Health

Selden Pharmacy, 1224B Middle Country Road, Selden closed its doors on July 30 after 40 years in business. In a letter sent out to his customers, owner George Akruwala said, “As much as I would love to continue this business, I have made the very difficult decision to retire, and spend more time with my children and grandchildren. It has been our great pleasure to serve this wonderful community. We wish you continued health and happiness.” All prescriptions have been transferred to Rite Aid, 229 Independence Plaza, Selden.

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Photo from Stony Brook Community Medical

Argen Medical recently joined Stony Brook Community Medical, Stony Brook Medicine’s expanding network of community practices and physicians. The medical group practices obstetrics and gynecology in Port Jefferson Station.

“We are extremely pleased that Dr. Gustavo San Roman is joining the Stony Brook family,” said Dr. Todd Griffin, chair, Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine. “He has been an outstanding Ob-Gyn in the community and a wonderful proponent of women’s health.”

Stony Brook Medicine welcomes private practices that are committed not only to the community but to providing the highest level of quality care. Argen Medical has been providing expert, comprehensive care to women of all ages in the community for more than 30 years.

“I am very excited to be back at Stony Brook University Hospital. I have built a practice based on the concept of providing excellent and personalized Ob-Gyn care,” said San Roman. “With this in mind, I have helped to build many strong families in our community. In fact, I am now taking care of the next generation of women whose births I attended many years ago.”

“As a member of Stony Brook Medicine, I have the honor to continue to provide complete personalized Ob-Gyn services in my Port Jefferson Station office and three local hospitals,” he added.

The Argen Medical team, comprised of San Roman and two nurse practitioners, Laura Doti and Jaclyn Cuccinello, welcomes new patients. And as a bilingual practice, they are able to offer comprehensive services to Spanish-speaking patients as well.

For more information, call 631-331-8777.

Pictured in photo, from left, Jaclyn Cuccinello, Gustavo San Roman and Laura Doti.

Balance and strengthening exercises help to prevent falls. Stock photo
Our best line of defense is prevention

By David Dunaief, M.D.

Dr. David Dunaief

When we are young, falls usually do not result in significant consequences. However, when we reach middle age and chronic diseases become more prevalent, falls become more substantial. And, unfortunately, falls are a serious concern for older patients, where consequences can be devastating. They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities (1). Ultimately, falls can lead to loss of independence (2).

Of those over the age of 65, between 30 and 40 percent will fall annually (3). Most of the injuries that involve emergency room visits are due to falls in this older demographic (4).

What can increase the risk of falls?

Many factors contribute to fall risk. A personal history of falling in the recent past is the most prevalent. But there are many other significant factors, such as age, being female and using drugs, like antihypertensive medications used to treat high blood pressure and psychotropic medications used to treat anxiety, depression and insomnia.

Chronic diseases, including arthritis, as an umbrella term; a history of stroke; cognitive impairment; and Parkinson’s disease can also contribute. Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression (5).

How do we prevent falls?

Stock photo

Fortunately, there are ways to modify many risk factors and ultimately reduce the risk of falls. Of the utmost importance is exercise. But what do we mean by “exercise”? Exercises involving balance, strength, movement, flexibility and endurance, whether home based or in groups, all play significant roles in fall prevention (6). We will go into more detail below.

Many of us in the Northeast suffer from low vitamin D, which may strengthen muscle and bone. This is an easy fix with supplementation. Footwear also needs to be addressed. Nonslip shoes, if recent winters are any indication, are of the utmost concern. Inexpensive changes in the home, like securing area rugs, can also make a big difference.

Medications that exacerbate fall risk

There are a number of medications that may heighten fall risk. As I mentioned, psychotropic drugs top the list. Ironically, they also top the list of the best-selling drugs. But what other drugs might have an impact?

High blood pressure medications have been investigated. A propensity-matched sample study (a notch below a randomized control trial in terms of quality) showed an increase in fall risk in those who were taking high blood pressure medication (7). Surprisingly, those who were on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase. One would have expected those on the highest levels to have the greatest increase in risk, but this was not the case.

While blood pressure medications may contribute to fall risk, they have significant benefits in reducing the risks of cardiovascular disease and events. Thus, we need to weigh the risk-benefit ratio, specifically in older patients, before considering stopping a medication. When it comes to treating high blood pressure, lifestyle modifications may also play a significant role in treating this disease (8).

Why is exercise critical?

All exercise has value. A meta-analysis of a group of 17 trials showed that exercise significantly reduced the risk of a fall (9). If the categories are broken down, exercise had a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in those falls requiring medical attention. Even more impressive was a 61 percent reduction in fracture risk.

Remember, the lower the fracture risk, the more likely you are to remain physically independent. Thus, the author summarized that exercise not only helps to prevent falls but also fall injuries. The weakness of this study was that there was no consistency in design of the trials included in the meta-analysis. Nonetheless, the results were impressive.

Unfortunately, those who have fallen before, even without injury, often develop a fear that causes them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased risk of falling (10).

What specific types of exercise are useful?

Many times, exercise is presented as a word that defines itself. In other words: Just do any exercise and you will get results. But some exercises may be more valuable or have more research behind them. Tai chi, yoga and aquatic exercise have been shown to have benefits in preventing falls and injuries from falls.

A randomized controlled trial, the gold standard of studies, showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (11). The aim of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the number of falls from a mean of 2.00 to a fraction of this level — a mean of 0.29. There was no change in the control group.

There was also a 44 percent decline in the number of patients who fell. This study’s duration was six months and involved 108 postmenopausal women with an average age of 58. This is a group that is more susceptible to bone and muscle weakness. Both groups were given equal amounts of vitamin D and calcium supplements. The good news is that many patients really like aquatic exercise.

Thus, our best line of defense against fall risk is prevention. Does this mean stopping medications? Not necessarily. But for those 65 and older, or for those who have “arthritis” and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before considering changing your BP medications, review the risk-to-benefit ratio with your physician. The most productive way to prevent falls is through lifestyle modifications.

References:

(1) MMWR. 2014;63(17):379-383. (2) J Gerontol A Biol Sci Med Sci. 1998;53(2):M112. (3) J Gerontol. 1991;46(5):M16. (4) MMWR Morb Mortal Wkly Rep. 2003;52(42):1019. (5) JAMA. 1995;273(17):1348. (6) Cochrane Database Syst Rev. 2012;9:CD007146. (7) JAMA Intern Med. 2014 Apr;174(4):588-595. (8) JAMA Intern Med. 2014;174(4):577-587. (9) BMJ. 2013;347:f6234. (10) Age Ageing. 1997 May;26(3):189-193. (11) Menopause. 2013;20(10):1012-1019.

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. 

Petra Aureliano with her family
Dorothy Crawford with her granddaughter and great-granddaughter

About 110 family and friends gathered at St. Johnland Nursing Center in Kings Park on Aug. 1 to celebrate its Medical Model Adult Day Health Service Annual Breakfast.

Participants who attend the Monday through Saturday program were joined by family and friends for a wonderful morning of food, fun and music. Guests had an opportunity to see the program firsthand and get a glimpse of how their loved one spends a typical day interacting with others and engaging in games and other mindful activities.

Lillian Safina with her son

Providing care for an aging parent, spouse or loved one can be an overwhelming responsibility for family members and friends. Adult Day Care at St. Johnland Nursing Center offers a wide range of services for adults who need a protective environment but choose to remain in the community and continue to be a vital part of family life.

St. Johnland Nursing Center is a nonprofit, nonsectarian facility, offering residents excellence in skilled nursing care and all aspects of rehabilitation, Alzheimer’s/dementia care, head injury rehabilitation, adult day care, home health care and subacute care.

To learn more about St. Johnland programs and services visit www.stjohnland.org.

Photos courtesy of St. Johnland

Cognitive behavioral therapy may improve outcomes

By David Dunaief, M.D.

Dr. David Dunaief

Though statistics vary widely, about 30 percent of Americans are affected by insomnia, according to one frequently used estimate, and women tend to be affected more than men (1). Insomnia is thought to have several main components: difficulty falling asleep, difficulty staying asleep, waking up before a full night’s sleep and sleep that is not restorative or restful (2).

Unlike sleep deprivation, patients have plenty of time for sleep. Having one or all of these components is considered insomnia. There is debate about whether or not it is actually a disease, though it certainly has a significant impact on patients’ functioning (3).

Insomnia is frustrating because it does not necessarily have one cause. Causes can include aging; stress; psychiatric disorders; disease states, such as obstructive sleep apnea and thyroid dysfunction; asthma; medication; and it may even be idiopathic (of unknown cause). It can occur on an acute (short-term), intermittent or chronic basis. Regardless of the cause, it may have a significant impact on quality of life. Insomnia also may cause comorbidities (diseases), including heart failure.

Fortunately, there are numerous treatments. These can involve medications, such as benzodiazepines like Ativan and Xanax. The downside of these medications is they may be habit-forming. Nonbenzodiazepine hypnotics (therapies) include sleep medications, such as Lunesta (eszopiclone) and Ambien (zolpidem). All of these medications have side effects. We will investigate Ambien further because of its warnings.

There are also natural treatments, involving supplements, cognitive behavioral therapy and lifestyle changes.

Let’s look at the evidence.

Heart failure

Insomnia may perpetuate heart failure, which can be a difficult disease to treat. In the HUNT analysis (Nord-Trøndelag Health Study), an observational study, results showed insomnia patients had a dose-dependent response for increased risk of developing heart failure (4). In other words, the more components of insomnia involved, the higher the risk of developing heart disease.

There were three components: difficulty falling asleep, difficulty maintaining sleep and nonrestorative sleep. If one component was involved, there was no increased risk. If two components were involved, there was a 35 percent increased risk, although this is not statistically significant.

However, if all three components were involved, there was 350 percent increased risk of developing heart failure, even after adjusting for other factors. This was a large study, involving 54,000 Norwegians, with a long duration of 11 years.

What about potential treatments?

Ambien: While nonbenzodiazepine hypnotics may be beneficial, this may come at a price. In a report by the Drug Abuse Warning Network, part of the Substance Abuse and Mental Health Services Administration (SAMHSA), the number of reported adverse events with Ambien that perpetuated emergency department visits increased by more than twofold over a five-year period from 2005 to 2010 (5). Insomnia patients most susceptible to significant side effects are women and the elderly. The director of SAMHSA recommends focusing on lifestyle changes for treating insomnia by making sure the bedroom is sufficiently dark, getting frequent exercise, and avoiding caffeine.

In reaction to this data, the FDA required the manufacturer of Ambien to reduce the dose recommended for women by 50 percent (6). Ironically, sleep medication like Ambien may cause drowsiness the next day — the FDA has warned that it is not safe to drive after taking extended-release versions (CR) of these medications the night before.

Magnesium: The elderly population tends to suffer the most from insomnia, as well as nutrient deficiencies. In a double-blinded, randomized controlled trial (RCT), the gold standard of studies, results show that magnesium had resoundingly positive effects on elderly patients suffering from insomnia (7).

Compared to a placebo group, participants given 500 mg of magnesium daily for eight weeks had significant improvements in sleep quality, sleep duration and time to fall asleep, as well as improvement in the body’s levels of melatonin, a hormone that helps control the circadian rhythm.

The strength of the study is that it is an RCT; however, it was small, involving 46 patients over a relatively short duration.

Cognitive behavioral therapy

In a study, just one 2½-hour session of cognitive behavioral therapy delivered to a group of 20 patients suffering from chronic insomnia saw subjective, yet dramatic, improvements in sleep duration from 5 to 6½ hours and decreases in sleep latency from 51 to 22 minutes (8). The patients who were taking medication to treat insomnia experienced a 33 percent reduction in their required medication frequency per week. The topics covered in the session included relaxation techniques, sleep hygiene, sleep restriction, sleep positions, and beliefs and obsessions pertaining to sleep. These results are encouraging.

It is important to emphasize the need for sufficient and good-quality sleep to help prevent, as well as not contribute to, chronic diseases, such as cardiovascular disease. While medications may be necessary in some circumstances, they should be used with the lowest possible dose for the shortest amount of time and with caution, reviewing possible drug-drug and drug-supplement interactions.

Supplementation with magnesium may be a valuable step toward improving insomnia. Lifestyle changes including sleep hygiene and exercise should be sought, regardless of whether or not medications are used.

References:

(1) Sleep. 2009;32(8):1027. (2) American Academy of Sleep Medicine, 2nd edition, 2005. (3) Arch Intern Med. 1998;158(10):1099. (4) Eur Heart J. online 2013;Mar 5. (5) SAMSHA.gov. (6) FDA.gov. (7) J Res Med Sci. 2012 Dec;17(12):1161-1169. (8) APSS 27th Annual Meeting 2013; Abstract 0555.

Pairing a healthy diet with regular exercise is the best way to prevent heart disease. Stock photo
Taking an active role can reduce your risk significantly

By David Dunaief, M.D.

Dr. David Dunaief

Heart disease is so pervasive that men who are 40 years old have a lifetime risk of 49 percent. In other words, about half of men will be affected by heart disease. The statistics are better for women, but they still have a staggering 32 percent lifetime risk at age 40 (1).

The good news is that heart disease is on the decline due to a number of factors, including better awareness in lay and medical communities, improved medicines, earlier treatment of risk factors and lifestyle modifications. We are headed in the right direction, but we can do better. Heart disease is something that is eminently preventable.

Heart disease risk factors

Risk factors include obesity, high cholesterol, high blood pressure, smoking and diabetes. Unfortunately, both obesity and diabetes are on the rise. For patients with type 2 diabetes, 70 percent die of cardiovascular causes (2). However, high blood pressure, high cholesterol and smoking have declined (3).

Of course, family history also contributes to the risk of heart disease, especially with parents who experienced heart attacks before age 60, according to the Women’s Health Study and the Physician’s Health Study (4). Inactivity and the standard American diet, rich in saturated fat and calories, also contribute to heart disease risk (5). The underlying culprit is atherosclerosis (fatty streaks in the arteries).

Another potential risk factor is a resting heart rate greater than 80 beats per minute (bpm). In one study, healthy men and women had 18 and 10 percent increased risks of dying from a heart attack, respectively, for every increase of 10 bpm over 80 (6). A normal resting heart rate is usually between 60 and 100 bpm. Thus, you don’t have to have a racing heart rate, just one that is high-normal. All of these risk factors can be overcome, even family history.

The role of medication

Cholesterol and blood pressure medications have been credited to some extent with reducing the risk of heart disease. The compliance with blood pressure medications has increased over the last 10 years from 33 to 50 percent, according to the American Society of Hypertension.

In terms of lipids, statins have played a key role in primary prevention. Statins are effective at not only lowering lipid levels, including total cholesterol and LDL — the “bad” cholesterol — but also inflammation levels that contribute to the risk of cardiovascular disease. The Jupiter trial showed a 55 percent combined reduction in heart disease, stroke and mortality from cardiovascular disease in healthy patients — those with a slightly elevated level of inflammation and normal cholesterol profile — with statins.

The downside of statins is their side effects. Statins have been shown to increase the risk of diabetes in intensive dosing, compared to moderate dosing (7).

Unfortunately, many on statins also suffer from myopathy (muscle pain). I have a number of patients who have complained of muscle pain and cramps. Their goal when they come to see me is to reduce and ultimately discontinue their statins by following a lifestyle modification plan involving diet and exercise. Lifestyle modification is a powerful ally.

Lifestyle effects

There was significant reduction in mortality from cardiovascular disease with participants who were followed for a very long mean duration of 18 years. The Baltimore Longitudinal Study of Aging, a prospective (forward-looking) study, investigated 501 healthy men and their risk of dying from cardiovascular disease. The authors concluded that those who consumed five servings or more of fruits and vegetables daily with <12 percent saturated fat had a 76 percent reduction in their risk of dying from heart disease compared to those who did not (8). The authors theorized that eating more fruits and vegetables helped to displace saturated fats from the diet. These results are impressive and, to achieve them, they only required a modest change in diet.

The Nurses’ Health Study shows that these results are also seen in women, with lifestyle modification reducing the risk of sudden cardiac death (SCD). Many times, this is the first manifestation of heart disease in women. The authors looked at four parameters of lifestyle modification, including a Mediterranean-type diet, exercise, smoking and body mass index. There was a decrease in SCD that was dose-dependent, meaning the more factors incorporated, the greater the risk reduction. There was as much as a 92 percent decrease in SCD risk when all four parameters were followed (9). Thus, it is possible to almost eliminate the risk of SCD for women with lifestyle modifications.

How do you know that you are reducing your risk of heart disease and how long does it take?

These are good questions. We use cardiac biomarkers, including inflammatory markers like C-reactive protein, blood pressure, cholesterol and body mass index. A cohort study helped answer these questions. It studied both high-risk participants and patients with heart disease. The results showed an improvement in biomarkers, as well as in cognitive function and overall quality of life.

Participants followed extensive lifestyle modification: a plant-based, whole foods diet accompanied by exercise and stress management. The results were statistically significant with all parameters measured. The best part is the results occurred over a very short period to time — three months from the start of the trial (10). Many patients I have seen have had similar results.

Ideally, if patient needs to use medications to treat risk factors for heart disease, it should be for the short term. For some patients, it may be appropriate to use medication and lifestyle changes together; for others, lifestyle modifications may be sufficient, as long as patients take an active role.

(1) Lancet. 1999;353(9147):89. (2) Diabetes Care. 2010 Feb; 33(2):442-449. (3) JAMA. 2005;293(15):1868. (4) Circulation. 2001;104(4):393. (5) Lancet. 2004;364(9438):93. (6) J Epidemiol Community Health. 2010 Feb;64(2):175-181. (7) JAMA. 2011;305(24):2556-2564. (8) J Nutr. March 1, 2005;135(3):556-561. (9) JAMA. 2011 Jul 6;306(1):62-69. (10) Am J Cardiol. 2011;108(4):498-507.

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.         

Yoga can be an effective way to increase bone density. Photo from Metro
Overtreatment and undertreatment of osteopenia and osteoporosis are common

By David Dunaief, M.D.

Dr. David Dunaief

As we get older, bone fractures can have potentially life-altering or life-ending consequences. Osteoporosis is a silent disease where there is bone loss, weakening of the bones and small deleterious changes in the architecture of the bone over time that may result in fractures with serious consequences (1). It affects millions of patients, most commonly postmenopausal women.

One way to measure osteoporosis is with a dual-energy X-ray absorptiometry (DXA) scan for bone mineral density. Osteopenia is a slightly milder form that may be a precursor to osteoporosis. However, we should not rely on the DXA scan alone; risk factors are important, such as a family or personal history of fractures as we age. The Fracture Risk Assessment Tool (FRAX) is more thorough for determining the 10-year fracture risk. Those who have a risk of fracture that is 3 percent or more should consider treatment with medications. A link to the FRAX tool can be found at www.shef.ac.uk/FRAX.

Most of us have been prompted all our lives to consume calcium for strong bones. In fact, the National Osteoporosis Foundation recommends that we get 1,000 to 1,200 mg per day of calcium from diet and supplements if we are over age 50, although recommendations vary by sex and age (2). However, research suggests that calcium for osteoporosis prevention may not be as helpful as we thought.

The current treatment paradox

Depending on the population, we could be overtreating or undertreating osteoporosis. In the elderly population that has been diagnosed with osteoporosis, there is undertreatment. One study showed that only 28 percent of patients who are candidates for osteoporosis drugs are taking the medication within the first year of diagnosis (3). The reason most were reluctant was that they had experienced a recent gastrointestinal event and did not want to induce another with osteoporosis medications, such as bisphosphonates. The data were taken from Medicare records of patients who were at least age 66.

On the other hand, as many as 66 percent of the women receiving osteoporosis medications may not have needed it, according to a retrospective study (4). This is the overtreatment population, with half these patients younger, between the ages of 40 and 64, and without any risk factors to indicate the need for a DXA scan. This younger population included many who had osteopenia, not osteoporosis.

Do we all need calcium?

Calcium has always been the forefront of prevention and treatment of osteoporosis. However, two studies would have us question this approach. Results of one meta-analysis of 59 randomized controlled trials showed that dietary calcium and calcium supplements with or without vitamin D did increase the bone density significantly in most places in the body, including the femoral neck, spine and hip (5). Yet the changes were so small that they would not have much clinical benefit in terms of fracture prevention.

Another meta-analysis of 44 observational dietary trials and 26 randomized controlled trials did not show a benefit with dietary or supplemental calcium with or without vitamin D (6). There was a slight reduction in nonsignificant vertebral fractures, but not in other places, such as the hip and forearm. Dietary calcium and supplements disappointed in these two trials.

Does this mean calcium is not useful? Not so fast!

In some individual studies that were part of the meta-analyses, the researchers mentioned that dairy, specifically milk, was the dietary source on record, and we know milk is not necessarily good for bones. But in many of the studies, the researcher did not differentiate between the sources of dietary calcium. This is a very important nuance. Calcium from animal products may increase inflammation and the acidity of the body and may actually leach calcium from the bone, while calcium from vegetable-rich, nutrient-dense sources may be better absorbed, providing more of an alkaline and anti-inflammatory approach.

What can be done to improve the situation?

Yoga has become more prevalent and part of mainstream exercise. This is a good trend since this type of exercise may have a big impact on prevention and treatment of osteoporosis. In a small pilot study of 18 participants, the results showed that those who practiced yoga had an increase in their spine and hip bone density compared to those who did not (7).

The researchers were encouraged by these results, so they performed another study. The results showed that 12 minutes of yoga daily or every other day significantly increased the bone density from the start of the study in both the spine and femur, the thigh bone (8). There was also an increase in hip bone density, but this was not significant. The strength of the study includes its 10-year duration; however, this trial did not include a control group. Also, while 741 participants started the trial, only 227 finished. Of those, 202 were women. 

Significantly, prior to the study there were 109 fractures in the participants, most of whom had osteoporosis or osteopenia, but none had yoga-related fractures by the end of the trial. The “side effects” of yoga included improved mobility, posture, strength and a reduction in anxiety. The researchers provided a road map of specific beneficial poses. Before starting any exercise program, consult your physician.

The moral of the story is that exercise is beneficial. Yoga may be another simple addition to this exercise regimen. Calcium may be good or bad, depending on its dietary source. Be cautious with supplemental calcium; it does have side effects, including kidney stones, cardiovascular events and gastrointestinal symptoms, and consult with your doctor to assess whether you might be in an overtreatment or undertreatment group when it comes to medication.

References:

(1) uptodate.com. (2) nof.org. (3) Clin Interv Aging. 2015;10:1813-1824. (4) JAMA Intern Med. online Jan. 4, 2016. (5) BMJ 2015; 351:h4183. (6) BMJ 2015; 351:h4580. (7) Top Geriatr Rehabil. 2009; 25(3); 244-250. (8) Top Geriatr Rehabil. 2016; 32(2); 81-87.

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.    

Barbara Zinna. Photo courtesy of Mather Hospital

Mount Sinai resident Barbara Zinna, a Mather Hospital, Northwell Health volunteer, was elected to a one-year term as president of the Nassau-Suffolk Council of Hospital Auxiliaries. Her term expires June 2020.

Zinna, an auxilian for 30 years, says one of her major roles as an auxilian is to raise awareness about the community services her hospital offers. Evidence of that commitment occurred when the Mather Auxiliary received the Healthcare Association of New York State’s Best Auxiliary Award in 2017. Also current president of Suffolk County Homemakers, an organization with 26 chapters throughout Long Island, Zinna previously served Mather Hospital’s Auxiliary as its president for four years. 

In her role as president of the Nassau-Suffolk Council of Hospital Auxiliaries, Zinna will continue to lead this organization of hospital volunteers that is aligned with the Nassau-Suffolk Hospital Council, the organization that represents Long Island’s not-for-profit and public hospitals.

Hospital auxilians play a vital role in the delivery of compassionate care at each of their facilities and are major fundraisers for their respective institutions. 

Collectively, Long Island’s volunteer auxilians raise millions through gift shop and thrift shop sales, fashion shows, boutiques and other events. In addition, they are actively involved in advocating on federal, state and local levels on behalf of their hospitals and the thousands of patients that these institutions serve each day.

German become Long Island’s official Man of the Year for the Leukemia and Lymphoma Society after raising a record-breaking $470,000 in 10 weeks.

Asaf German said he grew up with nothing and played stickball in the streets of Brooklyn. This year, the 47-year-old Lloyd Neck resident has become Long Island’s official Man of the Year for the Leukemia and Lymphoma Society after raising a record-breaking $470,000 in 10 weeks.

“What he’s been able to accomplish is priceless,” said Meagan Doyle, who serves as campaign director for the  Leukemia and Lymphoma Society in its Melville office.

Each year the society recruits candidates to compete and run a 10-week fundraising campaign. Proceeds go towards finding a cure for blood cancers leukemia, lymphoma myeloma and Hodgkin’s disease. Eight candidates on Long Island competed and collectively raised $863,000 for the organization.

German, who raised more than anyone ever has on Long Island, pulled together a team of 75 people, mostly women, who helped him organize events and solicit donations. In total, more than 5,000 people contributed to German’s team with donations ranging from $5 to $55,000.

“Nobody said no,” German said. “I am a machine and found very special, passionate, amazing, like-minded people to help.”

Two pediatric cancer patients or survivors participate in the society’s Man of the Year campaign as Boy and Girl of the Year honorees.  Jesse Pallas, age 12, of Miller Place and Morgan Sim, age 5, of Port Washington served as inspiration for German and his team.

“When I met Asaf in person for the first time, he shook my hand and said I’m going to win this thing.  Who would have known that just 10 weeks later he would raise $470,000,” said RuRu Sim, Morgan’s mother. “It was almost unbelievable and he turned my skepticism into pure admiration.  Asaf poured his heart and soul into the Man of the Year campaign and he helped us take a huge step closer to finding a cure for cancer.  The cancer community is so blessed to have found such a dedicated and wonderful man!”

Prior to the fundraising campaign, German, a real estate attorney, knew nothing about fundraising or blood cancer diseases.  He’s become passionate about the cause.

“It’s been the second most rewarding experience of my life after having children,” German said.

Nationally, the society raised $52 million through the Man of the Year campaigns. German ranked eighth nationally in total funds raised.

German thanks Mary Jo White, who had previously pulled together a Woman of the Year campaign for the society.  He said she shared fundraising suggestions with him.  He’s become close with White and her husband through the society’s fundraising mission.  So close, he said he spent Christmas with them.

“People keep telling me ‘Do you realize the magnitude of what you just did,’” said German. “I can’t stop here. I’m a machine.”

He’s recruiting now for next year’s ambassador.

German’s two children, with the help of a committee at Accompsett Elementary and Middle Schools, where they’re students, raised $500 for the cause at Ralph’s Italian Ices on Maple Avenue in Smithtown.

“It’s not all about the money,” German said. “It’s about raising awareness and saving people’s lives.”

Participants in the Empower Spinal Cord Injury program held at Stony Brook University play quad rugby. Photo from Empower Spinal Cord Injury

Stony Brook University students and local community members stopped by the Walter J. Hawrys Campus Recreation Center July 23 to check out the latest equipment created to make life easier for those with spinal cord injuries.

Empower Spinal Cord Injury program participant turned mentor Jack Gerard poses with his dog Radar. Photo by Rita J. Egan

Organized by Boston-based nonprofit Empower Spinal Cord Injury, the expo featured vendors from the health care field who specialize in innovative products for individuals with spinal cord injuries. On display were products such as the Action Trackchair that can handle rocky, dirt roads and go through streams, and a wheelchair called permobil that helps those who are paralyzed to maneuver upright. Participants also demonstrated a wheelchair rugby game called quad rugby, also known as murderball, where players sit in custom-made, manual wheelchairs and play a chair-based form of rugby, physical contact and all.

In attendance were participants from Empower SCI’s two-week program that began July 14 at the university. The residential program, in its eighth year at SBU, provides an opportunity for participants to be involved in an immersive rehabilitation experience with a mix of recreational activities such as cycling, yoga, quad rugby and kayaking in Setauket Harbor. Attendees also learn techniques such as how to make getting out of bed and dressing for the day easier on the body.

Stephanie Romano, assistant director of the program, said each year approximately 50 volunteers help a dozen program participants regain independence and passion in activities, as spinal cord injuries alter the ability to control parts of the body.  According to the organization, more than 17,000 people are affected by the injuries each year in the United States.

Andrew Gallo, from Lake Grove, has participated in the program for the last two years. The 28-year-old was injured in December 2016 while diving in the ocean in Florida when he hit a sandbar. He learned about the program through his therapy office, and he said a friend told him, “There’s life before Empower, and there’s life after Empower and that I had to go.”

Participants in the Empower Spinal Cord Injury program held at Stony Brook University play quad rugby. Photo from Empower Spinal Cord Injury

Gallo said it’s difficult for wheelchair users to get together, and he said he learned from his fellow participants several tricks to help navigate the day a little easier.

“To be around like people makes all the difference,” Gallo said. “You get to interact with them and see what they would do at home in their regular lifestyle.”

He said due to this year’s program he had a chance to try kayaking again, something he had done a few times before his accident. After last year’s event, he has tried adaptive hand cycling, and now he’s looking into buying his own bike.

Jack Gerard, of Massachusetts, who was injured three years ago while swimming in Cape Cod, was also in attendance with his service dog Radar, named after the M*A*S*H character. He first attended the program a few years ago when he couldn’t get out of bed or dress on his own. This year he is a mentor.

“We learn to adapt here rather than trying to change things, Gerard said. “So, I just find a different way to do it, and that’s how I go forward in my life.”

Gerard said he wanted to use the skills that helped him look at life differently and share them with others. He said his life is back on track with returning to school at the University of Massachusetts, playing sports and attending social events. The former lacrosse player and high school track and field player is now into quad rugby, adaptive surfing and hand cycling where he recently cycled 750 miles.

Everyone learns from each other, he said, even mentors from volunteers, especially since sometimes people don’t know what’s possible until others show them.

“One of the biggest things is that you have to be vulnerable to be brave,” he said. “There are a lot of things in our lives that we have to figure out by saying maybe this isn’t the right way to do it. I need to push through this wall to find a different way to get around it.”

For more information about Empower Spinal Cord Injury, visit www.empowersci.org.