Category Archives: Expert Health Advice

Kids and the Flu: Symptoms, When to Seek Care

Posted on: January 29, 2015

Flu Season’s in High Gear: How to Protect and Care for Your Kids

By Dr. Pete Richel

We are now in the middle of Influenza season (“the Flu”), which is typically October ID-100228285_Boy And Vaccine Syringe by Sura Nualpradidthrough March. Locally we did not see much of this in October and November, but it commenced last month and is going strong.

Most of the positive cultures are revealing Influenza type A, and even though the Influenza vaccine was not a great match this year, we still encourage all to receive it, since it may be protective against some strains, and we find no significant down side.

All children 6 months and older should be vaccinated against the flu.
-Centers for Disease Control and Prevention

It’s not too late to receive this at your doctor’s office. The vaccine is approved for those 6 months of age and older. When someone gets “the Flu” at any age, the classic symptoms are:

  • temperature instability (fever) as the body’s immune system fights for us,
  • generalized achiness,
  • and a rather hacking cough.

“…frequent hand washing for patients and their caretakers
will help to prevent contagion.”

When any of these symptoms occur, bring your child to see your pediatrician. We can evaluate them with a physical exam, of course, and we can do a rapid Flu test and make the diagnosis in minutes. If the test is positive, then we can prescribe Tamiflu, a medication which may lessen the severity of symptoms, and may shorten the usual week long course of the illness.

In addition, it is always prudent to keep up with plenty of fluids to prevent dehydration and the need for hospitalization. And we all know that good frequent hand washing for patients and their caretakers will help to prevent contagion. This is something that you don’t want to share!

According to the Centers for Disease Control and Prevention, “some children are at especially high risk.” Children at greatest risk of serious flu-related complications include the following:
1. Children younger than 6 months old -These children are too young to be vaccinated. The best way to protect them is to make sure people around them are vaccinated
2. Children aged 6 months up to their 5th birthday.
3. American Indian and Alaskan Native children.
4. Children with chronic health problems, such as: Asthma, neurological and neurodevelopmental conditions, Chronic lung disease, Heart disease, Diabetes or a weakended immune system.

Editor’s Note:
Peter Richel, MD, FAAP is Chief of Pediatrics at Northern Westchester Hospital. He is a member of Westchester Health Associates and has practiced on Smith Avenue in Mt. Kisco since 1990. Dr. Pete has authored “Happy and Healthy,” a book on wellness in the first year of life, and produced a CD of children’s songs called “Welcome to Dr. Pete’s Office.” Both of these are intended to educate and entertain children and their families.

Dr. Pete, as he’s fondly known, has received numerous recognitions including: Castle Connolly Top Doctor, Top Pediatrician by the Consumer’s Research Council of America and honored with Patients’ Choice Awards and Compassionate Doctor Awards.

Photo Credit: Sura Nualpradid / FreeDigitalPhotos.net

 

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Plant-based Diet Considered Healthiest by Dietitian

Posted on: January 28, 2015

Healthful Eating: The Plant-based Diet

By Jill Ashbey-Pejoves

As a dietitian I am often asked what I consider to be the healthiest diet. This is an easy question to answer because the research is fairly clear that a plant-based diet is best for farmers market 2overall health. You may be wondering exactly what a plant-based diet is. Well the definition ranges from one in which no animal products are consumed, a vegan diet, to one in which some animal products are consumed and not others, a vegetarian diet, to one in which all foods are consumed, but plant foods comprise the majority, a flexitarian or Mediterranean diet. A well balanced plant-based diet provides all the essential amino acids necessary for adequate protein and is high in fiber.

Here are just a few of the many benefits of a plant-based diet:
• Improved weight control – most plant-based foods are high in nutrients and low in calories by volume.
• Improved blood pressure, cholesterol, and blood sugar control.
• Decreased risk of cardiovascular disease and numerous cancers.
• It is cost effective. Vegetables, grains and legumes are less expensive than meat and dairy products.
• It’s good for the planet. It takes less environmental resources to sustain a plant-based diet than a meat-based one. Plants produce oxygen, not CO2.

“Eat food. Mostly plants. Not too much.”  
– Michael Pollan, In Defense of Food

Ways to incorporate more fruits, vegetable, beans, legumes and whole grains into your diet?
• Replace 1-2 meals per week with a vegetarian option. Think meatless Monday!
• Replace refined grains with whole grains such as brown rice, millet, bulgur, wheat berries.
• Get sneaky; add beans to soups, salads, and stews.
• Drink your greens, blend spinach or kale into your fruit smoothie.
• Aim for 3-5 servings of non-starchy vegetables and 2-4 servings of fruits every day.
• For convenience, keep canned beans on-hand; just remember to rinse them to remove the excess salt.
• Join a co-op or CSA (community supported agriculture) to always have a variety of seasonal, local or organic vegetable and fruits available.

If you, or someone you love, are interested in changing your diet to improve a chronic health condition, a Registered Dietitian can help.

For more information on plant-based diets, visit www.Oldwayspt.org and www.vrg.org.

To learn more about co-ops, CSAs and to find one in your area, visit http://www.ecolife.com/health-food/eating-local/food-coops-csa.html

 RECIPES

Sweet Potato & Black Bean Burritos
Courtesy of Moosewood Restaurant & Recipes

Ingredients
6 cups peeled and cubed sweet potatoes (about 21⁄2 pounds)
2 cups chopped onions
3 garlic cloves, minced or pressed
1 fresh hot pepper, minced (for a milder “hot,” seeded first)
1 tsp salt
2 Tbsp vegetable or olive oil
1 Tbsp ground cumin
1 Tbsp ground coriander
2 15-ounce cans of black beans, drained (3 cups)
1 Tbsp lemon juice
1⁄2 cup chopped cilantro
salt to taste
6 10-inch flour tortillas

Preparation
1. In a covered saucepan, bring the sweet potatoes to a boil in salted water to cover
2. Simmer until tender, about 15 minutes.
3. Drain and mash. Set aside.
4. While the sweet potatoes are cooking, in a covered saucepan on low heat, cook the on-ions, garlic, hot peppers, and salt in the oil until the onions are soft, about 10 minutes.
5. When the onions have softened, stir in the cumin and coriander and cook for another minute or two.
6. Preheat the oven to 350°. Oil a large baking pan or sheet.
7. Combine the mashed sweet potatoes, the onion-spice mixture, and the black beans.
8. Stir in the lemon juice and cilantro; add salt to taste.
9. Place about a 1 cup of filling on the bottom half of each tortilla and roll up.
10. Lightly brush the tops of the burritos with oil and cover with foil.
11. Bake for 25 to 30 minutes, until hot.
Try these Variations: Add a diced bell pepper to the onions as they cook. Replace the fresh hot pepper with 1⁄4 teaspoon cayenne or 1⁄2 teaspoon red pepper flakes. For a smoky flavor, use a minced canned chipotle pepper with a spoonful of adobo sauce. Stir a cup of corn kernels into the filling. Use corn tortillas instead of flour for a gluten-free alternative.
Per Serving:
312 Calories;  1.9g Fat;  0.0mg Cholesterol;  423mg Sodium;   62g Carbohydrates;  12g Fiber;  12g Protein

Recipe by Moosewood Restaurant & Recipes | Ithaca, NY at http://www.moosewoodcooks.com/2014/07/black-bean-sweet-potato- burritos/

Spiced Chickpea “Nuts”
Courtesy of Eatingwell.com

When roasted in a hot oven, chickpeas become super crunchy. They’re a great low-fat substitute for nuts when salty cravings hit.

Ingredients 
1 15-ounce can chickpeas, rinsed
1 Tbsp extra-virgin olive oil
2 tsp ground cumin
1 tsp dried marjoram
1/4 tsp ground allspice
1/4 tsp salt

Preparation
1. Position rack in upper third of oven; preheat to 450°F.
2. Blot chickpeas dry and toss in a bowl with oil, cumin, marjoram, allspice and salt. Spread on a rimmed baking sheet. Bake, stirring once or twice, until browned and crunchy, 25 to 30 minutes. Let cool on the baking sheet for 15 minutes.

Per serving :
103 Calories; 5 g Fat; 0 g Sat; 3 g Mono; 0 mg Cholesterol; 14 g Carbohydrates; 4 g Protein; 5 g Fiber; 303 mg Sodium; 2 mg Potassium

Make Ahead Tip: Cover and store at room temperature for up to 2 days.

http://www.eatingwell.com/recipes/spiced_chickpea_nuts.html

Preventing Cervical Cancer

Posted on: January 23, 2015

Women – This Regular Screening Can Save Your Life

by Dr. Navid Mootabar

There’s important news for every woman in a recent report from the Centers for Disease

Navid Mootabar, MD Chief, Obstetrics & Gynecology Director, Institute for Robotics & Minimally Invasive Surgery Northern Westchester Hospital

Navid Mootabar, MD
Chief, Obstetrics & Gynecology
Director, Institute for Robotics & Minimally Invasive Surgery
Northern Westchester Hospital

Control and Prevention (CDC): Despite evidence that cervical cancer screening saves lives, about eight million women, ages 21 to 65 years, have not been screened for cervical cancer in the past five years. In addition, more than half of new cervical cancer cases occur among women who have never or rarely been screened.  Here, I explain which tests you need, when to get screened, and demystify the protective HPV vaccine. I also offer women a silver lining: You rarely have to worry about advanced cervical cancer if you are regularly screened.

Did you know that cervical cancer was the leading cause of death among women 40 years ago?

The introduction of screening through the Pap smear has caused the disease to drop to the fourth cause of female mortality. But that incidence could be lowered even further if more women had the recommended Pap test. To understand this screening’s exceptional value, you need to know more about the primary cause of cervical cancer: Human Papillomavirus (HPV).

HPV causes approximately 90 percent of all cervical cancer cases.

This sexually transmitted virus is so common, most people will contract it at some point in their lives. There are many strains (types) of HPV. Certain HPV strains are responsible for changes on a woman’s cervix that can result in cervical cancer. Other strains may cause genital or skin warts.  Additional factors that contribute to an increased risk for cervical cancer include smoking, extended use of birth control, and having multiple sexual partners.

Most women who have cervical cancer will have no symptoms. However, infrequent symptoms may include unexplained vaginal bleeding, bleeding after intercourse and abnormal vaginal discharge. What’s more, the strains of HPV that may lead to cervical cancer are also asymptomatic.

Regular screening for cervical cancer has extraordinary life-saving potential.

The screening test — the Pap smear– involves brushing cells off the cervix, which are then examined for abnormalities. Our goal is to identify cervical cancer in a precancerous state, when it is highly curable. The impact of identifying the disease early through a Pap smear is evidenced by the fact that, from 2001 to 2010, the incidence of the disease decreased by almost two percent per year.

So when should you get screened? New guidelines recommend that women start at age 21. A Pap smear is recommended every three years, combined with an examination of the same cervical cells for HPV, until the age of 65, provided you have no risk factors or abnormal Pap smears. At 65, screenings can be discontinued if there have been no abnormal results in the previous 10 years, or no history prior to the past ten years of moderately pre-cancerous growth.

“Seeing your gynecologist annually is a vital
part of a woman’s comprehensive health care.”

The three-year guideline takes into account that for most women, cervical cancer doesn’t progress quickly. Very rarely does it advance from normal to cancer in one year. Therefore, if a woman is screened every three years, there is every likelihood the disease will be caught while still in the highly curable pre-cancerous stage.

Keep in mind that the guideline represents the minimum number of screenings you need to be safe. However, some women require more frequent screenings. At each visit, your gynecologist will determine if it is appropriate to do a Pap smear, by assessing all risk factors.

There are two other forms of prevention for cervical cancer.

One is the condom. The other is the HPV vaccination, which protects women from several of the most common and aggressive strains of HPV that can lead to cervical cancer. However, it does not protect against all strains that can lead to the disease. The vaccine – a series of three injections over six months – is recommended any time from age 9 to 26. Because HPV is transmitted through intercourse, I often recommend to my patients that they wait until they are considering becoming sexually active. Many parents question if their daughter needs the vaccine at such an early age.  The decision as to when to receive the vaccine is very individual, and I believe it should be made in consultation with the patient’s gynecologist or pediatrician.  I want to stress that the vaccine does not replace regular Pap smears.

Treatment for cervical cancer in the pre-cancerous stage can be as simple as an office procedure called a LEEP (loop electrosurgical excision procedure) which involves a local anesthetic and removal of all pre-cancerous cells from the cervix. There is a low incidence of recurrence. If the disease advances to cancer, treatment depends on the stage and the woman’s wish to remain fertile.  It can involve a cone biopsy, in which the outer portion of the cervix is removed; a hysterectomy, involving removal of the uterus and cervix; or radiation therapy.

It is essential to understand that, although the recommendations call for a Pap smear every three years, seeing your gynecologist annually is a vital part of a woman’s comprehensive health care. Pelvic exams, Pap tests and cancer screenings can help prevent illness and detect problems at an early and potentially more treatable stage. All women need to be diligent about visiting their gynecologist each year.

Editor’s Note:
Dr. Navid Mootabar is a member of Westchester Health Associates in Mount Kisco, NY. He is the Chief of Obstetrics and Gynecology and a Director of the Institute for Robotic & Minimally Invasive Surgery at Northern Westchester Hospital. He received his medical degree from the Mount Sinai Medical School, where he also completed his residency in Obstetrics, Gynecology, and Reproductive Medicine. Dr. Mootabar completed his undergraduate courses at Columbia University and was named among “America’s Top Obstetricians and Gynecologists” from the Consumer Research Council of America. Dr. Mootabar has received advanced training in robot-assisted Single Incision Laparoscopic Surgery (SILS) and utilizes this approach for select gynecologic surgery procedures.

 

 

Flu Season is Upon Us

Posted on: January 14, 2015

Flu 9401Flu season is upon us.  Therefore, it is important to understand what you can do to prevent getting the flu.  Simple steps include frequent hand-washing, keeping your hands away from your mouth and face, and getting a flu vaccination.

Annual outbreaks of seasonal flu usually occur during the fall through early spring, and in a typical year, approximately 5 to 20 percent of the population gets the seasonal flu.

This year the peak of the flu season is expected in February. However, there are effective ways to avoid the flu.

According to the Centers for Disease Control and Prevention (CDC) 43 states are reporting widespread flu outbreaks, including New York State. Across the state, including Westchester County and New York City, nearly 4,000 cases of the flu have been confirmed. Continue reading

Relief from Sinusitis

Posted on: December 18, 2014

Oh, the Pressure! Relief from Sinusitis

by Dr. John Scott

A runny nose may seem par for the course in winter. The dry air, colds and flu all add up to sinus troubles. But occasionally nose problems veer into more serious territory. The term “sinusitis” refers generally to inflammation in the nasal passages that persists. The glands in the nose become irritated and produce excess mucus. The cause can be a cold virus, infection from bacteria that reside in the nasal passages, irritants in the air or a combination of these factors. Whatever the source, about 37 million Americans suffer from at least one episode of sinusitis yearly, according to the Mayo Clinic.

There are varying degrees of sinusitis: Acute sinusitis comes on suddenly and lasts 10 to 14 days. Subacute sinusitis refers to inflammation that lasts for four to eight weeks. Sinusitis becomes chronic when it lasts longer than two months. Along with a runny nose, patients often suffer from headaches, fatigue, and facial pain.

Often, sinusitis can be treated with mucus-thinning drugs, antibiotics, and sometimes steroids. The goal is to get the nose draining, to decrease the inflammation, and to treat any underlying infection. When the sinusitis persists and moves into the chronic category, an otolaryngologist may schedule a CT scan to check for nasal polyps. Polyps trap mucus and make a person more susceptible to infections.

If the patient has polyps, excess tissue, or trapped mucus, an otolaryngologist can use special surgical tools to access the sinus and clear up the problem. We do the procedures trans-nasally — there’s no need for incisions in the face.

Only a small percentage of patients with sinusitis wind up needing surgery. In fact, many people manage their congestion with over-the-counter remedies. I suggest using saline rinses, decongestants, and acetaminophen/ibuprofen combination painkillers. However, I recommend people avoid so-called neti pots, which irrigate the sinuses. The amount of saline is too high and the pressure is too forceful. The pots can actually worsen the infection by pushing bacterial-laden mucus deeper into the sinuses. Stick to room-temperature rinses. If those fail you, your internist can prescribe stronger measures such as the antibiotics and steroids. If you’re still suffering or have recurrent infections, it may be time to consider making an appointment with an otolaryngologist.

Advanced Sinus Care
Northern Westchester is on the leading-edge of nasal surgery. The use of advanced technology such as the Brainlab system allows surgeons access to narrow, incredibly sensitive areas of the nasal cavity. The instruments are CT-scan guided; during the operation surgeons can see exactly where the instrument is in the nose. This allows them to comprehensively remove damaged tissue and work more safely. We’re working incredibly close to the eyes and brain tissue, and you really want to be sure you’re not encroaching on those areas. The CT-scan guidance provides new levels of precision.

Another exciting development at Northern Westchester Hospital is Balloon Sinuplasty which is used to treat blocked sinuses. In this procedure, the doctor guides a balloon similar to those used for cardiac angioplasty into a blocked passage, gently inflating it and dilating the sinus opening. The balloon widens the passage, allowing mucus to drain more readily. Because there’s no cutting, the procedure leaves an undisturbed lining behind. This means there’s no scar tissue, and that will help keep the sinuses open.

Editor’s Note: Dr. John Scott is the Chief of the Division of Otolaryngology at Northern Westchester Hospital. He is a physician with the Mount Kisco Medical Group, and a 2013 New York Magazine Best Doctor and a Best Doctors in America recipient. In 2013 and 2014 he was recognized as a Castle Connolly and Westchester Magazine Top Doctor. Dr. Scott is board certified in Facial Plastic and Reconstructive Surgery and Otolaryngology Head and Neck Surgery.