Category Archives: Expert Health Advice

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.

 

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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.

Protect Yourself from Skin Cancer Year-Round

Posted on: May 4, 2015

Surprising Facts About Year-Round Skin Cancer Risks…
…And Tips to Protect Yourself

By Dr. Stuart Zweibel

Did you know that skin cancer is the most common cancer in the United States? Now, a recent SunProtection_HiRezstudy from the Centers of Disease Control (CDC) finds an increase of 50 percent in the average annual number of adults treated for skin cancer. We all know how and when to protect our skin – or do we?  It’s essential to know the risk factors for skin cancer and the best forms of protection.  That’s particularly important during times, such as hazy days and winter, when many of us underestimate the risks to our skin from sun, and therefore relax our necessary safeguards.

Skin cancer occurs in two forms: melanoma and non-melanoma. Non-melanoma cancers, which are the most common, are almost always caused by sun exposure. For the more dangerous melanoma, genetics plays a larger role in determining your risk.

When we talk about sun exposure, we refer to the effect of three types of ultraviolet (UV) light – or radiation – on our skin: UVA, UVB and UVC. Skin cancer can develop when these skin-penetrating rays damage the DNA of our skin cells.

UVC is filtered out by the ozone layer. UVB causes sunburns and tans. While less UVA enters our atmosphere than UVB, it penetrates our skin deeply enough to potentially cause skin cancer. That’s why using “broad-spectrum” sunscreen is so important – only this type guards against both A and B.

Sunburn occurs when intense exposure to sun causes inflammation of the skin. Tanning is our body’s natural “sunscreen,” in which the skin’s pigment-producing cells increase production of pigment (in the form of the chemical compound melanin) to block harmful UV radiation. Sunburn is a visible sign of damage to the skin cells’ DNA. But while tanning may not produce inflammation, DNA damage has taken place.

The majority of people who develop a melanoma have a genetic predisposition to the disease.  For non-melanoma skin cancers, which are primarily caused by sun exposure, skin type becomes the dominant risk factor. You probably know that people with very pale or “porcelain” skin are at increased risk for skin damage from sun. In reality, four skin types are at greatest risk.  The first two will not surprise you – very pale skin that always burns and pale skin that tans minimally. But also vulnerable is skin that tans uniformly and only sometimes burns mildly, as well as skin that always gets the proverbial “beautiful” tan, with no burning.

Here is how I advise patients about skin cancer risks throughout the year,
and my best tips for protection:

Best year-round protection: Only use broad-spectrum protection with an SPF of 30 or higher. Even if a product is labeled as such, check that it contains the necessary ingredients meroxyl – sometimes called ecamsule – and avobenzone, which can be called parsol 1789. The Anthelios brand is one example of a very effective broad-spectrum sunscreen.

High-risk scenarios in winter:  Those enjoying outdoor sports in winter, particularly skiers and snowboarders, need to know that snow reflects UV rays and that higher altitudes mean slightly higher UV penetration. That makes sunscreen and lip protection vital, especially during spring skiing at higher altitudes. This is the case even when temperatures are low and it seems that sun exposure is not an issue. What’s more, winter’s low humidity and wind exposure can dry and irritate the skin, making moisturizers another key protection.

Are we at risk on overcast days? Radiation does penetrate on cloudier days. However, most people don’t realize that hazy days create significant UV ray exposure. People are fooled due to the seeming lack of intensity of the sun.

What times of day present greater risk from UV radiation?  During warm weather, the peak time is between 10 am and 4 pm. In winter in our latitude, peak UV radiation occurs around 11 am to 3 pm. That means you need sunscreen protection at certain times year-round.

When to apply: Sunscreen takes up to an hour to be fully effective. The biggest mistake people make is to get settled on the beach, and only after 15 minutes, have someone apply sunscreen to their back. By then, they will probably develop a burn from the exposure.

How much to apply: Most people apply far too little sunscreen. The average adult needs approximately one ounce to be protected.

Where to apply: Everywhere that is exposed – make sure to get it in your ears and behind your ears.  Protecting the nose is critical. 15 to 20 percent of all skin cancers occur on the nose. Protect your lips with balm or Chapstick with sun protection. If your clothing is sheer, apply sunscreen to your entire body. Wear sunglasses, a hat and protective clothing.

Protecting children:  Do not use sunscreen on babies under one year old. If needed, use protective clothing and consider using a non-chemical sunblock. However, be aware of recent suggestions that certain chemical-free blocks are ground so finely, they might enter the skin. So ask your pediatrician’s advice before using this type of sunblock on a child.

 

Editor’s Note:
By Stuart Zweibel, MD, PhD, is a board certified dermatologist and dermatologic surgeon specializing in skin cancer, laser surgery and cosmetic dermatology. Dr. Zweibel served as the Chief of the Division of Dermatology at Northern Westchester Hospital from 1999 to 2007. He has been recognized as a ‘Best Doctor’ in both New York Magazine and Westchester Magazine.

Dr Stuart Zweibel | Dermatologist Scarsdale NY | Mount Kisco NYDr. Zweibel is a graduate of Cornell University and completed his graduate studies at Temple University School of Medicine and Harvard School of Public Health earning a PhD in Microbiology and Immunology.

He graduated from Mount Sinai School of Medicine. He completed his residency at Brown University and a fellowship in Mohs and Dermatologic Surgery under Dr. Mohs in the department of Surgery at the University of Wisconsin Hospital.

 

 

 

 

 

Healthy Snacks On-The-Go

Posted on: April 6, 2015

Nutritionist Approved:
Healthy snack products to look for on your next grocery trip

By Elisa Bremner, RD
This is the first edition of a series of nutritionist-approved food products on the market.

Snacks are an important and useful way to stave off hunger, bolster nutrient intake, keep energy up and satisfy the occasional craving (for emotional health!). But the best food is always the whole food. For snacks, I recommend fruit, vegetables and “mini meals” like a bowl of soup or ½ sandwich.

Processed, packaged food can fit into your balanced diet, but should never become the basis of your diet. Unfortunately, it’s just not possible for most of us to prepare fresh, whole-food snacks every time we get hungry. Practically speaking, when we’re running around all day, a packaged snack food may be the only option. We have choices. Here are five of my faves:

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Pulmonary Rehab and Quality of Life

Posted on: April 1, 2015

Pulmonary Rehab Can Improve Quality of Life

By Harlan R. Weinberg

Pulmonary rehabilitation (PR) is increasingly recognized as a significant part of treatment for Human respiratory system, artworkpeople with chronic respiratory illnesses and other lung conditions. Even for those with very impaired lung function, this specialized rehab can improve quality of life and the ability to live independently. Here, I explain how PR offers new hope to people with breathing difficulties.

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