Health

Pictured above, from left, Paige Hubbard, office manager; Councilman Neil Foley; Dr. Rohit Reejsinghani; Councilman Timothy Hubbard; Catrina Grefe, NP; Dr. Vishnu Seodat; Councilwoman Jodi Giglio; Councilwoman Catherine Kent; Tina Toulon, physician liaison for NYCBS; and Amanda Brown, medical assistant. Photo courtesy of New York Health

New York Health (NYHealth) recently announced the addition of family physician Dr. Vishnudat Seodat. To celebrate the opening of his two new offices — at 6144 Route 25A, Suite 19 in Wading River and 32645 Main Road, Suite 7-8 in Cutchogue — a ribbon-cutting ceremony was held at the Wading River location on June 25. 

The event was attended by the Executive Director of New York Health, Dr. Rohit Reejsinghani; Brookhaven Town Councilman Neil Foley: Riverhead Town Councilmembers Catherine Kent, Jodi Giglio and Timothy Hubbard; and members of the staff and community.

Dr. Vishnudat is presented with a Certificate of Congratulations from the Town of Riverhead. Photo courtesy of New York Health

“At the end of the day, New York Health is really about patient care and having the basis of a large group of patients with such a great practitioner in this area really compliments our group very well so we are very happy to have Dr. Seodat on board and we think this is going to be a successful operation moving forward,” said Dr. Reejsinghani.

“As a child, I developed pneumonia which led to a house call from my family physician. The physician did not accept payment from my family for the appointment due to my less fortunate financial living conditions at the time,” said Dr. Seodat. Inspired by the physician’s compassion, Dr. Seodat navigated his life so that he could become a doctor for everyone. “My journey began as a nurse and a pharmacist dispenser before traveling to New York to earn my degree in medicine.”

Working alongside him for the past two years is Adult-Geri Nurse Practitioner, Catrina Grefe, MS, RN-BC, AGNP-C. “Patients can feel confident with me as their practitioner, and I am eager to deliver high-quality care to patients on the East End,” she said.

“Supervisor Yvette Aguiar of the Town of Riverhead together with the entire town board extend their best wishes for success to New York Health Family Medicine … on the opening of your new practice in Wading River. We look forward to having your quality of business in our town and wish you great success,” said Councilman Hubbard before presenting Dr. Seodat with a Certificate of Congratulations.  

“This ribbon cutting ceremony, in my mind, signifies not only the clearing of a barrier but to open a new door and the birth of a new venture with New York Health,” said Dr. Seodat. “It offers an opportunity to expand medical care … to the East End of Long Island. I am thrilled to be given the opportunity to partner with this multidisciplinary group and I hope to set the standard for family practice and primary care in this community and many other communities on Long Island.”

To make an appointment with Dr. Seodat or Catrina Grefe, please call ​631-758-7003.

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After months in which COVID deaths robbed families throughout Suffolk County of grandparent, parents, siblings, sons and daughters, the county reported no deaths from the virus for the second time in three days.

“From where we’ve been to where we are today is a world of difference,” County Executive Steve Bellone (D) said on a daily conference call he’s conducted with reporters since the third week of March. “The last two out of three days is a good indicator of where we are and the positive direction we continue to move in.”

Bellone described the other numbers for the virus as “also very good.”

The number of new positive tests was 42, out of a total of 4,047. The positive tests represented about 1 percent of tests, which is about the recent rate. The total number of positive tests since the pandemic began in the county stands at 41,420.

The number of residents who have the antibody but haven’t had a positive test stands at 19,270.

The number of hospitalizations was one of the few figures that moved in an unfavorable direction, as seven additional people entered the hospital with COVID-19, bringing the total to 73.

The number of people in the Intensive Care Unit declined by one.

Hospital bed use was at 70 percent, with 57 percent of ICU beds occupied.

An additional six people were discharged from the hospital. The county distributed 34,000 pieces of personal protective equipment over the last day.

Finally, Bellone is hosting a webinar on July 7th at 10 am to provide information to residents interested in entering the food truck business.

“Outdoor dining has proven successful during the COVID-19 pandemic, and food trucks are uniquely positioned to adapt to the challenges posed by this crisis,” Bellone said in a statement.

Suffolk County currently has 228 mobile vending vehicles, which offer food, coffee and dessert. The webinar is a part of Suffolk Count’s Business Recovery Unit. Residents interested in attending the webinar can register here.

Bethpage Ballpark in Central Islip. Photo from LI Ducks website

The Long Island Ducks will not take the field this season, as New York State wouldn’t allow the baseball team to allow fans to attend an abbreviated season.

While Major League Baseball teams, at least for now, can make a shortened season work without fans because of television and advertising revenue, the Ducks couldn’t make a fan-free season work.

“I’m disappointed the Ducks won’t be on the field,” County Executive Steve Bellone (D) said on his daily conference call with reporters. Bellone had hoped that the state would support capacity limits, especially in an outdoor environment which would lower the risk from the transmission of COVID-19.

Bellone said the state’s decision with the Ducks shouldn’t have any impact on youth sports, in which parents are hoping to watch their children return to fields after their sons and daughters spent months away from the competition, the teammates, and the opportunity to enjoy summer games and competition.

Viral Numbers

The number of residents who tested positive for the coronavirus was 46, bringing the total to 41,386. A total of 3,312 people were tested, which means 1.4% of the tests had a positive result, which is among the higher levels of positive tests in recent weeks.

While the percentage is higher than it’s been recently, Bellone said he doesn’t put too much stock in any one day’s results.

Hospitalizations declined by six, with 66 residents now hospitalized with COVID-19. That is the first time since March that the number of people battling against the virus in the hospital was below 70.

The number of people in the Intensive Care Unit with symptoms from the virus increased by one to 24.

Hospital capacity remained below pre-set caution levels. Overall hospital occupancy was at 67%, while ICU bed occupancy was at 59%.

Nine people were discharged from hospitals in the last 24 hours.

After a day without any fatalities from complications related to COVID-19, two people died in the last day. The death toll from the coronavirus stands at 1,981.

The county distributed 5,000 pieces of personal protective equipment in the last 24 hours.

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For the first time since June 12, Suffolk County reported no deaths from COVID-19.

“I do hope and pray that it will not be another 17 days for me to be reporting zero deaths again,” County Executive Steve Bellone (D) said on his daily call with reporters. “Hopefully, this is the start of something we will continue to see.”

The total number of deaths from the virus in the county remained at 1,979.

The number of positive tests, meanwhile, was 33, bringing the total to 41,339. With 4,481 people receiving tests in the past day, the positive tests were among the lowest the county has had in weeks, at 0.7 percent.

The number of people who tested positive for the antibody who didn’t have a positive COVID-19 test was 19,074.

Hospitalizations continued to trend slightly lower. The number of people in the hospital overall fell by three to 72. The number of people in Intensive Care Units with COVID-19 also declined by three to 23.

Hospital bed occupancy was at 68 percent, down from 70 percent the day before. ICU bed occupancy was at 62 percent.

An additional 20 people were discharged from the hospital in the last day.

Separately, the county announced a plan, starting today, to walk back some protective measures put in place for Suffolk County Transit. In March, the county asked residents to use fast fare. Busses did not take cash, riders had to board from the back of the bus, and residents needed to leave the first few rows of the bus vacant to protect drivers.

Now that the county is in Phase 3, Suffolk County Transit has re-instituted front door boarding and will accept cash, even as it is encouraging riders to use the mobile app.

The county has provided protective barriers on all busses to keep the drivers safe from infection. Riders are still required to wear face coverings until further notice.

Finally, officers in the Third Precinct arrested Pablo Figuero, a convicted sex offender, last night at 10:20 pm. He was found in a parked car on Suffolk Avenue in Central Islip and was charged with Criminal Possession of a Controlled Substance in the 7th Degree. He was taken for arraignment today and will be held in jail. Bellone said he is wanted out of New Mexico.
This post was updated at 4:30 p.m. Monday.

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Suffolk County continued to keep viral numbers low. The number of new cases in the last day was 53, bringing the total since the beginning of the COViD-19 epidemic to 41,306.

The number of people who have tested positive for the antibody was 18,970.

The hospitalization figures remained relatively flat. In hospitalizations as a whole, two people left the hospital. The total stands at 75.

The number of people in the Intensive Care Unit with the virus was 26, which is an increase of 1.

An additional 10 people were discharged from the hospital.

Capacity remained at safe levels, with hospital occupancy at 70 percent and ICU bed capacity at 63 percent.

One person died in the last day, bringing that total to 1,979.

GERD is a common condition in which the esophagus becomes irritated or inflamed because of acid backing up from the stomach. Stock photo
You may avoid medications by making simple changes

By David Dunaief, M.D.

Dr. David Dunaief

Wherever you look there is an advertisement for the treatment of heartburn or indigestion, both of which are related to reflux disease.

Reflux typically results in symptoms of heartburn and regurgitation, with stomach contents going backward up the esophagus. For some reason, the lower esophageal sphincter, the valve between the stomach and esophagus, inappropriately relaxes. No one is quite sure why it happens with some people and not others. Of course, a portion of reflux is physiologic (normal functioning), especially after a meal (1). As such, it typically doesn’t require medical treatment.

Gastroesophageal reflux disease (GERD), on the other hand, differs in that it’s long-lasting and more serious, affecting as much as 28 percent of the U.S. population (2). Can you understand why pharmaceutical firms give it so much attention?

GERD risk factors are diverse. They range from lifestyle — obesity, smoking cigarettes and diet — to medications, like calcium channel blockers and antihistamines. Other medical conditions, like hiatal hernia and pregnancy, also contribute (3). Diet issues include triggers like spicy foods, peppermint, fried foods and chocolate.

Smoking and Salt

One study showed that both smoking and salt consumption added to the risk of GERD significantly (4). Risk increased 70 percent in people who smoked. Surprisingly, people who used table salt regularly saw the same increased risk as seen with smokers.

Medications

The most common and effective medications for the treatment of GERD are H2 receptor blockers (e.g., Zantac and Tagamet), which partially block acid production, and proton pump inhibitors (e.g., Nexium and Prevacid), which almost completely block acid production (5). Both classes of medicines have two levels: over-the-counter and prescription strength. Here, I will focus on PPIs, for which more than 100 million prescriptions are written every year in the U.S. (6).

The most frequently prescribed PPIs include Prilosec (omeprazole), Protonix (pantoprazole), Nexium (esomeprazole), and Prevacid (lansoprazole). They have demonstrated efficacy for short-term use in the treatment of Helicobacter pylori-induced (bacteria overgrowth in the gut) peptic ulcers, GERD symptoms and complication prevention and gastric ulcer prophylaxis associated with NSAID use (aspirin, ibuprofen, etc.) as well as upper gastrointestinal bleeds.

However, they are often used long-term as maintenance therapy for GERD. PPIs used to be considered to have mild side effects. Unfortunately, evidence is showing that this may not be true. Most of the data in the package inserts is based on short-term studies lasting weeks, not years. The landmark study supporting long-term use approval was only one year, not 10 years. However, maintenance therapy usually continues over many years.

Side effects that have occurred after years of use are increased risk of bone fractures and calcium malabsorption; Clostridium difficile, a bacterial infection in the intestines; potential vitamin B12 deficiencies; and weight gain (7).

Bacterial infection risks

The FDA warned that patients who use PPIs may be at increased risk of a bacterial infection called C. difficile. This is a serious infection that occurs in the intestines and requires treatment with antibiotics. Unfortunately, it only responds to a few antibiotics and that number is dwindling. In the FDA’s meta-analysis, 23 of 28 studies showed increased risk of infection. Patients need to contact their physicians if they develop diarrhea when taking PPIs and the diarrhea doesn’t improve (8).

B12 deficiencies

Suppressing hydrochloric acid produced in the stomach may result in malabsorption issues if turned off for long periods of time. In a study where PPIs were associated with B12 malabsorption, it usually took at least three years’ duration to cause this effect. B12 was not absorbed properly from food, but the PPIs did not affect B12 levels from supplementation (9). Therefore, if you are taking a PPI chronically, it is worth getting your B12 and methylmalonic acid (a metabolite of B12) levels checked and discussing possible supplementation with your physician if you have a deficiency.

Lifestyle modifications

A number of modifications can improve GERD, such as raising the head of the bed about six inches, not eating prior to bedtime and obesity treatment, to name a few (10). In the same study already mentioned with smoking and salt, fiber and exercise both had the opposite effect, reducing the risk of GERD (5). This was a prospective (forward-looking) trial. The analysis by Journal Watch suggests that the fiber effect may be due to its ability to reduce nitric oxide production, a relaxant for the lower esophageal sphincter (11).

Obesity

In one study, obesity exacerbated GERD. What was interesting about the study is that researchers used manometry, which measures pressure, to show that obesity increases the pressure on the lower esophageal sphincter significantly (12). Intragastric (within the stomach) pressures were higher in both overweight and obese patients on inspiration and on expiration, compared to those with normal body mass index. This is yet another reason to lose weight.

Eating close to bedtime       

Though it may be simple, it is one of the most powerful modifications we can make to avoid GERD. A study that showed a 700 percent increased risk of GERD for those who ate within three hours of bedtime, compared to those who ate four hours or more prior to bedtime. Of note, this is 10 times the increased risk of the smoking effect (13). Therefore, it is best to not eat right before bed and to avoid “midnight snacks.”

Although there are a number of ways to treat GERD, the most comprehensive have to do with modifiable risk factors. Drugs have their place in the arsenal of choices, but lifestyle changes are the first — and most effective — approach in many instances. Consult your physician before stopping PPIs, since there may be rebound hyperacidity (high acid produced) if they are stopped abruptly.

References:

(1) Gastroenterol Clin North Am. 1996;25(1):75. (2) Gut. 2014 Jun; 63(6):871-80. (3) emedicinehealth.com. (4) Gut 2004 Dec.; 53:1730-1735. (5) Gastroenterology. 2008;135(4):1392. (6) Proton Pump Inhibitor, ClinCalc DrugStats Database, Version 20.0. Updated December 23, 2019. Accessed June 23, 2020. (7) World J Gastroenterol. 2009;15(38):4794–4798. (8) www.FDA.gov/safety/medwatch/safetyinformation. (9) Linus Pauling Institute; lpi.oregonstate.edu. (10) Arch Intern Med. 2006;166:965-971. (11) JWatch Gastro. Feb. 16, 2005. (12) Gastroenterology 2006 Mar.; 130:639-649. (13) Am J Gastroenterol. 2005 Dec.;100(12):2633-2636.

Dr. David 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. 

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County Executive Steve Bellone (D) reminded Suffolk County residents as they grapple with the mental health toll from the public health and economic crisis of the services that can help.

Residents can reach out to the Family Services League at FSL-LI.com. They can also call a hotline that is available 24 hours a day and seven days a week at (631) 952-3333.

Residents who know people who are struggling with their mental health or substance abuse that are exacerbated by COVID-19 should reach out to these services, Bellone urged.

As for the viral data, the numbers continued to move in a favorable direction for a region that is still recovering from the virus.

Over the last 24 hours, an additional 45 people tested positive, bringing the total to 41,253. These positive tests represented less than a percent of the total tests.

An additional 18,816 people tested positive for antibodies.

Hospitalizations remained steady, with one person leaving the Intensive Care Unit, bringing that total to 25.

Hospital occupancy was at 70 percent, while ICU occupancy was at 60 percent.

An additional three people died in the last 24 hours, bringing the total for the region to 1,978.

The county distributed 20,000 pieces of personal protective equipment in the last day.

Photo from SBU

Pierce Gardner, MD, Professor Emeritus at the Renaissance School of Medicine at Stony Brook University, is the recipient of the 2020 Dr. Charles Mérieux Award for Achievement in Vaccinology and Immunology from the National Foundation for Infectious Diseases (NFID). The award honors individuals whose outstanding lifetime contributions and achievements in the fight against vaccine-preventable diseases have led to significant improvement in public health.

Dr. Gardner’s career has centered on global health policy and training the next generation of public health providers to tackle health issues in low-resource countries. The Setauket resident has done extensive international work and has been a consultant for the World Health Organization, the Centers for Disease Control, and the Armed Forces Epidemiological Board (now the Defense Health Board). He served in many educational roles while at the Renaissance School of Medicine and remains instrumental in fostering students’ global health interests related to their career paths.

Previous recipients of this national award include luminaries in infectious diseases such as D.A. Henderson (who wiped out smallpox), Arnold Monto (a pioneer in influenza vaccine), and Kristin Nichol (a pioneer in pneumococcal vaccination).

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As the number of COVID-19 infections and hospitalizations in other parts of the country, such as Florida and Texas, surge to levels that put a strain on the health care system, County Executive Steve Bellone (D) appreciates the difficult and hard-fought effort that has put the county on the other side of the deadly viral curve.

“The numbers that we have right now relative to where we’ve been… are really outstanding,” Bellone said on his daily conference call with reporters.

Bellone empathized with the challenges other states and counties faced.

“To see it happening to other places around the country, it’s a terrible thing,” Bellone said.

Bellone urged residents to follow the same “common sense” things they have been doing, including wearing face coverings when they can’t socially distance, staying home when they’re not feeling well and washing their hands and using hand sanitizer.

Indeed, the numbers for the county continued to be well within the limits, even as the county entered the third day of the Phase 3 reopening.

An additional 57 people tested positive for the coronavirus, bringing the total to 41,208 since the pandemic started. The total number of tests administered in the county was 5,076, which means positive tests were around 1.1 percent.

The number of people who tested positive for the antibody, who didn’t have a previous COVID-19 test, was 18,669.

Hospitalizations declined by eight to 77. The number of people in the Intensive Care Unit increased by one to 26.

Hospital capacity was at 68 percent overall and 58 percent in the ICU.

An additional 10 people were discharged from the hospitals.

One person died in the last 24 hours, bringing the total killed from complications related to COVID-19 to 1,975.

The county distributed 12,000 pieces of personal protective equipment over the last day.

Bellone urged residents to participate in the Veteran Run Series, which has raised about $1 million this year. The third race, the Michael P. Murphy run around the lake, is this Saturday Residents interested in running can register at sufflkcountyveteransrunseries.com.

Suffolk County Legislator Kara Hahn file photo

County Executive Steve Bellone (D) was pleased that the county legislature passed the Child Protective Transformation Act this week.

Created after the death of eight-year old Thomas Valva, who died in his father’s garage from hypothermia, the package of six bills creates new measures to strengthen the child protective system, the improve oversight and to institute safeguards to protect children.

“This will ensure that [Child Protective Services] never operates the same way again,” Bellone said on his daily conference call with reporters. “What happened to Thomas Valva can never happen again.”

The transformation act, which passed in the legislature June 23, puts in place measures to make sure the CPS is operating as efficiently and effectively as possible, Bellone suggested.

Bellone thanked Suffolk County Legislator Kara Hahn (D-Setauket), Deputy County Executive Jon Kaiman and Deborah Thivierge, the Founder of the Elija School and the Elija farm for their help in this effort.

As for the viral figures, the numbers continue to remain within a safe range for the county.

The number of people who tested positive for COVID-19 in the last 24 hours was 50, bringing the total to 41,151. The percentage of people who tested positive for the coronavirus was 0.9 percent.

The number of people with the antibody to the virus stands at 18,513.

Hospitalizations declined by three to 85, while the number of people in Intensive Care Unit beds declined by one to 25.

Hospital occupancy overall was at 69 percent, while the percent of occupied ICU beds was at 59 percent.

In the last day, 14 people have been discharged from hospitals in the county.

The number of deaths from complications related to COVID-19 increased by 2 to 1,974.

The county distributed 25,000 pieces of personal protective equipment in the last day.

Separately, the county is canceling the movies scheduled for the rest of this week because of a problem with the equipment that needs repair. The county hopes to have those movies back up and running by next week.