Out With Bones, In With Beets: Our Ever-Evolving Passover Celebration

I’ve always loved the traditions of Passover, the Jewish holiday that commemorates the liberation of the Israelites from Egyptian slavery. Now that I have my own family, I’ve adapted my own traditions in ways I didn’t expect but find exciting. Our new family traditions are on display the most at the family meal of Seder, which marks the first of the eight-day observance. (This year, the first night of Passover is April 19.)

Everything on a Seder plate carries symbolism and purpose. But then, my daughter became a vegetarian. She was bothered by the bone that is traditionally displayed on the Seder plate.

So we did what any family would do: improvise.

Shevah’s daughter helps set the table for the Seder.

We spoke with other vegetarians and discovered they replaced the bone with a beet. She’s not bothered by the egg on the Seder plate, but some replace it with an avocado pit. It carries similar symbolism, but without involving animals. There are even new additions to the Seder plate such as adding an orange to represent gender equality.

Then there’s the meal. There’s some debate in my household about what’s allowed. My husband’s family has Sephardic roots (mainly Southern European) and observe different food customs, allowing beans and corn, for example, whereas my Eastern European ancestors did not. Last year, we had a lively discussion about quinoa! The verdict? We ate it!

And I still enjoy some of the foods from my childhood, including gefilte fish and chicken soup with matzo balls. It’s fun to experiment with matzo over the week-long holiday. We also enjoy a visit to the Model Matzha Bakery at the Louis S. Wolk Jewish Community Center of Greater Rochester.

Shevah’s son at the Model Matzha Bakery.

The Old and the New

Although my husband and I have adopted new customs, some are nice to hang on to from our childhood, like:

  • Find a hidden piece of matzo after the meal
  • See who can eat horseradish without making a face
  • Share the meal with friends and family
  • Sing loudly and off key, of course

My fondest memories of Seder include reading aloud the story of the holiday. It was a three-hour affair, usually with my grandfather reading while the rest of us followed along or bustled about in the kitchen. We stretched it out by singing songs and lingering over the table after the meal. (We weren’t always singing in tune with each other!)

While many people my age remember the story being read from the Maxwell House version, my family prefers the New American Haggadah. Edited by Jonathan Safran Foer, it incorporates poetry, notable quotes and interesting stories in the telling of the Passover story. You can even make your own kid-friendly version with your children.

In telling the story of Passover, we ask why traditions during this observance differ from what we do most other nights. I particularly like highlighting this idea with my children: this holiday gives us the opportunity to talk about bigger ideas like fighting hunger. We eat matzo to remind ourselves that the Jewish people experienced hunger as they fled Egypt. But I also feel it’s important to take action, such as bringing leftover items to a local food bank.

There are even whole Seders revolving around women or the theme of freedom from slavery.

Family Matters

Passover traditions vary from family to family. Some Jewish families use only special dishes set aside for Passover, or remove all foods that won’t be eaten during the observance. I choose not to do those things because that’s not the tradition I’ve set with my family, but the reminders are always appreciated.

The most important thing, whether you stick with tradition or have incorporated new ideas into your Passover, is spending time with family, taking time to pause and reflect, and most of all, counting your blessings!

We’d love to learn more about other favorite Passover customs – new or old. Post your memories and recipes below.

Knocking on doors. Looking under bridges. How we find hard-to-reach members.

Dajia Richardson parked her truck outside a house in a suburb of Rochester, N.Y.

She peered at the freshly-fallen snow on the driveway. No car. No footprints. “I’m still hopeful that someone is inside,” said Richardson, as she got out of the truck.

She trudged through the snow and knocked on the front door. Unlike some of her other visits this February morning, the man she was looking for opened the door.

 

Knocking On Members’ Doors

Richardson is part of the Safety Net CARE team at Excellus BlueCross BlueShield in upstate New York. CARE stands for Committed and Accountable to Relentless Engagement.

Richardson supervises the Community Connections team. These employees try to find hard-to-reach and medically-fragile Medicaid members and connect them back to the Health Plan.

If a care manager is unable to reach a Medicaid member, for example, the employees will look for members wherever they may be – at home, living under a bridge or at a friend’s house. The team, for example, connected almost 600 Medicaid members back to the Health Plan in the fourth quarter of 2018.

On this February morning, the member who answered the door struggled with high blood pressure. A nurse care manager kept calling him, but he wasn’t answering her calls.

That’s why he had an unannounced visit that morning from Richardson. The two talked for a few minutes. Then he invited her inside.

Another Nurse To Care About You

Richardson’s team of six employees look for Medicaid members daily. They look for Excellus BCBS members who live within eight counties of upstate New York: Broome, Erie, Livingston, Monroe, Oneida, Ontario, Otsego, and Wayne counties.

The employees have discovered that a personal visit may do more than an official letter or phone call to encourage Medicaid members to:

  • take advantage of community resources
  • talk to a care manager and enroll in a health-improvement program. Care managers help members with medical conditions, including pregnancies, diabetes and behavioral health issues.

The member with the high blood pressure, for example, told Richardson that he didn’t answer the care manager calls because he didn’t recognize the number. His girlfriend was also a nurse, he said, so he didn’t need to work with another one.

Dajia Richardson of Excellus BlueCross BlueShield

“It’s sometimes a little bit different when you have someone who works as a nurse and you know them personally, as opposed to a nurse care manager specifically for you and your care,” Richardson told the member. “When I put it to him that way, that he would have another nurse to care about him, he was definitely interested,” Richardson added.

By the time Richardson left his house, the member was on the phone talking to the nurse care manager at the Health Plan.

Looking Under Bridges

The hardest members to find are often those who are homeless. “We look for those bread crumbs that tell us where the member may be,” Richardson said.

Community Connections representatives, for example, traced one member with behavioral health issues to his parent’s house. They learned the member was living under a bridge. The parents shared details about the member. He was in his 20s, with a blonde ponytail and a scooter. After several trips to the bridge, Community Connections representatives found him and connected him to a care manager.

Click on the video below to learn about Richardson’s favorite success story – a member who needed help with her health and with other issues, including an eviction.

 

“We’ve Got the Goods”

Richardson and her team often go above and beyond to help members with other parts of their life.

On a day in January, for example, Richardson started her morning at the Angel Care ministry in a suburb of Rochester. The ministry helps financially-strapped moms acquire portable baby beds and other items.

“We’ve got the goods,” Richardson joked as she left the ministry with a pack n’ play and other baby items for a Medicaid member. She loaded the items in her vehicle. She then headed to the member’s home in the inner city of Rochester.

Community Connections representatives have cultivated contacts in the community – churches, government agencies, nonprofits, etc. – who can help employees secure items such as:

  • Special formula for premature babies
  • Help with an eviction
  • Government-subsidized cell phones
  • Beds for a family sleeping on wood pallets
  • Car seats for newborns

For the member receiving the pack n’ play, a care manager had learned that the new mom didn’t have a safe place for her newborn to sleep. That’s why Richardson trekked to the ministry that morning.

“A lot of moms plan to sleep with their baby in their beds, with no plans after that,” said Richardson, as she turned her car out of the ministry’s driveway.  “That’s where we can help.”

Chris Booth, CEO of Excellus BCBS, said the work of employees with Community Connections – and many others at the Health Plan – get at the heart of the company’s mission as a nonprofit health plan.

“The reason our Health Plan exists is to make sure as many people as possible have access to high quality, affordable health care,” he said. “We have a lot to be proud of, given all the work we do in our communities and especially with our Medicaid members.”

5 Ways to Reduce Caregiver Stress

When I was in high school, there were several years where my mom devoted herself to taking care of my grandparents. We lived in Syracuse, but my grandparents lived in Watertown, so my mom would regularly travel the hour or so north up I-81 to be with them. Back then, and for years after, she would often say how glad she was to be able to be there for her parents during that time. Despite the gratification caregiving brought her, I know it was hard for her to balance helping her parents while taking care of me and my sisters and working a full-time job.

Caregiving can be a rewarding experience, but it can also be very stressful. You may be experiencing caregiver stress if you’re feeling overwhelmed, alone, or are often worried. Whether you’re providing hands-on care or helping from afar, here are some tips from fellow caregivers to help reduce caregiver stress.

Take a break

Recognize that providing care for someone is an important job. Like all jobs, it’s important to seek a well-deserved break when you can. Don’t be shy about asking others for help. Jan Caster, a caregiver from Onondaga County, says that when someone offers to help, it’s important to “be specific about what the individual can do for you. Suggest choices like respite care, preparing meals or providing transportation.”

If you’re a long-distance caregiver, offer what you can to help the caregiver who is local. You can help research community resources or even give a small gift card to help give the other caregiver a break. That kind of help can be “a better gift than any ‘thing’,” says Jan.

There are also more formal respite services available to help give you a break and reduce caregiver stress. These services include:

  • In-home care: regular or periodic in-home care can provide someone to help with personal care, providing medical services and respite care.
  • Programs for All-Inclusive Care for the Elderly (PACE): these programs provide both medical and social services to individuals who live in the community.
  • Adult Day Care Centers: provide your loved one with some socialization while giving you an opportunity to work, run errands or take a break.
  • Nursing homes: many communities have nursing homes or other residential care facilities that can provide short-term overnight care if you need to go out of town.

Check with your local Office for the Aging and NY Connects to learn more about these and other respite services available in your community.

Communication is Key

Having open and honest conversations with your loved one can help to take the burden off of you, the caregiver. It’s helpful to understand the wishes of your loved one and make sure everyone is on the same page. Jim Redmond, a caregiver from Monroe County, says that when you’re a caregiver “you may need to have difficult conversations with your loved one…but you can still maintain a level of respect and help them preserve as much of their independence as possible. Part of having a difficult conversation is helping your loved one determine realistic goals based on their condition and the way it is changing.” Resources like AARP offer tips for having those difficult conversations.

It’s also important to establish open communication with other family members. “We have an on-going group text with my siblings and our spouses,” says Jim, “It helps everyone get the same information at the same time”. It’s one way to include everyone, even if they live out of town.”

Do Something You Enjoy

When you’re caring for someone else, you often prioritize your loved one’s health over your own. It’s important to remember to take care of your own health too to help you provide your loved one with the best care.

While it can be hard to do, Jan says it’s also helpful to “do something for yourself that you’ll look forward to.” You could watch a movie or take an exercise class. Jan enjoys a yoga class as one way to take time for her health. Finding time to rest or nap is important too, as many caregivers struggle with sleep. “Sleep is not overrated!” adds Jan.

Seek Support

Feeling isolated can be a challenge for caregivers. When you’re feeling alone, talking with others can help you to cope, whether it’s with a counselor or with a few good friends. My aunts were a main source of support for mom. They were helping to take care of my grandparents too. I remember the long phone calls my mom would have with them late into the night. Like with many of life’s challenges, it helps so much just to know you’re not alone.

Support groups are another great resource for caregivers. They can provide a safe space for venting frustration or sharing struggles. To find an in-person or online support group, contact your local Office for the Aging.

Keep Things in Perspective

It’s easy to become overwhelmed when caregiving, whether it’s with your loved one or with the situation in general. Jim says it helps to “maintain perspective” and remember that “everyone will have good days and bad days.” Many fellow caregivers say that when providing care for a loved one, it’s helpful to focus on what’s really important and not sweat the small stuff.

When all else fails, take deeps breaths and give yourself credit for doing one of the toughest jobs that there is. Jan adds, “Trust yourself when it comes to your loved one’s care – you know them better than anyone.”

Tips for Caregivers: 5 Ways to Help Your Loved One

Like in many families, my mom and my aunts spent several years caring for my grandparents. Each sister had a caregiver role. While one advised on medical decisions, another assisted with legal affairs. They did chores around the house, cooked meals, and helped my grandparents get to appointments. Most importantly, they all continued to bring laughter and joy to my grandparents, even in the most difficult of times.

In upstate New York, 20 percent of adults identify as informal, family caregivers. Another 14 percent of upstate New York adults are expecting to step into a caregiver role within the next two years. Caregiving can be a rewarding experience, but it can also be very stressful. Whether you’re providing hands-on care or helping from afar, here are some tips from fellow caregivers to help you provide care for your loved one.

Make a Plan and Put it to Paper

Phil Fielding of Monroe County learned a lot about caregiving from watching his own parents take care of his grandparents. “Have a plan way earlier than you think you need it,” suggests Phil, “Because you just never know when you may need it.” Phil added that making a plan early is “nothing to be scared of. But you need to make sure that your loved ones have a plan in place and wishes on file for what they want.”

Start planning by working with your loved one to complete necessary paperwork. Forms for a HIPAA authorization, or advance directives including a health care proxy, may need to be completed. For more information on advance care planning, visit CompassionandSupport.org. It may also be useful to consult with an elder law attorney to help protect your loved one’s finances should he or she need institutionalized care later.

Be an Advocate

It can be overwhelming when a loved one is diagnosed with a medical condition. If you’re suddenly in a caregiver role, Jan Caster, a caregiver from Onondaga County suggests learning about your loved one’s medical condition to “be your loved one’s best advocate.” Local chapters of health organizations like the Alzheimer’s Association, the American Cancer Society, and the American Heart Association can be good places to start when looking to learn more about a medical condition.

If you’re able to go with your loved one to the doctor, take notes during the appointment. This can help you and your loved one remember more about the appointment. Taking notes can also help trigger questions you may have. At home, using a calendar can help you keep track of your loved one’s health and activities. That makes it easier to share the information with the health care provider at the next appointment.

Choosing Wisely is another resource that can help with learning about whether certain tests, treatments or procedures are necessary for certain conditions.

Get Organized

Keeping track of documents can be challenging when medical bills, statements and educational materials start to pile up. Phil suggests “finding a system that works for you and using it to stay organized.” A filing cabinet or labeled folders can help you keep track of all the paperwork. Phil adds that you’ll also want to “find out the system of the person you are giving care for.” That way you can easily find the important documents that they were keeping track of.

Manage Medications

It’s important for your loved one to take any medications as directed by their doctor. One of my aunts, a pharmacist, took charge of helping my grandparents with their medications. She would explain why the medication was recommended, what the potential side effects were, and look for any potential drug interactions. For caregivers without a medical background, spending time looking up the medications and side effects can be helpful. The pharmacist or health care provider can also answer any medication questions.

Using a pill box can also help your loved one remember to take the right medications at the right time. You may even be able to save yourself a trip to the pharmacy by signing up for prescription home delivery. Some home delivery pharmacies will deliver a 90-day supply of a monthly medication right to the home, saving you time and/or money. Talk with the pharmacist to learn more.

Use Community Resources

Many caregivers stress the importance of having a strong network of community resources. But when you’re new to caregiving, it can be hard to even know where to start looking for help. Based on his experiences, Phil says that “Eldersource has been a huge help with linking to resources in the area. Senior centers in the region are also a great contact when caring for the elderly.” Contact your local Office for the Aging for assistance with things like transportation, long-term care insurance, or housing resources. To learn more about available services and supports for people with disabilities of all ages, utilize a hospital social worker or NY Connects to help you explore options.

Thank you, Henrietta Lacks

Earlier in my public health career, I lived in Baltimore, Maryland. There I met a successful nurse practitioner with whom I maintained a close connection even after I relocated to Rochester, New York. Angel and I shared similar interests in community health. Over the years, we traded stories of our professional experiences and inspired each other to improve the health and well-being of the communities where we lived and worked.

One day, Angel told me about a book she was reading, The Immortal Life of Henrietta Lacks, by Rebecca Skloot.

I had never heard of Henrietta’s story. But as a health care leader, I was deeply inspired to learn more about her life. I would soon learn that Lacks played a monumental role in modern health care. As I learned more about her, I developed a deep connection with her.

The Mother of Modern Medicine

Henrietta Lacks was born in the 1920s in Roanoke, Virginia. Like most African-Americans living in the South during that time, Lacks was deeply disenfranchised by racism and Jim Crow policies and had no access to education or health care. In the early 1940s, she and her husband moved to Baltimore for economic opportunities. When she was barely 30 years old, she was diagnosed with an aggressive form of cervical cancer at Johns Hopkins Hospital, which was one of the only hospitals that provided health care to African-Americans during that time.

While receiving treatment for cervical cancer, Lacks’s cancerous and non-cancerous cells were removed from her body without her knowledge. While this would be regarded as shocking now, it was a common practice back then.

Then her healthy and malignant tissues were acquired by a cancer researcher who had been trying to successfully clone human cells for years. Lacks’s “HeLa” cells were the first and only cells to survive and multiply exponentially. They were also the first cells to be successfully cloned. This was a huge breakthrough not only for cancer research, but for medicine in general.

Henrietta Lacks tragically died at the age of 31, nine months after her diagnosis. Her cells, however, lived on. As news spread about the immortal cells, Johns Hopkins shared the HeLa cells with many other research institutes.

How HELA Cells Transformed Health Care

Over time, the HeLa cells were used to help develop the polio vaccine, AIDS and chemotherapy treatments, in vitro fertilization, gene mapping and other significant medical and research breakthroughs.  HeLa cells contributed to many of the Nobel Prizes given in medicine over the last 60 years.

Regrettably, Henrietta’s family did not learn about the use of her cells and how they had transformed health care until decades after her death. Neither Johns Hopkins nor the family of Henrietta Lacks ever received compensation for the cells, even though the cells ended up being used for commercial and for-profit purposes.

Skloot’s book and a movie about her life have helped spread awareness about Lacks’s story. Often called The Mother of Modern Medicine, Lacks is just now receiving the recognition she deserves for the significant part her cells have played in the development of modern medicine.

Given the significance of the HeLa cells, I think it’s important for Americans, especially health care professionals, to know this amazing story. I feel a strong connection to Lacks. We are both African-American women who lived and raised families in Baltimore.  I am inspired to keep her memory alive by helping to raise awareness about her contributions to health care and by continuing the work to solve the social issues that impacted her and her family.

Thank you, Henrietta.

A Grandmother’s story: What you need to know about cystic fibrosis

On September 6, 2011, I was introduced to a beautiful new grandson named Owin. All outside appearances indicated that he was a healthy, handsome little man, and I remember being simultaneously thrilled, thankful and a bit taken aback by the new addition to our family.

What made me a little uneasy was his mom, Karee, matter-of-factly saying that “We would know for sure how healthy Owin was when the doctors completed their newborn testing.”

A few days later, Karee called our house to talk to her mom, Karen. “Mom,” she said (you could tell she was fighting back tears). “We got some news back from the doctor. Owin has cystic fibrosis.”

I remember looking at Karen with kind of a blank stare, not having any idea what cystic fibrosis was. This was my first introduction to the disease is as it hit home right in our own family.

Three years later, we had our next introduction to cystic fibrosis. It came in the beauty of a little girl, whose name is Rori. Rori is Owin’s sister.

From the moment Rori was born, I knew she was full of spunk. Unfortunately, we received the same kind of call as we had with Owin. A few days after her birth, we learned that Rori also has cystic fibrosis.

My grandchildren have undergone a lot over the years to keep their health in check. Along the way, I’ve developed a passion for educating others about the disease. My family and I are also doing what we can to help find a cure for this very difficult disease.

What is cystic fibrosis?

Cystic fibrosis is a genetic disease that comes from both parents, as each parent must carry at least one copy of the defective gene in order for a child to be born with the disease.

Each time two cystic fibrosis carriers have a child, the chances of the child contracting some form of cystic fibrosis are:

  • 25 percent that the child will have the disease
  • 50 percent that the child will be a carrier but will not have the disease
  • 25 percent that the child will not be a carrier and will not have the disease

Any abnormality in the cystic fibrosis gene is called a mutation. Currently, there are about 1,700 known gene mutations that can cause cystic fibrosis. Most testing for the disease only screens for common disease mutations. More than 30,000 people in the United States today live with cystic fibrosis, and more than half of those people are older than age 18. Approximately 1,000 new cases of cystic fibrosis are diagnosed each year.

Why is cystic fibrosis so difficult to treat?

Cystic fibrosis brings with it many different battles. According to the Cystic Fibrosis Foundation, It is a genetic disease that affects the lungs, pancreas and many other parts of the body. A buildup of mucus in a patient’s lungs clogs up airways, making it very difficult to breathe. This sticky mucus also traps bacteria and makes the person very susceptible to lung infections, lung damage and respiratory failure.

In the pancreas, the clogged mucus prevents the body from releasing enzymes used for digestion to break down food and absorb vital nutrients.

What are the symptoms?

Symptoms of cystic fibrosis include (but are not limited to):

  • Very salty tasting skin
  • Persistent cough
  • Frequent lung infections like pneumonia or bronchitis
  • Wheezing
  • Shortness of breath
  • Stunted growth
  • Poor weight gain regardless of appetite
  • Difficulty with bowel movements
  • Male infertility

What does a day with cystic fibrosis look like?

Each day, Owin and Rori take many different medications. The last time I was at their house, the top of their dishwasher was covered with pill bottles and boxes of medications, including pancreatic enzyme supplements to improve the absorption of nutrients into the body.

Along with these medications, the children also must work to keep their airways open with several breathing treatments and other therapies each day. Daily nebulizer treatments supply antibiotics to help them fight lung infections.

Both children have learned to do other things – such as playing a game or watching TV – while getting their breathing treatments.

Comparing the amount of medications that these children take every day to the three I take every other day sure makes my medication regimen seem like nothing to me.

Normal, active and energetic in every way

One of the many struggles that Owin and Rori’s parents, Karee and Zack, have every day is being sure that both children have enough salt in their diet. Children with cystic fibrosis have a higher concentration of salt in their sweat and need to replace any salt that is lost. Often, their water must include added salt to make up for the salt that is lost.

Rori and Owin Pelis with their parents Zack Pelis and Karee Perry

In spite of all this, Owin and Rori are two of the most normal, active and energetic children I’ve ever known. Now ages 7 and 4, Owin is in 2nd grade, and Rori is not in school yet. Owin has played soccer on a team at his local soccer facility. Both children love hiking, swimming and having picnics with family and friends.

Here’s why I support the Cystic Fibrosis Foundation

I hope this explanation of cystic fibrosis has helped show what the disease is all about and what people who live with it every day of their lives go through.

Because it’s so close to me and my family, we all have become very involved in supporting and raising funds for The Central New York Chapter – Syracuse Office of the Cystic Fibrosis Foundation.

Fundraising in Central New York for cystic fibrosis is a win-win situation, because the money raised in Central New York goes directly to the CNY Chapter of the Cystic Fibrosis Foundation. In other words, it stays here to benefit the people for whom we directly raised it.

For our family and for others who support the Cystic Fibrosis Foundation, we made a commitment to never stop fundraising and working toward a cure until “CF stands for CURE FOUND.” In a world where so much uncertainty exists, that’s something you can count on.

The Cystic Fibrosis Foundation is there and will be there for families like ours that have been affected by this disease.

If you’d like more information regarding cystic fibrosis, visit cff.org/CentralNY, cff.org, or search cystic fibrosis on nih.gov.

CF stands for CURE FOUND!!!!!!!!!!!!!

Will you join me? New York City at 3 mph

Growing up on Long Island and then while attending college in New York City, I had the opportunity to enjoy many of the things that make the “Big Apple” an endlessly interesting and special place.

But it was not until several years ago that I was made aware of the opportunity to experience Manhattan in two very challenging and unique ways.

In a few months, I’ll again experience Manhattan in this very unique way. I’d love for you to join me. But first, read on.

Experience Manhattan by bike

Several years ago, my brother and I joined about 4,000 other cyclists and rode our bicycles in the New York City Bike MS event to raise funds for the many individuals (including our Dad) who struggle with multiple sclerosis.

The first year we participated, we rode about 30 miles on closed roads around the perimeter of Manhattan. The following year, a friend joined us, and we took an extended, 45-mile ride on (mostly) closed roads that included the ride around Manhattan and a ride through the Lincoln Tunnel to New Jersey and then back into Manhattan via the George Washington Bridge.

Experience Manhattan on foot

A few years ago, my mother-in-law made me aware of a chance to experience Manhattan in yet another unique way, through a Shorewalkers event known as “The Great Saunter.” Held the first Saturday in May, it’s a one-day, 32-mile walk around the perimeter of Manhattan.

The majority of the walk is along the Manhattan waterfront, including the Hudson and East Rivers, and traverses more than 20 parks. It begins and ends in Battery Park at the southernmost tip of the island.

On my first Great Saunter experience in 2015, one of my good friends from college and I joined 1,500 other walkers who set out early in the morning. Although my friend and I did not complete the entire walk, we did cover more than 25 miles! By late afternoon/early evening, more than half of the original group had completed the course.

It is amazing how different Manhattan looks and feels “from the edges,” rather than being immersed in the glass and steel canyons of the usual street grid. Highlights of the walk include stunning views of the Statue of Liberty and the New Jersey, Queens and Brooklyn waterfronts.

We walked under several bridges, including the Brooklyn, Manhattan and Williamsburg Bridges.  At the northern tip of Manhattan, we ate lunch at the base of the Little Red Lighthouse in Fort Washington Park, and we later passed through almost 200 acres of the beautifully wooded (and quiet!) Inwood Hill Park. At that point, it was difficult to believe that we were still in Manhattan!

Armed with an excellent map of the Great Saunter route, we were guided along the way by Shorewalkers volunteers, who also provided snacks, drinks and plenty of encouragement.

Preparing for The Great Saunter

If you’re anything like me, you won’t be able to undertake a 32-mile walk on the spur of the moment. To prepare for the Great Saunter, I added several long (six- to seven-hour) walks in the Syracuse area to my usual, regular daily walks. My favorite places to go for the longer walks are Green Lakes State Park, Onondaga Lake Park, and during those cold winter months, Destiny USA mall.

My challenge for 2019:  Walk AND bike Manhattan

I may have to do a little more training for my trip to New York this year. I recently learned of the annual Five Boro Bike Tour, a one-day, 40-mile ride that begins and ends in Staten Island on the first Sunday of May (the day after the Great Saunter).

As the name suggests, this event is a ride through all five of the New York City boroughs (also on closed roads), including a trip on the Staten Island Ferry and a ride over the Verrazzano Narrows Bridge. Each year, more than 30,000 people from around the world participate in the Five Boro Bike Tour.

So this year, I’ve made it my personal challenge to spend the first weekend in May in New York, walking in the Great Saunter on Saturday, May 4, and then riding in the Five Boro Bike Tour the following day, May 5.

Anyone care to join me? If so, please respond in the comments section below.

11 Easy Snacks to Help You Sleep Better

Almost everyone loves to grab a snack before they go to sleep. But what you choose to eat could determine whether or not you fall asleep right away.

Before you begin nighttime noshing, ask yourself:

  • What’s your motivation?
  • Are you bored? Stuffing emotions? Munching while watching TV?
  • Or, are you really hungry, and if so, how hungry?

If you’re eating just to eat – or to cure boredom or make you feel better – you might want to think twice before indulging.

But if you’re really running on empty, opt for snacks that won’t add extra pounds or result in a restless night.

Large portions and high fat foods (like French fries) interfere with falling asleep. Spicy foods slow down digestion. Alcohol may make you feel drowsy and have a relaxing effect at first, then cause you to wake up because it interferes with deep sleep and interrupts the sleep cycle. The stimulant powers of caffeine, found in coffee, tea or chocolate, take several hours to wear off. Even decaf has some caffeine. High-sugar foods and overeating can also interfere with your ability to sleep.

Not all bedtime snacks are bad for you. Some can help you take in more nutrients that you still need for the day. Going to bed hungry can actually keep you awake.

If you’re considering a bed time snack, try incorporating foods that help boost your levels of serotonin, the calming and “feel good” hormone. You could consider:

  1. Nuts, including walnuts, almonds, cashews and pistachios
  2. Seeds, such as flax seeds, pumpkin seeds and sunflower seeds
  3. Lean protein, such as chicken, fish and low-fat cheese

Choose a small snack with protein and carbohydrates – these types of foods either contain or help create an amino acid called tryptophan that can cause sleepiness.

Try these protein and carbohydrate combinations:

  1. Whole-grain cereal with low-fat milk
  2. Peanut butter on whole-grain toast
  3. Low-fat cheese with whole-grain crackers
  4. One ounce of turkey or chicken on a slice of whole grain bread

Other snack options could include:

  1. Bananas and other foods high in potassium, which helps you to stay asleep

Foods high in calcium also contain certain sleep-causing hormones, such as tryptophan and melatonin. So don’t feel bad if you grab a snack that consists of:

  1. A container of low-fat yogurt
  2. A cup of low-fat milk
  3. A slice of low-fat cheese, such as mozzarella.

Good snacking and good night!

For more advice on what to eat at night, go to:
sleep.org
health.clevelandclinic.org
sleepassociation.org
sleepfoundation.org

Sepsis: A deadly condition that happens fast

Something in Jean Hopkins’ gut told her to take her daughter to urgent care.

It was after school, and her 8th grader didn’t feel well enough for cheerleading practice. She had a slight fever, nausea and was tired. Her daughter said she felt like she did when she had a bladder infection.

Hopkins’ husband wondered whether they should wait until morning for the trip to urgent care.

Hopkins’ daughter, Riley

“But something in me told me she needed to go to urgent care now,” said Hopkins, of Rochester.

Her husband took their daughter to urgent care while Hopkins, a youth cheerleading coach, went to practice. By the end of practice, her husband called to say their daughter needed to go to the hospital.

Once in the emergency room, her daughter’s health quickly spiraled downward.

Her daughter threw up green bile that looked like antifreeze. She had dangerously low blood pressure that staff couldn’t control. By 4 a.m. her daughter was in the intensive care unit.

 

“It’s scary how quickly Sepsis can happen”

Hopkins’ daughter had Sepsis, a condition that can come on quickly and lead to death. Sepsis is the body’s extreme response to an infection. If not treated quickly, Sepsis can cause tissue damage, organ failure and death, according to the Centers for Disease Control and Prevention.

According to the Sepsis Alliance, there are 1.7 million cases of sepsis and 270,000 deaths each year in the United States. The sepsis death toll exceeds annual deaths in the U.S. from breast cancer, prostate cancer and AIDS combined.

Hopkins’ daughter did recover. She spent a week in the hospital.

“It’s scary how quickly Sepsis can happen,” Hopkins said. “Just listen to your inner voice.  We were very fortunate that everything happened as it should. I don’t want to think about what could have happened if we didn’t take her right away to urgent care.”

 

Sepsis: Get treatment quickly

It’s critical that patients with Sepsis receive treatment as early as possible, said Gregory Carnevale, M.D., a chief medical officer for Excellus BlueCross BlueShield in upstate New York. Early treatment with antibiotics and large amounts of intravenous fluids improves your chances for survival, he said.

“Act fast and get medical care immediately if you suspect sepsis or have an infection that’s not getting better or is getting worse,” said Carnevale.

Barkley Klaiber of Syracuse said she’s grateful. She acted quickly when she didn’t feel quite right and had some abdominal cramping. Klaiber was 20-weeks pregnant with her second daughter.

Barkley Klaiber with husband Karl and daughters Sutton and Carson.

Normally, Klaiber would have waited a little before seeking treatment. She figured the cramping was related to kidney stones. She’s prone to getting them when pregnant.

But Klaiber had just been in a minor car accident a few days earlier. She thought she should go to the emergency room as a precaution.

Turns out Klaiber did have kidney stones, along with a bladder infection. But she had also developed a kidney infection as a result. Barkley went into septic shock after arriving at the hospital.

Barkley did recover after a 9-day stay.

“The car accident was a blessing,” she said. “Otherwise, I don’t think I would have gone to the emergency room as quickly. If I had gone into septic shock and I wasn’t in the hospital? I don’t want to think about what could have happened.”

Her daughter remained strong throughout the ordeal. “We just celebrated her second birthday,” she said.

 

Who gets Sepsis?

Anyone can get sepsis. But those at higher risk include babies and those with chronic conditions or weakened immune systems.

The elderly are also at high risk. Meg Thoin of Buffalo said her 86-year-old mother died of sepsis about a week after breaking her hip. She was in rehabilitation at a nursing home when her mom started suffering from diarrhea and confusion, and then nausea and vomiting.

Her mom was transferred to the hospital. She had kidney failure and had become septic. She died the next day, Thoin said.

“My hope is that others become more aware of what sepsis looks like, especially if you have elderly family members or if you know someone who is in a hospital or nursing facility,” she said.

There are a variety of warning signs associated with sepsis. The most common signs include:

  • Fever, shivering or feeling very cold
  • Elevated heart rate
  • Rapid breathing
  • Disorientation or confusion
  • Clammy or pale skin

“I was an educated person,” added Thoin, who is a nurse. “I knew what to look for, and I really wished I pushed harder for her to be tested when I started to notice certain symptoms.”

Excellus BlueCross BlueShield is proud to provide educational content regarding topics such as Sepsis. For more information, view our infographic on Sepsis.

 

Why every day is a good time to talk about breast cancer awareness

During the month of October, it’s difficult to ignore the stories, commercials, advertisements, pink T-shirts and other paraphernalia proclaiming Breast Cancer Awareness Month. For Excellus BlueCross BlueShield employee Maria Horton, however, every month and every day is a good time for breast cancer awareness.

Maria has learned that the hard way. She is a breast cancer survivor.

Maria Horton

An Otherwise perfectly normal mammogram

Due to a family history of breast cancer, Maria knew she was at high risk of also developing breast cancer. That’s why she started annual mammography screenings when she turned 40. Everything appeared normal for Maria up until three years ago.

It was just a few months after an otherwise perfectly normal mammogram that Maria noticed a change in one of her breasts. Not one to brush it off in ignorance in hopes that it will go away, she followed up with her doctor.

That led Maria to a ductogram and a core needle biopsy. When her doctor scheduled fine needle guided biopsies, the physician didn’t need to tell her she had breast cancer. “I already knew,” she said.

While her husband, three children and work family were aware of what was going on, Maria then had to break the news to her parents, siblings and in-laws. “This was very tough and very emotional,” she said. “I was numb.”

Once she shared the news, however, it was these same people who helped carry Maria through her 10½-hour bilateral mastectomy and reconstructive surgery. “Without the support of my loving family and the wonderful, caring people I work with, I don’t know how I would have gotten through all of my difficult days,” she said.

During her eight-week recovery, Maria’s family took care of her and helped with everything. Friends brought cards, food, flowers and her favorite Starbucks coffee.

“The support I had meant the world to me and still does,” she said.

Advice from a breast cancer survivor

Maria considers herself lucky in that she did not need follow-up chemotherapy or radiation. She does see her surgical and medical oncologists every three months and takes oral medication.

Her advice to all women is to know their personal risk factors for breast cancer, schedule their mammograms as recommended by their doctors and perform monthly breast self-checks.

The U.S. Preventive Services Task Force recommends that all women ages 50 to 74 be screened for breast cancer every two years, but an Excellus BlueCross BlueShield report shows that nearly one in five upstate New York women still does not get a biennial mammogram.

“The evidence is clear that early detection saves lives,” said Nicholas Massa, M.D., medical director, Excellus BlueCross BlueShield. “Given the fact that most health insurers cover preventive breast cancer screenings in full every one to two years for women older than age 40, we would like to see even higher percentages of women being screened for breast cancer.”

3 reasons  women skip breast cancer screenings

A recent Excellus BlueCross BlueShield survey of members who hadn’t had a mammogram revealed three top reasons why women opt out of their recommended screening:

1. Concerned about pain

Women who haven’t gone through menopause can minimize the pain and discomfort of having their mammogram by scheduling their screening a week after having their period, when breasts are less tender. Avoiding caffeine the week before your mammogram may also help. Take it from Maria, who offered this sage advice, “Yes, having a mammogram is uncomfortable, but it beats the alternative of having breast cancer.”

2. Concerned about test results

Mammograms can detect lumps in your breast when they are small, even before you can feel them. Breast cancer found early is easier to treat and results in better clinical outcomes. Generally, you can get your mammogram results within a day or so by calling your doctor’s office. There may be times when you receive a call from your doctor’s office recommending further testing. This does not mean you have cancer, but it is very important that you follow up if asked to do so. For Maria, it’s simple. “Do it!” she said.

3. Concerned about radiation

According to the American Cancer Society, the benefits of the small amount of radiation to which we are exposed during mammography screening outweigh any possible harm from radiation exposure. The peace of mind you’ll receive from having completed your mammogram is immeasurable, added Maria. “This takes a few minutes, and it’s done.”

Breast cancer can affect women of any age or race. Dr. Massa noted that your risk for breast cancer increases with age and if you have a family history. A woman’s risk factors determine when she should begin getting screened.

Learn more about breast cancer risk factors and screenings by talking to your doctor, or by visiting the U.S. Preventive Services Task Force website.

For more on the best ways to protect your health, read this Women’s Health Checklist from Excellus BlueCross BlueShield.