Home Health

Miracle case at Stony Brook hospital revisited

by Victoria Espinoza - August 17, 2015

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Errante-Family-w — The Errante family celebrates with a cake to mark 10 years since a life-changing surgery. Photo by Victoria Espinoza

Ten years ago, at Stony Brook University Hospital, a life-saving operation was performed on a mother of triplets.

Michael, Samantha and Joseph Errante were born on Aug, 29, 2005, in an emergency cesarean section, after it was discovered that their mother, Roseann, had an aortic dissection.

“Technically, they saved my life,” Roseann Errante said. “I would’ve never felt the amount of pain if I wasn’t pregnant.”

The family gathered at the hospital on Monday, Aug. 10, so that the triplets could meet the doctors and nurses that saved their lives, and also have a surprise tenth birthday party thrown in their honor by the hospital.

Roseann Errante said she felt overwhelmed and grateful being back.“We never thought we’d be here 10 years later.”

In 2005, Roseann and Joe Errante arrived at Stony Brook University Hospital because she was complaining of intense chest pains. They had already been sent home from another hospital after being told it was just heart burn, however once the pain persisted, the couple decided to go to Stony Brook.

“They told us ‘we don’t know what’s wrong with you, but you’re not leaving until we find out’ which was so reassuring,” Roseann Errante said.

Dr. Frank Seifert, a cardiothoracic surgeon at Stony Brook, was soon operating on her for an aortic dissection, which is a tear on the inside wall of the aorta. If untreated, this disease can kill within the first 48 hours, and 95 percent are dead within a month.

But before Seifert could begin, Roseann Errante had to undergo a caesarean section, so that the triplets could be born as safely as possible.

“Forget Stephen King, this was much more terrifying than anything else I’d ever heard,” Joe Errante said of his wife’s diagnosis and emergency surgery.

The multi-hour surgery was a success, and while one of the triplets, Joseph, had to undergo two surgeries shortly after he was born to repair a burst intestine, all three babies and Roseann Errante returned home completely safe and healthy.

“I’m sure I speak for all the health care providers, seeing this right now is the ultimate satisfaction. Seeing patients go out and do so well, and then wanting to come back and express their thanks, it’s really heartwarming,” said Dr. Richard Scriven, who worked on the triplets and both of Joseph’s surgeries.

Both parents praised everyone in the hospital for how they treated them during that tough time, from the doctors and nurses to the workers in the cafeteria.

Now, as Michael, Samantha and Joseph turn 10, they have all grown into healthy kids, and enjoy playing sports, watching their favorite television shows and attending camps together, along with their older brother Anthony.

“We like the batting cages, playing European handball, running bases,” the triplets listed off together.

The Errante family resides in Hauppauge. The triplets are about to start their last year at Forest Brook Elementary School, and Anthony is in Hauppauge Middle School.

“I tell her, we’re never going to win the lottery because we used every bit of luck we had right then and there, and it was all worth it,” Joe Errante said.

Huntington Hospital takes to the skies

by Rohma Abbas - August 13, 2015

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Town board, hospital ink helipad agreement

1014-1331 SkyHealth Team_Photo-from-Huntington-Hospitalw — The SkyHealth team. Photo from Huntington Hospital

Huntington Hospital is flying high.

The town board on Tuesday approved a license agreement with the hospital to use a portion of the town’s parking facility adjoining Mill Dam Park as a helipad. The agreement spans from August to July 31, 2017.

With the helipad, the hospital will be air-transporting, via helicopter, patients in need of urgent or emergent care to the most appropriate health care facility to address their needs. The hospital will also transport “harvested organs to and from the Huntington Hospital,” according to the town board resolution.

“North Shore – LIJ Health System has developed a new air medical service program called SkyHealth, which is staffed by highly skilled medical professionals,” Randolph Howard, vice president of operations at Huntington Hospital said in a statement through a hospital spokeswoman. “Developing a heliport in Huntington provides a key location from which SkyHealth can transport critically ill patients who require immediate medical transportation. Through this heliport, SkyHealth will provide a vital service to the residents of the greater Huntington area.”

James Margolin, an attorney with the firm Margolin & Margolin, said the helipad already exists, but it is in need of an upgrade — one that the hospital will undertake.

“We thank the town board for its continuing commitment to getting the lifesaving community service into effect,” he said.

SkyHealth is a partnership with Yale New Haven Health in Connecticut and the North Shore- LIJ Health System. Patients of both health systems in need of lifesaving care for major traumas, heart attack, stroke and other life-threatening brain injuries will receive emergency medical care by helicopter and be quickly flown to the most appropriate hospital, according to the North Shore-LIJ Health System’s website.

The helicopter would be staffed with a nurse, a critical care paramedic, all certified in New York and Connecticut, and a pilot. That would be the “standard crew,” according to Gene Tangney, senior vice president and chief administrative officer of North Shore-LIJ in a SkyHealth promotional video.

Huntington Hospital will pay the town $14,062 upon the execution of the license agreement, and another $14,062 at the end of the agreement, according to the resolution.

Councilwoman Tracey Edwards (D) requested quarterly reports from the hospital to ensure the volume is “consistent with what we agreed upon.” Margolin agreed to the request.

Otitis externa: Those itchy ears

by Matthew Kearns - August 12, 2015

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By Matthew Kearns, DVM

“Ooooooh … those itchy ears. My dog or cat is constantly scratching or shaking its head. I feel terrible for them and it sometimes keeps me up at night. My vet calls it an ear infection. It clears up on the medication but once finished it keeps coming back. Why does this happen?”

That is the million dollar question (actually, I’m sure millions of dollars are spent on ear infections every year). To call every dog or cat that comes in with itchy ears an ear infection is misleading.

These pets have otitis externa, and “otitis externa” literally means inflammation (not infection) of the external ear canal. Although we veterinarians commonly dispense medications with antibiotics and antifungals in them, the bacteria and yeast we are treating are considered natural flora (in the ear canal at all times in lower numbers).

So why do we get “flora gone wild”? Usually some other primary trigger is involved and the infection is secondary overgrowth. Examples are parasitic infections (ear mites), pets that swim or get baths and get water (and shampoo) in their ears, ear tumors (both benign polyps and cancerous tumors) etc. However, the most common cause of recurrent otitis externa is allergies. I consulted with a veterinary dermatologist, and she estimated that between 80 and 90 percent of all recurrent otitis externa in dogs is related to allergies.

To understand why an allergy would cause such problems in the canine and feline ear canal we first have to describe the anatomy. Unlike a human ear canal, which has a shorter external component in a horizontal direction only, the canine and feline external ear canal is much longer and has both a vertical and horizontal component. Therefore, there is a much greater distance from the opening of the ear canal to the ear drum. This shape and extra distance plays a critical role in otitis externa.

Also, the healthy ear canal is lined with three types of cells: epithelial cells (those similar to skin), ceruminous cells and apocrine cells (cells that produce earwax). Just like the epithelial cells of the skin, these cells will be replaced every few days. The new cells push the old (dead) cells out to the entrance of the canal, and the small amount of earwax produced in the healthy ear migrates out with the dead epithelial cells.

However, if the lining of the ear canal becomes inflamed, it narrows due to swelling and excessive earwax is produced. This not only overwhelms the ability to clear the wax, it also leads to a warm, dark and moist environment and allows the normal bacteria and yeast to overgrow and a true ear infection is produced.

This will clear up with medication but, if your pet is exposed to the same trigger, it will come back again. Certain breeds such as Labrador retrievers, golden retrievers, cocker spaniels, shar-peis and many others may have complicating factors such as hair in the ear canal, floppy ears, narrow ear canals or a combination of these things. Now, this does not mean that every member of these breeds is guaranteed to have chronic ear infections, rather it means that if you have a member of these breeds and they have even low-grade allergies the ears can spiral out of control quickly.

In my next article I will describe how to manage chronic or recurrent otitis externa.

Dr. Kearns has been in practice for 16 years and is pictured with his son, Matthew, and his dog, Jasmine.

Dozens more mosquito samples test positive for West Nile

by Rohma Abbas - August 10, 2015

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County: 26 samples collected last month bring total up to 46 this year

Twenty-six mosquito samples and one bird have tested positive for the West Nile virus in various parts of Suffolk County, Dr. James L. Tomarken, the county’s health commissioner, announced on Friday.

The bird, an American crow, was collected on July 31 from Port Jefferson. All the mosquito samples that came back positive were collected on July 29, according to the county. Five of them were from West Babylon, four were from Farmingville and three were from Lindenhurst; as well as two samples each from Northport, East Northport, Huntington Station, Nesconset and Port Jefferson; and one sample each from Greenlawn, Selden, North Babylon and West Islip.

To date this year, 46 mosquito samples and four birds have tested positive for West Nile virus.

The virus was first detected in birds and mosquitoes in Suffolk County in 1999. It is transmitted to humans by the bite of an infected mosquito. No humans or horses have tested positive for West Nile virus in Suffolk this year.

While Dr. Tomarken said there’s no cause for alarm, he urged residents to take steps to reduce exposure to the virus.

Residents should eliminate stagnant water, where mosquitos breed. Popular breeding grounds include tin cans, plastic containers, ceramic pots, discarded tires, wading pools, wheelbarrows and birdbaths. In addition, residents can make sure their roof gutters are draining properly, clean debris from the edges of ponds and drain water from pool covers.

Minimize outdoor activities between dusk and dawn to avoid mosquito bites, make sure windows and doors have screens and wear clothing that covers you when outdoors for long periods of time, or when mosquitos are more active.

To report dead birds, which may indicate the presence of the virus, residents should call the county’s West Nile virus hotline at 631-787-2200 from 9 a.m. to 4 p.m., Monday through Friday. Residents are encouraged to take a photograph of any bird in question.

To report mosquito problems or stagnant pools of water, call the vector control division at 631-852-4270.

For medical questions, call 631-854-0333.

Taking the next step to provide excellence

by TBR Staff - August 5, 2015

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By L. Reuven Pasternak, M.D.

To keep health care strong across Suffolk County and Eastern Long Island, Stony Brook University Hospital and Eastern Long Island Hospital will move forward with next steps toward an affiliation — following a unanimous vote by ELIH’s board of trustees at a meeting held on July 9.

This affiliation will help both hospitals provide excellence in health care for the communities we serve. It would allow both hospitals to continue to bring new and strengthened clinical services to the North Fork of Eastern Long Island, including Shelter Island.

The best affiliations allow hospitals to make sure that each patient receives the right level of care in the right facility to match the right level of services needed. We believe this affiliation will do just that.

Our relationship with ELIH is a longstanding one with a history of the two hospitals working closely together to improve health care access and quality. Stony Brook Medicine clinicians have staffed and assisted in the development of ELIH inpatient behavioral health programs, cared for patients who needed specialty services not available at ELIH, and provided support and patient transport services during times of emergency. For example, following damage from Hurricane Sandy, Eastern Long Island patients were transferred to Stony Brook Medicine for care until the Greenport facility was restored.

The next step is for Stony Brook Medicine and ELIH to develop an integration and affiliation agreement. Then, the State University of New York board of trustees will need to approve the transaction. And finally, multiple regulatory steps must be approved through various New York State agencies.

We are grateful to SUNY’s support and visionary leadership for our continued work to establish affiliations with community hospitals in Suffolk County for the care of Long Island residents. On behalf of all of Stony Brook, we especially want to thank Thomas Murray Jr., chairman of the ELIH board of trustees, and the board for choosing Stony Brook as their strategic partner.

We look forward to strengthening our relationship with ELIH and working with Paul Connor III, president and CEO of ELIH, to fulfill our shared promise to meet the health care needs of the community for years to come.

L. Reuven Pasternak, M.D., is chief executive officer at Stony Brook University Hospital and vice president for Health Systems, Stony Brook Medicine.

U.S. senator supports microbead ban

by Elana Glowatz - August 3, 2015

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A local effort to ban a popular ingredient in beauty products has support on the federal level.

U.S. Sen. Kirsten Gillibrand (D-N.Y.) and state Attorney General Eric Schneiderman visited Long Island recently to announce the Microbead-Free Waters Act of 2015, a bipartisan federal bill that would ban cosmetics containing plastic pellets called microbeads, which are frequently smaller than 1 millimeter in diameter and are found in face washes, shampoos, beauty products and other soaps.

Because of their size, most wastewater treatment systems are unable to filter out the microbeads, so they are released into local waterways like the Long Island Sound. But microbeads accumulate toxins in the water, and fish and birds ingest them. Public health could be at risk if the fish are reeled in and eaten.

Schneiderman reported that about 19 tons of the small pellets pass through New York wastewater treatment plants each year.

Gillibrand’s bill has sponsors and co-sponsors from both sides of the aisle, most of them from the Midwest, according to a press release from the senator’s office. It is similar to a New York state-level bill of the same name, which is Schneiderman’s effort to prohibit the sale and distribution of products containing microbeads.

“These tiny pieces of plastic have already caused significant ecological damage to New York’s waterways,” Gillibrand said, “and they will continue to do so until they are removed from the marketplace.”

The state bill passed the Assembly in the last session but was not put up for a vote in the Senate, despite having more co-sponsors than the number of votes it would have needed to pass.

New York is not alone in pushing to ban microbeads — Illinois has already given them the axe, and other states are considering similar legislation.

Many local residents first heard about the issue when Suffolk County Legislator Kara Hahn (D-Setauket) led her colleagues to passing a law that required the county to study how a microbead ban would affect health and the economy.

She commended officials for their anti-microbead effort on the national stage.

“The threat posed by microbead waste is of national consequence,” Hahn said in the press release. “The cumbersome task of tackling this issue [from] municipality to municipality and state to state will never prove as effective as a federal approach.”

Adrienne Esposito, the executive director of the local Citizens Campaign for the Environment, said there are other effective alternatives to microbeads, such as apricot shells, salt and oatmeal.

“The public expects facial soaps and toothpaste to clean our face and teeth, not pollute our waters,” Esposito said. “Plastic microbeads pollute our waters, contaminate our fish and shellfish, and could end up back on our dinner plates. They are completely unnecessary.”

No swimming at Huntington area beaches after storm

by Elana Glowatz - July 31, 2015

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Centerport-Yacht-Club-beach-reopening-7_ABBASw — Young bathers dive into the waters of a newly reopened beach at the Centerport Yacht Club. Photo by Rohma Abbas

The county health department warned locals on Friday against bathing at 25 Huntington area beaches, the morning after heavy rainfall drenched the North Shore.

According to the Suffolk County Department of Health Services, it issued the advisory because the rain could have led to bacteria levels in the water that exceed state standards.

“The beaches covered by the advisory are located in areas that are heavily influenced by stormwater runoff from the surrounding watersheds and/or adjacent tributaries,” the department said in a press release, “and, because of their location in an enclosed embayment, experience limited tidal flushing.”

Affected beaches include Eagle Dock Community Beach, Cold Spring Harbor Beach Club beach, West Neck Beach, Lloyd Neck Bath Club beach, Lloyd Harbor Village Park beach, Gold Star Battalion Park beach, Head of the Bay Club beach, Nathan Hale Beach Club beach, Baycrest Association beach, Bay Hills Beach Association beach, Crescent Beach, Knollwood Beach Association beach, Fleets Cove Beach, Centerport Beach, Huntington Beach Community Association beach, Centerport Yacht Club beach, Steers Beach, Asharoken Beach, Hobart Beach (both the Long Island Sound and cove sides), Crab Meadow Beach, Wincoma Association beach, Valley Grove Beach, Prices Bend Beach and Callahans Beach.

The advisory was scheduled to be lifted at 9 p.m. on Friday, to give enough time for two tidal cycles to clear out the water. However, the health department said the advisory would not be lifted if water samples from the affected beaches showed continued high levels of bacteria.

For up-to-date information on the affected beaches, call the health department’s bathing beach hotline at 631-852-5822 or visit the beach monitoring webpage.

Protect against uptick in scalp skin cancer cases

by Giselle Barkley - July 31, 2015

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Skin_Cancer_Sunscreen-w — People should go through several bottles of sunscreen in one season. Using an ounce of sunscreen is ideal, as companies measure the SPF of a sunscreen by applying that amount of sunscreen to the body. Photo by Giselle Barkley

A little dab here and a little dab there. That’s usually how people apply sunscreen to their skin, according to Dr. Michael Dannenberg of Dermatology Associates of Huntington, chief of dermatology at Huntington Hospital. But with around one in five people developing skin cancer on their scalp, a dab of sunscreen isn’t enough.

Skin cancer is one of the most prevalent cancers in America, and cases for scalp cancer have increased in the past several years. While those who don’t have hair may be more prone to getting scalp cancer in comparison to those with hair, anyone can develop any form of skin cancer on this area of their body.

Squamous cell and basal cell carcinoma are common for those who are frequently exposed to the sun and those who are losing hair. Melanoma can also develop on the scalp. In 1935, one in 1,500 people developed melanoma, but the rate has since increased. Now, one in 50 people have a lifetime risk of developing melanoma.

According to Dr. Tara Huston, a surgeon in the Melanoma Management Team for Stony Brook Medicine, there will be 74,000 new cases this year of melanoma in the United States alone. Huston also said that this form of skin cancer usually requires a surgeon’s attention, as it calls for “a larger excision margin than either basal or squamous cell skin cancer.”

Huston and her team help patients with various forms of skin cancer. While dermatologists treat skin cancers like melanoma if caught early, people with more advanced stages of skin cancer may need surgery and additional treatment to recover. A patient’s lymph nodes are also examined. Lymph nodes are responsible for the drainage of certain parts of the skin. Doctors can further repair issues found from examining the nodes associated with the cancer in that area.

Sunburns, above, and increased sun exposure increase an individual’s risk of getting skin cancer like Melanoma, which accounts for four percent of cases, but 75 percent of skin cancer-related deaths according to Dr. Huston. Photo from Alexandra Zendrian

Although skin cancer of the scalp is not difficult to detect, Dr. Dannenberg says it can be missed because it is on the head. Lesions can vary based on the form of skin cancer on the scalp. Yet, it is easy to detect, especially when people receive frequent haircuts. According to Dannenberg, his office receives countless referrals from barbers and hairstylists who may find a cancerous lesion on their client’s heads.

Huston agreed with Dannenberg regarding the role of barbers and hairstylists, as a number of skin cancer lesions are identified by these professionals.

Squamous cell carcinoma appears in dull, red, rough and scaly lesions, while basal cell carcinoma appears as raised, pink and wax-like bumps that can bleed. Melanoma on the scalp appears as it would on any other part of the body — irregularly shaped, dark-colored lesions.

While sunscreen is more often associated with skin protection, dermatologists like Dannenberg also recommend protective clothing and hats. Cloth hats allow the wearer’s head to breathe while protecting the scalp. Hats with a three and a half inch or more rim offer the best protection, as they cover the head while protecting the ears and other parts of the face or neck. While people can also use straw hats, the hats should be densely woven and not allow sun to penetrate. Hats as well as sunscreen and protective clothing should be used together to provide people with the best form of sun protection.

“Nobody is completely compulsive about putting on that hat every moment they walk out the door,” Dannenberg said. “Likewise, even for people [who] are using sunscreens, people tend not to use enough of it and they don’t reapply it as often as necessary.”

One ounce of sunscreen might be hard to hold without dripping down the side of someone’s hand, but it is the amount of sunscreen people should use on their entire body. Dannenberg also says that sunscreens usually last for about three hours before people need to reapply.

Since few people follow the directions when applying sunscreen, Dannenberg as well as the American Academy of Dermatology recommend people use sunscreens with at least SPF 30. Using sunscreens with higher SPF counts means that people can under apply and still get some degree of sun and ultraviolet radiation protection.

Huston said individuals who don’t want to wear sunscreen or those with a history of tanning should seek a dermatologist and schedule appointments at least once a year to conduct a full body skin examination.

According to Huston, operating on areas of the head like the ears, nose, eyelids, lips and scalp is difficult because of the surrounding tissue.

“Reconstruction of a 2 cm defect on the nose may require multiple stages/surgeries in order to optimize the aesthetic result,” Huston said in an e-mail interview.

While some patients need skin grafts upon the removal of a cancerous lesion, Huston said, “incisions on the scalp can lead to alopecia, or hair loss along the incision line, if it stretches, and can be very upsetting to patients.”

Both Huston and Dannenberg emphasized the importance of protecting the skin and skin cancer education. Dannenberg hopes that the rates of skin cancer will decrease if people are more consistent about protecting their skin with protective attire, sunscreen and hats.

“We’ve been talking to people for years about wearing hats…telling them that as fashion always seems to follow need, that these hats are going to be coming in style,” Dannenberg said. “We’re hoping that over the next 10 or 15 years, we’ll be able to get a drop in the incidences of skin cancer.”

Charity swim goes the distance for Alzheimer’s

by TBR Staff - July 28, 2015

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Annual Asharoken swim to benefit Alzheimer's disease research raises more than $6,000

By Talia Amorosano

On Tuesday morning, more than 20 kayakers and swimmers gathered for the 12th Annual Distant Memories Swim, an event created and organized by Bryan Proctor, a Harborfields physical education teacher, to raise awareness for Alzheimer’s disease, the most common form of dementia. Participants traveled two nautical miles from Asharoken Beach in Northport to Knollwood Beach in Huntington and were cheered on by family members and supporters who waited and watched the event from shore. This year’s event has raised more than $6,000 for the Alzheimer’s Disease Resource Center so far, and over the course of its existence, has raised over $100,000. Organizers hope that the money will eventually help researchers find a cure for this increasingly prevalent disease.

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Putting together puzzle pieces of human origins

by TBR Staff - July 28, 2015

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By Elof Carlson

Fossils are relatively rare because most of the animals and plants that have died in nature have been eaten or decomposed. Fossils are often found in sedimentary rocks, and those dead organisms were buried after drowning, caught by volcanic ash, buried in a mudslide or sucked down by quicksand or some other event less likely than falling on a field or in the underbrush of a forest, or left as scattered bones by hungry predators. Only in the past few ten thousand years have humans buried their dead, improving the chances that their remains will someday be unearthed and studied by paleontologists.

Until the last half of the twentieth century, the only way to use human fossils to work out a historical association was through comparative anatomy and a variety of chemical and physical tools to determine the age of the sediments in which they were unearthed. The idea of a paleogenetics arose in 1963, with the use of that term by Linus Pauling and his colleagues, who studied the amino acid sequences in hemoglobin molecules of numerous organisms, from sipunculoid worms to humans, that use hemoglobin to carry oxygen to body tissues.

In 1964, the first sequence of fragments of the DNA of an extinct quagga were worked out using the skin of an extinct specimen in a museum. The quagga was an animal that looked like a chimera of giraffe and a zebra.

Once DNA sequencing was worked out, especially by Fred Sanger and his colleagues, viruses, bacteria, single-celled organisms, and then more complex worms and flies were sequenced. By 2000, the human genome was being worked out. Svante Pääbo and his colleagues are leaders in the working out of fossil human DNA.

This is what has been found so far. Four contenders for species status lived about 40,000 years ago. Three populations of humans arose after an initial origin in Africa. Of these three, the Neandertals (Homo neanderthalis) left Africa earlier than our own Homo sapiens. The Neandertals were named for the Neander river valley where they found in Germany. We were named by Linnaeus as Man (Homo) the Thinker (sapiens).

Two additional populations were found, one in western Siberia and the other in Indonesia. The Siberian humans are called Denisovans (Homo denisova). They were named for the Denis cave in which they were found and they also had an exit from Africa. The Indonesian humans are called Homo floresiensis and are named for the island Flores in Indonesia where they were found. Where they came from is not yet known. They are unusual for their small size, a Hobbit-like three- and-a-half feet tall.

The DNAs of three forms of humanity have been sequenced. The complete sequence of DNA of an organism’s cell is called a genome. The Indonesian form went extinct about 12,000 years ago, but no DNA has been extracted from their remains. Neandertals and Denisovans went extinct about 40,000 years ago.

Analysis of the three available genomes shows that most Europeans have about 4 percent Neandertal DNA. Living people in Melanesia and Australian aborigines have about 4 percent H. denisova DNA. About 17 percent of Denisovan DNA is from Neandertals. The human branch Homo bifurcated and one branch split into H. neanderthalis and H. denisova. The other branch from Homo produced us, H. sapiens. We are 99.7 percent alike for H. sapiens and H. neanderthalis.

Since we have 3 billion nucleotides to our genome, there remain 9 million mutations between us, most of it in our junk DNA. There are, nevertheless, hundreds of gene differences between our two species. It also means that where these populations came into contact, fertile matings occurred, and remain in our DNA from our ancestral “kissing cousins.”

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

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