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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

I’ve been on a long journey that’s taken me around the world for more than two and a half years. Many hosts have provided for me, enabling me to grow and, in some cases, make changes.

I don’t recall the beginning. The first host I remember was an incredibly kind doctor. She spent countless hours caring for others, looking into their eyes, assuring them she would do everything she could for them.

She was so focused on helping others that she didn’t even know she was hosting me. I stayed quiet just long enough to make the jump to a famous American actor who was working in Australia.

He and his wife didn’t enjoy their time with me. They warned the world about me and my extended family.

My next host was a businessman. He had been in a hospital with his son, who had a broken leg. The businessman stayed in the waiting room for hours, trying to do his work but unable to focus because he was so concerned about his boy.

Finally, after hours of surgery, the doctor came out to talk to him and that’s when I found a new host.

This businessman worked hard. Once he discovered his son was safe, he ignored me and my needs.

I developed without anyone noticing me. At one point, I heard someone come looking for me, but I hid just far enough away. I traveled a great distance on a plane with him. Once we were in a new country, I had so many choices.

Realizing it was time to go, I jumped to an elderly bus driver. He was a gentle man. The lighter laugh lines near his eyes looked like waves approaching the shore on his dark chocolate skin.

Before he collapsed into bed the second evening we were together, he seemed to be staring directly at me. In his house, I had a choice of other possible hosts, but decided to hitch a ride with his son.

That one almost cost me my life. His son soon realized I was there, and he stayed away from everyone. I was curled up alone with him. He barely moved for long periods of time, except when he coughed or sat up and sent text messages and emails. One night, when he was finally sleeping, a man came into his room to clean it. That’s when I escaped.

This man didn’t even know he hosted me. He wasn’t stuck in bed, and he didn’t cough. I traveled with him to several events. After other trips, I found an important politician. We took a ride in a helicopter and went to a hospital where doctors provided all kinds of new medicines.

I became like a game of telephone, passing along from one person to the next. And, like a game of telephone, the message changed, as I demanded different things from my host.

I found myself at a concert with a young woman who sang and danced for hours. She looked so vibrant and full of life.

She was a friendly enough host, until I set up camp with her mother. Then, she shouted at me, praying to keep me away. She took me to a hotel, where she seemed to stare at me while she prayed.

When someone delivered food and walked in the room to wait for payment, I made the jump to him. During the day, he was a student with a full and busy life. I didn’t stay long, moving on to his girlfriend, her roommate, and, eventually, to a professor.

I stayed with the professor for over a week. She spent considerable time grading papers, writing at her computer, talking to family members, and taking medicine.

I have made some changes along the way. I don’t travel with as much baggage as I used to. I know people think I’m not as much of a burden as I was in the early days. My most recent host would disagree. He couldn’t talk, had trouble sleeping and was exhausted all the time. I’m getting ready to travel the world again this fall and winter. You can ignore me all you want, but I’m still here, making changes and preparing to find more hosts.

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Pictured from left, Board Member Marian Conway, Board President David Deming, St. Johnland CEO Mary Jean Weber, Board Members Heather Spehr, Mike Agnes and Arlene Vermylen at the ribbon cutting.
The library at the new assisted living facility at St. Johnland.
The outdoor dining area at the new assisted living facility at St. Johnland.
Photo from St. Johnland
Photo from St. Johnland
An aerial view of the new facility at St. Johnland.

St. Johnland recently held a celebration to commemorate the newly completed Assisted Living Facility on their Kings Park campus. The Assisted Living facility is the newest addition to St. Johnland which was founded in 1866 and since then has been providing care and support for the community.

Located in a serene woodland setting, the 100-bed facility will provide homes for individuals that are Medicaid eligible. They will also accept residents who are depleting their resources to become Medicaid eligible. The focus is to provide a residential and social setting where all residents can receive the care they need in order to maintain their optimal level of function and freedom while knowing they are supported by the residential services, medical supervision and personal care assistance they need.

The facility, which came about to meet the pressing need for expanded Medicaid Assisted Living Program capacity, will welcome residents who are ambulatory but may need assistance with daily care and medical services. The newly-formed St. Johnland Licensed Health Home Care Service agency will help secure treatment and services for residents. Residents who need more care as time passes will have the option of transferring to the Nursing Center, allowing the opportunity to age in place and have continuity of care.

For information about admission, please call 631-663-4444.

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Legume consumption plays an important role

By David Dunaief, M.D.

Dr. David Dunaief

Coronary artery disease is the most common type of heart disease, which can cause heart attacks. How common is it? According to the Centers for Disease Control and Prevention, about 6.7 percent of U.S. adults over the age of 19 have coronary artery disease (CAD) (1). There are 805,000 heart attacks in the U.S. annually, and 200,000 of these occur in those who’ve already had a first heart attack.

Among the biggest contributors to heart disease risk are high blood pressure, high cholesterol, and smoking. In addition, if you have diabetes or are overweight or obese, your risk increases significantly. Lifestyle factors also contribute to your risk: poor diet, lack of physical activity and high alcohol consumption are among the most significant contributors.

This is where we can have a tremendous impact and significantly reduce the occurrence of CAD. Evidence continues to highlight lifestyle changes, including diet, as the most important factors in preventing heart disease. Changes that garner a big bang for your buck include the consumption of chocolate, legumes, nuts, fiber and omega-3 polyunsaturated fatty acids (PUFAs).

Chocolate’s benefits

Preliminary evidence shows that two pieces of chocolate a week may decrease the risk of a heart attack by 37 percent, compared to those who consume less (2). However, the authors warned against the idea that more is better. In fact, high fat and sugar content and calorically dense aspects may have detrimental effects when consumed at much higher levels. There is a fine line between potential benefit and harm. The benefits may be attributed to micronutrients referred to as flavonols.

I usually recommend that patients have one to two squares — about one-fifth to two-fifths of an ounce — of high-cocoa-content dark chocolate daily. Aim for chocolate labeled with 80 percent cocoa content.

Alternatively, you can get the benefits without the fat and sugar by adding unsweetened, non-Dutched cocoa powder to a fruit and vegetable smoothie.

Who says prevention has to be painful?

Increase dietary fiber

Fiber has a dose-response relationship to reducing risk. In other words, the more fiber you eat, the greater your risk reduction. In a meta-analysis of 10 studies, results showed for every 10-gram increase in fiber, there was a corresponding 14 percent reduction in the risk of a cardiovascular event and a 27 percent reduction in the risk of heart disease mortality (3). The authors analyzed data that included over 90,000 men and 200,000 women.

According to a 2021 analysis of National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018, only 5 percent of men and 9 percent of women get the recommended daily amount of fiber (4).

The average American consumes about 16 grams per day of fiber (5).

So, how much is “enough”? The Academy of Nutrition and Dietetics recommends 14 grams of fiber for each 1,000 calories consumed, or roughly 25 grams for women and 38 grams for men (6).

We can significantly reduce our risk of heart disease if we increase our consumption of fiber to reach the recommended levels. Good sources of fiber are fruits and vegetables with the edible skin or peel, beans and lentils, and whole grains.

Consume more legumes

In a prospective (forward-looking) cohort study, the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, legumes reduced the risk of coronary heart disease by a significant 22 percent (7). Those who consumed four or more servings per week saw this effect when compared to those who consumed less than one serving per week. The legumes used in this study included beans, peas and peanuts. There were over 9,500 men and women involved, and the study spanned 19 years of follow-up.

I recommend that patients consume at least one to two servings a day, or 7 to 14 a week. Imagine the impact that could have, compared to the modest four servings per week used to reach statistical significance in this study.

Focus on healthy nuts

In a study with over 45,000 men, there were significant reductions in CAD with omega-3 polyunsaturated fatty acids (PUFAs). Both plant-based and seafood-based omega-3s showed these effects (8). Good sources of omega-3s from plant-based sources include nuts, such as walnuts, and ground flaxseed.

Your ultimate goal should be to become “heart attack proof,” a term used by Dr. Sanjay Gupta and reinforced by Dr. Dean Ornish. While even modest dietary changes can significantly reduce your risk, the more significant the lifestyle changes you make, the closer you will come to achieving this goal.

References: 

(1) cdc.gov. (2) BMJ 2011; 343:d4488. (3) Arch Intern Med. 2004 Feb 23;164(4):370-376. (4) nutrition.org (5) NHANES 2009-2010 Data Brief No. 12. Sep 2014. (6) eatright.org. (7) Arch Intern Med. 2001 Nov 26;161(21):2573-2578. (8) Circulation. 2005 Jan 18;111(2):157-164.

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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Doctors suggest getting immunized before the holiday gathering season begin. Stock photo from Metro

This fall and winter, several infections have their sights set on your lungs.

Amid threats from diseases that affect other organ systems, three of them — COVID-19, the flu and respiratory syncytial virus — can and often do attack the lungs.

While the current strain of COVID isn’t as lethal as the original, the virus continues to mutate, leading to new strains and, potentially, to different strains later this fall.

At the same time, the flu and RSV have been waiting for an opening after COVID protections like masks also kept them at bay during 2020 and 2021.

“How bad is the winter going to be?” asked Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “It will be based on more [COVID] variants coming through, with a strong flu season, which is never something you want to see.”

The number of cases of respiratory illnesses like RSV and the flu has been lower in the last few years. The lack of exposure to those viruses, however, may give them an opening for a stronger return in the population.

These viruses “didn’t paddle along for a while,” Nachman said. “Now, they are paddling furiously. Everyone is seeing them.”

People’s immune systems may not be prepared for the threat from these recurring viruses.

When people arrive at the hospital, health care officials often see the same symptoms, with coughing and sneezing.

“It could be one, two or three” causes at the same time, Nachman said.

The combination of contracting more than one virus at the same time could lead to prolonged and painful illnesses.

COVID reality

Much as people would like to return to a pre-pandemic reality, the SARS-CoV2 virus not only continues to infect people, but it also remains something of an evasive target, with mutations leading to new variants.

While area hospitals don’t test for the specific COVID strain when patients are sick, doctors expect that some of the people who have contracted the disease have the modern variants.

“Undoubtedly, many cases that are coming to our Emergency Department are due to the new Omicron sub-variants,” said Dr. Sunil Dhuper, chief medical officer at Port Jefferson’s St. Charles Hospital. “Information from the Centers for Disease Control and Prevention has shown that Omicron BA.5 cases are trending downwards and the cases due to the sub-variants are on the rise.”

“The purpose of the vaccine is to attenuate the symptoms from the virus and reduce the severity of illness, hospitalizations and/or death.”

— Dr. Sunil Dhuper

Symptoms of the newer variants are similar to others, with fever, chills, cough, runny nose, fatigue, muscle or body aches, shortness of breath, loss of smell or taste, sore throat, nausea or vomiting and diarrhea, Dhuper explained.

Doctors said it was difficult to gauge how effective the new bivalent COVID vaccines are against the latest strains.

The latest booster may “not be active against all the coming variants,” explained Dr. Phillip Nizza, attending infectious disease physician at St. Charles Hospital.

The new booster was designed to enhance the reaction to the BA.4 and BA.5 variants.

“We don’t have enough data” to determine the effectiveness of the booster against current and future threats, Nachman said. “How effective it will be depends” on differences between the booster and the strain someone contracts.

Still, the vaccine is likely to provide some benefits, doctors said.

“The purpose of the vaccine is to attenuate the symptoms from the virus and reduce the severity of illness, hospitalizations and/or death,” Dhuper wrote. “And I think the vaccines would be very successful in accomplishing that objective.”

Even for people who have been infected recently with COVID, Nachman urged people to get a booster.

The combination of an infection and a booster “Is always better than not getting a vaccine,” Nachman said. “You should get a vaccine. The timing is tricky” and could involve getting a dose two weeks after contracting the virus or waiting.

The viral threat during the December holidays, in particular, is higher, so Nachman urges being as immunized as possible before then.

With people not wearing masks and not even testing for the virus even when they get sick, Nachman suggested that it’s “highly likely” the country will see new variants by the spring.

Nachman urged people to take steps to protect themselves, which includes eating well, exercising, receiving the latest vaccination and limiting exposure, particularly for those who might be vulnerable.

“Take care of yourself,” Nachman urged.

At Stony Brook University Hospital, the wards are busy, with a steady stream of patients coming in, receiving treatment and getting discharged, Nachman said.

“We’re seeing a lot of other viral illnesses,” she added.

She sees a ramp-up in RSV, which she doesn’t expect to peak until Thanksgiving.

Dhuper remains concerned about viral threats this fall and winter.

“We do anticipate a worse flu season this year as the herd immunity is at a lower level,” he wrote. “People should get their flu shots sooner rather than later as that is the only primary protection we have to offer. People with comorbidities should particularly be concerned as the likelihood of severe illness, hospitalization and even death could be higher without the protection from the vaccine.”

While Nizza hasn’t seen any major spike in the flu yet, he suggested in an email that “now would be a good time to get vaccinated.”

Got all that? Good, now, when you’re outside, far from other people and you want to give your lungs a break, take a deep, cleansing breath. Other times? Protect your health and the health of your family and community.

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Alex Sutton died of a heroin/fentanyl overdose on April 8, 2018. That year he was one of nearly 600 people on Long Island whose death was caused by a fatal overdose. This year statistics are no better, in fact Suffolk County has the MOST O.D. deaths of any county in New York State, with more than 500 deaths so far.

Alex’s mother, Carole Trottere, is hosting an event to mark what would have been his 35th birthday by giving out a FREE slice of pizza and a drink at her son’s favorite pizza place, Station Pizza, located at 1099 N. Country Road in Stony Brook on Saturday, Oct. 29 from noon to 5 p.m. The offer is for the first 100 customers. The Suffolk County Police Department will also be present to give out Narcan, with training instruction. Trottere hopes this will help raise awareness of the fentanyl epidemic. And help save lives.

“Every death from overdose affects so many people…parents, grandparents, siblings, friends, and colleagues. It’s like a spider web of grief for those left behind,” said Trottere. “Fentanyl is the deadliest drug to ever hit the streets and is responsible for nearly 70% of nationwide drug deaths. I want to plead with anyone thinking about it to not spin that Roulette wheel. Don’t take a chance. It may sound silly to say that death is permanent, but it’s the truth. There’s no do-over.” For more information call 631-275-5277.

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Breast cancer myth busters

By Melissa Arnold

Each October, it seems like the whole world turns pink in the name of breast cancer awareness. From fundraisers to billboards, clothing and social media campaigns, that ubiquitous pink ribbon is everywhere. Of course, there’s a clear need for awareness, as 1 in 8 women on Long Island will develop invasive  breast cancer in their lifetime. But even with the October blitz, myths and misconceptions remain widely circulated among women of all ages.

Susan Samaroo is the executive director of The Maurer Foundation (www.maurerfoundation.org), a nonprofit organization in Melville established in 1995 with one goal in mind — to save lives through breast education. Their interactive workshops held in schools, colleges and community locations debunk long-held breast cancer myths, teach people how to lower their risk through lifestyle modification, and provide instruction to find breast cancer in its earliest stages when it is easiest to treat.

“We believe that it’s important to educate young people specifically and give them the information they need early on,” said Samaroo. “It’s never too early to learn what to look for and how to make positive changes that reduce breast cancer risk.”

The foundation educates roughly 20,000 people each year, the majority in co-ed settings. And Samaroo noted that they tend to hear the same rumors about breast cancer year after year. Let’s set the record straight on some of the most common myths.

MYTH: If you don’t have a family history, you won’t get breast cancer.

FACT: While family history is an important factor when considering potential risk, the National Institutes of Health reports that around 85 percent of people diagnosed with breast cancer do not have a family history.

For people that do have a family history, it’s critical to have a conversation with your doctor as soon as possible. Mammograms and other screening may be recommended as early as age 25, and in some cases, genetic testing is warranted. Having certain genetic mutations causes an individual’s risk to skyrocket, and preventative medication or surgery could be necessary.

MYTH: Only older women get breast cancer.

FACT: There are actually two false statements here. First, the age factor. According to Eileen Pillitteri, program manager of The Maurer Foundation, approximately 12,000 women in their 20s and 30s receive a breast cancer diagnosis each year.

Furthermore, men can and do get breast cancer. The Centers for Disease Control and Prevention (CDC) states that 1 in 100 breast cancers patients are men, making it critical for both men and women to familiarize themselves with the look and feel of their breasts and check regularly for lumps, discharge and changes in appearance.

MYTH: Size matters.

FACT: Some people believe that having larger breasts reflects a greater risk of cancer, but that doesn’t matter. It’s worth noting, however, that some women’s breasts are more difficult to screen for abnormal growths.

“An annual mammogram is the best overall screening test for breast cancer. There are some limitations, especially in women with dense breast tissue,” said Dr. Erna Busch-Devereaux, chief breast surgeon at Huntington Hospital, Northwell Health. “Having dense breasts means that there is not a lot of fatty tissue present in the breasts. These breasts are mostly glandular and the X-rays don’t penetrate that tissue as well, so the picture is not as clear. Finding cancer can be more difficult with dense breasts — it’s like finding a snowball (cancer) in a snowstorm (background breast tissue).”

Your doctor will let you know if you have dense breasts. Different types of screening, such as 3-D mammograms, ultrasound or MRI might be suggested for a clearer picture.

MYTH: Your deodorant or your bra could give you cancer.

FACT: As of right now, there is no scientifically-backed evidence showing an increase in breast cancer risk for women who use antiperspirants or deodorants, though there are “general concerns surrounding the impact of environmental and consumed chemicals on our health,” Busch-Devereaux said, adding that more study is needed.

And as for the rumor that wearing tight bras with underwire or any other type of bra can cause breast cancer by obstructing lymph flow? “That’s completely unfounded,” Pillitteri said.

MYTH: Lifestyle doesn’t change your cancer risk.

FACT:  Across the board, limiting or avoiding alcohol consumption and eating a well-rounded, nutritious diet can help lower your risk of many cancers.

When it comes to breast cancer specifically, other choices you make can make an impact as well, but the specifics can be complicated. 

“Having children at a young age and having multiple children results in a reduced breast cancer risk, but this protection is seen decades later. In the short term, there is an increased risk for breast cancer after having a child which is associated with pregnancy-related hormone surges,” Pillitteri explained.

Contraception is another tricky topic. Hormonal IUDs and oral birth control pills can increase breast cancer risk, but they can also greatly reduce the risk of ovarian and endometrial cancers, Pillitteri said.  Other health professionals, including Dr. Busch-Devereaux, said that birth control pills don’t appear to increase overall breast cancer risk.

Healthcare organizations agree that most types of hormone replacement therapy (HRT) to cope with symptoms of menopause does increase breast cancer risk.

The takeaway: “It’s important to talk to your doctor about the products that are right for you based on your individual risk factors,” Pillitteri said.

Be proactive

In the end, risk of breast cancer can vary from person to person based on genetics, body type and lifestyle. But it’s never too late to make positive changes.

“Eat a healthy, well-balanced diet, exercise, maintain an average weight, avoid smoking or vaping, and limit alcohol — things that are good for overall health are good for the breasts,” Busch-Devereaux said. 

Make sure you have an annual mammogram screening beginning at age 40. If you have a family history or genetic mutations, talk to your doctor about when to start screenings.

And don’t be embarrassed if it’s been a while since your last mammogram. The important thing is to go.

“Sometimes women are too worried to go for a mammogram, or they delay seeking care because they’re afraid,” Busch-Devereaux said. “We stand an excellent chance of curing cancer when it is found early, so mammograms are very important and should always be encouraged. Additionally, women shouldn’t feel afraid or embarrassed to come in for an evaluation if they feel a lump or notice a change in their breast and haven’t gone for a mammogram. We’re here to help.”

This article first appeared in TBR News Media’s Focus on Health supplement on Oct. 20, 2022.

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Sugar control and regular eye exams are your best defense

By David Dunaief, M.D.

Dr. David Dunaief

We talk a lot in the medical community about the vascular consequences of diabetes, and rightly so. If you have diabetes, you are at high risk of vascular complications that can be life-altering. Among these are macrovascular complications, like coronary artery disease and stroke, and microvascular effects, such as diabetic nephropathy and retinopathy.

Here, we will discuss diabetic retinopathy (DR), the number one cause of blindness among U.S. adults, ages 20 to 74 years old (1). Diabetic retinopathy (DR) is when the blood vessels that feed the light-sensitive tissue at the back of your eye are damaged, and it can progress to blurred vision and blindness.

As of 2019, only about 60 percent of people with diabetes had a recommended annual screening for DR (2). Why does this matter? Because the earlier you catch it, the more likely you will be able to prevent or limit permanent vision loss.

Over time, DR can lead to diabetic macular edema (DME). Its signature is swelling caused by fluid accumulating in the macula (3). An oval spot in the central portion of the retina, the macula is sensitive to light. When fluid builds up from leaking blood vessels, it can cause vision loss.

Those with the longest duration of diabetes have the greatest risk of DME. Unfortunately, many patients are diagnosed with DME after it has already caused vision loss. If not treated early, patients can experience permanent damage (2).

In a cross-sectional study using NHANES data, among patients with DME, only 45 percent were told by a physician that diabetes had affected their eyes (4). Approximately 46 percent of patients reported that they had not been to a diabetic nurse educator, nutritionist or dietician in more than a year — or never.

Unfortunately, the symptoms of vision loss don’t necessarily occur until the latter stages of the disorder, often after it’s too late to reverse the damage.

Treatment options

While DME has traditionally been treated with lasers, injections of anti-VEGF medications may be more effective. These eye injections work by inhibiting overproduction of a protein called vascular endothelial growth factor (VEGF), which contributes to DR and DME (5).

The results from a randomized controlled trial showed that eye injections with ranibizumab (Lucentis) in conjunction with laser treatments, whether laser treatments were given promptly or delayed for at least 24 weeks, were equally effective in treating DME (6). Other anti-VEGF drugs include aflibercept (Eylea) and bevacizumab (Avastin).

Risk from diabetes treatments

You would think that using medications to treat type 2 diabetes would prevent DME from occurring as well. However, in the THIN trial, a retrospective study, a class of diabetes drugs, thiazolidinediones, which includes Avandia and Actos, actually increased the occurrence of DME compared to those who did not use these oral medications (7). Those receiving these drugs had a 1.3 percent incidence of DME at year one, whereas those who did not had a 0.2 percent incidence. This incidence was persistent through the 10 years of follow-up. Note that DME is not the only side effect of these drugs. There are important FDA warnings for other significant issues.

To make matters worse, those who received both thiazolidinediones and insulin had an even greater incidence of DME. There were 103,000 diabetes patients reviewed in this trial. It was unclear whether the drugs, because they were second-line treatments, or the severity of the diabetes itself may have caused these findings.

This is in contrast to a previous ACCORD eye sub-study, a cross-sectional analysis, which did not show an association between thiazolidinediones and DME (8). This study involved review of 3,473 participants who had photographs taken of the fundus (the back of the eye).

What does this ultimately mean? Both studies had weaknesses. It was not clear how long the patients had been using the thiazolidinediones in either study or whether their sugars were controlled and to what degree. The researchers were also unable to control for all other possible confounding factors (9). There are additional studies underway to clarify these results.

Glucose control and diet

The risk of progression of diabetic retinopathy was significantly lower with intensive blood sugar controls using medications, one of the few positive highlights of the ACCORD trial (10). Unfortunately, medication-induced intensive blood sugar control also resulted in increased mortality and no significant change in cardiovascular events. However, an inference can be made: a nutrient-dense, plant-based diet that intensively controls blood sugar is likely to decrease the risk of diabetic retinopathy and further vision complications (11, 12).

If you have diabetes, the best way to avoid diabetic retinopathy and DME is to maintain good control of your sugars. Also, it is imperative that you have a yearly eye exam by an ophthalmologist so that diabetic retinopathy is detected as early as possible, before permanent vision loss occurs. If you are taking the oral diabetes class thiazolidinediones, this is especially important.

References: 

(1) cdc.gov. (2) www.aao.org/ppp. (3) www.uptodate.com. (4) JAMA Ophthalmol. 2014;132:168-173. (5) Community Eye Health. 2014; 27(87): 44–46. (6) ASRS. Presented 2014 Aug. 11. (7) Arch Intern Med. 2012;172:1005-1011. (8) Arch Ophthalmol. 2010 March;128:312-318. (9) Arch Intern Med. 2012;172:1011-1013. (10) www.nei.nih.gov. (11) OJPM. 2012;2:364-371. (12) Am J Clin Nutr. 2009;89:1588S-1596S.

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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Pixabay photo

By Daniel Dunaief

Daniel Dunaief

My grandmother was a worrier. 

Even she, however, would have had a hard time worrying about other major challenges, problems and threats during the worst of the COVID-19 pandemic.

That, it turns out, was also true for the world during COVID when it came to discussions about the threat from climate change.

In a recent study published in the prestigious journal Proceedings of the National Academy of Sciences, Oleg Smirnov, associate professor in the Department of Political Science at Stony Brook University, examined the level of concern on Twitter about climate change during 2020 and 2021 and compared those numbers to 2019, the last year before COVID.

According to the pool of finite worry, which Princeton professor of Psychology Elke Weber developed, environmental and climate concerns decline amid worries about other major threats.

Smirnov found that the total number of tweets that mention climate change dropped to 5.6 million in 2020 and 5.3 million in 2021, from 8 million in 2019. This, Smirnov points out, occurred despite an increase in Twitter users, more climate disasters and more climate news in 2021.

“The psychological foundation tell us that people may only really respond to one threat at a time,” Smirnov said in an interview. The anxiety and the reaction to that threat may be limited because it requires major energy.

“Maybe, for biological reasons, [people] put all their energy into responding to the most immediate threat,” Smirnov added.

By tracking daily tweets and various measures of COVID cases, Smirnov found on a finer scale as well that discussions of climate change diminished amid higher infections and mortality.

For every thousand new COVID-19 cases in the United States, climate change tweets decreased by about 40.5 tweets per day. Every thousand new deaths resulted in 3,308 fewer climate tweets.

While Smirnov understood the need to focus on the pandemic, he suggested a lack of concern about climate change could disrupt efforts to protect the planet

“This has profound implications,” Smirnov said. “Without a focus on climate change, without an emphasis on its importance, there is less urgency and less pressure on politicians to do something about it.”

Even in better times, climate change efforts are “fragile,” he said, which adds to the uncertainty about the ability to address the challenge adequately.

Indeed, even the sentiment analysis, in which Smirnov reviewed the emotional content of words used to describe climate change and the threat to the planet and humanity, became less negative during the worst of the pandemic.

When asked about the possibility that climate change concerns might have declined during COVID in part because the carbon footprint declined amid travel restrictions and slowdowns in industrial production, Smirnov likened such an approach to short-term fasting or extreme dieting.

While spending a few days on these extreme diets can reduce a person’s weight over the course of days, such an approach provides “no substantial improvement in your health” longer term, he said.

So, what about now, as concerns about the pandemic abate, people have stopped wearing masks and schools and stadiums are full?

Smirnov plans to continue to collect Twitter data for the remainder of this year, to see whether a return to normalcy brings the focus back to the threat from climate change.

As for his own experience, Smirnov recognized that climate change took a back burner amid the worst of the pandemic.

“My attention certainly was hijacked by COVID-19, despite the fact that climate change is part of my work,” Smirnov said. In April of 2020, Smirnov recalled worrying about where his family would find food instead of thinking about greenhouse gases and rising sea levels.

In the present, Smirnov remains concerned about the kind of tipping points and climate inertia that threatens the future.

Ever the worrier, my grandmother might be relieved enough by the less virulent form of the virus and the availability of vaccines and treatment to return to worrying about the threat climate change poses.

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WTC responders at Ground Zero, working on the pile in the aftermath of 911. Photo by John Bombace

As the medical challenges to first responders at the World Trade Center site after the 9/11 attacks increase, Stony Brook University’s treatment program has increased the number of people it helps and, recently, also the federal funds to support efforts to treat people.

Dr. Benjamin Luft at the Stony Brook WTC Wellness Program, where he serves as director. File photo

Recently, the National Institute for Occupational Safety and Health, which is part of the Centers for Disease Control and Prevention, awarded the Stony Brook World Trade Center Health and Wellness Program $147 million over an eight-year period to expand patient care and support infrastructure needs.

The SB World Trade Center Health and Wellness program now sees up to 13,000 patients, which is more than double the 6,000 patients it used to see.

“Patients are getting sicker and their diseases are much more complex with a variety of different systems being involved, both psychologically as well as physically,” said Dr. Benjamin Luft, director of the WTC Wellness Program.

Through the work the SB WTC group has conducted, doctors and researchers have demonstrated that diseases and physical and cognitive challenges associated with aging have occurred more rapidly in the WTC population.

At the same time, COVID-19 has also exacerbated conditions related to exposure to the site, with over 20% of this population experiencing lingering symptoms due to the pandemic.

The WTC first responders have developed chronic sinusitis and a variety of gastrointestinal disorders, such as gastroesophageal reflux disease (or GERD).

While these diseases occur in the general population, “the chronicity is unique,” Luft added.

The SB WTC Wellness program will use the funds to hire additional staff with specialties in pulmonology and psychiatry, among other areas, Luft said.

The majority of the work occurs at the Wellness Center’s main facility and clinic in Commack. SB also runs a site in Mineola. The funds will help revamp the Mineola site as well.

The two sites will use updated technologies and will deploy emerging capabilities in telehealth and artificial intelligence to communicate, diagnose and monitor cases.

Federal funds have supported the effort for 18 years, as NIOSH has funded clinical services for WTC patients treated at Stony Brook.

Medical conditions for this population have included post-traumatic stress disorder and respiratory illnesses.

The funding more than doubles the $60 million, five-year award the WTC Wellness Program received in 2017 from NIOSH that had provided support until the end of March of this year. NIOSH had extended the grant for six months until the current funding started at the end of September, Luft said.

Patients have developed a range of cancers, as well as lung issues such as asthma and chronic obstructive pulmonary disorder.

Additionally, patients are struggling with a variety of mental processing challenges.

“We see a lot of patients who have a variety of cognitive and memory problems,” Luft said. 

Luft emphasized that many of the thousands of patients he treats have several health issues simultaneously. By using new technologies, these efforts will enhance the quality of life for people who were on site after the attack.

Luft added that the connection and support from NIOSH have helped support health care for this population.

“The various people at NIOSH are really involved in the program,” he said. “It’s been very satisfying.”

Stony Brook University faculty in public health, psychiatry, pulmonary care, cardiovascular care and neuroscience all take part in ongoing research related to the health issues of WTC responders.

Luft emphasized that the care first responders at the WTC receive tries to be “proactive” with an extensive effort to screen for various diseases, including cancer.

The research and treatment efforts for the WTC population extends to other health care initiatives for people exposed to carcinogens in wars or from other unintentional exposures.

The exposure from 911 is similar to those from burn pits, Camp Lejuene and other hazards.

“The toxins are similar,” Luft said.

 

 

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St. Charles Hospital
Dr. Arif Ahmad

Do you suffer from acid reflux/GERD? St. Charles Hospital’s Wisdom Conference Center, 200 Belle Terre Road, Port Jefferson will host a free community lecture on acid reflux on Thursday, Nov. 10 from 6 to 7:30 p.m.

Presented by Arif Ahmad, MD, FRCS, FACS Director, Acid Reflux and Hiatal Hernia Centers of Excellence at St. Charles Hospital and St. Catherine of Siena Hospital, topics will include why PPI drugs are not always the answer as a treatment option and permanent solutions with minimally invasive anti-reflux surgery procedures.

Followed by a Q&A. Light refreshments will be served and masks are required. To register, please call 631-474-6797.

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