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TBR staff, current and former, gather at the office for a celebratory lunch provided by DJ’s Clam Shack.

By Leah S. Dunaief

Leah Dunaief,
Publisher

It’s been quite a week for all of us. First we experienced an earthquake, and not an insignificant one. Centered in New Jersey, it measured 4.8 magnitude and was felt from Washington, D.C. to Philadelphia to New York City and even to Maine. That was followed by at least 11 aftershocks, one of which was 4.0 magnitude that struck nearly eight hours after the initial quake. This was the strongest quake for New Jersey in more than 240 years, according to the US Geological Survey.

I never felt the first one.

Although it excited millions of people across hundreds of miles, according to CNN, I was driving to a doctor’s appointment and never felt a thing. Others who were driving said the same. I guess if you’re traveling in an automobile, you expect the road to shake you up a bit.

When I entered the doctor’s office, however, I was amazed at the high pitch of voices and the animation of the staff members. “Did you feel it? Did you feel it?” I was asked. “The blinds all shook and the stools rolled.”

I felt like I had missed out on a memorable event.

Fortunately there seems to have been little damage and no injuries. The infrastructure was checked out; bridges and tunnels intact, subway lines moving normally, buildings sound, with only a handful of mild exceptions.

That was Friday. Monday we had a solar eclipse, as a band of total darkness 100 miles wide moved diagonally across North America from the West coast of Mexico to Newfoundland, Canada. The duration of total darkness at any given point was 4 minutes and 28 seconds. 

Millions of us donned special glasses and looked at the sun. Some thousands traveled to locations beneath the total darkness, in New York State around the Syracuse area, to view the full impact. We on the North shore of Long Island saw only 90 percent of the sun blacked out, but as a show put on by Nature, that wasn’t bad. While the light did become strangely grey and the birds and insects did get quieter, and the temperature perceptibly dropped, the drama was less but real. And it was a great excuse for a Monday afternoon eclipse party, of which there were many across backyards, back decks and parking lots facing west.

We can be casual about eclipses, since we have seen at least one of them before, in 2017, and understand that the world is not coming to an end. But the whole idea of huge bodies performing a ballet with each other across the heavens in an orderly fashion, when you think about it, has to leave you with a profound sense of awe and spirituality. It was an incredible performance.

The third marvel, back on Earth, was our celebratory 48th party for The Village Times and TBR News Media on Tuesday. We invited current and former staffers and some neighbors to a lunch provided in the parking lot by a fire-engine red food truck from DJ’s Clam Shack of Stony Brook. Even our mailman came. Paul Riggio, the owner, offered, lobster rolls, crab cakes, crab cake sandwiches, shrimp scampi rolls, hot dogs, coleslaw and quesadillas filled with a choice of lobster, shrimp, chicken or cheese.

We went to the truck window, gave Paul our order, and he gave us each a number. When that order was prepared, he called out the number and we received our food.

As it happened, the weather was perfect— not too hot, not too cool with a blue sky and a soft breeze. We could have eaten outside, but since there were no tables and chairs, we carried our lunch into the office building. As one of our guests said, there was a party in every room.

Cookies, inside, completed the meal. Then we went back to work.

It’s hard to recall each of those 48 years. They slide into each other, although we can remember particular incidents. It was wonderful seeing former staffers mingling with current members. The commitment is carried on.

We will recall this party as a tune-up for our 49th & 50th.

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By Fr. Francis Pizzarelli

Fr. Francis Pizzarelli

Two presidents have declared that the heroin/fentanyl epidemic is a national health crisis. Both administrations dropped the ball on this critical health issue. The death toll due to overdoses has increased exponentially in the past year. We have less beds for treatment today than we had four years ago.

Our political leadership, from both sides of the aisle, have gotten lost in the rhetoric about our southern borders and the drug cartels. That’s all part of this tragic story but that’s not the story. The story is that a growing number of young men and women are dying senselessly because we do not have the appropriate treatment professionals and beds to respond. We need to advocate for more comprehensive treatment programs for those who are in need and want to change their lives.

Every week our local newspapers tell horrific stories about talented, gifted young people who have lost their lives due to heroin and fentanyl. We get monetary action and concern when someone of importance overdoses and dies. Meanwhile there is not a family in America that directly or indirectly has not been touched by this horrific crisis.

Talk is cheap … actions speak louder than words. St. Charles Hospital in Port Jefferson has been on the frontline and is a backbone in the area of treatment for addiction for decades. Jim O’Connor, the President of St. Charles Hospital, has been a leader in the trenches advocating for more beds and giving voice for the need for more comprehensive payment for treatment.

We need more people to step up and offer creative treatment possibilities, especially for the dually diagnosed — those who suffer from a substance use disorder and an untreated mental health issue.

The chronic heroin and fentanyl user needs more than 11 days. One has barely detoxed within that timeframe. The evidence-based research in this regard speaks to at least a year of comprehensive treatment.

My experience after working and living with addicts for more than three decades is that they absolutely need long-term treatment to reclaim their lives and move in positive directions.

Outpatient treatment programs tend to be disasters for people in early recovery from any kind of opioid addiction. Drug dealers just wait outside to prey on them.

The other issue that no one speaks to is the insurance industry and their destructive influence on people’s road to recovery. Very few insurance companies will pay for long-term treatment; they talk the talk but refuse to walk the walk.

We need to support legislation that is advocating that clinical social workers be empowered to write scripts for long-term care and that insurance companies, Medicare and Medicaid will have to pay.

People do get better and make positive contributions to our larger community. I see it firsthand every day; it sustains my ministry. I see men on the recovery journey becoming doctors, lawyers, teachers, tradesmen who are determined to give back and to help make the world a better place!

Father Francis Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

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Joseph Smith Hawkins and his wife Henrietta. Photo courtesy Beverly C. Tyler

By Beverly C. Tyler

A fine example of the many Colonial farmhouses in the Three Village area is the two-and-a-half story farmhouse on Main Street in Stony Brook, just west of the mill pond, at the corner of Hawkins Road. This attractive white farmhouse with its nine-over-six small-pane windows was built about 1750. 

The earliest known resident of this farmhouse was Joseph Smith Hawkins, son of George and Ruth Hawkins. He was born in Stony Brook on February 7, 1763. Like his father, Joseph was a farmer. He married Phebe Williamson and they had two sons, Nathaniel – born 1791 – and Joseph Smith – born 1796. 

Sometime after 1810, Joseph Smith Hawkins built the house diagonally across the street. When their father died in 1827, the brothers traded houses. Joseph moved across the road to the original family farmhouse and Nathaniel moved into his brother’s house. Nathaniel was a wheelwright and operated a shop near his home.

Joseph Smith Hawkins built this Federal-style house, circa 1810, which was Victorianized and subsequently restored to its Colonial appearance by Ward Melville. Photo courtesy Beverly C. Tyler

Joseph was a farmer his entire life and his son Joseph Smith Hawkins – born 1827 – continued to live in the farmhouse. Joseph married Henrietta Sophia Davis on February 10, 1858 and together they farmed the land until the early 20th century. Henrietta died June 6, 1907 and Joseph died April 12, 1911. The farm, until about 1950, included a number of barns and related outbuildings.

Joseph Hawkins’ grandson Percy Smith, born 1892, and a Stony Brook resident his entire life, remembered, in an interview in 1976, when his grandfather ran the 65-acre farm. “He used to raise wheat and rye and corn, no small vegetables except in the family garden. There was a big barn on the south side of the house, a hog pen and many other buildings which are all gone now. There was, as I remember, six horses and ten to twelve cows. I used to, when I was a boy, drive the cows to pasture each morning and back in the evening. The pasture was more than a mile away and I got 75 cents a week.”

“He used to make butter and take it to the store and trade it in and get groceries. Farming used to be a mainstay of the village, plus the boats that used to bring things in and take things out. My grandfather used to cut and ship cordwood to New York City. The dock at Stony Brook used to be covered with hundreds of cords of wood.” 

Percy also remembered how Stony Brook families relied on each other for many of their necessities of life. The farmers supplied the food products and the ship captains supplied transportation for the goods that were sold in New York City and Connecticut. The coastal schooners also brought to Stony Brook many items that were not grown or manufactured here. The merchants then bought and sold from both the farmers and the schooner captains. 

The 19th century brought many changes that affected the close interdependent relationship of the farmers, ship captains, and merchants. The opening of the Erie Canal in 1826 brought coal for fuel from Pennsylvania and other states and hastened the decline of the use of cord wood for fuel in New York City. 

Wheat and other grains from the midwest, first from Ohio, were shipped on the Erie Canal and began arriving in New York City in large quantities. Most of the local grist mills found it difficult, if not impossible, to match the low price of midwest grains and either adapted or went out of business. Percy Smith also noticed these changes. 

Joseph Smith Hawkins house, circa 1750. Photo courtesy Beverly C. Tyler

“The older people died off and the younger ones didn’t want to bother with farming because they could make more money doing something else. They didn’t want the drudgery that their fathers had so the farms were sold off.”

 Thus ended most of the small individual farms in the Three Village area. The local farmer was always a hardworking individual who took a great deal of pride in his work. Most of the farmers continued to work their farms as long as they were able and, in the decades leading up to the 20th century, they usually passed the farm on to their sons and grandsons. 

The farms are gone, but many of the farmhouses remain as witnesses to a lifestyle that has passed on. With a bit of imagination you can stand in front of these homes and visualize what it was like to be a part of that era.

Beverly Tyler is Three Village Historical Society historian and author of books available from the Three Village Historical Society, 93 North Country Rd., Setauket, NY 11733. Tel: 631-751-3730. 

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By Hon. A. Gail Prudenti, Esq.

Hon. A. Gail Prudenti, Esq.

After working most of your life and finally paying off your mortgage, the last thing you want is to see the assets you’ve accumulated through years of diligence fall into the government’s hands because you required long-term care either at home or in a nursing home. There is a way — a perfectly legal and legitimate way — to shield those assets and protect your children’s inheritance. But there’s really no time to lose. One of the ways in which we protect assets is by creating a Medicaid Asset Protection Trust (MAPT).

With a MAPT, you can protect your assets from the cost of long-term care. But there is a hitch: The trust must be created sixty (60) months before nursing home care is necessary. Currently, in New York, there is no lookback for transfers made before you apply for home care or Community Medicaid. At the writing of this article, we are unsure if a lookback will ever be implemented in the homecare setting. To be safe, planning early is imperative and the key to asset protection and preservation.

Let’s back up a second. Nursing home care is extremely expensive (very roughly $15,000 a month) and few people can afford to pay this amount over the long haul. Ultimately, they will rely on the Medicaid benefits to which they are entitled. In fact, approximately 72% of all nursing home costs in New York are covered by Medicaid. That means if you are in a nursing home paying privately, you are in the minority.

Under the 2024 Medicaid resource allowance, the application can have $30,182.00. If you have assets that exceed that amount, there could be a spenddown. If you do nothing, you could lose your home and investment assets. If you establish a MAPT — and stay out of a nursing home for sixty (60) months — those assets are out of the government’s reach and will be there for your benefit and ultimately, your beneficiaries.

In addition to the resource allowance, a Medicaid recipient can have retirements accounts in an unlimited amount (provided those accounts are set up for a specific monthly distribution), an irrevocable pre-paid burial, and a car. At death, there will be recovery for the benefits paid by Medicaid during the recipient’s life. This recovery can be avoided if assets avoid probate by having a joint owner, beneficiary, or are held in a MAPT when the recipient passes.

Although situations differ, what happens most often is an aging person or couple, as part of sound estate planning, will consult with an elder law or trust/ estate lawyer to weigh the benefits and drawbacks and determine if a MAPT makes sense and which assets should go into the trust. The trust funding is a crucial part of this process as is choosing a trustee. Often, the trustee is an adult child or other relative or friend who you can trust to follow your wishes.

What happens if your house is in a trust, and you decide to move? No problem. The trustee can sell the house and then the proceeds can be used to buy another home or simply invested to pay you income from the trust. 

Similarly, if you put your stock investments in the trust, the trustee can buy and sell securities in the trust. The new home and the new stock stays in the trust. The grantor of the trust keeps all the income, and the principal is protected.

Trusts can be legally complicated, and if you do decide to investigate a MAPT, it’d be wise to consult with an attorney who specializes in that area of law and keeps a close watch on statutory changes that may affect the operation of the trust. Mistakes and oversights can have devastating unintended consequences. It may be difficult or impossible — and it will certainly be expensive — to revise a trust. Better to get it nailed down just right from the start.

Hon. Gail Prudenti, Esq. is a Partner at Burner Prudenti Law, P.C. focusing her practice on Trusts and Estates. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.

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Tobias Janowitz and Hassal Lee. Photo by Caryn Koza

By Daniel Dunaief

Before treatments for any kind of health problem or disease receive approval, they go through a lengthy, multi-step process. This system should keep any drugs that might cause damage, have side effects or be less effective than hoped from reaching consumers.

In the world of cancer care, where patients and their families eagerly await solutions that extend the quality and quantity of life, these clinical trials don’t always include the range of patients who might receive treatments.

Hassal Lee. Photo by Caryn Koza

That’s according to a recent big-picture analysis in the lab of Cold Spring Harbor Laboratory Professor Tobias Janowitz. Led by clinical fellow Hassal Lee, these researchers compared where clinical trials occurred with the population near those centers.

Indeed, 94 percent of United States cancer trials involve 78 major trial centers, which were, on average, in socioeconomically more affluent areas with higher proportions of self-identified white populations compared with the national average.

“We should test drugs on a similar population on which we will be using the drugs,” said Lee. In addition to benefiting under represented groups of patients who might react differently to treatments, broadening the population engaged in clinical trials could offer key insights into cancer. Patient groups that respond more or less favorably to treatment could offer clues about the molecular biological pathways that facilitate or inhibit cancer.

Janowitz suggested that including a wider range of patients in trials could also help establish trust and a rapport among people who might otherwise feel had been excluded.

The research, which Lee, Janowitz and collaborators published recently as a brief in the journal JAMA Oncology, involved using census data to determine the socioeconomic and ethnic backgrounds of patient populations within one, two and three hour driving distances to clinical trials.

The scientists suggested researchers and drug companies could broaden the patient population in clinical trials by working with cancer centers to enlist trial participants in potential life-extending treatments through satellite hospitals.

Project origins

This analysis grew out of a study Janowitz conducted during the pandemic to test the effectiveness of the gerd-reducing over-the-counter drug famotidine on symptoms of Covid-19.

Janowitz generally studies the whole body’s reaction to disease, with a focus on cancer associated cachexia, where patients lose considerable weight and muscle mass. During the pandemic, however, Janowitz, who has an MD and PhD, used his scientific skills to understand a life-threatening disease. He designed a remote clinical trial study in which participants took famotidine and monitored their symptoms.

While the results suggested that the antacid shortened the severity and duration of symptoms for some people, it also offered a window into the way a remote study increased the diversity of participants. About 1/3 of the patients in that population were African American, while about 1/4 were Hispanic.

Lee joined Janowitz’s lab in early 2022, towards the end of the famotidine study. 

“The diverse patient population in the remote trial made us wonder if commuting and access by travel were important factors that could be quantified and investigated more closely,” Janowitz explained.

Lee and Janowitz zoomed out to check the general picture for cancer clinical trials.

To be sure, the analysis has limitations. For starters, the threshold values for travel time and diversity are proof of concept examples, the scientists explained in their paper. Satellite sites and weighted enrollment also were not included in their analysis. The cost other than time investment for potential clinical trial participants could present a barrier that the researchers didn’t quantify or simulate.

Nonetheless, the analysis suggests clinical trials for cancer care currently occur in locations that aren’t representative of the broader population.

The work “leveraged freely available data and it was [Lee’s] effort and dedication, supported by excellent collaborators that we had, that made the study possible,” Janowitz explained.

Since the paper was published, Cancer Center directors and epidemiologists have reached out to the CSHL scientists.

Searching for clinical research

After Lee, who was born in Seoul, South Korea and moved to London when she was five, completed her MD and PhD at the University of Cambridge, she wanted to apply the skills she’d learned to a real-world research questions.

She found what she was looking for in Janowitz’s lab, where she not only considered the bigger picture question of clinical trial participation, but also learned about coding, which is particularly helpful when analyzing large amounts of data.

Lee was particularly grateful for the help she received from Alexander Bates, who, while conducting his own research in a neighboring lab in the department of Neurobiology at the MRC Laboratory of Molecular Biology in Cambridge, offered coding coaching.

Lee described Bates as a “program whiz kid.”

A musician who enjoys playing classical and jazz on the piano, Lee regularly listened to music while she was in the lab. Those hours added up, with Spotify sending her an email indicating she was one of the top listeners in the United Kingdom. The music service invited her to an interview at their office to answer questions about the app, which she declined because she had moved to the United States by then.

The top medical student at Cambridge for three years, Lee said she enhanced her study habits when she felt unsure of herself as a college student.

She credits having great mentors and supportive friends for her dedication to work.

Lee found pharmacology one of the more challenging subjects in medical school, in part because of the need to remember a large number of drugs and how they work.

She organized her study habits, dividing the total number of drugs she needed to learn by the number of days, which helped her focus on studying a more manageable number each day.

Lee will be a resident at Mt. Sinai Hospital later this year and is eager to continue her American and New York journey.

As for the work she did with Janowitz, she hopes it “really helps people think about maintaining diversity in clinical trials using data that’s already available.”

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Chicken Cordon Bleu

By Heidi Sutton

Did you know that April 4 is National Chicken Cordon Bleu Day? Chicken Cordon Bleu is a classic dish that many associate with fine French cuisine. It features a chicken breast stuffed with ham and cheese, then breaded and pan-fried. 

The name “cordon bleu” literally translates to “blue ribbon” in French. In the 1500s, the Order of the Knights of the Holy Spirit became known as “Les Cordon Bleus.” The knights used a blue ribbon to hang their talisman, and eventually the term became associated with distinction and honor. It was then used in the 16th century to refer to an honor bestowed upon excellent cooks. 

The earliest known recipe for chicken cordon bleu was published in 1950 in a Minneapolis food magazine. It spread across the Midwest over the next decade and was likely rebranded as a French dish due to the fancy name.

Julia Child helped popularize chicken cordon bleu nationwide when she included a recipe in her acclaimed 1961 cookbook Mastering the Art of French Cooking. Her version stuffed chicken with ham and Gruyère cheese, then dipped it in egg and breadcrumbs. This became the standard way of preparing chicken cordon bleu in American homes and restaurants. So while it sounds like an elite French dish, its roots as a breaded, cheese-stuffed chicken cutlet are thoroughly American. 

To celebrate National Chicken Cordon Bleu Day, cook up some delicious chicken cordon bleu for your family to enjoy tonight! 

Bon appétit! 

Chicken Cordon Bleu

Chicken Cordon Bleu

YIELD: Serves 3

PREPARATION TIME:  10 to 15 minutes

INGREDIENTS:

1 package boneless, skinless chicken breasts

6 thin slices of salt-cured Virginia-smoked ham or prosciutto ham

3 slices domestic Swiss cheese or Gruyère cheese

1 whole egg

1/4 cup water

1/4 cup flour

1 cup breadcrumbs

1/2 teaspoon kosher salt

1/2 tablespoon table ground black pepper

1 tablespoon olive oil

DIRECTIONS: 

Slice chicken horizontally without cutting all the way through to create butterfly breast. Place chicken on cutting board with sheet of plastic wrap over top. With meat mallet, gently pound chicken to even thickness of breast. Place two slices ham and cheese on one side of breast and fold back over.

In bowl, whip together egg and water to create egg-wash. On two separate plates, put flour and breadcrumbs. Season flour with salt and black pepper. Carefully dredge chicken first into seasoned flour, then into egg-wash, followed by breadcrumbs.

Heat olive oil in ovenproof sauté pan. Place chicken in pan to brown. Cook for 2 minutes on one side, then flip each breast over. Place pan into oven at 350°F and cook until each chicken breast reaches 170°F internal temperature, about 20-25 minutes.

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Silas

Welcome to the 28th edition of Paw Prints, a monthly column for animal lovers dedicated to helping shelter pets find their furever home.

 

 

Milo

Meet Milo

In his prime at the age of seven, this modest, mild mannered Terrier mix at Little Shelter in Huntington is Milo. Always happy to see you, he loves going on walks and participating in all your plans for the day. Deferring to you for the itinerary, he’s content just to be by your side, whether you’re working to bring home the bacon ( did someone say bacon?) or taking the day off to enjoy the spring weather. Affable and courteous, Milo is the perfect gentleman and the best storyteller, making him the most popular guest at any gathering. If our man Milo sounds like the ideal addition to your family, stop by soon to say hello! 631-368-8770, ext. 2

Peluche

Meet Peluche

With a name meaning “plush”, this one year old Chihuahua mix at Little Shelter in Huntington is Peluche. Somewhat shy, he’s nevertheless eager to meet and make new friends, expand his social circle, and become more well-rounded and confident. Enjoying long walks filled with sights, sounds, and interesting smells, he’s also available when you need someone fluffy to cuddle. Quick-witted and motivated, he’s ready to learn new skills while priding himself on his already acquired knowledge of quality companionship. “And, they say life is an adventure full of mystery, so let’s go….” Stop by Little Shelter and start your latest escapade with Peluche by your side! 631-368-8770, ext. 21

Blaze

Meet Blaze

Can you imagine 5 years (1,825 days) without a family, a home, a couch to veg on, a friend to snuggle with?  March 29 was Blaze’s 5th shelter-versary at the Town of Smithtown Animal Shelter and Adoption Center. At 11 years old, this boy is a staff favorite. He’s affectionate, well mannered, knows his commands, loves fiercely and vocalizes what he wants. Blaze is nervous of strangers and protective of his people. That’s his only (very workable) quirk. He doesn’t deserve to spend another anniversary in the shelter.  Will you be his hero?  631-360-7575

Catastrophe

Meet Catastrophe

Catastrophe is a one and a half-year-old male cat up for adoption at Kent Animal Shelter in Calverton. This handsome boy was rescued from a high kill shelter in Georgia. He gets along well with humans and felines alike, and adjusted quickly to the open living cat room at the shelter. Catastrophe has made friends with a few other cats and enjoys head rubs from the staff and volunteers. Come meet this wonderful cat today! 631-727-5731, ext. 1

Silas

Meet ‘Spicy’ Silas

Currently up for adoption at the Brookhaven Animal Shelter, Silas is a pint-sized bundle of energy and personality! At approximately 2 years old and 30lbs, this spunky terrier mix is ready to charm his way into your heart.

Despite his small stature, Silas has a BIG personality! He’s full of sass and loves to play, especially with other dogs. Silas may be little, but he’s fearless and enjoys romping around with bigger pups. He can be weary of strangers but with a bit of patience and continued training, Silas is sure to thrive in a loving home.

Silas is seeking a forever family with experience handling feisty terriers. He’ll do best in a quieter adult home without children, but another dog-friendly dog would be the perfect companion for him. Silas thrives on playtime and goofiness, and he’s eager to show off his full personality in a supportive environment.

If you’re ready to welcome this lively little guy into your home and heart, fill out a matchmaker application at www.brookhavenny.gov/152/Animal-Shelter. Silas can’t wait to find his forever family and share all his love and playfulness with them. Let’s make Silas’s dreams of a forever home come true! 631-451-6955/ 631-451-6953

Rescue is a lifestyle. Adopt, don’t shop.

Check out the next Paw Prints in the issue of May 2.

Paw Prints is generously sponsored by Mark T. Freeley, Esq.

 

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Antibiotic use can affect the microbiome

By David Dunaief, M.D.

Dr. David Dunaief

Each of us has a microbiome — trillions of microbes that include bacteria, viruses and single-cell eukaryotes that influence our body’s functions. When “good” and “bad” microbes are in balance, we operate without problems. However, when the balance is tipped, often by environmental factors, such as diet, infectious diseases, and antibiotic use, it makes us more susceptible to diseases and disorders.

While the microbiome is found throughout our bodies, including the skin, the eyes and the gut, we’re going to focus on the gut, where most of our microbiome lives.

Research into the specifics of our microbiome’s role in healthy functioning is still in its infancy. Current research into the microbiome’s effects include its role in obesity, diabetes, irritable bowel syndrome, autoimmune diseases, such as rheumatoid arthritis and Crohn’s, and infectious diseases, such as colitis.

What influences our microbiome?

Lifestyle, such as diet, can impact our microbiome positively or negatively. Microbiome diversity may be significantly different in distinct geographic locations throughout the world, because diet and other environmental factors play such a large role.

When we take drugs, such as antibiotics, we can wipe out our microbial diversity, at least in the short term. This is why many have gastrointestinal upset while taking antibiotics. Antibiotics don’t differentiate between good and bad bacteria when they go to work.

One way to counteract these negative effects is to take a probiotic during and after your course of antibiotics. I recommend Renew Life’s 30-50 billion units once a day, two hours after an antibiotic dose and continuing once a day for 14 days after you have finished your prescription. If you really want to ratchet up the protection, you can take one dose of probiotics two hours after each antibiotic dose.

How does the microbiome affect weight?

Many obese patients continually struggle to lose weight. Obese and overweight patients now outnumber malnourished individuals worldwide (1).

For a long time, the paradigm for weight loss had been to cut calories. However, extreme low-calorie diets were not having a long-term impact. It turns out that our guts may play important roles in obesity and weight loss, determining whether we gain or lose weight.

The results from a study involving human twins and mice are fascinating (2). In each pair of human twins, one was obese and the other was lean. Gut bacteria from obese twins was transplanted into thin mice. The result: the thin mice became obese. However, when the lean human twins’ gut bacteria were transplanted to thin mice, the mice remained thin.

By pairing sets of human twins, one obese and one thin in each set, with mice that were identical to each other and raised in a sterile setting, researchers limited the confounding effects of environment and genetics on weight.

The most intriguing part of the study compared the effects of diet and gut bacteria. When the mice who had received gut transplants from obese twins were provided gut bacteria from thin twins and given fruit- and vegetable-rich, low-fat diet tablets, they lost significant weight. Interestingly, they only lost weight when on a good diet. The authors believe this suggests that an effective diet may alter the microbiome of obese patients, helping them lose weight. These are exciting, but preliminary, results. It is not yet clear which bacteria may be contributing these effects.

Does gut bacteria contribute to the development of rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that can be disabling, with patients typically suffering from significant joint soreness and joint breakdown. What if gut bacteria influenced RA risk? In a study, the gut bacteria in mice that were made susceptible to RA by deletion of certain genes (HLA-DR genes) were compared to those who were more resistant to developing RA (3). Researchers found that the RA-susceptible mice had a predominance of Clostridium bacteria and that those resistant to RA were dominated by bacteria such as bifidobacteria and Porphyromonadaceae species. The significance is that the bacteria in the RA-resistant mice are known for their anti-inflammatory effects.

Although we can’t yet say what the ideal gut bacteria should consist of, we do know a few things that can help you. Diet and other lifestyle considerations, such as eating and sleeping patterns or their disruptions, can affect the composition and diversity of gut bacteria (4). Studies have already demonstrated prebiotic effects of fiber and significant short-term changes to the microbiome when eating fruits, vegetables, and plant fiber. The research is continuing, but we’ve learned a lot already.

References:

(1) “The Evolution of Obesity”; Johns Hopkins University Press; 2009. (2) Science. 2013;341:1241214. (3) PLoS One. 2012;7:e36095. (4) Nutrients. 2019 Dec;11(12):2862.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Change is not just a distant possibility, it’s a force shaping the way we live, work and connect with one another today. 

From artificial intelligence and machine learning to environmental and clean energy initiatives, the landscape of technology is evolving at an unprecedented pace, presenting us with both challenges and opportunities. 

In recent news we have seen the incorporation of AI in the classroom, workforce and in industry. We have seen integration of technology on a local level as in the case of the CBORD Patient app for meal ordering at Stony Brook University Hospital. We even see technology connecting one another in civics and other community gatherings with the use of platforms such as Zoom. We have the opportunity to chat in the many community-run online forums accessed via Facebook and other platforms.

We have seen proposals for clean energy initiatives such as the Sunrise Wind project or the governor’s proposal for electric school buses. We have also seen investments and grants given to institutions such as Brookhaven National Lab and Stony Brook University to help further innovation and creation. 

While some may view these changes with apprehension or skepticism, we must recognize that the march of progress is unavoidable. Rather than resisting the tide of innovation, let us embrace it as a means to propel our community forward into a brighter, more prosperous future.

One of the most promising aspects of integrating emerging technologies into our community is the potential to enhance efficiency and effectiveness across various sectors. Whether it’s optimizing transportation systems through the use of predictive analytics or improving access to health care services through telemedicine and patient assistive applications, technology has the power to revolutionize the way we deliver essential services and meet the needs of our residents.

Moreover, the integration of emerging technologies can foster economic growth and innovation, attracting new businesses, entrepreneurs and investment opportunities to our community. 

However, as we embark on this journey of technological integration, it’s essential that we do so with careful consideration for the ethical, social and environmental implications of our actions. 

As we embrace emerging technologies, let us not lose sight of the importance of human connection and community cohesion. While technology has the power to connect us in unprecedented ways, it can never replace the warmth of a face-to-face conversation or the sense of belonging that comes from being part of a close-knit community. 

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By Daniel Dunaief

Daniel Dunaief

We have learned to be impatient. Combining our instant gratification experiences with the information, access and communication at our fingertips, we have less tolerance to wait for anything.

When we find out we’ll have to stand in line for a meal for more than half an hour, we dive into our phones, searching for other nearby restaurants where we can eat within 10 minutes or less.

When we wait on the phone for customer service, we shake our heads, bite our lips, roll our eyes and sigh repeatedly while waiting for someone who encourages us to try the app or to use the automated system next time.

We want life to be at least as good if not better today than yesterday and we want that now. It’s a tough time to have to demonstrate patience and to show that we understand that life involves processes.

When we recover from an injury, we want to look at the damaged part of our bodies and, like Superman, somehow fix it by glaring at it or willing the cells involved in the process to work faster and to allow us to run on a stress fracture in our foot or to self-heal a torn rotator cuff so we can go back out and play tennis or softball again.

It’s tough to celebrate or appreciate small victories because we know where the finish line of our recovery is, where the endpoint of our request is and whatever we want immediately.

Perhaps we need to recalibrate our expectations to understand and appreciate what small wins look like. While we know what we’d like with the end result, we can see small improvements as a way to enjoy the moment and to understand and appreciate how we’re on the right track.

In recovering from my stress fracture, I have been impossibly impatient, staring at the treadmill the way I used to long for an ice cream sundae with hot caramel and chocolate sprinkles.

The treadmill, where I overdid my exercise routine and created the stress fracture, had been a source of relief.

Several times over the last few weeks, I was tempted to see if I could restart my running, only to decide, reluctantly, that I would be jeopardizing my longer term recovery.

Instead, I limited my walking and have appreciated how much better my foot feels when I maneuver around the house. The recovery isn’t complete, but the improvement, which seemed imperceptible at first, is now noticeable.

Recently, on a short walk with my dog, I spoke with a friend whose mother was celebrating a milestone birthday. Paul was frustrated with the lower quality of life that his mother is enduring, as she struggles with her memory and doesn’t enjoy many of the same things, like food and family, that used to bring her pleasure.

Paul wondered at the regular frustration he felt at the incremental losses he, his mother and their family felt each day.

While both my brothers are doctors, as was my father, I have no medical training, which makes it impossible for me to offer an informed opinion on the cognitive and physical processes that occur at the end of people’s lives.

That didn’t stop me from suggesting ways to find small wins each day, which may depend on the mental state of his mother.

At some point, those wins, whether they involve a memory of something meaningful to his mother, a card game that reaches completion, or a song she enjoys hearing can become the focus of a visit, rather than the parts she and they lose, can become the new yardstick for a win.

Impatience for something better immediately is a luxury, as are so many other aspects of life, we take for granted.

When the light turns green, we want to make the light so we can reach our destination. At the same time, a red light can give us a few extra seconds to look at the spring flowers blooming around someone’s house, to hear children shouting with delight as they pile into a car on the way to their youth soccer game, or to extend a conversation that might otherwise end when we step out of the car.

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