Health

Being a hospital patient for any length of time is not likely an experience that engenders tranquility or inner peace for most, but local artists and hospital staff are doing their best to change that.

The 3 North Patient Care Unit at Port Jefferson’s John T. Mather Memorial Hospital, a newly constructed intermediate care unit on the third floor, is now furnished with paintings from artists who donated their work to be displayed for and enjoyed by patients and staff.

The hospital hosted a reception to thank the artists, including Irene Ruddock, president of Setauket Artists, who played a leadership role in getting the idea off the ground.

“The art installation endeavor was the inspiration of Dr. Shug-Hong Young, a cardiologist at Mather Hospital, who purchased one of my paintings which he donated to the hospital’s newest wing,” Ruddock said.

She said Young then took the idea to Mather president, Kenneth Roberts, who liked the concept and requested works featuring Long Island waterways and boats be displayed.

“This is actually a wonderful opportunity and a wonderful meeting of community members and artists with their local community hospital resource,” Roberts said. “We put a brand new wing on with private rooms with computers in the rooms so we don’t have all of the [computers on wheels] or [workstations on wheels] out in the hallways, so nothing is crowded. So we have this brand new nursing station with beautiful finishes, but the one thing we didn’t have was artwork.”

Ruddock was tasked with selecting paintings from her group’s members that fit the bill.

“I chose art that would add to the beauty of the already beautiful space, create a peaceful, serene environment that might provide a sense of spiritual healing,” she said. “I wanted paintings that touch people’s hearts and souls — ones that were memorable and draw you right into the painting.”

Young explained why he donated Ruddock’s initial painting, and why he thought it would brighten up the wing.

“It came to me that if we could bring all of these local artists [works] to the hospital, because many of the artworks reflect local scenes — the beach, the port, the pond — that would make patients feel they are not isolated, they are still connected to the beautiful environment,” he said.

Emily Emma, nurse manager for 3 North who recently transferred to the position, said she asked colleagues in her unit if there was anything she could do to elevate their work and the care they provide to patients, and a common theme emerged in the answers.

“Most of them had said, ‘We would really like some artwork on the walls,’” Emma said. “Patients can’t get enough of them. It’s really a nice peaceful journey to get through their progression of health.”

Jim Molloy, a Miller Place-based artist, was among those who donated a piece to the hospital that he called “Turning Tides.”

“I think that’s what art is about — it’s about brightening up someone’s day,” Molloy said. “If somebody can look at a piece of art and kind of escape for a while, then that makes me feel good, it makes them feel good — it’s perfect.”

Ruddock thanked Roberts, Young and Emma for their efforts in bringing the idea to fruition, as well as Mather employees Nancy Uzo, vice president of public affairs, and Laura Juliano, director of annual giving. Juliano said artist Renée Caine also provided invaluable help during the planning and installation phases of the idea. Caine donated one of her own works.

“By far, the most rewarding aspect of the project was the reaction of the patients, caregivers and staff to the paintings,” Ruddock said. “One staff member said of Michael Kutzing’s painting of a sailing vessel, ‘I mentally take a ride on the boat every day on the Long Island Sound to breathe in the air.’”

Placing one foot in front of the other can lead to impressive mental and physical benefits. Stock photo
Benefits are seen with modest exercise

By Dr. David Dunaief

Dr. David Dunaief

There is great emphasis on exercise. We have heard it is good for us ever since we were children in gym class striving for the presidential fitness award. 

The average reaction, unfortunately, is an aversion to exercise. As kids, many of us tried to get out of gym class, and as adults, we “want” to exercise, but we “don’t have time.” The result of this is a nation of couch potatoes. I once heard that the couch is the worst deep-fried food. It perpetuates inactivity, especially when watching TV. Even sleeping burns more calories.

I think part of the problem is that we don’t know what type of exercise is best and how long and frequently to do it. 

Well, guess what? There is an easy way to get tremendous benefit with very little time involved. You don’t need expensive equipment, and you don’t have to join a gym. You can sharpen your wits with your feet.

Jane Brody has written in The New York Times’ Science Times about Esther Tuttle. Esther was 99 years old, sharp as a tack and was independently mobile, with no aids needed. She continued to stay active by walking in the morning for 30 minutes and then walking again in the afternoon. The skeptic might say that this is a nice story, but its value is anecdotal at best. 

Well, evidence-based medicine backs up her claim that walking is a rudimentary and simple way to get exercise that shows incredible benefits. One mile of walking a day will help keep the doctor away. 

Walking has a powerful effect on preserving brain function and even growing certain areas of the brain (1). Walking between six and nine miles a week, or just one mile a day, reduced the risk of cognitive impairment over 13 years and actually increased the amount of gray matter tissue in the brain over nine years.

Those participants who had an increase in brain tissue volume had a substantially reduced risk of developing cognitive impairment. Interestingly, the parts of the brain that grew included the hippocampus, involved with memory, and the frontal cortex, involved with short-term memory and executive decision making. There were 299 participants who had a mean age of 78 and were dementia free at the start of the trial. Imagine if you started earlier? 

In yet another study, moderate exercise reduced the risk of mild cognitive impairment with exercise begun in mid-to-late life (2). 

Even better news is that, if you’re pressed for time or if you’re building up your stamina, you can split a mile into two half-mile increments. How long does it take you to walk a half-mile? You’ll be surprised at how much better you will  feel — and how much sharper your thinking is.

If you ratchet up the exercise to running, a study showed that mood improves, mollifying anger (3). The act of running actually increases your serotonin levels, a hormone that, when low, can make people agitated or angry. So exercise may actually help you get your aggressions out.

Walking has other benefits as well. We’ve all heard about the importance of doing weight-bearing exercise to prevent osteoporosis and osteoporotic fractures. The movie “WALL-E” even did a spoof on this, projecting a future where people lived in their movable recliners. The result was a human skeletal structure that had receded over the generations from lack of use. Although it was tongue in cheek, it wasn’t too far from the truth; if you don’t use them, bones weaken and break. Walking is a weight-bearing exercise that helps strengthen your joints, bones and muscles. 

So remember, use your feet to keep your mind sharp. Activities like walking will help you keep a positive attitude, preserve your bones and help increase the plasticity of your brain.

References: 

(1) Neurology Oct 2010, 75 (16) 1415-1422. (2) Arch Neurol. 2010;67(1):80-86. (3) J Sport Exerc Psychol. 2010 Apr;32(2):253-261.

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.

We invite you to check out our new weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.

Choppy conditions in Port Jefferson Harbor forced the cancellation of the race portion of the 2018 Village Cup Regatta Sept. 8,  but the annual fundraiser was a success anyway.

For the ninth year, the Port Jefferson Yacht Club and the Port Jefferson Village Center were the home for the event, which features a parade past the village-owned pier at Harborfront Park, a race out in the open water between sailboats representing the village and John T. Mather Memorial Hospital, and a banquet to conclude the festivities. This year, conditions weren’t conducive to holding the race, but the event still raised about $70,000 for two worthy causes, according to Mather’s Facebook page.

Funds raised by the regatta will be split between Mather Hospital’s Palliative Medicine Program and the Lustgarten Foundation for Pancreatic Cancer Research.

For the sixth year,  actor/director and local resident Ralph Macchio served as community ambassador for the event. Macchio helps to publicize the important work of the two programs funded by the regatta. His wife, Phyllis, is a nurse practitioner in Mather’s Palliative Medicine Program.

There are serious side effects of NSAIDs and Tylenol

Dr. David Dunaief

Most of us keep a few key items in our medicine cabinets. In addition to aspirin, among these are usually NSAIDs (non-steroidal anti-inflammatory drugs) and acetaminophen (Tylenol). We often use them for relief of pain, fever or inflammation. Familiar NSAIDs include ibuprofen (Advil, Motrin) and naproxen sodium (Aleve). It is estimated that more than 17 million people use NSAIDs on a daily basis. According to a poll of these regular users of over-the-counter (OTC) NSAIDs, a substantial number — 60 percent — were unaware of their dangerous side effects (1).

Acetaminophen is used frequently, as well. On a weekly basis, one quarter of Americans take it. 

We think of these drugs as relatively benign. In fact, I find that unless I specifically ask about their use, most patients don’t include them on a list of their medications on a patient registration form. 

NSAIDs: The statistics

Unfortunately, NSAIDs, according to the Centers for Disease Control and Prevention, are responsible for 7,600 deaths annually and 10 times that number in hospitalizations (2). These are not medications that should be taken lightly. NSAIDs increase the risk of several maladies, including erectile dysfunction, heart attacks, gastrointestinal bleeds, exacerbation of diverticular disease and chronic arrhythmias (abnormal heartbeats). In some instances, the cardiovascular effects can be fatal. 

NSAIDs: Studies demonstrating adverse side effects

In a case control (epidemiologic, retrospective) study using the UK Primary Care Database, chronic users of NSAIDs have a significantly increased risk of a serious arrhythmia (abnormal heartbeat) called atrial fibrillation (3). Patients were between 40 and 89 years of age. 

Interestingly, chronic users were defined as patients who took NSAIDs for more than 30 days. Those patients who used NSAIDs more than 30 days had a 57 percent increased risk of atrial fibrillation. A Danish study reinforces these results after the first month of use (4). This is not very long to have such a substantial risk. For patients who used NSAIDs longer than one year, the risk increased to 80 percent. Caution should be used when prescribing NSAIDs or when taking them OTC. Atrial fibrillation is not an easy disease to treat.

NSAIDs also increase the risk of mortality in chronic users. Older patients who have heart disease or hypertension (high blood pressure) and are chronic NSAIDs users are at increased risk of death, according to an observational study (5). Compared to those who never or infrequently used them over about 2.5 years, chronic users had a greater than twofold increase in death due to cardiovascular causes. High blood pressure was not a factor, since the chronic users actually had lower blood pressure. Yet I have seen with my patients that NSAIDs can increase blood pressure. 

Is acetaminophen the answer?

Acetaminophen does not cause gastrointestinal bleeds, arrhythmias and deaths due to cardiovascular events that NSAIDs can. However, the Food & Drug Administration announced in 2011 that acetaminophen should not exceed 325 mg every four to six hours when used as a prescription combination pain reliever (6). The goal is to reduce and avoid severe injury to the liver, which can potentially cause liver failure. 

There is an intriguing paradox with acetaminophen: Hospitals typically dispense regular-strength 325-mg doses of the drug, whereas OTC doses frequently are found in extra-strength 500-mg tablets, and often the suggested dose is two tablets, or 1 gram. Patients should not take more than 4 grams a day to lower their risk of liver damage. The 4-gram amount sounds like a significant quantity, but it translates into two pills of extra-strength Tylenol every six hours.

I have patients who have taken three pills at one time thinking that, since it is OTC, exceeding the dose is okay. Unfortunately, this is not true. 

The FDA’s recommendations for limiting the dose result from a conglomeration of data. For instance, one study that showed acute liver failure was due primarily to unintentional overdoses of acetaminophen (7). Accidental overdosing is more likely to occur when taking acetaminophen at the same time as a combination sinus, cough or cold remedy that also contains acetaminophen. Over-the-counter cold medications can contain acetaminophen. 

In order to be aware of potentially adverse events, you have to be your own best advocate and read labels. Remember to tell your physician if you are taking OTC medications. If you are a chronic user of NSAIDs because of underlying inflammation, you may find an anti-inflammatory diet, which is usually plant-based, is an effective alternative.

References: 

(1) J Rheumatol. 2005;32;2218-2224. (2) Annals of Internal Medicine, 1997;127:429-438. (3) Arch Intern Med. 2010;170(16):1450-1455. (4) BMJ 2011;343:d3450. (5) Am J Med. 2011 Jul;124(7):614-620. (6) FDA.gov. (7) Am J Gastroenterol. 2007;102:2459-2463. 

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.

٭We invite you to check out our new weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

Aaron Sasson. Photo courtesy of Stony Brook Medicine

By Daniel Dunaief

Thanks to the efforts of Stony Brook University School of Medicine’s Chief of Surgical Oncology Aaron Sasson and numerous doctors and researchers at Stony Brook, Long Island has its first National Pancreas Foundation Center.

A nonprofit organization, the National Pancreas Foundation goes through an extensive screening process to designate such centers around the country, recognizing those that focus on multidisciplinary treatment of pancreatic cancer. The NPF offers this distinction to those institutions that treat the whole patient and that offer some of the best outcomes and improved quality of life for people suffering with a disease who have an 8 percent survival rate five years after diagnosis.

Sasson appreciates the team effort at the medical school. “As opposed to one person leading this, there are many people here who are required to have an interest in pancreatic cancer,” he said. “We are not only looking to build a great infrastructure for the treatment of pancreatic cancer, but we’re also looking to build a team for research on pancreatic cancer.”

Sasson highlighted the research efforts led by Yusuf Hannun, the director of the Cancer Center at SBU, who has helped attract a “tremendous number of scientists” to engage in research into this disease.

The recognition by the NPF helps the university recruit physicians who are clinically interested in developing ways to improve the outcome for patients.

Pancreatic cancer presents particular challenges complicated by its biological aggressiveness, its difficulty to detect and by the many subtypes of this disease. “It’s similar to lung and breast cancer,” Sasson said. “There are many facets of those cancers. You can’t lump them all together.”

Researchers and clinicians are still trying to understand pancreatic cancer in greater detail. Once they have done that, they can advance to treating the possible subtypes.

Numerous researchers at SBU have developed collaborations with scientists at Cold Spring Harbor Laboratory. David Tuveson, the director of the National Cancer Institute-designated Cancer Center, has engaged in collaborations with SBU scientists in his work on organoids, which are model human organs grown in a lab. Scientists use organoids to test drugs and molecular pathways involved in pancreatic cancer.

Members of the Long Island community can take comfort in the continuing dedication of the numerous staff members committed to finding a cure. “Residents of Suffolk County and Long Island should be proud of what Stony Brook has been able to accomplish,” Sasson said.

Stony Brook University has been involved in several clinical efforts. The university developed a drug called CPI-613, for which Rafael Pharmaceuticals is in the early stage of clinical trials in combination with other drugs.

In early stages, the treatment increases the vulnerability of cancer cells to numerous other drugs. Newark, New Jersey-based Rafael Pharmaceuticals is testing this treatment in pancreatic cancer and in acute myeloid leukemia.

At SBU facilities, Sasson explained that researchers and clinicians are taking a multidisciplinary approach in their work. One study, he said, is exploring the effects of a kind of radiation therapy for a subpopulation of pancreatic cancer that combines expertise in radiology, gastroenterology, pathology and medical and surgical oncology.

Sasson himself is interested in screening and biomarkers. At least half of his work is related to pancreatic cancer. When he thinks about people who have battled pancreatic cancer, several patients come to mind. He had a patient who was about 80 at the time of his diagnosis. His primary doctor told him to get his affairs in order.

“We operated on him and he lived another six or seven years,” Sasson recalls. “He was grateful to see his grandchildren graduate and to see his great-grandbabies being born.”

While every patient is unlikely to have the same outcome, Sasson said surrendering to the disease and preparing for the inevitable may not be the only option, as there may be other courses of action.

Another patient had advanced pancreatic cancer for 18 months before Sasson met her. She had received no treatment and yet the cancer didn’t progress, which is “almost unheard of and unbelievable.” In fact, the case defied medical expectations so dramatically that the doctors conducted two more biopsies to confirm that she had pancreatic cancer. “She did well for many years despite having advanced pancreatic cancer.”

In another case, a patient was receiving surveillance for lung cancer every three months. In between those visits, he had developed metastatic pancreatic cancer. This patient example and the previous one show the range of cancer progression.

The value of having an integrated clinical and research program is that scientists can look for subtle clues and signals amid the reality of cancer with a wide range of outcomes. Indeed, scientists attend the weekly tumor board meeting, so they can learn about the clinical aspects of the disease. Doctors also attend research collaborations so they can hear about developments in the lab.

Rather than dictating how researchers and clinicians should collaborate, Sasson hopes to facilitate an environment that sparks these partnerships.

Sasson joined Stony Brook Medical School almost three years ago. He said he is “impressed with the caliber of physicians.” It took time to get the critical mass and organization for pancreatic cancer to match the number of basic science investigators.

“I’m hopeful for the progress we’ll be able to make to treat this terrible disease,” he said.

District’s environmental consultants took 26 samples earlier this week; results to be reviewed by New York State Department of Health

Northport-East Northport school officials and parents are awaiting the results of the latest
Middle School K-wing air quality samples prior to the school’s reopening next week.

The district’s environmental consultant firm J.C. Broderick & Associates Inc. took 26 air samples throughout the K-Wing of Northport Middle School earlier this week to see if issues with gasoline fumes have been fully resolved after extensive summer renovations.

“The question I have been asked is are we going to test before we reopen the K-Wing,” Superintendent Robert Banzer said. “The answer is yes.”

The question I have been asked is are we going to test before we reopen the K-Wing. The answer is yes.”

— Robert Banzer

Edward McGuire, of J.C. Broderick & Associates, said the testing consisted of placing two air sampling cannisters in every single classroom and office space, two in the hallway, and two in the warehouse space beneath the wing, which was the previous site of chemical storage, to see what level of volatile organic compounds, known as VOCs or fumes, are present. In addition, two cannisters were placed outside the building to represent the ambient air that is brought into the school building via the ventilation systems.

“It is the créme de la créme of VOC sampling,” the consultants said. “There is no better methodology.”

The cannisters were placed at varying heights 3 to 5 feet off the ground in each location, according to McGuire, meant to replicate the typical breathing zone of a seated or standing person within the space. Each room was independently sealed off before air samples were collected for a continuous eight-hour period while the newly installed rooftop ventilation systems ran, McGuire said, meant to replicate “typical occupancy conditions.”

Brandon Weisberg, project superintendent for district contractors Park East Construction, said the K-Wing classrooms were ripped down to the studs this summer. New plumbing was installed, fire stoppers sealed, and a special heavy-duty vapor barrier applied on the concrete subsurface between the underground warehouse storage and K-Wing to prevent any fumes from penetrating into the air, according to Weisberg. The district also had new rooftop heating, air conditioning and ventilation units installed while also sealing the older ground-level passages with concrete.

The environmental consultants said their staff has worked with the district’s contractors to obtain safety data sheets for each material used in renovating the K-Wing this summer, providing a list of any potentially hazardous chemicals contained in each product. McGuire said this data will be used to help analyze the air samples and potentially used to identify the source of any abnormally high fumes or airborne chemicals found during the sampling.

“The sensitivity of the analysis will always find VOCs in the air,” McGuire said. “Our expectations are also a little higher because we know everything is brand new.”

The sensitivity of the analysis will always find VOCs in the air. Our expectations are also a little higher because we know everything is brand new.”

— Edward McGuire

The consultants were asked to explain during a presentation at an Aug. 23 board of education meeting that any smell in the K-Wing could be similar to the odors detected by new car owners when they sit inside the vehicle.

J.C. Broderick said they will be doing a two-part comparison of the air samples taken. The first part will be a report on the ambient levels of each VOC detected, while the second phase will examine the levels found against healthy safety guidelines established by New York State Department of Health. McGuire said the standards being used will be compared against the U.S. Environmental Protection Agency’s dose concentration guidelines, which consider different levels for sensitive populations, such as young children.

The results of the air quality testing were expected to be received within approximately 72 hours of the end of sample collection, or 48 hours after the cannisters were delivered to the laboratory. The final report will be sent to New York State Department of Health for its review prior to the classrooms being reopened to student and staff use.

The results were not yet available as of noon Aug. 29, according to the superintendent.

Banzer assured residents the district has repurposed the old warehouse space as a dry storage for “paper goods” and other such things.

“There are no chemicals stored down there, all that was eliminated last year,” he said.

BOE approved changes in 2017, slow transition to full compliance to continue into ’18-19 school year

A BOE policy is increasing healthy food options in PJ schools. Stock photo from Metro

Port Jefferson School District is looking to become a healthier place.

Students and parents returning this fall should expect to see further changes to foods offered in cafeterias, sold for team and club fundraisers, and even those foods allowed at school celebrations for the 2018-19 year to meet standards set in a May 2017 board of education policy change.

In a July letter addressed to parents from Danielle Turner, the now-departed district director of health, physical education and athletics, the policy was enacted to address nutritional concerns as well as increase students’ physical activity throughout the school day, a move designed to keep the district in line with state and federal regulations.

“Elements of the policy went into effect last year,” Superintendent Paul Casciano said. “We chose a path of gradual compliance starting with last year so our students and advisers could plan accordingly going into the 2018-19 school year.”

Under the policy, school meals in the district now must include fruits, vegetables, salads, whole grains and low-fat items, adherent to federal standards. In addition, food and beverages sold in vending machines and school stores must meet nutrition standards set by federal regulations. Food and beverages sold by clubs and teams for fundraisers, both on school grounds and off, will also be subject to the same regulations. The policy also impacts in school celebrations and parties where food and drinks are provided, saying building principals will “encourage” parents and staff to follow the guidelines, and restricts the use of food “as
an incentive or reward for instructional purposes.”

“As a school community, it is important that we model what we teach about health,” Casciano said.

Student body president and Port Jefferson senior Reid Biondo said clubs and teams were made aware the policy change was coming last year and started to make preparations to adhere to the changes when it comes to fundraising.

“The fundraisers are very important for clubs and teams,” he said. “Not being able to fundraise by selling food is a source of concern but the students at Earl L. Vandermeulen are very creative and are already coming up with solutions. Last year, one of the classes hosted a volleyball tournament in place of a bake sale. There are plenty of alternatives to bake sales but students and teams are going to need to work a little harder for their money.”

Despite the challenges created by the policy, Biondo said he sees the district’s point of view in trying to foster a healthier school environment.

“I think they are right to encourage a more healthy lifestyle and I think it is a step in the right direction,” he said. “Students should have access to healthy eating options and that part of this change in the school district excites me. However, I do not think removing the unhealthy choices entirely is the solution.”

Biondo pointed out that CVS is less than a five-minute walk from the school’s front door, and he suspects many of his peers will go there to purchase an unhealthy after-school snack. This would mean the revenue from bake or candy bar sale would be going to an outside source, while students continue making unhealthy choices. The senior also suggested the district should provide additional education about healthy lifestyle choices and consuming snacks in moderation, to encourage students to lead a healthy lifestyle in and outside of school.

Casciano said the district took the fundraising obstacles for extracurricular organizations into account when crafting the policy and suggested healthier alternatives can still be sold to raise money. He added the district’s hiring of Adam Sherrard to take over for Turner will have no bearing on the implementation of the policy.

The full board wellness policy can be found at www.portjeffschools.org under “Community” tab.

The best protection against kidney stones is a combination of low sodium and high fluid intake. Stock photo
Calcium from supplements may increase risk of kidney stone formation

By David Dunaief, M.D.

Dr. David Dunaief

Kidney stones are relatively common, occurring more often in men than women (1). I have seen many patients who have a history of forming these stones. Unfortunately, once a patient forms one stone, the incidence of another increases significantly over time. However, there are several ways to reduce your risk.

Kidney stones, or nephrolithiasis, can be asymptomatic (no symptoms at all) or may present with the classic symptoms of blood in the urine and colicky pain. Pain can be intermittent or constant, ranging from dull to extremely painful, described by some as being worse than giving birth or being shot or burned. 

The pain may radiate from the kidneys to the bladder and even to the groin in males, depending on the obstruction (2). Stones are usually diagnosed through clinical suspicion and abdominal X-rays and/or noncontrast CT scans.

Unfortunately, the first line treatment for passing kidney stones — at least small ones — involves supportive care. This means that patients are given pain medications and plenty of fluids until the stone(s) pass. Usually stones that are <4 mm pass spontaneously. Location is an important factor as well, with stones closest to the opening of the urethra more likely to pass (3).

Prevention is the way to go

The good news is there are lifestyle changes that can reduce the risk of kidney stones. First, it is very important to stay hydrated, drinking plenty of fluids, especially if you have a history of stone formation (4).

One of the easiest methods is to significantly reduce your intake of calcium supplements, including foods fortified with calcium. There are two types of stones, with calcium oxalate being the dominant one, occurring approximately 80 percent of the time (5). Calcium supplements increase the risk of kidney stones. When physicians started treating women for osteoporosis with calcium supplements, the rate of kidney stones increased by 37 percent (6). 

According to findings from the Nurses’ Health Study, those who consumed highest amount of supplemental calcium were 20 percent more likely to have kidney stones than those who consumed the lowest amount (7). It did not matter whether participants were taking calcium citrate or calcium carbonate supplements.

Interestingly, calcium from dietary sources actually has the opposite effect, decreasing risk. In the same study, those participants who consumed the highest amount of dietary calcium had a 35 percent reduction in risk, compared to those who were in the lowest group. Calcium intake should not be too low, for that also increases kidney stone risk. However, the source of calcium is a key to preventing kidney stones. 

Another modifiable risk factor is sodium. It’s important to reduce sodium for many reasons, and this provides one more. Again, in the Nurses’ Health Study, participants who consumed 4.5 g sodium per day had a 30 percent higher risk of kidney stones than those who consumed 1.5 g per day (7). The reason is that increased sodium causes increased urinary excretion of calcium. When there is more calcium going through the kidneys, there is a higher chance of stones. 

Animal protein also seems to play a role. In a five-year, randomized clinical trial, men who consumed small amounts of animal protein, approximately two ounces per day, and lower sodium were 51 percent less likely to experience a kidney stone than those who consumed low amounts of calcium (8). These were men who had a history of stone formation. The reason that animal protein may increase the risk of calcium oxalate stones more than vegetable protein is that its higher sulfur content produces more acid, which is neutralized by release of calcium from the bone (9).

Some medical conditions may increase the likelihood of stone formation. For example, in a cross-sectional study (a certain population during a specific period) with Italian men, those with high blood pressure had a two times greater risk of kidney stones than those who had a normal blood pressure (10). Amazingly, it did not matter if the patients were treated for high blood pressure; the risk remained. This is just one more reason to treat the underlying cause of blood pressure, not the symptoms.

The most productive way to avoid the potentially excruciating experience of kidney stones is to make these relatively simple lifestyle changes. The more changes that you implement, the lower your risk of stones.

References: 

(1) Kidney Int. 1979;16(5):624. (2) emedicine Jan 1, 2008. (3) J Urol. 2006;175(2):575. (4) J Urol. 1996;155(3):839. (5) N Engl J Med. 2004;350(7):684. (6) Kidney Int 2003;63:1817–1823. (7) Ann Intern Med. 1997;126(7):497-504. (8) N Engl J Med. 2002 Jan 10;346(2):77-84. (9) J Clin Endocrinol Metab. 1988;66(1):140. (10) BMJ. 1990;300(6734):1234. 

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.

٭We invite you to check out our new weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

By Yusuf A. Hannun, M.D.

Dr. Yusuf Hannun

Recently the New York State Department of Health (DOH) reported elevated levels of leukemia, bladder cancer, thyroid cancer and lung cancer in three central Long Island communities — Farmingville, Selden and Centereach. 

As Suffolk County’s only academic-based cancer research facility, Stony Brook University Cancer Center has researchers working with DOH scientists to interpret the data and look at possible causes of these high incidence rates.

More information and analysis are needed

The state’s reports raise important questions about possible reasons, what the results mean and what can be done to change them. First, we need to determine which subtypes of the four cancers are responsible for these higher incidence rates. Each type of cancer can be divided into subtypes, based on certain characteristics of the cancer cells, and these subtypes may have distinct causes and risk factors. It’s important to know the subtype of a cancer to identify the possible causes.

Also, it is important to know whether mortality rates from these cancers are higher in the three Long Island communities than they are in the rest of the state. This information is critical because sometimes increases in incidence rates are due to improved diagnosis and detection. We must determine if the data in the DOH study truly are the results of higher incidences, which can be assessed by determining whether the higher incidence rates have translated into higher mortality rates. 

Findings for Farmingville, Centereach and Selden

Bladder cancer, lung cancer, thyroid cancer and leukemia were diagnosed at statistically significant elevated levels in Farmingville, Centereach and Selden, according to the DOH data. The cancer incidences were identified with information from the New York State Cancer Registry.

The registry collects reports on cancer diagnoses from health care providers, which include the sites of tumors, the stages when diagnosed, the cell types of the cancer, treatment information and demographic information. Every person diagnosed with cancer in New York state is reported to the registry. The incidences also were identified from statistical mapping of neighborhoods in the three communities. 

We learned that, from 2011 to 2015, the following number of cases occurred:

• 311 cases of lung cancer, 56 percent above statewide rate

• 112 cases of bladder cancer, 50 percent above statewide rate

• 98 cases of thyroid cancer, 43 percent above statewide rate

• 87 cases of leukemia, 64 percent above statewide rate

Cancer research

With all the resources of an academic medical center, the Stony Brook Cancer Center will move quickly to examine the findings from this study.

Transforming cancer care is the driving force behind the construction of our new cancer center, which will be located in the 240,000-square-foot, eight-story Medical Research and Translation (MART) building opening in November. It is where researchers will revolutionize breakthrough medical discoveries and create lifesaving treatments to deliver the future of cancer care today.

For more information on the DOH study, or the Stony Brook Cancer Center, call us at 631-638-1000 or visit www.cancer.stonybrookmedicine.edu.

Dr. Yusuf A. Hannun is the director of the Stony Brook University Cancer Center and vice dean for cancer medicine.

Tom Manuel

Making Memories with Music, a special program for people with dementia and their care partners, returns to the Cinema Arts Centre, 423 Park Ave., Huntington on Aug. 27 at 11 a.m. Facilitated by Marcy Rhodes, the morning will feature a performance by The Jazz Loft Trio — Tom Manuel on cornet and vocals, Steve Salerno on guitar and Keenan Zach on double bass. Admission is $5 per person. Popcorn and beverages will be served. Registration is required by calling 631-423-7610, ext. 0.