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October 16, 2017

Caregiving in America

In the poem, Untitled by Carol Dix, she states, “I look into your face, Your eyes stare into space, I try to search deep into your soul, To find the man I once knew, But he is not there. The emptiness goes beyond compare. Where are you..? I ask. Where have you gone..?” Dix speaks to the millions of caregivers who witness Alzheimer’s, dementia, and other chronic diseases steal away their loved ones. If statistics run true, more and more of us will be caregivers to loved ones with Alzheimer’s or dementia. According to the Alzheimer’s Association, over 5 million Americans are living with Alzheimer’s. By 2050, this number could rise as high as 16 million. Those sobering numbers illustrate how taxing this disease is on society, the patients, and those who care for them. November is National Family Caregiver’s month, a time to concentrate on the services and support available to caregivers. The job of caregiving is tiring, stressful, and at times painful emotionally and financially. In 2016, 15.9 million family and friends provided 18.2 billion hours of unpaid assistance to those with Alzheimer's and other dementias, a contribution to the nation valued at $230.1 billion. Approximately two-thirds of caregivers are women, and 34 percent are age 65 or older. Forty-one percent of caregivers have a household income of $50,000 or less. Approximately one quarter of dementia caregivers are "sandwich generation" caregivers — meaning that they care not only for an aging parent, but also for children under age 18. Alzheimer's takes a devastating toll on caregivers. Compared with caregivers of people without dementia, twice as many caregivers of those with dementia indicate substantial emotional, financial and physical difficulties. These numbers can be staggering but there is hope and help for caregivers. Knowing the stages of caregiving and your resources can assist you during this time of transition. Just as the patient with Alzheimer’s or another chronic disease will go through stages, so too, will the caregiver. Your role will change from being a care partner to a caregiver. As time progresses and the loved one depends more and more on you, it is important to take care of yourself. The Centers for Disease Control and Prevention offers this advice to caregivers: Keep up with your own medical care. Don't skip regularly scheduled preventive care, such as flu shots or mammograms. Make sure to get enough rest. Inadequate sleep impairs your ability to give care. Continue or start to get regular physical activity. In addition to a variety of benefits for your physical health, regular physical activity is one of the best stress reducers available. Continue to nurture your own social relationships. A strong social network can help you cope with stress and provide support. Reach out for help when you need it. Get acquainted with your local support services. Locally, there are events and services available for caregivers. On Saturday, November 4, 2017, from 10 am to 2 pm, UR Medicine Noyes Health in conjunction with the Alzheimer’s Association, Kiwanis Club of Geneseo, Mental Health Association, Livingston County Office for the Aging and Mama Cindy will sponsor the annual Caregiver Retreat. The event will take place at the Celebrate Family Church in Leicester, is free of charge for caregivers, and includes a complimentary lunch. This year’s keynote speaker is Elaine W. Miller, popular international author and speaker. She has brought Splashes of Serenity to audiences for over 25 years. Ms. Miller will encourage caregivers with, Sink or Swim (SOS): Three Things You Will Never Change About Your Life and Ten Things You Can. In addition, a speaker panel will include Roseann Kraus of the Alzheimer’s Association, Christa Barrows, Caregiver Resource Center Coordinator at Noyes Health, Jose Cruz of Lifespan Finger Lakes Caregiver Institute, and John Vogel, Dansville Attorney. Registration is required and residents from Livingston County and surrounding counties are invited. Call 585-335-4358 or email: caregiver@noyeshealth.org to register. Also available locally is the Noyes Caregiver Resource Center, a collaborative effort between UR Medicine Noyes Health and the Livingston County Office for the Aging. The center comes alongside family caregivers in Livingston County and provides them with the support they need to meet the challenges that come with caring for someone at home with Alzheimer’s, dementia, or another chronic health condition. The Caregiver Resource Center supports caregivers by providing information and assistance, education, support groups, and respite care services. Caregivers often neglect themselves and suffer with high rates of stress-related illness that can affect their ability to be successful caregivers. Taking care of yourself and learning about resources is vital to the patient, the household, and the caregiver. For more information on the Noyes Caregiver Resource Center or if you are interested in volunteering to provide respite services for caregivers, call 585-335-4358 or email: caregiver@noyeshealth.org. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. If you have questions or suggestions for future articles, contact her at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

October 9, 2017

Yoga – Ancient Practice Meets Modern Medicine

I am what you call a Tigger. You know - the bouncy one in Winnie the Pooh. I like to move, generally have lots of energy, and talk a fair amount. For these reasons and more, I have written off yoga for years. One, I thought you had to bend like a pretzel (and be super toned, young, and beautiful). Two, I assumed some sort of chanting was involved (I’m not exactly a chanting kind of gal). Three, I could not imagine myself calming down for a half hour or more. However, research reports supporting the practice of yoga continued to pour across my desk. I decided it was time to try yoga for myself. Research indicates this ancient practice may indeed be more than a good stretch and time to get in tune with oneself. It may be an integral part of future preventive and healing medicine. While there are several different types of yoga, the modern yoga I attended was based on Hatha yoga, the most commonly practiced in the United States and Europe. It emphasizes postures (asanas) and breathing exercises (pranayama). For one hour, I concentrated on breathing deeply, holding, and moving through various yoga positions. My mind was engaged in the process the whole time and amazingly enough did not wander. Afterwards, I felt refreshed and relaxed. For someone who likes to work out and push herself, yoga proved to be both relaxing and challenging. More Americans than ever are trying yoga. According to the Yoga in America Survey, over 20 million citizens of all ages are practicing yoga on a regular basis. The reasons people choose to incorporate yoga into their lives varies but most center on physical well-being and stress relief. The top five reasons for practicing yoga according to the 2016 Yoga in America Study Conducted by Yoga Journal and Yoga Alliance are: flexibility (61 percent), stress relief (56 percent), general fitness (49 percent), improve overall health (49 percent), and physical fitness (44 percent). Continued yoga will definitely improve all those categories. In addition, the National Center for Complementary and Integrative Health (a department of the National Institutes of Health) reports that science now has at least some proof that yoga may in the future be part of a treatment plan for lower back pain and more. Here is what the National Center for Complementary and Integrative Health reports to date: Current research suggests that a carefully adapted set of yoga poses may reduce low-back pain and improve function. Other studies also suggest that practicing yoga (as well as other forms of regular exercise) might improve quality of life; reduce stress; lower heart rate and blood pressure; help relieve anxiety, depression, and insomnia; and improve overall physical fitness, strength, and flexibility. One NCCIH-funded study of 90 people with chronic low-back pain found that participants who practiced Iyengar yoga had significantly less disability, pain, and depression after 6 months. In a 2011 study, also funded by NCCIH, researchers compared yoga with conventional stretching exercises or a self-care book in 228 adults with chronic low-back pain. The results showed that both yoga and stretching were more effective than a self-care book for improving function and reducing symptoms due to chronic low-back pain. Conclusions from another 2011 study of 313 adults with chronic or recurring low-back pain suggested that 12 weekly yoga classes resulted in better function than usual medical care. However, studies show that certain health conditions may not benefit from yoga. A 2011 systematic review of clinical studies suggests that there is no sound evidence that yoga improves asthma. A 2011 review of the literature reports found that few studies looked at yoga and arthritis. Those that did were inconclusive. The two main types of arthritis—osteoarthritis and rheumatoid arthritis—are different conditions, and the effects of yoga may not be the same for each. In addition, the reviewers suggested that even if a study showed that yoga helped osteoarthritic finger joints, it might not help osteoarthritic knee joints. Further research is required to determine the potential benefits for arthritis. Furthermore, there are side effects and risk associated with certain conditions. Yoga is generally low-impact and safe for healthy people when practiced appropriately under the guidance of a well-trained instructor. Overall, those who practice yoga have a low rate of side effects, and the risk of serious injury from yoga is quite low. However, certain types of stroke as well as pain from nerve damage are among the rare possible side effects of practicing yoga. Women who are pregnant and people with certain medical conditions, such as high blood pressure, glaucoma (a condition in which fluid pressure within the eye slowly increases and may damage the eye’s optic nerve), and sciatica (pain, weakness, numbing, or tingling that may extend from the lower back to the calf, foot, or even the toes), should modify or avoid some yoga poses. Always speak with your physician before starting any new exercise. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. For article suggestions, questions, or comments, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

October 2, 2017

Breast Cancer Awareness

October is breast cancer awareness month and the pink ribbons are flying. Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. The American Cancer Society estimates that there will be close to 252,000 new cases of invasive breast cancer and over 63,000 cases of carcinoma in situ (CIS), the earliest form of breast cancer, diagnosed in 2017. In addition, almost 41,000 women will die from breast cancer this year. Survival rates, however, are on the rise. Currently, there are more than 3.1 million breast cancer survivors in the United States. Understanding the risk factors and receiving screening is the key to survival. According to the American Cancer Society, risk factors fall into two major categories: 1) risk factors not related to personal choice (no control) and 2) life-style related risk factors. Risk Factors Not Related to Personal Choice (those things we have no control over) Simply being a woman. Breast cancer is about 100 times more common in women than in men. This is most likely due to higher levels of estrogen and progesterone in women. Growing old. Your risk of developing breast cancer increases as you age. Most breast cancers are found in women age 55 or older. Genetics. About 5-10% of breast cancer cases are thought to be hereditary, the direct result of a gene defects inherited from a parent. Family history of breast cancer. Have one first-degree relative (mother, sister, or daughter) with breast cancer almost doubles a woman’s risk. Having two first-degree relatives increases her risk 3-fold. Overall, less than 15% of women with breast cancer have a family member with this disease. Personal history of breast cancer. A woman diagnosed with breast cancer has an increased risk of developing a new cancer in the other breast or in another part of the same breast. Race and ethnicity. White women are slightly more likely to develop breast cancer than are African-American women. However, in women under age 45, breast cancer is more common in African American women. Dense breast tissue. Women with more glandular and fibrous tissue in their breasts and less fatty tissue are said to have dense breasts. Women with dense breasts on a mammogram have a breast cancer risk that is 1.5 to 2 times that of women with average breast density. Early periods and late menopause. Women who have had more periods because they started menstruating before age 12 or went through menopause after age 55, have a slightly higher risk of breast cancer. Radiation exposure. If a woman received radiation treatments to her chest as a child or young adult, her risk of breast cancer is increased. Exposure to diethylstilbestrol (DES). From the 1940s through the early 1970s, some pregnant women were given an estrogen-like drug called DES because it was thought to lower their chances of miscarriage. These women have a slightly increased risk of breast cancer. Lifestyle-related risk factors Having children. Women who have never been pregnant or who had their first child after age 30 have a slightly higher breast cancer risk overall. Birth control. Women who use birth control pills have a greater risk of breast cancer than women who never used them. Some studies found that women using birth control shots (Depo-Provera) seem to have an increase in breast cancer risk. Hormone therapy after menopause. Studies indicate that using combined hormone therapy (estrogen and progesterone) after menopause increases the risk of getting breast cancer. Breastfeeding. Some studies suggest that breastfeeding may slightly lower the breast cancer risk, especially if it is continued for 1 ½ to 2 years. Drinking alcohol. Drinking alcohol is linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Those who have 2 to 3 drinks daily have about 20% higher risk compared to women who do not drink alcohol. Being overweight or obese. Being overweight after menopause increases the breast cancer risk. Before menopause, ovaries produce the majority of estrogen. After menopause, most of a woman’s estrogen comes from fat tissue. Higher amounts of fat may lead to elevated estrogen levels and put a woman at greater risk for cancer. Physical activity. A Women’s Health Initiative study suggested that as little 1.25 to 2.5 hours per week of brisk walking reduced a woman’s risk of breast cancer by 18%. Walking 10 hours per week reduced the risk even more. Besides knowing your personal risk factors, it is also important to be screened for breast cancer. To screen for breast cancer, health care providers use mammograms, breast ultrasounds, and breast MRIs. While there is not complete consensus in the medical field regarding at what age to start screening, many recommend age 40 including the Mayo Clinic and UR Medicine Noyes Health. Discuss all your risk factors with your doctor to determine the right screening and age for you. For more information about breast cancer risks, symptoms, screening, and treatments, connect with the American Cancer Society at https://www.cancer.org/cancer/breast-cancer.html the Centers for Disease Control and Prevention at http://www.cdc.gov/cancer/breast or the National Cancer Institute at http://www.cancer.gov/types/breast. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. If you have questions or suggestions for future articles, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

September 22, 2017

Prostate Cancer Awareness

Approximately 161,000 men will be diagnosed with prostate cancer this year and almost 27,000 will die. After skin cancer, prostate cancer is the most common cancer for men. Prostate cancers, however, usually grow slowly and most men with prostate cancer are older than 65 years and do not die from the disease. Because of its slow growth, lower mortality rate, and serious treatment side effects, screening for prostate cancer is controversial. The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen. As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. This is called benign prostatic hyperplasia, and it is not the same as prostate cancer. According to the CDC, the following are risk factors for prostate cancer: Age: The older a man is, the greater his risk for getting prostate cancer. Family history: Certain genes (passed from parent to child) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself. Race: Prostate cancer is more common in African-American men. It tends to start at younger ages and grow faster than in other racial or ethnic groups, but medical experts do not know why. Like so many cancers, symptoms vary from person to person. Some men experience no symptoms. In general, however, a man may experience one or more of the following symptoms if he has prostate cancer: Difficulty starting urination Weak or interrupted flow of urine Frequent urination, especially at night Difficulty emptying the bladder completely Pain or burning during urination Blood in the urine or semen Pain in the back, hips, or pelvis that doesn’t go away Painful ejaculation Two common screening tests for prostate cancer are: Digital rectal exam (DRE): A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities. Prostate specific antigen (PSA) test: Measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate. As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. However, many factors, such as age, race, medical procedures, medications, an enlarged prostate, or infection can affect PSA levels. Some prostate glands make more PSA than others. Because so many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. Only a biopsy can diagnose prostate cancer for sure and even then, your doctor may not recommend treatment. If the cancer is small and low risk, you and your doctor may decide on active surveillance, which means closely monitoring with PSA tests and biopsies over time to see if there are any changes. As mentioned, most prostate cancers found by screening are small and slow growing and may not be fatal. In addition, the side effects from radiation and/or surgery may include impotence, loss of bladder control, and problems with the bowels. Due to these serious side effects and the fact that most prostate cancers are not fatal, medical groups do not agree on screening recommendations. Many believe screening is not necessary for most men. Others believe a baseline PSA level should be measured and looked at over time. The CDC indicates that the decision to be screened is a personal one. Men should work with their doctors to understand the benefits and harms of screening. Keep in mind that if a man chooses not to be screened, he can always change his mind in the future. In addition, if a man is screened and cancer is found, it does not necessarily mean immediate treatment. It is important to have these discussions with your doctor so he or she can discuss your risk factors and determine if screening is right for you. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. For article suggestions or questions, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

September 18, 2017

Gynecologic Cancer Awareness

September is Gynecologic Cancer Awareness Month. Every year, 90,000 to 100,000 women are diagnosed with gynecologic cancer and almost 30,000 die. Vagina, uterus, cervix, vulva, and ovary – not exactly dinnertime conversation vocabulary. Nonetheless, these words are particularly important to every woman. They are body parts just like an arm, leg, shoulder, or knee and need proper medical care and consideration. The female reproductive system is complex. Being in tune with it and one’s health in general is crucial for overall wellbeing and early diagnosis of cancer should it appear. There are five major types of gynecologic cancer are: Cervical cancer: Begins in the cervix, the lower part of the uterus (or womb). Ovarian cancer: Begins in the ovaries, located on each side of the uterus. Uterine cancer: Begins in the uterus, the pear-shaped organ in a woman’s pelvis where the baby grows when a woman is pregnant. Vaginal cancer: Begins in the vagina, the hollow tube-like channel between the bottom of the uterus and the outside of the body. It is also called the birth canal. Vulvar cancer: Begins in the vulva, the outer part of the female genital organs, which includes the inner and outer lips of the vagina, the clitoris, and the opening of the vagina and its glands. Signs and symptoms of each type of gynecologic cancer vary. The following is a list of symptoms typically associated with gynecologic cancers: Abnormal vaginal bleeding or discharge Feeling full too quickly or difficulty eating Pelvic pain or pressure More frequent or urgent need to urinate and/or constipation Bloating Abdominal or back pain Itching, burning, pain or tenderness of the vulva Changes in vulva color skin, such a rash, sores, or warts According to the CDC, there is no way to know which women will get gynecologic cancer. Each type has unique risk factors. However, HPV infections that do not go away increase the risk of getting several types of gynecologic cancer. HPV (human papillomavirus) is a common sexually transmitted virus that can cause cervical, vaginal, and vulvar cancers. Any woman who has ever had sex is at risk for getting HPV. Women are more likely to contract HPV if they started having sex at a young age or if the woman or her partner have had sex with multiple people. There is no known way, however, to prevent gynecologic cancers. Nonetheless, there are some things your can do to lower your chance of cancer or to catch it early when treatment will be most effective. The CDC recommends the following: Pay attention to your body and know what is normal for you. If you have any abnormal vaginal bleeding, or if you have any other signs and symptoms of gynecologic cancer for two weeks or longer and they are not normal for you, talk to a doctor right away. Make healthy lifestyle choices. For overall good health, eat a diet rich in fruits and vegetables; exercise regularly; maintain a healthy weight; avoid smoking; and practice safe sex. Know your family health history. Share it with your doctor. Get the HPV vaccine. The vaccine is recommended for preteens (both boys and girls) aged 11 to 12 years, but can be given as early as age 9 and until the age of 26. Get regular Pap tests. Pap tests (or smears) are one of the most reliable and effective cancer screening tests available. Pap tests can find precancerous changes on the cervix that can be treated so that cervical cancer is prevented. A Pap test can also find cervical cancer early when treatment is most effective. The only cancer the Pap test screens for is cervical cancer. Get the HPV test if your doctor recommends it. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. For article suggestions or questions, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

September 8, 2017

Understanding Cholesterol

High cholesterol is a sneaky thing. It does not happen overnight, there are no symptoms, and unless you get a blood test, there is no way to know if you have it. However, it can lead to heart disease the number one killer in the U.S. People with high total cholesterol have approximately twice the risk for heart disease as people with optimal levels. Overtime, too much cholesterol in your system clogs the arteries, narrows the channel for blood flow, and puts you at risk for heart disease and stroke. More than 102 million American adults (20 years or older) have total cholesterol levels above 200 mg/dL, which is above healthy levels and an additional 35 million have levels of 240 mg/dL, which puts them at risk for heart disease. Moreover, many factors potentially affect cholesterol such as genetics, diet, activity level, and other chronic diseases. Cholesterol is a waxy, fat-like substance found naturally in our bodies and in many foods, like meat and dairy products. Your body, mainly your liver, produces 75 percent of your cholesterol and your small intestine aids in both the creation and absorption of cholesterol. In addition, your diet can add 300 to 500 mg or more of cholesterol. A simple blood test called a lipoprotein profile can measure your total cholesterol levels, including LDL (low-density lipoprotein, or "bad" cholesterol), HDL (high-density lipoprotein, or "good" cholesterol), and triglycerides. LDL cholesterol makes up the majority of the body’s cholesterol. LDL is “bad” cholesterol because high levels lead to plaque buildup in your arteries and result in heart disease. HDL cholesterol, on the other hand, absorbs cholesterol and carries it back to the liver, which flushes it from the body. HDL is “good” cholesterol because high levels reduce the risk for heart disease and stroke. Triglycerides are a type of fat found in your blood that your body uses for energy. The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol can increase your risk for heart attack and stroke. Because high cholesterol has no symptoms, it is important to go to the doctor and get blood drawn for the lipoprotein profile. If you are 20 years or older and have not been diagnosed with heart disease, the CDC recommends your cholesterol be checked every 5 years. All children and adolescents should have their cholesterol checked at least once between the ages of 9 and 11 years, and again between ages 17 and 21 years. People of any age (including children) who are overweight/obese, have a family history of high cholesterol, a family history of heart disease, diabetes, high blood pressure, or certain chronic conditions (chronic kidney disease, chronic inflammatory diseases, congenital heart disease, and childhood cancer survivorship) should be checked more often. When the bloodwork results are in, your numbers will fall somewhere in this chart: Total Cholesterol Level Category Less than 200mg/dL Desirable 200-239 mg/dL Borderline high 240mg/dL and above High LDL (Bad) Cholesterol Level LDL Cholesterol Category Less than 100mg/dL Optimal 100-129mg/dL Near optimal/above optimal 130-159 mg/dL Borderline high 160-189 mg/dL High 190 mg/dL and above Very High HDL (Good) Cholesterol Level HDL Cholesterol Category Less than 40 mg/dL A major risk factor for heart disease 40—59 mg/dL The higher, the better 60 mg/dL and higher Considered protective against heart disease Source: National Heart, Lung, and Blood Institute Doctors, however, look at more than just the cholesterol numbers. Your physician will look at other risk factors for heart disease such as cigarette smoking, hypertension (high blood pressure), low HDL (good) cholesterol, family history of premature heart disease, fasting blood glucose level, gender, and age. Combining all these factors, your doctor will determine if you need a therapeutic lifestyle change (TLC) including diet, weight management, and increased physical activity or if you need TLC with medication to control your cholesterol. To maintain healthy cholesterol levels and help prevent heart disease, the CDC and the American Heart Association recommend the following: Don’t smoke. If you do smoke, quit. For help quitting, call the NYS Smoker’s quit line at 1-866-697-8487 or visit www.nysmokefree.com. Locally, call UR Medicine Noyes Health at 585-335-4327 or email lwichtowski@noyeshealth.org. Know what NOT to eat. What you eat can affect your LDL cholesterol. Avoid or limit foods high in saturated or trans fats. The majority of saturated fat comes from animal products such as beef, lamb, pork, poultry with skin, butter, cream, cheese and other dairy products made from whole or 2 percent milk. Trans fats (or trans fatty acids) are created in an industrial process that adds hydrogen to liquid vegetable oils to make them more solid. Another name for trans fats is “partially hydrogenated oils." Trans fats are in many fried foods and baked goods such as pastries, pizza dough, piecrust, cookies and crackers. Avoid fast food. One should also eliminate or severely limit all sugary drinks including soda, fancy coffee drinks with added sugar and dairy, and fruit juice. Know what to eat. The vast majority of your diet should include fruits, vegetables, whole grains (oats, barley, brown rice, quinoa, buckwheat, popcorn, whole-wheat crackers, pasta, or tortillas), low-fat dairy products, poultry, fish, beans, and nuts. Exercise regularly. Regular physical activity can lower LDL (bad) cholesterol and raise HDL (good) cholesterol. Adults should be physically active for at least 2 ½ hours each week – that breaks down to about 20 minutes a day of walking, biking, dancing, running, yoga…you choose! Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. For article suggestions or questions, contact Lorraine at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

August 31, 2017

Tips for a Healthy, Successful School Year

Healthy habits at home and school success go hand in hand. Numerous studies have linked good academic performance with healthy habits, regular routines, and communication skills. Setting the scene in early childhood and working together as a family team ensures a solid foundation for both good health and grades. The American Academy of Pediatrics and HealthierUS.gov offer the following tips for setting your child up for success this school year. Create a Healthy Home Life for a Successful School Life Decide on a bedtime that will give your child plenty of rest. 3-6 Years Old: 10 - 12 hours per day 7-12 Years Old: 10 - 11 hours per day 12-18 Years Old: 8 - 9 hours per day Provide a healthy breakfast every morning. Start the day with vegetable or fruit juice. Slice fruit on top of whole grain cereal or yogurt. Cook up some eggs with fruit and whole grain toast. Pack a healthy lunch. Include fruits, veggies, whole grain bread and a good protein like chicken, turkey, or hummus. Water or low-fat milk are good drinks. Avoid soda and salty snacks like potato chips. Limit screen time and music listening to one to two hours (including screen time at school) per day. Encourage outdoor play and sports. Children need at least 60 minutes of physical activity (running around being kids) every day. Be a good role model and play with your child. Adults need play and exercise time, too! Wash hands and use hand sanitizer. The best way to keep students healthy during the school year is to make sure they wash their hands before meals, after bathroom use, nose blowing, or playground use. When a sink and soap are not available, hand sanitizer is a great option. Sneeze and cough properly. Teach your child to cough or sneeze into the crook of his or her elbow. (Sneezing or coughing into a tissue and then washing hands is best but not always possible.) Stick to a routine (as much as possible). Most children thrive on structure and routine. They like to know what to expect. Set up a morning, afternoon, and evening schedule that includes when to play, when to eat, and when to do homework. Be organized. Set up a single place in the home to put backpacks, jackets, shoes, lunchboxes, and school projects each day. Everyone is stressed less when everything can be easily grabbed going out the door in the morning. Set up a homework zone. A designated homework space makes it easier and more fun for kiddos to complete their homework. A desk or stretch of kitchen counter with a basket full of necessary supplies works beautifully. Note: Children should not do homework in front of the TV, as it is distracting. Read to your kiddo every day. Reading is the single best indicator of academic success. Reading well is necessary for every subject matter and comprehension. Try to sit down and read with your child for at least 15-20 minutes per day. This should be a fun time of reading together. Go to the local library and let your child pick out books he or she likes. Learn and teach. Most of life does not involve research papers but it does involve cooking, cleaning, buying, and selling. Incorporate math, science, and reading into everyday life with your child. If you are cooking, read the recipe together, measure the ingredients, and of course, sample the product! Talk often. Give your little one a chance to talk. Ask open-ended questions such as “What was the best part of your day?” “What was the worst part of your day?” “What was the grossest thing that happened today?” By asking questions and listening, you will learn about your child’s likes, dislikes, anxieties, excitements, and disappointments. Get involved. Meet the teachers and stay in regular contact with them via phone or email. Ask questions, offer encouragement, and listen to their comments. Eat dinner together. Whenever possible, eat dinner together at the dinner table with all electronics put away (TV and smartphone). Children of families who eat together are more likely to succeed in school. It is also a great time to reconnect as a family and communicate about the day. Lorraine Wichtowski is a community health educator at Noyes Health in Dansville. If you have questions or suggestions for future articles, she can be reached at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

August 25, 2017

Screen Time – Not So Good For a Lifetime

Recently, I had an interesting conversation with a friend. She recounted her visit the previous weekend to a large metropolitan museum. As she and her husband wandered about the dinosaur, mummy, and gem exhibits, they saw several families with children. The overwhelming majority of the kiddos’ eyes were glued to smartphones and tablets. This was true for toddlers in strollers and hunched over, bored to be with mom and dad, teens. My friend’s description of the modern day scene made me think of my weekly trips to the grocery store. I routinely see toddlers in grocery cart seats swiping their pudgy fingers across a screen oblivious to the real world around them. It begs the question, what is all this screen time doing to our children? To us? While the jury is out about all the long-term ramifications, the evidence is mounting that early childhood screen time literally can affect the brain for life and continued use upsets healthy social, emotional, and physical development. The rapidly growing brain is very sensitive to input and interaction between birth and the age of three. During this critical period, the child needs lots of interaction with the world to develop all the various parts of the brain. Playing, reading, talking, singing, and exploring are crucial for the development of problem solving, attention span, imagination, and positive social interactions. According to Liraz Margalit, in her article, “What Screen Time Can Really Do to Kids’ Brains,” tablets and iPhones are exactly what the brain does not need – too many fast-paced actions all at the same time. Margalit comments, “Tablets are the ultimate shortcut tools: Unlike a mother reading a story to a child, a smartphone-told story spoon feeds images, words, and pictures all at once to a young reader. Rather than having to take the time to process a mother’s voice into words, visualize complete pictures and exert a mental effort to follow a story line, kids who follow stories on their smartphones get lazy. The device does the thinking for them, and as a result, their own cognitive muscles remain weak.” Victoria Dunckly, M.D., author of Reset Your Child’s Brain, goes so far as to say screen time is disturbing physiological development that in turn creates mood disturbances. As a child and adolescent psychiatrist, she writes that whether there exists a true underlying diagnosis (depression, bipolar, ADHD), “successfully treating a child with mood dysregulation today requires methodically eliminating all electronics for several weeks to allow the nervous system to reset.” Dr. Dunckley lists the following six physical reasons electronics tend to produce mood disturbance: 1. Screen time disrupts sleep and desynchronizes the body clock. Because light from screen devices mimics daytime, it suppresses melatonin, a sleep signal released by darkness. Just minutes of screen stimulation can delay melatonin release by several hours and desynchronize the body clock. Once the body clock is disrupted, all sorts of other unhealthy reactions occur, such as hormone imbalance and brain inflammation. In addition, high arousal does not permit deep sleep, and deep sleep is how we heal. 2. Screen time desensitizes the brain’s reward system. Many children are “hooked” on electronics, and in fact, gaming releases so much dopamine—the “feel-good” chemical—that on a brain scan it looks the same as cocaine use. However, when reward pathways are overused, they become less sensitive, and more and more stimulation is needed to experience pleasure. This sets the scene for addiction. Meanwhile, dopamine is also critical for focus and motivation. Even small changes in dopamine sensitivity can wreak havoc on how well a child feels and functions. 3. Screen time produces “light-at-night.” Light-at-night from electronics has been linked to depression and even suicide risk in numerous studies. In fact, animal studies show that exposure to screen-based light before or during sleep causes depression, even when the animal is not looking at the screen. 4. Screen time induces stress reactions. Screen time whether it be the news or a violent video game can cause acute stress (fight-or-flight) and chronic stress. Stress produces changes in brain chemistry and hormones that can increase irritability. Cortisol, the chronic stress hormone, seems to be both a cause and an effect of depression—creating a vicious cycle. Additionally, both hyper-arousal and addiction pathways suppress the brain’s frontal lobe, the area responsible for keeping mood steady. 5. Screen time overloads the sensory system, fractures attention, and depletes mental reserves. Experts say that what is often behind explosive and aggressive behavior is poor focus. When attention suffers, so does the ability to process one’s internal and external environment, so little demands become big ones. By depleting mental energy with high visual and cognitive input, screen time contributes to low reserves. One way to temporarily “boost” depleted reserves is to become angry, so meltdowns actually become a coping mechanism. 6. Screen-time reduces physical activity levels and exposure to “green time.” Research shows that time outdoors, especially interacting with nature, can restore attention, lower stress, and reduce aggression. Electronics do just the opposite and reduce our exposure to a world that naturally puts you in a better mood. Lorraine Wichtowski is a community health educator at Noyes Health in Dansville. If you have questions or suggestions for future articles, she can be reached at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

August 18, 2017

Fall Prevention

An older adult falls every second of every day. Those falls are the number one cause of death from injury and injuries among older Americans. Every year, more than 27,000 die because of falls – that is 74 older adults every day. As we age, we are more likely to fall. The percentage of adults between the ages of 65 and 74 that report a fall is 27% versus 37% for folks 85 years and older. Educating older adults, their families, and friends about the importance of fall prevention is paramount in keeping older Americans safe and containing healthcare costs. With over 10,000 people in the U.S. turning 65 every day, the healthcare burden is ever increasing. Falls and fall injuries cost over $31 billion per year. The financial costs and the impact on families will continue to rise unless preventive measures are adopted. Falls are not just a normal part of getting older – they are preventable. The CDC recommends the following simple steps for staying independent as long as possible. Speak Up. Talk openly with your doctor about fall risks and prevention. Tell your doctor right away if you have fallen, if you are afraid you might fall, or if you feel unsteady. Work together, review all of your medications, and discuss any side effects like feeling dizzy or sleepy. See if taking vitamin D supplements for improved bone, muscle, and nerve health is right for you. Keep Moving. Activities that strengthen your legs and help your balance (like Tai Chi or even walking on a regular basis) can help prevent falls. Check Your Eyes. Have your vision checked once a year and update your glasses as needed. Make Your Home Safe. Most falls happen at home. Keep your floors clutter free. Remove small rugs, tape them down, or secure them. Add grab bars in the bathroom. Have handrails and lights installed on all staircases in and outside the home. Make sure your home is well lit with plenty of lights in every room of the house. Take a class and learn about fall prevention. Locally, the 4th Annual Fall Prevention Workshop will be held on Friday, September 15, 2017 from 10:00 am to 1:30 pm at the Lakeville Training Grounds, 5939 Stone Hill Road in Lakeville. Speaker topics at the free workshop will include: Talking with Your Doctor Medications that Impact Your Fall Risks Your Eyes Help Keep You on Your Feet Home Safety and Medical Services In addition, all participants will: Learn strategies and skills to prevent falls in the home. Connect with available local fall prevention resources such as agencies, exercise and strengthening classes, and home safety. Be able to review medications with a local pharmacist A complimentary lunch will be served to all workshop attendees. This event is free but registration is required. To reserve your spot, contact Noyes Community Outreach Services by September 8. Call 585-335-4359 or email lifeline@noyeshealth.org. The event is sponsored by the Genesee Valley Health Partnership in collaboration with UR Medicine Noyes Health, Wegmans, the Livingston County Department of Health, and the Office for the Aging. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville. If you have questions or suggestions for future articles she can be reached at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

August 17, 2017

Sheriff’s Office expands drug drop box program

The Livingston County Sheriff's Office has added additional drug drop box locations in Caledonia and Dansville... Read More

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