WINTER SUNSET
Dawn Olenick of Baiting Hollow snapped this winter sunset in Calverton on Jan. 1 with her ‘trusty Nikon.’ She writes, ‘Winter sunset … never disappoints .’
Send your Photo of the Week to [email protected]
Photo of the Week
Home Columns
Ask the Vet: Home dental care for your pet
By Matthew Kearns, DVM
When I bring up dental procedures with pet owners, the concern is pets require anesthesia for dental work. That invariably brings the question, “Is there anything we can do at home to prevent this?” The answer is a resounding “YES!!!”
First, I would like to briefly review the pathology of periodontal disease. Dogs and cats do not suffer from dental disease as much as humans. They suffer from periodontal disease.
Dental disease refers to pathology with the tooth itself: caries, cavities, etc. Periodontal disease refers to pathology of the structures around the tooth: gingiva (gums), the periodontal ligament, perialveolar bone.
Periodontal disease begins with plaque. It has been proven that even within 24 hours of a professional cleaning, a thin film of bacteria, saliva and food (also known as plaque) accumulates on the enamel of the tooth. Plaque that is not removed mineralizes within 10 days into tartar or a calculus. Once tartar takes hold a shift develops from aerobic bacteria (bacteria that need oxygen to survive) to nasty anaerobic bacteria (those that need little or no oxygen to survive). Anaerobic bacteria secrete toxins that inflame the gums and lead to small abscesses or pockets under the gums. Bacteria start to destroy the support structures around the tooth which is very painful. If not treated then the tooth will need to be removed.
Brushing: Brushing the teeth removes this film before it has a chance to mineralize. If you do decide to brush your pet’s teeth first pick a toothbrush and toothpaste that is veterinary approved. We humans know to rinse and spit when done brushing, but our pets do not. Swallowing human toothpaste is harmful because it has too much sodium, fluoride and is sweetened with saccharin.
Pet-safe toothpaste comes in a variety of flavors that pets will like (chicken, beef, fish, etc.) better than good old-fashioned fresh mint. When you first begin just put a little toothpaste on the end of the brush and let your pet investigate. If they sniff, lick or even just chew on the brush that is fine. Then start by gently just brushing the front teeth. Once they tolerate that, start to work toward the back teeth.
Dental Treats/Diets: Effective brushing of your pet’s teeth needs to be done daily (at least four times per week) and scheduling time to brush your pet’s teeth can be difficult. I have yet to meet an owner able to teach his or her dog/cat to brush their own teeth. Certain prescription diets (Hill’s t/d® and Purina Pro Plan DH®) literally clean the teeth as your pet eats. There are also treats that do the same. Look for the Veterinary Oral Health Council (VOHC) seal on the packaging. If you can’t find a VOHC-approved treat, remember this slogan, “If you wouldn’t want to get hit in the knee with this dental treat, don’t let your pet chew on it.” That means if it is too hard your pet runs the risk of damaging their teeth.
Rinses: Again, look for the VOHC seal of approval. The safest and most effective rinses contain chlorhexidine. Chlorhexidine is most effective against the development of plaque, and chlorhexidine-based rinses are considered the gold standard of veterinary oral rinses. Rinses containing xylitol, or fluoride, should be avoided in my opinion because of their potential for toxicity.
This is not a complete list of dental home care products so, as always, please consult with your own veterinarian for a more in-depth conversation. In addition, I can’t guarantee that even if you follow through with all these recommendations that your dog or cat will not need professional dental care (including extractions), but it certainly helps. Remember, BIG SMILES!!!
Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. Have a question for the vet? Email it to [email protected] and see his answer in an upcoming column.
Medical Compass: Diet’s effects on cataracts
Lowering your meat intake may reduce cataract risk
By David Dunaief, M.D.
Cataracts affect a substantial portion of the U.S. population. In fact, 24.4 million people in the U.S. over the age of 40 are currently afflicted, and this number is expected to increase approximately 61 percent by the year 2030 — only 10 years from now — according to estimates by the National Eye Institute (1).
Cataracts are defined as an opacity or cloudiness of the lens in the eye, which decreases vision over time as it progresses. It’s very common for both eyes to be affected. We often think of cataracts as a symptom of age, but we can take an active role in preventing them.
There are enumerable modifiable risk factors including diet; smoking; sunlight exposure; chronic diseases, such as diabetes and metabolic syndrome; steroid use; and physical inactivity. I am going to discuss the dietary factor.
Prevention
In a prospective (forward-looking) study, diet was shown to have substantial effect on the risk reduction for cataracts (2). This study was the United Kingdom group, with 27,670 participants, of the European Prospective Investigation into Cancer and Nutrition (EPIC) trial. Participants completed food frequency questionnaires between 1993 and 1999. Then, they were checked for cataracts between 2008 and 2009.
There was an inverse relationship between the amount of meat consumed and cataract risk. In other words, those who ate a great amount of meat were at higher risk of cataracts. “Meat” included red meat, fowl and pork. These results followed what is termed a dose-response curve.
Compared to high meat eaters, every other group demonstrated a significant risk reduction as you progressed along a spectrum that included low meat eaters (15 percent reduction), fish eaters (21 percent reduction), vegetarians (30 percent reduction) and finally vegans (40 percent reduction).
There really was not that much difference between high meat eaters, those having at least 3.5 ounces, and low meat eaters, those having less than 1.7 ounces a day, yet there was a substantial decline in cataracts. Thus, you don’t have to become a vegan to see an effect.
In my clinical experience, I’ve also had several patients experience reversal of their cataracts after they transitioned to a nutrient-dense, plant-based diet. I didn’t think this was possible, but anecdotally, this is a very positive outcome and was confirmed by their ophthalmologists.
Mechanism of action
Oxidative stress is one of the major contributors to the development of cataracts. In a review article that looked at 70 different trials for the development of cataract and/or maculopathies, such as age-related macular degeneration, the authors concluded antioxidants, which are micronutrients found in foods, play an integral part in prevention (3).
The authors go on to say that a diet rich in fruits and vegetables, as well as lifestyle modification with cessation of smoking and treatment of obesity at an early age, help to reduce the risk of cataracts. Thus, you are never too young or too old to take steps to prevent cataracts.
How do you treat cataracts?
The only effective way to treat cataracts is with surgery; the most typical type is phacoemulsification. Ophthalmologists remove the opaque lens and replace it with a synthetic intraocular lens. This is done as an outpatient procedure and usually takes approximately 30 minutes. Fortunately, there is a very high success rate for this surgery. So why is it important to avoid cataracts if surgery can remedy them?
Potential consequences of surgery
There are always potential risks with invasive procedures, such as infection, even though the chances of complications are low. However, more importantly, there is a greater than fivefold risk of developing late-stage age-related macular degeneration (AMD) after cataract surgery (4). This is wet AMD, which can cause significant vision loss. These results come from a meta-analysis (group of studies) looking at more than 6,000 patients.
It has been hypothesized that the surgery may induce inflammatory changes and the development of leaky blood vessels in the retina of the eye. However, because this meta-analysis was based on observational studies, it is not clear whether undiagnosed AMD may have existed prior to the cataract surgery, since they have similar underlying causes related to oxidative stress.
Therefore, if you can reduce the risk of cataracts through diet and other lifestyle modifications, plus avoid the potential consequences of cataract surgery, all while reducing the risk of chronic diseases, why not choose the win-win scenario?
References:
(1) nei.nih.gov. (2) Am J Clin Nutr. 2011 May; 93(5): 1128-1135. (3) Exp Eye Res. 2007; 84: 229-245. (4) Ophthalmology. 2003; 110(10): 1960.
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.
SBU’s Peng Zhang hopes microgrids stabilize power delivery amid storms
By Daniel Dunaief
If Peng Zhang succeeds in his work, customers on Long Island and elsewhere will no longer lose power for days or even hours after violent storms.
One of the newest additions to the Department of Electrical and Computer Engineering at Stony Brook University, Zhang, who is the SUNY Empire Innovation associate professor, is enhancing the resiliency and reliability of microgrids that may be adaptable enough to provide energy to heat and light a home despite natural or man-made disruptions. Unlike the typical distributed energy network of most utilities around the country, microgrids are localized and can function on their own.
A microgrid is a “central theme of our research,” said Zhang, who joined Stony Brook at the beginning of September. “Even when a utility grid is down because of a hurricane or an attack, a microgrid is still able to supply the local customers” with power. He is also using quantum information science and quantum engineering to empower a resilient power grid.
Zhang expects that the microgrid and utility grid will be more resilient, stable and reliable than the current system. A microgrid will provide reliable power even when a main grid is offline. The microgrid wouldn’t replace the function of the grid in the near future, but would enhance the electricity resilience for customers when the central utility is unavailable or unstable.
Part of his motivation in working in this field comes from his own experience with a weather-related loss of power.
Even though Zhang, who used his training in mathematics to develop an expertise in power systems, had been working on wind farms and their grid integration, he decided after Hurricane Irene and a nor’easter that he should do more research on how to restore power after a utility became unavailable.
Irene hit in August, while the nor’easter knocked out power in the winter. After the storms, Northeast Utilities, which is currently called Eversource Energy, asked him to lead a project to recommend solutions to weather-induced outages.
Zhang plans to publish a book through Cambridge University Press this year called “Networked Microgrids,” which not only includes his previous results but also presents his vision for the future, including microgrids that are self-healing, self-protected, self-reconfiguring and autonomous.
He recognizes that microgrids, which are becoming increasingly popular in the energy community, present a number of challenges for customers. For starters, the cost, at this point, for consumers can be prohibitively high.
Zhang can cut those expenses, however, by replacing hardware upgrades with software, enabling more of the current system to function with greater resilience without requiring as many costly hardware modifications.
His National Science Foundation project on programmable microgrids will last until next year. He believes he will be able to verify most of the prototypes for the programmable microgrid functions by then.
Zhang called advances in energy storage a “key component” that could improve the way microgrids control and distribute power. Energy storage can help stabilize and improve the resilience of microgrids.
He is eager to work with Esther Takeuchi, who has dual appointments at Stony Brook University and Brookhaven National Laboratory, not only on microgrid technologies but also on renewable integration in the transmission grid.
Zhang appreciates SBU’s reputation in physics, applied math, computer science and electrical and computer engineering. When he was young, he said he also heard about and saw Chen-Ning Yang, whom he described as a model and legend.
“I feel proud and honored to be working at Stony Brook where Dr. Yang taught for more than three decades,” he stated in an email.
In his lab, Zhang has six doctoral students, one visiting doctoral student and two master’s students. A postdoctoral researcher, Yifan Zhou, who worked with him at the University of Connecticut, will soon join his Long Island lab.
Zhang, who earned doctorates from Tsinghua University and the University of British Columbia, brought along a few grants from the University of Connecticut where he held two distinguished titles.
Zhang has “high expectations for the people who work for him,” Peter Luh, a board of trustees distinguished professor at the University of Connecticut, explained in an email. “However, he is considerate and helps them achieve their goals.”
Zhou, who comes from Tsinghua University, is working with him on stability issues in microgrids to guarantee their performance under any possible scenario, from a major storm to a cyberattack.
Zhang is working with Scott Smolka and Scott Stoller, both in the Computer Science Department at Stony Brook, on resilient microgrids
“We are planning to use simulations and more rigorous methods for formal mathematical analysis of cyberphysical systems to verify resiliency properties in the presence of fault or attacks,” said Stoller who described Zhang as a “distinguished expert on electric power systems and especially microgrids. His move to Stony Brook brings significant new expertise to the university.”
The Stony Brook scientists have created an exercise in which they attack his software systems, while he tries to ensure its ongoing reliability. Zhang will develop defense strategies to guarantee the resilience and safety of the microgrids.
Zhang was born in Shandong Province in China. He is married to Helen Wang, who works for a nonprofit corporation as an electrical engineer. The power couple has three sons: William, 13, Henry 10, and Benjamin, 8. They are hoping their sons benefit from the public school system on Long Island.
Zhang’s five-year goal for his work involves building an institute for power engineering, which will focus on microgrids and other future technologies. This institute could have 20 to 30 doctoral students.
An ambitious researcher, Zhang would like to be the leader in microgrid research in the country. “My goal is to make Stony Brook the top player in microgrid research in the U.S.,” he said.
Meng Yue, scientist in the Sustainable Energy Technologies Department at Brookhaven National Laboratory who has been collaborating with Zhang for over five years, anticipates that Zhang’s research will help consumers.
“As New York State has more aggressive renewable portfolio, I believe the research achievements will soon advance technologies in the power grid application,” he said.
Making Democracy Work: She took action to ensure the vote … will you?
By Lisa Scott
The new year brought the optimism of lengthening days, even as the undeniable effects of climate change frighten and yet drive the desire to “do something.”
Nationally, January brought the commemoration of Martin Luther King Jr. stopping us to think about his legacy, inspiring yet so unfulfilled more than 50 years after his death. The legions of civil rights workers, volunteers, freedom riders, protesters and women and men of all faiths, colors and origins knew that past and present wrongs could be exposed through demonstrations and civil disobedience, and then made right by law.
And 100 years ago, after many decades of struggle, women finally won the right to vote in the 19th Amendment to the U.S. Constitution. Yet the United States was born out of compromise and states’ rights, leading to today’s patterns, in many states, of voter suppression eroding the democracy we had strengthened for nearly 250 years.
Yes, all women and men 18 and over have the constitutional right to vote. But in practice many eligible individuals don’t register, or don’t exercise their right to vote, or have that right taken away if they’ve been convicted of felonies, or are arbitrarily removed for the voting rolls, or they are gerrymandered to limit the value of their vote, etc.
Yet voting this year, 2020, is critical; for president, for all members of the House of Representatives, and for one-third of senators. In a polarized and cacophonous political climate, what can be done to ensure a fully participatory democracy?
Meet Lisa M. La Corte, a resident of Riverhead township, who wanted to honor King as an icon for civil rights and voter engagement, and honor the suffragists and all people who risked and gave all for the right to vote in a free election. The League of Women Voters learned about someone who was riding the Patchogue-Riverhead Suffolk bus in the afternoons in January, getting passengers to register to vote. We invited her to a recent board meeting, and heard her story.
La Corte boarded the bus at the beginning of its weekday route, introduced herself to the driver, and when everyone had boarded she stood at the front and made a public announcement, introducing herself. She said she was there to help register voters and hear riders’ concerns of poor transportation for underserved communities as well as other issues. She stressed the importance of the passengers’ having their voices heard through the vote. She then walked from the front to the back asking each person individually if they were registered and if not (but eligible) she would register them then and there.
Most passengers are shy or skeptical but La Corte perseveres. When speaking with riders who do not want to register, she reminds them that “what they want for you to not do is vote” and reminds them by staying out of the democratic process elected officials can ignore or minimize their needs and concerns. Their voices are not heard and their community exerts no pressure for change.
The challenge for someone working with communities of color, in her view, is that black and brown people have no trust in any level of government or the process in general because they have been left behind so many times. Poor people feel that they don’t count no matter what they do, resulting in a sense of hopelessness. Our fractured communities are separated by a chasm of real-life experiences; why should they participate in a system that ignores or mistreats them? Why is authority not being held accountable? Why are black and brown people incarcerated on a hugely disproportionate basis, breaking up families and communities?
La Corte engages with all riders, whether or not they register to vote. She listens to their stories and challenges and hopes to build trust and commitment to the vote. As she said to the league, “I would love a movement that would transcend what I could ever imagine. I am but one person with ideas that hopes to inspire others. Like James Baldwin said, ‘Not everything that is faced can be changed, but nothing can be changed until its faced’.”
What are you doing to ensure access to the vote for all our fellow citizens, educate them on the issues, and reestablish trust in our civic institutions and government?
Lisa Scott is president 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 www.lwv-suffolkcounty.org or call 631-862-6860.
Medical Compass: Lower sodium to protect your kidneys
High sodium’s impact extends beyond hypertension
By David Dunaief, M.D.
By now, most of us have been hit over the head with the fact that too much salt in our diets is unhealthy. Still, we respond with “I don’t use salt,” “I use very little,” or “I don’t have high blood pressure, so I don’t have to worry.” Unfortunately, these are myths. All of us should be concerned about salt or, more specifically, our sodium intake.
Excessive sodium in the diet does increase the risk of high blood pressure (hypertension); the consequences are stroke or heart disease. Approximately 90 percent of Americans consume too much sodium (1).
Now comes the interesting part. Sodium has a nefarious effect on the kidneys. In the Nurses’ Health Study, approximately 3,200 women were evaluated in terms of kidney function, looking at the estimated glomerular filtration rate (GFR) as related to sodium intake (2). Over 14 years, those with a sodium intake of 2,300 mg had a much greater chance of an at least 30 percent reduction in kidney function, compared to those who consumed 1,700 mg per day.
Why is this study important? Kidneys are one of our main systems for removing toxins and waste. The kidneys are where many initial high blood pressure medications work, including ACE inhibitors, such as lisinopril; ARBs, such as Diovan or Cozaar; and diuretics (water pills). If the kidney loses function, it may be harder to treat high blood pressure. Worse, it could lead to chronic kidney disease and dialysis. Once someone has reached dialysis, most blood pressure medications are not very effective.
Ironically, the current recommended maximum sodium intake is 2,300 mg per day, or one teaspoon, the same level that led to negative effects in the study. However, Americans’ mean intake is twice that level.
If we reduced our consumption by even a modest 20 percent, we could reduce the incidence of heart disease dramatically. Current recommendations from the American Heart Association indicate an upper limit of 2,300 mg per day, with an “ideal” limit of no more than 1,500 mg per day (3).
If the salt shaker is not the problem, what is?
Most of our sodium comes from processed foods, packaged foods and restaurants. There is nothing wrong with eating out on occasion, but you can’t control how much salt goes into your food. My wife is a great barometer of restaurant salt use. If food from the night before was salty, she complains of not being able to get her rings off.
Do you want to lose 5 to 10 pounds quickly? Decreasing your salt intake will allow you to achieve this goal. Excess sodium causes the body to retain fluids.
One approach is to choose products that have 200 mg or fewer per serving indicated on the label. Foods labeled “low sodium” have fewer than 140 mg of sodium, but foods labeled “reduced sodium” have 25 percent less than the full-sodium version, which doesn’t necessarily mean much.
Soy sauce has 1,000 mg of sodium per tablespoon, but low-sodium soy sauce still has about 600 mg per tablespoon. Salad dressings and other condiments, where serving sizes are small, add up very quickly. Mustard has 120 mg per teaspoon. Most of us use far more than one teaspoon of mustard. Caveat emptor: Make sure to read labels on all packaged foods very carefully.
Is sea salt better than table salt?
High amounts of salt are harmful, and the type is not as important. The only difference between them is slight taste and texture variation. I recommend not buying either. In addition to the health issues, salt tends to dampen your taste buds, masking the flavors of food.
If you are working to decrease your sodium intake, become an avid label reader. Sodium hides in all kinds of foods that don’t necessarily taste salty, such as breads, soups, cheeses and salad dressings. I also recommend getting all sauces on the side, so you can control how much — if any — you choose to use.
As you reduce your sodium intake, you might be surprised at how quickly your taste buds adjust. In just a few weeks, foods you previously thought didn’t taste salty will seem overwhelmingly salty, and you will notice new flavors in unsalted foods.
If you have a salt shaker and don’t know what to do with all the excess salt, don’t despair. There are several uses for salt that are actually beneficial. According to the Mayo Clinic, gargling with ¼ to ½ teaspoon of salt in eight ounces of warm water significantly reduces symptoms of a sore throat from infectious disease, such as mononucleosis, strep throat and the common cold. Having had mono, I can attest that this works.
Remember, if you want to season your food at a meal, you are much better off asking for the pepper than the salt.
References:
(1) cdc.gov. (2) Clin J Am Soc Nephrol. 2010;5:836-843. (3) heart.org.
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.
Shelter Pet of the Week: Momoa
MEET MOMOA!
This week’s shelter pet is Momoa, a 2½-year-old male domestic shorthair, currently at the Smithtown Animal Shelter. He originally came to the shelter as a stray in April of last year. He was quickly adopted due to his beautiful coat and sweet temperament.
Unfortunately, he was brought back when he couldn’t get along with the owner’s dog. He would be best as the only pet in the household and a great fit for a family that has older children.
The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Walk-in hours are currently Monday to Friday, 8 a.m. to 4:30 p.m., Saturday from 8 a.m. to 3:30 p.m. and Sundays by appointment only. For more information, call 631-360-7575.
SBU’s Adam Singer shows benefits of lowering potassium for emergency room patients
By Daniel Dunaief
A patient comes rushing into the emergency room at a hospital. He has numerous symptoms and, perhaps, preexisting conditions, that the staff gather together as they try to stabilize him and set him back on the path toward a healthy life.
Emergency room protocols typically involve testing for the function of major organs like the heart, even as a patient with diabetes would also likely need a blood sugar test as well.
For a specific subset of patients, hyperkalemia, in which a patient has potentially dangerously elevated levels of the element potassium, may also merit additional testing and treatment.
In a recent study in the American Journal of Emergency Medicine, Adam Singer, a professor and vice chair for research at the Department of Emergency Medicine at the Renaissance School of Medicine at Stony Brook University, found that mortality rates were cut in half when doctors corrected for high levels of potassium.
“This study was focused on what we could do” to help patients with hyperkalemia, Singer said. “We always knew that rapid normalization was important, but we did not have the evidence except for anecdotal cases.”
Examining about 115,000 hospital visits to the Stony Brook Emergency Department between 2016 and 2017, Singer and his colleagues found that the mortality rate fell to 6.3 percent from 12.7 percent for patients whose potassium level was normalized.
Singer is “tackling a topic which is very important, which is life threatening and for which there is no clear standard,” said Peter Viccellio, a professor and vice chairman in the Department of Emergency Medicine at the Renaissance School of Medicine at SBU.
Viccellio said Stony Brook has become “more conservative over the last couple of years in treating patients with lower levels” of potassium.
One of the challenges with hyperkalemia is that it doesn’t usually come with any tell-tale symptoms. Emergency room doctors can’t determine an elevated level of potassium by looking at a patient or by hearing a list of symptoms.
Sometimes, people with hyperkalemia show weakness, nausea or vomiting, but those three conditions are also present in numerous other medical challenges.
Singer said not all the patients died directly from hyperkalemia. Most people with hyperkalemia have significant co-morbidities that put them at risk from other causes. Nonetheless, the higher level of mortality for patients above a threshold for potassium suggests that evaluating patients not only should include an awareness of the amount of this element in the blood, but also a clear set of guidelines for how to reduce it.
“This strengthens the need to call for more evidence-based studies to figure out the best and most effective therapies,” Singer said. “The higher the level of potassium, the greater the urgency for rapid correction,” he added.
Some hospitals may be using point-of-care tests and newer medications, especially new potassium binders. These treatments, however, have not been studied in large numbers yet.
As the population ages, more chronic disease patients take medicines that affect potassium levels. This, in turn, increases the risk of hyperkalemia, in part because chronic conditions like diabetes are so common. This risk extends to people who are obese and are developing diabetes.
On the positive side, Singer said some hospitals are using rapid point-of-care testing and, when they discover evidence of higher potassium, are using a new class of medications that treats the condition.
While the urgency for emergency room attendants is high enough to add potassium tests, especially for vulnerable patients, Singer does not believe that first responders necessarily need to add these tests to their evaluations on the way to the hospital. Such testing might be more urgent in rural areas, where transportation to a medical facility would take more time.
“Generally, such testing is not going to make a big difference” because patients will arrive at the hospital or medical facility before hyperkalemia becomes a contributing factor in their health, said Singer.
Changing a person’s lifestyle to lower the risk of hyperkalemia can be difficult because diets that are low in potassium are “hard to follow,” he said. Additionally diets that are low in potassium are often “lacking in other important food contents.”
Patients who are prone to hyperkalemia include people who are dehydrated, have kidney disease and missed a dialysis treatment, or are taking medications that can, as a side effect, boost the amount of potassium.
Generally, people don’t suddenly develop a high risk for hyperkalemia without any past medical history that suggests they are susceptible to it. During annual physicals, doctors customarily test for the level of potassium in the blood.
In terms of the total emergency room population, about 1 percent have higher potassium. During the years of the study, 308 patients had elevated potassium levels that remained high, while 576 had potassium levels that were high, but that were stabilized through treatment.
Higher potassium levels don’t necessarily require immediate treatment, in part because of a person who vomited several times might be getting fluids that restore the potassium balance
As director of research, Singer balances between his clinical responsibilities and his interest in conducting scientific research. When he sees an issue in the clinic, he can go back to the lab and then translate his research into clinical practice.
Viccellio said Singer is “internationally renowned” as a researcher and that he was a “superstar from day one.”
Singer’s primary interests are in acute wound care and burns. He has recently been studying a new, minimally invasive, nonsurgical technique to remove dead tissue after burns that involves an enzymatic agent and has been involved in several promising clinical trials of this technique.
Viccellio said Singer has done “fantastic work” on cosmetic repair of facial lacerations. Viccellio also suggested that Singer was “like the Bill Belichick” of research, helping numerous other people who went on to become research directors at other institutions.
A resident of Setauket for the last quarter of a century, Singer and his wife, Ayellet, have three children. Following in his father’s footsteps, his son Daniel is finishing his residency in emergency medicine at Stony Brook.
While Singer was born in Philadelphia and lived in Israel for part of his life, including during medical school, he has roots on Long Island. His grandparents originally lived in Ronkonkoma. Singer Lane in Smithtown, which was named after his realtor grandfather Seymour Singer, includes the one-room schoolhouse where Walt Whitman was a schoolmaster.
As for his work on hyperkalemia, Singer is pleased with the way he and his colleagues at Stony Brook have contributed to an awareness of the dangers of this condition. “We are identifying these patients and treating them,” he said.
Photo of the Week
DIVING IN
Tom Caruso of Smithtown was in the right place at the right time when he snapped this photo on Nov. 23. He writes, ‘I was photographing the river at the Nissequogue River State Park when I heard a commotion behind me. I turned to see this deer jumping into the river to escape someone’s dog who had chased it out of the woods. I quickly snapped a few shots and was lucky to get this one just as the deer hit the water. He swam across the river and exited on Short Beach.’
Send your Photo of the Week to [email protected]
D. None of the Above: Top 10 Republican Solutions to the Bolton Problem
By Daniel Dunaief
What should the Republicans do about former National Security Adviser John Bolton? In this topsy-turvy battle in Washington, Bolton has become a lightning bolt with his claims about his recent boss, President Donald Trump (R).
So, the Republicans, particularly under Trump, have a playbook for dealing with disaffected former staffers. That’s not terribly surprising, given that the president’s previous job involved letting people know that, “You’re fired!” Here are my top 10 options for dealing with Bolton.
10. Pretend no one knew him and that he wasn’t significant. The president has used that approach with other people with varying levels of success. The problem is that there were far too many pictures and meetings. For crying out loud, the guy was the national security adviser. Disavowing any knowledge or contact with him strains the willing suspension of disbelief required for so many other excuses. Let’s pass on that one.
9. Claim he’s trying to make money on a book. That’s what some have suggested, ignoring that he might be trying to make money and be telling the truth.
8. Insist that the book is a national security threat. That’s a technique the president has said he’d use to keep everyone else from testifying during his hotly contested impeachment trial.
7. Suggest that Trump would “love” to have him testify, but that someone else — a lawyer, a member of the FBI or CIA, or someone in the shadows who the president and his staff feel has a valid argument — has suggested that his testifying would destroy the Constitution, ruin the presidency or alter the course of history in a negative way for everyone.
6. Create a new, outlandish and riveting conspiracy theory. Maybe he’s still John Bolton, but the Democrats, and in particular House Speaker Nancy Pelosi, got a hold of him and somehow figured out how to reprogram him. This is doubly delicious, like a cheeseburger with extra bacon, deep fried in lard, because it unites Bolton with Pelosi and suggests that he’s lying and has sold his soul to a lower form of political being.
5. Develop a diversion. (Don’t you love alliteration?) Come up with a Mideast peace plan, a Chinese trade policy, a cure for coronavirus or a way to provide energy that removes the hippy-dippy greenhouse gases and cools the Earth. The short attention spans will seize on this as the one and only part of the news that’s worth covering. Surely, with all the events of the world, the drama, the excitement and the immediate need to feed the news beast, there must be some way to send eyeballs elsewhere, turning Bolton into an afterthought.
4. Ban anyone with a bushy, white mustache from entering the Senate chamber. The Democrats and all their supporters picked on Bolton mercilessly when he became national security adviser, focusing on his facial hair. Surely it’s fair to suggest that this defining characteristic makes him untrustworthy?
3. Give him the wrong time and day to show up. When he doesn’t arrive, suggest that he must have had a change of heart and it’s time to move on with a process that has a predetermined ending anyway.
2. Someone to whom Bolton lied could claim that the former national security adviser didn’t always tell the truth, which would undermine anything Bolton claimed the president said.
1. Let him testify. Bolton was always part of a Republican plan anyway. Once Republicans allow him to come before the Senate, he can deny the “leaks,” undermining the credibility of the media and the Democrats. In return, he can get another position, like maybe an ambassadorship?
Prev
