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. A recent study reports that  sepsis may have been responsible for 20 percent of all deaths worldwide in 2017.

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.


Tim Truax

Why I Donated Stem Cells

About three years ago, Excellus BlueCross BlueShield Network Analyst Tim Truax felt inundated by stories about children dealing with cancer. A couple of them hit really close to home. He saw the lives of a close friend — and then a family member — turned upside down when they learned of their children’s cancer diagnoses.

“I wanted to find a way to help, but quickly realized that all I could do was respond with the usual platitudes that we all say when we don’t know what else to say or do,” said Truax. “I’m so sorry to hear that.” “I’ll keep you and your family in my prayers.” “If you need anything, please let me know.”

All of these usually heartfelt responses seemed insufficient.

Be the match

For Truax, an answer came a couple of years later in a most unlikely place, Golf Digest. That’s when an article detailing former PGA Tour player Jarrod Lyle’s battle with acute myeloid leukemia caught his eye.

The article noted that the Australian golfer had undergone bone marrow transplants as he battled the disease. Highlighting a procedure whereby people can determine if they could be a match for anyone on a bone marrow waiting list, the article linked to the national marrow donor program,

Online, Truax learned that anyone who is between the ages of 18 and 44, is committed to donating to any patient in need and meets the health guidelines makes an ideal bone marrow donor candidate.

Truax decided to register with He created an account, answered some questions and requested a registry kit. It arrived about a week later.

The kit’s instructions involved touching the inside of his mouth with cotton swabs. Then he sent the cheek cell swab samples to

The Green Light

In a matter of weeks, Truax was matched to a 23-year-old male who was battling acute lymphocytic leukemia. He agreed to participate in additional testing to see if he’d be the best candidate.

Once Truax received the green light to move ahead in the donation process, he met with Upstate Medical University doctors, who conducted additional tests.

Preparing for stem cell donation

Soon after, Truax learned that the patient with whom he was matched needed a stem cell, rather than a bone marrow, donation. His preparation changed slightly given the change in donation.

For the actual donation, he was hooked up to what looked like a dialysis machine. As Truax described it, this machine took stem cells, along with red and white blood cells, from one arm. At the same time, it injected blood and some clotting factors into the other arm. The procedure took six hours. Then, he was able to go home for a couple of days of recovery.

In remission

Truax was relieved and happy to hear that thanks to his donation, the young man’s cancer was in remission. Truax, however, counts those feelings as secondary to his desire to spread the word regarding the relative ease of the stem cell donation process. He speculated that the process may have been a little more difficult if he had donated bone marrow.

Still, the process was far easier than anticipated.

“I honestly thought there would be more to it,” he said.

Tim Truax

Photo of Tim Truax

It’s Time to Have “The Vape Talk”

When Shaquana Divers talked with her teenage daughter about e-cigarettes, she was shocked to learn just how popular they are with kids at school. Her daughter said that even though kids are told about the harms of e-cigarettes, many still use them. Some start using as early as sixth grade. Divers, an Executive Program Manager with Excellus BlueCross BlueShield, was concerned about the growing popularity of e-cigarettes.

Numbers to Gasp At

Parents like Divers aren’t the only ones shocked to learn about the popularity of e-cigarettes. In New York state, e-cigarette use among youth increased 160 percent between 2014 and 2018.

Trends in e-cigarette use among high school student in New York

One in four high school students in New York said they used e-cigarettes at least once in 2018.  The U.S. Surgeon General has gone so far as to declare the  increase in youth vaping as an epidemic. 

Behind the Smokescreen

E-cigarettes are battery-operated devices that heat a liquid (sometimes called “vape juice” or “e-juice”) to produce an aerosol vapor that is inhaled. They are also known as vape pens, e-cigs, mods or by a common brand name,  JUUL®.

E-cigarettes can look like a variety of objects, such as USB drives, cigarettes or pens. They can easily be hidden. In fact, some devices don’t even produce a vapor cloud when exhaled, making them harder to spot.

Small Device, Big Problems

Many young people believe that e-cigarettes are less harmful than other tobacco products. But e-cigarettes are not harmless. They can contain a number of dangerous ingredients such as:

  • cancer-causing chemicals
  • chemicals linked to lung disease
  • heavy metals, such as nickel, tin, and lead
  • ultrafine particles that can be inhaled deep into the lungs
  • high levels of nicotine

It is unsafe for young people to use any product containing nicotine. Nicotine can cause addiction, harm the developing brain and affect memory and attention. Some e-cigarette cartridges have a higher concentration of nicotine than a pack of cigarettes.

Many people aren’t aware that e-cigarettes can contain nicotine. One study showed that 63 percent of JUUL® users between 15-24 years old didn’t know the product contains nicotine.

Wheezing, Explosions and Long-Term Risk

Research shows that e-cigarettes can also have other health impacts. E-cigarette use among young people may:

According to the CDC, e-cigarettes can also have defective batteries that can cause fires and explosions. A few of these have led to serious injuries, including  third degree burns, broken teeth, and even loss of vision.

Since e-cigarettes are still a relatively new product, scientists don’t know all of the long-term side effects of e-cigarettes.

Tips For Having “the vape talk”

With serious health risks and a lot of misinformation, it’s important to talk with your child about e-cigarettes. For Divers, open conversations are a key to her parenting strategy. That’s why she made it a priority to talk with her daughter about e-cigarettes and support her in continuing to make good, healthy choices.

But, it’s not always easy to have sensitive discussions with your children. The American Lung Association offers these tips for having the “vape talk” with your child:

  1. Choose a time and place where you are both comfortable and more likely to open up, like when you’re riding in the car or having dinner.
  2. Acknowledge the smart decisions your child makes  every day. Encourage them to keep positive choices going.
  3. Ask open-ended questions  to encourage conversation. Some suggested conversation starters include: Are a lot of kids vaping at your school? What do you think about vaping? Do you know how vaping can damage your health?

Resources for quitting

E-cigarettes are not approved by the FDA as a method to quit smoking. Use only FDA-approved methods when trying to quit.

Here’s just a few ways to get the ball rolling when it comes to quitting or helping someone quit:

  • Talk with your doctor
  • Call the NYS Smoker’s Quitline at 1-866-NY-QUITS (1-866-697-8487)
  • Visit
  • Visit The Truth Initiative website to learn about text message programs that help young people stop using e-cigarettes

A free e-cigarettes educational poster is available to download here

Prediabetes: More Common Than You Might Think

Nearly 1 in 10 upstate New Yorkers has been told they have prediabetes. Pat Salzer, a Registered Dietitian and Workplace Wellness Support Coordinator with Excellus BlueCross BlueShield, is one of those people.

Why all the Fuss?

Salzer was diagnosed with prediabetes 15 years ago.

She works to manage her prediabetes by applying what she preaches as a dietitian to what she practices in her own lifestyle. She acknowledges that it’s challenging to manage her prediabetes, especially when it comes to healthy eating, sleep and stress. But, she works hard to stay consistent with healthy habits. For example, she uses her own portion containers to take home leftovers from a restaurant and she sticks to a consistent bedtime. She also enjoys physical activity with friends to help keep her active and socially connected.

Why all the fuss? Though the “pre” may lead you to believe that it isn’t serious, prediabetes is a serious disease. People with prediabetes have up to a 50 percent chance of developing type 2 diabetes over the next 5-10 years. It also increases the risk of heart disease and stroke.

90 percent don’t know they have it

Prediabetes means that your fasting blood sugar level is higher than normal but not yet high enough for you to be diagnosed with type 2 diabetes.

The rising of blood sugar levels associated with type 2 diabetes occurs when your body does not respond to the hormone insulin properly. This is known as insulin resistance. Insulin resistance leads to more glucose (sugar) in the bloodstream, raising the blood sugar levels to higher than normal. High blood sugar levels can be very damaging to your body.

While 1 in 3 U.S. adults has prediabetes, 90 percent of them don’t know they have it.

Prediabetes generally shows no signs or symptoms. Damage can be happening to your eyes and blood vessels over time even before the disease progresses to type 2 diabetes.

Know Your Risk for Prediabetes

There are many things that can put someone at risk for developing prediabetes.

Many of the risk factors for prediabetes are modifiable. That means that you can take steps to reduce your risk. You may be at risk for prediabetes if you:

  • Are overweight
  • Are physically active less than 3 times per week
  • Eat a diet high in processed foods and sugar-sweetened beverages
  • Smoke (Smoking damages the organs and cells of the body. According to the CDC, people who smoke are 30-40 percent more likely to get type 2 diabetes than people who do not smoke)

Other risk factors are not modifiable. These include having a parent or sibling with type 2 diabetes, race, and previous diagnosis of gestational diabetes.

But First, Diagnosis

The first step is to talk with your doctor about your risk. Your doctor may suggest doing a fasting blood sugar test to find out if you have prediabetes.

A fasting blood sugar test is very common. The blood sample for this test is taken after you fast overnight or for at least eight hours. The results will show if your blood sugar levels are normal or indicative of prediabetes or type 2 diabetes.

  • Normal: below 100 mg/dL
  • Prediabetes: 100 mg/dL to 125 mg/dL
  • Type 2 diabetes: 126 mg/dL or higher

Other blood sugar tests include an A1C blood test and an oral glucose tolerance test. A conversation with your doctor will help determine the right blood test for you.

Taking Steps to Manage Prediabetes

Prediabetes is serious, but it can be managed and is even reversible. Once Salzer became aware that she was prediabetic, she could take steps to manage it.

Making healthy lifestyle modifications can help you control your blood sugar levels. Lifestyle modifications include:

  • Eating a diet rich in vegetables, fruits and lean meats and avoiding foods that are high in sugar or highly processed. Salzer recommends meal planning as they key to having a healthy pantry and refrigerator.
  • Incorporating physical activity into daily life. Salzer suggests making exercise a social activity by walking with friends or taking a group fitness class.
  • Quitting smoking. For help with quitting, visit

For Salzer, it’s not always easy, but she finds the joy in caring for her body. “Grocery shopping and cooking can be therapeutic and fun,” said Salzer, Her routine is to practice healthy habits most of the time, with some room for dark chocolate. “It’s all about balance,” she adds.


A free, downloadable educational poster on prediabetes is available at

How to Skip Traffic and Get a Workout, All Before 8am

The average American commute is getting longer. Between construction, accidents and traffic, it seems there is always something stopping you from getting to work on time.

The daily grind of his commute is what led Scott Pudney, a Software Engineer with Excellus BlueCross BlueShield to start biking to work. Pudney began by riding with a co-worker who lived nearby, which helped him get used to biking in traffic. He admits that biking to work has challenges, like showing up sweaty, storing his bike on site, and riding in the rain. Despite those challenges, Pudney says that having a bike that is capable, safe to ride and easily maintained made his new commute worth it.

This summer, you too can experience the benefits of biking to work.

it won’t burn a hole in your pocket

Cars are expensive. Just this year, the cost of owning a car has gone up to over$9,000 a year. On the other hand, it costs 30 times less to keep bikes in shape. So, if American drivers were to make just one four-mile bike round trip a week, they would save almost 2 billion gallons of gas a  year.

burn fat not fuel

On average, bicycle commuters lose  13 pounds in their first year of cycling alone. With biking, you can get your workout in before work, without all the hassle of paying for and finding time to hit the gym. Plus, because it’s low impact, biking is great for your bones and joints.

Stay Safe

Biking to work is only effective if you can stay safe on your bike. Pudney recommends finding the safest route, obeying traffic rules and making yourself seen.

Follow these tips to get the most out of your new commute. While many of them might seem simple, Pudney adds that “as a biker, you are much harder to see, therefore, you need to follow the rules and be twice as careful to make it to your destination.”

  • Helmets.  You’ve heard this one since you were little; every bike ride should begin with putting on a helmet. But it’s equally important that your helmet fits you right. Follow these steps to ensure your helmet can protect you on your ride.
  • Crash Prevention.  If you’re riding a bike, you should follow the same rules as people driving a car. For a reminder on the traffic laws, check the National Highway Traffic Safety Administration. Pudney says that while you “might feel the urge to skip traffic by weaving in and out of cars…you should maintain a straight, predictable line so cars can see you from far away. Popping out of nowhere might not only scare drivers, but also increase your risk of an accident.” You can also avoid a potential crash by staying alert of the traffic around you. If you can anticipate what others may do, it can help you prevent a crash.
  • Signal. Bicycles don’t come with turn signals and brake lights. But fortunately, there’s already a universal language for turns and stops on a bike.
  • Be Seen. An avid cyclist, Eileen Mazzo,  Financial Analyst at Excellus BlueCross BlueShield, suggests increasing your visibility, by adding a “flashing white front light, a flashing red rear light, and reflectors” to your bike.

How to Get Started

Ready to give biking to work a try? Here are some tips to get you started.

  • Tune Up. Before you head out, make sure you are riding a bike that works and fits you. Check the brakes, tires and gears to prevent problems down the road.
  • Plan Your Route. Depending on how you drive to work, you may need to find a new route that helps you avoid the highway on your bike. Choosing a route with less traffic and slower speeds can be a good option for new bikers. Your safest route may be one away from traffic altogether in a bike or on a bike path.
  • Be Kind. A little kindness on the road goes a long way. Mazzo says that, it’s great to wave or even say thank you when cars are courteous. It makes them think of the cyclist in a more personal and respectable way.
  • Try a Bike Share. If you don’t own a bike, a bike share program can help! Bike sharing is a rental system, whereby you can pick up, ride and drop off bicycles at numerous points across the cities – usually at automated stations close by. Rochester has an established bike share program called Pace, and Syracuse is starting to break into the bike share program with Gotcha.  For more information on bike sharing, check out 12 Things to Know Before Using a Bike Share.

Ins and Outs of a Volunteer Vacation

Planning a summer vacation? Why not  take a trip that makes a difference and lets you explore the world? Consider taking a volunteer vacation.

What’s a volunteer vacation? While you are off exploring the world, you could also be living with a host family, working in the community, and getting to know the local people.

If you’re on the fence on this travel trend, check out some more reasons to try it out.

The Best Way to Experience the Culture

Dr. Gregory Carnevale, a Chief Medical Officer at Excellus BlueCross BlueShield, went to Haiti for a volunteer vacation. He said it was amazing “to see a different part of the world and to be able to help a population that has nothing compared to what we have here in the US.” Carnevale and the volunteer team were deeply immersed in the Haitian culture through their work in a local orphanage.

Dr. Gregory Carnevale on his volunteer vacation

You can also enjoy authentic home-cooked meals from local villages, while becoming immersed in the local language. Learn the rich history of the culture around you by attending traditional festivals and holiday celebrations with your host family or fellow volunteers.

Carnevale adds that,”volunteer vacations give not only meaningful perspectives on difficult issues in other parts of the world, but also how different people live their daily lives.”

Explore the World and Give Back

Pat Salzer,  a Registered Dietitian and Workplace Wellness Support Coordinator with Excellus BlueCross BlueShield, visited Thailand on her volunteer vacation. The experience gave her the opportunity to explore a beautiful location with breathtaking views while she was working for the community there.

Salzer and husband on their volunteer vacation

Not only can you explore picturesque places, but you can contribute to a meaningful cause. By having this sense of purpose in your travel, you can opens the doors for learning about the people in the communities you serve.


During these programs, you’ll likely create life-long friendships with host families and other volunteers. Salzer stresses that this was her favorite part of her volunteer vacation. She knows that, “the bonds that are made with the family who we help build their home are lasting memories.” Salzer adds “even if language is a barrier, we are able to communicate and learn about other.”

Salzer and her husband on their volunteer vacation

Life Changing

Many people who choose a volunteer vacation are forever impacted by the experience. The lessons learned through the immersion into another culture are often something that become  integrated into daily life when the trip is over. There’s also the opportunity to teach others from those lessons and encourage more acceptance of the culture you experienced.

Where to begin

Here are some possible programs to choose from:

  • International Volunteer HQ is the most widely-used provider of volunteer travel, and works with local organizations so that costs stay low and go directly towards community projects and jobs.
  • Volunteering Solutions offers multiple excursions that you can pick while volunteering. Some include Safari tours, bungee jumping, and language courses.
  • WWOOF pairs those who want to learn about organic farms with farm-owners that want to share their skills and lifestyles.
  • UN Volunteers assignments generally run for six to 12 months, with the possibility of extending for one to two years. If you are looking for a long-time commitment, this program would be a great fit.
  • Transitions Abroad can help you search through the many programs throughout the world to find your perfect match. Just put in the country or region and it will provide the programs!
  • REI Volunteer Adventures combines outdoor adventuring with volunteering. Programs are one to two weeks, and range from relocating sea turtle nests to helping rangers renovate trails.

Important Tips:

  • Decide the type of work before hand by researching the destination. Making sure your program is a good match for you will make the trip most memorable. Carnevale says that advance planning is critical to avoid unnecessary worries. A lot of people forget to consider time-off, necessary immunizations, travel documents, travel arrangements, currency, language barriers, etc.
  • Contacting the organization and asking a lot of questions will ensure that you know all the details of your program before you leave. Even asking people that have done the program previously will give you good background information.
  • By working with certain local organizations, fees are low and usually go towards community projects or employment. You can save money, and do good.
  • Creating a budget before the trip will help you plan out your extra activities throughout the entirety of the program, while also keeping you on track for your spending goal.

How Knowing the Signs of Stroke Saved My Life

“You’re too young to have a stroke!”

That’s what I’ve heard countless times since I had my first Transient Ischemic Attack (TIA), or mini stroke, at 24 years old. After suffering a second stroke-like episode at age 28, I can say firsthand that strokes do not discriminate by age. In my family, many of the women have suffered a stroke when they were young. Because of that, when I was growing up, I was taught to be aware of the signs of stroke. That may have saved my life.

Every 40 seconds

A stroke happens when the blood supply to the brain stops or when a blood vessel bursts. When the brain doesn’t have oxygen, brain cells die, resulting in disability or death. According to the CDC, a person in the United States suffers a stroke every 40 seconds. Fortunately, timely treatment can lower the risk of disability and death from a stroke. That’s why you need to get help quickly when the sudden signs of stroke appear.

I knew I needed help

It was late February 2019 and I was 28 years-old. I suddenly felt the left side of my face begin to tingle. The sensation moved down my left side to my left arm, hand, leg and foot. My symptoms came on suddenly and got worse quickly. I do also suffer from hemiplegic migraines, which can mimic a stroke, but the symptoms develop slowly over the span of a few hours. This time, I knew something was different.

Within minutes, I had extreme weakness in my left arm and leg. My face started to droop on the left side and speech became difficult. I knew I needed help. This is where knowing the symptoms of a stroke and educating my family and friends became so important.

Sudden signs of stroke

The sudden symptoms I was experiencing were characteristic symptoms of a stroke. According to the CDC, the sudden signs of stroke include:

  • Numbness or weakness in the face, arm, or leg, especially on one side
  • Confusion or trouble speaking
  • Trouble seeing in one or both eyes
  • Difficulty with walking, balance, or dizziness
  • Severe headache with no known cause

When every minute counts

I was fortunate that the people who were around me recognized that I was having a stroke. They knew I had to get to the hospital as soon as possible to ensure I received the “blood clot busting” drug – Tissue Plasminogen Activator (tPA). This drug works to dissolve any clots and helps regain blood flow to the brain. Furthermore, it helps reduce the risk of longer lasting residual effects from a stroke. However, there is only a short window of time that this powerful drug can be administered.

There are several other treatment options for stroke. The recommended treatment depends on the cause of the stroke. Some strokes are treated with a mechanical device that removes or breaks up the blood clot. Other options can include controlling high blood pressure and surgery.

With any treatment, time is crucial when a stroke is suspected. Every minute counts. You, and those surrounding you, should take quick action. That’s why it was important for the people around me to move fast and for me to note the time my symptoms started.

Act F.A.S.T.

If you think someone may be having a stroke, it’s important to remember to act F.A.S.T.:

  • F = Face. Ask the individual to smile. Does one side of their face droop?
  • A = Arm. Ask the individual to raise both arms. Is one arm drifting down or appearing weak?
  • S = Speech. Ask the individual to repeat a simple phrase. Is the speech slurred or confused?
  • T = Time. Note what time the stroke symptoms first appeared. Call 9-1-1 right away.

Knowing the signs of stroke may someday save your life, or someone else’s life.

Risk factors and causes

I am lucky that I knew my family history of stroke and was taught from a young age about the signs and symptoms of stroke. It allowed me to be prepared for this situation, to educate others, and understand my risk for having a stroke. Aside from family history, your sex and race or ethnicity can also increase your risk for stroke. While a stroke can occur at any age, the risk for stroke does increase as you get older.

There are many causes of stroke. According to the CDC, the leading causes of stroke are high blood pressure, high cholesterol, smoking, diabetes, and obesity. You can help prevent a stroke by making healthy lifestyle choices like eating a healthy diet, exercising regularly, and quitting smoking.

Walking down the aisle

Doctors are still working to formally diagnose the episode I had in February. Fortunately, the quick action of those around me and the administration of the tPA helped to lessen the severity of my side effects. After my stroke, I needed in-home physical and occupational therapy. Without the tPA, the residual side effects could have been much more severe.

Now, thanks to hard work and determination, I’m walking again without the assistance of a walker or cane. Some days when I get tired, I still notice weakness on my left side. But for the most part, I am proud to say that I have made a full recovery. I’m even going to achieve my goal of walking down the aisle on my upcoming wedding day without a cane.

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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.”