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APRIL 2021 • ISSUE 188

AUTISM Pandemic creates learning challenges for children with autism

ALSO IN THIS ISSUE: Pandemic has varied effects on autism organizations n How service dogs help people with autism n Meet Lawana Jones, who leads Autism Council of Rochester. n The Norman Howard School in Rochester: In-person classes continue. Starts on p. 15

INSIDE: ‘Alexa, Is My Heartbeat Healthy?’

COVID-19 & POLITICS Starting in early summer last year, analysis finds that states with Republican governors had higher case and death rates

HOW COVID-19 VACCINES STACK UP Mona Chitre, chief pharmacy officer at Excellus BlueCross BlueShield talks about the various COVID-19 vaccines. Which one is the best? See p. 8

HELP WANTED: MENTAL HEALTH PROVIDERS Why we don’t have enough mental health providers

Feel like smashing everything around you? Now you can — right here in Henrietta. Page 9

‘Alexa, Is My Heartbeat Healthy?’

ne in four U.S. households use smart speakers to check the weather, play music and query search engines. But a new technology may soon have folks asking, “Hey Google, how’s my heart?” Researchers from the University of Washington, Seattle, have developed a skill for Amazon Alexa and Google Home that allows the devices to check heart rhythms. Like a bat using echolocation to hunt for food, inaudible sound waves

radiate from the speaker and bounce off the surroundings before returning to the device to paint a detailed picture of the space — so detailed, in fact, that the technology can differentiate between a person breathing and her heart beating. This phenomenon is possible because your heart actually creates a tiny movement in your chest wall every time it beats. “The question we were asking is, ‘Can we transform these smart speakers into ways in which we can

do medical diagnosis?’” said researcher physician Shyam Gollakota. He’s an associate professor in the University of Washington’s School of Computer Science & Engineering. “Specifically, in the study, we showed that we can use a smart speaker like an Alexa or Google Home to figure out if you have irregular heart rhythm.” For the technology to work, users must be one to two feet away from the speaker, the researchers said. They tested the accuracy of their work using 26 healthy participants and 24 hospitalized patients with heart conditions, such as atrial fibrillation and heart failure. Then, the scientists collected all participants’ heart rhythms using their sound technology as well as a standard heartbeat monitor. “This is similar to how Alexa can always find my voice even if I’m playing a video or if there are multiple people talking in the room,” Gollakota explained in a statement. “When I say, ‘Hey, Alexa,’ the microphones are working together to find me in the room and listen to what I say next. That’s basically what’s happening here, but with the heartbeat.” Of the 12,300 or so heartbeats the researchers collected from the healthy individuals, the smart speaker’s reported time between waves was within 28 milliseconds of the standard heart monitor. For the nearly 5,600 heartbeats collected from people with cardiac conditions, the speaker’s time differed from the monitor by 30 milliseconds. The findings were published online March 9 in the journal Communications Biology. “I think the exciting part of the study is that we actually evaluated this with patients with cardiac condi-

tions like heart transplants, irregular heartbeats and a variety of different heart conditions,” Gollakota said. “And it was really promising that even not just for regular participants, but even people who are actually in the hospital with cardiac conditions, it was able to deliver the results. So, that’s actually pretty promising.” The ultimate goal of the technology is to allow people to monitor their heart from the comfort of their homes, the study authors said. “One of the things with cardiac conditions like, for example, irregular heart rhythms is that they don’t appear often,” Gollakota explained. “So, having a solution which is nonintrusive, contactless and it’s just sitting by your desk and monitoring your heartbeat all the time, can be pretty promising,” he said. “The second advantage is that as we have seen with COVID, a lot of the [medical] practice has actually gone online to telemedicine,” Gollakota added. “So, in this telemedicine set-up, if you want to monitor someone’s heart conditions, or figure out if they have irregular heartbeats, a tool like this can be pretty useful to perform tests and understand how the heartbeat of the person is.” This latest smart speaker adaptation is just one example of how existing technology is being reworked to try to improve the health of users. According to a survey conducted last year by the Pew Research Center, about one in five Americans have smart watches, and the medical capabilities of these devices are rapidly expanding. Fitbit CEO James Park, for example, told Axios in February that his company’s product can now help detect a coronavirus infection and depression in the early stages.

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Meet

Your Doctor

By Chris Motola

Why Cotton Masks Are Safer Masks

otton masks provide better protection against the new coronavirus than those made with synthetic fabrics, researchers say. In a new study, investigators tested different mask fabrics under conditions that mimic the humidity of a person’s breath in order to assess how the fabrics perform in actual use. Under humid conditions, filtration efficiency (a measure of how well a material captures particles) increased by an average 33% in cotton fabrics, according to the study published March 8 in the journal ACS Applied Nano Materials. That’s because cotton is hydrophilic, meaning it attracts water. By absorbing small amounts of exhaled water in a person’s breath, cotton fibers create a moist environment inside the fabric. That makes them more efficient filters compared to masks made of synthetic fibers. In general, synthetic fabrics performed poorly in comparison to cotton, and their performance did not improve with humidity. Material used in medical masks was about as effective as cotton, but did not improve with humidity, the researchers said. A previous study by the same team at the National Institute of Standards and Technology (NIST) and the Smithsonian’s Museum Conservation Institute found that dual-layer masks made of tightly woven cotton fabrics with a raised nap, such as flannel, are particularly effective at filtering breath. That study was conducted under relatively dry conditions in the lab. “Cotton fabrics are still a great choice,” said Christopher Zangmeister, a research scientist at NIST, in Gaithersburg, Maryland. “But this new study shows that cotton fabrics actually perform better in masks than we thought.” While the researchers found that humidity doesn’t make it harder to breathe through fabric masks, breathing may become difficult if fabric masks get wet in other ways. They should be changed if they get wet due to weather. The findings offer useful information for people who wear masks, as well as for scientists working to improve masks and measure their performance, the study authors said in an NIST news release.

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Matthew P. Schiralli, M.D. Geriatrician chief explains why Unity Hospital has been recognized for the care of seniors in need of surgical procedures Q: Unity Hospital just became the first in the nation to receive Level 1 verification from the American College of Surgeons Geriatric Surgery verification program. What is the organization’s relationship to hospitals like Unity? A: The organization that is sponsoring all of this is the American College of Surgeons. It’s the largest governing body for surgeons in North America, and it’s one of the largest surgical organizations in the world. Most of the general surgeons in the United States are members. But, it doesn’t limit itself to surgeons. Q: What is the geriatric surgery verification program? A: The American College of Surgeons now sponsors this program. It was originally created by a task force across about 50 different stakeholders in the country who came together under a grant from the John A. Hartford Foundation. It was a five-year grant to study and create a best practice standard for taking care of elderly surgical patients. As a part of the original work done by the task force, they created a set of standards and then went and tested those standards at different hospitals. Unity Hospital was one of eight beta sites around that country that it was tested at. The task force was very interested in the work we were doing because we’re not a university-based hospital. So we’re resourced differently and take care of slightly different populations than major universities do. So after the beta site study was completed, we knew that the task force was going to bring this whole program to the ACS and that they were going to adopt it as one of their verification programs. So we continued to work at Unity Hospital in anticipation of the ACS taking this on. Q: Who does the program cover? A: It encompasses all patients 75 and older who have surgery with a required hospitalization. We cover all electively scheduled patients as well as all patients who come through our emergency department and are hospitalized through that pathway. It’s a very large program that’s been running now from 2019. Because we’ve prepared ourselves for verification we were the first hospital to go through the program and be verified by the ACS. Q: What do the levels refer to? A: The lowest level is called a “commitment level.” When you identify yourself as a commitment level hospital that means you’re actively working to become a Level 1 or Level 2 hospital. Those commitment level hospitals have the expectation that they’re going to build their program

thing we try to do is anticipate and mitigate delirium in patients after an operation or hospitalization. Delirium is one of the biggest factors for having bad outcomes. Q: What is delirium? A: It’s confusion, specifically new confusion or disorientation related to stress. The stressors can be physical — blood loss, infection, sleep deprivation — or it can be disorientation from being in an unfamiliar setting and the bells and whistles of what happens in a hospital. To give you the big picture, somewhere around 25% of older adults experience delirium after an operation. So it’s very common. Once they experience delirium, they’re at higher risk of needing intensive care and prolonged hospitalizations. So we try to anticipate those who are at highest risk and manage it as best we can. And the final aspect of the program is anticipating what the patients will need after discharge. Q: How do you go about that? A: We try to get as much of that coordinated as we can as early as possible. So we have very active physical and occupational therapists who work with patients in hospital, setting up home care needs or making referrals into rehabilitation facilities. We want to begin setting this up before they have their hospitalization.

within 24 months. The step up from that is designation as a Level 1 or Level 2 hospital. The difference between those two levels is really the volume of total patients that you include. So Level 2 is the lower level. It’s designed to verify hospitals that include 25-50% of the total patients that are eligible. Level 1 is more than 50% of all eligible patients. We pushed ourselves at Unity, so we’re including above 90% of our patients in the program. Q: What do geriatric patients in particular need in terms of surgical care that other patients do not? A: The first step in adopting these programs is to recognize that the geriatric population isn’t just older adults — they have their own special needs. In pediatrics they like to say that kids are not just little adults, they need their own specific needs recognized. It’s the same for the geriatric population. What those are is to set goals of care for patients around what matters to that patient rather than just pushing forward with every operation. For example, I recently had a patient in their middle 90s with a problem that I certainly could have operated on, but the operation and recovery would have been very difficult. But that wasn’t what they wanted right now. Living longer wasn’t as important as their quality of life. So we first have to identify the patients’ goal of care and tailoring our care around that. We also need to measure and risk-stratify patients based on what’s generally called frailties. That can be things like cognitive needs, physical needs, education needs or social needs. So we tailor their care plan toward their risk factors as well. The other big

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

Q: How difficult was this program to bring online during the pandemic? A: It’s been about three-and-ahalf years we’ve been working on this, and I have had the privilege of leading this really dynamic team of folks that encompasses all aspects of nursing care. The nurses have been just outstanding. Hospital medicine, geriatric medicine, nutritionists, social workers, physical therapy, just an extensive group that has come together because we understand the need to plan for and treat these patients differently. We’ve all been dealing with the baby boomer generation getting older for a few years now. So the excitement when we started in 2018 carried over to 2019 and especially into 2020. We all had the shock of how frail this population is and how easy it is to affect them with stress due not only to a novel virus, but social isolation and access to care. The pandemic has hit this population especially hard, but it’s inspired our program to work extra hard and demonstrated the need for it. We know it’s the right way to care for these folks.

Lifelines Name: Matthew P. Schiralli, M.D. Position: Director of the geriatric program at Rochester Regional Health; chief of surgery, eastern region, Rochester Regional Health Hometown: Fredonia Education: SUNY Upstate Medical University Affiliations: Unity Hospital; Rochester General; Newark-Wayne Community Hospital; Clifton Springs Hospital Organizations: American College of Surgeons; Monroe County Medical Society Family: Married, two sons Hobbies: Camping, fishing, woodworking

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Couples Everywhere Are Having More Twins

es, you really are seeing double — more twins are being born now than ever before. There are a number of reasons why, according to a new study. Since the 1980s, twin births rose by a third worldwide — from 9 to 12 per 1,000 deliveries. About 1.6 million twins are born each year and one in every 42 babies is a twin. A big reason for all those twins is an increase in medically assisted reproduction, including in vitro fertilization, ovarian stimulation and artificial insemination. Another reason is that women in many countries are having babies at older ages. The chances of having twins increases with age, according to the study published March 12 in the journal Human Reproduction. “The absolute number of twin deliveries has increased everywhere except in South America,” said study author Christiaan Monden, a professor of sociology and demography at the University of Oxford in England. “In North America and Africa, the numbers have increased by more than 80%, and in Africa this increase is almost entirely caused by population growth.” For the study, the researchers analyzed 2010-2015 data from 165 countries with 99% of the world’s population. They also looked at 19801985 data from 112 countries. They found substantial increases in twinning in many European coun-

tries, in North America and in Asia. In 74% of the 112 countries with data from both periods, the increase topped 10%. Asia saw a 32% increase and North America a 71% increase. Only seven countries had a decrease of more than 10%. “In both periods Africa had the highest twinning rates and there was no significant increase over time. However, Europe, North America and the Oceanic countries are catching up rapidly. About 80% of all twin deliveries in the world now take place in Asia and Africa,” Monden said in a journal news release. He noted that the twinning rate is so high because of the high number of twins born from two separate eggs. There has been little change in the rate of twins born from the same egg — which stands at about four per 1,000 deliveries worldwide. The authors think rates of twinning may have peaked — particularly in Europe and North America — due to increasing emphasis in assisted reproduction trying to achieve singleton pregnancies. It’s not clear if this is also the case in lower-income nations, and has important implications for the health of mothers and babies, as well as health care resources, according to the researchers. The American Academy of Pediatrics has more about having twins. Visit www.healthychildren.com and type “twins” in the search bar.

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Serving Monroe and Ontario Counties A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations. In Good Health is published 12 times a year by Local News, Inc. © 2021 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Todd Etshman, John Addyman, Michael E. McRae Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas Office Manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Healthy Spiritual Life Can Uplift Those Who Live Alone

pril showers bring May flowers and so much more. In addition to warmer weather, new growth and budding possibilities, April is also a time for worship and family gatherings that embrace reflection, contemplation and celebration. Easter, Passover and Ramadan all traditionally take place in the springtime when hope springs eternal. The coinciding of these religious holidays reminds me of the healing power of faith. Almost without exception, the women and men who have found their way after a divorce or the death of a spouse have been bolstered by a healthy spiritual life. Many of the participants in my “Alone and Content” workshops take advantage of every spiritual connection they can find. They regularly attend worship services, find

comfort in prayer and hymns, and faithfully observe religious holidays. Others march to a different drummer and nourish their spiritual life in private moments: listening to music, communing with nature, reading, writing or sitting in contemplative silence. In all its varied expression, my observations tell me that those who find sustenance in spirituality fare better when challenged by life’s transitions. They take time to spiritually connect with themselves and others and, in doing so, find the inner strength to navigate unchartered waters and to help others along the way. Even when their own sense of self-worth is fragile or failing, I’ve seen devout divorcees and widows reach out to others with encouragement and emotional support. Spiritually grounded, their empathy runs deep and their desire to uplift others

is steadfast. In helping others, they help themselves. Last month, I heard from a woman whose husband abruptly left her and their three teenage children after 28 years of marriage. She was in shock and consumed with pain. She shared with me how comforting it would be to hear from her minister and church friends, but they didn’t know her situation. It had been years since she had been to church and those relationships had fallen by the wayside. Similarly, a neighbor of mine confided that he stopped going to temple after he lost his “bride” to breast cancer. Mad at the injustice of it all, he couldn’t bring himself to attend services without her. This led to years of isolation, during which he was overcome with loneliness and guilt. I wasn’t surprised when he talked of numbing his pain with alcohol. My message to both was simple: Renew your spiritual connections. It’s easy to imagine how difficult it might be to contact a minister, priest, rabbi or other spiritual adviser and ask for help if you’ve been absent from services for many years or when loneliness has you in its grip. But any religious organization worthy of its mission will respond with open arms, even in COVID-19 times. A metaphorical warm embrace is waiting for those who reach out by phone, email or participation in livestream or limited in-person worship services.

Likewise, if other paths beckon — if nature or poetry or meditation feed your soul — go forth and embrace those opportunities. My spiritual battery gets recharged when I take time out from my busy schedule to be still and meditate. Quiet time in an inspirational setting allows me to contemplate my most deeply held beliefs, let go of fear, and set my intentions. I emerge more grounded, grateful, and ready to embrace the day with an open heart. The power of a spiritual life is mighty. When you pursue your spiritual goals and teachings, life can be more manageable and your ability to cope with loss, loneliness and everyday struggles is strengthened. However you pursue a spiritual connection, I encourage you to make that connection or re-connection now. Today. A belief in something greater than yourself and the company of people who share your faith can lead to a richer, more meaningful, and peaceful existence. You do not have to go through life alone. And what a blessing that can be. Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite Voelckers to speak, visit www.aloneandcontent.com

tion “may be simply because they’re a year older and more developmentally mature,” Xie said in a university news release. Two other factors associated with higher levels of motivation included prior academic achievement and what the researchers called “school belongingness.” “This may be one area where we can help students become more motivated,” Xie said. “Belongingness is something schools can change. They can find ways to help students feel like they are part of the school

community.” This and a previous study by the same research team suggest that schools should routinely assess students’ motivation to identify those most at risk for dropping out or underperforming. Schools can create personalized intervention programs that target students based on their motivational profile, according to Xie. “We need to tailor the motivation strategies to specific profiles,” he said. “There is no one universal strategy that will work for all groups.”

s d i K Corner

Is Your Teen Unmotivated at School? That Might Change

f your teen seems disinterested in school, new research suggests there’s a good chance that things will get better over time. “Our results point to a more hopeful picture for students who start out with lower levels of motivation,” said study senior author Kui Xie, a professor of educational studies at Ohio State University in Columbus. The study included 1,670 students at 11 public high schools in central and northeastern Ohio who were followed for two years. They were in grades nine to 11 at the start of the study. Overall, the students’ motivation to learn improved during the study period. For example, the percentage of students who were self-motivated to learn rose from 8% in the first year to over 11% in the second year. Meanwhile, the percentage of students who had no motivation to Page 6

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“Belongingness is something schools can change. They can find ways to help students feel like they are part of the school community.”

Kui Xie, a professor of educational studies at Ohio State University in Columbus. do well in school fell from nearly 3% in the first year to about 2% in the second year, according to the study published online recently in the Journal of Educational Psychology. One reason why there was a general positive shift in terms of motiva-

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Healthcare in a Minute By George W. Chapman

COVID-19 Relief and ACA

assed in March, the $1.9 trillion package afforded more relief to people living at poverty levels who are insured through the ACA — currently, those under 400% of federal poverty guidelines qualify for prorated premium subsidies. The lower your income, the greater the subsidy. These subsidies are paid by the federal government directly to the insurer selected by the member.

(Federal poverty levels, for examples, are $12,880 for an individual and $26,500 for a household of four.) For 2021, members with incomes more than 400% of poverty guidelines will to have to pay more than 8.5% of their income for insurance. The number of people seeking health insurance on the exchanges has surged due to the pandemic and related loss of employer-sponsored insurance.

“Lethal weapon”

ers have tended to mimic Medicare when it comes to telehealth.) Eshoo not only wants to retain existing telehealth services, she proposes to expand the list of eligible health services. Critics and skeptics are concerned that the ease or convenience of telehealth could result in costly unnecessary services, fraud, abuse and worse outcomes. According to the HHS inspector general who has been monitoring claims throughout the pandemic, that has not occurred. As payers transition away from feefor-service and toward capitation or bundled payments, (see below) the issue of unnecessary services or overutilization becomes moot.

That is how NYS prosecutors described the prescription pad of Nassau County general practitioner George Blatti, 75. He is facing a 59-count indictment including five counts of second-degree murder and 11 counts of first-degree reckless endangerment. The physician showed “depraved indifference to human life” as he illegally prescribed “massive amounts” of opioids to patients despite increasing warnings and pleas from patients, family and friends. Blatti, “often working out of his car like a common drug dealer,” prescribed opioids to people who were not officially his patients, (no medical record or having done an exam.) He was back in court last month for sentencing. He could receive 25 years to life.

Telehealth’s future

House health subcommittee chairwoman Anna Eshoo wants to make Medicare’s temporary expansion of telehealth services due to the pandemic permanent, across the entire country. Right now, only certain areas of the country will remain eligible (typically rural) once the pandemic ends. (Commercial pay-

Bundled payment study

A bundled payment to a certain provider covers all services delivered by all associated providers for 30 days related to a specific surgical procedure. For example, an orthopedic group receives say $50,000 from Medicare to replace a member’s hip. The bundled payment covers basically everything from soup to nuts: including the surgeon, the surgery center, nursing, the anesthesiologist, lab and X-rays, supplies, equipment, the artificial hip and post- operative April 2021 •

therapy. It would be up to the orthopedic group to pay the associated providers. The Rand Corp. studied 2,400 bundled procedures including hip and knee replacement, bariatric weight surgery and spinal infusions. Medicare saved an average $4,200, or 10%, per case versus what Medicare would have paid everyone individually fee for service. Even better, patients saved an average $500 out of pocket. For some reason, commercial carriers are not totally on board yet with bundled payments.

World vaccination

While we are focused on vaccinating 330 million Americans, there are 8 billion people worldwide that must be vaccinated as well if we are to effectively end the pandemic. Vaccine manufacturers have teamed up with other companies to distribute vaccines world-wide over the next two years. Pfizer and BioNTech have partnered with 10 other companies to produce two billion doses this year. Product development starts in St. Louis, goes to Andover, Mass., for additional work and then on to Kalamazoo, Mich., for final touches. In Europe, after it starts in St. Louis, the vaccine goes to Belgium then to Germany before final distribution. Britain-based Astra Zeneca is scheduled to produce three billion dosed via the Netherlands and Belgium. They will supply Mexico and South America. Novavax will produce two billion and will supply Japan and the South Pacific. Moderna will produce two billion vaccines focused on Asia and Africa.

Friendlier MRI

If you suffer from claustrophobia, or just plain anxiety, getting an MRI is not a pleasant experience. Declining to receive one deprives both you and your physician of a valuable diagnostic tool. Seeing a potential market, imaging giant Philips has

collaborated with Disney to produce the “Philips Ambient Experience.” Patients are able to personalize the lighting in the room and select video entertainment while inside the MRI tube. There are already about 2,000 of these. Kids can select animated shorts featuring characters like Mickey Mouse, Aladdin and the Avengers.

Artificial Intelligence

More so than any other industry, healthcare and pharma are bullish on AI. Accounting firm KPMG surveyed 950 business leaders including 100 healthcare executives and 100 from life sciences. Historically, AI has been used predominantly to improve electronic records and processes. Going forward, the survey revealed the top five areas for AI growth during the next two years will be: telemedicine; robotic based process improvement; delivery of care; clinical trials; and diagnosis. The pandemic has clearly contributed to the acceleration of AI in healthcare. It is being used to monitor COVID19 and is used to develop and distribute vaccines. The vast majority of respondents see the current administration in Washington as very supportive of AI development. The executives want the government to establish robust and reasonable regulations to keep the playing field level, encourage cooperation and to avoid a “wild west chaos” scenario.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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How COVID-19 Vaccines Stack Up

ona Chitre is the chief pharmacy officer at Excellus BlueCross BlueShield. As such, she leads Excellus BlueCross BlueShield’s pharmacy strategy and is responsible for driving affordability, innovation and operational excellence. She completed her undergraduate and graduate training at Rutgers University and her post-doctoral primary care residency at the VA Hospital in Buffalo. The Johnson & Johnson (J&J) vaccine is the third COVID-19 vaccine being distributed in the U.S. Is it safe? Why do we need a third vaccine option? All vaccines have the same goal — to protect us. The J&J vaccine was tested thousands of times to ensure safety and is authorized for use in the U.S. It’s important that everyone who wants the COVID-19 vaccine can receive it. In addition to the Moderna and Pfizer/BioNTech vaccines, the J&J vaccine is another way to help increase protection against the COVID-19 virus. Since all three vaccines are safe, the best vaccine is the one you have access to. How does the J&J vaccine differ from Moderna’s and Pfizer/BioNTech’s? The J&J vaccine is a single dose which offers maximum protection quicker than Moderna’s and Pfizer/ BioNTech’s vaccines. The J&J vaccine has proven to be 66% effective at preventing moderate to severe cases of COVID-19. With all three vaccine options, no fragment of the live

virus is in the vaccine so the vaccine itself cannot make you sick with COVID-19. Should we be concerned with a less effective rate? No, there is no need to be concerned. The only way to accurately compare the effectiveness of these vaccines is by direct comparison in head-to-head clinical trials, which did not happen across the three vaccine options. Testing took place in different regions, at different points in time, and with varying COVID-19 occurrences. It is best not to compare the effective rates between the vaccines. The data proves that the J&J vaccine is 85% effective against severe COVID-19 cases, and 100% effective at preventing death from COVID-19. Based on the data, the J&J vaccine is a very safe and effective option. There is mention of a booster vaccine to help protect against the COVID-19 variants. What information is known or suggested about this? Scientists are currently looking into if a booster dose is needed to address variants. It is emerging science at this time, but it is still recommended that you get your vaccine as soon as it is available for you. How do we know that these vaccines are safe when they are so new? COVID-19 vaccines are being held to the same rigorous safety and efficacy standards as all other vac-

COVID-19 & Politics Starting in early summer last year, analysis finds that states with Republican governors had higher case and death rates

he per-capita rates of new COVID-19 cases and COVID-19 deaths were higher in states with Democrat governors in the first months of the pandemic last year, but became much higher in states with Republican governors by mid-summer and through 2020, possibly reflecting COVID-19 policy differences between GOP- and Democrat-led states, according to a study led by researchers at the Johns Hopkins Page 8

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Bloomberg School of Public Health and the Medical University of South Carolina. For their study, the researchers analyzed data on SARS-CoV-2-positive nasal swab tests, COVID-19 diagnoses, and COVID-19 fatalities, for the 50 U.S. states and the District of Columbia. After adjusting for confounding factors such as state population density, they found that Republican-governed states began to

Mona Chitre is the chief pharmacy officer at Excellus BlueCross BlueShield. cines — and have been tested thousands of times to ensure safety. The scientific technology used to develop the first COVID-19 vaccines is called mRNA. mRNA has been studied for decades and looks at the genetic makeup of the virus, and then uses that genetic code to teach our cells how to trigger an immune response to combat the virus. The platform that is being used to produce this vaccine has been studied and used for over a decade, and we had a jump-start on the COVID-19 vaccine because it’s a coronavirus which we’ve studied in the past. have consistently higher rates of positive swab tests in May, of COVID-19 diagnoses in June, and of COVID-19 mortality in July. The results, published online March 10 in the American Journal of Preventive Medicine, suggest that policy differences between Republican- and Democrat-governed states, including mitigation measures such as mask mandates and social distancing requirements, may have led to systematic differences in COVID-19’s impact on public health, the researchers say. “Governors’ party affiliation may have contributed to a range of policy decisions that, together, influenced the spread of the virus,” says study senior author Sara Benjamin-Neelon, Ph.D., professor in the Bloomberg School’s Department of Health, Behavior and Society. “These findings underscore the need for state policy actions that are guided by public health considerations rather than by partisan politics.” The analysis covered March 15 to December 15, 2020, and included the number of SARS-CoV-2 tests, positive tests, COVID-19 case diagnoses, and COVID-19 fatalities. The researchers used a sophisticated statistical tool called a Bayesian negative binomial model to estimate, for each day in the nine-month study window, the relative risks or chances of getting tested, testing positive, getting COVID-19, or dying of COVID-19, for people in 26 GOP-governed vs. 25 Democrat-governed states. Washington, D.C. was treated as Democrat-governed. The researchers were aware that

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

Are you saying that getting the COVID-19 vaccine cannot make a person get COVID-19? Exactly. The COVID-19 vaccines that are being distributed in the U.S. do not use any fragment of the live virus and cannot make you sick with COVID-19. The vaccines teach your body how to recognize the virus and then create defenses against it. What about the side effects of the vaccine? Side effects are possible with any type of vaccination. The most common issue is a sore arm, which can happen with most vaccines. Other reactions include fatigue and headache. It is important to note that the vaccine is not making you sick, but this is the body’s natural immune system response. Also, I know many people with seasonal allergies are concerned with taking the vaccine. If you have seasonal allergies (e.g., pollen, dust, ragweed, etc.), the vaccine should not cause any issues. But anyone with allergic reactions to other vaccinations should talk with your doctor to see what is best for you. We know that vaccines were given to high-risk groups first. The data suggests that the number of deaths in nursing homes is going down by more than 60%. Do you feel this is because of the vaccine? Absolutely. Nursing home residents were among the first people to receive the vaccine. The data shows how powerful the vaccines are against the virus, which is encouraging to hear. Reports like these make me so hopeful as the vaccines continue to rollout. I’m excited for my children to be reunited with their grandparents. I’m optimistic about the future.

“Governors’ party affiliation may have contributed to a range of policy decisions that, together, influenced the spread of the virus.” many other factors, including the natural progression of the pandemic from early waves in urban areas, such as New York City and Seattle, to later waves in rural areas, might have contributed to differences between Republican- and Democrat-led states. However, they attempted to correct for these confounding factors in their analysis. Their findings, even when factoring in these confounders, revealed a clear pattern in which Democrat-led states were hardest-hit early in the pandemic, but after a few months Republican-led states on average began to have more positive tests, COVID-19 cases, and more COVID-19 deaths. The transition occurred for testing-positivity on May 30, for COVID-19 case diagnoses on June 3, and for COVID-19 deaths on July 4. The differences between the two groups of states peaked in the period from late June to early August—for example, on August 5 the relative risk of dying of COVID-19 was 1.8 times higher in GOP-led states.

Ready to be smashed at Smash Therapy in Henrietta: Car windshields, all kinds of glassware, electronic devices like coffee makers, vacuum cleaners, stereo sets and toasters and printers, among other things.

Smash Your Stress Away in Henrietta By John Addyman

ave you had a moment when you were angry or frustrated enough that you could just tear something down or smash it to bits? Think of that piece of pottery that wouldn’t glue back together properly or your frustration trying to get a COVID-19 vaccine appointment. You’d look silly — or unhinged — throwing the pottery against the wall or screaming at your computer screen or phone … even though that’s exactly what you want to do. Steve Shortino, 24, and his company, Smash Therapy, have a solution. Phone his company or access the website and make an appointment. When you get to the site on Jefferson Road in Henrietta, he’ll hand you work gloves, goggles, a face shield and if you want one, a full body suit. You’ll then be ushered into your suite, which is yours for the next 20 minutes. Leaning up against the wall is your choice of implement — crowbars, aluminum baseball bats, lengths of metal pipes and golf clubs. And in front of you are items that are awaiting their fate — car windshields, all kinds of glassware, electronic devices like coffee makers and stereo sets and toasters and printers. “Enjoy!” your host will tell you and close the door. And it’s smashin’ time. When Jen Barr from Newfane and Brandon Clouser of Batavia made their first visit to Smash Therapy, it was her idea. Two weeks later they were back — Brandon’s request. “We were looking for something fun to do in the area,” she said. “We considered axe-throwing, but this won out. It’s reasonably priced and fun. This is the second time we’ve come here and this time, it was his idea: we got the extra package.” Brandon said that “something that ticked me off” was one motivation for the second trip, but it was more fun with Jen along. “The coffee cups were all mine,” Jen said. “He went for the electronics because they take a lot of effort to smash.” While the couple was in the closed room raining destruction, the concussion sounds audible outside were matched with big laughs. Brandon came out of the session sweat-

ing. “That was hot fun,” he said. Shortino heard about people making a business out of letting people smash things in 2017 from his boyhood friend Branden Williams, who suggested they go into business. “I thought that was the dumbest thing of all time,” Shortino said. He recalled a story about a guy in Japan in the 1990s who set up a business handing people plates they could smash. “The line was a mile long behind him.” Eventually getting a little more interested in the idea because nothing better had come along, Shortino opened Smash Therapy in 2018, in 2,200 square feet of space. “I had no idea what I wanted to do after high school,” he said. “Zero clue.” “And when we opened, I was surprised that we were a lot busier than I thought we’d be,” he said. The following year, he was closed like almost everything else for three months during the pandemic. Shortino’s business reopened tentatively in July last year “and COVID-19 seems to have helped me. When it started getting colder, there wasn’t enough for people to do. They wanted to get out and do something and that seemed to accelerate our business. April 2021 •

Jen Barr of Newfane and Brandon Clouser of Batavia at Smash Therapy in Henrietta. We are something different, something fun, and we’re reasonable priced. You can come here and spend $20 and you’ll have a blast.” Once on site, “everyone’s got their own private room, their own time, and they’re never with any strangers. They can book ahead of time online or over the phone. We take walk-ins but we haven’t been able to accommodate them lately because we’re so busy,” he said. The clientele is varied and surprising. Shortino said 60% of his

customers are female: “The overwhelming number of people come here just to have fun because they heard other people came here and had a good time. You also obviously get those people who are stressed or angry. Most come for fun or something to do with their friends. Ninety-nine percent of people are happy when they leave. Most are tired, too, because they get really into it.” Joseph Cruz Sr. and his wife, Ryan, brought their son Joe Jr. and his fiancé, Victoria Rivera. After their time a-smashin’, Joe Sr. said he was exhausted after 11 minutes. “I needed that.” A supervisor at work, he said the trip to Smash Therapy “is a good team-building activity.” Ryan said she brought the family to Smash Therapy on the advice of a friend who had brought her family. “That’s one of the reasons why this business is great,” said Shortino, “all walks of life can have fun here. Kids love it.” He said one mom told her son she was taking him to “therapy.” When he found out where that was, he told her, “I’m so excited.” Another family with a child with autism has taken a yearly membership to come every week. Smash Therapy couldn’t exist without its suppliers – windshields come from FB Glass, Mr. Glass and Ray Sands Glass, the electronics are from Sunnking in Brockport, and all glassware comes from Goodwill. Another Smash Therapy location is due to open this spring at Destiny Mall in Syracuse as Shortino expands. He won’t have any trouble getting people in the door. “I’m surprised how far people will drive to come here,” he said. “We’ve had people come from New Jersey, New York City. They have rooms down there, but we’re so much a better deal, have so much more stuff, and so many more add-ons.” That success comes at a price. “I’ve never taken a day off,” Shortino said. “I don’t plan to, either. The moment I start taking time off is the moment someone starts to catch up to me.” n Editor’s Note: If you’re interested in smashing things and having fun, contact Smash Therapy www.smashtherapyinc. com

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Mind/Body Connection Is Important During Pandemic Certain activities can help people feel more in control By Deborah Jeanne Sergeant

hysical activities that offer a mind/body connection such as martial arts, Pilates and yoga are nothing new. However, in recent months, more people have become interested in these activities. Physician Kerry Graff, board-certified in family and lifestyle medicine at RRH Family and Lifestyle Medicine in Canandaigua, has practiced yoga for many years. She said that activities with a strong mind and body connection “reduce stress and offer physical activity. It is stress relief that helps people feel more in control.” “In history, threats were more immediate and you had an adrenaline rush. But you can’t fight COVID by running away or fighting. Our normal body defenses won’t work,” she said. “When you’re physically active, you burn through stress hormones.” While pedaling on a stationary bike may fulfill the physical aspect of exercise, it lacks a mental aspect that relates to the activity. That’s where an activity like yoga, Pilates and martial arts bring in the mental aspect as participants focus on their breath, body placement and movement. “It’s super helpful to stay centered and calm in the middle of utter chaos,” Graff said. “On days it

doesn’t happen, I’m not as resilient. I get more irritable. It really helps to do yoga. I started doing it faithfully at the beginning of the pandemic and it has been a lifesaver.” Gary Evarts, seventh-degree blackbelt, is the owner and master instructor at Kuk Sool Won of Williamson. He said that the Korean martial art that he teaches “puts us in a state of total awareness. From our head to our feet, we’re totally aware of how Evarts we stand, move and breathe. The calmness of when we’re learning forms is like a meditation in movement.” Instead of ruminating over anxious thoughts, students step outside their stress while they remain focused on what their bodies are doing. The classes also promote body strength, endurance, flexibility, agility and balance, as well as self defense skills. Despite the pandemic, Evarts has gained a few students. Nicole Crump, licensed clinical social worker with Modern Thera-

py Services in Rochester, said that the pandemic has given people a break from busyness to become more introspective about what they want and need in their lives. “Yoga and meditation Crump allow people to go within to connect to their inner thoughts, physical pains, mental blocks, and traumas so they can learn effectively what will help them heal,” Crump said. “But to heal, we need to feel our emotional pain and scars. Learn the true impact it has had on our life paths. The social isolation people are going through is felt the same way physical pain is experienced. No longer can we turn a blind eye to feeling unsatisfied lives, careers, relationships because we are in it daily.” She said that activities like running may help work out “toxic energy” but activities such as yoga can be used as tools to help in healing emotionally. Exercise also releases serotonin and other endorphins, the “feel-

good” hormones that lift mood. The reason that mind and body activity is so helpful is that it keeps participants in the current moment, combined with working out stress hormones. Laura Jowly, interim director of behavioral health for the Rochester Regional Health’s Eastern Region in Clifton Springs and Newark, said that the effect is similar to that of mindfulness. “It is about paying attention in the moment,” she said. “Yoga, Pilates, and some imagery all can really help bring someone into focusing on the moment. The more we talk about mindfulness and paying attention to in the moment, the more senses you bring into it, the more effective it is.” While stressed and anxious, the body begins to breathe irregularly. Exercise regulates breathing and in activities that focus on breath, the effect is even better. At Evarts’ martial arts school, for example, students breathe in through their noses and out through their mouths. They also perform specific poses during breathing exercises. “If you’re just mindlessly on the elliptical, there isn’t as much focus on connecting the breath with the movement and understanding your body,” Jowly said. Of course, any form of exercise is good for the body. However, activities that include a built-in stress management component provide additional benefit. “It doesn’t have to be an hourlong workout,” Jowly said. “Stretching or just taking time to focus on breathing can help. Even taking five minutes to breathe and stretch to form that mind-body connection can help.”

WHAT TO KNOW ABOUT THE COVID-19 VACCINES COVID-19 vaccines are a hot topic and on the minds of many. Is a vaccine that was created so quickly actually safe? Can I stop wearing a mask if I receive the vaccine? What will our “new normal” look like? Meet Mona Chitre, PharmD. She’s our Chief Pharmacy Officer and a wealth of knowledge on all things COVID-19 vaccine-related.

Q. HOW DO WE KNOW THAT THESE VACCINES ARE SAFE WHEN THEY ARE SO NEW? Great question. COVID-19 vaccines are being held to the same rigorous FDA safety and effectiveness standards as all other vaccines — and have been tested thousands of times to ensure safety. The scientific technology used to develop the Moderna and Pfizer/BioNTech COVID-19 vaccines is called mRNA. mRNA has been studied for decades and looks at the genetic makeup of the virus, and then uses that genetic code to teach our cells how to trigger an immune response to combat the virus. The platform that is being used to produce this vaccine has been studied and used for over a decade, and developers had a jump-start on the COVID-19 vaccine because it’s a coronavirus which they’ve studied in the past.

MONA CHITRE, PharmD Chief Pharmacy Officer

Dr. Chitre completed her undergraduate and graduate training at Rutgers University and her post-doctoral primary care residency at the VA Hospital in Buffalo, New York.

Q. MONA, THE JOHNSON & JOHNSON (J&J) VACCINE IS THE THIRD COVID-19 VACCINE BEING DISTRIBUTED IN THE U.S. IS IT SAFE? WHY DO WE NEED A THIRD VACCINE OPTION? All vaccines have the same goal – to protect us. The J&J vaccine was tested thousands of times to ensure safety and is authorized for use in the U.S. It’s important that everyone who wants the COVID-19 vaccine can receive it. In addition to the Moderna and Pfizer/BioNTech vaccines, the J&J vaccine is another way to help increase protection against the COVID-19 virus. Since all three vaccines are safe, the best vaccine is the one you have access to.

A nonprofit independent licensee of the Blue Cross Blue Shield Association

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

Read the full Q&A and watch our videos:

ExcellusBCBS.com/COVID19

Integrative Medicine Sees Uptick During Pandemic Many are concerned about having a healthy lifestyle currently By Deborah Jeanne Sergeant

octors practicing integrative and holistic health are seeing increased interest from new and returning patients because of the pandemic. Physician Az Tahir, who practices holistic medicine in Rochester and Syracuse, said that his patient load has increased, even though he is seeing patients only via Zoom and Facetime. “We’re very busy,” he said. “I think people are more concerned about AzTahir their health than before Coronavirus. If they have any long-term health issues they’re neglecting, they are concerned about that. They want preventative care. There’s a lot of because of the media, interest in vitamin D and zinc. They’re getting more concerned about a healthy lifestyle.” Although patients seek his care for other symptoms, he notes symptoms of anxiety and depression during visits as he discusses their health concerns. Tahir believes that the pandemic is causing those with history of anxiety and depression to experience these issues again. “I’ve had an upsurge in new pa tient requests,” said physician Leila Kirdani, practicing family medicine at Quality of Life Medicine in Rochester. “I’m getting more requests from existing patients to see their family Kirdani members. I feel pretty blessed that my practice has remained currently stable. Most my patients have been with me for a while.” She added that many people who know about functional medicine are asking about supplements to im-

prove their health. Although many people try to be stoic about stress, “it shows up on everybody’s lab” results, Kirdani said. “I’m addressing it with most of our patients. Stress definitely affects our immune system, which isn’t good. Stress can increase inflammation, heart disease and, obviously, people don’t sleep as well so they’re more fatigued. It perpetuates the cycle and leads to poor coping skills.” For providers like physician Ted Barnett, founder of Rochester Lifestyle Medicine Institute and Rochester Lifestyle Medicine Group, the pandemic helped expand the organizations’ reach. The medical group offered telehealth from the start and is now back to offering in-person appointments. “In doing so, the silver lining in the cloud has been that RLMI has been able to reach many more people than we did Barnett previously with in-office programs,” Barnett said. One of his programs has been taken by people in more than 30 states and two foreign countries, he said. “Participants still get the benefit of medical supervision, both by the presence of a medical provider at the Jumpstart Zoom meetings, and by before-and-after medical consults scheduled either with their primary care provider, or with one of our own RLM group providers if the participant lives in New York state or Michigan,” Barnett said. Concerns about immune response have in part driven a 15% increase in patient load for Steven Sadlon, chiropractor and head of Chiropractic Health and Acupuncture in Penfield. “People come in for a variety of reasons,” he said. “Some want an immune boost. Sometimes there’s only so much that traditional practices can do with the filter they work

A Holistic Approach to Wellness & Pain Management

through.” Some of his patients want to reduce inflammation in their bodies, as they believe it places them at a greater risk for becoming severely ill with COVID-19. Several of the diseases listed by the Centers for Disease Control and Prevention for increasing risk of COVID-19 complications have been correlated with inflammation. But, inflammation itself is not directly listed. Sadlon makes recommendations based upon each person’s health and health history. Physician Lesley James, family medicine specialist practicing integrative medicine in Pittsford, encourages patients concerned about COVID-19 to make health decisions based upon evidence-based practices. “People who come to my prac-

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tice are interested in prevention and optimal health,” James said. “I think more people are looking more at preventative health. There are some practitioners out there where people are going because they want to avoid vaccines and they’re looking for alternative treatments which I don’t think that’s good medicine.” She thinks that maintaining sufficient vitamin D levels is important but advises against taking supplements that lack evidence for efficacy in reducing the virus load. For James, maintaining good health comes down to the basics. “Get enough sleep,” she said. “Manage stress. Eat lots of vegetables. Make sure your vitamin D is sufficient. Exercise. Maintain a healthy weight.”

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Health Career

Speech-Language Pathologist The demand for workers in this field is growing over the next few years By Deborah Jeanne Sergeant

he speech-language pathologist does much more than train children not to lisp. The career can include people of all ages and a wide array of issues. According to the Bureau of Labor statistics, the expected rate of growth for the career is 27% through 2028 and those in the Rochester area earn a median annual salary of $77,510. People who want to work as a speech-language pathologist need a bachelor’s degree in speech pathology. After graduation, they can begin working in schools but must earn a master’s degree in speech pathology within five years. After that, they complete a nine-month clinical fellowship year. At that point, they are typically hired as a full-fledged staff member, but are mentored by a

clinical supervisor for a while. To maintain national licensure, speech-language pathologists must take 30 hours of continuing education units every three years. The same credits may apply to both. The American Speech Language Hearing Association is the national organization that issues licenses. Credits may be earned online or through in-person classes. Once speech language pathologists complete the clinical fellowship year, they can then take an exam and, if they pass, receive their certificate of clinical competence. They can also seek board certification. Beyond the education, a few intrinsic qualities can help someone become a speech-language pathologist.

Eat Right for Life Stages

or National Nutrition Month 2021, celebrated in March, the Academy of Nutrition and Dietetics recommends Page 12

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people adjust their eating habits to address the nutritional needs of their bodies during all stages of life. “What works for you in your 20s

“We tend to be very organized,” said Erin M. McCarthy, speech language pathology supervisor of acute care at Unity Hospital. “We often joke that we’re a type A personality. We’re very compassionate and empathetic, whether working with pediatrics, adult or geriatric patients. We really enjoy learning and the educational process. Speech-language pathologists are very invested in their clients, their patients and they truly want to help.” She added that strong English and linguistic skills could be helpful. The settings where they can work include preschools, elementary, middle or high schools, private practices, early intervention, hospitals, skilled nursing, home care, acute rehab settings. “The vast number of patients and disorders we treat blows my mind,” McCarthy said. McCarthy is board-certified specialist in swallowing and swallowing disorders. She currently works parttime at the hospital and part-time at a private practice setting seeing medically fragile pediatric patients in their homes. She has heard from her colleagues who are in the schools that the longer they stay, the less comfortable they feel with coming into the medical setting because those patients may have ventilators, tracheostomy or problems with feeding and swallowing. The specialization includes certified brain injury specialist. McCarthy became interested in the field when she was in sixth grade. Her cousin received speech therapy services and McCarthy’s aunt let her tag along. That early exposure made her aware of the career and she decided that was what she wanted to do when she grew up. McCarthy enjoys the problem-solving aspects of her work and that she can help people work through a disorder or deficit. She recommends that anyone interested in the career should shadow

a speech-language pathologist (pandemic permitting) and see if this is the right path. McCarthy is currently pursuing a clinical doctorate degree through Northwestern University. “My best days are the days I get to work with my patients,” she said. “I can do direct patient care and feel like I’m making a difference in their life.” Janice Masterson is a speech-language pathologist for Finger Lakes Health at Geneva General Hospital. She felt drawn to the wide number of jobs and the variety of the patient population in the speech-language pathology career. She said that it’s a challenging educational path and not an easy graduate program to get into. Her day includes working with doctors and nurses, performing tests and making recommendations and treatment plans. “We see people with brain tumors, stroke, voice disorders and more,” she said. Those working in schools make the same salaries as the teachers. But, they also work only 180 days a year and can work elsewhere during the summer break. Those working in medical settings work on a different pay scale. “You have to have dedication for the profession,” Masterson said. “There’s constant learning every day. Every patient is different and every day is different. You’re never going to get old at it. It’s very rewarding. People are appreciative of the help you give them. We see people with memory disorders from a brain injury or tumor.” Those trained in a medical setting stay in that setting, just as those in the educational setting stay there because of how their training prepares them. “It’s a very rewarding career,” Masterson said. “I think what I’m most surprised about it is that people aren’t aware of it.”

won’t necessarily work for you in your 50s. As you age and evolve, so do your health and nutrition needs. It’s important to eat right for life,” said registered dietitian nutritionist Colleen Tewksbury, a national spokesperson for the Academy of Nutrition and Dietetics in Philadelphia. The new 2020-2025 Dietary Guidelines for Americans provide authoritative advice to help people of all ages meet their dietary needs while limiting added sugars, sodium and saturated fat. The federal guidelines are issued and updated every five years. In addition to maintaining healthful eating habits throughout life, Tewksbury recommends the following tips: • Teens to 20s — Build bone density by eating and drinking calcium-rich foods and beverages such as fat-free or low-fat dairy milk or yogurt or calcium-fortified soy beverages. Non-dairy sources of calcium include fortified cereals, beans, some leafy greens and canned salmon with bones. • 20s to 30s — Reduce your risk of chronic diseases such as obesity, Type 2 diabetes and heart disease by eating more dietary fiber, including whole grains, legumes, fruits, vegetables, nuts and seeds. Women of childbearing age should include

sources of folate, such as beans and peas and dark-green leafy vegetables, and eat foods fortified with folic acid such as breads, cereals and other grain products. A folic acid supplement may also be needed and should be discussed with a health care provider. • 30s to 40s — Continue to eat a variety of nutritious foods, especially plenty of fruits and vegetables, whole grains and beans, peas and lentils for vitamins, minerals, antioxidants and dietary fiber. • 40s to 50s — Fine tune your healthful eating habits and continue to incorporate regular physical activity as your body changes due to fluctuating hormones and slowing metabolism. Also continue to focus on ways to limit foods and beverages with added sugars, salt and saturated fat. • 60s and beyond — Continue to include a variety of protein-rich foods to maintain bone strength and incorporate strength-building activities to maintain muscle. Good sources of protein include seafood, lean cuts of meat, eggs, beans, tofu and nuts. Animal-based protein foods also provide vitamin B12, which is a concern for some older adults. Foods also may be fortified with vitamin B12 or a supplement may be recommended by your health care provider.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

SmartBites

The skinny on healthy eating

Popcorn Is Popping Good for You!

y love affair with popcorn began after my first child. Desperate to shed pregnancy pounds, I reached for the puffy stuff daily. Oh, the satisfaction! It filled me up, I lost weight, it became my BSF: Best Snack Forever. The main perk of popcorn is that it’s a whole grain snack. Unlike refined grain snacks that have been stripped of some nutrients, popcorn, with its entire seed intact, boasts a slew of health benefits. As with other whole grains, consuming popcorn may reduce

inflammation, lower cholesterol and decrease the risk of Type 2 diabetes, heart disease, obesity and some forms of cancer. A three-cup serving of popcorn provides a whopping 3.5 grams of fiber, which is about 14% of the recommended daily intake of fiber for women and about 12% for men. These days, with my finicky digestion and high cholesterol, all that fiber makes me deliriously happy, not to mention, remarkably full. A recent study, in fact, found that 15 calories of popcorn was just as satisfying as 150 calories of potato chips. Beyond its fiber, popcorn is a good source of polyphenols, which are powerful antioxidants that have been linked to better circulation, improved digestion and a reduced risk of certain cancers and age-related diseases. Looking to lose some weight? Popcorn is a dieter’s best friend. It’s

super low in calories (a three-cup serving of air-popped popcorn has fewer than 100); it provides prolonged satiety because its complex carbohydrates take longer to digest; and it has scant fat and salt. Of course, popcorn can quickly become an unhealthy snack if it’s doused with oil or butter, salt or sugar. A big tub of movie theater popcorn, for example, can inflict over 1000 calories and several days’ worth of salt and fat. So, mindful preparation is key. Air-popped popcorn is your healthiest bet because it provides some control over the seasonings added afterwards. Microwave popcorn can be a healthy choice, too, especially since most brands have removed trans fats and the chemical linked to “popcorn lung” — the wheezing disease that resulted from fumes inhaled when a bag was opened.

Helpful tips When buying microwave or popped popcorn, read labels carefully. You might be surprised by the calorie and sugar counts of kettle corn, as well as the calorie and salt counts of cheddar cheese popcorn. Pop your own kernels in the microwave using a brown paper bag or (my favorite!) a silicone BPA-free popcorn popper. pinch of cayenne (optional) ¼ teaspoon salt Pop the popcorn kernels: in the microwave (using a folded-over brown lunch bag or a silicone popcorn popper) or in an air popper. If using a microwave, cook until there are 2 to 3 seconds between pops, about 3 minutes. Transfer the popcorn to a big bowl. In a small glass bowl, mix together the olive oil and all the spices, then microwave for 20 seconds and stir again. Drizzle the oil mixture over the popcorn, tossing with your hands. Enjoy!

Anne Palumbo is a lifestyle colum-

Fajita-Flavored Popcorn ¼ cup popcorn kernels 1 tablespoon olive or canola oil ½ teaspoon chili powder ½ teaspoon ground cumin ¼ teaspoon paprika ¼ teaspoon garlic powder ¼ teaspoon dried oregano

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

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April 2021 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Mental Health

Daniel’s Law Seeks to Help Mental Health Crises The legislation is ‘a benefit to a person in crisis’ By Deborah Jeanne Sergeant

n Feb. 4, New York Assemblyman Harry B. Bronson (D-138) and Sen. Samra Brouk (D-55) introduced legislation to establish state and regional mental health councils to bring mental health care professionals to the scene of mental health emergencies and train 911 dispatchers to summon the needed personnel. The proposed law is named “Daniel’s Law” after Daniel Prude, a man who died in March 2020 of asphyxiation days after an altercation with Rochester Police. Prude was experiencing a mental health crisis and was allegedly high on PCP, a mind-altering drug that may lead to hallucinations. The law seeks to meet the needs of people who need crisis services for which law enforcement officers may not have adequate training. James Acquilano, a semi-retired licensed psychologist, calls the legislation “a benefit to a person in crisis.” Acquilano worked for the Office for People with Developmental Disabilities and Office of Mental Health and has extensive experience with people in crisis. He currently consults with organizations serving people with brain injuries, epilepsy and developmental disabilities. Acquilano said that the typical responses of law enforcement such as authoritative postures and commands work well in typical scenarios, but not for soothing people in a

mental health crisis. In addition, “if physical restraints are used too early in an intervention, they may lead to an escalation and the person with mental health needs or the law enforcement personnel may become injured,” Acquilano said. “In addition, if a law enforcement officer is involved in a physical intervention it is potentially a crime charged against the person with mental health needs. It is typically not charged as a crime if a mental health professional is involved in a physical intervention.” “I think this law is a good first step towards moving us in the direction we need to be,” Acquilano said. “There’s a perception in our society about those with mental illness that is similar to the one where people think that people of color are more violent. Some think that people with mental illness are more prone to violence and neither of those is true. We need to move people away from that viewpoint. If people come into a crisis and have a perception that people with mental health issues are dangerous, they will move towards control.” He added that many people with underlying mental health issues are driven to a point of crisis because of the stressors of inadequate support such as housing and physical and mental healthcare. With those needs taken care of, “people are less likely to be in a state of crisis. There’s a

huge systemic change that needs to take place. We need to figure out why the person is in crisis.” Although law enforcement personnel receive some training in crisis intervention, it is not at the level of a mental healthcare provider. “There are some law enforcement personnel that do a good job; however, it should not be their job to be the first responders to people with mental health disorders who are in crisis,” Acquilano said. “As with any professional, the more jobs you ask them to take on, the more stressed they become and the less efficient.” Since law enforcement personnel are trained to both gain control of situations and enforce the law, their expertise is not attuned to supporting mental health issues, according to Charles E. Cote, licensed clinical social worker in private practice in Rochester. “Mental health is not their expertise,” Cote said. “What we see in Rochester is situations escalating unnecessarily as people with mental health issues are treated as engaging in criminal behavior. Mental health approaches could de-escalate these situations to avoid ending in vio-

lence. There still might be violent situations that can happen in a mental health episode, but someone with mental health training could help de-escalate. Law enforcement does this, but it is not their core competency.” He said that part of the problem is that some people view law enforcement personnel “as someone trying to arrest them or get them into the criminal justice system,” Cote said. That misguided perception of the police as foe and not as a helpful community resource may be hurting the chances of law enforcement personnel de-escalating mental health crises. Peg DeBaise, licensed marriage and family therapist in private practice in Brighton, pointed out that the training level among mental healthcare providers affects their ability to assist in mental health emergencies. “There’s a specialization in dealing with crisis,” she said. “Not all of us are trained in crises intervention. That’s why with continuing education, we do things like learn about suicide prevention and how to help people when they’re at their lowest point of crisis. Not everyone can do this.”

Mental Health Providers in Short Supply The profession has seen drastic changes in recent years By Deborah Jeanne Sergeant

s with physical healthcare providers, America is facing a crisis-level shortage of mental healthcare providers. The US has 30 psychologists per 100,000 people and 15.6 psychiatrists per 100,000. More than 115 million people live in designated shortage areas where the ratio of mental healthcare provider to resident is lower than 1 per 30,000 people, according to www.goodtherapy.org. As the stressors of the pandemic have raised the need for mental healthcare, the problem has worsened. While expanding insurance coverage to include telehealth visits has helped, it cannot solve the dearth of providers. Peg DeBaise, marriage and family therapist in private practice in Rochester, said that the area of child psychology particularly lacks professionals. “When I try to find psychiatric services for children, if a child or an adult has a crisis, they’re sent to the psychiatric ER. What happens is

Page 14

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they’re evaluated and sent back out into the community,” DeBaise said. “If they have a mental health provider, it’s assumed they’re okay. We’re the ones who sent them to the in-patient. The emergency situation is bad and the lack of psychiatric providers for both children and adults.” She is completely booked at her practice and knows many other mental healthcare providers who also cannot take on any more patients. Charles E. Cote, licensed clinical social worker in private practice in Rochester, receives many more requests for care than he can handle. “I hear from a lot of people saying they’re having trouble getting appointments,” he said. He added that for those who are underinsured, the problem is even worse. Some providers with openings do not want to take on clients whose insurance will not provide sufficient remuneration, although many offer sliding scale fees and pro bono appointments. He believes that some providers do not want to work with children as

their cases are more complex. “You work with the children and family system and community,” he said. The aging baby boomer generation is decreasing the pool of therapists faster than they are being replaced by new therapists according to www.goodtherapy.org. James Acquilano, a semi-retired licensed psychologist in Rochester who currently consults with organizations serving people with brain injuries, epilepsy and developmental disabilities, said that more people are turning to primary care providers and physician extenders for pharmacological treatment because there are fewer psychiatrists. “If you go back to when the baby boomers were first starting to work, it was a more viable field,” Acquilano said. “There were new treatments starting up. It drew a lot of people in. More recently, it’s not that popular of a field so fewer and fewer are coming in. It’s not just due to financial reason. It just doesn’t attract people. There are a lot of other jobs that peo-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

ple might move towards.” While those entering mental healthcare usually do so to help people, they discover that much of their time is consumed by non-billable services such as completing paperwork and responding to insurance companies and Medicaid. “It makes it difficult,” Acquilano said. “Due to that, some providers have gone to private pay, which decreases the number of people available.” He said that in addition to children and people who are underinsured, those who are chronically impaired in mental health are often overlooked. “Insurance companies want to say you get 10 or 20 sessions and to move them on,” Acquilano said. “For more chronically mentally ill people, that’s not a reality. There may be services needed for months or years.”

Things You Need to Know About Foot Care

Proper foot care helps ensure overall good health By Ernst Lamothe Jr.

onsistent foot care is often overlooked until it’s too late. However decisions you make about your overall health can impact your feet. Diabetes complications can include nerve damage and poor blood circulation that can affect the area and lead to amputations if not properly handled. “Any visit to a podiatrist for vascular compromised feet would include a proper vascular work up, monitoring for pressure sites to prevent ulcerations and recommendations for the most appropriate footwear based on individual patient assessment,” said John Ellie, a board-certified podiatrist at St. Ann’s Podiatry Place in Rochester. Ellie offers five essential thoughts about foot care.

diseases 1.Vascular impact the feet

Peripheral vascular disease is a very common illness that unfortunately affects many middle-aged and elderly adults. This disease can be due to many other conditions such as diabetes, poor diet, smoking and some genetic disorders. Peripheral vascular disease in itself or as a component of other diseases can impact the feet. “Absence of hair growth, pain, skin and nail changes, as well as slow healing are all signs of a compromised vasculature to the feet. Probably the most important impact on the

feet is pain,” said Ellie. In addition, peripheral artery diseases affect the circulatory system where narrow arteries reduce blood flow to your limbs. When developing peripheral artery disease, your legs fail to receive enough blood flow to keep up with needed demand for your body. It can cause leg pain when walking.

your soles or padding if necessary can lighten the impact of walking or running. “You have to self-monitor to ensure that changes in hair growth to the lower extremity and nail changes are noticed early on. You must do routine podiatry visits for patients with any changes to lower extremity skin and nail changes,” said Ellie.

2.Watch for symptoms

falling prey to 4.Avoiding myths

Your feet can serve as an impactful litmus test for your overall health. Dry skin can be an indication of thyroid conditions, foot numbness can be a sign of early diabetic issues and black spots could be the first signs of melanoma. Even sore feet may be an indication of heart disease. “You will see warning signs of vascular disease including pain at rest, calf pain while walking, skin and nail changes and slow wound healing,” said Ellie.

3.Preventive steps help

While random foot accidents and injuries can’t be prevented, there are myriad ways to make sure you are doing the best you can to keep your feet strong. Podiatrists suggest running regular checks on your feet. Any loss of sensation should be a warning. Also washing and drying your feet properly is key because moisture can stay trapped and lead to sores. Wearing comfortable footwear that cushions

Autism Awareness

Pandemic Has Varied Effects on Autism Organizations By Deborah Jeanne Sergeant

onprofits relying on donor funding have been affected in different ways the by pandemic. As some families may still feel the strain from work layoffs and furloughs, others work for businesses that have boomed during the pandemic. Depending upon their type of donor funding, autism organizations may be struggling or doing fine financially. Jen Hackett, executive director of Camp Puzzle Peace, Inc. headquartered in Penfield, said that the pandemic has curtailed the organization’s fundraising efforts. “We usually do a number of fundraising events, but we were not able to last year and still not sure for this year,” Hackett said. “The pandemic has caused a huge strain on our organization. We have had to be very frugal.” If conditions continue as expected, Camp Puzzle Peace’s annual golf tournament, usually held in September, may be “on” for this year.

Organizations that rely more on a variety of donation sources, especially larger gifts over fundraisers, are doing better than others. Empreinte Consulting, LLC in Pittsford, works with nonprofit in many sectors and advises philanthropists and organizations as to how to give. Marc Misiurewicz, president, said that autism organizations are among the 40 nonprofit clients the organization has helped in the past two years. “It’s been interesting,” he said of the pandemic. “We saw a slight increase in philanthropy from grants and private organizations. Individual fundraising changed as it became the annual appeal level.” Misiurewicz said that autism organizations’ biggest hurdle is showing that they still need financial support and that dollars donated will have a positive impact even though the ability to deliver services has been hampered by the pandemic. “People have struggled with access to services,” Misiurewicz said. April 2021 •

When it comes to foot care information, myths abound. There are some who believe if you can walk on your foot that means it is impossible for a broken bone to exist. “There are many myths that I would like to dispel when it comes to overall foot care such as many home remedies for thick fungal nails are ineffective, the idea that pain is normal with aging and treating your broken toe at home,” said Ellie. Another myth is people who say their feet don’t change once they become an adult. “Most people find their feet changing after skeletal maturity due to lifestyle changes and exercise,” said Ellie. “Tendons and ligaments weaken, as do bony structures. When tendons weaken, people can see a major change in foot structure and size. Arthritis also plays a major role in reshaping bones. These changes can lead to foot deformities, causing pressure, which can eventually lead

“Are we able to demonstrate we need your money because we can use it in a way to provide services? It’s been a challenging year for individuals with autism. We’re starting to turn the corner, though.” He added that non-profits that requested COVID-19 relief did well in receiving $100 to $200 gifts. But the major gifts at the “annual appeal level” of $25,000 or larger depend more upon personal relationships and one-on-one interactions. Usually, those are not generated through fundraisers, unless that serves as the point of first contact. “We’ve seen organizations shift to a greater emphasis on annual appeals, grants and personal appeals,” Misiurewicz said. Rather than hosting virtual events—which Misiurewicz said have mixed results—he said his company has helped organizations develop strategies for engagement and outreach. That begins with building a case for support and developing a meaningful relationship. The success of virtual events relies heavily upon the ability to use technology successfully. But Misiurewicz warned that “Zoom fatigue” has led some organizations to experience poor turnout, which in turn leads to lower fundraising levels. When people attend virtual work meetings all day and help their children with virtual meetings, they likely will not want to attend yet

John Ellie, a board-certified podiatrist at St. Ann’s Podiatry Place in Rochester. to skin breakdown and non-healing ulcers.”

5.Barefoot is not ideal

Ellie said there are some mistakes that people make routinely when it comes to taking care of their feet. One of them is going barefoot around the home or outside, which can cause an injury that patients are unaware of or an injury that does not heal. “I would absolutely agree with anyone who asks me if walking barefoot is bad for you,” added Ellie. “Barefoot walking or running has been a hot topic for many years. Most current literature agrees that less support causes more foot problems. Barefoot walking and running puts patients at very high risk for pain, injury and possible ulceration.”

another virtual meeting. As COVID-19 restrictions begin to loosen, Misiurewicz said he is speaking with some organizations about hosting in-person events comprised of small groups of 20 or fewer, such as golf tournaments. Many people will likely embrace the opportunity to get out and do something in person again. Because fundraising events incur sizable overhead and require much planning, they are not as remunerative as flat-out donations. Misiurewicz said that a golf tournament could raise $40,000 but one donor giving $40,000 as an annual gift would make acquiring those dollars much easier. But fundraisers provide a big benefit for non-profits: awareness. Non profit organizations usually want to promote their cause and fundraisers offer a good opportunity to share their message. They also result in subsequent gifts are more people become cognizant of their needs. “We urge clients to have smaller, more intimate events where people can share their story,” Misiurewicz said. He envisions this summer as becoming “inundated with walks, 5ks and small outdoor events,” he said. “I think fall will be very busy as many organizations feel this will be the time to reengage on a mass scale.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

Autism Awareness

Dogs Serving People with Autism

‘Man’s best friend is much more than just a family pet By Deborah Jeanne Sergeant

ssistance dogs can perform more tasks than guiding. Their role has expanded considerably to provide help for a variety of needs, including helping people with autism. At Camp Puzzle Peace, Jen Hackett, executive director, is training a dog to work on the trail. “The goal for the CPP dog is to help children develop some independence on the trail,” she said. “He is being trained as a therapy dog and will be able to be tethered to an individual and if that person should try and elope then then a command will be given and the dog will drop to secure the individual.” By fall, her dog, Quin, will be about 100 to 120 pounds, plenty sizable to deter a child prone to wandering. Hackett clarified that a therapy dog and a service dog “do not have the same access.” She said, “On the trail we will have service dog accessibility but we will need to consider people bringing

therapy dogs to the trail.” Therapy dogs are trained and can be certified to aid in providing comfort and emotional support. Service dogs can also provide emotional support but are also trained and certified in specific tasks to help mitigate the effects of a disability. Karen Shirk, CEO and founder of 4 Paws for Ability in Xenia, Ohio, has bred and trained dogs for service for 20 years, including for people with autism. She places 120 trained dogs annually. As the mother of a child with autism, she understands what families with an autistic child experience. She is also a person who relies upon a service dog for her own disability. “They have a lot of issues with behavior,” Shirk said of children with autism. “A lot of times the children have meltdowns and if they’re non verbal, there’s no way to know why they’re in such a state. They usually have certain behaviors before they go into a meltdown and we use the dog before they get into that state. They

can have the dog touch the child. That can disrupt or break the thought process with repetitive behaviors. The dog can also lie across part of the child’s body. It gives weighted, deep pressure that sensory seeking kids need.” By minimizing the number and extent of meltdowns, families can feel freer to go places and spend time in public with their children. Along with reducing behavioral issues, service dogs can also wear a harness that can tether the child to prevent children from bolting from their parents. “The family can walk and hold the leash of the dog and the child won’t get away,” Shirk said. “What we’ve seen in 20 years is that these children accept that boundary. We’ve had parents try it with themselves in place of the dog and the children retaliate and want the parents to let them go. They don’t like it.” At times, when the child cannot be tethered, such as at a playground, the service dog is trained to track the child in a search and rescue fashion. Shirk recalled a dog she placed that tracked a child who disappeared at 10 p.m. With a minus 10 degrees windchill, the child was unclothed and in danger. Within minutes, the dog tracked the child to a neighbor’s heavily wooded lot. “The family would likely not have found that child in time to save that child’s life,” Shirk said. Since 60% of children with autism have other, unrelated neurological conditions, service dogs can be trained to assist with other tasks such as sensing seizures so the child can lie down in a safe place and minimize the risk of injury or altering diabetic emergencies. “These dogs are service dogs under the Americans with Disabilities Act and are task trained to mitigate disability,” shirk said. “The family can navigate the community with this dog and can go anywhere a guide dog can go.” In addition, service dogs perform helpful tasks that are not trained, such as providing a social bridge for children who typically feel left out and stigmatized because of their differences. Typical children spot the service dog and gravitate towards the child with autism. These interactions can help foster friendships something

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that can challenge children with autism. Shirk said that she provided a dog for a boy with autism who showed him a picture of his “home planet.” “He said that everyone there accepts you as you are and doesn’t care you’re different,” Shirk said. “It struck me deep. Six to nine months after he got his dog, he said, ‘Karen, I’m not really from that planet.’ With the dog, people got to know him. Everyone in his town knew his name.” Dogs also help children with autism better understand emotional relationships and practice making connections by bonding to their dogs. Animals are always happy and interact in a simpler way than people. Shirk said that dogs aren’t right for every family. However, for some, they make a significant difference, such as Heather Burroughs and her daughter, 14-year-old Devyn Pereira, of Hilton. The girl has Angelman syndrome a rare neuro-genetic disorder and autism. Burroughs had worked as a school psychologist and recognized that her daughter missed developmental milestones. At 17 months, she was diagnosed. Angelman syndrome brings its own challenges, including seizures, limited communication and difficulty with walking. Acquiring a service dog helped Devyn learn to walk, communicate, and improve her interactions with others. Her dog could also warn her about seizures and provide comforting weight and pressure. Burroughs, now the director of the behavioral health team at Monroe Community Hospital, said that the service dog changed Devyn’s life. “She went from crying and trying to leave to staying and trusting that if she stayed with the dog, she felt safe,” Burroughs said. “It was so nice. She went from being in a wheelchair to walking, as the dog helped her move more and get stronger.” Burroughs also noticed that Devyn’s dog helped more children want interaction with her. She learned about personal interaction and relationships. Instead of Devyn’s differences turning others away, the dog helped draw them in. “They remembered she was a little kid,” Burroughs said. “That was an aspect I hadn’t considered.”

Autism Awareness

Pandemic Creates Learning Challenges for Children with Autism Things like remote learning and masks make things difficult for a student with autism By Deborah Jeanne Sergeant

For more information, call Riley Eike at 585-412-9040 x1322 or email: reike@happinesshouse.org

U P C O M I N G E V E N TS !

he COVID-19 pandemic has brought a plethora of changes to everyday life, including to children newly educating at home. For children with autism spectrum disorder (ASD), learning in the classroom was already challenging. Filtering lessons through Zoom or other remote means adds an additional layer of difficulty. Jen Hackett, a teacher with Webster Central School District, teaches children with ASD as part of the virtual team. She calls remote learning “very challenging.” Hackett is also executive director of Camp Puzzle Peace, Inc., headquartered in Penfield. “The lack of socialization for these kids is huge,” Hackett said. “For many kids with ASD, they struggle with socialization and interacting with others.” Schooling at home may seem a big relief and a welcomed retreat. However, Hackett said that is not what they need. “Face to face schools forces them to interact with others and be social,” she said. “We are greatly concerned the impact the isolation will have on them.” Heather Burroughs, a Hilton resident, knows that all too well. Her daughter, Devyn Pereira, has autism. The 14-year-old had been learning at home through Hilton Central School District.

“With remote learning for Devyn, you might as well not do it,” Burroughs said. “She will tune into what’s important to her like her music therapist playing a song, but she’d much rather be in person. On the screen, it’s like a boring video they’re making her watch.” Devyn is not verbal, which makes it even tougher for her to learn remotely. Burroughs is thankful that the school district allowed her daughter to go back to school five days a week. Otherwise, Burroughs feared her daughter would begin to lose her hard-earned skills. Going through the pandemic has been hard enough on her education and socialization. “Not being able to go to stores and restaurants and practice skills has been a big deal,” Burroughs said. “All children benefit from the social experience, but for children with autism, they need extra opportunities to practice skills.” Burroughs directs the behavioral health team at Monroe Community Hospital and has previously worked with children with disabilities in a school setting for 15 years. Some children on the autism spectrum struggle to understand appropriate social interactions. Changing the “rules” because of the pandemic confuses matters further. “Now having social distancing, they’ll never be as able to accept a

Devyn Pereira is a student at Hilton Central School District. “With remote learning for Devyn, you might as well not do it,” her mom says. “She will tune into what’s important to her like her music therapist playing a song, but she’d much rather be in person. On the screen, it’s like a boring video they’re making her watch.” kind gesture like a high five or pat on the back,” Burroughs said. “’Those things aren’t important’ is what they’ll start to think. I worry for kids with autism now. Once they learn something a certain way, it’s hard to change.” Burroughs said that her daughter’s classroom team has worked to help send home materials as needed. But while she educated Devyn at home, it was difficult for Burroughs to instinctively mimic the teaching methods that her teachers were using at school. “I don’t want to undo anything,” she said. “A lot of times, remote learning was me and one of her aids at home. She has people with her all the time; they were teaching us to teach her. You don’t want to do it wrong.”

Burroughs said that learning at home is also confusing to children accustomed to attending school because home should be where they relax, have fun and unwind. Even though Devyn is back at class, it’s still difficult. Though Devyn is not deaf, she relies on facial expressions to help process what is spoken. The presence of the masks — both in muffling speech and obscuring the speaker’s face — adds yet another layer of barrier for Devyn to work through in addition to the other stimuli that are not miniscule to her. “If the light is buzzing, her shirt’s tag is itchy or her sock is crooked, those things are all distracting for a kid with autism,” Burroughs said. “It makes it 10 times harder for them to understand the situation.”

Medication Drop Box Locations BRISTOL

Town Hall (585.229.4523)

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Autism Awareness Walk Join us online for a fun and inclusive, community walk to celebrate diversity and raise awareness for Autism!

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DMV Office (585.396.4210) FLCC, near gym (585.785.1000) Police Department (585.394.3311) The Medicine Shoppe (585.337-4300) Thompson Hospital, lobby (585.396.6000)

Police Department (315.828.6771) North Street Pharmacy (315.787.5388)

HOPEWELL

Ontario County Mental Health Clinic (585.396.4363)

NAPLES

Village Hall (585.374.2111)

PHELPS

Community Center (315.548.8484)

CLIFTON SPRINGS

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Hospital & Clinic, lobby (315.462.9561) Town Hall (585.657.6515)

FARMINGTON

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Town Hall (585.229.5757) CVS Pharmacy (585.229.2285) Village Hall (585.554.3415)

SHORTSVILLE

Red Jacket Pharmacy (585.289.3002)

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Page 17

Autism Awareness

Jones Leads Community Efforts to Combat Autism More needs to be done to increase autism awareness By Todd Etshman

hen Lawana Jones was invited to the Obama White House in 2011, for the first ever World Autism Day Conference, the Rochester area disability rights advocate and president of the Autism Council thought it was a prank. It wasn’t, however. Jones has been tirelessly working to increase autism awareness in the community and training medical and educational personnel to assist those with autism for more than 25 years. Awards for her tireless volunteer effort are common including being the 2020 Woman of Distinction for the 56th Senate District.

The work of Jones and the Autism Council

Jones has become the go-to person in Rochester for autism assistance, advocacy, education and support. She founded the Autism Council to help support the 85,000 to 90,000 people in the metro area who she estimates have it. The council strives to give everyone afflicted with autism the same opportunities to succeed that others have. In addition to volunteering countless hours to autism and mental health awareness and response, Jones is finishing her master’s degree in education at Nazareth College and working full time in IT. Former state Sen. Joseph Robach encouraged her to run for office but if anything she said she may have seen enough of politics from the sidelines and might prefer an administrative role in government instead. “I went down this path because I had to,” she said referring to her parental experience with her autistic daughter, Marsche, 31, who can’t converse but is a musical genius.

There was no one to really help her and she doesn’t want others to feel there is nowhere to turn. Today, parents of children with autism call her to find out what towns and schools do the best job for students with autism. Unfortunately, she said, it’s not the Rochester City School District. As a certified autism trainer, Jones provides training to special education teachers who are required to have three hours of autism education training. In addition, Jones provides training to those who are likely to come into contact with autistic persons such as first responders, law enforcement, nurses and fire departments. She singles out Irondequoit as an autism-friendly town that sought her assistance in training law enforcement personnel and town officials. Webster, Greece and Gates town representatives have worked with Jones and The Autism Council, too. The council and its volunteer staff works to eliminate the stigma associated with autism by creating viable opportunities for inclusion, employment and social activities through support services and advocacy for those on the autism spectrum.

Jobs

In 2015, Jones began a yearly job fair for those with autism. Like most everything in the pandemic, it’s virtual this year. Many on the autism spectrum are particularly good at software development and have mathematical skills, something Microsoft recognized and developed a job hiring program for. Having an extraordinary talent

is not unusual for those with autism, but their perception of the world around them is noticeably different. They have trouble expressing their feelings and may exhibit odd or negative behavior.

What autism is

“It’s a neuro developmental disorder,” she explained. “It affects the development of a child’s brain and manifests itself in social interaction, communications and behavior.” The lifetime affliction is typically found medically at 18 months or older at child wellness visits. The age of diagnosis is later for Latino and African American children. The needs of children with autism are very different than normal students, Jones explained. And, their parents may not be able to help them if they aren’t committed to learning what it takes.

We can do better

Jones grew up in the city but went to Pittsford as part of an urban transfer program. In the 1980s children with autism were much less understood, kept in separate areas of school and not included in all activities. Today, she said, “We’ve done a good job of integrating them but not of supporting them. We are better than we were with regard to recognizing it today, but we have to dig deeper.” We can’t have Trevyan Rowe happen again, she said of the unfortunate incident in which a young man with special needs lost his life after wandering away from a city school that didn’t recognize he was gone. Switching to remote learning in the

Lawana Jones leads Autism Council of Rochester. COVID-19 era is particularly bad for autistic children who benefit from a predictable schedule and being with friends. Jones said there is no special protocol for students with autism who must log on to their computers like everyone else for remote learning that suits them even less than normal students. Parts of their education have to be done in person such as speech and language and occupational therapy. “We’re missing out on a big opportunity to show people we know how to do this right,” Jones said. “There is so much more that could be done here but nobody cares enough to put up the funding. They want to say Rochester is rich in mental health and autism services, but people aren’t connected to those services.” For more information on Lawana Jones and the Autism Council, go to www.theautismcouncil.org.

The Norman Howard School: The Value of In-Person Classes By Deborah Jeanne Sergeant

erving children with special learning needs, The Norman Howard School in Rochester has met the challenges of educating during the pandemic. The school offers a small, structured and supportive learning environment with full access to the general education curriculum. When most schools suspended in-person education in March 2020, Norman Howard continued school via live, remote instruction via the Chromebooks distributed to each student. Last spring, the school hosted an in-person ceremony to honor graduating seniors. Beginning in the fall, the school was one of the few in the region to offer in-person schooling five days a week, although some students chose to stay remote because of health concerns in their household. About 50 of the 100-plus students are on the autism spectrum and are Page 18

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taught using a wide range of social, emotional and learning strategies. The school accepts students in grades 5-12. Rosemary Hodges, the school’s co-head and longtime director of education, credits the school’s faculty with developing creative ways to keep students engaged both remotely and in-person. “Our teachers have had to become adept at delivering to students in the classroom and the few at home,” she said. “Those at home need to follow along with the instruction and feel motivated to learn. We have a very creative faculty. They’ve really worked hard to keep it lively and motivating.” To accommodate in-person learning, the school reconfigured its space. Teachers travel to rooms so that small cohorts of students stay together. This strategy is designed to minimize exposure in case of an outbreak.

“Our students all have learning challenges,” Hodges said. “We feel that in-person helps them stay engaged. Our teachers can give them the support they need. It’s important for our students to socialize with others and have the genuine experience they had pre-pandemic even though they are wearing mask.” This strategy is not possible at all schools. Norman Howard’s student body size and its building configuration has helped the school rearrange classes to improve the safety of going back to school live. “When you have larger schools, it’s so much harder to have a place for everyone,” Hodges said. “They have to go to hybrid models. We’re very thankful we can use an in-person model.” Although those studying remotely can at least keep up with their class, it is less than ideal, especially for children with special needs that

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

affect their understanding of social situations and relationships. “Remote learning just doesn’t have the richness of the interaction between a teacher and student,” Hodges said. “Also, if the student is online, they don’t have their peers.” The school’s outdoor space includes an amphitheater, which has been used as a teaching space in good weather. Despite all the maintained normalcy, students miss elements like most extra-curricular activities such as drama club and yearbook club. With a few restrictions, ski club continued this year. “We’re looking forward to getting our full array of extra-curriculars back,” Hodges said. “Our seniors would sell pizzas for fundraisers or operate a sub shop and we couldn’t do that. But we’ve been able to have the kids in school which is most important.”

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Dear Viagra, It’s true. If you’re age 62 or older and are still raising young children, there’s a Social Security benefit strategy that can put some extra money in your family coffers. Here’s how it works. When you file for Social Security retirement benefits, your minor children can get money on your work record equaling half of what you would receive at full retirement age, now gradually rising from 66 to 67. Even if you were to take a smaller benefit by claiming earlier, your kids will still get half of your full-retirement age amount. To qualify, your daughter — whether she’s biological, adopted or a stepdaughter — must be unmarried and under age 18. Kids who are over 18 but still in high school, can collect too until they graduate or turn 19, whichever comes first. (Other rules apply to kids that are disabled.)

But that’s not all. Because one of your children is only 14, your wife (if you’re married) can collect Social Security benefits on your work record too, and it doesn’t matter if she’s just 40 years old. The minimum age requirements to collect retirement benefits (62) or survivor benefits (60) does not apply when it comes to collecting benefits as the caregiver of a young child. The spouse’s benefit, which is also worth up to half of your benefit, will stop when your daughter turns 16. But note that there are limits to the amount of money that can be paid to a family. The Social Security “family maximum payment” is determined by a complex formula and can range from 150% to 180% of your full retirement benefit amount. If the total exceeds that, each person’s benefit, except yours, is cut proportionately until it equals the maximum. Here’s an example of how that’s figured. Let’s say, for example, that your full retirement age benefit is $2,400 per month. That would make your family maximum benefit (according to the Social Security formu-

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la at SSA.gov/oact/cola/familymax. html) roughly $4,200 per month. Subtract your $2,400 benefit from the $4,200 family maximum benefit, which leaves $1,800. That’s the monthly amount that can be split between your two children — $900 each. If your wife wants in on it too, the individual checks are smaller, at $600 a piece, but the family amount is the same. You should also know that minor children can collect up to half of a disabled parent’s Social Security disability benefit. And if the parent dies, they will get a survivor’s benefit, which is up to 75% of the deceased parent’s basic Social Security benefit. To learn more, see the SSA publication (No. 05-10085) “Benefits for Children” at SSA.gov/pubs/EN-0510085.pdf.

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One Caveat Social Security benefits for your kids may not be available before full retirement age if you are still working. In 2021, you will lose $1 in benefits for every $2 earned over $18,960, except in the year you reach full retirement age. In that case, the earnings limit is $50,520, with $1 in benefits withheld for every $3 earned over the limit. If you lose your benefits, your dependents also lose theirs. You can recoup those payments later, but your kids can’t.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. April 2021 •

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Page 19

Ask St. Ann’s

By Michael E. McRae

‘New Normal’ for Nursing Home Visits

ith spring just around the corner, we’re all looking forward to a little fresh air. That means not only better weather but also a refreshing change in our lives now that COVID-19 vaccinations are under way. This includes new visitation policies at nursing homes in accordance with federal and state health guidelines — welcome news for residents, their families and those of us who work in senior care. It doesn’t mean, however, that everything is back to normal — or at least what “normal” used to look like. Nursing homes continue to serve those who are the most vulnerable. It has always been our top priority to protect their health and safety. Over the past year that bar has been even higher, and thanks to an extremely dedicated workforce we have risen to the challenge. Get vaccinated We’ve also been at the forefront when it comes to vaccinations. St. Ann’s Community, for example, has offered the vaccine to all of its residents and staff, as have nursing homes across the state. Similarly, we encourage visitors to get the vaccine if you are eligible. When you do, you develop enough antibodies to help your body fight COVID-19 effectively and potentially prevent it altogether. While no vaccine is perfect, it’s safe to say that the vaccines now available and those to come will be crucial in ending the pandemic. Even if you’ve already had COVID-19 and developed antibodies, it’s wise to get vaccinated so you are protected against future infections. The Centers for Disease Control and Prevention (CDC) recommends waiting 90 days after your infection to be vaccinated. Get tested We also continue our focus on testing. Currently nursing home employees are required to be tested twice a week to reduce the risk of virus transmission in our communities. At St. Ann’s we have invested in “point of care” testing, which means employees can be tested on site. The tests are self-administered and yield

results in just 15 minutes. Testing is important for nursing home visitors, too. The New York State Department of Health recommends they test negative for COVID-19 before their visit. That’s sound advice. Free, rapid testing for individuals who are not exhibiting symptoms is offered by the Monroe County Health Department. (Details at monroecounty.gov/health.) At St. Ann’s, for the convenience of our visitors, we offer “point of care” testing Mondays and Thursdays from 10 am to 2 pm. As with our employees, visitors can self-administer the test and get results in 15 minutes. (Details at stannscommunity.com/coronavirus.) We encourage everyone to take advantage of testing to ensure a safe visit with your loved one. Stay vigilant The everyday precautions we’ve been taking for the past year continue to be important in helping keep everyone as safe as possible. That means social distancing, wearing masks and frequent hand washing/ sanitizing. These measures remain in place in nursing homes (and elsewhere) even as vaccines lower the risk of infection. By remaining vigilant and not dropping our guard, we can enjoy the beauty of springtime and in-person visits with our elders while maintaining good health for all. Note: By the time that this article is published, some information may have changed. Contact St. Ann’s Community if you have any questions. Michael E. McRae is president and CEO at St. Ann’s Community. For more information about St. Ann’s, visit www. stannscommunity. com.

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Ask The Social

Security Office

From the Social Security District Office

Submit your Disability Update Report Online

e are required to conduct continuing eligibility reviews for disabled beneficiaries every three years. This process requires that beneficiaries complete a Continuing Disability Review mailer to update information about their medical conditions and recent treatments. We now offer an online option to complete this update and provide any supporting documents about your medical treatment or your work. We designed this new form with convenience in mind — and to save you time. You can access the online form at www.ssa.gov/ssa455-onlineform. (Use either Microsoft Edge or Google Chrome for the best online experience.) You will need your Social Secu-

Q&A Q: Who can get “Extra Help” with Medicare prescription drug coverage? A: Anyone who has Medicare can get Medicare Part D prescription drug coverage. Joining a Medicare prescription drug plan is voluntary, and you pay an additional monthly premium for the coverage. People with higher incomes might pay a higher premium. If you have limited income and resources, you may be eligible for “Extra Help” to pay for the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan. To qualify for “Extra Help,” you must reside in one of the 50 states or the District of Columbia. For 2021, your resources must be limited to $14,610 (or $29,160 if you are married and living with your spouse). Resources include such things as bank accounts, stocks and bonds. We do not count your house and car as resources. Your annual income must be limited to $19,140 (or $25,860 if you are married and living with your spouse). Even if your annual income is higher, you still may be able to get some help. Learn more at www.saa. gov/prescriptionhelp. Q: If I receive Supplemental Security Income (SSI) disability benefits, what is the effect on my benefits if I work? A: In most cases, your return to work would reduce your benefit amount. Unlike Social Security disability, there is no “trial work

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

rity number, your current address and phone number, and a valid email address to complete the form. Also, you must have received a request for an updated disability report in the mail. Once you “Click to Sign,” you will receive an email from echosign. com asking you to confirm your digital signature. Check your junk folder if you don’t receive it within a few minutes. Your signature isn’t complete — and your form won’t be processed — until you complete the instructions in your email. Please visit our blog at blog.ssa. gov for more articles — and our frequently asked questions page at ssa. gov/faq. Please be sure to let your friends and loved ones know about this new online option. NOTE: The mention of Microsoft Edge and Google Chrome is for informational purposes only and does not constitute an endorsement by the Social Security Administration

period” for people who get SSI disability benefits. Reporting wages each month helps us pay the correct amount of SSI. Timely reporting may also prevent you from owing us money or may allow us to pay a higher amount. We have several publications about SSI, including “Reporting Your Wages When You Receive Supplemental Security Income,” available at www.ssa.gov/ pubs. Note that there are other work incentives that can help you return to work when you receive SSI. You can read about them in “What You Need To Know When You Get Supplemental Security Income (SSI),” also available at www.ssa.gov/pubs. For more information, visit www.ssa.gov. Q: I recently applied for a replacement Social Security card, but I might be moving before it arrives in the mail. What should I do if I move before I get it? A: Once we have verified all your documents and processed your application, it takes approximately 10 to 14 days to receive your replacement Social Security card. If you move after applying for your new card, notify the post office of your change of address and the post office will forward your card to your new address. If you do not receive your card, please contact your local Social Security office. To get a replacement, you will have to resubmit your evidence of identity and U.S. citizenship, or your lawful immigration status and authority to work. You can learn more at www.ssa.gov/myaccount.

H ealth News New director appointed at Cloverwood Senior Living Cloverwood Senior Living announced that Richard Finn has joined the organization as the community’s new executive director. Finn has over 35 years of leadership experience in both the hospiFinn tality and senior living realms throughout the country, including Rochester. Trained by the Walt Disney Company in operations management and customer service, Finn is a collaborative and innovative leader focused on providing a worldclass resident experience. “We are thrilled to have someone of Richard’s caliber join the Cloverwood team. His professional background, accomplishments and proven track record will ensure Cloverwood’s continued success as Rochester’s premier senior living community,” says Glen Cooper, president and chief executive officer of Friendly Senior Living. As executive director, Finn is responsible for the successful operation of Cloverwood’s programs and services. He, along with the entire Cloverwood Senior Living team, is committed to providing the highest levels of quality and excellence to residents. Finn is a graduate of the Rochester Institute of Technology with Bachelor of Science and Master of Business Administration degrees. Finn resides in Victor.

Schultz honored for residency program leadership

Physician Stephen Schultz has recently received the Nikitas J. Zervanos Outstanding Program Direc-

tor Award, given by The New York State Academy of Family Physicians (NYSAFP). Schultz, director of the University of Rochester/Highland Hospital family medicine residency program received the award in a virtual ceremony in March. “For nearly two decades, Dr. Schultz has served as a teacher and mentor to countless students who are now board-certified family physicians, serving their patients and communities as he taught,” said NYSAFP President Jason Matuszak. “Dr. Schultz places strong emphasis on advocacy and global health, teaching students about the positive impact that they can have, not only on their own communities, but also working with impoverished and underserved areas around the world,” Schultz has led the nationally renowned Highland Hospital/University of Rochester Medical Center family medicine residency for the past 19 years “During his tenure, he developed and added new programs in global health, political advocacy and leadership, and developed areas of concentration in psychosocial medicine and maternity care to enhance family medicine residents’ training experiences,” said physician Colleen T. Fogarty, William Rocktaschel Professor and chairwoman of the department of family medicine at the University of Rochester. “He additionally developed systems and support for residents’ learning and competency assessment. Dr. Schultz accomplished all of this as program director while continuing a longstanding continuity practice at Highland Family Medicine and attending on the Department of Family Medicine inpatient service at Highland Hospital. I’m so pleased for him to be recognized by this national honor” Upon learning of his award, Schultz said, “…This is what I’m meant to do, working with residents and helping patients. Someone comes to me as a medical student, and three years later they’re a board-certified family physician. There’s a high level of satisfaction in that.”

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Members of Unity Hospital involved in the getting the “Level 1 — Comprehensive Excellence” verification status from the American College of Surgeons Geriatric Surgery Verification Program (ACS GSV). The recognition means a higher level of care to older patient adults.

Unity Hospital Recognized for the Care of Older Adult Patients

nity Hospital is the first in the nation to achieve “Level 1 — Comprehensive Excellence” verification status from the American College of Surgeons Geriatric Surgery Verification Program (ACS GSV). This recognizes the hospital’s dedication to providing optimal care for its older adult patients. The GSV program in 2019 introduced 30 new surgical standards designed to systematically improve surgical care and outcomes for aging adults. By identifying geriatric surgery patients at higher risk of delirium, functional decline and other complications, these standards help patients get home sooner and in better shape. “We have created a new standard of care at Unity, a better way of approaching the individual needs of the community,” said physician Matt Schiralli, director of the geriatric program and Rochester Regional Health’s chief of surgery, eastern region. “By assessing preoperative risks, we are able to provide anticipatory care that is tailored to a patient to help them meet their

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individual goals of surgery.” Unity Hospital was one of eight hospitals nationwide to pilot the program that helped develop the ACS standards. After the final standards were released, Unity was the first hospital to complete the process and underwent an extensive site visit by an ACS team who reviewed the hospital’s structure, process, and clinical outcomes data. Unity is the first to achieve this status by demonstrating the ACS GSV standards are verified across one or more surgical specialties, and reach 50% or more of their hospital’s total population of eligible surgical patients aged 75 years or older. “This unprecedented achievement is another reflection of our team’s commitment to patient-centered care and the culture of collaboration and teamwork at Unity Hospital”, said physician Manuel Matos, chief medical officer of Unity Hospital. “We are thankful and proud of the large interdisciplinary team that implemented these standards even while grappling with the COVID-19 pandemic.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021

CALENDAR of

HEALTH EVENTS

April 6, 13, 15

Hearing loss group holds virtual meetings

Hearing Loss Association of America (HLAA) Rochester Chapter offers a trio of virtual programs for anyone interested in hearing loss. All use the Zoom platform. Preregistration is required by visiting the HLAA website at: http://hearinglossrochester.org. All are free and in real time. Closed captioning is an option for all participants as well. • Noon, April 6. Physician Elise dePapp will discuss “Pathological Anatomy of Hearing Loss.” During her presentation she will talk about how we hear and why we don’t while clarifying the mechanics and terminology of deafness. She will demonstrate the three-part anatomy of the ear and the detailed structure of the inner ear and brain pathways and auditory centers for understanding sounds. A graduate of Sweet Briar College, dePapp earned her medical degree at the University of Rochester. She is a retired pathologist who became interested in the pathology of hearing loss. She has served on the

HLAA Rochester Chapter board of directors. • 10 a.m., April 13. Retired audiologist and hearing aid user Joseph Kozelsky will present “Hearing Other People’s Experiences (HOPE).” Prospective, new, or experienced hearing aid users can share their experiences, questions and hearing loss journeys in an informal virtual round table discussion. • 10 a.m., April 15. The HLAA-Rochester technology team will present “Virtual ALD Demo Center.” This is a continuing orientation to the online “Virtual Demo Center” website. It is a review of selected assistive listening devices, captioning-capable and amplified telephones, signaling-alerting devices and smart phone APP’s related to hearing enhancement and gives the opportunity for the presenters to answer questions from those joining the Zoom meeting. HLAA is the nation’s leading organization representing consumers with hearing loss. HLAA opens the world of communication to people with hearing loss through information, education, support and advocacy.

April 8, 15

Hearing aids for the beginner Hearing Loss Association of America/Rochester Chapter offers two Zoom sessions: one for people considering hearing aids followed by a second for beginning hearing aid users. They are scheduled for 10–11:30 a.m. April 8 and April 15. Retired audiologist Joseph Kozelsky, who also uses hearing aids, leads the programs. To register and obtain a Zoom link, visit the Hearing Loss Association website at www.hearinglossrochester.org and click on “Zoom session registration.” The first session deals with initiating your hearing aid journey — where to start, what to look for and what to look out for. The second session covers reasonable expectations for new users and some issues and problems users should never have to put up with. The sessions will not be commercialized in any way. No products or providers will be endorsed. HLAA’s mission is to serve as a resource for individuals with hearing loss at all levels, providing support, education and advocacy. For more information go to www.hearinglossrochester.org

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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We finally got our pool. We waited our whole lives, but with all that was going on we just never had the time. Now we do—and time for a lot more. Like cooking and fitness classes, relaxing dinners, and just enjoying our time together. Best part: it all happens right here at Chapel Oaks.

Come see our indoor pool and much more! Schedule a tour today: (585) 697-6606 St. Ann’s Community at Chapel Oaks, Irondequoit Page 24

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2021