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Can Pulmonary Rehab Help Me?

Posted on: November 17, 2015

Pulmonary Rehab Westchester

If you experience shortness of breath, pulmonary rehab may help you. Pulmonary rehab lessens your sensation of shortness of breath, while helping improve activity endurance–and quality of life.  You may have a respiratory problem that can be effectively treated with pulmonary rehab.

Am I a Candidate for Pulmonary Rehab?

Take the self-assessment below to see if pulmonary rehab may be right for you. Pulmonary rehab is covered by most insurance companies. Our Pulmonary Rehab staff can help you get a referral from your physician.

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The Key to Reversing Pre-Diabetes

Posted on: November 9, 2015

The Key to Reversing Pre-Diabetes

By Pat Talio

A diagnosis of pre-diabetes means that you are at high risk for developing diabetes, and without lifestyle changes are likely to be diagnosed with Type 2 diabetes within 10 years. Better nutrition and exercise may help you prevent or delay the diagnosis of Type 2 Diabetes.

The arrow image depicts the differences between the blood sugar level of someone without diabetes, someone considered pre-diabetic and diabetessomeone with diabetes. Pre-diabetes means your blood sugar is higher than normal but not yet high enough to be diagnosed with diabetes.  A diagnosis of pre-diabetes is a reason to slow down and examine what you are eating and how active you are. Research shows with an improvement in your diet and with an increase in activity, which results in weight loss and better nutrition, Type 2 diabetes can be prevented or delayed.

The Diabetes Care and Education practice group of the Academy of Nutrition and Dietetics suggest the following tips to reverse Pre-Diabetes:
1. Move more – take a walk after dinner, stand up while talking on the phone, walk to your coworkers desk rather than use e-mail, jog in place or stand and stretch during TV commercials. Move if you’ve been sitter for 30 minutes. Remember every step counts.
2. Water is the way to go – replace juice, soda and other sugary drinks with water.
3. Just say no – Politely refuse the extra serving at the family dinner and powdered donut from a co-worker. Friends and family often have good intentions, but practice saying “No thank you!” to stay on track.
4. Size matters – be mindful of your portion sizes. Keep your protein to 4-6 ounces; a serving of starchy food should be less than one cup, and vegetables should cover at least one-half of your plate.

Change is always difficult but it may be easier with the support of a partner so grab a family member or friend and work together to make healthy lifestyle choices a reality.

Editor’s Note: Pat Talio, MS, RDN, CDE, CDN is a registered dietitian at Northern Westchester hospital and is a diabetes educator.

Lung Cancer Screening Detects Cancer Sooner

Posted on: November 3, 2015

Westchester Thoracic Surgery Chief on the Advanced Lung Cancer Screening that’s Saving Record Numbers of Lives

By Christos Stavropoulos, MD, FACS, Chief of the Thoracic Surgery Division and Director of the Lung Cancer Program at the Cancer Treatment and Wellness Center at Northern Westchester Hospital

You may know that lung cancer is the number one cause of cancer death in the U.S. (and worldwide).*  But you may not know that an advanced type of screening — the Low-Dose CT Scan – is reducing lung cancer deaths by 20 percent.* Its effectiveness makes this scan today’s “standard of care” for those at high risk; and it is newly covered by Medicare and most health insurance plans. Read on to see if you meet the screening criteria, and to learn how Northern Westchester Hospital (NWH) makes sure every eligible person can afford this test.

Who should get a Low-Dose CT screening?

If you meet each of these criteria, Low-Dose CT (LDCT) lung cancer screening, which is conducted at NWH, may be right for you:

  • You are between 55 and 74 years old;
  • You have a smoking history of 30 pack years. That means you smoke (or smoked) one pack daily for 30 years, two packs daily for 15 years, or three packs daily for 10 years;
  • You currently smoke or quit within the past 15 years;
  • You have no symptoms of lung cancer.

What exactly is LDCT screening?

LDCT lung cancer screening is a new form of traditional CT (computed tomography) imaging technology that uses a very low dose of radiation to provide critical 3-D information about the lungs. It is unprecedented in its ability to detect ever-smaller lung cancers called nodules – small lesions or defects in lung tissue that can represent early cancers. The life-saving power of earlier detection can’t be overstated. When we catch cancer early — when it is smallest — we can have the most impact on prognosis and survival. According to the American Cancer Society, LDCT screening is shown to prevent up to 12,000 deaths from lung cancer a year in the US.

Why is getting screened so essential?

Screening for lung cancer is particularly vital, as this cancer presents no symptoms in its early stage. Here’s why: The lung is a relatively large organ. Picture a marble floating within a big balloon. For the marble to have a noticeable impact, it must become bigger. Only when that marble becomes the size of an acorn or an orange, do symptoms develop. There may be pain as the now-bigger growth presses against neighboring lung tissue or blood vessels; or a persistent cough can develop from its pressure against the airways. That is why a person harboring early-stage lung cancer usually reports they “feel fine,” and precisely why screening is necessary and effective.

What are the chances of something being found?

Most screening results are negative. The overwhelming majority of nodules are benign. Fewer than three percent of those screened will need intervention in the form of a biopsy. Of those people, only a small percentage wind up having cancer. That’s the point: We are looking for those few people with lung cancer. As with any screening, a small number of false positives can lead to unnecessary diagnostic biopsies. However, every biopsy performed at Northern Westchester Hospital is done using the most up-to-date, minimally invasive method possible. When lung cancer is diagnosed, NWH offers comprehensive oncologic care second to none.

How affordable is the LDCT screening?

Medicare now covers LDCT screening and commercial insurers are moving toward coverage. But what if you meet the eligibility criteria, and don’t have commercial insurance or Medicare? NWH can help — with a wide range of payment options and below-average pricing. We will work with you. If you can benefit from the screening, we make sure you get it.

Steps to take

If you believe you meet the screening criteria, speak to your primary care physician about ordering an LDCT. If you don’t have a physician who can refer, NWH’s nurse practitioner will perform a comprehensive assessment, determine eligibility and order an LDCT if necessary. NWH is going the extra mile to make this potentially life-saving screening 100 percent accessible to everyone who needs it.

*National Institutes of Health (NIH)

To learn more about the Lung Cancer Screening Program or to make an appointment with our Nurse Practitioner, call 914-242-7695 from 8:30 am to 4:30 pm.  

When Should I Get a Mammogram?

Posted on: October 27, 2015

New guidelines for when women should start getting mammograms have raised questions.

Dr. Bonnie Litvack, Director, Women's Imaging Center, Northern Westchester HospitalDr. Bonnie Litvack, Medical Director of the Women’s Imaging Center at Northern Westchester Hospital, answers questions many women have about when to start getting mammograms in light of the new breast cancer screening guidelines issued by the American Cancer Society, which raised the suggested age that women start getting mammograms at age 45, up from 40 years of age.

The American Cancer Society (ACS) recently issued new guidelines for when women should begin getting mammograms. They previously recommended that women begin getting mammograms at the age of 40, and now they are recommending women begin getting mammograms at age 45. I understand that this can be confusing and frustrating for women, and I want to share information that I hope is both helpful and reassuring.

First and foremost, these new guidelines are meant for women with an average risk of getting breast cancer – women with no family history of breast cancer. These recommendations are not for women who have a family history of breast cancer or who carry the BRCA gene. And if there is any take-away from this message, every woman is different and every woman should speak with her doctor to determine the best plan and timing for beginning or continuing to get mammograms.

I recommend that women begin getting mammograms at the age of 40 and continue to get them annually as long as they are in good health. Why? Because research and science have shown that the maximum amount of lives are saved when we start screening annually at the age of 40, again for women with an average risk of getting breast cancer.

The ACS reasoned that certain “risks” are presented in younger women who get mammograms, such as false positives that lead to additional screenings, or in rare cases, a biopsy. However, I want to be clear, that the benefits of getting a mammogram are objective – it is proven to save lives. The risks are completely subjective. Some women might feel anxious getting a mammogram, or hearing that they need to get additional screening. We work tirelessly to reduce anxiety associated with getting a mammogram. But ask many women, and they would rather have a false positive only to hear that everything is fine after additional screening. We’re balancing anxiety with saving lives, and mammograms save lives.

About those false positives…

At Northern Westchester Hospital, all of our technology is digital. We do not use film mammography, which is what was used in the studies that the ACS based their latest recommendations on. Radiologists have made significant improvements in mammography using digital technology, and we have been using tomosynthesis radiation (3D mammography) which provides quick, clear, and more definitive results. Scientific studies have shown that 3D mammography has reduced false positives by up to 1/3, meaning many fewer of our patients are called back for additional screening.

Finally, the ACS also recommended that all women can skip the clinical breast exam, which is conducted manually by your doctor. I disagree. For our patients, we want to find anything unusual as early as possible. This exam is part of our patients’ regular annual exams, and it does not cost anything. I recommend that women continue to get regular clinical breast exams.

Editor’s Note:
Under the leadership of Dr. Bonnie Litvack, the Women’s Imaging Center at Northern Westchester Hospital has been acclaimed as a Breast Imaging Center of Excellence by the American College of Radiology. She is fellowship trained in MRI and has extensive experience in all aspects of women’s imaging, including mammography.

Read more about Northern Westchester Hospital’s 3-D mammography.

Catching Lung Cancer Early

Posted on: October 26, 2015

A Story of Hope…

Dr. Christos StavropoulosAlthough my patient quit smoking six years ago, she remained at high risk for lung cancer. When a Low-Dose CT screening showed something like a little marble in her lung, I recommended a surgical biopsy. But my patient hesitated, feeling “very nervous” about the procedure. When I gently told her that “If it were my mother, this is the advice I’d give her,” she agreed to proceed.

During the operation, I extracted a piece of lung with the nodule to obtain the diagnosis. When it tested positive for cancer, I performed a lobectomy during the same procedure, sparing my patient a second exposure to anesthesia. Afterwards, she was immensely relieved that her cancer was removed, and very pleased to be “up and around” almost immediately after the minimally invasive procedure.

Today, my patient is incredibly grateful that her cancer was found at stage 1A, and that, as a result, she didn’t need radiation or chemotherapy, just ongoing surveillance CT scans.

This is the best possible scenario for someone with lung cancer. Because we caught her cancer early, she has a real chance for a cure.

To see if you’re a candidate for low-dose CT scans, take this self-assessment.

Editor’s Note:  Dr. Stavropoulos is the Director of the Lung Cancer Program at the Cancer Treatment & Wellness Center at Northern Westchester Hospital