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Lifesaving Transplant Comes After Decade-Long Struggle With Heart Failure By Alissa Silber Dan Krauss is a father, husband, community member, and — as of this year — a heart transplant recipient, who up until 11 years ago was in good health. In 2006, at just 30 years old, Mr Krauss contracted a virus that changed the course of his life forever. Looking to remedy what he originally thought was a simple cold, he went to his primary care doctor and received antibiotics. Upon finishing the medicine, he felt a little better but not great. He was put on a second round of antibiotics to treat the lingering effects, but this time when he finished them he became alarmingly sick. Instead of receiving a different prescription when he returned to his doctor, he was informed that he needed to go to the emergency room right away. Mr Krauss’s wife, Betsy, with their infant daughter, immediately picked him up and brought him to Danbury Hospital. When they arrived, he was pumped full of fluids, suspecting he was suffering from severe dehydration. Shortly thereafter, a nurse came in and told everyone to stop what they were doing. Unsure what was going on, Mr and Ms Krauss were approached by a doctor who began to tell them it was not a case of dehydration. The doctor explained to the young couple that Mr Krauss had congestive heart failure, brought on by the virus. “We were totally shocked,” Ms Krauss said about hearing the news. “That was the furthest thing from my mind that a 30-year-old could have heart problems.” Mr Krauss agrees, saying, “I nearly fell of my gurney when they told me I had congestive heart failure.” Neither had much experience with anyone they knew having the life-threatening disease, except for Mr Krauss’s grandmother, who only lived three years after being diagnosed with it. “I thought I was dying,” Mr Krauss said. After the diagnosis, he was out of work for six weeks and put on a drug regimen of ACE inhibitors, beta blockers, and diuretics. Despite constant fatigue, he explained the medicine allowed him to start feeling well enough to return to work and go back to a relatively normal routine. Every three to four weeks, though, Mr Krauss would see the cardiologist his
father recommended, Dr Ulrich Jorde. He would have his heart’s ejection fraction measured to see the percentage of blood that was leaving when his heart contracted and relaxed. “Most people pump out like 60 percent of the blood in the heart, and I was at 15 percent,” Mr Krauss explained. That blood count can cause serious problems, as it essentially starves all the cells in the body of crucial oxygen and nutrients. Six months after being diagnosed with congestive heart failure, his ejection fraction rose to 35 percent giving the Krauss family a false sense of ease before it took a turn for the worse and plummeted back down close to 20 percent. Testing And Waiting In November 2008, Mr Krauss had surgery at Danbury Hospital to place a defibrillator inside his chest with a lead attaching into his heart. By the following spring, both he and his wife began being evaluated to see if Mr Krauss was eligible to be put on the organ transplant list for a new heart, as one of the most important features of the assessments was to make sure Mr Krauss had a good support system in place. Together they had to meet with a cardiologist, psychiatrist, social worker, financial person, and nutritionist — just to name a few — to see if he would be a good transplant candidate. Mr Krauss also went through multiple physical and mental tests to ensure the rest of his body was healthy enough to receive the organ. “It was two of the most draining days that either one of us had gone through at that point,” Ms Krauss said. He passed the tests and was able to be put on the transplant list with the intention that he was going to need a new heart sometime in the next few months. Over the following years, however, Mr Krauss received countless calls about possible matches from the transplant organization United Network for Organ Sharing (UNOS), but each time Columbia Presbyterian Hospital, where Dr Jorde worked at the time, determined Mr Krauss was too healthy and turned him down. Throughout those years Mr Krauss tried to not let waiting for a heart consume him and went back to work, doing family activities, and finding anything to
in the afternoon to restore a semblance of energy in him. “He went in for testing one day on the defibrillator,” Ms Krauss said, “and they told him he had been in atrial fibrillation, which was a new problem.” In addition to the irregular heartbeat, it appeared they found a blood clot in his heart, so he was immediately put on blood thinners for a month. In June, doctors at Danbury Hospital defibrillated him, shocking his heart back into a normal rhythm, and he was sent home. After taking a nap later that afternoon, he woke up struggling to breathe. “The procedure was successful, it stopped the atrial fibrillation, but it put him into active heart failure,” Ms Krauss said. Mr Krauss was admitted into the hospital that Thursday night and was diuresed of all the fluid in his lungs. The following Saturday, a mere two days later, he was released, being told he was most likely experiencing sleep apnea and that there was nothing more that could be done. All the while, Ms Krauss felt something was not right. She had been in constant communication with their trusted cardiologist Dr Jorde, who was now working at Montefiore in the Bronx, N.Y. She let him know what was happening, and Dr Jorde was adamant he wanted to see him right away.
After being diagnosed with congestive heart failure more than a decade ago, Newtown resident Dan Krauss received a left ventricular assist device, known as an LVAD, prior to getting a heart transplant. Pictured is Mr Krauss with the LVAD battery packs and computer over his clothes. —photo courtesy Dan Krauss take his mind off it all. Shocking The Heart “I was relatively healthy until the win-
ter of 2016, around January,” Mr Krauss said. He noticed he was becoming more tired than usual and would have to take naps
LVAD Mr Krauss was admitted into Montefiore that Monday where a bed was waiting for him in the intensive care unit. By the next day, they performed a right-heart catheterization, to measure the pressures of the heart. It was determined Mr Krauss would need a left ventricular assist device, known as an LVAD. He remained in the hospital for a week before his open-heart surgery on August 2, where they cracked open his chest and implanted the LVAD. When he awoke from the five-hour surgery, he found he was in the intensive care on a ventilator. “I was in the hospital for a total of 29 days,” Mr Krauss said. “Recovery was slow… and I was in some pain.” While he recuperated at Montefiore, Ms Krauss was by his bedside every day, working only when she could find a moment.
“I really didn’t sleep very much,” Ms Krauss said, adding that she was grateful her mother stayed with them to help take care of their young daughter. The particular LVAD that Mr Krauss received was called a Heartmate 3. At the time of the surgery it was considered a trial model (that became officially approved in August 2017). The device pumps blood in a continuous stream throughout the body and causes patients to not have a pulse or normal blood pressure while on it. The Heartmate 3 not only had a pump attached to his heart, but also a tube that exited his lower abdomen and attached to a portable computer. From there two lines attached to batteries that rested on his sides. It was crucial the tube always be in a sterile environment, so Ms Krauss was in charge of learning from the nurses how to change the dressing over it. Once her husband was discharged from the hospital, she would change the dressing three times a week. The couple was also trained on what to do with the batteries and controller in case there was ever an emergency. “Any time I went out of the house I had to carry a backpack that had spare [batteries]. If it were to malfunction you’d need to change it,” Mr Krauss said. “My big thing was that I was always concerned I was going to snag it in the car door.” For eight months, Mr Krauss had to live with the restrictive device and even though he was upset at first with it, he knew it was keeping him alive until he could receive his much-needed heart transplant. A New Heart It was on April 7 this year that Ms Krauss received the long-awaited call they had been hoping for: there was confirmed match for a heart. The couple dropped off their daughter at a sleep over and drove to Montefiore that night to have Mr Krauss ready for the 15½-hour transplant surgery the next morning. Unfortunately, Mr Krauss said, “Surgery did not go well.” The transplanted heart that was put in his body did not start, due to a very rare complication called primary graft failure. Mr Krauss was hooked up to a type of life support machine called an extracorpo( continued on page C - 2 )
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Lifesaving Transplant Comes After Decade-Long Struggle With Heart Failure ( continued from page C - 1 )
real membrane oxygenation (ECMO), which required large tubes going into his groin to attach to an artery that took over the job of pumping the heart. â€œIt also did the job of the lungs, changing the oxygen into carbon dioxide,â€? Mr Krauss explained. He was on ECMO for six days before his new heart started to work. During that time, he had been in the operating room four times: first for the transplant, then because they thought he was bleeding and needed to wash him out, third to close his chest back up, and lastly when they took the ECMO out. While Mr Krauss was in the hospital, his wife again dedicated all her time to being by his side. She drove the hour-and-a-half trip each way from Newtown to Montefiore every day to be with him as he recovered. â€œI was in the hospital for 41 days, from April 7 to May 19. The last two weeks I spent at a rehab hospital,â€? Mr Krauss said. He went to Burke Rehab Hospital in White Plains, N.Y., for the unexpected residual damage the ECMO had on his leg. The inserted tubes disrupted some of his nerves, causing him to lose feeling in parts of his leg, making walking difficult. â€œHe is not as strong as he would like to be, and I think that has been frustrating for him,â€? Ms Krauss said. Even though the chain of events did not turn out the way they had expected, she said, â€œIf I look back and kind of compare, he could be a lot worse.â€? Road To Recovery Since then, Mr Krauss has been able to return home and begin some of his usual activities, like working out at the gym and attending Sandy Hook Permanent Memorial Commission meetings. Once a month he is required to go to Montefiore for heart biopsies to ensure the transplant does not show signs of rejection, and he gets blood work done on a weekly basis. Mr Krauss is also on a strict regimen of daily medication, some of which he will be on for the rest of his life. The pills he takes include three types of anti-rejection drugs to prevent his body from attacking his new heart as a foreign body. Those same medicines just so happen to suppress his immune system, making him more susceptible to other viruses and bacteria, resulting in him having to take other medication to combat that. Every Sunday morning Ms Krauss prepares his daily medication boxes, so her husband knows what to take at what times of the day. She estimates he was originally put on 45 pills a day, but the number has since decreased now that time has gone by. Due to his repressed immune system, Mr Krauss was required to wear a face-mask for the first six months after his surgery and go on a low fat/low sodium diet with certain food restrictions to avoid getting sick. It is also vital that he now only drink bottled water, even when he brushes his teeth. The Krauss family looks forward to the six-month marker from his heart transplant surgery, as it will reduce the frequency of his heart biopsies and allow him to cut back on some medications. Mr Krauss has been fortunate to not have had any recent complications with his transplant and understands that it will take a year to fully recover from the type of intensive surgery he underwent. Each year, though, will be a positive reminder of the immense progress he is making. â€œThey say that once you have a heart transplant you have two birthdays: your regular birthday and your transplant birthday,â€? Ms Krauss said. She says her family is already looking forward to having a big party on her husbandâ€™s transplant birthday in April 2018 to celebrate the major milestone of having a new healthy heart.
â€”Donate Life image
Help Save A Life By Becoming A Donor By Alissa Silber Twenty-two people die every day waiting for an organ transplant, according Donate Life, a national nonprofit organ and tissue donation group. Since being diagnosed with congestive heart failure nearly a decade ago and undergoing a heart transplant surgery in April of this year, Dan Krauss has been volunteering with Donate Life to advocate for people to become donors. Having received not only a heart, but also a significant amount of blood throughout his surgeries, he understands the incredible impact people can make by donating their blood, organs, or tissue. His family has made it their mission to educate people about the importance of becoming a donor. â€œA single donor can donate eight organs: a heart, two lungs, a pancreas, two kidneys, a liver, and your
Sports Medicine Specialist Talks Common Soccer Injuries And Provides Tips To Avoid Them GREENWICH â€” With nearly a million American high school girls and boys participating in soccer, the worldâ€™s most popular sport, parents should be aware that all of them â€” and especially girls â€” are prone to season-ending knee ACL tears. According to orthopaedic surgeon Kevin D. Plancher, MD, founder of Plancher Orthopae-
dics & Sports Medicine in Greenwich and New York City, anyone involved in the game from casual pick-up players to dedicated year-round participants should take steps to prevent common injuries that can cut into their time on the field. Nearly 400,000 girls played high school soccer in 2015-16 in the United States, according to
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national figures, comprising about 40 percent of the total for both genders. Participation continues to climb each year, but so do injuries resulting from this rough-and-tumble sport. Tracking a nationally representative sample of 100 schools in the United States, a March 2017 study in the British Journal of Sports Medicine estimated that 3.38 million high school soccer injuries took place over the tenyear study period. Boys and girls playing high school soccer suffered similarly increasing rates of concussion, but unfortunately girls sustained higher rates of ACL/MCL liga-
ment sprains than boys, who were more likely to sustain fractures, the study found. â€œThis recent research shows that most injuries for boys and girls resulted in staying off the field less than a week, but nearly seven percent resulted in waiting more than three weeks before returning to play,â€? Dr Plancher noted. â€œThe findings demonstrate exactly why preventing soccer injuries is so important in the first place.â€? What are the most common soccer injuries? Among both high school boys and girls, the list is topped by ligament sprains (nearly 30 per-
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intestines â€” plus two corneas and skin, bones, ligaments, tendons,â€? he explained. According to Donate life, 117,000 people are currently waiting to receive a lifesaving organ, while every ten minutes another person is added to the national transplant waiting list. Signing up to be a donor is as easy as visiting registerme.org or asking for it to be indicated on a driverâ€™s license. Those who have smart phones can even go to their Medical ID settings right now and sign up through there. â€œAnyone can sign up to be a donor,â€? Mr Krauss explained, and it can make all the difference in helping save someoneâ€™s life. To learn more about Donate Life, visit donatelife. net or call 804-377-3580.
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cent), concussion (nearly 18 percent) and muscle strains (16 percent), the 2017 study found. Of the injuries resulting in a loss of play for three weeks or more, the three most common injuries among girls were knee sprains (26 percent), concussions (22 percent) and ankle sprains (13 percent). Among boys, these injuries included concussions (17.8 percent), knee sprains (15.5 percent) and ankle sprains (almost 9 percent). Other typical soccer injuries among both genders, according to Dr Plancher, include fractures, tendinitis, skin injuries such as cuts or lacerations, shin splints, wrist sprains, and fractures (from falling on an outstretched arm), shoulder dislocations, bruising, and neck sprains â€œNotably, the rate of ligament sprains requiring surgery was much higher in girls in the recent study than boys,â€? says Dr Plancher, who lectures globally on issues related to orthopaedic procedures and sports injury management and takes care of professional athletes. â€œPrior research has already established that tears to the ACL, or anterior cruciate ligament, are eight times higher in girls than boys.â€? While several anatomical and hormonal factors seem to make females more prone to ACL tears, the most prominent include a wider pelvis, more lax ligaments, a smaller groove in the legâ€™s femur bone, slower reflex time, and landing with appropriate proprioception are some of the factors, he says. Stopping soccer injuries before
they happen is obviously preferable to treating them later. Dr Plancher offers these ways to try to avoid injuries on the soccer field: *Proper conditioning: Conditioning-related injuries such as sprains and strains happen most frequently at the start of soccer season, before young athletes are fully in shape. To prevent them, follow a coach-sanctioned conditioning program that includes running and stretching. â€œFocus especially on building up the hamstring and inner quadriceps muscles on the thighs,â€? he says. *Proper pivot and jumping techniques, which can help avoid ACL tears. These techniques include landing on flexed knees and avoiding abrupt stops and pivots. â€œGirls especially should practice these methods,â€? he says. *Proper warm-ups and cooldowns: â€œLogically, cold muscles are more prone to injury, so spending the time to stretch each muscle group before and after play is crucial,â€? Dr Plancher says. *Wear shin guards and mouth guards *Wear shoes designed specifically for soccer (typically molded cleats) *Drink plenty of water before, during, and after play â€œSoccer is largely a safe sport, and while some injuries arenâ€™t preventable, many are,â€? Dr Plancher says. â€œPlayers should be educated about what they can do to avoid as many of these injuries from happening as possible.â€? For more information, visit plancherortho.com.
THE NEWTOWN BEE, FRIDAY, OCTOBER 13, 2017
Dr Kenneth A. Litwin Delivers Patient-Centered Functional Medicine
By Kendra Bobowick A doctor for more than 15 years in primary care, Sandy Hook practitioner Dr Kenneth A. Litwin said he was not satisfied with what conventional medicine offered his patients, and he was not seeing the kinds of positive outcomes he was hoping for treating or complementing therapies with just prescription drugs. So he turned to functional medicine for nutritional treatments of many conditions, including diabetes and high blood pressure. “By spending just 15 minutes talking about diets and what might help them was better than just a change in [patient] medications,” he said. While not for acute medical care, he said, “If it’s something chronic that you have or are trying to prevent, functional medicine is made for this.” He took courses and learned functional medicine is “not just complementary or integrative.” “It’s more a way of understanding how the body works and what is underlying all these conditions. It is a different lens for viewing patient health and you apply other integrative therapies into the frame work.” He may recommend herbal or acupuncture or “whatever may help that patient.” Mainly, Dr Litwin and his patients focus on lifestyle medicine. “Meaning the most important thing we can do is direct a patient toward an appropriate food plan with their specific issues.” Not every diet is right for every patient, however. “We start with food first,” he said, starting with testing that conventional medicine “for whatever reason, does not use yet.” Consider irritable bowel syndrome for example. “Why wouldn’t you want to take a look at digestive function and imbalances in intestinal microbiome?”
is weaker, digestion is damaged, and immune function is actually worse.” “Our main focus is any condition that is autoimmune, Crohn’s disease, rheumatoid arthritis, multiple sclerosis, and autoimmune thyroid,” he said. “We are basically the only type of doctor to view autoimmune as having similar underlying cause that is usually dealt with as a specialty.” An underlying cause of all those conditions “can be addressed through similar approaches through nutrition, sleep, exercise, and variations on their conditions.” Dr Litwin might also consider particular diets. An autoimmune diet “excludes a lot of triggers like gluten and diary,” he said. Consider exercise. “I might waste 15 minutes every morning on something when I could definitely spend 15 minutes on a walk. No gym. I get up and put sneakers on and go for a walk.” People can incorporate little changes that “absolutely” are beneficial long-term, he confirmed. Patients can also make incremental changes to what they eat. He suggests making the change from foods higher in fat and higher in sugar, which could spell diabetes. “It was better when we were eating better whole food,” he said. Dr Kenneth Litwin Much of food choices available His practice uses “different asks, “What is the environment are processed food, which could testing, nutritional support, where Lyme bacteria is doing be “a reason behind diabetes, and nutritionists to help sup- its thing? Does the person have and maybe we should just get port recommendations ranging immune, digestive, or nutrition- back to basics, to fruit and nuts from getting more sleep to al deficiencies, or other prob- and protein sources — that stress management and exer- lems that make them have could maybe get our society off cise — and we put it all togeth- trouble?” of proscriptions.” Youraddressing elderly or loved will have a While thedisabled Lyme er as a formal plan to incorpoPatientsone interested in speakinfection, “We work to improve ing with Dr Litwin, or Dr Kara rate all those things.” Regarding the earliest signs of internal environment of patient Fitzgerald, can schedule a comdiabetes, he said, “We find it by so they can best fight it off.” plimentary consultation “to see Dr Litwin said a common if it is right for them,” Dr Litwin doing tests that a conventional doctor might not do, and we can approach to Lyme leads to a said. detect changes long before a doctor “prescribing multiple Call 203-304-9502, or visit antibiotics for a prolonged peri- website drkarafitzgerald.com. person develops diabetes.” Looking at Lyme disease od, but if you don’t pay atten- The doctors are located at 27 through functional medicine, he tion to other factors, the person Glen Road in Sandy Hook. At some point in our lives we face the difficult and often agonizing decision of “what’s best for mom or dad”
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DANBURY — Western Connecticut Health Network (WCHN) has named Linus T. Chuang, MD, as chairman of obstetrics and gynecology. Dr Chuang is a professor of obstetrics and gynecology at the Icahn School of Medicine at Mount Sinai. Before joining WCHN, he was director of the Minimally Invasive and Robotic Surgery Fellowship at Mount Sinai, director of minimally invasive and robotic surgery and director of gynecologic oncology at Count Sinai Queens Hospital. Dr Chuang will develop a network-level Minimally Invasive Fellowship Program in gynecology at WCHN and looks forward to his continuing contributions in basic science and clinical research. Additionally, he will continue to standardize care across the network and plan for further growth in obstetrics and gynecology. Dr Chuang will be practicing at both Danbury and Norwalk Hospital campuses. Dr Chuang received his medical degree from the Kaohsuing Medical College in Taiwan and
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Economist Doubts Value Of Certificate-Of-Need Laws
By Andrew Gorosko A research economist at George Mason University in Virginia doubts whether statebased certificate-of-need (CON) laws, which have been in effect in states across the country for decades, are achieving their goals. At the university, Matthew Mitchell, PhD, who is a senior research fellow and adjunct professor, heads the Mercatus Center’s Project for the Study of American Capitalism. Mercatus is a nonprofit, free market-oriented think tank. Dr Mitchell’s research focuses on economic freedom and economic growth. Generally, CON laws require health care providers to obtain state permission before they open or expand their medical
practices or purchase certain devices or acquire new technologies, according to Mercatus. In its research, Mercatus has reviewed the CON laws in the 35 states that still have such laws in effect. Connecticut has 12 CON laws on the books, Dr Mitchell said. “Applicants must prove that the community ‘needs’ the new or expanded service, and existing [health care] providers are invited to challenge would-be competitors’ applications,” it adds. In a document describing how Connecticut’s CON laws affect the provision of medical services to its citizens, Marcatus states,”CON laws have persisted in spite of mounting evidence from health economists, regula-
tory economists, and anti-trust lawyers showing that these laws fail to achieve their intended goals.” In Connecticut, health care services that require a CON include: acute hospital beds, ambulatory surgical centers, cardiac catheterization, computed tomography scanners, linear accelerator radiology, long-term acute care, magnetic resonance imaging scanners, mobile medical imaging, positron emission tomography scanners, psychiatric services, radiation therapy, and substance/drug abuse treatment. The Connecticut Office of Health Care Access is the agency that reviews CON applications. Based on the tenets of econom-
ic theory and data that has been collected and analyzed, increased competition promotes lower costs for patients and higher quality medical care, Dr Mitchell said. Research has shown that the presence of CON laws in a state tends to benefit the interests of the existing medical community and result in increased medical costs, Dr Mitchell said. “The CON laws benefit the medical establishment,” he explained. Dr Mitchell suggested that CON laws be eliminated to increase the public’s access to medical care, and subsequently increase the quality of medical care. A 1974 federal law, known as the National Health Planning and Resources Development Act,
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withheld federal funds from states that failed to enact CON laws. The intent of the federal act was to restrain health care costs, increase health care quality, and improve access to health care for poor people and underserved communities, according to Dr Mitchell. However, in 1986, Congress repealed that federal law, as it became apparent that the CON laws were failing, he said. The federal repeal eliminated the federal incentives for states to keep their CON laws. Connecticut remains one of the 35 states and District of Columbia that still have CON laws on the books. In New England, New Hampshire repealed its CON laws in 2016. In about a dozen other states, there are active drives for the repeal or partial repeal of CON laws, Dr Mitchell said. According to Mercatus Center research on the effect of existing Connecticut CON laws, it is estimated that if the CON laws were repealed here, annual per capita health care spending would decrease by $283. Also, the presence of CON laws tends to decrease the potential number of rural health care facilities. More broadly, research indicates that states with CON laws tend to have fewer hospitals and fewer ambulatory surgical centers than they would have if there were no CON laws, according to Mercatus. “CON programs are a remnant of an era in which it was thought that central regulatory planning could yield better [medical] outcomes by restricting the supply of services valued by consumers... The justifications for these programs are compelling when they are taken at face value, but a review of the [research] literature finds that CON regulations fail to achieve their worthy goals,” Dr Mitchell wrote in a recent Mercatus Center analysis on the certificate-of-need issue.
Maintaining Oral Health During A Dental Emergency HARTFORD — The Connecticut State Dental Association (CSDA) offers advise to patients one how to react in a dental emergency. “Although we hope people avoid dental emergencies, we’d rather our patients be prepared if one happens,” said Dr Gary Linker, CSDA president. “In a dental emergency — from a cracked tooth to severe toothache — there are simple actions you can take to address pain and prepare your mouth and teeth as you head to an emergency visit with a dentist.
“Believe it or not, most dentists keep time in their daily schedules open for emergency visits from patients,” said Dr Linker. “If you need to see a dentist in an emergency, give your dental office a call to see if they can see you first. Otherwise, patients should visit the emergency room for immediate attention.” Below are some tips for how to handle a dental emergency, if an accident happens: *For a knocked-out permanent or adult tooth, keep it moist at all times. If you can, try placing
the tooth back in the socket without touching the root. If that is not possible, place it in between your cheek and gums, in milk, or use a tooth preservation product. Then, get to your dentist’s office right away. *For a cracked tooth, immediately rinse the mouth with warm water to clean the area. Put cold compresses on the face to keep any swelling down. *If you bite your tongue or lip, clean the area gently with water and apply a cold compress. *For toothaches, rinse the
mouth with warm water to clean it out. Gently use dental floss to remove any food caught between the teeth. Do not put aspirin on the aching tooth or gum tissues. *For objects stuck in the mouth, try to gently remove with floss but do not try to remove it with sharp or pointed instruments. “There are ways to protect your mouth from injury like wearing protective gear when playing sports, avoid chewing ice, popcorn kernels and hard candy, which can crack a tooth.
Also, use scissors, and never use your teeth when trying to cut something,” said Dr Linker. “Accidents happen and these simple steps can help patients take care of their mouths in the moment.” The Connecticut State Dental Association has approximately 2,300 members. The leader and voice for oral health care in Connecticut, CSDA has advocated for the public’s health and promoted the art and science of dentistry since 1864. For additional information, visit csda.com.
Newtown Physician Named Medical Director For American Family Care Urgent Care
Newtown resident Iftikar Ali, MD, was recently promoted to medical director for American Family Care (AFC) of greater Hartford. In his new position, Dr Ali will serve as medical director of three state-of-the-art AFC urgent care walk-in cen-
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Saint Barnabas Medical Center in Livingston, N.J., and finished his residency in nuclear medicine at Danbury Hospital. He is board certified in two specialties, has appeared in numerous medical publications, and has received several awards. In addition to serving as medical director for greater Hartford, Dr Ali is heavily engaged in the full spectrum of clinical care, including outpatient, procedures, adult inpatient and pediatric care. He is a certified USCIS Civil Surgeon, allowing him to perform full immigration physicals. He is also interested in workforce needs, collaborating with employers on occupational medicine and Workers’ Compensation. Founded by Dr Bruce Irwin with a single location in 1982, American Family Care helped
pioneer the concept of nonemergency room urgent care. With its 2013 acquisition of the Doctors Express, and its subsequent rebranding, AFC has become a leading provider of urgent care, accessible primary care, and occupational medicine, with more than 180 clinics and 600 in-network physicians caring for nearly 3 million patients a year. Ranked by Inc magazine as one of the fastest growing companies in the United States, AFC’s stated mission is to provide the best health care possible, in a kind and caring environment, while respecting the rights of all patients, in an economical manner, at times and locations convenient to the patient. For information about the clinics and their services, visit www.afcurgentcarewesthartford.com or call 860-986-6440.
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Ouch! Providers Proffer Tips To Prevent, Treat Sensitive Teeth By Alissa Silber Have you ever experienced a twinge of cold in your teeth while trying to enjoy a frozen treat — or winced in pain biting into crunchy foods? If so, you may be suffering from teeth sensitivity. The Connecticut State Dental Association said that teeth sensitivity is a common condition that can be caused for many reasons, such as worn tooth enamel. Dentist Dawn Bogdan, DDS, says she often sees patients in her Bethel and Newtown office who have damaged their enamel “from tooth brush abrasions, erosion, and just wear and tear on the teeth.” Enamel is the hard, thermal barrier that coats the outside of a tooth, and is a vital to shielding the sensitive interior layers. Directly underneath the enamel is dentin, a honeycomb-like structure, and below that by the root area is a layer called cementum. When the protective enamel coating on the outside of a tooth is impaired with cracks or is brushed away, it puts the tooth at risk for exposure to the tooth’s inner layers. These layers can also become vulnerable when there is gum erosion. Newtown orthodontist Curtis Beck, DMD, MSD, explained, “The dentin has a lot of little tubules, and our nerves inside the teeth reach out to those tubules. What causes the discomfort is when the cementum gets brushed away sometimes where the tooth meets the gums or it can be a crack. That causes osmolarity — a chemical reac-
like Sensodyne, and other oral care products that are available on the market to help with sensitive teeth. If those particular kinds do not suffice, dentists can give patients prescription toothpaste that has extra fluoride and potassium nitrate. However, Dr Bogdan says, it is important to remain consistent with using a sensitive toothpaste and not switch back to regular types, because doing so may just cause the sensitivity to return. Dr Beck explained that sensitive toothpastes work by deadening the nerve and essentially “put the nerve to sleep” so that patients do not feel the pain anymore.
tion that pulls on those extensions of the cell sitting in the tubules.” Over time the exposure can become worse and have cold or hot temperatures trigger intense pain in the tooth’s nerve. In orthodontics, another form of teeth sensitivity can happen during the process of moving teeth. “When we go to move a tooth, our teeth are held in the bone by a ligament, and we are actually stretching the ligament a little bit,” Dr Beck said. “That increased pressure in the ligament that’s holding the teeth in the mouth can actually stimu-
late the nerves in the periodontal ligament.” Fortunately, this type of discomfort is temporary, and Dr Beck estimates that the pain can typically be felt four to six hours after an adjustment and generally last between 24 to 48 hours. For these particularly sensitive teeth cases, he says, Tylenol is the best remedy for those experiencing any residual pain. Other possible reasons for tooth sensitivity can be a result of teeth whitening treatments, cavities, cracked fillings, grinding teeth, and consuming food with high acidity.
Keep Treatment Consistent To alleviate the pain felt with teeth sensitivity, people should always consult with their dentist to get the best individual treatment for their particular sensitivity first. Also, it is important to understand that once gums have receded, there is no way to bring them back up without doing surgery. Bonding is a beneficial option for extreme cases of tooth sensitivity where a space has been physically worn into the side of a tooth and needs to be filled. Many people opt for the many drugstore brands of toothpaste,
Prevention Is Key To help prevent teeth from developing a sensitivity in the first place, people should begin by evaluating their oral care routine. “You always want to use a soft or extra soft toothbrush,” Dr Bogdan said. She uses a Sonicare electric toothbrush that does the brushing motion for her. As it pulsates, it beeps to indicate when a certain area is done and to let you know to rotate it to the next section. Toothbrushes like those help people refrain from brushing to harshly, which can damage the teeth. Dr Beck does not recommend using tooth sensitive toothpaste as a prevention method, but instead advises looking for toothpaste that the seal from the American Dental Association.
That way people can be assured it is a highly tested product that contains fluoride and is not too abrasive. Thankfully, with access to oral care specialists and products designed specifically to reduce teeth sensitivity, people experiencing tooth pain no longer have to simply grin and bear it and can now smile with ease.
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Bill Proposed To Bolster Veteran Peer Specialist Services WASHINGTON, DC — On September 27, US Senator Richard Blumenthal (D-CT), a member of the Senate Committee on Veterans’ Affairs, and US Senator Roy Blunt (R-MO) introduced bipartisan legislation to expand veterans’ access to peer counseling specialists to better combat the risks of suicide and treat associated mental health conditions. “The Veteran PEER Act would establish peer specialists in patient-aligned care teams within VA medical centers to undertake veteran outreach. The peer to peer relationship among veterans is an effective way to enable more access,” said Sen Blumenthal in a hearing of the Veterans’ Affairs Committee. “Our nation has a responsibility to ensure our veterans have access to quality behavioral and mental health treatment,” said Sen Blunt. “Given
US Senator Richard Blumenthal their shared experiences, peer specialists are uniquely positioned to provide veterans the support they need in their care and recovery. I urge my colleagues to support this bill, and help connect more veterans with peer counselors who
can make a difference in their lives.” The US Department of Veterans Affairs (VA) currently employs peer specialists to assist veterans in treatment for mental health and substance abuse disorders. Peer specialists support fellow veterans and encourage recovery by helping veterans access health services and navigate the VA healthcare system; and teaching coping and positive health-affirming behavior. The VA was instructed by a 2012 Executive Order to hire and train 800 peer counselors by December 31, 2013, to treat the estimated 1.5 million veterans requiring mental health services. The Veteran Partners’ Efforts to Enhance Reintegration Act (Veteran PEER Act) would expand veterans’ access to peer specialist services by specifically targeting shortcomings in
the current program, including peer specialists’ restricted participation in primary care services; persistent stigma attached to seeking treatment for mental health disorders; and underpromoted proven successes of the peer specialist program in veteran reintegration. The Veteran PEER Act would: *Authorize the VA to establish peer specialists in Patient Aligned Care Teams within VA medical centers to promote the
use and integration of mental health and substance use treatment services in the primary care setting. *Implement the program in 50 locations across the nation over two years, with required consideration of rural and underserved areas when selecting program locations. *Require regular reports to Congress with information on the benefits to veterans and their families derived from use of peer specialists.
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Your Child’s Vision! School eye exams are only screenings and do not test for everything. They may test for distance vision in each eye separately, but do not test for near vision (reading) or how the two eyes work together as a unit. According to Prevent Blindness America, vision problems affect one out of every four school-age children. "If a child is struggling in school, it may well be an indication of a vision problem," says Dr. Joseph Young of Village Eye Care. Dr. Young tests for ocular problems that can impact learning and development. He also stresses the importance of proper eye movements, and the ability to read and comprehend. We have worked with many children whose reading and writing skills have greatly improved. Another concern for parents is sports vision. According to Prevent Blindness America, there are 40,000 ocular sports related injuries per year. Dr. Young has many solutions for your "sports child", from contacts to REC SPECS Sports Eyewear. Please visit our web site for more information, and we hope you see that an eye exam is part of "getting your child ready for a great school year!"
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