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GVHEALTHNEWS.COM
OCTOBER 2020 • ISSUE 182
Defeating Cancer
Breast Cancer Awareness Month INSIDE n Is breast cancer the leading cause of cancer death in women? (It’s not) n 10 things young women should know about breast cancer n Latest news in cutting-edge gene-targeting and testing n The history of the pink ribbon Starts on p. 10
Cancer Risk & Your Genes
SIMPLY SMILING MAY BOOST YOUR OUTLOOK
5
Cara Cappello, founder of Breast Previvors ROC, a group for women who choose prophylactic mastectomy. The “previvors” in Capello’s group carry a strong predisposition to cancer. Story on p. 12
Things You Need to Know About Depression
Americans Now More Likely to Get COVID-19 Vaccine: Poll
Brussel sprouts America’s most-hated vegetable doesn’t deserve the bad rap P. 15
SHIFT WORK
Another health risk for workers in healthcare and other fields P. 9
Which is Better, Working Out Early or Later in the Day? By Deborah Jeanne Sergeant
W
hich is better, working out first thing in the morning or later in the day? Early work-
out proponents say that exercise before breakfast “tricks” the body into burning stored fat. Others say that
working out later allows the body to fuel up for an optimal performance. A topic of much debate in the fitness world, the timing of one’s workout may not make a huge difference. Garrett Bacher, personal trainer with a master’s degree in exercise science and nutrition, owns ATR Fitness in Webster. He doesn’t see much benefit in the early workout time. “I believe the best time for an individual to work out would be the time that best fits their schedule and allows them to be the most consistent,” Bacher said. “Consistency is the key to obtain the physique a person desires. “Consistent workouts and proper meal planning will ensure results. For the average person timing will not make a difference.” He likes to work out at 5 each morning because it ensures he fits his workout into his busy schedule and “it makes me feel fantastic throughout the day.” Kaitlyn Vittozzi leads yoga classes at Finger Lakes Yogascapes in Canandaigua. She also believes that listening to your own body’s needs and energy levels makes a difference. “You should take note of how you feel,” she said. The activity and the intensity of the movement involved also makes a difference. “It may require a different energy
level to lift weights than go for a run,” she said. “If you don’t have a lot of food in your stomach, you’re less sluggish.” But on the other hand, a very vigorous workout may need you to fuel up first. “Don’t push yourself so you’re so hungry that you can’t complete the workout,” Vittozzi said. Early birds should also make sure they plan to get a good night’s rest before their workouts. Staying up too late will make it much harder to workout at sunrise. Those who work out later should take care that their exercise doesn’t hamper their sleep. “Resting is a process and it does take a bit to wind your body down,” Vittozzi said. “If you want to go to bed at 10, you have to start the process a couple hours before.” Vigorous workouts before bed can hamper good sleep, so allowing enough time to relax after an evening workout can help ensure better rest. “If right before bed is the only time you can work out, look at something like yoga or barre that’s less stressful than a high energy class like spinning,” Vittozzi suggested. The Centers for Disease Control and Prevention recommends engaging in 150 minutes of aerobic physical activity per week, such as walking, biking or swimming and performing muscle-strengthening activity twice per week, such as lifting free weights, using exercise bands, performing body weight exercises or using a weight machine. The activity doesn’t need to take place all at once; however, as Bacher said, consistency is vital for promoting good health.
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Page 3
Meet
Your Doctor
By Chris Motola
Simply Smiling May Boost Your Outlook
S
miling can trick your mind into being more positive, according to a new study. Researchers at the University of South Australia found that the simple act of moving your facial muscles into a smile can make you view the world more positively. “When your muscles say you’re happy, you’re more likely to see the world around you in a positive way,” said lead researcher Fernando Marmolejo-Ramos, a human and artificial cognition expert at the university. He and his colleagues studied how people interpret various images of facial and bodily expressions that range from happy to sad, based on whether or not they were smiling themselves. The study involved 256 volunteers from Japan, Poland, Spain and Sweden. Participants were asked to hold a pen between their teeth, an act that forces facial muscles to replicate the motions of a smile. They were then shown images of facial expressions that ranged from frowning to smiling, and videos of a person walking in different positions, ranging from “sad walking” to “happy walking.” The participants viewed each image or video with and without a pen in their teeth, and then evaluated if the evoked emotion was “happy” or “sad.” The researchers observed that the participants were more likely to view a broader range of the images and videos as “happy” when smiling themselves. “In our research, we found that when you forcefully practice smiling, it stimulates the amygdala — the emotional center of the brain — which releases neurotransmitters to encourage an emotionally positive state,” Marmolejo-Ramos said in a university news release. The results suggest that everyone, and particularly those suffering from mental health issues like anxiety and depression, may benefit from the simple act of smiling. “For mental health, this has interesting implications. If we can trick the brain into perceiving stimuli as ‘happy,’ then we can potentially use this mechanism to help boost mental health,” Marmolejo-Ramos said. “A ‘fake it till you make it’ approach could have more credit than we expect.” The study was published recently in the journal Experimental Psychology.
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Jeffrey A. Goldstein, M.D. New Thompson Health gastro talks about IBS, reflux, Crohn’s disease and other intestinal issues Q: What kinds of conditions does a gastroenterologist see? A: We cover digestive issues and liver issues. So, starting from the top down, we cover esophageal reflux, problems swallowing, abdominal pain, change in bowel movements, blood in the stool, any combination of symptoms that lead to weight loss, changes in appetite. For liver, changes in liver enzymes. From the screening aspects, we do colonoscopies as well. So we do both diagnostic and screening services. Q: What are the most common ones you see? A: It’s a smattering of things, but the most common are probably reflux-related issues, irritable bowel syndrome (IBS), different types of anemia, most commonly iron-deficiency related, blood in the stool, problem swallowing. Q: You deal with a very big and complex bodily system. What tends to cause issues within it? A: It is. When you look at patients who have changes in their bowel movements, we try to zero in on cause and effect. We’ll make sure they’ve had a recent colonoscopy to make sure there’re no structural lesions. It all depends on the context. If there’s an associated issue with regard to the symptoms, we target the symptoms. If someone says they’ve had diarrhea for three months and have blood in their stool, we may take a stool culture. Colonoscopy is usually the gold standard there. On the other end, if someone has heartburn and regurgitation issues, we’ll do an endoscopy, go through their history and direct them accordingly with regard to health modifications and anti-reflux measures, and then we might even put them on something like Prilosec or another proton pump inhibitor, and then look at
what’s going on structurally with the endoscopy. We target the symptoms, we look at the labs, we do a physical and the procedures if we need to. Q: Does your practice involve any surgery? A: It’s not considered surgery — well, maybe at some levels colonoscopy might be, but there’s no open stuff. Q: Do we understand what causes IBS at this point? A: We don’t know the exact definitives, but studies point to a braingut interaction and a connection to the serotonin family of receptors. It’s not just a matter of being stressed out — there are chemical factors. Historically what they did was they took a rectosigmoid balloon and inflated it inside both normal patients and patients with IBS. The normal patients didn’t feel much, the IBS patients nearly jumped off the table. There’s a visceral hypersensitivity present in IBS patients, which we believe is related to a brain-gut interaction. The exact mechanism isn’t necessarily well-ironed out for each patient, but it’s a multifactorial process. Q: Is it too far to say there’s a psychosomatic component to it? A: We prefer to say there’s a brain-gut interaction. They once did this study that you probably could not do today, where they took this med student and they measured what’s called the amplitude of the colonic contraction. They measured the baseline of the colonic contraction on the student, which appeared to be normal. Then they did a biopsy and told the student that he had a cancer when he didn’t. Then they re-did the contraction test and it was off the charts. Then they told him everything was fine and his readings returned to normal. So there definitely is a brain interaction there, but I don’t want people to think it’s all in
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
In the News With more than 20 years’ experience in the greater Rochester region, gastroenterologist Jeffrey A. Goldstein joined UR Thompson Gastroenterology at F.F. Thompson Hospital Sept. 8. A fellow of the American College of Gastroenterology and member of the Bockus International Society of Gastroenterology, Goldstein most recently practiced at the Digestive Center of Western NY in Rochester. He is board-certified in gastroenterology, having completed his residency at the University of Rochester School of Medicine and Dentistry, followed by a gastroenterology fellowship through the University of Miami School of Medicine in Florida. Goldstein treats a number of digestive conditions, including acid reflux/heartburn, irritable bowel syndrome, celiac disease, Crohn’s diseases/ulcerative colitis and other conditions. their head either. Stress and anxiety can definitely play a big factor in some patients, but I don’t think it’s in every patient. But there is a brain-gut interaction, so we try to look at the wiring between the brain, the gut and the autonomic nervous system. Q: Another big illness associated with the gastrointestinal system is Crohn’s disease. It’s a systemic autoimmune disease, but why does it seem to cause such problems in the intestines? A: Crohn’s often affects the colon first, but it can affect other organs like the eyes, joints and skin. It’s an autoimmune condition, but sometimes in medicine when a disease doesn’t have an etiology, we name it after a patient or physician. I think that kind of condition is definitely autoimmune, but we don’t know why it primarily affects the colon and small bowel. It’s a minority of patients who experience the extra-intestinal manifestations. Q: With as large and complex a system as you’re dealing with, how broad does your knowledge base need to be compared to other specialties? A: It’s exciting and interesting. There’s a lot I can do without relying on other specialties. You can do some somewhat surgical things, you can investigate symptoms by yourself, order tests. So we can do a lot of good ourselves.
Lifelines Name: Jeffrey A. Goldstein, M.D. Position: Gastroenterologist at F.F. Thompson Hospital Hometown: Buffalo Education: University of Rochester School of Medicine and Dentistry; University of Miami School of Medicine Affiliations: F.F. Thompson; Rochester Regional Health Organizations: American College of Gastroenterology; Bockus International Society of Gastroenterology Family: Daughter, 13 Hobbies: Sports, time with family, exercising
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Page 5
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Asking for Help: Don’t be Frightened by October Chores
H
appy October, dear readers! I love this time of year with all its fabulous autumn colors, cooler weather and cozy fall fashions. October is all about a change: a change of season, a change in priorities and a change in perspective. I don’t know about you, but I always need some help when confronted with all the chores and changes this time of year presents. I need help with raking leaves, stowing hoses, putting away lawn furniture, cleaning gutters and downspouts, etc. I may even need some “emergency” pet-sitting, if I choose to take off and enjoy a leaf-peeping weekend in Vermont. We all need a helping hand from time to time. Giving and receiving help from my friends and family has proven to be a wonderful way for me to deepen relationships and strengthen bonds. It’s another one of the many “life lessons” I’ve learned while on my own — that asking for help brings blessings, not burdens. If asking for help is difficult or awkward for you, know that you are not alone. Many people — and, regrettably, many of those who may need it most — find it hard to reach out and ask for help in times of need. There are many reasons, but my
experience tells me that lots of women and men who live alone avoid asking for help because they fear being seen as weak or vulnerable. I know that after my divorce I was reluctant to ask for help. I wanted to show the world that I was perfectly fine, thank you. When I really could have used some help, I avoided asking anybody for anything, determined to muscle through on my own. It led to isolation and pointless hardships. Not asking for assistance kept me distant from friends and family. I denied myself (and them) the chance to connect on a genuine and meaningful level. Looking back, it’s clear to me that my healing and personal growth were compromised as a result. I encourage you to let go of any excuses not to ask for help. Instead, be true to yourself and to those who love and want to support you. Below are some words of encouragement and a few tips to help you help yourself: n Be honest. What keeps you from asking for help? Could it be pride? Do you think you’ll be seen as incapable or weak? Are you concerned about being a bother? Or, would asking for help force you to acknowledge that, indeed, you need it?
Take a moment and reflect on what keeps you from asking for assistance. n Redefine what it means to be strong. Everyone needs support every once in a while, and seeking help is not a weakness. In fact, the strongest people are often those who have the courage to admit they need help and reach out. I’ve always admired this quality in others. Real strength is knowing your personal limitations and having the confidence to recruit assistance when you need it. n Have a little faith. Believe that people truly want to help. Just turn the tables, and think about how you’d respond if a friend, family member or co-worker asked for a helping hand. Chances are you wouldn’t hesitate. You might even feel slighted if not asked, especially if someone you cared about was having real difficulty. Know that others, too, want to be there for their friends and family (and you!) when in need. n Take a chance. When you choose to be vulnerable and ask for help, you are opening yourself up and exposing your authentic self. While it may feel risky, when you are “real” like this, you have an amazing opportunity to cultivate deeper bonds with others. It can be a positive, life- and relationship-changing experience, but only if you are willing to take a chance and make your needs known. n Make the ask. As a first step, put some thought into where you could really use some support and then ask for help with one specific item. It could be something as simple as asking a neighbor for help raking leaves to something as important as requesting a recommendation for a financial adviser. If finding just the right words is
hard to come by, you might start out by saying, “You know, I’m not very comfortable asking for favors, but I wonder if you might be able to help me with something?” n Express your gratitude. You know this, of course. A heartfelt thank you in person or in writing will be warmly received by the person whose help you have accepted. No need to go overboard. Remember, people often want to help others and don’t expect to be compensated for doing a good deed. n Offer help in return. Because giving can be as gratifying as receiving, you’ll want to make it known that you, too, are available to return the favor. We all have gifts, we all have needs, and we all can be of great assistance to one another. Look around, and you’ll find plenty of opportunities to help those who have helped you during your time of need. Asking for help becomes easier with practice. Just as I did, you’ll soon discover the benefits that lie in the aftermath of the ask — benefits that include stronger relationships with existing friends and family members, as well as the prospect of making new connections with others. The rewards inherent in accepting help and expressing your gratitude are many and go both ways. So, take it from me: Life can be better, just for the asking.
what is happening in the broader communities,” Goza said in an AAP news release. “A disproportionate number of cases are reported in Black and Hispanic children, and in places where there is high poverty. We must work harder to address societal inequities that contribute to these disparities,” she added. Physician Sean O’Leary is vice chairman of the academy’s committee on infectious diseases. “This rapid rise in positive cases occurred over the summer, and as the weather cools, we know people will spend
more time indoors,” he said. “The goal is to get children back into schools for in-person learning, but in many communities, this is not possible as the virus spreads unchecked,” O’Leary added. With flu season approaching, it›s important to «take this seriously and implement the public health measures we know can help,» he said. That includes wearing masks, avoiding large crowds, maintaining social distance and getting a flu shot. “These measures will help protect everyone, including children,” O’Leary said.
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 her to speak, visit www. aloneandcontent.com
s d i K Corner
Over Half a Million U.S. Kids Already Infected With COVID-19
M
ore than 500,000 U.S. children had been diagnosed with COVID-19 as of early September, with a sizable uptick seen within weeks, a new report reveals. There were 70,630 new child cases reported between Aug. 20 and Sept. 3. That brought the total to 513,415 cases — a 16% increase over two weeks, according to state-bystate data compiled by the American Academy of Pediatrics (AAP) and the Children›s Hospital Association. “These numbers are a chilling reminder of why we need to take this virus seriously,” said AAP president,
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physician Sara Goza. As of Sept. 3, children accounted for nearly 10% of all reported COVID-19 cases in the United States since the start of the pandemic, according to the latest weekly report from the two organizations. The findings highlight the need to redouble efforts to curb the spread of the new coronavirus, the experts said. The virus has surged in Southern, Western and Midwestern states during the summer, they pointed out. “While much remains unknown about COVID-19, we do know that the spread among children reflects
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
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Americans Now More Likely to Get COVID-19 Vaccine: Poll
J
ust over 54% of Americans now say they would get a COVID-19 vaccine in the first 12 months after it’s introduced, a significant increase from 42% in July, a new WebMD poll finds. However, only 27% of the 1,000 readers who participated in the survey said they’d get a vaccine within the first three months after it becomes available, which is just slightly higher than 26% who said so in the July poll. In the new survey, 12.5% of respondents said they wouldn’t get a vaccine at all, and 21.4% said they’re unsure. For any COVID-19 vaccine to be approved by the U.S. Food and Drug Administration, it has to prevent or reduce the severity of infection in at least 50% of people who receive it. But only 8.8% of survey participants said they consider that 50% standard effective, with 65.2%
saying a vaccine should be 75% to 99% effective to be approved by the FDA, WebMD reported. Only 25.6% of respondents said they would get a vaccine that was 50% effective, 35.5% said they wouldn’t get the vaccine, 25.6% said maybe and 13.3% said they weren’t sure. “We already know that people are worried about getting a COVID vaccine, and understanding how well the vaccine works could be another hurdle for patients,” said physician John Whyte, chief medical officer of WebMD. “Public health officials face a tough challenge explaining to consumers what this vaccine can and can’t do.” There are more than 170 potential COVID-19 vaccines being developed worldwide, with 142 in preclinical evaluations and 31 in clinical trial, according to WebMD.
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s the popularity of electric 2014 to 2019, more than 70,000 Workersinjuries • Clinicians scooters has accelerated in the e-scooterSocial riders sustained United States, so have serious severe enough toSupport warrant aStaff trip to injuries, which nearly doubled in just a U.S. emergency department. The Your commitment and dedication one year, a new study reveals. number was less than 5,000 in 2014, is inspiring! In 2019, more than 29,600 before the convenient, environmene-scooter riders were treated in U.S. tally friendly vehicles really took off. emergency rooms, up from about E-scooters look like toys, but 1000 Elmwood Avenue • Rochester, NY 14620 • 585-271-0761 • MaryCariola.org 15,500 the year before, the researchthey’re not, said physician Amishav ers found. Bresler, from the department of “I probably operate on at least otolaryngology-head and neck surtwo to three people that have scootgery at Rutgers New Jersey Medical During this unprecedented time er injuries every month, especially School, in Newark. during the summer months,” said “A lot of people are really ununprecedented timeteam! We’dweDuring love tothis have you join our honor our Cariola Superheroes— study co-author Eric Wagner, a physi- aware how dangerous they can be,” we honor Cariola Superheroes— cian and director of upper extremity said Bresler, who wasn’t involved in Direct our Support Professionals surgery research at Emory Universithe study. ty, in Atlanta. “I see many broken bones. PaDirect Support Managers Professionals Residential “These injuries are increasing tients end up in the ICU due to being Teachers •Managers Nurses Residential and they aren’t benign. Many of thrown off the scooter and hitting the them are fractures, many of them ground at high velocity. So they can Social Workers• Nurses • Clinicians Teachers are head injuries, and some of the be even life-threatening, causing conSupport Staff Social Workers • Clinicians head injuries require hospital admiscussions, skull fractures, even brain sion, which means that they’re very bleeds,” Bresler said. Support Staff Your commitment and dedication is inspiring! severe,” Wagner said. Men aged 15 to 39 accounted for Show Your Character and Apply Today The study authors noted that the greatest increase in injuries, the Your commitment and dedication is inspiring! only a minority of riders wear helstudy findings showed. mets and that riders often misunderOf all injuries, 27% were to the 1000 Elmwood Avenue • Rochester, NY 14620 stand traffic laws governing e-scooter head. And half of these were clas1000 Elmwood Avenue • Rochester, NY 14620 • 585-271-076 use. sified as a traumatic brain injury, 585-271-0761 • MaryCariola.org Wagner’s team found that from which can include concussions and 1000 Elmwood Avenue • Rochester, NY 14620 • 585-271-07 skull fractures.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Healthcare in a Minute By George W. Chapman
Presidential Candidates’ Misleading Messages About Drug Prices
E
lections are just around the corner and political ads, national and local, are rife with claims that their candidate is confronting drug manufacturers regarding their outrageous pricing. I wrote about this early this year, but I think it’s worth repeating as we are bombarded with these misleading claims by candidates. It is well documented that we pay more for drugs and use more of them per capita than most if not all other countries. We spent about $345 billion or over $1,000 per capita on drugs last year. In countries with a single payer or universal healthcare model, the government uses its massive purchasing power to negotiate prices with drug manufacturers. But not the USA. We squander our purchasing power when it comes to drugs. The Centers for Medicare & Medicaid Services (CMS) covers 60 million people on Medicare and 70 million people on Medicaid for a staggering 130 million people or roughly 40% of the U.S. population. By comparison, Canada negotiates drug prices, paying far less than we do, with a purchasing power of a relatively paltry 30 million people. So why doesn’t CMS use its huge purchasing power to at least negotiate drug prices? Simply: because of the powerful drug lobby. It is the No. 1 lobby on the Hill by far, spending $4 billion over the last 20 years and employing almost 1,300 drug lobbyists. That’s 2.4 lobbyists per congressperson. (How are they not tripping over each other as they enter and exit congressional offices?) The ubiquitous drug lobby has suc-
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ceeded in quashing this “no brainer” negotiating issue, which would save us literally billions in drug costs, by contributing heavily to campaigns. While drug prices are allowed to escalate untethered, CMS clamps down on physicians and hospitals by unilaterally setting their reimbursement. Take it or leave it. CMS seeks “input” from physician and hospital lobbyists, but still establishes their fees in advance every year. The drug manufacturers attribute their high prices and healthy profits to: research and development, the cost of going through FDA approval, getting drugs to market and potential lawsuits. All those points may be valid, but if CMS is not going to set drug prices like it does for providers, can’t they at a minimum negotiate prices? The U.S. government and consequently U.S. consumers are paying anywhere from four to 120 times the price paid by other countries, no questions asked. A lot of congressman continue to parrot the drug lobby mantra that controlling drug prices will lead to less innovation and fewer new drugs entering the market. No one is begrudging drug manufacturers a fair profit. Congressman Tom Reed (R-NY) said, “You are putting too much weight in the hands of the government dictating price.” What? Where is this when it comes to physicians and hospitals? CMS should be the 800-pound gorilla at the negotiation table when it comes to drug prices. Campaigns are expensive so most candidates are more than willing to accept drug company donations
and look the other way. Instead of a bill with some real teeth that would simply and broadly allow CMS to negotiate prices for all drugs and save us billions, a bipartisan bill from Congress, (the 2019 Elijah Cummings bill), feebly suggests allowing CMS to use its substantial purchasing power to negotiate a pithy 25 (yes, 25) drug prices. The bill then suggests allowing CMS to negotiate 35 (yes, 35) drug prices — by 2033. That means, 13 years from now. This bill remains buried on Senate Leader Mitch McConnell’s desk as he has yet to present it to the Senate for a vote. Despite the unanimous consensus that drugs cost way too much, you can thank the drug lobby and a beholden Congress for nothing being done about it and a lot of misleading lip service.
COVID-19 Price Gouging
This is a summary of an article by ProPublica, a nonprofit newsroom that investigates fraud and abuses of power. Zach Sussman was employed as an emergency physician for a free-standing, for-profit chain of emergency facilities called Physicians Premier ERs. The chain is not affiliated with any hospitals. Being a good employee, he went to one of the Physicians Premier emergency facilities for a COVID-19 test and was told by his employer he would be held harmless for any copays. He was shocked to discover his employer billed his insurance company for close to $11,000 for a 30 minute visit. About $2,000 was for the professional and physician component of the visit and about $9,000 was for the ER facility component. For perspective, Medicare pays about $42 for COVID-19 antibody testing. He was astonished
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
to see that his insurance company, Golden Rule, which is a subsidiary of insurance giant UnitedHealthcare, paid 100% of the $11,000. Because Physicians Premier ERs did not participate in his insurance, they were not beholden to any predetermined or pre-negotiated rates. Consequently, Physicians Premier ERs jacked up its charges and hoped for the best. Coding experts called the $11,000 bill totally obscene and fraudulent. Commercial insurers do audits for fraud but not nearly enough so cases like this can fall through the cracks. Sussman did not want to be associated with this kind of price gouging and resigned from the ER company. Physicians Premier did not respond to ProPublica for comment.
Caregiver Stress
If being an unpaid caregiver isn’t bad enough, a recent study by BlueCross BlueShield found it has a considerably negative impact on caregiver health. A review of 6.7 million member claims revealed that caregivers experience on average 26% worse health than non-caregivers. By generation: Gen Xers were 45% worse than their age benchmarks; boomers were 38% worse than their age benchmarks and millennials were 11% worse than their age benchmarks. Caregivers typically experienced more hypertension, depression, anxiety, obesity, hospitalization and ER visits. Millennials fared the worst of the three generations. 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.
Shift work: Not Good For Your Health By Eva Briggs, MD
Y
ou probably read a lot about the health risk to essential workers of potential exposure to COVID-19 during the current pandemic. Another health risk for essential workers in healthcare, police, firefighting, food service, transportation and similar occupations is shift work. Shiftwork is defined as any work that takes place outside of the traditional 9 to 5 workday, such as evening, night, early morning, or rotating shifts. About 15% of workers are affected by shift
work. Potential adverse effects of shift work are due to a combination of lifestyle and biology. Lifestyle effects include less time to exercise regularly. Shift workers might eat at odd times and be more likely to eat an unhealthy diet. Shift workers are more prone to feeling isolated, because their jobs may hinder interactions with family and friends. Shiftwork also clashes with most people’s natural internal clock, the circadian rhythm, which is linked to natural daylight and darkness. This tells us to be awake when it is light and to sleep when it is dark. When the natural sleepwake cycle is disrupted, it alters the natural release of hormones and chemicals in your body. Shiftwork adversely affects the cardiovascular system. It changes the level of cholesterol, leading to an increase in arterial disease such as heart attacks. It increases insulin resistance, raising the risk of diabetes. Other effects include elevated blood pressure and obesity. Sleep
alterations include trouble falling asleep and trouble staying asleep. Excessive sleepiness or drowsiness develops during times when individuals need to stay alert, such as driving home after work. Night shift workers enroute to home are much more likely to be involved in a drowsy-led driving accident or near accident than daytime shift workers.
What can be done? The problem isn’t going to go away because many professions require shift work. But there are measures workers can take to combat the effect. The most important is to prioritize adequate sleep, seven to eight hours per night for most people. Some ways to accomplish this start with minimizing light exposure during sleep times. Use room darkening curtains or shades. Try to keep the same schedule. If your shifts change, try to schedule your sleep times to include at least four of the same hours each night. Adhere to the same schedule even on weekends and days off. Ask other household members to help maintain the quiet and dark, such as by wearing headphones and avoiding noisy activities like vacuuming while you’re trying to sleep. Put a “Do Not Disturb” sign on your front door so that delivery people and friends will not ring the doorbell or knock. Experts also recommend work-
ing no more than five eight-hour night shifts or four 12-hour night shifts in a row. I know from experience that’s not always achievable. After a string of night shifts, try to be off 48 hours. Avoid long commutes, if possible. Be aware that prolonged shifts and excessive overtime contribute to the adverse effects of shift work. Rotating shifts are also particularly problematic. Plan to nap before the night shift, which can approve your alertness. Can medicines help? Caffeine is more effective than placebo in reducing errors and improving performance for night shift workers. Frequent small doses seem to work best. Be aware that for some people caffeine too close to bedtime can interfere with sleep. So, you may need to restrict it to the first half of the shift. If all else fails, after appropriate changes to your sleep environment and schedule, prescription medicines such as modafinil (Provigil) and armodafinil (Nuvigil) can combat excessive sleepiness and promote alertness.
Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Cancer
ing of the skin • A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out) • Skin redness, soreness, rash • Swelling • Nipple discharge (could be a watery, milky, or yellow fluid, or blood) Normal breast tissue may be lumpy, which is why it is important to know how your breasts normally feel. Most lumps are not cancer. Many women choose to perform breast self-exams so they will know if a new lump appears or an existing lump changes size. However, breast self-exams are not a substitute for mammograms. These changes may not necessarily indicate that you have breast cancer, but they could and should be evaluated.
Persistent and Speak 4.Be Up
Breast Cancer in Women Under 40: 10 Things You Need to Know
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ach year, nearly 13,000 women under age 40 will be diagnosed with breast cancer, making up about 7% of all breast cancer cases, and 40% of all cancers of women in this age group. Throughout her lifetime, a woman has a one in eight risk of developing breast cancer. No matter what your age you need to be aware of risk factors. In many cases of breast cancer early diagnosis is the key to survival.
What is Breast Cancer? Breast cancer is the most common cancer in American women, and it is the second most common cause of cancer deaths in women. (Lung cancer still kills almost 4 times as many women each year as breast cancer.) Breast cancer occurs rarely in men as well. There are about 230,000 new cases of breast cancer diagnosed in women the U.S. each year, and about 2,300 new cases diagnosed in men. To understand breast cancer, it’s important to learn the anatomy of the breast. Most of the breast is comprised of fatty (adipose) tissue, and within that are ligaments, connective tissue, lymph vessels and nodes, and blood vessels. In a female breast there are 12-20 sections within it called lobes, each made up of smaller lobules that produce milk. The lobes and lobules are connected by ducts, which carry the milk to the nipple. The most common type of breast cancer is cancer of the ducts, called ductal carcinoma that accounts for just over 80% of all breast cancers. Cancer of the lobes (lobular carcinoma) makes up just over 10% of cases. The rest of the breast cancers have characteristics of both ductal and lobular carcinomas, or have unknown origins. Page 10
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1.Know Your Breasts
While women under 40 only make up about 7% of all diagnosed breast cancer cases, breast cancer is a leading cause of death among young women age 15-34. It is important to know your breasts. Know how they feel, and have your doctor teach you how to do a proper breast self-exam, if you choose, to help you notice when there are changes that need to be examined by a doctor.
2.Know The Risk Factors
Younger women may have a higher risk for developing breast cancer with the following risk factors: • Certain inherited genetic mutations for breast cancer (BRC A1 or BRCA2) • A personal history of breast cancer before age 40 • Two or more first-degree relatives (mother, sister, daughter) with breast cancer diagnosed at an early age • High-dose radiation to the chest • Early onset of menstrual periods (before age 12) • First full-term pregnancy when you are over 30 years old • Dense breasts • Heavy alcohol consumption • Obesity • Sedentary lifestyle • High intake of red meat and poor diet • Race (Caucasian women have a higher risk) • Personal history of endometrium, ovary, or colon cancer • Recent oral contraceptive use
3.Breast Changes to Watch Watch for changes to your breasts, and if you notice any of the following, see your doctor: • A lump in or near your breast or under your arm • Changes in the size or shape of your breast • Dimpling, puckering, or bulg-
Be your own health advocate and make sure you mention any breast changes or lumps to your doctor. Some patient concerns are dismissed because they are “too young” to have breast cancer. If you think you feel something, seek answers. Don’t be afraid to get a second opinion and more information.
5.Find The Right Doctor
If you are diagnosed with breast cancer, it’s important to find the right medical team to work with you. It may be tempting to stick with your first doctor, but it’s always a good idea to get a second opinion and make sure you are seeing the right specialists for your type of cancer. You may see several different types of oncologists (cancer specialists), including medical, surgical, and radiation oncologists. The medical specialists you see should be well versed on all the new treatments and approaches including genetics and neoadjuvant therapy (chemotherapy before surgery). Make sure your doctors know the National Comprehensive Cancer Network (NCCN) treatment guidelines which determine treatment based on stage of the disease and prognostic factors of the tumor that are considered the gold standard. You may also want a caremanager or caseworker to help you on your journey.
Your Medical His6.Know tory
It is important to know your family history and share it with your doctor. Women with a first-degree relative (mother, sister, daughter) with breast cancer have nearly twice the risk of being diagnosed with breast cancer as a woman who has no family history. Tell your doctor which family member(s) had breast cancer or other breast diseases, and how old they were when diagnosed.
7.Seek a Second Opinion
Most doctors will suggest getting a second opinion, and even if they do not, it is always a good idea. Most insurance will cover it. It’s important to seek a specialist in breast cancer who is up to date on the latest treatments and can help you make the best decisions on how to proceed. You may discuss your diagnosis with another pathologist who can review your breast tissue slides and confirm a diagnosis, or another medical oncologist, surgical oncologist, or radiation oncologist to determine the
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
best treatment choices.
It’s OK to Ask 8.Know Questions
Ask questions! You should be an active participant in your care. Your medical team should explain to you any medical terms you do not understand, explain your treatment choices, possible side effects, and expected outcome. Ask for references to additional specialists you can talk to so you can learn more about your breast cancer. If you have not yet been diagnosed with breast cancer but are at high risk, ask your doctors about testing and any preventive measures you can take. Also don’t be afraid to ask family and friends for support. Seek support groups with other people who are going through what you are, or who have gone through it. Bring a close friend or family member to your appointments to both take notes, or record your visit, and to encourage you to request clarification if anything is unclear. Express your feelings and concerns.
9.Do Some Research
If you are diagnosed with breast cancer, learn about your specific diagnosis. Understand what terms such as stage and grade mean, and how they impact your treatment options. Helpful resources include BreastCancer.org and NCCN.org — guideline on breast cancer written for patients
Network With Other 10.Young Women
It can feel isolating to be diagnosed with breast cancer at a younger age, but there is support available and it can be helpful to connect with other women your age who are going through what you are, or who have beat breast cancer. You can start by asking your doctor about any local support groups. In addition, you can find support groups by searching online. Some resources to find support groups include: • The National Cancer Institute’s Cancer Information Service (1-800-4-CANCER; 1-800-422-6237) • Local chapters of the American Cancer Society • Local chapters of Susan G. Komen for the Cure Source: Onhealth.com, operated by WebMD LLC, part of the WebMD Consumer Network.
Breast Cancer Prevention for Young Women If you are a young woman there are some risk factors for breast cancer you can avoid. • Don’t smoke • Exercise regularly • Eat a healthy diet, with an emphasis on plant foods • Limit consumption of red meats and processed meats • Maintain a healthy weight • Limit or avoid alcohol consumption • If possible, avoid shift work, especially at night Changing your lifestyle and habits may not completely prevent you from getting cancer but it can lower your risk, especially if you have some unavoidable risk factors already such as a genetic history.
Cancer
Colleen Conner Ziegler of Rochester visited Wyoming’s Grand Teton National Park after she received a diagnosis of lung cancer five years ago, even though she never smoked in her life. She now is an advocate for more lung cancer research funding.
Lung Cancer Kills More Women Than Any Other Cancer Lung cancer — not breast cancer as some may think — is the leading cause of cancer death for women By Deborah Jeanne Sergeant
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ore women die of lung cancer than colon and breast cancer combined. Twenty-five percent of all cancer deaths are from lung cancer. According to the American Lung Association, 15% of people diagnosed with the disease have never smoked. Among nonsmokers, women are three times as likely to have lung cancer. One of them is Colleen Ziegler, who lives in Rochester. She has never smoked but was diagnosed five years ago with stage 4 lung cancer. “A lot of people are not aware of the impact that lung cancer [has]. It is the leading cause of cancer death,” said Ziegler, a patient at Massachusetts General Hospital in Boston. “Four hundred and thirty-three [people] a day die from lung cancer.” Breast cancer research has helped reduce death rates among patients through proven prevention programs and treatments. Ziegler said that acquisition of research dollars is driven by awareness. Twenty years ago, she survived breast cancer. She believes that lung cancer is not as “popular” of a cancer because of lack of awareness. “One of the challenges with lung cancer is there appears to be a stigma associated with it,” Ziegler said. “A lot has to do with the perception that tobacco use is the only cause. Lung cancer receives only 6% of
federal funding available for cancer research.” Ziegler said that currently, the federal government designates $14 million to lung cancer research, compared with $90 million to prostate cancer and $150 to breast cancer. Because of discrepancies like these, she usually travels to Washington, DC, annually to advocate for lung cancer research funding. Ziegler said oftentimes, representatives say they did not realize that lung cancer leads in cancer deaths — nor why lung cancer research has so few dollars allocated to it. As to why women are three times as likely to have lung cancer as men, Ziegler said that researchers do not know. She was diagnosed at age 58, but knows women diagnosed in their 20s who have never smoked and lived healthy lifestyles. “People think it’s only a 70-yearold guy who smoked his whole life,” Ziegler said. Jennifer C. King, chief science officer for GO2 Foundation for Lung Cancer, said that it’s unclear as to why women are more prone to lung cancer. “There is a critical need for more research in this area,” King said. “GO2 Foundation’s work has shown that younger individuals diagnosed with lung cancer have a higher percentage of ‘oncogenic drivers’ — October 2020 •
mutations in certain genes — that promote growth of the lung cancer. However, the scientific community is still learning about environmental, hormonal and immunological factors that may drive the sex-based differences in lung cancer. There is a great need to study these differences between men and women and understand how they may impact lung cancer prevention, diagnosis, treatment and survivorship.” Ziegler said very few treatments are available for lung cancer patients. She is currently enrolled in a clinical trial for alectinib, daily oral pills providing targeted therapy that “mutes” the cancer, though it won’t destroy it. Ziegler thinks that eventually, the cancer will outsmart her treatment and mutate into a different type of lung cancer or another cancer that won’t respond to treatment. In the meantime, she travels to Boston every two months for a check-up and deals with side effects like fatigue, muscle pain, edema, weight gain, cataracts and shortness of breath — all of which she says are manageable compared with cancer. Five years ago, she was told she had three to six months to live. “My lung tumors have significantly decreased due to the target therapy,” she said. “Overall, I feel very lucky. It’s a matter of perspective and how you choose to look at
what your life is like.” She thinks that few people with lung cancer have as long to live because most lung cancers are discovered by the time they’re at stage 4. She said she was sick 15 months before she received a diagnosis. Ziegler said that many do not get screened for lung cancer because for insurance to cover it, the person must have numerous risk factors. Among those who qualify, only 5% seek screening. Physician Albert Rizzo, chief medical officer with the American Lung Association, believes that many women are not aware of “how significant lung cancer is for their health,” he said. While Rizzo acknowledged that many current cancer cases are attributable to the tobacco use of the 1980s and 1990s, “there seems to be a number of young women who are nonsmokers who are diagnosed with lung cancer.” In these cases, the cancer is more treatable, but only if caught early. Unfortunately, few seek screening unless they have smoking history. Even if money were no impediment, screening everyone is not a good idea. “If you screen too widely, you find things that don’t need to be found and put people through needless procedures,” Rizzo said. “You want to screen people who benefit the most.” The recommendations are mostly based upon smoking history. That does not help those who have lung cancer for non-tobacco causes. Rizzo said that environmental or occupational exposure are not included as risk factors. About 7 million to 8 million Americans are eligible for screening, but only 5% follow through. “It’s another mission messages: assess yourself for being at high risk and talk with your physician about being screened,” Rizzo said. “If you’re screened, you’re more likely to have it diagnosed it while it’s early. If it’s at stage 3 or 4, the survivability drops off significantly.” He thinks that hormones may affect why non-smoking women have three times the rate of lung cancer as non-smoking men. “There are genetic studies that it occurs more in Asian women than non-Asian women,” Rizzo added. “Is it due to the size of the lungs? It may have to do with anatomy.”
Lung Cancer at a Glance • This year 228,820 Americans will be diagnosed with lung cancer. • Lung cancer is the leading cause of cancer death in the US. • Lung cancer claims more lives annually than either colorectal, pancreatic, breast or prostate. • Nearly 20% of men and women diagnosed with lung cancer are never smokers. Source: GO2 Foundation for Lung Cancer:
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Cancer
Family History Plays a Role in Cancer Risk In addition to predicting risk of cancer, genes can also make a difference in treating cancer By Deborah Jeanne Sergeant
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any factors play into why cancer develops, both known and unknown. For some people, family history plays a role, yet only 5 to 10% of cancers are caused by inherited gene mutations, according to the American Cancer Society. Other health factors, such as obesity, diet, exercise and stress management make a difference as do environmental influences, including radiation, certain chemicals, tobacco use and smog exposure. The American Cancer Society recommends exploring genetic testing for people who have a strong family history of certain types of cancer, those already diagnosed with cancer (especially if it appears an inherited mutation could have caused it), and people whose family members have a known inherited gene mutation. A lack of a gene mutation does not meant cancer cannot occur. “We often talk with women on knowing their history and knowing their genetics, but a family history doesn’t preclude you from having breast cancer,” said Andrea Moran, executive director of the Upstate New York affiliate of Susan G. Komen Breast Cancer Foundation. “They may say, ‘No one ever had it in my family history’ or ‘It doesn’t show up in my genetic testing,’ but that doesn’t mean you should take your eye off regular screening, at home breast care and mammograms.”
She encourages people to “know your normal” when it comes to their own bodies. Whether it is the breasts or other areas of the body, “if you see something abnormal, that should prompt a call to a provider,” Moran said. For those who undergo genetic testing, it is important to understand how a mutated cancer risk gene, such as BRCA1, BRCA2 or Chek2 for breast cancer, can raise risk for other areas of the body. “With the BRCA1 or 2 gene, you’re at high risk for ovarian cancer,” said Cara Cappello, founder of Breast Previvors ROC, a group for women who choose prophylactic mastectomy. About 44% of females with a BRCA1 and 17% of those with BRCA2 mutation will have ovarian cancer by age 80, according to www. cancercenter.com. The “previvors” in Capello’s group “carry a strong predisposition to cancer,” Cappello said. She encourages people with cancer gene mutations to remain vigilant about their health and to ask their providers about other screenings and preemptive measures they may need. Most insurance companies cover genetic testing for people with enough risk factors. The testing can reveal if they carry genes that raise their lifetime risk of cancer or if waitand-see is a reasonable approach. While preemptive surgery is not easy, it virtually eliminates the risk
Is There a Link Between Hair Dyes and Cancer?
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illions of people color their own hair, even though some of the chemicals in permanent hair dyes are considered possible carcinogens. So, is home hair coloring safe? According to a new study, the answer is a qualified yes. After tracking cancer risk among more than 117,000 U.S. women for 36 years, the investigators found that personal use of permanent hair dyes was not associated with any increase in the risk of developing bladder, brain, colon, kidney, lung, blood or immune system cancer. Nor were these dyes linked to an uptick in most skin or breast cancers. “We observed no positive association between personal permanent hair dye use and risk of most cancers or cancer-related mortality,” said study lead author Yin Zhang, a physician and re-
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search fellow in medicine with Brigham and Women’s Hospital, Harvard Medical School and the Dana-Farber Cancer Institute, in Boston.
Cara Cappello, founder of Breast Previvors ROC, a group for women who choose prophylactic mastectomy. The “previvors” in Capello’s group “carry a strong predisposition to cancer,” Cappello says. of ever needing cancer treatments for that type of cancer. Patients are essentially consenting to surgery now to avoid the great likelihood of surgery plus chemotherapy and/or radiation later. People with genetic predisposition to certain types of cancer must also determine how preemptive surgery would affect other areas of life. A young adult who has not yet had children may want to delay surgery that would affect fertility, for example, compared with someone who has already had a family. Capello said that because she carries the Chek2 mutation, she has an elevated risk for colon cancer, in addition to the 46% risk of breast cancer which her surgery mitigated. Knowing her elevated risk causes her to receive earlier and more regular colonoscopies. “Insurance now pays for them for age 45 if you have a predisposition,” she said. Instead of paying for frequent rounds of imagery, insurance companies are usually more ready to pay for preemptive surgery and reconstruction for patients with high risk cancer gene mutations. In addition to predicting risk of cancer, genes can also make a difference in treating cancer. Physician Albert Rizzo, chief medical officer with the American Lung Association, said that in the past five to 10 years, “there are at least 20 new drugs targeting mutations.” The treatment is most effective if begun with an early diagnosis.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
“It’s probably more relevant in lung cancer because that’s where the genetic markers have been identified,” Rizzo added. “It’s part of the discussion when you talk with an oncologist. One question is, ‘Will my treatment change if we do genetic testing?’ They may give good reasons as to why they don’t want to do genetic testing. It may depend on the stage of the cancer or comorbidity of the patient.”
Cancer at a Glance • This year alone, breast cancer is estimated to be diagnosed in more than 252,000 women. • Of those 252,000 women, an estimated 12,600 to 25,200 have a BRCA mutation. • If you have a BRCA1 mutation, you have an estimated 72% chance of developing breast cancer by age 80. If you have a BRCA2 mutation, you have an estimated 69% chance of developing breast cancer by age 80. • 100% of patients with ovarian cancer and pancreatic cancers should consider genetic testing. • One in 10 breast cancers have hereditary causes • One in six patients with prostate cancer have a germline variant (gene variation) • One in five patients with pancreatic cancer have a germline variant. Source: BeBRCAware.com and www.invitae.com.
Cancer
The History of the Pink Ribbon By Deborah Jeanne Sergeant
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n addition to the orange, gold and red foliage colors, you’re likely seeing a lot of pink this time of year as October is Breast Cancer Awareness Month. Most people realize that a looped pink ribbon represents breast cancer awareness; however, many do not know about the origin of the campaign. Ancient texts relate that ribbons used in décor have traditionally symbolized longing for those absent during wartime. The 1973 song, “Tie a Yellow Ribbon Round the Old Oak Tree” (Irwin Levine, L. Russell Brown), echoes the sentiment of a ribbon symbolizing support and welcome for a loved one at war. According to www.pinkribbon. org, Charlotte Hayley, a breast cancer patient in California, thought the ribbon was appropriate to symbolize the fight against breast cancer. In 1991, she started distributing peach ribbons with a handbill urging more funding for breast cancer. Hayley handed them out at grocery stores and sent them to public figures such as former first ladies and Dear Abby. Self magazine editor Alexandra Penney adapted the symbol by shifting the color to pink. In 1991, the Susan G. Komen Breast Cancer Foun-
dation established the pink ribbon as a national symbol for breast cancer awareness by distributing one to every participant in the organization’s NYC Race for the Cure. Though Hayley died at age 91 in 2014, her grassroots effort demonstrated that everyday people could make a difference. That is the mindset behind organizations like Komen, which was founded by Nancy G. Brinker in 1982 to fulfill a promise to her sister, Susan G. Komen as Komen was dying from breast cancer. Brinker said she would do everything she could to eradicate breast cancer. A sister’s promise has grown into an internationally recognized organization. Andrea Moran, executive director of the Upstate New York affiliate, said that the grassroots beginnings of Komen “is one of our strengths, and that we focus only on breast cancer. “We also take a 360-degree approach. It’s not just research or patient care or advocacy. Because we’re grassroots, a lot of what we achieve is community-led and integrated into the landscape of small towns and communities.” The organization is shifting in 2020 and 2021 to consolidate local affiliates under a national organization
based in Dallas. “We’ll be able to engage even if there’s not an affiliate where they live,” Moran said. “We will continue to have a presence in Upstate New York.”
Local grassroot groups Breast Cancer Coalition in Rochester also started from grassroots efforts. The organization supports people touched by breast cancer to provide information, offers advocacy for breast cancer and helps patients speak up regarding their care. Founder Sylvia Cappellino established Breast Cancer Coalition in her home in 1997. “Those present certainly realized the importance of the journey they were about to embark on,” said Holly Anderson, president and executive director, “but it’s doubtful they foresaw the major force their fledgling group would become.” The Breast Cancer Coalition has earmarked $750,000 to breast cancer research among organizations in the region. The organization hosts numerous fundraisers manned by volunteers. The largest three fundraisers are the Pink Ribbon Walk and Run, the Tee’d Off at Breast Cancer Golf Tournament, and the ARTrageous Affair gala. “Those who give of their time and talents have assured the coalition stands on solid financial ground and can continue to offer programming free of charge for survivors,” Anderson said. “Our volunteers are our greatest treasure.” Anderson joined the group after receiving a breast cancer diagnosis in 1999 and has served as executive director since 2001. Another grassroots organization, Breast Previvors ROC was founded by Cara Cappello. The term “previvor” was coined by Facing Our Risk of Cancer Empowered (FORCE) in Tampa, Florida, to describe people who have a predisposition to cancer but have not actually developed cancer. Cappello learned in 2018 that she carries the Chek2 gene mutation.
Her lifetime risk of breast cancer was 42%. A 20% or greater risk is considered high risk. She opted for bilateral prophylactic mastectomy to reduce her risk to a nominal 5%. While recovering from surgery in early 2019, she discovered no organizations in the area that fit her needs: someone who did not have cancer but was recovering from double mastectomy. Cappello did not have the same types of struggles as many typical breast cancer patients, such as fear of metastasis, undergoing radiation and experiencing chemotherapy and effects such as hair loss, vomiting and nausea. Oftentimes, people who had never experienced the surgery did not understand. “‘Oh, you had a “boob job,”’ people would say. A mastectomy isn’t a ‘boob job,’” Cappello said. “You’re left with implants if you chose that. You have rippling. It’s a new you. You’re never the same. It’s a life-altering, body-altering thing. You don’t have cancer yet, but are you willing to alter yourself. There are side effects with having mastectomy.” Initially, she had difficulty performing activities of daily living like reaching into a cupboard for dishes. Cappello said she felt like she had T-rex arms. Rigorous rounds of acupuncture and physical therapy helped reduce pain and restore function; however, she still experiences numbness, on the sides of her back and up to her collar bones. Her breasts feel numb and cold all the time. She started Breast Previvors ROC in the spring of 2019 with a private Facebook page for women with similar surgeries where they can ask questions and emotionally support each other. Before the pandemic, they met in person but now meet via Zoom to connect. “What I have learned is you have to love yourself despite your flaws, no matter what,” Cappello said. “You have to support your local ‘breasties.’ You can look at yourself and say, ‘I’m strong and I beat cancer first.’”
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Career in Healthcare
Wound Care: A Medical Specialty By Deborah Jeanne Sergeant
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o an extent, medical professionals know how to care for wounds and ostomies; however, wound care also represents a medical specialty. Extra training and education in wound care can augment any medical professional’s resume and help segue into leadership roles. Sarah E. Clayson, who earned a doctorate in health sciences and master’s in health administration, is also a bachelor’s trained nurse. She serves as education coordinator and stroke coordinator for Finger Lakes Health. She said that many health systems have wound care nurses and wound care teams to assess and treat hard-to-heal wounds. “When you look at nursing, there’s cardiac nurses and other specialties, but the skin is the largest organ of the body and we don’t talk about it enough,” Clayson said. In May, she enrolled in the Cleveland Clinic’s online program for wound care, ostomy and continence, which takes about five months to complete. Some programs focus only on wound care; others include ostomy and continence because urine or feces remaining on skin for extended periods breaks down the skin. Wound care specialists tend to serve many older adults, since their skin does not heal as quickly as younger people, and who are more likely to have conditions that raise their risk of pressure ulcers. Diabetics are also frequent patients of wound
care specialists. “If you have a diabetic who doesn’t manage diabetes, they may not feel there is a wound and they continue to get worse, which leads to amputation of a foot or limb,” Clayson said. “If it’s not identified and well-managed from the beginning, they can have significant issues.” For these reasons, she felt it was important to bring specialized wound care to Geneva. Otherwise, the closest wound care centers are half an hour from the hospital. As more providers realize the benefits of wound care, the demand for the specialty will continue to increase. Clayson added that home-based and nursing-home-based wound care is growing because of the expanding healthcare needs of the aging baby boomer generation. “At larger centers, they look for board-certified wound care nurses,” Clayson said. “It absolutely will help your career.” Nurses with a wound care certification cannot diagnose but discuss with providers their findings and “help bridge that gap with the nursing staff to deliver that care.” The Cleveland Clinic’s wound care, ostomy and incontinence program costs $6,000. Other organization such as Wound Care Institute offer online classes. “I never thought I would love wound care but it has brought me
back to the bedside,” Clayson said. “I have a better appreciation for the overall care of patient, prevention of skin breakdown and improving their quality of life.” David E. Balliette, program director of The Center for Wound Care & Hyperbaric Medicine at Clifton Springs Hospital & Clinic, said that nurses and doctors with wound care certifications are preferred for his organization. “It teaches protocols, how to work with other primary care providers, as well as the modalities and advanced therapies we use,” he said. “When that patient is done with treatment, there’s definitely a connection where the patient is thankful for how they were treated. Their case manager is their coach for the healing processes.” He added that the extra training may mean a higher paycheck, depending upon the organization, but the real perk is that working in wound care means regular work hours, without on-call or weekend work. Like Clayson, he thinks that wound care will continue to grow as a specialty area. Tara Weedar, a registered nurse and clinical nurse manager at Clifton
Tips How to Fall Asleep Fast
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hronic insomnia affects up to 20% of adults, of which many don’t seek any treatment. If you cannot fall asleep within 20-30 minutes of getting into bed or stay wide awake even after being extremely tired, then here are some tips for you to fall asleep instantly: • Relax your mind and body before going to bed. Try doing simple exercises or some unwinding activities such as reading books or listening to soothing music. Deep breathing or meditation can calm your mind. • Dim the lights of your house an hour before sleeping to induce sleep. Keep the sleeping room lights to dim. Dark rooms result in better quality sleep. • Turn-off electronic gadgets such as mobile, laptop, tablets, and television one hour before sleeping. The lights emitted via these gadgets disturbs the sleep cycle. This includes e-books as well. • Try to fix a time for sleeping to adjust your body’s clock. Follow this every day (weekends included) and Page 14
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even on days when it’s hard to get up in the morning due to lack of sleep. • Have an early dinner before 7 p.m. or two hours before sleeping. Have a glass of milk while sleeping to reduce hunger and induce sleep. Milk contains an amino acid (L-tryptophan) which helps in inducing sleep. • Stimulants such as nicotine and caffeine (coffee, cola, tea, and chocolate) should be avoided four to six hours before bedtime. Stimulants may interfere with sleep. If you are addicted to caffeine, try to reduce the amount of caffeine gradually to prevent unpleasant reactions such as headaches caused because of the withdrawal of caffeine at once (withdrawal symptoms). • Consuming liquor during bedtime is not advisable because it may lead to nightmares and sweating. Although alcohol is a depressant and helps in falling asleep, the body tends to clear it, leading to night awakenings (withdrawal symptoms). • Avoid long afternoon naps; however, take a power nap off 15-20
minutes about eight hours after you wake up. • Discontinue any tasks one hour before sleeping to reduce anxiety and worry. Do not discuss any emotional issues during bedtime. • Progressive muscle relaxation: This involves relaxation of various muscle groups by first tensing muscle and then relaxing them, starting from the feet and slowly moving upwards. • Keep a record of your sleep pattern: The number of times you woke up during the night, how much caffeine or alcohol you had during the day. Mention it down in a diary. • The bed should be used only for sleeping and intimacy. Avoid eating or working on the bed. • Refrain from watching the clock as it can lead to unnecessary stress and in turn cause less sleep. • Make your sleeping time and environment comfortable by maintaining the room temperature at optimum. The mattress and pillow should be comfortable too. The bed-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
Springs Hospital, said that nurses can attend weeklong classes at Healogics in Jacksonville, Florida, to receive extra wound care treatment expertise. The organization also offers online courses. Rochester General Hospital offers wound care at Clifton Springs by outsourcing to Healogics. Weedar said that completing coursework “would open more opportunities for them to provide services to their patients. Being in a wound care center, we have all the advanced modalities they can use. With the partnership with Healogic, our success rates outstrip any other facility.” She said the care involves assessing wounds, understanding antimicrobial treatments, knowledge of devices for pressure ulcers and dressing wounds. “When I look for staff, I look for someone with good bedside manner,” Weedar said. “Our patients come in weekly. Being able to connect with patients is important. We not only heal their wounds but we get to know people.” She added that anyone can learn the technical aspects of wound care, “but the soft, bedside manner skills are not replaceable.”
How to fall asleep fast using the military way?
A scientific method is developed to help the pilots fall asleep by the U.S. Navy Pre-Flight School. It involves: • Relax every muscle of the face by breathing slowly and taking deep breaths. • Relax your shoulders to release tension and drop your hands to the side of your body. • Relax your thigh, calf, ankle, and foot of both legs one by one. • Remove your worries and clear your mind by paying attention to your breaths. • Once your body is relaxed, you should fall asleep within seconds. These are some effective tips that might help in falling asleep. However, if these techniques don’t work out, talking to a doctor would be an ideal option. room should be painted in mellow colors. • Avoid drinking too much water during night time to avoid trips to the bathroom during sleep. Pets shouldn’t be allowed on the bed as they can bring allergy triggers like fleas, fur, and pollen.
SmartBites
The skinny on healthy eating
Why Brussels Sprouts Deserve a Shout-Out America’s most-hated vegetable doesn’t deserve the bad rap
S
taunchly refused by many and accused of smelling like old socks when boiled, America’s most-hated vegetable doesn’t deserve the bad rap. Replete with flavor when properly prepared, Brussels sprouts pack an astonishing array of nutritional benefits. Plus, these unsung heroes are affordable, in season now, and last over a week in your fridge (a true bonus when grocery shopping is the last thing you want to do). Nicely low in both calories and carbs, Brussels sprouts are exceptionally high in vitamins K and C. One cooked cup of these tiny green globes packs over 250% of the minimum daily target for vitamin K and over 150% of the minimum vitamin C target. Vitamin K plays an important
role in blood clotting, bone health and possible protection against osteoporosis, while vitamin C supports collagen production, iron absorption, wound healing and immunity. Like its cruci-
ferous cousins — cabbage, kale, cauliflower and broccoli — Brussels sprouts are rich in fiber, boasting nearly 4 grams per cooked cup. A valuable but often overlooked nutrient, fiber promotes regularity, helps regulate blood sugar levels and may reduce the risk of heart disease and diabetes. Brussels sprouts teem with multiple disease-thwarting compounds — phytochemicals, antioxidants, anti-inflammatories — that help deactivate potentially damaging chemicals or shuttle them out of the body more quickly. Though more research is needed, some studies have suggested that the compounds found in Brussels sprouts may help decrease the risk of cancer, suppress inflammation, lower cholesterol and promote heart health. A final shout-out: Brussels sprouts can help prevent ulcers. The sulfur compounds in this cruciferous gem are known to reduce ulcer risk by squelching the overgrowth of H. pylori, a type of bacteria linked to stomach sores.
Shredded Brussels Sprout Salad with Toasted Pecans Serves 4-6
For the vinaigrette: 1 lemon juiced, about ¼ cup 1 tablespoon honey 1 tablespoon Dijon mustard 1 tablespoon minced shallot 1 garlic clove, minced ½ teaspoon salt ¼ teaspoon coarse black pepper 2 tablespoons extra virgin olive oil For the salad: 1 pound Brussels sprouts, shredded 1 pear or apple, chopped ½ cup dried cranberries ½ cup chopped pecans, toasted
Helpful tips
Steaming and boiling Brussels sprouts can make them mushy and stinky—not a good combo. Instead, give them the treatment they deserve by shredding them in a salad or roasting them at a high oven temperature, which creates crispness and a sweet, nutty flavor. Select tight, firm sprouts with healthy green leaves. Smaller sprouts run sweeter. Refrigerate unwashed and uncut in a sealed plastic bag for up to 10 days. ½ cup gorgonzola cheese crumbles In a small bowl, whisk together the vinaigrette ingredients until well combined. Set aside. Wash the Brussels sprouts and removed any damaged outer leaves. Cut the sprouts in half lengthwise. Place cut side down and thinly slice crosswise to create shreds. Discard the tough root end and separate the shreds with your fingers. You may also use a mandolin or food processor to create shreds. In a large bowl, combine sprouts, chopped pear or apple, cranberries, pecans, and gorgonzola crumbles. Add vinaigrette, toss to coat, serve.
Anne Palumbo is a lifestyle colum-
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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Page 15
Suicide Prevention. Yes, There Is an App for That By Deborah Jeanne Sergeant
P You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org
hone apps can help with items frivolous to serious. Apps that address mental health issues may prove helpful tools in preventing death by suicide. Laura Jowly is interim director of behavioral health for Rochester Regional Health, eastern region. She said that apps on mindfulness, coping skills and tracking recovery can help patients struggling with mental health issues that can contribute to death by suicide. “It’s important to know the resources available,” Jowley said. “Apps for journaling can help for journaling emotions. Some apps can help with safety planning.” Of course, it is important to seek mental healthcare from professionals as phone apps cannot replace this care; however, apps can help support and reinforce the work done in therapy. Apps can also provide a means to supplement the care the patient receives between sessions. That daily or as-needed maintenance may enhance the therapist’s work. For some people, apps offer a measure of convenience. Emergency care is available 24 hours a day; however, that’s not always what’s most effective during off hours. Sometimes, a nudge in the right direction
is all that’s needed. One app example is Virtual Hope Box, a virtual safety plan. It stores the contact information of people patients can call, music and photos that help them feel grounded, and other aspects of their safety plan. Kelly Mohrman, licensed clinical social worker and suicide prevention coordinator with REACH VET Coordinator at VA Rochester Outpatient Clinic, said that her organization works with vets to create a safety plan on paper; however, they don’t always carry it around with them. Most people always have their cellphones with them, making it the ideal means of keeping their safety plan on hand. Mohrman added that apps for mindfulness “can help bring them down” when anxious. “Certainly, we have had anecdotal reports that PSTD and mindfulness apps have been helpful,” she said. “There’s no cookie cutter approach for any one person. Finding that fit that works for everyone is key. It’s a different fit that works for each person.” Free, helpful apps include: • For veterans
My HealtheVet www.myhealth.va.gov Mobile Blue Button for Veterans: www.va.gov/health-care/ get-medical-records/ • Mental health: PTSD Coach, https://mobile. va.gov/app/ptsd-coach CPT Coach, www.ptsd.va.gov/ appvid/mobile/cpt_app_pro.asp PE Coach, www.ptsd.va.gov/appvid/mobile/pecoach_app_public. asp Mood, depression, and/or bipolar disorder: T2 Mood Tracker For more apps, visit www.militaryonesource.mil/health-wellness/ recommended-wellness-apps: Positive Activity Jackpot Virtual Hope Box: Moving Forward BreatheThinkDo Provider Resilience Naturally, a phone app is only as helpful as the user makes it. Like any other tool, if it is not used, it is not helpful, so people reluctant to use their smartphones will not benefit from these apps as much as someone who consistently turns to a smartphone for help. Veterans can use the resources at www.veteranscrisisline. net. General resources are at the National Suicide Prevention Lifeline website, suicidepreventionlifeline.org or by calling 800-273-8255.
Number of Suicides Up 35% since 1999 By Deborah Jeanne Sergeant
T
he most recent numbers from the Centers for Disease Control and Prevention indicate that 48,344 people died by suicide in 2018, an increase from the previous year’s number, 47,173. Although that represents only two-tenths of 1%, it continues the trend of the past two decades, up by 35% since 1999. “I think the acuity of the patients is going up,” said Larua Jowly, interim director of behavioral health at Rochester Regional Health, eastern region. “A big factor we’re seeing in the concurring substance use with mental health disorders. It impacts impulsivity, and lower cognitive ability to process through things.” Jowly said that high stress levels also contribute to the trend, along with social isolation — issues which may lead to higher increases in 2020. The veteran population faces additional contributing factors, such as post-traumatic stress disorder, according to Kelly Mohrman, licensed clinical social worker and suicide prevention coordinator with REACH VET Coordinator at Rochester VA Outpatient Clinic. “The suicide rates have gone up Page 16
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over the years,” Mohrman said. “Our latest numbers are 20 vets a day. Only six are using VA services. We’re always looking for information and trying to do research to find out what is causing these increases and what we can do to prevent this. Every time we have a veteran die by suicide, we meet with the family and look at what we can do to prevent suicide.” She thinks that part of the reason is that veterans aren’t linked with services that can help, such as counselor or peer services. The VA coordinates with the American Foundation for Suicide Prevention while following confidentiality laws. Linking with OnStar enables the VA to help locate a veteran who calls a crisis line and take help to the individual. If someone you care about appears to be struggling, “the biggest things is to ask them, ‘Are you having thoughts of suicide? Are you struggling?’ If so, let’s get you somewhere to get help’ like ER, urgent care, or healthcare provider for an appointment. If someone has started to hurt themselves like take pills, call 911. If not, ask, ‘What can I do to help support you? What’s going on?’” Mohrman said that it is vital for
Kelly Mohrman, licensed clinical social worker and suicide prevention coordinator with REACH VET Coordinator at Rochester VA Outpatient Clinic. “The suicide rates have gone up over the years. Our latest numbers are 20 vets a day,” she says. people helping to not judge those in distress. What may seem trivial feels overwhelming to them. Saying it’s silly or to “get over it” minimizes their struggle. She added that it’s a big step to reach out for help or feel willing to talk about mental health — though it shouldn’t be stigmatized. “It’s not shameful to go to the doctor about mental health,” Mohrman said. “It’s just like going to the doctor for chest pains.” Jowly believes that isolation and busyness make a difference in how people relate and in individual mental health.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
“A little compassion and kindness can go a long way,” Jowly said. “People battle with thigs on a day-today basis. Human compassion and kindness and taking the time to say, ‘How are you doing today?’ makes a difference. The busier we get in our lives, the more distance we get from that. Technology has killed human companionship. It’s getting in the way of relationships.” In addition to educating the public about mental health, Jowly said that teaching healthcare workers about mental health screening is vital to lowering the rates of death by suicide.
Recovery from Problem Gambling: Challenges During Times of COVID-19 By Jennifer Faringer
S
eptember was National Recovery Month, a time to celebrate recovery from all addictions including one that’s not always openly discussed — problem gambling. Recognized as a hidden addiction, the signs of a problem gambling addiction are not as easy to recognize as with dependence on alcohol or other drugs. It is especially important to increase the awareness of problem gambling, making it a priority in terms of prevention education and awareness, as well as screening, counseling and treatment services. During COVID-19, access to the primary three staples of gambling (casinos, sports and racetracks) have all been very limited and restricted as all involve large gatherings and were deemed non-essential. Only very recently are casinos in the early stages of reopening on a limited basis. However, since the mid-March closures, online gambling opportunities have been thriving and expanding in access and availability. Online gambling includes online poker, online lottery, online casinos and eSports. Those in early recovery from a problem gambling disorder have been faced with not only increased access to online gambling but also the sharp increase in anxiety and depression, which may accompany the uncertainty and social and physical isolation associated with the pandemic. Additionally, gamblers that are in early recovery have lost their access to in-person Gamblers Anonymous (GA) meetings. GA meetings are still available but now through a virtual format, which for some has not been ideal. The National Council on Alcoholism and Drug Dependence-Roch-
ester Area (NCADD-RA) has developed and continues to update the Problem Gambling Services Directory, which includes regional resources for prevention education, private practice counseling and treatment, with many, if not all, offering services virtually. For more information, visit https://ncadd-ra.org/services/finger-lakes-addiction-resource-center/. NCADD-RA continues to partner with the New York Council on Problem Gambling on their YOUth Decide 2020 Project. We ask parents to consider taking a pledge to talk to your children, nieces, nephews and grandchildren about the risks of problem gambling. Parent pledges may be accessed virtually at: https://www.surveymonkey. com/r/YDNY-Parent-Pledge Additionally, we ask all youth between the ages of 13-18 to take a confidential five-mintute survey regarding the myths and facts surrounding problem gambling and media literacy. Youth surveys may be accessed virtually at: www.surveymonkey. com/r/YDNY-Youth-Pre-Survey Jennifer Faringer is the director, DePaul’s NCADD-RA (National Council on Alcoholism & Drug DependenceRochester Area). She can be reached at jfaringer@ depaul.org or 585-719-3480.
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Page 17
5
Things You Should Know About Depression By Ernst Lamothe Jr.
D
epression is a topic that is hard for many to understand, difficult for sufferers to cope with and often something challenging to talk about. Whether it’s because of the various misconceptions or the complexity of the subject, too often depression gets misdiagnosed or ignored. Making matters worse, 2020 has offered a consistent plate of unpredictability, tragedy and anxiety that has led to an increase in reported depression cases. “It’s important to shed light on mental health and depression,” said Laura Jowly, outpatient behavioral health manager at Clifton Springs Hospital and Clinic. “We’re living in a time now with the pandemic and everything else is going on where people are struggling and learning how to deal with everything. That’s why we can’t be afraid to talk about depression openly.” Mental health experts view trauma as any event or circumstances where an individual experiences overwhelming or life-changing feelings. It can have physiological, social and spiritual impact. Jowly discusses five aspects of depression that people should know.
Watch the symptoms 1. Although depression symptoms may vary in intensity or frequency, there are a few warning signs of which people should be aware. A person may feel sadness, tearfulness, emptiness or hopelessness. There are times with angry
outbursts, irritability or frustration, even over small matters. When depression hits, there is a loss of interest or pleasure in most or all normal activities, sleep disturbances, including insomnia or sleeping too much and reduced appetite and weight loss or increased cravings for food and weight gain. There can be feelings of worthlessness or guilt, fixating on past failures or self-blame. “You have to watch if you’re feeling large bouts of hopelessness, having a difficult time sleeping for long periods of time and you stop enjoying the activities that used to give you so much joy,” said Jowly. Difficult talking about it 2. There is still a stigma about people expressing their inner
thoughts about their depression. Some people will simply call it the blues or dismiss it as something that can easily be solved with a nap or vacation. However, it goes deeper than that. And because of the layers associated with depression and the backlash from family and friends, sometimes people decide to keep that part of their lives to themselves. “Even though I do think the stigma of depression is decreasing, you still have stereotypes of people who need mental health services,” said Jowly. “Some people resist getting the help they need because of that stigma. We all need coping mechanisms for issues we deal in life.”
COVID-19 and depression 3. This pandemic is currently having an impact on the way
people live and navigate the world. It is also causing a great deal of terror, despair and even grief given the enormous and yet rising death toll. It can impact a person’s sense of control, encroaching on the comfort zones and requiring them to adjust to continually fluid situations. Being quarantined at home for months during this year has also had an impact. “A lot of people felt isolated at first with the stay-at-home order,” said Jowly. “Even when things start opening back up you have the whole social distancing as well as limiting the number of people who can be together, which also affects people and can make them feel isolated. We need a support network in life to function and when you have to be away from those important people anxiety can arise.” Depression and addiction 4. “They can go hand-inhand. There are people who have
done well with medication for their depression,” said Jowly. “But there are others who when prescribed certain drugs for depression it led them to other drugs and over dependency on them.” Depression looks different 5. Exposure to and living through traumatic events has the
A
s the coronavirus pandemic has swept across America, so has an epidemic of depression, a new study shows. Since the pandemic began, the prevalence of depression symptoms has roughly tripled, with the poor who lost jobs and savings most affected, researchers report. “People with lower income were twice as likely to have depression, and people with the same income but who had less savings were 1.5 times more likely to have depression,” said lead researcher Catherine Ettman, director of strategic development at
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belief, knock us off our equilibrium and rock a person to their core at a fundamental level. That is why reaching out to a psychological expert is important. “People feel like there’s one type of image for those who are dealing with depression,” said Jowly. “It’s a stereotype of someone who is homeless, who looks disheveled and living under a bridge. That’s the problem with depression; it doesn’t just have one face. There are so many people who you would never think who are battling with this. Even worse, they feel like they have to fight the battle within because they don’t feel comfortable talking to people about it. We are very good as human beings at convincing ourselves and others that we’re doing well even when we’re not.”
strong potential to shape a person’s
A U.S. Pandemic of Depression, Too? Rates Are Triple Pre-COVID Levels
Page 18
Laura Jowly, outpatient behavioral health manager at Clifton Springs Hospital and Clinic.
Boston University’s School of Public Health. “We were surprised at the high levels of depression,” she said. “These rates were higher than what we’ve seen in the general population after other large-scale traumas like Sept. 11 and Hurricane Katrina.” The current pandemic is not just one event. With COVID-19 there is fear, anxiety and dramatic economic consequences, especially among people with fewer resources, Ettman said. “This calls for us paying attention to mental health problems that are arising at this moment that will need attention in the coming months and years,” she said. For the study, the researchers
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
used a survey of more than 1,400 people aged 18 and over who completed the COVID-19 and Life Stressors Impact on Mental Health and Well-Being survey, conducted March 31 to April 13. That data was then compared with data on more than 5,000 people who took part in the National Health and Nutrition Examination Survey from 2017 to 2018. Since the pandemic, 25% of responders reported being mildly depressed, compared with 16% before the pandemic. Fifteen percent were moderately depressed, compared with 6% before the pandemic. There were 8% with moderately severe depression, compared with 2% before COVID-19 and 5% with severe depression, compared with less than 1% before COVID-19. The risk for depression symptoms was highest among people with less than $5,000 in savings, the researchers found. Ettman believes that in addition to more access to mental health care, programs that keep people’s heads above water economically are needed to ensure that they have the resources to weather through these times. These can include moratoriums on evictions, extended unemployment compensation and universal access to health care. The report was published online Sept. 2 in the journal JAMA Network Open.
COVID-19
Study Confirms Restaurants, Bars Are COVID Infection Hotspots
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elaxation of face mask requirements in restaurants, coffee shops and bars could make those venues prime areas for transmission of the new coronavirus, research shows. The new study compared the behaviors of people diagnosed with COVID-19 and those without such diagnoses. It uncovered one clear difference: Newly ill people without any known contact with a person with COVID-19 were almost three times as likely to have patronized a restaurant over the prior two weeks, and almost four times as likely to have visited a bar or coffee shop, compared to uninfected people. The study suggests that situations “where mask use and social distancing are difficult to maintain, including going to places that offer on-site eating or drinking, might be important risk factors for acquiring COVID-19,” the research team said. The findings come at a moment when more locales are allowing eating establishments and bars to reopen. In mid September, officials announced that restaurants in New York City could serve customers again starting Sept. 30, albeit with a 25% occupancy limit. “As we learn more about transmission, it is not surprising that activities that cannot maintain social distancing and are not amenable to mask wearing — such as eating and drinking in close proximity to others— would result in a higher transmission rate,” said physician Teresa
Murray Amato, who heads emergency medicine at Long Island Jewish Forest Hills, a hospital in New York City. She wasn’t involved in the new study, which was led by Kiva Fisher of the U.S. Centers for Disease Control and Prevention’s COVID-19 Response Team. Fisher and her colleagues conducted detailed interviews with 314 U.S. adults during the month of July, about half of whom were diagnosed with COVID-19. Comparing the activities of people who did and did not have COVID-19, the investigators found no significant differences in their patronage of venues where the use of face masks at all times was required — activities such as taking public transportation, shopping or attending church. Mask use was common among most of the study participants. A similar number of people with or without COVID-19 said they always wore some kind of mask or face covering when out in public — 71% and 74%, respectively. The only big difference in terms of behavior between the infected and uninfected groups was a visit over the prior two weeks to a bar, restaurant or coffee shop, Fisher’s group found. More than half (58%) of study participants diagnosed with COVID-19 said that they’d had no close contact with a person known to have been infected with the new coronavirus. But these individuals did have 2.8 times the odds of having patronized a restaurant over the prior
Is it a Flu or COVID-19? COVID-19 and the flu share many symptoms, says Excellus medical director
K
nowing the difference between influenza (the flu) and COVID-19 may be hard for an individual who isn’t feeling well since the illnesses share many symptoms, according to the U.S. Centers for Disease Control and Prevention (CDC). “Connect with your health care provider right away to get an accurate diagnosis and appropriate treatment,” said Excellus BlueCross BlueShield Medical Director Nicholas Massa, M.D. The CDC lists common symptoms that COVID-19 and flu share, including: • Fever or feeling feverish/chills • Cough • Shortness of breath or difficulty breathing • Fatigue (tiredness) • Sore throat • Runny or stuffy nose
• Muscle pain or body aches • Headache • Some people may have vomiting and diarrhea, though this is more common in children than adults The COVID-19 pandemic has raised awareness of how dangerous a virus can be and how important it is to have an effective vaccine. “In 2019, the CDC estimates between 39 million and 56 million people got sick with the flu and between 24,000 and 62,000 people died of flu complications,” said Massa. “Fortunately, we have a flu vaccine in hand for this year’s strains that can provide a level of immunity or reduce the severity if you do get sick.” The first place you should call to get the flu vaccine is always your primary care provider. If needed, the flu vaccine can also be obtained at most major pharmacies, and at other sites in our community. The CDC recomOctober 2020 •
two weeks, and 3.9 times the odds of having been at a bar or coffee shop, compared to uninfected people. The study wasn’t able to ascertain whether participants had consumed food or drinks in an indoor or outdoor space.
Lack of good ventilation “The bottom line is that many people don’t put their mask back on when they aren’t eating and drinking, and may be engaged in conversation,” said Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City. ”This very fact increases the risk of transmission, and is compounded by lack of enforcement by management at eating and drinking establishments.” Glatter also noted that ventilation within restaurants or bars is
mends it for everyone 6 months and older. Most health insurance plans cover the flu vaccine in full, and you usually don’t need an appointment to receive it at a pharmacy. “The flu season could last as late as May in a given year, but it is important to get vaccinated sooner than later to help establish a level of immunity in our community,” said Massa. “It takes about two weeks for the vaccine to provide protection.” Older adults should consult with their health care provider to see if they recommend the high-dose flu vaccine that is approved for people ages 65 years and older. A study published in the New England Journal of Medicine indicated that the highdose vaccine was 24% more effective in preventing flu in adults 65 years and older relative to a standard-dose vaccine. One person with the flu can infect other people one day before any symptoms develop, and up to about seven days after they become sick. For the very young, the very old, women who are pregnant, and individuals with compromised immune systems including many patients on chemotherapy, catching the flu can place them at high risk for serious complications, including death. It isn’t always obvious who among us
often less than adequate, and research has shown that “aerosolized droplets containing virus in normal conversation may be transmitted to others in close proximity, but may also remain suspended in air for up to three hours and travel as far as 13 feet during normal conversation. Such aerosolized droplets may also travel as far as 26 feet during sneezes and 15 feet during coughs.” Finally, he said, alcohol is often a factor. Drinking “makes people move closer together, speak louder,” Glatter said, “thereby generating more aerosolized droplets that may contain infectious viral particles.” The study was published in the Sept. 11 issue of the CDC’s Morbidity and Mortality Weekly Report.
Nicholas Massa MD is vulnerable. “The safety protocols we practice for COVID-19 should also help reduce the spread of the flu virus,” said Massa.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Hearing Loss Association of America Rochester chapter (HLAA) offers a series of virtual programs during October for anyone interested in hearing loss. All use the Zoom platform. • Noon on Tuesday, Oct. 6. Program will feature Danny Martinez, supervisor of the Rochester Veterans Service Center. Titled “Veterans’ Benefits at the Veterans’ Service Center,” Martinez will discuss the many services offered by the Calkins Road center, which opened last year. For example, the VA is the country’s largest dispenser of hearing aids — what are the criteria for audiology services? Martinez will answer questions about veterans’ eligibility, compensation, caregiver services, pension benefits and a collection of other entitlements for honorably discharged veterans. He is a retired Navy chief who calls San Antonio, Texas, home.
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Dr. Kornfeld sees patients in Syracuse Rochester, Watertown, Elmira, Buffalo, Niagara Falls, and Scranton, PA Page 20
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• 10 a.m., Tuesday, Oct. 13. Joseph Kolesky, a retired audiologist and hearing aid user, 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., Thursday, Oct. 15. Chas Johnstone, a retired professor from RIT, will present “Demo Center. A Virtual Tour of Assistive Listening Devices.” He will demonstrate warning, television and phone devices to enhance hearing in this online version of the real time center in the Lifespan building. • Noon, Tuesday. Oct. 27. The program “Cochlear Implant Group” will feature a virtual gathering for people considering, preparing for or using cochlear implants. Peter Fackler, who has a bilateral cochlear implant, will facilitate. Preregistration is required by visiting the HLAA website at hearinglossrochester.org. All programs are free and in real time.
here’s no cutoff age for being an organ donor. Anyone, regardless of age or medical history, can sign up. In fact, there are many people well up into their 80s who donate. The decision to use your organs is based on health of the organ, not age. So, don’t disqualify yourself prematurely. Let the doctors decide at your time of death whether your organs and tissues are suitable for transplantation.
Donating Facts In the United States alone, more than 112,000 people are on the waiting list for organ transplants. But because the demand is so much greater than the supply, those on the list routinely wait three to seven years for an organ, and more than 7,000 of them die each year. Organs that can be donated include the kidneys, liver, lungs, heart, pancreas and intestines. Tissue is also needed to replace bone, tendons and ligaments. Corneas are needed to restore sight. Skin grafts help burn patients heal and often mean the difference between life and death. And heart valves repair cardiac defects and damage. By donating your organs after you die, you can save or improve as many as 50 lives, according to The United Network for Organ Sharing. Some other things you should know about being an organ donor are that it does not in any way compromise the medical care you would receive in a hospital if you are sick or injured, nor does it interfere with having an open-casket funeral if you want that option. And, most major
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
religions in the United States support organ donation and consider it as the final act of love and generosity toward others.
How to Donate If you would like to become a donor, there are several steps you should take to ensure your wishes are carried out, including: • Registering: Add your name to your state or regional organ and tissue donor registry. You can do this online at either OrganDonor.gov or DonateLife.net. If you don’t have internet access, call Donate Life America at 804-377-3580 and they can sign you up over the phone. • Identify yourself: Designate your decision to become an organ donor on your driver’s license, which you can do when you go in to renew it. If, however, you don’t drive anymore or if your renewal isn’t due for a while, consider getting a state ID card — this also lets you indicate you want to be a donor. You can get an ID card for a few dollars at your nearby driver’s license office. • Tell your family: Even if you are a registered donor, in many states, family members have the ultimate say whether your organs may be donated after you die. So, clarify your wishes to family. Also tell your doctors and indicate your wishes in your advance directives. These are legal documents that spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. If you don’t have an advance directive, go to MyDirectives.com where you can create one for free.
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Do what you love. Even if it’s nothing at all. As one of the most important people on earth, you should have nothing to worry about but choosing today’s activity, outing or dining option. Or just enjoying quiet time in beautifully maintained surroundings with 24-hour security. St. Ann’s Community at Chapel Oaks has no entrance fee, only a low, monthly service fee for all your amenities. You also have complimentary transportation for appointments and activities, and access to higher levels of care if you ever need it. 1- and 2- Bedroom Apartments • Wellness Center/Pool • Multiple Dining Venues
stannscommunity.com 1500 Portland Avenue l Rochester, NY 14621 l 585-697-6606 October 2020 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 21
Henrietta-Based Vuzix Makes Augmented Reality a Reality Reality glasses made by a Henrietta-based company could change the way orthopedic surgeons perform operations By Todd Etshman
K
nee replacement surgery utilizing augmented reality glasses made by Vuzix Corporation, a Henrietta-based company, could change the way orthopedic surgeons perform the operation in the future. Currently, around 600,000 people in the United States need knee replacement surgery per year, according to the American Academy of Orthopedic Surgeons. Nearly half of all adults in the U.S. will develop osteoarthritis in one or both knees during their lifetime. As Rochester orthopedic surgeon Thomas Myers explains, it can take a long time for American medical procedure to catch up with new technology but the augmented reality glasses that allow for extremely precise bone cutting and to guide a surgeon through the procedure was performed successfully in Paris earlier this summer. The Vuzix glasses display essential information to the orthopedic surgeon’s field of view as she navigates through the procedure. By attaching a metal marker with a bar code to bone the exact location of the operation is seen through the AR glasses. “They’re deadly accurate and allow the physician to know exactly where he is in putting the knee back together. There’s no more sloppiness,” Vuzix President and CEO Paul Travers explains. The compact wireless glasses have gone through years of improvement at the company’s manufacturing plant in Henrietta. They’re lighter, more comfortable, significant-
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ly less expensive and more accurate than ever before, Travers says. “It’s a race horse of a pair of glasses. It’s a hands-free computer with the processing power of a smart phone with a camera,” Travers says of the technology that has the potential to improve accuracy and outcomes for patients. Vuzix augmented reality glasses are already found in many healthcare places these days, including the intensive care unit, emergency rooms, nursing home patient care, and medical education. When Travers, an electrical engineer, left Kodak and started the company in 1997, he couldn’t imagine the innovative ways its augmented reality technology would be utilized a couple decades later. “Healthcare has quickly emerged to become an important business segment for Vuzix, including telemedicine and telehealth solutions related to patient care, training and surgery as well as providing technicians with hands-free support within medical facilities,” Travers says. The company is working with Verizon on a high bandwidth version of AR glasses to be used by first responders in ambulance vans by next year. Also this summer, the University of Louisville School of Medicine utilized Vuzix M400 glasses for emergency response, medical evaluation and training and in the care of nursing home and aging in place patients. The hungry for innovation healthcare field is just one area the
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Financial
use of the company’s augmented reality smart glasses are found today. Others include its use as an improved means of virtual meeting, training in many fields, quality assurance and inspection, warehousing and inventory, manufacturing orders and placement and in many more applications to come. Here in Rochester, doctors use AR technology in training and education but aren’t sure when they’ll be using it in live surgery. As the associate director of the University of Rochester Medical Health Lab, Michael Hasselberg, explains, AR glasses overlay a specific real world environment that can be seen by others anywhere in the world. Virtual reality creates a whole new world entirely. “Their applications are very different in health care, he says. “AR is the stepping stone to virtual reality. Where AR is used the most today is in the medical training of students,” Hasselberg says. Medical students can put the glasses on and literally see the human heart come out of the pages of a textbook. It’s also used to help educate patients understand their surgical procedure and the parts of the anatomy affected. The University of Rochester Medical Center has been testing Vuzix AR technology to determine its utility. Using Vuzix AR technology,
a distant supervising physician can look in on a procedure and circle a tumor or anything else the resident physician should address. Nurses can use it, too, and a specialist can be there remotely looking on and determining where a nurse should focus her assessment. “We’ve been testing it out like that,” Hasselberg says. “AR is easy to use in training. The software behind it is very seamless. Vuzix is innovative and making their hardware more user friendly and more comfortable to use for longer periods of time.” Elsewhere, AR is used in vein visualization to avoid having to repeatedly stick patients with needles until a vein can be located. Automated reality functions also include being the basis for the extremely popular Pokemon Go game. Myers wants to work with engineers to make a knee joint model that will feel more realistic and have an AR overlay especially since the use of cadavers in training is expensive. Even getting training participants physically together in one place is expensive. AR and VR can help lower those costs. Hasselberg says a logistical problem for new AR and VR uses is that it isn’t currently reimbursable or FDA approved. “But, I do think it’s where we’ll be at in five years,” he says. Just as global apps are very main stream today, touchless AR and VR applications will be soon.”
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
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MEDICARE MADE EASY By Jim Miller
Should I Buy Long-Term Care Insurance? Dear Savvy Senior,
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Who Needs LTC Insurance? As the cost of LTC — which includes nursing home, assisted living and in-home care — continues to rise, it’s important to know that most people pay for LTC either from personal savings or Medicaid when their savings is depleted, or through a LTC insurance policy. National median average costs for nursing home care today is around $92,000 per year, while assisted living averages around $50,000 per year. While national statistics show that about 70% of Americans 65 and older will need some kind of LTC, the fact is, many people don’t need to purchase a LTC insurance policy. The reasons stem from a range of factors, including the fact that relatively few people have enough wealth to protect to make purchasing a policy worthwhile. Seniors with limited financial resources who need LTC turn to Medicaid to pick up the tab after they run out of money. Another important factor is that most seniors who need LTC only need it for a short period of time, for example, when they’re recovering from surgery. For those people, Medicare covers in-home health care and nursing home stays of 100 days or less following a hospital stay of more than three consecutive days. So, who should consider buying a policy? LTC insurance policies make the most sense for people who can afford the monthly premiums, and who have assets of at least $150,000 to $200,000 or more that they want to protect, not counting their home and vehicles. Another factor to weigh is your personal health and family health history. The two most common reasons seniors need extended longterm care is because of dementia
Jim Knipper, Health Insur. Broker (585) 880-5327 • Jknipper11@gmail.com
My wife and I have thought about purchasing a long-term care insurance policy, but we hate the idea of paying expensive monthly premiums for a policy we may never use. Is there a good rule of thumb on who should or shouldn’t buy long-term care insurance?
There are two key factors you need to consider that can help you determine if purchasing a long-term care (LTC) insurance policy is a smart decision for you and your wife. One factor is your financial situation and second is your health history. Currently, around 8 million Americans own a policy.
Medicare Advantage Plans NY State EPIC Prescription Drug Plans Supplement Plans Dental Plans Fitness Memberships
or disability. And, almost half of all people who live in nursing homes are 85 years or older. So, what’s your family history for Alzheimer’s, stroke or some other disabling health condition, and do you have a family history of longevity? You also need to factor in gender too. Because women tend to live longer than men, they are at greater risk of needing extended LTC.
Choosing LTC Insurance After evaluating your situation, if you’re leaning toward buying a LTC policy, be sure to do your homework. The cost of premiums can vary greatly ranging anywhere between $2,500 and $8,000 per year for a couple depending on your age, the insurer and the policy’s provisions. Also note that because of coronavirus, it may be more difficult to qualify for coverage now if you’re age 70 or older, in a high-risk group or have had a positive COVID-19 test. To find a policy, get a LTC insurance specialist who works with a variety of companies. See the American Association of Long-Term Care Insurance website (AALTCI.org) to locate one. Also shop insurers like Northwestern Mutual and New York Life, who work only with their own agents. Another option you may want to consider are hybrid policies that combine long-term care coverage with life-insurance benefits. These policies promise that if you don’t end up needing long-term care, your beneficiaries will receive a death benefit.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 23
Ask St. Ann’s
By Patty Finnigan
Ask The Social
Security Office
From the Social Security District Office
Tips for Staying Active and Engaged During Quarantine
B
eing in quarantine due to COVID-19 is the perfect opportunity to approach daily life more intentionally. Allowing curiosity to lead the way can help keep loneliness at bay, especially if you’re a senior who’s at greater risk for complications associated with the virus. Computer and smartphone technology are great ways to stay connected with family and friends and tap into virtual exercise, entertainment, cultural, travel and educational opportunities. But what can older adults do if they’re not online or comfortable using technology? The wellness team at St. Ann’s Community offers the following tips and activities to help homebound seniors stay active, engaged, connected, and safe.
Tend to Your Body Physical activity will help you maintain the mobility and muscle strength you need for doing daily living tasks and reduce boredom, stress and anxiety. Many Cherry Ridge residents at St. Ann’s Community started an exercise routine to combat the boredom of quarantine and love it! Be sure to get up from your chair and move around at least once an hour. Weather permitting, get outside to walk with friends, keeping six feet apart. Stay active indoors by following a yoga or fitness class on TV or doing basic calisthenics as a daily exercise routine. Put on music and dance like nobody’s watching! Keep your energy up by eating well and meditating to help you relax and sleep well. Have meal kits such as Hello Fresh delivered to your home to discover new recipes and flavors or get take-out or delivery from your favorite local restaurant.
Exercise Your Mind Short on ideas? Think back to the things you loved to do before adult responsibilities and distractions got in the way. Games and activities like SudoPage 24
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ku, solitaire, crossword puzzles, sewing and jigsaw puzzles are excellent ways to keep your mind busy. While you have fun, you’ll also stimulate your thinking and help memory, concentration and overall mood. Learning new things also creates new brain connections, such as a second language or a musical instrument. Catch up on your reading. Pull out your art supplies and be creative.
Keep in Touch Write letters to family and friends or find a pen pal. When COVID-19 hit, residents at Cherry Ridge decided to exchange notes with students at Roberts Wesleyan College and with residents at another senior living community. Make a phone call to check in with family and friends. If you have a smartphone or a computer with internet access, try a video chat platform like Zoom, Skype or Facetime. This allows you to virtually see friends and family from a far while maintaining a safe social distance. Connecting with nature will also help you feel less alone during the quarantine. Place bird feeders near your windows now to enjoy colorful visitors during the winter months. While no one likes being homebound because of COVID-19, slowing down has its blessings. Ensure your well-being by embracing safe self-care practices that tend your body and mind and keep you connected to the love and companionship of friends and family.
Q: My child, who gets Social Security, will be attending his last year of high school in the fall. He turns 19 in a few months. Do I need to fill out a form for his benefits to continue? A: Yes. You should receive a form, SSA-1372-BK, in the mail about three months before your son’s birthday. Your son needs to complete the form and take it to his school’s office for certification. Then, you need to return page two and the certified page three back to Social Security for processing. If you can’t find the form we mailed to you, you can find it online at: www.socialsecurity.gov/ forms/ssa-1372.pdf. Q: How can I get a copy of my Social Security Statement? A: You can get your personal Social Security Statement online by using your personal account. If you don’t yet have an account, you can easily create one. Your online statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability, and survivors benefits you and your family may be eligible for. To set up or use your account to
get your online Social Security Statement, go to www.socialsecurity.gov/ myaccount. We also mail statements to workers age 60 and over who aren’t receiving Social Security benefits and do not yet have a my Social Security account. We mail the statements three months prior to your birthday. Q: How are my retirement benefits calculated? A: Your Social Security benefits are based on earnings averaged over your lifetime. Your actual earnings are first adjusted or “indexed” to account for changes in average wages since the year the earnings were received. Then we calculate your average monthly indexed earnings during the 35 years in which you earned the most. We apply a formula to these earnings and arrive at your basic benefit. This is the amount you would receive at your full retirement age. You may be able to estimate your benefit by using our Retirement Estimator, which offers estimates based on your Social Security earnings. You can find the Retirement Estimator at www.socialsecurity. gov/estimator.
We Are Open and Accepting New Patients
Specialized Outpatient Physical Therapy — At Home Whether you have had a recent event, such as a fall, joint replacement, or stroke, or if you just don’t have the energy you once did—we are here to help you get back to doing what you love. Best of all, there’s no need to leave home for your physical therapy visits when your personal Thrive rehabilitation therapist comes to you!
We are also known for our unique expertise in working with people with Parkinson’s disease. Things to Know:
n Thrive offers outpatient PT in your home. You do not need to be homebound to qualify. n Thrive does not charge extra for services being delivered at home. n We accept Medicare and most commercial insurances.
Patty Finnigan is cultural arts and resident services manager at Cherry Ridge, part of St. Ann’s Community. Contact her at pfinnigan@ MyStAnns.com or visit www. stannscommunity. com.
n You do not need a doctor’s referral to get started.
Contact us today to speak with a physical therapist about how Thrive can help you get back to doing what you love!
P: 585-851-8259
info@thriveptandwellness.com | www.thriveptandwellness.com We make it easy for you to consistently get the therapy you need — and consistency is the key to results.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
H ealth News St. Ann’s has new chief information officer St. Ann’s Community, Rochester’s leading senior housing and health services provider, announced the hiring of Aaron Fields as chief information officer. Fields earned his Bachelor of Science in Business Aaron Fields Management from St. John Fisher College. He comes to St. Ann’s Community with 16 years of experience in information technology and leadership, including prior experience at a senior living organization and four years spent serving as a sergeant in the United States Marine Corps. Fields is active in the Rochester community as a member of the Society for Information Management and is involved with events supporting neonatal research for Golisano Children’s Hospital. As a member of the information technology team, Fields will be responsible for the overall strategy and framework of technology solutions within St. Ann’s Community. He will be tasked with ensuring St. Ann’s is leveraging existing and emerging technology to better serve the residents, families, and staff and providing a connected experience for all.
St. Ann’s continues partnership to provide tuition assistance St. Ann’s Community will con-
tinue its partnership with the Diocese of Rochester Catholic Schools to offer family tuition assistance to nursing employees. The program, now entering its second year, offers significant tuition reimbursement for children of St. Ann’s nursing employees to attend any one of the Catholic schools in the Rochester Diocese. The program is open to any fullor part-time benefit-earning licensed practical nurses (LPN) and registered nurses (RN) at St. Ann’s Community’s Irondequoit and Webster locations. St. Ann’s also welcomes new RNs or LPNs to participate in the program. St. Ann’s provides up to $5,000 of tuition assistance per household. The benefit provides eligible employees up to $3,000 (for elementary and middle school level) or up to $5,000 (for high school level) of tuition assistance. “Continuing this benefit is part of our ongoing effort to attract and retain top nursing talent,” said Bob Bourg, senior vice president of human resources. “We want to continue to offer meaningful benefits to contribute to our nursing employees’ lives and their families.” “We know how difficult it can be to send children to private school,” said Michael McRae, President and CEO of St. Ann’s Community. “As an organization founded in the Catholic tradition of excellence, we believe strongly in the value of a Catholic education. If we can help support our nursing employees and defray some of those costs for their families, we see it as a win-win.” St. Ann’s Community has a rich history of investing in their workforce through programs such as college tuition reimbursement, awarding scholarships and giving of grants. St. Ann’s is excited to continue this
program to give back to nursing employees and help them provide their children with a Catholic education.
meeting everyone’s needs, regardless of sexual orientation, gender identity or any other reason,”
Thompson Health earns LGBTQ designation
Thompson hosts physician assistant student
UR Medicine Thompson Health recently announced F.F. Thompson Hospital’s third consecutive “LGBTQ Health Care Equality Leader” designation from the Human Rights Campaign Foundation (HRC). Every year, HRC recognizes participating health care facilities for their dedication and commitment to LGBTQ inclusion. The latest designations were awarded in the 13th edition of HRC’s Healthcare Equality Index, released Aug. 31 and based on four criteria: non-discrimination and staff training, patient services and support, employee benefits and policies, and patient and community engagement. Thompson and other facilities earning “LGBTQ Health Care Equality Leader” designation received the maximum score in each section and earned an overall score of 100. Facilities scoring from 80 to 95 points earned the “Top Performer” designation. Thompson previously received the “LGBTQ Health Care Equality Leader” designation from the HRC in 2019 and 2018 as well, having previously received other distinctions from the HRC in 2017, 2016 and 2014. “Receiving this designation for the third year in a row — and being recognized by the HRC for the sixth time — is a tremendous honor for our hospital,” said Thompson Health President/CEO Michael F. Stapleton, Jr. “In caring for our community, we welcome all patients, visitors and staff members, and we appreciate the HRC’s guidance in ensuring we are
UR Medicine Thompson Health recently announced that the physician assistant (PA) student it is hosting for 2020-2021 is Canandaigua native Rory Doremus. Thompson has hosted PA students for a Doremus decade with the goal of increasing students’ interest in pursuing their careers in rural settings. A graduate of Keuka College, where he majored in biology and minored in chemistry, Doremus is enrolled in the physician assistant studies master’s degree program at Upstate Medical University in Syracuse. At Thompson, Doremus will complete 11, four-week clinical rotations. These will include family practice, women’s health, pediatrics, inpatient medicine, internal medicine (outpatient), general surgery, long-term care, emergency medicine, behavioral medicine and two elective clinical rotations in a sub-specialty of medicine or surgery. He began his first rotation Aug. 24, with physician Jonathon Lammers at Midlakes Medical Care, a Thompson Health family practice located in Clifton Springs.
Thompson Health WELCOMES Gastroenterologist
Dr. Jeffrey A. Goldstein With over 25 years experience in gastroenterology, Dr. Goldstein is seeing patients for these and other digestive conditions: n n n
Please call the office for currently-accepted insurances.
n
Acid reflux/heartburn Irritable bowel syndrome Crohn’s disease/Ulcerative Colitis Celiac disease
If you are over 50 and have not had your recommended colonoscopy screening, call us. No referral is needed.
n n n n
Colon polyps/cancer Hepatitis Gastritis Gastrointestinal Bleeding
585-602-0280
ThompsonHealth.com/GI
Part of F.F. Thompson Hospital
October 2020 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 25
Balance Immune System Build Stronger Immunity www.AcupunctureCenterUSA.com 7th Generation Medical Acupuncture Rui Wang, MD of China, L.Ac. Featuring RUI Anti-Inflammatory Acupuncture, Medical Oncology Acupuncture, and Neuromedicine Acupuncture Pain, Neuropathy, Cancer Care, Ob/Gyn & Women’s Health, Inflammatory Diseases, Neurological Disorders, Autoimmune Diseases, Digestive System Disorders, and More Experienced in both Western Medicine & Traditional Chinese Medicine Experienced in both Academic & Private Practice Experienced in both Basic Science & Clinical Science Experienced in Cancer Research at Major Medical Centers in USA
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LIFE CHANGING MEDICINE, MOVING MEDICINE FORWARD Page 26
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020
H ealth News Memory care manager receives All Star award Kelsey Persons, memory care manager at the Landing of Brighton, is one of the recipients of All Star award, given by the he Empire State Association of Assisted Living (ESAAL) during the National Assisted Living Week, Sept. 13-19. Each of Persons the 11 winners is employed by ESAAL member communities across New York state and was chosen by the heads of over 300 assisted living communities that employ tens of thousands of New Yorkers. “These All-Stars are true examples of healthcare heroes,” said Lisa Newcomb, executive director, ESAAL. “During the COVID-19 pandemic, assisted living staffers were put under unprecedented pressure, fulfilling healthcare necessities, enforcing proper safety protocols, and keeping up the spirits of residents while they were isolated from each other as well as family and friends.” Persons joined The Landing of Brighton in December 2018 and spent her first year transforming its memory care unit into a superior quality, highly rated option for families, according to an ESAAL news release . During this time, she hired and trained all new staff, while learning all she could about her residents and their families and created a top notch work environment and loving home for all. Within the first year, The Landing’s census went from 16 residents to 31 in its memory care unit as a direct result of Persons’ devotion, time, and unparalleled program-
ming, stated the news release.
Highland doctor accepted as fellow in ELAM program Physician Colleen T. Fogarty, the William Rocktaschel Professor and chairwoman of the University of Rochester Medical Center’s department of family medicine, has been accepted as a fellow in the 2020-2021, Hedwig van Ameringen Executive Fogarty Leadership in Academic Medicine (ELAM) program for women. Established in 1995, the ELAM program, which is hosted by Drexel University College of Medicine, offers an intensive one-year fellowship of leadership training with extensive coaching, networking and mentoring opportunities aimed at expanding the national pool of qualified women candidates for leadership in academic medicine, dentistry, public health and pharmacy. Acceptance into ELAM is determined through an annual competitive selection process, in which approximately 60 candidates are chosen each year. “I am truly honored to be part of this distinguished program,” said Fogarty, who has served as associate chairwoman of clinical practice and interprofessional education, medical director at Highland Family Medicine, and during her tenure on University of Rochester faculty has also served as assistant residency director and as director of the faculty development fellowship.
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. © 2020 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 • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Jennifer Faringer, Patty Finnigan, Todd Etshman, Eva Briggs (MD) 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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Rochester Regional Health Expands School of Nursing to Skyview on the Ridge
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the school in June and 310 students are now enrolled which is the largest class ever at the school. “Nurses are the backbone of healthcare, and the COVID-19 pandemic put a spotlight on their crucial role in caring for patients. The selflessness and compassion they display to anyone who needs their help set an example for all of us,” Bieber said. “We need more nurses and we need to make sure whoever wants to become one has a clear and easy path to receive the training and education they need to make this happen,” said Chief Nursing Education Officer Deborah Stamps. “An educated community improves health disparities – as we educate LPNs they can educate family and friends and members of the network to make more informed health care decisions leading to a decrease in health disparities.” The current Isabella Graham Hart School of Practical Nursing is located at the Wegman Center for Workforce Development on Portland Avenue. Other medical education programs will operate in that facility after the expansion is complete.
ochester Regional Health is addressing two significant community needs with its recent Move: growing a diverse generation of nurses for the future while revitalizing a commercial space that has been dormant for far too long. The health system announced in September the expansion of its Isabella Graham Hart School of Practical Nursing in a new location: the former Macy’s building at Skyview on the Ridge (former Medley Centre) in Irondequoit. “This is another important way to keep our community healthy,” said Rochester Regional Health President and CEO Eric Bieber, MD. “This move is helping bring new life to Skyview on the Ridge and helping us build a nursing workforce that will serve our community for decades to come.” The large renovated space at Skyview on the Ridge enables Isabella Graham Hart School of Practical Nursing to increase its student volumes and programs. Currently, the school offers day and evening classes for licensed practical nurses (LPN). Students in the LPN program receive hands-on training and utilize state-of-the-art technology. More than 120 students graduated from
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • October 2020