Category Archives: Northern Westchester Hospital News

Kidneys: What do they do and How to keep them healthy

Posted on: June 5, 2015

Kidneys: Your Built-in Detox System

By Dr. Martin Saltzman

Your kidneys are easy to ignore. They purr away filtering your blood, eliminating toxins and impurities, and they rarely complain. However, you don’t want to take these vital Kidneyorgans for granted. When a kidney infection or chronic disease progresses too far, your kidneys can sustain permanent damage. Should something go wrong with your kidneys, your life can change dramatically for the worse. In fact, 90,000 Americans die each year from kidney disease.

Among the many duties of these unassuming organs, topmost is removing waste from your bloodstream for elimination from the body. Each day they filter up to 150 quarts of blood, producing about one to two quarts of urine. They also help maintain the balance of water and electrolytes like sodium and potassium in your body. On top of that important work, the kidneys also generate hormones that help regulate blood pressure and make red blood cells.

Kidneys accomplish this valuable work through the use of roughly a million filtering units per kidney known as nephrons. This is why kidney specialists are known as nephrologists, and the field of kidney medicine is called nephrology. A number of systemic, or underlying, conditions such as diabetes mellitus and cardiovascular disease can damage nephrons. A family history of kidney disease, autoimmune diseases – which can cause nephritis or vasculitis – allergic reactions to drugs and kidney stones can also damage your kidneys and place them at higher risk of failure. Behaviors that can damage kidneys include smoking or relying too much on over-the-counter NSAID pain medications such as ibuprofen or naproxen. When kidneys begin to fail, waste products build up in the body leading to very serious health issues.

Unfortunately, early kidney disease is difficult to spot. There are rarely obvious symptoms, so it’s important to check with your primary care physician if you notice any small changes such as discoloration of—or a decrease in—urine, or any swelling that may be due to the retention of fluids. If you’re under doctor’s orders to take large doses of NSAIDs, your kidney function should be closely monitored. When kidney disease is suspected, your primary care physician will refer you to a nephrologist for consultation and evaluation. A thorough examination, blood tests, imaging studies, and occasionally a biopsy are tools used to help uncover the underlying cause, which will guide treatment. It is also necessary to determine the stage of kidney disease if it is present.

Many people with CKD (chronic kidney disease) remain stable or progress slowly if their underlying condition is caught early enough and treated. However, in some instances kidney disease does progress, for those cases, renal replacement therapy (RRT) is available in the form of dialysis (hemodialysis and peritoneal dialysis) or a transplant.

Preventing Kidney Disease
You can avoid trouble by making sure you control high blood pressure, or if you have diabetes, managing your blood sugar by being careful to take your medications. People at elevated risk due to chronic conditions like heart disease or diabetes should get blood tests and urine tests to screen for early kidney disease. Have a chat with your doctor about the health of your kidneys and whether it makes sense to have them tested. This organ is critical for life. You won’t regret it, especially if you’re able to catch any kidney damage early.

If you have chronic kidney disease, I strongly urge you to visit www.davita.com and find a FREE Kidney Smart® Class near you.

Be Kind to your Kidney’s
Maintaining a healthy weight, working with a renal dietitian and following a renal diet of kidney-friendly foods is vital for people with kidney disease. Try adding some of these to your diet each day and be sure to keep it colorful.*
Fruits & Vegetables
Apples
Blackberries
Blueberries
Cranberries
Garlic
Plums
Raspberries
Red bell peppers
Red cabbage
Red leaf lettuce
Strawberries
Herbs & Spices
Cinnamon
Curry powder
Oregano
Pepper
Turmeric
*Source: www.davita.com

Editor’s Note: Martin Saltzman, MD is Chief of the Division of Nephrology at Northern Westchester Hospital.

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Likely treatment and rehab that U.S. Secretary of State John Kerry will Face

Posted on: June 2, 2015

The Road Ahead: What Treatment and Rehab Options Might Look Like for Secretary Kerry

Dr. Victor Khabie, Chief of the Department of Surgery and Chief of Sports Medicine at

new york orthopedist, orthopedic surgeon westchester

Dr. Victor Khabie, Chief of the Department of Surgical Services, Co-Chief of Orthopedics & Sports Medicine, Co-Director of the Orthopedic & Spine Institute and Director of the Sports Medicine Section, Northern Westchester Hospital

Northern Westchester Hospital in Hospital in Mount Kisco, NY explains the likely treatment and physical rehabilitation that U.S. Secretary of State John Kerry will receive after breaking his right femur in a bicycling accident.

Dr. Khabie says, “While it might take a full year for Secretary Kerry to completely heal, with advances in surgical procedures, he should be up and walking with crutches the same day as the surgery to repair his broken leg.”

Options to fix the femur
“While there are two options, it really only comes down to one option, and that is surgery. The other option would be to remain bedridden for six weeks as the broken bone heals, but that is not a good idea. People can develop bed sores, blood clots, and even pneumonia if they stay in bed that long. This should be fixed surgically by stabilizing the bone with a rod, plates, or screws, depending on the pattern of the fracture,” says Dr. Khabie.

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Mammograms: An Effective Tool in the Fight Against Breast Cancer

Posted on: May 13, 2015

Sandra Lee’s Diagnosis Has Many Women Asking: Should I Get a Mammogram?

Dr. 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 news that Food Network star and author Sandra Lee, who is Gov. Andrew Cuomo’s partner, has been diagnosed with breast cancer.

When should I start getting routine mammograms?
I, along with the American Cancer Society, recommend women start getting annual mammograms at the age of 40. I know there are differing opinions, but there is not a high incidence of breast cancer before the age of 40. There are some exceptions, of course, which I explain below.

What if I have a history of breast cancer in my family? Should I start getting mammograms earlier?
If you have a family history of breast cancer, whether it is your mother, aunt, or grandmother on either side of the family, you should start getting mammograms 10 years earlier than the age your family member was diagnosed. For example, if your mother was diagnosed with breast cancer at age 35, you should begin to get mammograms at age 25. However, 25 is the youngest age that I would recommend a woman get a mammogram. If your mother was diagnosed at age 30, I’d still recommend you begin getting mammograms at age 25.

What if I feel a lump in my breast?
Call your doctor and make an appointment. Your doctor will make recommendations about next steps, including getting a mammogram, if deemed necessary.

How long does a mammogram take, and does it hurt?
Typically a mammogram only takes a few minutes. While some patients experience some discomfort, they are in the minority, and if they feel any pain, we manage it.

What if I have no family history of breast cancer? Do I still need to get mammograms?
Absolutely. In fact, 75%-80% of breast cancer diagnoses are with women with no family history.

How effective are mammograms?
They are very effective. Since 1990, mammograms have helped decrease the death rate among breast cancer patients by 15%-40% depending on which studies you read. That is an impressive and encouraging number given that up until 1980, the death rate was steady. Mammograms are an incredibly effective tool to detect breast cancer early, or to rule it out.

Editor’s Note:
Under the leadership of Dr. Bonnie Litvak, 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.

Northern Westchester Hospital also offers 3-D mammography.

 

Manny Pacquiao, Punching Power and the Rotator Cuff

Posted on: May 8, 2015

Manny Pacquiao, Punching Power and the Role of the Rotator Cuff

Dr. Victor Khabie, 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 in Mount Kisco, NY dispenses advice on rotator cuff surgery in light of professional boxer Manny Pacquiao’s shoulder injury.

When Dr. Khabie is not performing orthopedic surgery, he is a Ring Side Physician for the New York State Athletic Commission where he cares for professional boxers and has been present at ringside for numerous world championship bouts.

Dr. Khabie says, “I will be very difficult to box at a high level with a rotator cuff tear. The rotator cuff is critical in generating the punching power that boxers require to fight effectively. I believe that his injury significantly influenced the outcome of the recent high-profile fight against Floyd Mayweather.”

He adds, “The good news is that rotator cuff surgery is generally a very successful operation but can take one year to fully heal. A rematch in one year may be of interest to fight fans as Pacquiao would be at full force and would probably make a more competitive opponent. Mayweather will want to prove that he can beat Pacquiao when Pacquiao is back at full force and injury free.”

A lot of people, not just professional athletes, tear the rotator cuff in their shoulders. Dr. Khabie shares his thoughts on the signs of an injury, and what to expect when having rotator cuff surgery.

Signs of a rotator cuff injury

“If an individual has pain in their shoulder for more than seven days, experiences pain in their shoulder while he or she is trying to sleep at night, or has trouble lifting their arm above their head, it is time to see an orthopedic surgeon to see what is going on.”

Dr. Khabie adds that, “If someone sustains an injury while engaging physical activity, or a heavy object falls on the shoulder, he or she should have it looked at by an orthopedic surgeon to get to the bottom of the injury sustained.”

Can this surgery be avoided?

“Sometimes,” says Dr. Khabie. “If there isn’t in fact  a tear, physical therapy can often help along with exercises at home using an exercise band.”

Why would someone have the surgery?

“When a rotator cuff tears, it is no longer connected to the bone in the shoulder, called the humerus. It can only be reattached with surgery,” says Dr. Khabie.

How long is the hospital stay?

“Rotator cuff surgery patients go home the same day as the procedure. We operate on our patients arthroscopically, meaning we use only tiny incisions, which is much less invasive and speeds up the recovery time,” says Dr. Khabie.

What is the recovery like?

“Patients spend about four to six weeks with their arm in a sling. It takes several months to recover. After six months, most people are cleared to begin normal physical activity and exercise, or in the case of a professional athlete, they can begin training,” says Dr. Khabie. “After nine months, most patients feel back to normal.”

Editor’s Note:
Dr. Victor Khabie, MD, FAAOS, FACS is a member of the Somers Orthopedic Surgery and Sports Medicine Group. Dr. Khabie received his medical degree from Harvard Medical School and completed his fellowship in sports medicine at the world-renowned Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California, where he served as assistant team physician to professional sports teams including the LA Lakers, Dodgers, Kings, Mighty Ducks, LA Sparks, and the USC Trojan football team.

Watch Dr. Khabie discuss the role of sports medicine in keeping athletes in competitive condition.

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.