Category Archives: Health News

Dr. Peris Discusses Relief from Back Pain

Posted on: September 16, 2015

How to Treat Your Aching Back

By Dr. Marshal Peris

You’ll be happy to hear that most people recover from back pain within a few days just by taking it easy, continuing gentle activity, and using over-the-counter pain medicine such as naproxen (Aleve) or ibuprofen to ease their pain. If the pain doesn’t resolve itself within a week or so, your doctor may suggest physical therapy where you can learn stretches and ways of moving that will ease the strain on your back.

If you are still experiencing pain, prescription pain medications and possibly steroid injections to reduce swelling in your back are likely next steps. Your physician may recommend imaging to determine if abnormalities in your spine are causing your pain. If your back pain doesn’t get better using these more conservative methods, your doctor may refer you to an orthopedic surgeon to determine if surgery can help. Sometimes abnormalities in the vertebrae or the soft discs that cushion your spine can press on spinal nerves and cause pain or numbness in your legs and make it difficult to walk or stand. In such cases, surgery can help immensely.

Your orthopedic surgeon will explore your options with you, and the two of you can decide on the best approach. The good news is that the surgical solutions for back pain are improving all the time. One exciting development used at Northern Westchester Hospital is direct lateral fusion, which can address back abnormalities that cause chronic pain. As “lateral” implies, the surgeon works from the side of the patient. This advanced technique is much less invasive and allows us to achieve amazing results. The incision is much smaller and we don’t have to fuse as many vertebrae to get great results. It’s often a simpler, more effective treatment, and patients are usually up and moving after one day (instead of three to four) and typically leave the hospital after three to four days versus six to seven. The vast majority of patients are much happier and back to their normal activities much sooner.

Editor’s Note: Marshal D. Peris, MD FAAOS is the Co-Director of Spine Surgery at the Orthopedic & Spine Institute at Northern Westchester Hospital.


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The Clever Cook: Back to School Lunchbox Learning

Posted on: September 8, 2015

The Clever Cook: Back to School Lunchbox Learning

By Amy Rosenfeld

Getting in the back-to-school swing after a relaxing, stress-free summer might be difficult, but Banana Sunbutter Sushiit’s definitely doable. Here are some tips to get lunchbox organized:

1) Start a lunchbox meal planner and start a rotation. It may sound silly but taking the task of thinking of ideas out of your daily routine is a real time saver.
2) Get organized with great lunchbox materials. Stock up on a variety of portable containers, including many sizes for hot and cold packing.
3) Make recipes ahead and freeze. As much as you can do ahead of time, the better off you will be. One way to get started: make soups ahead and freeze in ice cube trays for easy defrosting.
4) Make time to pack lunches ahead. Pack ahead as much you can on the weekends for easy lunchbox stuffing. Get the kids to help and make an assembly line into a game! Then, take a few minutes at night to pack lunches instead of during the morning rush.

Fun and easy out-of-the-box lunchbox ideas:

1) BYO Pita Pizzas – Pack the tools they need to make their own pizza at lunch. Pack different sauces like tomato, pesto, or hummus as the base and send a variety of cheese and veggies for toppings. Here is a great example of hummus pizza:
2) Whole Grain Pasta and Noodle Salads – Cold and hot noodle or pasta salads can be an easy way to get all the food groups. Experiment with different types of pasta, everything from Asian Buckwheat Noodles to Orzo Salad:
3) Summer Soups with Grilled Cheese Dippers – Who doesn’t love soup in a thermos? Add a side of grilled cheese dipper strips and you have a balanced, delicious lunch. Plus, soup is an easy, nutrient rich make-ahead meal for a whole week of lunches or from the freezer. Try this End of Summer Soup Recipe:
4) Bento Box – Make meals out of snacks. Make sure to include proteins, including cheese, nut butters, tuna/egg/chicken salad, or sliced turkey or chicken, and a whole grain, like whole grain crackers or pretzels. Experiment with different dips like hummus, guacamole and veggie dips. Add a side of fruit and veggies.
5) Breakfast in a Box – Your little one doesn’t like lunch food? Pack a brunch style lunch with breakfast foods instead. Add yogurt parfaits, cottage cheese with fruit, whole grain pancakes or waffles, sweet and savory muffins, and hardboiled eggs.

Try NWH’s Sunbutter Sushi:

(serves 1)
1 6” tortilla wrap
1 banana, whole
1 tbsp sunflower seed butter*
1 tsp chocolate shavings

*Feel free to substitute peanut or almond butter as great alternatives!

1) Lay the tortilla on a flat surface. Spread the sunflower seed butter evenly over one side of the tortilla.
2) Place the banana on one edge of the tortilla. Roll the banana inside the tortilla until completely rolled up. Slice the tortilla into 6 even pieces (like sushi).
3) Dip each piece of sushi into the chocolate shavings. Eat immediately or wrap for an easy snack on the go!

Nutrition Facts (per serving): 370 calories, 13 g fat, 1.1 g saturated fat, 390 mg sodium, 55 g carbohydrates, 8.5 g fiber, 10 g protein
Breakfast for Lunch: Silver Dollar Oatmeal Pancakes

(serves 4, make 16 silver dollar cakes)
1 cup all-purpose flour
½ cup old fashioned oatmeal
2 tsp cinnamon
1 tsp nutmeg
1 tbsp sugar
1 tsp salt
2 ¾ tsp baking powder
1 egg, beaten
1 cup skim milk
4 tbsp unsweetened applesauce
1 cup fresh berries
1 cup low-fat Greek yogurt
1 tbsp pure maple syrup

1) Preheat the griddle on medium heat and the oven to 200 degrees.

2) While the griddle is heating up, in a large bowl mix all the dry ingredients. Make a small well in the center of the dry ingredients and add the egg, milk, applesauce to the center. Slowly mix the dry ingredients into the wet until just combined. Do not over-mix – some lumps are ok. Let the batter stand for about 5 minutes.

3) Spray the grill with cooking spray. Using a small ladle, spoon batter carefully onto the grill – 1 ladles per pancake. Do not touch until you start to see some bubbles start to form on the surface.  Add a few berries to each cake. Cook for about another 1-2 minutes.

4) As each pancake is done, place in the oven to stay warm. Mix the Greek yogurt with pure maple syrup and top with a dollop of Greek yogurt on each pancake.

Nutrition Facts (per serving): 320 calories, 4 g total fat, 1.5 g saturated fat, 600 mg sodium, 60 g carbohydrates, 4.5 g fiber, 9.5 g protein

Editor’s Note: Amy Rosenfeld, M,S RD, CDN is a Registered Dietitian at Northern Westchester Hospital

NAVIO robot-assisted partial knee replacement

Posted on: September 3, 2015

Amazing New Mobility after Advanced NAVIO Partial Knee Replacement Surgery

By Dr. Victor Khabie

Recently, advanced NAVIO robot-assisted partial knee replacement surgery was performed for iStock_18235142_RET3_HiRezthe first time in New York State at Northern Westchester Hospital. The technology uses sophisticated computer modeling that lets the surgeon create a unique, individualized surgical plan and then simulate that plan prior to surgery. The result is a transformation of partial knee replacement surgery – a great leap forward in precision and accuracy. The result for patients? A remarkable new option that restores natural movement as never before possible.

When painful and debilitating arthritis of the knee limits a person’s day-to-day activities, and all non-surgical measures have failed, the person is a candidate for knee replacement surgery. When it affects the whole knee, surgeons perform a full knee replacement. But when arthritis affects only part of the knee, most surgeons still perform a full knee replacement because until now, a partial replacement was a difficult and imprecise procedure. So much so that up to 30 percent of people getting a full knee replacement are actually candidates for a partial knee replacement.

Partial knee replacement requires that the implant synchronize perfectly with the remaining healthy portion of the knee, leaving almost zero leeway for surgical error. If the surgeon miscalculates by even a few millimeters in removing bone to make way for the implant, it will not fit properly. However, when successful, a partial knee replacement offers dramatic advantages, especially to those who enjoy an active lifestyle. The healthy parts of a person’s own knee are preserved, and the knee retains a more natural feel. Typically, the patient remains fully active. Why tear down the whole house just to renovate one room?

 unheard-of mobility post-surgery

Now, thanks to the precision of robot-assisted partial knee replacement surgery, that is no longer necessary. The breakthrough technology offers suitable candidates a viable alternative to a full knee replacement, and makes possible unheard-of mobility post-surgery. This leading-edge technology can provide patients suffering from arthritic pain another 10 to 15 years of an active lifestyle. What’s more, within just a few weeks of surgery, many patients are back to skiing, swimming, golfing, even playing tennis.

How does robot-assisted partial knee replacement surgery achieve
unprecedented results?

The NAVIO technology lets the surgeon do something entirely new in a partial knee replacement operation: remove only the diseased section of bone. The remaining cavity is then fitted with a metal insert that replaces the section of removed bone.

The surgeon starts by brushing a wand containing GPS coordinates over the arthritic section of the knee, thus feeding a 3-D image into the computer system. The computer registers the alignment of the entire limb, from ankle to hip, and how the whole leg moves together. The model shows every feature of a person’s leg – it’s as unique as a fingerprint. Now the surgeon can plan how much bone to remove for the implant and actually test the plan on the computer before beginning the surgery. The computer provides answers to key questions: If I remove this much bone, will the knee fully extend?  Will the knee feel natural — not too tight or too loose?

The technology ensures the accuracy needed for truly successful partial knee replacement.

Once perfected, the plan is coded into the handheld instrument used by the surgeon to perform the operation.  To help ensure safety, the device only permits movements in accordance with the plan – any deviation from the plan and the tools freeze, preventing the removal of any excess bone. The technology ensures the accuracy needed for truly successful partial knee replacement.

Robot-assisted partial knee replacement surgery offers a great new option to many age groups. It lets active people continue to engage in more strenuous sports than they could following a full knee replacement, which limits flexion. They can do anything that involves deep knee bending — rock climb, ski, cycle, hike, play tennis. The new approach also benefits those who may have other medical issues. This is a much smaller operation than a full knee replacement, offering a quicker, easier recovery, and a far lower rate of complications. It is the ideal procedure for those with some arthritic pain and limitation, but who do not want to sacrifice ligaments or remove healthy parts of the knee. By saving as much of a person’s own bone and ligaments as possible, NAVIO surgery lets them remain active for many years.

Editor’s Note: Victor Khabie. MD, FAAOS, FACS is Chief of the Department of Surgery, Co-Director of the Orthopedic and Spine Institute and Director of Sports Medicine, at Northern Westchester Hospital.

Neurosurgeon Sheds Light on Former President Jimmy Carter’s Cancer Diagnosis

Posted on: August 27, 2015

Neurosurgeon Sheds Light on Former President Jimmy Carter’s Cancer Diagnosis

By Dr. Ezriel Kornel

Former President Jimmy Carter recently received his first radiation treatment targeting four Kornel, (Ezriel Kornel, MD)spots of melanoma on his brain.

Many people have only heard of melanoma on the skin. However, melanoma has a high rate of metastasizing to the central nervous system, including the brain and spinal cord. In the case of a single metastasis, surgical removal is typically an option. In the case of Jimmy Carter, he has multiple melanoma spots on his brain, and is being treated with radiation.

At Northern Westchester Hospital, we treat many of our brain cancer patients with radiation using a Gamma Knife. Not to be confused with an actual knife or incision, it is a large helmet-shaped device which the patient slides into after having a head-frame placed under brief sedation.  It delivers high doses of radiation in one sitting that lasts  from a half hour to a couple of hours.

The primary goal of this procedure is to stop the cancer from growing, and it has a very high success rate – more than 90% – with minimal if any side effects. It is very successful in that it is so precise that it does not damage surrounding areas in the brain.

While I’m not treating Jimmy Carter, I would say that at the age of 90, if he has no new cancerous lesions elsewhere, he can continue to maintain his current schedule and activities. And if there are new lesions discovered in the future in his brain, he can repeat his radiation treatments.

The melanoma, itself, presents risks. Some patients experience seizures or neurologic symptoms such as balance issues. And melanoma has tendencies to bleed, which can have devastating neurologic consequences.

The good news is that melanoma is to a large extent preventable. Avoiding excessive exposure to sunlight is important, and wearing sunscreen is always imperative with prolonged sun exposure. If you see any questionable spots on your skin, or spots that change, make an appointment with your primary care physician or dermatologist as soon as possible. Like many cancers, if melanoma is caught early, it is treatable.

Editor’s Note: Ezriel Kornel, MD, FACS, is a Neurosurgeon and a Director of The Orthopedic and Spine Institute at Northern Westchester Hospital. 

Read additional blog posts about the gamma knife, melanoma and sun safety.

Living Well with Age-Related Macular Degeneration

Posted on: August 25, 2015

Living Well with Age-Related Macular Degeneration

Not a day goes by that I don’t see vibrant and articulate patients in their 90s. The fact that Americans are living longer – much longer – also means that I’m seeing more cases of age-related macular degeneration (AMD), a disease of the retina that is the leading cause of visual impairment in people over 65, and it’s on the rise.

This typically progressive disease involves the deterioration of the macula, a small area at the center of the retina (essentially the film of the camera which captures visual images and transfers them to the brain). The macula provides your most sensitive vision, the kind you use to look directly ahead. It is the area of the eye you are using right now, to read this article; and which enables you to look at faces. Fortunately, recent advances in treatments for AMD are offering vision-saving results, while a host of low-vision aids can boost quality of life even for those with significantly impaired sight.

Age is the main risk factor for AMD, though smoking doubles your chance of developing the illness. AMD is more common among Caucasians, and genetics also play a part. Detected through a dilated eye exam, AMD has dry and wet stages. The dry stage, involving atrophy of the macula, can cause visual impairment or produce no symptoms at all. In the wet stage, blood vessels growing abnormally below the retina leak fluid and blood that can severely impair central vision or cause central visual blindness.

In recent years, medications have been developed that “are nothing short of a miracle.” When these new drugs are injected through the white of the eye into the vitreous — the fluid-filled cavity that comprises the back of the eye – they can prevent additional visual loss in 90 percent of patients, even preventing central vision blindness. What is more, the medications restore some lost central vision to approximately 40 percent of patients. To be effective, they must be administered by a retinal specialist for the rest of a patient’s life, either monthly or bimonthly.

Recently, a national eye study showed that for people in the intermediate stage of AMD, taking certain combinations of vitamins may slow the progression of the disease, thereby decreasing the risk of the dry stage progressing to the wet.

Dr. Fern adds that there is some evidence that once a person has AMD, maintaining a healthy weight, normal blood pressure and cholesterol level, not smoking, engaging in regular exercise, and eating a diet rich in green leafy vegetables and possibly fish, can prevent or slow the development of the disease.

Boosting Quality of Life

First, remember that no one goes completely blind from AMD because you don’t lose peripheral vision. You can still live independently even with an advanced stage of the disease. In addition, certain eye professionals — usually optometrists — specialize in low-vision aids. The wide range of supportive devices includes high-powered lenses for reading, and closed-circuit monitors on which a book’s print appears much larger. The Kindle e-book reader or similar devices can now dramatically enlarge the size of a book’s text.  These devices allow you to keep reading many of the things you enjoy.
Editor’s Note: Dr. Craig Fern is an Ophthalmologist and Chief of the Division of Ophthalmology at Northern Westchester Hospital (NWH).