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Monthly Archives: April 2015

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By Matthew Kearns, DVM

In our previous article we discussed predisposing factors to obesity such as breed, spay/neuter status, age and underlying disease. This article will focus on a brief overview of tackling the obesity problem. The short answer here is there is no magic bullet for weight loss, but rather the same answer there is for humans: diet and exercise. With that said let’s take a closer look at that and give some more specific recommendations.
Diet:    In a veterinary article I recently read, management of obesity in dogs and cats is as easy as following the three A’s: awareness, accurate accounting and assessment.

Awareness refers not only to coming to terms with obesity in your pet but also certain risks as well (breed, spay/neuter status, etc.). How does one identify obesity in a pet? Usually it’s a vet (the bad guy) that hints at the fact that Spike has gotten a little husky or Fifi a little fluffy. However, you can actually assess your own pet at home. Just go online and look up “Body Conditioning Score,” or “BCS” for short. If, after reviewing information online you are still unsure, I would recommend scheduling an appointment to consult with your veterinarian.

Accurate accounting may be the hardest thing (for us as pet owners) to face.  Food can be an act of bonding not only with other people but also with our pets.  We had one pet owner at our clinic with an obese dog she swore was only getting its food and no extra snacks or table food. After a bit of investigation I found out that the owner loved to cook and the dog was the “official taster” for every meal.  No table food meant no food directly from the table. This was a smart woman, but she felt that the dog would no longer love her if she took this bonding moment away. Unfortunately, this also meant the dog would soon have to be rolled into the clinic and not walk in under its own power.

To make life a little easier, there is a way to actually calculate calorie requirements by using a calculation called the Resting Energy Requirements, or RER for short. The RER is a starting point, and then in conjunction with your veterinarian or a veterinary nutritionist you can calculate how much food to give at each meal. After accurately calculating how much food your dog needs for the whole day, you can break that up into as many meals as you’d like. It has been found that it is more effective to feed at least two and up to four smaller meals a day to lose weight than to free feed (fill up the bowl).

Treats also have calories and should not exceed 10 percent of the diet. There are now low-calorie treats available both commercially and as prescription low-calorie treats through your veterinarian.

Lastly, in terms of assessment, it is important to either weigh your pet at home or bring your pet to your veterinarian’s office for a weight (this helps with consistency especially for larger pets). We encourage pet owners with obese pets trying to lose weight to bring their pets in (at no charge) to be weighed.

Exercise: Exercise is key to good health for many reasons: It helps to maintain and strengthen muscle, it promotes cardiovascular health, it provides mental stimulation, and it increases energy expenditure and fat oxidation.

Obese dogs should be given low-impact cardiovascular exercise (a longer walk or swimming rather than chasing a ball) to avoid heat stroke or injury.

Obese indoor-only cats should have their play geared toward outdoor hunting and playing behaviors (climbing, balancing, scratching). Toys work well for some cats, while others prefer cat trees or play stations.  Interactive toys with the owner are best (especially for single-cat households) to lose weight, as well as promote bonding with the owner.

I hope that this series of articles will help to make our pets the healthiest and happiest pets ever this summer.

Dr. Kearns has been in practice for 16 years.

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BOE President Karen Lessler seeks sixth term

Karen Lessler is running unopposed for the Middle Country Board of Education. File photo by Erika Karp

When hitting the ballots in May, community members will be voting on more than the budget. They will also vote for Middle Country Board of Education trustees who will run the school board, help shape future budgets and make sure proper programs are in place. There are three seats open this year and three incumbent board members are running unopposed.

Karen Lessler
President Karen Lessler is up for re-election and the 15-year veteran said she is seeking another three years in office.
Lessler has held the position of president since 2003 and said being on the school board is a passion of hers.
“I’m very committed to being a child activist,” Lessler said in a phone interview.
The Kings Park school district teacher has been living in the community for 34 years and has had a son and stepson graduate from Centereach High School.
Lessler has been vocal about the fight to keep public education alive and critical of recent changes in education proposed by Gov. Andrew Cuomo (D).
If re-elected, Lessler said she would continue to be fiscally responsible for the community and fight for students.
“I think the issues I continue to focus on are the needs of students and making them good citizens,” Lessler said.

James Macomber is running unopposed for the Middle Country Board of Education. Photo from Middle Country school district
James Macomber is running unopposed for the Middle Country Board of Education. Photo from Middle Country school district

Rev. James Macomber
James Macomber moved to Centereach in 2010 and has served on the board for the last three years.
Currently, Macomber is chair of the educational advancement commission, which spearheaded the science, technology, engineering and math program, which is commonly referred to as STEM. Macomber has been very involved in the STEM program as he feels it provides students with the tools they need to be successful.
Macomber is seeking re-election as he enjoys the community he serves and the board he works with. He called it one of the strongest board of educations around.
“It’s a satisfying way to give back to the community,” Macomber said. “I’ve always been a fan of public education.”
If re-elected, Macomber said he would continue his work to advance the STEM program and work to create partnerships and internships through local businesses for the students in the district.
Macomber, a Vietnam veteran, previously taught business at the University of Tennessee, and has lived in Ohio, Tennessee, New Mexico and Georgia. He has four adult children who have graduated from other school districts.

Arlene Barresi is running unopposed for the Middle Country Board of Education. Photo from Middle Country school district
Arlene Barresi is running unopposed for the Middle Country Board of Education. Photo from Middle Country school district

Arlene Barresi
Arlene Barresi has been on the board for the last nine years and is seeking a fourth term.
Barresi said she has enjoyed her time on the board and is hoping to get a chance at another term.
“We’re in a good place now,” she said. “We have our bond and I want to see it through.”
Last November, the community approved an approximately $125 million bond for capital improvements and security upgrades to the district’s 15 schools.
“We’ve come through very hard times and now we’re doing good, and I want to be a part of that,” Barresi said.
In the past, the district has faced aid cuts, which forced the board and the district to make some cuts. The district, like many across Long Island, is beginning to slowly restore offerings and Barresi hopes to be part of it. On her wish list: an art and music teacher for kindergarten students. Currently, kindergarten teachers provide instruction on the subjects.
Barresi added that she would like to provide younger students who are struggling with additional help, instead of letting problems progress. In addition, she wants high school students to be prepared for life after they graduate, regardless of their path.
“I would like to see more technology programs so people are not only college ready but career ready,” she said.

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Rally against New York State education changes

A protestor stands on North Country Road in Mount Sinai on Tuesday afternoon. Photo by Barbara Donlon

Educators, parents and students gathered outside state Sen. Ken LaValle’s Mount Sinai office Tuesday with one clear message: They won’t forget he voted “yes” on Gov. Andrew Cuomo’s budget when it’s their turn to vote in November 2016.

Nearly 100 people rallied in front of the North Country Road office of LaValle (R-Port Jefferson), holding signs letting the senator and the community know they were upset he voted in favor of a portion of the 2015-16 state budget that amended the teacher evaluation system, lengthened the time before teachers can gain tenure and created new designations for failing schools.

Beth Dimino, president of the Port Jefferson Station Teachers Association and a John F. Kennedy Middle School teacher, said her association and other groups coordinated the protest to show the senator they don’t take his vote lightly.

“The purpose of this rally is to remind Mr. LaValle that his vote in favor of Mr. Cuomo’s budget and anti-public education agenda will be remembered by the parents and taxpayers in the November elections,” Dimino said.

A child hoists a sign during a public education protest. Photo by Barbara Donlon
A child hoists a sign during a public education protest. Photo by Barbara Donlon

LaValle, who was in Albany at the time of the protest, was just re-elected to his 20th term in the Senate and will be up for election again next year.

He said in a statement Wednesday, “We improved on what the governor put in his budget proposal and I fully expect we will continue to fix the education piece, with the final result addressing parents and educators concerns.”

April Quiggle, a Port Jefferson parent, said she came out to show how disappointed she is in the senator she always supported.

“I feel betrayed by him,” Quiggle said.

Not one person at the education rally was without a sign. Young children also held signs.

Miller Place resident Erik Zalewski, who teaches in the Middle Country school district, said LaValle and other politicians who voted in favor of the governor’s reform sold out educators and kids.

“It seems money is more important than the children,” Zalewski said.

Lucille McKee, president of the Shoreham-Wading River Teachers Association, joined in to let everyone know she is tired of non-educators making decisions about education.

Halfway through the rally supporters broke out in a cheer: “Ken LaValle you let us down, Ken LaValle you let the students down, Ken LaValle we will not forget!”

Many parents at the picket said they tried numerous times to reach out to the senator by phone and email and never heard back.

Hundreds of cars drove by as everyone protested on the corner of the road. Drivers honked, gave thumbs-up signs and cheered, letting the protesters know they supported them.

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From left, Bobby Montaniz, Amanda Geraci and James D. Schultz in ‘The Littlest Pirate.’ Photo by Peter Lanscombe, Theatre Three Productions, Inc.

Avast ye! Theatre Three’s world premiere of the musical adventure, “The Littlest Pirate,” which opened last Saturday, takes us from a baseball diamond to a treasure hunt on Diamond Isle and is a rollicking home run.

Written by Tim Peierls and Jeffrey Sanzel, the play tells the story of Annalise, a young girl who wants to play on the Petaluma Pirates Little League baseball team who are always losing to the Rovers from Roger’s Refrigeration. When the coach tells her that the only way she can be on the team is to cheat, Annalise is torn between playing a sport she loves and doing the right thing. She falls asleep on a bench and is swept away into a Pirate Dreamland where she faces the same dilemma when she encounters a band of pirates who want her to switch a real treasure map with a fake one.

Sanzel, who also directed the show, has gathered an enormously talented group of seven adult actors who all tackle duel roles with inexhaustible energy. The petite Amanda Geraci is the perfect choice to play Annalise, the littlest pirate. An incredible actress and singer, Geraci’s solo, “Always Wanted to Play Baseball,” is amazing.

James D. Schultz shines as Coach Wallop and Captain Pyrate who only speaks Pyrish. The one and only Bobby Montaniz is hilarious as he tells numerous jokes as Bobbo and Pirate Parrot. Hans Paul Hendrickson plays the role of twins, Fred and Norville and the Pirate Forvilles, which wasn’t an easy task, but he pulls it off with ease. Jenna Kavaler is wonderful as Jenny, the Petaluma Pirates’ best baseball player who really just wants to play the oboe. Evelyne Lune, as Erin Petaluma and The Pirate Queen, is the all-knowing matriarch of the group and switches roles effortlessly. Rounding out the cast is Andrew Gasparini as Boyd and Pirate Boyd, a terrific actor who has found his own niche on stage and clearly enjoys what he’s doing.

Although the set is minimal with only a few props, costume designer Margaret Ward has spared no expense with matching baseball uniforms and colorful pirate outfits. Choreographed by Marquéz Stewart and accompanied on piano by Peierls and on bass by David Goldberg, the musical numbers are superb, especially “How to Speak Pyrish” and the delightful “Great Day for a Treasure Hunt,” which you will be humming on your way out of the theater.

As with most children’s shows at Theatre Three, there are moral lessons sprinkled throughout the performance. In this case, kids will learn about cheating and the everlasting lesson of “it’s not whether you win or lose, it’s how you play the game.” It is no easy task getting a young audience to sit still for periods at a time, but “The Littlest Pirate” does the trick. No restlessness here  — just children sitting wide-eyed on the edge of their seats, enthralled by the enchantment of live theater. Kids of all ages will enjoy “The Littlest Pirate.” It is funny, entertaining and a great way to spend a Saturday morning.

The entire cast will be in the lobby after the show for a meet and greet and photo opportunities.

Theatre Three, 412 Main St., Port Jefferson will present “The Littlest Pirate” on Saturday mornings at 11 a.m. through May 9. Tickets are $10 per person. For more information, call 631-928-9100 or visit www.theatrethree.com.

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Jennifer Jordan mugshot from SCPD

A woman allegedly crashed through a fence as she fled from an officer who was attempting to pull over her car on Tuesday afternoon, but she was later apprehended.

According to the Suffolk County Police Department, 3rd Precinct officer Craig Knudsen tried to pull over the 2010 Volkswagen at Manor Lane and Bay Shore Road in Bay Shore when the driver fled. Jennifer Jordan, 25, crashed through a fence on the side of the road, at the Sunrise Highway South Service Road near Howells Road.

A short time later, Knudsen arrested the suspect at Howells Road and Richland Boulevard.

Police said Jordan, a Centereach resident and the Volkswagen’s only occupant, was not hurt.

Jordan, who lives on Bonnybill Drive, was charged with fourth-degree criminal possession of a controlled substance, seventh-degree criminal possession, driving under the influence of drugs and unlawfully fleeing a police officer.

Attorney information for Jordan was not immediately available. On a previous unrelated charge pending against her, for petit larceny, she was listed in the New York State court system’s online database as representing herself. She is also separately facing prior charges of speeding and unlicensed operation of a vehicle.

Police said Jordan is scheduled to be arraigned on Wednesday.

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The Huntington library is packed with people reading, studying and doing other work. File photo

Voters in the Huntington Public Library district overwhelmingly approved an $8.9 million budget for next year that stays within a state-mandated cap on property tax levy increases.

Residents also elected a new library trustee, Pat McKenna Bausch, knocking eight-year incumbent Harriet Spitzer off the board.

In total, 423 voted in favor of the budget and 88 voted against it, according to library director Joanne Adam.

“I feel wonderful,” Adam said in a phone interview on Wednesday. “Of course, I’m happy that it passed. I think what makes me even more happy is the amount that it passed by.”

Bausch was the top vote-getter in a contest of three vying for one seat. Candidate Yvette Stone earned 53 votes and incumbent Spitzer amassed 174 votes.

Looking forward, Adam is most excited about renovations at the library’s Main Street branch, which include reconfiguring some spaces and updating the building’s lighting, heating and ventilation.

“Redoing the space, I think, will kind of just give us a nice facelift.”

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Invited INN to hold annual walkathon on Saturday

Volunteer Giovanni Cassino, of Miller Place, helps set the table at the Invited INN soup kitchen at the Trinity Evangelical Lutheran Church in Rocky Point. File photo by Erika Karp

By Erin Dueñas

In order to raise funds to continue 23 years of preparing a warm and nutritious meal to those in need, the Invited INN soup kitchen of Rocky Point will host a walkathon this Saturday, April 25, at the Shrine of Our Lady of the Island in Manorville.

Every Thursday, volunteers at the soup kitchen cook and serve dinner to anywhere from 40 to 70 people who come seeking a fresh-cooked meal and the companionship that comes with eating together. According to Invited INN’s Director and President Carol Moor, the soup kitchen has a “no questions asked” policy on who gets served.

“We don’t check income or anything like that, some people come just for the company. Anyone who shows up gets a meal,” she said. “Everyone who comes is treated with dignity and respect.”

According to Moor, the guests of the Invited INN are a diverse group, including seniors and families with young children, as well as single adults. Although housed in the Trinity Evangelical Lutheran Church, the soup kitchen is ecumenical and any and all faiths are welcome to dine.

The INN, which stands for Interfaith Nutrition Network, is a nonprofit that provides food, shelter and support services to Long Island residents.

Moor said she helped start the soup kitchen more than two decades ago when she was chair of social ministries at Trinity.

“The church recognized a need for a soup kitchen,” she said. “We had the pantry, but we needed something more.”

The very first meal prepared at the Invited INN was served to just six people.

“It’s really grown since then and it’s been very successful,” Moor said. “People aren’t aware that people in their community need this kind of help.”

This is the seventh year the soup kitchen will host the walkathon, the only formal fundraiser it does throughout the year, according to Moor.

“You get a lot of bang for your buck doing a walkathon, and we tend to do very well,” Moor said. “The shrine is a beautiful place to walk and we make some money so it is really a win-win.”

Registration for the walk will begin at 10 a.m. and Moor said walkers can walk as many or as few times as they want around the shrine.

Every penny earned Saturday will go directly to providing the food prepared each Thursday. Running with no overhead and completely by volunteers, any donations the INN receives throughout the year goes solely toward buying food to prepare the weekly dinner.

Donated food items come from organizations such as Long Island Cares and Island Harvest, but the bulk of Invited INN’s monetary donations come from private donors: the congregation at Trinity, as well as from the Rocky Point Lions Club and the Rotary Club of Rocky Point.

Rotary member Tom Talbot said his organization’s intent is to provide help to people and that they enjoy giving to the Invited INN.

“The volunteers are very nice people who are so grateful for our help,” Talbot said. “They run a very important facility in Rocky Point.”

Talbot, who has volunteered at the soup kitchen as a pot washer for 10 years, said that the people who eat there seem to enjoy the meals.

“They are usually very satisfied with the food and it gives them the chance to be social too,” he said. “Some of them come early to make sure they get the same seat they have been sitting in for years.”

Trinity’s pastor Jeffrey Kolbo said that although the Invited INN is essentially a free hot meal program, he has found that it provides much more than that.

“For those who live on a limited income, money saved by eating each week at the Invited INN can be spent on other necessities,” he said. “For those who live by themselves, a night out at the INN breaks the tedium of eating alone. Our volunteers know this and do what they can to build community and feed those who come for our meals.”

To participate in the walkathon or sponsor a walker, contact Moor at 631-744-8686.

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By Linda M. Toga

The Facts: I recently listed my house for sale with a real estate agent and signed a brokerage agreement. Someone offered the full asking price for the house. My attorney forwarded a contract of sale to the potential buyer’s attorney.

Although the potential buyer had the assets needed to purchase my house, he insisted that costly repairs be made to the house and he did not want to close on the transaction for six months. Since I refused to do the repairs and to wait to close, the deal fell through. The agent is now claiming she is owed the commission since she found a buyer who offered to pay me the full asking price for my house.

The Question: Does a real estate agent earn a commission simply by bringing in a potential buyer who agrees to pay the asking price?

The Answer: Although it is impossible to definitely answer your question without reviewing the brokerage agreement you signed, it would be very unusual if a commission was earned based solely on a potential buyer agreeing to the purchase price. When it comes to residential real estate, commissions are generally earned only when the agent produces a buyer who is “ready, willing and able” to purchase the property.

This standard requires that the seller and the buyer not only agree on the price to be paid, but also on other terms such as the condition of the property, what personal property or fixtures may be included in the sale, financing and the date of possession. A buyer may be ready and willing to purchase but, if he lacks the resources, he won’t be able to make the purchase, precluding the agent from earning a commission.

Similarly, a buyer may have sufficient funds and be able to make the purchase but, if he is not willing to accept the house in its present condition, the sale will not proceed and the agent generally would not have earned a commission under most brokerage agreements.

Even if the buyer and the seller agree on all of the terms and a contract of sale is signed, an agent may not earn a commission if, for reasons beyond the seller’s control, the deal falls through.

In difficult real estate markets where there are many obstacles to closing, experienced real estate attorneys are often able to negotiate and find creative solutions to those obstacles that turn potential buyers into buyers who are ready, willing and able to close on a purchase. When that happens, both the seller and the buyer, as well as the broker, reap the benefits of the sale.

Linda M. Toga, Esq. provides legal services in the areas of litigation, estate planning and real estate from her East Setauket office. The opinions of columnists are their own. They do not speak for the paper.

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By David Dunaief

We know that inflammation is a critical part of many chronic diseases. Rheumatoid arthritis (RA) is no exception. With RA, inflammation is rampant throughout the body and contributes to painful joints, most commonly concentrating bilaterally in the smaller joints of the body, including the metacarpals and proximal interphalangeal joints of the hand, as well as the wrists and elbows. With time, this disease can greatly diminish our ability to function, interfering with our activities of daily living. The most basic of chores, such as opening a jar, can become a major hindrance.

In addition, RA can cause extra-articular, a fancy way of saying outside the joints, manifestations and complications. These can involve the skin, eyes, lungs, heart, kidneys, nervous system and blood vessels. This is where it gets a bit dicier. With increased complications comes an increased risk of premature mortality (1).

Four out of 10 RA patients will experience complications in at least one organ. Those who have more severe disease in their joints are also at greater risk for these extra-articular manifestations. Thus, those who are markedly seropositive for the disease, showing elevated biomarkers like rheumatoid factor (RF), are at greatest risk (2). They have an increased risk of cardiovascular disease events, such as heart attacks and pulmonary disease. Fatigue is also increased, but the cause is not well understood. We will look more closely at these complications.

Are there treatments that may increase or decrease these complications? It is a very good question, because some of the very medications used to treat RA also may increase risk for extra-articular complications, while other drugs may reduce the risks of complications. We will try to sort this out, as well. The drugs used to treat RA are disease-modifying antirheumatic drugs (DMARDs), including methotrexate; TNF inhibitors, such as Enbrel (etanercept); oral corticosteroids; and NSAIDs (non-steroidal anti-inflammatory drugs).

It is also important to note that there are modifiable risk factors. We will focus on two of these, weight and sugar. Let’s look at the evidence.

CARDIOVASCULAR DISEASE BURDEN
We know that cardiovascular disease is very common in this country for the population at large. However, the risk is even higher for RA patients; these patients are at a 50 percent higher risk of cardiovascular mortality than those without RA (3). The hypothesis is that the inflammation is responsible for the RA-cardiovascular disease connection (4). Thus, oxidative stress, cholesterol levels, endothelial dysfunction and high biomarkers for inflammation, such as ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein), play roles in fostering cardiovascular disease in RA patients (5).

THE YING AND YANG OF MEDICATIONS
Although drugs such as DMARDS (including methotrexate and TNF inhibitors, Enbrel, Remicade, Humira), NSAIDs (such as celecoxib) and corticosteroids are all used in the treatment of RA, some of these drugs increase cardiovascular events and others decrease them. In meta-analysis (a group of 28 studies), the results showed that DMARDS reduced the risk of cardiovascular events by up to 30 percent, while NSAIDs and corticosteroids increased the risk (6). The oral steroids had the highest risk of heart complications, approximately a 50 percent rise in risk. This may be one reason rheumatologists encourage their RA patients to discontinue oral steroid treatments as quickly as possible.
In an observational study, the results reaffirm that corticosteroids increased the risk of a heart attack in RA patients, this time by 68 percent (7). The study involved over 8,000 patients with a follow-up of nine years. Interestingly, there was a dose-response curve. In other words, the results also showed that for every 5 mg increase in dosage, there was a corresponding 14 percent increase in heart attack risk.

BAFFLING DISEASE COMPLICATION
Most complications seem to have a logical connection to the original disease. Well, it was a surprise to researchers when the results of the Nurses’ Health Study showed that those with RA were at increased risk of cardiovascular disease and of respiratory disease (8). In fact, the risk of dying from respiratory disease was 106 percent higher in the women with RA compared to those without, and the risk was even higher in women who were seropositive (had elevated levels of rheumatoid factor). The authors surmise that seropositive patients have greater risk of death from respiratory disease because they have increased RA severity compared to seronegative patients. The study followed approximately 120,000 women for a 34-year duration.

WHY AM I SO TIRED?
While we have tactics for treating joint inflammation, we have yet to figure out how to treat the fatigue associated with RA. In a recently published Dutch study, the results showed that while the inflammation improved significantly, fatigue only changed minimally (9). The consequences of fatigue can have a negative impact on both the mental and physical qualities of life. There were 626 patients involved in this study for eight years of follow-up data. This study involved two-thirds women, which is significant; women in this and in previous studies tended to score fatigue as more of a problem.

LIFESTYLES OF THE MORE PAINFUL AND DEBILITATING
We all want a piece of the American dream. To some that means eating like kings of past times. Well, it turns out that body mass index plays a role in the likelihood of developing RA. According to the Nurses’ Health Study, those who are overweight or obese and are ages 55 and younger have an increased risk of RA, 45 percent and 65 percent, respectively (10). There is higher risk with increased weight because fat has pro-inflammatory factors, such as adipokines, that may contribute to the increased risk. Weight did not influence whether they became seropositive or seronegative RA patients.
With a vegetable-rich, plant-based diet you can reduce inflammation and thus reduce the risk of RA by 61 percent (11). In my clinical practice, I have seen numerous patients able to reduce their seropositive loads to normal or near-normal levels by following this type of diet.

SUGAR, SUGAR!
At this point, we know that sugar is bad for us. But just how bad is it? When it comes to RA, results of the Nurses’ Health Study showed that sugary sodas increased the risk of developing seropositive disease by 63 percent (12). In subset data of those over age 55, the risk was even higher, 164 percent. This study involved over 100,000 women followed for 18 years.

THE JUST PLAIN WEIRD – INFECTION FOR THE BETTER
Every so often we come across the surprising and the interesting. I would call it a Ripley’s Believe It or Not moment. In a recent study, those who had urinary tract infections, gastroenteritis or genital infections were less likely to develop RA than those who did not (13). The study did not indicate a time period or potential reasons for this decreased risk. However, I don’t think I want an infection to avoid another disease. When it comes to RA, prevention with diet is your best ally. Barring that, disease-modifying anti-rheumatic medications are important for keeping inflammation and its progression in check. However, oral steroids and NSAIDs should generally be reserved for short-term use. Before considering changing any medications, discuss it with your physician.

REFERENCES
(1) J Rheumatol 2002;29(1):62. (2) uptodate.com. (3) Ann Rheum Dis 2010;69:325–31. (4) Rheumatology 2014;53(12):2143-2154. (5) Arthritis Res Ther 2011;13:R131. (6) Ann Rheum Dis 2015;74(3):480-489. (7) Rheumatology 2013;52:68-75. (8) ACR 2014: Abstract 818. (9) RMD Open 2015.  (10) Ann Rheum Dis. 2014;73(11):1914-1922. (11) Am J Clin Nutr 1999;70(6),1077–1082. (12) Am J Clin Nutr 2014;100(3):959-67. (13) Ann Rheum Dis 2015;74:904-907.

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, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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By Bob Lipinski

With the cold weather finally leaving and the holidays just a memory, what better way is there to celebrate warmer weather than with a wine and cheese party. Some helpful hints for a successful party include:

Cheese
Choose an interesting variety of cheeses. Different milks, different countries, the cheese-making styles … all play a role in the subtle differences in each cheese’s color, texture and flavor. Your guests will appreciate the unique colors and textures of the cheeses.
Cheese has sufficient beauty to stand by itself. It shows off best on white dinner plates, plain wooden cheese boards, rustic wooden boards, marble slabs, flat wicker baskets or trays, straw mats or other natural materials.
Do not precut cheese for guests. It exposes too much surface to the air and the cheese will dry out. Before serving the cheese, allow it to sit for 30 minutes to one hour at room temperature, which will soften the texture, release the aromas and maximize the flavor. Serve three to five different types of cheese. More than this causes confusion and leads to cheeses left untouched. Be certain to include one well-known cheese.
Allow approximately four ounces of cheese per person at cocktail parties, unless lots of other food is being served. For eight to 12 guests, have no less than three-quarters of a pound of each cheese.
Provide each cheese with its own knife or spreading utensil, especially soft cheeses. This is necessary, particularly for all blue cheeses. Use tags or flags to identify each cheese … don’t forget the country of origin.

Wine
Offer wines from the same country as the cheese or even decide on a French, Italian or Spanish theme for the festivities. Put up some decorations, play some ethnic music, and perhaps have some small nibbles in addition to the cheese. Provide your guests with small cards containing information about each cheese and matching wine, next to each being served.
Wine choices may include sparkling, dry white or red, sweet white or red, sherry, port or maybe even a pitcher of sangria, decorated with fresh lemons, oranges and several maraschino cherries.
To determine how much wine to purchase, figure on two (6-ounce) glasses of wine per person or one bottle (750-ml = 25.4 ounces) for every two guests. Always purchase one additional bottle in the event of a “bad” bottle or just so you don’t run out. If you don’t use the extra bottle, you can enjoy it when your guests leave!

Bob Lipinski, a local author, has written nine books, including “Italian Wine Notes” and “Italian Wine & Cheese Made Simple” (available on Amazon.com). He conducts training seminars on wine and cheese; sales, time management and leadership. He can be reached at boblipinski.com or at [email protected].

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