Community gathers at the Old First Church in Huntington to celebrate those who have conquered addiction and remembering those who have been lost.
The Town of Huntington Opioid and Addiction Task Force invited residents to join a special program Oct. 28 at the Old First Presbyterian Church in Huntington celebrating those who have conquered addiction and remembering those who have been lost.
The program, “A Recovery Event: Celebrating Hope in Huntington,” featured first-hand accounts from those who have conquered addiction, information about local prevention, treatment and recovery programs, and a stirring performance by the Old First Church Sanctuary Choir.Sharon Richmond shared her story about her son Vincent.The ceremony was dedicated to his honor. (See page A5 for her story.)
“Huntington, like every other community in America, has been hit hard by the opioid crisis,” said Huntington Councilman Mark Cuthbertson (D), who sponsored the program with the task force. “We created this event to show that there is a cause for hope and that in fact that there are thousands of local residents who have found a path to recovery,”
The event drew more than 100 people to the Old First Church. A highlight of the evening was a candlelight circle to celebrate, honor and remember those who were lost as a result of their addiction.
Created by a town board resolution in December 2017, the Opioid and Addiction Task Force includes local health care professionals, educators and community leaders. It works to unify, support and strengthen prevention, treatment and recovery efforts within the town. Its goals include reducing the incidence of substance abuse, promoting timely access to care for consumers and their families, creating environments conducive to recovery and reducing the stigma associated with substance use disorders.
“Many of our families have been greatly affected — their lives changed forever after losing a loved one to addiction,” Cuthbertson said. “We know that substance abuse is preventable, addiction is treatable and recovery works.”
The town is hanging resource information posters around town.
“Somebody is waiting for you to come to them,” said Stephen Donnelly, who has sponsored different opioid services in the past. He encourages people to ask people impacted:“How can I help you?”
For Treatment Referral List contact the 24/7 hotline 631-979-1700. Help is a phone call away.
Sharon Richmond poses with her son Vincent D'Antoni in Battery Park on Mother’s Day 2016. “One day society will look back at this time period and think what a terrible atrocity we allowed to happen to our most vulnerable children,“ Richmond said. Photo by Sharon Richmond
I am educator, an advocate and most importantly a parent who lost her only child to the disease of addiction. Unfortunately, I know I am not alone. The truth is: I stand with more than 72,000 other parents who grieve the loss of their child to an overdose.
When I speak publicly about addiction issues and look out at people, I see a small piece of me. When I look at your child, I see the beautiful potential of what could have been my child. If only mental health and the disease of addiction had the same basic human right to health care as other illnesses. I hope that by sharing my son’s story, I can create a future where all people are treated equally, no matter their ability or disability.
My son Vincent was sensitive, kind, funny and insightful. He was popular, played almost every sport, and his teachers always said he brought conversations to the next level and stood up for those who couldn’t stand up for themselves. I will always stand tall and be proud of the person my son was.
The one thing that most people never knew was that, no matter how hard he tried, Vincent still battled with serious mental health issues: ADHD, trichotillomania (hair-pulling disorder), anxiety and low self-esteem, which eventually led to a deep depression. Even though Vincent had a family that absolutely adored him and everyone he met thought he was handsome, smart and funny, Vincent … never saw himself that way. Children need to be taught how to communicate and be given a variety of strategies to cope in today’s world. We have to work together. It needs to be at the family, school and community level.
Vincent started smoking marijuana in high school. Toward the end of my son’s life, he shared that “pot” had been his gateway drug to stronger drugs. After high school, he was hanging around with a different crowd. During college, his “A” grades started to falter. Then, he lost his job. Something wasn’t right. I searched his room and found what I feared most: Oxycodone had become Vincent’s drug of choice. We had heated discussions that oxycodone was extremely dangerous and addictive. He would show me research that denied it. As we all know, powerful companies can find ways around the law and can state just about anything they want and get away with it.
The oxycodone amplified my son’s anxiety and depression. He began to isolate himself. He could hardly get himself to go to work or even out of the house. Vincent tried to self-detox and get drug free on his own, failing several times.
Finally, Vincent agreed his addiction was out of his control. I had so much hope he was going to get the treatment he desperately needed. Over the course of just one year, prior to my son passing away, he would get denied by the insurance company over four times!
The insurance company stated he didn’t fit “medical necessity.” First, he had supportive parents. Second, he was motivated to get better. By the third denial, I filed a complaint with the attorney general’s office. They were able to get my son 14 days. 14 days … is such a short time to physically and emotionally overcome addiction, and certainly not enough time for Vincent. My son came out and soon relapsed. This time to heroin.
After battling with the insurance company for months, they finally approved my son. Regrettably, unbeknownst to us, insurance companies are allowed to back-deny services within 30 days of approval. After detox and 14 days, my son was back-denied, stating he had no other mental health illnesses, was highly motivated to get better, and had a supportive family. He was crying that he needed more time. He was extremely anxious and severely depressed. They placed Vincent on anti-anxiety and anti-depression medication, even though my son was denied treatment due to not having any mental health illnesses.
My son was trying to get better. He went to out-patient almost every day, met weekly with his counselor, and attended meetings at night.
In the next few weeks, Vincent stayed drug free … he was beginning to be himself again. However, without getting the services he desperately needed and deserved, my son relapsed and bought drugs unknowingly laced with the deadly drug fentanyl. My son Vincent had no chance. I lost my shiny star, my beautiful son, Vincent on Sept. 13, 2017. Last month would have been his 28th birthday.
Vincent’s battle is one like too many others. In his honor, I advocate for change. He had so many barriers making it so difficult to get the help he needed: whether it be getting denied Suboxone for detox, incorrect information to determine appropriate services, or getting the Vivitrol shot to help prevent relapse. No one should ever have to fight so hard for the basic human right to health care.
Insurance companies need to be held accountable. They need to cross reference information for accuracy prior to denying inpatient treatment. They need to comply with the Mental Health Parity and Addiction Equity Act. Federal law states that anyone with a mental health illness or the disease of addiction should get the same basic human rights to healthcare as those who have regular medical conditions.
I couldn’t imagine if my son or anyone’s child had a regular health disease such as diabetes, a heart condition or cancer that they would get denied the medical care they needed, if they had a supportive family and were motivated to get better.
Over 200 loved ones die from an overdose every single day. We don’t have the luxury of time. In order to create any meaningful change, we need you to be a part of making a difference in our community. Your voice needs to be heard. It is so powerful and very important. If you truly want to see change … Reach out to your local and state representatives, ask them what their action plan is, and hold them accountable. Let them know how important it is for you and your children to have a future where everyone has the same right to get the care they need to be healthy.
It is my hope that by sharing my son’s story, I can raise awareness, encourage the importance of communication, education and most importantly equality for basic human right to healthcare.
Sharon Richmond lives in Northport and is part of the Town of Huntington’s Opioid Task Force. She is also a member of the Northport-East Northport Drug and Alcohol Task Force. She works closely with F.I.S.T (Families In Support of Treatment), LICADD (Long Island Council on Alcoholism and Drug Dependence), FCA (Family and Children’s Association),the North Shore CASA (Coalition Against Substance Abuse) and Nassau County Heroin Prevention Task Force. She is a teacher at North Shore Schools in Nassau County.
Local officials and health professional are urging residents to get this year's flu shot. Stock photo
By Saul Hymes, M.D.
Dr. Saul Hymes
Make sure you and your loved ones are ready for the flu season by getting vaccinated. While the best time to get vaccinated is October or November, you can get vaccinated before the flu season and even in December or later. We don’t yet know what type of season we will encounter, so it’s better to be safe than sorry.
Cold or flu: How can you tell?
Influenza, or the flu, is a contagious respiratory illness caused by influenza viruses and tends to be more severe than a cold. A cold is caused by a different virus and has milder symptoms. People with the flu will usually have fever, muscle aches and more fatigue.
The flu can also cause very severe complications including pneumonia and can lead to hospitalization and death. More mild cases may be indistinguishable from a cold and the duration can be the same (about 5-7 days). There may be times when you’re uncertain if you have the flu or a cold, so it’s good to know that there’s a test to diagnose the influenza virus, which most doctors’ offices and ERs are able to perform.
Treating the flu vs. a cold
Both are treated with rest and lots of fluids, while the pain and fever associated with either can be treated with medicines like acetaminophen and ibuprofen. Influenza may also be treated with a direct antiviral medication, Tamiflu. However, depending on risk factors and the person’s age, not all people with influenza need Tamiflu. This should be discussed with your physician.
Who is at risk?
People who are over the age of 65, adults and children with conditions like asthma, diabetes, heart disease and kidney disease need to get a flu shot. Pregnant women and people who live in facilities like nursing homes are also encouraged to get a flu shot. In fact, the Centers for Disease Control and Prevention recommends that everyone six months of age and older should get their yearly flu vaccine. There are documented benefits from this, including reductions in illnesses, related doctors’ visits and missed work or school. Even an imperfect vaccination can contribute to fewer hospitalizations and deaths from influenza.
Dispelling the myths
Some people think that the flu shot can cause the flu. Not true. While some people get a little soreness or redness where they get the shot, it goes away in a day or two. And the nasal mist flu vaccine might cause nasal congestion, runny nose, sore throat and cough. But the risk of a severe allergic reaction is very rare — it’s less than one in four million.
Others say the flu shot doesn’t work, which is also not true. Most of the time, the flu shot will prevent the flu. In scientific studies, the effectiveness of the flu shot has ranged from 70 to 90 percent when there’s a good match between circulating viruses and those in the vaccine.
Habits that can help
Help keep the flu at bay. Avoid those who are ill. Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, then cough or sneeze into your elbow or shoulder (not into your hands). Wash your hands frequently and thoroughly. Stay home from work if you’re sick. Keep your children out of school and after-school activities if they’re sick.
At Stony Brook University Hospital, we also encourage visitors who may be experiencing symptoms not to visit their loved ones in the hospital until they are healthy.
If you would like to get a flu shot, we can refer you to a provider in your area. Call Stony Brook Medicine’s HealthConnect at 631-444-4000 or visit your physician or local pharmacy.
Dr. Saul Hymes is an assistant professor of clinical pediatrics and specialist in pediatric infectious disease at Stony Brook Children’s Hospital.
Osteoarthritis is a common form of arthritis that often affects the knee. Stock photo
Lifestyle changes may slow progression
Dr. David Dunaief
Osteoarthritis is widespread. Most commonly, it affects the knees, hips and hands. There are three types of treatment: surgery, involving joint replacements of the hips or knees; medications; and nonpharmacologic approaches. The most commonly used first-line medications are acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen. Unfortunately, medications mostly treat the symptoms of pain and inflammation.
However, the primary objectives in treating osteoarthritis should also include improving quality of life, slowing progression of the disease process and reducing its disabling effects (1).
Dairy and milk
When we think of dairy, specifically milk, there are two distinct camps: One believes in the benefits, and the other thinks it may contribute to disease. In this case they both may be at least partly correct. In the Osteoarthritis Initiative study, an observational study of over 2,100 patients, results showed that low-fat (1 percent) and nonfat milk may slow the progression of osteoarthritis (2). The researchers looked specifically at joint space narrowing that occurs in those with affected knee joints. Radiographic imaging changes were used at baseline and then to follow the patients for up to 12 to 48 months for changes. Compared to those who did not drink milk, patients who did saw significantly less narrowing of knee joint space.
Was it a dose-dependent response? Not necessarily. Specifically, those who drank less than three glasses/week and those who drank four to six glasses/week both saw slower progression of joint space narrowing of 0.09 mm. Seven to 10 glasses/week resulted in a 0.12 mm preservation. However, those who drank more than 10 glasses/week saw less beneficial effect, 0.06 mm preservation compared to those who did not drink milk. Interestingly, there was no benefit seen in men or with the consumption of cheese or yogurt.
However, there are significant flaws with this study. First, the patients were only asked about their dietary intake of milk at baseline; therefore their consumption could have changed during the study. Second, there was a recall bias; patients were asked to recall their weekly milk consumption for the previous 12 months before the study began. I don’t know about you, but I can’t recall my intake of specific foods for the last week, let alone for the past year. Third, there could have been confounding factors, such as orange consumption.
Oddly, this was not a dose-response curve, since the most milk consumption had less beneficial effect than lower amounts. Also, why were these effects only seen in women? Finally, researchers could not explain why low-fat or nonfat milk had this potential benefit, but cheese was detrimental and yogurt did not show benefit. We are left with more questions than answers.
Would I recommend consuming low-fat or nonfat milk? Not necessarily, but I may not dissuade osteoarthritis patients from drinking it. There are very few approaches that slow the progression of joint space narrowing.
Vitamin D
Over the last five years or so, the medical community has gone from believing that vitamin D was potentially the solution to many diseases to wondering whether, in some cases, low levels were indicative of disease, but repletion was not a change-maker. Well, in a randomized controlled trial (RCT), the gold standard of studies, vitamin D had no beneficial symptom relief, nor any disease-modifying effects (3). This two-year study of almost 150 men and women raised blood levels of vitamin D on average to 36 ng/ml, which is considered respectable. Researchers used MRI and X-rays to track their results.
Weight
This could not be an article on osteoarthritis if I did not talk about weight. In a study involving 112 obese patients, there was not only a reduction of knee symptoms in those who lost weight, but there was also disease modification, with reduction in the loss of cartilage volume around the medial tibia (4).
On the other hand, those who gained weight saw the inverse effect. A reduction of tibial cartilage is potentially associated with the need for knee replacement. The relationship was almost one-to-one; for every 1 percent of weight lost, there was a 1.2 mm³ preservation of medial tibial cartilage volume, while the exact opposite was true with weight gain.
Exercise and diet
In a study, diet and exercise trumped the effects of diet or exercise alone (5). Patients with osteoarthritis of the knee who lost at least 10 percent of their body weight experienced significant improvements in function and a 50 percent reduction in pain, as well as reduction in inflammation, compared to those who lost 5 to 10 percent and those who lost less than 5 percent. This study was a well-designed, randomized controlled single-blinded study with a duration of 18 months.
Researchers used a biomarker — IL6 — to measure inflammation. The diet and exercise group and the diet-only group lost significantly more weight than the exercise-only group, 23.3 pounds and 19.6 pounds versus 4 pounds. The diet portion consisted of a meal replacement shake for breakfast and lunch and then a vegetable-rich, low-fat dinner. Low-calorie meals replaced the shakes after six months. The exercise regimen included one hour of a combination of weight training and walking with alacrity three times per week.
Therefore, concentrate on lifestyle modifications if you want to see potentially disease-modifying effects. These include both exercise and diet. In terms of low-fat or nonfat milk, while the study had numerous flaws, if you drink milk, you might continue for the sake of osteoarthritis, but stay on the low end of consumption. And remember, the best potential effects shown are with weight loss and with a vegetable-rich diet.
References:
(1) uptodate.com. (2) Arthritis Care Res online. 2014 April 6. (3) JAMA. 2013;309:155-162. (4) Ann Rheum Dis online. 2014 Feb. 11. (5) JAMA. 2013;310:1263-1273.
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.
GoHealth Urgent Care, together with its partner Northwell Health, recently opened a new Northwell Health-GoHealth Urgent Care center to serve the communities of Huntington and Centerport. Located at 241 East Main Street in Huntington, next to the Huntington Crescent Club, the new center offers convenient services such as onsite laboratory and X-rays, electronic medical record integration with Northwell Health, with day/walk-in visits and short wait times, extended hours and are open on weekends and holidays.
“We’re excited that the Huntington and Centerport communities will have another Northwell Health-GoHealth Urgent care center right in their neighborhood,” said Sarah Arora, New York market president. “Our centers provide unmatched customer experience and top-quality urgent care, allowing patients to stay within the Northwell Health network they already know and trust.”
“Northwell Health’s partnership with GoHealth Urgent Care will continue to provide patients with a more personalized and innovative urgent care experience,” said Adam Boll, executive director of Joint Venture Operations at Northwell Health. Call 631-812-2873 for more information.
“Life is like a disco, no matter how the music changes, you just keep on dancing.” The charmed quote is taken from the 2011 movie, Jumping the Broom, and captured the essence of St. Catherine of Siena Hospital’s 8th Annual Pink Ribbon Salute, held on Oct. 2. Each year, the breast cancer survivor event adopts a creative theme to add a layer of fun to the celebration.
This year, the event took on a disco theme — and more than 100 breast cancer survivors showed up in their best Saturday Night Fever attire ready to dance the night away as they triumph, despite the changes cancer may have brought upon their lives.
“It was wonderful to see familiar and new faces in our growing family of courageous women celebrating their fearless determination to overcome,” said St. Catherine’s Administrative Director of Reconstructive Microsurgery Dr. Diana Yoon-Schwartz.
The event was moderated by St. Catherine’s breast health navigator Meiling Alsen, and a special welcome was given by chief nursing officer Mary Jane Finnegan.
“When I look at all of you, I know I am surrounded by strong, courageous women, along with your family members and friends, who have survived or are in the process of surviving a fight that no one should ever have to fight — you truly are my inspiration,” said Finnegan.
The welcome was followed by the latest updates in breast care by St. Catherine’s Medical Director of Breast Health Services Dr. Jana Deitch, who also took the opportunity to address survivors directly. “Tonight is a wonderful night about celebrating women who fight the tough fight every day — you are not only surviving, but thriving and giving back to other women who may need some encouragement on the journey to healing,” said Deitch.
The disco mood was further set with live renditions of the era’s top hits, played by Just Cause Band. The band, originated by attorneys, has grown into a diversified group, born from the love of music and a desire to help the community by supporting charity events at no cost. Thanks to the philanthropic and harmonizing skills of Just Cause Band, survivors and supporters danced and sang all night, and when the rendition of Gloria Gaynor’s “I Will Survive” was played, the room erupted in unified triumph.
“It is a moment I will always remember — it was electrifying and inspiring,” said Deitch.
The Pink Ribbon has become a tradition that survivors and staff look forward to annually. “Our survivors and staff dance the night away in celebration — it is an evening we all cherish, filled with laughter and hope, share with family and friends,” said St. Catherine’s Medical Director of Breast Imaging Dr. Anne Green.
“I’m proud to be a part of an exceptional group of compassionate breast health specialists who service patients from one location in their own community — we are a community that provides the true continuum of care for our patients — so, we will keep on dancing right beside them!”
The Pink Ribbon Salute is supported by St. Catherine of Siena’s senior leadership, and the event was co-sponsored with the support of Suffolk Anesthesia Associates, Genomic Health Inc. Myriad Genetics, New York Cancer Specialists, New Street Plastic Surgery and Square Care.
Exercise, especially endurance-based, can reduce your risk of forming gallstones. Stock photo
Weight and inactivity are among the greatest risk factors
By David Dunaief, M.D.
Dr. David Dunaief
Gallstones affect up to 20 million Americans between the ages of 20 and 74, with a more than two times increased occurrence in women than in men, according to the NHANES III survey (1). There are two types of gallstones, 80 percent of which are cholesterol stones and 20 percent of which are pigment stones.
Common symptoms
Gallstones may be asymptomatic; however, when gallstones block either the cystic or common bile ducts, symptoms occur. Symptoms include dull or crampy abdominal pain that is exacerbated by meals and lasts one to five hours. Jaundice, which includes yellowing of skin and eyes, is another symptom. Others include nausea and vomiting, rapid heart rate, hypotension (low blood pressure) and fever (2).
Tests used for diagnosis
Blood tests include complete blood count, where there may be a rise in white blood cells; liver enzymes; and the pancreatic enzymes lipase and amylase. Diagnostic tests that have more accuracy are the endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiopancreatography (ERCP); however, these are invasive. Less accurate but noninvasive tests include abdominal X-ray, ultrasound and CAT scan (CT). The tests used also depend on where the stone may be located. Hepatobiliary (HIDA) scans are accurate if the stone is located in the cystic duct. And magnetic resonance retrograde cholangiopancreatography (MRCP) is used if the stone is thought to be located in the common bile duct (2).
What are the risk factors?
There are a multitude of risk factors. Some of these are modifiable, others are not. The modifiable ones include obesity, measured by body mass index (BMI); rapid weight loss; fat consumption; hormone replacement therapy (HRT); oral contraceptives; decreased physical activity; Crohn’s disease; and certain drugs. One nonmodifiable risk factor is age; the older we get, the higher the risk, with age 40 being the demarcation line (3). Other risk factors are gender, with females being more predisposed; pregnancy; and family history (4).
Let’s look at the evidence.
Obesity risks
Obesity may play an important role. The reason obesity is implicated is potentially due to bile becoming supersaturated (5). Bile is a substance produced in the liver and stored in the gallbladder. Bile aids in the digestion or breakdown of fats in the small intestines. Crystals may form, creating cholesterol gallstones from the bile.
Body mass index
A body mass index of greater than 30 kg/m² is considered obese. In a meta-analysis of two prospective, forward-looking observational trials, Copenhagen General Population Study and the Copenhagen City Heart Study, those in the highest quintile of BMI were almost three times as likely to experience symptomatic gallstones compared to those who were in the lowest quintile (6). The highest quintile was those who had a mean BMI of 32.5 kg/m² and thus were obese, whereas those in the lowest quintile had a mean BMI of 20.9 kg/m². This is a comparison of obese to ideal BMI. Not surprisingly, since women in general have a higher risk of gallstones, they also have a higher risk when their BMI is in the obese range compared to men, a 3.36-fold increase and 1.51-fold increase, respectively.
Also, the research showed that for every 1 kg/m² increase in BMI, there was a 7 percent increase in the risk of gallstones. Those who had genetic variants that increased their likelihood of an elevated BMI had an even greater increase in gallstone risk —17 percent — per 1 kg/m². In the study population of approximately 77,000, more than 4,000 participants became symptomatic for gallstones.
Physical activity
In the Physicians’ Health Study, a prospective observational trial, those in the lowest quintile of activity between the ages of 40 and 64 had a 72 percent increased risk of gallstone formation, and those 65 and older had a 33 percent increased risk (7). Also, men who were 65 and older and watched television more than six hours a week were at least three times as likely to have gallstones as those who watched fewer hours. There was a substantial increased risk for those under 65, as well, though to a slightly lesser degree.
Diabetes rears its ugly head
Just like with obesity, diabetes is almost always a culprit for complications. In a prospective observational study, those with diabetes were at a significant 2.55 times greater risk of developing gallstones than those without (8). Again, women had a higher propensity than men, but both had significant increases in the risk of gallstone formation, 3.85 times and 2.03 times, respectively. There were almost 700 participants in this study. The researchers believe that an alteration in glucose (sugar) metabolism may create this disease risk.
Hormone replacement therapy
If you needed another reason to be leery of hormone replacement therapy (HRT), then gallstones might be it. In a prospective observational trial, women who used HRT, compared to those who did not, had a 10 percent increased risk in cholecystectomy — removal of the gallbladder — to treat gallstones (9). Though this may not sound like a large increase, oral HRT increased the risk 16 percent, and oral estrogen-only therapy without progestogens increased the risk the most, 38 percent. Transdermal HRT did not have a significantly increased risk.
It is never too early or too late to treat obesity before it causes, in this case, gallstones. With a lack of exercise, obesity is exacerbated and, not surprisingly, so is symptomatic gallstone formation. Diabetes needs to be controlled to prevent complications. HRT, unless menopausal symptoms are unbearable, continues to show why it may not be a good choice.
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.
Birds are known as indicator species: they tell us if things are alright in the ecosystem. Photo above: A male rose-breasted grosbeak rests in a tulip tree. Photo by Luci Betti-Nash
A new study in the Sept. 20 issue of Science has found that in the United States and Canada bird populations have fallen a staggering 29 percent since 1970.
Such a dramatic drop has scientists concerned that the decline could be a sign of an ecosystem collapse. Habitat loss is considered a prime culprit.
Huntington resident Coby Klein understands the big picture. He’s an ecology professor at Baruch College and a guide with the Huntington-Oyster Bay Audubon Society.
“If the arctic continues to become warmer and drier, it will cause larger and more frequent fires,” he said. “Fires kill birds and destroy nesting habitats and drive down populations of sandpipers, gulls, terns, waterfowl and birds of prey that migrate through or winter on Long Island.”
The best thing people can do, if you really have an interest in protecting birds and the environment, he said, is to vote.
Otherwise, the Audubon Society is committed to transforming communities back into places where birds flourish. Sterile lawns, ornamental species, pesticides and herbicides mean that on a local level, the landscape no longer supports functioning ecosystems.
Klein himself said that he lives on a postage-stamp-sized lot and the only native plant that thrives in his yard is poison ivy. But he notes that the Audubon Society is sponsoring a campaign called Creating Bird-Friendly Communities. The program is designed to educate the public on what they can do to help reverse the damage done and revive disappearing bird populations.
Growing native plants is a key component to re-establishing the ecological functions of cities and towns, according to the society and its experts. And they say the concept is easier on the back and wallet.
To flourish, birds need (a) plenty of food, (b) shelter where they can rest, (c) clean water to drink and bath in and (d) safe places to raise their young. Native plants and the insects that co-evolved around them are vital to a healthy system. The more native plants, the Audubon emphasizes, the more food and shelter. More bugs, caterpillars and seed pods on more public and private land is part of the solution.
The Audubon’s Native Plants Database, which is on its website, suggests plants according to ZIP code. The choices were hand-selected by local experts and include information about the birds and creatures it benefits. Serviceberry, for example, is recommended for Long Island’s North Shore communities. The small, shrublike tree with dense branching produces white flowers in the spring followed by red, purple or black berries. It attracts butterflies and caterpillars, as well as warblers and woodpeckers and about nine other types of birds. The database can be a good first place to explore landscape options.
The Long Island Native Plant Initiative’s website is another good resource. The local nonprofit gathers wild seeds and makesnative plants commercially available. It also grows and sells the native plant species to local nurseries to increase availability. Polly Weigand, the executive director, recommends requesting native plants from your favorite garden center to increase demand. It’s goal is to reach more businesses in the nursery industry. Once people get into the habit ofproviding suitable habitats, birds become less vulnerable and are potentially more capable of adapting to climate conditions, according to the Audubon.
Native gardens, experts agree, are also relatively maintenance free and require little to no special irrigation system or fertilizers or toxic chemicals.So, it saves time and money and is ahealthier option for people in the long run.
This fall consider practicing less drastic and costly yard cleanup. The Audubon recommends leaving the seed heads of perennials in the garden and skipping the raking. Leaf litter, they say, is free fertilizer, and a good place for birds to forage for worms and other critters. If tree limbs fall, they say, consider building a brush pile that will provide birds with shelter from the wind and predators. Branches settle and decompose over the seasons and make room for the next year’s contributions.
Plant asters and woody shrubs like bayberry and winterberry this fall.The waxy fruit of bayberry provides an important source of energy to migrating birds. Evergreens, too, like cedars, firs and holly, provide shelter and something for birds to eat in winter. In general, milkweed, goldenrod and sunflowers are important plants for the rest of the year.
“When you plant native species in your home landscapes it’s a protective way of ensuring that invasive ornamental species seeds don’t spread and dominate the rest of Long Island’s landscape,” said Weigand.
Overall, the objective is to lose some lawn, or create pathways through it, and create habitat layers. Tall canopy trees produce nuts and provide nest cavities for shelter. Shrubs and small trees throw fruit for bird food and herbaceous plants supply seeds and a habitat for pollinators. Decaying leaves produce the base of all habitats. It also happens to be where moth pupae live, a favorite food of baby birds.
Start small, the Audubon states, and cluster plants in groupings of five or more of the same species. Pollinators, they say, prefer to feed from masses of the same flower. And remember to include a birdbath or hollowed out rock where rainwater collects, so birds have a supply of fresh water.
In the end, you’ve created a backyard sanctuary and a sure method for healthy, sustainable living.
Three Village Central School District becomes the first school district in New York to join a national lawsuit against e-cigarette manufacturer Juul. TBR News Media file photo
Three Village Central School District is joining the fight against vaping devices.
In a letter from Superintendent Cheryl Pedisich and Board of Education President William Connors, the district announced it became the first school district in New York to join a national lawsuit against e-cigarette manufacturer Juul.
“As educators, it is our duty to protect the health and safety of our students, and we believe this company is compromising those efforts while simultaneously disrupting the educational process by marketing to teens,” Pedisich and Connors wrote.
Officials stated in the letter that legal fees will be covered by the firms representing the parties in the suit and will not come from district taxes.
The district officials said in the letter vaping devices are easy for teenagers to hide and use.
“This epidemic, while a national one, has had a direct and grave impact on our local school community,” school officials said. “As a district, we have needed to divert resources and deploy new ones to combat the problem of teen vaping.”
Three Village has installed devices to detect vaping, created prevention programs, adjusted health curricula to focus on the dangers of vaping, created a new student assistant counselor position to focus on prevention and treatment, and embraced new disciplinary actions and a districtwide zero-tolerance policy on vaping, according to the letter.
Nearly 40 percent of 12th grade students and 27 percent of high school students in New York State are now using e-cigarettes, according to New York State officials.
The U.S. Centers for Disease Control and Prevention states on its website that the use of e-cigarettes is unsafe for children, teens and young adults, as most e-cigarettes contain nicotine and other harmful substances. According to the agency, highly-addictive nicotine can harm adolescent brain development, which continues into the early to mid-20s.
As at Oct. 8, the CDC has reported 1,080 vaping-associated illnesses in the United States with 23 deaths. There have been 110 cases attributed to New York, according to the state’s health department. On the same day, the death of a Bronx teen was announced as the first confirmed fatality related to vape products in New York.
Steroids can be helpful but in moderation. Stock photo
Studies suggest shorter duration treatments can be as effective, with fewer side effects
By David Dunaief, M.D.
Dr. David Dunaief
Steroids typically make headlines related to their use as a performance-enhancing drug in sports. However, if we look beyond the flashy headlines, we see that corticosteroids, or steroids, play an important role in medicine.
Medical use
Steroids have an anti-inflammatory effect. This is critical since many acute and chronic diseases are based at least partially on inflammation. Chronic diseases that benefit include allergic, inflammatory and immunological diseases (1). These types of diseases touch on almost every area of the body, from osteoarthritis and autoimmune diseases to asthma, COPD (emphysema and chronic bronchitis) and eye disorders.
Steroids are delivered orally, topically as creams, lotions and eye drops, or via injections, intravenous solutions and inhaled formulations. The most commonly known medication is prednisone, but there are many others, including prednisolone, methylprednisolone, cortisone, hydrocortisone and dexamethasone.
Their benefits can be tremendous, improving functionality and reducing pain or improving breathing. You could say they are lifesaving in some instances, and with rescue inhalers they may just be that.
The bad
However, there is a very big caveat: They come at a price. Steroids cause weight gain, increased glucose (sugars), high blood pressure, cardiovascular events, osteoporosis, change in mood (psychoses), cataracts, glaucoma, infection, peptic ulcers, Cushing’s syndrome, and the list goes on. These are among the reasons medical professionals recommend using the least amount for the shortest time.
The upshot
The good news is that a plant-based diet may have similar beneficial effects in chronic diseases as steroids without all the downsides. Let’s look at the evidence.
The role in pneumonia
Pneumonia is among the top-10 leading causes of death in the world (2). In a meta-analysis (a group of nine studies), there was no overall effect of corticosteroids in reducing the risk of mortality in community-acquired pneumonia (3). However, when the data was broken into subsets, the findings were different. In subset data of those who had severe pneumonia, there was a statistically significant 74 percent reduction in mortality. And when duration was the main focus in subgroup analysis, those who received prolonged use of steroids reduced their risk of mortality by half.
Unfortunately, with the benefit comes an increased risk of adverse events, and this meta-analysis was no exception. There was a greater than two-times increased risk of abnormally high glucose levels with prolonged use. Thus, when giving steroids, especially for a prolonged use, it may be wise to check glucose levels.
In a randomized controlled trial (RCT), the gold standard of studies, results reinforced the beneficial effects of steroids on pneumonia. They showed that in those with both severe pneumonia and high inflammation, there was a two-thirds reduction in treatment failures when corticosteroids were added to the regimen (4). There were 120 patients involved in the study. They received antibiotics plus either methylprednisolone or placebo for five days.
Osteoarthritis: surprising results
As we know, osteoarthritis specifically of the knee is very common, and intra-articular (in the joint) injections directly into the knee are becoming routine treatment. A study compared injectable hyaluronic acid to injectable corticosteroid (5). The results showed that over three months, the corticosteroid was superior to hyaluronic acid in terms of reducing pain, 66 percent versus 43.8 percent, respectively.
Interestingly, over the longer term, 12 months, hyaluronic acid reduced the pain and maintained its effect significantly longer than the steroid, 33 percent versus a meager 8.2 percent, respectively. Study groups received five injections of either steroid or of hyaluronic acid directly to the knee over a five-week period. Thus, steroids may not always be the most effective choice when it comes to pain reduction. Hyaluronic acid may have caused this beneficial effect by reducing inflammation, protecting cartilage and preventing cell death, according to the authors.
COPD: Length may not matter
It is not unusual to treat COPD patients with oral steroids. But what is the proper duration? The treatment paradigm has been two weeks with 40 mg of corticosteroids daily. However, results in an RCT of 600 patients showed that five days with 40 mg of corticosteroid was equivalent to 14 days of the same dosage and frequency (6). The hope is that the shorter use of steroids will mean fewer side effects. We have come a long way; prior to 1999, eight weeks of steroids was a more commonplace approach to treating acute COPD exacerbations.
Dietary effect
One of the great things about steroids is that they reduce inflammation, and we know that the basis of greater than 80 percent of chronic disease is inflammation. A plant-based diet involving lots of vegetables and fruits and some grains may have a similar effect as steroids, but without the side effects. The effect may be to modify the immune system and reduce inflammation (7).
The bioactive substances from plants thought to be involved in this process are predominantly carotenoids and the flavonoids. Thus, those patients who respond even minimally to steroids are likely to respond to a plant-based diet in much the same beneficial way without the downsides of a significant number of side effects. Diet, unlike steroids, can be used for a long duration and a high intake, with a direct relationship to improving disease outcomes.
In conclusion, it is always better to treat with the lowest effective dose for the shortest effective period when it comes to steroids. The complications of these drugs are enumerable and must always be weighed against the benefits. Sometimes, other drugs may have more beneficial effects over the long term, such as hyaluronic acid injections for knee osteoarthritis. A plant-based diet, with anti-inflammatory properties similar to steroids, may be a useful alternative for chronic disease or may be used alongside these drugs, possibly reducing their dosage and duration.
References:
(1) uptodate.com. (2) N Engl J Med. 1995;333(24):1618-1624. (3) PLoS One. 2012;7(10):e47926. (4) JAMA. 2015;313(7):677-686. (5) Open Access Rheum 2015;7:9-18. (6) JAMA. 2013;309(21):2223-2231. (7) Int J Vitam Nutr Res. 2008 Dec;78(6):293-298.
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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