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Tom Cassidy with his late father, Hugh 'Joe' Cassidy. Photo by Jonathan Spier

By Thomas M. Cassidy

Thomas M. Cassidy

Artificial Intelligence (AI) will cost many people their jobs. But some occupations desperately needed by a rapidly aging population cannot be replaced by computers or machines. For example, nurse assistants in hospitals and nursing homes.

Research conducted by Goldman Sachs estimates that 25% of current work tasks could be automated by Artificial Intelligence (AI). Unlike prior technological advances that replaced workers in labor intensive occupations, this time “it’s the higher-paying jobs where a college education and analytical skills can be a plus that have a high level of exposure to AI,” according to The Pew Research Center.

During my twenty-year career as an investigator for the New York State Attorney General’s Office, I conducted many investigations of potential patient abuse in nursing homes and other health facilities. I had the privilege of meeting hundreds of nursing assistants. Most were dedicated, knowledgeable and compassionate, but a few were not. Nursing aides dress, bathe, toilet and ambulate patients among many other services. Sometimes they also interact with families, which can be a difficult task. Let me explain:

I was assigned to investigate a possible case of patient abuse at a nursing home. An elderly woman with a doctor’s order for a two-person transfer was helped from her bed for a bathroom trip by only one nurse aide. The elderly woman fell and fractured her hip. The nursing assistant was immediately suspended pending an investigation. My assignment was to investigate this incident as a possible crime. Here’s what happened:

The nursing home patient had a visit from her daughter. Mom told her daughter to help her get out of bed and walk her to the bathroom. The daughter obeyed and helped mom get out of bed. The daughter tried to hold her up, but mom was weak and started to slip. The daughter screamed for help. A nursing assistant rushed to help the falling patient, but it was too late. Mom fell and fractured her hip. There was no crime. The nursing assistant returned to work the next day.

Fast forward twenty years. My father, a World War II combat veteran and a decorated NYPD Detective Commander, fractured his hip at age 80. I visited him at the Long Island State Veterans Nursing Home in Stony Brook. He was alone in his room. He says, “Tom, help me get to the bathroom.” I say, “Dad, let me get an aide to help you.” He says, “YOUR MY SON, just do this for me. I don’t want anyone else to help.” I told him about the elderly woman who fractured her hip when her daughter tried to help her. He said, okay, go get someone to help. If not for my experience as an investigator, I might have tried to help my father. I was taught “To Honor Thy Father and Thy Mother.” But instead, two aides moved my dad safely to the bathroom and back into his bed. Nine months later he walked out of the nursing home to live at home with my mother. 

Not every resident of a nursing home is elderly, but most are. In the United States today, one in every six Americans is age 65 or older. That number will increase dramatically in the next six years to 20% of the population or 70 million older Americans. Incredibly, nursing homes are closing, instead of opening. 

The American Health Care Association reports that since 2020 almost 600 nursing homes have closed, and more than half of nursing homes limit new admissions due to staffing shortages. As a result, there is a shortfall of hospital beds nationwide because displaced nursing home patients remain in hospital beds until they can be safely transferred home or to a care facility.

The Massachusetts Hospital Association reports that one out of every seven medical-surgical beds are unavailable due to patients remaining in the hospital when they no longer need hospital care. Keep in mind that hospitals are required by federal law to provide emergency care, stabilize patients, and discharge patients to a safe environment.

The Bureau of Labor Statistics reports that nursing assistants have one of the highest rates of injuries and illnesses because they frequently move patients and perform other physically demanding tasks. For these, and many other tasks, nurse assistants are paid a median wage of less than $18 per hour; not even close to a salary that is in line with the responsibilities of their job. Small wonder that a survey by the American Health Care Association found that one of the biggest obstacles for hiring new staff in nursing homes is a lack of interested candidates.

Reversing the hemorrhage of nursing home closures requires leaders with Natural Intelligence (NI). It benefits all generations of Americans when hospitals fulfill their mission for acute care and not operate as quasi-nursing homes. After all, languishing in a crowded emergency room “Can Be Hazardous To Your Health!”

Thomas M. Cassidy is the creator of the TV series, Manhattan South, which is in development. (ktpgproductions.com)

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Injuries from falls can result in a loss of independence. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Taking a tumble can result in broken bones and torn ligaments. These can be serious for older patients, where the 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, a fall can lead to loss of independence (2).

What can increase your fall risk?

Of course, there are environmental factors, like slippery or uneven surfaces. Other contributing factors to personal fall risk include age and medication use. Some medications, like antihypertensive medications, which are used to treat high blood pressure, and psychotropic medications, which are used to treat anxiety, depression and insomnia, are of particular concern. Chronic diseases 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 (3).

What are some simple ways to reduce your fall risk?

It is most important to exercise. This means exercises that involve balance, strength, movement, flexibility and endurance, all of which play significant roles in fall prevention (4). The good news is that many of these can be done inside with no equipment or with items found around the home. We will look more closely at the research.

Nonslip shoes are a big help and, during the winter months, footwear that prevents sliding on ice, such as slip-on ice cleats that fit over your shoes.

In the home, inexpensive changes, like securing area rugs, removing tripping hazards, installing grab-bars to your bathroom showers and tubs, and adding motion-activated nightlights can also make a difference.

And, of course, pay attention when you’re walking. Resist the urge to text or read from your mobile device while you’re moving around. A recently published study of young, healthy adults found that texting while walking affected their gait stability and postural balance when they were exposed to a slip hazard (5).

How does medication put you at risk?

There are several medications that heighten fall risk. Psychotropic drugs top the list, but what other drugs might have an impact? A well-designed study showed an increase in fall risk in those who were taking high blood pressure medication (6). Those on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase.

These medications can reduce significantly the risks of cardiovascular disease and events, so physicians need to consider the risk-benefit ratio in older patients before stopping a medication. We also should consider whether lifestyle modifications, which play a significant role in treating this disease, can reverse your need for medication (7).

How much does exercise reduce fall risk?

A meta-analysis showed that exercise significantly reduced the risk of a fall (8). It led to a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in falls that required 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. The author summarized that exercise not only helps to prevent falls but also fall injuries. Unfortunately, those who have fallen before, even without injury, often develop a fear that leads them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased fall risk (9).

What types of exercise are best?

Any consistent exercise program that improves balance, flexibility, and muscle tone and includes core strengthening can help improve your balance. Among those that have been studied, tai chi, yoga and aquatic exercise have all been shown to have benefits in preventing falls and injuries from falls.

A randomized controlled trial showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (10). The goal of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the overall number of falls and a 44 percent decline in the number of exercising patients who fell during the six-month trial, with no change in the control group.

If you don’t have a pool available, tai chi, which requires no equipment, was also shown to reduce both fall risk and fear of falling in older adults (11).

Another pilot study used modified chair yoga classes with a small assisted-living population (12). Participants were those over 65 who had experienced a recent fall and had a resulting fear of falling. While the intention was to assess exercise safety, researchers found that participants had less reliance on assistive devices and three of the 16 participants were able to eliminate their use of mobility assistance devices.

Our best line of defense against fall risk is prevention with exercise and reducing slipping opportunities. In addition, if you are 65 and older, or if you have arthritis and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before you consider changing your blood pressure medications, review your risk-to-benefit ratio with your physician.

References:

(1) MMWR. 2014; 63(17):379-383. (2) J Gerontol A Biol Sci Med Sci. 1998;53(2):M112. (3) JAMA. 1995;273(17):1348. (4) Cochrane Database Syst Rev. 2012;9:CD007146. (5) Heliyon. 2023 Aug; 9(8): e18366. (6) JAMA Intern Med. 2014 Apr;174(4):588-595. (7) JAMA Intern Med. 2014;174(4):577-587. (8) BMJ. 2013;347:f6234. (9) Age Ageing. 1997 May;26(3):189-193. (10) Menopause. 2013;20(10):1012-1019. (11) Mater Sociomed. 2018 Mar; 30(1): 38–42. (12) Int J Yoga. 2012 Jul-Dec; 5(2): 146–150.

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

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It’s difficult to meet vitamin D needs with sunlight. Pixabay photo

By David Dunaief, M.D.

Dr. David Dunaief

This weekend, we’ll all “Spring forward” to Daylight Saving Time. While we’ll lose an hour of sleep on Sunday, the trade will be more hours of sunshine each day.

If you are like many in the Northeast, this is good news for your vitamin D3 levels. In practice, though, it’s still difficult to get enough sun exposure without putting yourself at higher risk for skin cancer.

There is no question that, if you have low levels of vitamin D, replacing it is important. Previous studies have shown that it may be effective in a wide swath of chronic diseases, both in prevention and as part of a treatment regimen. However, many questions remain.

Many of us receive food-sourced vitamin D from fortified packaged foods, where vitamin D3 has been added. This is because sun exposure does not address all of our vitamin D needs. For example, in a study of Hawaiians, a subset of the study population who had more than 20 hours of sun exposure without sunscreen per week, some participants still had low vitamin D3 values (1).

There is no consensus on the ideal blood level for vitamin D. For adults, the Institute of Medicine recommends between 20 and 50 ng/ml, and The Endocrine Society recommends at least 30 ng/ml.

Does body fat affect Vitamin D absorption?

An analysis of data from the VITAL trial, a large-scale vitamin D and Omega-3 trial, found that those with BMIs of less than 25 kg/m2 had significant health benefits from supplementation versus placebo (2). These included 24 percent lower cancer incidence, 42 percent lower cancer mortality, and 22 percent lower incidence of autoimmune disease. Those with higher BMIs showed none of these benefits.

Does vitamin D increase cardiovascular health?

Several observational studies have shown benefits of vitamin D supplements with cardiovascular disease. The Framingham Offspring Study showed that patients with deficient levels were at increased risk of cardiovascular disease (3).

However, a small randomized controlled trial (RCT) questioned the cardioprotective effects of vitamin D (4). This study of postmenopausal women, using biomarkers such as endothelial function, inflammation or vascular stiffness, showed no difference between vitamin D treatment and placebo. The authors concluded there is no reason to give vitamin D for prevention of cardiovascular disease.

The vitamin D dose given to the treatment group was 2,500 IUs. Some of the weaknesses of the study were a very short duration and small study size, so the results were not conclusive.

How does vitamin D affect mortality risk?

In a meta-analysis of a group of eight studies, vitamin D with calcium reduced the mortality rate in the elderly, whereas vitamin D alone did not (5). The difference between the groups was statistically important, but clinically small: nine percent reduction with vitamin D plus calcium and seven percent with vitamin D alone.

One of the weaknesses of this analysis was that vitamin D in two of the studies was given in large amounts of 300,000 to 500,000 IUs once a year, rather than taken daily. This has different effects.

Does vitamin D help you lose weight?

There is moderately good news on the weight front. the Study of Osteoporotic Fractures found that vitamin D plays a role in reducing the amount of weight gain in women 65 years and older whose blood levels are more than 30 ng/ml (6).

This association held true at baseline and after 4.5 years of observation. If the women dropped below 30 ng/ml in this time period, they were more likely to gain more weight, and they gained less if they kept levels above the target. There were 4,659 participants in the study. Unfortunately, sufficient vitamin D did not result in weight loss.

USPSTF recommendations and fracture risk

The U.S. Preventive Services Task Force recommends against giving “healthy” postmenopausal women vitamin D, calcium or the combination of vitamin D3 400 IUs plus calcium 1,000 mg to prevent fractures, and it found inadequate evidence of fracture prevention at higher levels (7). The supplement combination does not seem to reduce fractures, but it does increase the risk of kidney stones.

When should you supplement your vitamin D3?

It is important to supplement to optimal levels, especially since most of us living in the Northeast have insufficient to deficient levels. While vitamin D may not be a cure-all, it might play a role with many disorders. But it is also important not to raise your blood levels too high (8). The range that I tell my patients to target is between 32 and 50 ng/ml, depending on their health circumstances.

References:

(1) J Endocrinology & Metabolism. 2007 Jun;92(6):2130-2135. (2) JAMA Netw Open. 2023 Published online Jan 2023. (3) Circulation. 2008 Jan 29;117(4):503-511. (4) PLoS One. 2012;7(5):e36617. (5) J Women’s Health (Larchmt). 2012 Jun 25. (6) J Clin Endocrinol Metabol. May 17, 2012 online. (7) JAMA. 2018;319(15):1592-1599. (8) Am J Lifestyle Med. 2021 Jul-Aug; 15(4): 397–401.

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

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Even modest exercise can affect your genes. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Last week, I wrote that we should not rely on exercise for weight loss. Exercise is still important, though. It can alter how our genes express themselves and improve our outcomes with diseases and other health issues, such as diabetes, kidney stones, osteoarthritis, cardiovascular disease and breast, colorectal and endometrial cancers (1).

Despite all the positives, it can be difficult to motivate yourself to exercise. However, there are some simple ways to motivate yourself during exercise. One study showed that those who repeated positive mantras to themselves during exercise were able to persist for longer periods (2).

Why is this so important? Because we are too sedentary, and this is the time of the year when we are especially so. According to data from the 2015-2018 Behavioral Risk Factor Surveillance System, the Northeast had among the highest levels of physical inactivity in the U.S., at 25.6 percent of the population (3).

Does exercise alter your genes?

While it may not change our genes, exercise may change how our genes express themselves.

One study’s results showed that thousands upon thousands of genes in fat cells were affected when participants exercised for six months (4). During the study, sedentary men exercised twice a week at a one-hour spin class. According to the researchers, this affected genes that are involved in storing fat and in risk for subsequent diabetes and obesity development. The participants also improved other important health metrics, including their cholesterol, blood-pressure, fat percent and, later, their waist circumferences.

The effect identified on the fat cells is referred to as epigenetics, where lifestyle modifications ultimately lead to changes in gene expression, turning them on and off. This has been shown with dietary changes, but this is one of the first studies to show that exercise also has significant impacts on our genes. It took only six months to see these numerous gene changes with modest amounts of cardiovascular exercise.

Want more encouragement? Another study showed considerable gene changes in muscle cells after one workout on a stationary bike (5). Yet another introduced six weeks of endurance exercise to healthy, but sedentary, young men and identified an abundance of genetic changes to skeletal muscle, which has broad impacts on physical and cognitive health (6).

Can you treat cardiovascular disease with exercise?

What if we could forgo medications for cardiovascular disease by exercising? One meta-analysis examined 57 studies that involved drugs and exercise. It showed similar benefits in mortality with secondary prevention of coronary heart disease with statins and exercise (7). So, in patients who already have heart disease, both statins and exercise reduce the risk of mortality by similar amounts. The same study also showed that for those with pre-diabetes, it didn’t matter whether they took metformin or exercised – they had the same effect.

While these results are exciting, don’t change your medication without consulting your physician.

Does exercise help with kidney stones?

Anyone who has tried to pass a kidney stone knows it can be excruciating. Most treatments involve taking pain medication and fluids and just waiting for the stone to pass. Truly, the best way to treat kidney stones is to prevent them.

In the Women’s Health Initiative Observational Study, exercise reduced the risk of kidney stones by as much as 31 percent (8). Even better, the intensity of exercise did not change its beneficial effect. What mattered more was exercise quantity. One hour of jogging or three hours of walking got the top results; however, lesser amounts of exercise also saw substantial reductions. This study involved 84,000 postmenopausal women, the population most likely to suffer from kidney stones.

Does sexual activity count as exercise?

We have heard that sex is a form of exercise, but is this a myth or is there actual evidence? According to research, this may be true. In a study, researchers found that young, healthy couples exert 6 METs — metabolic energy, or the amount of oxygen consumed per kilogram per minute — during sexual activity (9).

How does this compare to other activities? We exert about 1 MET while sitting and 8.5 METs while jogging. In terms of energy used, sexual activity can be qualified as moderate activity. Men and women burned almost half as many calories with sex as with jogging, burning a mean of 85 calories over about 25 minutes. Who says exercise can’t be fun?

Movement and exercise not only help you feel better, they may also influence your genes’ expression. In certain circumstances, they may be as powerful as medications in preventing some diseases.

References:

(1) JAMA. 2009;301(19):2024. (2) Med Sci Sports Exerc. 2013 Oct 10. (3) cdc.gov. (4) PLoS Genet. 2013 Jun;9(6):e1003572. (5) Cell Metab. 2012 Mar 7;15(3):405-11. (6) Mol Metab. 2021 Nov;53:101290. (7) BMJ. 2013; 347. (8) JASN. 2013;24(3):p 487-497. (9) PLoS One 8(10): e79342.

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

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From left, Jefferson’s Ferry’s President and Chief Executive Officer Bob Caulfield, Director of Admissions Dawn Flowers-Leib, Director of Housekeeping Patti Gallagher, Culinary Manager Heidi Vargas, Assistant Director of Nursing Kathy Koutouvidis, Director of Nursing Richelle Rugolo, and Vice President of Health Services Anthony Comerford. Photo courtesy of Jefferson's Ferry

Resident survey scores Jefferson’s Ferry in top 15% nationwide in skilled nursing care

For the sixth year running, the Vincent Bove Health Center at Jefferson’s Ferry Life Plan Community in South Setauket has received the Pinnacle Quality Insight Customer Experience Award for outstanding resident satisfaction and overall achievement in skilled nursing care. 

The Pinnacle Award process examines “Best in Class” service in skilled nursing over a 12-month period of study by surveying residents and their families about the quality of 14 target areas: Nursing care, activities, dining services/food quality, cleanliness, laundry services, therapy services, response to problems, dignity and respect, individual needs, would they recommend to others, the overall customer experience and satisfaction by residents or family members. The survey placed the health center in the top 15% of skilled nursing facilities nationwide. 

“For more than 20 years, Jefferson’s Ferry, Long Island’s first Life Plan Retirement Community, has set a high bar for extraordinary care,” said Jefferson’s Ferry President and CEO Bob Caulfield. “We strive every day to provide the highest quality care experience in a community setting that respects individuality and promotes dignity, privacy, and independence for every resident. The Pinnacle Award is a direct reflection of our families’ recognition of the outstanding work that our staff performs on a daily basis and a vote of confidence that all of us take very seriously.” 

The survey sampling of Vincent Bove Health Center residents and their families takes place over the course of a year with monthly telephone interviews that ask the participants open-ended questions to rate their experiences in the specific categories. Jefferson’s Ferry staff receive that feedback each month to gain a better understanding of emerging resident needs and make improvements when necessary. 

“The Pinnacle Award is especially meaningful to our caregivers and other staff, as the results come directly from the people they help on a daily basis,” explained Anthony Comerford, Vice President of Health Service at Jefferson’s Ferry. 

“It is important to know that we are consistently hitting the mark, meeting or exceeding the best standards or practices within our industry. Our goal is always to provide residents with the peace of mind to live their best life here. The staff and residents form close relationships based on mutual respect, trust, and quality care,” he said.

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Exercise without dietary changes may not help you lose weight. METRO photo
Exercise without dietary changes may not help you lose weight

By David Dunaief

Dr. David Dunaief

We’re just past the point on the calendar when those who committed to exercising more in the new year are likely to have fallen off their resolutions. If you’re still following through, congratulations!

Exercise has benefits for a wide range of medical conditions, from depression, insomnia, fatigue and balance to cognitive decline, chronic kidney disease, diabetes, cardiovascular disease and osteoporosis.

Will it help you lose weight, though? While gym membership ads emphasize this in January, exercise without dietary changes may not help many people lose weight, no matter what the intensity or the duration (1). If it does help, it may only modestly reduce fat mass and weight for the majority of people. It may, however, be helpful with weight maintenance.

Ultimately, it may be more important to examine what you are eating than to succumb to the rationalization that you can eat without care and work it off later.

Will exercise help you lose weight?

The well-known weight-loss paradigm is that when you burn more calories than you consume, you will tip the scale in favor of weight loss. The more you burn, the more you will lose. However, study results say otherwise. They show that in premenopausal women there was neither weight nor fat loss from exercise (2). This involved 81 women over a short duration, 12 weeks. All of the women were overweight to obese, although there was great variability in weight.

However, more than two-thirds of the women gained a mean of 1 kilogram, or 2.2 pounds, of fat mass by the end of the study. There were a few who gained 10 pounds of predominantly fat. A fair amount of variability was seen among the participants, ranging from significant weight loss to substantial weight gain. These women were told to exercise at the American College of Sports Medicine’s optimal level of intensity (3). This is to walk 30 minutes on a treadmill three times a week at 70 percent VO2max — maximum oxygen consumption during exercise. This is a moderately intense pace.

The good news is that the women were in better aerobic shape by the end of the study. Also, women who had lost weight at the four-week mark were more likely to continue to do so by the end of the study.

Other studies have shown modest weight loss. For instance, in a meta-analysis involving 14 randomized controlled trials, results showed that there was a disappointing amount of weight loss with exercise alone (4). In six months, patients lost a mean of 3.5 pounds, and at 12 months, participants lost about 3.75 pounds.

Does exercise play a role in weight maintenance?

Exercise may help with weight maintenance, according to observational studies. Premenopausal women who exercised at least 30 minutes a day were significantly less likely to regain lost weight (5). When exercise was added to diet, women were able to maintain 30 percent more weight loss than with diet alone after a year (6).

How does exercise help with disease?

Let’s look at chronic kidney disease (CKD), which affects roughly one in seven U.S. adults, as a simple example of exercise’s impact on disease (7).

Trial results showed that walking regularly could reduce the risk of kidney replacement therapy and death in patients who have moderate to severe CKD (8). There was a 21 percent reduction in the risk of kidney replacement therapy and a 33 percent reduction in the risk of death when walkers were compared to non-walkers.

Walking had an impressive impact, and the more frequently patients walked during the week, the better the probability of preventing complications. Those who walked between one and two times per week had 17 and 19 percent reductions in death and kidney replacement therapy, respectively, while those who walked at least seven times per week saw 44 and 59 percent reductions in death and kidney replacement. These are substantial results. The authors concluded that the effectiveness of walking on CKD was independent of kidney function, age or other diseases.

There are many benefits to exercise; however, food choices will have a greater impact on weight and body composition. The good news: exercise can help maintain weight loss and is extremely beneficial for preventing progression of chronic diseases, such as CKD.

By all means, exercise, but to lose weight, also focus on consuming nutrient-dense foods instead of calorie-dense foods that you may not be able to exercise away.

References:

(1) uptodate.com. (2) J Strength Cond Res. 2015 Feb;29(2):297-304. (3) ACSM.org. (4) Am J Med. 2011;124(8):747. (5) Obesity (Silver Spring). 2010;18(1):167. (6) Int J Obes Relat Metab Disord. 1997;21(10):941. (7) cdc.gov. (8) Clin J Am Soc Nephrol. 2014 Jul;9(7):1183-1189.

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

 

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Photo from Deposit Photos

By Daniel Dunaief

In a nod to the herd immunity from a combination of illnesses and vaccinations in the population, the Centers for Disease Control and Prevention is widely expected to reduce the recommended number of days of isolation after a positive test to one day from five days.

Even as most of the population has returned to a normal life after the pandemic — toughing through colds with relatively mild symptoms at work and staying home, for the most part, when symptoms become severe — the CDC had urged Americans to remain isolated for five days.

“Covid has diminished as a real threat for the majority of people,” said Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “The responsiveness between vaccinations and multiple events [such as infections] is reasonable to prevent hospitalization and death in most people.”

In addition, Covid treatments, such as Pfizer’s Paxlovid, have become effective in reducing the severity and duration of symptoms.

The CDC likely couldn’t have provided such guidance a year ago, but, for most people, the consequence of contracting the virus that altered the course of life for people for several years, has been less problematic for their health, doctors said.

Despite ongoing illnesses and symptoms, people have become less likely to test for Covid.

“Insurance companies used to pay for eight per month, but now, people just buy one [test box] at a time,” said Michael DeAngelis, the owner of Village Chemist in Setauket.

Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital, understood the CDC’s decision, with an important warning.

“The rationale behind changing the timing of isolation guidelines is based on looking at the evolving severity of cases,” Dhuper said.

“People who are younger get more mild levels of illness and recover,” he added.

Concerns for the elderly

“The disease is beginning to behave more and more like other respiratory viruses, but we are not there yet,” Dr. Dhuper cautioned, particularly for those who are over 65.

Hospitalization for people who contract Covid is 11.2 per 100,000 for people over 65, compared with 6.9 per 100,000 in the week ending Feb. 10, according to data from the Centers for Disease Control and Prevention. 

The mortality for those over 65 from Covid is higher than for the flu, Dr. Dhuper said.

“We have to be a little cautious, sending a message to the community that you can continue to do what you want to do,” Dr. Dhuper said. “When they are around the elderly” people, particularly those who might have symptoms even if they haven’t been tested, should consider wearing masks or keeping their distance.

The incidence of Covid, among other illnesses, climbed after the December holidays and the start of 2024, as people traveled to visit with family or on vacations. Those numbers have come down, although the upcoming spring break from secondary schools and colleges raises the possibility that illnesses could climb again, doctors predicted.

Be careful of grandkids

While the public may not want to hear it, Dr. Dhuper expected that it might take another five years before Covid reaches a comparable level of potential risk to the elderly as the flu, which could also present a risk to people’s health.

Dr. Dhuper urged those who have symptoms to test themselves for Covid. Even if they don’t isolate themselves for more than 24 hours, they should be cautious around vulnerable groups.

Dr. Dhuper’s advice to grandparents is to “be careful when you’re around your grandkids, because they are like petri dishes, harboring tons of infections.”

While for many people in the community, Covid has become like white noise, it’s still causing medical problems and leading to some hospitalizations, the St. Charles doctor added.

Any change in isolation guidance from the CDC should come with an asterisk that “yes, we are changing the guidelines, but people should still exercise precautions,” Dr. Dhuper said.

Vaccination research

Amid discussions related to vaccines, Dr. Nachman added that several compelling papers have demonstrated that people who are up to date on their vaccines, including flu, are at lower risk for dementia.

The link between vaccinations and overall brain health is unclear, and it is possible that people who receive vaccines also have a lifestyle that reduces the risk of developing dementia.

“We have an aging population in New York, particularly on Long Island,” said Dr. Nachmman. “If we want to keep them healthier longer, getting appropriate medical care, including vaccines, is probably helpful.”

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Wend Wellness Chiropractic
Dr. Shane Wend of Wend Wellness Chiropractic. Photo from WMHO

Stony Brook Village is home to a new chiropractic practice. 

Wend Wellness Chiropractic, located at 21 Main Street, opened its doors in January. Led by Dr. Shane Wend, the office offers comprehensive initial evaluations, chiropractic adjustments, free nutrition plans, natural supplementation recommendations for specific issues and pathological implications, fitness plans, and all-natural supplements (Super U), which provides focus, smooth energy, and mental clarity, according to a press release.

Super U is a proprietary blend of nutrients created and tested over 3 years by Dr. Wend. It is available only through Wend Wellness Chiropractic.

A native of Northport and current resident of Head of the Harbor, Dr. Wend developed an early passion for the intricacies of the human body and a genuine desire to enhance people’s well-being and health. He graduated from Saint Anthony’s High School in 2009 and pursued a degree in biology at Stony Brook University. Later, he studied at the Palmer College of Chiropractic and, since 2020, has been practicing chiropractic care while sharing informative tips on nutrition, health, and wellness through his website and social media pages.

Wend Wellness Chiropractic is open Mondays, Wednesdays, Thursdays and Fridays from 8 a.m. to 7 p.m. by appointment, closed on Tuesdays and on weekends. For  more information, call 631-485-3643 or visit www.wendwellness.com.

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BODY20 ribbon cutting on Feb. 2, 2024. Photo courtesy of Councilwoman Bonnner's office

On February 2, Town of Brookhaven Councilwoman Jane Bonner and Mt. Sinai Miller Place Chamber of Commerce President Holly Bottiglieri helped celebrate the grand opening of BODY20, the new boutique fitness studio located at 275 Route 25A, Suite 28, Route 25A in Miller Place, with a ribbon cutting ceremony.

BODY20 is a personalized, technology-based workout experience that creates up to 150 times more muscle contractions versus conventional training. Combined with their personalized workout experience, results are achieved in just 20 minutes that would require hours in a traditional gym. 

“I am happy to welcome Body20 to Miller Place and I encourage everyone to stop in meet the staff and see what they have to offer. It’s a great addition to the community and I wish them the best of luck,” said Councilwoman Bonner. 

Pictured from left is Eva Zherberlyaeva (employee); Gianna Marfoglio (employee); Maureen Bond (Mt Sinai Miller Place Chamber) Yvonne Levine (employee); Jim Carlson (Owner), Connie Marfoglio (employee); Holly Bottiglieri (Mt. Sinai Miller Place Chamber President); Councilwoman Jane Bonner and Jade Noll (employee). 

The studio is open from 7 a.m. to 8 p.m. Mondays through Fridays, 8 a.m. to 1 p.m. on Saturdays, and 8 a.m. to noon on Sundays. For more information, call 631-683-3543.

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ICR Program Team from left, Brittany Decker, LCSW; Christina Di Lieto, RDN, CDN; Neal Patel, MD, FACC, FSCAI, Medical Director of the ICR Program; Jennifer Cain, RN, ICR Program Administrator; Ashley Ryan, Unit Coordinator; Veronica Barat, MS, CEP, CISSN. Photo from North Suffolk Cardiology

North Suffolk Cardiology, a practice of Stony Brook Medicine Community Medical Group, has recently launched its Pritikin Intensive Cardiac Rehabilitation Program (ICR). The first-of-its-kind initiative on Long Island marks a significant milestone in North Suffolk Cardiology’s mission, continuing its longstanding tradition of pioneering cardiac care. 

“Unlike traditional cardiac rehab programs which are primarily exercise-focused, North Suffolk Cardiology’s ICR program offers patients comprehensive lifestyle education at every visit, plus one-on-one access to a multidisciplinary cardiac care team in a state-of-the-art location,” said Neal Patel, MD, ICR Program Medical Director at North Suffolk Cardiology. “Through dynamic interaction with a cardiac nurse, exercise physiologist, nutritionist and licensed clinical social worker, an individualized cardiac wellness plan is created, and patients are taught specific lifestyle methods to enact meaningful change.”  

This program complements the existing comprehensive cardiac services offered by North Suffolk Cardiology, whose mission is to provide full-service exceptional cardiac care to improve a patient’s quality of life. The practice now offers an expanded array of services tailored to a patient’s unique care plan following a cardiac condition or procedure.  

“This groundbreaking program will serve as a tremendous resource to our patients, families and community — both through its ability to help people live heart-healthy lives and because of the expertise, advanced approaches and compassion of North Suffolk Cardiology’s physicians and staff,” said William Wertheim, MD, MBA, Interim Executive Vice President for Stony Brook Medicine and President of Stony Brook Medicine Community Medical Group. “I am so proud that this program is part of Stony Brook Medicine.” 

Located at 45 Research Way, Suite 108 in East Setauket, North Suffolk Cardiology is currently accepting new patients. For appointments, call 631-941-2000. For more information, visit northsuffolkcardiology.com.

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