Category Archives: Health News

The Pathologist: The Expert Behind the Scenes

Posted on: April 20, 2015

The Pathologist: The Expert Behind the Scenes

By Dr. Thomas Higgins

When patients are being treated for cancer, they may not realize that there is a specialist who PathologyMicroscope_silo_1plays an incredibly vital role in their care. One whom they will never meet — a pathologist like myself — who will provide a firm diagnosis, analyze the type of cancer the patient has, and provides information to suggest a course of treatment. We’re behind the scenes, but our input is necessary for oncologists and surgeons in understanding the type of tumor they’re dealing with.

Tissue biopsies are sent to a pathology laboratory to be carefully scrutinized by pathologists. In most cases we’re not only able to verify whether the tissue is cancerous, we can diagnose whether the tumor is aggressive or slower growing, and what type of drug might be most effective against the cancer. For example, a breast tumor that tests positive for a protein known as HER2 can be very aggressive and is unlikely to respond to hormone treatment. However, there are drugs that have been developed specifically to target tumors with this marker, and I provide information that the oncologist uses to decide upon the patient’s protocol.

As you can imagine, the need to properly identify the cancer and fully characterize it so the right treatment is prescribed is critical. We may not be meeting face to face with patients, but each slide we examine represents a real person. That’s why pathologists are careful to eliminate the chance of any possible errors. I will often consult one of the other pathologists in our department to help ensure accuracy. Northern Westchester Hospital has four pathologists on staff and we help check each other’s work.

Pathologists also send all their diagnoses to a state and national database through our cancer registry that can help keep track of the incidence of cancer and cancer types around the country. What’s more, I submit many of my reports to researchers who are overseeing clinical trials at the hospital. We’re part of about a dozen trials testing different types of treatments and protocols.

So if you or a loved one get a pathology report that identifies the type of cancer you have and the drugs that might help overcome the disease, you’ll know that you have a pathologist on your side.

Editor’s Note:
Thomas Higgins, MD is the Medical Director of Pathology at Northern Westchester Hospital.

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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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Hip Replacement Surgery on the Rise

Posted on: March 19, 2015

Hip Replacement Surgery on the Rise

By Dr. Eric Grossman

Researchers at the Centers for Disease Control and Prevention (CDC) recently released findings iStock_3875724_LoRezthat from 2000 to 2010, the number of hip replacements for those older than 45 more than doubled.

The CDC said: “The number and rate of total hip replacements among inpatients aged 45 and over increased significantly from 2000 through 2010. The greatest increase in absolute numbers was in the 55–64 age group, where the number of total hip replacements almost tripled, whereas the greatest percentage change was in the 45–54 age group, which experienced a 205% increase. The 45–54 age group also had the greatest increase in rate, which more than doubled from 45 to 117 total hip replacements per 100,000 population.” (February 12, 2015).

I am not surprised by these trends based on improvements in surgical technique, durability of the procedure, durability of the implants, and patients’ desired active lifestyles. In my practice, I use what is called the “anterior approach” which can result in a faster recovery time, without postoperative restrictions, less muscle damage and a more natural feel to the artificial hip.

Previous generations of general practitioners were reticent to suggest hip replacement to their patients because of longer hospital stays, unproven effectiveness and longer recovery times. There was a time when doctors did not suggest hip replacement due to arthritis pain until their patients could not bear to suffer any longer.

Now, with advances in the surgical procedure, primary care physicians are more inclined to suggest the surgery. This is in part driven by their patients’ expectations. Individuals with painful arthritis are taking a proactive approach – they do not want to suffer in pain any longer than necessary. Additionally, they want to engage in an active lifestyle, and many advances in the surgery since it began to be performed approximately 50 years ago have made the new hips more durable.

The CDC also found that “In 2010, the average length of stay was shortest for the youngest age group and longest for the oldest group. Among those aged 45–54, the average stay was 3 days, lower than for each of the other age groups, while the average among those aged 75 and over was 4 days, higher than for each of the other age groups. From 2000 through 2010, the average length of stay decreased for each age group.”

These findings studied patients until 2010. Now, in 2015, I am seeing much shorter hospital stays after hip replacement surgery. Approximately 80 percent of my patients go straight home from the hospital – not to an inpatient rehabilitation facility as had been routine in the past – within 24-48 hours after surgery. Some select patients are even able to go home the same day of surgery. Our rehab protocols include rapid mobilization where the patients are expected to walk the same day as their surgery.

Watch Dr. Grossman’s patients tell their stories of
living life without pain after hip replacement.
View patient testimonials.

Hip replacement surgery has become more routine and is now being offered to a much wider demographic of patient, particularly patients ages 45-64 and it is not only helpful for senior citizens. There is no need to suffer with painful and activity-limiting hip arthritis. Talk to your doctor to see if hip replacement surgery is an option to explore.

Editor’s Note:
Eric L. Grossman, MD, FAAOS is Co-Director of Joint Replacement Surgery at the Orthopedic and Spine Institute at Northern Westchester Hospital and a member of Mount Kisco Medical Group.

Dr. Grossman is a fellowship trained, board certified orthopedic surgeon who specializes in all facets of hip and knee joint replacement surgery including primary and revision total joint replacement, with a focus on the Anterior Approach to Total Hip Replacement.

 

 

 

 

Simple, Slimmed-down Slow Cooking

Posted on: March 18, 2015

Simple, Slimmed-down Slow Cooking

By Caryn Huneke

In theory, I love the idea of using my Crock Pot to help get dinner on the table during the busy pulled-porkworkweek (or weekend for that matter). But with the exception of chili and soup, my track record for finding timesaving, healthy, and delicious recipes wasn’t exactly stellar. Over time, I noticed there were three main culprits robbing me from slow-cooking culinary success:

1) Time: Is it really going to save me time or will I have to prep a ton of ingredients or remember to brown the meat first?
2) Nutrition: Is it going to be laden with butter, cream-of-anything, and flavor packets, piling on the calories, fat, and sodium?
3) Taste: Will it actually be a satisfying meal that I’d want to make again?

Turning to cooking blogs, Pinterest, and family and friends, I started gathering (and tweaking) recommended recipes. Below you’ll find four easy slow-cooker recipes that you can feel good serving to your family. (Disclaimer: I’ve yet to try each one, but they all come on excellent authority to be foolproof and tasty.)

• Filipino Adobo Pulled Pork
• Flank Steak Fajitas
• Brown Sugar Balsamic Glazed Pork Tenderloin (
• Beef Stroganoff

Filipino Adobo Pulled Pork
Adapted from Skinnytaste.com

Ingredients
• 1.75 lb lean pork center loin or tenderloin
• 1/4 cup low-sodium soy sauce
• 1/3 cup apple cider vinegar
• 1/2 cup water
• 5 cloves garlic, crushed
• 6 ground peppercorns
• 4-6 bay leaves
*Optional: 1 jalapeno, chopped; 2 tablespoons chopped scallions for garnish

Directions
• Place pork, soy sauce, vinegar, water, garlic, peppercorns and bay leaves (jalapeño if using) in the Crock Pot.
• Cover and cook at low heat 6-8 hours turning over half way through cooking (note: I did not do this and I cooked it closer to 9 hours).
• Remove the pork, shred with two forks and put it back in the Crock Pot.for one more hour to let the flavor get into the meat (note: I probably only left it for another 15-20 mins).
• Discard bay leaves and serve over brown rice and top with chopped scallions.

Slow-Cooker Flank Steak Fajitas
Courtesy of Against All Grain, by Lisa Leake (link from Lisa’s 100 Days of Real Food website)

Ingredients
• 1 ½ lbs flank steak
• 1 ½ teaspoons chili powder
• 1 teaspoon cumin
• 1 teaspoon coriander
• ½ teaspoon salt
• ¼ teaspoon black pepper
• 2 tablespoons low-sodium soy sauce
• 1 jalapeno pepper, seeded and chopped
• 2 cloves garlic, minced
• 4 – 5 bell peppers, sliced, any color
• 1 onion, diced
*Optional fajita fixings: whole-wheat flour tortillas, reduced-fat grated cheese, fresh sliced avocado, cilantro, lime slices, fresh spinach leaves, reduced-fat sour cream, hot peppers, etc.

Directions
1) In a small bowl, mix together the chili powder, cumin, coriander, salt and pepper.
2) Rub the spice mixture over all sides of the flank steak and place it in the bottom of the slow cooker.
3) Pour the reduced-sodium soy sauce on top of the steak and add in the diced jalapeno and minced garlic. Slice the bell peppers and onion and throw those on top of the steak.
4) Cook on high for 5-6 hours or low for 8-9 hours, until the steak can easily be shredded with two forks.
5) Drain the meat and peppers and serve with the optional fajita fixings listed above.

Brown Sugar Balsamic Glazed Pork Tenderloin
Courtesy of Food52.com

Ingredients
• 2 pounds pork tenderloin
• 1 teaspoon ground sage
• ½ teaspoon salt
• ¼ teaspoon pepper
• 1 garlic clove; crushed
• ½ cup water
Glaze
• ½ cup brown sugar
• 1 tablespoon cornstarch
• ¼ cup balsamic vinegar
• ½ cup water
• 2 tablespoons soy sauce

Directions
1) Combine sage, salt, pepper and garlic and rub over pork tenderloin.
2) Place 1/2 cup water in slow cooker and add the tenderloin on top.
3) Cook on low for 6-8 hours.
4) About 1 hour before roast is done, combine ingredients for the glaze in small saucepan. Heat and stir until mixture thickens.
5) Brush roast with glaze 2-3 times during the last hour of cooking. (For a more caramelized crust: remove from crockpot and place on aluminum lined sheet pan, glaze, and set under broiler for 1-2 minutes until bubbly and caramelized. Repeat 2 to 3 more times until desired crust is achieved.)
6) Serve with remaining glaze on the side.

Slow Cooker Beef Stroganoff
Adapted from FiveHeartHome.com

*Note: Five Heart Home’s recipe for beef stroganoff doesn’t use cream-of-mushroom soup so you have to add a few more ingredients to make up for it, but it’s worth the sodium savings. To make it even healthier and easier, this modified version trims more calories and extra ingredients.

Ingredients
• 1.5-2 pounds lean beef stew meat (or lean beef round steak)
• 12 ounces white mushrooms, cleaned and pre-sliced
• ½ – 1 cup diced yellow onion (adjust the amount based on preference)
• 2 tablespoons minced fresh garlic (frozen or jarred would work too)
• 1 1/2 cups fat-free, low-sodium beef broth
• 1 tablespoon Worcestershire sauce
• 1 tablespoon Dijon mustard
• 1/2 teaspoon dried thyme
• 6 tablespoons whole wheat flour
• 4 ounces Neufchâtel cheese or one-third less fat cream cheese, at room temperature
• 8 ounces light sour cream
• Salt and freshly ground black pepper, to taste
• Bag of whole wheat egg noodles

Directions
1) Place beef, mushrooms, and garlic in Crock Pot.
2) In a medium bowl, mix together beef broth, Worcestershire sauce, mustard, thyme, and flour. Whisk mixture until flour is dissolved. Pour into Crock Pot and stir all ingredients until coated.
3) Place lid on Crock Pot and cook for 8-10 hours on low (or 4-5 hours on high).
4) About 20 minutes before serving time, start boiling water to cook whole wheat egg noodles according to package directions.
5) Also add cream cheese to Crock Pot, replace lid, and after 10 minutes stir warmed/softened cream cheese into sauce, pushing with the back of a spoon to break it up and incorporate it into sauce.
6) Stir sour cream into sauce. Replace lid and cook on low for a few more minutes until heated through.
7) Season beef stroganoff with salt and pepper as desired and serve over hot egg noodles.

Editor’s Note:
Caryn Huneke is a Registered Dietitian at Northern Westchester Hospital.

If you have any tried-and-true Crock Pot recipes, please send them to nwhealth@nwhc.net for possible inclusion on our website’s recipe page. Be sure to include your name for proper acknowledgement.

 

A NEW KIND OF Rx: E-Prescribing

Posted on: March 6, 2015

A NEW KIND OF Rx: E-Prescribing

By Dr. Brian Blaufeux

UPDATE — as of Friday 3/13/15, the mandate for electronic prescriptions has been extended to March 27 of 2016.

In case you hadn’t heard, your prescription routine is about to change–permanently. Getting a prescription used to mean your doctor would scribble something unintelligible on a paper pad and you’d deliver it to your pharmacist. In New York, beginning March 27, 2015, all prescriptions will be electronic, and you’ll never get that scrap of paper again.

Electronic prescribing, also called e-prescribing, is the computer-based electronic generation, transmission, and filling of a prescription that replaces paper and faxed prescriptions.

In New York,
as of March 27, 2015, 2016
all prescriptions will be electronic

Why the change?
There are a few reasons to ditch the old prescription pad. Doctors and pharmacists both hope to eliminate errors that might have crept in through illegible scrawls. Also, when a doctor enters a patient’s prescription electronically, the system can flag any possible negative drug interactions. Another important advantage to electronic prescribing is that New York State drug enforcement officials will be better able to crack down on over-prescribing and abuse of prescription narcotics–in fact, that’s the primary reason the state passed the law requiring the change.

You’ll be happy to know that it will actually make the whole prescription process much simpler for patients. Your doctor will electronically submit your prescription to the pharmacy you use, and your medications should be ready for you when you arrive. So don’t worry if your doctor leaves out the scrap of paper when he or she gives you a new prescription.

Editor’s Note: Brian Blaufeux, MD is Chief Medical Informatics Officer at Northern Westchester Hospital.