Health

Lisa Cooper embraces her son Dante Lombardo at a recent reunion. Photo from Lisa Cooper

Mental health, particularly among service members, often seems to be a forgotten topic. One man and his Northport High School friends want to change that by riding bicycles this June from New York to California to raise awareness about mental health concerns among those who have served our nation’s military. 

Dante Lombardo in uniform. Photo from Lombardo

Dante Lombardo is a former U.S. Marine who was medically discharged due to his mental health. The East Northport resident,  who graduated from Northport High School in 2015, served in the U.S. Marine Corps Reserve from 2015 to 2019. He was trained as a digital wideband transmission equipment operator and as a field radio operator. 

Throughout Lombardo’s time in the Marine Reserves, he struggled with depression and anxiety, and like many others in a similar position, tried to “tough it out,” because that’s what he said the current military culture dictates. “Nearly anybody who has served can tell you that it is highly frowned upon to seek out mental health care,” he explained.

These issues came to a head in April of last year for Lombardo, when he attempted to take his own life. Thankfully, he was connected with a local behavioral health service, giving access to the counseling and the psychiatric care he needed. 

“Had it not been for these services, I do not believe I would have ever begun the path to wellness that I am on today,” said Lombardo.

Unfortunately, many service members suffer from similar mental health issues but do not seek out the help provided by the military, Lombardo said, in fear of being separated from duty due to their issues.

The statistics are staggering.

“We see 20 veterans each day take their own lives,” said Barbara Van Dahlen, a clinical psychologist who created in 2005 a national network of professionals who provide free services to U.S. troops, veterans, their loved ones and their community. “People think that because the war is over, so are the challenges, but that’s not the case.” 

‘People think that because the war is over, so are the challenges, but that’s not the case.’

— Barbara Van Dahlen

As for Lombardo, he may no longer wear his Marine uniform, but he and his bike team are committed to fighting for their fellow service members. 

Lombardo, Brian Fabian and Anthony Rubin, all Northport High School graduates,  just earned their college degrees. Lombardo graduated from Clinton College, Fabian from SUNY Plattsburgh last weekend and Rubin from SUNY Buffalo. Now, they’re raising money in a GoFundMe campaign to pay for expenses that occur throughout the trip. Proceeds remaining will be donated to Give an Hour, which earns exceptional ratings as a charity on Guidestar. 

Give an Hour was chosen, the bike team stated, because it is an organization that is not affiliated with the Department of Defense and can provide mental health services to those in need, without running the risk of negative consequences from the service members chain of command. Lombardo said that the charity could provide service members the opportunity to get help and start healing before their issues become a crisis that demands the official attention of their command, or one that brings harm to themselves or others, while simultaneously defending them from the stigma of needing mental health care while serving.

“The need is huge,” Van Dahlen said in a phone interview. She is honored and grateful for Lombardo’s efforts to raise awareness and funds for the non-profit. 

Van Dahlen emphasizes the need for collaborative approach to address the issues. “We really can take care of the understandable mental health needs of those who serve and their families,” Van Dahlen said. “If we work together and coordinate services — we in the government, nonprofit and private sectors — our country can hopefully step up to serve those who have given so much.”

Northport residents Dante Lombardo, Brian Fabian and Anthony Rubin are riding bicycles cross-country to raise awareness about military mental health issues. Photo from Coast to Coast for Mental Health, Dante Lombardo’s supporters.

It’s a concept that Lombardo and his bike team understand. “This fight is not one person’s burden to bear, but instead one we face together.”

During the team’s travels cross-country, they plan to volunteer in soup kitchens, homeless shelters, elderly care homes and other places that offer opportunities to give back. Their journey aims to seek out and hear the testimonies of veterans nationwide so their stories may be heard. 

The bike team has created a Facebook group page, Coast-to-Coast for Mental Health, which will be updated to post stories and experiences of the team, as well as testimonies of those who have suffered. This trip is a humanitarian interactive wellness journey as seen through three young Long Island men who are raising awareness for those who suffer with mental health issues all too often in silence. 

Lombardo encourages people to share the funding page, the Facebook page, as well as sharing their own stories. His message to the public, “We’ll be seeing you on the trail.”

The Times of Huntington will provide updates of the team’s journey in upcoming issues.

The GoFundMe page, Give an Hour website and an overview of the charity from Charity Navigator  can be found at: 

GoFundMe: www.gofundme.com/tmt6z-coast-to-coast-for-mental-health

Give an Hour: www.giveanhour.org

Charity Navigator: www.charitynavigator.org/index.cfm?bay=search.summary&orgid=17415

In a recent study, those who watched at least six hours of TV per day during their lifetime had a decrease in longevity of 4.8 years. Stock photo
Television viewing can lower your physical and mental health

By David Dunaief, M.D.

Dr. David Dunaief

According to the Nielsen Company, Americans spend an average of 10½ hours per day watching programming of some kind, whether on a television, computer or a portable device (1). For our purposes, we’ll call this TV, because most is consumed while sitting, although the average watching modality has shifted considerably.

What impact does all this watching have on our lives? It may be hazardous to your health. I know this seems obvious, but bear with me. The extent of the effect is surprising. According to 2013 Netflix research, binge-watching, or watching more than two or more episodes of a single program in a row, is perceived as providing a refuge from our busy lives. This also has an addictive effect, prompting dopamine surges as we watch. Interestingly, it also can lead to postbinge depression when a show ends and to isolation and lower social interaction while viewing (2).

TV’s detrimental effect extends beyond the psychological, potentially increasing the risk of heart attacks, diabetes, depression, obesity and even decreasing or stunting longevity. My mother was right when she discouraged us from watching television, but I don’t think even she knew the extent of its impact.

Cardiovascular events including heart attacks 

There was a very interesting observational study published in the New England Journal of Medicine that showed watching sporting events increases the risk of heart attacks and other cardiovascular events, such as arrhythmia (irregular heartbeat) and unstable angina (severe chest pain ultimately due to lack of oxygen). The researchers followed Germans who watched the FIFA (soccer) World Cup playoffs in 1996. 

How much did watching increase the risk of cardiovascular events? This depended on what round of the playoffs and how close a game it was. The later the round and the closer the game, the greater the risk of cardiovascular events. Knockout games, which were single elimination, seemed to have the greatest impact on cardiovascular risk. When Germany was knocked out in the semifinals, the finals between France and Italy did not have any cardiovascular effect. 

Overall, men experienced a greater than threefold increase in risk, while women experienced an increased risk that was slightly below twofold. According to the authors, it was not the outcome of the game that mattered most, but the intensity. The study population involved 4,279 German residents in and around the Munich area (3). 

Another study found that, compared to fewer than two hours a day, those who watched four or more hours experienced an increased risk of cardiovascular disease mortality of 80 percent. I know this sounds like a lot of TV, but remember that the average daily American viewing time is significantly over this. This study, called the Australian Diabetes, Obesity, and Lifestyle study (AusDiab) was observational, looking at 8,800 adults over a six-year period (4). 

Impact on life expectancy 

The adage that life tends to pass you by when you watch TV has a literal component. An observational study found that TV may reduce the life expectancy of viewers. In the study, those who watched at least six hours per day during their lifetime had a decrease in longevity of 4.8 years. However, this is not the whole story. What is even more telling is that after the age of 25, for every hour of TV, one might expect to potentially lose 21.8 minutes of life expectancy (5). According to the authors, these results rival those for obesity and sedentary lifestyles.

Diabetes and obesity risk

In the Nurses’ Health Study, for every two hours of television viewing on a daily basis there were increased risks of type 2 diabetes and obesity of 23 and 14 percent, respectively (6). The results show that sitting at work for two hours at a time increased the risk of diabetes and obesity by only 5 and 7 percent, respectively, much less of an effect than TV watching. The authors surmise that we can reduce the incidence of diabetes and obesity by 43 and 30 percent, respectively, by cutting our TV time by 10 hours a week.

Modestly reducing the amount of television is a simple lifestyle modification that can have a tremendous impact on longevity, quality of life and prevention of the top chronic disease. So, step away from your television, tablet or computer and get out in the world.

References:

(1) Nielsen.com (2) nbcnews.com/better/health/what-happens-your-brain-when-you-binge-watch-tv-series-ncna816991. (3) N Engl J Med 2008; 358:475-483. (4) Circulation. 2010 Jan 26;121(3):384-391. (5) Br J Sports Med doi:10.1136/bjsm.2011.085662. (6) JAMA. 2003 Apr 9;289(14):1785-1791.

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. 

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Anthony Amen, back middle, with his emplyees at Redefine Fitness in Mount Sinai. Photo from Anthony Amen

Helping people and seeing the positive impacts on their lives is the best part of the job for Anthony Amen, the owner of Redefine Fitness in Mount Sinai. 

“There’s nothing better than that,” he said. 

Though for Amen, his path to opening his new business last fall started almost a decade ago when he was a sophomore in college at SUNY Oswego.  

It was there in February 2010 when Amen was playing broomball, a game played on ice in a similar way to hockey, but instead of a stick it’s done with a rubber-headed broom, and instead of skates players wear rubber-soled shoes. He was playing with his friends, but his life changed when a friendly game took a turn for the worse.

Anthony Amen after his injury in 2010. Photo from Amen

“We were playing a game and a friend of mine went in for a slide tackle,” he said. “I was trying to avoid the hit and slipped, fell backwards and whacked my head on the ice very hard.”

Amen suffered a serious concussion, along with injuries to his neck and back. For three-and-a-half months he was unable to look at any visible light and sat in his bed in the dark for much of the time.  

As a result of his head injury, Amen began suffering from debilitating migraines. He could barely move his head and he was unable to put his hands above his head. 

He said sought help from doctors, but each told him that concussions take time to recover from, and it was something he would have to learn to deal with. 

“I went to 25 different doctors and they all told me the same thing — ‘There’s nothing wrong with you. We can’t do anything,’” Amen said. “They put me on Percocet and muscle relaxants and told me ‘Good luck.’”

He said a doctor told him he was “a physician, not a magician. I don’t know what you want from me.”

It was those experiences that served as the catalyst that would change Amen’s life. 

Amen said he was stubborn, and he didn’t want to give up and didn’t want this to be his norm. 

“I started experimenting and working out in the gym to try to make myself better,” he said. “The more I did the better I felt.”

The Mount Sinai business owner said he was able to fix himself from getting migraines every week and being unable to get out of bed, to never having one in more than five years. 

“One of the biggest moments for me was being able to put my hands over my head again,” he said. 

Amen works on a fitness ball at his gym. Photo from Amen

Amen fell in love with fitness and wanted to teach people what he had learned. He began working at various gyms throughout Long Island as a trainer and in management, with a goal to eventually own a place of his own. A year-and-a-half ago, his vision became a reality when he decided he would open Redefine Fitness. 

“It was very stressful to open a business, but I was passionate about this and I had to try,” he said. ”I think it was the right time for me to try. I have no wife and kids — I didn’t want to regret not doing this.”  

In fall 2018, Redefine Fitness opened its doors with one of the goals of making the connection between fitness, medicine and rehabilitation. They use research-based information in conjunction with their certified trainers to make tailored workout programs for their clients. 

Amen admits the first few months open have gone better than he could have ever imagined.  

“The clients have been so great, they tell me they see the passion in me,” he said. 

One experience that sticks out to Amen was when he trained a 65-year-old woman who had a lung transplant and had a breathing machine. He said she would struggle to tie her own shoes. 

“We got her to squat 175 pounds and got her to run,” he said. “It was amazing seeing this woman’s life change from being told you couldn’t do something. It shows that if you put your mind to something you could achieve anything.”

The Mount Sinai gym has five trainers, including Amen, and offers one-on-one training sessions, weight loss programs and various classes as well as special needs and post-rehab programs. 

In the future, Amen hopes to expand the gym to other locations, and wants to continue making a positive impact in the community.  

Reflecting to his pre-college days, Amen said he was not the athlete type and used to run 15-minute miles and be happy about it. 

“Looking back I would’ve never pictured this in a million years,” he said. “I want to show [people] that there’s no giving up. I want to pass that knowledge and passion to everybody else.”

Members of the Royal Educational Foundation with Jill Nees Russell, center, in 2016

The Royal Educational Foundation of Port Jefferson is a not-for-profit educational corporation established in 1993 for the sole purpose of raising money to support and enhance the educational process in the Port Jefferson School District and to promote and support creative and innovative teaching techniques, programming initiatives and the utilization of new technologies in the classroom.  

Its board of trustees is comprised of community members who volunteer their time to organize fundraising events and to administer the foundation’s funds in cooperation with the school administration and board of education. Since its inception, the foundation has facilitated the granting of several hundred thousand dollars to the district.

Jill Nees Russell at Heritage Weekend in Port Jefferson in 2016.

Recently, the foundation lost a vital member of its board with the passing of Jill Nees Russell. She was a tremendous asset to the foundation, as well as to the school district and the greater Port Jefferson village community. She was a kind, caring and positive person who focused her energy on making Port Jefferson a better place. She led by example, was instrumental in moving many projects forward (new PTA events like the Science Fair and The Green Team, village programs like the Boater’s Maritime Festival, Heritage Weekend, Festival of Trees and The Holiday Light Show at Village Hall, just to name a few) and the positive impact of her selfless efforts will be felt for years to come. She is sorely missed by everyone who knew her.

At this time, the Royal Education Foundation takes special pride in announcing the renaming of the annual community walk-run event in Jill’s honor. Commencing with this year’s Family Fun Run, the event will be known as the Jill Nees Russell Power of One Family Fun Run!

The Power of One Award could not have a better namesake as Jill was the personification of its required attributes. The award inscription reads in part:

“The little things you do each day have the power to affect a great many people. You inspire us with your willingness and ability to help others. You take on the world, one day at a time, continuously searching for a way to make things better…”

This year will be the sixth time that the Royal Educational Foundation will present the award in conjunction with the annual Family Fun Run. The foundation is pleased to hold this event alongside the Port Jefferson Chamber of Commerce’s annual Health and Wellness Fest and looks to continue this partnership in the future.  

The Fun Run was started as a way to encourage physical activity and to celebrate the positive influence we can have on one another within our families and the community.    

The Power of One Award is presented to an outstanding community member who positively impacts the lives of those he/she touches on a daily basis. Past award recipients were Thomas Meehan, Richard Anderson, Deidre Filippi, Jesse Rosen and Christian Neubert. This year, the recipient of the Jill Nees Russell Power of One Award is Anthony Butera. Butera is an elementary school teacher in the district; heads the HS/MS drama program; and regularly volunteers for the Dickens Festival, the Harbor Ballet Theater’s “Nutcracker” production and with Theatre Three. The proceeds of this fundraiser will be used to enhance the quality of education in the Port Jefferson School District.

The Royal Educational Foundation invites you to participate in the 6th annual Jill Nees Russell Power of One Family Fun Run on Saturday, May 18. Whether you wish to walk or run, the 2-mile course is open to all ages. The run begins at 8 a.m. at the Port Jefferson Village Center, 101-A East Broadway, continues through the streets of Port Jefferson village, and ends in the High School Bowl. It coincides with the start of the Chamber of Commerce’s Health and Wellness Fest at 9 a.m. and all participants are invited, and urged, to attend.  

You may register for the run at www.reffundraiser.ticketleap.com/royal-educational-power-of-one-fun-run/ or on the day of the run between 7:30 and 8 a.m. at the Village Center. Advanced registrants need to check in no later than 8:15 a.m. 

Spring has sprung and that means it’s time for the Greater Port Jefferson Chamber of Commerce’s annual Health and Wellness Fest. Celebrating its 10th year, the event returns to the Earl L. Vandermeulen High School, 350 Old Post Road, Port Jefferson on Saturday, May 18 from 9 a.m. to 1 p.m. 

Face artist Joanie Baloney with friends.

Ten years of healthy living; what a milestone for this event! To help celebrate this anniversary there are a lot of special activities planned. For the younger visitors there will be three super heroes walking around for photo opportunities. Have fun meeting Captain America, Wonder Woman and Batman! Face painting will be provided by professional face painter Joanie Baloney. A face art service provider with top-notch skills, both personal and professional, she is an artist and longtime children’s physical therapist who is skilled and is sensitive in working with all ages.

For those who want to experience something more on the wild side, there will be Goat Yoga from 11 a.m. to noon. Goat Yoga is an interactive yoga class that helps you get Zen with goats. This class is suitable for beginners or experienced yogis looking to practice in a new setting. A certified yoga instructor will blend movements and gentle stretches with the playful antics of live goats. Try the “downward goat” or “stretching kid” poses. You won’t want to miss this unscripted one-of-a-kind experience. There will be a group of 12 goats that will assist you in your yoga positions. This will be great fun for those new to yoga or those who need more goats in their life! 

Enjoy goat yoga at this year’s event!

If you want to enjoy more traditional activities, there will be a Zumba class and join in for free lessons on how to line dance with My Country Radio station 96.1. 

In addition, 50 vendors will be on hand to share all types of health-related wellness products and services. This year learn about Community Supported Agriculture (CSA), a system that connects the producer and consumers within the food system more closely by allowing the consumer to subscribe to the harvest of a certain farm or group of farms! 

Or what about cryotherapy, an innovative, holistic wellness solution that enables the human body to recover and rejuvenate itself naturally. By exposing the body to extremely low temperatures (for 1 to 3 minutes), it triggers the body’s most powerful mechanisms of self-protection, self-recovery and self-rejuvenation! Stop by Vita Whole Body & Cryo table and experience a sampling of a facial or local cryotherapy.  

Visit the free food court at this year’s Health and Wellness Fest, courtesy of St. Charles Hospital!

Attendees also will have the benefit of many giveaways along with free screenings that are so important for good health, including blood pressure, body mass index screening (BMI), glucose, lung cancer, colorectal cancer, otoscopy for cerumen (earwax), hearing, cholesterol, balance and fall prevention and posture.

Longtime supporter St. Charles Hospital will again have its healthy food court offering free nutritional food all day. The event has partnered with the Royal Educational Foundation of Port Jefferson, which will be celebrating its sixth annual Power of One Family Fun Run. The 2k race finishes at the high school where runners are welcome to visit the health fest.

Come join the Greater Port Jefferson Chamber of Commerce for this fun Eat Well, Live Well free event. For further information, call 631-473-1414 or visit www.portjeffhealth.com.

Stock photo
Medication guidelines have changed with recent studies

By David Dunaief, M.D.

Dr. David Dunaief

May is National Stroke Awareness Month, with a focus on raising awareness of stroke risk factors and prevention. This is valuable, since stroke remains one of the top five causes of mortality and morbidity in the United States (1). As a result, we have a wealth of studies that inform us on the roles of medications and lifestyle in managing risk. Of particular importance are changes in medication guidelines that balance the risks and benefits of different stroke prevention regimens.

Medications with beneficial effects

Two medications have shown positive impacts on reducing stroke risk: statins and valsartan. Statins are used to lower cholesterol and inflammation, and valsartan is used to treat high blood pressure. Statins do have side effects, such as increased risks of diabetes, cognitive impairment and myopathy (muscle pain). However, used in the right setting, statins are very effective. In one study, there was reduced mortality from stroke in patients who were on statins at the time of the event (2). Patients who were on a statin to treat high cholesterol had an almost sixfold reduction in mortality, compared to those with high cholesterol who were not on therapy.

There was also significant mortality reduction in those on a statin without high cholesterol, but with diabetes or heart disease. The authors surmise that this result might be from an anti-inflammatory effect of the statins. Of course, if you have side effects, you should contact your physician immediately.

Valsartan is an angiotensin II receptor blocker that works on the kidney to reduce blood pressure. However, in the post-hoc analysis (looking back at a completed trial) of the Kyoto Heart Study data, valsartan used as an add-on to other blood pressure medications showed a significant reduction, 41 percent, in the risk of stroke and other cardiovascular events for patients who have coronary artery disease (3).

It is important to recognize that high blood pressure and high cholesterol are two of the most significant risk factors for stroke. Fortunately, statins can reduce cholesterol, and valsartan may be a valuable add-on to prevent stroke in those patients with coronary artery disease.

Medication combination: negative impact

There are two anti-platelet medications that are sometimes given together in the hopes of reducing stroke recurrence — aspirin and Plavix (clopidogrel). The assumption is that these medications together will work better than either alone. However, in a randomized controlled trial, the gold standard of studies, this combination not only didn’t demonstrate efficacy improvement but significantly increased the risk of major bleed and death (4, 5).

Major bleeding risk was 2.1 percent with the combination versus 1.1 percent with aspirin alone, an almost twofold increase. In addition, there was a 50 percent increased risk of all-cause death with the combination, compared to aspirin alone. Patients were given 325 mg of aspirin and either a placebo or 75 mg of Plavix. The study was halted due to these deleterious effects. The American Heart Association recommends monotherapy for the prevention of recurrent stroke. If you are on this combination of drugs, please consult your physician.

Aspirin: low dose vs. high dose

Greater hemorrhagic (bleed) risk is also a concern with daily aspirin regimens greater than 81 mg, which is the equivalent of a single baby aspirin. Aspirin’s effects are cumulative; therefore, a lower dose is better over the long term. Even 100 mg taken every other day was shown to be effective in trials. There are about 50 million patients who take aspirin chronically in the United States. If these patients all took 325 mg of aspirin per day, an adult dose, it would result in 900,000 major bleeding events per year (6). Do not take an aspirin regimen – even a low-dose aspirin regimen – for stroke prevention without consulting your physician.

Lifestyle modifications

A prospective study of 20,000 participants showed that consuming white fleshy fruits — apples, pears, bananas, etc. — and vegetables — cauliflower, mushrooms, etc. — decreased ischemic stroke risk by 52 percent (7). Additionally, the Nurses’ Health Study showed that foods with flavanones, found mainly in citrus fruits, decreased the risk of ischemic stroke by 19 percent (8). 

The authors suggest that the reasons for the reduction may have to do with the ability of flavanones to reduce inflammation and/or improve blood vessel function. I mention both of these trials together because of the importance of fruits in prevention of ischemic (clot-based) stroke.

Fiber’s important role

Fiber also plays a key role in reducing the risk of a hemorrhagic stroke. In a study involving over 78,000 women, those who consumed the most fiber had a total stroke risk reduction of 34 percent and a 49 percent risk reduction in hemorrhagic stroke. The type of fiber used in this study was cereal fiber, or fiber from whole grains.

Refined grains, however, increased the risk of hemorrhagic stroke twofold (9). When eating grains, it is important to have whole grains. Read labels carefully, since some products that claim to have whole grains contain unbleached or bleached wheat flour, which is refined.

Fortunately, there are many options to help reduce the risk or the recurrence of a stroke. Ideally, the best option would involve lifestyle modifications. Some patients may need to take statins, even with lifestyle modifications. However, statins’ side effect profile is dose-related. Therefore, if you need to take a statin, lifestyle changes may help lower your dose and avoid harsh side effects. Once you have had a stroke, it is likely that you will remain on at least one medication — typically low-dose aspirin — since the risk of a second stroke is high.

References:

(1) cdc.gov. (2) AAN conference: April 2012. (3) Am J Cardiol 2012; 109(9):1308-1314. (4) ISC 2012; Abstract LB 9-4504. (5) www.clinicaltrials.gov NCT00059306. (6) JAMA 2007;297:2018-2024. (7) Stroke. 2011; 42: 3190-3195. (8) J. Nutr. 2011;141(8):1552-1558. (9) Am J Epidemiol. 2005 Jan 15;161(2):161-169.

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.  

Dr. Frank S. Darras presents a signed baseball from the Stony Brook Medicine kidney transplant program to the 1969 World Champion Miracle Mets player Edward Kranepool. Photo from Stony Brook University

Ed Kranepool has proven once again that miracles do happen, especially when one is part of a team.

The former baseball player, who was a member of the Miracle Mets in 1969, received a new kidney last week at Stony Brook University Hospital thanks to a kidney paired exchange. Kranepool said before the transplant he had two teams — his family, and the Mets organization.

Dr. Frank S. Darras, medical director of Transplantation Services, back row left, and Dr. Wayne Waltzer, director of Kidney Transplantation Program, back row right, discuss four life-changing kidney swap surgeries in one day May 10. Photo from Stony Brook Medicine

“Now I have an extended team,” he said. “I have our donors here today who certainly without them this program doesn’t exist, and you have to be forever grateful to them.”

Kranepool, 74, received a kidney from Deborah Barbieri, who was hoping to donate a kidney to her husband, but it turned out she wasn’t a match for him due to their different blood types. However, it turned out she was a match with Kranepool. Her husband Al Barbieri received a kidney the same day donated from Port Authority police officer Brian Cooney.

At a May 10 press conference at the hospital, three days after Kranepool, the Barbieris and Cooney underwent their procedures, they joined Dr. Frank Darras, medical director of Transplantation Services, and Dr. Wayne Waltzer, director of Kidney Transplantation Program, to discuss their experiences.

Darras said many with a need for a new kidney are on a waiting list for months or even years. More than 113,000 Americans are waiting for a transplant of some kind, and 80,000 are waiting for a kidney transplant. Out of those 80,000, 8,000 of them live in New York state.

He said many times a family member or friend wants to help a patient, but their blood types don’t match, like in the case of the Barbieris, or the potential donor has health problems of their own. Because of those long odds, he called the donors heroes.

“They do this to help somebody else,” Darras said.

He said Cooney’s altruistic call to the program set the paired exchange chain in motion.

“With that came the reality that we can do a paired exchange, because when he was tested the highest person of his blood type, blood type A, was Mr. Barbieri,” Darras said. “So, then we looked at his wife, who had been a willing donor for a couple of months as blood type AB, which is the most uncommon blood type, and we ran the AB blood list, and Mr. Kranepool was the highest on the AB list with the longest waiting time. So that’s what triggered us to get to this point today.”

The doctor said after the surgery, the remaining kidney of Cooney and Deborah Barbieri would grow and compensate to do 75-80 percent of the work, and there is no significant decrease in life expectancy or increase in kidney failure. He said patients have lived entire lives with a sole kidney, and those who receive one before undergoing dialysis treatments tend to do better. Kranepool was not at the point where he needed dialysis, and Darras said it would have been difficult for him due to high blood pressure and diabetes. A patient on dialysis can gain another five to seven years, while one who receives a new kidney can live another 15 years or more.

Waltzer added there is a discrepancy between those who need a kidney and those who donate. In 2018 there were only 1,619 living donor transplants in the state of New York and 1,047 deceased organ donors. He said the national visibility that Kranepool has given the cause could benefit everyone in need of an organ.

Cooney, 45, a former NYPD officer, said when he responded to Ground Zero after the World Trade Center terrorist attacks Sept. 11, 2001, he witnessed devastation and, in the years that followed, more tragedy as first responders died from 9/11-related diseases. He said he realized how fortunate he is.

“I’d have a blessed life and a blessed career,” Cooney said. “I have very few problems to speak of and nothing to complain about.”

“It’s very difficult to see when you sit there with people who are next to you one day in the chair, and the next day they’re not there.”

— Al Barbieri

It was a few months ago he placed a call to the transplant center, and he said a few days after a visit to the hospital for a general checkup and consultation, he received the call that he was a match for someone.

“Sure enough I was able to set a chain in motion,” he said.

Al Barbieri, a volunteer firefighter in Glenwood Landing since 1982, said he was grateful for all the help in him getting his new kidney. He was placed on dialysis in 2016, four hours at a time, and he has seen many fellow patients lose their battles against kidney disease.

“It’s very difficult to see when you sit there with people who are next to you one day in the chair, and the next day they’re not there,” he said.

At the brink of crying, the organ recipient said he felt fortunate that he could now see his children graduate and be able to go to their weddings and meet his future grandchildren one day.

“Police officers are here in the world today, so firefighters can have heroes too,” he said.

Deborah Barbieri said that dialysis had made it difficult for the couple to go places, especially on vacation, something both of them are looking forward to doing once again.

“I decided to take a shot and go on the list, and it’s the best thing I ever did,” she said.

Kranepool said he felt fortunate to have Deborah Barbieri and Cooney step forward, and he wants to see the same happen for others by continuing to raise awareness. Last year, the former Mets player held press conferences around Long Island to urge residents to sign organ donation forms, and he said he plans to continue spreading the word about the importance of organ donations.

“You get that call,” he said. “I mean, they saved your life.”

This summer, Kranepool said he’s looking forward to spending time in the Hamptons with his wife, and also celebrating in the 50th anniversary of the Miracle Mets in June.

On the day he received the call that there was a donor for him, Kranepool said he had just finished telling his wife to stay positive about his situation. Then 10 minutes later the phone rang.

“It was like magic,” he said. “Something really happened right there.”

Doc Spencer at a previous health fair

Join Leg. William “Doc” Spencer (D-Centerport) for his annual Community Health & Information Fair at Harborfields Public Library, 31 Broadway, Greenlawn on Wednesday, May 15 from 11:30 a.m. to 5 p.m. Representatives from more than 30 agencies will provide vital information relating to health, legal matters, business, child care, senior outreach, housing and much more. Free. Call 631-854-4500 for more information.

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Improving RHR can improve your healthy life span 

By David Dunaief, M.D.

Dr. David Dunaief

What does our heart rate, or pulse, tell us beyond the obvious fact that we are alive?

Our “normal” resting heart rate is between 60 to 100 beats per minute (bpm). A resting heart rate (RHR) above 100 bpm is referred to as tachycardia, or a racing heartbeat, and it has potentially serious consequences. 

However, even normal RHRs can be stratified to identify risks for diseases. What I mean is that, even in the normal range, as your resting heart rate increases, so do your potential risks. Actually, resting heart rate below approximately 70 bpm may be ideal.

Resting heart rate’s importance should not be underestimated. In fact, it may play a role in longevity, heart disease — including heart failure, arrhythmias, heart attacks and sudden cardiac death — and even chronic kidney disease. The good news is that RHR is modifiable. Methods that may reduce your rate include medications for high blood pressure, such as beta blockers, and lifestyle modifications, including meditation, dietary changes and exercise.

Impact on life span

Reducing RHR may be an important component in living a longer, healthier lifestyle. In the Copenhagen Male Study, a prospective study that followed 2,798 participants for 16 years, results showed that those with higher resting heart rates had a greater risk of death (1). There was a linear relationship between the risk of death and increasing RHR. Those who had a resting heart rate above 90 bpm were at a threefold greater risk of death, compared to those who had a RHR at or below 50 bpm. RHR was inversely related to the amount of physical activity.

Thus, the authors concluded that a “healthy” person with higher RHR may still have a shorter life span, with all other factors being equal, such as physical activity and blood pressure.

In contrast with the previous study, the following one took a “glass is half-full” approach to longevity. The Jerusalem Longitudinal Cohort Study showed that elderly women and men who had a lower RHR lived the longest (2). There were more than 2,000 study participants, ranging from 70 to 90 years old.

Your resting heart rate can help identify
potential health problems as well as gauge your current heart health.
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Heart disease mortality

In the Nord-Trondelag Health Study, a prospective observational study, those who had a higher RHR at the end of the study than they did at the beginning of the study 10 years prior were more likely to die from heart disease (3). In other words, as the RHR increased from less than 70 bpm to over 85 bpm, there was a 90 percent greater risk of heart disease, compared to those who maintained a RHR of less than 70 throughout the two measurements. This study involved 30,000 participants who were healthy volunteers at least 20 years old.

Heart attacks

In the Women’s Health Initiative, results showed a 26 percent decrease in the risk of cardiovascular events in those postmenopausal women who had a RHR below 62 bpm, compared to those who had a RHR above 76 bpm (4). Interestingly, these results were even more substantial in the subgroup of women who were newly postmenopausal, ranging in age from 50 to 64.

Effect on kidney function

I have written many times about chronic kidney disease. An interesting follow-up is resting heart rate and its impact on kidney function. In the Atherosclerosis Risk in Communities Study, results showed that the most severe form of chronic kidney disease, end-stage renal disease, was 98 percent more likely to occur in those with the highest RHR, compared to those with the lowest (5). There were approximately 13,000 participants in the study, with a 16-year follow-up. The authors hypothesized that this negative effect on the kidney may be due to a loss of homeostasis in the autonomic (involuntary) nervous system, resulting in blood vessel dysfunction, such as increased inflammation and vasoconstriction (narrowing).

Can RHR be too low?

Is there a resting heart rate that is too low? Well, it depends on the context. If you are a marathoner or an athlete, then a RHR in the 40s may not be abnormal. For a healthy, physically active individual, it is not uncommon to have a resting heart rate in the 50s. However, if you are on medications that reduce your RHR and/or have a chronic disease, such as heart failure, it is probably not advisable to go much below 60 bpm. Always ask your doctor about the appropriate resting heart rate for your particular situation.

Thus, resting heart rate is an easy and inexpensive biomarker to potentially determine risk stratification for disease and to increase longevity, even for those in the normal range. By monitoring and modifying RHR, we can use it as a tool for primary disease prevention. 

References:

(1) Heart Journal 2013 Jun;99(12):882-887. (2) J Am Geriatr Soc. 2013;61(1):40-45. (3) JAMA 2011; 306:2579-2587. (4) BMJ. 2009 Feb 3;338:b219. (5) J Am Soc Nephrol. 2010 Sept;21(9):1560-1570.

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 weekly Medical Compass MD Health Videos on                                        Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

By David Dunaief, M.D.

Dr. David Dunaief

Obesity is continuously covered in the media. And rightly so. Its economic cost to the U.S. is massive: in 2016, the cost of chronic diseases for which being obese or overweight is a risk factor totaled over $480 billion in direct health care costs and $1.24 trillion in lost economic productivity (1). These startling numbers don’t even consider the human cost of these diseases.

Obesity and its effect on life span

It’s well-known that obesity could have an impact on development of other chronic diseases and decrease quality of life, but to what extent? A 2013 study indicated that almost as many as one in five deaths in the U.S. is associated with obesity (2).

In a computer modeling study, results showed that those who are obese may lose up to eight years, almost a decade, of their life span (3). But that is only part of the picture. The other, more compelling result is that patients who are very obese, defined as a BMI >35 kg/m², could lose almost two decades of healthy living. According to the researchers, this means you may have diseases such as diabetes and cardiovascular disease. However, even those patients who were obese and those who were overweight could have reductions in life span, up to six years and three years, respectively.

This study evaluated 3,992 adults between the ages of 20 and 79. The data was taken from an NHANES database from 2003 to 2010, which looked at participants who went on to develop diabetes and cardiovascular disease. Though this is not a clinical trial, and there is a need for more study, the results are eye-opening, with the youngest and very obese negatively impacted the most.

Cancer impact

Since it is very difficult to “cure” cancer, it is important to reduce modifiable risk factors. Obesity may be one of these contributing factors, although it is hotly debatable how much of an impact obesity has on cancer development.  The American Society of Clinical Oncologists (ASCO), in a position paper, supported the idea that it is important to treat obesity in the fight against cancer (4). The authors indicate obesity may make the prognosis worse, may hinder the delivery of therapies to treat cancer, and may increase the risk of malignancy.

Also, possibly reinforcing ASCO’s stance, a study suggested that upward of a half-million cases of cancer worldwide were related to being overweight or obese, with the overwhelming concentration in North America and Europe (5).

Possible solutions

A potential counterweight to both the reductions in life quality and life expectancy may be a Mediterranean-type diet. In a published analysis of the Nurses’ Health Study, results show that the Mediterranean diet helped slow shortening of the telomeres (6). Repeat sequences of DNA found at the end of chromosomes, telomeres, shorten with age; the shorter the telomere, the shorter life expectancy.

Thus, the Mediterranean-type diet may decrease occurrence of chronic diseases, increase life span and decrease premature mortality — countering the effects of obesity. In fact, it may help treat obesity, though this was not mentioned in the study. Interestingly, the greater the adherence to the diet, rated on a scale of 0 to 9, the better the effect. Those who had an increase in adherence by three points saw a corresponding decrease in telomere aging by 4.5 years. There were 4,676 middle-aged women involved in this analysis. The researchers believe that the anti-inflammatory and antioxidant effects could be responsible for the diet’s effects.

According to an accompanying editorial, no individual component of the diet was identified as having beneficial effects by itself, so it may be the diet as a whole that is important (7).

Short-term solutions

There are easy-to-use distraction tactics that involve physical and mental techniques to reduce food cravings. These include tapping your foot on the floor, staring at a blank wall and alternating tapping your index finger against your forehead and your ear (8). The forehead and ear tapping technique was most effective, although probably most embarrassing in public. Among mental techniques, seeing pictures of foods that were unhealthy and focusing on their long-term detriments to health had the most impact (9). These short-term distractors were done for 30 seconds at a time. The results showed that they decreased food cravings in obese patients.

Exercise impact

I have written that exercise does not lead to fat percentage loss in adults. The results are different for adolescents, though. In a randomized controlled trial, results show that those in a resistance training group and those in a combined resistance and aerobic training group had significantly greater percentages of fat loss compared to a control group (10).

Interestingly, the aerobic group alone did not show a significant change in fat percent versus the control. There were 304 study participants, ages 14 to 18, followed for a six-month duration, and results were measured with MRI. The reason that resistance training was effective may have to do with an increase in muscle mass rather than a decrease in actual fat.

Obesity can have devastating effects, from potentially inducing cancer or worsening it, to shortening life expectancy and substantially decreasing quality of life. Fortunately, there may be ways to help treat obesity with specific lifestyle modifications. The Mediterranean diet as a whole may be an effective step toward decreasing the burden of obesity and reducing its complications. Kids, teenagers specifically, should be encouraged to do some resistance training. As we mentioned, there are simple techniques that may help reduce short-term food cravings.

References:

(1) “America’s Obesity Crisis,” Milken Institute. October, 2018. (2) Am J Public Health. 2013;103:1895-1901. (3) The Lancet Diabetes & Endocrinology, online Dec. 5, 2014. (4) J Clin Oncol. 2014;32(31):3568-3574. (5) The Lancet Oncology. online Nov. 26, 2014. (6) BMJ. online Dec. 2, 2014. (7) BMJ 2014;349:g6843. (8) Obesity Week 2014 abstract T-2658-P. (9) Obesity Week 2014 abstract T-3023-OR. (10) JAMA Pediatr. 2014;168(11):1006-1014.

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 weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

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