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Jennifer Keluskar. Photo from SBU

By Daniel Dunaief

In the second of a two-part series, Times Beacon Record News Media describes the clinical and research work of Jennifer Keluskar, a Clinical Professor in the Department of Psychiatry at Stony Brook University.

Keluskar and Matthew Lerner, an Associate Professor of Psychology, Psychiatry & Pediatrics (see last week’s paper), recently received a grant from the Office of the Vice President for Research & the Institute for Engineering-Driven Medicine to study the effects of COVID-19-induced social isolation on people with Autism Spectrum Disorder. 

Keluskar spends half her time working at the Outpatient Department of Psychiatry, Child and Adolescent Services, where she provides cognitive behavioral intervention and ASD diagnostic evaluations for youth with autism, and the other half working on the SB Autism Initiative.

The pandemic has challenged young people with autism, as they manage through social isolation and worry about an uncertain future. Many of Jennifer Keluskar’s patients are struggling, with some dreading the return to school in the fall and others grappling with the removal or change in a routine or structure.

Some of her clients have felt increased pressure to organize their time and be productive amid a lack of peer support and without the opportunities to model their performance based on interacting with other students at school.

Through modeling, some students take notes when they notice their classmates writing down concepts or ideas a teacher is sharing or gaining some measure of reassurance when they see that everyone is struggling with the work load.

“This latter point is particularly relevant given the novelty of this situation for teachers as well as the consequent likelihood that they will have trouble knowing how much work to give, especially given the wide variety” of circumstances at home, Keluskar explained in an email.

For some students with autism who have a measure of social-anxiety disorder, the remote learning environment has provided some measure of relief, reducing the difficulty in reading nonverbal cues from their classmates and teachers.

Now that these students are learning remotely, these “social stressors have been lifted,” Keluskar said.

Nonetheless, even the patients who have felt relieved about fewer anxiety-inducing social interactions are starting to develop concerns about a potential resumption of classes in the fall.

Keluskar has already seen some patients who are perseverating on that future upcoming transition. “We are going to see more of it in my clientele as we get closer to reopening schools,” she said, adding that she has some patients who are afraid of not being able to advance in life, to college or to jobs, but who, at the same time, are afraid of taking the next step after getting used to quarantine.

Jennifer Keluskar with her husband Raja, 5-year-old daughter Skylar and three-year-old son Colby.

Working with Alan Gerber, a graduate student in Matthew Lerner’s lab at SBU, Keluskar will assess responses to COVID-19. They have sent out two questionnaires. One, which was released by other researchers, examines how the pandemic has affected circumstances and behaviors, from employment changes to junk food consumption. The other is an evidence-based measure of parental stress that is not specific to the virus. She is going to measure anxiety and depression to see how they change during quarantine. 

Keluskar appreciates how the Initiative offers programs such as a homework club, which students can attend virtually for an hour each day. “I have connected some of my clients in the clinic to undergraduate mentors and so far this has been quite successful” although the scale of these connections has been small so far.

The Initiative currently has a mentoring program geared towards older adolescents. She is planning to offer this program to younger individuals.

Deborah Gross, the Initiative’s coordinator, runs a program called the Sidekicks Squad, which is for older adolescents and young adults with special needs.

“Some of my patients would benefit from pairing with a mentor,” Keluskar said. “Through these mentoring sessions, people with autism hang out with their mentors.”

Child-directed interpersonal time is “so important for people’s well being and development,” Keluskar explained, referring to both the mentor and the mentee.

She appreciates that this mentoring program is laid back and fun and believes that mentors benefit just as much from it as mentees.

Through the Initiative, the group has also done eight weekly, Facebook livestream events. The organizers discuss a topic and add three tips at the end. The tips have provided suggestions, including: using creativity to engage children by adding special interests into activities; taking a collaborative problem solving approach when running into difficulties getting a child to cooperate; and understanding emotional underpinnings to children’s behavioral difficulties.

Keluskar recognizes the challenge that come from having self-directed resources available to children and their parents. Even when people have access to many resources, they do not always know where to begin or what to prioritize, she said.

She advises a parents to try to get enough rest for themselves. “You need to take care of yourself so you can model [appropriate behavior] to your children,” she said.

Through the pandemic challenges, Keluskar also urges parents to be creative in their responses to the stressors that are affecting them and their children. She suggests people to take chances in how they approach their interactions with anxious children.

“You can’t be creative if you’re afraid of being wrong,” she said. “Being able to move past little mistakes shows flexible control. Set limits and be structured, but also be flexible at the same time.”

A resident of Commack, Keluskar lives with her husband Raja Keluskar, who is an engineer, their five-year old daughter Skylar and their three-year old son Colby.

Keluskar said she has been anxious about public speaking since she was young and can empathize with others who struggle with this. Through Facebook groups and other efforts, she said she can “personally attest to the value of multiple exposures and say that it can even become enjoyable with time and practice.”

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The Rocky Point Drive-In sign in 1988, the year it closed. Photo courtesy of Cinema Treasures

There were once things called cassettes. Those were discarded in favor of CDs, but now there’s nothing of music but bits of stored data on a computer. Actually, maybe not. Maybe your music is stored in a cloud, a server bank thousands of miles away from where you even live.

But still, people are buying vinyl records again. There’s a certain quality to them you won’t get with digitized music, people say. Not only that, it simply feels different, like one is feeling the rough memories of the music artist. 

It goes to say that there is a certain quality to things gone past that goes beyond nostalgia. In today’s crisis, it may be best to look for the things we once thought defunct to perhaps help us and our local businesses combat the economic impacts of COVID-19 in unique ways. While Suffolk County begins the reopening process this week, businesses must think about the greater good, and look for unique ways to service customers without potentially causing an uptick in cases.

We’re not the only folks to recognize the possibilities presented by drive-in movies. We have heard leaders in multiple North Shore communities mention the possibility of setting up some kind of in-car theater experience. What it takes is space, and that’s the main issue. Places like Stony Brook University may be tricky because of all the coronavirus-related activity going on there. Landlords with strip malls or other large parking lots should start considering the possibility to help out their tenants. Imagine people being able to order food that then gets delivered to cars while they’re watching a movie right there in the parking lot.

Above, an ad placed in the Port Jefferson Record in 1961 announcing the drive-in’s grand opening

There’s one noticeable location right on the North Shore that is almost too perfect a spot. The former Rocky Point Drive-In on Route 25A may be too apt a name for what’s now an overgrown property. It’s owned by Heidenberg Properties Group, a national company that wanted to put a big box store there before local communities and governments came out against it. Maybe it’s time for the property owner to think of something else for that location, and we feel the community would embrace the return of a local landmark.

Summer on Long Island might be drier than any in living memory. Beaches might very well be restricted. Parks and sports fields and courts may be similarly closed. The annual summer concert series, hosted by Suffolk County legislators along with civic leaders in various locations across the North Shore, may very well not happen this year. 

It’s going to take ingenuity to fill the summer with something other than backyard escapades and hours spent couch surfing. 

Some places, such as Port Jefferson Village and the Smith Haven Mall in Lake Grove, are opening up some space for farmers markets, though the one at the mall has found unique success by having people stay in their cars and roll up to each individual stall along a line. 

We encourage more of our shopping centers to embrace outdoor dining experiences. Even as Long Island inches closer to starting the reopening process, many will find people may still be anxious of eating inside enclosed dining areas. 

But with that there has to be restriction and conscientiousness. On Memorial Day, downtown Port Jefferson was packed with a slew of people, many not wearing face coverings or practicing much social distancing. 

While we begin the reopening process this week, we should remember the worst-case scenario is a second wave of the virus that could force businesses to shut down all over again. Our local business owners are smart, and we’re sure they will think of unique ways to facilitate customers while keeping the virus from spreading once again.

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Photo from METRO

By Daniel Dunaief

Daniel Dunaief

Our world is filled with all kinds of new terms, like social distancing, face coverings and viral peaks. We could use a few new terms to describe the modern reality, which might give us greater control over the unsettling world around us. How about:

Zoom Staging: The process of setting up our best artwork and most intelligent books behind us. We might have read “War and Peace” or “Crime and Punishment” or “An American Tragedy” in college. It’s time to find those and put them on the shelves behind us, leading to a deep discussion about our favorite books as we wait for other people to join the calls. We could also add a few adorable pieces of incomprehensible artwork from our children that none of our coworkers would dare criticize.

Curbworld: Even though we’re opening up parts of the economy starting this week, we still can only do some retail shopping through curbside pickup. We have become a world that exists at the curb, where retail space goes untouched and where curbs have become the intersection of our outings and the stuff we bring home.

Googleversity: To some extent, we were living in this world before the virus, but search platforms have become a critical part of our children’s home learning environment. In addition to listening to a professor with a headset or air pods on, our children are also frantically searching the web in real time to answer questions about the War of 1812 or about theorems that sound vaguely familiar.

Coviracy Theories: The world was filled with conspiracy theories before President Donald Trump (R) came along and will have plenty of conspiracy theories after he leaves. Still, the preponderance of conspiracy theories related to the virus should have its own lexicon, as people have blamed everyone from foreign governments to incredibly rich and successful technology geniuses for the virus.

Insertcollege.edu: Up until now, people have graduated from colleges where they had unique, on site experiences. This year, that’s not the case, as distance learning seems to have become something of a commodity, with professors of all talent levels struggling to engage a group of people remotely. None of the books we have that are supposed to help with the college hunt — and we have plenty of them now with a high school junior and a college freshman in our midst — help us differentiate among the online platforms of the institutions of higher learning. It’s unclear how, if at all, any of these institutions stands out.

SWSD: Second Wave Stress Disorder. Over the last several weeks, we have heard plenty about a coming second wave. In fact, some colleges that are reopening their doors this fall, such as North Carolina State University, plan to start their semester early, go through fall break and then send students home for an extended break that they hope allows them to avoid a second wave at school.

91 Divoc Dreams: Given the dream world, it seems fitting that we reverse the order of COVID-19 to suggest the upside down world that haunts our dreams, which is a mixture of the realities of our daily fears, anxieties and discomforts blended with the imaginative world of science fiction drama that we beam into our bedrooms that distract and unnerve us.

Masksession: Some of us have become obsessed with the right not to wear a mask, even as others feel an urgency to ensure everyone wears masks. The mask discussion has become an obsession.

2020 No More: To finish the vernacular, we should no longer consider perfect vision to be 20-20 because, after all, 2020 sucks. We could change it to 21-21 or anything else, where we don’t need to link the perfect vision of hindsight to this imperfect year.

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Photo from METRO

By Leah S. Dunaief

Leah Dunaief

Perhaps the worst is over. With this first phase of recovery for Long Island, suddenly there is hope that the strange pandemic life we are leading will pass into history. Of course, we are far from home free. The virus is still just as contagious and the threat is still real. We continue to ache for those whose lives have been cut short by this virulent disease, and our hearts go out to the families who lost loved ones without even a farewell or proper service. 

But we have, to a great extent, adapted to a coexistence with the virus as we wear face masks, habitually practice social distancing, wash our hands frequently for at least 20 seconds each time and otherwise limit our interactions with family, friends and colleagues to regular Zoom sessions. 

Working remotely, for those who can, has proven not to be so bad and will probably carry over well beyond sheltering-in-place. And for those on the front lines of response, the intensity, if not the fear, may have somewhat diminished.

We are thrilled to see the stores open up, if only for curbside or doorway pick up of items. Some of the establishments have constructed barriers to keep customers safely apart or added ultraviolet lighting to kill the microbes. And perhaps those on unemployment can now be called back to work. 

Some may not return even though they are required to respond to their employer’s call. Ironically, they may be doing better financially by being on unemployment, at least for the short term. The federal government has put itself in competition with small businesses, who can’t pay workers as much, and sometimes the Feds win. Those small businesses that have received the Payroll Protection Plan money are able to call back workers and to pay them until their eight-week period runs out.

Gov. Andrew Cuomo (D), who has built up quite a following for his daily briefings and won positive ratings for his down home manner, offered this as he rang the opening bell at the New York Stock Exchange Tuesday: “Wearing a mask has got to be something you do every day. When you get up, when you walk out of the house, you put the mask on. This is cool.” 

He also admonished people not to be rude to those who might not be wearing masks, that we should encourage them to do so nicely and politely. He did go on to add, recognizing that he was, after all, governor of New York State, “But it’s New York. We have to be careful that nice and polite stays nice and polite.” 

Cuomo met with President Donald Trump (R), a longtime fellow New Yorker, Wednesday, and urged spending for infrastructure as a way to provide many jobs. That goal was mentioned by Trump shortly after he took office in 2017 and is considered one of the few subjects on which there could be bipartisan support. In particular, Cuomo advocated for an AirTrain to La Guardia Airport, a rail tunnel under the Hudson River and a northern extension of the Second Avenue subway.

It is most unfortunate that, along with the deadly consequences of the novel coronavirus, there is an underpinning of highly partisan sentiment in the country. Traditionally, when there is a crisis, Americans pull together. Certainly that was true during Pearl Harbor, 9/11 and Hurricane Sandy, for example. But the nature of this pandemic is asymmetrical in that areas of greater density tend to be more stricken, while those more rural or away from the big cities and the coasts are more lightly touched. 

It is hard for those not in the throes of the ghastly metrics of death and affliction to feel the extreme stress of those who are. It just so happens that the divide between red and blue states overlays our map, not perfectly, but remarkably. Suffolk County, considered a red county, yet in a dense area, is an exception with its high casualties. 

So we have those demanding an “opening” of the economy vs. those who are concerned about contagion. We must unfailingly continue to practice what has worked to win us entry thus far into Phase One. 

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From left, Ramona Edith-Williams and Kelly O'Sullivan in a scene from Saint Frances. Photo courtesy of Oscilloscope Labs

By Jeffrey Sanzel

Saint Frances begins with Bridget (Kelly O’Sullivan) listening passively to a man drone on about a dream he had and how life is about purpose. This indulgent harangue only ends when he discovers that she is not in her twenties but a 34-year-old server; upon hearing this, he unceremoniously moves on. 

This sets the tone for a story of someone who exists but does not actually live in her own life but drifts from moment to moment. Bridget seems unphased and unaffected by his rudeness and remains impassive. 

She is then engaged by a younger man, Jace (sweetly earnest Max Lipchitz). That night, they fall into bed. It is clear that Jace wants more than just the hook-ups that seem to populate Bridget’s life. But this is not Bridget. The self-described feminist-atheist doesn’t know who she is or, more importantly, what she feels. 

In short, she is a mess.

Gradually, details of her life are teased out.  As a server, she has no affinity for the job, shown as soul-crushing drudgery. She then interviews for a nannying position, clearly ambivalent about the actual work but just wanting to escape the restaurant. The situation is to take care of six year-old Frances (Ramona Edith-Williams). Frances’ mothers, pregnant Maya (Charin Alvarez, heartbreaking in her struggle, triumphant in her resolution) and lawyer Annie (layered and dimensional Lily Mojekwu) are dubious and pass on her.

In the meantime, Bridget discovers she is pregnant and Jace willingly offers to support her in any way. Almost immediately, Bridget decides to terminate the pregnancy. It is not so much a cavalier choice as it is, like all of her actions, done almost at a distance. Bridget is someone who lives apart from herself.

Two months later, after the original nanny is let go, Bridget is offered the position. She readily accepts even though she seems to have no affinity for children. Maya is now struggling with postpartum depression, and Annie is now back at work full-time and seemingly unavailable.  

Initially, Bridget is emotionally absent as a caretaker. She makes a series both benign and what could be (but do not result in) calamitous mistakes. However, she  gradually awakens to her responsibility, and not just to Frances, but to herself. Her journey is both darkly funny and achingly melancholy. Much of the film is excruciating as she perpetually teeters on and often goes over the edge of poor judgment. But, through her commitment to her charge, she grows. 

In the tumult of the chaos that is Bridget, there are many astute and charming scenes.  A hike with her parents who are humorous but caring eschews the usual clichés. Following the baptism of Maya and Annie’s baby, Frances gives confession to Bridget.  A sleepover shows that there is joy in the simplest moments.

At the center of the film is Kelly O’Sullivan’s riveting and nuanced performance, letting the light ever so gradually shine into Bridget’s life, building up to several wonderfully cathartic moments. She is matched by Ramona Edith Williams, an honest and endearing child actor. Whether dismissing Bridget with a “We’re done” or subtlety crumbling under the fear of being replaced by her new sibling, she is unmannered and, most importantly, real.  Together, they make the film beat as one.

Director Alex Thompson allows Kelly O’Sullivan’s insightful screenplay to breathe, never giving away what will happen next, but drawing us further and deeper into Bridget’s tumultuous wake. It is all beautifully filmed by cinematographer Nate Hurtsellers. Together, they have created a film that dissects and yet celebrates the fact that family given or chosen are equal parts love and dysfunction.

Ultimately, Saint Frances’ heart lies in purpose. Prior to Frances, Bridget is wandering ambivalently through her own story. Even her mother asks her if is she was happy she was born, even with her life “the way it is.” But with responsibility, Bridget becomes awakened, aware, and empowered. By actively involving herself in this family — by finding her purpose — she not only finds herself but her sense of value. Saint Frances leaves Bridget — and us — in a better place.

Not rated, Saint Frances is now streaming on-demand.

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Dr. Anthony Fauci

By Peggy Olness

“Everyone is entitled to his own opinion, but not his own facts” said our NY Senator Daniel Patrick Moynihan. This simple but important statement has re-emerged in this unusual era as a call for truth, and can sometimes be the difference between life and death. Being informed is every citizen’s responsibility, whether making sense of a cacophony of voices during a pandemic or ultimately choosing leaders on election day. Use this time of enforced and prudent social distancing to educate yourself on how to separate fact from opinion and fiction. 

Over 100 doctors and nurses serving on the front lines of the coronavirus pandemic recently sent a letter to the largest social media platforms, Facebook, Twitter, Google, & YouTube, warning that misleading information about COVID-19 is threatening lives. The letter called on these organizations to more aggressively monitor the posting of medical misinformation appearing on their websites.

Misinformation about COVID-19 includes unfounded claims and conspiracy theories about the virus originating as biological weapon development and being deliberately spread by various groups or countries. Even more dangerous have been the unsubstantiated claims for “sure cures” that involve certain types of therapies or treatments with substances, many of which are poisonous or which must be monitored by a medical professional. There have been documented instances of people dying or suffering serious harm as a result of following this misinformed advice.

For COVID-19 information dependable places to start are the websites of the CDC and the National Institute of Allergy and Infectious Diseases. The Center for Disease Control and Prevention (CDC) was created by Congress in 1946 to focus on infectious disease and food borne pathogens. It functions under the US Public Health Service (PHS) to provide leadership and assistance for epidemics, disasters and general public health services. It is responsible for the Strategic National Stockpile, a stockpile of drugs, vaccines, and other medical products and supplies to provide for the emergency health security of the US & its territories.

Also under the PHS are the National Institutes for Health (NIH), responsible for basic and applied research for biomedical and public health, founded in the 1880’s to investigate the causes of malaria, cholera and yellow fever epidemics. A subagency, of the NIH, the National Institute of Allergy & Infectious Diseases (NIAID), is the lead agency studying the nature of the coronavirus and its treatment and prevention. 

Dr. Anthony Fauci, M.D, NIAID Director since 1984, has helped NIAID lead the US through a number of crises including HIV-AIDS, Ebola, West Nile Virus, SARS, H1N1 flu, MERS-CoV, Zika and COVID-19. Dr Fauci has been trying to communicate the facts his agency has discovered about coronavirus and COVID-19. Scientists are seekers of findings that can be replicated, and their research is constantly being updated, revised, communicated, and it is collaborative and open. 

Misinformation and rumor have always been a part of society, and the children’s game of “Telephone” has been used for generations to show how factual information can become changed or distorted when it is passed down a line of people. So what can we do about it? Before making decisions about action, be sure that the information and sources that are guiding you are reliable and trusted. During this COVID-19 crisis, actions taken by those around you can have negative consequences. Remember to use social media with an emphasis on “social;” your source for facts and your basis for decisions should be well-documented media/journalism and peer-reviewed science. Be sure, as President Reagan advised, you have trusted but also verified.  

The Suffolk Cooperative Library System, with the assistance of the Suffolk County League of Women Voters and building on the work of the Westchester LWV, has produced a 10 minute professional development video: “INFODEMIC 101: Inoculating Against Coronavirus Misinformation” which can be found on the Livebrary YouTube channel https://youtu.be/7qmy3FaCjHU

Peggy Olness is a board member of the League of Women Voters of Suffolk County, a nonprofit, nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. For more information, visit http://www.lwv-suffolkcounty.org, email [email protected] or call 631-862-6860.

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Studies have shown 50 percent fewer cardiac events with CoQ10 supplementation. Stock photo
Supplementation may improve outcomes

By David Dunaief, M.D.

Dr. David Dunaief

Heart attacks and heart disease get a lot of attention, but chronic heart failure is often overlooked by the press. The reason may be that heart failure is not acute like a heart attack.

To clarify by using an analogy, a heart attack is like a tidal wave whereas heart failure is like a tsunami. You don’t know it’s coming until it may be too late. Heart failure is an insidious (slowly developing) disease and thus may take years before it becomes symptomatic. It also increases the risk of heart attack and death.

There are about 6.5 million Americans with heart failure (1), and heart failure contributed to one in eight deaths in 2017 (2).

Heart failure (HF) occurs when the heart’s pumping is not able to keep up with the body’s demands and may decompensate. There are two types — systolic and diastolic. The basic difference is that the ejection fraction, the output of blood with each contraction of the left ventricle of the heart, is more or less preserved in diastolic HF, while it can be significantly reduced in systolic HF.

We have more evidence-based medicine, or medical research, on systolic heart failure. Fortunately, both types can be diagnosed with the help of an echocardiogram, an ultrasound of the heart. The signs and symptoms may be similar, as well, and include shortness of breath on exertion or when lying down, edema or swelling, reduced exercise tolerance, weakness and fatigue. Major risk factors for heart failure include diabetes, coronary artery disease, high blood pressure, obesity, smoking, poor diet, being sedentary and drinking alcohol excessively.

Typically, heart failure is treated with blood pressure medications, such as beta blockers, ACE inhibitors and angiotensin receptor blockers. We are going to look at how diet, iron and the supplement CoQ10 impact heart failure.

Effect of diet

If we look beyond the usual risk factors mentioned above, oxidative stress may play an important role as a contributor to HF. Oxidative stress is thought to potentially result in damage to the inner lining of the blood vessels, or endothelium, oxidation of cholesterol molecules and a decrease in nitric oxide, which helps vasodilate blood vessels.

In a population-based, prospective (forward-looking) study, called the Swedish Mammography Cohort, results show that a diet rich in antioxidants reduces the risk of developing HF (3). In the group that consumed the most nutrient-dense foods, there was a significant 42 percent reduction in the development of HF, compared to the group that consumed the least. According to the authors, the antioxidants were derived mainly from fruits, vegetables, whole grains, coffee and chocolate. Fruits and vegetables were responsible for the majority of the effect.

This nutrient-dense approach to diet increased oxygen radical absorption capacity. Oxygen radicals have been implicated in cellular damage and DNA damage, potentially as a result of increasing chronic inflammation. What makes this study so impressive is that it is the first of its kind to investigate antioxidants from the diet and their impacts on heart failure prevention.

This was a large study, involving 33,713 women, with good duration — follow-up was 11.3 years. There are limitations to this study, since it is an observational study, and the population involved only women. Still, the results are very exciting, and it is unlikely there is a downside to applying this approach to the population at large.

CoQ10 supplementation

Coenzyme Q10 is a substance produced by the body that helps the mitochondria (the powerhouse of the cell) produce energy. It is thought of as an antioxidant. 

Results of the Q-SYMBIO study, a randomized controlled trial, showed an almost 50 percent reduction in the risk of all-cause mortality and 50 percent fewer cardiac events with CoQ10 supplementation (4). This one randomized controlled trial followed 420 patients for two years who had severe heart failure. This involved using 100 mg of CoQ10 three times a day compared to placebo.

The lead author goes as far as to suggest that CoQ10 should be part of the paradigm of treatment. This the first new “drug” in over a decade to show survival benefits in heart failure.

A meta-analysis involving 13 studies of CoQ10 supplementation with HF confirmed that CoQ10 resulted in ejection fraction improvements among patients with less severe stages of HF, although the authors suggest that studies with more diverse demographics and that refine and compare dose responses are warranted (5).

Thus, if you have heart failure, you may want to discuss CoQ10 with your doctor.

Iron deficiency

Anemia and iron deficiency are not synonymous, since iron deficiency can occur without anemia. A recent observational study that followed 753 heart failure patients for almost two years showed that iron deficiency without anemia increased the risk of mortality in heart failure patients by 42 percent (6).

In this study, iron deficiency was defined as a ferritin level less than 100 μg/L (the storage of iron) or, alternately, transferrin saturation less than 20 percent (the transport of iron) with a ferritin level in the range 100–299 μg/L.

The authors conclude that iron deficiency is potentially more predictive of clinical outcomes than anemia, contributes to the severity of HF and is common in these patients. Thus, it behooves us to try to prevent heart failure through dietary changes, including high levels of antioxidants, because it is not easy to reverse the disease. Those with HF should have their ferritin and iron levels checked, for these are correctable. 

I am not typically a supplement advocate; however, based on the latest results, CoQ10 seems like a compelling therapy to reduce risk of further complications and potentially death. Consult with your doctor before taking CoQ10 or any other supplements, especially if you have heart failure.

References:

(1) Circulation. 2019;139(10):e56–528. (2) cdc.gov. (3) Am J Med. 2013 Jun:126(6):494-500. (4) JACC Heart Fail. 2014 Dec;2(6):641-649. (5) Am J Clin Nutr. 2013 Feb; 97(2): 268–275. (6) Am Heart J. 2013;165(4):575-582.

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

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METRO photo

By Elof Axel Carlson

Elof Axel Carlson

Some of my friends and relatives since I was a high school student have told me that I know a lot. In one sense I do because I have an excellent retentive memory and can recall isolated facts that struck me as interesting at the time. 

In my high school history class, my teacher Mr. Emil, was groping for the name of a German reverend who opposed Hitler and was imprisoned for his preaching. I raised my hand and said, “Was it Pastor Niemöller?” I was looked upon as a freak by my classmates because I recalled this from listening to a radio program with my father and brother called This is the Enemy. 

I identified this talent as having “a flypaper memory.” If it’s significant to me, it sticks in my head. Of course, I also read a lot and since my father bought a set of the Encyclopedia Britannica when I was born in 1931, I browsed through it on rainy days and amassed enormous trivial knowledge from Japanese bonsai gardens to a graveyard (necropolis) of embalmed cats mummified by ancient Egyptians who worshipped a cat goddess, Bubastis (or Bastet).  

What I have learned over all these years of reading widely is that it would take centuries to read all there is to know of the known world and that as much as I have learned over the 88 years of my life so far, only gives me a small amount of the knowledge that exists.  

Furthermore, we don’t know how much of the universe works, whether it is life or the earliest stages of the birth of the universe. We don’t even know how many laws of science are yet to be discovered. 

But look at it this way. We live at best some 90 years today. Of recorded history (3000 years), that’s about 3 percent of the time humans have accumulated knowledge and written about it. No single person can read all the books in the Library of Congress, or the British Museum or the Vatican Library. This means when we try to solve concerns in our own lives and times, we are limited in the resources we can reasonably read relevant to what we want to do or solve. 

In a democracy we are diverse and have competing needs and priorities. We do as best we can with what we already know or with the help of others who know more than we know because their interests are slightly different from ours. It is this pooling of knowledge that allows us to do better than trying to “reinvent the wheel” each time we come across something new in our lives or our country’s experience. 

Complicating our ability to solve problems is the way we accept or reject evidence or information. We filter knowledge through mental prisms that include our religious beliefs, our ideological beliefs (liberalism versus capitalism, democracy versus authoritarianism, patriotism vs  criticism of government policy), or our professional habits (debate and amassing one sided briefs for those in legal professions including politics) and the apparently inconsistent findings science provides through experimentation and evidence (radiation is good for diagnosis and treatment but it also can cause harm to healthy cells or mutate genes in our gonads and pass them on to future generations.  

We like to have simpler ways of seeing things and doing things. But reality is often more complex, more intertwined with other things that make a simple approach difficult and often strewn with unintended consequences.  People who dump waste in rivers and lakes I believe are sincere when they feel that nature heals itself. But being sincere is not the same as being right and we have numerous episodes of smog, polluted rivers that kill off fish and other life in them and make our drinking water contaminated with toxic chemicals. People are sincere also when they feel God looks after us or that the virtuous are spared in natural disasters .

Would 500 people huddle in a church during a tornado or would they rather be in several hundred separate underground shelters? The more complex the issues are in society, the more likely is it that there are no simple responses to them, and we need to listen to many and go with the best that we have available from our collective knowledge.  Unfortunately, informed debate is not always what we experience at the political level where decisions are made.  

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

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MEET PEGGY!

This week’s shelter pet is Peggy, an adorable seven-month-old female domestic shorthair who is patiently waiting at the Smithtown Animal Shelter for her furever home. Here’s her story:

Peggy came to the shelter as part of the Trap-Neuter-Release program, and she instantly started looking for affection. Peggy is gentle, and sometimes can be a little shy, but she loves to be loved by people! She’s great with children, and would do well in a home with other feline friends. In the past, Peggy had to deal with a ruptured ear drum, but she has since improved her condition and is now feeling much better and happier. She has learned to come out of her shell recently, and she would love the opportunity to socialize and make new friends! Her perfect home would be a quiet place where she can cuddle, lounge around, and play all day.

*Due to the health risk presented by the COVID-19 pandemic, there will be limited public access to the shelter. If you are interested in meeting Peggy please fill out an adoption application online at www.townofsmithtownanimalshelter.com.

The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. For more information, call 631-360-7575.

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