Arts & Entertainment

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2017 finalists from left, fourth runner-up Rose Scalia; second runner-up Elaine Whitehouse; Queen Lee Ann Brill; first runner-up Jeanne Marino and third runner-up Barbara Antes. Photo from Mary Malloy

The New York Senior America Organization is seeking gracious women 60 or older who best exemplify the qualities of the modern dynamic senior to audition for the upcoming July 29 pageant, to be held at the Madison Theatre at Molloy College in Rockville Centre. The queen receives a crown, sash and a cash reward.

Auditions will be held in March, April and May, at the Massapequa Bar Harbor Library, 40 Harbor Lane, Massapequa Park. Call to arrange for your audition. There will be an array of talent on display, including singers, dancers, musicians and comediennes. This is the first step to compete in the National Pageant in Atlantic City. Those that successfully pass the auditions will compete in the Ms. New York Senior America Pageant and the winner will move on to the national pageant.

To participate in the audition, call NYSA State Director Marleen Schuss at 516-678-3242 or email [email protected] for an appointment time and date. Also check out their website at www.newyorksenioramerica.org.

Roast Pork with Garlic and Rosemary

By Barbara Beltrami

Garlic. Is there anyone who doesn’t love it? It has long been known to keep vampires away, and some say that it also, like the apple, keeps the doctor away. In fact, wise women and men have been touting its health-preserving properties for ages.

To name but a few of the myriad ancient civilizations that put their faith in its medicinal and culinary benefits, as far back as 1550 B.C. the Egyptians were prescribing no less than 22 garlic-based remedies for physical ailments. Good old Hippocrates swore by its use as a digestive aid, and my nana claimed, as did yours I bet, that it warded off cramps, colds and hiccups. And it certainly wards off other people, particularly if you breathe in their faces after you’ve eaten it.

As well as its medical virtues, garlic has a spate of gastronomic ones. If cooked properly and not allowed to burn or if used only in its freshest form, garlic can be intense and sublime. It makes a pork roast regal when combined with rosemary; a simple pasta sauce that uses an olive oil base splendid; and is a terrific compliment to vegetables, meat, poultry and shellfish. For the ultimate garlic experience, try cream of garlic soup.

Roast Pork with Garlic and Rosemary

Roast Pork with Garlic and Rosemary

YIELD: Makes 4 to 6 servings

INGREDIENTS:

8 to 10 garlic cloves

2 sprigs fresh rosemary, defoliated

2 tablespoons olive oil

Salt and freshly ground black pepper, to taste

One 3- to 4-pound pork loin roast, bones in (allow at least one bone per person)

DIRECTIONS:

Place garlic, rosemary leaves, olive oil, salt and pepper in bowl of food processor and pulse to create a coarse paste. Place pork in roasting pan; rub the paste on all surfaces. Cover loosely with aluminum foil and let sit for 30 minutes. Preheat oven to 375 F. Roast pork uncovered for approximately 30 minutes per pound or until a meat thermometer reads 170 to 185 degrees. Remove from oven and let sit for 15 to 20 minutes. Carve between the bones to create individual pork chops. Place on serving platter; reheat pan juices and pour over chops. Serve with roasted potatoes and a hearty green veggie.

Spaghetti with Garlic and Olive Oil

Spaghetti with Garlic and Olive Oil

YIELD: Makes 4 to 6 servings

INGREDIENTS:

10 garlic cloves

¼ cup extra virgin olive oil

1 cup finely chopped fresh Italian parsley

1 teaspoon anchovy paste

½ teaspoon dried hot pepper flakes

¾ cup freshly grated Parmesan cheese

1 pound good quality spaghetti

DIRECTIONS:

Mince half the garlic and coarsely chop the other half. Place all in a medium skillet with the oil, parsley, anchovy paste and pepper flakes and heat, stirring constantly, until the garlic sizzles but has not begun to brown. Remove from heat and set aside. In a large pot cook spaghetti according to package directions until it is tender but firm to the bite (al dente). Drain, place in a large bowl and toss with the garlic and oil mixture. Pass grated cheese separately. Serve immediately with a crunchy mixed green or tomato salad or sautéed broccoli rabe or escarole.

Cream of Garlic Soup

Cream of Garlic Soup

YIELD: Makes 4 to 6 servings

INGREDIENTS:

4 tablespoons unsalted butter

2 onions, coarsely chopped

4  garlic bulbs, peeled and mashed

1 quart chicken broth or stock

½ pound stale French or Italian bread, sliced

1 bay leaf

2 sprigs fresh thyme, defoliated

6 ounces cream

Salt and pepper, to taste

DIRECTIONS:

In a large saucepan melt butter; add onion and garlic and sauté over medium heat for about five minutes, until onion becomes transparent but garlic doesn’t brown. Stir in bread slices, bay leaf and thyme leaves.  Add broth, stir and simmer 20 minutes; remove bay leaf and discard. Remove mixture from heat and let cool for 10 minutes. Place in small batches in food processor and puree until smooth. Return to pot. Add cream and stir but do not allow to boil. Add salt and pepper to taste. Serve hot in winter or cold in summer with crusty bread, cheese and a kale or spinach salad.

Note: This article is adapted from one written by the author for this publication in 1990.

Photo courtesy of Kent Animal Shelter

MEET SASHA!

Sasha

Eagerly waiting for you at Kent Animal Shelter is Sasha, a 3½-year-old shepherd/husky mix who is full of life and energy. On her short wish list is a great big fenced-in yard to play in and to have all of your attention, so she would prefer to be the only pet in the home. This sweet girl walks nicely on a leash and would do best in an active, adult home where she can get lots of exercise and lots of love. Sasha comes spayed, microchipped and up to date on all her vaccines.

Kent Animal Shelter is located at 2259 River Road in Calverton. For more information on Sasha and other adoptable pets at Kent, visit www.kentanimalshelter.com or call 631-727-5731.

Update: Sasha has been adopted!

Author Brian Kilmeade will make a stop at the Setauket Neighborhood House as part of a tour to promote his latest book ‘Andrew Jackson and the Miracle of New Orleans.’

By Heidi Sutton

Fox News’ “FOX & Friends” morning show co-host Brian Kilmeade will visit the Setauket Neighborhood House, 95 Main St., Setauket on Monday, Feb. 26 from 7 to 9 p.m. to promote his latest book, “Andrew Jackson and the Miracle of New Orleans: The Battle That Shaped America’s Destiny.” The event is hosted by the Three Village Historical Society and will include a special book signing, lecture and Q&A.

This is Kilmeade’s fifth book and his third history-focused book with co-author Don Yaeger. The first two, “George Washington’s Secret Six” (2013) and “Thomas Jefferson and the Tripoli Pirates” (2015), spent a combined 37 weeks on the New York Times Best Sellers list.

“I’ve always found Andrew Jackson interesting, especially the way he led America to victory during the Battle of New Orleans,” said Kilmeade in a recent email when asked why he chose Jackson to be the topic of his new book, adding, “Jackson was a self-taught Militia General who won almost every battle he faced while suffering from bullet wounds and dysentery.”

In summarizing the book, Kilmeade said, “I like to think of the War of 1812 as a rematch of the Revolutionary War — this time without the help of the French. Before Jackson was called on to lead, the British were slaughtering the Americans on the battlefield — and it really looked like we needed a miracle. Notorious for his leadership and tenacity, Jackson led a ragtag team of frontier militiamen, French-speaking Louisianans, Cherokee and Choctaw Indians, freed slaves, and even pirates. On Jan. 8, Jackson’s troops defeated the British in under 45 minutes. In this book, you’ll learn how this oft-forgotten battle shaped America’s destiny.”

The Massapequa resident last visited the area in 2014 to promote his book on George Washington. “It was wall to wall people,” said Steve Healy, president of the Three Village Historical Society in a recent interview. “The history topic was a little closer to home. ‘George Washington’s Secret Six’ was about the Culper Spy Ring in Setauket, which always creates local interest.”

Healy said the historical society recently reached out to Kilmeade again and invited him to speak at its monthly lecture series. “We are very excited,” he said. “We love it when history is the main topic. The Battle of New Orleans was an interesting battle that propelled Andrew Jackson into the national spotlight.”

Kilmeade is looking forward to returning to Setauket. “I love the rich history and character that emanate through the unique little town,” he said.

According to the TVHS president, Kilmeade will briefly talk about his first two history-focused books and then delve into his current book. “There is a lot to discuss in the battle of New Orleans,” said Healy, adding that photos may be taken at the book signing portion of the program.

Preregistration is required by visiting www.tvhs.org as space is limited. No tickets will be sold at the door. Entry fee, which includes a copy of Kilmeade’s book to be signed, is $40 per person, $30 members. Entry to the lecture only is $10 per person, free for TVHS members. For further information, please call 631-751-3730.

Update: This event is sold out!

A haven for Long Island’s injured wildlife

By Kevin Redding

Three weeks ago at a construction site in Elwood, a young red-tailed hawk was lying on the ground with its eyes closed. It had been hit by a car and its skull was fractured.

But today, that same bird of prey can be found perched inside a spacious flight aviary at Sweetbriar Nature Center in Smithtown, gliding from one branch to another and darting its head in every direction in search of its next meal. Dan’s Bird, as it’s known on the property after it was rescued by Daniel DeFeo, a Sweetbriar volunteer since 2015, will eventually be released back into the wild as one of more than 1,000 injured animals the nonprofit will rehabilitate this year. 

“As a wildlife rehabilitation center, we are about 50 percent successful with what goes back into the wild, where most other centers are at about 30 percent,” said Janine Bendicksen, Sweetbriar’s curator and wildlife rehabilitation director. “We can do everything a vet hospital can do except surgeries, as far as medications and setting bones. We’re also the only center where people can just walk in and drop animals off. It’s a real service to the public.” Whatever the site can’t do on its own, she added, is handled by the staff at Best Friends Veterinary Care in Nesconset.

All in a day’s work

On a recent sunny Saturday afternoon, Bendicksen — who has been at Sweetbriar for 18 years, is at the site five days a week and is in charge of teaching educational programs, fundraising for big events and running the summer camp and wildlife rehabilitation camps — made her rounds throughout the property, making sure to greet every critter along the way, including permanent wildlife patients like Einstein the screech owl, who has suffered a broken wing and leg and takes shelter among piles of towels and blankets inside a laundry room; Jack, a kestrel with a missing eye and a crossed beak due to exposure to the pesticide DDT; an old turkey vulture that was hit by a car in Pennsylvania, broke its hock and sustained a wing fracture; and an opossum that was found starving to death and is expected to be released in the spring.

There are also box turtles, mallard ducks, rabbits and chipmunks. A groundhog and a deer too. The site is licensed to take in almost any animal, Bendicksen said, except rabies vector species like raccoons and skunks.

Squeezed into a tiny wooden habitat, Bendicksen summoned two flying squirrels from inside a nesting box. Although they are nocturnal, she said these animals only slip into semihibernation during the day and can be woken up to eat and play. “These guys came from somebody’s attic,” she said. “Every couple of weeks we get another one because somebody uses a Havahart trap to catch them.”

Even though the nonprofit, which officially opened in 1986, has been rehabilitating wildlife for more than 30 years, Bendicksen said the program has grown in “leaps and bounds” over the last decade and each year the site takes in more and more. This is due to both Sweetbriar’s growing popularity in the community and people and developments “encroaching on animal’s habitats,” Bendicksen said.

The goal of Sweetbriar, of course, is to bring every animal back into the wild, and specifically back to exactly where they were found, but in many cases, the outcome depends on the specific animal and its situation. For instance, some injured animals can’t live in captivity and these — as well as animals that don’t recover from their severe traumas — must be euthanized.

“It’s the humane thing to do,” Bendicksen said. “Seagulls come in all the time and they don’t do well in captivity. While in cages, they get what’s called bumblefoot [inflammation on the soles of the feet], which they eventually die from.”

Not long after she explained this, William and Mary Krumholz of Smithtown brought in a box containing a seagull they found hobbling in the Costco parking lot.

“It looks like the wing is broken,” William Krumholz said. “It could hardly run away from me. It was only a matter of time before it got run over.”

After wrapping the seagull in a towel and doing some quick detective work in the rehabilitation room, Bendicksen deduced more than likely it was struck by a car, and found that the last digit of its wing was separated and hanging on by a part of the bone. She assured the Krumholzs that it would be taken to the veterinarian to be checked out further and told them about the inflammation concern with seagulls.

“But, if that’s the case, what you did do was save him from starving to death or being eaten or run over,” she said to them. “We’ll do our best.”

Mary Krumholz nodded her head. “I mean, that’s nice, but … It was only a car ride over here and I already feel bad.”

Bendicksen later said one of the most challenging parts of the job was to resist the urge to become attached to the animals that come in.

“It’s why we try not to give names to any injured animals we release, just the permanent ones,” she said, “because you become too close to the animals and it makes it very, very hard if you have to make a difficult decision. We wish we could release everything back where we found them.”

The human touch

People have been bringing animals to Bendicksen to be patched up since she was a young girl growing up in Hauppauge.

“There are little kids here who just stick their hands into cages and that would’ve been me — I was always told to be a veterinarian,” Bendicksen said. “My mom’s friends would call and say, ‘The cat just grabbed a baby bunny and it survived.’ I would always build little habitats for them and make sure they had a comfortable bed, even if it was just, like, a frog.”

Bendicksen grew up to be the owner of a children’s clothing business called Janine, which employed stay-at-home moms. In the late 1990s, however, she was diagnosed with stage IV breast cancer, which forced her to give up everything for a while.

“I went through two years of hell and then had to kind of start my life over again,” she said. When she became cancer free, she came to Sweetbriar with her children for one of its volunteer picnics. She struck up a conversation with the site’s director, who, after finding out more about her, asked if she’d be interested in helping them curate the site.

After some extensive training, a licensing process and testing from the New York State Department of Environmental Conservation, Bendicksen was a teacher on the site. It didn’t take long before she became director of wildlife rehabilitation. “This place saved my life,” she said. “What makes you happy as a child should be what you do as an adult. I’m extremely lucky.”

Val Timmerman, a Stony Brook University student and one of Sweetbriar’s 14 volunteers, said everything she knows she learned from Bendicksen.

“She’s so awesome and knows everything,” said Timmerman, who stumbled across Sweetbriar almost two years ago while searching for animal rescue facilities close by. “Being able to make even a small difference in the patient’s lives, making things a little bit better for them, is what I love. And, of course, releasing them, finding out that a possum or something we didn’t think was going to make it is doing so well now. It’s great.”

Bendicksen said without her volunteers, the site wouldn’t survive. “These people are near and dear to my heart,” she said.

DeFeo, who studies biology at Suffolk County Community College and hopes to be a zookeeper one day, is at Sweetbriar every Saturday between 9 a.m. and 4 p.m. taking care of all the birds of prey on the property, preparing all their food, changing their water bowls and cleaning out their dirty cages.

“I’ve always loved animals,” DeFeo said. “Just going out there and saving an animal’s life — it’s such a beautiful feeling. And I always feel a sense that I will do anything to save that life.”

Before pursuing the animal field, DeFeo said he was an electrician. But he knew he had to call it quits after nearly suffering a severe injury.

“If I fell off a ladder and broke my back, I’d be miserable for the rest of my life,” he said. “But if I got my arm bitten off by an animal, I’d probably still be happy and go to work the next day. This is what I’m meant to do.”

How you can help

“The public needs to be better educated on what they need to be afraid of, what they shouldn’t be afraid of and what they should do when they find an animal,” Bendicksen said, adding that any and all residents who do come across an injured animal should call Sweetbriar before handling it or bringing it in.

Here are some helpful tips Sweetbriar staff members have assembled:

• Baby birds are often seen fully feathered but trying to fly, with the parents nearby. These are fledglings. If they look bright and alert, it is best to leave them alone. If possible, keep cats and dogs away from the area for a few days in which time the birds will learn to fly. The parents will continue to care for them even though they are on the ground. If you are not sure the parents are nearby and you are concerned, you may put the bird in a nearby bush or on a tree branch and observe from inside the house for a few hours. If the mother sees you in the yard she will not come near.

• If an adult bird can be caught, probably something is wrong and it needs help.

If you encounter any kind of turtle crossing the road, it is okay to help it along. However, please carry it to the side of the road in the direction it is heading. By putting it back on the side it is crossing from, it will start crossing the road all over again.

If an opossum is found smaller than 8 to 10 inches, it probably needs attention. Orphaned babies are often found looking for food near a dead mother, especially alongside roads. These animals rarely contract rabies because of their low body temperature.

• DO: Place the animal in a secure cardboard box with small holes placed on the side or lid. The box should be just big enough for the animal to stand and turn around, to prevent the animal from thrashing around and hurting itself. Place paper towels or a T-shirt on the bottom of the box.

• DON’T: Keep peeking at the animal or handling the animal. The more you look at an animal or handle it, the more you stress the animal and reduce its chance of survival. Resist the temptation to put an animal inside your shirt. Cute little squirrels are notorious for being covered with fleas.

Sweetbriar Nature Center is located at 62 Eckernkamp Drive in Smithtown. The center is open daily from 8:30 a.m. to 4:30 p.m. For more information, call 631-979-6344 or visit www.sweetbriarnc.org.

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Above, Begonia ‘Pink Minx,’ with its constant bloom of bright pink flowers and unique Angel Wing leaves, is easy to grow, making it a top contender for the title of perfect houseplant. Photo courtesy of Logee’s Plants for Home and Garden

By Kyrnan Harvey

As a plantsman and gardener, I have always been more generalist than specialist. There are avid collectors of day-lilies or hostas, roses or rhododendrons, Japanese maples or dwarf conifers, snowdrops, dahlias and peonies. There are rock garden enthusiasts who have to grow every Saxifraga and Primula and Penstemon. In the U.K. and Ireland there are 630 National Plant Collections in which special-interest plant groups are identified, documented and conserved in private gardens, nurseries, local parks, botanic gardens and historic estates.

I love all these plants. Phases of zeal come and go for me, but of paramount importance to the garden designer is the creation and sustaining of harmonious environments, keyed in to the genius loci, pleasing to our senses and attractive to wildlife too — the whole is greater than the sum of its parts.

Houseplants too can inspire passions. Cacti and succulents are ideal objects for homes with plenty of bright light but excessively dry heat. If you are not one to turn your thermostat down to 60 at night, but keep your home uniformly cozy at 72, then you can have a dozen or more different African violets featuring delightful colors on extremely compact plants. Following International Aroid Society on Instagram has been an eye-opener for me: stunning foliage in unbelievable variety. I would collect these Philodendron and Anthurium and Monstera and Alocasia if I had a large airy home or lived in the tropics.

Above, Begonia ‘Potpouri’ is the perfect houseplant for winter months, covering itself with fragrant rose-pink blooms from January to June. Photo courtesy of Logee’s Plants for Home and Garden

But I must say, if I were to amass a small collection of a single plant group of houseplants, it would be begonias. There was a great bookstore back in the aughts on Bedford Ave in Williamsburg. The owner Miles kept a solitary cane begonia in a glazed Oriental jardiniere in the center display table a good distance from the storefront window. I donated an old jade plant for the window and neither it nor the begonia ever received water. When my brother was moving last summer, I adopted two cane begonias. They hadn’t been watered in months. I cut the woody stems down to a few inches; then repotted and watered the plant. A few weeks later it was gorgeous.

The wax begonias that we plant as annuals are dead easy to grow, and cane begonias (these are the old-fashioned “angel-wing” begonias, now also called “fibrous”) are nearly so. They are very resilient and tolerant of neglect. Let them dry between waterings indoors, cut the canes hard at the end of winter, and move outdoors in bright — but indirect — light from May to October. The leaves can be reddish or green and mottled or spotted in white or silver. Logee’s catalog has a couple dozen varieties, and in the summer they will outdo themselves with the most charming sprays of pendant flowers in varying shades of pink. Such dignified plants, begonias give much more than they require.

The leaves of rhizomatous begonias are even more stunning, a limitless variety of color, texture and form. More compact than cane begonias, they also will be covered in flowers. Be sure to let them dry between waterings, but then water until it reaches the saucer.

Rex begonias are a type of rhizomatous (creeping rootstocks) begonia, in the prima donna class: showboats with their psychedelic leaves but demanding more accurate watering, humidity and temperature. Even then, they go dormant in winter for two or three months. A well-grown rex is spectacular, but their flowers are inconspicuous.

Any and all houseplants should summer outdoors. Indeed, this is crucial to their prosperity. Best to resist the temptation of moving them outside too early; wait until well into May and acclimate them by moving them during a forecast of two or three mild, sunless days. I like soft rain on warm days.

Do not leave them, in the first week or two, exposed to full sun, even for a couple hours, or desiccating wind. Situate them in bright, filtered light, and you will treasure your begonias when, in October, you can cut the exuberant growth and bring them indoors.

Kyrnan Harvey is a horticulturist and garden designer residing in East Setauket. For more information, visit www.boskygarden.com.

FROZEN IN TIME

Margo Arceri of Strong’s Neck snapped this photo of two Betsy Ross flags flying at the grave site  of Patriots Selah and Anna Smith Strong at St. George’s Manor Cemetery in Setauket on a chilly Jan. 30. This version of the United States flag, rumored to have been created by Betsy Ross, was used from 1777 to 1795 and has 13 stripes with 13 stars in a circle all facing outward to represent a new constellation.

Send your Photo of the Week to [email protected].

One simple lifestyle change is to make certain that those susceptible to gout attacks remain hydrated and consume plenty of fluids. Stock photo
Most risk factors are modifiable

By David Dunaief, M.D.

Dr. David Dunaief

Gout is thought of as an inflammatory arthritis. It occurs intermittently, affecting the joints, most commonly the big toe. The symptoms are acute (sudden onset) and include extremely painful, red, swollen and tender joints. In terms of symptoms, if you have ever had kidney stones, gouty arthritis is just as painful.

Uric acid (or urate) levels are directly related to the risk of gout attacks. As uric acid levels increase, there is a greater chance of urate crystal deposits in the joints. Although, and unfortunately, some patients can still experience gout attacks without high levels of uric acid.

This disease affects approximately 8.3 million people in the United States (1). This number has doubled since the 1960s. Men between 30 and 50 years old are at much higher risk for their first attack (2). For women, most gout attacks occur after menopause.

There are a number of potential causes of gout, as well as ways to prevent and treat it. The most common contributors include drugs, such as diuretic use; alcohol intake; uncontrolled hypertension (high blood pressure); obesity; and sweetened beverage and fructose intakes (3). Though heredity plays a role, these risk factors are modifiable.

The best way to prevent and treat gout is by modifying medications and lifestyle. One simple lifestyle change is to make certain, just like with kidney stone prevention, that those susceptible to gout attacks remain hydrated and consume plenty of fluids.

Just like there are medications that may cause gout, there are also medications that can treat and help prevent gout. If you do get a gout attack, NSAIDs such as indomethacin or steroids such as a Medrol pack help treat the symptoms. In terms of prevention, allopurinol helps to reduce the risk of a gout attack.

I thought we might look at gout by using a case study. I had a patient who had started a nutrient-dense, plant-based diet. Within two weeks, she had a gout episode. Initially, it was thought that her change in diet with increased plant purines might have been an exacerbating factor. Purines are substances that raise the level of uric acid. So, it is not surprising that foods with containing purines might substantiate a gout attack. However, not all purines equally raise uric acid levels.

Animal versus plant proteins

In a case-crossover (epidemiologic forward-looking) study, it was shown that purines from animal sources increase our levels of purines far more than those from plant sources (4). The risk of a gout incident was increased approximately 241 percent in the group consuming the highest amount of animal products, whereas the risk of gout was still increased for those consuming plant-rich purine substances, but by substantially less: 39 percent.

The authors believe that decreasing the use of purine-rich foods, especially from animal sources, may decrease the risk of incidences and recurrent episodes of gout. Plant-rich diets are the preferred method of consuming proteins for patients who suffer gout attacks, especially since nuts and beans are excellent sources of protein and many other nutrients.

In another study, meats — including red meat, pork and lamb — increased the risk of gout, as did seafood (5). However, purine-rich plant sources did not increase risk of gout. Low-fat dairy actually decreased the risk of gout by 21 percent. The study was a large observational study involving 49,150 men over a duration of 12 years.

There are several more studies indicating and reaffirming that plant foods do not increase the risk of gout attacks. The Mayo Clinic also suggests that plants do not increase the risk of gout. When considering my patient’s circumstances, it was unlikely that her switch to a nutrient-dense, plant-rich diet had increased her risk of gout.

Diuretics (water pills)

My patient was on a diuretic called hydrochlorothiazide for hypertension (high blood pressure). There are several medications thought to increase the risk of gout, including diuretics and chronic use of low-dose aspirin. In the ARIC study, patients who used diuretics to control blood pressure were at a 48 percent greater risk of developing gout than nonusers (6). In fact, nonusers had a 36 percent decreased risk of developing gout. This study involved 5,789 participants and had a fairly long duration of nine years. The longer the patient is treated with a diuretic, the higher the probability they will experience gout. It is likely that my patient’s diuretic contributed to her gout episode.

Vitamin C

Vitamin C may reduce gout risk. In the Physicians Follow-up Study, a 500-mg daily dose of vitamin C decreased levels of uric acid in the blood (9). However, be careful with vitamin C supplementation because it can increase the risk of kidney stones.

Medical conditions

There are a number of medical conditions that may impact the risk of gout. These include uncontrolled high blood pressure, diabetes and high cholesterol (7). My patient’s high blood pressure was under control, but she also had diabetes and high cholesterol. These disorders may have also contributed.

Obesity

Obesity, like smoking, seems to have its impact on almost every disease. In the CLUE II study, obesity was shown to not only increase the risk of gout but also to accelerate the age of onset (8). Those who were obese experienced gout three years earlier than those who were not. Even more striking is the fact that those who were obese in early adulthood had an 11-year earlier onset of gout. The study’s duration was 18 years. My patient was obese and had just started to lose some weight before the gout occurred.

Prevention

The key to success with gout lies with prevention. Patients who do get gout writhe in pain. Luckily, there are modifications that significantly reduce the risks. They involve very modest changes, such as not using medications called diuretics in patients with a history of gout; losing weight for obese patients; and substituting more plant-rich foods for meats and seafood. Increasing levels of uric acid may be a useful biomarker for indicating an increased risk of gouty arthritis attacks. However, gout attacks do occur without a rise in uric acid levels, so it is not a perfect. Although the cause of gout may be apparent to you, always check with your doctor before changing your medications or making significant lifestyle modifications, as we have learned from this case study of my patient.

References:

(1) Arthritis Rheum. 2011 Oct;63(10):3136-3141. (2) Arthritis Res Ther. 2006;8:Suppl 1:S2. (3) Am Fam Physician. 2014 Dec 15;90(12):831-836. (4) Ann Rheum Dis. online May 30, 2012. (5) NEJM 2004;350:1093-1103. (6) Arthritis Rheum. 2012 Jan;64(1):121-129. (7) www.mayoclinic.com. (8) Arthritis Care Res (Hoboken). 2011 Aug;63(8):1108-1114. (9) J Rheumatol. 2008 Sep;35(9):1853-1858.

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

By Joanna Chickwe, MD

Dr. Joanna Chickwe

February means heart health awareness, but taking care of your heart requires a year-round commitment that has lifelong benefits. What will you do differently to take better care of your heart?

Heart disease can affect anyone, regardless of gender, age or background. That’s why all of our cardiac care experts at Stony Brook University Heart Institute remain focused on how to best prevent heart disease and heal the heart.

We fight cardiovascular disease from every angle, using the best that cardiovascular medicine can offer: risk factor prevention; state-of-the-art diagnostics, such as 3-D cardiovascular imaging; advanced minimally invasive interventions, including mitral valve repair using a patient’s own valve tissue versus an artificial heart valve; and advanced lifesaving technology, including ECMO (extracorporeal membrane oxygenation) that gives new hope to people with a serious heart or lung failure.

In the hands of our highly trained heart specialists, these and other important new state-of-the-art therapies are changing cardiac care and lives:

• Transcatheter aortic valve replacement (TAVR) for patients with inoperable aortic stenosis (failing heart valves)

• MitraClip, a less invasive treatment option for mitral regurgitation (caused by a leaky mitral valve), for patients who are not candidates for open-heart surgery

• The HeartMate 3 left ventricular assist device (LVAD) for patients with advanced heart failure

• Watchman to provide lifelong protection against stroke in appropriate patients for heart rhythm disorders

• Impella, the world’s smallest heart pump, making procedures safer for high-risk individuals

And while we hope that you and your family never need our acute cardiac services, you can be assured knowing that Long Island’s only accredited Chest Pain Center is right in your community. As one of only nine Chest Pain Centers statewide, Stony Brook Heart Institute is a leader in saving the lives of heart attack victims.

Since “time is muscle” when it comes to treating heart attacks, it is critical to treat patients as fast as possible, so less muscle is damaged. Stony Brook has achieved a “door-to-balloon” time, spanning the arrival at the hospital until the blockage is cleared, of 55 minutes — much better than the American College of Cardiology and the American Heart Association guidelines to open the blockage in 90 minutes or less.

And, if you suspect a heart attack, it’s best to call 911. Ambulances are equipped with defibrillators and most are equipped with 12-lead EKGs (electrocardiograms), which means they can transmit results to the hospital while en route. At Stony Brook, we assemble the treatment team and equipment you need before you arrive.

Have a question about heart disease prevention? Seeking a solution to a cardiac problem? Call us at 631-44-HEART (444-3278). We’re ready to help.

Joanna Chikwe is the director of Stony Brook University Heart Institute; chief, Cardiothoracic Surgery; and T.F. Cheng professor of cardiothoracic surgery.

The TCJA enacts a number of important tax changes. Stock photo

By Nancy Burner, ESQ.

Nancy Burner, Esq.

The Tax Cuts and Jobs Act increased the federal estate tax exclusion amount from $5 million to $10 million indexed for inflation for decedents dying in years 2018 to 2025. This amount is indexed for inflation back to 2011. The exact amount of the exclusion amount is not yet known for 2018. However, it is estimated to be $11.18 million. This means that an individual can leave $11.18 million and a married couple can leave $22.36 million dollars to their heirs or beneficiaries without paying any federal estate tax.

This also means that an individual or married couple can gift this same amount during their lifetime and not incur a federal gift tax. The rate for the federal estate and gift tax remains at 40 percent.

The doubling of the basic exclusion also means that the generation-skipping transfer tax (GST) exclusion is doubled to match the basic exclusion amount of $11.18 million for an individual and $22.36 million for a married couple.

The sunsetting of the doubled basic exclusion amount after 2025 raises the prospect of exclusions decreasing in 2026. Taxpayers with estates over $11.18 million will want to discuss with their estate planning attorneys the potential for making transfers to take advantage of the larger exclusion amount before the anticipated sunset.

The act does not make changes to the rules regarding step-up basis at death. That means that when you die, your heirs’ cost basis in the assets you leave them are reset to the value at your date of death.

The portability election, which allows a surviving spouse to use his or her deceased spouse’s unused federal estate and gift tax exemption, is unchanged. This means a married couple can use the full $20 million exemption (indexed for inflation). To make a portability election, a federal estate tax return must be timely filed by the executor of the deceased spouse’s estate.

In 2018, the annual gift tax exclusion has increased to $15,000. This means that an individual can give away $15,000 to any person in a calendar year ($30,000 for a married couple) without having to file a federal gift tax return.

Despite the significantly larger federal estate tax exclusion amount, New York State’s estate tax exemption for 2018 remains at $5.25 million. New York State still does not recognize portability.

With the current New York State estate tax law as enacted in 2014, there is a limited three-year look-back period for gifts made between April 1, 2014, and Jan. 1, 2019. This means that if a New York resident dies within three years of making a taxable gift, the value of the gift will be included in the decedent’s estate for purposes of computing the New York estate tax.

The following gifts are excluded from the three-year look-back: (1) gifts made when the decedent was not a New York resident; (2) gifts made by a New York resident before April 1, 2014; (3) gifts made by a New York resident on or after Jan. 1, 2019; and (4) gifts that are otherwise includible in the decedent’s estate under another provision of the federal estate tax law (that is, such gifts aren’t taxed twice).

Under the act’s provisions, most taxpayers will never pay a federal estate tax. Even with the enlarged exemption, however, there are many reasons to engage in estate planning. Those reasons include long-term care planning, tax basis planning and planning to protect your beneficiaries once they inherit the wealth.

In addition, since New York State has a separate estate tax regime with a significantly lower exclusion than that of the federal regime, it is still critical to do estate tax planning if you and/or your spouse have an estate that is potentially taxable under the New York State law.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.