Category Archives: Expert Health Advice

Kidneys: What do they do and How to keep them healthy

Posted on: June 5, 2015

Kidneys: Your Built-in Detox System

By Dr. Martin Saltzman

Your kidneys are easy to ignore. They purr away filtering your blood, eliminating toxins and impurities, and they rarely complain. However, you don’t want to take these vital Kidneyorgans for granted. When a kidney infection or chronic disease progresses too far, your kidneys can sustain permanent damage. Should something go wrong with your kidneys, your life can change dramatically for the worse. In fact, 90,000 Americans die each year from kidney disease.

Among the many duties of these unassuming organs, topmost is removing waste from your bloodstream for elimination from the body. Each day they filter up to 150 quarts of blood, producing about one to two quarts of urine. They also help maintain the balance of water and electrolytes like sodium and potassium in your body. On top of that important work, the kidneys also generate hormones that help regulate blood pressure and make red blood cells.

Kidneys accomplish this valuable work through the use of roughly a million filtering units per kidney known as nephrons. This is why kidney specialists are known as nephrologists, and the field of kidney medicine is called nephrology. A number of systemic, or underlying, conditions such as diabetes mellitus and cardiovascular disease can damage nephrons. A family history of kidney disease, autoimmune diseases – which can cause nephritis or vasculitis – allergic reactions to drugs and kidney stones can also damage your kidneys and place them at higher risk of failure. Behaviors that can damage kidneys include smoking or relying too much on over-the-counter NSAID pain medications such as ibuprofen or naproxen. When kidneys begin to fail, waste products build up in the body leading to very serious health issues.

Unfortunately, early kidney disease is difficult to spot. There are rarely obvious symptoms, so it’s important to check with your primary care physician if you notice any small changes such as discoloration of—or a decrease in—urine, or any swelling that may be due to the retention of fluids. If you’re under doctor’s orders to take large doses of NSAIDs, your kidney function should be closely monitored. When kidney disease is suspected, your primary care physician will refer you to a nephrologist for consultation and evaluation. A thorough examination, blood tests, imaging studies, and occasionally a biopsy are tools used to help uncover the underlying cause, which will guide treatment. It is also necessary to determine the stage of kidney disease if it is present.

Many people with CKD (chronic kidney disease) remain stable or progress slowly if their underlying condition is caught early enough and treated. However, in some instances kidney disease does progress, for those cases, renal replacement therapy (RRT) is available in the form of dialysis (hemodialysis and peritoneal dialysis) or a transplant.

Preventing Kidney Disease
You can avoid trouble by making sure you control high blood pressure, or if you have diabetes, managing your blood sugar by being careful to take your medications. People at elevated risk due to chronic conditions like heart disease or diabetes should get blood tests and urine tests to screen for early kidney disease. Have a chat with your doctor about the health of your kidneys and whether it makes sense to have them tested. This organ is critical for life. You won’t regret it, especially if you’re able to catch any kidney damage early.

If you have chronic kidney disease, I strongly urge you to visit www.davita.com and find a FREE Kidney Smart® Class near you.

Be Kind to your Kidney’s
Maintaining a healthy weight, working with a renal dietitian and following a renal diet of kidney-friendly foods is vital for people with kidney disease. Try adding some of these to your diet each day and be sure to keep it colorful.*
Fruits & Vegetables
Apples
Blackberries
Blueberries
Cranberries
Garlic
Plums
Raspberries
Red bell peppers
Red cabbage
Red leaf lettuce
Strawberries
Herbs & Spices
Cinnamon
Curry powder
Oregano
Pepper
Turmeric
*Source: www.davita.com

Editor’s Note: Martin Saltzman, MD is Chief of the Division of Nephrology at Northern Westchester Hospital.

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Likely treatment and rehab that U.S. Secretary of State John Kerry will Face

Posted on: June 2, 2015

The Road Ahead: What Treatment and Rehab Options Might Look Like for Secretary Kerry

Dr. Victor Khabie, Chief of the Department of Surgery and Chief of Sports Medicine at

new york orthopedist, orthopedic surgeon westchester

Dr. Victor Khabie, Co-Chief of Orthopedic Surgery,  Orthopedic and Spine Institute, Northern Westchester Hospitl

Northern Westchester Hospital in Hospital in Mount Kisco, NY explains the likely treatment and physical rehabilitation that U.S. Secretary of State John Kerry will receive after breaking his right femur in a bicycling accident.

Dr. Khabie says, “While it might take a full year for Secretary Kerry to completely heal, with advances in surgical procedures, he should be up and walking with crutches the same day as the surgery to repair his broken leg.”

Options to fix the femur
“While there are two options, it really only comes down to one option, and that is surgery. The other option would be to remain bedridden for six weeks as the broken bone heals, but that is not a good idea. People can develop bed sores, blood clots, and even pneumonia if they stay in bed that long. This should be fixed surgically by stabilizing the bone with a rod, plates, or screws, depending on the pattern of the fracture,” says Dr. Khabie.

How long will it take to heal?
Dr. Khabie says, “Typically, the broken bone will take six to eight weeks to heal, and a year for a full recovery.”

What is to be expected when it is time for physical rehabilitation?
“This injury will require months of physical rehabilitation,” says Dr. Khabie. “The muscles in the leg will atrophy, meaning they will wither and shrink in size. When the bone is healed, he will begin a more aggressive rehabilitation to include strength training. It’s a good thing he likes bicycling. He will start rehab using a stationary bike in about six weeks.”

Are there added concerns since Secretary Kerry had hip surgery on his right side as well?
“That previous surgery on his right hip makes this surgery more delicate,” says Dr. Khabie. “Care must be taken that the rods and screws used to fix his femur fracture do not interfere with his prior procedure. It is wise that he is having the same team of doctors perform both surgeries.”

Editor’s Note:
Dr. Victor Khabie, MD, FAAOS, FACS is a member of the Somers Orthopedic Surgery and Sports Medicine Group. Dr. Khabie received his medical degree from Harvard Medical School and completed his fellowship in sports medicine at the world-renowned Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California, where he served as assistant team physician to professional sports teams including the LA Lakers, Dodgers, Kings, Mighty Ducks, LA Sparks, and the USC Trojan football team.

What are the Health Benefits of Vitamin D

Posted on: May 20, 2015

Get the Details on Vitamin D

By Agnes Lu

Adequate vitamin D is important to your overall health for several reasons. It is essential for Grilled salmon with lemon isolated on whitestrong bones as it helps the body absorb calcium. It’s also needed for muscle movement, necessary for your nervous system and important to your immune system. Recent research shows that vitamin D may be key to the prevention of a number of long-term health problems such as cancer, type II diabetes and hypertension.

 

How much vitamin D do I need?
The amount of vitamin D needed depends on your age:
Birth – 12 months:                       400 IU/day
Age 1 – 70:                                     600 IU/day
Age 71 and older:                         800 IU/day
Pregnant and breastfeeding:     600 IU/day

How do I get vitamin D?
You can absorb vitamin D in three ways: through the skin, from diet, and from supplements.

Your body can produce vitamin D when your skin is sufficiently exposed to direct sunlight; however, unless you live in the South or Southwest, you are unlikely to get enough sunlight throughout the winter for your body to produce adequate amounts of vitamin D. Keep in mind, the American Academy of Dermatology does not recommend getting vitamin D from unprotected exposure to sunlight – which can increase your risk for skin cancer. Individuals with dark skin will absorb sunlight less efficiently.

There are a few foods that naturally contain vitamin D, and Americans get most of their vitamin D from fortified foods: milk, cereal, orange juice, and yogurt. If you’re looking for the natural sources of vitamin D, it can be found in fatty fish such as salmon, tuna and mackerel. In smaller amounts, it can be found in beef liver, cheese and egg yolks.

Am I at risk for vitamin D deficiency?
There are certain groups that have a higher risk of being vitamin D deficient:
• Breastfed infants
• Older adults
• Individuals with limited sun exposure
• Individuals with dark skin
• Individuals with inflammatory bowel disease and other conditions that cause fat malabsorption
If you think you might be vitamin D deficient, speak with your doctor.

Try these two salmon and egg dishes.

Lox, eggs and onions (Serves 4)

Modified from foodnetwork.com

Ingredients
1 large Spanish onion
1 tablespoons canola oil
3oz lox, chopped
8 eggs
Pinch of pepper

Directions
Cut the onion in half, then slice thinly. In a large saute pan, heat the oil over high heat, then saute the onions until lightly colored.
In a bowl, beat eggs with a fork, then add to the pan. When the eggs have set on the bottom, scramble in the lox and flip over.
Cook and scramble until just set.
Serve with fresh fruit or side salad for a complete breakfast or lunch.
Nutrition Facts (per serving): 220 calories, 14.1 g fat, 3.4 g saturated fat, 975 mg sodium, 4 g carbohydrates, 1 g fiber, 19 g protein

 

Scandinavian Eggs Benedict with Yogurt Sauce

courtesy of Gooseberry Mooseberry http://www.gooseberrymooseberry.com/2012/04/scandinavian-eggs-benedict-with-yogurt.html
(Serves 2)

Ingredients
1 cup low-fat Greek yogurt
1/8 tsp powdered turmeric
1 Tbsp chopped fresh dill
Juice of 1/2 lemon
1 tsp horseradish
A crackle of white pepper
2 whole wheat English muffins, halved and toasted
4 slices of smoked salmon
4 poached eggs
Optional: chopped chives for garnish

Directions
In a medium bowl, whisk together yogurt and turmeric until yogurt turns a pale gold color.
Then stir in dill, lemon juice, horseradish, and pepperuntil combined. Leave it at room temperature for a few minutes as you cook the eggs. If you would like the sauce warmer, put it in the microwave for about 30 seconds.
Top each toasted English muffin half with a slice of smoked salmon, a poached egg and a dollop of yogurt sauce. Sprinkle with chopped chives for garnish.
Serve with fresh fruit or side salad for a complete breakfast or lunch.
Nutrition Facts (per serving): 400 calories, 12 g total fat, 4 g saturated fat, 750 mg sodium, 51 g carbohydrates, 4.8 g fiber, 25 g protein

Editor’s Note: Agnes Lu, MS, RD, CDE, CDN

Mammograms: An Effective Tool in the Fight Against Breast Cancer

Posted on: May 13, 2015

Sandra Lee’s Diagnosis Has Many Women Asking: Should I Get a Mammogram?

Dr. 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 news that Food Network star and author Sandra Lee, who is Gov. Andrew Cuomo’s partner, has been diagnosed with breast cancer.

When should I start getting routine mammograms?
I, along with the American Cancer Society, recommend women start getting annual mammograms at the age of 40. I know there are differing opinions, but there is not a high incidence of breast cancer before the age of 40. There are some exceptions, of course, which I explain below.

What if I have a history of breast cancer in my family? Should I start getting mammograms earlier?
If you have a family history of breast cancer, whether it is your mother, aunt, or grandmother on either side of the family, you should start getting mammograms 10 years earlier than the age your family member was diagnosed. For example, if your mother was diagnosed with breast cancer at age 35, you should begin to get mammograms at age 25. However, 25 is the youngest age that I would recommend a woman get a mammogram. If your mother was diagnosed at age 30, I’d still recommend you begin getting mammograms at age 25.

What if I feel a lump in my breast?
Call your doctor and make an appointment. Your doctor will make recommendations about next steps, including getting a mammogram, if deemed necessary.

How long does a mammogram take, and does it hurt?
Typically a mammogram only takes a few minutes. While some patients experience some discomfort, they are in the minority, and if they feel any pain, we manage it.

What if I have no family history of breast cancer? Do I still need to get mammograms?
Absolutely. In fact, 75%-80% of breast cancer diagnoses are with women with no family history.

How effective are mammograms?
They are very effective. Since 1990, mammograms have helped decrease the death rate among breast cancer patients by 15%-40% depending on which studies you read. That is an impressive and encouraging number given that up until 1980, the death rate was steady. Mammograms are an incredibly effective tool to detect breast cancer early, or to rule it out.

Editor’s Note:
Under the leadership of Dr. Bonnie Litvak, 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.

Northern Westchester Hospital also offers 3-D mammography.

 

Manny Pacquiao, Punching Power and the Rotator Cuff

Posted on: May 8, 2015

Manny Pacquiao, Punching Power and the Role of the Rotator Cuff

Dr. Victor Khabie, Chief of the Department of Surgery and Chief of Sports Medicine at
Northern Westchester Hospital in Mount Kisco, NY dispenses advice on rotator cuff surgery in light of professional boxer Manny Pacquiao’s shoulder injury.

When Dr. Khabie is not performing orthopedic surgery, he is a Ring Side Physician for the New York State Athletic Commission where he cares for professional boxers and has been present at ringside for numerous world championship bouts.

Dr. Khabie says, “I will be very difficult to box at a high level with a rotator cuff tear. The rotator cuff is critical in generating the punching power that boxers require to fight effectively. I believe that his injury significantly influenced the outcome of the recent high-profile fight against Floyd Mayweather.”

He adds, “The good news is that rotator cuff surgery is generally a very successful operation but can take one year to fully heal. A rematch in one year may be of interest to fight fans as Pacquiao would be at full force and would probably make a more competitive opponent. Mayweather will want to prove that he can beat Pacquiao when Pacquiao is back at full force and injury free.”

A lot of people, not just professional athletes, tear the rotator cuff in their shoulders. Dr. Khabie shares his thoughts on the signs of an injury, and what to expect when having rotator cuff surgery.

Signs of a rotator cuff injury

“If an individual has pain in their shoulder for more than seven days, experiences pain in their shoulder while he or she is trying to sleep at night, or has trouble lifting their arm above their head, it is time to see an orthopedic surgeon to see what is going on.”

Dr. Khabie adds that, “If someone sustains an injury while engaging physical activity, or a heavy object falls on the shoulder, he or she should have it looked at by an orthopedic surgeon to get to the bottom of the injury sustained.”

Can this surgery be avoided?

“Sometimes,” says Dr. Khabie. “If there isn’t in fact  a tear, physical therapy can often help along with exercises at home using an exercise band.”

Why would someone have the surgery?

“When a rotator cuff tears, it is no longer connected to the bone in the shoulder, called the humerus. It can only be reattached with surgery,” says Dr. Khabie.

How long is the hospital stay?

“Rotator cuff surgery patients go home the same day as the procedure. We operate on our patients arthroscopically, meaning we use only tiny incisions, which is much less invasive and speeds up the recovery time,” says Dr. Khabie.

What is the recovery like?

“Patients spend about four to six weeks with their arm in a sling. It takes several months to recover. After six months, most people are cleared to begin normal physical activity and exercise, or in the case of a professional athlete, they can begin training,” says Dr. Khabie. “After nine months, most patients feel back to normal.”

Editor’s Note:
Dr. Victor Khabie, MD, FAAOS, FACS is a member of the Somers Orthopedic Surgery and Sports Medicine Group. Dr. Khabie received his medical degree from Harvard Medical School and completed his fellowship in sports medicine at the world-renowned Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California, where he served as assistant team physician to professional sports teams including the LA Lakers, Dodgers, Kings, Mighty Ducks, LA Sparks, and the USC Trojan football team.

Watch Dr. Khabie discuss the role of sports medicine in keeping athletes in competitive condition.