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Where people live, conflicts thrive.

It’s inevitable. Get two people in a room for long enough and, eventually, they will find elements about the other person that irritate them. It’s what drives people to watch some reality TV shows. Participants can’t stand each other, they call each other names and, before you know it, someone is screaming at someone else and the viewing audience at home is rubbernecking through the drama.

When it happens to other people, it’s entertainment. When it happens to us, it can hurt.

Why do we care what other people think? We know that some people will find fault with everyone — their mothers, siblings and bosses — making criticism inevitable and, ultimately, meaningless.

If someone stood on the side of the road and yelled “Duck!” often enough, pretty soon people would stop ducking, would stop looking for ducks, and, like so many other noises around them, wouldn’t hear the warning anymore.

And yet, when someone we know or even someone we’ve recently met indicates a disdain for us, scowls at our presence, or undermines our abilities, intelligence or effort, we feel cut to the quick. That person might just be repeating the same criticisms to us that he or she levies at everyone all the time.

It’s like a fortune cookie. We read something that says, “You need to think twice before taking advice.” Wow, we think, how incredibly insightful, even as we ignore the irony that we are taking advice from a small slip of paper crushed into a Pac-Man shaped cookie. Someone recently gave me advice that seems valuable, like quitting a job I hate, but maybe that person just wants to take my job or doesn’t want to hear me complaining. Maybe that advice doesn’t really apply to me after all.

The same holds true for insults, criticism and nastiness. It could apply to us or it could just be fortune cookie nastiness, conjured up by someone who may not enjoy the life he or she leads, trying to make everyone as miserable as them.

Insults are ubiquitous. Much of the time, however, the insult is an opinion, not a fact. There are times when an admonishment such as “You weren’t driving well” is accurate, particularly if you were driving the wrong way on a one-way street.

We don’t immediately imagine the person doing the insulting might be sharing an opinion about us that we would almost instantly dismiss if it were about our spouse, our children, our parents or our close friends. We think, “Maybe I am terrible at this,” or “Maybe I should be embarrassed.”

People make puppets, write stories about fictional characters, draw cartoons and imaginary figures because they want to control something.

But just because they want control doesn’t mean you have to give it to them. Even assuming someone doesn’t like you, your appearance or your ideas, so what? Our preferences are so subjective that we can’t or shouldn’t try to please everyone.

We don’t have to play those reindeer games. We can disagree and express our opinions without attacking someone else. We follow whatever rules we set for ourselves and don’t need to fight fire with fire, hit back 10 times harder or show that we mean business. We can be more graceful than our detractors.

When someone attacks us, we don’t have to act as if we’re wearing a target. We can look at that person, put a slow smile on our face and say, “It’s too bad you feel that way. Maybe a good fortune cookie would cheer you up?”

There are serious side effects of NSAIDs and Tylenol

Dr. David Dunaief

Most of us keep a few key items in our medicine cabinets. In addition to aspirin, among these are usually NSAIDs (non-steroidal anti-inflammatory drugs) and acetaminophen (Tylenol). We often use them for relief of pain, fever or inflammation. Familiar NSAIDs include ibuprofen (Advil, Motrin) and naproxen sodium (Aleve). It is estimated that more than 17 million people use NSAIDs on a daily basis. According to a poll of these regular users of over-the-counter (OTC) NSAIDs, a substantial number — 60 percent — were unaware of their dangerous side effects (1).

Acetaminophen is used frequently, as well. On a weekly basis, one quarter of Americans take it. 

We think of these drugs as relatively benign. In fact, I find that unless I specifically ask about their use, most patients don’t include them on a list of their medications on a patient registration form. 

NSAIDs: The statistics

Unfortunately, NSAIDs, according to the Centers for Disease Control and Prevention, are responsible for 7,600 deaths annually and 10 times that number in hospitalizations (2). These are not medications that should be taken lightly. NSAIDs increase the risk of several maladies, including erectile dysfunction, heart attacks, gastrointestinal bleeds, exacerbation of diverticular disease and chronic arrhythmias (abnormal heartbeats). In some instances, the cardiovascular effects can be fatal. 

NSAIDs: Studies demonstrating adverse side effects

In a case control (epidemiologic, retrospective) study using the UK Primary Care Database, chronic users of NSAIDs have a significantly increased risk of a serious arrhythmia (abnormal heartbeat) called atrial fibrillation (3). Patients were between 40 and 89 years of age. 

Interestingly, chronic users were defined as patients who took NSAIDs for more than 30 days. Those patients who used NSAIDs more than 30 days had a 57 percent increased risk of atrial fibrillation. A Danish study reinforces these results after the first month of use (4). This is not very long to have such a substantial risk. For patients who used NSAIDs longer than one year, the risk increased to 80 percent. Caution should be used when prescribing NSAIDs or when taking them OTC. Atrial fibrillation is not an easy disease to treat.

NSAIDs also increase the risk of mortality in chronic users. Older patients who have heart disease or hypertension (high blood pressure) and are chronic NSAIDs users are at increased risk of death, according to an observational study (5). Compared to those who never or infrequently used them over about 2.5 years, chronic users had a greater than twofold increase in death due to cardiovascular causes. High blood pressure was not a factor, since the chronic users actually had lower blood pressure. Yet I have seen with my patients that NSAIDs can increase blood pressure. 

Is acetaminophen the answer?

Acetaminophen does not cause gastrointestinal bleeds, arrhythmias and deaths due to cardiovascular events that NSAIDs can. However, the Food & Drug Administration announced in 2011 that acetaminophen should not exceed 325 mg every four to six hours when used as a prescription combination pain reliever (6). The goal is to reduce and avoid severe injury to the liver, which can potentially cause liver failure. 

There is an intriguing paradox with acetaminophen: Hospitals typically dispense regular-strength 325-mg doses of the drug, whereas OTC doses frequently are found in extra-strength 500-mg tablets, and often the suggested dose is two tablets, or 1 gram. Patients should not take more than 4 grams a day to lower their risk of liver damage. The 4-gram amount sounds like a significant quantity, but it translates into two pills of extra-strength Tylenol every six hours.

I have patients who have taken three pills at one time thinking that, since it is OTC, exceeding the dose is okay. Unfortunately, this is not true. 

The FDA’s recommendations for limiting the dose result from a conglomeration of data. For instance, one study that showed acute liver failure was due primarily to unintentional overdoses of acetaminophen (7). Accidental overdosing is more likely to occur when taking acetaminophen at the same time as a combination sinus, cough or cold remedy that also contains acetaminophen. Over-the-counter cold medications can contain acetaminophen. 

In order to be aware of potentially adverse events, you have to be your own best advocate and read labels. Remember to tell your physician if you are taking OTC medications. If you are a chronic user of NSAIDs because of underlying inflammation, you may find an anti-inflammatory diet, which is usually plant-based, is an effective alternative.

References: 

(1) J Rheumatol. 2005;32;2218-2224. (2) Annals of Internal Medicine, 1997;127:429-438. (3) Arch Intern Med. 2010;170(16):1450-1455. (4) BMJ 2011;343:d3450. (5) Am J Med. 2011 Jul;124(7):614-620. (6) FDA.gov. (7) Am J Gastroenterol. 2007;102:2459-2463. 

Dr. 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.

٭We invite you to check out our new weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

Aaron Sasson. Photo courtesy of Stony Brook Medicine

By Daniel Dunaief

Thanks to the efforts of Stony Brook University School of Medicine’s Chief of Surgical Oncology Aaron Sasson and numerous doctors and researchers at Stony Brook, Long Island has its first National Pancreas Foundation Center.

A nonprofit organization, the National Pancreas Foundation goes through an extensive screening process to designate such centers around the country, recognizing those that focus on multidisciplinary treatment of pancreatic cancer. The NPF offers this distinction to those institutions that treat the whole patient and that offer some of the best outcomes and improved quality of life for people suffering with a disease who have an 8 percent survival rate five years after diagnosis.

Sasson appreciates the team effort at the medical school. “As opposed to one person leading this, there are many people here who are required to have an interest in pancreatic cancer,” he said. “We are not only looking to build a great infrastructure for the treatment of pancreatic cancer, but we’re also looking to build a team for research on pancreatic cancer.”

Sasson highlighted the research efforts led by Yusuf Hannun, the director of the Cancer Center at SBU, who has helped attract a “tremendous number of scientists” to engage in research into this disease.

The recognition by the NPF helps the university recruit physicians who are clinically interested in developing ways to improve the outcome for patients.

Pancreatic cancer presents particular challenges complicated by its biological aggressiveness, its difficulty to detect and by the many subtypes of this disease. “It’s similar to lung and breast cancer,” Sasson said. “There are many facets of those cancers. You can’t lump them all together.”

Researchers and clinicians are still trying to understand pancreatic cancer in greater detail. Once they have done that, they can advance to treating the possible subtypes.

Numerous researchers at SBU have developed collaborations with scientists at Cold Spring Harbor Laboratory. David Tuveson, the director of the National Cancer Institute-designated Cancer Center, has engaged in collaborations with SBU scientists in his work on organoids, which are model human organs grown in a lab. Scientists use organoids to test drugs and molecular pathways involved in pancreatic cancer.

Members of the Long Island community can take comfort in the continuing dedication of the numerous staff members committed to finding a cure. “Residents of Suffolk County and Long Island should be proud of what Stony Brook has been able to accomplish,” Sasson said.

Stony Brook University has been involved in several clinical efforts. The university developed a drug called CPI-613, for which Rafael Pharmaceuticals is in the early stage of clinical trials in combination with other drugs.

In early stages, the treatment increases the vulnerability of cancer cells to numerous other drugs. Newark, New Jersey-based Rafael Pharmaceuticals is testing this treatment in pancreatic cancer and in acute myeloid leukemia.

At SBU facilities, Sasson explained that researchers and clinicians are taking a multidisciplinary approach in their work. One study, he said, is exploring the effects of a kind of radiation therapy for a subpopulation of pancreatic cancer that combines expertise in radiology, gastroenterology, pathology and medical and surgical oncology.

Sasson himself is interested in screening and biomarkers. At least half of his work is related to pancreatic cancer. When he thinks about people who have battled pancreatic cancer, several patients come to mind. He had a patient who was about 80 at the time of his diagnosis. His primary doctor told him to get his affairs in order.

“We operated on him and he lived another six or seven years,” Sasson recalls. “He was grateful to see his grandchildren graduate and to see his great-grandbabies being born.”

While every patient is unlikely to have the same outcome, Sasson said surrendering to the disease and preparing for the inevitable may not be the only option, as there may be other courses of action.

Another patient had advanced pancreatic cancer for 18 months before Sasson met her. She had received no treatment and yet the cancer didn’t progress, which is “almost unheard of and unbelievable.” In fact, the case defied medical expectations so dramatically that the doctors conducted two more biopsies to confirm that she had pancreatic cancer. “She did well for many years despite having advanced pancreatic cancer.”

In another case, a patient was receiving surveillance for lung cancer every three months. In between those visits, he had developed metastatic pancreatic cancer. This patient example and the previous one show the range of cancer progression.

The value of having an integrated clinical and research program is that scientists can look for subtle clues and signals amid the reality of cancer with a wide range of outcomes. Indeed, scientists attend the weekly tumor board meeting, so they can learn about the clinical aspects of the disease. Doctors also attend research collaborations so they can hear about developments in the lab.

Rather than dictating how researchers and clinicians should collaborate, Sasson hopes to facilitate an environment that sparks these partnerships.

Sasson joined Stony Brook Medical School almost three years ago. He said he is “impressed with the caliber of physicians.” It took time to get the critical mass and organization for pancreatic cancer to match the number of basic science investigators.

“I’m hopeful for the progress we’ll be able to make to treat this terrible disease,” he said.

TAKING A REST ON A HOT DAY

Bill Pollack of East Setauket took this lovely photo of a cabbage white butterfly sitting on a cucumber leaf in his garden on Aug. 12  with a Samsung Galaxy S7. He writes, ‘I followed it for several minutes while it was deciding which leaf to land on.’

Send your Photo of the Week to leisure@tbrnewspapers.com.

District Attorney Tim Sini (D) has announced a new initiative to combat the drug epidemic ravaging Suffolk County. File photo by Victoria Espinoza

By Fr. Francis Pizzarelli

Father Frank Pizzarelli

Recently District Attorney Tim Sini (D) announced a new initiative to combat the drug epidemic ravaging Suffolk County. The Comprehensive Addiction Recovery and Education Program, or CARE Program, allows nonviolent defendants with substance abuse disorders a full dismissal of chargers if the person successfully completes a 90-day treatment program. It was designed by prosecutors, defense attorneys and court officials.

This initiative is definitely a positive step in the right direction. As someone who has provided outpatient and residential treatment for addictions for more than 25 years, I am deeply concerned that this effort lacks substance and appropriate resources for those struggling with substance abuse and mental health issues.

Many of our judges have already been open to alternative sentencing for nonviolent drug offenders. 

There are some important facts that seem to always get buried when this important issue is raised. These are facts that the public should know. 

First and foremost, we do not have nearly enough detox and/or residential treatment beds.

And insurance no longer covers a full 28-day stay in a residential treatment program. At best, most will only cover 7 to 11 days. That is unconscionable. More tragically, many insurance companies tell those battling chronic addiction “try outpatient treatment first — fail at this then we will pay for residential care.”

A growing number of young men and women are trying outpatient treatment first and are failing in record numbers. They are dying! What is very disturbing is that few to no voices are crying out about this horrific human atrocity.

Evidence-based treatment grounded in competent research states that the chronic opioid and heroin addict needs long-term residential treatment if long-term recovery is the hope for outcome.

Presently in Suffolk County we have two programs that provide more than three months of care. Only one program is not insurance based.

So the CARE initiative is a great step forward. Let’s not set those struggling with addictions within the criminal justice system up for failure because we lack the comprehensive and competent resources to make the CARE Program an effective tool on one’s road to recovery and wellness.

Unfortunately, outpatient programs have very limited success with chronic drug abusers. Do some enter and sustain health recovery? Yes, but a growing number fail.

As one local religious leader, I have presided at way too many funerals for young people who have died senselessly around addiction. In the past three weeks, I have had three young adults with tremendous potential lose their lives because of overdosing on heroin. I have talked with many of my colleagues in religion who are burying a record number of young people within their own faith traditions. 

Actions speak louder than words. The violence of our silence is contributing to this national health crisis. Change and transformation is possible. I live among these miracles everyday.

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

The first question that must be answered is whether you are determined a resident of New York. Stock photo

By Nancy Burner, Esq.

Nancy Burner, Esq.

We have seen many clients considered “snowbirds,” those who maintain a residence in New York but travel down south during our harsh winters. For our snowbird clients who want to create estate planning documents and plan for possible care needed in the future, it is important to determine if you should see an attorney in New York or elsewhere. 

The first question that must be answered is whether you are determined a resident of New York or of the other state you are visiting. Some factors to determine residency include the amount of time spent in each state, your mailing address, which state your driver’s license is held, where your car is registered, where you are registered to vote and where you file your income taxes.

Once you determine which state is your primary residence, there are other considerations to be examined regarding your estate plan. Snowbirds should consider where they plan on living in the future and where they think they will likely receive care. There may be a possibility that you move down south upon retirement but you plan to move back to New York to be with family members when you are in need of assistance. Since most clients do not have a plan set in stone, they should have estate planning documents, which may include Medicaid asset protection, that would cover them in either state.

Because the laws governing estate planning and Medicaid benefits differ from state to state, it is advisable that you have your documents reviewed by an attorney in both states to ensure that they comply with the laws in both places. For example, there is an additional signature required on a last will and testament in Florida that is not required in New York. Complying with Florida law when executing a last will and testament will not invalidate the document if it is probated in New York. This will avoid any issues or delay in administration if your will is probated in Florida. 

Additional examples of differences in the law are for powers of attorney and advance directives, including health care proxy and living will documents. Since these are state-specific laws, they often have different terminology that can be confusing when moving between locations. 

For a health care proxy in New York the person named to make your medical decisions is called your “agent.” In Florida the term for the agent acting as your health care proxy is a “surrogate.” In Florida the term used under the law to name the default agent appointed is “proxy.” This could cause unnecessary confusion and should be addressed by your estate planning attorney. 

The language and powers listed in your power of attorney will also differ by state. This becomes especially important when your agent is assisting in long-term care planning. You should make sure that your power of attorney includes all of the possible powers your agent may need should you need long-term care whether it is by privately paying or applying for Medicaid to cover your care costs. This may include: the power to prepare, sign and amend a trust agreement; allow for transfers of assets to your agent; and enter into contracts for caregivers or home health care services. 

For our snowbird clients it is important to consider where you are likely to receive care in the future. We recommend that you have your estate planning documents reviewed by an elder law and estate planning attorney in New York and your warm winter destination. 

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

Flatbread with Ricotta, Swiss Chard and Scallion Topping

By Barbara Beltrami

One of the nice things about the influx of immigrants in recent years is that they’ve brought with them cultures that we were formerly unfamiliar with and have added a whole new dimension to our own culture and cuisine. 

For years, we’ve accepted and taken for granted the cuisines that western European and British immigrants brought with them and actually integrated them into what we now think of as basic American cuisine. But now dishes from regions in the Far and Near East as well as the Caribbean, Mexico and Central and South America have also assumed dynamic roles in our basic American cuisine. 

A good example is flatbread. Acting as the base for a limitless number of toppings, it makes a great light meal, tasty appetizer and healthful snack.

Basic Flatbread

YIELD: Makes approximately 20 pieces

INGREDIENTS:

2¼ ounces active dry yeast

1¾ cup flour

1 teaspoon coarse salt

¾ cup warm (100 F) water

2 teaspoons olive oil

DIRECTIONS:

In a large mixing bowl, combine yeast, flour and salt. Slowly add water and mix until dough starts to form a ball. Coat hands and a flat surface with flour and knead dough until it feels smooth and elastic. Place dough in oil-coated large bowl; cover with a clean damp linen or cotton towel; and let sit in a warm place about one hour or until doubled in size. Remove from bowl to floured surface and punch and knead gently. Separate dough into golf ball size pieces. With a rolling pin flatten each piece into a ⅛-inch-thick disk. Heat an ungreased skillet over medium setting and cook disk until dough begins to bubble, about one minute, flip it and cook other side. Serve warm with olives, olive oil, hummus, tzatziki or baba ghanoush or top with other ingredients in this column and broil.

Tomato, Feta, Chickpea and Kalamata Olive Topping

YIELD: Makes approximately 6 to 8 servings

INGREDIENTS:

One 15½-ounce can chickpeas, rinsed, drained and lightly mashed

2 large garden tomatoes, sliced thin

2 garlic cloves, minced

½ cup chopped fresh parsley

1 cup pitted chopped Kalamata olives

¹/₃ cup extra virgin olive oil

Juice of half a lemon

Freshly ground black pepper

DIRECTIONS:

Preheat broiler. Arrange first five ingredients on flatbread; drizzle with olive oil and lemon juice; sprinkle with black pepper; and place on a broiler pan rack and broil until topping starts to bubble, 5 to 10 minutes. Serve hot or warm with hard or soft cold drinks and spinach salad.

Ricotta, Swiss Chard and Scallion Topping

Flatbread with Ricotta, Swiss Chard and Scallion Topping

YIELD: Makes approximately 6 to 8 servings

INGREDIENTS:

1 bunch Swiss chard, cleaned, washed and chopped

1 teaspoon salt

Freshly ground black pepper

1 bunch scallions, cleaned, washed and sliced thin

1 cup fresh ricotta

¼ cup extra virgin olive oil 

Grated zest of half a lemon

Coarse salt and freshly ground black pepper

DIRECTIONS:

In a large covered skillet over medium heat, cook Swiss chard with salt, pepper and one cup water until limp and tender. When cool enough to handle, squeeze or press out all liquid and divide and spread evenly on flatbreads. Top with scallions and ricotta. Broil until bubbly, 5 to 10 minutes, remove, drizzle with oil and sprinkle with lemon zest and salt and pepper. Serve hot or warm with tomato and onion salad and cold drinks.

Photo courtesy of Kent Animal Shelter

MEET AVA!

The stories Ava could tell if she could talk. At only 1 year old this sweet but shy girl has had a rough start to life. Rescued from South Carolina, she’s now safe at Kent Animal Shelter looking for a home and family with lots of love and patience to help her come out of her shell. Could that be with you? Ava has beautiful brown eyes, a light and dark brown coat and a brown nose. She is spayed, microchipped and up to date on vaccines.

Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open from 10 a.m. to 4 p.m. every day. For more information on Ava and other adoptable pets at Kent, call 631-727-5731. 

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Summer is about to end, and with it the most mellow time of the year. I’d like to leave this season with a gentle and accurate message that came from the internet and resonates with me:

A newlywed young man was sitting on the porch on a humid day, sipping ice tea with his father. As he talked about adult life, marriage responsibilities and obligations, the father thoughtfully stirred the ice cubes in his glass and cast a clear, sober look on his son.

“Never forget your friends,” he advised, “they will become more important as you get older. Regardless of how much you love your family, you will always need friends. Remember to go out with them occasionally — if possible — but keep in contact with them somehow.”

“What strange advice!” thought the young man. “I just entered the married world. I am an adult and surely my wife and the family that we will start will be everything I need to make sense of my life.”

Yet he obeyed his father, kept in touch with his friends and annually increased their number. Over the years, he became aware that his father knew what he was talking about.

Inasmuch as time and nature carry out their designs and mysteries on a person, friends are the bulwarks of our life. After 70-plus years of life, here is what he, and you, and I will have learned:

Time passes.

Life goes on.

Children grow up. They cease to be children and become independent. And to the parents, it breaks their hearts but the children are separated from the parents because they begin their own families.

Jobs/careers come and go.

Illusions, desires, attraction, sex … weaken.

People can’t do what they did physically when they were young.

Parents die but you move on.

Colleagues forget the favors you did.

The race to achieve slows.

But true friends are always there, no matter how long or how many miles away they are. A friend is never more distant than the reach of a need, intervening in your favor, waiting for you with open arms and in some way blessing your life.

When we started this adventure called life, we did not know of the incredible joys or sorrows that were ahead. We did not know how much we would need from each other. Love your parents, take care of your family, but keep a group of good friends. Stay in touch with them. [Tell this to] your friends — even those you seldom see — who help make sense of your life. (End)

Friends, especially old friends, are witnesses to our life. They have helped us soldier though the hard times and been there with us for the celebrations and the fun times. We don’t have to explain much to them because they know most of the details already. They have aged along with us and can laugh at the same incongruities and absurdities that are specific to our generation. We can compare our satisfactions as well as our aches and pains, and share the advice and names of our physicians and our medicines. As we are reduced in stature, we are reduced together so the same relative heights hold and we continue on unperturbed.

Most satisfying is the shared wisdom that has come from living a substantial number of years. We can comfort each other as we laugh about the difficulties and perceived difficulties in our lives, and we never need to feel embarrassed about our thoughts or our hang-ups.

The most painful part comes with the inevitable loss of close friends. They are irreplaceable and their absence leaves a hole in our lives and our hearts. “I’m only going to befriend younger people I meet,” we declare. The same for our doctors and dentists, who have the temerity to retire or die.

So to my dear friends — and yes, those professionals who keep me together — just know how I treasure you.

Labor Day offers a chance to consider the division of labor that makes living on Long Island and in the United States so incredible.

Police officers stand ready to protect and serve. They leave their homes with the best of intentions, providing safety, security and order to our communities.

Similarly, firefighters offer an enormous measure of protection for us individually and collectively, racing into burning buildings to save us and keeping fires from spreading to nearby homes.

Members of the military protect our interests and help residents in our communities, country and strangers around the world.

Priests, rabbis, imams and other spiritual leaders encourage us to aspire to greatness, to see beyond our frustration and anger, and to believe in a higher purpose and a grander plan. They bring out the best in us and suggest ways to give our lives meaning beyond meeting our basic needs.

Psychologists and psychiatrists act as handrails for people’s minds and emotions, helping us deal with a wide range of challenges, frustrations and difficulties.

Doctors, nurses and medical health professionals refuse to allow bacteria, viruses or injuries to get the better of us, standing ready to help us fight an infection, determining what that mysterious pain is and, at best, help treat the cause of the disorder and not just the symptoms.

Sanitation workers enable us to keep our homes and communities clean.

Supermarket workers stock the shelves, help us find gluten-free food to manage our growing list of allergies, and make sure they have the specific brand of the milk we buy.

Car mechanics allow us to reach our appointments on time and make it to our children’s concerts.

Teachers feed hungry young minds, encouraging and inspiring the next generation, coming in before school or staying late to will students across another academic finish line.

Beyond offering the welcoming smile at many companies, receptionists wear numerous hats, directing traffic through offices, sending phone calls to the right extension, and knowing how to find anything and everything.

When we maneuver through the purchase of a home, the establishment of a will or the adoption of the newest member of our family, lawyers guide us through each process, becoming advocates for our interests and close confidants.

In the wee hours of the morning, bakers start the process of creating scones, heating up coffee and mixing the batter for birthday cakes.

Truck drivers spend hours on the road, carting all manner of goods, bringing foods or marble we have to have on our kitchen counters.

Ferry workers usher us back and forth on the Long Island Sound to visit family, to take ski trips, to return to college, or to visit sites in Connecticut and farther north.

Plumbers, electricians and structural engineers make sure our homes and offices operate smoothly, preventing a leak from becoming a flood, a spark from becoming a fire or a weak wall from becoming an accident site.

Driven by the desire to inform and to beat the competition, journalists search for news that offers valuable information.

Entertainers of all stripes keep us laughing, allow us to relate to people from other places or times — or take us on fantastic journeys to places in their minds.

Politicians represent our interests, debating and hopefully instituting the best policies for the rest of us.

Numerous others, whose professions didn’t make it into this space, also help our communities function.

While Labor Day is a chance to say “goodbye” to summer, it presents an opportunity to appreciate the hard work everyone performs.

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