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Lee Zeldin. File photo by Victoria Espinoza

Rep. Lee Zeldin took to Kings Park on Sunday to join the fight against drug abuse, an issue that is plaguing communities on Long Island and across the nation.

Zeldin (R-Shirley) announced his backing of two bills in Congress — the Comprehensive Addiction and Recovery Act of 2015, H.R. 953, and the Stop Overdose Stat Act, H.R. 2850 — which seek to help those struggling with drug abuse and prevent future abuse. Zeldin is co-sponsoring both bills.

“It’s clear we must come together as a community and a nation to combat this growing issue,” Zeldin said.

According to the New York State Office of Alcoholism and Substance Abuse Services, the percentage of state high school students who reported use of heroin more than doubled between 2005 and 2011, from 1.8 percent to 4 percent.

“We can’t treat them and street them, which is what is currently happening in our emergency rooms,” said Linda Ventura, treasurer of Families in Support of Treatment, known as F.I.S.T., a nonprofit organization dedicated to supporting and educating families which are struggling with a loved one’s addiction. “There should be no more shame with someone struggling with this disease, no, stigma — that has to go.”

Ventura, who is also involved with the Suffolk County Prevention Resource Center, is more than just a member of activist groups. She lost her son, Thomas, in March 2012 to drugs.

Bill 953 would help people grappling with drug abuse obtain the services needed to put them on the road to recovery. It would provide up to $80 million in the form of grant funding to help treat and prevent addiction through community-based education and prevention programs, and treatment and recovery programs.

The grants would further help expand prescription drug monitoring programs and provide police forces and emergency medical responders with higher supplies of Narcan, a prescription drug that reverses opioid overdoses.

The legislation has 20 co-sponsors — both Democrats and Republicans — and was introduced by Rep. Jim Sensenbrenner (R-WI).

“It’s a good bill on its merits alone, and it doesn’t matter what names or letters are attached to it,” Zeldin said.

Bill 2850 would provide an additional $25 million over a five-year period for Narcan production and distribution and provide more medical professionals and families with the lifesaving drug.

The act, introduced by Rep. Donna Edwards (D-MD), would also establish a preventative research task force that would look into ways to prevent future overdose deaths, while taking a preventative approach against drug abuse.

Zeldin was joined by members of the community including Suffolk County Legislators Rob Trotta (R-Fort Salonga) and Leslie Kennedy (R-Nesconset); Kim Revere, president of Kings Park in the kNOw, a task force promoting a drug-free community; and Dr. Andrew Kolodny, chief medical officer of Phoenix House, a drug and alcohol rehabilitation center. The congressman wanted to show the only way to win the battle was to remain united.

Like Ventura, the fight was personal for some of those in attendance at Sunday’s press conference.

“I lost my son, Timothy, in August of 2009 after a 14-month struggle with prescription drugs, which eventually led to heroin,” said Teri Kroll, secretary for F.I.S.T.’s board of directors and a member of the resource center. “He passed away after eight and a half months of sobriety.”

Saji Francis, the doctor who prescribed Timothy the drug he eventually became addicted to, was arrested shortly after Timothy passed away. In 2010, Francis was convicted of illegally selling prescription pills and sentenced to six months in jail.

Kolodny, who also serves as the director of Physicians for Responsible Opioid Prescribing, explained how many people start abusing drugs after taking prescription medications.

“To control this epidemic we need to prevent new people from getting this disease, and treat those who are suffering,” he said. “We also need to get doctors and dentists to prescribe more cautiously. If not, these overdose levels with continue to rise.”

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Photo from the health department

Blue-green algae has made some waters in Suffolk County unsafe for residents, according to the county health department.

The New York State Department of Environmental Conservation reported recently that in seven nearby bodies of water, levels of cyanobacteria, also known as blue-green algae, have exceeded health criteria, according to the Suffolk County Department of Health Services.

While cyanobacteria appear naturally in lakes and streams in low levels, the department said, they can become abundant and form blooms that are green, blue-green, yellow, brown or red in color. The algae can appear in “floating scums on the surface of the water, or may cause the water to take on [a] paint-like appearance.” Contact with those scummy or discolored waters should be avoided.

Currently affected waters include parts of Lake Ronkonkoma; Old Town Pond, Agawam Lake and Mill Pond in Southampton; Maratooka Lake in Mattituck; Kellis Pond in Bridgehampton; and Wainscott Pond in Wainscott.

Lake Ronkonkoma Beach has already been closed to bathing for more than a week, a health department official said on Monday, because test results showed high levels of a different bacteria — E. coli, caused by fowl droppings.

The levels of cyanobacteria and “associated toxins” are particularly high at Agawam Lake, the health department said in a recent press release, so residents should avoid direct exposure to water there.

At all of the affected locations, the health department said, residents should not use the water, and should not swim or wade in it. Officials also advised residents to keep both children and pets away from the areas.

If people or pets come in contact with the affected water, health officials said, they should be rinsed off immediately with clean water. If the affected person experiences symptoms such as nausea, vomiting, diarrhea, allergic reactions, breathing difficulties or irritation in the skin, eyes or throat, he should seek medical attention.

More information about cyanobacteria is available on the county health department’s website.

To report a cyanobacteria bloom at a county beach where bathing is permitted, call the Suffolk County Department of Health Services’ Office of Ecology at 631-852-5760. To report one at a body of water in Suffolk County without a bathing beach, call the Division of Water at the New York State Department of Environmental Conservation at 518-402-8179.

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Get healthier before the season ends

By Lisa Steuer

Summer is in full swing. Ideally, you would have started working toward your summer body a few weeks or even months ago. But if you still have some progress to make, here are some last minute steps to get in better shape before summer ends.

Increase water intake. Leave a full 24 to 32-oz water bottle by your bed every night, and when you wake up in the morning, immediately drink that as you get ready. During the night your body hasn’t taken in much liquid, so it’s thirsty in the morning. Drinking water immediately in the morning gets your systems running and can aid in fat loss. You’ll also find that it’s very energizing. In addition, increase your water intake throughout the day, aiming for a gallon. Stay away from soda and other sugar-laden beverages.

Drinking water immediately in the morning gets your systems running and can aid in fat loss.

Eat a healthy breakfast. This can set you up for eating healthy the rest of the day. Try Greek yogurt with fruit, an omelet with veggies, or throw some fruit, natural peanut butter and almond milk in the blender for a delicious smoothie you can take on the go.

Prepare your lunches for the week every Sunday. Being prepared is one of the most important keys to success when it comes to health and weight loss. An example of a meal you can easily make in bulk: 4 oz. of lean ground turkey or chicken, one-fourth cup of quinoa, and one cup of veggies like broccoli. Bake the broccoli in the oven while making the quinoa and meat on the stove, and before you know it you’ve got a week’s worth of healthy lunches.

Replace your morning coffee with green tea with lemon at least a few times a week. While black coffee is healthy, the cream and sugar that often accompanies coffee is full of calories. Green tea has zero calories, contains antioxidants and has been shown to aid in fat loss.

Order smart at restaurants. It’s not as difficult as one may think, especially because many restaurants now have healthier menu sections. As a basic rule, look for words on the menu like grilled, baked or broiled and stay away from anything fried or breaded.  If possible, view the menu online before you go so that you’re prepared.

Increase cardio activity. Try to do something at least five days a week. Schedule a run every morning or a walk every evening. Go for a bike ride or swim laps. Sign up for a new and different fitness class each week. Just get out and get moving!

Have fun experimenting with new recipes. Eating healthy doesn’t have to be boring. Experimenting with new recipes can help keep you motivated. Try out healthy swaps— for instance, more often than not, you won’t even notice the difference when you swap out sour cream for Greek yogurt. Check out fitnessrxwomen.com for some great ideas.

Green tea has zero calories, contains antioxidants and has been shown to aid in fat loss.

Be active during downtime. While at home watching TV, do some crunches, planks, sit-ups, jumping jacks, etc. Do some squats while you’re heating something up in the microwave. Get creative!

Cut down on sugar, alcohol and sodium. It’s OK to have a treat once a week or so, but you may find that when you cut out sugar and alcohol, you’ll feel much better anyway. When a sweet craving strikes, try a small piece of dark chocolate or a chocolate protein shake. And while we do need some sodium in our diet, too much will lead to bloating.

Track your food intake with a food log or app like My Fitness Pal. You may be surprised at how much you’re actually consuming without realizing it.

Sign up for a 5K that occurs in the fall. It will keep you on track this summer and help motivate you to stay active. Even if you’ve never done a 5K before, it’s a great way to challenge yourself. You’ll feel amazing when you cross that finish line after all your hard work!

Lisa Steuer is the managing editor of FitnessRx for Women and FitnessRx for Men magazines. For more fitness tips, training videos, healthy recipes and print-and-go workouts that you can take with you to the gym, visit www.fitnessrxformen.com and www.fitnessrxwomen.com.

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By Gerard Frank Schafhautle

Wild dogs, such as wolves, are carnivorous by nature, whereas domesticated dogs have adapted to more omnivorous diets. Therefore, there are plenty of plants that, in moderation, may be consumed by our canine comrades. Some examples include carrots, blueberries, white rice and yes, peanuts. Whether butter in a jar or nuts in a bag, peanuts are generally a safe choice (in moderation) compared to many other plants that we call nuts.

Ironically, peanuts are not actually nuts, but rather legumes, like peas and beans. The true nuts are those from trees, such as walnuts, pecans, hickory, hazelnuts, macadamia, cashew, Brazilian nuts, Cocoa (Chocolate), and acorns. Before venturing into the harmful effects of tree nuts, allow me to explain an oddity in the nut family that was not mentioned — almonds.

Almonds come in two varieties: sweet and bitter. Bitter almonds are more related to the fruit tree family of peaches and apricots. If you were to crack open the pit of an apricot or peach, you will see one or two seeds that look suspiciously like almonds. Bitter almonds and the center of a fruit pit all contain a cyanide-related chemical called benzaldehyde as well as other harmful chemicals, which are capable of symptoms ranging from lethargy to fatality. So be careful of bitter almonds and pets, as well as letting them chew on a fruit pit.

Nuts from trees can be contaminated with a mold type fungus called Aspergillus. This type of mold fungus secretes a type of poison called aflatoxins. Aflatoxins can cause damage to the liver and potentially lead to cirrhosis (scarring), or carcinoma (cancer). Best not let your fluffy family members eat any fallen tree nuts.

Although chocolate tastes great, cocoa products contain theobromine, which is deadly to your pets in even small amounts. Theobromine is found in all forms of chocolate and cocoa butters, in increasing concentrations from white chocolate (the least) to dark chocolate (the greatest). Theobromine is a stimulant that could lead to irregular heart rhythms and seizures. Both could be fatal.

Nuts of the arboreal nature may contain one other toxic substance harmful to your pets. Walnuts, American black and English, amongst other species, are formed under a thick leather skinned exterior. The space between the nut’s shell and this protective barrier is filled with a soft black resin full of tannins. Tannins are substances that act as astringents which bind proteins and amino acids in the body. The effect is rapid onset vomiting and diarrhea, followed by life threatening and sometimes fatal kidney and liver damage.

Peanuts. Finally we come around to the safe “nut” — well , almost. Peanuts are high in fats, which can clog up the liver and pancreas, which can lead to pancreatitis, inflammation of the pancreas and/or hepatitis, inflammation of the liver. These issues are easily treated by your veterinarian by switching your dog to a bland, low-fat diet and halting the “treating” of peanut butter in a hollow bone toy. Chemicals originating from tree nut consumption are much more difficult to treat, and may require special attention by the animal poison control hotline or an emergency veterinary clinic or hospital.

Benjamin Franklin once said, “an ounce of prevention is worth a pound of cure.” Do not allow your dog access to any human-edible tree nuts. Keep your veterinarian’s office phone number, as well as the closest after-hours veterinary emergency clinic and animal poison control hotline, in a spot that is accessible to all family members. Finally, if you feel the need to treat your pet with a few peanuts or some peanut butter, do so in careful moderation. Be safe, be wise, and be informed.

Gerard Frank Schafhautle has worked for Dr. Matthew Kearns at Countryside Animal Hospital in Port Jefferson for 6 years. He has a certification in Animal Science and will be attending Stony Brook University this fall, working toward an undergraduate degree in Biology.

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File photo

Stony Brook Medicine announced on Friday that the Eastern Long Island Hospital board of directors has voted unanimously to approve an affiliation with Stony Brook University Hospital, subject to the successful completion of the definitive agreement and all regulatory and other approvals.

The decision was ruled an important first step toward advancing Stony Brook’s collaboration to ensure North Fork residents have greater access to high-quality care, according to Kenneth Kaushansky, senior vice president for Health Sciences and dean of the Stony Brook University School of Medicine.

“We are grateful to SUNY’s visionary leadership in its support of our continued work to establish agreements with community hospitals in Suffolk County for the care of Long Island residents,” said Reuven Pasternak, chief executive officer for Stony Brook University Hospital and vice president for health systems at Stony Brook Medicine.

Thomas E. Murray Jr., chairman of the Eastern Long Island Hospital board of trustees said his group had been deliberating over the past several months on finding a strategic partner. He said Stony Brook best fulfilled the board’s mission to best address what he called the evolving health needs of his eastern community.

State Sen. Ken LaValle (R-Port Jefferson) said he could not be more pleased with the news, given his experience working to move the hospital forward.

“Throughout my tenure, I have worked hard to make certain that quality, affordable medical services are accessible to residents throughout my district,” he said. “This unanimous decision ensures that people on the North Fork and Shelter Island will continue to receive expert medical care close to home.”

Stony Brook and Eastern Long Island will immediately initiate a collaborative planning effort to develop a long-term strategic plan to ensure current and future health care needs are addressed.

“While the delivery of health care and especially hospital care is rapidly changing, becoming a part of Stony Brook University Hospital will allow Eastern Long Island Hospital to make this complex transition while continuing to carry out our long-time promise to the community. The hospital has been here for 110 years and this affiliation will ensure that the health care needs of the community are met for years to come,” said Paul J. Connor, III, president and CEO of Eastern Long Island Hospital.

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An expert panel at Stony Brook University discusses environmental issues facing Long Island. Photo by Talia Amorosano

By Talia Amorosano

After a month of increased algal blooms, reduced water quality and two of the most severe fish kills the county has ever experienced, Long Island scientists and officials have decided it is past time — yet about time — to address the issue of harmful nitrogen pollution in our waterways.

Hosted by the New York League of Conservation Voters Education Fund, a forum on water pollution in Suffolk County was held at Stony Brook University’s Charles B. Wang Center on June 23 to identify the core causes of nitrogen pollution and brainstorm functional, cost-effective technological solutions.

In his welcome address, Suffolk County Executive Steve Bellone (D) emphasized the gravity of the problem.

“This problem wasn’t created overnight, and it won’t be solved overnight,” he said. “Big challenges like this won’t be solved in election cycles.”

But he has noticed signs of progress.

“To see this group all coming together, saying we’re going to work to solve this problem, gives me great hope and optimism that we have actually turned the corner and we are now on the road to addressing our water quality issues in a real way.”

At the forefront of the technical and technological sides of this progress are panelists Walter Dawydiak, director of the Suffolk County Department of Health Services; Amanda Ludlow, a scientist at Roux Associates Inc.; Theresa McGovern, a water resources engineer at VHB; and Harold Walker, a professor of Mechanical and Civil Engineering at Stony Brook University.

Dawydiak identified unsewered septic flow as the main source of the nitrogen problem.

“Nitrogen, which we expected to level off, is not leveling off,” he said.

He noted that 85 percent of unsewered septic flow originates in residential areas.

“The elephant in the room is us.”

He said a change in health department standards for residential wastewater treatment — for the first time in 40 years — could mitigate the problem by regulating the installation, operation, and maintenance of septic systems. He referred to this proposed set of regulations as an example of policy driving the technology to where it needs to be.

“We need better technology in this area,” Walker said. “If we’re going to solve this problem, we need to expand the tool box that we have available. … We need to think about systems operating effectively for as long as possible, with little or no maintenance. That’s the challenge.”

Ludlow agreed, and emphasized the importance of implementing systems that treat nitrogen and other pollutants, like pharmaceuticals and hormones, on the 360,000 homes running on old systems: “Focus on technologies that affect all the constituents in our wastewater.”

McGovern said that a holistic yet specific approach to wastewater management would make improvements possible.

“We need to be consistent and science-based with the targets, yet still allow some flexibility,” she said. She suggested setting a universal — instead of concentration-based — limit on the amount of nitrogen allowed to remain in wastewater, while allowing households that consistently perform under that limit increased wastewater flow.

Of course, new technologies and oversight costs money. During the second panel discussion on funding proposals, Suffolk County Planning Commission co-chair David Calone suggested using Hurricane Sandy recovery funds to improve storm-water drainage and prevent sewage from entering waterways.

Dorian Dale, director of sustainability and chief recovery officer for Suffolk County, noted that, though the $16 million of Sandy relief money would cover some of the cost for improvements, it could not provide the minimum $8 billion necessary to replace 360,000 septic systems.

He said changing the tax on drinking water from a base price to one that reflects household usage could help close the gap.

Calone brought up the possibility of reaching out for federal funding and increasing the cap on private activity bonds to spur work on water quality issues.

“Involving the private sector is where we’ve shown a lot of leadership on Long Island,” said Anna Throne-Holst, Southampton Town supervisor. “It has to be a public/private partnership.”

The panelists were optimistic about the county’s ability to undertake the project.

“The last sewer project, 40 years ago, was rife with cesspool corruption,” Dale said. “I don’t think anybody’s going to have time for the shenanigans of the past.”

Throne-Holst expressed her faith that the public will remain informed and engaged on this issue.

“The public education process is well underway,” she said. “People are well aware of what a crisis this is.”

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The Metabolic Reboot Smoothie, pictured above. Photo by Lisa Steuer

By Lisa Steuer

Contrary to what some may believe, there are many tasty ways to eat healthy. Whether your goal is to lose weight or improve your well being, smoothies are a great and easy option.

Making a smoothie — when you blend ingredients together — is different from juicing. When juicing, the juice is extracted from fruits and vegetables, leaving behind a pulp that is often thrown away. In addition, this strips the fruit of its fiber but leaves the sugar.

While juicing is still considered healthy in moderation, having a fiber source with your healthy drink is important, said Shoshana Pritzker, RD, CDN, who owns Nutrition by Shoshana in East Islip. Fiber keeps you feeling fuller for longer, is good for digestion and helps control blood sugar.

Still, many people turn to juicing-only type diets in order to “cleanse.” However, this is not really necessary, Pritzker said.

“You have a liver and a kidney that do a phenomenal job at making sure your system is clean and healthy, so there really is no way to detox better than what your body does already on its own,” said Pritzker. A better option, instead, is to focus on filling your diet with plenty of fiber-rich fruits and vegetables to keep you healthy and your system running smoothly.

The kind of smoothie you make can be dependent on your goals. For instance, add green tea to a smoothie to help boost your metabolism if you want to lose weight. Or make a health blend with antioxidant-rich ingredients like blueberries. “Overall, you should just be looking for a healthy blend of ingredients you like. Because if you don’t like it, you’re not going to drink it,” said Pritzker.

Making the Perfect Smoothie
Like any healthy meal, the ideal smoothie should contain all three macronutrients: protein, complex carbs and healthy fats. For protein, you could use a scoop of protein powder, non-fat dairy milk or non-fat yogurt (either Greek or regular, depending on your personal preference); the healthy fat could be fish oil, flaxseed, peanut butter, nuts, coconut oil or even an avocado (“You can’t even taste it. It makes it really thick and creamy,” said Pritzker). And your complex carb could be a high-fiber cereal or granola. A smoothie that contains all three macronutrients could even work as a meal replacement.

In addition, if you’re concerned about your fruit going bad before you get a chance to use it, give frozen fruit a try, as it’s just as healthy as fresh fruit (just check the label to make sure it contains no added sugar). “The only thing you want to stay away from is canned fruit,” said Pritzker. “Canned fruit is usually kept in syrup.”

Here are three smoothie recipes Pritzker shared. For more recipes, visit her website at nutritionbyshoshana.com, where you can also download a free smoothie recipe e-book.

Metabolic Reboot Smoothie: Makes 1 serving
Ingredients:
1 scoop vanilla whey protein powder
1/2 frozen banana
1/4 fresh avocado
1 cup chopped kale
1 cup fresh or frozen blueberries
1/2 – 1 cup brewed green tea, cooled
Ice
Directions:
Add ingredients to blender and blend until smooth. Enjoy!

Antioxidant Power Smoothie: Makes 1 serving
Ingredients:
1 cup fresh or frozen mixed berries (blueberries, raspberries, strawberries, blackberries, etc.)
1 cup frozen chopped spinach
1 apple, cored and cubed
1/2 frozen banana
1 tablespoon flaxseeds or ground flaxseeds
1/2 – 1 cup water or milk of choice
Ice (optional)
Directions:
Add ingredients to blender and blend until smooth. Enjoy!

PB & J Breakfast Smoothie: Makes 1 serving
Ingredients:
6 ounces plain, nonfat, Greek-style yogurt
2 tablespoons natural peanut butter
1/2 cup fresh or frozen purple grapes
or strawberries
1/2 cup dry oats
1/2 to 1 cup milk of choice
Ice (optional)
Directions:
Add ingredients to blender and blend until smooth. Enjoy!

Lisa Steuer is the managing editor of FitnessRx for Women and FitnessRx for Men magazines. For fitness tips, training videos and healthy recipes, visit www.fitnessrxformen.com and www.fitnessrxwomen.com.

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A deer tick is a common type of tick on Long Island. Stock photo

As Long Islanders are warned about an uptick in Lyme disease, another tick-borne virus has emerged in Connecticut across the Long Island Sound.

Nearly 12 years ago, Eric Powers, a biologist and wildlife educator, noticed an increase in the tick population at Caleb Smith park in Smithtown, after pulling nearly 40 ticks off a group of his students.

Powers conducted a survey of the park and discovered the population of tick predators had decreased, as feral and outdoor house cats either chased them off or killed them.

“It’s becoming a huge nationwide issue with our wildlife,” Powers said during a phone interview. “Wherever people are letting their cats out, we’re seeing this disruption in ecosystem where these tick predators are gone.”

But what Powers did not find was the prevalence of a tick-borne virus, the Powassan virus, which recently appeared in Bridgeport and Branford in Connecticut.

Between 1971 and 2014, 20 cases of POW virus were reported in New York, according to the Cornell Cooperative Extension in Suffolk County. The Centers for Disease Control and Prevention reports the virus has been found in Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Virginia and Wisconsin.

Like Lyme disease, the virus can cause long-term neurological problems if left untreated. But Long Island POW virus incidences remain low despite the increase in tick population, according to Daniel Gilrein, an entomologist at Cornell Cooperative Extension.

POW virus, which is related to the West Nile virus, was first identified in Powassan in Ontario, Canada, in 1958 after a young boy was bitten by an infected tick.

Little is known about how much the tick population has exactly increased on Long Island, but Tamson Yeh, pest management and turf specialist for the Cornell Cooperative Extension, said it is unlikely cats are contributing to the increase by eating tick predators like birds.

“Birds will eat ticks, but not all birds are insect eaters,” Yeh said in a phone interview.

She said the snow cover during the winter months served as insulation for the ticks hiding in the ground, which helped them survive during the colder weather.

Richard Kuri, president of R.J.K. Gardens, a St. James-based landscaping company, has not noticed an increase in tick population recently. Regardless, he and his men continue to wear long sleeves and use a variety of sprays to ward off bugs while on the job. Kuri also said people may use more natural remedies to deter ticks.

“There are people who apply peppermint oil and rosemary mix that will help,” Kuri said. “But none of them are cure-alls.”

He added that granular insecticides, like Dylox, help kill a variety of unwanted bugs including ticks carrying viruses like Powassan.

There are two strains of the virus, which are carried by woodchuck and deer ticks. Since only about 60 cases of POW virus were reported in the United States in the past 10 years, Yeh said the chance of encountering POW virus is unlikely since the virus is rare.

Symptoms of the virus include fever, headaches, vomiting, weakness, confusion, drowsiness, lethargy, partial paralysis, disorientation, loss of coordination, speech impairment, seizures, and memory loss. Other complications in infected hosts may possibly arise, such as encephalitis, inflammation of the brain and meningitis.

Powers said he hopes to reduce tick population on Long Island through his quail program. He encourages local teachers, who use chicks or ducklings to educate their students about the circle of life, to raise bobwhite quails. He said releasing these quails annually will not only help them adjust to the presence of cats, but also control the tick population.

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Focusing on clinical and population improvements for our communities

By Joseph Lamantia

Whether or not you’ve already heard of the Delivery System Reform Incentive Payment Program, one thing is for certain: it’s about to change health care in our state.

In April 2014, New York State Governor Andrew M. Cuomo announced that New York had finalized terms with the federal government for a groundbreaking waiver enabling the state to reinvest $6.2 billion in federal savings generated by Medicaid Redesign Team reforms. Known as DSRIP, the program promotes community-level collaborations, with a focus on improving health care for patients covered by Medicaid and those who are uninsured.

The main goal of the program is to reduce avoidable emergency room visits and avoidable hospital admissions among Medicaid and uninsured populations by 25 percent over a five-year period. The plan is to accomplish this through enhanced collaboration among providers, improved electronic and direct communications, and ready access to primary care and behavioral health services.

For example, offering after-hours appointments can help patients who work full-time; translation services can assist those for whom English is a second language; and transportation to appointments can help patients who don’t have access to a vehicle or public transportation.

The DSRIP initiative for Suffolk County and its network of providers is called the Suffolk Care Collaborative.

The Office of Population Health at Stony Brook Medicine is administering the SCC and is responsible for coordinating more than 500 countywide organizations, including hospitals, skilled nursing facilities, long-term home health care providers, behavioral health professionals, community-based organizations, certified home health agencies, physician practices and many other integral health care delivery system partners.

Some of the 11 focus areas of the SCC are diabetes care, pediatric asthma home-based self-management, cardiovascular care, behavioral health access and substance abuse prevention programs. Central to all programs is a coordination-of-care effort using care mangers embedded in the community to support health care providers and patients to achieve individual health goals. Connecting with patients at the point of care, identifying needs and providing appropriate support in the community will help prevent unnecessary emergency room visits and hospitalizations, and support a healthier population.

Suffolk County has approximately 150,000 uninsured residents and 240,000 Medicaid enrollees who can benefit from the program’s initiatives. And, because improvements made will affect the overall health care delivery system, they have the potential to benefit everyone — enhancing the patient experience and outcomes. When providers collaborate on patient care, information can be shared, test duplication can be avoided and preventive measures can be put in place to help all patients stay healthier.

Visit www.suffolkcare.org to learn more about the Suffolk Care Collaborative.

Joseph Lamantia is the chief of operations for population health at Stony Brook Medicine.

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By Matthew Kearns, DVM

I recently authored a two-part series entitled “A Long (and Fat) Winter’s Night,” with ideas on the management of the obese patient. However, if your pet is not obese but the long winter has affected them, what do we do? Stiff, creaky joints may make it difficult for him or her to rise. Just doesn’t seem to be able to finish those long walks (or even have the willingness to take them).  These are difficult to see in our aging babies but are also something that can be addressed. Physical therapy along with low-impact exercise can be helpful in not only improving our pet’s mobility and stamina but also has a positive effect on their sense of well-being.

Before I discuss physical therapy and low-impact exercise specifically, I would recommend that all pet owners visit their veterinarian’s office to rule out possible underlying or concurrent disease. This may be something that you already do during an annual wellness exam. However, if you’ve missed a few years, please do make an appointment to have your four-legged family member examined and consider some basic diagnostics (if warranted) such as blood work, X-rays, etc. If all is well, then let’s get started.

The one good thing about physical therapy (unlike missing a dose of medication) is every little bit helps. If you can perform certain exercises and therapies only once daily instead or more often, remember every little bit helps.

Heat Therapy and Massage: It has been shown that heat therapy causes vasodilation and improves circulation to tissues. This increases tissue oxygenation and transportation of metabolites. It has been proven that five to 10 minutes of heat before physical therapy and exercise can reduce joint stiffness and increase range of motion. Make sure to use a blanket or towel as an insulating layer between your pet’s skin to prevent burns. After heat therapy, gentle massage therapy manipulates muscles and tissues around joints to reduce pain, stiffness, muscle knots/spasms, increase blood flow and promote relaxation.

Range of Motion and Stretching Exercises: This type of exercise helps improve joint motion and flexibility in patients. Simple flexion and extension exercises are excellent. Find a part of the house where your pet will feel most relaxed and least likely to try to get up and move around. Manipulate each affected joint only as far as your pet will tolerate initially but hold for 15 to 30 seconds at full flexion and again at full extension. Repeat the process for three to five repetitions.

Low-Impact Exercise: The most accessible (and most commonly used) low-impact exercise is controlled leash walks.Controlled leash walks (slowly at first) will help to achieve the most normal gait possible. Slow walks increase flexibility, strength and weight bearing. After slow walks have been mastered, then we can increase the pace, incorporate gentle inclines or different surfaces (e.g., sand) to further develop endurance, strength, balance and coordination.

Swimming: Swimming is somewhat controversial in veterinary medicine. Some believe swimming (because of the non-weight-bearing component) is the ideal at-home exercise for older patients. Others believe the movements are too “herky-jerkey” and could lead to hyperextension of already arthritic joints. First, access to a pool that has stairs that the pet can walk in and out of is important (this eliminates swimming in the ocean or above-ground pools). Make sure active swimming only continues for five minutes before taking a break. It would also be a good idea to purchase a pet-specific life jacket to ensure that if your pet does tire there is no risk of drowning.

There are other physical therapy modalities such as therapeutic ultrasound, therapeutic laser, transcutaneous electrical nerve stimulation (TENS), underwater treadmills, etc. Unfortunately, these modalities are neither readily available nor inexpensive so I thought I would concentrate on therapies one could do at home. If interested in more advanced therapies, make an appointment with your veterinarian to discuss them.

Dr. Kearns has been in practice for 19 years.

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