Story & Photos by William M. Dowd

By William M. Dowd

Story & Photo by William M. Dowd

By William M. Dowd

PHOTO FROM THE JOHN J. MAYER COLLECTION

By William M. Dowd

PHOTO BY APRIL L. DOWD
(Double-click to enlarge image)

Story & photo by William M. Dowd

By William M. Dowd

By William M. Dowd

By William M. Dowd

By William M. Dowd

Story & Photo by William M. Dowd

The Olde Rhinebeck Inn, Rhinebeck, NY

By Mary Beth DeCecco

An hour and 15 minute drive is a perfect amount of time for a day trip. It’s even better when the destination is the quaint, charming village of Rhinebeck in Dutchess County.
The short distance affords you the luxury of enjoying the many area attractions without being so far from home that you dread the drive back.

Though it’s a small town, there is plenty to keep you busy in Rhinebeck. There is history, gorgeous homes to tour, unique shopping, farm markets, and, of course, the food. With the prestigious Culinary Institute of America (CIA) just 10 minutes away, the area is a mecca for gastronomical experience.

Located on the Hudson River near Poughkeepsie, Rhinebeck was named after the river of Europe, with the “beck” referring to the original landholder, Henry Beekman. My fiancé (an always-willing travel companion) and I started out on our trip from Albany on a sunny, summer day. Our first stop was a historic house tour. Though the area is known for its majestic “cottages” along the Hudson, such as Franklin Deleno Roosevelt’s Hyde Park, his wife’s home Val-Kill, Mills Mansion and the Vanderbilt Mansion, my research took me to a different home: the Wilderstein Historic Site on Morton Road in Rhinebeck (www.wilderstein.org). Situated off a quiet country road, the beautiful Italianate villa rises up above the trees and expansive lawn, offering the visitor the surprise of a sweeping view of the Hudson River. Built in 1852 for Thomas Holy Suckley and later enlarged by his son Robert in 1888, the estate was home to three generations of Suckleys, the last of whom was Margaret (Daisy) Suckley, a cousin and confidant of FDR. The estate maintains many of the characteristics of the original home, and even features clothing, letters and other items used by the Suckley’s throughout their residency.
Once our tour ended, we eagerly headed to the Olde Rhinebeck Inn located just off Rt. 9G on Wurtemburg Road. Listed on the National Register of Historic Places, the inn was built more than three decades before the Revolutionary war by German settlers and, although replete with modern accommodations such as air conditioning and direct TV, the home retains its historic charm.

After pulling into the gravel driveway, we admired the three acres of grounds. There are ducks, goats, chickens, a rustic wood shed, a stone patio, a hammock and two Adirondack chairs facing the spring-fed pond, which had our names on them for later that evening. Being here truly means relaxation.

Upon entering the historic farmhouse inn, we were cheerfully greeted by owner/innkeeper Jonna Paolella. The inn has four spacious rooms; ours was the Spirited Dove. Jonna led us up a quaint staircase to the room, which was charmingly rustic with exposed wood beams and wide plank floor, but also refreshingly modern —the room even contained a Jacuzzi tub! There was also a small balcony overlooking the pond, where my fiancé and I enjoyed a nice bottle of wine later than evening.

After checking in, we headed back into town for dinner. Since it was after 5pm on a Sunday, most of the shops had closed up, so we missed out on the usual bustle of tourists and locals shopping the unique stores. But we did manage to wile away some time at the Oblong Books & Music in Montgomery Row (a row of various shops) and even purchased a few books before heading a few doors down to Terrapin (www.terrapinrestaurant.com), which was set in a renovated church. Featured on the list of Jonna’s recommended restaurants, Terrapin did not disappoint. We both enjoyed pasta dishes – his had sausage and a garlic cream sauce while mine was a vegetable primavera with a parmesan sauce. Even the local beer was refreshing!

Our stomachs full, we headed back to the inn for an evening of relaxation. We read by the pond for a little while before heading up to our room to enjoy a bottle of wine under the stars.
Breakfast the next morning was nothing short of a feast. We dined at the rustic harvest table with a couple visiting from Manhattan. All four of us enjoyed an exceptional meal by Jonna, consisting of eggs from chickens raised on her farm, potatoes, fruit, sausage, scones and a baked French pear pancake which was out of this world (here’s a secret: the recipe is online at www.olderhinebeckinn.com).

The gentleman, an avid traveler who described himself as a “Ritz Carlton” type of guy, praised the Olde Rhinebeck Inn as the finest inn he has ever stayed at. Sounds like a convert to me!
Rhinebeck is a quaint, historic town with gorgeous scenery. To fully enjoy the experience, check into the Olde Rhinebeck Inn and let Jonna take care of you for a day or two. You won’t be sorry.

By William M. Dowd

Best Doctors of the Capital District

Finding a doctor you trust and feel comfortable with is important. The list of doctors on the following pages will be a valuable source when making informed decisions about your healthcare.
We worked with Best Doctors, Inc. to bring you our debut Best Doctors issue. According to their statistics, New York ranks second in the United States for Best Doctors per state. The number of Best Doctors selected for New York for 2007-2008 is 3,314 representing 43 specialties and over 400 subspecialties. But, we whittled the list down to cover the Capital Region area, listing 150 doctors in varying specialties.
Best Doctors, Inc. was founded in 1989 by two renowned physicians affiliated with Harvard Medical School. Their goal was to provide greater access to dependable, high quality medical information and care for individuals with serious illnesses and injuries. That concept continues to propel Best Doctors and has led to their pioneering work being featured on 60 Minutes, The Wall Street Journal, USA Today, Reader’s Digest and CNN. Today, Best Doctors is the world’s leading resource for patients, families and physicians seeking expert medical resources and guidance to treat illnesses and injuries of all kinds.
Best Doctors® believes that physicians are the most qualified to evaluate the experience and skill sets of other physicians. The Best Doctors survey asks physicians: “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” The responses form the basis of the Best Doctors’ global database, which has been consistently recognized by doctors, patients and the public for its quality and integrity.

Dr. Barry Kogan

“I’m a urologist that takes care of children, not a true pediatric physician,” said Pediatric Urologist Dr. Barry Kogan, who treats children up to age 14 or 15, but mostly focuses on infants and young children.
Kogan, who has 25 years in the field, is in private practice at Community Care Physicians, P.C. in Latham and is also a professor of surgery and pediatrics at Albany Medical Center.
His practice is about 50/50 surgery and office based. They treat three major areas including congenital anomalies of the genitalia, where penises aren’t completely formed or testicles aren’t descended. With infants and older children, they focus on urinary infections including anomalies of the kidneys and bladder that cause urinary infections. The final category involves daytime incontinence and bedwetting.
Bedwetting can originate from many causes including genetic issues, inappropriate fluid intake and child abuse.
“You could spend years treating someone inappropriately if you didn’t know that they were abused,” said Kogan. “Very few parents will openly talk about that stuff. They say their child is lazy or stupid, which makes self-esteem even more of a problem.”
Patients from low socio-economic groups are at higher risk for incontinence problems and bedwetting. They typically have less prenatal care, take fewer vitamins, have more prevalence for genetic issues and have poorer outcomes.
He likes the surgical aspects of his job because so much of what he does is really fixable. “Kids and parents are very anxious about genitals, so if we can fix them, it’s very rewarding. And helping out children with incontinence and bedwetting is rewarding because these diseases impact their lives and self–esteem.”
A critical component of treating children born with ambiguous genitalia, or disorders of sexual differentiation, involves counseling the parents to choose to raise the child with the sex that is most appropriate.
“We try to explain the pros and cons to the family of each alternative and what the likely results would be, and where necessary, perform reconstructive surgery, Kogan said.”
The Capital Region lacks enough psychologists who specialize in the issues surrounding incontinence, bedwetting and ambiguous genitalia.
“The psychological aspects are important across the board,” Kogan stated. “You can’t fix one thing without dealing with the other. I think the health care system doesn’t have the best resources for this group.”
As Chair of the Division of Urology at Albany Med, Kogan is responsible for the educational programs for the medical students in the field of urology, as well as all of the residents. The residency is one of the best in the country from an educational standpoint and Kogan describes the combination of teaching and private practice as a model for the country in terms of future medical care.
“We’re all full-time faculty at Albany Med and are very dedicated to teaching, research and the academic functions of our field,” said Kogan. “But our business at Community Care Physicians is more private practice. We try to be a model center for providing patient care and at the same time advancing the field to be role models for a system that can achieve both.”
Kogan attended medical school at Northwestern University in Chicago and completed his residency in surgery and urology at the University of Michigan. He completed his fellowship in pediatric urology at the world famous Alder Hey Children’s Hospital in Liverpool, England.
“I love taking care of children because they’re so honest and straight forward. When they’re sick, they’re really sick,” he said.
—Amy E. Tucker

Dr. Kevin Costello

Dr. Kevin Costello is a very busy man. Not only is he a Lieutenant Colonel in the Army Reserves and a father of six children, he is also a geriatrician who practices internal medicine at Albany Medical Center.
His two main charges involve a post-hospital care program called the Early Facilitated Discharge Program (EFDP) and his primary care practice for home-bound patients. EFDP is part of the Hospitalists program at Albany Med and is a collaborative program with the Visiting Nurses Association of Albany, the Case Management Department and the Department of Medicine.
“We enroll primarily elderly patients and help facilitate and coordinate post-discharge care for patients leaving the hospital until they get re-established with their primary care providers.”
Costello, born and raised in Cohoes, was an orderly with the old Cohoes Hospital before it closed and was always interested in geriatrics.
His mother was a caretaker for older relatives and his great aunt lived with them. While in college, he lived for awhile with his grandfather who had Parkinson’s.
He attended Columbia University Medical School and spent five years in Montreal where he completed both his residency and fellowship at McGill University.
With five boys under age 18 and a five-year-old daughter, Costello, who also comes from a large family, said his home-care practice allows him the flexibility in his schedule to juggle work and family life.
“It’s a challenge,” said Costello, whose wife is a stay-at-home mom. “When emergencies come up I have to miss events that are important. But, most times I’m able to be there for my family.”
He describes home-care medicine as a growing field, in great demand with few providers in the area.
“The elderly population is growing, causing an influx in need of home-based care. Most of the patients are home-bound or end up in my care because they’re referred by the Visiting Nurses Association.”
Costello finds it helpful to be in the home from a diagnostic point-of-view. He can accomplish things in a house call that he can’t do in an office visit, such as inspecting the home environment for safety and seeing how a patient’s prescriptions are kept.
Though he tries to work efficiently and schedule appointments geographically, emergencies sometimes make traveling distances unavoidable.
Also, because many of his patients are frail and sick, he typically sees only five to six patients a day, much less than a doctor would see in an office setting.
“This type of practice used to be common before WWII,” said Costello. “Before the War, 40 percent of all physician encounters were in homes. After WWII, because of increasing specialization and reliance on equipment, it became less and less common.”
Costello understands war and medicine, having returned from his second tour of Iraq in May 2006. Doctors in the Army Reserves do short, 90-day rotations, but Costello did eight months the second time because he voluntarily extended his tour. He provided internal medicine and critical care to a mix of American soldiers and Iraqis.
“Ironically, the same technology that made doctors want to stay in the office has now been miniaturized to the point that, with laptops and portable EKG machines, we can bring that technology out on the road with us. Technology has enabled us to go back out to the patients’ homes again.”
Costello’s military salary supplements his salary from Albany Med, but he maintains that even with reimbursement changes made a decade ago, performing house calls still isn’t economically feasible.
“It’s still not a money-making proposition by any means”.
—Amy E. Tucker

Dr. Edward Lee

Colorectal cancer is the second leading cause of cancer-related deaths in the United States and is expected to cause about 52,180 this year, according to the American Cancer Society.
But, there is hope. Getting a colonoscopy at age 50 is still the best preventive for colon cancer. However, according to Dr. Edward Lee, one of three colon and rectal surgeons in the Gastrointestinal and Surgical Oncology Department at Albany Medical Center, there is still have a long way to go in educating both the public and their primary care providers.
“Teaching the general public to be screened for colon cancer is only half the battle. More than 50-60 percent of our patients with colon cancer weren’t screened because their primary care physician didn’t talk about it,” said Lee, who has had 15 years in the field.
Cancers such as breast and prostate are discussed more often because, said Lee, they’re a more ‘sexy’ cancer to talk about. “Colon cancer, because it’s a dirty organ, isn’t talked about as much.”
He sees colon cancer patients in their 70s who have never had a colonoscopy and feel cheated that their primary care physicians never suggested screenings.
Lee came to Albany in 1995 and pursued the field of colon and rectal surgery because of the variety it provided. He attended medical school at the University of California in San Diego and completed his residency at the New England Deaconess Hospital in Boston.
“This field provides me with a variety of patients and opportunities from private practice to performing surgeries. I can do small surgeries or big operations for patients with colon and rectal cancer or inflammatory bowel disease.”
He also enjoys the combination of surgery with medicine, including diagnostic treatments.
“Many surgeries are strictly that—you meet the person, operate and never see them again,” said Lee. “With my patients, I follow them for a long period of time and get to know them.”
Patients with chronic diseases like Crohn’s Disease have multiple surgeries in their lifetime requiring continuity of care.
Lee performs nearly 300 laparoscopic surgeries for colon and rectal cancer annually.
“It’s not a rare procedure, it’s just not the current standard of care at this time because few people are facile at the [laparoscopic] surgery.”
The procedure involves a smaller incision, producing less pain and recovery time. Because laparoscopic tools are more expensive, however, the cost currently remains about the same, even with the shortened hospital stay.
“It’s still in-patient surgery because we’re removing a few feet of the colon,” said Lee. “It shortens the hospital stay from five to seven days to only three to four. Patients pass gas and have bowel movements much quicker with laparoscopy, usually after the second day versus the third or fourth day.”
Surgeons started doing colon surgeries in the early 1990s, but the learning curve was very steep and involved doing many surgeries. Unlike gall bladder surgeries, which have been done laparoscopically for some time, colon and rectal surgeons had to take the cancer into effect.
“There was a moratorium on doing cancer surgeries via laparoscopy for five years until we had some good data” Lee explained. “Three years ago, a randomized trial showed that laparoscopic surgery was safe for cancer surgery, but the average general surgeon only performs about 15-20 colon surgeries a year.”
Residents in the program at Albany Medical Center are now taught how to do it. And, some patients come in specifically asking for laparoscopic surgery because they heard it from the Internet or word-of-mouth, said Lee.
Lee stresses that both men and women should have a colonoscopy at age 50, or sooner if you’re showing symptoms of colon cancer or have a genetic history of the disease.
“We, as a collective group of physicians, should be better at preventive medicine,” said Lee. “Women are much better at it. They’re used to seeing gynecologists and doctors early on. Men avoid doctors.”
—Amy E. Tucker

Dr. Daniel Kredentser

September is Ovarian Cancer Awareness Month. Despite the ongoing crusade to encourage women to be proactive about their health—such as performing monthly breast exams—many don’t and choose to ignore the risks.
“It’s hard to blame the patients for their diseases,” said Dr. Daniel Kredentser, surgeon and gynecological oncologist with 24 years of experience in the field. “I think there’s a segment of the population that is proactive and there’s a large segment of the population that will avoid doctors at all costs.”
Kredentser, who has been in this area since 1991, has a private practice at Women’s Cancer Care Associates and chose this field because he found it “interesting, challenging, difficult, and rewarding.”
He attended medical school at the University of Alberta, Canada and completed his three–year residency in California at Stanford. His fellowship work in gynecologic oncology was at Mt. Sinai Hospital in New York City.
Kredentser’s practice has a large hereditary genetics program providing genetic counseling for patients with breast and ovarian cancer.
Because few Capital Region surgeons practice gynecological oncology, Women’s Cancer Care Associates services a geographic area from Poughkeepsie to Plattsburgh and from Southern Vermont to Oneonta.
“You don’t have to go to New York City or Boston or Philadelphia for treatment,” explained Kredentser. “Whether you come here or see one of my colleagues in San Diego, you’ll get the same type of treatment here as you would anywhere else.”
The practice belongs to the GYN-Oncology Group, a National Cancer Institute-sponsored group for women with cancer which sponsors all of their research. Kredentser explained how treatment has changed over the years.
“Our surgical techniques are better, our radiation techniques are better and every year we have new chemotherapy drugs. So, our ability to treat the diseases is infinitely better than it was a decade ago and certainly much better than when I started.”
Kredentser’s group of four gynecologic oncologists is pioneering the use of laparoscopic surgery in the field. Using a robot at St. Peter’s Hospital, dubbed “DaVinci” after a naming contest, they’re able to perform procedures that were previously only possible with large incisions and have dramatically cut down on hospital and recovery time.
Whereas patients used to be in the hospital for a week, and were out of commission for six weeks following surgery, with laparoscopic surgery, they’re in the hospital for 24 hours and only out of commission for three weeks.
Approximately half of Kredentser’s surgeries are done laparoscopically now, compared to five percent when he started. He described the transition as a “gradual process” where the surgeons progressed from open laparoscopy to standard laparoscopy, where your hands hold the equipment, and finally, to using the robot.
“It was just a better way of doing things,” said Kredentser. “When there’s a new generation of computer, it’s not hard to learn, it’s just different. It’s very different for a surgeon not to be standing beside the patient, but to be standing in the corner playing with what is probably the most expensive video game in the Capital District.”
Standard laparoscopy uses a flat, two-dimensional screen. The robot enables surgeons to work on very large patients and, because it has binocular, three-dimensional vision, allows for more precise and delicate surgeries.
The equipment maneuvers the same way your wrist would. “It’s like a better mouse trap. I would imagine in the future there will be a robot in every other operating room.”
—Amy E. Tucker

Dr. Alan M. Sanders

Dr. Alan M. Sanders is an Infectious Disease internist in private practice with six others at Upstate Infectious Disease Associates (UIDA) and is the Chief of Infectious Disease at St. Peter’s Hospital.
The last decade has seen major changes in his field. From 1988-95, when he was in training and beginning private practice, there was much more in-patient care of AIDS patients with fewer positive outcomes. Since the introduction of more potent anti-viral medications in 1996, the care of HIV patients has changed dramatically.
“It’s rare when we take care of patients in the hospital anymore,” said Sanders. “My outpatient HIV practice has grown exponentially because more people are staying around longer.”
In fact, he has patients from the mid-90s who are still alive. “I follow AIDS patients for 10-12 years now. Before, it was rare to follow a patient more than five years. It’s been a major plus.”
Sanders, an Albany High School graduate, stayed close to home for medical school. He entered Albany Medical Center and did his first year of residency at New England Deaconess Hospital in Boston. He returned to Albany Med for his last two years of residency and did his fellowship in infectious diseases at Charity Hospital in New Orleans from 1992-94, before returning to Albany.
The internists at his practice treat a broad base of hospital-acquired infections and severe community-acquired infections. Their major focus areas include AIDS/HIV treatment, Lyme disease (which is showing increasing prevalence in this area), severe community-acquired diseases and skin infections, hospital-acquired infections and performing extensive research to find novel antibiotics and new ways to treat antibiotic-resistant infections.
“It’s never boring in my field,” laughed Sanders. “Every two years there’s a new disease to fight—be it avian flu, SARS, anthrax, E-coli or bioterrorism. The anthrax scare evoked fear in people, but there were few actual numbers impacted. What affects my everyday life is the emergence of antibiotic resistance.”
What Sanders is referring to is the over-prescribing of antibiotics for benign diseases to the point where bacteria are mutating and becoming resistant to treatment.
“There aren’t a whole lot of new antibiotics on the horizon,” he conceded. “The bugs and bacteria are winning the war and remain a step ahead of production. It’s a challenge every day to make sure physicians prescribe antibiotics appropriately and responsibly.”
Sanders described his practice as 90 percent in-hospital and 10 percent outpatient, and said that longer life spans and dramatic therapies are compromising immune systems, making it harder to fight off even simple infections.
“You’re dealing with a different patient population than you were 20 years ago. More folks are living longer and more medical procedures are being done to keep people alive. When you start doing bypass surgeries on eighty-five-year-old patients, they can’t bounce back as quickly.”
He and his colleagues are seeing a wider array of hospital-based infections from post-operative wounds and severe pneumonias to severe gastrointestinal infections. “We’re not going to turn back the clocks, so doctors have got to start prescribing judiciously.”
If you’re still wondering why someone would pursue a career diagnosing flesh-eating bacteria, let Sanders put your mind at ease.
“It’s fun and you make a difference,” he said. “It’s amazing and gratifying when you walk into a room, recognize a really bad infection that someone could die from, and say, ‘I know what this is!”
I’m not a macabre sicko like Dr. House on TV, and a good flesh-eating bacterium is not what I live for. I’m not taking out brain tumors or fixing hearts. But diagnostically, if we can make a rapid and precise diagnosis and save someone’s limb or their life, you can really change someone’s outcome. That’s rewarding.”
—Amy E. Tucker

Dr. Sharon Ann Alger-Mayer

Dr. Sharon Ann Alger-Mayer is a Clinical Nutritionist at Albany Medical Center studying childhood obesity and eating disorders among teens and adults. She attended medical school at the University of Buffalo and completed her fellowship in Clinical Nutrition at Albany Med. Following her fellowship, she conducted a year of research in metabolism and appetite regulation through the NIH in Phoenix, AZ, and joined the faculty at Albany Med in 1990.
The Plattsburgh native was always interested in nutrition and prevention, but it was her year of research in Arizona that became a catalyst for her career pursuits.
“I learned about appetite regulation from Rockefeller University in New York City and found it fascinating that the same chemicals that impact our moods also regulate appetite,” said Alger-Mayer. “I studied how serotonin and dopamine affect mood and appetite and the links between depression and anxiety with anorexia/bulimia and morbid obesity.”
The nutrition program at Albany Med focuses on anorexia/bulimia and morbid obesity including patients being considered for gastric bypass.
Even though they’re on opposite ends of the eating disorder spectrum many of the environmental and emotional triggers are the same, explained Alger-Mayer. “My practice began as a combination of in-patient nutrition and out-patient support and has become almost exclusively outpatient because of the growing number of patients with eating disorder and obesity needs.”
Traditionally, more women seek assistance with obesity. Nationally, the incidence of males with anorexia/bulimia is increasing from roughly 10 percent to nearly one in six.
Another high risk population for eating disorders has always been teenagers and young adults making the transition from high school to college. But, in the last decade, Alger-Mayer cites an increase in older women in their 40s and 50s who seek help for eating disorders triggered by divorce, their children leaving home or other life-changing situations.
“Albany Med is a center of excellence for obesity with a comprehensive educational program including exercise, dieting, nutrition and lifestyle changes for obesity and eating disorder patients,” said Alger-Mayer. “Our vision moving forward is to continue to bring in the lifestyle changes population and have experts available to create exercise and relaxation programs, to help people deal with emotional eating and to achieve and maintain healthy lifestyles.”
Two years ago Albany Medical Center received a Department of Health grant in conjunction with Four Winds Hospital in Saratoga and Bellevue Hospital in Schenectady to develop a comprehensive, team, outpatient approach and services to help people with eating disorders stay out of the hospital and transition back into their families and jobs. This as yet unnamed “Comprehensive Wellness Center” for outpatient services will be on Washington Avenue Ext. in Albany.
“The vision is an integrated medicine program featuring a variety of services from onsite psychologists, nutritionists, massage therapists, exercise physiologists and more,” Alger-Mayer explained.
Respecting that genetic differences among patients can prove challenging for treatment considerations, she also understands the importance of an individual’s environment in achieving success.
“Genetics loads the gun and the environment pulls the trigger,” she said, quoting renowned physician George Bray, M.D.
“It’s not a level playing field. “People who have a genetic predisposition to obesity will have to work harder and be smarter about their food than someone without that genetic predisposition.”
Alger-Mayer also spearheads a program for the Northeast Comprehensive Care Center for Eating Disorders (NECCCED) and encourages anyone in need of assistance for treatment with anorexia/bulimia or morbid obesity to contact Christine Campagna at 262.5391.
—Amy E. Tucker

Dr. Robert Giombetti

If you want to be a pediatrician, you have to love children. That’s one of the reasons why Dr. Robert Giombetti decided to enter pediatrics.
After completing his residency at New York Hospital in 1966, Giombetti entered the Army and spent two years stationed in Fort Rucker, Alabama. The NYC native moved to Delmar in 1968 and took over an already-established medical practice behind Saratoga Shoe Depot, off of Delaware Avenue.
When asked what drew him to the medical field, Giombetti laughs. “What doesn’t?” It was his own family physician he had while growing up who served as a role model to a young Giombetti, who always had an interest in medicine. “We were fortunate to have him as our physician,” he said. “He was a great example and gave me great pointers on what to look for [in the field].”
Of course, the children are important too. “I love kids,” said Giombetti, who has five of his own.
Having been in the industry almost 40 years, the doctor has seen the positive effects of technological advances.
“The more dramatic things have been in the therapies with children with leukemia,” he said.
That wasn’t the case 30 or 40 years ago. A child diagnosed with this dreaded blood cancer had little hope. “It was difficult to do anything for them.”
But today, with advances in bone marrow transplants, patients are diagnosed, treated and able to live longer, fuller lives.
When he first went into practice, Giombetti said caring for infectious diseases such as meningitis and pneumonia, was more prevalent. Fortunately, doctors today don’t see as many bad diseases as they once did, thanks to better immunizations and control of infectious disease.
Instead, what Giombetti sees among children today are psycho-emotional problems, such as depression.
He identifies technology as a cause for the increase in these problems. “Maybe society has developed at a faster pace. With technology, kids are learning about life a whole lot quicker.” He also feels that reality television, unstable families and academic pressures in schools can contribute to emotional problems.
About five years ago, Giombetti relocated to a bigger office down the street from his previous one, after his son Todd and daughter-in-law Kathleen joined him in practice. His other son, Greg, serves as office manager.
It’s not just working with his family that makes each day gratifying. It’s also getting the chance to meet several generations of families.
“That’s the great thing about pediatrics. Patients grow up, come back and bring their own children.”
He admits that working with children takes a little bit of creativity, especially talking to them while trying to relate to their parents. “It’s a balancing act when trying to deal with two individuals.”
What advice does Giombetti have for those contemplating a career in pediatrics? “Maintain a sense of humor and you’ll really enjoy pediatrics and medicine as a whole.”

—MBD

Harvesting your happiness

By Michelle Heffernan

September 26th marks the date of this year’s Harvest Moon. Sun and moon conspire this month to provide more light for harvesting hands. As we race to local orchards to enjoy the last of the pick-your-own season, it seems timely to consider what you have been cultivating in your own life.

While the pursuit of happiness is collectively agreed upon, it is not generally a daily conscious focus. It is too often a vague and broad description of a peaceful and satisfactory life. Yet, it takes only one experience; irrepressible sadness or euphoric bliss and you know the tremendous value of happiness in your life. Happiness is feeling free and alive, rather than just merely existing. How alive are you? Do you know what makes you truly happy? What follows is meant to inspire personal reflection and clarity about your own pursuit.

Start by personalizing it. When your eyes open each morning, which descriptive words best reflect your state of mind? The list of possibilities could include: sluggish, depleted, exhausted, anxious, irritated, frustrated, lonely, sad, snippy, frenzied, worried, woeful, tense, restless, angry, demanding, commanding, content, peaceful, curious, safe, interested, awake, enthusiastic, gracious, light-hearted, appreciative, adventurous, loving, affectionate, authentic or attractive.

This query is not meant to reveal which half of the list best suits or describes you, but rather which combination you are. Are you appreciative for what you have and perpetually worried about the future? Are you depleted and still always giving and extending a loving hand? Are you peaceful yet lonely for someone to share your heart’s desires with? You might consider re-reading the list and circling the applicable words. Regardless if you embody 10 antonyms for happiness or one, it’s important to notice the signals of discontent to help you gage where you’re at.

Cultivating balance
Your mind experiences happiness in different ways. Happiness in the left hemisphere of the brain includes such things as a fantastic bank account, the test you aced, the competition you won and the completed to-do list. The left hemisphere loves verbal, analytical, rational and sequential information. In contrast, happiness in the right hemisphere is your smile when seeing someone you love, the vision of your wedding day or the panoramic ocean view from a seat on the sand. The right side is visual, spatial and intuitive. It connects us to creativity, aesthetics, emotion and the senses.
Balancing experiences in these two hemispheres cultivates happiness because each side provides different, yet important levels of satisfaction. For instance, take perpetual multitasking. Here the focus is on deadlines, schedules, efficiency and performance. While there is great reward in this type of achievement, the lack of balance limits the experience of a fulfilled life. The right mode of happiness is stifled when you stop tasting the food you are eating or not being able to drive without returning calls.
Discover how balanced you are. Try this Happiness Experiment by making a list of 100 things that bring you a sense of joy, peace and light-heartedness. This encourages balance through analytical list making, while engaging your imagination and senses. So be descriptive. It’s not just cookies; it’s homemade chocolate chip cookies. It’s not birds; it’s birds in the morning. Look at how many things you list and what types of happiness they are. Keep and grow this list over time. Practice them. Ask someone you love to also create one. You will learn invaluable things about yourself and them. This is a powerful experience, especially when shared.

Blocks in the mind
The work of Daniel Gilbert, renowned Harvard psychologist and best-selling author of Stumbling on Happiness, further analyzes this topic. His kiss-the-brain genius clarifies the biggest block to the left-brain’s pursuit of happiness. Much of his work is centered on the desire to control and predict happiness in our lives. We are consumed with the idea of having control over outcomes, because it gives a sense of safety and the illusion that displeasure and pain are avoidable. This is especially dangerous for perfectionists. Moreover, if you take one thing away from this column, do yourself a favor and leave perfectionism here. The perfectionist is a harsh critic that is never completely satisfied because there is always a “but,” “should have” or “if only.” Therefore, the pursuit is endless, because satisfaction is temporary or never fully experienced. Relax. The more the critic in your mind is turned off, the more balanced you become, which magnifies the height and breadth of joy.

Harvesting the heart
Joy has also been the topic of best-selling author and Newsweek columnist Anna Quindlen. Her melt-your-heart prose conveys the human experience with gifted clarity. In her book, A Simple Guide to a Happy Life, Quindlen advises readers to simply “Get a life.” Life through her right brain lens is the cultivating and harvesting of loving relationships over a paycheck and a loving home over a bigger home. A real life according to Quindlen is the marveling at and connecting with nature—the view of sky, earth and animals instead of your cell phone.
Perhaps a tipping point has happened for you. Perhaps one is at the threshold of your life. Clearly happiness is vital, and its meaning is yours to define and create. So focus on it, notice when it arrives, learn to gage and balance it. After all, to live without joy is to merely exist. To live joyfully is to feel alive. Become more alive. Be inspired to nurture happiness in yourself. The harvest season beckons us to consider such things as summer fuses with fall. Just look out your door.

Michelle Heffernan is the founder of Artista, a healing arts practice for mind, body and spirit. She holds degrees in design and Creative Arts in Therapy and is a professional member of the International Expressive Arts Therapy Association. She is also a consultant for Synergy Counseling Associates in Albany, where she facilitates wellness through expressive arts for adults, children and adolescents. She can be contacted at healingARTS@nycap.rr.com.

Is your favorite machine telling you the correct calorie burn?

By Judy Torel

“I worked out on the elliptical trainer yesterday and burned 1,400 calories in one hour” reported one of my clients.
Another female client who is 5’1”, 110 lbs. and is an avid runner said: “I burned 500 calories for my 30-minute jog on the treadmill.”
Most gym and home-use cardio workout machines will give you a total calorie burn at the completion of your workout. Can these numbers actually be correct or is 1,400 calories for one hour an over-estimation that can mislead a person to think they can eat more food when they are trying to lose weight?

How do the machines determine calorie burn?
The computer on a cardio machine has been programmed with standardized equations that estimate calorie burn for the type of activity performed on the machine. These equations have been developed from actual measurements taken by exercise researchers on subjects who have been hooked up to special lab equipment while exercising on a various machines. Hundreds and thousands of measurements have been taken and then equations were designed based on these measurements. So for instance, hundreds of measurements were taken of males of a variety of body weights while they walked on a treadmill at 4.0 miles per hour while not holding onto the hand rails. This information is transposed into a calorie burn equation and then put into the computer on a treadmill. The same has been done for bikes, rowing machines, arc trainers and ellipticals, among others.

What can cause the machines to over-estimate your calorie burn?
There are many factors that must be taken into consideration in order to determine an accurate calorie burn on a piece of cardiovascular equipment: Weight, height, age and gender. If you have not programmed your personal data into the computer on a piece of cardio equipment, then the calorie burn total displayed will not be accurate.
Most machines have a quick start button that will use a default weight and age already pre-programmed into the machine. Each type of machine has different default settings because there has yet to be a standardization of this in the fitness industry. And, many machine companies will use a large default setting, like a 180 pound, 5’8”, 25-year-old male so that the calorie burn will appear to be large. This will make the user feel like they get the better workout on this machine and therefore will want to use it more.
If you do plug in your personal data, you will get a more accurate measurement than if you use the standard default setting, however even plugging in your data does not guarantee accurate calorie readings.
Level of fitness. If you are a seasoned runner then you are going to burn less calories at the same speed of a less fit person who is the same age, gender, height and weight. The more fit you are in a particular activity, the more efficient you become at that activity, therefore the less calories you burn. So, two people running on a treadmill who are alike in all personal data except fitness level will not burn the same amount of calories. Unfortunately, the computers on the machines cannot determine fitness level and therefore will assign the same number of calories to each individual once their personal data has been entered.
How you use the equipment. If you hold the handrails while walking or running on a treadmill, you are displacing your weight onto the machine, therefore reducing the amount of calories required to move your body weight on the machine. If you plugged in your body weight, but 10 pounds of your weight is supported on the handrails, then the calorie reading will be higher than what you actually burn because the equation in the computer assumes no handrail-holding.
If you lean on the handles on the elliptical machine, you are displacing up to half your body weight, resulting in a calorie reading that is significantly higher than what you are actually burning!
If you vigorously swing your arms while you walk on a treadmill, you may get a calorie reading that is too low because the program in the computer assumes normal movement of the arms while walking.
History of the equipment in the fitness industry. Treadmills are more accurate in their calorie readings than the elliptical machines because they have been around much longer and the equations used to estimate calorie burn at specific speeds and inclines have been tested on many more subjects than the newer elliptical or arc trainer machines.
According to John Porcari, PhD, a cardio-machine researcher and professor in the Department of Exercise and Sport science at the University of Wisconsin in La Crosse, because there are many more variables that the machines take into consideration, these machines can be anywhere from right on the money to 50 percent off.
So how do you know if the calorie reading is accurate for you? What I tell my clients is to do a 10 minute warm up on a treadmill. Then restart the machine, plug in your personal data and either walk or run at a speed that is a challenging, but maintainable effort for one mile (without using handrails). Check how many minutes it took and look at the calorie readout. Use this calorie burn for all other machines when working out at a similar effort. For instance, if your readout on the treadmill test says you burned 125 calories for one mile and it took you 16 minutes to walk it, then when you are on the elliptical, make sure you are on a setting that feels like the same effort as the treadmill test and for every 16 minutes use the 125 calorie as your burn.
Just don’t be surprised when you discover that what the machine tells you that you are burning is significantly higher than what you get when you use my equation!

Judy Torel is a therapist/personal trainer with a Master’s degree in psychology. She is certified through the American College of Sports Medicine as a fitness trainer and works out of Planet Fitness and Deb's Sweat Shop Extension. She can be reached at JTOREL2263@yahoo.com

Bridges

By Ed Lange

Marching in the forward ranks of the baby boom generation, I was eleven years old when the totally cool ’57 T-Bird hit the streets. That same year, I sobbed inconsolably when my folks told me we were moving from Albany to some hick town hamlet of 600 in the Heldebergs—which may as well have been a galaxy far, far away, cuz it sure was the end of the world as I wished it.

But after about only one lunar cycle in the hinterlands, it finally dawned on me that we had relocated to “boy paradise.” Within less than a mile of my bedroom was a gorgeous gorge with waterfalls, swimming and fishing holes, secret rocky hideouts, and cliffs we’d climb, our fingers and toes precariously hoping the next rock or root would hold our weight and keep us from tumbling broken-boned into The Crick. Our backyard looked over a vast woods where the guys and I chopped down small trees to make lean-tos and “log cabins,” camped out, and (if you can communicate with the dearly departed, don’t tell my Mom) – had B-B gun fights with each other. Boy, does that sting! Less than a mile from our front yard, loomed a mighty mountain rising to 1,100 feet beckoning us to climb it—which, of course, we did many times.

Half a mile up the main road sat a Mobil gas station where they actually did car repairs and gasoline sold at 24.9¢ a gallon. Across the road was a general store with all the same great stuff as the little corner stores I had left behind in the city—and lots more, too. It was run by a round, apple-cheeked woman out of a Franz Hals painting who wouldn’t tell your mother if you ate a whole box of Freihofer’s glazed donuts. A couple hundred yards farther up the road you could turn off into another woods, trek into its secret depths and find yourself staring into a deep, scary pit. At the bottom of that pit lurked a narrow hole that opened among jagged rocks. The air flowing from its darkness smelled not of Hell’s brimstone, but of cool, mossy moisture. A cave. Not some commercially developed cave, but a real, honest-to-gosh, natural cave with a stream running through it in the spring, a small pond at the far end, imagination-inspiring vaulted rooms with unnerving shadows, dripping crevices, chillingly narrow passages and crawl-on-your-belly-in-the-mud spaces; and when you switched off your flashlight, the blackest black that ever was—anywhere. You could hold your hand an inch from your face, wiggle your fingers and not see a doggone thing. Nothing. Which made us worry about what might happen if our flashlights quit. Would they ever find our bodies? Maybe someday, long after our corpses had shriveled like a shrunken head from New Guinea.

And so my boyhood was spent in outdoor adventure, exploration, imagination, and of course, baseball. We wielded knives, hatchets, B-B guns (and later, rifles), ropes, baseball bats and mitts, and occasionally a tool or two pilfered from our fathers’ workshops. Some days we were Indian fighters, pirates, Lewis and Clark, desperadoes, Mickey Mantle, pioneers, Edmund Hillary, and in the winter, Admiral Byrd or Roald Amundsen, struggling to survive in the frigid wilderness. Our days and nights were spent in places with wonderful, evocative names: Pinnacle Bank, Indian Head, The Lair, The Path of the Serpent and the Impassable Pool. But the cave was always just, “The Cave.” It didn’t need any more cachet than that. Video and computer games weren’t even a twinkle in anyone’s eye, cell phones were science fiction at best, and VCR, DVD and HBO were nothing more than letters in the alphabet.

Today, I live in the suburbs. Behind our house stands a small patch of woods, with its own little stream—one of those many Dutch kills we have here in the Capital Region—that wends its way along the bottom of our small hill, topped with its red pines, sugar maples and oaks. Across the stream is a section of the neighborhood that is somewhat isolated from the rest because of the stream. The kids who live there have a long walk to their school bus stop, the ball field and their friend’s homes on our side of the stream. Sometimes in the summer, when the stream draws shallow, the kids struggle to cross it on stepping stones, but as often as not, they’d get their sneakers soaked or drop a baseball glove into it. And a soggy baseball glove is darn near useless.

So, my imagination remembered my boyhood and I built a bridge back into my past. Among the trees in our little back woods were some dead pines with their nice, straight trunks. I cut a couple of them down, stripped them of their bark with my trusty ol’ hunting knife, and built a simple little bridge for the kids to cross the stream, lashing the logs together with knowledge learned as a Boy Scout—back when being a Boy Scout was still a grand thing in the eyes of the young. And since I was already out there building bridges between today’s youth and my own, I also built a loveseat with the same pine logs for my wife and I to hold hands on.

The kids use the rustic little bridge all the time, and one especially thoughtful teenage girl stopped by our door one afternoon carrying her lacrosse stick, and said, “Thanks for building the bridge.”
You bet, Kaylee.

Ed Lange is an award-winning writer, stage director, sailor and new student pilot.

Debt doesn’t have to be a four letter word

For the average American, debt is a fact of life. But not all debt should be considered detrimental. Buying a house or a car, or funding your education can be positive, wealth-building steps, even though they often require incurring some debt. The key, then, is not to avoid taking on debt at all costs, but to only take on specific, well-considered debts, and manage them wisely so that you control the debt, rather than letting the debt control you.
No matter what kind of debt you are thinking of taking on, there are some basic steps you can take to manage it.
• First, make sure you are getting the best deal, and therefore taking on the least debt, by comparison shopping before you buy. “Whether shopping for a car or a cell phone plan, consumers should do their homework,” suggests Stephen Semprevivo, president of LowerMyBills.com. “A few minutes of research could add up to big savings.”
• Think about making a sizeable down payment. Financing as little as possible will help ensure that you are able to pay the debt off in a timely manner.
• Look for room to negotiate. Many companies - yes, even credit card companies - may be willing to negotiate in order to win and keep your business. Always negotiate whenever possible.
Hopefully, if you take steps to manage the expense, you may be able to comfortably take on those necessary, and often beneficial, debts that many of us incur without putting your financial stability in potential jeopardy.
Of course, there are many consumers for whom debt has already become a burden. If this is your situation, take steps to alleviate the problem and get yourself back on the track to sound financial management.
• If you carry a large balance on your credit card, start making bigger payments. If the calculated minimum payment is only on the accrued interest, then you would need to make a larger payment to hit the principal of the debt. By finally hitting the principal, and discontinuing use of the card for purchases, you should see the balance begin to drop.
• If you own your home, consider refinancing to potentially achieve a better rate or terms on the mortgage, or to use equity to pay off other high-interest debt. “Interest rates are still low,” notes Semprevivo. “Refinancing to a lower rate may free up money each month that can be used to pay down unsecured debt such as credit card debt.” Web sites like LowerMyBills.com can help you evaluate your refinancing options.
• If you’re in over your head, don’t be afraid to ask for help. Debt counseling may help you if you are feeling overwhelmed by assisting with possible ways to help prevent you from defaulting on your debt. The Internet has made it easier than ever to find help. Sites like LowerMyBills.com can help you find the right debt solution for your needs.
• Finally, remember that it’s always a good idea to check with your personal financial and legal advisors for additional information.
Once you’ve taken control of your debt, you can keep on top of things by spending responsibly and living within your means. That way, when the time comes to incur some positive debt, you’ll be ready to make the most of the opportunity.

For more information on how to save money on your monthly bills, visit www.LowerMyBills.com.
Courtesy of ARAcontent

Reality talk for resistant teens

By Randy Cale, PH.D

Let me begin by emphasizing that this article is not about every adolescent. However, for some of you, you have become quite familiar with the teen I am about to describe. Let’s imagine you asked the question, “How was your day?”
It seems innocent enough. It seems that you are concerned. There was no tone in your voice. There is nothing that you are angry about. Your adolescent appears to be sitting at the table doing nothing. All appears okay.
Yet the response that you get sounds something like this:
• “None of your business!”
• “Leave me alone!”
• “Why do you keep bothering me?”
• “What’s wrong with you?”
• “Uggghhh!”
• “Don’t bother me!”
• “Why are you always asking me questions?”
• And so forth….
Of course, with this adolescent, you have probably been through this several hundred times, maybe more.
It doesn’t matter the time of day. It doesn’t matter what question you ask. It doesn’t matter how you ask it. The more concerned and worried we become about their guarded or resistant responses, the more we tend to press and the uglier things seem to get.
The only exception might be in the event that your son or daughter actually WANTS something from you. The response then sounds more like a human being. In fact, they can be “sweet as pie” as long as they are getting what they want. If this is your child, you may have a case of what I call, “The Adolescent Third Degree Burn!”

What is the Adolescent Third Degree Burn?
While not every teenager goes through this phase, many certainly do. This is a stage of life where every question, inquiry or request is taken as an imposition. It’s as if you are probing into their personal world with a dagger in your hand.
To understand this metaphor, imagine their self-esteem has been burned and the boundaries are hypersensitive to any effort to find out, “What’s going on in there?” The more you try to get inside, the more reactive they become.
If you are dealing with this, you are probably aware that most of what you read says that you should just keep asking. This is wrong. Why? Because it doesn’t work for resistant kids!
Does your teen seem to appreciate your repeated worry, concern and efforts to connect? Do they ever open up to your questioning and probing? No! Notice it just keeps pushing your son or daughter further and further away.
Now, this doesn’t mean you give up communicating; it just means that you approach “touching” a child who has been “burned” very differently than you might approach others.

What’s the advantage of this metaphor?
First, it prepares you for the reality of trying to communicate with a teen who has landed in this place. Be prepared for the hypersensitivity and don’t take it personally. Just hold the awareness that if you probe, it will get ugly.
Secondly, it implies that there will be great sensitivity to touch or pressure. It’s not that you can’t communicate; it’s just that there can’t be an effort to move inside this psychological sphere of energy, which is hypersensitive.
Third, all burns eventually heal if you stop probing and picking at them. Thus, the metaphor implies that this is not a lifelong condition.
Finally, when you cease efforts to probe into your teenager’s world, you’ll find more opportunities for dialogue and discussion. How? Rather than inquiry, we focus on meeting them where they are at.
You’re probably wondering how to do that. First, rather than probing about their day, comment on it. Simply state, “It was a beautiful day outside.” Don’t get hooked by their response. If it’s positive, keep going. If not, ignore it.
Secondly, don’t ask questions that you already know or can get the answer to. Instead of asking who won the game, do a little research and then say: “I heard you guys won by five points. Nice job.”
Third, rather than asking about the results of their math quiz, say: “I noticed how hard you studied for your math quiz last night. I am sure you did your best.”
Finally, try to resonate at their level of emotional investment. By meeting them where they are at, you actually show respect for their struggle. While it seems counter-intuitive, I encourage you to simply notice the results. You don’t have to wait weeks or months to see the effect of this strategy.

“But won’t they think that I don’t care?”
No, this is not the case. The probing approach (with resistant teens) just pushes them away. You invest more and more energy in the resistant, ugly comments and in return you just keep receiving more ugly comments.
With this approach, you stop investing in those ugly moments and you stop being the only one always investing in the relationship. By doing this, you give your teenager the chance to begin investing in your family. Just notice what happens when you try! And remember, it doesn’t happen overnight! Burns take a while to heal…just be patient for a few weeks.

Dr. Randy Cale, a Clifton Park based parenting expert, author, speaker and licensed psychologist, offers practical guidance for a host of parenting concerns. Dr. Cale’s new website, www.TerrificParenting.com offers valuable free parenting information and an e-mail newsletter.

The sky is the limit when it comes to miles cards

Whether you’re loading up your cart with groceries or paying for your fall wardrobe at the counter, you can—in the process— rack up miles toward that well-deserved trip. More and more people today are using their rewards cards for everyday purchases, such as groceries and clothing, to build their rewards bank and transform their purchases into free rewards.

For those with both a love of travel and a good deal, a miles card can be a smart credit card choice. However, before you choose one, here are a few things to consider to ensure that you are getting the most value, choice and control out of your miles reward program.

Travel with no restrictions
Miles aren’t any good if you can’t redeem them when and how you would like. Don’t settle for blackout dates or booking restrictions. Look for a card that gives you the freedom to book any kind of travel you want anywhere, anytime, with no restrictions, no advance bookings and no blackout dates.
Understand how to maximize your miles
Be smart about where you use your card since some rewards programs offer the chance to earn additional miles when you shop at certain merchants. Some cards even let you earn two miles for every dollar spent on travel or at restaurants, in addition to the regular one mile earned for every dollar spent on all other purchases.

Seek unlimited miles that never expire
Make sure you pick a card that offers miles that never expire. You don’t want to rack up enough miles to take that voyage to Alaska, but determine that you won’t have enough vacation time saved until next year. Additionally, make sure that the credit card company doesn’t put a cap on the number of miles you can earn.

Redeem your miles easily with more options
Choose a card that doesn’t limit your redemption options to just free travel. Some cards also offer flexible redemption options such as gift cards with brand name retailers. Others offer the ability to redeem rewards as cash, such as money credited to your account, deposited directly to your bank account. You should also be able to manage your miles by phone or online—anytime 24/7 - before or after you travel. Find a miles card that puts you in control.

Travel with confidence knowing you’re covered
Explore the card’s benefits beyond miles. For example, consumers who use the Miles by Discover Card are covered by the most complete free travel benefits offered by any no-fee credit card, including access to Global Traveler’s Hotline, a service that provides fast, friendly travel assistance, such as finding lost luggage or arranging medical assistance. Miles card members are also covered by $500,000 scheduled air travel accident insurance and car rental insurance for collision and damage at no cost when they use their card for air travel and car rentals.

No annual fee is key
Be sure to check and see if your card has any annual fees. If you’re looking to make your money go further, it’s best to choose a miles card that gives you all of these great benefits without charging a fee. By doing a bit of research, you can let your miles card take you further. It’s up to you how far you go.
Courtesy of ARAcontent

Garden Guru

By Kerry A. Mendez

Q: In one of my garden magazines I saw a picture of a lawn covered with spring blooming bulbs. Can you tell me how to do this so I can gear up for my fall bulb planting?
A:It is always so uplifting to see jewel-like flowers adorning a bright green carpet of lawn in the spring. And the good news is that this is not a difficult masterpiece to create. Smaller bulbs work best as their foliage ripens quickly, a crucial factor since you cannot start mowing your lawn until the foliage has died back. If you cut off the green blades before they’ve browned out, you sabotage the plant’s effort to store food needed for next year’s flowers. Thankfully, smaller bulbs have shorter, thinner leaves that are not as noticeable as they ripen. Species tulips are great choices. They are up 4” to 6” tall and come in many bright colors. A few of my favorites are T. humilis Persion Pearl (magenta-rose with bright yellow centers), Little Beauty (cherry-red), turkestanica (yellow and ivory) and saxatilis (lilac-rose). Most people think of crocus for lawn plantings. You can use species varieties such as tommasinianus (range of colors from lilac to deep reddish-purple) that get 4” tall with petite flowers or go with large flowering crocus that get a tad taller (5”-6”) and have showier flowers. Additional bulbs include galanthus (snowdrops), dwarf irises (iris reticulata), and for a rich blue, Siberian Squill (scilla). But don’t stop at spring blooming bulbs! Plant some fall blooming crocus and colchicum for September color. The easiest way to plant any bulb is with a power drill and bulb auger. You can purchase bulb augers at many garden centers and online. Simply insert the auger into the power drill and drill away. To save your lawn from pock marks when using larger-sized augers (2.75” in width), first peel back small sections of turf with a flat-edged spade and drill holes about 6” apart. Toss in the bulbs, kick the dirt back into the holes and lay the turf back in place. Water bulbs in well after planting. All of these recommend bulbs are good naturalizers and will bring you joy for many years.

Q: What are some fragrant flowering shrubs to plant near my back patio?
A: There are so many great ones, but for the sake of space I’ll share a few favorites by season. Let’s begin with spring bloomers. I would be remiss if I did not kickoff with lilacs. But rather than recommending the common lilac (vulgaris) that matures to 12’ to 15’, I suggest dwarf varieties that are more appropriate around a home’s foundation. There are many new cultivars. ‘Tinkerbelle’ has burgundy colored buds that open to pink; ‘Joess’ has lavender-pink flowers; ‘Palibin’ has light purple; and ‘Miss Kim’ has lavender-blue flowers. All get between 4’ to 6’ tall and are hardy to zone 3. Daphne ‘Carol Mackie’ is another favorite spring bloomer with cream edged leaves and fragrant whitish-pink flowers. It reaches 3’. Fothergilla has honey-scented flowers with striking red, orange and yellow leaves in the fall. F. ‘Mt. Airy’ gets 4’ to 5’ tall and gardenii stays between 2’ and 4’. Both are hardy to 4. Moving into summer, roses are a favorite. Any of the shrub roses in the Knockout series are incredible; long blooming, disease-resistant and very hardy. These will revolutionize the way you think about roses. Another winner is Clethra, a native shrub with pink or white flowers that blooms in July and August. Heights range from 2’ to 8’ depending on the cultivar with hardiness to zone 3. Philadelphus, commonly known as mock orange, blooms in early summer. Fragrant white flowers cover this shrub for up to four weeks. Plants can reach 6’-8’ tall and many are hardy to zone 3. My pick for a fall blooming shrub with great fragrance is butterfly bush (Buddleia). These start blooming in August, are hardy to zone 5 and come in a range of colors from pinks, lavender-blue, white and purple. A word of caution about these lovely butterfly magnets – place them in a sheltered part of your yard, NOT in the path of cold, winter winds. To provide additional protection, wrap them with chicken wire in late fall and stuff raked leaves inside the hoop for added insulation.

Q: While on a garden tour the other week, I saw an orange coneflower. It was stunning. I am only familiar with the purple ones. Can you tell me about this one?
A:There has been an explosion of new cultivars in the world of coneflowers; orange coneflowers are just one of the fabulous new looks in this family. In the past we were limited primarily to purplish-pink coneflowers. Our only other choice was a white cultivar called ‘White Swan’. Not anymore. Now, coneflowers come in yellow, orange, orangey-red, melon and a double-decker pink. One of the first colors was a burnt orange coneflower called ‘Art’s Pride’. Other noteworthy introductions include: ‘Sunrise’ (soft yellow); ‘Sunset’ and ‘Sundown’ (vibrant orange), ‘Harvest Moon’ (melon), ‘Twilight’ (rosy-red); and ‘Paranoia’ (lemon yellow with deeply curved petals and a dark center cone). These are all reported to be fragrant, supposedly smelling like roses. Other cool choices include ‘Doubledecker’ (purplish-pink, two flowers on top of each other); ‘Fragrant Angel’ (white, horizontally held petals, fragrant); and ‘Razzmatazz’ (bright pink with a mounded, mum-like pink center and shorter light pink petals that curve down from this). Please note that the funky looking ‘Doubledecker’ is usually normal in appearance its first year and then does its wacky tiering thing the second year. All of the above coneflowers grow to around 30” (‘Doubledecker’ can reach 40”) and are hardy to zone 4. Coneflowers are super butterfly magnets, great for cut flowers, are disliked by deer and provide wonderful winter interest in the landscape, as well as seeds for foraging birds.

Kerry Mendez is the owner of Perennially Yours and is a teacher, writer, speaker and consultant residing in Ballston Spa. To learn more about her work, please visit her web site at www.pyours.com.

Sun Sign Forecast
For September 2007

By Arlene DeAngelus

Best Days for September: 10, 11, 24 and 29

Aries: (March 21 to April 20) Examining your work habits, co-workers and the services that you provide for others will be your focus for this month. After the 11th, your attention turns to your diet and exercise regimen. Make whatever changes that are needed. You may be called upon to compromise in a one-to-one partnership toward the end of the month.

Taurus: (April 21 to May 20) Exploring your relationships with your loved ones and children will be your focus for this month. After the 11th, lend them your support and listen to what they are saying without being critical of them. Strengthen these important relationships. Later in the month, peace of mind and spiritual growth are sought and gained through the correcting of any past mistakes.

Gemini : (May 21 to June 20) Researching your roots, rekindling family relationships and strengthening home life will be your focus for this month. You are able to make changes and resolve outstanding issues after the 11th. Plan some happy times with your family. You look for new understanding and spirituality in both your emotional and physical homes toward the end of the month.

Cancer: (June 21 to July 22) Increasing your knowledge through new studies and expressing yourself in new ways will be your focus for this month. All types of communications are favored. This is a time when you can break bad habits. Plan short trips after the 11th. Later in the month, career areas, or the equivalent, may change. This is also a time when you may need to be open-minded and compromise.

Leo: (July 23 to August 22) Re-evaluating your finances, financial success and ambitions will be your focus for this month. Look for ways to increase your income if it is needed. Read all contracts and financial papers carefully. Prepare a new budget after the 11th. Toward the end of the month, take an inventory of your possessions to see what you really need and what you don’t need.

Virgo: (August 23 to September 22) Exploring new ways of personal expression and self-awareness will be your focus for this month. Pay attention to your personal and body’s needs. You become more aware of your appearance and may decide to alter your way of dress after the 11th. Later in the month, there can be changes in your marital and partnership funds. This is the time to settle old debts.

Libra: (September 23 to October 22) Pursuing your inner child and spiritual enlightenment will be your focus for this month. You begin to understand your need for solitude. You have opportunities to discover why your life is the way it is after the 11th. This discovery makes you attempt to correct any past mistakes. Toward the end of the month, you work to improve your relationships and will compromise if required.

Scorpio: (October 23 to November 21) Setting long-term goals, directions and achieving your hopes and wishes will be your focus for this month. There can be changes in your social circle. You search out people with whom you are more compatible after the 11th and share with others in humanitarian causes. Later in the month, you evaluate your life-path and make the changes that you feel are necessary.

Sagittarius: (November 22 to December 21) Measuring your status and prestige in career areas, or the equivalent, will be your focus for this month. Your ambitions become important and recognition for past deeds is possible. After the 11th, rethink and alter your goals, if you are dissatisfied in any way with your recent accomplishments. Toward the end of the month, you share good times with children and loved ones.

Capricorn: (December 22 through January 19) Defining your intellectual and spiritual needs will be your focus for this month. Your faith is tested in some way and you see what you truly believe. Mid-month is a time to alter your attitudes if necessary and there are opportunities to expand your horizons. Later in the month, changes can occur in personal and home areas. You work to successfully resolve these outstanding matters.

Aquarius: (January 20 to February 18) Evaluating shared assets and needs will be your focus this month. You take more responsibility in shared resources and joint finances. This may not be a good time to begin business ventures or go into debt. After the 11th, you gain insights into your attitudes on sharing. Toward the end of the month, you take an interest in new studies either formal or informal.

Pisces: (February 19 to March 20) Learning about your one-to-one relationships and reaching out to others will be your focus for this month. This is a time when the “I / We Concept” becomes important. Circumstances around mid-month point out how your behavior has influenced these important relationships. Later in the month, you compromise and improve your understanding of others.

Doctor Doctor
Give Me Da News

By John Gray

I have a confession to make—I’ve always wanted to be a doctor. Think about it. The pay is great, you never have to worry about what to wear to work (one white jacket is all you need), you get to talk to cute nurses all dayand you use cool medical jargon that makes you sound really smart. Even if you’re not the sharpest scalpel in the drawer like me, youjust say a bunch of ridiculously long words like “metacarpal” in a sentence and then shout, “STAT”. Do you actually know what STAT means? I looked it up in a medical book I purchased at the dollar store and it stands for Someone Took Allison’s Tent. Now, I don’t know who Allison is or why she’s tenting, but that’s just plain wrong that someone would steal her stuff. I hope the police have a suspect.

Anyway, back to my medical career. So I was going to be a doctor except for a few hurdles. First, I could never manage more than a grade of ‘C’ in biology and apparently (and I was as shocked as you to learn this) you have to be good at science to be a doctor. Also, the teachers get really upset if you make jokes about the human anatomy during class. Example—shouting out to the professor, “Rectum? I damn near killed him.” What? Ithought it was funny.

The other nice thing about being a doctor is your parents get to tell every single person they meet for the rest of their lives, “Did I mention my son’s a doctor?!” They can even work it into everyday conversations. “You see that tall building over there? If someone fell off of that they’d most certainly need a doctor. Did I mention my daughter is a doctor?” This bragging thing only works with doctors andlawyers I think. I mean when is the last time you heard someone say, “Hey, I notice your garbage can in the kitchen is overflowing a bit. There may be a way to shove more trash in that can. Why don’t I call my son the garbage man and ask him what he thinks.” Just doesn’t have the same effect.

If I was a doctor, I would have to specialize in an area of medicine where no one dies and I don’t have to touch any part of a person’s body that I consider icky. Which means the feet, mouth, inner ear and anything between the belly button and knees is out. Elbows don’t bother me. Can you specialize in ‘elbow medicine’? I could be the expert in repairing tennis elbow. And it’s not like you are going to have someone die on the operating table. Okay, you might botch the surgery and your patient might not be able to hold a cup of coffee in that hand anymore. But they have two elbows right? So the person goes through life with the nickname ‘lefty’. This is what malpractice insurance is for.

I’m always nervous I’m going to get a horrible doctor when I go in for a checkup. You know the old joke, “What do they call the guy who graduates last in his medical class?” Answer—Doctor. I think back to some of my college classmates who slept late, skipped class and cheated on their finals. I’m worried this is the guy I’ll have poking me down there. Speaking of which, guys, were you aware that doctors no longer do the ‘turn your head and cough’ thing during a physical? No kidding. I was up late the night before my appointment practicing my cough, but it never came up during the examination. I probably had the doctor who cheated off his lab partner and missed that day of medical school.

Of course, this month’s issue is highlighting the best of the best doctors out there. These are guys and gals who got at least a B on all their science courses and actually know what the word dehydroepiandrosterone means. It’s actually a hormone produced by the adrenal gland that is converted into testosterone and estrogen in the body. Check out the brain on John Gray!
Okay, I totally cheated and looked it up. What did you expect? Hello—Liberal Arts major here!

While it’s a great honor to be publicly recognized as being a top doctor you know there is a downside to it. Now even more people will be approaching these doctors at picnics and cocktail parties saying, “I know you’re not working, but could you look at this pulsing boil on my backside? Does this look normal to you?”

I can’t stand going to the doctor’s office. I’m always worried that the people in there have something contagious and I’m going to catch it by touching the 1997 issue of People Magazine. Hey look, it’s the girl who played Blossom on the cover. Memo to the doctor’s office manager—please update the magazines. Also, enough with the waiting. You are not landing airplanes at LaGuardia and Kennedy–stop stacking us up like sardines out here. Also, what’s with the backless paper thin gown? If I’m having a problem with sinus headaches why does everyone in the hallway need to see my naked rear? And for the prices you are charging can you get some decent coffee? Every time I drink cheap coffee I suffer from Zygomycosis (a dangerous infection caused by a water-borne fungus). Yup, cheated again.

Speaking of cheating—real life doctors must hate all the TV dramas. I mean, nobody seems to be able to keep their scrubs on or their hands to themselves for goodness’ sake. Not to mention that everybody is gorgeous—George Clooney on ER, Patrick “McDreamy” Dempsey on Grey’s Anatomy. I wouldn’t want my doctor spouse going to work at a place where everyone looks like an underwear model. Right now, someone who works at Albany Med is saying, “Trust me sweetie, nobody here looks like Clooney or Dempsey.”

With all due respect to the fine doctors who save lives each and every day, I would be remiss if I didn’t tip my hat to the nurses, lab technicians and other medical professionals who do the lion’s share of the work. Every time I’ve been at the hospital visiting someone, it’s usually a nurse fluffing the pillow, handing out the meds and sharing a smile with the person lying in bed with tubes coming out of them. The hours stink, the pay isn’t enough, and honestly, I don’t know where we would be without all of them helping us at our most vulnerable time.

I’ll leave you today with a true story told by a hospital priest who was making the rounds offering comfort to the severely ill and dying. He stopped by hospital Room 214 and sat quietly at the bedside of a middle–aged woman who looked afraid. As he held her hand he said, “I know this looks bad and I know you are alone and scared, but the journey does not end here. Have faith and don’t be afraid to go to God when he calls you.” The woman shot up in her bed and said, “I’m here to have my tonsils out and you’re telling me I’m dying. Oh God Father, why me?” The priest looked over his shoulder at the door and said, “I’m sorry hon, I thought this was Room 114. I got off the wrong floor. Have a nice day.” She buzzed the nurse’s station and said she wanted to go home STAT.

John Gray is a Fox23 News anchor and contributing writer at the Troy Record. He can be reached at johngray@fox23news.com

By William M. Dowd

By William M. Dowd