Category Archives: Hospital Services

Northern Westchester Hospital provides services for everybody’s health need.

Flu Shot Facts for Pregnant women

Posted on: October 16, 2014

Pregnancy, Your Immune System and the Flu Vaccine

By Maureen Varcasio, RN

NWHmaternalchild.orgPregnant women can protect themselves and their babies by getting the flu shot. The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists recommend that all pregnant women get vaccinated with the Influenza (Flu) vaccine.

During pregnancy changes in the immune system, heart and lungs put women at an increased risk for severe illness, hospitalization or even death from the flu. Continue reading

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Sports Medicine Expert on Concussion Symptoms and Dangers

Posted on: October 14, 2014

Concussion Management. Assessing the Symptoms.

By Dr. Eric Small

While a headache is among the best-known and first symptoms of a concussion, there are often delayed symptoms that indicate ongoing mild brain damage and require treatment. Ten percent of symptoms don’t present for a week or more.

For this reason, it is essential that parents and teachers as well as emergency room physicians and pediatricians recognize the need to monitor a young injured athlete for the full spectrum of possible symptoms. In my experience, when the athlete gets over the initial headache, or perhaps never experiences this symptom, parents and youngster often push for a quick return to all activities. But that can put a young person at serious risk.

Today’s best concussion management involves assessing all symptoms – early and late, including many that can seem unrelated to the injury — to determine the proper timing of an athlete’s return to play and also to learning, that is, the resumption of a full academic load.

Often-overlooked symptoms of a concussion include sleep disturbances and personality changes, in which, for example, a very sociable teen becomes quiet. It’s also important to know that post-injury cognitive impairment often causes academic difficulties to emerge over time. For example, an A student in math becomes, two or three months later, a B student. I particularly advise parents to keep an eye on their child’s performance in math and foreign language. As both subjects require doing multiple mental tasks simultaneously, and rely heavily on memory, they are usually the most affected. When I see a young athlete who appears fine after a concussion, I ask two targeted questions: First, “How are you sleeping?” And always – “Are you having problems with math?”

Be aware that cognitive symptoms may not surface until triggered by a heavy cognitive stress, such as back-to-back tests in school – and that this delay in symptoms can lead to dangerously delayed treatment. A little-known fact about this type of injury is that an untreated concussion can keep getting worse.

Another surprising fact to most people is that a broken nose or broken tooth suffered during sports can also cause head trauma, causing the same set of often-delayed symptoms. This is why I strongly advise that even a symptom-free child see a doctor within 48 hours of the injury, and that visits continue as the child is watched for late-arriving symptoms.

It is now recognized that proper concussion rehabilitation often involves not only physical rest and rehabilitative therapies – but rest and rehab for the brain. Ideally, a physician prescribes personalized guidelines for modifying physical and mental activities. The guidelines typically encompass texting and computer screen time, both of which can add visual over-stimulation to the stress of cognitive processing.

For day one post-concussion, I typically recommend that the student go to school a few hours late. If they tolerate that, day two is a full day. But during non-core classes, such as gym and music, I recommend they rest in the nurse’s office. And no tests. Similarly, a return to play might start the student off with a little jogging, then add push-ups. What you don’t want is the old method of rehab where the athlete stays out of school for a period of time and then returns to a full regimen. A gradual progression is a must.

Editor’s Note: Dr. Eric Small is a past chairman of the AAP committee on Sports Medicine and is active in creating national policy regarding children and sports. He has been named Sports Medicine Best Doctor in New York Magazine and Westchester Magazine  since 2007, and has over 20 years of experience with athletes.

For more information on concussions, visit www.cdc.gov/concussion

 

Northern Westchester Hospital Chief of Endocrinology on Diabetes, Weight Loss, Healthcare Costs

Posted on: September 24, 2014

Adults with Type 2 Diabetes: Weight Loss Lowers Healthcare Costs

By Dr. Jeffrey Powell

A recent study found that overweight individuals with diabetes who lose weight by dieting and increasing their physical activity can reduce their healthcare costs by an average of more than $500 a year. While we always look at better health outcomes through diet and exercise, this is the first study to show that weight loss can save money. The findings were published in the journal Diabetes Care.

This makes a lot of sense. If an individual with diabetes can lose weight, he or she will likely see fewer and shorter hospital stays, and could eventually end up on less medication. That’s not only good for one’s health, but for the wallet.

At the Division of Endocrinology at Northern Westchester Hospital, we regularly encourage our diabetes patients to see a nutritionist. Patients are counseled to eat healthy. This includes limiting the portions of food high in carbohydrates, which when broken down they can raise glucose levels. We also advise patients to avoid fried foods and juices that can affect blood sugar levels.

Physical activity and regular follow-up medical appointments are also encouraged so that we can work together with our patients to achieve the greatest possible health outcome for them.

Aside from the study mentioned above, it is also very important to note that many people with type 2 diabetes are not aware that they have it. Individuals who are overweight and who have high cholesterol and high blood pressure should get checked. This is because cardiovascular disease is a main complication of diabetes.

Managing weight is also important because many malignancies are associated with obesity. According to the National Cancer Institute, obesity is tied to the occurrence of cancers of the esophagus, breast, colon, rectum, kidney, pancreas, gall bladder, thyroid, and possibly others.
One thing that many people who struggle with their weight know is that trying to lose weight is a full time job. What many people do not know is that the body naturally works against weight loss. But there are a variety of ways that our dedicated team can help.

The Center for Diabetes at Northern Westchester Hospital is dedicated to providing a wide range of services and programs for people with diabetes.

In addition to supporting the needs of inpatients, the Center offers a comprehensive outpatient education program that focuses on meeting the individual needs of persons living with diabetes and their families. The Center also sponsors a monthly diabetes support group for adult patients to help them achieve their best possible health outcomes.

Editor’s Note:  Jeffrey Powell, MD is Chief of the Division of Endocrinology at Northern Westchester Hospital

Attend the monthly Diabetes Support Group at Northern Westchester Hospital. Discussion topics are developed around the American Association of Diabetes Educators Seven Self Care Behaviors such as healthy eating, being active, medication, monitoring, reducing risk, healthy coping and problem solving. Guest speakers often include dietitians, pharmacists, exercise physiologist and other specialists. Contact Meagan Sullivan, RN, MSN, Diabetes Educator at 914-666-1861 to register.

Northern Westchester Hospital Pediatric Pulmonologist on Kids and Asthma

Posted on: September 22, 2014

Managing Childhood Asthma

by Lynne Quittell, MD

The soft wheeze or whistle as a child breathes. The chin tucked and chest pinched as he coughs incessantly. These are signs of childhood asthma, a maddening, frightening condition for kids and parents — and a leading cause of ER visits for children. While in the past asthma has been difficult to treat and manage, advancements in medications and methods have allowed doctors and families to tame this potentially dangerous condition in children.

The reasons why a child develops asthma can be murky. Potential triggers can be allergies, exposure to secondhand smoke, or a family history of asthma. Premature babies who spend time on a ventilator appear to be at higher risk.

The reason a child struggles to breathe is that the airways can easily become inflamed, muscles that support the airways can constrict, and mucus production can increase. Some kids will have exercise-induced asthma while others may find allergy season to be the source of troubles. Even a sudden change  in temperature or a rise in humidity can set off an attack.

Parents and children should work with their doctor to develop a treatment and medication plan. This is the aspect of asthma treatment that has really changed over the years. The medications have improved greatly. We teach children and parents to recognize the earliest signs of an attack, and encourage them to treat symptoms promptly — before they worsen. I like to use the analogy of smoke in the kitchen… You wouldn’t just let it go — you’d address it immediately. Asthma is the same: Stop the attack before the symptoms become more difficult to control.

When setting up a plan, a doctor must take into consideration the child’s triggers and needs. During the spring or fall allergy season, some children will require a daily preventive medication to minimize airway inflammation, while others may be okay using an inhaler to treat occasional flare ups linked to exercise. The next step is managing more serious flare ups, and then knowing when to seek emergency help. No one leaves my office without a written treatment plan. “It’s one of the most important aspects of asthma care.

Children whose asthma isn’t responding to treatment can benefit from pulmonary exercise program, similar to what is offered at Northern Westchester Hospital. An effective program would involve exercise and respiratory therapists who would create a program for your child to help him or her build physical strength and exercise capacity. The plan should be specifically tailored to your child’s needs and include education and advice for caregivers. The goal? To get your child to the point where they can play and partake in activities with their peers, without limitations.

With the excellent treatment available, I expect my patients to be able to take part in all age-appropriate activities with no restrictions.

Editor’s Notes:
Lynne Quittell, MD, is a pediatric pulmonologist who specializes in pediatric asthma at Northern Westchester Hospital

Did you know…
Asthma affects 7 million children under the age of 18.*
*Centers for Disease Control and Prevention

Study: Genetic Testing for Ashkenazi Jews

Posted on: September 10, 2014

Study: Ashkenazi Jewish Descent as a Criterion for Genetic Testing
by Nancy Cohen, MS, CGC

Nancy Cohen Genetic Counselor WestchesterA new study, Population-based screening for breast and ovarian cancer risk due to BRCA1 and BRCA2 (abstract available in PubMed), suggests that population screening of Ashkenazi Jews for BRCA mutations may be beneficial because the cancer risks of those without a family history suggestive of a BRCA gene mutation were shown to be very similar cancer risks to those with such a history.

Since 2.5% of Ashkenazi Jews harbor BRCA mutations, and increased cancer surveillance and cancer risk reduction have been shown to improve outcomes for mutation carriers, such screening may have a useful role in this population. It will be interesting to see whether or not the guidelines from the NCCN will be adjsted to reflect this study.

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