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By Daniel Dunaief

They don’t always follow the same path with any two sufferers, but people who have migraines can and often do find themselves with symptoms including head pain, discomfort, numbness and nausea that make working, caring for family members or functioning difficult.

Dr. Sharon Nachman. Courtesy Stony Brook Medicine Facebook page

Among the first symptoms listed when COVID-19 became a pandemic in 2020, headaches can and have become more severe for people who become infected and then endure additional symptoms in the ensuing weeks and months.

People with migraines often suffer from a throbbing headache, nausea, sensitivity to light and loud noises that worsen with movement.

The other associated features can be “just as disabling as the pain,” said Dr. Noah Rosen, director of the Headache Program for Northwell Health. “Now that we see some of the symptoms cross over with long COVID symptoms, that becomes more salient.”

At this point, amid anecdotal evidence of migraines and long COVID, health care providers can’t say conclusively whether an infection with the current strain of the virus presents any more risk of developing migraines sometime after an infection than they were with earlier strains of the SARS-CoV-2 virus.

“There’s no central reporting of symptoms,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “If you get a vaccine and you have an adverse event, you can report it. There’s no such thing for long COVID.”

Indeed, with people continuing to pass along the virus in schools, workplaces, crowded subways and other places where people gather in confined indoor spaces, the long COVID population has “overtaken any ability to track those symptoms,” Nachman said.

Nachman added that migraines could be a symptom of something else.

“It’s hard to say a true cause and effect” with regard to a particular symptom, as some immune systems may have such a strong response that they are creating autoimmune problems.

Migraines are also seen in patients with autoimmune diseases, Nachman said.

For some patients, doctors may want to do a full immune workup to make sure they are not having an autoimmune reaction.

As for long COVID symptoms, people “across the board” are developing various maladies after contracting the illness that caused the pandemic, Nachman said.

While it’s unclear at this point whether migraines or other specific symptoms increase amid the current strain of long COVID, doctors urged people who have underlying medical conditions to get tested when they develop symptoms.

“Fewer people are actually treating the acute phase,” said Rosen. “There was some evidence that early treatment with Paxlovid can reduce the risk of long-term COVID.”

Indeed, people in high-risk groups can lower the chance of dealing with additional symptoms, called sequelae, after an initial infection.

Treatments

While numerous treatments are approved for migraines, it is unclear which might be best for people who develop these extreme and potentially debilitating headaches in the aftermath of COVID.

“Many of the new treatments haven’t been specifically looked at for post-COVID” migraines, said Rosen.

Migraines can become enough of an interruption to daily life that people alter their behaviors in between episodes, during the so-called interictal period.

Even without the pain, migraine sufferers can avoid activities because they are afraid of a trigger.

This can affect people’s social interactions or their job choices, among other decisions.

“If people are noting that they are unable to do things that they were doing before or are avoiding certain tasks, they need to step up in treatment,” said Rosen.

In terms of treating migraines, Rosen suggested that beneficial pharmacological options, such as triptans, have been around since the 1990s.

Triptans are a group of medicines that treat migraines by changing how blood circulates in the brain and how the brain processes pain signals, according to the Cleveland Clinic.

Rosen said Imitrex and Maxalt are used to treat migraines during the mild phase.

“Early treatment can lead to shorter symptoms or less medicine being used and less disability,” Rosen said.

The average migraine lasts about four hours. A migraine that lasts more than 72 hours is described as “migrainosis,” which can be disabling and can require a combination of medications.

People can reduce the risk of migraines through some lifestyle modifications, such as ensuring sufficient hydration, not skipping meals, getting regular sleep, avoiding stress or engaging in behaviors that improve resilience to stress, and exercise, Rosen said.

Migraines affect about 12 percent of the population. Additionally, anyone with a migraine has about a 70 percent chance of having a first-degree relative — a parent, sibling or child — who also has migraines, according to Rosen.

Researchers have identified over 40 genes associated with migraines, which makes determining a specific genetic link complex, Rosen said.

With a link between migraines and hormones, women suffer from them at about a three-to-one ratio to men.

Other triggers

Migraine sufferers often try to identify triggers that can bring on these painful and disturbing episodes that can cause fatigue and discomfort even after the episodes end.

Many people are sensitive to environmental changes, like low barometric pressure from storms or excessive changes in temperature.

All of those are increasing amid climate change, which has had a significant effect on migraine sufferers, Rosen said.

Obesity, which is a health issue for the country, can also affect migraines.

“That places an additional burden on the health of people who suffer” from migraines, said Rosen.

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Photo courtesy Metro Creative Graphics

By Daniel Dunaief

While the fall provides a break from the summer heat and a respite for exhausted parents who coordinate and carpool for recreational activities, it also can trigger a return to more concentrated time indoors.

Dr. Sharon Nachman, Chief of the Division of Pediiatric Infectious Diseases at Stony Brook Children’s Hospital.
File photo

That can trigger the beginning of the flu season, as students and their families share much more than the lessons of the day and stories about teachers and classmates.

Timing shots can be a delicate balance, as the antibody coverage from these shots is typically about three months.

With the peak flu season often occurring during December and January and even into February, Dr. Sharon Nachman, Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents receive their vaccines in a few weeks.

“Getting a vaccine in October is probably the right time,” Nachman said.

Dr. Gregson Pigott, Commissioner of the Suffolk County Department of Health Services, added that the timing for Covid vaccinations is somewhat trickier.

“Because the evolution of new variants remains unpredictable, SARS-CoV2 [the virus that causes the disease] is not a typical ‘winter’ respiratory virus,” Pigott explained in an email.

The county health department recommends that residents stay up to date with their vaccinations.

“Individuals should speak with their healthcare providers for advice that is specific to them,” Pigott added.

Simultaneous shots

Doctors generally recommend receiving both shots at the same time, if people are eligible and the timing for each vaccine is right. Residents who are unsure about their eligibility should speak with their healthcare providers, Pigott explained.

Dr. Gregson Pigott, Suffolk County Health Services commissioner. File photo

The flu and Covid are viruses that change over time, creating a battle between the pharmaceutical companies that manufacture vaccinations and the viruses that attempt to evade them.

Each year, the vaccines attempt to provide the best match against the dominant or most likely strains.

The Centers for Disease Control and Prevention “determines if the vaccine will protect against a circulating virus by conducting laboratory studies on circulating flu viruses,” Pigott explained in an email. “Updated 2024-2025 flu vaccines will be trivalent” and will protect against H1N1, H3N2 and a B/ Victoria lineage virus.

Vaccine manufacturers create immunizations based on the flu strain circulating in the southern hemisphere during the recent season.

“We expect that those are what’s going to hit us in our winter,” Nachman said. “The science is there. We know generally what types will be rolling around. We could hit or miss it by a subtype.”

Nachman added that the flu vaccines represent educated guesses about the type of microbe that might cause illnesses.

“The educated guesses are still better than no vaccine, which will, for sure, not cover you at all,” Nachman said

As for the Covid immunization, doctors added that it is also likely to change as the virus that caused the pandemic mutates.

Nachman said people should plan to get the Covid shot around once a year.

“I don’t think we’re going to go to more often” than that, Nachman said.

During the summer, when an infectious strain of Covid surged across the county, state and country, Nachman said the data is not available to determine how much protection a vaccine provided.

“Only on TV do computer models work instantly,” Nachman said.

She suspects that the Covid shot offered some protection for residents, who may not have been as sick for as long as some of those who dealt with a range of symptoms.

Concussion awareness

With the start of a new school year and the beginning of contact sports like football, school districts are continuing to ensure that coaches and athletes follow concussion protocols.

“Schools have done a nice job thinking and talking about it,” said Nachman. “Coaches know you can’t throw [student athletes] out and say, ‘You’ll do fine,’” after a head injury.

Nachman suggested that area athletes may engage in activities that are not connected to the schools and that may involve head injuries that people ignore.

“We know what’s happening with school-regulated” sport, but not with those that are outside the academic umbrella, she added.

As for the emotional or psychological impacts of a divided and bitter electorate during an election year, Nachman said people are under considerable emotional stress.

“The social media echo chamber is making it worse,” she said. The abundance of misinformation on both sides is causing mental anguish.

“Election times are very stressful and I think, in particular, this election may be even more stressful,” Nachman said.

Nachman urges people to minimize their time on social media and to create down time from electronics during meals.

As students move up a grade and into new places, they also can endure stressors, peer pressure and bullying. She suggests that parents understand what their children are seeing online.

Newborn RSV protection

Children born in March or later are eligible to receive an approved shot called Beyfortus, which, in 80 percent of cases during clinical trials, prevents the development of respiratory syncytial virus, or RSV.

The Beyfortus monoclonal antibody will make a “huge difference” for newborns and their parents, Nachman said. Last year, Stony Brook had numerous hospitalizations in children under one year of age.

“We’re not going to have those children coming into the hospital,” Nachman said. “That’s amazing and is a huge step forward.”

When newborns get RSV, doctors don’t have an effective treatment for the virus and typically treat the symptoms.

The mortality rate from RSV is low, but the morbidity is high. Newborns who contract RSV can end up developing chronic asthma.

As with any shot, Beyfortus can have side effects, with the most common including rash and pain, swelling, or hardness at the site of the injection, according to AstraZeneca and Sanofi, which manufacture the antibody.

Beyfortus is covered by insurance and is under the vaccine for children program and numerous private health insurance plans. Parents can opt out of the shot. Nachman suggested they should understand what they are opting out of when they make that decision.

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Stony Brook doctor, tending to a newborn baby. Courtesy Stonybrookchildrens.org

By Daniel Dunaief

Water inside a house isn’t just bad for the structure, it can also be damaging to your health.

Local health care professionals suggested that Stony Brook residents whose basements flooded from this weekend’s heavy rainfall should be careful about the growth of mold or mildew, which can be especially problematic for anyone with chronic breathing issues.

“People can inhale spores over a period of time and can develop respiratory symptoms,” said Dr. Sunil Dhuper, Chief Medical Officer at Port Jefferson’s St. Charles Hospital.

People with asthma, chronic obstructive pulmonary disease, bronchitis and emphysema “need to be particularly concerned about some of these issues,” he continued.

Dr. Sharon Nachman, Chief of Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, suggested that residents of Stony Brook, who experienced a localized 10 inches of rain this weekend, should “aggressively clean” their basements, from any standing water, as mold and mildew can start growing within a few days.

“You won’t see it because it’s small,” but people should dry the walls and under the floorboards and carpet, she said. “You want to get the water out.”

Local doctors, also, recommended dumping standing water off any surface that might become a breeding ground for mosquitoes, who can carry the West Nile virus.

At this point, the County Department of Health believed the West Nile threat wasn’t likely particularly high.

“The heavy rains and wind might have washed away adult larvae and adult mosquitoes,” Dr. Scott R. Campbell, Laboratory Chief in the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services, explained in an email.

“Wet springs and hot, dry summers — in which mosquitoes and birds may congregate at limited sources of water — may be conducive to higher West Nile virus transmission.”

The heavy rain, which was triple the usual average for the entire month of August, according to Weather Spark, likely reduced area mosquitoes.

Local medical care professionals suggested that residents should still remove standing water as a way to protect themselves against any remaining mosquitoes.

Congenital viral infection

Apart from the impact of local flooding, doctors discussed a host of other medical issues.

New York State has been testing newborns, since last fall, for congenital cytomegalovirus, or CMV, which infected mothers can give to their unborn children.

The testing so far has shown that CMV is less prevalent than previous estimates.

The state started the one-year study of the virus to track children who might develop symptoms, such as hearing loss or learning challenges, later on.

“The earlier you identify babies with hearing deficits, the sooner you can act, and there will be fewer ramifications on their intellectual development, as a result of it,” said Dr. Andrew Handel, pediatric infectious diseases expert at Stony Brook Children’s Hospital, and a co-leader, along with Dr. Nachman, of one of the 11 units across the state.

Dr. Sharon Nachman. Courtesy Stony Brook Medicine Facebook page

Earlier medical sources estimated that the infection rate for newborns was about one in 200 babies. But, with about 300 newborns testing positive, the rate is closer to one in 325.

The percentage of symptomatic babies is tracking with previous expectations, at around 10 percent. Symptoms of congenital CMV at birth include hearing loss, jaundice, low birth weight, seizures and retinitis.

“Our numbers are matching up with the 90 percent” of those who have the virus, but are asymptomatic, Handel added.

“That’s why we feel screening is so important.”

For the asymptomatic newborns, about 10 percent will develop permanent hearing loss, which is why doctors are tracking them so closely.

The virus, which is a relative of the Epstein Barr virus, which causes mononucleosis, is spread through direct contact with body fluids, such as tears, saliva or urine. Over half of all adults have had a CMV infection, with some studies estimating the rate as high as 80 percent.

Adults can shed the virus for a few weeks after contracting it, while children can shed it for a few months.

While all newborns will receive CMV screening after birth, parents have five days to opt out of any link to a report of the presence of the virus in their children.

At this point, fewer than one percent of parents are opting out of the testing. Some of the parents aren’t interested in the test, others don’t believe it’s useful, while some believe their babies look fine, and don’t want the additional test.

Most parents appreciate the opportunity to gather information about their children’s health. Patients are “grateful the state has this program,” said Dr. Sunil Sood, Systems CMV specialist at Northwell Health.

At Stony Brook and other hospitals, doctors are monitoring those babies who test positive.

The County Department of Health supports the testing, as well.

“Routine screening of newborns for [congenital CMV] will help identify affected infants early on so they can receive appropriate follow-up and treatment,” Cynthia Friedman, Director of Public Health Suffolk County Department of Health Services, explained in an email.

“Infants who screen positive … should be followed closely by their pediatricians and referred to specialists as needed to ensure early detection of problems with hearing, vision or development so that appropriate care and support can be implemented.”

Once the funding for the testing runs out, which will be around October, hospitals around the state will no longer perform the test.

Parents can ask for a urine test, which doctors estimate could cost between $50 and $100, but which insurance, likely, won’t pay for — especially if the child is asymptomatic.

Legislators, including Assemblymember Linda Rosenthal (D-NYC) plan to introduce a bill in January that would fund tests, in future years.

“We would advocate that that become a permanent part of infant testing,” said Sood. “There are diseases that are far less common than CMV that have made it into the newborn testing programs.”

Immunization

Amid pushes by some pharmacies to encourage people to get flu shots, health care experts suggest waiting until closer to late September, or early October, for the inoculation.

“Vaccine efficacy is about three to four months,” said Nachman. “If you get it in August, when the flu season hits in January, you may not have much protection.”

The Centers for Disease Control and Prevention recommends similar timing, around September or October.

At the same time, Nachman expects a new batch of Covid vaccines will be available around September.

She recommends getting both shots at the same time, which increases both vaccines’ effectiveness.

Pharmaceutical giant, Pfizer, and BioNTech, recently reported that a single combined shot for Covid and flu was not effective against influenza B, which means that people interested in receiving vaccines this fall should plan to get two shots.

Covid numbers

As for Covid, the current strain has made the rounds this summer.

“Everybody and their neighbor had Covid,” said Nachman, who added that the virus has spread across all ages. Covid was “clearly more infectious than what we had in the spring” and people were sicker for longer.

While the number of infected people has decreased, the start of the fall semester could trigger an increase.

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By Daniel Dunaief

For the first time since May 2023, Brookhaven National Laboratory required masks on site at its facility starting on Jan. 8, as the rate of hospital admissions for the virus that caused the pandemic climbed.

Following the Safer Federal Workforce Task Force, BNL, which is a Department of Energy-sponsored site, reinstituted the mask policy once Covid admissions climbed above 20 per 100,000 people in the county, as determined by the Centers for Disease Control and Prevention data.

The CDC level rose to 24.8 on the evening of Jan. 5 and the lab re-implemented its mask requirement on the following Monday. Area doctors said they’ve seen an increase in illnesses tied to Covid, particularly after people traveled during the December holidays.

“We’ve seen a lot more Covid,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. 

Dr. Nachman said people who are talking to friends and neighbors are hearing regularly about those who are sick with Covid.

Stony Brook University Hospital is not requiring masking at all times. The hospital is recommending that people consider wearing masks. Medical staff entering patient rooms are wearing them.

People walking into the hospital will see “more people wearing masks” in general, she added. In addition to Covid, hospitals in the area are also seeing a “huge amount of flu,” Dr. Nachman said.

 

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Photo by Katja Fuhlert from Pixabay

The U.S. Food and Drug Administration has approved a new COVID-19 booster, which will protect against the virus’s circulating strain.

With hospitalizations and cases rising in Suffolk County and nationwide, single booster shots from Pfizer-BioNTech and Moderna should be available soon.

Local doctors recommended that people at the highest risk consider getting the shot.

That includes those with other medical issues, such as a 45-year-old smoker or a 65-year-old with diabetes.

Health care providers generally believe people who recently had COVID have at least three months of protection, although no definitive rule exists.

“If you had it in August, you probably don’t need to get a booster now,” said Dr. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital. “If you had it in January and you’re high risk, you should get it now.”

Nachman added that no study has indicated the age at which patients should get a booster shot.

People should consult their physicians to determine how their underlying health can affect the decision to get an updated vaccine.

“That gets back to the doctor-patient relationship,” Nachman said.

People who are 70 years old and planning a cruise that stops in several ports might want to get a shot at least two weeks before they travel because “the last thing you want happening is to be hospitalized in a foreign country,” Nachman said.

Nachman suggested that this vaccine, like the others that people have taken, won’t prevent illnesses but will keep people from shedding the virus and can reduce the symptoms and duration of an infection.

The FDA approval of the current vaccine is welcome news because it is a “good match” for the current strain, Nachman indicated.

It’s difficult to predict how much protection the current vaccine will provide for whatever strain might be circulating in February.

When a higher percentage of the population receives the vaccine, the likelihood of new variants declines, she added.

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As children return to school this fall, doctors in Suffolk County expect COVID-19 cases to rise. Photo by Ronny Sefria from Pixabay

People may think COVID-19 is out of sight and out of mind, but the virus, which is still around and is making people sick, doesn’t care. 

The new variant of COVID, EG.5, or “Eris,” is making people sick in the area, with hospital admissions and visits creeping up over the last few weeks.

Left, Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services. Right, Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. Left file photo; right file photo from Stony Brook Medicine

As of Aug. 9, 105 patients were hospitalized with COVID across the entire Northwell system, including 82 people on Long Island. That compares with 63 hospitalized patients on July 9, with 46 on Long Island exactly a month earlier.

That’s also the case for other area hospitals, doctors said.

“The numbers are definitely going up,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “That’s probably a snapshot of what we expect in the fall and the winter.”

Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services, explained that COVID-19 is “no longer an emergency” but is “still with us and we continue to see new variants.”

In an email, Pigott explained that the county has seen a “slight uptick in hospitalizations” that is still low in comparison to the earlier days of the pandemic.

He urged those at high risk to take precautions that could include avoiding crowded places, wearing a mask and meeting people at outdoor venues rather than indoors.

While the numbers of people sick with COVID are substantially lower than they were during the worst of the pandemic in 2020, health care professionals suggested that the fall and winter could be challenging for families, particularly as children return to school.

“The first two weeks of school, every kid is sick,” said Nachman. “Come November-ish, that’s when we see” that increase.

Dr. Bruce Hirsch, attending physician in Infectious Disease at Northwell Health, also anticipates a rise in COVID-19 cases coming this fall and early winter.

“I think there’s a very good chance that a lot of people will be having COVID,” he said.

Hirsch added that the symptoms for those people who don’t have underlying medical conditions, such as cardiac or lung-related problems, are likely to be considerably milder than they had been in the early stages of the disease, when no one had resistance.

“The sickness will not have the severity and mortality except in those of us who are unfortunate to have weak immune systems, other health problems or who are elderly or frail,” Hirsch said.

Pigott added that Eris, which is a subvariant of omicron, is not a variant of interest or concern, according to the World Health Organization.

Vaccine options

Doctors urged people to consider getting vaccines for COVID, the flu and respiratory syncytial virus for this coming fall.

The Centers for Disease Control and Prevention and the U.S. Food and Drug Administration are expected to approve the latest booster for COVID in late September or early October.

The newest booster, which should be available from Pfizer, Novavax and Moderna, should include protection against the latest COVID strain.

“The new booster formulation is much more similar and much more protective [against] the current strains,” Hirsch said. “The booster available now is protective against a couple of strains ago.”

Pigott urged people to get the new vaccines in the fall when they become available and before the holidays.

The vaccination may not prevent infection or all symptoms, but doctors suggested it would make illnesses shorter and less severe and could make the virus less infectious.

That could be particularly helpful for those who might otherwise develop more significant symptoms as their bodies attempt to fight off the virus.

Health care professionals suggested residents could receive several vaccines at the same time, enabling their immune systems to build resistance to a host of potential health threats.

“Our immune systems can chew gum and walk at the same time,” said Hirsch. “They are miraculous at reacting to all kinds of things every day anyway. The immune system is more than up to the challenge of handling two [shots] at the same time.”

Receiving several shots at once could give people a sore arm and a short-term fever that will likely respond to Tylenol, Nachman said.

“The science has shown that if you give a bunch of vaccines, you get a great response to everything,” Nachman added.

People who would prefer to get the vaccines in separate doses should space them out over several weeks, rather than getting one after another on consecutive days, she said.

Warning to pregnant women

Apart from viral infections, doctors warned pregnant women and those who might get pregnant  this winter about the ongoing shortage of a form of penicillin to treat syphilis.

Penicillin G benzathine, or Bicillin, is expected to be in short supply through the start of the summer of 2024.

The medicine is not only the only treatment recommended for pregnant people with syphilis, but is also the only one recommended for infants.

“We are prioritizing that medicine specifically only for that vulnerable population,” said Nachman.

The dangers of syphilis in pregnant women are significant, with the CDC estimating that about 40% of babies born to women with untreated syphilis can be stillborn or die from the infection.

Other dangers from syphilis include bone damage, anemia, enlarged liver and spleen, jaundice, nerve problems causing blindness or deafness, meningitis and skin rashes.

With cases of congenital syphilis more than tripling in recent years, the demand for Bicillin has exceeded the supply.

“It has been a concern for those in our Bureau of Sexually Transmitted Diseases,” Pigott explained. “They have been in consultation with the state. We defer to the state regarding supply.”

Locally, hospitals have been exploring other options without much success.

“We are looking for alternatives” to Bicillin, said Nachman, but “we are not necessarily finding them.”

Doctors urged pregnant women who think they might have syphilis to get tested to protect themselves and their unborn children.

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Beef with a copy of Charles Armstrong's book

By Melissa Arnold

Author Charles Armstrong

A few years ago, Smithtown resident Charles Armstrong was looking forward to a long, lazy summer break from high school. Then, everything changed when doctors found a tumor in his brain. He was only 15 years old.

Throughout the course of his intense treatment regimen, Armstrong was comforted and entertained by his family’s sweet new dog, Beef. In fact, Beef had such a special personality that someone suggested he write a book about her.

And that’s exactly what he did. Now 18 and thankfully cancer-free, Armstrong decided to share his story to help other kids with cancer feel a little less alone. His debut book, The Dog Named Beef and Her Superpower, focuses on Beef’s relationship with Charlie as she works to help him feel better. It’s light and approachable for young kids, and includes a note from Armstrong in the back that goes into more detail for older readers. The book has cute illustrations throughout and some real pictures of Beef and her family at the end. Kids stuck in bed will enjoy the activity pages that were wisely included as well.

Did you ever consider writing a book prior to your illness?

I wasn’t much of a creative kid. In fact, I had to take extended English classes because I struggled with it. I always told my parents I hated reading. But then in my junior and senior year of high school, I had a few teachers tell me that they really liked my writing. After my treatment, I realized I actually liked to read and started writing things on my own.

Charles Armstrong and Beef

Did you have any warning signs that something was wrong prior to your diagnosis?

I was out riding my bike with some friends right after school got out for the summer in 2020. It was a hot day, and my head really started to hurt. I had lots of pressure in my head, along with black spots in my vision and nausea. I came home and told my parents, and they figured it was heat exhaustion, but decided to be on the safe side and take me to the doctor. Not long after that, results of the scans came back to show a ping pong ball sized tumor in the center of my brain. It flipped our whole world upside down.

It was a type of tumor called a pineoblastoma. The tumor was causing spinal fluid to build up and I developed hydrocephalus, so I had surgery to address that, and then the biopsy confirmed it was cancer. During a second surgery, they were able to remove 99 percent of the tumor. After that, I had six weeks of radiation and six months of chemo infusions at Stony Brook.

It’s hard for anyone to face cancer, but it’s even rarer for young people to be in that position. Were you lonely?

It was tough because the COVID pandemic was also going on at the time, so there were a lot of restrictions on hospital visitors. But the staff did whatever they could to keep me connected to people while I was in the hospital. I would stay there for four or five days every month as part of my treatment routine. But my mom was able to take time off of work to stay with me, and I was able to use my phone to text with friends.

Did you have pets growing up?

Yes! We had both a cat and a dog when I was younger. My brother has a ferret, and we also have a bird. 

Whose idea was it to get a dog?

It was a family decision. After our first dog passed away, we took some time to grieve and after a while we decided to go to an adoption event at Last Chance Animal Rescue in June of 2020. That’s where we met Beef. My brother and I volunteered there when we were younger.

What drew you to Beef?

She was so timid and hiding in the back of the area, but when we approached her she got so excited and licked our faces. We all fell in love with her right away. Other people were looking at her, but we said, “No way, this is our dog now!” As it happens, she had been up for adoption for several months before we met her. I guess she was waiting for us.

Many animals are known to be very caring, especially when a family member is sick. Did Beef treat you differently?

We hadn’t had her for that long when I got sick, but she could tell that something was wrong in the house. She knew we were distraught, and at night she would always snuggle with me.

How did she help you? Did she affect your family too?

She just always knew what to do to lift me up, whether it was putting her head on my shoulder or chasing her tail to snap me out of a rut. On days when I was feeling okay we would play together. She makes all of us laugh. There’s a scene in the book where she does a handstand, and something very similar to that actually happened. She’s so emotionally intelligent and funny.

Why did you decide to write a book about your experience?

Going through all of the treatment associated with cancer, I had support from so many different directions. I wanted to find a way to provide that support in some way to other kids My cousin’s girlfriend joked that I should write about Beef, but the more I thought about it, the more I realized it could help other kids that were going through an illness. Beef is a funny dog, and the story could help them feel some of the love she showed me in that time.

Did you self-publish or use a traditional publisher?

I self-published through Amazon KDP. They made it very simple. It’s a lot of work, but the process was pretty streamlined and it was a great experience overall.

Who is the illustrator?

The illustrator is Inga Buccella. My mom found Inga on Etsy, and she was so enthusiastic about being a part of the book when I told her my story.

What was it like for you when the book arrived?

It felt so surreal to hold it in my hands. It still doesn’t feel real to think of myself as a published author, but it’s great.

How are you doing now? What are you up to?

I had my most recent scans a few months ago, and they showed that I am still cancer free. I work a couple different jobs and am interested in getting into marketing. I’ve been working out a lot and just did my first Spartan race! I also got a chance to be a part of a short student film in New York City.

What is the target age for the book? 

I wanted it to be accessible to as many kids as possible. I think it would be right up the alley of kids between the ages of 3 and 7, though other age groups might find it relatable, too.

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The Dog Named Beef and Her Superpower is available now at Amazon.com. Keep up with Charles on Instagram @charlesparmstrong, and follow Beef’s antics on TikTok @the_dog_named_beef.

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Pixabay photo

By Daniel Dunaief

[email protected]

The number of people battling significant symptoms from the flu and respiratory syncytial virus has been coming down since its peak in January, as these infections have run their course.

“This year, we experienced the most severe flu and RSV waves in decades, and our COVID wave wasn’t small either,” said Sean Clouston, associate professor of Public Health at Stony Brook University.

The number of these illnesses was high as people no longer wore masks in places like schools and after people experienced lower-than-usual illnesses in the months before the mask mandate was lifted, creating fertile ground for viruses to spread.

“The most likely reason that the current flu and RSV seasons have improved is that we have had such a bad season earlier on that we have hit a natural ceiling on the ability for these diseases to successfully infect more people,” Clouston said in an email.

As for COVID-19, the numbers of people who have developed significant illnesses has continued to decline as well, through a combination of the natural immunity people have after their bodies successfully fought off the infection and from the protection offered by the vaccine and boosters.

Doctors added that the vaccine and natural immunity hasn’t prevented people from getting infected, but they have helped people avoid severe and potentially life-threatening symptoms.

“All these people who run around saying, ‘My vaccine isn’t working because I got reinfected,’ are missing the point,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases at Stony Brook Medicine. “It is working. It doesn’t protect you from infection, but [it does prevent] a bad outcome.”

Indeed, during the most recent COVID surge during the winter, Fries said the hospital continued to care for patients, most of whom recovered. 

Vaccine timing

Amid discussions from the Centers for Disease Control and Prevention and health organizations throughout the state and country about the timing of future booster shots, local health care providers indicated the increasing likelihood of an annual COVID booster.

Fries said we will get to an annual vaccination for COVID, adding, “It’s the same as we see with the flu.”

In general, people aren’t rushing off to get an updated COVID booster.

“To maximize the protective value of the vaccine while minimizing the number of vaccines you use, people should likely get the vaccine two weeks before they anticipate heavy exposure,” Clouston said.

For most people, that would mean getting the shot in early November to prepare for larger indoor gatherings, like Thanksgiving and the December holidays.

In a recent article in the journal Lancet, researchers conducted an extensive analysis of COVID reinfection rates.

The study dealt only with those people who had not had any vaccinations and addressed the effectiveness of natural immunity from preventing infections and from the worst symptoms of the disease.

Prior infections in general didn’t prevent people from getting reinfected, but it does “protect you from getting a really bad disease and dying,” Fries said.

Long COVID

Even with the number of people contracting COVID declining, the overall population of people battling symptoms of long COVID, which can still include anything from loss of smell and taste to chronic fatigue, continues to increase.

“There’s a plethora of symptoms of long COVID,” Fries said. “We’ll have to figure out how to classify this and hopefully come up with better therapy. Right now, we can only symptomatically treat these patients.”

Dr. Sritha Rajupet, director of the Stony Brook Medicine Post-COVID Clinic, explained in an email that some patients who have lost their sense of smell or have a distorted sense of taste have tried a process called a stellate ganglion block “after several case reports and early research have shown that it could be helpful.”

In such a procedure, doctors inject a local anesthetic on either side of the voice box into the neck. Rajupet said that “additional research and clinical trials still have to be performed.”

Newborns and COVID

As for children infected with COVID soon after birth, doctors suggested that the impact has been manageable.

“The great majority of young children who contract COVID do quite well and recover fully,” Dr. Susan Walker, pediatrician with Stony Brook Children’s Services, explained in an email. “The impact on their development from having actually experienced COVID illness is minimal.”

Children hospitalized with more significant illness from COVID might experience temporary developmental regression which is common in children hospitalized for any reason. The developmental impact seems more tied to social isolation.

“Children born during the pandemic spent their first years of life rarely seeing adults or children other than those in their immediate family,” Walker said. “The result is that many of these kids became excessively stranger anxious and timid around others.”

The lost social opportunities, the pediatrician said, resulted in delays in the personal/social domain of development. She added, “The good news is that kids are resilient and, in time, with appropriate social stimulation, [these children] should be able to regroup and catch up developmentally.”

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By Leah S. Dunaief

Leah Dunaief

This message is for older people who are reading this column and may get COVID-19. The information may save your life. It may have saved mine.

Especially for older people, COVID is a deadly virus. What defines older? Let’s say, beyond 50. Now there is a medicine that dramatically reduces severity and possible death from this virus, but many Americans are not taking it. Its name is Paxlovid.

“Never really in recent history for a respiratory virus can I think of an anti-viral medication being as effective, demonstrated in scientific literature, as what Paxlovid has shown,” stated Dr. Rebecca Wang, an infectious disease specialist at Dartmouth Hitchcock Medical Center, when interviewed by The New York Times.

Both random trials and data from electronic health records have shown this medicine to be effective, particularly among older patients. The medicine works by inhibiting the virus’s replication once it invades the body. Its underuse is already associated with thousands of preventable deaths, according to Dr. Robert Wachter, chair of the medicine department at the University of California, San Francisco.

“A large chunk of deaths are preventable right now with Paxlovid alone,” Dr. Ashish Jha, the White House COVID response coordinator told David Leonhardt of The New York Times. He predicted that if every American 50 and above with COVID received a course of either Paxlovid or monoclonal antibodies, daily deaths might fall to about 50 per day, from about 400 per day.

So why aren’t people taking the medicine?

For one reason, Paxlovid, which is taken twice a day for five days, does leave a metallic taste in the mouth. So I found that by eating half a banana after each dose, I got rid of the unwelcome taste. I also got the benefit of a banana a day, which is a healthy and nutritious fruit containing fiber and some essential vitamins and minerals.

Another possible reason is the association of Paxlovid with “rebound,” a second session of the disease which can occur a week to a month after the end of the first round. Experts don’t know what causes the rebound. A rebound is possible even if the patient never used Paxlovid. And even if he or she did, perhaps a longer duration of the drug is necessary for some patients than the five days currently administered.

Research has shown that out of sample of 568,000 patients, 0.016% over 50 who used Paxlovid died. For a similar cohort of patients who did not use the drug, the death rate was four times higher or 0.070. But only 25% of patients eligible to receive the drug actually took it, even though it is available and free.

Thanks to my son, Daniel Dunaief, who has spoken with two infectious disease experts, we also have some local reaction to the drug. Dr. Andrew Handel, pediatric infectious disease physician at Stony Brook Children’s Hospital, commented, “Hesitancy to take Paxlovid seems to fall in line with the general ‘COVID fatigue.’  COVID is clearly less lethal now than during prior surges, thanks in large part to vaccinations, but it still causes some hospitalizations. Those at highest risk of severe disease, particularly those who are unvaccinated, benefit from antiviral treatment if they are infected.”

Dr. David Galinkin, infectious disease expert at St. Charles Hospital, said, “The media has overblown this rebound experience. In the literature, about 10% of cases [have a rebound.] Like any other medication, people that could really benefit from Paxlovid [should consider it.] … We are still seeing people dying from this.”

Perhaps more doctors could be better informed about this drug. Additional information and encouragement are needed from the White House, and a lot more public announcements should be placed in the media to reach people. As has been the case throughout these last two-and-one-half COVID years, instructions have been changing, adjusted as the scientific and medical professions learn more about this pathogen. Proper treatment is still a work in progress.

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Now available at a doctor’s office or pharmacy near you: the latest COVID-19 booster.

Last week, the Food and Drug Administration gave Pfizer and Moderna Emergency Use Authorization to start distributing their newest COVID booster, which includes protection against the highly infectious Ba.4 and Ba.5 strains of omicron.

A few days later, the Centers for Disease Control and Prevention approved the administration of the booster.

Area doctors welcomed the news and suggested the newest booster would be helpful for certain groups.

“I suspect that, at a minimum, those who needed to get a fourth booster (elderly, comorbidity, immune issues) should get” it, explained Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, in an email. “I believe that its approval will include all individuals over age 12.”

Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health, agreed that senior citizens and immunocompromised people should consider the latest booster.

With other shots available until now, residents may need to consider how much time to wait between boosters.

People are eligible for another booster two months after a previous COVID vaccine, according to the FDA website.

The FDA authorized single doses of Moderna’s booster for people 18 and over and Pfizer’s booster for those 12 and older.

The incidence of hospitalizations among people who have COVID at area hospitals has remained fairly stable during the summer. Stony Brook University Hospital has about 50 COVID inpatients each day, while Huntington Hospital has about 11.

Doctors cautioned, however, that those numbers include people who are hospitalized for other procedures or treatments and who test positive as a part of the hospital’s effort to monitor the pandemic.

“The vaccines, to a large extent (primary series plus a booster-protection) are working quite well” at preventing the need for hospitalizations, Nachman wrote.

Doctors urged people to take steps to protect themselves, their families, and their communities against contracting the virus.

“With the virus changing, it’s even more important to keep yourself and your family safe from getting COVID again and remain vigilant about taking precautions, i.e. hand washing, social distancing, mask wearing,” Nachman added.

A minority of residents treated with Pfizer’s antiviral therapy Paxlovid have experienced a rebound, testing positive days or even a week or more after receiving the antiviral treatment.

“Viral rebound occurs in about 10%” for those who have taken Paxlovid, with the majority in the older age groups, Nachman wrote. Having said that, the rebound we are seeing has not led to Emergency Department visits or hospitalizations.” 

As for mental health issues, residents of Suffolk County, as with other communities, have generally seen an improvement amid a relaxation of restrictions that limited social contact and kept people from their routines.

“Mental health issues were mostly related to the isolation mandates that were required to slow the spread of COVID,” Popp explained. “The reduction in restrictions has improved the mental health issues for many people.”

Monkeypox vigilance

Area hospitals continue to remain on the lookout for potential outbreaks of monkeypox.

“We are aggressively evaluating all suspected cases of monkeypox and have protocols in place for testing as well as treatment,” Nachman wrote. “We will be rolling out a [National institutes of Health] funded clinical trial for treating individuals across the ages with TPOXX.”

Huntington Hospital has had two confirmed cases of monkeypox. Popp expects the virus will “likely continue to spread.”

Several medical facilities continue to administer the limited monkeypox vaccines.

SBUH is working with the Suffolk County Department of Health to provide vaccinations at the Edie Windsor Healthcare Center in Hampton Bays.

On the official Suffolk County website, eligible residents can schedule monkeypox vaccinations through Northwell Health at the Bayshore Mall on Sunrise Highway.

As for the flu, Nachman urged residents to get their vaccines prior to the start of the seasonal flu season, sometime between now and November.

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