News and Articles

Stay up to date on Noyes Health news

November 12, 2017

Diabetes Food – Myths and Realities

November is National Diabetes Month. During the month, we are looking at some of the myths surrounding this condition. This week, the myths are about food and diabetes. Myth #1: Now that I am diabetic, I can’t have any sweets and chocolate. Reality: Diabetes is a condition that effects how the body is able to use glucose from all the foods we eat which leads to a higher than normal blood sugar. Sweets and chocolate do affect your blood sugar but they also affect your weight. Your physician may want you to cut back on these items to help lower your weight. Will you never eat sweets or chocolate again? Probably not. Should you be aware of what these food choices are doing to your weight and blood sugar? Absolutely! Myth #2: A diabetic should not eat any fruits and vegetables or a diabetic should eat lots of fruits and veggies because they are good for you. Reality: All foods in moderation. Fruits and vegetables are among the foods with carbohydrates along with milk and grains. We are all individual. Some foods will send blood sugars very high in one person and not impact the next person much at all. Today, diabetes educators and registered dietitians look at the total carbohydrate intake and the volume of food at any given meal. The role of the diabetic is to make notes about what they have eaten and with glucometers in hand, learn what impact certain foods have on their blood sugar readings. The diabetic is then in charge of making food and servings size changes. Myth #3: You must eat special diabetes food when you are diabetic. Reality: NO. Diabetics need to watch the carbohydrate intake of foods. Foods labeled for diabetics have adjusted the carbohydrate content of the foods, but check the label. In making this adjustment, the manufacturer may have increased other ingredients such as fats or sodium content to compensate for other ingredient changes. You may find it easier and less expensive to purchase a regular brand, note the amount you have had and again with glucometer in hand, learn what impact the food has on your blood sugar. Myth #4: Healthy food won’t increase blood sugar. Reality: Any food with carbohydrates has the potential to raise blood sugar. It is supposed to because the body’s main source of energy is glucose and the only source of energy our brain will use. Glucose comes from foods with carbohydrates and healthy foods contain carbohydrates; milk, fruits, vegetables and whole grains. The body’s goal is to move the glucose from the blood into the cells and insulin must be present for this to happen. Everyone should eat healthy foods, the challenge for someone with diabetes is learning how much of these healthy foods to have at one time. Testing blood sugars at different times after eating will help the diabetic discover just that. Myth #5: With diabetes, you can’t eat potatoes, bread, rice or pasta ever again. Reality: This does need repeating. Any food with carbohydrates will raise blood sugar. In many individuals, grains raise blood sugar more than fruits, vegetables or milk. That does not mean you never eat these foods again. It does mean, watch portion size and with your glucometer, learn the impact on your blood sugar. Registered Dietitians (RD) are a part of every ADA Recognized Diabetes program. When was the last time you met with an RD or took a nutrition class? Nancy M. Johnsen RN, CDE is a Certified Diabetes Educator, Community Health Education Coordinator, and Coordinator of the Diabetes Education Program at Noyes Health. The program has locations in Geneseo, Dansville, Hornell and some local physician offices. If you have questions about diabetes, contact Nancy at 585-335-4355. ... Read More

November 6, 2017

Diabetes – Myths and Facts

November is National Diabetes Month. For the next few weeks, we will look at some of the myths surrounding this condition. This week, we’ll look at general diabetes information. In future weeks, the truth concerning diet, medications, and testing will be explored. Diabetes is on the rise. Every year 1.5 million more Americans are diagnosed with diabetes. According to the Center for Disease Control (CDC), in 2015, 30.3 million Americans, or 9.4% of the population, had diabetes. Of those 30 million, approximately 1.25 million American children and adults are type 1 diabetics. The remainder are type 2 diabetics. Myth #1. You can catch diabetes from someone else. Reality: NO! Diabetes is not contagious like a cold or flu. For some individuals there may be a genetic link but for many, diabetes is lifestyle related. Myth #2. If diabetes is not in my family, I don’t have to worry as I won’t get it. Reality: Many diabetics have no family history of the disease. There are risk factors for diabetes that we cannot control such as age, ethnic background, gestational (pregnancy) diabetes, and family history. However, many cases of diabetes are due to lifestyle. Weighing too much and being sedentary are contributing factors. As a society, we move less. Think about it, when was the last time you got out of your chair to change a TV channel? Myth #3. You get diabetes from eating too much sugar. Reality: You do not get diabetes just from eating too much sugar. The reality is many folks overeat nutritious and not-so nutritious foods. This myth is based on the belief that people overeat sweets when the reality is overly large portions of all foods is to blame. That being said, as was pointed in myth #2, there are other factors to consider in the diagnosis of diabetes not just the food consumed. Myth #4. Someone says they have “borderline diabetes” or a “touch of diabetes.” Reality: There is no such diagnosis as having “Borderline” or a “Touch” of diabetes. The term is “Pre-diabetes”, which is a fasting blood sugar between 100-125mg. According to the CDC, pre-diabetes now affects over 5 million New Yorkers or 36.2% of the population; of this number some New Yorkers could be among the 65% - 70% who will go on to become diabetic. Myth #5: Type 1 diabetes is worse than Type 2 diabetes. Reality: This myth has historic roots. It goes back to the time before insulin was discovered. At that time, physicians understood that the person had a problem with the metabolism of food. The treatment was to take away most of the individual’s food. As a consequence, the person, usually a child, died. With the discovery of insulin, this changed. Many type 1 individuals are able to live long, productive lives. Both type 1 and type 2 diabetes are serious as both types can result in high blood sugars which may lead to serious complications. Myth #6: If I get diabetes, or have pre-diabetes, there is nothing I can do. Reality: There is a lot you can do starting with a meeting with your health care provider and following up with a Certified Diabetes Educator (CDE). A Certified Diabetes Educator is an individual with years of diabetes training. He or she is qualified by passing a certification exam and completing a certain number of required hours. In addition, the CDE stays up to date with current trends and research. This person will help you understand the disease process, the treatment your physician has prescribed, how to exercise, what to eat, how to test your blood sugar and more. CDE’s work in Diabetes Programs recognized by the American Diabetes Association or the American Association of Diabetes Educators. Nancy M. Johnsen RN, CDE is a Certified Diabetes Educator, Community Health Education Coordinator, and Coordinator of the Diabetes Education Program at Noyes Health. The program has locations in Geneseo, Dansville, Hornell and some local physician offices. For more information about diabetes, Nancy can be reached at 585-335-4355. ... Read More

October 27, 2017

Antibiotic Resistance Awareness

Alexander Fleming, a Scottish bacteriologist, discovered penicillin in 1928. By the early 1940s, this antibiotic miracle drug was being used to fight off everything from blood infections to syphilis. However, the miracle was short-lived. According to the National Academy of Sciences penicillin-resistant, staph bacteria emerged as early as 1942. Today, 75 years later, all Staphylococcus aureus are penicillin resistant. This is the story of antibiotics and bacteria. As the World Health Organization (WHO) explains, antibiotic resistance happens when bacteria change and become resistant to the antibiotics used to treat the infections they cause. As a result, medicines become ineffective and infections persist in the body, increasing the risk of spread to others. Without effective antibiotics for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarean sections or hip replacements) become very high risk. A growing number of infections such as pneumonia, tuberculosis, and gonorrhea are becoming harder to treat as the antibiotics used to treat them become less effective. Even the simple ear infection may require two to four courses of various antibiotics due to resistance. This problem is so widespread that the WHO and the CDC have called it a global threat. Their concern is that today’s problem will be tomorrow’s crisis. To understand the scope of the problem, one needs to look at the numbers. In India, 58,000 babies died in one year from super-resistant bacterial infections. In the European Union, antibiotic resistance causes 25,000 deaths per year and 2.5 million extra hospital days. In Thailand, antibiotic resistance causes over 38,000 per year and 3.2 million hospital days. Moreover, in the United States antibiotic resistance causes 23,000 deaths per year and more than 2 million illnesses. The WHO lists the following six reasons as causes of antibiotic resistance: Over-prescribing of antibiotics - The overuse and misuse of antibiotics is by far the single most important factor leading to antibiotic resistance around the world. Up to 50% of all the antibiotics prescribed for people are not needed or are not optimally effective as prescribed. It is estimated that more than half of antibiotics are unnecessarily prescribed to children for cough and cold illnesses, most of which are caused by viruses. Patients not finishing their treatment Over-use of antibiotics in livestock and fish farming - Antibiotics are commonly used for promoting growth in food animals. Animals develop resistant bacteria in their guts. The drug-resistant bacteria can remain on meat from animals. When not handled or cooked properly, the bacteria spreads to humans. Poor infection control in hospitals and clinics Lack of hygiene and poor sanitation Lack of new antibiotics being developed During November 13-19, the annual U.S. Antibiotic Awareness Week will be observed. The theme of the campaign, “Antibiotics: Handle with Care,” reflects the overarching message that antibiotics are a precious resource and should be preserved. In particular, antibiotics are not always the answer. The CDC recommends that patients know the following before heading to the doctor’s office. What can you do? Only use antibiotics when prescribed by a certified health professional Always take the full prescription, even if you feel better Never use left-over antibiotics Never share antibiotics with others Prevent infections by regularly washing your hands, avoiding close contact with sick people, practicing safer sex, and keeping your vaccinations up to date. What to ask your physician? What is the best treatment? Antibiotics are not needed for common illnesses like colds, most sore throats, the flu and even some ear infections. These illnesses are often caused by viruses, which do not respond to antibiotics. Sometimes the best treatment is symptom relief. Is this the right antibiotic for this infection? It is important to use an antibiotic that is designed to fight the bacteria causing the specific illness. Ask if the antibiotic prescribed, is the most “targeted” to treat the infection while causing the least side effects. What can I do to feel better? Pain relievers, fever reducers, saline nasal spray or drops, warm compresses, liquids, and rest may be the best thing. Ask your healthcare provider what symptom relief is best. Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. If you suggestions or questions, please contact her at lwichtowski@noyeshealth.org or 585-335-4327. ... Read More

October 21, 2017

Halloween Safety

On October 31, our streets will be invaded by goblins, princesses, celebrities, and comic book heroes and they will all be chanting the same mantra, “Trick or Treat!” For many, fall celebrations like Halloween or Harvest parties are a chance to dress up in costume, gather with friends, and eat delicious treats. Halloween night can also be a bit scary when it comes to safety. According to Safekids.org, only one-third of parents talk to their kids, annually about Halloween, although three-fourths report having Halloween safety fears. Those fears are warranted in that twice as many as child pedestrians are killed while walking on Halloween compared to other days of the year. That statistic may in part be due to lack of reflective tape and adult supervision. Only 18% of parents use reflective tape on their children’s costumes and 12% of children five years of age or younger are permitted to trick-or-treat alone. To combat these numbers and make Halloween as safe and fun as possible, Safekids.org and the American Academy of Pediatrics recommend the following safety tips: Walking and Traffic Safety Children under 12 should trick-or-treat and cross streets with an adult. Always walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the side as possible. Cross the street at corners, using traffic signals and crosswalks. Cross the street as a group when possible. If older children are going alone, plan and review the route ahead of time. Agree on a specific time when they should return home. Consider providing the child with a cell phone. Review emergency procedures and how to dial 911. Put reflective tape on costumes and bags for easy visibility. Only go to homes with a porch light on and never enter a home or car for a treat. Instruct children to only visit well-lit homes and never accept rides from strangers. Motorist Safety Drivers should slow down and be especially alert in residential neighborhoods. Put away all cellular devices and turn down the radio. Children are excited on Halloween and may move in unpredictable ways. 2. Watch for children walking on roadways, medians and curb. 3. Enter and exit driveways and alleys carefully. 4. At twilight and later in the evening, watch for children in dark clothing. Costume Safety Plan costumes that are bright and reflective. Make sure shoes fit well and costumes are short enough to prevent tripping. Masks can block or limit eyesight, consider non-toxic makeup or hats instead. Buy only flame resistant costumes, wigs, and accessories. Swords, knives, and other costume accessories should be short, soft, and flexible. Obtain flashlights with fresh batteries for all children and their supervisors. Do not use decorative contact lenses. Decorative contacts without a prescription are both dangerous and illegal. These lenses can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss. Home Safety Small children should never carve pumpkins. Little ones can draw a face with markers and parents can do the cutting. Consider using a flashlight or glow stick instead of a candle to light your pumpkin. If using a candle, choose a votive and place pumpkins on a sturdy table, away from curtains and other flammable objects. Never leave a lit pumpkin unattended. Check outdoor lighting prior to Halloween. Replace burned-out bulbs. Sweep sidewalks and steps to remove any wet leaves or snow. Keep your pets away from trick-or-treaters. Many little ones are fearful of animals and the animal may inadvertently jump on or bite a child. Tummy Safety Eat a good, well-balanced meal before heading out on the Halloween trail. This will discourage youngsters from filling up on Halloween treats. Wait until children are home to sort and check treats. Tampering is rare; however, an adult should closely examine all treats and throw away any spoiled, unwrapped, homemade treats made by strangers, or suspicious items. Try to ration treats for the days following Halloween. Consider putting candy in the freezer and allotting a few pieces per day. For more information about Halloween safety tips, visit any of the following websites: http://www.cdc.gov/family/halloween/, https://www.safekids.org/halloween or the American Academy of Pediatrics Halloween safety page at www.aap.org. Happy Halloween and be safe out there! 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

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

Pages