Category Archives: Health News

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.

Activate Your Defenses Against the Flu

Posted on: October 12, 2015

Activate Your Defenses Against the Flu

This year, government analysis indicates the vaccine will be a good match for this year’s flu strains. Read on…

By Dr. Debra Spicehandler

Believe it or not, it’s already flu shot time. If you haven’t already scheduled one, now is the time. Gaining full immunity can take about two weeks, and you want to make sure you’re protected before the flu begins circulating in your community.

You may have heard that last year’s vaccine didn’t offer as much protection as usual, but that’s no reason to skip the shot this year. Developing the yearly flu vaccine is a complex process: Several months in advance of flu season, public health officials have to predict which strain of flu virus will be most prevalent come winter in order to give vaccine makers time to produce the nearly 180 million doses America requires. Occasionally, the predictions miss the target—or the target moves. In 2014, the flu virus mutated after the vaccine had shipped. As a result, the shots were only about 13% effective, according to the Centers for Disease Control and Prevention.

This year, a recent government analysis indicates the vaccine will be a good match for this year’s flu strains. The CDC recommends that everyone 6 months and older should get the vaccine, which now comes as a needle injection, a jet (air) injection, and a nasal spray. You can get vaccinated at your doctor’s office, your workplace, or at local pharmacies, health departments, and schools.

Flu shots are available right now, and the sooner you get your dose the better. It takes about two weeks for immunity to kick in, and you want to be sure you have immunity before the virus starts circulating in your area. People who should be first in line are those at higher risk for complications from the flu, such as the elderly, young children, and anyone with a compromised immune system. You can rest assured that the vaccine is safe; the only reason to avoid it is if you have a history of an allergic reaction to the shot. (By the way, you do need to get a shot every year—immunity doesn’t carry over.)

In order to protect against catching the flu, get the vaccine and be careful to always wash your hands. If symptoms do develop, see your doctor. If you test positive for the flu, you can get a prescription for antiviral drugs, which can reduce your symptoms and help you heal faster.

Find a flu vaccine location near you…

Editor’s Note:
Debra Spicehandler, MD is Co-Chief, Division of Infectious Diseases at Northern Westchester Hospital

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 Director of Spine Surgery at the Orthopedic & Spine Institute and President of the Medical Staff at Northern Westchester Hospital.

 

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.

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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 Surgical Services, Co-Chief of Orthopedics and Sports Medicine, Co-Director of the Orthopedic and Spine Institute and Director of Sports Medicine, at Northern Westchester Hospital.