CLOSE
Health

by -
0 757
Pixabay photo

By David Dunaief, M.D.

Dr. David Dunaief

June is cataract awareness month. How much do you know about how to reduce your risk?

A cataract is an opacity or cloudiness of the lens in the eye, which decreases vision over time as it progresses. Typically, it’s caused by oxidative stress, and it’s common for both eyes to be affected. As we get older, the likelihood we will have cataracts that affect our vision increases.

In the U.S., 24.4 million people over the age of 40 were afflicted in 2015, according to statistics gathered by the National Eye Institute of the National Institutes of Health (1). Approximately 50 percent of Americans have cataracts by age 75.

Cataract prevalence varies considerably by gender, with 61 percent of cases being women, and by race; 80 percent of those affected are white. Chronic diseases, such as diabetes and metabolic syndrome; steroid use; and physical inactivity can contribute to your risk. 

The good news is that we can take an active role in preventing them. Protecting your eyes from the sun and injuries, quitting smoking, and increasing your consumption of fruits and vegetables can improve your odds. Here, we will focus on the dietary factor.

How does meat consumption affect cataract risk?

Diet has been shown to have substantial effect on the risk reduction for cataracts (2). One of the most expansive studies on cataract formation and diet was the Oxford (UK) group, with 27,670 participants, of the European Prospective Investigation into Cancer and Nutrition (EPIC) trial. Participants completed food frequency questionnaires between 1993 and 1999. Then, they were checked for cataracts between 2008 and 2009.

There was an inverse relationship between cataract risk and the amount of meat consumed. In other words, those who ate more meat were at higher risk of cataracts. “Meat” included red meat, fowl and pork. These results followed what we call a dose-response curve.

Compared to high meat eaters, every other group demonstrated a significant risk reduction as they progressed along a spectrum that included low meat eaters (15 percent reduction), fish eaters (21 percent reduction), vegetarians (30 percent reduction) and finally vegans (40 percent reduction).

There really was not that much difference in meat consumption between high meat eaters, those having at least 3.5 ounces, and low meat eaters, those having less than 1.7 ounces a day, yet there was a substantial decline in cataracts. This suggests that you can realize a meaningful effect by reducing or replacing your average meat intake, rather than eliminating meat from your diet.

In my clinical experience, I’ve had several patients experience cataract reversal after they transitioned to a nutrient-dense, plant-based diet. This is a very positive outcome and was confirmed by their ophthalmologists.

Do antioxidants help prevent cataracts?

Oxidative stress is one of the major contributors to cataract development. In a review article that looked at 70 different trials for the development of cataract and/or maculopathies, such as age-related macular degeneration, the authors concluded antioxidants, which are micronutrients found in foods, play an integral part in eye disease prevention (3). The authors go on to say that a diet rich in fruits and vegetables, as well as lifestyle modification with cessation of smoking and treatment of obesity at an early age, help to reduce the risk of cataracts. You are never too young or too old to take steps to protect your vision.

Among antioxidant-rich foods studied that have shown positive effects is citrus. The Blue Mountains Eye Study found that participants who had the highest dietary intake of vitamin C reduced their 10-year risk for nuclear cataracts (4).

How effective is cataract surgery?

The only effective way to treat cataracts is with surgery; the most typical type is phacoemulsification. Ophthalmologists remove the opaque lens and replace it with a synthetic intraocular lens. This is an outpatient procedure and usually takes about 30 minutes. Fortunately, there is a very high success rate for this surgery. So why is it important to avoid cataracts if surgery can remedy them?

There are always potential risks with invasive procedures, such as infection, even though the chances of complications are low. However, more importantly, there is a greater than fivefold risk of developing late-stage, age-related macular degeneration (AMD) after cataract surgery (5). This is wet AMD, which can cause significant vision loss. These results come from a meta-analysis (group of studies) looking at more than 6,000 patients.

It has been hypothesized that the surgery may induce inflammatory changes and the development of leaky blood vessels in the retina of the eye. However, this meta-analysis was based on observational studies, so it’s not clear whether undiagnosed AMD may have existed prior to the cataract surgery, since they have similar underlying causes related to oxidative stress.

If you can reduce the risk of cataracts through diet and other lifestyle modifications, plus avoid potential consequences from cataract surgery, all while reducing the risk of chronic diseases, why not choose the win-win scenario?

References:

(1) nei.nih.gov. (2) Am J Clin Nutr. 2011 May; 93(5):1128-1135. (3) Exp Eye Res. 2007; 84: 229-245. (4) Am J Clin Nutr. 2008 Jun; 87(6):1899-1305. (5) Ophthalmology. 2003; 110(10):1960.

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 or consult your personal physician.

by -
0 513
Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children's Hospital. File photo from Stony Brook Medicine

With COVID-19 pandemic restrictions in the rearview mirror, residents have been returning to the open road and the open skies, visiting places and people.

In addition to packing sunscreen, bathing suits and cameras, local doctors urge people to check the vaccination status for themselves and their children, which may have lapsed.

“During COVID, many people did not keep up with their vaccines,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “That has led to a decrease in the amount of children who are vaccinated.”

Last week, the Centers for Disease Control and Prevention issued a health advisory to remind doctors and public health officials for international travelers to be on the lookout for cases of measles, with cases rising in the country and world.

As of June 8, the CDC has learned of 16 confirmed cases of measles across 11 jurisdictions, with 14 cases arising from international travel.

Measles, which is highly contagious and can range from relatively mild symptoms to deadly infections, can arise in developed and developing nations.

Measles can be aerosolized about 60 feet away, which means that “you could be at a train station and someone two tracks over who is coughing and sneezing” can infect people if they are not protected.

The combination of increasing travel, decreasing vaccinations and climbing levels of measles in the background creates the “perfect mixture” for a potential spread of the disease, Nachman said.

Typical first symptoms include cough, runny nose and conjunctivitis.

Conjunctivitis, which includes red, watery eyes, can be a symptom of numerous other infections.

“Many other illnesses give you red eyes,” Nachman said, adding, “Only when you start seeing a rash” do doctors typically confirm that it’s measles.

People are contagious for measles when they start to show these symptoms. Doctors, meanwhile, typically treat measles with Vitamin A, which can help ease the symptoms but is not an effective antiviral treatment.

As with illnesses like COVID, people with underlying medical conditions are at higher risk of developing more severe symptoms. Those with diabetes, hypertension, have organ transplants or have received anticancer drugs or therapies can have more problematic symptoms from measles.

In about one in 1,000 cases, measles can cause subacute sclerosing panencephalitis, or SSPE. About six to 10 years after contracting the virus, people can develop SSPE, which can lead to coma and death. 

In addition to children who need two doses of the measles vaccine, which typically is part of the measles, mumps and rubella vaccine, or MMR, doctors urge people born between 1957 and 1985 to check on their vaccination status. People born during those years typically received one dose of the vaccine. Two doses provide greater protection.

Two doses of the MMR vaccine provide 97% protection from measles. One dose offers 93% immunity, explained Dr. David Galinkin, infectious disease specialist at Port Jefferson-based St. Charles Hospital.

People born before 1957 likely had some exposure to measles, which can provide lifelong immunological protection.

Nachman also urged people to speak with their doctor about their vaccination status for measles and other potential illnesses before traveling. People are protected against measles about two weeks after they receive their vaccine.

Doctors suggested that the MMR vaccine typically causes only mild reactions, if any.

Tetanus, Lyme

In addition to MMR vaccines, doctors urged residents to check on their tetanus vaccination, which protects for 10 years.

“The last thing you want to do is look for a tetanus vaccination in an international emergency room,” Nachman added.

During the summer months, doctors also urged people to check themselves and their children, especially if they are playing outside in the grass or near bushes, for ticks.

Intermediate hosts for Lyme disease, a tick typically takes between 36 to 48 hours from the time it attaches to a human host to transmit Lyme disease.

Nachman suggested parents use a phone flashlight to search for these unwelcome parasites.



by -
0 413
Fancy sea salts are not better than regular salt. METRO photo

By David Dunaief, M.D.

Dr. David Dunaief

Sodium and high blood pressure are often linked in our minds. But what if we don’t have high blood pressure? Does our salt intake matter? According to the Centers for Disease Control and Prevention, about 90 percent of Americans consume too much sodium – and it’s not just about our risk for high blood pressure (1).

Why does sodium matter?

Of course, excessive sodium in our diets increases our risk of high blood pressure (hypertension), which has consequences like stroke and heart disease.

Now comes the interesting part. Even if we don’t have high blood pressure, sodium can impact our kidney function. In the Nurses’ Health Study, approximately 3,200 women were evaluated in terms of kidney function, looking at the estimated glomerular filtration rate (GFR) as related to sodium intake (2). Over 14 years, those with a daily sodium intake of 2,300 mg had a much greater chance of a 30 percent or more reduction in kidney function when compared to those who consumed 1,700 mg per day.

Kidneys are an important part of our systems for removing toxins and waste. They are also where many initial high blood pressure medications work, including ACE inhibitors, such as lisinopril; ARBs, such as Diovan or Cozaar; and diuretics (water pills). If the kidney loses function, it can be harder to treat high blood pressure. Worse, it could lead to chronic kidney disease and dialysis. Once someone has reached dialysis, most blood pressure medications are not very effective.

How much sodium is too much?

Interestingly, the current recommended maximum sodium intake is 2,300 mg per day, or one teaspoon. If you’ve been paying attention, you’ve probably noticed that’s the same level that led to negative effects in the study. However, Americans’ average intake is 3,400 mg a day (1).

If we reduced our consumption by even a modest 20 percent, we could reduce the incidence of heart disease dramatically. Current recommendations from the American Heart Association indicate an upper limit of 2,300 mg per day, with an “ideal” limit of no more than 1,500 mg per day (3).

Where we get most of our sodium

Most of our sodium intake comes from processed foods, packaged foods and restaurants, not the saltshaker at home. There is nothing wrong with eating out or ordering in on occasion, but you can’t control how much salt goes into your food. My wife is a great barometer of restaurant salt use. If food from the night before was salty, she complains that her clothes and rings are tight.

Do you want to lose 5 to 10 pounds quickly? Decrease your salt intake. Excess sodium causes the body to retain fluids.

One approach is to choose products that have 200 mg or fewer per serving indicated on the label. Foods labeled “low sodium” have fewer than 140 mg of sodium, but foods labeled “reduced sodium” have 25 percent less than the full-sodium version, which doesn’t necessarily mean much. Soy sauce has 1,000 mg of sodium per tablespoon, but low-sodium soy sauce still has about 600 mg per tablespoon.

Salad dressings and other condiments, where serving sizes are small, add up very quickly. Mustard has 120 mg per teaspoon. Most of us use far more than one teaspoon of mustard. Make sure to read the labels on all packaged foods and sauces very carefully, checking for sodium and for serving size.

Breads and rolls are another hidden source. Most contain a decent amount of sodium. I have seen a single slice of whole wheat bread include up to 200 mg. of sodium. That’s one slice.

Soups are also notoriously high in sodium. There are a few packaged soups on the market that have no sodium, such as some Health Valley soups. You can use these and add your own seasonings. Restaurant soups are a definite “no.”

If you are working to decrease your sodium intake, become an avid label reader. Sodium hides in all kinds of foods that don’t necessarily taste salty, such as cheeses, sweet sauces and salad dressings. I recommend putting all sauces and dressings on the side, so you can control how much — if any — you choose to use.

Is sea salt better than table salt?

Are fancy sea salts better than table salt? High amounts of salt are harmful, and the type is not important. The only difference between them is slight taste and texture variation. I recommend not buying either. In addition to causing health issues, salt tends to dampen your taste buds, masking the flavors of food.

As you reduce your sodium intake, you might be surprised at how quickly your taste buds adjust. In just a few weeks, foods you previously thought didn’t taste salty will seem overwhelmingly so, and you will notice new flavors in unsalted foods.

When seasoning your food at home, use salt-free seasonings, like Trader Joe’s 21 Seasoning Salute or, if you prefer a salty taste, use a salt substitute, like Benson’s Table Tasty.

References:

(1) cdc.gov. (2) Clin J Am Soc Nephrol. 2010;5:836-843. (3) heart.org.

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 or consult your personal physician.

by -
0 934
1 of 3
Jefferson’s Ferry President and CEO Bob Caulfield (center) snips the ribbon to commemorate the opening of the Life Plan Community’s fully renovated and expanded Community Center. Joining Caulfield are (left to right) Jefferson’s Ferry board members James E. Danowski, CPA, Vice Chair; John R. Sini, CPA, Treasurer; Gloria Snyder, Chair; along with Jefferson’s Ferry Resident Council Chair Pat Boone, and Construction Project Manager Matthew Moroney. Photo from Jefferson's Ferry
Jefferson's Ferry residents and staff filled the lobby of the new Commons building to witness the ribbon cutting and take a tour of the new building. Photo from Jefferson's Ferry
Jefferson's Ferry Board Members joined Jefferson's Ferry President and CEO Bob Caulfield (center) to commemorate the opening of the Life Plan Community's new Commons building. Pictured with Caulfield (l-r) are trustees Kenneth Roberts, John R. Sini, CPA, Treasurer; Gloria Snyder, Chair; and James E. Danowski, CPA, Vice Chair. Photo from Jefferson's Ferry

The lobby of Jefferson’s Ferry community center was abuzz on June 5 as residents, employees and guests packed in to witness the ceremonial ribbon cutting of the Life Plan community’s new commons building. The mood was buoyant as residents and friends prepared to embark on tours of the spaces.

The audience joined in on the countdown as scissors wielded by Jefferson’s Ferry’s President and CEO Bob Caulfield; Board of Directors Chair Gloria Snyder; Vice Chair James Danowski and Treasurer John Sini; Resident Council Chair Pat Boone and Construction Project Manager Matthew Moroney cut the ribbon to enthusiastic applause. 

Addressing the crowd, Bob Caulfield thanked the residents and staff for their patience and support during the renovation process, dubbed Journey Toward Renewal, which has taken place in stages over the past several years. Additional renovations and expansions are currently underway in Jefferson’s Ferry’s Vincent Bove Health Center, including a new Memory Care Unit which is expected to open in the fall.  

“This is a landmark day for us, as our new commons building adds beautiful new spaces to our community center, the heart of Jefferson’s Ferry,” said Caulfield. “We’ve all been patiently awaiting this day, and I thank every one of you who has been as eager as I have been to celebrate this major milestone. This includes the Board of Trustees, who had the strategic foresight and financial oversight of the ambitious project, our construction team, who labored to complete this phase of the project, and of course, our residents and staff.”

Among the latest updates and additions to the social and recreational aspects of the community center are a variety of new gathering spaces, including a larger and redesigned creative arts center, expanded card rooms for the popular bridge and gin rummy tournaments, and a game room with billiards, ping pong, shuffle boards and large screen television.  Another bright open space is dedicated to puzzling, newspaper reading and socializing.  The fitness center, which can be accessed 24-7 through a separate keypad operated entrance includes a full complement of exercise machines, a dance/yoga studio and separate locker rooms with showers for men and women.  Right down the hall, a salon offers hair cuts and styling, manicure and pedicures by appointment.  

Earlier this year, six new dining venues opened, each one offering a distinct menu to suit a variety of tastes and preferences. Options range from grab and go to casual, and from pub dining to a more formal dining room.

Adjacent to the workout rooms is a new physical therapy and rehabilitation suite that includes a replica of a Jefferson’s Ferry apartment that enables residents to easily transfer what they’ve learned during rehabilitation to their own home.  The rehabilitation suite also features an outdoor therapy courtyard with different surface areas and slopes to help residents fare better in a variety of indoor and outdoor environments post rehab.   

The addition of the commons building has made room for an expansion of the Health and Wellness Program.  Residents can now schedule in-house physician visits with doctors and a nurse practitioner who offer office hours at Jefferson’s Ferry.

“Since its opening in 2001 as the first not for profit Life Plan community on Long Island, Jefferson’s Ferry has set the standard for continuing care for older adults, providing a vibrant, caring community and peace of mind to its residents,” concluded Caulfield. “Over our more than 20 years in operation, Jefferson’s Ferry has continued to evolve to meet the changing needs of the people who have made Jefferson’s Ferry their home. Journey Toward Renewal is evidence of our commitment to excellence.”

Jefferson’s Ferry, a not-for-profit Life Plan Community for active adults aged 62 and above, is located at One Jefferson’s Ferry Drive in South Setauket. For more information, call 631-650-2600 or visit www.jeffersonsferry.org

by -
0 404
From left, Allison McLarty, MD, Marc Goldschmidt, MD, Hal Skopicki, MD, PhD. Photo from Stony Brook Medicine

In 2010, Stony Brook Heart Institute’s Ventricular Assist Device (VAD) Program was established on Long Island to implant this life saving device. A VAD, also often called a left ventricular assist device or LVAD, is a surgically implanted, battery powered pump that, by supporting the lower left ventricle (the heart’s main pumping chamber), helps a failing heart to do its job more efficiently. The VAD can be used as an intermediary step before heart transplantation or, in patients who, due to advanced age or medical condition are not transplant candidates, as a long-term “destination” device. 

VAD patient Joseph Cerqueira and his wife.

Now 10+ years later, patients, their families and medical staff from the Heart Institute gathered on June 15, to celebrate the anniversary of this life saving heart device and program. (The 10-year event was postponed in 2020 due to Covid-19.) 

“Nobody knew when we began putting in heart pumps 13 years ago that they would be this durable and reliable,” says Allison McLarty, MD, Surgical Director of the VAD program. “This amazing device has revolutionized the management of advanced heart failure.”  

“For the VAD team, there is the immense reward of seeing these extraordinary individuals return to their homes and families with a much better quality of life,” added Marc Goldschmidt, MD, Director, Heart Failure and Cardiomyopathy Center and Medical Director, Ventricular Device Program.

“A VAD program at Stony Brook Heart Institute has been a tremendous asset for both the community and the hospital. Patients with the most complex heart conditions have access right here, close to home, to all the state-of-the-art services they need,” said Hal Skopicki, MD, PhD, Co-Director, Stony Brook Heart Institute and Chief of Cardiology.  

Among the patients who attended today’s event was Joseph Cerqueira, 63, who received a VAD in 2017 and a heart transplant the following year. Following his surgery, Joseph returned to his work as a corporate chef. 

“Everybody went the extra mile to make me comfortable and knowledgeable on how to adapt to every aspect of life with a VAD,” said Cerqueira. “Now my quality of life is perfect. I still get tired and I know my limitations, but besides that I do whatever has to be done.”

To learn more about the Ventricular Assist Device Program, visit https://heart.stonybrookmedicine.edu/services/vad.

by -
0 619
Legislator Stephanie Bontempi (standing left) thanks the presenter and welcomes attendees at the Cold Spring Harbor Library. 

Legislator Stephanie Bontempi (R-18th L.D.) recently joined with the Alzheimer’s Association Long Island Chapter to deliver an informative presentation to the public entitled, “10 Warning Signs of Alzheimer’s.”  This event took place at the Cold Spring Harbor Library and drew people of varying ages interested in the sensitive subject matter. 

“Alzheimer’s is a major issue that affects both individuals and families,” said Bontempi.  “Being aware of the warning signs can put those involved in a much better position to deal with the condition and seek treatment when the issues appear.”

The event’s presenter outlined the signs most commonly associated with the onset of Alzheimer’s, and educated the attendees on assessment tests and other helpful resources available.  The importance of early detection was made abundantly clear.

To learn more about the Alzheimer’s Association Long Island Chapter, along with their programs and resources, visit: https://www.alz.org/longisland. 

by -
0 967
1 of 2
Paul Kazemier
Kathryn Paliotta

New York Cancer & Blood Specialists (NYCBS) has announced the appointments of Paul Kazemier to Senior Vice President of Patient Communications and Kathryn Paliotta to Vice President of Patient Communications.

“Paul’s appointment as Senior Vice President of Patient Communications is a testament to his exceptional leadership in overseeing a team of over 275+ employees and his continued dedication to enhancing patient communication,” said Jeff Vacirca, MD, CEO of NYCBS. “His forward-thinking approach and adaptability to change will enable the organization to achieve improved outcomes for healthcare providers and patients, demonstrating our commitment to delivering exceptional value to our partners, patients, and the community.”

“Kathryn’s dedication and leadership have been invaluable to our organization, and we are thrilled to recognize her contributions with this well-deserved promotion,” said Vacirca. “Her extensive clinical background, coupled with her ability to effectively manage our patient communication departments, has allowed us to provide even better care and support to our patients. We look forward to seeing her continued success in her new role as Vice President of Patient Communications.”

“I am incredibly grateful for this promotion and the opportunity to continue to lead and grow my departments. It means the world to me,” said Kazemier. “My goal is to not only ensure the highest level of patient satisfaction and experience but also to foster an environment where employees can grow within the company and achieve their own success.”

“I am immensely grateful to have found my niche,” Paliotta said. “Working for an organization as diverse as ours has afforded me the privilege to care for patients across various specialties. I have also had the pleasure to learn from an inspiring group of mentors and look forward to growing my career at NYCBS.”

For more information, visit nycancer.com.

by -
0 349
A potassium-rich diet may help to reduce blood pressure. Stock photo

By David Dunaief, M.D.

Dr. David Dunaief

Hypertension, also commonly called “high blood pressure,” is pervasive in the U.S., affecting approximately 47 percent of adults over 18 (1). Since 2017, hypertension severity has been categorized into three stages, each with its recommended treatment regimen. 

One of the most interesting shifts with this recategorization was the recategorization of what we used to call “prehypertension” into what we now call “elevated” blood pressure and “hypertension stage 1.” 

Elevated blood pressure is defined as systolic blood pressure (the top number) of 120-129 mmHg and diastolic blood pressure (the bottom number) of less than 80 mmHg, while Stage 1 includes systolic blood pressure of 130-139 mmHg or diastolic blood pressure of 80-89 mmHg (2). A simple chart of all levels can be found on The American Heart Association’s website at www.heart.org.

Both elevated blood pressure and stage 1 hypertension have significant consequences, even though there are often no symptoms. For example, they increase the risks of cardiovascular disease and heart attack dramatically.

In an analysis of the Framingham Heart Study, researchers found a 3.5-fold increase in the risk of heart attack and a 1.7-fold increase in the risk of cardiovascular disease among those with prehypertension (3). This is why it’s crucial to address it, even in these early stages.

Another study, the Women’s Health Initiative, which followed more than 60,000 postmenopausal women for an average of 7.7 years, showed an increase in heart attack deaths, heart attacks and strokes compared to those with normal blood pressure (less than 120/80 mmHg). In the Strong Heart Study, prehypertension independently increased the risk for cardiovascular events at 12 years significantly (4).

The good news is that, over the last decade, new and extended studies have given us better clarity about treatments, stratifying approaches to ensure the best outcomes.

Do you need to treat elevated blood pressure?

In my view, it would be foolish not to treat elevated blood pressure. Updated treatment recommendations, according to the Joint National Commission (JNC) 8, the association responsible for guidelines on the treatment of hypertension, include lifestyle modifications (5).

Lifestyle changes include dietary changes. A Mediterranean-type diet or the DASH (Dietary Approaches to Stop Hypertension) diet are both options. It’s important to focus on fruits, vegetables, sodium reduction to a maximum of 1500 mg (2/3 of a teaspoon on a daily basis), exercise, weight loss and no more than moderate amounts of alcohol (1 or fewer drinks for women and 2 or fewer drinks for men on a daily basis) (6). 

Some studies have also shown that a diet rich in potassium helps to reduce blood pressure (7). Fortunately, foods like fruits, vegetables, beans and legumes have significant amounts of potassium. However, do not take potassium supplements unless instructed for other reasons by a physician; high potassium can be very dangerous and may precipitate a heart attack.

Some drugmakers advocate for using medication with those who have elevated blood pressure. The Trial of Preventing Hypertension (TROPHY) suggests the use of a hypotensive agent, the blood pressure drug Atacand (candesartan) to treat prehypertensive patients (8)(9). The drug reduced the incidence of hypertension significantly compared to placebo over two years. However, after stopping therapy, the following two years showed only a small benefit over placebo. Still, the authors implied that this may be a plausible treatment. The study was funded by Astra-Zeneca, which makes the drug. 

In an editorial, Jay I. Meltze, M.D., a clinical specialist in hypertension at Columbia University’s College of Physicians and Surgeons, noted that the results were interpreted in an unusually favorable way (10). 

Elevated blood pressure has been shown to respond well to lifestyle changes – so why add medication when there are no long-term benefits? I don’t recommend treating elevated blood pressure patients with medication. Thankfully, the JNC8 agrees.

Do lifestyle changes help with Stage 1 hypertension?

For those with Stage 1 hypertension, but with a low 10-year risk of cardiovascular events, these same lifestyle modifications should be implemented for three-to-six months. At this point, a reassessment of risk and blood pressure should determine whether the patient should continue with lifestyle changes or needs to be treated with medications (11). 

It’s important to note that your risk should be assessed by your physician.

I am encouraged that the role of lifestyle modifications in controlling hypertension has been recognized and is influencing official recommendations. When patients and physicians collaborate on a lifestyle approach that drives improvements, the side effects are only better overall health.

References:

(1) cdc.gov. (2) heart.org. (3) Stroke 2005; 36: 1859–1863. (4) Hypertension 2006;47:410-414. (5) Am Fam Physician. 2014 Oct 1;90(7):503-504. (6) J Am Coll Cardiol. 2018 May, 71 (19) 2176–2198. (7) Archives of Internal Medicine 2001;161:589-593. (8) N Engl J Med. 2006;354:1685-1697. (9) J Am Soc Hypertens. Jan-Feb 2008;2(1):39-43. (10) Am J Hypertens. 2006;19:1098-1100. (11) Hypertension. 2021 Jun;77(6):e58-e67.

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 or consult your personal physician.

by -
0 351
Dr. Justice Achonu. Photo by Jeanne Neville/ Stony Brook Medicine

Justice Achonu, MD, an orthopaedic surgery resident at Stony Brook Medicine, is one of four orthopaedic surgeons in the U.S. to be selected for the American Board of Orthopaedic Surgery’s (ABOS) Resident Advisory Panel. Responsible for providing insight into the resident experience, the panel collaborates with multiple other committees within the ABOS to support the interests of residents throughout the country. His two-year term on the panel begins July 1, 2023.

According to the ABOS, each applicant to the panel is reviewed by at least two ABOS Board members who are all accomplished leaders in their field. Applicants practice in all regions of the country. Dr. Achonu’s panel cohort is the third ever selected by the ABOS. Every year, the panel is tasked with identifying and completing a project that will benefit orthopaedic residents across more than 200 accredited training programs nationwide.

Panelists are encouraged to provide the ABOS with recommendations, several of which have been adopted by the Board, including an official Residency to Retirement Roadmap.

Dr. Achonu received a B.S. in neuroscience from the University of Pittsburgh in 2015 and graduated from the Renaissance School of Medicine at Stony Brook University in 2020. He resides in Holbrook.

Stony Brook’s Department of Orthopaedics provides full-service patient care and sub-specialty resident and faculty training in all areas of Orthopaedics. The department includes a comprehensive Orthopaedic Research Program featuring clinical and laboratory facilities and resources for investigation of molecular, biologic, and biomechanical research topics.

by -
0 620
Canadian wildfire smoke reduced the amount of sunlight reaching the ground over Long Island. Photo by Terry Ballard from Wikimedia Commons

Brian Colle saw it coming, but the word didn’t get out quickly enough to capture the extent of the incoming smoke.

Dr. Jeffrey Wheeler, director of the emergency room at St. Charles Hospital in Port Jefferson. File photo from St. Charles Hospital

The smoke from raging wildfires in Quebec, Canada, last week looked like a “blob out of a movie” coming down from the north, said Colle, head of the atmospheric sciences division at Stony Brook University’s School of Marine and Atmospheric Sciences. As the morning progressed, Colle estimated the chance of the smoke arriving in New York and Long Island was “80 to 90 percent.”

Colle, among other scientists, saw the event unfolding and was disappointed at the speed with which the public learned information about the smoke, which contained particulate matter that could affect human health.

“There’s a false expectation in my personal view that social media is the savior in all this,” Colle said. The Stony Brook scientist urged developing a faster and more effective mechanism to create a more aggressive communication channel for air quality threats.

Scientists and doctors suggested smoke from wildfires, which could become more commonplace amid a warming climate, could create physical and mental health problems.

Physical risks

People in “some of the extremes of ages” are at risk when smoke filled with particulates enters an area, said Dr. Jeffrey Wheeler, director of the emergency room at St. Charles Hospital in Port Jefferson. People with cardiac conditions or chronic or advanced lung disease are “very much at risk.”

Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital. Photo from Stony Brook University

Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital, believed the health effects of wildfire smoke could “trickle down for about a week” after the smoke was so thick that it reduced the amount of sunlight reaching the ground.

Amid smoky conditions, people who take medicine for their heart or lungs need to be “very adherent to their medication regimen,” Schwaner said.

Physical symptoms that can crop up after such an event could include wheezing, coughing, chest tightness or breathing difficulties, particularly for people who struggle with asthma or chronic obstructive pulmonary disease.

When patients come to Schwaner with these breathing problems, he asks them if what they are experiencing is “typical of previous exacerbations.” He follows up with questions about what has helped them in the past.

Schwaner is concerned about patients who have had lung damage from COVID-related illness.

The level of vulnerability of those patients, particularly amid future wildfires or air quality events, will “play out over the next couple of years,” he said. Should those who had lung damage from COVID develop symptoms, that population might “need to stay in contact with their physicians.”

It’s unclear whether vulnerabilities from COVID could cause problems for a few years or longer, doctors suggested, although it was worth monitoring to protect the population’s health amid threats from wildfire smoke.

Local doctors were also concerned about symptoms related to eye irritations.

Schwaner doesn’t believe HEPA filters or other air cleansing measures are necessary for the entire population.

People with chronic respiratory illness, however, would benefit from removing particulates from the air, he added.

Wildfire particulates

Dr. Mahdieh Danesh Yazdi, an air pollution expert and environmental epidemiologist from Stony Brook University’s Program in Public Health. Photo from Stony Brook University

Area physicians suggested the particulates from wildfires could be even more problematic than those generated from industrial sources.

Burning biomass releases a range of toxic species into the air, said Dr. Mahdieh Danesh Yazdi, an air pollution expert and environmental epidemiologist from Stony Brook University’s Program in Public Health.

The U.S. Environmental Protection Agency has done a “fairly decent job” of regulating industrial pollution over the last few decades “whereas wildfires have been increasing” amid drier conditions, Yazdi added.

In her research, Yazdi studies the specific particulate matter and gaseous pollutants that constitute air pollution, looking at the rates of cardiovascular and respiratory disease in response to these pollutants.

Mental health effects

Local health care providers recognized that a sudden and lasting orange glow, which blocked the sun and brought an acrid and unpleasant smell of fire, can lead to anxiety, which patients likely dealt with in interactions with therapists.

As for activity in the hospital, Dr. Poonam Gill, director of the Comprehensive Psychiatric Emergency Program at Stony Brook Hospital, said smoke from the wildfires did not cause any change or increase in the inpatient psychiatric patient population.

In addition to the eerie scene, which some suggested appeared apocalyptic, people contended with canceled outdoor events and, for some, the return of masks they thought they had jettisoned at the end of the pandemic.

“We had masks leftover” from the pandemic, and “we made the decision” to use them for an event for his son, said Schwaner.

When Schwaner contracted the delta variant of COVID-19, he was coughing for three to four months, which encouraged him to err on the side of caution with potential exposure to smoke and the suspended particulates that could irritate his lungs.

Prev1...464748...180Next Page 47 of 180
TBR News Media is your local news and entertainment website.
We provide you with the latest breaking news and information for your community.
Contact us: [email protected]

Most Viewed

©