Category Archives: Health News

THE MYSTERY OF AUTOIMMUNE DISORDERS

Posted on: January 26, 2016

By Dr. Ronen Marmur

Without your immune system, your body would be open to infection from viruses and bacteria.

Ronen Marmur, MD/PhD

Ronen Marmur, MD/PhD

But this helpful ally can sometimes turn on you and mistakenly attack joints, muscles, and even organs. Because no one is sure what triggers autoimmune disorders, diagnosing and treating the problems can be puzzling for patients and doctors. Recognizing some of the potential risks and symptoms can help you get the care you need.

Early diagnosis is crucial to successfully managing autoimmune disorders.

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New Solutions for Inflammatory Bowel Disease (IBD)

Posted on: January 12, 2016

Something to Cheer About

By Dr. Elie Abemayor

I remember the day when an 18-year-old cheerleader came to see me, she knew something was dramatically wrong—but she didn’t want to talk about it. The normally bouncy high school student was becoming less social, and she was losing weight. She was having bowel issues, and she really didn’t want to talk about it.

Northern Westchester Eli AbemayorAfter discussing her symptoms, I checked for blood in her stool, and then confirmed her diagnosis with a colonoscopy and a biopsy. She had ulcerative colitis, a form of inflammatory bowel disease (IBD). Luckily, her condition was still in the mild to moderate stage; after she started medications she had a complete reversal within a few weeks. She was able to get back to a healthy weight and her symptoms subsided.

IBD, which includes Crohn’s disease and ulcerative colitis (the cheerleader’s condition), plagues as many as 1.4 million Americans, according to the Centers for Disease Control and Prevention (CDC). Given the nature of the symptoms, many people wait too long to seek treatment. Treating IBD early can make such a big difference in being able to manage the disease successfully.

Both Crohn’s and colitis can be characterized by persistent diarrhea, abdominal pain, cramping, fatigue, and blood in the stool. The reason for these symptoms is chronic inflammation in the digestive tract, which interferes with normal digestion. Crohn’s disease can target any part of the gastrointestinal (GI) tract, from the mouth to the anus, and it can penetrate the intestine walls to affect nearby organs. Ulcerative colitis, on the other hand, only involves the colon or rectum and irritates only the inner wall of the intestine.

If you’re seeing a GI specialist about IBD, expect to be questioned in depth about your symptoms. If your doctor believes you may be suffering from Crohn’s disease or colitis, he or she may order a colonoscopy, endoscopy, or other imaging such as a CT scan to check for inflammation. A biopsy of the inflamed area may also be necessary to confirm the diagnosis. Although it’s not possible to cure these conditions with medications, there are many effective drugs that can control symptoms, as was the case with the cheerleader. Anti-inflammatory drugs can calm a severe attack; immune system modulators can also quell symptoms. Often we find that a combination of medications works best.

For more severe cases, surgery may be required. Not too many years ago, surgeons would remove the entire colon and rectum in patients with ulcerative colitis. A patient would have to use a colostomy bag for the rest of his or her life. No more: New techniques such as ileal pouch anal anastomosis can create part of the rectum. In a two- or three-stage procedure, the surgeon can fashion a new rectum using healthy intestine, and reconnect to the anus so that the patient’s daily life is minimally affected.

Although about half of people with Crohn’s disease will require surgery at some point, the procedure won’t be curative unlike ulcerative colitis. In some cases a patient may need more than one operation. The goal of the procedure is to remove the damaged portions of the digestive tract and reconnect the healthy sections. With the right medications and a careful eating plan, patients may be able to avoid a return of their symptoms.

People with IBD can find excellent information and support through groups such as the Crohn’s and Colitis Foundation of America www.ccfa.org. Just remember that it’s key to seek treatment early, no matter how unpleasant it may seem to discuss your symptoms. You’ll have many more options for treatment and much greater success.

Editor’s Note: Elie Abemayor, MD is the Chief of Gastroenterology at Northern Westchester Hospital.

Making the Holidays Special for Loved Ones in the Hospital

Posted on: December 15, 2015

Making the Holidays Special for Loved Ones in the Hospital

Tips for caregivers, family and friends from The Ken Hamilton Caregivers Center

Here are some tips that you may find helpful while your loved one is in the hospital during the holidays.  Remember for safety reasons, it’s very important to check with hospital staff before you bring any items into the hospital room.

1)       Bring small gifts to your family member if they are well enough to un-wrap the item.
2)       Bring something pleasant and safe as a decoration for their hospital room.
3)       Bring in some comforts of home, such as your loved one’s favorite pajamas, blankets or pillow.
4)       Deliver their favorite snacks or holiday food that fits within any dietary restrictions.
5)       If you think it will raise their spirits, assemble a photo album of pictures from previous holidays.
6)       If religious, bring in a recording of a religious service, or watch one on television.
7)       Play some holiday music or watch a favorite holiday movie together.
8)       If family is unable to visit, reach out to the volunteer department for visitors.

Gift Suggestions for hospitalized family members
Entertainment:  Books, magazines, music, movies, crossword puzzles, and playing cards.

Enjoyment:  Get well cards, holiday cards, and small gifts.
Gift of Service:  Have someone offer to run an errand for your loved one – this can feel very supportive when in the hospital.  If your family member needs information about a community resource, you can offer to assist them in gathering information.

Editor’s Note: The Ken Hamilton Caregivers Center is dedicated to caring for the family caregiver. The Caregivers Center serves as a private sanctuary during the very demanding and stressful times of providing care for your loved one, regardless of  whether they are hospitalized at NWH, at another facility or at home.

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.

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.