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St. Catherine of Siena

Joshua Bozek. Photo courtesy Bozek

By Aidan Johnson

Summer has arrived, and with it warm weather and longer days. However, as kids participate in outdoor activities, it is important for parents, coaches and camp counselors to watch for signs of heat-related illnesses, including heatstroke, sunburns and dehydration.

Dr. Joshua Bozek, emergency medicine physician at St. Catherine of Siena Hospital in Smithtown, discussed how to identify the causes of heat-related illnesses in kids in an exclusive interview June 5.

“The first thing that I usually look for is when the kids are grabbing for their water bottle a little bit more frequently,” Bozek said.

“If they suddenly start feeling kind of weak, more tired … let’s say they’re playing a sport and suddenly they want to go on the bench, that’s a sign that they’re getting a heat illness,” he said, also noting nausea and vomiting, muscle cramps and irritability. He described more serious symptoms such as fainting, severe headaches and cool, clammy skin.

It’s important to remember that some conditions, such as heatstroke, do not only occur outside or on sunny days, but can happen when it’s cloudy or in places like gyms.

If symptoms of heat illness appear to be present in a child, it is important to move to a cooler area, such as a building with air conditioning. He suggested changing to lighter clothing like shorts and a T-shirt and laying the child down with their feet slightly raised.

If the symptoms start to progress even more, Bozek recommended spreading water on their skin, which can help to cool down the blood vessels underneath, though he clarified that this shouldn’t be done to the point where the child is frigid.

Importance of hydration

“As long as they’re not actively vomiting, you want to try to get some fluids into their system,” Bozek said, adding, “If you drink some cold liquid, your esophagus, your stomach, your intestines, until it warms up will help cool you from the inside out.”

However, if symptoms continue to worsen to severe vomiting, fainting or seizure activity, the best option would be dialing 911.

Bozek also discussed preventing sunburn in children, saying, “The number one thing that you can do with kids that are going to be out, particularly when they’re at camp, is making sure that they have adequate amounts of sunblock on and reapplying frequently.”

Hydration once again plays an important role, as when sunburn progresses and the skin gets hot, which dehydrates the inflicted person much more quickly. Therefore, it is important to drink more water than normal, even if the kids are not feeling thirsty.

Sunburns can progress into severe degrees of burns, with blistering being a sign of severity.

“You don’t want to get to the point where you’re actually getting some necrosis of the skin or blisters that become deep, but the main thing is just when it’s very sunny out, if you can do activities that are in the shade or indoors, that’s better,” the emergency doctor added.

Bozek noted the difference between sunscreen and sunblock, with sunscreen used as the generalized “full body preventative measure,” and sunblock being used more “for areas that are at higher risk,” such as the ears and nose, since they’re directly pointing up to the sky.

It’s important to remember to apply sunblock to the lips, as it is possible to develop blisters, or even skin cancer, if left unprotected. Additionally, wearing a hat can keep the sun off of a person’s scalp and potentially cool them down by providing some shade to their face.

Bozek recommends using SPF 50 and above for children.

Kids are more susceptible to sun burning and dehydration due to having more sensitive skin and being able to drink less liquid than an adult, along with not necessarily being able to recognize the symptoms of heat-related conditions as well. 

It is important for everyone to practice safety in the heat and sun, so the fun can continue throughout the summer.

Joel Gonzalez, right, with his wife Amanda, daughter Isabella and son Julian. Photo courtesy Gonzalez

Joel Gonzalez was waking up in the middle of the night, gasping for air. During the day, if he ate too quickly, he felt like food was getting stuck in his throat.

In 2018, Gonzalez, who lives in Coram and is a high school counselor, was diagnosed with gastroesophageal reflux disease, or GERD. A small hiatal hernia, in which part of his stomach bulged through an opening in his diaphragm and into his chest, caused the condition.

Gonzalez started taking medications, which helped relieve the symptoms and enabled him to sleep without experiencing discomfort or waking up suddenly.

In August 2022, after learning that his hiatal hernia had gotten slightly larger and deciding he didn’t want to continue taking reflux medicine for the rest of his life, he met with Dr. Arif Ahmad, director of the St. Charles and St. Catherine of Siena Acid Reflux and Hiatal Hernia Centers of Excellence, to discuss the possibility of surgery.

Gonzalez was so convinced that the surgery would help and confident in Dr. Ahmad’s experience that he scheduled the procedure during that first meeting. Since his November surgery, which took about an hour, he hasn’t had any GERD symptoms and is not taking any medication for the condition.

Gonzalez said he would “absolutely” recommend the surgical procedure, which became a “simple decision” after consulting with Dr. Ahmad.

Caused by a mechanical problem with a valve at the bottom of the esophagus called the lower esophageal sphincter that allows stomach acid to enter the esophagus, GERD affects over 20% of the population.

Symptoms of GERD vary, which means doctors can and do take a range of approaches to treatment.

Hospitals, including St. Charles, St. Catherine of Siena, Stony Brook and Huntington Hospital, have been ramping up their efforts to evaluate and treat GERD.

Port Jefferson-based St. Charles and Smithtown-based St. Catherine of Siena, both part of the Catholic Health system, have been expanding these services at the Acid Reflux and Hiatal Hernia Centers of Excellence.

“There is a big need” for this increasingly focused effort to help patients dealing with the symptoms of GERD, said Dr. Ahmad.

At St. Charles and St. Catherine, Dr. Ahmad, who has been doing hiatal hernia and GERD-correcting surgery for over 25 years, created the center to ensure that the nurses on the floor, the people who do the testing, and the recovery staff are aware of the specific needs of these patients.

Dr. Ahmad has done presentations for the staff to ensure they have “the highest level of expertise,” he added.

Dr. Ahmad, also the director of the Center of Excellence in Metabolic and Bariatric Surgery at Mather Hospital, said he could perform surgery, if a patient needs it, at any of the hospitals, depending on a patient’s request.

Stony Brook’s efforts

At the same time, Stony Brook recently created a multidisciplinary Esophageal Center at Stony Brook Medicine, designed to provide a collaborative care model for diagnosing and treating GERD.

The center provides minimally invasive endoscopic treatments as well as surgical options.

Dr. Lionel D’Souza, chief of endoscopy, said the center provides a cohesiveness that “allows an evaluation by a group of people who are experts and can communicate with each other” to provide a patient-specific plan.

Dr. D’Souza suggested people seek medical attention from their primary care physician or gastroenterologist if they experience any of the following conditions: heartburn every day or severe heartburn several times a week, trouble swallowing, food getting stuck in the throat, anemia, blood in the stool or weight loss without another explanation.

Other partners in the Stony Brook GERD Center include Dr. Olga Aroniadis, chief of the division of gastroenterology, Dr. Alexandra Guillaume, director of the gastrointestinal motility center, and Dr. Konstantinos Spaniolas, chief of the division of bariatric, foregut and advanced GI surgery at Stony Brook Medicine and director of Stony Brook’s bariatric and metabolic weight loss center.

“When someone has a lot of excess weight, the chance of developing GERD is a lot higher,” Dr. Spaniolas said. “Sometimes, getting patients through a program to facilitate with weight loss can help [people] avoid GI symptoms, such as heartburn.”

Stony Brook will see patients in different parts of its network and then, depending on the needs, will determine who is best-suited to start their work up and treatment, Dr. Spaniolas added.

While a potential option, surgery is among a host of choices for people who have ongoing heartburn.

Huntington Hospital, meanwhile, will begin offering esophageal motility testing starting in June. Patients can call Northwell Health’s Heartburn and Reflux Center to schedule an appointment.

A team of gastroenterologists, surgeons and dietitians will work with patients at Huntington to determine the cause of GERD and possible treatments, according to Dr. David Purow, chief of gastroenterology.

Soft foods

Those who have surgery return to solid foods gradually.

Marlene Cross, a resident of St. James who struggled with GERD for about a decade, had the procedure in March.

For the first few weeks, she ate primarily liquids, with some protein drinks and puddings. She added Farina and oatmeal to her diet and then could eat flaky fish.

At 83, Cross, who lost sleep because of GERD-induced heartburn, said the surgery was a success.

“I’m not running a marathon, but I’m definitely feeling a lot better,” said Cross, who is a retired teacher’s assistant for special education students.

Cross urged others who might benefit from surgery to “see a specialist and ask questions and do it” if the doctor recommends it. “The younger you do it, the better.”

From left, Joe Martinez; St. Catherine of Siena’s Chief Operating Officer John Pohlman; St. Catherine of Siena’s President James O’Connor; and St. Catherine of Siena’s Director of Colon and Rectal Surgery Tara Martinez. Photo from St. Catherine of Siena

Habberstad BMW in Huntington hosted St. Catherine of Siena’s Cocktails for a Colorectal Cause event on March 27. Dr. Tara Martinez, director of Colon and Rectal Surgery, took the opportunity to use the unique space to raise awareness about the importance of screenings during Colorectal Cancer Awareness month, celebrated nationally during March. 

The special fundraising event was attended by St. Catherine’s senior and departmental leadership, medical staff and community members, many of whom were dressed in blue for the cause.

The two-hour cocktail party had a two-prong objective. The first was to raise awareness about the new American Cancer Society screening guidelines for colorectal cancer, which was moved from age 50 to 45 for both men and women in 2018. The second goal was to raise funds to support the hospital’s community service initiative to provide free colonoscopy screenings to underserved populations on Long Island.

“Colorectal screenings save lives and the earlier you are screened, the better your outcomes,” said Martinez. “Colorectal cancer affects men and women alike, so please be diligent about your health, and encourage your loved ones to get screened at the appropriate age.”

Martinez also took the opportunity to thank Habberstad BMW General Manager Jim McCarthy for supporting the medical center and joining such important dialogue

In addition to co-hosting the event in its showroom, the dealership sponsored the hors d’oeuvres and  donated raffle prizes, including a BMW Genuine Cruise M-Bike. The event’s raffle sales yielded $2,120, and Habberstad BMW also donated a percentage of all sales during the month of March to support free colonoscopy screenings to be provided by St. Catherine of Siena throughout the year. 

“The event was certainly fun, well attended and most importantly, it offered the unique opportunity for me to educate the community about updates in colorectal screenings. We look forward to doing it again next year,” said Martinez. For more information about colorectal screenings, please call 631-870-3444.