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Hypertension risk factors include poor diet, lack of exercise, age and depression.
Complications are highest during sleeping hours

By David Dunaief, M.D.

Dr. David Dunaief

Hypertension (high blood pressure) deserves a substantial amount of attention. There are currently about 76 million people with high blood pressure in the U.S. Put another way, one in three adults have this disorder (1). If that isn’t scary enough, the Centers for Disease Control and Prevention reports that the number of people dying from complications of hypertension increased by 23 percent from 2000 to 2013 (2).

And talk about scary, it turns out that fear of the boogie man should take a back seat to high blood pressure during nighttime sleeping hours. This is when the probability of complications, such as cardiovascular events and mortality, may have their highest incidence.

Unfortunately, as adults, it does not matter what age or what sex you are; we are all at increased risk of complications from high blood pressure, even isolated systolic (top number) blood pressure, which means without having the diastolic (bottom number) elevated as well. Fortunately, hypertension is highly modifiable in terms of reducing the risk of cardiovascular disease and mortality (3). At least some of the risk factors are probably familiar to you. These include being significantly overweight and obese (BMI >27.5 kg/m²), smoking, poor diet, lack of exercise, family history, age, increased sodium, depression, low vitamin D, diabetes and too much alcohol (4).

Of course, antihypertensive (blood pressure) medications treat this disorder. In addition, there are nonpharmacological approaches that have benefits. These include lifestyle modifications with diet, exercise and potentially supplements. An item on the game show “Jeopardy” read: “You can treat it with diet and lifestyle changes as well as drugs: HBP.” The corresponding answer was, “What is high blood pressure?” We made the big time!

Risk factors matter, but not equally

In a study, results showed that those with poor diets had 2.19 times increased risk of developing high blood pressure. This was the greatest contributor to developing this disorder (5). Another risk factor with a significant impact was being at least modestly overweight (BMI >27.5 kg/m²) at 1.87 times increased risk. This surprisingly, albeit slightly, trumped cigarette smoking at 1.83 times increased risk. Interestingly, weekly binge drinking at 1.87 times increased risk was equivalent to being overweight. This study was observational and involved 2,763 participants. The moral is that a freewheeling lifestyle can have a detrimental impact on blood pressure and cause at least stage 1 hypertension (systolic between 140 and 159 mmHg and/or diastolic between 90 and 99 mmHg).

High blood pressure doesn’t discriminate

One of the most feared complications of hypertension is cardiovascular disease, because it can result in death. In a study, isolated systolic hypertension was shown to increase the risk of cardiovascular disease and death in both young and middle-aged men and women between 18 and 49 years old, compared to those who had optimal blood pressure (6). The effect was greatest in women, with a 55 percent increased risk in cardiovascular disease and 112 percent increased risk in heart disease death. High blood pressure has complications associated with it, regardless of onset age. Though this study was observational, which is not the best, it was very large and had a 31-year duration.

Nightmares that may be real

Measuring blood pressure in the clinic can be useful. However, in a meta-analysis (involving nine studies from Europe, South America and Asia), the results showed that high blood pressure measured at nighttime was potentially a better predictor of myocardial infarctions (heart attacks) and strokes, compared to daytime and clinic readings (7).

For every 10 mmHg rise in nighttime systolic blood pressure, there was a corresponding 25 percent increase in cardiovascular events. This was a large meta-analysis that utilized studies that were at least one year in duration. Does this mean that nighttime readings are superior in predicting risk? Not necessarily, but the results are interesting. The nighttime readings were made using 24-hour ambulatory blood pressure measurements (ABPM).

There is something referred to as masked uncontrolled hypertension (MUCH) that may increase the risk of cardiovascular events in the nighttime. MUCH occurs in those who are well-controlled during clinic readings for blood pressure; however, their nocturnal blood pressure is uncontrolled. In the Spanish Society of Hypertension ABPM Registry, MUCH was most commonly seen during nocturnal hours (8). Thus, the authors suggest that ABPM may be a better way to monitor those who have higher risk factors for MUCH, such as those whose pressure is borderline in the clinic and those who are smokers, obese or have diabetes.

Previously, a study suggested that taking at least one antihypertensive medication at night may be more effective than taking them all in the morning (9). Those who took one or more blood pressure medications at night saw a two-thirds reduction in cardiovascular event risk. Now we can potentially see why. These were patients who had chronic kidney disease (CKD). Generally, 85 to 95 percent of those with CKD have hypertension.

Dietary tidbits

Diet plays a role in controlling high blood pressure. In a study, blueberry powder (22 grams) in a daily equivalent to one cup of fresh blueberries reduced systolic blood pressure by a respectable 7 mmHg and diastolic blood pressure by 5 mmHg over 2 months (10). This is not bad, especially since the patients were prehypertensive, not hypertensive, at baseline, with a mean systolic blood pressure of 138 mmHg.

This is a modest amount of fruit with a significant impact, demonstrating exciting results in a small, preliminary, double-blind, placebo-controlled randomized trial. Blueberries increase a substance called nitric oxide, which helps blood vessels relax, reducing blood pressure.

The results of another study showed that girls who consumed higher levels of potassium-rich foods had a significant reduction in both systolic and diastolic blood pressure (11). The highest group consumed at least 2,400 mg of potassium daily, whereas the lowest group consumed less than 1,800 mg. The girls were 9 and 10 years old and were followed for a 10-year duration. Though the absolute change was not large, the baseline blood pressure was already optimal for both groups, so it is impressive to see a significant change.

In conclusion, nighttime can be scary for high blood pressure and its cardiovascular complications, but lifestyle modifications, such as taking antihypertensive medications at night and making dietary changes, can have a big impact in altering these serious risks.

References: (1) Health Stat Report 2011. (2) CDC.gov. (3) Diabetes Care 2011;34 Suppl 2:S308-312. (4) uptodate.com. (5) BMC Fam Pract 2015;16(26). (6) J Am Coll Cardiol 2015;65(4):327-335. (7) J Am Coll Cardiol 2015;65(4):327-335. (8) Eur Heart J 2015;35(46):3304-3312. (9) J Am Soc Nephrol 2011 Dec;22(12):2313-2321. (10) J Acad Nutr Diet 2015;115(3):369-377. (11) JAMA Pediatr online April 27, 2015.

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.

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Paris

Meet Paris!

Ooh La La! This pretty girl is Paris, a 6½ years young Shepherd mix. Super adorable and friendly, Paris was rescued from a Texas kill shelter and was transported to Kent Animal Shelter for a second chance at a wonderful life with a new family! She gets along well with other dogs and children and 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 Paris and other adoptable pets at Kent, please call 631-727-5731 or visit www.kentanimalshelter.com.

Update: Paris has been adopted!

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'Grateful' by Lana Ballot

By Irene Ruddock

Lana Ballot, a signature member of the Pastel Society of America is known for her stunning seascapes and coastal scenes, one of which just won first place (‘Grateful’) in The Art Guild of Port Washington Juried Exhibition “America.” Here, she shares her views on her art with us.

What is your heritage and how has it affected your art?

Lana Ballot

I was born in Siberia, Russia, but most of my childhood was spent in Kyrgyzstan, in the south of the former Soviet Union. We lived near a resort area with a large beautiful lake (the second largest mountain lake in the world), beaches and distant mountain views. I remember watching how the lake changes colors depending on the weather, or how the setting sun colors the mountain peaks golden and pink. There I started paying close attention to colors in nature and I’m sure that’s why now, as an artist, I’m so attracted to landscape and seascape as my main subjects.

Where did you study?

It was clear since I was a child that I had some artistic ability, but there were no art schools where we lived. After I came to the United States, I felt that I was given a chance to start over and do what I really love. I enrolled as a studio arts major at Stony Brook and spent years immersed in drawing, painting and learning art history.

Why do you prefer to work with pastels?

‘Sayville Vines’ by Lana Ballot

Pastels are a perfect medium that fits so well in a contemporary lifestyle — it does not require much space or use of any toxic solvents and it’s very portable, which makes it perfect for painting outdoors. Pastels are made of pure powdered pigment that is held together with very little binder, so they have the highest color concentration than any other artist’ medium. The colors in paintings made with pastels will stay brilliant and fresh for centuries!

Where do you teach?

I was fortunate to have been invited to join the group of talented artists teaching at The Atelier at Flowerfield in St. James. Currently, I offer two classes — a studio Pastel Painting class on Tuesday evenings and a Plein Air with Pastels class on Friday mornings. In addition to these ongoing classes, I teach workshops that are usually focused on a specific subject, like Painting Seascapes with Pastels from Aug. 18 to 20. This June, I’m teaching a week-long Plein Air workshop in Tuscany, Italy — a dream destination for a landscape painter!

‘Stony Brook Sunset’ by Lana Ballot

Tell me about your Tuscany workshop. Can people still sign up for it?

Yes, there’s still time to sign up. This is a painting vacation from June 17 to 24. The group will be staying in a villa in Tuscany, near the beautiful town of Cortona, the filming location for the movie “Under the Tuscan Sun.” Learning in a relaxed atmosphere in a gorgeous setting, while enjoying Italian food and wine will be a wonderful experience.

Do you have a favorite place to paint on Long Island?

Smith Point Beach in Shirley and Cedar Beach in Mount Sinai are my go-to places for seascapes and coastal subjects. It does not matter how many times I’ve walked through the dunes or by the water, I’ll find something new and exciting, because the light is never quite the same. I’m also fortunate to live near the beautiful village of Stony Brook, where I’ve painted in different seasons and weather, and where I’m bringing my plein air students during this spring semester.

Why do you like painting en plein air?

There’s no substitute for learning about color for a landscape artist than to paint outside en plein air. Besides, it’s just great to be immersed in my subject, with all senses engaged.

‘Snow in Cedar Beach Dunes’ by Lana Ballot

Who is your favorite artist?

[John Singer] Sargent is one of the biggest influences on my work for his sense of color and expressive brushwork.

If you had to choose one word to describe your art, what would that be?

Color! That is what most people would mention when they speak about my work. It’s also the brilliant color that is found in, and is so special about, my preferred painting medium — pastels.

Where can we see your work and learn more about your teaching and the workshops?

Visit my website at www.lanaballot.com or call me at 262-347-1176. You may also register for my classes or workshops at The Atelier in St. James by calling 631-250-9009 or by visiting their website, www.atelieratflowerfield.org.

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Mediterranean Diet
Can we overcome our genes?

By David Dunaief, M.D.

Dr. David Dunaief

We have made great strides in the fight against heart disease, yet it remains the number one cause of death in the United States. Approximately one-third of Americans over the age of 35 will die of heart disease (1). I hope this statistic has captured your attention, because it should. What is causing or contributing to such high numbers of heart disease deaths: genetics, environment or both? Many of us have the propensity toward heart disease. Can we alter this course, or is it our destiny?

A 2013 study, involving the Paleo-type diet and other ancient diets, suggests that there is a significant genetic component to cardiovascular disease, while another study looking at the Mediterranean-type diet implies that we may be able to reduce risk factors greatly. Most of the risk factors for heart disease, such as high blood pressure, high cholesterol, sedentary lifestyle, diabetes, smoking and obesity are modifiable (2). Let’s look at the evidence.

Genetic components

In a study published online in The Lancet, researchers used computed tomography scans to look at 137 mummies from ancient times across the world, including Egypt, Peru, the Aleutian Islands and Southwestern America (3). The cultures were diverse, including hunter-gatherers (consumers of a Paleo-type diet), farmer-gatherers and solely farmers. Their diets were not vegetarian but rather involved significant amounts of animal protein: fish and/or cattle.

Researchers found that one-third of these mummies had atherosclerosis (plaques in the arteries), which is a precursor to heart disease. The ratio should sound familiar. It seems to coordinate with modern times.

Interestingly, but not surprisingly, the average age of death was 43. The authors concluded that atherosclerosis could be part of the aging process in humans. In other words, it may be a result of our genes. Being human, we all have a genetic propensity toward atherosclerosis and heart disease — some more than others — but many of us can reduce our risk factors significantly.

I am not saying that the Paleo-type diet specifically is not beneficial compared to the standard American diet. Rather, that we do not know it based on this study, which was not meant to provide the validity of the Paleo-type diet, but whether atherosclerosis is part of the normal aging process. However, other studies demonstrate that we can reduce our chances of getting heart disease with lifestyle changes, potentially by following a Mediterranean-type diet with an emphasis on a plant-rich approach.

Mediterranean-type diet

A study about the Mediterranean-type diet and its potential positive impact on cardiovascular disease risk was published in the New England Journal of Medicine (4). Here, two variations on the Mediterranean-type diet were compared to a low-fat diet. People were randomly assigned to three different groups. The two Mediterranean-type diet groups both showed about a 30 percent reduction in the risk of cardiovascular disease, with end points including heart attacks, strokes and mortality, compared to the low-fat diet. This improvement in risk profile occurred even though there was no significant weight loss.

The Mediterranean-type diets both consisted of significant amounts of fruits, vegetables, nuts, beans, fish, olive oil and potentially wine. I call them “the Mediterranean diet with opulence,” because both groups consuming this diet had either significant amount of nuts or olive oil and/or wine. If the participants in the Mediterranean diet groups drank wine, they were encouraged to drink at least one glass a day.

The study included three groups: a Mediterranean diet supplemented with mixed nuts (almonds, hazelnuts or walnuts), a Mediterranean diet supplemented with extra virgin olive oil (at least four tablespoons a day) and a low-fat control diet. The patient population included over 7,000 participants in Spain at high risk for cardiovascular disease. The high-risk population included those with high blood pressure (80 percent of the population), diabetes and those who were overweight and/or were smokers.

The strength of this study, beyond its high-risk population and its large size, was that it was a randomized clinical trial, the gold standard of trials. However, there was a significant flaw, and the results need to be tempered. The group assigned to the low-fat diet was not, in fact, able to maintain this diet throughout the study. Therefore, it really became a comparison between variations on the Mediterranean diet and the standard American diet.

What do the leaders in the field of cardiovascular disease and integrative medicine think of the Mediterranean diet study? Interestingly there are two diametrically opposed opinions, split by field. You may be surprised by which group liked it and which did not. Cardiologists hailed the study as a great achievement. They included Henry Black, M.D., who specializes in high blood pressure, and Eric Topol, M.D. They emphasized that now there is a large RCT measuring clinical outcomes, such as heart attacks, stroke and death.

On the other hand, the integrative medicine physicians, Caldwell Esselstyn, M.D., and Dean Ornish, M.D., both of whom stress a plant-rich diet that may be significantly more nutrient dense than the Mediterranean diet in the study, expressed disappointment with the results. They feel that heart disease and its risk factors can be reversed, not just reduced. Both clinicians have published small, well-designed studies showing significant benefits from plant-based diets (5, 6). Ornish actually showed a reversal of atherosclerosis in one of his studies (7).

So which group of physicians is correct about the Mediterranean diet? Each opinion has its merits. The cardiologists’ enthusiasm is warranted, because a Mediterranean diet, even one of “opulence,” will appeal to more participants, who will then realize the benefits. However, those who follow a more strict diet, with greater amounts of nutrient-dense foods, will potentially see a reversal in heart disease, minimizing risk — and not just reducing it.

Thus, even with a genetic proclivity toward cardiovascular disease, we can very much alter our destinies. The degree depends on the willingness of the participants. Potentially, we can have an impact that ranges from reduction to reversal.

References: (1) Circulation. 2008;117(4):e25. (2) www.uptodate.com. (3) The Lancet. 2013;Mar 11. (4) N Engl J Med. Online 2013;Feb 25. (5) J Fam Pract. 1995;41(6):560-568. (6) Am J Cardiol. 2011;108:498-507. (7) JAMA. 1998 Dec 16;280(23):2001-2007.

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.

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Lemon Souffle

By Barbara Beltrami

Well into my cooking years, the idea of making a soufflé had always terrified me. I don’t remember when but at some point I learned that the famous dish with the reputation of being a success standard for any real cook originated in France in the early 18th century. I do remember being astounded. Really? The early 1700s?

So I decided right then and there that if they could make soufflés way back then with relatively primitive implements and heat, surely, armed with my electric mixer and oven and my trusty “New York Times Cook Book,” so could I. Hey, it was just some beaten eggs with a few other ingredients added, right?

I started with a cheese soufflé, then as I gained courage and confidence, I experimented with other recipes. That is not to say that I didn’t have some real flops along the way, but when those soufflés came out of the oven looking and tasting like the real thing, I couldn’t have been prouder. Here are the recipes that worked for me.

Cheese Soufflé

Cheese Souffle

YIELD: 4 small or 2 large servings

INGREDIENTS:

3 tablespoons butter

3 tablespoons flour

1 cup milk

¾ cup shredded cheddar cheese

3 eggs, separated

Salt and freshly ground pepper, to taste

DIRECTIONS: Preheat oven to 375 F. Lightly butter a 7-inch soufflé dish. In a saucepan melt butter, then add flour and stir with a wire whisk until thoroughly blended. In another saucepan bring milk to a boil and, stirring vigorously, add all at once to flour mixture. Stir in cheese. Beat egg yolks, then once the cheese has melted, add a little of the hot mixture to them; mix and, stirring constantly, return slowly to the saucepan. Beat the egg whites until stiff and gently but thoroughly fold them into the cheese mixture. Pour mixture into soufflé dish and bake until fairly firm, about 30 to 45 minutes. Serve immediately.

Lemon Soufflé

Lemon Souffle

YIELD: Makes 6 servings

INGREDIENTS:

4 eggs, separated

¼ cup hot water

1 cup sugar

½ teaspoon salt

2 teaspoons lemon zest

¼ cup freshly squeezed lemon juice

DIRECTIONS: Preheat oven to 350 F. Butter bottom and sides of one-and-a-half quart soufflé dish and sprinkle with sugar. Beat yolks until thick; gradually add hot water and continue beating with a wire whisk. Beating thoroughly after each addition, gradually add sugar. Add salt, lemon zest and juice and fold in stiffly beaten egg whites. Turn into soufflé dish and place dish in a pan of hot water. Bake 30 to 45 minutes, until golden and fairly firm. Serve immediately.

Chocolate Soufflé

Chocolate Souffle

YIELD: Makes 6 servings

INGREDIENTS:

2 tablespoons butter

2 tablespoons flour

¾ cup milk

Pinch salt

2 ounces unsweetened chocolate

1/3 cup sugar

2 tablespoons cold strong coffee

½ teaspoon vanilla extract

3 egg yolks, lightly beaten

4 egg whites, stiffly beaten

DIRECTIONS: Preheat oven to 375 F. Butter a two-quart soufflé dish, then sprinkle bottom and sides with sugar. In a saucepan melt butter, add flour and stir with a wire whisk until blended. In another saucepan, bring milk to a boil and, stirring vigorously with the wire whisk, add all at once to the butter-flour mixture; add salt. In a double boiler with the water hot, but not boiling, melt the chocolate with the sugar and the coffee; stir into sauce, add vanilla and beat in egg yolks, one at a time. Cool, then fold in beaten egg whites and turn mixture into soufflé dish. Bake 30 to 45 minutes, until puffy and brown. Serve immediately.

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Irises come in a variety of colors including these bearded varieties. Photo by Ellen Barcel

By Ellen Barcel

The catalogs have started to arrive — select the bulbs you want to grow next spring but need to plant this fall. So, place your advanced order now. One of the plants you may enjoy in future gardens are irises.

There are hundreds of species of irises. The name comes from Greek, meaning rainbow, although the most commonly seen irises are in shades of purple. Irises are perennial plants growing from rhizomes that do well, in general, in U.S.D.A. zones 5 through 9 (Long Island is zone 7). Check the directions that come with each package, however, as different varieties can have different requirements.

One of the interesting features of irises is how their bloom time varies, by species, from early spring through summer and even into early fall. So, select the varieties you want based not only on color but on when you want to see flowers. Irises that bloom early will generally go dormant in the heat of summer. Iris rhizomes are usually available in nurseries for fall planting.

Above, Dutch iris with some scattered orange poppies. Photo by Ellen Barcel

Once established, the plant’s rhizomes spread, resulting in a larger and larger patch of flowers each year. Seed pods form after the flowers have faded. Yes, in some cases you can grow new plants from the seeds, but sometimes the flowers are sterile. You can also remove the seed pods when they start to form in order to direct the plant’s energy into the plant itself. As with all bulbs, do not cut the greenery off after the flowers have faded. This greenery is feeding the rhizomes for next year’s flowers.

Since this plant spreads by itself, you may find that you need to divide the clump periodically. Rule of thumb is to divide spring flowering plants in the fall. As with most very showy flowering plants, Irises grow best in full sun but will tolerate light shade. A soil pH that is slightly acidic to neutral (6.8 to 7) is ideal. That means for most of us, we need to add lime to the soil. Test yours to be sure. Irises are deer resistant, but no plant is deer proof if the critters are really hungry.

If you cut some of the darker flowers, check the bouquet every day to see if the flowers are wilting. Once that happens you may see drops of a purple liquid dripping from the flowers. Yes, irises were used as a natural dye before the industrial revolution and the introduction of modern dyes.

Some of the most commonly seen irises include:

· Bearded iris (Iris × germanica) has the largest flowers with a “beard,” a hairlike structure on the petals. Most will bloom in late spring to early summer (but can vary depending on variety and weather). They usually reach a height of about 3 feet tall and are two toned. For example, ‘Pirate Ahoy’ is yellow with deep purple, ‘Stairway to Heaven’ has ruffled white and medium blue petals and ‘Ocelot’ is peach and maroon.

· Reblooming bearded iris (I. germanica) blooms in midspring and then again in late summer or early fall. They, too, come in a wide variety of color combinations.

The Yellow Iris aka Iris pseudacorus is an invasive species growing in a local pond on Long Island. Photo by Ellen Barcel

· Dutch iris (I.× hollandica) does not have the “beard” of I. germanica and the petals tend to be narrower. The plants reach about 2 feet tall. They bloom in late spring to early summer and generally are two toned, various combinations of purple and yellow.

· Orchid iris (I. reticulate) is a dwarf plant reaching just 5 or 6 inches high. This Canadian cultivar blooms in early spring and has white and purple flowers with a touch of yellow. These are really cute little flowers.

· Yellow iris (I. pseudacorus) is native to Europe and Asia. It was used to control water pollution but has become invasive in some areas including ours, so this iris is on Suffolk County’s Do Not Sell List and is not available here and should not be propagated if you see it growing.

For more information, visit the American Iris Society website at www.irises.org.

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension and its Master Gardener program, call 631-727-7850.

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Father Frank with Bill Reitzig Sr. at the Hope Walk for Addiction in Mount Sinai. Photo by Kevin Redding
Fr. Francis Pizzarelli

The political rhetoric is deplorable. International tensions are at an all-time high. Social chaos seems to rain everywhere. Despite this contentious landscape, there are still courageous men and women among us that are doing extraordinary things to make our community a better place to live.

On Saturday, April 22,, on the first anniversary of their son’s death due to a heroin overdose, a Miller Place family led the first Hope Walk for Addiction at Cedar Beach in Mount Sinai. More than 600 people gathered on that Saturday morning to celebrate the belief that miracles do happen and hope does live!

What was so impressive about that morning is that it brought the young, the old, the rich and the poor, the religious and not so religious together. This national health crisis does not know a particular profile. This epidemic is infecting families everywhere; no one is exempt.

The Reitzig family was the prime movers behind this day of hope. The Town of Brookhaven and Hope House Ministries were the co-sponsors of this life-giving event. Billy Reitzig was 25 years old when he passed. He was born into a loving family. As a family, they were really connected to each other. Like many young men his age, he had his struggles but was getting help. He used heroin only once and lost his life. He was bright, good-looking and had a great job. He was well-liked in the workplace and in the neighborhood where he grew up. Unfortunately, the affliction of addiction had its death hold on him.

Every parent’s nightmare is to bury a child. To lose a son to the heroin epidemic is beyond words. His parents would have been justified because of their unbearable loss and grief to have withdrawn quietly and suffered with their pain and profound loss in silence. Instead of withdrawing, they decided to celebrate their son’s life by becoming activists in educating and raising public awareness about this horrific national health crisis. To honor their son’s memory, they have aggressively been raising awareness and raising money for desperately needed long-term treatment beds, which are in short supply.

Countless families came wearing T-shirts; honoring their sons and daughters who have senselessly been lost to this infectious epidemic. Those who spoke that morning were challenging, inspirational and people filled with a renewed sense of hope. Supervisor Ed Romaine (R), Councilwoman Jane Bonner (C-Rocky Point) who were co-sponsors, Legislator Sarah Anker (D-Mount Sinai) as well as a number of other elected officials made an appearance to show their support.

In mid-April Governor Andrew Cuomo (D) announced that millions of dollars are being allocated to provide treatment for those suffering from addiction. The more important question is when are the RFPs (requests for proposal) going to be released for that important money? Will government streamline the regulations so that that money can be utilized sooner rather than later? Treatment beds are needed ASAP!

Enough with the passive lip service alleging support; we need aggressive action yesterday. By the time you read this column, I will have buried another 25-year-old young man from Miller Place with untapped potential and possibility due to the heroin epidemic.

In addition to our urgent need for long-term treatment beds, we need extensive, comprehensive prevention education and treatment resources to support the growing number of families being infected by this horrific epidemic.

Bill Reitzig Sr. and his family are an inspiration to all who are struggling with the burden of addiction. Despite their pain and profound loss, they are beacons of hope within our community that this epidemic will end one day and the day will come when parents will not bury their children anymore due to this devastating affliction.

Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

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Patricia Wright speaks at the Earth Optimism Summit in April. Photo by Ronda Ann Gregorio

By Daniel Dunaief

Determined to share success stories instead of doom and gloom, Nancy Knowlton, the Sant Chair of Marine Science at the Smithsonian Institution’s National Museum of Natural History, decided to change the tone of the conservation dialog.

Knowlton organized the first Earth Optimism Summit around the most recent Earth Day this April. She searched for speakers who could share their progress and blueprints for success. That included Patricia Wright, a Stony Brook University distinguished professor who has developed an impressive legacy during her 25 years in Madagascar.

Nancy Knowlton, organizer of the first Earth Optimism Summit in April. Photo by Ronda Ann Gregorio

In Madagascar, the 10th poorest country on Earth, optimism has been growing, perhaps even more rapidly than the 1,000 endemic trees that have been making a comeback in the island nation off the southeast coast of Africa. The growth of those trees has encouraged the return of animals that had retreated from an area thinned out by selective logging.

“This year, the rare and furtive bird, the scaly ground roller, came back and nested,” Wright reported. The “black and white ruffed lemur gave the area the thumbs up and reestablished territories and reproduced.”

The critically endangered golden bamboo lemur also doubled the size of its population. “The forest took 25 years to recover, but it can recover,” Wright said in her speech. Dedicated to the study of lemurs, Wright in 1991 helped create Ranomafana National Park, which is the third largest park in Madagascar. She served as a plenary speaker for a gathering that drew over 1,400 people to Washington. Scientists and policymakers held sister summits in nine other countries at the same time.

“You can’t possibly make progress in conservation if you only talk about the problems,” said Knowlton, a co-host of the summit. Knowlton knew Wright from serving on the Committee for Research and Exploration, where the two interacted six times a year. When she was putting together the list of speakers, Knowlton approached the 2014 winner of the Indianapolis Zoo Prize to see if she could share a positive message in conservation.

When Wright accepted, Knowlton was “thrilled, not only because she’s a good storyteller, but because she’s also done incredibly important work in Madagascar.” Indeed, Wright said national parks have greatly expanded from only two in the 1980s. “Now with the work of many dedicated environmentalists, including the enlightened policy of the U.S. government through USAID, we have 18 National Parks and a National Park Service to manage and protect them,” she told the session.

Restoring trees to the area also offers economic opportunity, Wright said. Under the endemic trees, farmers can grow crops like vanilla, chocolate, cinnamon and wild pepper, she said. “All these products can be marketed for high prices. We will take back that land and make it productive again, doubling or tripling its value,” Wright continued.

A scientist featured in the 2014 film “Island of Lemurs: Madagascar,” Wright has engaged in a wide range of efforts on behalf of the Malagasy. Last year, she negotiated with a mayor on the island to pick up trash in exchange for the purchase of several wheelbarrows. She also helped encourage the renovation of 35 schools in communities around Ranomafana, where students learn critical thinking and molecular biology. This, Wright said, is occurring in a country where three out of five students don’t remain in school past fifth grade. “More children in this region are graduating from high school and over a handful have received university degrees,” she explained.

A health team also walks to 50 nearby villages, carrying medicines and basic health lessons. SBU brought drones last year, which can fly medicines as far as 40 miles away. Drones could monitor the outbreak of any unknown and potentially dangerous disease and can offer health care for people who live in ares that are inaccessible by road.

The financial support of the National Science Foundation helped create Centre ValBio, a field station and campus in the middle of the rainforest. The research station has modern facilities and equipment to conduct genetics and disease analyses. “We provide tools and training and even fiber-optic cable internet, the fastest in the region,” Wright said. They are expanding the research facilities this year.

Through research efforts, Wright and other scientists have also discovered two new species of lemurs and found two others that were considered extinct. Restoring the national forest not only brought back animals that had retreated into the inner part of the forest, but it also encouraged the growth of ecotourism.

In 1991, there was only one tourist hotel and now there are 32 hotels, providing facilities for the 30,000 tourists. “That can start to change an economy,” Wright suggested. “Cottage industries have developed like the woman’s weaving group and the basket weavers and blacksmiths who all make a good living from selling to tourists and researchers.”

Wright attributes these positive steps to a dedication to working with residents in the area. “We have been successful by training local residents and university students, by listening to what the communities want, rather than what we think is best,” she said.

Knowlton suggested that “you can’t helicopter conservation into a particular place. It’s got to be built from the ground up. She’s done it in Madagascar.” While these are positive steps, Wright declared this is just the beginning. “There are endless possibilities of scientific knowledge and research,” she said. “They all matter and impact our daily lives.”

As for the Earth Optimism Summit, Knowlton said this is just the beginning as well, originally thinking of organizing a second summit in 2020, but may hold the next one sooner. “We’re identifying what’s working and putting a spotlight on it,” Knowlton said. “The feedback has been extraordinarily, unbelievably positive. We’ve come to realize that people are demanding” another conference.

She appreciated Wright’s contribution to April’s conference.“By sharing her successes, Pat Wright brings home the message that if she can do it, so can we all,” Knowlton said. “The summit succeeded because Wright and over 240 other speakers made it obvious, through the successes that they shared, that solving the environmental problems we face is not out of reach.”

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By Nancy Burner, ESQ.

Nancy Burner, Esq.

Most veterans are not aware of the wide range of benefits they may be entitled to under the United States Department of Veterans Affairs even if they did not directly retire from the military or suffer injuries in the line of duty.

For example, there is a benefit referred to as the improved pension through the Department of Veteran’s Affairs (VA), more commonly referred to as Aid and Attendance Pension (A&A). Assuming you meet the eligibility requirements, the VA permits payments to caregivers (including family members, but not spouses) for care provided to the veteran and/or the spouse.

This benefit is also commonly used for veterans and/or their surviving spouses who reside in an assisted living facility. This monthly benefit can be used along with income in order to prevent the depletion of assets for care services. There are three main requirements to qualifying for Aid and Attendance.

First, the claimant must have served at least 90 days active duty with one day served during wartime. There are specific wartime periods: World War II (Dec. 7, 1941 – Dec. 31, 1946); Korean conflict (June 27, 1950 – Jan. 31, 1955); Vietnam era (Feb. 28, 1961 – May 7, 1975, for veterans who served in the Republic of Vietnam during that period; otherwise Aug. 5, 1964 – May 7, 1975); or Persian Gulf War (Aug. 2, 1990 – through a future date to be set by law or presidential proclamation as well as current Iraq and Afghanistan war veterans). The claimant must have received a military discharge “other than dishonorable.”

Second, the claimant must be declared permanently and totally disabled. The definition for “permanently and total disability” is residing in a nursing home, total blindness, or so nearly blind or significantly disabled as to need or require the regular aid and attendance of another person to complete his or her daily activities. In most circumstances, if the claimant can show he or she requires assistance with at least two activities of daily living (e.g., bathing, dressing, ambulating), the disability requirement is satisfied.

Third and final, the claimant must meet the financial means test. Unfortunately, there is no set financial standard, which can make it very difficult to ascertain if the claimant qualifies for the benefit. As a general rule, the claimant should not have more than $50,000 to $80,000 in net worth excluding the home of the claimant.

Additionally, the claimant must make a showing that his or her monthly unreimbursed medical expenses exceed his or her monthly income. When making this determination, the claimant should add up all of his or her monthly medical costs, including but not limited to the cost of services provided by professional caregivers as well as family members and rent paid to an assisted living facility.

Once all three prongs are satisfied, the veterans and/or spouse can receive this pension. The maximum benefit available for a single veteran in 2017 is $1,794 per month. A widow of a veteran is eligible for a maximum benefit of $1,153 per month in 2017. A married veteran is eligible for $2,127 per month in 2017. A veteran couple is eligible for $2,841 per month in 2017.

It is imperative to understand that currently there is no look-back period for VA planning, which makes asset eligibility and planning possible in most cases. There is planning that can be done in order to qualify the veteran or the surviving spouse for this benefit.

The application process can be lengthy, but the claimant can always seek help from a local accredited VA attorney or through the United States Veteran’s Services Agency, Human Services Division. If the benefits are denied, applicants should be aware that the decision for these claims can be appealed by the veteran and/or the surviving spouse.

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

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Above, a harvested horseradish root

By Ellen Barcel

Horseradish should be planted at the end of April or beginning of May to be harvested the following late fall.

It’s time to plan and plant your herb garden, a garden filled with plants used to provide flavoring for a wide variety of dishes. I particularly like horseradish (Armoracia rusticana) so am planning to grow a bit this year.

How does one use horseradish? My father loved roast beef with horseradish spread on it, whether it be on hot roast beef just out of the oven or on a cold sandwich. I once had a great chicken dish served in a resort where the chicken was baked covered with a thin layer of horseradish.

Several companies also make a cheddar flavored with horseradish. I used to be able to find a hummus with horseradish. Now, if I want it, I need to mix my own horseradish with the hummus. I’ve seen a great recipe for a cream sauce flavored with horseradish. So, basically, horseradish can be used as a flavoring for almost any savory dish if you like its strong taste.

According to the Horseradish Information Council, it has been used as far back as 1500 B.C. by the Egyptians. Since horseradish is hot, one or maybe two plants at the most are usually enough for a family, unless you and your friends and relatives really love the taste. You can buy crowns from a nursery or even use a root from the supermarket.

The horseradish plant can be planted in a pot to keep it from spreading.

Horseradish can be grown in the ground or in pots. Personally, I prefer to raise my herbs in pots or in window boxes. Plants in pots are less likely to be strangled by nearby plants and less likely to spread into other plants, taking over my garden (as horseradish and plants like mints can do). Also, I control the soil — I usually use a good-quality potting soil.

Plant your horseradish at the end of April or beginning of May, depending on weather and then harvest the following late fall (after a hard frost for the hottest flavor), winter or early spring, making sure you keep a few pieces of root in the soil for the following year’s harvest since horseradish is a perennial plant. It does well in U.S.D.A. zones 4 to 7 (Long Island is zone 7) and requires little care. If you decide you don’t want to grow horseradish next year, make sure you remove all the sections of roots or it will regrow.

Horseradish grows in a wide variety of conditions but does require a rich soil, so add a generous amount of compost to the soil. Like most herbs, it grows best in sun but will tolerate light shade. Long Island’s soil is very acidic (test yours), but horseradish prefers a soil near neutral (a pH of 7). This means you need to use a good-quality potting soil if growing it in a container or add lime to your garden soil if growing in the ground. Water the plants once a week as long as there is some rain, more in drought conditions, but make sure that you don’t overwater them. They like moist but not soggy soil. If you decide to add fertilizer, do it only once in spring — personally I prefer to add more compost.

Store the harvested roots in the fridge. When ready to use, peel and then grate the harvested roots, add a dash of salt and cover with vinegar and store in your fridge for future use. I’ve read that a bit of sugar added to the mixture will cut the hot flavor. Remember that a little horseradish goes a long way. For more recipes and uses visit the Horseradish Information Council website at www.horseradish.org.

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension and its Master Gardener program, call 631-727-7850.

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