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Yearly Archives: 2015

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Fire district offering $1,000 reward

The Lake Grove playground that was set on fire on Sunday, July 26. Photo from Centereach Fire District

The Centereach Fire District is offering a $1,000 reward for information leading to the arrest and conviction of the person responsible for burning down a playground at Eugene Auer Elementary School.

On Sunday, July 26, Centereach firefighters responded to a call for a fire behind the Lake Grove school, according to a press release from the fire district. The plastic playground was fully engulfed, but the fire quickly put out. However, the playground was destroyed.

“This wasn’t just any playground,” Fire Commissioner Julia Wilson said. “The community pitched in, joined together and raised money to erect it.”

The Suffolk County Police Department is investigating the Sunday night incident.

The board of fire commissioners unanimously voted to offer a $1,000 reward at their meeting last week. Anyone with information related to the crime, is asked to call Suffolk County Crime Stoppers at 800-220-TIPS (8477) or submit the information electronically at www.tipsubmit.com.

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Nikki Ortega maintains possession of the ball in USA’s semifinal game against England/ Photo from Alan Rennie/Lacrosse Magazine

Nikki Ortega has earned a spot on the US Lacrosse All-World team.

This news made for a bittersweet Saturday, as Ortega, a former Middle Country girls’ lacrosse standout and incoming freshman at the University of Notre Dame, was part of the U.S. Under-19 women’s lacrosse national team that went undefeated before falling short in the finals of the Federation of International Lacrosse World Championship, 9-8, to Canada.

“The experience was awesome and to be on that team is such an honor,” Ortega said. “It’s something that I’ll always remember, and it taught me so much about myself, and it’s made me so much of a better player over this past year that I learned so much more about the game of lacrosse.”

According to Kim Simons Tortolani, the U19 women’s head coach, more than 800 girls applied to be on the team. As part of the extensive process, regional tryouts were held beginning in August of last year, and the girls were dwindled down during several tryouts until the final team of 18 girls was chosen in January. Ortega was one of seven girls from New York to make the team. 

“The competition was really good and it was something I hadn’t really seen,” Ortega said of the tryout process. “To go up against great competition, especially once we had the team solidified, every practice we got better because all of the girls are so talented. They really challenged me.”

Simons Tortolani said Ortega made an impression early on in tryouts.

“Nikki is one of those players I can remember from the beginning being very strong and stood out amongst a lot of great players,” she said. “She is a very consistent player and played at a really high level from tryouts all the way through the tournament.”

Nikki Ortega reaches her stick out in an attempt to block. Photo from Alan Rennie/Lacrosse Magazine
Nikki Ortega reaches her stick out in an attempt to block. Photo from Alan Rennie/Lacrosse Magazine

The coach said the girls were put through a rigorous mental, physical and emotional tryout process, some of the stress being intentional, to see if the girls had what it took to be a part of the team.

“Nikki was able to manage and handle all of that, and that’s why she made it through the process,” she said. “We had some athletes who maybe, at times, were a little bit flashier, but were not nearly as consistent, and the thing about Nikki was that she quietly does what she needs to do on the offensive end.”

After the roster was solidified, the girls practiced for a few weekends before heading to Scotland to compete in the tournament.

The girls went undefeated at 5-0 through pool play, making them the No. 1 seed heading into the quarterfinals. During pool play, USA outscored its opponents by a combined score of 90-19.

In the team’s third game, Ortega had her breakout performance of the competition. In a 19-6 win over Australia, the attack scored six goals and added two assists, to be named the Player of the Match.

“She really just was unstoppable every time she touched the ball,” Simons Tortolani said. “She’s smart, she reads the game well, we had enough confidence in her to ask her to help start to run the offense, calling the plays and I think that’s because she has a calm, steady effect on the offensive end.”

USA came close to shutting out New Zealand in the quarterfinals, topping its opponent 18-1, and followed with a semifinal win over England, 20-4, before taking on Canada in the finals.

“The atmosphere the entire 10 days of the tournament was really exciting,” Ortega’s mother, Sue, said. “All of the parents of team USA were wearing red, white and blue and they were very excited and supportive for the girls. It’s an unbelievable feeling to see Nikki representing her country and being a contributor, and I’m just full of pride and proud of the player and the person she’s become.”

Team USA, which was vying for its fifth consecutive gold medal, lost in a close match that involved several ties and started off being a difficult matchup because of the weather. Ortega, who scored 19 goals and 10 assists over the course of the tournament, and had at least a hat trick in four of her seven games, said the team did not play like themselves.

“I personally think we were more talented and it just didn’t go our way,” she said. “The weather when we got out there was horrible and a lot of us couldn’t even catch, but lacrosse means so much to me and I had to give up so much to get to where I am, so to know it all paid off in the end really means a lot. I never dreamed of accomplishing all of these things.”

The team had outscored Canada 15-9 in pool play, but Simons Tortolani said she thinks part of the team’s downfall was that it’s competition wasn’t as tough as Canada’s was throughout the tournament.

“I think the team did come together and certainly improved, in retrospect, it probably would’ve been better for us if we had some more challenging games during the pool play,” she said. “But it was a great experience for all of us who were involved. Getting to know these girls and coaching players like Nikki is a privilege and an honor and the girls represented our country and our sport in a way that I’m truly proud of.”

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File photo by Michael Ruiz

The Emma Clark Library, located on Main Street in Setauket, is pleased to announce new video game collections for both the Children’s and Teen departments. Games for teens are coming in August, and the children’s games will be available this fall.

Video and computer game playing, when practiced in moderation, has many benefits. While kids are gaming, they are also learning how to collaborate in a team, strategize, explore, make decisions and take risks. The games help kids prepare for today’s fast-paced digital world. Video games can be fun and motivating, and along with books and traditional games, they are another method of educating our youth in the 21st century.

The library has ordered games for PlayStation 3, PlayStation 4, Wii, Wii U, Xbox360, and Xbox One and will include popular titles such as “Splatoon,” “Just Dance 2015,” “Little Big Planet 3,” “Lego Jurassic World” and “Batman: Arkham Asylum.” Like movies, video games will circulate for one week and may be renewed as long as no one else has reserved the game. Patrons may also recommend games for the library to purchase; the library will be accepting suggestions for games rated T or lower.

The library also holds special “Minecraft,” Xbox, and Wii U programs throughout the year for both kids and teens in the Technology Center. All programs may be found in the printed newsletter or online at www.emmaclark.org/newsletters.

If you have any questions about the new video game collections, you may contact [email protected] or [email protected].

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Wacky Chad, the stunt comedian, gets some air in the company of West Meadow Beach visitors at last Wednesday’s Jewish festival. Photo by Peter DiLauro

By Carin M. Smilk

It was a real scorcher, according to those who attended the sixth annual Jewish Summer Festival, referring to Wednesday’s, July 29, event at West Meadow Beach in East Setauket in the midst of a heat wave that marked a week of 90-degree weather.

But it also turned out to be the largest turnout yet, with more than 500 people attending of all ages, backgrounds and affiliations.

The festival was sponsored by the Chabad Jewish Center of Stony Brook, which serves the Jewish community on Suffolk’s North Shore from Smithtown to Port Jefferson, and is co-directed by Rabbi Motti and Chaya Grossbaum. On tap was live music in the form of the high-energy Jewish rock band Yellow Red Sky; family entertainment, including a moon bounce, face painting and the award-winning stunt comedian Wacky Chad; and a kosher barbecue with all the trimmings, as well as cotton candy and Italian ices for the kids and grown-ups, too.

“There was something for every generation to appreciate,” said Jodi Casciano of Port Jefferson. “It was an evening full of warmth and connectedness — very good for the soul. The kids all had a blast, and the live music was phenomenal.”

The feeling of connectivity was alive throughout the event. In fact, the band dedicated a song in tribute to the four young women who were killed last month in a tragic limousine crash in Cutchogue: Smithtown’s Brittney Schulman, 23, and Lauren Baruch, 24, as well as Stephanie Belli, 23, of Kings Park, and Amy Grabina, 23, of Commack.

One of the more colorful notes of the three-hour festival occurred when the beach balls were distributed as an event giveaway. They were donated by Gayle Stock of Setauket, owner of TakeStock Inc., who declared the evening “fabulous” and is already planning to return next year.

Marty Gerber, a retiree from St. James, has been involved with Chabad for about a year and went to the festival for the first time. He said he was surprised by the size of the crowd, noting that “the tent area was overflowing.”

There were rows of chairs arranged under the shade of the tent, he described, and some even brought their own to position on the beach. The food was tasty, Gerber said.

“It’s a very good place for kids to have fun, and for the parents to relax and socialize,” Gerber said.

And that was the whole point.

“The goal is simply to bring the community together in unity for an upbeat Jewish experience,” said Rabbi Grossbaum. “It was a ‘feel good’ time for everyone there. A special shout-out goes to the main corporate sponsors, without whom it would not be possible.”

They included Jefferson’s Ferry, the Suffolk Center for Speech, Fairy LiceMothers, 3 Village Wellness, Nguyen Plastic Surgery, Gourmet Glatt, Gurwin Jewish and the Times Beacon Record Newspapers.

The event ended around 8 p.m., with the seasonal sky bringing its own sort of closure: a spectacular sunset over the beach.

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Debate focuses on bar fights downtown, narcotics uptown

File photo

Residents and village officials butted heads with a police lieutenant on Monday night, debating the level of coverage officers provide in Port Jefferson.

The downtown commercial district, with its numerous bars and restaurants, is busy on summer nights, particularly on the weekend. Village officials have lobbied over the years to increase Suffolk County police presence downtown during those peak times, and to have more bodies in the uptown area, which sees criminal activity such as drug sales and has a consistent homeless population.

Lt. Donato Mignone said at the village board meeting Monday that there are additional officers patrolling Port Jefferson on Thursday, Friday and Saturday nights, pointing out that the village gets more police coverage relative to its number of police incidents. Mignone said of the 7,800 incidents the Suffolk County Police Department’s 6th Precinct handled in July, 385 of them were in Port Jefferson.

While he agreed the village deserves more attention than it gets, the department is working with limited resources and “you want to be wise with your manpower.”

But Trustee Larry LaPointe argued, “If you’re not here, there is no incident to report. If a tree falls in the woods and nobody’s there to hear it, the tree didn’t fall. That’s what’s happening in this village.”

The trustee called for more police coverage.

“There’s too much violence downtown,” LaPointe said.

The lieutenant said he would pass on the village’s concerns to his superiors. He added, “I absolutely understand, I agree, I commiserate.”

Later in the meeting, after Mignone left, LaPointe said the village might take its fight to a higher level, like the county executive’s office, if things don’t change.

“It’s their job to keep our community safe,” the trustee said. “We will exhaust every possible avenue that we can think of to bring our needs and our concerns to their attention and to push our case as hard as we can.”

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Jason Kontzamanys takes on Dan Losquadro on Nov. 3

Road paving is just one of the issues highway superintendent candidates will debate. File photo by Erika Karp

Jason Kontzamanys has been working in the Town of Brookhaven parks department for a decade, but the Democrat said he is looking for a new challenge, which prompted his decision to face off against Republican incumbent Highway Superintendent Dan Losquadro in November.

Jason Kontzamanys is running on the democratic ticket against incumbent Republican Dan Losquadro. Photo from the candidate
Jason Kontzamanys is running on the democratic ticket against incumbent Republican Dan Losquadro. Photo from the candidate

In a recent interview, Kontzamanys, 45, of Port Jefferson Station, spoke about his plans for his campaign and what he would do if elected to the position. He said his years of experience working as a maintenance mechanic in the parks department and with blue-collar workers makes him the man for the job.

This is Kontzamanys’ first time running for office and the Comsewogue High School alumnus recently went back to school to earn his master’s degree in social studies education from Dowling College. He plans to obtain his doctorate in education administration and become a school administrator.

“I knew I could make a difference,” he said about accepting the nomination.

Kontzamanys said he believed the biggest issue plaguing the department is the overuse of subcontracting.

“The taxpayers should be upset as well,” he said. “The taxpayer is paying for a unionized workforce and they’re not being worked to their full potential.”

Kontzamanys began working for Brookhaven at the landfill and currently works out of the parks department’s base in Holtsville, where he helps with “all aspects of construction and maintenance,” he said. This has given him the opportunity to be versatile and get to know the whole town, he said.

He also has his Class A Commercial License to operate heavy equipment.

Bringing the subcontracted work in house is one of the first steps Kontzamanys would take to help boost the department’s morale, which he alleged is almost non-existent. He said keeping an open-door policy would also help boost spirits.

“You have to keep an open mind, because everybody has the right to be heard, whether it’s a taxpayer or an in-house union member,” he said.

Kontzamanys also said he has a vision to modernize the department and reduce the department’s debt service.

Jason Kontzamanys is running on the democratic ticket against incumbent Republican Dan Losquadro, above. File photo by Erika Karp
Jason Kontzamanys is running on the democratic ticket against incumbent Republican Dan Losquadro, above. File photo by Erika Karp

Losquadro, who was elected as superintendent in 2013, said in a phone interview that he disagreed with Kontzamanys’ notion that subcontracting was bad for the department and the workers aren’t being used. Losquadro said there was a tremendous backlog of work that needed to be done when he took office.

“We needed to go out and contract for that work to keep up with the volume,” he said.

He added that department crews are still responsible for responding to day-to-day complaints and completing routine work. He said the response time for services performed has greatly improved and the fixed-cost contracts gave the department the ability to attend to a high volume of work.

“I think it has been a great boon for the taxpayer,” Losquadro said.

Losquadro also responded to Kontzamanys’ claim that morale was down in the department, stating it is “exactly the opposite,” as he as tried to maintain a direct and open line to his employees.

Making the department more environmentally friendly is also crucial to Kontzamanys, he said, and he spoke about going after federal grants for solar sidewalks and solar panels on highway department land.

Looking at the big picture, Kontzamanys wants to explore additional shared services between municipalities in order to create a synergy between them. For example, collectively bidding on asphalt could help drive down the price.

“I don’t want to just manage, I want to completely transform,” he said.

Election Day is Nov. 3.

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Kristen Digilio and Jon Rivera in a scene from ‘South Pacific.’ Photo by Lisa Schindlar

By Charles J. Morgan

The antics and other distracting, diversionary activities stationed on a backwater island during World War II form the structure of Rodgers and Hammerstein’s great hit “South Pacific” which opened on Oakdale’s CM Performing Arts Center’s Noel S. Ruiz Theatre’s massive stage last Saturday.

Wonderfully directed by Ed Brennan, the story takes place during World War II, following the love story between a U.S. Navy nurse from Arkansas, Nellie, and French planter, Emile, a widower raising his two children. A second love story develops between Liat, a local girl living on the island of Bali Ha’i, and Lt. Joseph Cable, who is conflicted with the duty he owes to his country and the love he feels for Liat.

With book by Hammerstein and Josh Logan, it guaranteed a smash hit at CMPAC … and so it was with Kristen Digilio as Nurse Nellie Forbush and Jon Rivera as Emile de Becque.

Digilio showed extraordinary range in both acting, singing and even dancing. Rivera was a baritone with some depth into basso and a lyricism especially in “Some Enchanted Evening,” the lyrical note on the last word alone culminating the depth of lower register of the baritone for a truly enhanced, musically aesthetic experience.

Digilio’s “I’m Gonna Wash That Man Right Outa My Hair” was a rollicking ensemble with a bevy of swimsuit-clad Navy nurses. She revealed a range of talent reaching from this signature number as well as the slapstick “Honey Bun,” to a totally plaintive solo in “Some Enchanted Evening.”

In the sassy, wise-guy role of Seaman Luther Billis, Marc Slomowitz leads the Seabees in “There is Nothing Like a Dame” which unlocks the rather libidinous leitmotif of the show. Brodie Centauro plays Lt. Cable. He is in love with Liat, a Polynesian girl played by Kate Apostolico. He sings “Younger Than Springtime” in a melodious tenor with Apostolico in his arms, coupled with a handsome stage presence and a powerful tenor.

Then there is the inevitable “Bloody Mary,” handled expertly by Angela Garofalo. A derivative of Little Buttercup in “H.M.S. Pinafore” she is earthy, but when she sings “Bali Ha’i” and “Happy Talk” one simply wants to give her a hug. The island’s commanding officer, Capt. Brackett, is played by Michael Sherwood; Comdr. Harbison is played by John J. Steele Jr. These two non-singing roles lend a fairly good sense of realism to the show.

Choreography is by the indomitable M.E. Junge. “There is Nothing Like a Dame,” “I’m Gonna Wash That Man Right Outa My Hair” and “Honey Bun” exhibited her best work. Music was under the baton of the indispensable Matthew W. Surico leading faultlessly a live 17-piece pit band with cleverly comic uses of dissonances in a well-rehearsed series of numbers.

Costume design fell to Ronald Green III, a veteran designer at CMPAC. His expertise in the native inhabitants’ costuming and the nurses’ swimsuits was faultless. The uniforms not so: Lt. Cable would have been written up if he actually appeared in a four-button open jacket, sunglasses hung out of pocket, hat on back of head, iniquitous boots and a leather flight jacket suitable for B-17 crews over Berlin. Only one sailor wore a regulation hat while the others wore what looked like the pope’s zucchetto; missing also were the U.S. Navy hat devices for Brackett and Harbison.

Anyway, the excellence of this production calls for maximum attendance by all who want top musical entertainment.

The Noel S. Ruiz Theatre at the CM Performing Arts Center, 931 Montauk Highway, Oakdale, will present “South Pacific” through Aug. 23. Tickets range from $20 to $29. For more information, call 631-218-2810 or visit www.cmpac.com.

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By L. Reuven Pasternak, M.D.

To keep health care strong across Suffolk County and Eastern Long Island, Stony Brook University Hospital and Eastern Long Island Hospital will move forward with next steps toward an affiliation — following a unanimous vote by ELIH’s board of trustees at a meeting held on July 9.

This affiliation will help both hospitals provide excellence in health care for the communities we serve. It would allow both hospitals to continue to bring new and strengthened clinical services to the North Fork of Eastern Long Island, including Shelter Island.

The best affiliations allow hospitals to make sure that each patient receives the right level of care in the right facility to match the right level of services needed. We believe this affiliation will do just that.

Our relationship with ELIH is a longstanding one with a history of the two hospitals working closely together to improve health care access and quality. Stony Brook Medicine clinicians have staffed and assisted in the development of ELIH inpatient behavioral health programs, cared for patients who needed specialty services not available at ELIH, and provided support and patient transport services during times of emergency. For example, following damage from Hurricane Sandy, Eastern Long Island patients were transferred to Stony Brook Medicine for care until the Greenport facility was restored.

The next step is for Stony Brook Medicine and ELIH to develop an integration and affiliation agreement. Then, the State University of New York board of trustees will need to approve the transaction. And finally, multiple regulatory steps must be approved through various New York State agencies.

We are grateful to SUNY’s support and visionary leadership for our continued work to establish affiliations with community hospitals in Suffolk County for the care of Long Island residents. On behalf of all of Stony Brook, we especially want to thank Thomas Murray Jr., chairman of the ELIH board of trustees, and the board for choosing Stony Brook as their strategic partner.

We look forward to strengthening our relationship with ELIH and working with Paul Connor III, president and CEO of ELIH, to fulfill our shared promise to meet the health care needs of the community for years to come.

L. Reuven Pasternak, M.D., is chief executive officer at Stony Brook University Hospital and vice president for Health Systems, Stony Brook Medicine.

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Above, Sergio Almécija sandwiches his own hand between skeletons of a chimpanzee and a human. The chimpanzee hand has evolved more than the human hand from a bone structure that predates human’s use of tools, altering the story about the evolution of the human hand. Photo by Ashley Hammond

He’s at it again.

Sergio Almécija ruffled feathers in 2013 when he looked at the femur bone of an ape that lived six million years ago and suggested that this leg bone might have been like that of a fossil ape, which upset the usual human evolution story. Almécija, who left his post as research instructor at Stony Brook University this summer and joined George Washington University in Washington D.C. as an assistant professor in the Department of Anthropology, recently compared the hands of humans with chimps and apes. His findings and possible conclusions have, once again, challenged some conventional wisdom.

In looking at hand bones, Almécija, working with Jeroen Smaers and William Jungers at Stony Brook, analyzed the length of thumbs compared with fingers. He discovered that human hands haven’t changed that dramatically over the last several million years, while those of chimpanzees have shown considerably more variation, with the length of their fingers getting longer relative to their thumbs. He published this research recently in the journal Nature Communications.

“The generally accepted hypothesis is that our hand proportions went through dramatic changes, starting from a chimp-like hand with long digits and relatively short thumb by means of selective pressure,” Almécija explained. This process would have started about three million years ago, when humans produced stone tools in a systematic way. Almécija’s analysis, however, suggests the most likely scenario is one in which humans changed little, with our fingers slightly shorter and thumbs slightly longer, than our ancestors, while chimps have had elongated digits to help them move around in trees.

“Humans are very good at using their hands to manipulate things and little hand evolution was necessary to allow this” because the likely starting point was “already pretty good,” he said.

This process is at odds with the usual evolutionary story of humans — who use their longer thumbs to build tools to conduct research, write about their findings and grasp and manipulate fine objects like an iPhone.

“It appears from our work that the human hand, not unlike that of a gorilla’s, is actually preserving many aspects of primitive, ancient hominoid proportions,” said Jungers, a distinguished teaching professor in the Department of Anatomical Sciences at Stony Brook.

The critical evolutionary process may not have been the development of a hand that could already create tools but rather the cognitive machinery that made it possible for early humans to create these tools.

“Rethinking the details of human evolution happens frequently when new fossils and new analytical methods appear,” Jungers explained. “It’s one of the exciting aspects of paleoanthropology and the hallmark of good science.”

In some respects, chimps have evolved more in their hands than humans.

Jungers, however, cautions that “more” doesn’t mean better. “The chimpanzee hand departs more from the primitive condition than does that of humans in overall proportions,” Jungers said. “Other details of the hand, for example, some of the wrist bones, are similar in chimpanzees and the earliest human relatives and it’s modern humans who have changed ‘more’ from the primitive carpal condition.”

To do this kind of analysis, Almécija said he collected and measured bones from existing fossils. He has also gone out on digs, where he hopes to unearth new fossils that will continue to help clarify the story of human evolution.

Indeed, years ago, Almécija had some success on a dig that helped fuel his interest in the field.

When Almécija was in college in Spain, in his first day at a site, he and his colleagues found an entire fossil ape face from a species previously unknown to science. The next year, he recalls, he spent 10 hours a day in a hot sun looking for fossils but wasn’t able to match the exciting find from that first excavation. By then, however, he was already hooked on anthropology.

Almécija and his wife Ashley Hammond, who also worked at Stony Brook, recently made the move to George Washington University together.

“We really loved being at Stony Brook,” he said. The faculty in Anatomical Sciences are “great scholars and better people.”

Almécija said he plans to continue to collaborate with those same staff members.

Jungers and Almécija are co-principal investigators on an active National Science Foundation grant. “I look forward to many more years of fruitful collaboration,” Jungers said.

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Dehydration is a topic that is often overlooked or given only cursory thought, but it’s very important. Dehydration is simple to avoid, right? Not necessarily. The problem is that we may be dehydrated prior to experiencing symptoms of thirst. In the heat of summer or while exercising, you’re more likely to think about hydration, though you may not actually hydrate enough; however, it’s relevant year-round. Complications and symptoms of dehydration can be mild to severe, ranging from constipation, mood changes, headaches and heart palpitations to heat stroke, migraines and heart attacks.

Effect on headaches and migraines

Temperature is a potential trigger for headaches and migraines. As the temperature rises by intervals of nine degrees, the risk for headaches and migraines increases by 8 percent (1). This study involved 7,054 participants from one emergency room site. Warmer temperatures can potentially reduce blood volume in the body, causing dilation of the arteries, resulting in higher risk of headaches and migraines.

In another study, those who drank four cups more water per day had significantly fewer hours of migraine pain than those who drank less (2). Headache intensity decreased as well. Anecdotally, I had a patient who experienced a potentially dehydration-induced migraine after playing sports in the sweltering heat. He had the classic aura and was treated with hydration, acetaminophen and caffeine, which helped avoid much of the suffering.

Impact on heart palpitations

Heart palpitations are very common. They are broadly felt as a racing heart rate, skipped beat, pounding sensation or fluttering. Dehydration and exercise are contributing factors (3). They occur mainly when we don’t hydrate prior to exercise. All we need to do is drink one glass of water prior to exercise and then drink during exercise to avoid palpitations. Though these are not usually life-threatening, they are anxiety-producing for patients.

Heart attacks

The Adventist Health Study, an observational study, showed a dose-response curve for men (4). In other words, group 1, which drank >five glasses of water daily, had the least risk of death from heart disease than group 2, which drank >three glasses of water daily. Those in group 3, which drank <two glasses per day, saw the least amount of benefit, comparatively. For women, there was no difference between groups 1 and 2; however, both fared better than group 3. The reason for this effect, according to the authors, may relate to blood or plasma viscosity (thickness) and fibrogen, a substance that helps clots form.

Stroke outcomes

Researchers at Johns Hopkins presented findings at the International Stroke Conference 2015 that suggest dehydrated stroke patients have a four times increased risk of having more severe outcomes between hospital admission and discharge than those without dehydration.

Dehydrated patients who presented to the emergency room within 12 hours of an ischemic (low blood flow caused usually by a clot) stroke had poorer outcomes four days later than those who were not dehydrated (5). Stroke severity was similar between the two groups, and none of these patients had kidney failure. The researchers used National Institutes of Health Stroke Scale (NIHSS) to assess daily stroke severity and used magnetic resonance imaging to calculate the number of resulting brain lesions.

The authors suggest that additional research is necessary to determine appropriate methods for rehydration that will avoid exacerbating some underlying medical conditions, like congestive heart failure.

There were some limitations of this study, including its small size, 126 patients, use of indirect markers to measure dehydration and varied MRI timing. It was also not clear whether the dehydration may have caused the strokes, or whether they were a result of medications that negatively affect the kidneys (6).

In an editorial response Dr. Jeffrey Berns, the editor-in-chief of Medscape Nephrology, noted that the above study was not one of dehydration but rather one of volume depletion (7). This is important because you can treat with the wrong substance and cause a negative effect. Dehydration results in elevated sodium in the blood and increased serum osmolarity, turning it a dark color — not to be confused with certain foods or medications that can color your urine.

However, volume depletion is a clinical diagnosis that might affect kidneys by raising the BUN/creatine ratio. If you treat the latter with water, you may cause low blood levels of sodium, which can be dangerous. Interestingly, in my clinical practice, I treat volume depletion and dehydration similarly with smoothies that predominantly contain fruits and vegetables. Regardless of which diagnosis, you may be able to treat with fluids that contain electrolytes, particulates and that are nutrient-dense.

Mood and energy levels

One small study found that mild dehydration resulted in decreased concentration, subdued mood, fatigue and headaches in women (8). In this small study, the mean age of participants was 23, and they were neither athletes nor highly sedentary. Dehydration was caused by walking on a treadmill with or without taking a diuretic (water pill) prior to the exercise. The authors concluded that adequate hydration was needed, especially during and after exercise. I would also suggest, from my practice experience, hydration prior to exercise.

Different ways to remain hydrated

Now we realize we need to stay hydrated, but how do we go about this? How much water we need to drink depends on circumstances, such as diet, activity levels, environment and other factors. It is not true necessarily that we all should be drinking eight glasses of water a day. In a review article, the authors analyzed the data but did not find adequate studies to suggest that eight glasses is supported in the literature (9). It may actually be too much for some patients.

You may also get a significant amount of water from the foods in your diet. A nutrient-dense diet, like the Mediterranean or DASH diets, has a plant-rich focus. A study mentions that diets with a focus on fruits and vegetables increases water consumption (10). As you may know, up to 95 percent of fruit and vegetable weight can be attributed to water. An added benefit is an increased satiety level without eating calorically dense foods.

The myth: Coffee is dehydrating

In one review, it was suggested that caffeinated coffee and tea don’t increase the risk of dehydration, even though caffeine is a mild diuretic (11). With moderate amounts of caffeine, the beverage has a more hydrating effect than the diuretic effect.

Thus, it is important to stay hydrated to avoid complications — some are serious, but all are uncomfortable. Diet is a great way to ensure that you get the triple effect of high amounts of nutrients, increased hydration and sense of feeling satiated without calorie-dense foods. However, don’t go overboard with water consumption, especially if you have congestive heart failure or open-angle glaucoma (12).

References:

(1) Neurology 2009 Mar 10;72(10):922-927. (2) Handb Clin Neurol 2010;97:161-172. (3) Clevelandclinic.org. (4) Am J Epidemiol 2002 May 1; 155:827-833. (5) International Stroke Conference (ISC) 2015. Abstract T MP86. Presented Feb. 12, 2015. (6) Medscape Feb. 19, 2015. (7) Medscape Mar. 27, 2015. (8) J. Nutr. Feb. 2012 142:382-388. (9) AJP -Regu Physiol 2002;283(3):R993-R1004. (10) Am J Lifestyle Med 2011;5(4):316-319. (11) Exerc Sport Sci Rev 2007;35(3):135-140. (12) Br J Ophthalmol 2005:89:1298-1301.

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 or consult your personal physician.

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