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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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Dr. Nick Fitterman with a copy of the $1 million check from New York State. Photo from Northwell Health

With financial support from New York State, Huntington Hospital is building it, and they hope undocumented and uninsured community members will have an easier time receiving care.

Dr. Nick Fitterman with a copy of the $1 million check from New York State. Photo from Northwell Health

At the former site of a Capital One Bank building at 1572 New York Avenue in Huntington Station, Huntington Hospital is renovating the building to create the Northwell Family Health Center at Huntington.

The center, which will open in the fall of 2023, will replace the Dolan Family Health Center in Greenlawn and will provide preventive care for children and adults.

The square footage of the new center will be about the same as the original family center but will have more clinical space. The current location in Greenlawn, which is 26 years old and will remain open until the Huntington Station location is up and running, has 3,000 square feet for meeting space. Huntington Hospital will dedicate that space to clinical programs.

The new location is “aligned with public transportation to improve the access for the people it serves,” said Dr. Nick Fitterman, executive director at Huntington Hospital. About 30% of the people who currently go to the Greenlawn facility have difficulty getting to the location. “Many of the people [the new site] serves can walk to the center.”

Working with Island Harvest, the Northwell Family Health Center will address food insecurity as well as overall health. Patients with high blood pressure, diabetes and heart failure will receive nutritional counseling which, coupled with the food banks, can provide the appropriate and necessary foods.

Those patients without diseases will also have access to fresh food through Island Harvest, Fitterman said.

In addition to providing a place for people who otherwise might not have a health care connection, the site will reduce some of the burden created when people use an emergency room for conditions that, when properly monitored, won’t require urgent services.

“When you come to a health care center like this, you get a continuity of care,” said Fitterman. That provides “better outcomes at a lower cost.”

At the Greenlawn facility on Wednesday, state Assembly Speaker Carl E. Heastie (D-Bronx) and Assemblyman Steve Stern (D-Dix Hills) presented the health center with a $1 million grant from New York State which will support the transition to the new facility, Fitterman said.

Donations from community members also help the center, which is being built to address a “gap in our community,” which exists in every community across the country, the doctor said.

On Wednesday, the Dolan Family Health Center in Greenlawn planned to host a baby shower for over 40 women who were expecting children.

The women are “single moms with no network of support,” Fitterman said. With balloons and tables filled with wrapped supplies like diapers, “we are connecting them to each other” to provide connections among these families.

The people coming to the center would otherwise not get antenatal care, which not only “improves their heath, but improves the health of their unborn babies,” Fitterman added.

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Sechrist model chamber for hyperbaric oxygen therapy. Photo courtesy Renee Novelle

Port Jefferson’s St. Charles Hospital will open its new Center for Hyperbaric Medicine & Wound Healing on July 18, as the hospital seeks to help people with chronic, nonhealing wounds.

The center, which will be located on the second floor of the hospital, will include two hyperbaric chambers that provide 100% pure oxygen under pressurized conditions and will have four examining rooms.

The chamber “provides patients with the opportunity to properly oxygenate their blood, which will increase wound healing and wound-healing time,” said Jason Foeppel, a registered nurse and program director for this new service.

Potential patients will be eligible for this treatment when they have wounds that fail to heal after other treatments for 30 days or more.

Residents with circulatory challenges or who have diabetes can struggle with a wound that not only doesn’t heal, but can cause other health problems as well.

More oxygen in people’s red blood cells promotes wound healing and prevents infection.

The treatment “goes hand in hand to deliver aid to the body’s immune system and to promote a healing environment,” Foeppel said.

Nicholas Dominici, RestorixHealth regional director of Clinical Operations; Ronald Weingartner, chief operating officer, St. Charles Hospital; Jim O’Connor, president, St. Charles Hospital; and Jason Foeppel, program director. Photo courtesy Renee Novelle

St. Charles is partnering with RestorixHealth in this wound healing effort. A national chain, RestorixHealth has created similar wound healing partnerships with other health care facilities in all 50 states.

The new wound healing center at St. Charles is one of several others on Long Island, amid an increased demand for these kinds of services.

Partnering with Healogics, Huntington Hospital opened a hyperbaric chamber and wound healing center in May 2021. Stony Brook Southampton Hospital also has a wound care center.

“There’s a great need for this in our community,” said John Kutzma, program director at the Huntington Hospital center. “We know that there are 7 million Americans living with chronic wounds,” many of whom did not receive necessary medical attention during the worst of the pandemic, as people avoided doctors and hospitals.

Concerns about contracting COVID-19 not only kept people from receiving necessary treatment, but also may have caused nonhealing wounds to deteriorate for people who contracted the virus.

Although Kutzma hasn’t read any scientific studies, he said that, anecdotally, “We’ve had patients that had COVID whose wounds haven’t healed as quickly as non-COVID patients.”

Patients at the Huntington Hospital center range in age from 15 to 100, Kutzma said. People with diabetes constitute about one-third of the patients.

Treatment plan

For the hyperbaric chamber to have the greatest chance of success, patients typically need daily treatments that last between one and a half to two hours, five days a week for four to six weeks. While the time commitment is significant, Foeppel said it has proven effective in wound healing studies.

“We pitch it as an antibiotic treatment,” he said. “You want to complete that full cycle to ensure the body has enough time to complete the healing process.”

Kutzma said Huntington Hospital reviews the treatment plan with new patients.

In following the extensive treatment protocol to its conclusion, he said, “The alternative is to live with this very painful, chronic wound that may lead to amputation.” Given the potential dire alternative, Huntington Hospital doesn’t “have a problem getting that kind of commitment.”

While the treatment has proven effective for many patients, not everyone is medically eligible for the hyperbaric chamber.

Colin Martin, safety director. Photo courtesy Renee Novelle

Some chemotherapy drugs are contraindicators for hyperbaric oxygen treatments. Those patients may have other options, such as skin grafts, extra antibiotics or additional visits with physicians for debridement, which involves removing dead, damaged or infected tissue.

“We invite patients to come in, go through the checklist and see what their plan of attack” includes, Foeppel said.

The cost of the hyperbaric treatment for eligible conditions is generally covered by most health insurance plans, including Medicaid and Medicare, he said. 

The two hyperbaric chambers at St. Charles can treat eight to 10 patients in a day.

Aside from the cost and eligibility, patients who have this treatment frequently ask what they can do during their treatments. The center has a TV that can play movies or people can listen to music.

“We don’t expect you to sit there like in an MRI,” Foeppel said.

As for complaints, patients sometimes say they have pressure in their ears, the way they would if they ascend or descend in an airplane. The center urges people to hold their nose and blow or to do other things to relieve that pressure.

Foeppel encourages patients to use the restroom before the treatment, which is more effective when people don’t interrupt their time in the chamber.

Prospective patients don’t need a referral and can call the St. Charles center at 631-465-2950 to schedule an appointment.

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Photo from Huntington Hospital

By Miriam Sholder

Huntington Hospital has earned the coveted Magnet® designation from the American Nurses Credentialing Center (ANCC), which recognizes excellence in nursing.

Huntington is the only hospital with a fifth consecutive designation on Long Island – the first in the Northwell health system, second in New York State and 32nd in the United States.

The Magnet Recognition Program® spotlights health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Developed by ANCC, Magnet is the leading source of successful nursing practices and strategies worldwide. Only 586 hospitals worldwide have achieved Magnet® status for nursing excellence since the program’s inception in 1983.

“Our nursing staff is known for upholding the highest standards of nursing,” said Susan Knoepffler, RN, chief nursing officer at Huntington Hospital. “With this accomplishment, our community is assured high quality compassionate care by our talented and dedicated nurses.”

The 371-bed hospital employs 600 nurses, 1,900 employees and specializes in neurosurgery, orthopedics and cancer care.

“The Magnet designation five consecutive times indicates this is no fluke,” Dr. Nick Fitterman, executive director of Huntington Hospital, said. “This represents consistent, high-quality care by a dedicated, professional, extraordinary nursing staff. The Magnet designation provides the foundation of care that has propelled Huntington Hospital to CMS 5-star recognition. The only Hospital in Suffolk County to achieve this.” He added, “The nursing staff continue to excel even while around the country we see health care workers burning out, leaving the profession. The staff here remain as committed as ever.”

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File photo

Even as the newer omicron subvariant of COVID-19 continues to spread throughout Long Island, hospitalizations and infections have been lower.

Hospitalizations, which had risen to 490 in mid-May from about 130 in early April, have been “slowly declining for the past week or two,” according to Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Service.

Area health care professionals suggested that the severity of symptoms also had eased up.

“COVID hospitalization rates are lower than in prior COVID waves,” Dr. Adrian Popp, chair of infection control at Huntington Hospital, explained in an email. Most of the patients have mild to moderate illnesses, although Huntington Hospital still does have some severe cases and/or a COVID-related death.

The average number of positive tests per 100,000 people in Suffolk County has declined from recent peaks. As of June 3, the 7-day average number of positive PCR and rapid tests per 100,000 people was 33, which is down from 52 on May 27 and 67.7 on May 20, according to New York State Department of Health data.

“If anything, Suffolk County rates are dropping,” said Dr. Michel Khlat, chief medical officer at St. Catherine of Siena in Smithtown. “We’re seeing a drop in inpatient cases.”

Many of the cases St. Catherine is finding are incidental, as the hospital tests for the virus in connection with other procedures.

At this point, the newer subvariant of omicron, called BA 2.12.1, accounted for 78.1% of the positive samples collected between May 22 and May 28 in New York, which is up from 593% in the prior two weeks, according to figures from the New York State Department of Health.

“Preliminary data suggest that Omicron may cause more mild disease, although some people may still have severe disease, need hospitalization, and could die from the infection with this variant,” Pigott added in an email.

Khlat suggested that hospitals aren’t tracking the type of variant. Even if they did, it wouldn’t alter the way they treated patients.

“It doesn’t make a difference” whether someone has one or another subtype of omicron, Khlat said. The treatment is identical.

Area doctors and medical care professionals continue to recommend that residents over 50 receive a second booster, particularly if they are immunocompromised or have other health complications.

“People over 50 should get the booster — it decreases the severity of COVID,” explained Popp.

Like much of the rest of the country, some Long Islanders have also contracted COVID more than once. The reinfection rate per 100,000 is currently 7.3%, according to New York State Department of Health figures.

“We are certainly seeing symptomatic COVID infections in persons who report having COVID at the beginning of this year or last year,” Dr. Susan Donelan, medical director of the Healthcare Epidemiology Department at Stony Brook Medicine, explained in an email. 

Popp explained that natural immunity from a COVID infection generally lasts about two to three months. Vaccine-related immunity generally lasts twice that duration, for about four to six months.

Doctors continue to urge caution during larger, poorly-ventilated indoor gatherings.

“Close crowds without masks, in an indoor setting with poor air flow, would be one version of a scenario with potential super-spreader potential,” Donelan explained.

Donelan said Stony Brook encouraged staff and patients to consider receiving boosters when they are eligible.

Popp believes wearing masks indoors while in a large gathering is a “reasonable” measure. That includes theaters, airplanes, buses and trains.

At Huntington Hospital, meetings continue to take place online.

“We decided as an organization that the risk of transmission is high enough to continue these measures,” Popp wrote. “We cannot afford to lose team members to COVID since it can negatively impact our operation.”

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Huntington Hospital is participating in Northwell Health’s initiative to plant a tree for each of the more than 30,000 babies born in its hospitals last year. Photo from Huntington Hospital

A tree grows in Huntington. When Huntington Hospital finishes its tree planting effort, 1,850 of them will grow.

Huntington Hospital will participate in Northwell Health’s initiative to plant a tree for each of the 30,500 babies born in its hospitals in 2021.

The babies born through the Northwell system, which includes Long Island Jewish Forest Hills, South Shore University Hospital, and Lenox Hill Hospital and six others, accounted for 15% of the births in New York and 1% of the total in the country.

“Northwell is committed to keeping our communities well — and to doing it in the most socially responsible way,” Donna Drummond, Northwell’s chief sustainability officer, said in a statement. “We believe that we will have a positive impact on the environment while providing our neighbors with a great way to commemorate a new life.”

Northwell started planting trees at its 10 hospitals April 29, on the 150th anniversary of Arbor Day, which is the last Friday in April.

At first, Northwell had considered planting plum trees, but those weren’t native to the area, so they planted cherry trees, said Adam Elbayar, senior project manager at Northwell.

The idea originated with Drummond, who suggested in a text to Elbayar that she wanted to plant a tree for each baby born in 2021.

Elbayar said Northwell is still working out the logistics of where to plant the trees, which will contribute to several efforts, including reforestation and a community canopy initiative.

Northwell plans to work with the Arbor Day Foundation as it searches for places to contribute these trees.

“What we’re planting on Long Island may be different than the trees we plant” in other areas, particularly the ones that rejuvenate an area after a wildfire, Elbayar said.

Northwell wants to focus on those areas where the need for trees is the highest and will use the tree equity score to find those neighborhoods that would benefit most from additional trees.

Northwell plans to work closely with leadership in obstetrician and gynecological offices to put together material that will alert new mothers to the project.

Part of the tree planting effort will include a children’s book new mothers receive in which the front page indicates that a tree was planted in honor of the child.

From what Northwell currently expects many of the trees will be saplings.

The tree planting effort at Northwell, which will cover the cost of the trees, represents one of several environmental initiatives at the health care company, including recycling and waste minimization.

Northwell’s goal is to make this an ongoing project, Elbayar said.

Elbayar said Northwell is pleased to join several other companies, including L’Oreal and Met Life, that are planting trees to boost reforestation and support the environment.

“There has been a lot of great work by other companies in this space,” Elbayar added.

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Commack resident Theodore Wawryk, above, recently received shockwave intravenous lithotripsy at Huntington Hospital. Photo from Wawryk

Theodore Wawryk, a resident of Commack who performs maintenance work at the Bronx Gardens nursing home, had six stents placed in his heart in 2005.

One of the doctors performing the procedure was Dr. Gaurav Rao. Photo from Rao

This past February, Wawryk, 52, had a buildup of calcium behind some stents at their edges, which could lead to restenosis, or a narrowing of the arteries again.

The patient came to Huntington Hospital, where his cardiologist, Dr. Raj Patcha, director of the Cardiac Catheterization Laboratory, couldn’t initially get through the blockage.

Patcha reached out to Dr. Gaurav Rao, director of Interventional Cardiology at Huntington Hospital, to see if Wawryk might be a candidate to become the first Huntington Hospital patient to receive shockwave intravascular lithotripsy, also known as IVL.

Rao had used the shockwave treatment, which uses pressure waves to create fractures in the calcium, for over a year at other hospitals and was prepared to introduce the procedure at Huntington Hospital.

Other options for breaking through the calcium, such as orbital or rotational atherectomies, which act more like miniature jackhammers breaking up the calcium in the arteries, are off label when a stent is nearby because it can shave off the metal in the stent, leading to other complications, Rao said.

Additionally, placing another stent in the area without modifying the calcium leads to stent failure.

Rao and Patcha performed the procedure in early February.

“This is a much safer” approach, Rao said. “It’s revolutionary in the way we deliver classic cardiac care.”

Shockwave IVL enables the placement of stents by creating fractures in the calcium that allow doctors to put in functional and durable stents, Rao explained.

Other area hospitals have used shockwave IVL for circulatory issues as well. Stony Brook Hospital, for example, uses shockwaves for peripheral arteries. Huntington Hospital also uses shockwaves to treat peripheral vascular disease.

While every surgical procedure includes risks, Rao cited studies that indicate that the possibility of a dissection, or a tear in the wall of the aorta, for heart-focused IVL is 0.3% for shockwave IVL, which is substantially lower than the 3.4% rate for orbital atherectomy and 3% for rotational atherectomy.

Rao said about 70% of patients who are coming in for stents are eligible for IVL, while the remainder are still candidates for atherectomy.

Extremely long lesions or lesions where the entry point is small so that doctors can’t deliver an IVL balloon make atherectomies, with their front cutting abilities, the preferred approach, he said.

So far at Huntington Hospital, the growing number of patients eligible for shockwave IVL have chosen to have this approach.

“No one has shied away from shockwave therapy,” Rao said.

Patient experience

As for the patient experience, Wawryk recalled how the operation, felt “a little weird.”

Wawryk described how the doctors told him he’d feel a “little zap” inside his body.

Indeed, Rao said the procedure uses an electrical pulse that can cause the heart rate, particularly for someone with a resting pulse below 60 per minute, to accelerate for about 10 seconds.

Intravenous lithotripsy, which uses a low energy pressure wave of about 8 to 10 nanojoules and involves inserting a tube through the arm or leg, is generally “well-tolerated” Rao said. Many patients don’t feel the effect of the procedure.

Even with the slight shockwave, Wawryk said he would recommend the procedure to other patients considering it.

Wawryk, whose father died of a heart attack at the age of 46, is grateful for the cardiac care he received. He appreciates the time he gets to spend with his wife Nydia and his 19-year-old son Michael.

The Commack resident spent a day at the hospital, as the procedure started at 7 a.m. and he was heading home by 7 p.m. that night. He said he felt like the staff treated him as if he were at a “five-star resort.”

Rao is pleased to offer this interventional cardiac approach at Huntington Hospital, which makes it possible for residents nearby to receive the treatment and head home, without a longer ride back from a hospital further away.

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Dr. Adam Bitterman. Photo from Huntington Hospital

Huntington Hospital has appointed Adam Bitterman, DO, chair of orthopedic surgery. Dr. Bitterman is a board-certified orthopedic surgeon and an assistant professor of orthopedic surgery at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. He is a foot and ankle specialist and has a focus in treating conditions of the lower leg. 

“Dr. Bitterman has the experience, demeanor and dedication needed to lead Huntington Hospital through its growth as a premier destination for orthopedics,” said Nick Fitterman, MD, executive director of Huntington Hospital. “I am confident he will set a vision and strategy well suited to support the orthopedic needs of residents in Huntington and Suffolk County.”

A native of Commack, Dr. Bitterman’s clinical interests include arthritis of the foot and ankle, deformity correction, Achilles’ tendon disorders, and sports-related injuries to the ankle and foot. He is highly skilled in arthroscopic, minimally invasive, and open approaches for various conditions surrounding the lower foot and ankle.

“The Department of Orthopedics at Huntington Hospital has enjoyed a rich history, and now with Dr. Bitterman as chair, we look forward to continuing to advance the highest quality patient-centric musculoskeletal care in our region,” said Nicholas Sgaglione, MD, senior vice president and executive director of Northwell Health Orthopedics. “I look forward to watching the department continue to grow under Dr. Bitterman’s leadership.”

“I am excited about continuing to raise the bar at Huntington Hospital, from clinical growth to the enhancement of efficiency and safety,” said Dr. Bitterman. “I’ve been fortunate to work at Huntington Hospital for six years and I look forward to continuing to build on the achievements we’ve made and I’m excited for what we will create in the future.”

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Daniel Tuttle received the therapeutic treatment Intracept for back pain. Photo from Tuttle

Over 30 years as a plumber took its toll on Daniel Tuttle.

Daniel Tuttle, who received the therapeutic treatment Intracept for back pain, enjoys a boat ride. Photo from Tuttle

The 79-year old Northport resident felt daily pain in his lower back, which limited his ability to walk for any length of time.

“I always lifted up [stuff] you shouldn’t lift,” Tuttle said. “It was too heavy. Over the years, I got more and more pain.”

Tuttle visited several specialists. His cardiologist recommended he see Dr. Frank Ocasio, director of Acute Pain Management and chair of Pain Management at Huntington Hospital and the director of North Shore Head and Spine in Huntington.

Ocasio recently started performing a therapeutic treatment called Intracept, which involves cutting a small incision in the back, inserting a tube and providing enough heat to deactivate the nerve that causes chronic lower back pain.

About a month after the procedure, Tuttle is pleased to report that his pain has declined from “an 11” to closer to a three on a daily basis.

Several doctors around Long Island have provided the Intracept procedure, which was developed by Relievant Medsystems, over the last few years, including at Stony Brook University and Port Jefferson’s St. Charles Hospital.

Dr. Jonathan Raanan, assistant professor of Neurosurgery, Physical Medicine & Rehabilitation in the Department of Neurosurgery at the Renaissance School of Medicine at Stony Brook University, has performed about 10 such surgeries over the last few years.

Raanan described such lower back pain that lasts more than six months or a year as being something of a “big black hole” in terms of treatment.

In a magnetic resonance image, the disc becomes darker, indicating it doesn’t have good hydration and that it isn’t an effective shock absorber.

Intracept can help reduce the pain.

“It’s very satisfying when someone comes in who has tried everything but the kitchen sink to treat this” who then says “I do feel better,” Raanan said.

Tuttle’s wife Susan, who has been married to him for over three decades, said the procedure has improved his quality of life.

Susan Tuttle said her husband has been able to “do everything he wanted to do.”

Ocasio found the idea of Intracept appealing, particularly because it was a one-time effort that didn’t require ongoing follow up visits.

“There’s not much out there in the pain management space that’s a non medication, a non-opioid strategy that’s a one and done,” Ocasio said.

The surgery is an outpatient procedure and can take anywhere from 45 minutes to two hours, depending on the area over which the nerve is sending a repeated pain signal.

Patients either receive mild sedation or are under general anesthesia.

“People see results within weeks,” Ocasio said. In some cases, they can get relief within 24 hours.

Dr. Frank Ocasio recently began to perform the therapeutic treatment. Photo from Ocasio

To be sure, the procedure, as with any, involves some level of risk and isn’t appropriate for everyone.

Raanan advised potential patients to discuss the risks and benefits with any provider.

Starting in January, Intracept will have a Current Procedural Terminology, or CPT, code, which will give health care providers a standard way to describe the procedure and insurance companies a way of determining patient eligibility.

Until then, patients need to appeal to indicate to insurance companies what other treatments they’ve had for back pain.

In Raanan’s experience, patients sometimes have flare-ups of other pain that is similar to sciatic discomfort after the treatment for days or even weeks after Intracept.

“That might be a reasonable trade-off in the eyes of the patient,” Raanan added.

Deadening the nerve doesn’t cause any loss of control of motor function, Ocasio said, as the nerve provides a sensory benefit while others provide necessary muscle control.

“You still have multiple nerves around that area,” Ocasio added.

Candidates for this procedure typically have lower back pain associated with activities that require bending forward, like loading a dishwasher or flexing at the waist, Ocasio described.

Ocasio said doctors who perform Intracept receive training under guidance from the company.

Patients interested in this approach are anywhere from their 30s through their late 70s, local doctors said.

For Daniel Tuttle, the procedure provided relief.

“He’s outside, puttering around, doing the things that make him happy,” Susan
Tuttle said.

“It gave me my lifestyle back,” Daniel Tuttle said.

The Tuttles are planning a trip to Italy next summer.

Raanan cautioned that, for at least one patient, the relief led to another problem.

A female patient returned to working out in the gym, where she exercised so vigorously that she created a different spine injury that he treated.

“When patients feel better, they have to remember they are still vulnerable,” Raanan said. “Poor mechanics, postures, flexibility or excessive and prolonged activity come with some risk.”

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Dr. Sharon Nachman, chief of Division of Pediatric Infectious Diseases at the Renaissance School of Medicine at Stony Brook University. Photo from Stony Brook Medicine

Dr. Sunil Dhuper’s actions speak as loudly as his words.

The chief medical officer at Port Jefferson’s St. Charles Hospital is planning to get a booster for the COVID-19 vaccine this Thursday, after the Centers for Disease Control and Prevention authorized Friday, Sept. 24, the additional shot for a range of adults, including those in jobs that put them at an increased risk of exposure and transmission, such as frontline health care workers.

Earlier, the U.S. Food & Drug Administration announced Sept. 22 that “a single booster dose” was allowed “for certain populations” under the emergency use authorization, although the EUA “applies only to the Pfizer-BioNTech COVID-19 vaccine.” 

Dhuper received his first vaccination in January and would like to raise his immunity.

“I am very eager to get the booster dose,” he said in an interview. “I reviewed scientific data from all over the world — from the United States, Israel, the United Kingdom — and I had reflected that, after six months after the second dose, it’s time to get a third dose.”

While St. Charles and other hospitals haven’t required a booster, Dhuper believes that state and national guidance will likely recommend it before too long.

“Over time, I do anticipate people may begin to get severe infections or get hospitalized” if they haven’t enhanced their immunity with a booster, he said. “It would be prudent to get the booster dose in the arms of those who are fully vaccinated.”

Stony Brook University Hospital is providing boosters to employees and to eligible members of the public.

Meanwhile, Northwell Health and Huntington Hospital are deliberating how to proceed and will announce a decision soon, according to Dr. Adrian Popp, chair of infection control at Huntington Hospital.

While boosters are available for education staff, agriculture and food workers, manufacturing workers, corrections workers, U.S. Postal Service employees, grocery store workers, public transit employees and a host of others, the overall infection rate in Suffolk County has stabilized over the past few weeks.

Decline in infections

As of Sept. 25, the seven-day average rate of positive tests in the county fell below 4% for the first time since Aug. 15, dropping to 3.9%, according to data from the New York State Department of Health.

“We think the numbers might have plateaued,” Dhuper said. That decline coincides with the increasing number of people who are vaccinated. In Suffolk as at Sept. 29, 1,043,478 people (70.7%) have received at least one dose and 950,058 (64.3%) are fully vaccinated, according to Covid Act Now. Anybody who is at least 12 years old is eligible to be vaccinated.

The number of COVID Patients from Huntington Hospital has fallen in the last month, dropping to 20 from about 30, according to Popp. Five patients are in the intensive care unit at the hospital with COVID.

Dr. Sharon Nachman, chief of pediatric infectious diseases at Stony Brook Children’s Hospital, described the downward trend in the seven-day average as “great news,” but added that such an infection rate is “not close to where we need to be to say we have turned a corner.”

The current infected population includes children, as “more kids are getting infected,” she said, with children currently representing 25.7 percent of all new COVID cases nationwide.

With the FDA and CDC considering approving the emergency use authorization that provides one-third of the dosage of the adult shot for children ages 5 to 11, Nachman urged residents to vaccinate their children whenever the shot is available to them.

“There is no advantage to picking the right age or dose for a child,” she explained in an email. “If they are 12 now, get that dose. If they are 11 and 8 months [and the CDC approves the vaccine for younger children], don’t wait until they are 12 to get a different dose. Get the dose now that is available for that age.”

When younger children are eligible for the lower amount of the vaccine, Dhuper also urged them to get that lower dose, which he feels “offers a good level of protection for the foreseeable future.”

Nachman said she sees the issue of weight or age bands regularly in pediatrics.

“The take-home message is to not play any games and treat the child at the age or weight that they are now and not wait for them to be older or heavier,” she suggested.

As for the next month, Dhuper cautioned that the county may show another peak, particularly with the increase of indoor activities where the spread of the more transmissible Delta variant is more likely. At this point, concerns about the Mu variant, which originated in South America and was much more prevalent in the United States and in Suffolk County in June, has decreased.

“We were seeing 5% of the cases in New York state were Mu variants and the remaining were Delta,” Dhuper said.

Popp estimated that the Mu variant constitutes between 0.1% and 0.3% of cases.

The World Health Organization has urged wealthier nations like the United States not to administer boosters to their populations widely before the rest of the world has an opportunity to vaccinate their residents.

Dhuper said the United States has contributed 500 million doses to the rest of the world this year and plans to donate about 1.1 billion doses to the rest of the world in 2022.

“I hope that other upper and middle income nations can do the same, so we can get [the shots] in the arms of those who need them,” he said.

Popp urged people to recognize that COVID is a global disease.

“We in the U.S. will not be safe until the epidemic is cleared in other parts of the world as well,” he explained in an email. “I believe it is in our national interest to help other countries fight the COVID epidemic.”

 

Popp said the United States has plenty of vaccine, with enough for boosters and to vaccinate those who haven’t gotten a shot.

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