Comsewogue Public Library in Port Jefferson Station presents an important online program, COVID-19 and Vaccines: Just the Facts, on Monday, Feb. 1 at 7 p.m.
Get a science-based overview of the novel coronavirus that causes COVID-19 including a discussion on the safety of vaccines, how long immunity may last, and more with Ph.D. pharmacologist Andrew Clair. Open to all. Visit www.cplib.org/a-online-programming/ for information on how to participate in this program. Questions? Call 631-928-1212 and ask for Adult Services.
Beginning February 4, Avalon Nature Preserve in Stony Brook presents a 9-week virtual Mindfulness-Based Stress Reduction (MBSR) program. The classes will be held on consecutive Thursdays via Zoom from 10:30 a.m. to 1 p.m. through April 1.
Are you ready to be more active in your own well-being and health? Would you like to strengthen your resilience, improve coping with stress, and gain a sense of greater ease and balance in your life?
If so, this winter may be the time to join this supportive and experiential 9-week MBSR course that teaches, in a step-by-step fashion, the practice of mindfulness meditation for well-being in daily life.
Known as the Gold Standard for learning mindfulness meditation, MBSR was developed by Dr. Jon Kabat-Zinn at the University of Massachusetts’ Medical Center has been featured in countless media segments, hundreds of research studies and is now offered all over the world in hospitals, schools, business and sports. And at Avalon for the past 10 years!
This course is offered by Cheryl Kurash, Ph.D, Psychologist and Certified MBSR Teacher through UMASS Center for Mindfulness
Want to know more? For additional information and to pre-register for the course,
click the button below:
Blood pressure numbers of less than 120/80 mm Hg are considered within the normal range.
Nighttime blood pressure readings may be more accurate predictors
By David Dunaief, M.D.
Dr. David Dunaief
What could we possibly learn about blood pressure that we have not heard already? Studies teach us about diagnostic techniques and timing, as well as consequences of hypertension and its treatment.
Two arms please
When you go to the doctor’s office, they usually take your blood pressure first. But do they take readings in both arms and, if so, have you wondered why? I take blood pressure readings in both arms, because there may be significant benefit from this.
Researchers analyzed the Framingham Heart Study and Offspring Study and found that when blood pressure was taken in both arms and there was a difference of more than 10 mm Hg in the systolic (top number) blood pressure, they could identify an almost 40 percent increased risk of having a cardiac event, such as a stroke or a heart attack (1).
So, the next time you go to the doctor’s office, ask them to take your blood pressure in both arms to give you and your doctor a potential preliminary indication of increased cardiovascular disease risk.
Night beats daytime
When do you take your blood pressure? For most of us it is usually at the doctor’s office in the middle of the day. This may not be the most effective reading. Nighttime blood pressure readings may be the most accurate, according to one study (2).
This was a meta-analysis of nine observational studies involving over 13,000 patients. Neither the clinical nor daytime readings correlated significantly with cardiovascular events when multiple confounding variables were taken into account. However, every 10 mm Hg increase at night had a significant predictive value.
With patients, if blood pressure is high in my office, I suggest that they take their blood pressure at home, both in the morning and at night, and send me weekly readings. At least one of the readings should be taken before antihypertensive medications are taken, since these will alter the numbers.
Pass on the salt
There has always been a debate about whether salt plays a role in high blood pressure and heart disease. A compelling British study, called the Health Survey from England, implicates sodium as one potential factor exacerbating the risk for high blood pressure and, ultimately, cardiovascular disease (3). The results show that when salt intake was reduced by an average of 15 percent, there was a significant blood pressure reduction and that this reduction may be at least partially responsible for a 40 percent reduction in stroke mortality and a 42 percent reduction in heart disease mortality.
One potential study weakness was that physical activity was not taken into account. However, this study’s strength was that it measured salt intake through 24-hour urine tests. Most of our dietary salt comes from processed foods we least suspect, such as breads, pastas and cheeses.
Check your eyes
When we think of blood pressure-lowering medications, we don’t usually consider age-related macular degeneration as a potential side effect. However, in the Beaver Dam Eye Study, patients who were taking blood pressure medications were at a significant 72 percent increased overall risk of developing early-stage AMD (4). It did not matter which class of blood pressure-lowering drug the patient was using, all had similar effects: calcium channel blockers, beta blockers, diuretics, and angiotensin receptor blockers.
However, the researchers indicated that they could not determine whether the blood pressure or the blood pressure medication was the potential contributing factor. This is a controversial topic. If you are on blood pressure medications and are more than 65 years old, I would recommend that you get yearly eye exams by your ophthalmologist.
Manage your fall risk
One study shows that blood pressure medications significantly increase fall risk in the elderly (5). Overall, nine percent of these patients on blood pressure medications were seriously injured when they fell. Those who were considered moderate users of these medications had a 40 percent increased risk of fall. But, interestingly, those who were consider high-intensity users had a slightly less robust risk of fall (28 percent) than the moderate users. The researchers used the Medicare database with 5,000 participants as their data source. The average age of the participants in the study was 80.
Does this mean that we should discontinue blood pressure medications in this population? Not necessarily. This should be assessed at an individual level between the patient and the doctor. Also, one weakness of this study was that there was no dose-response curve. In other words, as the dosage increased with high blood pressure medications, one would expect a greater fall risk. However, the opposite was true.
So, we have some simple, easy-to-implement, takeaways. First, consider monitoring blood pressure in both arms, since a difference can mean an increased risk of cardiovascular events. Reduce your salt intake; it appears that many people may be sensitive to salt, as shown by the British study. If you do take blood pressure medications and are at least 65 years old, take steps to reduce your risk of falling and have annual ophthalmic exams to check for AMD.
References:
(1) Am J Med. 2014 Mar;127(3):209-215. (2) J Am Soc Hypertens 2014;8:e59. (3) BMJ Open 2014;4:e004549. (4) Ophthalmology online April 30, 2014. (5) JAMA Intern Med. 2014;174(4):588-595.
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.
Teresa Habacker, MD, FAAOS, FASSH and her practice, East End Hand Center, have joined Stony Brook Medicine Community Medical Group, Stony Brook Medicine’s expanding network of community practices.
“We are happy to welcome Dr. Habacker to a more inclusive role in Stony Brook Medicine. For more than five years, Dr. Habacker has served the Stony Brook Medicine community on the hand surgery/trauma team and the Hand Surgery Fellowship Training Program,” said Lawrence Hurst, MD, Professor and Chair of Orthopaedics, Chief of Hand Surgery at Stony Brook Medicine. “In our new relationship, we look forward to expanding her role in these areas, as well as the Center for Musculoskeletal Health, providing world-class care to patients on the East End.”
Dr. Habacker is a board-certified orthopedic surgeon with an additional certification in hand surgery. She provides comprehensive orthopedic care in Mattituck, Port Jefferson, Southampton and Wading River.
“I have had the pleasure of working with Dr. Hurst and the hand surgery team,” said Dr. Habacker. “I am pleased to be a part of the Center for Musculoskeletal Health and I look forward to working with the local physicians and ancillary teams as I continue to serve the communities on the East End of Long Island.”
Dr. Habacker completed her medical degree at the Medical College of Virginia in Richmond, VA. She completed her surgical residency at SUNY Downstate Medical School in Brooklyn, NY and her orthopedic surgical residencies at Louisiana State University in New Orleans, LA and Long Island Jewish Medical Center in New Hyde Park, NY. Dr. Habacker then went on to complete a hand surgery fellowship at Thomas Jefferson University in Philadelphia, PA. She is an Assistant Clinical Professor and has admitting privileges at Stony Brook University Hospital, Catholic Health Services and Northwell Health hospitals in Suffolk County.
East End Hand Center is accepting new patients. Office hours are Monday through Friday. To make an appointment, call 631-473-4263.
About Stony Brook Medicine
Stony Brook Medicine integrates and elevates all of Stony Brook University’s health-related initiatives: education, research and patient care. It includes five Health Sciences schools — Dental Medicine, Health Technology and Management, Medicine, Nursing and Social Welfare — as well as Stony Brook University Hospital, Stony Brook Southampton Hospital, Stony Brook Eastern Long Island Hospital, Stony Brook Children’s Hospital and more than 230 community-based healthcare settings throughout Suffolk County. To learn more, visit www.stonybrookmedicine.edu
About Stony Brook Medicine Community Medical Group
Stony Brook Medicine Community Medical Group, an arm of Stony Brook Medicine, includes over 35 community practices with over 50 locations across Long Island, from Farmingdale to Greenport. We offer exceptional care by more than 100 providers in 18 specialties committed to enhancing medical care coordination in the community. To learn more, visit sbcommunitymedical.org
From left, Richelle Rugolo and Debbie Loggia (Photo from Jefferson's Ferry)
Jefferson’s Ferry in South Setauket recognized two employees for their outstanding commitment and exceptional care and leadership at the award-winning life plan community located at One Jefferson Ferry Drive. Director of Nursing Richelle Rugolo was named Manager of the Year and Certified Nursing Assistant Debbie Loggia was named Employee of the Year. The announcement was made by Jefferson’s Ferry CEO Bob Caulfield.
“2020, though one of the most challenging we’ve faced due to COVID-19, showcased the caliber, dedication, and heart of our employees,” said Caulfield. “Individuals like Richelle and Debbie protect and care for our residents, inspire our teams, and exceed the high standards we set for ourselves as a premier life plan community.”
Rugolo has served as the director of nursing at Jefferson’s Ferry for six years. Under her leadership, Jefferson’s Ferry has resulted in an overall 5 Star Rating by The Centers for Medicare and Medicaid Services (CMS), and was named a “Best Of” nursing home by U.S. News & World Report.
“Richelle consistently strives for exceptional outcomes and manages performance to the highest standards which are reflected in the results of our third-party satisfaction surveys and NY State Department of Health surveys,” said Caulfield. “She’s a respected professional whose sound leadership created a safe haven for both residents and staff.”
Loggia joined Jefferson’s Ferry as a certified nursing assistant in 2011. “Debbie is a dedicated and respected member of the nursing team, who cares for residents with a smile and a positive attitude,” said Caulfield.
Residents and families express their respect and appreciation for Debbie through surveys and positive messages, and recognize her as an advocate, always trying to better accommodate residents’ needs.
Online education has been part of the School of Nursing since 1994. Photo from Stony Brook Medicine
For the second year in a row, the Stony Brook University School of Nursing’s Online Master’s Program was ranked in the top 10 schools nationwide by the U.S. News and World Report in its 2021 College Rankings.
The program has remained in the top 20 for online graduate nursing programs in all but one of the past eight years. In 2020, the program was ranked 7th and in 2021 ranked 9th in the list of Best Online Master’s in Nursing Programs. Officials at the school say the change in ranking from last year to this year may be due to the slight decline in faculty numbers because additional hiring remained difficult due to the pandemic.
The School of Nursing began offering online education in 1994. It started with a Midwifery program and developed into an array of other nurse practitioner education programs. This led to more than 25 years of developing and refining innovative online programs to provide a firm foundation of new online learning applications for nurses and future nurses.
“Our longstanding experience became critical to continued success with online learning this past year in responding to the health care needs and educational changes during the pandemic,” says Annette Wysocki, PhD, RN, FAAN, Dean of the School of Nursing. “Our constant attention to content and presentation methods provides students with visual, graphic and other ways to access content, and this even includes active engagement with simulated clinical experiences within online educational platforms.”
According to U.S. News, online graduate nursing data used as methodology to calculate the rankings included five areas of data: engagement (30 percent); expert opinion (20 percent); faculty credentialing and training (20 percent); services and technologies (20 percent); and student excellence (10 percent).
For more details about the methodology, see this link.
GAL resident Harry Cohen receives first dose of COVID-19 Vaccine
Residents and staff at Gurwin Jewish ~ Fay J. Lindner Residences assisted living community, part of the Gurwin Healthcare System in Commack, received their first dose of the two-dose BioNTech Pfizer vaccine for COVID-19 this week.
Walgreens, Gurwin’s pharmacy partner in providing the COVID-19 vaccine, had a number of pharmacists on hand to administer more than 200 doses of the vaccine on Monday at the assisted living community, and are scheduled for two additional clinics to complete the vaccination and allow others who may have missed the first clinic to receive it.
Residents and staff at Gurwin Jewish Nursing & Rehabilitation Center, the Healthcare System’s 460-bed skilled nursing facility, received their first dose of the vaccine in December. Visiting has been restricted at all assisted living and long-term care facilities since March, when the COVID-19 crisis began, and is dependent on new cases of COVID-19 among staff and residents. The vaccine is seen as a ray of hope in fully reuniting families and returning to typical activities for residents.
“Our staff has done an amazing job in keeping our residents engaged and well,” said Michael Letter, Administrator/COO of the assisted living community. “Even though we’ve been able to have modified visiting sporadically, the vaccine is the first real step in being able to return to normalcy, and we are thankful to have been prioritized to receive the vaccine.” More than 50% of Gurwin’s assisted living community staff, and all but one resident, will have been vaccinated after the second clinic, set for February 8.
New York State has partnered with Stony Brook University to provide drive-through testing for the coronavirus at Stony Brook University’s South P Lot off Stony Brook Road. Residents must make appointments in advance by phone at 888-364-3065 or online at covid19screening.health.ny.gov.
Beginning tomorrow, January 24, the COVID-19 testing site at South-P Lot will change to the following hours:
Monday through Friday, 8 a.m. to 6 p.m.
Saturday, 8 a.m. to 3 p.m.
Sunday, 8 a.m. to 1 p.m.
For more information about Stony Brook’s coronavirus drive-through testing, click here.
Anyone who believes they’re at risk should call the Department of Health Hotline, 888-364-3065, and talk to experts to determine if and how they should be tested.
Walk-ins are not accepted and will not be seen.
All test results will be provided by the Department of Health. Call the DOH Hotline at 888-364-3065.
Click here for a map and directions to the testing site.
Exercise and sleep are crucial to clearing the clutter
By David Dunaief, M.D.
Dr. David Dunaief
Considering the importance of our brain to our functioning, it’s startling how little we know about it.
We do know that certain drugs, head injuries and lifestyle choices negatively impact the brain. There are also numerous disorders and diseases that affect the brain, including neurological (dementia, Parkinson’s, stroke), infectious (meningitis), rheumatologic (lupus and rheumatoid arthritis), cancer (primary and secondary tumors), psychiatric mood disorders (depression, anxiety, schizophrenia), diabetes and heart disease.
Although these diseases vary widely, they generally have three signs and symptoms in common: they either cause altered mental status, physical weakness or change in mood — or a combination of these.
Probably our greatest fear regarding the brain is a loss of cognition. Fortunately, there are several studies that show we may be able to prevent cognitive decline by altering modifiable risk factors. They involve rather simple lifestyle changes: sleep, exercise and possibly omega-3s.
Let’s look at the evidence.
Clutter slows us down as we age
The lack of control over our mental capabilities as we age frightens many of us. Those who are in their 20s seem to be much sharper and quicker. But are they really?
In a study, German researchers found that educated older people tend to have a larger mental database of words and phrases to pull from since they have been around longer and have more experience (1). When this is factored into the equation, the difference in terms of age-related cognitive decline becomes negligible.
This study involved data mining and creating simulations. It showed that mental slowing may be at least partially related to the amount of clutter or data that we accumulate over the years. The more you know, the harder it becomes to come up with a simple answer to something. We may need a reboot just like a computer. This may be possible through sleep, exercise and omega-3s.
Get enough sleep
Why should we dedicate 33 percent of our lives to sleep? There are several good reasons. One involves clearing the mind, and another involves improving our economic outlook.
For the former, a study done in mice shows that sleep may help the brain remove waste, such as those all-too-dangerous beta-amyloid plaques (2). When we have excessive plaque buildup in the brain, it may be a sign of Alzheimer’s. When mice were sleeping, the interstitial space (the space between brain gyri, or structures) increased by as much as 60 percent.
This allowed the lymphatic system, with its cerebrospinal fluid, to clear out plaques, toxins and other waste that had developed during waking hours. With the enlargement of the interstitial space during sleep, waste removal was quicker and more thorough, because cerebrospinal fluid could reach much farther into the spaces. A similar effect was seen when the mice were anesthetized.
In another study, done in Australia, results showed that sleep deprivation may have been responsible for an almost one percent decline in gross domestic product for the country (3). The reason? People are not as productive at work when they don’t get enough sleep. They tend to be more irritable, and concentration may be affected. We may be able to turn on and off sleepiness on short-term basis, depending on the environment, but we can’t do this continually.
According to the Centers for Disease Control and Prevention, four percent of Americans reported having fallen asleep in the past 30 days behind the wheel of a car (4). And “drowsy driving” led to 83,000 crashes in a four-year period ending in 2009, according to The National Highway Traffic Safety Administration.
Prioritize exercise
How can I exercise, when I can’t even get enough sleep? Well there is a study that just may inspire you.
In the study, which involved rats, those that were not allowed to exercise were found to have rewired neurons in the area of their medulla, the part of the brain involved in breathing and other involuntary activities. There was more sympathetic (excitatory) stimulus that could lead to increased risk of heart disease (5). In rats allowed to exercise regularly, there was no unusual wiring, and sympathetic stimuli remained constant. This may imply that being sedentary has negative effects on both the brain and the heart.
This is intriguing since we used to think that our brain’s plasticity, or ability to grow and connect neurons, was finite and stopped after adolescence. This study’s implication is that a lack of exercise causes unwanted new connections. Human studies should be done to confirm this impact.
Consume omega-3 fatty acids
In the Women’s Health Initiative Memory Study of Magnetic Resonance Imaging Study, results showed that those postmenopausal women who were in the highest quartile of omega-3 fatty acids had significantly greater brain volume and hippocampal volume than those in the lowest quartile (6). The hippocampus is involved in memory and cognitive function.
Specifically, the researchers looked at the levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in red blood cell membranes. The source of the omega-3 fatty acids could either have been from fish or supplementation.
It’s never too late to improve brain function. Although we have a lot to learn about the functioning of the brain, we know that there are relatively simple ways we can positively influence it.
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.
The next stop for the St. Francis Hospital community health van will be St. Anthony of Padua Parish Outreach, 1025 Fifth Ave., East Northport on Friday, Jan. 22.Free health screenings will be offered from 10 a.m. to 2 p.m. Services include a blood pressure check, a simple blood test for cholesterol, a heart health history and a diabetes screening for patients older than 18. Free flu shots are also available. No appointment is needed. Face masks are mandatory. For further details, call 631-261-1695.
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