will start at 2 p.m. New this year is a pre-sale event on April 26 though April 28. For information, call 716633-5138 or email shannon.winney@ clarenceseniorcenter.org.
May 5
Children Awaiting Parents marks 45 years Children Awaiting Parents (CAP)’s annual Derby Party will mark 45 years of finding homes for waiting foster children during an event from 6 to 10 p.m., Friday, May 5, at the Rochester Riverside Convention Center. The event — CAP’s Kentucky Derby style gala — will feature CAP’s version of a horse race game, silent auction, live music, dancing, mint juleps, and a sit-down dinner. For more information and registration, visit www. ChildrenAwaitingParents.org, email david@capbook.org or call 585232-5110. Cost to attend is $100 per person.
Have Americans Given Up on Losing Weight? Study finds more are overweight, obese than two decades ago, but fewer are trying to shed pounds
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ore Americans are overweight or obese, but many have given up on trying to lose those excess pounds, a new study shows. One in every three people in the United States is now obese, compared with one in five 20 years ago, researchers report. But people surveyed between 2009 and 2014 were 17 percent less likely overall to say they’d tried to lose weight during the previous year than those surveyed between 1988 and 1994, the study found. People who were overweight but not yet obese have experienced the greatest loss of interest in maintaining a healthy weight, said senior researcher, physician Jian Zhang. “This is not good. We are missing the opportunity to stop overweight
from becoming obesity,” said Zhang, who is an associate professor of epidemiology with Georgia Southern University. Zhang and his colleagues analyzed data from the U.S. National Health and Nutrition Examination Survey, a federally funded ongoing survey that keeps track of Americans’ health and diet habits. All racial/ethnic groups across both genders reported decreased interest in weight loss, but women in particular were more likely to say they’d given up on it, the findings showed. By 2014, black women were 31 percent less likely to have tried to lose weight compared with two decades prior, and white women were 27 percent less likely to have made the attempt, the researchers found.
People might be giving up on weight loss because it’s just too difficult, Zhang said. “It’s painful,” he explained. “It’s hard to drop pounds. Many of us tried and failed, tried and failed, and finally failed to try anymore.” Modern medicine also has gotten better at preserving the overall health of overweight people, perhaps causing them to ask why they should bother, Zhang continued. “There’s increasing evidence that adults with overweight may live as long as and sometimes even longer
than normal-weight adults, making many question whether you have to take it seriously,” Zhang said. “In clinical practice, we consider treatment of overweight only when patients have two or more additional risk factors,” such as high blood pressure or high cholesterol. It’s also possible that overweight has become the new normal. “Today, we believe that majority are right,” Zhang said. “As more than half of people are overweight, we simply think we are fine, and there’s no need to do anything with body weight.”
Healthcare in a Minute By George W. Chapman
Social media.
Social media (SM) is having more and more of an impact on consumers and their behaviors every year. 40 percent say information gleaned from SM affects how they deal with their health. 19 percent of smartphone owners have at least one health related app. 41 percent of us say SM influences our choice of providers and hospitals. 30 percent of healthcare professionals use SM for networking. When it comes to sharing health info via SM, 43 percent of us are comfortable sharing with hospitals, 47 percent with physicians, 38 percent with insurers and 32 percent with pharmacies. 60 percent of physicians report SM actually improves the quality of health in their patients.
Dementia & Sleep
46 million people worldwide suffer from some sort of dementia. In the US, 5 million people have Alzheimer’s disease. One in three seniors will die from dementia complications. Dementia costs us about $236 billion a year. Researchers at Boston University School of Medicine found that people who sleep more than nine hours on average are twice as likely to develop dementia than those who sleep less than nine hours on average.
Telehealth
More and more insurance companies are paying for telehealth. The immediate benefits are easier access, enhanced doctor/patient communication and remote monitoring of incapacitated patients. It will take more time and experience to determine whether or not the increased utilization of physician services via telehealth is eventually outweighed by cost reductions in
other areas like inpatient care and drug utilization. A study published in Health Affairs followed three years of claims for respiratory infections. The study concluded that nine of 10 telehealth visits (for this condition) represented new or additional utilization versus visits that substituted for an in-person encounter. The authors of the study recommended insurers or even providers might want to increase patient out-of-pocket costs to prevent frivolous or unnecessary telehealth utilization and that telehealth might have more of a positive impact for those patients with traditionally undertreated conditions like diabetes and mental health.
Affordable Care Act
A bill to replace the ACA, called the “American Healthcare Act,” has just passed the Ways and Means committee in the Republican controlled House. The bill would: eliminate many of the taxes that support expanded Medicaid and the premium subsidies on the exchanges and replace them with consumer tax credits, provide block grants to the states for Medicaid, and discontinue the individual mandate requiring all to have insurance or pay a penalty. The bill would continue, however, the basic cornerstones of the ACA: allow children to remain on a parent’s plan until age 26, no lifetime monetary caps on illnesses, and insurers cannot deny coverage for pre-existing conditions. Rather than going through a disruptive and highly political repeal and replace process, many industry observers wonder why the changes proposed in the new bill were not simply introduced in Congress, over the last six years, as amendments to the ACA. The insurance lobby (AHIP) has expressed approval of some of
the changes, but it has expressed concern about the potential decline in coverage and the negative impact on our most vulnerable populations. The American Medical Association flat out will not support the new bill. The hospital lobby says the probable increase in the uninsured will cost hospitals billions. Washington observers and healthcare policy experts believe the bill, as written, will not garner enough support in the Senate. The Congressional Budget Office still has to determine if the new bill’s numbers add up. The CBO has estimated that 15 million people could lose their insurance.
Mega merger drama
Critics of the ACA have maintained many consumers really don’t have choices because one in three markets has only one insurance company left on the exchange. Consequently, consumers, physicians and hospitals could potentially be at the mercy of monopolistic pricing. Insurance companies maintain that mergers (resulting in less choices) will allow them to reduce costs and increase efficiencies which would benefit the consumer. The Department of Justice isn’t buying that and has blocked the mega merger of Anthem and Cigna, the second and third largest commercial insurers in the nation. Incredibly, Cigna is now suing Anthem to end the merger agreement and for damages. Anthem has countersued. The AMA has expressed its strong concern over the possibility of politically driven settlement negotiations between Anthem and the DOJ that could result in Anthem closing the deal with Cigna.
Accountable Care Organizations
ACOs were established by the ACA to cut costs and improve
April 2017 •
access and quality. More than 850 ACOs across the country care for over 28 million people. Hospitals, physicians and insurers have been collaborating the past six years. The majority of ACOs participate in shared savings programs with Medicare and commercial insurers. Industry experts are confident ACOs will survive any changes in the laws of the land.
Obesity
In a study published in Cell Metabolism, researchers found that a dopamine deficit may be the major cause of physical inactivity which has often been blamed on obesity. Lab mice were divided into two groups. The first group was fed low-fat food while the second received high-fat food. The mice on the high-fat diet naturally gained more weight, but researchers noted all mice were inactive — due to low dopamine levels — to start. So weight gain itself did not lead to inactivity in these mice.
Really?
And finally this. “Nobody knew that healthcare could be so complicated.” President Donald Trump, Feb. 27, 2017. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ gwchapmanconsulting.com.
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Meet
Your Doctor
By Chris Motola
Robert S. Miletich, M.D. UB researcher working to advance nuclear medicine techniques to better diagnose brain diseases, including Alzheimer’s, autism, Parkinson’s. He’s studying brain scans from 16,000 patients Q: Can you give us a brief overview of what nuclear medicine is? A: Nuclear medicine is the use of radioactive drugs for treatment and diagnosis of different disorders. At this point, nuclear medicine test exists to study every single organ system in the body. It’s established medicine that every hospital does, or should be doing. The most common test is looking at blood flow to the heart for the diagnosis of coronary heart disease. What I’m involved with is the development of a field that uses nuclear medicine techniques for the diagnosis of brain disorders. This is complex because the brain is the most complex organ in the body and there are many different kinds of illnesses that can cause the same symptoms. So the number of potential illnesses and diseases for any particular system is pretty wide. I’m an expert in that and have been doing that for 30 years, but it hasn’t really gotten off the ground in the United States due to the complexity. So it’s a mission of mine to help develop nuclear neurology by helping to train young physicians in how to do it. Q: Was there a turning point that made nuclear neurology seem more practical? A: Honestly, it’s mostly me. I’m getting to the end of my career and looking at the state of affairs and realized that, as I’m not planning to work until I die, I should probably start training some young physicians in it. There’s also greater availability of new kinds of drugs that target the processes I’m looking at. Nuclear neurology uses a couple different imaging techniques. We had PET scans way back when, but we mostly only used them for research until about 20 years ago. In the early 1990s, there was a drug released that allowed us to look at brain blood flow. So, I’ve been using that drug since then. More recently, the FDA approved the use of three or four compounds to look at amyloids. Amyloid is said to be involved in Alzheimer’s disease. It’s a contemptuous issue, but the drugs can be used to diagnose Alzheimer’s. About five years ago, the FDA approved a drug that looks at dopamine and related neurons, which is useful when you’re looking at movement disorders, particularly Parkinson’s disease. It’s a constantly evolving field. As our understanding of cell biology develops, we develop new techniques for diagnosing Page 6
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illnesses based on observing problems in the cells. Q: Are Alzheimer’s and Parkinson’s the diseases it’s most useful in detecting? A: I routinely get referrals from doctors to diagnose just about any kind of neurological problems: dementia, Parkinson’s, strokes. Really, just about any disease process that affects the brain. These tests are particularly good at detection of neurodegenerative diseases. The most exciting thing for me is how early we can detect the disorders. We can then develop drugs to combat those illnesses before they do most of their damage. The problem has been that patients present with symptoms, but you don’t understand what disease they have. So, this testing will be increasingly important in developing new drugs by first providing accurate diagnosis. We haven’t had great biomarkers for a lot of these diseases. Nuclear neurology provides that opportunity, but it’s very complex and requires a lot of training.
neurodegenerative illnesses is that brain cells die. The field has kind of lost track of that. Q: Where do you think they’ve gone astray? A: The popular theory right now is called amyloid theory. It claims that amyloids cause the illness. There’s been billions of dollars spent on this hypothesis, but it’s been a complete failure. The drugs they’ve developed haven’t worked because the theory’s wrong. Some drug companies are still beating that dead horse. Now I’m not saying amyloid’s not involved, because you do see amyloid built up in the brain, and any kind of garbage that builds up is going to impede function, but it’s not the primary cause. It’s multifactorial. Decreased blood flow is also big component. So that’s just one example of what I’m currently focused on. Q: What other research are you working on? A: I’m working on research into cerebrovascular disease. I have seen that there’s a lot of vascular disease that isn’t even recognized in American citizens. It’s the disease of the small vessels. It’s not recognized because it’s almost microscopic in nature, but it’s causing dysfunction in the brain. So we’re trying to make people aware of this huge source of morbidity. Grandma may not be walking or thinking well because she’s suffering from small vessel disease that we’re not
Q: What have you learned about the mechanisms behind these diseases? A: I actually have a new theory of Alzheimer’s disease that comes from my imaging of patients with dementia. I call my hypothesis the stressed homeostasis hypothesis. Right now I’m engaged in pulling together my data to validate each of the different points in that hypothesis. What this hypothesis stresses is that the derangements within Alzheimer’s is a multi-factorial process where the individual nerve cells get stressed to the point where they die. The common factor for all
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
In the News
Robert S. Miletich, MD, PhD, interim chairman and professor of the Department of Nuclear Medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, is studying brain scans obtained from 16,000 patients. He says the wealth of information nuclear imaging techniques provide could pave the way toward a dramatic improvement in the clinical detection and treatment of many brain disorders. even aware of. I do not accept that aging is a condition associated with decreased function. With aging there are illnesses that get worse. Much of what we call normal aging is disease process. Q: Does it have applications for autism? A: I really haven’t studied autism, so I can’t comment, but there’s been some advances with autism with regards to brain imaging. I just haven’t been personally involved. Q: What are the challenges of creating this program? A: Institutional groundwork that allows me to do it, really. It’s having the opportunity to invite these young doctors in to share the opportunity with me. Whenever you want to do something new, you’ll encounter institutional inertia. That’s where I’m at right now.
Lifelines Name: Robert S. Miletich, M.D., PhD Position: Interim chairman and professor of the department of nuclear medicine at the Jacobs School at UB Hometown: East Moline, Ill. Education: University of Illinois Affiliations: Kaleida Health Organizations: Society of Nuclear Medicine and Molecular Imaging; American Academy of Neurology; American Society of Neural Imaging Family: Married, two children Hobbies: Wood working
Plans for the new ECMC emergency department call for a 54,000-sq.-ft. facility with 54 treatment stations, including four trauma rooms and two medical resuscitation rooms, compared to the current 34 rooms in 26,000 square feet. The department would be adjacent to ECMC building.
New ER at ECMC
Construction of a new ER at ECMC expected to start this summer, complete by 2019 By Tim Fenster
W
hen Western New Yorkers suffer the most horrifying, traumatic injuries, they are usually rushed to the same place — the emergency department at the Erie County Medical Center. As the hospital with the only Level 1 trauma center for adults, ECMC’s emergency department takes in Western New York patients with the most terrible injuries — victims of car wrecks, shootings, stabbings, high falls and serious burns. “Almost all the major trauma injuries tend to come to ECMC because we are the only adult trauma center in Western New York,” said physician Michael Manka, chief of emergency medicine at ECMC. “What that means from a patient care perspective is we have resources available to take care of our patients here at ECMC for trauma that other hospitals don’t have.” Those resources include a trauma surgeon on-call 24 hours a day in the hospital, a trauma team of surgical residents and all other specialties in trauma care — neurosurgeons, orthopedic surgeons, radiologists — just a phone call and short drive away. Not only does ECMC boast the only Level 1 trauma center, but it is also simply the busiest ER in all of WNY. Last year, the ED saw 69,290 patients, and Manka says they are on track to see even more patients for several years to come. Since 2010, ECMC’s ER visits have increased 20 percent.
Contributing factors
He attributes the rise to closures of other area ERs, an aging local population, more people having insurance after passage of the Affordable Care Act and a shortage of primary care doctors. It might also be from a cultural change, in which patients seek to have any care they need done in the shortest possible time. “Those are a handful of things. Trying to weigh what factor has had the most impact on rising emergency
department visits is very difficult,” Manka said. “Everybody has their theory.” To handle the increase, the hospital has boosted its staffing levels and added a “fast track” for patients with minor ailments that can be treated quickly. But those steps have only done so much to improve care and reduce wait times. The largest problem, Manka said, is the space itself is sorely outdated. The ER is still housed in its original space built in the late 1970s, and the ER has not seen a major renovation since 1996. The result is an ER that is at full capacity on a daily basis. When it overfills, patients are lined up on ambulance stretchers in hallways, where they have no privacy and where physicians cannot perform many examinations. “It’s really discouraging as a health care provider to have to take care of patients with serious complaints and problems in the middle of the hallway,” Manka said. That’s why ECMC is moving ahead on plans for an entirely new ER at the west side of the hospital, near an outdated ambulance ramp. Plans call for a 54,000-sq.-ft. facility with 54 treatment stations, including four trauma rooms and two medical resuscitation rooms, compared to the current 34 rooms in 26,000 square feet. Speedy, streamlined care will be a focus of the new space. It will include a care initiation zone with six stations where nurses can triage incoming patients, as well as indepartment X-ray and CT scan equipment. “The point of entry and streamlining the flow of patients into the department is going to be a big improvement over the state we currently have,” Manka said. The facility carries an estimated price tag of $58 million. ECMC is in discussions with the county over a borrowing plan to fund the project. Hospital administrators hope to start construction this summer and finish the facility in 2019.
Physician Michael Manka, chief of emergency medicine at ECMC, escorts a patient on gurney. “Almost all the major trauma injuries tend to come to ECMC because we are the only adult trauma center in Western New York,” he says.
ER VISITS Hospitals in Buffalo area with most annual emergency department visits. Hospital
Number of patients a year
ECMC
70,054*
Buffalo General Medical Center
55,860
Mercy Hospital
53,369
Women & Children’s Hospital
47,957
Sisters of Charity Hospital
42,087
* Number of visits include patients at ECMC Behavioral Health ER. Excluding those figures, ECMC ER had 58,054 visits
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6 Tips to Get Savvy on
Autism Research By Deborah Jeanne Sergeant
T
he prevalence of autism spectrum disorders is one in every 54 live births, according to the Centers for Disease Control. If autism affects your life, you likely home in on stories about it. Or well-meaning friends tag you about new autism research. Though widespread, autism remains little understood by the medical community. Because scientists have discovered little about what causes autism, it’s only natural for parents, grandparents, teachers Panzarella and others interested in autism to seek answers from perhaps less-than-accurate sources. Consider these tips for finding accurate information on autism. Turn to well-known, reputable organizations. “The CDC is a good place to start,” said Tracy Panzarella, director of clinical services with Autism Services, Inc. in Amherst. She is a licensed speech-language pathologist. “The Autism Society of America is also a great resource. They have some parenting resources as well. American Speech Language Hearing Association has information
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for both parents and professionals. They’re the accrediting body for speech language pathologists. They address the language piece of it. AOTA, American Occupational Therapy Association, is another good one. They have information for both parents and professionals.” Don’t drop current interventions to try something yourself at home. “Before you try anything, check with the pediatrician,” Panzarella said. Be wary of therapy that can harm the child physically or psychologically. Is it safe? Universally accepted? Will insurance cover it?” Take a wary look at research from a less-than-well-known research organization. Sound research should have a large group of participant’s number in the several thousand over a long period of time. A small, shortterm, local study can indicate skewed results. Anytime you hear phrases such as “cure your child’s autism” or any type of pigeonholing such as “every child with autism responds to this” consider those red flags. “Each child is unique a snowflake and responds to things
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HEALTHCARE CAREERS
Make $45,000+ with an Associate’s Degree Great opportunities in the health industry available for people who have only a two-year degree By Deborah Jeanne Sergeant
J
oining the health care field doesn’t require 12 years of training to become a medical doctor. Many good-paying, satisfying positions in health care require only an associate’s degree. These careers limit the amount of debt the student acquires as they’re attending classes only two years. Plus, many community colleges and smaller, less expensive institutions offer the coursework required. In addition, students uncertain of their career path invest only two years in their education. Some of these positions also may segue into provider positions with additional education. The annual mean wage and projected growth (through 2024) statistics are according to the Bureau of Labor Statistics, specific to Western New York.
Food Services Manager
The food services manager’s role includes working with dietitians, medical staff and social workers to meet patients’ dietary needs while in the hospital. It’s also a managerial role, involving working with staff that prepare and deliver meals. Page 8
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Food knowledge and good people skills combine in this career. Local schools offering a certificate in food services management include Erie Community College (www.ecc.edu). Annual mean wage: $50,170 Projected growth: 5 percent
Respiratory Therapist
Whether from an injury of lung illness or disease, patients seek the help of a respiratory therapist to improve their breathing. Like a physical therapy assistant, a respiratory therapist should relate well to people, record accurate information in patient charts and exhibit an ability to think creatively to help patients who struggle with completing their exercises. Many respiratory therapists work in hospitals. Erie Community College (www.ecc.edu) offers a certificate in respiratory therapy. Median annual salary: $59,870 Projected growth: 12 percent
Radiographers and MRI Technologist
At hospitals, outpatient clinics and independent diagnostic offices,
differently,” Panzarella said. “I watch out when I hear these big claims. Kids on the spectrum can amaze you, but that is one unique child’s experience. You can’t generalize.” Take a wary look at a small, shortterm, local study. “Look at the sample size of the population,” said Lawana Jones, founder and executive director of The Autism Council of Rochester, certified autism specialist and parent of a child on the autism spectrum. “Is it a complete representation of the data? What are some of the different elements of the data, like the race and ethnicity of the subjects? Ages? Make sure it’s a broad range of ages and sample size. If they don’t have a good sample size, it should make you wonder.” Anecdotes can sound very convincing because of the emotional element and personal information they contain, but they hold the least amount of weight. It’s not that parents of autistic children purposefully lie about their experience; however, many other factors may be involved which they have not considered. Or they may cite factors that have nothing to do with their child’s autism. “Reach out to a professional,” Jones said. “Most parents whose children are newly diagnosed, it’s by a professional who’s familiar with the spectrum. “Be careful of people who say they’re experts but have no credentials. Make sure they’re certified and check the source of the certification, not just people who know people on the spectrum or have a special education degree.”
4.
5.
radiographers perform diagnostic tests, including X-rays and MRI techs perform MRIs. People with empathy and attention to detail can fit well in these careers. Erie Community College (www.ecc.edu) offers certificates in radiation therapy technology. Median annual salary: MRI: $58,280; radiographer: $56,670 Projected growth: 9 percent
Echocardiography Technician
As its name denotes, an echocardiography technician helps people with heart problems. Specifically, they use imaging equipment to perform diagnostic tests physicians use to diagnose heart problems. “Soft skills” and ability to follow protocols can help cardiovascular technicians succeed. They usually work in hospitals or heart centers. Erie Community College (www.ecc.edu) offers a certificate in echocardiography. Median annual salary: $53,770 Projected growth: 24 percent
Medical Sonographer
Working in outpatient, hospital and physicians’ offices, the medical sonographer operates equipment used to perform diagnostic tests on organs and soft tissues. They can specialize in maternity, children, breasts or other areas. Trocaire College (www.trocaire.edu) offers a certificate in diagnostic medical sonography. Median annual salary: $66,020 Projected growth: 24 percent
Dental Hygienist
Dental patients often spend more time with their dental hygienist than the dentist. But they do far more than
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
What is Autism?
“
Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. ASD is defined by a certain set of behaviors and is a ‘spectrum condition’ that affects individuals differently and to varying degrees. There is no known single cause of autism, but increased awareness and early diagnosis/ intervention and access to appropriate services/supports lead to significantly improved outcomes. Some of the behaviors associated with autism include delayed learning of language; difficulty making eye contact or holding a conversation; difficulty with executive functioning, which relates to reasoning and planning; narrow, intense interests; poor motor skills and sensory sensitivities. Again, a person on the spectrum might follow many of these behaviors or just a few, or many others besides. The diagnosis of autism spectrum disorder is applied based on analysis of all behaviors and their severity. Source: Autism Society of America
“
Organizations selling information or 6. products may be the least reliable sources. That doesn’t mean their
ideas have no merit; however, their claims may be overinflated since they want to profit. “That is not a site they want to use as a source,” Jones said. just clean teeth. They also perform patient intakes, update charts, screen for a variety of oral health issues and take X-rays. Dental hygienists need a warm personality as well as close attention to detail. Erie Community College (www.ecc.edu) is one example of a local school offering dental hygienist certificates. Median annual salary: $56,650 Projected growth: 19 percent
Radiation Therapist
Usually working with oncologists, radiation therapists treat cancer patients in hospital and cancer clinic settings. Radiation therapists work with equipment that delivers doses of radiation, so complying with safety guidelines is extremely important. Solid science and math skills and also exceptional people skills are required for the radiation therapist, as they work with patients and families facing what’s often a life-changing diagnosis. Erie Community College (www.ecc.edu) and Trocaire College (www.trocaire. edu) offer a certificate in radiation therapy. Median annual salary: $62,660 Projected growth: 14 percent Of course, the employee’s location, specific employer, experience, and coursework can influence the annual salary. The New York Office of College and University Evaluation website (www. nysed.gov/heds/IRPSL1.html) can help you determine the educational requirements of these professions and what New York-based institutions can help you obtain the education required to practice these careers in New York.
Opioid Dependence Can Start in Just a Few Days Prescribing narcotic painkillers for three days or less may lower chances of addiction, study finds
D Joseph Borgisi organizes WOD (Workout of the Day) for Autism. He lost 200 pounds since 2013, when he started his CrossFit regimen. He weighted 550 pounds at the time.
Workout for Autism Dedicated fitness buff gives of himself to help daughter, others with autism By Tim Fenster
M
any have come and launched fundraisers based around runs, walks and bike races. But for years Joseph Borgisi has been most into CrossFit. He has now dropped hundreds of pounds and even landed work as a personal trainer. So when Borgisi wanted to raise money for The Summit Center — a Northtowns school for children with autism and other developmental disabilities, which he says has been with his daughter “every step of the way” — he decided on something a little different. He organized a WOD (Workout of the Day) for Autism in April 2013 at a Lockport gym called House of Fitness, where he’d taken CrossFit classes for years. The idea, he points out, is not totally original. In fact, CrossFit gyms are encouraged, and frequently do, hold fundraising events for local nonprofits. “It was kind of a coincidence, because at CrossFit we do a lot of events like this,” Borgisi said. Dozens of gym members and good Samaritans came out and hit the gym for the cause, raising thousands for The Summit Center. For the last few years, attendance and total donations held fairly steady, at around 70 to 100 and $3,000-$4,000, respectively. But this year, with his WOD for Autism moving to Harborside CrossFit, 340 Seneca St., Borgisi expects a better turnout than ever on April 8. “Even just from membership here we’ll probably end up with a lot more people,” Borgisi said. In years past, his WOD for Autism has drawn dozens of novices, too, and Borgisi said CrossFit’s positive, communal atmosphere makes it a welcoming place for all. Workouts include combinations of weightlifting, gymnastics, running, and rowing — from dead lifts to hand-walking to front squats and running — and are always performed in classes, where
Workout of the Day, April 8 The WOD for Autism will be held from 9 a.m. to 1 p.m. April 8 at Harborside CrossFit, 340 Seneca St., Buffalo. Tickets are $15 in advance and $20 at the door. Participants can also buy raffle tickets for a Jack Eichel jersey. For more information, search for “WOD 4 Autism” on Facebook.com or Eventbrite.com. Also visit www.wod4autism. eventbrite.com. everybody’s in it together and does their best to encourage each other. Of course, there will be a workout group for those who need to take it a little easier. “The workouts are scalable. We try to fit workouts to what people are familiar with,” Borgisi said. “We try to be as inclusive as possible.”
200 pounds and counting
Borgisi himself realized that inclusivity when he started doing CrossFit himself in April of 2013, and weighed some 550 pounds. His fellow gym-goers made him feel welcome, and he progressed one WOD at a time. In the years since, he’d shed more than 200 pounds, grown stronger and fitter, and even become a personal trainer himself, at The Biggest Loser resort in Java. “I always felt included and that I was a part of something bigger,” he said. “For me, it’s just a fun way to bring together two things that I’m very passionate about.” It’s clear to see why he’s passionate for both the event host and the beneficiary. Ever since his daughter, Maggie, was diagnosed with autism at 2 years old, he and his wife Julia have gone through plenty of challenges, as do millions of parents of children on the autism spectrum. But, he says, The Summit Center
Participants in a recent WOD (Workout of the Day) for Autism. The event was started by Joseph Borgisi in a Lockport gym called House of Fitness. In 2013 he came up with the idea of getting people to workout (instead of walk or run) to raise money for The Summit Center, a Northtowns school for children with autism and other developmental disabilities. This year’s event will take place April 8 at Harborside CrossFit, 340 Seneca St., Buffalo. has been there from the start, first offering in-house services of speech and occupational therapy. Now that she’s 10, she goes to school daily at The Summit Academy in Getzville. There she attends structured classes led by special education teachers with applied behavior analysis-trained support staff. Instructors give her clear daily goals, and she has access to physical, speech and occupational therapy. And perhaps most importantly, they offer Borgisi’s peace of mind. “Her communication skills are lacking, so we worry constantly. But we can trust them,” he said. The Summit Center also helps the family navigate through Medicaid waiver programs, and offers a respite program one evening a week and one Saturday a month, to give the parents a welcomed break. “They really do everything for us. I can’t talk enough about the place,” Borgisi said. “They’re amazing. They’ve improved our lives for sure.
April 2017 •
octors who limit the supply of opioids they prescribe to three days or less may help patients avoid the dangers of dependence and addiction, a new study suggests. Among patients without cancer, a single day’s supply of a narcotic painkiller can result in 6 percent of patients being on an opioid a year later, the researchers said. The odds of long-term opioid use increased most sharply in the first days of therapy, particularly after five days of taking the drugs. The rate of long-term opioid use increased to about 13 percent for patients who first took the drugs for eight days or more, according to the report. “Awareness among prescribers, pharmacists and persons managing pharmacy benefits that authorization of a second opioid prescription doubles the risk for opioid use one year later might deter overprescribing of opioids,” said senior researcher Martin Bradley. He is from the division of pharmaceutical evaluation and policy at the University of Arkansas for Medical Sciences. “The chances of long-term opioid use, use that lasts one year or more, start increasing with each additional day supplied, starting after the third day, and increase substantially after someone is prescribed five or more days, and especially after someone is prescribed one month of opioid therapy,” Bradley said. The odds of chronic opioid use also increase when a second prescription is given or refilled, he noted. People starting on a longacting opioid or tramadol (Ultram) were more likely to stay on opioids than those given hydrocodone (Vicodin) or oxycodone (Oxycontin), Bradley said. The highest probability of continued opioid use at one and three years was seen among patients who started on a longacting opioid, followed by patients who started on tramadol, he said. Tramadol is a narcotic-like painkiller that has been touted as not being addictive. Patients can, however, become dependent on tramadol. Patients need to discuss the use of narcotic painkillers when they are prescribed, Bradley said. “Discussions with patients about the long-term use of opioids to manage pain should occur early in the opioid-prescribing process,” he said.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 9
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone Obstetrics & Gynecology
Appointments & sonograms are now being offered every day, including Saturdays, early mornings and early evenings. Same-day appointments available. Accepting new patients All female providers and staff Two on-site mental health counselors specializing in women’s health issues. High priority given to continuity of care and patient satisfaction. Monthly team meetings to discuss our high-risk prenatal patients with our physicians, nurse practitioners and clinical staff. Seven Board-Certified physicians and five certified Women’s Health Nurse Practitioners. We have the only Dr. Sears Certified LEAN Expectations Health Coach in WNY. We offer monthly pregnancy workshops, health classes and 1:1 coaching to meet individual needs.
WE ARE MOVING
THIS FALL
into a new, STATE-OF-THE-ART FACILITY! See our article in this section! Follow us on:
#audubonmove2017
www.audubonwomens.com 1360 North Forest Road • Suite 102 • Williamsville, NY 14221 Phone: 716.639.4034 • Fax: 716.929.8940
Special Golden Years Issue Don’t miss the next issue of In Good Health.
Reach more close to 100,000 readers (based on 35,000 copies distributed) Call 716-332-0640
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Being Your Own Sole Supporter Can be Taxing
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ell, tis’ the season . . . the tax season that is. This time of year always reminds me how important it is for those living alone to take responsibility for their financial health. The fear of ending up “alone and penniless” is a seemingly universal fear shared by many women (and some men) who are divorced or widowed in mid-life, either by choice or by chance. It certainly was the case for me. While shared responsibility for financial matters is becoming more common these days, it is still true that in many marriages the men pull the purse strings and manage the financial decisionmaking. It’s the “way it was” for many traditional couples, when the man was the primary bread winner, but it’s also the “way it is” for more progressive couples who simply want to divide and conquer when it comes to managing household responsibilities. Problem is, once a spouse is out of the financial loop, he or she often remains uninvolved for the long haul, which can put them at a real disadvantage. Their knowledge of and self-confidence around money matters becomes very diminished. Simply put, when one spouse controls the finances, the other can be left in a vulnerable position if and when the marriage ends. I consulted with my financial adviser and together we identified a few essential steps to help those flying solo to gain control of their money and make progress toward financial autonomy: Come out from under the covers. Ignorance is not bliss when it comes to financial management. Women, and men alike, need to find the courage to get “up close and personal” with their financial circumstances. I avoided looking into my financial mirror for years until the fear of not doing anything was greater than the fear of facing reality. Fear, in my case, turned out to be a blessing in disguise — a real motivator. It prompted me to get my act together and seek help. There’s no time like the present to take charge of your money and your destiny. Find your stuff. David Bach, renowned financial expert and best-selling financial author, says it best: “Getting organized is one of the keys to
financial security. It begins with finding your stuff.” Before you can plan your financial future, you need to figure out where you stand financially in the present. It starts with gathering together all your financial documents in one place. I cleared out a file drawer in my desk, purchased new hanging file folders, and started labeling the files according to the instructions in David Bach’s book titled, “Smart Women Finish Rich.” It didn’t take as long as I thought it would and I felt a great sense of accomplishment once I had everything collected together. And guess what? This simple step helped me feel in more control. Almost immediately, my fears began to lessen. Get help, if you need it. Once I had my “stuff” organized, I was in a much better position to make sense of my financial situation. I continued to work through Bach’s book, but I found I needed more — I needed a real, live person to help me take the next step and make more progress. That’s when I engaged the help of a financial representative who helped me align my spending, saving and investing with my needs and priorities. He’s been an invaluable coach and motivator. If you are like me, you may benefit from engaging a professional. If you are more self-directed and inclined to educate yourself on money matters, there are excellent resources out there in books, magazines and on the web. Peace of mind and a sense of empowerment are the rewards for women and men who get their financial house in order. Solid information, personal discipline and good help from a trusted adviser can turn financial uncertainty into financial security. With increased self-confidence and awareness, you can better protect your future and more fully embrace the pleasures of living alone . . . with a little left over to splurge on something special just for you! Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive”, empowerment workshops for women held throughout the year in Mendon, New York. For information contact Gwenn. To speak, call (585) 624-7887 or email: gvoelckers@ rochester.rr.com.
See us online @ bfohealth.com
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
SmartBites
over 200. What cheddar calls for then is moderation. Depending on your dietary needs, it may also call for eating some of the reduced-fat versions. A final cheer: Sodium-wise, cheddar has less salt than most cheeses per 1-ounce slice, clocking in at 174 mg. The same amount of Parmesan has 450 mg.
The skinny on healthy eating
Cheers for Nutrient-Rich Cheddar
H
as your relationship with dairy products soured? You’re not alone, especially when it comes to cheese. Fearing the relatively high fat, calorie and sodium content of some cheeses, many of us have curtailed our consumption of this beneficial food. I’m not one of them. For me, a life without cheese would hardly be a life worth living. Yes, I adore cheese, most kinds, but the cheese I adore most is cheddar. And the reason my heart cheers for cheddar is because it’s a nutritional superstar, packed with protein, calcium and phosphorous. A 1-ounce portion (think a pair of dice) fulfills 14 percent of our protein needs with 7 grams, 20 percent of our calcium needs, and 14 percent of phosphorous. All together, this powerful team supports our muscles, bones, teeth, tissues and immune system. I’m also a huge cheddar fan because its bold flavor helps me eat it in moderation, which is the key to eating cheese, according to the American Dietetic Association. On the fat front, cheddar serves up 9 grams of total fat per ounce, with 6 of those being saturated fat.
The American Heart Association recommends that we consume no more than 13 grams of saturated fat a day due to its propensity to raise our bad cholesterol, which may then increase our risk for heart disease and stroke. Some recent studies, however, have indicated that cheese — even in high amounts — may not raise bad cholesterol after all. While more research is clearly needed, scientists think multiple mechanisms are involved, possibly related to calcium (shown to reduce the absorption of fat during digestion), protein and a cheese’s unique nutrient matrix. Something else to cheer about: Cheddar may protect our teeth, according to a study published in General Dentistry. Research has revealed that eating cheddar at the end of a meal helps to neutralize acids that form while eating, which may then thwart cavity formation. Cheddar for dessert, anyone? Much like some other delicious foods that are good for us — nuts, avocados, peanut butter, olive oil — cheddar is no slouch when it comes to calories: a 1-ounce slice has about 115 calories. Eat a few slices at a cocktail party and you’re
and set aside. Top four of the bread slices with cheese; spread with avocado mixture and top with tomato slices. Add the four remaining bread slices on top. Heat 1½ teaspoons canola oil in a large nonstick skillet over mediumhigh heat. Add 2 sandwiches to pan; top with another heavy skillet. Cook 3 minutes on each side or until golden; remove sandwiches from pan. Repeat procedure with remaining oil and sandwiches. PS: Celebrate: April 12 is National Grilled Cheese Sandwich Day! According to a reader’s opinion poll, grilled cheese sandwiches are among one of the top comfort foods in the United States.
Helpful tips
Grilled Cheese with Mashed Avocado and Tomato Adapted from Food.com
1 ripe peeled avocado 1 tablespoon lemon juice ½ teaspoon ground cumin ¼ teaspoon kosher salt ¼ teaspoon coarse black pepper 1 teaspoon dried basil 8 slices whole-grain bread 6 ounces cheddar cheese, sliced 1 large tomato, thinly sliced and patted dry 1 tablespoon canola oil, divided In a small bowl, mash together avocado, lemon juice, cumin, salt, and pepper until smooth. Stir in basil
Choose sharper cheddars with stronger flavors to help monitor intake. Lactose intolerant? Aged cheeses like cheddar contain relatively low levels of lactose. Read cheese labels carefully: some reduced-fat versions contain fillers and additives that don’t suit everyone. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorieconscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
Bad Diets Tied to 400,000 U.S. Deaths in 2015 Adding healthy foods such as nuts, seeds, vegetables, whole grains might help prevent premature demise, researchers suggest
U
nhealthy diets may have contributed to as many as 400,000 premature deaths from heart disease and strokes in 2015, a new study estimates. And, it’s not just the things you should be avoiding — such as salt and trans fats — that are contributing to these deaths. The excess deaths may also be caused by what’s missing in your diet — namely, nuts and seeds, vegetables and whole grains, the researchers said. “Cardiovascular disease is the No. 1 cause of death in the United States, killing more people in 2015 than any other cause,” said lead researcher, physician Ashkan Afshin of the University of Washington
in Seattle. He’s an acting assistant professor of global health at the university’s Institute for Health Metrics and Evaluation. “Poor diet is the top risk factor for cardiovascular disease death and, therefore, deserves attention from decision-makers in the U.S. when setting health agendas,” Afshin said. The study results suggest that nearly half of heart disease and stroke (cardiovascular disease) deaths in the United States might be prevented with improved diets, he explained. Debates on dietary policies in the United States tend to focus on cutting out unhealthy foods and nutrients, such as trans fats, salt and sugar-
sweetened beverages. But this study shows that a large number of heartrelated deaths may be due to a lack of healthy foods, Afshin reported. “This study highlights the urgent need for implementation of policies targeting these unhealthy food groups as well healthy foods, such as nuts, whole grains and vegetables,” he said. The study data came from the U.S. National Health and Nutrition Examination Survey from 1990 to 2012. The researchers also used food availability data from the Food and Agriculture Organization of the United Nations and other sources. Looking at deaths in the United States from heart and blood vessel
April 2017 •
diseases for 2015, the investigators found unhealthy diet choices and lack of eating healthier foods had a part in the deaths of more than 222,000 men and over 193,000 women. The study could not, however, prove a direct cause-andeffect relationship. Low intake of nuts and seeds likely accounted for nearly 12 percent of deaths. Too few vegetables probably contributed to as many as 12 percent of the heart disease and stroke deaths. And, low intake of whole grains may have been responsible for more than 10 percent of those deaths. Too much salt likely accounted for 9 percent of deaths, Afshin said.
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Page 11
Women’s HEALTH Long-term Contraceptives Offer Convenience Long-acting, reversible contraception methods provide nearly foolproof contraception for three to 10 years By Deborah Jeanne Sergeant
I
nstead of remembering to take a daily oral contraceptive pill or recalling to keep contraceptives such as condoms or spermicidal inserts available, women have many other long-acting, reversible contraception (LARC) options. Once you decide you’d like to have a baby, your health care provider can remove the LARC and within a few weeks, you can become pregnant. Two popular LARCs offered today are the intrauterine device (IUD) and hormonal implants. Once inserted, “they’re both very, very safe and effective,” said physician Gale R. Burstein, commissioner of health for the Erie County Department of Health. “There’s no contraindication by age, so they’re good for youth that are sexually active and when you want to delay pregnancy.” Since neither contains estrogen, they are safe for women 35-plus and smokers.
Both IUDs and hormonal implants reduce menstrual flow significantly, a side effect many women embrace. Since these LARCS can cost hundreds of dollars, more women are seeking them since they are now covered by health insurance. Depending upon the type, IUDs provide nearly foolproof contraception for three to 10 years and don’t interfere with breastfeeding for women who want contraception to space their children. “There’s no room for human error,” Burstein said. “No one has to remember anything.” All IUDs are approximately the same size in the shape of a small “t”, dangling a string. Inserting the IUD doesn’t require anesthesia and most women feel one sharp cramp and it’s over. Copper-based IUDs contain no hormones and work for 10 years. At
first, women may experience heavier periods; however, eventually, their cycles resume their regular intensity. Implantable progestin involves inserting the contraceptive into the upper arm to slowly release over the next three years. Faye Justicia-Linde, an OB-GYN at University at Buffalo, said that implanted progestin works well for women “who are leery of pelvic exams and placing anything in the vagina.” Women who can’t tolerate estrogen contraceptives can usually use progestin implants. They require a minor, out-patient procedure where the skin is numbed and within minutes, the implants are placed in a small incision the arm. “It’s very rare for people to have a serious side effect,” JusticiaLinde said. “An IUD could move or shift. Only once or twice a year, we have a patient who needs an IUD
removed. It takes about two minutes. It’s annoying for patients, but not serious. It’s an uncommon issue. Most women are happy with the convenience.” Justicia-Linde said that one previous IUD design was prone to complications such as infection; however, newer IUDs available have corrected those issues. “We check people first to make sure they have no infection,” JusticiaLinde said. “Once it’s there, it doesn’t increase the risk of infection over one who doesn’t have an IUD.” She said that compared with the Pill, condoms, spermicidal inserts, quarterly progesterone shots and other contraceptives, the IUD and implant make it easy to prevent pregnancy. “The more the person has to remember to do, the higher the failure rate,” Justicia-Linde said.
Shift Work May Hamper Conception Harvard study suggests that women who work late shifts may have problems conceiving a baby By Deborah Jeanne Sergeant
A
study recently released by the Harvard T.H. Chan School of Public Health in Boston states that women who work second or third shift may experience a reduced ability to conceive. The disrupted sleep schedule — resting while others are awake and working when most are asleep — may be partly to blame. Faye Justicia-Linde, an OBGYN at University at Buffalo, said that shift work “has a propensity of increasing high cholesterol, blood pressure and hypertension.” She said these conditions can affect ovular function and decrease the chances of pregnancy by disrupting the woman’s hormonal level and the regulation of the menstrual cycle. The couple’s work schedule may also negatively affect their chances of conception. If they seldom have intercourse because he works first shift and she works third, they may miss her most fertile time of the Page 12
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month. Kiltz is a diplomate of the “That’s not going to work out American Board of Obstetrics and well,” Justicia-Linde said. “There are Gynecology and board-certified in logistics involved that may not be as reproductive endocrinology and obvious until you start infertility. probing.” He said that But if they’re circadian rhythm affects having intercourse ovulation dysfunction, frequently and “likely affecting the pregnancy remains hormonal environment elusive, working that supports the early nights could influence embryonic environment. the problem. It could throw off the “Anything that hormones that support disrupts the circadian early pregnancy.” rhythm throws off Other work factors our hormonal and can reduce the woman’s endocrine and even ability to conceive, such our immune system,” as performing heavy said physician Rob physical labor. The study Kiltz, founder and indicated that wemon OB-GYN Justicia-Linde director of CNY working physically Fertility in Buffalo. intense employment had “The stress factors that go along with fewer eggs than women working that and the fact that we may not sedentary jobs. be in synch with the partner, that Kiltz said that these somewhat probably doesn’t help.” androgenic activities release cortisol,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
the stress hormone. That promotes inflammatory conditions that can negatively affect how egg and sperm interact, ovulation and implantation of a fertilized egg. While exercise is healthful, strenuous, heavy activity may make having a baby tougher. In addition to physical stress, emotional stress can also inhibit conception. “This is why we recommend yoga, exercise, acupuncture, going for a walk, listening to nature and soothing music and reading a good book,” Kiltz said. “Turn off the TV news. If you do have shift work, imagine you’re able to come home, reduce the light, and change that circadian rhythm a bit to get a quiet time of rest and relaxation.” He also recommends limiting carbohydrates in the diet. Working with an OB-GYN and fertility expert can help women struggling to conceive to eliminate factors that decrease their likelihood of pregnancy.
Women’s HEALTH
6
Things You Should Know About Miscarriages
By Ernst Lamothe Jr.
F
or pregnant women, a miscarriage is an unexpected and emotionally devastating loss. Physician Angelle A. Brebnor, an OB-GYN and clinical assistant professor at the Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, understands that effects it can have on a woman. Miscarriage, which is the spontaneous loss of a pregnancy in the first 22 weeks, is the most common type of pregnancy loss. About 10 to 20 percent of known pregnancies end in miscarriage, according to the Mayo Clinic. The risk of miscarriages can change with age and history. “Unfortunately, it is difficult to pinpoint all the reasons for the miscarriage,” said Brebnor. “That doesn’t make it any easier for families to deal with. It is very important to know most times there is nothing the mother or father could do to prevent it from happening.” Brebnor, who provides services at Women and Children’s Hospital of Buffalo as well as Millard Fillmore Suburban Hospital, said women should have at least five things in mind when it comes to miscarriage. They are:
1.
Talk with your doctor
While the decision to have children is an intimate conversation between partners, she suggests having a talk with a physician early-on. A simple pre-consultation or overall exam can help, especially in high-risk pregnancies, which includes potential parents with high blood pressure or diabetes, taking multiple medications or having a family history of illness.pressure, diabetes, taking multiple medication or family history illness. Brebnor says the pre-conception visit can be essential to avoiding obstacles during pregnancy. Patients have come with diabetes, thyroid conditions, blood clots and other medical ailments. “It’s incredibly important to have that visit where you can talk with your doctor about your family history and conditions that might affect your pregnancy,” she said.
2.
Vitamins
Brebnor believes ensuring proper nutrition is key to a successful pregnancy. That includes prenatal vitamins with folic acid. “Vitamins should be taken at least a month before pregnancy if possible,” she said. “Prenatal vita-
Sitting the Month Chinese practice calls for moms to do nothing for a month after they deliver their baby By Deborah Jeanne Sergeant
T
raditional Chinese mothers practice “zuo yuezi” — or “sitting the month” — after delivering their babies. Whether it’s assistance from relatives at home or at a facility designed to aid new moms — and staffed with nurses and nutrition experts — these mothers take it very easy for 30 days. They eat special foods to help them recover and avoid chills to help restore their body’s balance. Beyond nursing, they literally do nothing and go nowhere for a month. While taking it this easy for a month may not be possible or advisable for many mothers, new moms should call upon whatever support they need to take care of their babies and themselves. Unfortunately, isolation from extended family and employment demands often mean that women don’t get the help and rest they may need. “One problem with modern life is we were meant to be in small
villages with family units to help new mothers and help in the process and be supportive,” said Rob Kiltz, founder and director of CNY Fertility in Buffalo. “We’re herd animals and meant to be interactive.” Kiltz is a diplomate of the American Board of Obstetrics and Gynecology and board-certified in reproductive endocrinology and infertility. Kiltz said that post-partum support should do more than just ease mom’s burden, but should include help from the family. “It’s not just about ‘Let me help you do nothing’, but as a village, tribe, family and group, ‘Let’s work together for the greater good.’ Raising a child is meant to be done as a family. That’s where we get our best creativity and joy out of life.” Women’s bodies change a lot from pre-pregnancy to pregnant to post-partum. “They should defer to the instructions their care providers give
mins have been known to reduce the number of miscarriages, and it does help with neurological deficiencies of the spine.” In addition, prenatal multivitamins have vitamin C, B6, B12, zinc and other essential nutrients for the body. The vitamins plus a balanced diet should provide the mother with all she needs during her pregnancy. “I would recommend every woman who wants to get pregnant take some form of prenatal vitamins,” said Brebnor.
3.
Maintain healthy weight and exercise
When it comes to thebody, keeping active is essential as we age. Even 20 minutes of activity a day, three to five times per week, provides benefits. Thirty minutes every day is even better. Research indicates that staying physically active can help prevent or delay certain diseases, including some cancers, heart disease and diabetes, and also relieve depression and improve mood. “In general, if you are too underweight or too obese, this can cause risks in your pregnancy,” said Brebnor. “Any exercise can help whether that is walking or even a light jog. Of course, as you get through your pregnancy, you may want to avoid very strenuous workouts; however, we recommend exercising throughout the entire pregnancy.”
4.
Stop smoking
Tobacco is the single greatest preventable cause of illness and premature death in the U.S. Tobacco use is now called “tobacco dependence disease.” The Centers for Disease Control and Prevention
OB-GYN Angelle A. Brebnor. says that smokers who try to quit are more successful when they have the support of their physician. “Smoking definitely increases your risk of a miscarriage,” she added. “We even tell mothers that they should do everything they can to avoid second-hand smoke.”
5.
Avoid caffeine
Americans like to drink a lot of caffeinated beverages whether that is soda or caffeine. While it tastes great, doctors recommend moderation for pregnant women. “You don’t have to completely give up your morning coffee. It is okay to have a 12-ounce cup of coffee each day,” said Brebnor. “The problem is that people usually have more than that several times a day. You want to avoid those giant mugs of coffee because a very high caffeine intake can lead to problems during pregnancy.”
Rob Kiltz, founder and director of CNY Fertility in Buffalo. “Raising a child is meant to be done as a family. That’s where we get our best creativity and joy out of life.”
them,” said Beth Carey, DONA-certified postpartum doula and birth doula, member of WNY Doulas and owner of Niagara Doula in Buffalo and Western New York. “If they have had a C-section, or tears and stitches, that makes a difference. They need support so they don’t overdo it.” Some of her clients have had their mother stay with them for the first postpartum month and their mother-in-law for the second. Engaging a postpartum doula can also help. “You need to know about these resources before you have the baby, not scrambling once you come home with the baby,” Carey said. “There’s a lot more out there than ever.” Lori Gehl childbirth educator, doula and child birth midwife assistant with WNY Childbirth, said that for many postpartum women, it’s OK to get up and move around, but “don’t get on the treadmill shortly after you give birth. For a good week or two, it’s best to spend lots of time cuddling your baby. Once you’re ready to get up, walking is the best way to start, along with gentle stretches.” Christine Kowaleski, New York state coordinator for Postpartum
April 2017 •
Support International, acknowledges that support for new moms helps them cope with the changes involved with having a baby. But once their doctors give them clearance to exercise, walking and yoga can help moms get active again. “Exercise is always good for everyone, and may be helpful in preventing baby blues,” she said. In addition to helping mothers reduce their risks for postpartum depression and develop coping mechanisms, Postpartum Support International also helps moms network. “Using complementary medicine team with our support group has really helped our moms and they decide on their own when they’re ready to go out on their own,” Kowaleski said.
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Women’s HEALTH
Mother of four and a native of Williamsville, Jill Chiacchia gave her career in the corporate world to start a business that focuses on healthy living.
From Spreadsheets to Smoothies Jill Chiacchia goes from corporate world to career of food, facts and fitness. The Williamsville native now runs beHealthy Institute in Hamburg By Daniel Meyer
I
t wasn’t too long ago that Jill Chiacchia was the vice president of finance and human resources at a mid-sized manufacturing facility in Cheektowaga. Having reached most of her goals in the corporate world, the mother of four always listened to a voice inside her head that was urging her to do something drastically different in her professional life. “I gave it a lot of thought and before you knew it I decided to pursue what I believe is my true calling in health and nutrition,” says Chiacchia. “As a wife and mother of four very busy children, I understand the tremendous challenges in feeding and nourishing each of us and helping guide our entire family to live as healthy a lifestyle as possible.” A native of Williamsville, Chiacchia is the founder and director of beHealthy Institute. Located at 40 Main St. in the heart of the village of Hamburg’s central business district, the business is owned and operated by Chiacchia, a 50-year-old certified health coach and a member of the American Association of Drugless Practictioners. Having received her health and Page 14
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nutrition training at the Institute of Integrative Nutrition in New York City, Chiacchia possesses the knowledge of traditional fitness and healthy living philosophies with modern concepts and strategies that cover the various dietary and lifestyle theories that exist. “What I do is work with individuals, couples, families and groups of friends and provide guidance in what they need to do to live a healthy lifestyle,” says Chiacchia, who also worked as a licensed insurance broker before launching her current career. “There is no perfect way of cooking or eating or exercising that works for everyone, but what I can do is get to know my clients and understand how they live and then coach and advise and mentor them to construct lifestyle choices that will help make a difference.”
Your choice to be healthy Chiacchia has built beHealthy Institute into a destination for people interested in taking a course, sitting in on a seminar or attending a clinic that all have a focal point of living
healthy. Fitness classes include yoga for adults, expectant mothers and for children, while clinics focus on topics varying from acupuncture to mental health consulting. Among the most popular classes are healthy cooking courses taught by local chefs and restaurant owners, while “living well seminars” feature local holistic health and wellness experts lecturing about detoxification, meditation, growing herbs and parenting tips for those dealing with troubled teens. “What we do is give our clients permission to make healthy changes in their lives,” says Chiacchia. “It is a lot of fun, not only for myself and our instructors, but for the people who come here looking for an opportunity to improve their lives in some fashion.” While based in Hamburg, beHealthy Institute has clients from throughout Western New York, including East Aurora, Orchard Park, Eden and Evans. Getting to know each individual is one of Chiacchia’s favorite parts of her daily interactions with each client. “I love the conversations that take place in our classes,” says
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
Chiacchia. “This is a fabulous place because we all want to live healthier. It is incredible to hear and be a part of the exchange of information. It motivates me and inspires me to come to work.” The beHealthy Instititute facility has 1,600 square feet of space, providing plenty of room for fitness instruction and lectures and a stateof-the-art kitchen for all cooking courses and demonstrations. There is also a lending library and private office space for one-on-one health coaching consultations. Chiacchia has no regrets in saying farewell to corporate spreadsheets and early morning staff meetings in favor of yoga pants and fruit smoothies. “This is where I want to be and this is what I envisioned when we opened our doors six years ago,” says Chiacchia. “I call each of our clients members of my tribe. I want others to join our tribe and find out that through proper planning, being healthy is possible if you just allow yourself to embrace making changes that will positively impact how you live your life.”
Women’s HEALTH What Disease Kills Women the Most? Heart disease claims more women’s lives than any other disease, including breast cancer By Deborah Jeanne Sergeant
W
hat disease kills more women than any other? Breast cancer? Lung cancer? Ovarian cancer? Colorectal cancer? Wrong. Heart disease is the leading cause of death among American women, totaling 161,698 deaths annually, according to WomenHeart. That’s more than one-third of all deaths for women. Compared to that, only 40,861 women die every year from breast cancer. Mary McGowan, CEO of WomenHear, The National Coalition for Women with Heart Disease (www.womenheart.org), Burch hopes that by promoting education about heart disease risks and signs of heart attack in women, her organization can help drive down those statistics. One means is Women Heart’s National Hospital Alliance program, which aids hospitals in educating clinicians and patients. Many women don’t realize that heart attack often presents differently in women than men. “It’s important for women to understand the difference because this can be lifesaving information,” McGowan said. Men may experience sharp pain in the chest, but women may feel
short of breath, pain in the arm and back, extreme fatigue and nausea. Because their symptoms differ from “classic” heart attack symptoms, they may not seek medical attention. “In general, most women put other people in their family before themselves,” said Erin Burch, registered dietitian in practice as Erin Burch Nutrition in Buffalo. Burch said that today’s women strive to “have it all”— career, home, and family — which adds up to a lot of stress and little time to cook or eat right. “Diet is part of most disease processes,” Burch said. “A lot of times, the diet is the first thing to get pushed to the back burner.” While prenatal health care may put women on the track for regular health care visits, once a child or more arrives, it’s harder to stay faithful to a regular health care regimen for some women, especially considering over-the-counter contraceptives can eliminate the need for doctor visits for prescribed contraceptives. Women can also use long-lasting contraceptives. Since they’re not seeking regular physicals, some women overlook the risk factors for heart disease, which include high blood pressure,
family history, high cholesterol, diabetes, smoking, and being postmenopausal. McGowan added that femalespecific risk factors include pregnancy if the mother experiences hypertension and pre-diabetes related to the pregnancy. “The science is showing that pregnancy is a first cardio stress test for many women,” McGowan said. “These issues that develop during pregnancy can be precursors for heart disease later in life.” Healthy women who become pregnant don’t elevate their risk of heart disease during pregnancy, but all women should receive prenatal care. Patients aren’t the only ones not thinking about heart disease. Women Heart literature states, “A 2005 American Heart Association study showed that only eight percent of primary care physicians and 17 percent of cardiologists knew that heart disease kills more women than men.” More women need to ask for the screenings that could save their lives. These include blood pressure, cholesterol, body mass index, and pulse, which can detect arrhythmia. It makes sense to get evaluated for heart disease risk since physicians can prescribe medication to protect against heart attack. But once heart damage is done, it’s done. On Feb. 3, WomenHeart is offering complementary screenings in 46 states at Burlington stores. Call store locations for more details.
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Are You at Risk? By the numbers According to WomenHeart, the following factors increase the risk of heart disease for women: • Cigarette smokers are two to four times more likely to develop heart disease than non-smokers. • 44.9 percent of women have total cholesterol of at least 200mg/dL. • 31.7 percent of women do not engage in leisure time physical activity. • 61.2 percent of Caucasian women, 81.9 percent of African-American women, and 76.3 percent of Mexican-American women are overweight or obese. • Women with diabetes have a 2.5-fold higher risk for developing cardiovascular disease (CVD) compared to women who do not have diabetes, and men with diabetes have a 2.4-hold higher risk for developing CVD compared to men who do not have diabetes; women with diabetes and CVD have a 2.2-fold higher risk of dying from CVD compared to women who do not have these two conditions; men with diabetes and CVD have a 1.7-fold increased risk of dying from CVD compared to men who do not have these two conditions. April 2017 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Special Golden Years Issue
The Social Ask Security Office
Don’t miss the next issue of In Good Health.
From the Social Security District Office
Representative Payee: Help a Loved One With Social Security
Reach more close to 100,000 readers (based on 35,000 copies distributed) Call 716-332-0640
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here are nearly 57 million people living with disabilities in the United States, according to the Census Bureau. Thirty percent of American adults help provide care for a sick or disabled family member. Caregivers provide physical and emotional support for the people in their care. It’s a demanding job with its stresses and rewards, but it can also be a labor of love. Social Security is committed to you throughout life’s journey, helping secure today and tomorrow for every American. This is especially true for people who need help managing their benefits. We work closely with caregivers through our representative payee program. A representative payee is someone who receives and oversees the Social Security or Supplemental Security Income (SSI) benefits for anyone who cannot manage their benefits. This can be a child or an adult incapable of managing their own funds. You can learn more about our representative payee program at www.socialsecurity.gov/payee.
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Q: I applied for a Social Security card for my child at the hospital and the card came back with the first name misspelled. What should I do? A: Go to your local Social Security office or card center to ask for a corrected card. We need to see at least two original documents proving your child’s: • U.S. citizenship; and
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• Identity. We also must see proof of your identity, as the parent. The documents you show us must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies. To find out more, go to www. socialsecurity.gov/ssnumber. There, you can learn what documents you need, fill out and print an application, and then bring or mail the information to us. You may also want to read the publication, Social Security Numbers For Children, available at www.socialsecurity.gov/ pubs. Q: I own a small business. How can I verify employees’ Social Security numbers? A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
A representative payee is usually a trusted family member or friend of the beneficiary, but when friends or family are not able to serve as representative payees, Social Security looks for qualified individuals or organizations to represent the beneficiary. You can learn about becoming a representative payee by watching our new series of videos on the duties of a representative payee at www.socialsecurity.gov/payee. It’s our hope that these videos will not only educate individuals about the roles and responsibilities of being a representative payee, but also provide further insight, broaden community awareness, and provide key resources to deal with the growing incidents of elder abuse, neglect, and financial exploitation. Caregivers are valuable and irreplaceable assets to our great nation. Please join us in celebrating them for all they do for those who cannot do for themselves.
purposes. For more information, go to www.socialsecurity.gov/ employer/ssnv.htm. Q: I know that Social Security’s full retirement age is gradually rising to 67. But does this mean the “early” retirement age will also be going up by two years, from age 62 to 64? A: No. While it is true that under current law the full retirement age is gradually rising from 65 to 67, the “early” retirement age remains at 62. Keep in mind, however, that taking early retirement reduces your benefit amount. For more information about Social Security benefits, visit the website at www.socialsecurity. gov/r&m1.htm. Q: I was speaking with my sister and she told me that she receives half of her spouse’s benefit. Why am I not eligible for benefits from my spouse? A: If your spouse is eligible for Social Security benefits, you could be eligible for one-half of their benefit at your full retirement age. However, if you worked and are eligible for Social Security benefits on your own record, your own benefit may be higher than what you could be eligible for on your spouse’s record. If you have questions regarding your eligibility for benefits, please call 1-800-772-1213 (TTY 1-800325-0778) between the hours of 7 a.m. and 7 p.m. Monday through Friday.
By Jim Miller
How to Help Older Drivers Give Up the Car Keys Dear Savvy Senior, What tips can you recommend that can help me deal with my mom’s bad driving? At age 83, her driving abilities have declined, but I know she’s bound and determined to keep driving as long as she’s alive. Nervous Nelly Dear Nelly, There’s no doubt that giving up driving can be a tough step for many elderly seniors, as well as a difficult conversation for concerned family members. While there’s no one way to handle this sometimes touchy topic, there are a number of tips and resources that can help you evaluate and adjust your mom’s driving, and ease her out from behind the wheel when she can no longer drive safely.
Assess Her Driving
To get a clear picture of your mom’s driving abilities, your first step — if you haven’t already done so — is to take a ride with her and watch for problem areas. For example: Does she drive at inappropriate speeds, tailgate or drift between lanes? Does she have difficulty seeing, backing up or changing lanes? Does she react slowly, get confused easily or make poor driving decisions? Also, has your mom had any fender benders or tickets lately or have you noticed any dents or scrapes on her vehicle? These, too, are red flags. For more assessment tips see SeniorDriverChecklist.info. If you need help with this, consider hiring a driver rehabilitation specialist who’s trained to evaluate older drivers. This typically runs between $100 and $200. Visit AOTA. org/older-driver or ADED.net to locate a specialist in your area.
Transitioning and Talking
After your assessment, if you think it’s still safe for your mom to drive, see if she would be willing to take an older driver refresher course. These courses will show her how aging affects driving skills, and offers tips and adjustments to help
ensure her safety. Taking a class may also earn your mom a discount on her auto insurance. To locate a class, contact the local AAA (AAA.com) or AARP (AARP.org/drive, 888-2277669). Most courses cost around $20 to $30 and can be taken online or in a classroom. If, however, your assessment shows that your mom really does need to stop driving, you need to have a talk with her, but don’t overdo it. If you begin with a dramatic outburst like, “Mom, you’re going to kill someone!” you’re likely to trigger resistance. Start by simply expressing your concern for her safety. For more tips on how to talk to your mom about this, the Hartford Financial Services Group and MIT AgeLab offers a variety of resources at TheHartford.com/lifetime — click on “Publications” on the menu bar, then on the “We Need To Talk” guidebook.
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Refuses to Quit
If your mom refuses to quit, you have several options. One possible solution is to suggest a visit to her doctor who can give her a medical evaluation and, if warranted, “prescribe” that she stop driving. Older people will often listen to their doctor before they will listen to their own family. If she still refuses, contact your local Department of Motor Vehicles to see if they can help. Or, call in an attorney to discuss with your mom the potential financial and legal consequences of a crash or injury. If all else fails, you may just have to take away her keys.
Alternative Transportation
Once your mom stops driving, she’s going to need other ways to get around, so help her create a list of names and phone numbers of family, friends and local transportation services that she can call on. To find out what transportation services are available in her area, contact the Rides in Sight (RidesInSight.org, 855-607-4337) and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Health News ECMC Internal Medicine Center earns NCQA Erie County Medical Center’s Internal Medicine Center has achieved recognition status for “patient-centered medical home,” according to the National Committee for Quality Assurance (NCQA). “For the second time in five months, the National Committee for Quality Assurance has bestowed their highest level of recognition status on an important health care service at ECMC,” said ECMCC President and CEO Thomas J. Quatroche Jr. “This is yet another example, from a national organization, of the high-quality care and services our caregivers provide to the residents of Western New York. As ECMC continues to be a leader in transforming healthcare in Western New York with our partners at the University at Buffalo, the patient–centered medical home effort demonstrates that we are on the forefront of bringing the right care at the right place at the right time to the patients of our community to improve the health of the community.” ECMC’s Internal Medicine Center, in partnership with UB Internal Medicine, offers access to a diverse group of university physicians for primary care. Adults and seniors have easy access to a variety of physicians, including primary care physicians, geriatric specialists for senior care, and an integrated variety of specialist physicians including podiatrists, rheumatologists and endocrinologists. The Internal Medicine Center offers flexible scheduling, including early morning hours and walk-in sick or urgent appointments. Doctors are on call 24 hours a day, and patients can also always speak to a nurse by phone during business hours to discuss any health questions and concerns. NCQA President Margaret E. O’Kane said, “The NCQA patientcentered medical home is a model of 21st century primary care that combines access, teamwork and
technology to deliver quality care and improve health.
Pediatric specialist, surgeon join Ross Eye Ross Eye Institute has announced the addition of two ophthalmologic specialists to its practice. They are: • Faruk M. Koreishi, a distinguished contributor to world health with more than 40 years of experience as an ophthalmologist. During his years in practice, Koreishi has helped thousands of individuals — from the neediest to the most prominent — maintain and improve their eyesight and has been recognized on numerous occasions. Koreishi Among his awards are the 2014 Ross Eye Institute Community Ophthalmologist of the Year Award and the 2012 Physician of the Year Award from the Asian American Physicians Association. • Andrew Reynolds specializes in pediatric eye care with a focus on the treatment of pediatric cataracts and glaucoma. He also treats Reynolds strabismus, or misalignment of the eye, in adults and children. Reynolds earned his medical degree from the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, graduating summa cum laude. He completed his ophthalmology residency at the Medical University of South Carolina Storm Eye Institute and his pediatric
ophthalmology and strabismus fellowship with the University of Michigan Kellogg Eye Center. He is a member of the American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus.
Windsong marks 30 years in business This year marks the 30th anniversary of Windsong Radiology Group, PC, which has come a long way since its humble beginning back in 1987. In the early days, it was known as Harlem Radiology, PC and was located in a remodeled Pizza Hut, employing only five people. Today there are 270 employees including 18 radiologists, two breast surgeons, nurse practitioners and physician assistants at six locations. Its flagship location in Williamsville is among the busiest stand-alone imaging facilities in the nation with over 340,000 annual visits, according to the practice. Physician Thomas Summers, president of Windsong Radiology, attributes the practice’s growth to a “deep-seated commitment to putting the patient first.” “As we celebrate this extraordinary anniversary of 30 years, we look back at the many successes we’ve accomplished but we also look forward to the new and exciting strategic opportunities ahead. As an organization, we promise never to lose sight of what made us successful in the first place — making certain that our patients always come first,” Summers said. He added that the practice is highly regarded for its reputation of pursuing and acquiring the most advanced technology available and employing only highly trained, certified technologists and fellowship-trained radiologists. It has been the largest provider of the state of the art 3-D mammography technology since 2011, which provides a clearer, more accurate view of the breast making it possible to identify abnormalities. It also offers prostate MRI, a
technology that allows radiologists to better visualize the prostate gland and determine if a biopsy is needed. Windsong was also the first accredited low-dose CT lung cancer screening center in the area.
UAHS, Kaleida Health affiliation moves forward The New York State Public Health and Health Planning Council has recently approved the active parent model for Upper Allegheny Health System (UAHS) and Kaleida Health. Under terms of the proposal, Kaleida Health will become the parent organization of UAHS. UAHS and its member hospitals, Bradford Regional Medical Center (BRMC) and Olean General Hospital (OGH), will become part of Kaleida Health while remaining separate legal entities with separate boards of directors. Approval by the state health planning council is one of the final hurdles bringing the two organizations together. The affiliation is also under review by the Pennsylvania Department of Health and officials are hopeful of approval. “Beyond approval by the Pennsylvania Department of Health there are filings with the Federal Trade Commission to be approved,” said Timothy J. Finan, president and CEO of Upper Allegheny Health System. We are hopeful that the entire process will be finished relatively quickly and the affiliation will become official later this spring.” “This is another positive step forward in our plans to fully affiliate,” said Jody Lomeo, president and CEO of Kaleida Health. “Together, our goal is to continue to support and serve the Southern Tier and Northwestern Pennsylvania communities. We want to continue to collaborate and improve care on the local level.” In May of 2016, UAHS signed a letter of intent to affiliate with Kaleida Health. The letter of intent proposes no immediate changes at either hospital, including staffing.
UBMD physicians moving to medical campus
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roviders from UBMD Physicians’ Group, the largest medical group in Western New York, will soon begin seeing patients in the Conventus building on the Buffalo Niagara Medical Campus. Twelve of the group’s 18 medical practices will see patients on the fourth floor of Conventus, located at 1001 Main St. in Buffalo at the corner of Main and High streets. This is the first location that brings these practices together under one roof. “Opening 12 UBMD practice locations on one floor in Conventus
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is an enormous opportunity for us and for our patients,” said physician Kevin Gibbons, the executive director of UBMD Physicians’ Group (UBMD) and a neurosurgeon with UB Neurosurgery, one of the 12 practices moving into the new location. “By bringing together 12 of our practices, we believe we’ll be able to enhance the patient experience by making it easier for patients to take care of their medical needs in one location. We are immensely fortunate to be at the epicenter of the Buffalo Niagara Medical Campus and collaborate with our many partners in Western New York’s health care.”
To keep patients informed about the move and answer questions, UBMD recently launched a new website, www.ubmdconventus.com. Visitors can get answers to frequently asked questions and learn more about the practices that are opening locations in the Conventus building and what patients need to do prior to their first appointment at the new location. The site also includes detailed patient parking and public transportation options, an interactive map for driving directions, and features the latest news about UBMD. The UBMD practices opening
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • April 2017
new locations in the Conventus building are: dermatology, family medicine, internal medicine, neurology, neurosurgery, obstetricsgynecology, orthopedics and sports medicine, pathology, pediatrics (subspecialties), psychiatry, surgery, and urology. Opening dates will be added to the website at www. ubmdconventus.com as they become available. “UBMD Physicians’ Group will be utilizing a phased move-in approach,” Gibbons said. “As our practices set open dates, we will be updating ubmdconventus.com with this information.”
Exuding Pride
H ealth News BRMC and OGH will continue to provide existing inpatient, outpatient, emergency, diagnostic and therapeutic services. In 2013, Kaleida Health and OGH jointly established an interventional cardiac catheterization laboratory in Olean. The cardiac program has performed more than 1,000 procedures, saving hundreds of lives in the process. Also in 2013, Kaleida Health and BRMC jointly established a home care agency, the VNA of Northwestern Pennsylvania in Bradford.
DeGraff Hospital ER project progressing Kaleida Health’s plan to enhance and upgrade its Niagara County hospital location continues to progress. The health system announced that The Pike Company will serve as the construction manager for the $7.8 million renovation DeGraff Memorial Hospital’s emergency department.
The plan is to relocate the emergency department from the west side of hospital campus to the east side, fronting the Twin City Highway and allowing for better access, parking and visibility for patients, families and visitors. The expansion calls for 17 treatment bays, including a trauma room, a dedicated bariatric room and an airborne isolation room. It will also include a decontamination area suitable for current and emerging infectious diseases. To further accommodate geriatric patients, DeGraff will use non-glare lighting, slip-proof flooring, increased family space, plus signage with oversized lettering. Last renovated in 1975, the space will more than double from 4,800 square feet to 10,000 square feet. In February, the New York State Department of Health approved Kaleida Health’s construction plans as well as their certificate of need for the expansion.
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he mission of the Western New York Pride Center is to work with the community to make Western New York a safe, healthy, and satisfying place for lesbian, gay, bisexual, transgender and queer people to live, work, and establish their families. Matthew Crehan Higgins is senior director of the nonprofit organization. He has been with the organization since September 2014; he formerly worked in various positions within immunodeficiency services at ECMC. He’s also a playwright, actor and activist. Pride Center’s Pride Week celebration, which includes a parade and street party, is the organization’s most well known public event. It takes place from May 30 through June 4, starting at Elmwood Avenue and Forest Avenue in Buffalo. Its day-to-day work, however, centers around several funded projects which serve the needs of its defined communities. “Through our general LGBTQ health and human services project, we manage our daily operations,” said Crehan Higgins. “People can access computers at our ‘cyber center’ and library. We coordinate the Silver Pride Project, an active social group for LGBTQ people 50 and better.’”
Setting the bar for Trans Wellness
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WNY Pride Center offers LGBTQ health, wellness and education programs
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Crehan Higgins said the Pride Center is one of only two organizations that have received a New York State Department of Health transgender grant. The other is in New York City. “With the success of our Trans Health Initiative, which addresses transgender communities’ healthcare needs throughout Western New York’s eight counties, we’ve demonstrated that programs like this should be rolled out across the state. These people are often at increased risk for certain health problems,” he said. Brittany Marie Cobb, 33, is a client of the center who has benefited from the Trans Initiative. “When I first came out, the Pride Center is where I went,” she said. “I was coming to terms with who I was. I didn’t know how to deal with myself or how to navigate the complicated legal and healthcare systems. Shevy [Siobhan Fitzgerald-Matson, the Center’s trans wellness coordinator] referred me to Evergreen Health for all kinds of healthcare. I don’t know what I have done without the Pride Center,
April 2017 •
especially support from Shevy, the staff and the other people I’ve met in person and online.” One of the Pride Center’s newer initiatives must consider that technology now affects people’s behaviors. “SCOUT addresses men under 30 who have sex with men,” said Crehan Higgins. “It’s also funded by the state Department of Health, and focuses on this population’s realworld sexual health experience and needs. One thing we have to account for is the fact that a lot of negotiation happens online or through a handheld GPS before people actually meet in person. We’ve had to update the models for planning, education and disease prevention.”
Branching out
Many of the same confounding and tragic health issues that affect the general public are also a focus for the Pride Center. “We’re now developing a program for caregivers of LGBTQ people and allies with Alzheimer’s or another dementia as part of a state initiative,” said Crehan Higgins. “We’re getting great support from the Alzheimer’s Association of Western New York.” Noting that because Gov. Andrew Cuomo is supportive, and that New Yorkers voted ahead of the rest of the country to approve marriage equality, Crehan Higgins said there have been gains and benchmarks set. Taking a wider view of the political climate, and the anxiety it can elicit in people and groups more likely to experience discrimination or attacks, Crehan Higgins said, “LGBTQ and other allied communities saw a long presidential campaign which, at the very least, contained a lot of negative rhetoric. We’ve experienced increased contacts from people looking for referrals and information.” The anxiety about the changing world is manifesting itself in different ways. “Last year the training course we offered through Spar Self Defense was only half-full,” said Crehan Higgins. “This year, it filled up so quickly that we’re adding a second one.” Striking a realistic tone, Crehan Higgins added, “We are in a balance between needing to recognize and affirm that people have real anxiety, while also continuing to give hope and remind them that their lives have value, and that they have a right to expect respect around that.”
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