Medical healthcare holding COVID-19 , Coronavirus swab collection kit, wearing PPE protective suit mask gloves, test tube for taking OP NP patient specimen sample,PCR DNA testing protocol process
In an effort to expand access to testing, Suffolk County Executive Steve Bellone today announced the opening of three new community based testing sites. Rapid Antigen COVID-19 tests, which will be administered by Baseline Health and Reef Technologies, will be on a first come, first served basis.
The first testing site at Hecksher State Park will open on Wednesday, December 29th, the second testing site at Red Creek Park, which was formerly located at Francis S. Gabreski Airport, will open on Monday, January 3rd, and the third testing site located at Cathedral Pines County Park will open on Tuesday, January 4th.
“What we have learned so far is that the Omicron variant is highly transmittable and causing a spike in our daily positivity rate,” said Suffolk County Executive Steve Bellone. “Testing is one of the best tools we have when it comes to containing the spread of this virus. As we approach the New Year, these three new sites will provide quick and convenient results for our residents so that they can protect themselves and their loved ones.”
Rapid Testing sites include:
Hecksher State Park, Field 8 (Opening on Wednesday, December 29th)
1 Heckscher State Parkway
East Islip
Open every Monday through Thursday from 8:00 AM to 4:00 PM
Testing Capacity: Up 1,000 tests a day
Red Creek Park (Opening Monday, January 3rd)
102 Old Riverhead Rd
Hampton Bays
Open for school-required testing and community testing
Open on Mondays only from 10:00 AM to 6:00 PM
Testing Capacity: Up to 500 tests per day
Cathedral Pines County Park (Opening on Tuesday, January 4th)
116 Yaphank Middle Island Rd
Middle Island
Open on Tuesdays and Fridays from 8:00 AM to 4:00 PM
Testing Capacity: Up to 500 tests per day
Residents with any questions can contact Suffolk311.
The Smithtown Senior Citizens Department has announced that it has recently expanded its Medical Alert Program. In addition to offering in-home medical alert monitoring services, residents now have the option to choose a GPS enabled system that travels where ever they go. The program is open to all residents age 60 and older.
This Medical Alert Program allows seniors to live independently, with the comfort and peace of mind, knowing that help is just a touch away. Through a partnership with American Medical Alert Corporation (AMAC), a Connect America Company, residents simply wear a lightweight, touch activated system that can be worn as a pendant or on the wrist (home based system only). Once an alert is activated, trained emergency operators respond to help with the situation, 24 hours a day, seven days a week.
“Our objective with this personal emergency response system is to ensure the well-being of our seniors and enable them to remain safely in their homes. Perhaps just as important is to provide seniors with the peace of mind knowing that if they ever need help they will get it,” said Doreen Perrino, Smithtown Senior Citizens Department Program Director.
Residents who are interested in obtaining a Connect America Medical Alert system can inquire through the Smithtown Senior Citizens Department at 631-360-7616. The service is available for a low monthly monitoring fee of $18 for the in-home system and $30 for the GPS enabled system. There are no installation fees, long term contracts or cancellation penalties.
For more information on this and other Smithtown services, please contact Smithtown Public Information Officer Nicole Garguilo at 631-360-7600 or via email at [email protected]
What’s in your medicine cabinet? If you’re like most people, you have your typical “go-tos” for pain relief, fever or inflammation. You might have aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) and acetaminophen (Tylenol).
Familiar NSAIDs include ibuprofen (Advil, Motrin) and naproxen sodium (Aleve). Over 70 million prescriptions for NSAIDs are written each year in the U.S., and Americans consume more than 30 billion doses, once over-the-counter (OTC) use is factored in (1).
According to a poll of these regular users of OTC NSAIDs, a substantial number — 60 percent — were unaware of their dangerous side effects (2). Acetaminophen is used frequently, as well. On a weekly basis, one quarter of Americans take it. Unfortunately, many think of these drugs as relatively benign. In fact, I find that until I specifically ask about their use, most patients don’t include them in a list of their medications.
NSAID risks
Unfortunately, NSAIDs, according to the Centers for Disease Control and Prevention, are responsible for 7,600 deaths annually and 10 times that number in hospitalizations (3). These are not medications that should be taken lightly.
NSAIDs increase the risk of several maladies, including heart attacks, gastrointestinal bleeds, exacerbation of diverticular disease, chronic arrhythmias (abnormal heartbeats) and erectile dysfunction. In some instances, the cardiovascular effects can be fatal.
These risks prompted the FDA to strengthen the warning labels on non-aspirin NSAID labels, advising that those taking NSAIDs should immediately seek medical attention if they experience chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body, or slurred speech (4).
Adverse side effects of NSAIDs
In a case control study using the UK Primary Care Database, chronic users of NSAIDs between ages 40 and 89 had a significantly increased risk of a serious arrhythmia (abnormal heartbeat) called atrial fibrillation (5).
Interestingly, chronic users were defined as patients who took NSAIDs for more than 30 days. Those patients who used NSAIDs more than 30 days had a 57 percent increased risk of atrial fibrillation. A Danish study reinforces these results after the first month of use (6). This is not very long to have such a substantial risk. For patients who used NSAIDs longer than one year, the risk increased to 80 percent.
Caution should be used when prescribing NSAIDs or when taking them OTC. Atrial fibrillation is not an easy disease to treat.
NSAIDs also increase the risk of mortality in chronic users. Older patients who have heart disease or hypertension (high blood pressure) and are chronic NSAIDs users are at increased risk of death, according to an observational study (7). Compared to those who never or infrequently used them over about 2.5 years, chronic users had a greater than twofold increase in death due to cardiovascular causes. High blood pressure was not a factor, since the chronic users actually had lower blood pressure. Yet I have seen with my patients that NSAID use can increase blood pressure.
Is acetaminophen better?
Acetaminophen does not cause gastrointestinal bleeds, arrhythmias and deaths due to cardiovascular events that NSAIDs can. However, the Food & Drug Administration announced in 2011 that acetaminophen should not exceed 325 mg every four to six hours when used as a prescription combination pain reliever (4). The goal is to reduce and avoid severe injury to the liver, which can cause liver failure.
There is an intriguing paradox with acetaminophen: Hospitals typically dispense regular-strength 325-mg doses of the drug, whereas OTC doses frequently are found in extra-strength 500-mg tablets, and often the suggested dose is two tablets, or 1 gram. At the FDA’s request, Tylenol lowered its recommended daily dosage for extra strength Tylenol to no more than 3 grams a day to lower the risk of liver damage.
I have patients who have exceeded this, thinking that, because it is OTC, this is “safe.” Unfortunately, this is not true and can be dangerous.
The FDA’s recommendations for limiting the dose result from a conglomeration of data. For instance, one study that showed acute liver failure was due primarily to unintentional overdoses of acetaminophen (8). Accidental overdosing is more likely to occur when taking acetaminophen at the same time as a combination sinus, cough or cold remedy that also contains acetaminophen. OTC and prescription cold medications can contain acetaminophen.
Of course, if you already suffer from liver damage or disease, you should consult with your physician before taking any medications.
In order to be aware of potentially adverse events, you have to be your own best advocate and read labels. Remember to tell your physician if you are taking OTC medications.
If you are a chronic user of NSAIDs or acetaminophen because of underlying inflammation, you may find an anti-inflammatory diet, which is usually plant-based, is an effective alternative.
References:
(1) Medscape.com, 2021 Oct 21 (emedicine.medscape.com/article/816117-overview). (2) J Rheumatol. 2005;32;2218-2224. (3) Annals of Internal Medicine, 1997;127:429-438. (4) fda.gov (5) Arch Intern Med. 2010;170(16):1450-1455. (6) BMJ 2011;343:d3450. (7) Am J Med. 2011 Jul;124(7):614-620. (8) Am J Gastroenterol. 2007;102:2459-2463.
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.
With Christmas this weekend, families are looking to get together for some quality time.
Last Christmas, in the midst of the coronavirus pandemic, people quarantined with just those in their households. It was lonely for some, but they stayed safe, away from contact with other people.
Then 2021 came around and with the vaccines we saw some hope — we began slowly peeling off our masks and traveling again. Families became reunited.
But unfortunately, that was premature and now Suffolk County is at a 14% positivity rate as of Tuesday, Dec. 21.
To put it in perspective, municipalities across New York state were shut down at 5% in the spring of 2020. We have doubled the seven-day average compared to where we were at that time and have not shut down.
And there are reasons for that. Luckily more than a year-and-a-half later we have the vaccines, we have boosters and we know that masks work — we just need to continue using them and continue using common sense.
It’s sad to think that this is the second Christmas where some families might not be able to see their loved ones out of fear. It’s sad that we as a country were doing well and now have fallen back into old habits of not taking care of ourselves and of others.
If we continue not to listen to the Centers for Disease Control and Prevention, our health care providers and the science,
Politicians insist we won’t go into lockdown, but what will happen if the infection rate goes to 20%? What will we do if the hospitals are overfilled again?
With the comfort we felt during this past summer, newly vaccinated with restrictions lifted, some might have forgotten what early 2020 looked like. Visits to grandparents were through a window. Restaurants were not allowed to have inside dining. Disinfectants and masks were impossible to find, while bodies were kept in outside trailers because the morgue was filled to capacity.
We don’t want to head back in that direction, especially with all of the resources now available to us. We have the vaccine, we have the booster, we have masks and we know how to combat this virus. We just need to collectively do it and not treat it lightly.
So, for this holiday season, and throughout the rest of the winter, please take care of yourself, take care of others and be cautious.
Livestream Event – Post-COVID: In it for the long haul
According to the CDC, most people with COVID-19 get better within weeks, though some experience long-term effects. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience weeks after first being infected. This Tuesday, December 21, experts from Stony Brook Medicine’s Post-COVID clinic, the first of its kind on Long Island, will discuss these long-term effects and approaches to care.
Stony Brook’s post-COVID facility opened in November of 2020 at Stony Brook Medicine’s Advanced Specialty Care in Commack to provide ongoing care and assessment of adult patients who are recovering from COVID-19. The clinic provides care for patients who are still experiencing symptoms as well as monitors patients for any late effects of COVID-19 infection. Patients have access to specialists in primary care, cardiology, pulmonary medicine, nephrology, vascular and neurology as well as to mental health providers.
Sritha Rajupet, MD, MPH, Director, Population-Based Health Initiatives, Department of Family, Population & Preventive Medicine and Primary Care Lead, Post-COVID Clinic, Stony Brook Medicine
If you were tuning into television in the U.S. for the first time, you would imagine we were a society of exercisers. Sports is big business. Ads for workout equipment, sneakers, and athletic clothing abound. And yet, many of us don’t exercise even the minimum to maintain good physical and mental health through adulthood.
As kids, many of us tried to get out of gym class, and as adults, we “want” to exercise, but we “don’t have time.” The result of this is a nation of couch potatoes. I once heard that the couch is the worst deep-fried food. It perpetuates inactivity, especially when watching TV. Even sleeping burns more calories.
I think part of the problem, generally, is that we don’t know what type of exercise is best and how long and frequently to do it. These days, many who depend on gyms, dance studios and other exercise-related facilities for exercise are struggling to find meaningful substitutes.
Well, guess what? There is an easy way to get tremendous benefit with very little time involved. You don’t need expensive equipment, and you don’t have to join a gym. You can sharpen your wits with your feet.
Jane Brody has written in The New York Times’ Science Times about Esther Tuttle. Esther was 99 years old, sharp as a tack and was independently mobile, with no aids needed. She continued to stay active by walking in the morning for 30 minutes and then walking again in the afternoon. The skeptic might say that this is a nice story, but its value is anecdotal at best.
Well, evidence-based medicine backs up her claim that walking is a rudimentary and simple way to get exercise that shows incredible benefits. One mile of walking a day will help keep the doctor away.
Walking has a powerful effect on preserving brain function and even growing certain areas of the brain (1). Walking between six and nine miles a week, or just one mile a day, reduced the risk of cognitive impairment over 13 years and actually increased the amount of gray matter tissue in the brain over nine years.
Those participants who had an increase in brain tissue volume had a substantially reduced risk of developing cognitive impairment. Interestingly, the parts of the brain that grew included the hippocampus, involved with memory, and the frontal cortex, involved with short-term memory and executive decision making. There were 299 participants who had a mean age of 78 and were dementia free at the start of the trial. Imagine if you started earlier?
In yet another study, moderate exercise reduced the risk of mild cognitive impairment with exercise begun in mid-to-late life (2).
Even better news is that, if you’re pressed for time or if you’re building up your stamina, you can split a mile into two half-mile increments. How long does it take you to walk a half-mile? You’ll be surprised at how much better you will feel — and how much sharper your thinking is.
This is a terrific strategy to get you off the couch or away from your computer. Set an alarm for specific points throughout the day and use that as a prompt to get up and walk, even if only for 15 minutes. The miles will add up quickly. In addition to the mental acuity benefits, this may also help with your psychological health, giving you a mental break from endless Zoom calls and your eyes a break from endless screens.
If you ratchet up the exercise to running, a study showed that mood also improves, mollifying anger (3). The act of running actually increases your serotonin levels, a hormone that, when low, can make people agitated or angry. So, exercise may actually help you get your aggressions out.
Walking has other benefits as well. We’ve all heard about the importance of doing weight-bearing exercise to prevent osteoporosis and osteoporotic fractures. The movie WALL-E even did a spoof on this, projecting a future where people lived in their movable recliners. The result was a human skeletal structure that had receded over the generations from lack of use. Although it was tongue-in-cheek, it wasn’t too far from the truth; if you don’t use them, bones weaken and break. Walking is a weight-bearing exercise that helps strengthen your joints, bones and muscles.
So, remember, use your feet to keep your mind sharp and yourself even-tempered. Activities like walking will help you keep a positive attitude, preserve your bones and help increase the plasticity of your brain.
References:
(1) Neurology Oct 2010, 75 (16) 1415-1422. (2) Arch Neurol. 2010;67(1):80-86. (3) J Sport Exerc Psychol. 2010 Apr;32(2):253-261.
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.
It’s no surprise that face mask use is mandated once again when visiting or working in a store or venue in the state of New York. Gov. Kathy Hochul (D) said earlier this year if the COVID-19 infection rate kept climbing, the mandatory health protocol would be needed again.
Until Jan. 15, 2022, when the state will reassess, unless an establishment has a vaccine requirement, a mask must be worn by everyone 2 years old and up. The governor announced the statewide mandate that began Monday, Dec. 13, during a press conference last Friday. In addition, businesses that do not comply can face fines up
to $1,000.
According to a recent article in The New York Times, the state’s infection rate last Saturday reflected a 51% jump over 14 days. With more than a 7% seven-day infection rate in Suffolk County, Hochul’s new mandate seems more than appropriate for our communities.
While some people still have been wearing masks either because they aren’t vaccinated or as an extra precaution, many have not since former Gov. Andrew Cuomo (D) lifted the initial mask mandate in the state.
The news can be frustrating for those who are vaccinated and even received the booster shot. However, Americans have known since the virus first reached our shores that it would take a while to figure out how to lessen transmission, especially since a virus can mutate. With no practice 100% effective — and some people resisting not only wearing masks but getting the vaccine — the virus has continued infecting people and new variants have developed, such as Delta and Omicron. While medical researchers are still trying to understand the virus, why not take extra precautions? Even if they are not guaranteed to stop transmission, they can lessen the chances of spreading the virus.
While face masks can be uncomfortable at times, the protective gear acts as a barrier to protect the wearer from droplets released in the air when someone coughs or sneezes. It also traps the wearer’s respiratory droplets. If someone is sick and they are wearing a mask, they are less likely to give someone else the virus.
When Cuomo issued mandatory business shutdowns in the early days of the pandemic, New Yorkers debated if this was the right approach. A good percentage of people thought it would be the demise of many businesses. Fortunately, many business owners were able to swim with the tide and come up with innovative solutions such as curbside service and selling merchandise on social media if they didn’t have a website.
Now more than ever, local businesses need our support as many of them cannot make it through another round of shutdowns. So, let’s mask up before stepping inside a favorite store, restaurant or theater so that we can keep these places not only open but give them a chance to thrive.
Brookhaven Town Hall, 1 Independence Hill, Farmingville hosts a blood drive on Wednesday, Dec. 15 from 9 a.m. to 3 p.m. in the 2nd floor auditorium. Appointments preferred by calling 1-800-933-2566 or by visiting www.nybc.org. All donors will be entered into a Home for the Holidays sweepstakes and receive a McDonald’s voucher. For more information, call 631-451-9100.
Despite the great strides we have made in the fight against heart disease, it is still the number one cause of death in the United States. Can we alter this course, or is it our destiny?
A study involving the Paleo-type diet and other ancient diets suggests that there is a significant genetic component to cardiovascular disease, while another study looking at the Mediterranean-type diet implies that we may be able to reduce our risk factors with lifestyle adjustments.
Most of the risk factors for heart disease, such as high blood pressure, high cholesterol, sedentary lifestyle, diabetes, smoking and obesity are modifiable (1). Let’s look at the evidence.
Do our genes matter?
Researchers used computed tomography scans to look at 137 mummies from ancient times across the world, including Egypt, Peru, the Aleutian Islands and Southwestern America (2). The cultures were diverse, including hunter-gatherers (consumers of a Paleo-type diet), farmer-gatherers and solely farmers. Their diets were not vegetarian; they involved significant amounts of animal protein, such as fish and cattle.
Researchers found that one-third of these mummies had atherosclerosis (plaques in the arteries), which is a precursor to heart disease. The ratio should sound familiar. It seems to coordinate with modern times.
The authors concluded that atherosclerosis could be part of the aging process in humans. In other words, it may be a result of our genes. Being human, we all have a genetic propensity toward atherosclerosis and heart disease, some more than others, but many of us can reduce our risk factors significantly.
I am not saying that the Paleo-type diet specifically is not beneficial compared to the standard American diet. Rather, that this study does not support that. However, other studies demonstrate that we can reduce our chances of getting heart disease with lifestyle changes, potentially by following a plant-rich diet, such as a Mediterranean-type diet.
Can we improve our genetic response with diet?
The New England Journal of Medicine published a study about the Mediterranean-type diet and its potential impact on cardiovascular disease risk (3). Here, two variations on the Mediterranean-type diet were compared to a low-fat diet. People were randomly assigned to three different groups. The two Mediterranean-type diet groups both showed about a 30 percent reduction in the risk of cardiovascular disease, compared to the low-fat diet. Study end points included heart attacks, strokes and mortality. Interestingly, the risk profile improvement occurred even though there was no significant weight loss.
The Mediterranean-type diets both consisted of significant amounts of fruits, vegetables, nuts, beans, fish, olive oil and wine. I call them “Mediterranean diets with opulence” because both groups consuming this diet had either significant amounts of nuts or olive oil and/or wine. If the participants in the Mediterranean diet groups drank wine, they were encouraged to drink at least one glass a day.
The study included three groups: a Mediterranean diet supplemented with mixed nuts (almonds, hazelnuts or walnuts), a Mediterranean diet supplemented with extra virgin olive oil (at least four tablespoons a day), and a low-fat control diet. The patient population included over 7,000 participants in Spain at high risk for cardiovascular disease.
The strength of this study, beyond its high-risk population and its large size, was that it was a randomized clinical trial, the gold standard of trials. However, there was a significant flaw, and the results need to be tempered. The group assigned to the low-fat diet was not, in fact, able to maintain this diet throughout the study. Therefore, it really became a comparison between variations on the Mediterranean diet and a standard diet.
What do the leaders in the field of cardiovascular disease and integrative medicine think of the Mediterranean diet study? Interestingly there are two diametrically opposed opinions, split by field. You may be surprised by which group liked it and which did not. Cardiologists, including well-known physicians Henry Black, M.D., who specializes in high blood pressure, and Eric Topol, M.D., former chairman of cardiovascular medicine at Cleveland Clinic, hailed the study as a great achievement. This group of physicians emphasized that now there is a large, randomized trial measuring clinical outcomes, such as heart attacks, stroke and death.
On the other hand, the integrative medicine physicians, Caldwell Esselstyn, M.D., and Dean Ornish, M.D., both of whom stress a plant-rich diet that may be significantly more nutrient dense than the Mediterranean diet in the study, expressed disappointment with the results. They feel that heart disease and its risk factors can be reversed, not just reduced. Both clinicians have published small, well-designed studies showing significant benefits from plant-based diets (4, 5). Ornish actually showed a reversal of atherosclerosis in one of his studies (6).
So, who is correct about the Mediterranean diet? Each opinion has its merits. The cardiologists’ enthusiasm is warranted, because a Mediterranean diet, even one of “opulence,” will appeal to more participants, who will then realize the benefits. However, those who follow a more focused diet, with greater amounts of nutrient-dense foods, will potentially see a reversal in heart disease, minimizing risk — and not just reducing it.
Ultimately, even with a genetic proclivity toward cardiovascular disease, we have confirmation that we can alter our cardiovascular destinies. The degree depends on the willingness of the participants.
References:
(1) www.uptodate.com. (2) BMJ 2013;346:f1591. (3) N Engl J Med 2018; 378:e34. (4) J Fam Pract. 1995;41(6):560-568. (5) Am J Cardiol. 2011;108:498-507. (6) JAMA. 1998 Dec 16;280(23):2001-2007.
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.
Stony Brook Music Department musicians spread joy to a mother and child on Dec. 3.
Photo from Staller Center
Photo-CH.1: (back row, L-R: Stony Brook Children's Child Life specialists along with Joan Alpers, Director of Child Life; Paul Newland, Staller Center Outreach Director & Stony BrooK Music Department Musicians; front row, L-R: Stony Brook Children's Child Life specialist; Alan Inkles, Director, Staller Center; Dr. Laura Hogan, Chief, Pediatric Hematology/Oncology, Stony Brook Children's; Chris Murray, VP Marketing, Island Federal and Stony Brook Children's Child Life specialist.) Photo from Staller Center
On Dec. 3, musicians from the Stony Brook Music Department’s Instrument Petting Zoo caroled throughout the Stony Brook Children’s Hospital spreading holiday cheer and joy to the children, families and staff, thanks to funding provided by Island Federal.
The Staller Center’s Instrument Petting Zoo is a program which helps the Staller Center for the Arts reach out to the community and share live interactive musical experiences for young people.
“To be able to spend time at the Children’s Hospital and see the smiles on the kids faces and the tears of joy in the parents eyes as the musicians performed holiday music was emotional, but we’re so happy we were able to come together and collaborate in this way,” said Paul Newland, the Staller Center’s Outreach Director. “We are grateful to Island Federal who helped provide the support for this initiative and we’re already planning more musical visits.”
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