Health

Huntington Hospital’s four midwives, from left, Laura Jabbour, Jessica Hilsenroth, Michele Mayer and Lindsay Price. Photo from Northwell Health

Huntington Hospital’s four midwives are now seeing patients at Northwell Health Physician Partners ob/gyn offices in Commack and Smithtown. 

Midwives Michele Mayer, Jessica Hilsenroth, Laura Jabbour and Lindsay Price have office hours at 777 Larkfield Road in Commack and 222 East Middle Country Road, Suite 114 in Smithtown. In addition, the midwives see patients at Huntington Hospital’s Women’s Center at 270 Park Ave. in Huntington.

“In response to patient requests, we have begun seeing women at these convenient offices to better serve the residents of Suffolk County,” said Mayer, supervisor of Huntington Hospital’s midwife practice. 

Midwives provide care to women from their first gynecologic visit through menopause with comprehensive prenatal care and natural childbirth; well woman exams; treatment of common gynecologic issues; and contraception consultation, initiation and surveillance.

To schedule an appointment with a Huntington Hospital midwife, please call 631-351-2415. 

For more information about the Northwell Health Physician Partners Obstetrics and Gynecology call 631-775-3290 (Smithtown office) or 631-470-8940 (Commack office).

Local officials and health professional are urging residents to get this year's flu shot. Stock photo

State, county and area hospitals are bracing for this year’s flu season following reports of a sharp increase in recent weeks in the number of flu cases in New York state.

About 11,000 confirmed cases of influenza were reported by the New York State Department of Health for the week ending Jan. 11. That’s an increase of 10 percent over the previous week, according to the New York State Flu Tracker. There were 641 new cases in Suffolk County. The statewide total this season stands at almost 44,000. 

Similarly, “widespread”’ flu activity was reported by health departments in 46 states as of the last week of December, according to Centers for Disease Control and Prevention data.

Stony Brook Children’s Hospital’s Dr. Sharon Nachman, division chief of Pediatric Infectious Diseases and professor of Pediatrics, said currently the hospital is in the midst of handling an influx of influenza cases.

“We are dealing with the children’s hospital being quite full,” she said. “We have a number of infants with the flu, and we are concerned about it.” 

“Community protection is everyone’s job.”

– Sharon Nachman

The hospital hopes to see an improvement in the next couple of weeks.

Nachman points to a number of reasons why we have been seeing more flu cases in the state: People unwilling to get vaccinated; individuals believing that they are safe from getting sick if they haven’t in the past; a belief that cold and flu medications are better than the shot, among other things.

“I ask patients, ‘Is there a legitimate reason why you don’t want to be vaccinated?’” Nachman said. “You have to think of who is also living in your household, like young people and the elderly. Community protection is everyone’s job.”

The division chief said if everyone got their flu vaccine there would be less people to treat.

“You are 100 percent at risk without the vaccine,” Nachman said. “The vaccine will not prevent someone from getting the flu, but it can lessen the severity of it and shorten its duration.”

She said despite some misconceptions, you can’t catch the flu from the vaccine as it does not contain a live virus. If you happen to get sick after getting a flu shot, it’s a coincidence as there are a lot of viruses and illnesses circulating during the winter months.

In an effort to curb flu cases in Suffolk County, officials announced recently that the county would be offering free influenza immunization to residents 6 months of age and older who are uninsured or whose health insurance does not cover flu immunization.

“The health and wellness of our residents is of utmost importance,” said Suffolk County Executive Steve Bellone (D) in a statement. “The flu has been on the rise, and we want residents to know it is not too late to protect yourself and your loved ones from what can turn into a debilitating disease by getting immunized as soon as possible.”

The county’s health department has been providing flu immunizations at a number of locations including Suffolk County Department of Health Services at Great River in the Town of Islip and at Riverhead Free Library.

Nachman said it is important to constantly wash your hands and if you are sick, stay home to avoid exposing others to the illness.

Flu shots are also available at local pharmacies, pediatrician and health care provider offices, as well at county-affiliated health centers.

People who are having difficulty finding flu shots or community groups serving those who are in need of flu shots are advised to contact the county Department of Health Services Bureau of Communicable Disease Control at 631-854-0333.

 

All fruits, vegetables, whole grains, nuts, seeds and beans contain some fiber. Stock photo
Fiber has powerful effects on disease prevention and reversal

By David Dunaief, M.D.

Many people worry about getting enough protein, when they really should be concerned about getting enough fiber. Most of us — except perhaps professional athletes or long-distance runners — get enough protein in our diets. Protein has not prevented or helped treat diseases in the way that studies illustrate with fiber. 

Americans are woefully deficient in fiber, getting between eight and 15 grams per day, when they should be ingesting more than 40 grams daily. 

In order to increase our daily intake, several myths need to be dispelled. First, fiber does more than improve bowel movements. Also, fiber doesn’t have to be unpleasant. 

The attitude has long been that to get enough fiber, one needs to eat a cardboard box. With certain sugary cereals, you may be better off eating the box, but on the whole, this is not true. Though fiber comes in supplement form, most of your daily intake should be from diet. It is actually relatively painless to get enough fiber; you just have to become aware of which foods are fiber rich.

Fiber has very powerful effects on our overall health. A very large prospective cohort study showed that fiber may increase longevity by decreasing mortality from cardiovascular disease, respiratory diseases and other infectious diseases (1). Over a nine-year period, those who ate the most fiber, in the highest quintile group, were 22 percent less likely to die than those in the lowest group. Patients who consumed the most fiber also saw a significant decrease in mortality from cardiovascular disease, respiratory diseases and infectious diseases. The authors of the study believe that it may be the anti-inflammatory and antioxidant effects of whole grains that are responsible for the positive results. 

Along the same lines of the respiratory findings, we see benefit with prevention of chronic obstructive pulmonary disease (COPD) with fiber in a relatively large epidemiologic analysis of the Atherosclerosis Risk in Communities study (2). The specific source of fiber was important. Fruit had the most significant effect on preventing COPD, with a 28 percent reduction in risk. Cereal fiber also had a substantial effect but not as great.

Does the type of fiber make a difference? One of the complexities is that there are a number of different classifications of fiber, from soluble to viscous to fermentable. Within each of the types, there are subtypes of fiber. Not all fiber sources are equal. Some are more effective in preventing or treating certain diseases. Take, for instance, a February 2004 irritable bowel syndrome (IBS) study (3). 

It was a meta-analysis (a review of multiple studies) study using 17 randomized controlled trials with results showing that soluble psyllium improved symptoms in patients significantly more than insoluble bran.

Fiber also has powerful effects on breast cancer treatment. In a study published in the American Journal of Clinical Nutrition, soluble fiber had a significant impact on breast cancer risk reduction in estrogen negative women (4). Most beneficial studies for breast cancer have shown results in estrogen receptor positive women. This is one of the few studies that has illustrated significant results in estrogen receptor negative women. 

The list of chronic diseases and disorders that fiber prevents and/or treats also includes cardiovascular disease, Type 2 diabetes, colorectal cancer, diverticulosis and weight gain. This is hardly an exhaustive list. I am trying to impress upon you the importance of increasing fiber in your diet.

Foods that are high in fiber are part of a plant-rich diet. They are whole grains, fruits, vegetables, beans, legumes, nuts and seeds. Overall, beans, as a group, have the highest amount of fiber. Animal products don’t have fiber. Even more interesting is that fiber is one of the only foods that has no calories, yet helps you feel full. These days, it’s easy to increase your fiber by choosing bean-based pastas. Personally, I prefer those based on lentils. Read the labels, though; you want those that are solely made from lentils without rice added.

If you have a chronic disease, the best fiber sources are most likely disease dependent. However, if you are trying to prevent chronic diseases in general, I would recommend getting fiber from a wide array of sources. 

Make sure to eat meals that contain substantial amounts of fiber, which has several advantages, such as avoiding processed foods, reducing the risk of chronic disease, satiety and increased energy levels. Certainly, while protein is important, each time you sit down at a meal, rather than asking how much protein is in it, you now know to ask how much fiber is in it. 

References:

(1) Arch Intern Med. 2011;171(12):1061-1068. (2) Amer J Epidemiology 2008;167(5):570-578. (3) Aliment Pharmacology and Therapeutics 2004;19(3):245-251. (4) Amer J Clinical Nutrition 2009;90(3):664–671. 

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.   

Artwork from local artists add beauty and warmth

By Heidi Sutton

John T. Mather Memorial Hospital in Port Jefferson recently completed an extensive renovation of its 2 South patient unit, designed to further reduce the risk of infection and increase patient comfort. The unit, which was named for New York Cancer & Blood Specialists thanks to its generous donation, officially reopened with a ribbon-cutting celebration on Jan. 6. The project was largely supported through community donations totaling close to $1.7 million.

Opened in 1973, 2 South, which primarily treats cancer patients, now features single-bed rooms for improved patient outcomes and privacy. Enhancements include new showers and enlarged bathrooms, a new nurses station, a patient family lounge and a serenity room for staff. 

One of the highlights of the newly renovated floor is the installation of 43 pieces of art that adorn the hallway walls. Titled “Wonders of Nature,” the pieces were chosen by curator Irene Ruddock. “My goal was to create a peaceful and serene environment that might provide a sense of spiritual healing. I looked for paintings that touched the soul and will provide comfort and solace for patients, staff, and visitors,” she explained. 

Twenty-nine local artists from LIMarts, the Setauket Artists and the North Shore Art Guild donated original works to add beauty and warmth to the unit including Ross Barbera, Shain Bard, Ron Becker, Joan Bloom, Kyle Blumenthal, Renee Caine, Anthony Davis, Bart DeCeglie, Julie Doczi, Lily Farah, Marge Governale, William Graf, Peter Hahn, Celeste Mauro, Judith Mausner, Lorraine McCormick, Ed McEvoy, Eleanor Meier, Rick Mundy, Karen Miller O’Keefe, Paula Pelletier, Joan Rockwell, Robert Roehrig, Joseph F. Rotella, Irene Ruddock, Ty Stroudsburg, Maria Lourdes Velez, Victoria Westholm and Patricia Yantz. 

“I will always to grateful to all the artists who, with their dedication to art, wished to share their gifts with Mather hospital,” said Ms. Ruddock.  

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Hospital Prez Looks Back at His 34 Years, End of Community Hospitals Across LI

Kenneth Roberts, Mather Hospital president, signs a banner that will be hung shortly outside the hospital to celebrate its 90th year. Photo by Kyle Barr

It all started with a dream from a local businessman and third-generation shipbuilder who lived in Port Jefferson. 

John Titus Mather passed away in 1928, but he was a huge part of the shipbuilding community during the later 19th century and early part of the 20th century. Before he died, he knew that he wanted to leave a legacy that would help the Port Jeff community for years to come. If only he could see it nine decades later. 

Mather held its cornerstone dedication ceremony May 4, 1929. Photo from Stu Vincent

This year celebrates the 90th anniversary of Mather Hospital, formally known as the John T. Mather Memorial Hospital, named after the man who envisioned the institution. His will clearly outlined that his family and loved ones were to be taken care of, and instructed his executor to “incorporate under the laws of the State of New York a nonsectarian charitable hospital, to be located in said village of Port Jefferson … so designed and constructed as to permit future enlargement, assuming that future needs may justify such action. It is my sincere hope that the citizens of Port Jefferson and vicinity will give their liberal and devoted support to said institution and endeavor to make it a success and a credit to the community,” the Mather website stated. Today, the hospital is decorated with a nautical theme to honor its founder. 

Opening Dec. 29, 1929, the hospital became a staple on Long Island, featuring 54 beds and state-of-the-art technology of its time. 

“Mather Hospital was the first community hospital in the Town of Brookhaven,” said Kenneth Roberts, president of the hospital. “So, for a long time, it was the gem of the community and it remains so to this day.”

And every 10 years or so, it seems like the hospital is adding a new service or wing, constantly evolving to become better than before. In 1962, a new surgical suite, emergency facility and an intensive care unit joined in. The expansion resulted in additional beds, totaling 110. A new psychiatric unit was added in 1973, upgrading the hospital to 203 beds and by 1997, the hospital reached its
current bed count of 248 spots. 

The reason for the constant upgrades was to continue better serving the community, the hospital president said. 

“Technology has changed dramatically,” Roberts said, “And has changed the delivery of health care here.”

Roberts became president of Mather in 1986 and has pioneered dozens of changes throughout the campus. For starters, people don’t smoke on the campus, anymore, which if one weren’t around at that time, came as a shock to the multitudes of hospital staff who weren’t shy of smoking. 

Mather Hospital was also the first hospital on Long Island, including Brooklyn and Queens, to have a successful in vitro fertilization program that started up in 1988. Being a leader in that program, it eventually became available elsewhere, so in 2008, the program closed to make room for others. 

“We just change with what the community needs,” Roberts said. 

Alongside the hospital, Roberts has also seen the community expand. 

Mather Hospital’s original facade. Photo from Stu Vincent

“I think it’s grown a lot,” he said. “Obviously the traffic, the expansion, the adding of lights on 347, the construction of the third lanes… there’s been a lot of growth in housing and in population out in this area. So basically, we made an attempt to change with the needs of the population.”

As the area grew, so did the competition from St. Charles Hospital down the road, and Stony Brook University Hospital just 15 minutes away. 

“We were the first community hospital and then St. Charles converted itself from a polio institution to a community hospital and we work closely with them to not compete in major services,” Roberts said. “But at the same time, to provide all the services that the community needed.” 

When St. Charles redesigned itself to a hospital in the 1940s, it actually ended up helping Mather which was at 120 percent patient occupancy. 

In 2013, it was recognized as a Magnet-designated hospital by the American Nurses Credentialing Center, which recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. 

Mather employs over 2,600 people, and has more than 600 staff and affiliated physicians. In 2016, the hospital cared for more than 12,500 inpatients and over 40,000 emergency patients. 

In December 2017, Mather formally joined the Northwell Health system as its 23rd hospital, something the hospital president constantly lauded. 

“It was a once-in-a-century decision going from an independent hospital to joining a larger system,” Roberts said. “Once you join a larger system, you’re in that larger system forever and it’s a big decision to make. We were extremely happy and pleased with the amount of resources that Northwell brings to the table.”

A group of nurses at Mather during its early years. Photo from Stu Vincent

Roberts added that there are no independently owned community hospitals on Long Island anymore. It’s a trend that’s predicated on costs and need, something, he said, a single standalone hospital would have a very difficult time doing on its own. Roberts said he sees a future where all hospitals and similar institutions are consolidated under just four or five health care companies.

“There’s a whole host of reasons why hospitals are going the same route, like all the other industries,” he said. “We see in the whole economy everybody’s changing: Airlines are basically consolidating, the big accounting firms … newspapers are consolidating.”

And although things have changed at Mather, Roberts is happy with what the
future holds. 

“I think that the future of Mather Hospital looks very good because of our affiliation with Northwell,” he said. “The services we will provide on a very high-quality basis, and we will continue to innovate and provide the services that the community needs.” 

He added that he is waiting on an approval to start a cardiac catheterization and electrophysiology service at Mather, and plans to grow its outpatient care over the next decade.

Stocking the fridge with healthy foods is a great way to start off the New Year. Stock photo

By David Dunaief, M.D.

Dr. David Dunaief

It is now the second week in January, and most of us have made a New Year’s resolution – or many of them. You’ve taken the first step, but how do you increase the “stickiness factor,” a term used by Malcolm Gladwell in his book, “The Tipping Point”?

Setting a goal that is simple and singular helps. We often overdo it by focusing on multiple resolutions, like eating better, exercising more and sleeping better. While these are all admirable, their complexity diminishes your chances of success. Instead, pick one to focus on, and make the desired impact part of your goal. For example, improve health by losing weight and reversing disease. 

Changing habits is always hard. There are some things that you can do to make it easier, though. 

Your environment is very important. According to Dr. David Katz, director, Yale-Griffin Prevention Research Center, it is not as much about willpower as it is about your environment. Willpower, Katz notes, is analogous to holding your breath underwater; it is only effective for a short timeframe. Thus, he suggests laying the groundwork by altering your environment to make it conducive to attaining your goals. Recognizing your obstacles and making plans to avoid or overcome them reduces stress and strain on your willpower. 

According to a study, people with the most self-control utilize the least amount of willpower, because they take a proactive role in minimizing temptation (1). Start by changing the environment in your kitchen.

Support is another critical element. It can come from within, but it is best when reinforced by family members, friends and co-workers. In my practice, I find that patients who are most successful with lifestyle changes are those where household members are encouraging or, even better, when they participate in at least some portion of the intervention, such as eating the same meals.

Automaticity: Forming new habits

When does a change become a new habit? The rule of thumb used to be it takes approximately three weeks. However, the results of a study at the University of London showed that the time to form a habit, such as exercising, ranged from 18 to 254 days (2). The good news is that, though there was a wide variance, the average time to reach this automaticity was 66 days, or about two months.

Lifestyle modification: Choosing a diet

U.S. News & World Report released its annual ranking of diets last week (3). Three of the diets highlighted include the DASH (Dietary Approach to Stop Hypertension) diet, the Ornish diet and the Mediterranean diet. These were the top three for heart health. The Mediterranean diet was ranked number one overall, and the DASH diet was ranked second. Both the Ornish and the DASH diets ranked in the top six. 

What do all of the top diets have in common? They focus on nutrient-dense foods. In fact, the lifestyle modifications I recommend are based on a combination of the top diets and the evidence-based medicine that supports them.

For instance, in a randomized crossover trial, which means patients, after a prescribed time, can switch to the more effective group, showed that the DASH diet is not just for patients with high blood pressure. The DASH diet was more efficacious than the control diet in terms of diabetes (decreased hemoglobin A1C 1.7 percent and 0.2 percent, respectively), weight loss (5 kg/11 lb vs. 2 kg/4.4 lb), as well as in HDL (“good”) cholesterol, LDL (“bad”) cholesterol and blood pressure (4). 

Interestingly, patients still lost weight, although caloric intake and the percentages of fats, protein and carbohydrates were the same between the DASH and control diets. However, the DASH diet used different sources of macronutrients. The DASH diet also contained food with higher amounts of fiber, calcium and potassium and lower sodium. 

Therefore, diets high in nutrient-dense foods may be an effective way to lose weight while treating and preventing disease. 

I will share one more tip: Take it day by day, rather than obsessing on the larger picture. Health and weight loss can – and should – go together.

References:

(1) J Pers Soc Psychol. 2012;102:22-31. (2) European Journal of Social Psychology, 40: 998–1009. (3) www.usnews.com. (4) Diabetes Care. 2011;34:55-57.

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.   

Suffolk County Legislator Sarah Anker speaks during the Jan. 2 press conference. Photo by David Luces

The opioid epidemic has hit Long Island hard over the past few years, but according to an annual county report, fatal opioid-related deaths have decreased significantly over the past year. 

The Suffolk County Heroin and Opiate Epidemic Advisory Panel’s 2019 Report released Jan. 2 found that opioid deaths in 2019 were projected at 283, which was an approximate 25.5 percent decrease from the 2018 total of 380.

“We are moving in the right direction,” said Suffolk County Legislator Sarah Anker (D-Mount Sinai), the chair of the panel, at the Jan. 2 press conference in Hauppauge. “The opioid crisis is costing Long Island upward of $8 billion a year in medical costs … that’s $22 million a day. Not only do we have to address the addiction issue, we have to also address mental health.”

“The opioid crisis is costing Long Island upward of $8 billion a year in medical costs … that’s $22 million a day. Not only do we have to address the addiction issue, we have to also address mental health.” 

– Sarah Anker

The 127-page report compiled by the 29-member panel highlights that the decreased numbers can be attributed to the increased use of Narcan, a drug that reverses the effects of overdoses. 

Other highlights from the previous year includes the panel collaborating to help open a DASH Center, a 24/7 resource center for individuals in search of treatment and resources located at 90 Adams Ave., Hauppauge. The officials also purchased a mass spectrometer, a device that detects and breaks down the chemical compounds of drugs. The device is used to help track where drugs are coming from, making it easier to identify dealers.  

Geraldine Hart, Suffolk police commissioner, said the force is focusing on addressing the drug dealer situation.  

“We have seen a decrease in opiate usage but that is not enough,” she said. “We have a strategy that is taking hold, it involves enforcement, prevention, education and treatment.”

The panel’s report also lists resources for residents, including a number of counseling programs, agencies, drug treatment courts and law enforcement initiatives like Sharing Opioid Analysis & Research (SOAR). 

The panel was created in 2017 in response to the growing opioid and substance abuse epidemic in Suffolk County and across the nation.

While deaths have decreased, the number of overdoses increased 140 percent from 71 to 170.

While members of the panel said the decrease in number of fatal overdoses is a great sign, the increasing number of overdoses not resulting in death is something that requires more investigation.

Jeffery Reynolds, president of the Family and Children’s Association, said the new data is encouraging but stressed that more needs to be done. 

“These gains can sometimes be precarious — it took a long time for opioids to brew in this region, we were slow to respond in the region and nation, and we paid the price for it,” he said. “We gave heroin a 10-year head start. The last thing we want to do is declare victory prematurely.” 

Reynolds said there is still a need for a DASH/recovery center on the east end of Long Island and that panel wouldn’t stop working until “the overdose number is at zero.”  

William “Doc” Spencer (D-Centerport), Suffolk County legislator and chair of the health committee, said it is also important to make sure the medical community is part of the solution. He mentioned there needs to be more research on genetic predisposition and environmental triggers relating to drug use.

“There’s a lot of work to be done but this is a major step [in the right direction],”Spencer said. 

Going into 2020, the panel will focus on addressing the following areas: the growing vaping epidemic, early education initiatives, childhood trauma intervention, possible marijuana legislation, the effects of recent bail reform laws, establishing a recovery high school, continuing overdose prevention discussions with the Metropolitan Transit Authority and Long Island Rail Road, increasing prescriber education, reducing the stigma of addiction and mental illness and collaborating with the Native American Advisory Board and establishing a youth committee. 

Anker said collectively the panel is trying to be as productive as possible. 

“It [the epidemic] is always changing and evolving,” she said. “The ability for law enforcement to work with the medical community, education [professionals] to work with advocates — this cross pollination is so vital in making sure this panel is successful.”

Contact the DASH Center at 631-952-3333

 

Photo from Made To Move

Made to Move Tennis & Wellness, 5 South Jersey Ave. in Setauket will hold a free fitness week from Jan. 13 to 19. Come in and try out a free tennis lesson, personal training session, nutrition coaching, life coaching and fitness and yoga classes. Call Tara at 631-751-6767 to reserve your spot. For more information, visit www.madetomovewellness.com.

Al Kirby, right, and his wife, Dawn, look on as Dr. Henry Tannous donates blood. Photo from Stony Brook Medicine

Stony Brook University Hospital doctors and staff members joined a Marine veteran to get a head start on National Blood Donor Month, which runs through January.

“Today is a good reminder of how we can all join together in turning a catastrophic event into a remarkable get together with a lot of potential to save numerous lives.”

— Dr. Henry Tannous

At a Dec. 23 press conference at the hospital, Al Kirby, 52, announced a blood drive to show his gratitude to SBUH doctors and staff members. The Shirley resident’s life was saved Christmas Day 2018 at Stony Brook after 10 hours of surgery where 27 units of blood were needed. Kirby’s doctors, wife, children, friends and family members joined him for the announcement.

“Today is a good reminder of how we can all join together in turning a catastrophic event into a remarkable get together with a lot of potential to save numerous lives,” said Dr. Henry Tannous, co-director of the Stony Brook University Heart Institute and chief of the Division of Cardiothoracic Surgery.

According to SBUH officials, one blood donation can potentially save three lives.

“This crucial act of kindness will allow more families like the Kirbys to spend more holidays together,” Tannous said.

Kirby was loading up his car with gifts after a visit to his in-law’s house when he felt an intense stabbing pain in his chest, a rapid heartbeat and a burning sensation in his throat. His wife, Dawn Kirby, called 911 and asked the emergency responders to bring her husband to SBUH. His wife after the press conference said she credits the doctors and those who donated blood for saving her husband’s life and is grateful for his recovery.

“Every day is like Christmas,” she said.

Emergency department providers and the Heart Institute’s Cardiac Catheterization Lab’s team ruled out a coronary blockage and discovered Al Kirby had a severe aortic dissection. It took seven hours in the operating room for doctors to repair the rupture of his main aortic vessel. The procedure also prevented further dissection. The seven-hour operation was followed by another three hours to stop the internal bleeding.

“To me, the doctors are gods here and the staff are beyond angels, because of you I’m alive.”

— Al Kirby

Tannous said the medical team didn’t let their guard down and pushed on until they found a diagnosis. For the operation, he said medical staff members had to leave their families abruptly, and the cardiovascular operating room team worked tirelessly through the night.

“A 9 hour and 52 minutes surgery is surely a test of what’s humanly possible,” Tannous said.

The doctor said the blood bank was a “powerful ally” that had the operating room team’s backs. He added that if one link was missing in the system, the operation wouldn’t have been as successful as it was. Half of those who suffer from the same medical condition die within 24 hours.

Dr. Puja Parikh, interventional cardiologist and co-director of the Transcatheter Aortic Valve Replacement Program at SBU Heart Institute, said that since the surgery she has been working with Kirby on controlling his blood pressure and that he is doing well. Uncontrolled blood pressure and underlying aortic aneurysms are risk factors of the condition, even though it’s not known what caused the veteran’s medical emergency.

Kirby said the staff has increased the size of his family.

“To me, the doctors are gods here and the staff are beyond angels, because of you I’m alive, and I thank all of you for donating blood, which allowed someone like me … to be here speaking today,” Kirby said.

After the press conference, the veteran’s family and Stony Brook Medicine team members headed to the blood bank to donate where Tannous was the first to roll up his sleeves.

For more information on how to donate to the Stony Brook Blood Bank, call 631-444-3662 or visit www.stonybrookmedicine.edu/patientcare/bloodbank.

A sedentary lifestyle can increase heart attack risk. Stock photo
Maintaining your mobility is crucial
Dr. David Dunaief

We have made great strides in reducing mortality from heart attacks. When we compare cardiovascular disease — heart disease and stroke — mortality rates from 1975 to the present, there is a substantial decline of approximately one-quarter. However, if we look at these rates since 1990, the rate of decline has slowed (1). We need to reduce our risk factors to improve this scenario.

Some risk factors are obvious. Others are not. Obvious ones include age (men at least 45 years old and women at least 55 years old), family history, high cholesterol, high blood pressure, obesity, sedentary lifestyle, diabetes and smoking. Less obvious ones include gout, atrial fibrillation and osteoarthritis. Lifestyle modifications, including a high-fiber diet and exercise, may help allay the risks.

Let’s look at the evidence.

Obesity

Obesity continually gets play in discussions of disease risk. But how substantial a risk factor is it?

In the Copenhagen General Population Study, results showed an increased heart attack risk in obese (BMI >30 kg/m²) individuals with or without metabolic syndrome (high blood pressure, high cholesterol and high sugar) and in those who were overweight (BMI >25 kg/m²) (2). The risk of heart attack increased in direct proportion to weight. Specifically, there was a 26 percent increase in heart attack risk for those who were overweight and an 88 percent increase in risk for those who were obese without metabolic syndrome. This study had a follow-up of 3.6 years.

It is true that those with metabolic syndrome and obesity together had the highest risk. But, it is quite surprising that obesity, by itself, can increase heart attack risk when a person is “metabolically healthy.” Since this was an observational trial, we can only make an association, but if it is true, then there may not be such a thing as a “metabolically healthy” obese patient. Therefore, if you are obese, it is really important to lose weight.

Sedentary lifestyle

If obesity were not enough of a wake-up call, let’s look at another aspect of lifestyle: the impact of being sedentary. An observational study found that activity levels had a surprisingly high impact on women’s heart disease risk (3). Of four key factors — weight, blood pressure, smoking and physical inactivity — age was the determinant as to which one had the most negative effect. Those under the age of 30 saw smoking as most negatively impactful. For those over the age of 30, lack of exercise became the most dominant risk factor for heart disease, including heart attacks.

For women over the age of 70, the study found that increasing physical activity may have a greater positive impact than addressing high blood pressure, losing weight or even quitting smoking. However, since high blood pressure was self-reported and not necessarily measured in a doctor’s office, it may have been underestimated as a risk factor. Nonetheless, the researchers indicated that women should make sure they exercise on a regular basis to most significantly reduce heart disease risk.

Osteoarthritis

The prevailing thought with osteoarthritis is that it is best to suffer with hip or knee pain as long as possible before having surgery. But when do we cross the line and potentially need joint replacement? Well, in a study, those with osteoarthritis of the hip or knee joints that caused difficulty walking on a flat surface were at substantially greater risk of cardiovascular events, including heart attack. (4) Those who had surgery for the affected joint saw a substantially reduced heart attack risk. It is important to address the causes of osteoarthritis to improve mobility, whether with surgery or other treatments.

Fiber

There have been studies showing that fiber decreases the risk of heart attacks. However, does fiber still matter when someone has a heart attack? In a recent analysis using data from the Nurses’ Health Study and the Health Professional Follow-up Study, results showed that higher fiber plays an important role in reducing the risk of death after a heart attack (5).  

Those who consumed the most fiber, compared to the least, had a 25 percent reduction in post-heart attack mortality. Even more impressive is that those who increased their fiber after the cardiovascular event had a 31 percent reduction in mortality risk. In this analysis, it seemed that more of the benefit came from fiber found in cereal. The most intriguing part of the study was the dose-response. For every 10-g increase in fiber consumption, there was a 15 percent reduction in the risk of post-heart attack mortality. Since we get too little fiber anyway, this should be an easy fix.

Lifestyle modifications are so important. In the Nurses’ Health Study, which followed 120,000 women for 20 years, those who routinely exercised, ate a quality diet, did not smoke and were a healthy weight demonstrated a whopping 84 percent reduction in the risk of cardiovascular events such as heart attacks (6).

What have we learned? We can substantially reduce the risk of heart attacks and even potentially the risk of death after sustaining a heart attack with lifestyle modifications that include weight loss, physical activity and diet — with, in this case, a focus on fiber. While there are a number of diseases that contribute to heart attack risk, most of them are modifiable. With disabling osteoarthritis, addressing the causes of difficulty with mobility may also help reduce heart attack risk.

References:

(1) Heart. 1998;81(4):380. (2) JAMA Intern Med. 2014;174(1):15-22. (3) Br J Sports Med. 2014, May 8. (4) PLoS ONE. 2014, Mar 14, 2014 [https://doi.org/10.1371/journal.pone.0091286]. (5) BMJ. 2014;348:g2659. (6) N Engl J Med. 2000;343(1):16.

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.