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160 seniors and school employees receive final COVID-19 booster dose at Kings Park High School
The Town of Smithtown, in partnership with Kings Park Central School District and Rite Aid, successfully hosted the second and final round of COVID-19 Booster vaccines for 160 school employees and residents ages 50 and up, over the weekend. On Saturday, May 15, a temporary COVID-19 Vaccine Site was implemented at Kings Park High School. Rite Aid facilitated and administered 160 Moderna vaccines to those individuals who previously received their first dose, four weeks prior.
Kings Park Fire Department was on standby protocol in the event of an adverse reaction. Six KPHS National Honor Society students volunteered to assist with logistics and registration during the event, alongside staff from the Smithtown Senior Center and Supervisor Wehrheim’s Office.
“The entire event was smooth sailing thanks to an incredible partnership with Kings Park School District and Rite Aid. I am especially grateful to the team at our Smithtown Senior Center, as well as some incredible high school students, all who volunteered their Saturdays to serve the people of our community,” said Supervisor Ed Wehrheim.
Approximately 160 Moderna vaccines were supplied and administered to Smithtown residents and surrounding school district employees courtesy of Rite Aid Pharmacy. Vaccines were administered by healthcare professionals from Rite Aid. Residents were then monitored during the required 20 minute observation period. The average appointment took a total of 30 minutes, with the bulk of time going towards monitoring. The Moderna booster vaccines were administered exactly four weeks from the date of each first vaccine appointment, held on Saturday, April 17th..
Town of Smithtown to offer free screenings for Brain Arteriovenous Malformation
The Town of Smithtown, in partnership with the Paige Elizabeth Keely Foundation, will host free Brain Arteriovenous Malformations & Aneurysms (AVM) screenings at Smithtown Town Hall, 99 Main St., Smithtown on Tuesday May 25. Screenings will take place from noon to 7pm in the Victor T. Liss Board Room. Appointments must be reserved in advance online at https://
“I’m grateful to Gina Keely, the Paige Elizabeth Keely Foundation, Dr. Bekelis and the Stroke and Brain Aneurysm Center of Long Island, for their partnership in providing this lifesaving service to the people of Smithtown. This is a magnificent way to honor Paige’s memory. I encourage everyone to learn more about AVM detection and take part in a free screening.” – Supervisor Ed Wehrheim
On January 8th, 2018, six year old resident Paige Keely was tragically taken from the world when a Brain Arteriovenous Malformation (AVM) had ruptured at school. Doctors informed her family that Paige was born with this condition and that it was treatable with early detection. The Paige Elizabeth Keely Foundation, a nonprofit 501c3 organization, was founded in Paige’s honor to help prevent further loss, through early detection, AVM screenings and community awareness about this treatable disease.
In February of 2021 the Town Board, by unanimous decision, declared the week of May 24th, 2021, (in honor of her birthday; May 24th, 2011) as Paige Elizabeth Keely AVM Awareness week in the Town of Smithtown. The intent is to bring AVM awareness to the community through events and screenings which promote the early detection, identifying and treating of Brain Arteriovenous Malformations & Aneurysms.
The free screening is a simple, non-invasive, basic exam and Q & A process. Screenings take approximately 15 minutes and can help to determine if further medical detection is needed.
DID YOU KNOW?
If Brain AVM’s & Aneurysms rupture, effective treatment becomes more difficult, and generally a person’s chances of surviving are much lower.
Brain AVM’s & Aneurysms that have not ruptured typically have little to no symptoms, until it’s too late. This is why early detection can save lives.
Medical Compass: How do we reduce heart attack risk?
Addressing weight and mobility issues may lower risk
By David Dunaief, M.D.
We have made great strides in reducing heart attack mortality. When we compare cardiovascular disease — heart disease and stroke — mortality rates since 1975 to present, there has been a substantial decline. However, since 1990, the rate of decline has slowed (1). We need to reduce our risk factors to improve this scenario.
Some risk factors are obvious. Others are not. Obvious ones include age (men at least 45 years old and women at least 55 years old), family history, high cholesterol, high blood pressure, obesity, sedentary lifestyle, diabetes and smoking. Less obvious ones include gout, atrial fibrillation and osteoarthritis. Lifestyle modifications, including a high-fiber diet and exercise, may help allay the risks.
Let’s look at the evidence.
Address obesity
Obesity continually gets play in discussions of disease risk. But how substantial a risk factor is it?
In the Copenhagen General Population Study, results showed an increased heart attack risk in obese (BMI >30 kg/m²) individuals with or without metabolic syndrome (high blood pressure, high cholesterol and high sugar) and in those who were overweight (BMI >25 kg/m²) (2). The risk of heart attack increased in direct proportion to weight. Specifically, there was a 26 percent increase in heart attack risk for those who were overweight and an 88 percent increase in risk for those who were obese without metabolic syndrome. This study had a follow-up of 3.6 years.
It is true that those with metabolic syndrome and obesity together had the highest risk. But, it is quite surprising that obesity, by itself, can increase heart attack risk when a person is “metabolically healthy.” This was an observational trial, so we can only make an association; however, if it is true, then there may not be such a thing as a “metabolically healthy” obese patient. If you are obese, this is one of many reasons that it’s critical to lose weight.
Get moving
Let’s consider another lifestyle factor, the impact of being sedentary. An observational study found that activity levels had a surprisingly high impact on women’s heart disease risk (3). Of four key factors — weight, blood pressure, smoking and physical inactivity — age was the determinant as to which one had the most negative effect. Those under the age of 30 saw smoking as most negatively impactful. For those over the age of 30, lack of exercise became the most dominant risk factor for heart disease, including heart attacks.
For women over age 70, the study found that increasing physical activity may have a greater positive impact than addressing high blood pressure, losing weight, or even quitting smoking. However, since high blood pressure was self-reported, it may have been underestimated as a risk factor. Nonetheless, the researchers indicated that women should make sure they exercise on a regular basis to most significantly reduce heart disease risk.
Manage osteoarthritis
The prevailing thought with osteoarthritis is that it is best to suffer with hip or knee pain as long as possible before having surgery. But when do we cross the line and potentially need joint replacement? In a study, those with osteoarthritis of the hip or knee joints that caused difficulty walking on a flat surface were at substantially greater risk of cardiovascular events, including heart attack (4). Those who had surgery for the affected joint saw a substantially reduced heart attack risk. It is important to address the causes of osteoarthritis to improve mobility, whether with surgery or other treatments.
Increase fiber
There have been studies showing that fiber decreases the risk of heart attacks. However, does fiber still matter when someone has a heart attack? In a recent analysis using data from the Nurses’ Health Study and the Health Professional Follow-up Study, results showed that higher fiber plays an important role in reducing the risk of death after a heart attack (5).
Those who consumed the most fiber, compared to the least, had a 25 percent reduction in post-heart attack mortality. Even more impressive is that those who increased their fiber after a cardiovascular event had a 31 percent reduction in mortality risk. The most intriguing part of the study was the dose response. For every 10-gram increase in fiber consumption, there was a 15 percent reduction in the risk of post-heart attack mortality. Since we get too little fiber anyway, this should be an easy fix.
Lifestyle modifications are so important. In the Nurses’ Health Study, which followed 120,000 women for 20 years, those who routinely exercised, ate a quality diet, did not smoke and were a healthy weight demonstrated a whopping 84 percent reduction in the risk of cardiovascular events such as heart attacks (6).
What have we learned? We can substantially reduce the risk of heart attacks and even potentially the risk of death after sustaining a heart attack with lifestyle modifications that include weight loss, physical activity and diet — with, in this case, a focus on fiber. While there are a number of diseases that contribute to heart attack risk, most of them are modifiable. With disabling osteoarthritis, addressing the causes of difficulty with mobility may also help reduce heart attack risk.
References:
(1) Heart. 1998;81(4):380. (2) JAMA Intern Med. 2014;174(1):15-22. (3) Br J Sports Med. 2014, May 8. (4) PLoS ONE. 2014, Mar 14, 2014. [https://doi.org/10.1371/journal.pone.0091286]. (5) BMJ. 2014;348:g2659. (6) N Engl J Med. 2000;343(1):16.
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.
Mather Hospital completes new cardiac catheterization labs
It’s finally here.
Mather Hospital announced this week its new cardiac catheterization lab is completed and is ready to serve patients — as soon as it receives its final Department of Health inspection and approval in the upcoming weeks.
According to Nursing Director for Cardiac Cath Services Nicole Hoefler, Mather Hospital in Port Jefferson is joining the few places on Long Island in hosting a cardiac catheterization lab to provide less invasive heart-related services to patients who need it.
“We’re here to basically help prevent serious heart attacks,” Hoefler said. “And prevent heart attacks that might be evolving.”
The labs specialize in using X-ray guided catheters to help open blockages in coronary arteries or repair the heart in minimally invasive procedures. These range from stenting to angioplasty and bypass surgery — that are less traumatic to the body and speed recovery.
“Sometimes, if a patient had a positive stress test, they’ll come in here so we can see what’s causing that pain they might have been having,” she noted. “Sometimes they need to have it for surgery clearance, like if they saw something on their EKG.”
The two new state-of-the-art rooms were approved by Northwell Health last year, alongside three other Northwell facilities. Construction began on the new spaces in August 2020, completing and turning over to the clinical staff on April 19.
By adding the two labs into Mather, Hoefler said they can help save a life.
“Every minute that passes when you’re having a heart attack slows your heart muscle,” she said. “So not having to transfer the patient out, and just bring them in from upstairs will be life changing.”
Both rooms will be able to accommodate approximately 20 patients per day with the 12 hours the labs are open.
The addition of the more than 3,000 square foot space is just another space that Mather can now provide patients better.
“I think the community just loves Mather,” Hoefler said. “Having this service
is just another reason to come here.”
Allied Physicians Group breaks ground for new location in Rocky Point
Melville-based Allied Physicians Group, an independent provider of comprehensive family health care services for both children and adults, held a “Start of Construction Ceremony” for its new Rocky Point office located at 346 Route 25A, Rocky Point, on April 6.
Local dignitaries and elected officials, including Town of Brookhaven Supervisor Edward P. Romaine and Town Councilwoman Jane Bonner, joined Allied physicians and executives at the ceremony.
The 5,500 sq. ft., state-of-the-art pediatric office will have eight employees, including 2 pediatricians and medical practitioners. Services for patients and families will include wellness care, vaccinations, sick care, a new parent helpline, breastfeeding support, telehealth services, social work access, nutrition assistance, asthma control education and community education (webinars, CPR classes). The build-out will be by the Klinger Construction Corporation, based in Coram.
The Rocky Point office will also feature new health safety focused enhancements to protect patients from the spread of COVID-19 and other illnesses. Design elements include separated sick and well areas and a state-of-the-art HVAC system with UV lighting to improve air quality.
“Allied Physicians Group is a physician led organization committed to quality, personalized health care. Our doctors know every one of our patients and their families, this is critical for providing the highest quality of care and exceptional patient experiences. Today, we mark the start of construction of our 24th Long Island independent Allied Physician Group office. This location will bring much needed care to Rocky Point and the surrounding communities,” said Dr. Kerry Fierstein, CEO Allied Physicians Group.
“Allied Physicians Group’s new pediatric practice here in Rocky Point is an important new medical practice in our community. We have a growing number of families with young children in the area and as is the case with children, they need regular checkups as well as medical care. This new office will be convenient for families living here in Rocky Point and the surrounding area,” said Supervisor Romaine.
“Rocky Point is a community with numerous young families and children who will be well served by this new facility from Allied Physicians Group,” said Councilwoman Bonner. “This is another great addition to the Rocky Point community, and I look forward to their grand opening.”
Pictured from left, Brianne Chidichimo, Director of Marketing; Valentin Staller, VP of Staller Associates; Councilwoman Bonner; Kevin Edwards, Sr. Vice President of Business Development; Jason Halegoua, Allied Partner Pediatrician; Andrew Phillips, Director of Operations; Kerry Fierstein, CEO of Allied Physicians Group; Robert Creaven, Chief Operating Officer; Gary Mirkin, President of Allied Physicians Group; and Supervisor Romaine.
Visit www.alliedphysiciansgroup.com for more information.
Medical Compass: Recognizing heart attack symptoms
Chest pain remains the most common symptom in both men and women
By David Dunaief, M.D.
When we refer to heart disease, it is an umbrella term; heart attacks are one component.
Fortunately, the incidence of heart attacks has decreased over the last several decades, as have deaths from heart attacks. However, there are still 790,000 heart attacks every year, and almost three-quarters of these are first heart attacks (1).
If you think someone is having a heart attack, call 911 as quickly as possible and have the patient chew an adult aspirin (325 mg) or four baby aspirins. While the Food and Drug Administration does not recommend aspirin for primary prevention of a heart attack, the use of aspirin here is for treatment of a potential heart attack, not prevention.
Heart attack symptoms
The main symptom is chest pain, which most people don’t have trouble recognizing. However, there are a number of other, more subtle, symptoms such as discomfort or pain in the jaw, neck, back, arms and epigastric, or upper abdominal areas. Others include nausea, shortness of breath, sweating, light-headedness and tachycardia (racing heart rate). One problem is that less than one-third of people know these other major symptoms (2). About 10 percent of patients present with atypical symptoms — without chest pain — according to one study (3).
It is not only difficult for the patient but also for the medical community, especially the emergency room, to determine who is having a heart attack. Fortunately, approximately 80 to 85 percent of chest pain sufferers are not having a heart attack. More likely, they have indigestion, reflux or other non-life-threatening ailments.
There has been a raging debate about whether men and women have different symptoms when it comes to heart attacks. Several studies speak to this topic.
Men vs. women
There is data showing that, although men have heart attacks more commonly, women are more likely to die from a heart attack (4). In a Swedish prospective (forward-looking) study, after having a heart attack, a significantly greater number of women died in hospital or near-term when compared to men. The women received reperfusion therapy, artery opening treatment that consisted of medications or invasive procedures, less often than the men.
However, recurrent heart attacks occurred at the same rate, regardless of sex. Both men and women had similar findings on an electrocardiogram; they both had what we call ST elevations. This was a study involving approximately 54,000 heart attack patients, with one-third of them being women.
One theory about why women are treated less aggressively when first presenting in the ER is that they have different and more subtle symptoms — even chest pain symptoms may be different. Women’s symptoms may include pain in the lower portion of the chest or upper portion of the abdomen, and they may have significantly less severe pain that could radiate or spread to the arms. But, is this true? Not according to several studies.
In one observational study, results showed that, though there were some subtle differences in chest pain, on the whole, when men and women presented with this main symptom, it was of a similar nature (5). There were 34 chest pain characteristic questions used to determine if a difference existed. These included location, quality or type of pain and duration. Of these, there was some small amount of divergence: The duration was shorter for a man (2 to 30 minutes), and pain subsided more for men than for women. The study included approximately 2,500 patients, all of whom had chest pain. The authors concluded that determination of heart attacks with chest pain symptoms should not factor in the sex of patients.
This trial involved an older population; patients were a median age of 70 for women and 59 for men, with more men having had a prior heart attack. The population difference was a conspicuous weakness of an otherwise solid study, since age and previous heart attack history are important factors.
In the GENESIS-PRAXY study, another observational study, but with a younger population, the median age of both men and women was 49. Results showed that chest pain remained the most prevalent presenting symptom in both men and women (6). However, of the patients who presented without distinct chest pain and with less specific EKG findings (non-ST elevations), significantly more were women than men. Those who did not have chest pain symptoms may have had some of the following symptoms: back discomfort, weakness, discomfort or pain in the throat, neck, right arm and/or shoulder, flushing, nausea, vomiting and headache.
If the patients did not have chest pain, regardless of sex, the symptoms were diffuse and nonspecific. The researchers were looking at acute coronary syndrome, which encompasses heart attacks. In this case, independent risk factors for disease not related to chest pain included both tachycardia (rapid heart rate) and being female. The authors concluded that there need to be better ways to calibrate non-chest pain symptoms.
Some studies imply that as much as 35 percent of patients do not present with chest pain as their primary complaint (7).
Let’s summarize
So what have we learned about heart attack symptoms? The simplest lessons are that most patients have chest pain, and that both men and women have similar types of chest pain. However, this is where the simplicity stops and the complexity begins. The percentage of patients who present without chest pain seems to vary significantly depending on the study — ranging from less than 10 percent to 35 percent.
Non-chest pain heart attacks have a bevy of diffuse symptoms, including obscure pain, nausea, shortness of breath and light-headedness. This is seen in both men and women, although it occurs more often in women. When it comes to heart attacks, suspicion should be based on the same symptoms for both sexes. Therefore, know the symptoms, for it may be your life or a loved one’s that depends on it.
References:
(1) cdc.gov. (2) MMWR. 2008;57:175–179. (3) Chest. 2004;126:461-469. (4) Int J Cardiol. 2013;168:1041-1047. (5) JAMA Intern Med. 2014 Feb. 1;174:241-249. (6) JAMA Intern Med. 2013;173:1863-1871. (7) JAMA. 2012;307:813-822.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. Visit www.medicalcompassmd.com.
Major milestone: SBU vaccine point of distribution hits 200,000
In the race to get Long Island vaccinated against COVID-19, Stony Brook University hit a major vaccine milestone, celebrating its 200,000th shot today. The mark was reached at the state-run mass vaccination site established by Governor Cuomo, located in the Innovation & Discovery Building (IDC) in the University’s Research and Development (R&D) Park. Stony Brook’s IDC Point of Distribution (POD) has been up-and-running since January 18. In total, Stony Brook Medicine (SBM) has administered 350,000 vaccines at PODs all across Long Island.
“I am so proud of the critical contribution Stony Brook University is making in the battle to stop the spread of this disease and bring the COVID crisis to an end,” says Maurie McInnis, President of Stony Brook University. “Today’s vaccine milestone is a profound testament to the dedication, expertise and resources we’ve been able to provide to the lives of those in our community and beyond.”
Stony Brook Medicine has also played a critical role in vaccinating residents on the East End of Long Island. SBM’s other state-run vaccination site located at Stony Brook’s Southampton campus opened on March 19 and has since distributed 30,000 vaccines. In addition, 20,000 shots have been distributed through PODs facilitated by Stony Brook Southampton Hospital in Southampton and Stony Brook Eastern Long Island Hospital in Greenport. Another 100,000 COVID-19 vaccines were administered at Stony Brook University Hospital.
Dr. Margaret McGovern, Vice President for Health System Clinical Programs and Strategy, Stony Brook Medicine, who oversees vaccine distribution, said, “Stony Brook Medicine has administered more than 350,000 vaccines at our various PODs, including Stony Brook University Hospital, the Stony Brook Union, Stony Brook Advanced Specialty Care in Commack, Stony Brook Southampton and multiple locations throughout the East End of Long Island, serviced by Stony Brook Southampton Hospital and Stony Brook Eastern Long Island Hospital.
“Today’s milestone of administering 200,000 COVID-19 vaccinations at the R&D Park, in partnership with New York State, demonstrates our responsiveness, capabilities and determination to protect the Long Island community. We will keep doing our part to vaccinate as many people as possible,” added Dr. McGovern.
To further serve its patients across the island, SBM worked with the state to successfully develop community PODs as pop-up sites in underserved communities on Long Island, to reach communities of color and the elderly, as well as help build trust.
For more information on COVID-19 vaccine rollout through Stony Brook Medicine, visit https://www.
Huntington Hospital earns five-star rating from federal agency
Huntington Hospital scored a five-star rating from the U.S. Centers for Medicare & Medicaid Services in its annual 2021 hospital rankings.
The hospital, which is the only one in Suffolk County to achieve a five-star rating this year, has climbed the rankings over the last year, with three stars in 2019 and four stars in 2020.
“This is a reflection of the dedication of all the staff here,” said Huntington Hospital Executive Director Nick Fitterman. “What it means for the community is that they can get great care in their backyard.”
The top 13.56 percent of hospitals nationwide received five stars in 2021, according to the CMS website.
The rating measures five qualities, including mortality, safety, readmission, patient experience and timely and effective care. The first four categories receive a 22 percent weighting, while timely and effective care receives 12 percent.
The star rating encompasses over 100 measures CMS publicly reports, including the death rate for heart attack patients, surgical site infections for colon surgery, percentage of health care workers given influenza vaccinations, and the percentage of patients receiving appropriate recommendations for follow-up screening colonoscopy, among other measures.
“The five-star quality rating system is ultimately grounded in helping patients and their families make informed care decisions,” a CMS spokesman said in a statement. The ratings provide a general indication or what to expect in the future based on how a facility performed in the past.
Fitterman suggested that the rating reflects the hospital’s dedication to its mission, rather than focusing on achieving a specific rating.
Delivering excellence in clinical care is “the best and only strategy,” Fitterman said. “We don’t perseverate on what the rating agencies are looking for: we perseverate on what we think we’re doing for our patient.”
The improvements over the last few years have been incremental in numerous areas, including in neurosurgery and stroke care, cardiovascular care, and orthopedic care, which is ranked in the top 50 in the country, Fitterman said.
Fitterman praised the nursing staff, which he described as “first class,” and suggested that their culture is “contagious.”
While Huntington Hospital, which is part of Northwell Health System, doesn’t negotiate independently as a hospital, he said companies and payers “want to align themselves with high quality institutions and providers in their networks, because good [care] equates to less expensive care.”
After Fitterman received the news last week about the five stars, he walked through the hospital, high-fiving and fist pumping everyone from valets to engineers, to the food and nutrition workers and the doctors and the nurses.
“There was such excitement and jubilation and everyone realizes the hard work, the blood, sweat and tears, that go into the job,” the executive director said. “They put their heart into what they do. To get that public recognition was outstanding.”
Fitterman said he walks the halls each day, thanking staff for what they do and reminding them that they don’t just do their own task. They are all “helping relieve the suffering of others.”
COVID-19 vaccines now available at all Rite Aid locations
Rite Aid announced on April 30 it is now administering the COVID-19 vaccine at all locations, spanning more than 2,500 stores in 17 states. Following the latest guidance from the Biden Administration, all those aged 16 years or older are now eligible for vaccination, and Rite Aid encourages everyone to schedule an appointment as soon as possible.
While scheduling appointments in advance is recommended to reduce wait time and guarantee availability of the vaccine, Rite Aid is now also accommodating walk-in vaccines on a limited basis in every store. Enabling walk-in appointments supports customers that may not have access to internet while also meeting the need for flexibility for customers. People interested in a walk-in appointment are encouraged to visit their local Rite Aid to confirm availability.
“The availability of vaccines in every Rite Aid location is a major milestone in our ongoing effort to fight COVID-19. We’ve been on the front lines since the beginning of the pandemic, working across our store footprint to bring testing and vaccines directly to local communities,” said Jim Peters, chief operating officer, Rite Aid. “Vaccine availability is improving every day, and our pharmacists are ready to administer vaccines safely and efficiently, providing the benefits of pharmacist-administered vaccines in a safe and sterile environment right in your neighborhood. Also, in addition to the grassroots efforts we’ve undertaken with our community partners, the availability of these walk-in appointments provides another way for those with limited or no technology access to more easily obtain COVID vaccines. We encourage everyone to make an appointment, or walk-in, today.”
Through its participation in the Federal Retail Pharmacy Program and as an Official COVID-19 Vaccination Program Provider, Rite Aid has accelerated its COVID-19 immunization efforts as allocation has expanded. Rite Aid’s certified immunizing pharmacists are administering the Moderna, Pfizer-BioNTech and Johnson & Johnson (Janssen) vaccines.
Individuals ages 18 and over can schedule appointments using the Rite Aid scheduling tool found at www.RiteAid.com/covid-19. Those ages 16 and 17 can schedule an appointment with guardian consent at any store administering the Pfizer vaccine by contacting the store’s pharmacy directly. Those stores can be found here.
For more information about Rite Aid’s COVID-19 vaccine efforts, please visit www.RiteAid.com/covid-19.
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