In Good Health: WNY #88 - February 2022 by In Good Health: WNY's Healthcare Newspaper

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FEBRUARY 2022 • ISSUE 88

You’re Not Getting Enough

VITAMIN D Many of us in Upstate New York are vitamin D deficient. Is it a big deal? We chat with local experts about why that’s the case and what we can do to cope with the problem. P. 7

ALSO INSIDE: COVID-19: One in 10 People May Still Be Infectious After 10 Days. P. 5 PHARMACISTS: Role Expected to Expand Over the Next Decade. P. 19 SMART BITES: Move Over Meat, it’s Tempeh Time! P. 11 GOLDEN YEARS SPECIAL. P. 10

HEART PROBLEMS AND COVID-19 Reza Banifatemi, cardiologist at Great Lakes Cardiovascular, discusses COVID-19 and how older patients with potential heart problems are negatively affected by it. P. 4

FIVE THINGS YOU SHOULD KNOW ABOUT THYROID ‘BITE-SIZED’ EXERCISE: A NEW MEANING TO SNACKING AT WORK

Runner Spotlight:

JUNETTE DIAZ

In this month’s “Writer on the Run” column, writer Jenna Schifferle highlights fellow Buffalonian runner, Junette Diaz. P. 10

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New Eye Drops Eliminate the Need for Reading Glasses Patients must have a thorough, dilated eye exam before obtaining a prescription of Vuity By Deborah Jeanne Sergeant

re you “playing trombone” with your phone or reading materials? Perhaps you’ve bought a pair of reading glasses—or two or three— and still never manage to have them when you need them. Now you have another option: VUITY (pilocarpine hydrochloride ophthalmic solution). The FDA-approved prescription eye drop can help correct age-related blurry near vision (presbyopia) in 45to 55-year-olds. Patients use it once daily and can gain improvement in their near vision by three lines on an eye chart. Those who wear contact lenses for their far vision can use VUITY if they wait at least 10 minutes between administering the drops and putting in their contact lenses. Contact lenses tend to absorb chemicals, including medication. Within about 15 to 30 minutes of using the drops, patients experience a notable improvement of their near vision that peaks for one to two hours. For the next three to 10 hours, the effect dissipates. This could help someone on the go who does not want to bother carrying reading glasses all the time. While Franklin S. Senia, optometrist and president of Eye To Eye Optical Inc. in Amherst, notes benefits to VUITY, he remains cautious about its adoption, since it constricts the pupil

Important Safety Information

D of the eye. “You’re playing with the dynamics of how the eye is working,” Senia said. “Long-term, I don’t know how that would affect the patient. Anytime you introduce a drug into the eye, the eye tends to adapt to that drug.” As an example, he cited over-thecounter eye drops for redness. After months of habitual usage, the eyes become accustomed to the drops. “When they stop using them, the eyes engorge themselves with blood, anticipating you’re going to put this drug in,” Senia said. “It’s counterproductive. The eye figures it out.” He speculated if VUITY may have a similar effect on the eye: developing eventual adaptation. “You’d be amazed at the number of things the FDA has approved that have been removed, even five or 10

years later, after they discover it has had complications,” Senia said. VUITY should not be used before nighttime driving since it allows less light into the eye. Insurance does not cover VUITY and its effectiveness varies among patients. Therese Farugia, optometrist with UR Medicine’s Flaum Eye Institute, said that for those who are very far sighted, “it may not help as much. It gives a very good depth of focus, so it depends on how much the pupil constricts.” She noted that patients interested in VUITY must have a thorough, dilated eye exam before obtaining a prescription for the drops. “It can cause redness,” Farugia said. “It’s a mild drop, but when you constrict a pupil, you’re at a higher risk for a retinal detachment.”

o not use VUITY if you are allergic to any of the ingredients. Use caution when driving at night or performing hazardous activities in poor lighting. Temporary problems when changing focus between near and distant objects may occur. Do not drive or use machinery if vision is not clear. Seek immediate medical care if you experience any sudden vision loss. If you wear contact lenses, they should be removed prior to VUITY use. Wait 10 minutes after dosing before reinserting contact lenses. Do not touch the dropper tip to any surface as this may contaminate the contents. If more than one topical eye medication is being used, the medicines must be administered at least five minutes apart. The most common side effects are headache and eye redness. These are not all the possible side effects of VUITY. Source: www.vuity.com

The Kensingtons Will Headline Annual ‘Rock for the Cure’ Mom Said No will also perform as part of fundraising event being presented by the Against the Storm Foundation, Inc.

he Kensingtons, the Sportsmen’s Americana Music Foundation 2018 Band of the Year, will headline the 6th Annual “Rock for the Cure” at the Tralf Music Hall in downtown Buffalo on Saturday, Feb. 26. The fundraising event is being presented by the Against the Storm Foundation, Inc. The band features three members of the Against the Storm Foundation’s board of directors — Tom Lillis (Tonawanda), Joey Nicastro (Amherst), and Jack Freedenberg (Snyder). Other members include

Tim Franczyk, Mike Lillis, and Justin Rizzo. Frank Nicastro of The Strictly Hip and Julie Lang will perform with the band as special guests. Mom Said No will open the show. The Buffalo-based group has gained growing popularity and notoriety for its high-energy, live performances. The band’s debut album, “Welcome To The Loser’s Club,” was recorded at Goo Goo Dolls bassist Robby Takac’s GCR Audio Studio in Buffalo, with Takac himself helping to produce the album. A 1977 Gibson Les Paul guitar

will be auctioned at the event and a commemorative poster designed by Bill Zulewski, who also created the foundation’s logo, will be available for sale. Proceeds from the Rock for the Cure will help the Against the Storm Foundation further its mission to fight blood cancers and support other causes that will improve the health and quality of life for people in need. The event has previously raised more than $50,000 for the benefit of the Leukemia and Lymphoma Society of Western and Central New York.

Page 2 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

Matt Connors, vice president of development at Sinatra and Company Real Estate, and Lauren Hall, local TV personality, will co-host the event. Bank of America is the major sponsor. Additional sponsorship packages are available, starting at $500. Ticket prices are $20 for general admission. They can be purchased at Ticketmaster.com, Tralfmusichall. com, and The Tralf box office at 622 Main St. in Buffalo. Doors will open at 7 p.m. and the show starts at 8 p.m.

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One in 10 People May Still Be Infectious for COVID-19 After 10 Days

ne in 10 people may have clinically relevant levels of potentially infectious SARSCoV-2 past the 10-day quarantine period, according to new research. The study, led by the University of Exeter and funded by Animal Free Research UK, used a newly adapted test which can detect whether the virus was potentially still active. It was applied to samples from 176 people in Exeter who had tested positive on standard PCR tests. The study, published in the International Journal of Infectious Diseases found that 13% of people still exhibited clinically relevant levels of virus after 10 days, meaning they could potentially still be infectious. Some people retained these levels for up to 68 days. The authors believe this new test should be applied in settings where people are vulnerable, to stop the spread of COVID-19. Professor Lorna Harries, of the University of Exeter Medical School, oversaw the study. She said: “While this is a relatively small study, our results suggest that potentially active virus may sometimes persist beyond a 10-day period, and could pose a potential risk of onward transmission. Furthermore, there was nothing clinically remarkable about these people, which means we wouldn’t be able to predict who they are.” Conventional PCR tests work by testing for the presence of viral fragments. While they can tell if someone has recently had the virus, they cannot detect whether it is still active, and the person is infectious. The test

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used in the latest study however gives a positive result only when the virus is active and potentially capable of onward transmission. Lead author Merlin Davies, of the University of Exeter Medical School, said: “In some settings, such as people returning to care homes after illness, people continuing to be infectious after 10 days could pose a serious public health risk. We may need to ensure people in those setting have a negative active virus test to ensure people are no longer infectious. We now want to conduct larger trials to investigate this further.” Animal Free Research UK CEO, Carla Owen, said: “The University of Exeter team’s discovery is exciting and potentially very important. Once more, it shows how focusing exclusively on human biology during medical research can produce results that are more reliable and more likely to benefit humans and animals. “Pioneering animal free work is providing the best chance of not only defeating COVID-19 but also finding better treatments for all human diseases. “The results also send a loud and clear message to the government to better fund modern medical research and make the UK a world leader in cutting edge, kinder science.” The research is a collaboration between the University of Exeter Medical School, the Royal Devon & Exeter NHS Foundation Trust, and the NIHR Exeter Clinical Research Facility.

SERVING WESTERN NEW YORK 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. © 2022 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., #251 • P.O. Box 550, Amherst, NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto

ADVERTISING SALES EXECUTIVE In Good Health: WNY’s Healthcare Newspaper is published by Local News, Inc., a small publishing company behind several magazines and newspapers in Upstate New York. We are hiring a responsible, upbeat, articulate sales person to sell print and digital ads for our Buffalo publication. Previous experience in ad sales preferred but will consider any strong sales background. Person will work independently—from own home ofﬁce. Great potential for the right person. Compensation is based on a weekly salary plus commission. Past sales reps have earned from $25,000 to $35,000-plus depending on performance.

Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Brenda Alesii, Daniel Meyer, Jenna Schifferle, Ernst Lamothe Jr., Jana Eisenberg, Amanda Jowsey Advertising: Anne Westcott, Amy Gagliano Layout & Design: Joey Sweener • Office Manager: Kate Honebein 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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February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 3

Meet

More Than 10 Million People Died of Cancer Worldwide in 2019

ancer remains a major killer, with 10 million deaths reported worldwide in 2019. More than 23 million new cases were documented globally in 2019, according to researchers at the University of Washington School of Medicine. By comparison, in 2010 there were 8.29 million cancer deaths worldwide and fewer than 19 million new cases. Deaths were nearly 21% higher in 2019 than 2010, and cases were about 26% higher, the researchers say. The study also highlighted the global disparities in treating the disease. “Ensuring that global progress against cancer burden is equitable is crucial,” said lead author, physician Jonathan Kocarnik, a research scientist at the university’s Institute of Health Metrics and Evaluation. “This will require efforts to reduce disparities in cancer prevention, treatment and survival, and the incorporation of local needs and knowledge into tailored national cancer control plans,” Kocarnik said in a university news release. The researchers looked at 204 countries and territories, estimating cancer burden and trends. They found that cancer was second to cardiovascular disease in the number of deaths among 22 groups of diseases and injuries. Lung cancer was the leading cause of cancer deaths in 119 countries and territories for males and 27 countries and territories for females. Breast cancer was the leading cause of cancer-related deaths among females worldwide, including for 119 countries. Also, lung cancer, colon cancer, stomach cancer, breast cancer and liver cancer accounted for the most years lived with ill health and disability, according to the study. There was a glimmer of good news: After adjusting for age, the researchers found death and incidence rates decreased by about 6% and around 1%, respectively. The age-standardized death rate decreased in 131 countries and territories, and the incidence rate fell in 75 countries and territories. Researchers called these small declines promising but cautioned there may be setbacks in cancer care and outcomes due to COVID-19. The report was published Dec. 30 in JAMA Oncology. It is part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019.

Your Doctor

By Christopher Motola

Reza Banifatemi, M.D.

Cardiologist at Great Lakes Cardiovascular discusses COVID-19 and how older patients with potential heart problems are negatively affected

Q: When it comes to preventive heart care for elderly patients, how much of an impact have the lifestyle changes people have made to avoid COVID-19 had on heart health? A: It’s certainly a concern. With COVID, a lot of people are staying home and not being seen when they need to be seen and assuming symptoms they’re having may be related to other things. We’ve seen some issues recently that arise from that. So it’s a challenge, obviously. Q: What kinds of symptoms are we talking about here? A: A lot of the time they’ll report just generally feeling tired. They assume it’s related to age when they could be having issues related to rhythm abnormalities, atrial fibrillation. A lot of these patients could have problems like that where they’re a little more tired, a little more short of breath, but don’t seek medical attention. And then the condition progresses. I see a lot of issues related to medications, confusion after going to multiple providers and getting different medications. Q: Would you say that’s largely a logistical problem? A: Yeah and in great degree reluctance to go to the hospital or to the doctor, for obvious reasons. Many of people are trying to ride it out to see if they get better or are just attributing it to old age. It can be very nonspecific in many cases. But they get sicker and sicker until they’re eventually seen in the hospital. Mean-

while, we could have intervened in the office maybe and we missed that opportunity. It’s a problem that’s gotten worse in the pandemic, but these issues—along with staying active—but it’s been an ongoing issue as well. Q: Is it difﬁcult right now to strike a balance between keeping seniors safe from COVID-19 and keeping them in good health generally? A: Exactly, that’s a particular challenge. You try to minimize exposure because these are the patients who are most vulnerable to it. But at the same time, these are the patients who are at higher risk for other medical issues as well. In my case, it’s cardiac issues. So trying to find the right balance and not miss something while also protecting them is a challenge. I’m not sure what the right answer is. Q: You mentioned patients confusing cardiac symptoms for natural effects of aging. How much should patients reasonably expect to decline as they age versus what’s the result of a disease process? A: It’s a tough question to answer because it’s very individual. I see patients in their 80s, sometimes early 90s that are still maintaining a very independent and active lifestyle. For them, any decline in the level of functioning might be cause for concern and lead them to seek medical attention. Patients that have other comorbidities

that accumulate over time may have limitations at an early age. They may become immobilized or dependent in their 70s. When they have a decline, they’re already very limited, so it might be harder to notice or appreciate that additional decline. To generalize, we should all expect a level of decline gradually after age 50 unless you really take measures to try to stop it. But again, it’s such an individual thing with genetic components. If you’re 60 and can’t walk two blocks, sometimes we’ll discover it’s just deconditioning, but it could also be a more serious issue. It’s really hard to generalize. Q: There’s been some discussion of the effects of both COVID-19 and the COVID-19 vaccines on the heart. Have you seen any impact from either on your patients? A: We have some data about the effects of the vaccines on younger patients where they could have an immune response that affects their heart. It has not, fortunately, been an issue with the elderly. They have a weaker immune response to the vaccines. The weaker response also means they tend to get less protection, but they don’t have the inflammatory issues that can come from an exaggerated immune response in younger patient. Definitely vaccination is highly encouraged for older adults and elderly in general. They have fewer risks and more benefits for that age group unless there’s a clear contra-indication for that specific patient. For the virus, age is a big factor when it comes to outcomes. The majority of patients who have a bad outcome are older patients. And it’s not just from age, but from the higher number of comorbidities that come with old age. If you have diabetes, renal dysfunction, the more of these issues you have, the more problems you’ll have. COVID isn’t just a respiratory virus. It affects other organs. It causes systemic inflammation. We’ll also see elderly patients who get it without that many issues because they don’t have that extreme autoimmune response to the virus that can be a problem in younger patients. It’s a complicated disease, unfortunately, but overall it’s a tougher one for older patients with multiple medical problems.

Lifelines

Name: Reza Banifatemi, M.D. Position: Attending cardiologist at Great Lakes Cardiovascular Special interest: Valvular heart disease, echocardiography, preventive cardiology. Hometown: Tehran, Iran Education: Medical degree from Pecs University School of Medicine, Pecs, Hungary (1997); internship and residency in internal medicine, Drexel University College of Medicine (2001-2004); fellowship in cardiology, Drexel University College of Medicine (2008-2011) Afﬁliations: Kaleida; Buffalo General; Suburban Hospital Organizations: American College of Cardiology; American Society of Echocardiography; American Society of Nuclear Cardiology Family: Wife; two children Hobbies: Travel, tennis, hiking, skiing

Know a physician who wants to be featured in Meet Your Doctor? Please contact editor Wagner Dotto at editor@bfohealth.com.

Page 4 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

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ki, registered and certified dietitian nutritionist with Buffalo Nutrition & Dietetics, PLLC in Orchard Park. “Vitamin D helps the body absorb calcium and regulates both calcium and phosphorous levels in the blood. It plays an important role in bone growth and maintenance, influences cell growth and development and is required for proper immune function.” She added that research shows the current recommended daily allowance could be lower than optimal for skeletal health. Research about vitamin D continues to reveal more of its functions. “Vitamin D works in every part of the body,” said Mary Jo Parker, registered dietitian in private practice in Williamsville. “It’s a prohormone that acts like a hormone. It does have vitamin properties but acts like a hormone in the body. They’re finding it’s beneficial in prevention and even treatments of so many conditions and diseases.”

Who needs more vitamin D?

age but also other health concerns and medication.

Where can we get vitamin D? Primarily, it’s through the UVB radiation in the sun. While too much exposure can cause skin cancer, 20 minutes’ exposure a few times in a week suffices for generating vitamin D. Commercially processed milk and other fortified products such as most boxed breakfast cereals contain vitamin D. Milk processed by an onfarm creamery may not have vitamin D added. “There’s not a ton of dietary ways to get vitamin D,” Langston said. She mentioned egg yolks, fatty fish like salmon and shellfish and mushrooms as naturally occurring dietary sources. “The only thing is, it’s not super dependable in terms of how much you’ll be getting,” Langdon said. “It varies with animal products based on what they’re exposed to.”

Nearly everyone in North America. The sun is not intense enough from about October through May to trigger production of vitamin D. Parker said that older adults are not as good as synthesizing sunlight for vitamin D and that people of any age with darker skin tones are not as good as absorbing sunlight.

How much D do we need?

Getting Enough Vitamin D?

When you’re not ingesting enough vitamin D with your food, supplements can help By Deborah Jeanne Sergeant

n addition to your summertime tan, your vitamin D stores have long since disappeared. While excessive sun is not so good for your skin, in moderation, it makes the body generate vitamin D, a pre-hormone that modulates many important bodily systems.

Why is vitamin D important? With insufficient vitamin D, people are less able to absorb other nutrients. “As many as 30% to 40% of those with hip fractures are vitamin D insufficient,” said Erica Smolins-

Andrea Langston, certified dietitian nutritionist with Thrive Nutrition & Wellness in Amherst. “There’s not a ton of dietary ways to get vitamin D,” she says.

As a fat-soluble nutrient, vitamin D is stored by the body if it gets too much. “The best way to know if you have enough is a blood test,” Parker said. “They’re pretty run of the mill. They’re not part of a typical metabolic panel. I routinely have my patients request to have that checked. Then we know what you’re doing, where you are on the range and if we need to supplement and how much.” Vitamin D generated through sunlight exposure does not cause toxicity. That is possible only through taking too many supplements. Most people older than 70 need more vitamin D than younger people. “There’s a natural decline in stomach acids as we get older,” said Andrea Langston, certified dietitian nutritionist with Thrive Nutrition & Wellness in Amherst. “Stomach acid breaks down food and helps us absorb them.” The amount of vitamin D one needs varies depending not only on

So Why Do I Have Vitamin D Pills?

nfortunately, doctors do not prescribe a vacation to a sun-soaked island for their patients deficient in vitamin D. Instead, it’s a supplement providing 50,000 international units (IUs) of vitamin D per dose. Over-the-counter vitamin D provides at most 10,000 IUs. Vitamin D helps the body absorb nutrients. Vitamin D deficiency can cause rickets in children and in adults, hypoparathyroidism, osteomalacia, hypocalcemia, or bone diseases, which is why a prescription is sometimes necessary.

February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 5

Trigger Point Therapy Offers Pain Relief Some patients express surprise that just one treatment offers relief By Deborah Jeanne Sergeant

hether it’s a frozen joint or localized pain, trigger point therapy from a licensed massage therapist can help. James Ligammare, licensed massage therapist and owner of Healing Hands Massage Therapy in Niagara Falls, said that many patients come to him with complaints such as neck, shoulder and low back pain, often from repetitive motion injuries. “Sometimes they’ll release fairly quickly,” Ligammare said. “It depends upon how bad it is and the area affected.” For some, it takes 30 to 60 seconds; other times, it can take five minutes. He uses hot and cold therapy with stretching to increase the range of motion and increase blood flow to the area. Some patients express surprise that just one treatment offers relief. For others, especially those who have endured a long-term issue, may take multiple treatments and need monthly “maintenance.”

Ligammare assigns “homework” for them to do between visits, such as stretches and using foam rollers to apply pressure. Once they begin feeling good, they can reduce the frequency to a biweekly or monthly session. They can come in if something arises sooner. He advises patients to hydrate well after treatment. They should also improve the healing process by alternating application of ice and heat to reduce any inflammation and to increase circulation. Some trigger points transfer pain between a series of trigger points. Cues from the patient can help the LMT to follow the path of the trigger points. Emily Ball, in private practice in Buffalo and founder of the HEAT Center, said that trigger points are “places of concentrated tension and the muscle fibers in this area are getting a signal from the nervous system, saying, ‘Go.’ They’re ready for action and it’s a communication problem. They did not get the signal

to relax.” She views trigger point therapy as a means of resetting the nervous system signal. “We can hit all the trigger points we want, but if they continue repetitive stress behaviors, then we have to keep doing it all over,” Ball said. Emotional and physical stressors can contribute to trigger points. That is why she assigns patients with movements to help them stretch and relax those areas, such as rolling the shoulders a few times twice a day for a trigger point in that area. As responsive as some patients are to the therapy, Ball advises them that it’s not a panacea for pain. Physical therapy, acupuncture and/or psychotherapy may be needed. Poor posture or movement while performing everyday tasks like texting, driving and typing can cause trigger point therapy. “When receiving trigger point therapy, breathing is very important,” Ball said. “Slowly, thoroughly and evenly. It gives the body an op-

portunity to allow the work to happen. Try to discern between pain and intense sensation. Intense sensation rides that edge of pain. You might be sore for a day. Pain, you might be sore for a week. A lot of people think massage should be painful. It can be intense sensation-wise.” It can also take therapists some time to get to the root of the issue. Rosie Klauk, licensed massage therapist with Essential Massage Therapy in Tonawanda, can take up to two hours in a session. “If it’s a chronic condition and it’s been around a while, they’ve had it for a while and it takes a while to address,” she said. The modality is not like receiving an injection or swallowing a pill for pain. But with sufficient sessions and following the therapist’s directions for stretching and posture, many patients can find lasting relief. Klauk said that trigger point therapy still has many unanswered questions. She advises people to not trust therapists who say, “I can fix your problem guaranteed” because so many factors are involved with pain relief. “It’s not a magic wand, but a tool,” Klauk said. “There’s more of a need for massage therapy than being treated as a luxury item.”

Healthcare in a Minute

By George W. Chapman

Provider Burnout: Many Physicians, Nurses Inclined to Retire Earlier Than Planned

recent survey by the American Medical Association (AMA) revealed 20% of physicians and 40% of nurses are inclined to retire or quit, earlier than planned, within two years. In addition to early retirement, about a third of these providers intend to decrease their hours until then in order to reduce stress, get their lives back and avoid potential infection or illness. Industry observers, the AMA and the ANA, are predicting new medical and nursing school graduates will not fill the near

Vaccine Proﬁteering

Perhaps in anticipation of negotiating prices with Medicare, drug manufacturers raised prices on 434 common drugs an average of 5.2%. Leading the way with higher than average increases were vaccine producers Pfizer, Moderna and BioNtech. Apparently, they really need the money. According to consumer advocate People’s Vaccine Alliance, based on financials released by these three drug manufacturers, collectively they will earn $34 billion in pretax profits. That comes to $65,000 profit a minute or $93 million a day. Nearly all (99%) of their vaccine supplies have been sold to wealthy countries, leaving the poorer countries to fend for themselves. Despite more than $8 billion in R&D funding from the US taxpayers, all three drug companies have outright refused to share their technology or know–how with struggling countries. The US has struck a “deal” to purchase 20 million doses of Pfizer’s anti-viral drug, Paxlovid, for more than $10 billion. The anti-viral pill and vaccines will result

future deficit. The AMA estimates the annual impact of earlier retirement and reduced hours to be $4.6 billion. The No. 1 complaint after burnout among providers is feeling undervalued. While employers can adopt strategies to mitigate stress and burnout, both nurses and physicians cited the drastic increase in non-compliant, belligerent, demanding and abusive consumers, especially among the unvaccinated, as a major reason for feeling undervalued.

is sales between $50 billion and $60 billion.

No More Surprises

Effective January 2022, you will no longer be liable for what has been deemed “surprise medical bills.” These are bills from contract physician companies that are considered out of network by your insurance companies. These bills typically emanate from services provided to you via your local emergency room. Unsuspecting consumers, who correctly go to their in-network emergency department, unknowingly receive services from an out-ofnetwork contract physician company. Sometimes, these bills come from the company that supplies the hospital with emergency room physicians. When it comes to out of network services, your insurance company will often pay you directly based upon what it would have paid an in-network physician. You then get the “surprise” bill from the out of network company leaving you to make up the difference between their

bill and the check you received from your insurance company. It is often a difference of hundreds of dollars. In fairness to hospitals, especially rural and isolated ones, it is difficult if not impossible to attract and retain certain physicians, so they are forced to use outside contract groups. Contract groups will either have to accept in-network payments from local insurers or go to arbitration to settle with insurers. In any case, the consumer is now held harmless.

2020 Costs

Total healthcare spending increased a staggering 9.7% in 2020. (It increased 4.3% in 2019. The jury and data are still out for 2021.) But that is misleading as most of the 9.7% increase was not due to claims. The majority of the increase was due to CMS providing needed financial support to hospitals, clinics, nursing homes, testing sites, physician practices and every state to weather the crisis. If this emergency funding for providers is excluded, the net increase in healthcare spending due to claims was about 2%. Compared to normal non-COVID-19 years, a 2% increase in costs due to claims is relatively low. That can be attributed to people still delaying care and hospitals having to cancel elective surgeries again. Consequently, because of profit limits established by the ACA, commercial insurers rebated over $2 billion to consumers via premium credits, check or debit cards in 2020. The rebate was $1.3 billion in 2019. The omicron variant is the monkey wrench making it difficult for industry analysts and actuaries to predict 2022 costs. Once again, as in 2020, hospitals and surgery centers are forced to cancel elective surgeries in reaction to the continuing pandemic and staffing shortages. A recent survey by the Kaiser Family Foundation revealed almost half of us did not

Page 6 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

bother to seek care due to household financial constraints and high out-ofpocket costs.

Fraud

In September 2020, the Criminal Division’s Health Care Fraud Unit organized and led a historic national takedown, in collaboration with USAOs, HHS-OIG, FBI, the Drug Enforcement Administration and other federal and state partners. Assistant Attorney General Brian Rabbitt announced this nationwide enforcement action, which involved 345 charged defendants across 51 federal districts, including more than 100 doctors, nurses and other licensed medical professionals. These defendants were collectively charged with submitting more than $6 billion in allegedly false and fraudulent claims to federal health care programs and private insurers, including more than $4.5 billion connected to schemes that involved telemedicine fraud, more than $845 million connected to substance abuse treatment facilities, or “sober homes,” and more than $806 million connected to other health care fraud and illegal opioid distribution schemes across the country. This enforcement initiative included cases charged during an unprecedented national health emergency.

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.

Snack Your Way to Better Health with ‘Bite-Sized’ Exercise Breaks Want to boost your daily physical activity? Enjoy exercise ‘snacks’ By Daniel Meyer

have simple advice for anyone who wants to drop a few pounds or has a desire to increase their overall level of physical activity: take more snack breaks. I’m not referencing daily doughnut consumption in between breakfast and lunch, regular mid-afternoon chow sessions courtesy of the closest vending machine or even those occasional late-night indulgences of ice cream. I am speaking about something I have been doing regularly for the past few months that is a relatively easy way to incorporate short bursts of activity into a typical day to help combat the well-documented negative effects of sitting for long periods of time. Embracing the concept of “exercise snacks” is something I committed to after reading news articles and scientific study summaries on

how moving several times a day can produce meaningful gains in fitness and overall health. A registered dietitian who I spoke with last year believes it is important to regularly monitor the balance of time we all spend exercising versus how often we are sedentary and not engaged in some type of movement. Exercise snacks can involve indoor or outdoor activities. With the cold weather months now upon us, I will suggest some exercise snacks that can be used by anyone who prefers to stay indoors. Some of these routines are so simple and basic that you will likely welcome the mindset of movement being an essential part of your day no matter how busy you may be at work or at home. Full disclosure: my personal obsession with how many steps I take every day drives me to earmark time for regular exercise snack breaks. I use a wristwatch FitBit step counter

Above Writer Daniel Meyer performs ‘snack’ exercises in his at-home office in Hamburg.“I have decided to make 2022 the year of exercise snacking enjoyment,” he says. with a daily step goal of 15,000. What I have found is that exercise snacking throughout my normal workday often gets me anywhere from 10,000 to 12,000 steps during a typical eighthour workday. My daily step goal combined with a concentrated focus on regular exercise snacking makes me more mindful about the small ways I can disrupt a sedentary lifestyle while working as well as when I at home. For example, I will make the effort to take the stairs instead of riding on the elevator at least once per day when at the office and I always park my vehicle in one of the farthest vacant spaces when I visit a grocery store, bank or any type of dining establishment or retail shopping location. I also pace while speaking with someone on the telephone by using the speaker phone option when appropriate. I also strategically schedule select calls so that I can “walk-and-talk” using my cellular telephone. When previously working out at a traditional fitness center a few times a week, I would typically accomplish approximately one hour of movement during each of those exercise sessions. Thanks to my exer-

cise snacking routine I now regularly find myself being actively engaged in physical activity of some type for close to two hours a day (sometimes even more than that) without a scheduled “gym workout” being part of my daily routine. I have decided to make 2022 the year of exercise snacking enjoyment. I believe anyone reading this can adopt the same mindset and be able to realize how exercising at the office or at home is completely changed by replacing the pressure of committing to lengthy sweat sessions with quickand-easy “movement moments” that can be enjoyable ways to engage in physical activity. While I cannot guarantee that my newfound love of these micro-workouts will encourage you to become a frequent consumer of exercise snacks, I can say it’s a concept that can reframe our collective mindset about physical activity. By overcoming the perception of exercise being a dreaded chore, we can replace that doom-and-gloom mentality by viewing physical movement of any type as a treat that can make you feel good when you accomplish it as part of the ongoing quest to effectively improve our personal health.

EXERCISE SNACKING SUGGESTIONS

xercise snacks help increase activity levels, burn calories and provide unique opportunities for mental health breaks. They offer brief but important moments of physical activity that are the perfect way to integrate movement into your daily life. The following exercise snacking suggestions can be implemented into your normal daily routine. ➤ EARLY MORNING WALK Start your morning with a quick walk, either outdoors or inside your home. Lay out your walking attire the night before so you have no excuse after you wake up to get a five- or 10-minute walk in before you take a shower, brush your teeth or take that first sip of coffee.

➤ DEEP BREATHING/INTENSE STRETCHING Many of us have busy lifestyles, but we all should be able to find the time to conduct some focused deep breathing and intense finger-tip-totoes-while-seated stretching. Break down mental barriers and help to relieve stress by engaging in breathing in through the nose and out through the mouth and then commencing elongated 30-second stretches of your legs while seated. ➤ FIFTEEN MINUTE WALK EVERY THREE HOURS Walking is an easy activity that doesn’t have to involve significant chunks of time. Break your day up into four three-hour blocks (9 a.m. to noon, noon to 3 p.m., 3 to 6 p.m., 6 to 9

p.m.) and commit yourself to take one 15-minute walk during each of those time periods. That results in one hour of activity in addition to your normal exercise routine. ➤ PUSH UPS/SIT UPS An easy routine to squeeze into your day is activating your arm muscles and your abdominal region by small sets of push-ups and situps or crunches. A quick session of 10 push-ups immediately followed by 10 sit-ups or crunches completed three times a day (morning, afternoon, evening) is a realistic goal. ➤ TELEVISION TIMEOUT I may be dating myself in today’s age of streaming services and TV series binge-watching, but doing

something physical during commercial breaks if watching a traditional broadcast or cable television program helps sneak in physical activity, especially in the evening when many people sit or lay down for extended periods of time. Walking up and down your basement stairs or from your first floor to the second level of your dwelling or walking from room to room if you don’t have access to stairs is one option. Other “TV timeout” possibilities include jumping jacks, split squat jumps, high knee walking, leg lifts, walking lunges, strength training with hand weights, head-to-toe stretching. By Daniel Meye

February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Will You Be Mine? Dating Tips for Finding that Special Someone

’m often asked by readers and those who have attended my “Live Alone and Thrive” workshops whether I ever date. My answer is unequivocally “yes!” More often than not, people are surprised by my answer. I like the question, because it gives me a chance to remind everyone that living alone with success isn’t about mastering the art of becoming a hermit. It doesn’t mean abandoning the idea of sharing a life with someone special. I’ve said it before and it bears repeating: Living alone doesn’t mean being alone. Many people satisfy their need and desire to be with others by developing a great group of friends, including family members. Some want more though, and long for romance and the exclusive domain of a loving relationship. It is to this latter group that I dedicate this column. If the idea of dating in mid-life following the loss of a long-term relationship or marriage seems daunting, know that you are not alone. I’ve talked with many older women and men who have resigned themselves to “terminal singlehood,” after having tried unsuccessfully to enter the dating scene. It only takes a few disappointments and rejections to send people

running for cover. But like any challenge, if you approach dating with care, a satisfying and lasting relationship is possible at any age. Below are a few tips I’ve assembled from my own experience and the experiences of others that may help you jump-start your search for a loving companion: • Deﬁne what dating means to you. If you haven’t dated in years (perhaps in decades), the term “dating” may suggest the first step in a predictable path to marriage. These days, dating is, well, dating. And you can define it anyway you like. Maybe you’re looking for a number of companions with whom you could enjoy movies, dinner, intimacy, etc. Perhaps you just want someone to join you for special events. Or you may be on a serious quest to find a new life partner. Your definition — your dating goal — will shape the style and pace of your search. • Know what you’re looking for. I remember reading a magazine article recently in which the author detailed her experience of writing down all the things she wanted in a man, and then — lo and behold — having the man of her dreams stroll

right into her life. Was it coincidence? Magic? Who knows, but the exercise has merit. Thinking about what you want as well as what’s unacceptable will help you refine your search and improve your chances of finding a compatible partner. • Be yourself. This is no time to try to become the person you wish you were or you think others will find attractive. One of the advantages of being a little older is increased self-awareness and the confidence to be who you truly are. Accept and embrace yourself “as is.” Pretending to be otherwise will only compromise your chances of meeting someone who loves you just the way you are. • Spread the word. If you want to meet someone, make your search a priority and let friends and family know you’re looking. Don’t be apologetic about expressing your desire to find a companion. It might sound like this: “You know it’s been a while, and I’m feeling ready to meet someone. May I ask a favor? Would you keep me in mind if you run into someone you think might be a good fit for me?” Other ways to initiate your search include joining a matchmaking website or by subscribing to a dating service. Having had no experience with these methods, I can only offer this bit of cautionary advice: It’s potentially risky, so take precautions. There’s a lot written on this subject, so conduct a web search to learn how best to protect yourself.

• Have fun and keep your expectations in check. We’ve all suffered the occasional bad date or rejection. Try not to let that stop you from meeting new people and pursuing that special someone. Dating, just as networking for a new job, can put you in the company of interesting, stimulating people. Even if your heart doesn’t go pitter-patter, you’ll be out in the world and expanding your experiences and circle of friends. So give it a whirl. Muster your courage and pick up the phone, sign up, or show up to fulfill your heart’s desire.

• Put yourself with like-minded people. Do you like music? Are you an athlete? Is reading your passion?

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 your teen staring at her smartphone all day? There are many things parents can do to protect kids from the potentially negative effects of social media, experts say. While there are positive aspects to social media, there’s evidence it can pose risks to teens’ mental health due to issues such as bullying, body image concerns and other social pressures. “The reality is that social media is part of the world we live in, and it’s not going away,” said Mari Radzik, a clinical psychologist in the division of adolescent and young adult medicine at Children’s Hospital Los Angeles. “We can’t just take away our kids’ phones or computers. It’s about figuring out how we can guide them on using and navigating these tools,” Radzik said in a hospital news release. Some signs of social media-related problems in teens include changes in mood, eating and sleep habits, as well as isolating in their room. In such cases, parents might want to begin a discussion about their teen’s social media use by using “I” instead of “you” statements, Radzik suggested. Instead of saying, “You’re on Instagram way too much and that’s bad for you,” try, “I noticed this and I’m really worried. Can we talk about it?” If your teen doesn’t want to talk at that moment, let them know you’ll be there when they feel ready. “Berating will make a young

person shut down,” Radzik said. “Or sometimes parents will dig through their child’s social media accounts and that can feel invasive. The approach has to come from a place of caring and concern, rather than something punitive or accusatory.” Parents should check in frequently and pay attention to their teens’ media use, said Sarah Voyer, lead social worker in the division of psychiatry at Children’s Hospital Los Angeles. Parents may want to ask their teens how they use social media -— do they share updates with their friends, follow certain celebrities or influencers, or are they seeking some kind of advice or help — and how they feel when they use it, Voyer said. If you’re certain that social media is affecting your teen’s mental health, suggest they take a break or even delete their account. “There are some kids who can break the cycle, and sometimes it takes the parent to help with that,” Radzik said. Before a child begins to use social media, parents should set parameters, according to Radzik. “It can be problematic when children are given regular access to cellphones at an early age,” she said. “I understand the need to use it at times, especially age-appropriate material. But as parents we need to encourage a curiosity of the world around them and use creativity tools rather than rely on social media all the time.”

Worried About Your Teen’s Social Media Use? Experts Offer Help

Or birdwatching? We all enjoy being with people who share our interests. One way to kick-start your dating adventure is to attend gatherings, classes, and social functions that attract the kind of partner you are looking for. I’ve heard from many happy couples who met on the pickleball court, in a book club, hiking group just for singles, dance lessons that didn’t require partners, or in a support group that caters to divorced or widowed men and women. Others met while volunteering or supporting a cause they believe in. To be successful, you need to get out of the house.

Page 8 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

community behavioral center. As a designated CCBHC by the federal government and New York state, we expanded services and established crisis centers in key communities, helping adults, children, and families with critical mental health and substance abuse needs. These centers often divert people in need from traditional emergency and hospital settings, providing focused care in the community. Q. Who typically calls your agency? A. Individuals themselves, parents, schools, referring physicians and health-care providers. For our C.A.R.E.S. Crisis team, when a school representative contacts us, the issue may involve a student who is suicidal or who’s behavior is erratic, or has depression and anxiety problems. A parent may call due to an addiction issues as well. Hospital personnel also look to link individuals coming out of a hospitalization or emergency room who need follow-up care. We evaluate the situation, try to help resolve things and develop a plan and link that individual to the appropriate services. Our goal is to get the individual and or family the right service and care.

Q A &

with Cindy Voelker

Associate CEO for Spectrum Health and Human Services talks about her agency’s scope and how COVID-19 has impacted residents in the Western New York counties

By Brenda Alesii

or nearly four decades, Cindy Voelker has helped people battling mental health challenges, behavioral issues and addiction-related disorders. Voelker, the associate CEO for Spectrum Health and Human Services, recently spoke to In Good Health about her agency’s scope and how COVID-19 has impacted residents in the Western New York counties they serve.

Q. What is the mission of Spectrum Health and Human Services and what geographic areas do you serve? A. We are a not-for-profit agency providing a wide range of comprehensive services both in-office and in the community. We cover Erie, Niagara, Wyoming, Genesee, and Cattaraugus counties. Our first office was in Springville in Erie County. Spectrum Health is a certified

Q. There are a lot of human services agencies in the region. What makes you different? A. We serve both urban and rural communities, starting 49 years ago in Springville. We have a downtown center with an Urgent Behavioral Care Center. In addition to clinical services, Spectrum Health offers supportive housing to individuals who are homeless or non-homeless with disabling conditions throughout Erie, Wyoming, and Monroe counties. Using a team approach, we pride ourselves on helping people get through difficulties with our housing services, case management, and peer services.

Q. How is your agency funded? A. We have diverse funding streams. We have revenue from major insurance companies, Medicare and Medicaid. We also receive numerous grants, because we assist with housing, Spectrum Health is aided by HUD, as well as local foundations and SAMHSA. Q. How has the need for your services changed since the pandemic? A. Our numbers are up by 35%, with more need than we have the capacity to handle at the moment. We try to prioritize higher need, higher risk, and engage in quick appointments. In 2021, deaths from overdoses increased across the board. Q. With unprecedented staff shortages affecting employers of every ilk, how has Spectrum been impacted? A. Everyone is struggling with shortages. We have 400 employees; most are clinical — social workers, licensed mental health counselors, care coordinators, case managers. We also employ nurses, nurse practitioners, psychiatrists, and staff that handle billing and finance. We have a number of open positions now, all listed on our website, www.shswny. org/careers.

Q. Does Spectrum Health have a Hotline Number? A. Yes, it is 716-710-5172. This number is available 24/7. Our C.A.R.E.S. program for youth under age 18 is also 24/7, at 716-882-4357

Q. Given the inherent stress of jobs dealing with mental health and addiction problems, now coupled with an ongoing pandemic, how do you maintain good morale among your staff? A. It’s been extremely challenging, especially in this era of COVID. While our staff is under a certain level of stress, we want to make people feel engaged and connected. With the demands of child care, we recognize that flexibility is critical. Wellness programs are offered to the staff. I went to every site during the holidays to tell staff face-to-face how much I appreciated their work and dedication. I want to know what we can do better. While we couldn’t have a holiday gathering or any in person gatherings, we have done many virtual or individual recognitions of staff, we recently offered staff free Spectrum hoodies or shirts, a small way to help us feel connected.

Q. How much does it cost for your services? A. Spectrum Health accepts all insurances, has a sliding scale fee for individuals without insurance and no one is turned away in a crisis. C.A.R.E.S. crisis services are provided at no charge and are supported by county and state dollars.

Q. How has the vaccine mandate for health workers been received by the employees? A. Most workers are fully vaccinated and working on getting booster shots. We take a partnership and educational approach, and encourage staff to consult with our medical staff or their doctor if they have questions.

Better Hearing Starts At Buffalo Hearing & Speech Center As a not-for-profit organization, we have two goals... to help you hear better and improve your quality of life – without breaking the budget. Choose from a wide selection of high-quality hearing aids. Plus, we offer a Free Consultation, 75-Day Risk-Free Trial and a 3-Year Warranty.

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50 E. North Street | Buffalo, New York 14203 | www.buffalohearingcenter.com February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 9

Come grow with us! • Stafﬁng Development Manager • HR Beneﬁts Specialist • Compliance Coordinator • Family & Community Partnership Coordinator • Community Crisis Specialist • Maintenance Associate • Maintenance Supervisor • Principal • ERSEA Manager • Operations Manager • Disability Service Area Manager • Disability/Mental Health Coordinator

Rushing sea. Whistling winds. Gulls calling. If you’re missing out on life, friendly support and help are available. Schedules and registration for free programs can be found at hearinglossrochester.org or call 585.266.7890

• • • • • • • • • • •

Family Case Worker Nutrition Associate Nutrition Supervisor Teacher IV, III, II, I Administrative Assistant (Youth Services) Teacher (Youth Services part-time) Youth Services Counselor (part-time) Case Worker (Youth Services) Activity Monitor (part-time) Family Partner Home Visitor

Openings in Erie & Niagara counties. For full job descriptions and to apply, please visit our website: www.caowny.org

Jenna Schifferle is a writer from Tonawanda. She runs to stay healthy, challenge herself, and collect new stories to write about.

Writer on the Run By Jenna Schifferle

jenna.schifferle@gmail.com

Runner Spotlight: Junette Diaz She regularly runs 5K and 8K races like the Moonlight 5K in Williamsville or the YMCA Turkey Trot

revious editions of the “Writer on the Run” column have focused on some pretty extreme goals: running 30 miles as a birthday landmark, completing the Chicago Marathon, sloshing through the snow for training and more. With 2022, we mark a new chapter. In honor of this, I thought we would turn the page and try something different. Starting with this edition, I will be sitting down with members of the Buffalo running community to hear their stories and see what moves them. This month, I caught up with Junette Diaz, 44, a benefits manager in Buffalo. Diaz’s fitness journey began in 2006 after having her youngest daughter. While caring for three children, she realized that she was doing a lot for her family and not taking the best care of herself. That day, she resolved to focus on her health. And she did. It wasn’t until 2008, though, that she finally decided to join a gym, where she dabbled with Zumba and weight training. As she got more into it, she realized that the three days a week she spent at the gym were much-needed “me” time. Then, in 2020, everything changed as the pandemic took hold. Diaz began working from home and found herself more sedentary and less happy and healthy overall. When regulations allowed, she increased her fitness routine to five days a week in an attempt to combat what she called the “quarantine 15.” During her gym sessions, she found inspiration in the people around her,

from her highly motivated fitness teacher, Tracy, to a new friend who encouraged her to rethink her diet. “We spend so much time at the gym, but if we go home and don’t eat the right things, it defeats the whole purpose,” Diaz said. “[This friend] really helped me see the light.” Diaz had already been a gym-goer for over a decade at that point, but it wasn’t until she started nourishing her body and thinking about what she was eating that she saw

any tangible progress. She’s proud to say that she did end up losing that quarantine 15 — while gaining more energy and joy than ever before. At the start of 2021, she entered yet another chapter of her fitness journey. She tied up her running shoes and joined a beginners’ run group on Saturdays. She then found another group called the Officially Unofficial Sunday Run Group. This group meets on Sunday mornings at various locations throughout Erie

Page 10 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

and Niagara counties. For Diaz, these groups were the perfect opportunity to get outdoors and take in nature. Diaz started slowly and gradually increased her mileage and pace. Over time, she managed to get her 5K time down to around 35 minutes and she soon realized she loved the sport. “It brings me joy to know I can do it, to know that I have both the ability and the strength to push forward,” she said. Now, Diaz regularly runs 5K and 8K races like the Moonlight 5K in Williamsville or the YMCA Turkey Trot. Sometimes, her kids join her and she takes joy in knowing she’s setting a strong example for them. It hasn’t always come easy for Diaz, but she’s proud of her journey and how far she’s come. Having been through periods of low motivation herself, she has a little advice for anyone looking to get started. “Go into it with the mindset that this is a habit. It doesn’t need to seem like a burden. Just find something you enjoy and run with it,” she said.

Above Junette Diaz (right) during the 2021 YMCA Buffalo Niagara Turkey Trot in Williamsville. On the far left is her daughter, Jeanique Diaz, 20, and son, Marcus Diaz, 18.

SmartBites By Anne Palumbo

The skinny on healthy eating

Move Over Meat, It’s Tempeh Time!

ver since I put the breaks on meat consumption, I’ve been on a quest to find plant-based meat alternatives. Like many, I first turned to a popular meat substitute: tofu. While I certainly like tofu and continue to consume it, I’m now smitten with tofu’s heartier cousin: tempeh (pronounced “tem-pay”). We met by accident. When I was reaching for some tofu, I happened to notice an ill-placed package of tempeh tucked amidst the tofu. Curious, I picked it up (firm and nubby), read the label (high in nutrients), and decided to throw caution to the wind (a true food romantic!). What is tempeh? Tempeh is a high-protein meat alternative made from fermented soybeans that have been cooked and compressed into a dense cake. Some versions also contain beans and grains, which is why gluten-sensitive folks should scour ingredient labels. Unlike tofu, tempeh has a meaty, firm texture and an earthy, nutty flavor. Tempeh has about 20 grams of protein per average serving, an impressive amount that puts it on par with some animal-based sources of protein, like shrimp, tuna, tilapia, and many lean meats. What’s more, its protein is complete, meaning it has all the essential amino acids every body needs. Studies show that a diet high in protein can aid appetite control by increasing fullness and decreasing hunger. For some, this means better weight management; for others, it can mean weight loss. Looking to shore up your bones? This tasty meat-alt brims with bone-building minerals: calcium, phosphorous, manganese and magnesium. All four work synergistically

to build and maintain strong bones, which is important in reducing the risk of bone fractures and osteoporosis. In addition, tempeh’s bounty of protein is also a boon for bones, say experts. Hearts benefit from tempeh in more ways than one. Its soy isoflavones — natural plant compounds — have been linked to reduced cholesterol levels. Studies show that these same plant compounds also have antioxidant properties and reduce oxidative stress by neutralizing toxic free radicals. A buildup of these highly unstable atoms has been linked to many diseases, including heart disease, diabetes, and cancer. And, unlike the unhealthy saturated fat in some meats, tempeh’s fat is mostly heart-healthy mono and polyunsaturated fats. An average serving of plain tempeh has about 170 calories, no sodium or cholesterol, good amounts of several B vitamins, iron, and, depending on the kind of tempeh you buy, even some fiber.

Helpful tips Buy tempeh in the refrigerated section of your grocery store, typically near tofu. Check the label: some flavored tempehs have added sugar and salt while others have gluten proteins. Tempeh loves marinades and absorbs flavors better with a thinner slice (1/4 “) or a finer chop. Use grated tempeh as you would ground meat for meatballs, taco fillings, or a meatless “meat” sauce for pasta.

Tempeh BLT (BaconLettuce-Tomato) Bowl Adapted from Salad Samurai Cookbook

Tempeh Bacon Bites 8 oz tempeh 2 tablespoons maple syrup 2 tablespoons soy sauce 1 tablespoon ketchup or hot sauce of choice 1 tablespoon vegetable oil ½ teaspoon salt ¼ teaspoon liquid smoke (optional) Olive oil for pan-frying 1 tablespoon water Salad 6-8 cups mixed greens ½ red onion, sliced in half-moons 1 pint grape or cherry tomatoes, sliced in half 1 ripe avocado, diced Dressing of choice

How Olive Oil Can Add Years to Your Life

wapping out the butter or other artery-clogging fats in your diet for heart-healthy olive oil may add years to your life, researchers say. Folks who consume more than 1/2 tablespoon of olive oil a day are less likely to die from heart disease, cancer, neurodegenerative diseases like Alzheimer’s or lung disease when compared to people who consume less of this healthy fat, a new study finds. It’s not just adding olive oil to your diet that staves off death from disease, said study author Marta Guasch-Ferre, a research scientist in the nutrition department at the Harvard T. H. Chan School of Public Health. “We need to pay attention to overall diet quality and lifestyle, and consistent with our results, the key would be to add olive oil into the diet as a substitution of other unhealthier fats.” Olive oil is rich in healthful antioxidants, polyphenols and vitamins and is a good source of heart-healthy monounsaturated fats. “One may

speculate that mechanisms related to the anti-inflammatory and antioxidant properties of olive oil may have played a role in these findings,” Guasch-Ferre said. Olive oil use could also be a marker for a healthier lifestyle. Folks in the study who consumed the most olive oil were more physically active, less likely to smoke and ate more fruits and vegetables than people who consumed less olive oil. For the study, the researchers analyzed data on more than 90,000 people from the Nurses’ Health Study and the Health Professionals Follow-Up Study who were free of heart disease and cancer when the study began in 1990. These folks were followed for 28 years. Every four years, they were asked how often they ate certain foods, including fats such as margarine, butter, mayonnaise, dairy

fat and olive oil. When compared with people who never consumed olive oil, those who consumed more than 1/2 tablespoon a day had a 19% lower risk of dying from heart disease, a 17% lower risk of dying from cancer, a 29% lower risk of dying from a neurodegenerative disease, and an 18% lower risk of dying from lung disease. The researchers also developed statistical models to simulate what would happen if a person swapped out 3/4 tablespoon of margarine, butter, mayonnaise or other vegetable oils with olive oil. This switch reduced the chances of dying from all causes. Substituting olive oil for other vegetable oils such as canola, corn, safflower and soybean didn’t have the same effect, the study showed.

1. Slice the tempeh (widthwise) into ¼-inch thin strips. Then, stack two strips at a time and slice the tempeh into bite-size pieces, about an inch long. 2. In a small metal baking pan (i.e., 9” x 5” loaf pan), whisk together the maple syrup, soy sauce, ketchup or hot sauce, vegetable oil, salt, and liquid smoke until smooth. Add the tempeh bites and gently toss to completely coat with marinade. Let stand for 10 minutes (flip after 5) or cover and chill overnight. 3. Use your fingers or a fork to transfer the tempeh pieces (leaving the marinade behind) to a lightly oiled skillet preheated over medium heat. Lay the pieces in a single layer. Cook until well browned on one side, flip, and cook the other side until browned, about 2 to 3 minutes per side. After the tempeh is browned on both sides, turn the heat to low, mix 1 tablespoon water into remaining marinade, and then pour the mixture over the bites and cook until the marinade is absorbed, about 1 to 2 minutes more. Turn off heat and cover to keep warm until ready to use. 4. Place the mixed greens, red onion slices, tomato halves, avocado dices, and tempeh bacon in a large bowl. Using your hands or tongs to combine, toss the salad with just enough dressing to moisten completely. Serve and enjoy! *Salad Samurai is my all-time favorite salad cookbook. Although geared to vegans, which I am not, its unique recipes are loaded with flavor and nutrients.

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.

The findings are published in the Jan. 11 issue of the Journal of the American College of Cardiology. Nutritionists not involved in the new study point out that eating a healthy, balanced diet is more important than any one food. It’s not just the olive oil that confers these health benefits, it’s likely what the olive oil travels with and adds flavor to, said Marion Nestle, professor of nutrition, food studies and public health emerita at New York University. “Olive oil is part of the classic heart-healthy Mediterranean diet,” Nestle noted. This style of eating includes lots of fruits and vegetables, whole grains, nuts, seeds and lean protein, and is low in processed foods. “It’s never about one food, it’s really about dietary patterns,” she said. Olive oil has calories, and they can add up quickly, Nestle pointed out. There are about 120 calories in one tablespoon of olive oil. This isn’t a lot of olive oil either, said Meghan McLarney, a dietitian at Nebraska Medicine in Omaha. “A typical salad at a restaurant has about four tablespoons of dressing.”

February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 11

The Link Between

MENTAL HEALTH STRUGGLES and Severe

COVID-19 OUTCOMES How to handle stress as the pandemic continues By Jenna Schifferle

ith the spread of the omicron variant comes a renewed concern for mental health. The pervasiveness of the virus adds a new level of complexity to the struggles many people have faced since the pandemic took hold nearly two years ago. But what about the way mental health impacts outcomes for those who contract the virus? A 2021 study published in the Journal of the American Medical Association by physicians Guillaume Fond, Ph.D., Katlyn Nemani, Damien Etchecopar-Etchart and others, showed that people with mental health disorders experienced poorer outcomes from COVID-19. The study also drew a correlation between severe mental health disorders and the risk for COVID-19 mortality, particularly in those with schizophrenia and bipolar disorders. The study examined a wide range of mental health conditions varying from psychiatric, psychotic, mood and personality disorders to anxiety, eating disorders and substance abuse. Of course, the reasons for this correlation are vast and nuanced and several factors may be at play. For instance, people with mental health disorders often have comorbidities like diabetes or heart disease, the study stated. Along with social and environment factors, these comorbidities may affect how people with mental health disorders fair when they contract COVID-19. So, what does this mean for people with mental health disorders? Two experts weigh in:

Amy Hequembourg, Ph.D.

Amy Hequembourg is the assistant dean for diversity and inclusion and an associate professor for the School of Nursing at the University at Buffalo. A sociologist by training, her research focuses on health disparities among LGBTQ+ populations with an emphasis on interpersonal violence, sources of minority stress

and health risk behaviors among these diverse populations. Hequembourg views the connection between severe COVID-19 and mental health disorders as only one part of a greater issue. “Mental and physical health are inexorably intertwined and the most vulnerable of our society are [at] greatest risk for severe COVID-19 symptoms,” Hequembourg wrote in an email statement. When asked about the reasons for the link between severe COVID-19 outcomes and mental health, Hequembourg said that pre-existing conditions, a person’s vulnerability to adverse outcomes and socioeconomic factors can all affect how someone will fair when it comes to being affected by an illness like COVID-19. Particularly susceptible are those groups that were vulnerable before the pandemic, like minorities and LGBTQ+ individuals. “[The LGBTQ+] population experiences unique stressors related

to negative social perceptions about them that adversely impact their health,” Hequembourg wrote. With the pandemic has also come a great deal of stress on frontline healthcare workers, she added. Caring for sick or dying COVID-19 patients and navigating patients’ families can cause emotional trauma that creates mental health concerns. This is all part of a greater need for federal funding to promote careers in the health field and improved access to health services to support more people, including marginalized groups. On an individual level, regular exercise, a healthy diet and seeking support from family, friends or coworkers are important self-care strategies for anyone struggling, Hequembourg said. Avoiding media overconsumption, misinformation and social nihilism are equally critical, even when taking these steps proves difficult. Learn more about Hequembourg’s research at bit.ly/3FjFaU5.

Erin M. Moss, LMHC

Erin M. Moss, a licensed mental health counselor at Erin M. Moss Mental Health Counseling private practice in Buffalo, has been in the counseling field for 15 years. After reviewing the study from the Journal of the American Medical Association, she said she wasn’t surprised to hear about the link between severe COVID-19 outcomes and mental health. “What we know is that men-

Page 12 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

tal health and physical health are linked. We see that even outside of COVID-19. A lot of times, when people have mental health issues, they also suffer from chronic pain or other physical illnesses,” she said. Moss added that if someone living with a mental health disorder contracts COVID-19, they’re prone to be impacted by it more because of the mind-body connection, physical illness can worsen mental illness and vice versa. The issue is also further complicated by the social determinants of health or factors that impact one’s ability to properly care for their health (i.e., economic stability, access to quality education and health care, community support, and environment). “Social inequalities lead to poorer mental health. We have to turn our attention to those populations and make sure that people who are lacking have proper support,” Moss said. Moss went on to say that these issues haven’t become any less pressing just because the pandemic is approaching the two-year mark. We’re seeing a surge in the omicron variant, which serves as a reminder that this pandemic hasn’t gone away. “While people may have gotten used to living in a world with COVID-19, we should all continue to take the pandemic seriously,” Moss added. “This means taking precautions like mask-wearing, extra handwashing and talking to your doctor about what’s best for your mind and body.” For those who are hesitant to get vaccinated, Moss encourages having conversations with a physician to learn more. Lastly, Moss had a message for anyone who is struggling. “Look at ways to acclimate and live during this time of COVID-19. Learn how to take care of yourself at home and to adjust the activities you do in your day-to-day life,” she said. “Most importantly, ask yourself: What can I do to inspire hope? What can I do to encourage myself and remember that tomorrow’s a new day? Because it is.” Learn more about Moss on her website at erinmmoss.com.

5 A

Things You Should Know About Thyroid Clearing up the stereotypes and misinformation

Ajay Chaudhuri, a board-certified endocrinologist, is the chief of endocrinology at the Jacobs School of Medicine and Biomedical Science in Buffalo.

a board-certified endocrinologist. “Some of these symptoms, if left unchecked, can cause tremendous health problems.” However, thyroid diseases have many stereotypes and misinformation. Chaudhuri, who is also a clinical professor of medicine and chief of endocrinology at the Jacobs School of Medicine and Biomedical Science in Buffalo, discusses five aspects of thyroid.

1.Misconceptions

Thyroid-related symptoms can be present as many different medical conditions. Common symptoms include extreme fatigue, brain fog, anxiety, heart palpitations, dry skin and high blood pressure. Lower-than-normal T4 levels usually mean you have hypothyroidism. Some people may have increased thyroid stimulating hormone (TSH) levels while having normal T4 levels. The thyroid helps regulate the heartbeat so it is not pumping blood too fast or too slow. Yet sometimes thyroid gets blamed for several negative symptoms in your overall health. “People make assumptions and self-diagnosis about thyroid issues. That is why it is essential if you start seeing symptoms for you to go to your physician and ask for a blood test,” said Chaudhuri. “We are able to detect rather easily if your thyroid level is above or below normal.” Chaudhuri added that what complicates the matter is that even when the test reveals that the thyroid is not the cause of their medical issues, patients still are determined with their original diagnosis.

What’s In Your Bathroom Medicine Cabinet? By Deborah Jeanne Sergeant

2.Symptoms

By Ernst Lamothe Jr.

n underactive thyroid can affect your life in many ways. Hypothyroidism happens when your thyroid doesn’t create and release enough thyroid hormone into your body. The effect makes your metabolism slow down and is a common condition. The thyroid gland is a small organ that’s located in the front of the neck, wrapped around the windpipe. It’s shaped like a butterfly, smaller in the middle with two wide wings that extend around the side of your throat. “People need to know about thyroid issues because it can truly affect your quality of life. It can lead to several health ailments like weight issues, constipation and menstrual difficulties,” said Ajay Chaudhuri,

ikely behind the bathroom mirror, the medicine cabinet is home to an assortment of health aids in most homes. Unfortunately, many cabinets are jammed with items that should not be there. Some also lack a few helpful essentials. “Get rid of unused medication, especially the controlled substances,” said Barb Madison, pharmacist and owner of Parker Pharmacy in Buffalo. “If people know you have them in your house, you don’t want them to break into your house to obtain them. You can take them to local police department. They have a bin to put

“Once we find out that it is not the thyroid, our best plan is to pivot and see what other ailments it could be. It doesn’t help you to keep believing that you have a thyroid problem if the blood and test work doesn’t back that up,” said Chaudhuri.

them in there.” Although you may feel your children would never take your prescriptions or over-the-counter drugs, what about the repairman, the friend-ofa-friend attending your house party or your teen’s new buddy? Some burglars ransack medicine cabinets looking for drugs to use or sell. Keeping this medication locked up and not in a likely place, like the medicine cabinet, prevents drug misuse. The bathroom is not even a good place for storing drugs to begin with. “The medicine cabinet, which is usually in the bathroom is not the best place to keep medicine,” said Steve Giroux, pharmacist at Middleport Family Health Center in Middleport in Niagara County. “Medications are often susceptible to humidity. Invariably, people open up a bottle over a sink and spill it. Consequently, the medicine cabinet is probably not the best place to keep medicine. Keep it in a dry, controlled place like a bureau drawer.” It is also important to occasionally look through medication for any you no longer take. Giroux views this as a task to perform every year to

Many of the symptoms for thyroid are universal. Thyroid-related symptoms can be present in many different medical conditions. Common symptoms include extreme fatigue, brain fog, anxiety, heart palpitations, dry skin and high blood pressure. Lower-than-normal T4 levels usually mean you have hypothyroidism. Some people may have increased TSH levels while having normal T4 levels. The thyroid helps regulate the heartbeat so it is not pumping blood too fast or too slow. In addition, some may confuse hypothyroidism with hyperthyroidism. The latter, which is diagnosed as an overactive thyroid, has symptoms that include nervousness, anxiety, irritability, difficulty sleeping, fatigue, sensitivity to heat and muscle weakness. “An underactive thyroid can cause a significant amount of weight loss, your heart is racing, sweating and trembling,” said Chaudhuri. A diagnosis is made with a physical examination and laboratory tests that measure the amount of thyroid hormone. Blood tests that measure thyroxine and thyroid-stimulating hormones can confirm the diagnosis. High levels of thyroxine and low or nonexistent amounts can indicate an overactive thyroid.

symptoms in the beginning,” said Chaudhuri. In cases of hyperthyroidism, the most common diagnosis is Graves disease. Graves’ disease is caused by a malfunction in the body’s disease-fighting immune system. It’s unknown why this happens. The immune system normally produces antibodies designed to target a specific pathogen. In Graves’ disease, the immune system produces an antibody to one part of the cells in the hormone-producing gland in the neck. Although Graves’ disease may affect anyone, it’s more common among women and in people younger than 40.

4.Thyroid and pregnancy

Untreated thyroid conditions during pregnancy are linked to serious problems, including premature birth, miscarriage and stillbirth. If your thyroid condition is treated during pregnancy, you can have a healthy pregnancy. “That is also why it is important to ask your physician if you are taking any thyroid medication because that can also affect your pregnancy,” he said. “Because the thyroid makes hormones that help your body, if it makes too little or too much it can affect your pregnancy.”

5.Diet

Often times hypothyroidism is caused by a condition called Hashimoto’s thyroiditis where a patient’s immune system attacks and destroys the thyroid. Hashimoto’s disease is the most common cause of hypothyroidism. “This autoimmune disease can progress very slowly during a number of years. It may have different

When it comes to diet and food, thyroid treatments have mixed messages. Some believe in iodine treatments. Iodine is an element that is needed for the production of thyroid hormone. The body does not make iodine, so it is an essential part of your diet. If you do not have enough iodine in your body, you cannot make enough thyroid hormone, according to the American Thyroid Association. Remedies such as iodine supplements are not viewed as necessary if you live in the United States or most developed countries. “We typically don’t have problems with iodine in our diet living in the United States because salt is often part of our diet,” said Chaudhuri.

get out old, superfluous and expired items. Taking any unnecessary drugs can lead to dangerous interactions and needless side effects. It can waste money. Many items from your local pharmacy may have expired such as over-the-counter ibuprofen, acetaminophen, aspirin, antihistamines, 1% hydrocortisone cream, antibiotic cream and cold medication. Check the packaging for their expiration dates and replace any needed with smaller containers so you won’t waste it. “Always check expiration dates and dispose of things that are expired,” Giroux said. Stocking huge bottles of overthe-counter medication that can expire is a bad idea since that can lead to items going bad if they’re not used up. Look over your bandages to ensure their packaging is still intact and that your sunscreen is not out of date. Test your thermometer occasionally so you won’t have to wonder if it works right or keep a back-up instrument. Some items may begin degrading after it’s opened, such as eye drops. While stocking up may make you feel better prepared, you must look things over periodically to ensure your health aids have not expired.

As you sort through the medicine cabinet, make sure you have a few helpful items on hand. Review the contents of the first aid kit to ensure that the contents are still used. For example, anyone who still has ipecac syrup should dispose of it, as it is no longer used as a poisoning treatment. Activated charcoal may be an advisable remedy, but call Poison Control Centers for guidance at 800-222-1222 before trying anything at home. “A well-stocked medicine cabinet should have ibuprofen, acetaminophen, antiseptic for cuts, and bandages,” Giroux said. In addition to these items, Barb Madison, pharmacist and owner of Parker Pharmacy in Buffalo, advises keeping topical oral pain medication for unexpected dental issues. “This always tends to happen in the middle of the night,” she said. She also recommends having over-the-counter COVID tests on hand. They can offer results in 15 minutes, which can help determine whether self-quarantining is needed. For comfortably recovering from a minor illnesses at home, stock cough medicine, saline drops, throat spray, decongestant, anti-diarrheal tablets and upset stomach medication. “Have some aloe vera gel for a burn or some kind of burn salve,” Madison added.

3.Causes

February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 13

10 Mistakes Contact Lens Wearers Make By Deborah Jeanne Sergeant

ontact lenses offer sharp peripheral vision and freedom from wearing glasses all day; however, they have certain care and use rules that help those wearing them reduce risk of injury and increase comfort. Avoid these mistakes when wearing contact lenses:

8. Sleeping with lenses in.

“I try to discourage this,” said Mark Deeley, a primary care optometrist for Rochester Regional Health. “Naps are okay—people have to live—but I don’t like patients to make it a habit. The lid closure at night makes the eye suffocated for oxygen. It can cause visual changes. Although there are FDA-approved options to wear lenses on an extended basis, it doesn’t mean they’re not at risk for inflammation that can be damaging.”

1. Wearing lenses beyond their disposal schedule.

“The biggest challenge is that once a blister pack is peeled, that lens is on the clock, whether or not they wear them daily,” said Franklin S. Senia, optometrist and president of Eye To Eye Optical, Inc. in Amherst. “It’s a one-month lens whether you wear them daily or not. Write on the calendar when you start the new lenses. If you take a one-day lens and wear it multiple days, a lot of times the lens will split in your eye. Lenses are designed a certain way for the replacement schedule. If you don’t follow guidelines, you’re putting yourself at risk for eye infections and the progression of having dryness at a younger age. Usually, dryness starts at 40 and older. You could be in your 20s and have dryness.”

2. Reusing disinfecting solution.

“Do not top off solution; any leftover solution in the case changes the concentration level,” Senia said. “You must dump out all the solution, allow the case to air dry and refill it the next time you put the contacts in the case. You should fill up the solution up to the line. If there’s any residue

left over, the concentration level will be altered. Do not reuse it.”

3. Using bargain disinfecting solution brands.

“People often buy generic solution to save money, but they’re the older formulas that the manufacturers no longer sell in the true sense because the newer ones replace them,” Senia said. “I don’t recommend the generics. Some newer ones may be less irritating to the eyes. I recommend the current solutions like Clear Care. It’s the best kill ratio compared with the other systems.”

4. Using saliva to clean a lens. “Do not do this,” Senia said. “The mouth is full of bacteria and you’re putting that into your eye, which can cause infections.”

5. Using the wrong eye product or

Supplements May Have Negative Affect on Heart Health Check with your health care provider to see what’s right for you By Deborah Jeanne Sergeant

aintaining heart health is vital for healthy longevity. Heart disease remains the leading cause of death in the United States, topping nearly 100,000 more deaths annually than all forms of cancer combined. It may seem that turning to supplements can help boost heart health. Not quite, says Mary Jo Parker, registered dietitian in private practice

“Bring an extra pair of lenses in your bag,” said Therese Farugia, optometrist with UR Medicine’s Flaum Eye Institute, “and bring your glasses wherever you go if you’re leaving home.”

in Williamsville. “Some herbals can cause heart palpitations and higher blood pressure,” Parker said, citing ginseng, bitter orange, licorice, caffeine, yohimbe, energy-boosting supplements, as examples. Many people rely on energy shots and drinks to power through their day. While many consumers think of these as pick-me-up beverages on par with coffee, they are classified as supplements because the beverages are fortified. They also contain a wallop of caffeine. Parker said that some of those ingredients can interact with medication and that taking too much of any one supplement can also cause problems as it can cause a mismatch of nutrients. “The optimal amount is somewhere in the middle and the symptoms that come from deficiency mirror those that come from excess,” Parker said. “Too much of a good thing is not a good thing. There is a sweet spot and optimal levels for everything. The research is in its infancy where we go with personalizing this stuff.” For example, garlic, whether as a supplement or the food, can negatively affect someone taking blood thinners or cholesterol lowering drugs since garlic does both of those naturally.

method for cleaning contacts.

“People use saline and think it’s enough to clean lenses,” Senia said. “Saline matches your tears but does nothing for killing microorganisms. Sometimes, they squirt solutions in their eye to rinse the lens and that’s a no-no. Some people will squirt disinfectant in their eyes to rewet them, but they should use lubricating drops like Sustain. Or they try to clean with Visine. That is not a disinfectant. Don’t do that.”

6. Wearing lenses the entire day.

“People try to save money by buying only contacts and no glasses and then wear their contacts all day long,” Senia said. “That does not give their eyes a break. Their eyes will develop dryness.”

9. Swimming while wearing contacts.

“Especially if patients are wearing lens that they do not replace every day, this can cause problems,” Deeley said. “The microbes and bacteria in a pool, hot tub, lake and fresh water can cause an infectious ulcer. If you have your head submerged, the bacteria and microbes stick to the lens. Sometimes, multipurpose solutions can irradicate those from the lens. It would be better with a daily disposable. Or you could wear goggles.”

10. Skipping check-ups.

7. Neglecting to prepare for a vision emergency.

“Just because patients are seeing well and are comfortable in their lenses doesn’t mean the lenses are fitting appropriately, Deeley said. “People should go in for their contact lens exams to make sure their eyes are truly healthy.”

“It’s important that people are careful, especially those on hard medication, to talk with someone who would know about possible interactions,” Parker said. “Sometimes, a registered dietitian nutritionist would know or should be able to find out. Sometimes the pharmacy can be a help or doctors. It depends on how well researched they are. You can check stuff out yourself, too. Do due diligence, especially if you’re on medication or if you have certain conditions.” Erica Smolinski, registered and certified dietitian nutritionist with Buffalo Nutrition & Dietetics, PLLC in Orchard Park, focuses on food as the best sources of nutrients for a healthy heart and supplements secondarily. “For those with specific health concerns such as high blood fats (triglycerides), supplementation with fish oil, an excellent source of omega-3 fats, may be recommended to help bring blood fats into a normal range,” she said. “Beets are rich in heart healthy phytonutrients. Tomatoes, especially cooked tomatoes, are excellent sources of lycopene, a free radical-quenching carotenoid. They also contain other heart-protective carotenoids like ß-carotene and tocopherol. “Blueberries are packed with healthy phytonutrients for the heart and blood vessels. Studies show that the flavonoid anthocyanin in blueberries helps to keep blood vessels open and even lower heart attack risk.” While red meat is typically discouraged for its effect on heart health, eating more fish is excellent for cardiovascular health. Smolinski

recommended one to two servings a week minimum, especially for varieties like wild salmon, as it can reduce risk for coronary death by 36%. “People with heart disease who incorporate more extra virgin olive oil in their diet demonstrate improvement in the ability of their blood vessels to expand along with a reduction in inflammation,” she said. Beverages also matter. Consuming green and black tea has been associated with a reduced risk of heart disease and stroke by 10% to 20%. “Three cups per day appears to provide the most benefit in blood pressure lowering and reducing cardiovascular risk overall,” Smolinski said. Decaffeinated varieties are available. People supplementing with calcium should be careful to discuss its implications with their healthcare providers. A study publicized in the April 2021 issue of Circulation indicates that patients who do not have heart disease but who have high levels of calcium in their heart’s arteries have a much higher likelihood of heart attack, stroke or other cardio events. The findings corroborate with a 10-year study publicized in 2016 by Johns Hopkins Medicine, which concludes “taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appears be protective.” Overall, it is important to eat a healthful diet rich in colorful fruits and vegetables, lean sources of protein and whole grains and discuss supplementation with a healthcare professional.

Page 14 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

Golden Years

Dorothy Shaw, 102, has driven for a long time, then recognized the need to change. She recently voluntarily gave up the keys to her car. “I noticed I was being more careful; more afraid of falling and breaking something,” she said. “I made up my mind that the time had come. If I read about a 102-year-old woman having a car accident, I’d think she was at fault.” Photo courtesy of Canopy of Neighbors.

When It’s Time to Give Up the Car Keys: Be Wise, Be a Role Model It’s not always just because of age By Jana Eisenberg

hile December’s “Older Driver Awareness Week” has passed, it’s never too late (or too early) to address the topic of whether older adults are still healthy and well enough to drive themselves or others safely. Or, if they should stop. This can be a difficult issue for older adults, and anyone with older parents or friends who drive. The American Occupational Therapist Association notes that it can be helpful to focus on solutions, rather than only focusing on the problem. The group outlines talking points which can be helpful to think about for you or loved one. The first one is to anticipate changes that can affect driving. Maria McLaughlin, is a specialist at the ECMC driver rehabilitation program, where she conducts in-depth driver assessments. She noted that age alone should not guide people. “The best predictor for ‘driving fitness’ is someone’s ability to function every day. In occupational therapy, we use the ‘IADL’ scale,

that’s ‘instrumental activities of daily living,’” she said. “When someone begins to decline on the IADL scale, things like manage medications, take care of finances, schedule and keep doctor appointments, or cooking and cleaning, those are warning signs about driving fitness.” She added that driving is the highest level of daily activity, one where speed and accuracy are critical; where split-second choices can be fatal. When things like decision-making and even balance start to diminish, those are also warning signs. If you haven’t in a while, get in the car and take a ride with your loved one. Have you noticed unexplained dents and dings on an older driver’s car? Has a neighbor or family member expressed concern? The second point is to have the conversations. McLaughlin suggests talking about the issue early and often, preferably when there is no pressure and not while driving or in the car. “Hopefully, you can just talk about it. For example, ‘Mom, you respect me, right? You trust me when I say that I’ve noticed some changes?’”

she said. “You can ask your parent open-ended questions, like if they remember when their parent stopped driving. Talk about accepting age-related limitations. Remind someone that how they accept it (or not) sets an example for their children and grandchildren. One of the biggest challenges now is that people are living—and driving—longer. Many people outlive driving by seven to 10 years, so it’s important to think about it before it becomes a concern.” Dorothy Shaw, 102, is an example of someone who drove for a long time, then recognized the need to change herself. She recently voluntarily gave up the keys to her car. “I noticed I was being more careful; more afraid of falling and breaking something,” she said. “I made up my mind that the time had come. If I read about a 102-year-old woman having a car accident, I’d think she was at fault.” Shaw also gave up her isolated country place where she kept goats, for the safer environment of her family’s city home. During driver assessments at ECMC, said McLaughlin, people who haven’t had any of those conversations with family or friends find it harder to accept that they may not be able to continue to drive. The first part of the assessment involves collecting medical, surgical and social history, conducting vision, cognitive and motor tests, and checking a person’s strength, coordination, and reaction time. Then there is a driving portion of the assessment. The screening and evaluation process can actually help bring clarity to the decision. “People can be referred here by the DMV, by their physician or the courts. Or they can self-refer,” said McLaughlin. “Coming for the assessment can be a relief if someone maybe knows that they’re having issues. It’s good to bring along a friend or family member. Sometimes their family might not be aware or they can be reassured that the parent is OK.” The results might be a recommendation to stop driving at night or to avoid long-distance driving. “Make the transition fun, share the driving,” she suggested. “Enjoy the positive aspects, relaxing, talking

while in the car.” Or it could be full “driving retirement.” “We counsel people, reassure them that there is life beyond the driver’s seat. We give them links to transportation and community resources,” said McLaughlin. “We don’t want them to sit at home.” Shaw, who up until a few years ago was driving others places through volunteer work at Canopy of Neighbors, a Buffalo-based organization that helps seniors age in place, exemplifies what McLaughlin hopes to see for people accepting the change in their lives. “I enjoyed driving. I thought I would miss it terribly, but now I and my friends or neighbors can take a cab together or join Canopy of Neighbors and use the services ourselves,” said Shaw. “It may take a bit more planning; I will try to combine things into one trip. But I have a feeling of relief.” To contact the ECMC driver evaluation program, call 716-898-3225 or visit ecmc.edu

Maria McLaughlin is a specialist at the ECMC Driver Rehabilitation Program, where she conducts in-depth driver assessments. She noted that age alone should not guide people

February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 15

Golden Years

Mike Schmidt, audiologist and owner of Accura Audiology, PLLC in Williamsville: “If the OTC push gets the rate of adoption of hearing aids a little higher and people have better quality of living, that’s a good thing,” he says.

Over-the-Counter Hearing Aids Coming Audiologists weigh in on the new hearing aid devices By Deborah Jeanne Sergeant

vailability of over-the-counter hearing aids may become reality sometime this year. The Food and Drug Administration recently proposed guidelines on allowing a new class of hearing aids to be sold without a prescription for people 18 and older with mild to moderate hearing loss. Congress approved OTC hearing aids in 2017. However, the industry has been waiting on the FDA’s guidance. The bill states: “The regulations for over-the-counter hearing aids must: (1) provide reasonable assurances of safety and efficacy; (2) establish output limits and labeling requirements; and (3) describe requirements for the sale of hearing aids in-person, by mail, or online, without a prescription.” Hearing instruments currently available include personal sound amplification products, which are currently available over the counter, and hearing aids, which are prescription-only devices presently. PSAPs are devices for people with normal hearing. These simply ramp up all sound and are used for certain hobbies such as bird watching. OTC instruments, once available, should offer more sophisticated help than PSAPs, but the FDA is still deciding how to describe and regulate these products. Hearing aids are much more sophisticated instruments than PSAPs lower cost OTC aids. They help users with hearing loss amplify and make sense of wanted sounds such as conversation. Top-of-the-line models use Bluetooth technology to communicate with each other to boost the user’s ability to locate sound origin. Some models can transmit phone calls and smart TV output directly to the user’s ears. OTC products will likely be much simpler as the cost associated with this kind of technology would disincentivize many consumers to purchase them. Jim Harter, audiologist and owner of Village Audiology & Hearing

in Lancaster, sees patient cost as the only benefit to offering OTC hearing aids. “They’re going to see a hearing aid that they can get for a lower price but who evaluates them and who will adjust it based on their hearing loss?” Harter said. “That’s my major concern.” The bill specifies that OTC devices must have reasonable assurance of safety. This may help reduce risk of injury, since the instruments do not require a professional to adjust them. Prescription hearing aids start at about $5,000; over the-counter models could cost as little as $200. Consumers who feel any stigma about obtaining hearing aids may feel more comfortable purchasing devices at a familiar location—their local drugstore—instead of seeking help at a hearing device office. One of the aspects of OTC devices that troubles Harter is the wording “mild to moderate hearing loss” referring to patients who would be good candidates. Many people presenting with a profound hearing loss often do not realize the extent of their hearing loss. On average, most people wait seven to 10 years before addressing their hearing loss and do not realize how bad their hearing has become. He hopes that patients will at least initially visit an audiologist for an exam to see if OTC devices might be appropriate and to seek follow-ups for adjustment to their devices. His wife, Georgia Harter, also an audiologist at Village Audiology & Hearing, expressed concern about the lack of patient care with OTC devices. “People really do need oral rehab and support in training in how to use it and keep it functioning,” she said. “If they don’t know how to change the wax filter, it will be worthless. If it over amplifies they’ll say hearing aids are no good.” Hearing instruments also need maintenance, cleaning and in some cases, battery replacement (although rechargeable devices are becoming

more available). A bad experience with a poor device can turn off a patient from seeking a better device, assuming little difference exists between a well-made hearing aid and a simpler over-the-counter device. Mike Schmidt, audiologist and owner of Accura Audiology, PLLC in Williamsville, said that his office uses objective measures to ensure the best hearing for patients instead of relying solely on the patient’s objective experience of what sounds right. “If that’s not being done, there’s a high chance they’re not getting the most out of their hearing aids,” Schmidt said. “That’s not being done with an OTC aid unless they bring it to an audiologist to get it verified as the closest match.” He wants people to assess how they want to live with their hearing devices: as aids to use all day long or in certain environments. For the former, OTC devices will likely disappoint because of the diverse environments in which devices must perform. The technology with OTC devices is not sophisticated enough to manage. But for those with mild to moderate hearing loss and an appreciation of the limitations of OTC devices, he said that’s better than nothing. “If the OTC push gets the rate of adoption of hearing aids a little higher and people have better quality of living, that’s a good thing,” Schmidt said. “People will see that it aids their hearing. Audiologists generally provide a service where they’ll consult at no charge. If someone needs information, they can make an appointment to go over the options.” Kelly L. Thurber is a New York State registered hearing care professional with Empire Hearing & Audiology. The organization’s New York locations include Amherst, Niagara Falls, Webster, Penfield, Greece, Auburn, Cicero, New Hartford, Rome, East Syracuse and Liverpool. Thurber compares OTC devices to drugstore reading glasses. “If your vision is impaired, you should see an optometrist for an

Page 16 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

assessment and prescription glasses. But if you just need a little help reading small print, a pair of OTC ‘cheaters’ can provide some help,” Thurber said. In a similar sense, people with hearing issues should seek an evaluation from an otolaryngologist or audiologist to rule out any medical issues before seeking a hearing instrument. Wax build-up, ear infections or tumors could all cause hearing impairment and may be medically addressed. Simply picking up a hearing aid at the drugstore would not address the problem. For those with an actual hearing loss, a professional exam is still important. “Without undergoing a comprehensive hearing evaluation from a licensed hearing care professional, the actual degree of loss is unknown,” Thurber said. “The risk is that the brain will not receive the appropriate levels of amplification necessary for proper sound and speech processing with an OTC hearing aid, this could be too little or too much amplification.” Hearing care professionals have completed training to help them offer custom hearing aid adjustments to the device that can offer the ideal hearing experience for the patient, which is especially important for patients with severe to profound hearing loss. Mike Halloran, president of Beltone based in Glenview, Illinois, sees easier adoption as a plus of OTC hearing instruments. “With the caveat that we still don’t know the final guidelines on OTC products, we welcome this new regulation and believe it will help many more people with mild-to-moderate hearing loss,” Halloran said. Beltone operates locations in Blasdell, Tonawanda, Batavia, Fayetteville, Liverpool and Watertown. Halloran said only 20% of people treat their hearing loss. New products and care models can help people seek treatment earlier. OTC devices “will be great for consumer choice, providing people with a lot of ways to treat their hearing loss sooner. That’s a very good thing,” he said. He expressed some concern over potential for confusion over the various types of hearing devices. He hopes that the FDA guidance will help consumers know what they are purchasing and that they will continue to seek the care of a hearing professional.

DID YOU KNOW?

Hearing loss is related to other medical conditions.

By Jim Miller

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Senior Apartments for 55+

South Pointe Senior Apartments • Hamburg

1 & 2 Bedroom Apartments Pet Friendly • Elevator Emergency 911 Pull Cords Central Heat & A/C Indoor Mail • Laundry • Trash

— Supplemental Sam

Dear Sam, There are actually several tax credits and deductions available to adult children who help look after their aging parents or other relatives. Here are some options along with the IRS requirements to help you determine if you’re eligible to receive them. • Tax Credit for Other Dependents: If your mom lives with you and you’re paying more than 50% of her living expenses (housing, food, utilities, health care, repairs, clothing, travel and other necessities), and her 2021 gross income was under $4,300, you can claim your mom as a dependent and get a nonrefundable tax credit of up to $500. If you happen to split your mom’s expenses with other siblings, only one of you can claim your mom as a dependent, and that person must pay at least 10% of her support costs. This is called a “multiple support agreement.” The IRS has an interactive tool that will help you determine if your mom qualifies as a dependent. Go to IRS.gov/help/ita, scroll down to “Credits,” and click on “Does My Child/Dependent Qualify for the Child Tax Credit or the Credit for Other Dependents?” • Medical Deductions: If you claim your mom as a dependent and you help pay her medical, dental or long-term care expenses, and weren’t reimbursed by insurance, you can deduct the expenses that are more than 7.5% of your adjusted gross income (AGI). So, for example, if your adjusted gross income is $80,000, anything beyond the first $6,000 of your mom’s medical bills — or 7.5% of your AGI — could be deductible on your return. So, if you paid $8,000 in medical bills for her, $2,000 of it could be deductible. You can also include your own medical expenses in calculating the total. You should also know that your state might have a lower AGI threshold, which means you might get a

OPEN HOUSE 02/12 10a.m.–12p.m.

ALL UTILITIES INCLUDED break on your state income taxes even if you can’t get one on your federal income taxes. To see which medical expenses you can and can’t deduct, see IRS Publication 502 at IRS.gov/pub/irspdf/p502.pdf. • Dependent Care Credit: If you’re paying for in-home care or adult day care for your mom so you are free to work, you might qualify for the Dependent Care Tax Credit which can be worth as much as $4,000. To be eligible your mom must have been physically or mentally incapable of self-care and must have lived with you for more than six months. To claim this tax credit, fill out IRS Form 2441 (IRS.gov/pub/irspdf/f2441.pdf) when you file your federal return. • Flexible Health Savings Accounts: If you have a health savings account (HSA) or your employer offers a flexible savings account (FSA), you can use them to pay for your mom’s medical expenses if she qualifies as a dependent. But be aware that if you use an HSA or FSA to pay for your mom’s medical costs, you can’t take a tax deduction on those expenses too. For more information, see IRS Publication 969, “Health Savings Accounts and Other Tax-Favored Health Plans” at IRS.gov/pub/irspdf/p969.pdf. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

716-648-0843 www.clovergroupinc.com

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February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 17

Ask The Social

Security Ofﬁce

From the Social Security District Office

Pill Splitting: When it’s Safe, and When it Isn’t By Jim Miller

ill splitting — literally cutting them in half — has long been a popular way to save on medication costs, but people doing this need to talk to a doctor or pharmacist because not all pills should be split. The reason pill splitting is such a money saver is because of the way drugs are manufactured and priced. A pill that’s twice as strong as another may not be twice the price. In fact, it’s usually about the same price. So, buying a double-strength dose and cutting it in half may allow you to get two months’ worth of medicine for the price of one. But is it safe? As long as your doctor agrees that splitting your pills is OK for you, you learn how to do it properly, and you split only pills that can be split, there’s really no danger.

V-shaped pill grip that holds the pill securely in place. You can find them at most pharmacies for $5 to $10. For convenience, you might be tempted to split the whole bottle of pills at once. But it’s best to do the splitting on the day you take the first half, and then take the other half on the second day or whenever you are scheduled to take your next dose. That will help keep the drugs from deteriorating due to exposure to heat, moisture or air. It will also help ensure that any deviation in the size of one dose is compensated in the next. It’s also important to know that pills are only safely split in half, and never into smaller portions such as into thirds or quarters.

Ask Your Doctor

Some pills should never be split. Drugs that are time-released or long-lasting and tablets that contain a combination of drugs probably shouldn’t be split, because it’s difficult to ensure a proper amount of active ingredient in each half. Pills with a coating to protect your stomach, and pills that crumble easily or irritate your mouth shouldn’t be split either, along with chemotherapy drugs, anti-seizure medicines, birth control pills and capsules containing powders or gels. Again, your doctor or pharmacist will know which drugs can and cannot be split. If you’re taking a medicine that can be split, you’ll need to get a prescription from your doctor for twice the dosage you need. Then you can start splitting and saving, safely.

If you’re interested in splitting your pills, talk to your doctor or pharmacist to find out if any of the medicines you use can be safely split. It’s also important to find out whether splitting them will save you enough money to justify the hassle. The pills that are easiest to split are those with a score down the middle. However, not every pill that’s scored is meant to be split. Pills that are most commonly split are cholesterol lowering drugs, antidepressants and high blood pressure medicines.

Use a Pill Splitter Having the right equipment is very important too. Don’t use a knife or scissors to cut your pills in half. This can cause you to split them unevenly resulting in two pieces with very different dosages, which can be dangerous. Purchase a proper pill cutter that has a cover and a

Don’t Split These Drugs

Jim Miller is the author of Savvy Senior, a column that is published monthly in In Good Health.

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Get Your Social Security Beneﬁt Statement (SSA-1099 / Ssa-1042s) We’ve made getting your annual Benefit Statement even easier. The Benefit Statement, also known as the SSA-1099 or the SSA-1042S, is a tax form we mail each year in January to people who receive Social Security benefits. It shows the total amount of benefits you received from us in the previous year. You can use this information when you file your tax return, as it shows how much Social Security income to report to the Internal Revenue Service. If you live in the United States and you need a replacement SSA1099 or SSA-1042S, go online to get your instant, printable replacement form using your personal my Social Security account at www.ssa.gov/ myaccount. Look for your replacement SSA-1099 or SSA-1042S for the previous tax year in your personal account after Feb. 1. If you don’t have access to a printer, you can save the document to your computer or email it to yourself. If you don’t have a my Social Security account, creating one is very easy to do and usually takes less than 10 minutes. And that’s not all you can do

Q&A

Q: I will rely on Medicare when I retire. Can you explain the different parts of Medicare? A: The different parts of Medicare cover your specific needs. There are four parts, all of which work in tandem to deliver healthcare services: • Part A (hospital insurance): Helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care. • Part B (medical insurance): Helps pay for doctors services and many other medical services and supplies that hospital insurance doesn’t cover. • Part C (Medicare Advantage plans): If you have Medicare Parts A and B, you can join a Medicare Advantage plan. Private companies offer Medicare Advantage plans, which are approved by Medicare. These plans generally help you pay the medical costs not covered by Medicare Part A and B. • Part D (prescription drug coverage): Helps pay for medications doctors prescribe for treatment. Q: What can I do if my Medicare prescription drug plan says it won’t pay for a drug that my doctor prescribed for me? A: If your Medicare prescription drug plan decides that it won’t pay for a prescription drug, it must tell

Page 18 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

with a personal account. If you receive benefits or have Medicare, your personal my Social Security account is also the best way to: • Request a replacement Social Security number card (in most states and the District of Columbia). • Get your benefit verification letter. • Check your benefit and payment information. • Change your address and phone number. • Change your direct deposit information. • Request a replacement Medicare card. • Report your wages if you work and receive Social Security disability insurance or Supplemental Security Income benefits. If you’re a non-citizen who lives outside of the United States and you received or repaid Social Security benefits last year, we will send you form SSA-1042S in the mail. The forms SSA-1099 and SSA-1042S are not available for people who receive Supplemental Security Income benefits. If you don’t have a personal my Social Security account, you can create one today at www.ssa.gov/ myaccount.

you in writing why the drug isn’t covered in a letter called a “Notice of Denial of Medicare Prescription Drug Coverage.” Read the notice carefully because it will explain how to ask for an appeal. Your prescribing doctor can ask your Medicare drug plan for an expedited redetermination (first level appeal) for you, if the doctor tells the plan that waiting for a standard appeal decision may seriously harm your health. For more information, visit www.medicare.gov. Q: What is the difference between Social Security disability and Supplemental Security Income (SSI) disability? A: Social Security Disability Insurance (SSDI) is based on prior earnings. SSDI is financed through the taxes you pay into the Social Security program. To be eligible for a SSDI benefit, the worker must earn sufficient credits based on taxable work to be “insured” for Social Security purposes. SSDI benefits are payable to eligible blind or disabled workers, the widow(er)s of a disabled worker, or adults disabled since childhood. SSI disability payments are made based on financial need to adults or children who are disabled or blind, have limited income and resources, meet the living arrangement requirements, and are otherwise eligible. SSI is a program financed through general revenues. For more information, visit www.ssa.gov.

Pharmacists’ Role Expected to Expand Over Next Decade Nearly 80% of patients see pharmacists as a key component of their health care team, but more advanced training needed to meet growing demand and ﬁll gaps in care

ew research released by Columbia University Mailman School of Public Health and Express Scripts Pharmacy, an Evernorth company, reveals that amid growing provider shortages, pharmacists in the U.S. are well-trusted by patients and projected to play an increasingly integral role in care

management. The Prescription of Trust report, which surveyed more than 3,000 patients, 1,000 pharmacists, and 500 providers (including physicians and nurse practitioners), was designed to more deeply understand the expanding role of pharmacists in transforming patient care. It is the largest study

of its kind ever conducted and is the first to include the voice of patients. “The results of the report are clear. Most people trust pharmacists to play a greater role in providing their care. As the shortage of doctors and nurses persists, and as complex new therapies and digital health care technology solutions are developed, the role of the pharmacist will continue to evolve,” said John McHugh, Ph.D., an assistant professor in the department of health policy and management at Columbia University Mailman School of Public Health. Key findings of the survey, conducted from November to December 2021, include: • Pharmacists Will Expand Responsibilities: Looking toward the field of pharmacy in 2030, a majority of pharmacists see a transition from transactional care to more direct patient care responsibilities. At the forefront of this trend are pharmacists in ambulatory clinics, health systems (hospitals) and home delivery pharmacies, who already often serve as specialists advising patients with specific diseases or interact with a larger health team to help manage complex patient care. • Providers, Patients Trust Pharmacists: Nearly 80% of patients said they see pharmacists as an integral part of their health care team. Providers reported a high level of trust, often exceeding 90%, in pharmacists’ current professional activities, including dispensing medications, communicating with health professionals and patients about potential adverse drug interactions, counseling patients on their medications, and administering vaccines. Notably, providers who collaborate with pharmacists have increasing

WHAT READERS ARE SAYING ABOUT

trust in pharmacists providing direct patient care and prescribing medications. • Advanced Care Requires Advanced Training: Pharmacists recognize that patients need more consistent clinical counseling and disease education, but say training will be a focus in key areas to fill gaps in patient care. More than half (53.3%) of pharmacists agreed their current training and education is sufficient to manage patients. However, pharmacists did identify opportunities for additional training in chronic disease education, diagnosing, and prescribing. • As Roles Evolve, So Does Patient Engagement: The study shows that nearly half (49.7%) of patients would find it very helpful to have routine testing and medical visits done from home. More than half of home delivery pharmacists report engaging more with patients via telepharmacy, while about 15% of retail pharmacists report using telepharmacy. Of pharmacists who use this technology, more than a third say it gives them more time to interact with patients, allowing them to provide crucial information and support when — and where — patients need it most. “While the role of pharmacists has been expanding in some areas of healthcare, the COVID-19 pandemic has spotlighted their accessibility and the trust people have in them as health care professionals,” said pharmacist Susan Peppers, vice president of Express Scripts Pharmacy, one of the nation’s largest and most experienced home delivery pharmacies that fills 281 million prescriptions every year.

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February 2022 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • Page 19

Maggie Keller is the executive director of The Lothlorien Therapeutic Riding Center in East Aurora. “In the beginning, this was for individuals that had a different ability (physical, cognitive, or emotional) and then we started to see the healing power of being with these horses here.”

The Healing Power of Horses: Lothlorien Therapeutic Riding Center

Therapeutic riding promotes growth in persons with many conditions By Amanda Jowsey

“W

hen you cannot walk, let me help you run. When you are afraid, let me teach you to trust. When you are weak, let me help you build strength. When you can’t find your voice, let us speak without words. When you want to give up, let me show you how far you can go.” This is the motto of the therapy horse. Equestrian therapy assists with cognitive, physical, emotional and social well-being. According to the Anxiety Treatment Center, therapeutic riding promotes growth in persons with ADD, anxiety and depression, PTSD, dementia, autism, cerebral palsy, traumatic brain inju-

ries, developmental delay, behavioral issues and many other conditions. The Lothlorien Therapeutic Riding Center in East Aurora focuses exclusively on facilitating this unique healing experience for countless individuals. They have been an invaluable community resource for the Buffalo area. They exist to foster the human-horse connection with one mission in mind: to help all people, no matter their situation, live their healthiest and happiest lives. Founded in 1983, Lothlorien now serves an average of 700 people a year and has more than 200 volunteers. Executive director Maggie Keller explained how the center has transformed over time: “In the beginning, this was for individuals that had a different ability (physical,

cognitive, or emotional) and then we started to see the healing power of being with these horses here.” They realized this therapy can help anyone with or without a diagnosis. “It’s for anybody that’s looking for some type of healing. This is the place to come,” Keller said. Lothlorien provides an experience like no other. It is an important supplement to traditional therapies. “We don’t say we’re therapists, because we’re not; but it’s all the secondary benefits from the horses that are amazing,” Keller said. “We see miracles here every day. And I think it’s the healing power of the horse. The connection is amazing. It’s beautiful to watch. We’re just a facilitator. That’s really where the magic happens is between the horses and the individuals that come here.” Katie Macre, program manager at LTRC, added: “Therapeutic riding means much more than sitting on a horse. The goals for each student vary and the benefits are endless.” Fine motor skills increase from adjusting how the reins are held. Gross motor skills advance by mounting and dismounting the horse. Confidence grows through conquering fears. Core strength, balance and coordination all show improvement. “We have had students speak for the first time on their horse, interact more at home and school after riding, and show progress from riding with complete support to riding independently. We have watched a rider struggle to complete a task, only to succeed with the help of their fourlegged friend,” Macre said. Their specially trained therapy horses are thoughtfully selected for individuals. “Our ‘good citizen’ horses are selected for soundness, temperament, willingness and a patient attitude... They are trained to accommodate youth and adults of all ability levels to both ride and work with on the ground. They have a personality that is accepting of diverse situations including, but not limited to, a rider that may not be balanced, is very vocal or uses a wheelchair or walker,” Macre explasined. In January of 2020, LTRC became an affiliate of People Inc., expanding their mission to help people reach their highest potential through therapeutically based equine activities. Lothlorien’s Way of the Warrior Veterans program collaborates with the Wounded Warrior Project to help veterans heal from their physical, mental or emotional wounds. Lothlorien has also worked with the Amputee Support Group of WNY. LTRC works with several dif-

Page 20 • IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • February 2022

ferent school districts throughout the area including the East Aurora BOCES Program. They also have a reading program with the Buffalo Boys and Girls Club called the Lothlorien Kids’ Pony Express where children come to practice reading aloud to horses in a judgement-free place. “[Children] may not want to read in front of their class, but when they read to the horse, there’s nobody telling them that they’re wrong. The horses will put their head over and put their heads right in the book,” Keller said. “It’s all a matter of thinking outside the box and trying something different.” She believes that the horses encourage creativity and freedom that cannot be found in another setting. Through the generosity of The Children’s Guild Foundation, they were able to put in a sensory trail that meanders through the back of their beautiful property. It can be enjoyed on horseback or walking with the horses. Interns studying Occupational, Physical and Speech therapy at D’Youville College helped design the trail. There are many different tactile or olfactory stations along the way. “We made a palette of different herbs you can touch and smell. We put musical instruments up in the trees, so if you’re on horseback you can reach and hear them,” Keller said. Different footing on the ground also offers different sensations. Three is the minimum age to participate in a program; there is no maximum age. Participants must have medical clearance from their physician. All instructors are certified or trained riding instructors and are CPR/AED trained. The cost of a four-week group lesson (one hour per week with up to four riders per group) is $200. Semi-private (two riders) and private lessons based on need are available. This equine-assisted therapy isn’t covered by insurance, but some insurance companies accept the program as a reimbursable expense. LTRC also offers a tuition assistance program for those with financial need. “We’ve never turned anyone away that could not self-pay,” Keller said. Lothlorien relies on grants and donations. “We’re always looking to add to the list of people that can help us,” Keller said. A wish list can be found on their website. LTRC is proud to offer this experience to the Buffalo area. They are always open to scheduling visits and love giving tours of their land.