To Health! To Your Your Health! A SPECIAL SECTION OF THE RECORD-REVIEW
O C TO B E R 7, 2016
Consider medicine-free remedies for your aches and pains By MARY LEGRAND
he problems sometimes encountered by individuals who use opiates for pain relief have been well documented and publicized in recent years. Alternative therapies can provide relief as well, and, in many cases, take the place of or be used alongside conventional treatments. James Silverman, M.S. L.Ac., LMT, of Mount Kisco Acupuncture & Massage, said there is a need to educate people about alternative/complementary therapy and to explain why alternative therapies can be helpful. “Options might not be offered, and the person with pain may not know that there are options prior to accepting or in conjunction with pain medication,” he said. “Alternative/complementary therapies I offer are acupuncture with various oriental modalities, as well as massage therapy that incorporates deep tissue/trigger-point release. Rather than rely on addictive drugs that do not solve the problem, acupuncture and massage therapy can produce lasting effects naturally.” Acupuncture is based on the principal theory of yin/yang and thereby restores harmony and balance within the body, Silverman said. “This in return stimulates our body’s natural healing response via our Qi,” he said. “Our body’s energy is called our Qi and is always looking for internal balance. Qi flows through the body along specific
Worried ab ou t addiction? pathways called meridians and through accessing points along the meridians, acupuncture brings the body back into balance. At Mount Kisco Acupuncture & Massage, I am always looking for the balance in the body and ways to provide sustained relief.” Silverman provided the Nei Jing quotation, “Where there is no flow there is pain; where there is flow there is no pain,” to sum up the idea that the body needs to have obstructions due to inflammation removed. “Inflammation is really the root of most pain and diseases,” he said. “I explain to my patients that if the obstructions in our body are removed, then the inflammation will eventually be resolved and the body will be restored to proper balance.” The main style of acupuncture at MKAM is Acupuncture Physical Medicine, or APM. “I believe the need to explain how a western approach to acupuncture is crucial in helping provide relief since the main belief of acupuncture is viewed as purely energetic as people are now becoming more aware of,” Silverman said. “APM specifically addresses pain in a western model that targets our body’s holding patterns by eliminating trigger points (tender muscle areas) that subsequently reduce local inflammation and holding patterns of Continued on page 5A
HEALTH CONNECT: Wearable medtech devices are here to stay By JENNIFER LEAVITT
one are the days when the only portable health or medical device was a trailing oxygen tank. And the Fitbit? So passé. Today’s iPhone has more memory than NASA’s original super computers did. Yes, big technology comes in little packages. As consumer electronics, fitness devices and medical equipment converge, it is becoming increasingly difficult to distinguish between the three. Smart watches have heart rate monitors and exercise trackers. Soon they will boast EKGs on demand, pulse oximetry, glucose monitors, even diagnostic tools and ultrasound scanners. These devices exist already as stand-alone wearables, but they will become progressively smaller, more portable, more powerful and more integrated with each new version. This goes beyond the cool factor. Wearable health and medical moni-
toring is incredibly valuable. They can track data continuously, providing incredibly accurate insight instead of merely a snapshot in time. The results can be quickly shared with healthcare providers, reducing office visits. Even as some in the medical community raise a skeptical brow, manufacturing companies are moving full speed ahead to better address a wide variety of the most common conditions. Continuous blood pressure and glucose monitoring Most patients have their blood pressure taken once or twice each year, tops, but even those who monitor at home can only hope to get blood pressure readings that represent 16 minutes of the day or so. Wearable, continuous blood pressure provides the most accurate possible reading of an average daily pressure, trumping every other option by leaps and bounds. Continuous glucose monitoring is one of the greatest breakthroughs in diabetes management in four decades.
The device consists of a an electronic receiver worn like a pager and a disposable sensor just under the skin that gets replaced every few days. For years, the only option was the inconvenient and irritating finger stick meter. CGM today measures glucose levels, direction, and rate of change with the push of a button, notifying the wearer when blood sugar dips too low or too high. This round-the-clock monitoring also reveals how blood glucose levels fluctuate with food intake, insulin, exercise and other factors. Such data can help patients choose medication dosages and food portions with far more precision. Monitoring overnight can also provide significant insight into how sleeping time influences the average numbers. Although the technology is still progressing, studies have shown that those with continuous monitors fair better. One device, the G5 Mobile System, even transmits blood sugar data to a smartphone. Continued on page 2A
INSIDE TO YOUR HEALTH!
Clock ticking when it comes to ticks new and old
BEYOND THE SNEEZE: could it be an allergy?
20 weird and wonderful ways to better health
INVISIBLE TRAUMA: concussions not just a sports injury
Page 2A | To Your Health!
The Record-Review | Friday, October 7, 2016
The clock is ticking when it comes to ticks new and old
By MAJA TARATETA
fever. A headache. Nausea. Body aches. Confusion. And often a telltale bull’s-eye rash. “Have you been hiking?” the doctor asks. While summer is prime time for ticks, Westchester County physicians who specialize in treating tick-borne illnesses still see patients who come in with symptoms like those described above into early fall. What patients have often brushed off for several days as flu or general malaise often turns out to be Lyme disease — or one of the other tick-borne illnesses known to occur locally, including ehrlichiosis (now called anaplasmosis) and babesiosis. More often than not, these patients don’t even know they have been bitten by ticks. “Seventy percent of Lyme patients have no recollection of a tick bite,” said Dr. Gary P. Wormser, M.D., chief of infectious diseases at Westchester Medical Center in Valhalla. “But all have a recollection of potential tick exposure,” most often a hike through the woods or other outdoor and off-road adventure, even those in your own front lawn. It is a similar story at Northern Westchester Hospital in Mount Kisco, where Dr. Debra Spicehandler, M.D., co-chief of infectious diseases, says she sees a lot of sicker patients who come in with later stages of undiagnosed Lyme, which usually occurs one to two weeks after a tick comes off or was removed. If not treated in the first week to 10 days, she said, Lyme can lead to hospital visits. “People say, ‘I didn’t have a tick bite’ or ‘I don’t have a rash,’” Spicehandler said. “You don’t always get a rash, and sometimes it’s in a place where you can’t see it,” like the scalp, she said. Wormser has seen patients with Lyme disease symptoms who don’t know they’ve been bitten by ticks — until he finds other ticks on them that are unrelated to their current symptoms, along with a hidden bull’s-eye rash. The challenge in diagnosing often involves “taking a relevant history and getting a bigger picture” of potential expo-
To Your Health!
How to remove a tick
• Use fine-point tweezers. Many tick removal devices are available, but none are better than a plain pair of fine-point tweezers. Grasp the tick at the place of attachment (by the head or mouthparts), as close to the skin as possible. Do not grasp the tick by the body. • Pull the tick firmly and steadily outward. Do not twist the tick. This may cause mouthparts to break off and stay in the skin. If this happens, remove the mouthparts with tweezers. Consult your healthcare provider if infection occurs. • Place the tick in a small vial or container with rubbing alcohol or vegetable oil to kill it. • Clean the bite wound with disinfectant. • Do not put Vaseline petroleum jelly, a hot match, alcohol or any other irritant on the tick before removing it. This can increase the chances of an infected tick transmitting bacteria to you. • Monitor the site of the bite for the next 30 days for the appearance of a rash. Learn about the other early symptoms of Lyme disease and ehrlichiosis. Report any of these signs to your healthcare provider. — From health.westchestergov.com
sures to ticks, said Dr. Waseem Shahid, M.D., an urgent care physician at Apple Medical in Dobbs Ferry, who sees patients on a weekly basis with tick-borne illnesses during the season. Between 2011-13, there were nearly 1,100 confirmed incidents of Lyme disease in Westchester County, according to the New York State Department of Health. The actual numbers, though, are thought to be much higher. In fact, cases of Lyme more than doubled in Westchester County between 2013 and 2014, when 746 cases were reported to the CDC. In 2014, there were 194 cases of Lyme in Westchester according to the New York State Department of Health. The best way to avoid Lyme disease, all three physicians say, is to avoid tick bites. All three adhere to the age-old adage: “An ounce of prevention is worth a pound of cure.” “It’s easiest, but it is hard to do in your practical life,” acknowledged Shahid, who recommends long pants tucked into socks, long-sleeve shirts and treating exposed skin (but not face or hands) with insect repellents containing DEET whenever hiking. But nothing — even covering most of your exposed body parts — will ever be 100 percent effective in preventing tick bites, he said.
The Record-Review P.O. Box 455, Bedford Hills, NY 10507 914-244-0533 www.record-review.com PUBLISHER Deborah G. White SECTION EDITOR Todd Sliss ART DIRECTOR Ann Marie Rezen ADVERTISING DESIGN Katherine Potter ADVERTISING SALES Francesca Lynch Thomas O’Halloran Marilyn Petrosa Barbara Yeaker ©2016 The Record, Llc. All rights reserved. Reproduction in whole or in part is forbidden without publisher’s written permission.
worry if a bit of the tick is left in as long as the body is removed. Strange “old wives tale” methods of tick removal — such as pouring kerosene on them, rubbing them with Vaseline, painting them with nail polish or lighting the tick with a match — are not only not recommended, but they can actually lead to infections or worse. After removing the tick, thoroughly clean the bite area — and your hands — with rubbing alcohol, an iodine scrub or soap and water. Ticks can be disposed of by submersing them in rubbing alcohol, placing them in sealed bags or containers, wrapping them tightly in tape or flushing them down the toilet. Ticks should never be crushed between your fingers. If you would like to know if the tick was actually carrying Lyme or one of the other tick-borne illnesses, you will need to bring it or send it to a lab in a sealed container or plastic zip-style baggie. During the summer months, New York Medical College offers a Lyme Diagnostic Center, where people can bring in ticks they have removed from their bodies for review. Open Mondays, Wednesdays and Thursdays in the evening, staff will review ticks to measure the degree of blood engorgement — a sign of how
long the tick was on the person. They also look at the type of tick and the stage of the tick. For example, a larvae will not transmit most of the tick-borne illnesses. Only nymphs and adult ticks are able to be infected and transmit Lyme, HGA (anaplasmosis) and babesiosis to humans. If it appears the tick is a potential Lyme carrier and was on a person for 36 hours or more, a single 200 mg dose of the antibiotic doxycycline can be administered prophylactically to most adults. “But it is not 100 percent effective,” explained Wormser. “Patients still need to look for fever, rash and other symptoms for 30 days.” Most people in the lower Hudson Valley are familiar with Lyme disease and its prevention, symptoms and cures due to its ubiquitous nature. “In terms of the number of cases, the most common is Lyme disease,” said Wormser. “But the most severe is babesiosis, and it’s flying under the radar as far as the public is concerned.” The number of Lower Hudson Valley residents in whom babesiosis was diagnosed increased 20-fold, from 6 to 119 cases per year from 2001-08. There were 40 reported cases in Westchester in 2010, 21 in 2014, according to the New York State Department of Health.
One big difference with babesiosis? “It is like getting malaria except through a tick transmission,” Wormser said. “It is the leading cause of transfusion-transmitted infection in the United States today.” Symptoms of babesiosis include high fever and anemia — a reduction in platelet counts — but no rash. Cases of anaplasmosis (formerly called ehrlichiosis) have also generally increased nationwide from 350 cases in 2000, when the disease became nationally notifiable, to 1,163 cases in 2009, according to the CDC. The number of reported cases increased 52 percent between 2009-10, with highest incidents in nine states, including New York. In 2002, 74 cases were reported in Westchester County, according to the CDC; eight cases were reported in Westchester in 2014. Symptoms are similar to Lyme disease, minus the rash, which is rare. And now, a relatively new tick-borne illness is being reported: Powassan. Physicians in Westchester say this is an extremely rare tick-borne illness for the area. Only 60 cases of the virus were reported in all of the United States in the past 10 years. There is no known treatment, and the virus is fatal in approximately 10 percent of cases.
HEALTH CONNECT: Wearable medtech devices are here to stay Continued from page 1A
A special section of
Shahid said his best advice to those in Westchester County hoping to avoid ticks is, “Be vigilant.” “I warn people to take precautions,” Spicehandler said. “The most important thing is to know that ticks are there — to be aware of ticks and to protect yourself. The best way not to get Lyme disease is to prevent, to be cautious and to be aware.” She also recommends wearing light-colored clothing in addition to Shahid’s points highlighting the importance of covering up. Wormser further advises that those who may have been exposed to ticks — this means anyone hiking in the woods, working in a yard or playing on a grass field — to shower within two hours and immediately run clothes through a hot dryer cycle. Many who find ticks on themselves or their children often feel confused about to do next — other than panic. If one finds a tick physicians and the CDC agree the most important first step is to remove the tick as quickly as possible. “Removing the tick before 24 hours have passed is very helpful in preventing infections and complications,” Wormser said. Ticks should be pulled out of the skin with tweezers and people should not
Taking diabetes management one step further, the MiniMed 530G System with Enlite Sensor actually takes the place of a pancreas, monitoring glucose levels but also automatically dispensing insulin, on demand. Have a heart An EKG to go? The iRhythm Zio XT Patch is a wearable, constant electrocardiogram that collects cardiac data over a long period of time to detect any abnormal heart activity. This is then transmitted to a clinical app that analyzes results based on algorithms. Another device, the WristOx2, is a pulse oximeter that monitors blood oxygen levels and heart rate in those who have asthma and are at risk for pulmonary disease. Falling and pain An incapacitated owner of a Numera
and BlueLibris device can communicate easily and be located effortlessly. This wearable is mobile and hands-free, using two-way voice communication through a cellular network and automated fall detection algorithms, as well as GPS and location tracking, for emergency response services. To manage the pain after that fall, NeuroMetrix created a wearable called Quell. This device has an accelerometer to gauge a user’s activity level and adjust stimulation intensity accordingly. The device uses Bluetooth technology to connect to a smartphone app, where the device features can be controlled and therapy and sleep can be tracked. Quell has received FDA approval and is sold over the counter. Baby planning The OvulaRing is placed inside the body to work its fertility magic, putting a whole new spin on wearables. Designed
to alert women when they are ovulating and most fertile, this device uses biosensor to monitor core body temperature throughout a woman’s cycle. Epilepsy Electrodermal monitoring with BioStampRC helps people with epilepsy monitor their body’s physiological stress levels during daily activities to help determine what circumstances precede a seizure. The body-worn sensor is so flexible and soft that it naturally conforms to contours. It is also especially discreet, so users can move freely from the doctor to home to gym, during waking and sleeping hours, unaffected by the sensors. Medical style Fashionable biomonitoring sounds like something from a sci-fi flick, but there are already several major players who specialize in biometric garments that measure vitals, both for fitness and medi-
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cal purposes. AiQ manufactures smart jackets and vests that can measure respiration rate, skin moisture and temperature, and even continuous monitoring of electrophysiological signals such as EKG, electroencephalography (EEG), or electromyography (EMG). The SolarMan vest contains solar panels so it can recharge at every opportunity. Even Tommy Hilfiger has a line of solar clothing that can charge wearable devices. The CameraMan jacket includes an HD camera worn over the heart and the ArmorMan has a mini internal airbag of sorts, padding that gets stiff when it senses pressure, to protect its owner from injury. Hexoskin and OMsignal also have a pretty impressive medtech fashion line up. Clothing optional On the opposite end of the spectrum are patches placed directly on the skin, like the Metria Wearable Sensor, a pre-
vention tool which collects data, such as the number of hours slept and breaths per minute, then directly transmits the data to the user’s or caregiver’s device, such as a smartphone. HealthPatch MD is a biosensor developed by Vital Connect that measures and tracks a patient’s heart rate, respiratory rate, skin temperature and body posture. It includes fall detection and can be used in a hospital, at home or at an outpatient facility. The future The self-tracking industry is growing exponentially. As it does, there is grumbling amid the medical community about how to use the data and how not to use it, and whether these devices are collecting the right kind of data. What few do argue about, however, is how exciting this technology is for the future of medicine.
Friday, October 7, 2016 | The Record-Review
To Your Health! | Page 3A
BEYOND THE SNEEZE: could it really be an allergy?
By JENNIFER LEAVITT
hen we hear about allergies, most of us picture sneezing, red, watery eyes, maybe an itchy palate or hives. Incidents of anaphylactic shock may even come to mind. But allergic reactions can manifest in a number of lesser-known ways, too, including arthritic-like symptoms, fatigue, bronchitis, asthma, depression, muscle weakness, insomnia, swollen tongue or hair loss. They can also transition from acute and emergent to chronic and lingering. Easy to miss Even seasoned healthcare providers can miss an allergic connection when a symptom is atypical or mimics something else entirely. In fact, only in very recent years have a growing number of allergists begun to agree that symptoms can be far more diverse and systemic than previously believed. The eyes, ears, nose, mouth and skin often represent both easy entry and site of first contact. Symptoms in those places appear faster and are more visible. They also distract us by interfering with our senses. Symptoms in other areas can be more elusive, but only in terms of cause and effect. Although there are well known common allergens (peanuts, wheat, soy, latex, mold and others), any food or substance can cause problems for someone out there. Scientists are still trying to discover why allergic reactions manifest so differently in each individual, and not at all in some people. The factors are almost certainly a combination of genetics, as well as internal (hormonal, disease state, pH balance, microbiome) and external (air quality, pets) environments. Despite the differences, an allergy is always the result of an overzealous immune response. Designed to fight harmful viruses, parasites and bacteria, the immune system isn’t supposed to attack the food you eat, the substances you smell or the things you touch. That is indeed what is happening when a trigger leads to an autoimmune reaction. As that reaction begins, the body produces antibodies, which lead to inflammation and sometimes excess mucus. When you eat, drink or touch a substance, it eventually gets absorbed into your bloodstream and all your tissues. Once this happens, you may experience symptoms in your eyeball or your liver. An allergic reaction can occur just about anywhere, from head to toe.
Arthritis and fatigue Research shows that allergens can lead to inflammation and arthritis, including rheumatoid or juvenile varieties and undefined joint pains, yet very few people think “allergy” when they wake up with a crimp in their backs. One clinical study found that some five percent of rheumatoid arthritis patients experience their symptoms in direct correlation with certain foods. General lack of energy can affect everyone from time to time, but for some, fatigue becomes both chronic and debilitating. Allergies may play a role in the diagnosis of chronic fatigue syndrome. Although no specific cause of CFS has been officially named, analysis of patient records indicate that those who do have CFS are often highly sensitive to allergens. Reduction in contact with a specific trigger can dramatically reduce malaise. Asthma and bronchitis Allergic asthma looks and feels like general asthma, but it is caused by extra sensitivity to allergens in the airways. Once in the body, the immune system goes into overdrive. The airways experience inflammation and mucus accumulates. Breathing becomes difficult and even painful. Allergic bronchitis is similar, specifically affecting the lining of the airways. Sinus pain and migraines A reported 15 percent of allergic Americans say that they get headaches from exposure to allergens. Most doctors agree that sinus flare ups are often linked, but a consensus on migraines is still up for debate.
In sinus headaches, an allergen enters the nasal passages and creates swelling that prevents drainage. The blockage creates pressure in the skull and a headache follows. Pain can also manifest in jaw, cheeks, forehead and behind the eyes. The migraine theory assumes that immune system cells release chemicals that cause swelling of blood vessels. Yeast infections Mold and yeast allergies are fairly common. One theory holds that as Candida albicans begin to reproduce, it evolves into a more threatening fungal form that takes hold in the intestinal tract and spews toxins and irritants into the bloodstream. While there is some controversy over various forms of Candida, vaginitis is a well known and undisputed condition that roughly 75 percent of all women will experience at some point. There are physicians who suspect sugars and yeasty foods like bread, while probiotics can fight yeast. Depression, anxiety Scientists now know that allergens can cause changes in mood, including bouts of sadness, irritability and anxiety. In others allergic reactions simply exacerbate mild depression. Recent research shows that altered moods are not caused from suffering allergy symptoms; there is a distinct biochemical process that indicates cause and effect, possibly related to inflammation. Hair loss and more For an unlucky few, allergies to both food and hair products manifest on the scalp, causing follicle damage and hair loss. Others suffer vague muscle weak-
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ness, and still others complain of brain fog or insomnia. If there’s a symptom the body can have, it can probably be triggered by an allergy in someone. Allergen sleuthing Because an allergic reaction can show up several hours or even days after contact with an allergen, it can be difficult to make the connection without careful scrutiny. Imagine how difficult this can become when the allergy is something as common as a dairy allergy, triggered by milk, yogurt, cheese, butter or even casein or whey that have been added to baked goods. A missed diagnosis can delay treatment, of course, and strain an immune system that is already maxed out. Mounting evidence suggests that conditions once thought chronic and incurable may actually go into remission once specific triggers are removed, making it incredibly likely that they qualify as actual allergies. To nail down the specific allergen, blood tests are more reliable than skin tests, but the best method of all may be your own careful sleuthing. When mystery symptoms strike, it may be incredibly worthwhile to make dietary or environmental changes using the elimination method, in which you remove all potential food and environmental triggers, then add one back at a time to determine which one is causing problems. Today’s medical providers are starting to embrace this notion: if a disease cannot explain chronic symptoms, you may just have a persistent allergy.
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Page 4A | To Your Health!
The Record-Review | Friday, October 7, 2016
20 weird and wonderful ways to better health and longevity
Human beings were not meant to compress and put weight on our organs for lengthy periods of time. For optimal health, work standing up, or at least get up once every hour to stretch or take a brief walk.
By JENNIFER LEAVITT
rom experiencing moments of awe to sniffing apples and wearing high heels, science has a few lesser known tips on how to keep us healthier, happier and living longer. Today more than ever, health headlines compete for our attention as they tout the latest findings on how to extend our stay on Earth and feel our best while we are here. For the most part, the focus is on eating right and working out, but science also has a few lesser known and slightly weirder lessons on how to keep us healthier, happier and living well. Make time for the awesome Taking in a breathtaking view of Yosemite’s valleys, standing in front of a stunning Monet or hearing about a random act of kindness could all reduce the risk of disease, say researchers at UC Berkley. Such moments of awe are correlated with lower levels of pro-inflammatory cytokines, which, in abundance, can contribute to diabetes, coronary artery disease, arthritis, Alzheimer’s and other ails. Draw for brain health Drawing instead of writing or typing can keep your brain sharp. Researchers at Canada’s University of Waterloo report significantly better recall when people draw objects. According to Scientific American, if you do need to use your words, writing them down with a pen or pencil is far more effective for memorization than typing is. Sorry, device lovers, sometimes the old fashioned way still trumps new fangled technology.
Make out more often Kissing a romantic partner raises respiration and pulse rates, as well as dopamine and oxytocin in the body. It reduces blood pressure, cortisol and as one Indian study found, histamine levels. All of these factors can reduce stress, condition the cardiovascular system and bolster immunity, but there’s one more benefit to kissing as well: we get to swap germs! This is not ideal when one partner has mono or a cold sore, obviously, but the majority of the time, sharing our microbes with others, say Dutch biologists, means increasing our population of the probiotic good guys so we are better equipped to fight off the bad. Get dirty Speaking of germs, a little dirt can go a long way towards making us healthier. Helpful bacteria boost our immune systems, but a study from England’s Bristol University also discovered that bacteria called mycobacterium vaccae, found in soil, reduce depression and accelerate
learning by triggering the same serotonin-releasing neurons that Prozac and other antidepressants do. Wear high heels After years of lectures about the crippling effects of wearing stilettos, Warwick University researchers have found that wearing high heels may actually ward off arthritis of the knee. Walking or dancing in heels also provides a dang good calf workout.
and heal faster, as well as helping to improve focus and mood. Some of the most beneficial plants for us to share our space with include aloe vera, Warneck dracaena, spider plants, gerbera daisies, snake plants, golden pothos, red-edged dracaena, weeping fig, English ivy, bamboo palm, Heart leaf philodendron, Chinese evergreen and peace lily.
Stop to smell the apples A study in Headache Quarterly reports that migraine sufferers felt significantly better when they sniffed green apples. Meanwhile, British researchers discovered that sniffing green apples or green bananas can curb our appetites. Learn to love hunger When we do get hungry though, we should stop and embrace the feeling rather than making a mad dash to stomp it out. Multiple studies have shown that restricting caloric intake increases longevity by an average of four percent. Being slimmer is an added bonus. For those who can’t bear to skimp every single day, intermittent fasting apparently does wonders for the body, including a boost in immunity and accelerated weight loss.
Develop a green thumb According to NASA research, houseplants clean and purify the air we breathe, actually removing harmful pollutants. They provide humidity to clear the sinuses, help people avoid illness
Get a mattress and a mask For the short and long snoozes alike, memory foam mattresses, breathable natural fabrics and complete darkness all improve sleep quality. In one 22-year study of twins, those who reported deeper sleep and who slept no less than seven hours per night and no more than eight, lived the longest. Let’s just breathe Breathe. It may sound like a no-brainer, but clinical studies confirm that many people don’t breathe properly and can suffer health consequences because of it. Breathing correctly is critical for good health, and, believe it or not, it may take practice. Each breath should reach the bottom of your lungs. Try to practice six seconds of breathing, counting to three on inhale and three on exhale. In case studies, people report significantly more energy, better concentration and enhanced mood when they learn to breath more slowly and deeply, then make a conscious effort to keep it up. Take a caffeinated snooze In a Japanese study that explored how to make the most of a nap, researchers
learned that consuming about 200 milligrams of caffeine (typically found in two cups of coffee) and then taking an immediate 20-minute nap, provided the biggest boost in energy and alertness compared with a nap or stimulants alone. Don’t brush Scientists were surprised to discover that brushing too soon after a meal can actually damage your teeth. Why? The brush can grind acid from food and drink further into your enamel and soften it. Waiting 30-60 minutes gives saliva a chance to restore pH balance first Do brush Most of us brush our hair to improve our looks, but using a brush on our skin may improve our health. Skin is the largest organ in the body, managing onefourth of the body’s daily detoxification. According to Cleveland Clinic, dry brushing stimulates the lymph, circulatory and nervous systems.
Walk, don’t run Running or jogging have long been favorite forms of exercise and many people assume that the greater the speed the better the workout. Not so, says the American Heart Association, which confirms that walking produces better physiological effects and is linked with a longer lifespan. The magic number is 10,000 steps per day. Fewer daily steps were linked to poorer health outcomes, but walking more than 10,000 steps each day did not improve outcomes (though it’s still good for you). Eat black pepper Black pepper is chock full of antioxidants, antimicrobial and gastro-protective properties. The key alkaloid components of piperine boost cognitive and gastrointestinal function, but they also help us better absorb the nutrients of everything else we eat in the same meal. Some supplement makers now add piperine to their products in order to make them that much more effective. Get chilly Sitting in cooler temperatures now and then can be a good thing. Exposure to the cold can increase the body’s stores of brown fat. Unlike white fat, brown fat is actually beneficial to health, keeping the body warm, improving insulin sensitivity and speeding up metabolism.
Improve your posture Good posture not only make you look better, it also makes you healthier by improving your breathing, reducing the risk of neck and back pain and increasing circulation. To get better posture, sit up with your back straight against a chair and try swapping out the chair for a balance ball now and then. Pay attention when standing as well, keeping shoulders high and aligned. Use your neti pot Don’t reserve the neti pot for stuffy nose days alone. This age-old sinus-rinsing practice flushes mucus and pollutants from the nasal passages. Scientific data has linked the practice with fewer colds, reduced allergy symptoms and improved air flow. There is also anecdotal evidence that using the neti pot can decrease the frequency and intensity of headaches and migraines. Get up, stand up A number of studies have found that even a marathon runner suffers health consequences from sitting for too long.
Laugh a lot Taking in a comedy or reading the Sunday comics are some of the healthiest things you can do, assuming they make you laugh. Numerous studies reveal that laughter reduces dangerous stress hormones and pain as it strengthens the immune system. Getting healthy doesn’t always have to be a chore. It can be a whole lot more fun and relaxing than we imagined it would be.
Technology simplifying relief of chronic pain sufferers Doctors hate seeing patients suffering from chronic pain, and not just because their instinct is immediately to want to help their patients to feel better. One of the primary challenges doctors confront is that even though chronic pain is common, it can be extremely difficult to diagnose and treat. The condition can be debilitating for patients and frustrating for the doctors trying to help them. “Chronic pain is a multi-faceted condition,” said Dr. Ahmed Raslan, assistant professor of Neurological Surgery at Oregon Health and Sciences University in Portland. “The causes are varied and each person experiences chronic pain differently. The sheer number of variables in play can make effective treatment extremely complex. It’s not unusual for doctors and patients to try multiple types and combinations of treatment before finding something that provides at least partial relief, and that process can take months and even years.” More than 11 percent of American adults suffer from chronic pain, according to a recent National Institutes of Health study. People who live with chronic pain report numerous negative effects on their lives, including damage to personal relationships, decreased productivity at work, disruption of their daily routine and even depression. The Institute of Medicine has estimated the medical costs and lost productivity associated with chronic pain could cost as much as $635 billion per year. “Many chronic pain patients face barriers to effective treatment, including the need for continual doctor visits to adjust aspects of their treatment, and difficulty traveling to meet with their physicians,” Dr. Raslan said. “Conditions such as intractable back pain, nerve injury, neck pain, pain after hernia operations, spinal cord injury pain, post herpetic neuralgia, complex regional pain syndrome and pain after failed back surgery can force patients to try multiple treatments. Once they’ve tried a number of options and still have not achieved the desired comfort they may become a candidate for spinal cord stimulation therapy.” Spinal cord stimulation (SCS) therapy treats chronic pain by interrupting pain signals before they reach the brain. According to Raslan, the therapy works by “flooding the gates of the spinal cord so it cannot allow unpleasant pain signals to pass through the gates. Depending on how fast and regular the therapy is being delivered, patients may feel a slight tingling sensation in the area of the body associated with their pain, and in most cases patients report that sensation replaces the feeling of pain, which corresponds to pain relief.” Though SCS has been around for years, recent advances from St. Jude Medical have made the proven effective treatment simpler for patients and doctors to use successfully. St. Jude Medical recently launched the Proclaim Elite SCS System, which is the most advanced SCS system the company has ever developed, and which includes a new, innovative platform that enables patients to adjust therapy
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Friday, October 7, 2016 | The Record-Review
To Your Health! | Page 5A
INVISIBLE TRAUMA: concussions not just a sports injury
By TODD SLISS
r. Bennet Omalu, journalist Alan Schwarz and ex-professional athlete Chris Nowinski, among others, have made “concussion” a household word. In their context, the word refers to sports, most notably the hard-hitting world of professional football. That doesn’t mean concussions are in any way limited to football or even sports — there are everyday ways to suffer from a concussion, which is a mild traumatic brain injury (TBI) that occurs when the brain hits against the skull due to some sort of force. “It’s an injury that’s invisible,” Chari Hirshson, Ph.D., said. “It’s not like a broken leg. You can see a bone sticking out of your leg. Here there’s no blood. There’s no bruise. There’s nothing.” Hirshson studied TBI and is a neuropsychologist at Northern Westchester Hospital, which, like many other medical groups, is putting together a concussion response department, “creating a system where the symptoms of concussion are managed by a multidisciplinary team,” she said. “If you’re experiencing something that’s persisting and won’t go away, the best place to go is to be seen by someone who specializes in concussion or brain injury,” Hirshson said. “They can provide the recommendations and accommodations.” Once the concussion occurs, whether it happen in a car accident or a fall in the tub, there’s no difference between that concussion and one sustained during an athletic event, whether competitive or not (playing hockey or riding a bike). There are two keys that now come into play: 1) making sure you rest physically and cognitively and 2) doing your best not to get another concussion, especially while still feeling the effects of the first one. According to the Westchester County Task Force on Concussions: 1) “Most concussions do not involve a loss of consciousness.” 2) “More than 80 percent of concussions resolve very successfully if managed well within the first three weeks of post-injury.” The task force’s warning signs list includes: • Appearing dazed or confused • Moves clumsily • Answers questions slowly • Can’t recall what happened before/ during/after injury • Headache or pressure in the head
Northern Westchester Hospital’s Concussion Rehab Program Our Concussion Rehabilitation Program at Chappaqua Crossing takes a multidisciplinary approach to effectively treat adolescents and adults who have sustained concussions. We help patients reach their individual goals safely, whether it’s to return to normal, daily function, return to school or work, or return to sports. Your multidisciplinary team Our experienced team of physical therapists, occupational therapists and speech therapists treat patients at all stages of concussion: from immediately after injury through to baseline function. Based on a comprehensive evaluation, we create individualized concussion treatment plans. Your team of concussion rehabilitation specialists will collaborate with your other medical professionals, such as your primary care physician and neurologist. Physical therapy Our physical therapists prescribe a comprehensive program that may entail oculomotor exercises, habituation exercises, balance exercises and prepare you to return to life, work and sport. You may benefit from concussion rehabilitation with a physical therapist if you are experiencing any of the following post concussion:
• Headaches • Dizziness • Imbalance • Light or sound sensitivity • Car sickness • Head, neck, or back pain • Inability to return to work, school, sports. Speech therapy Our speech therapists work with patients on cognitive-communication impairments. You may benefit from concussion rehabilitation with a speech therapist if you are experiencing any of the following post concussion: • Attention and concentration problems • Problems processing and understanding information • Language and communication problems • Problems learning and remembering new information • Planning and organization problems • Problems with reasoning, problem-solving and judgment • Inappropriate, embarrassing or impulsive behavior • Inability to return to work or school. Occupational therapy Our occupational therapists address
cognitive deficits related to visual-spatial tasks and activities of daily living. You may benefit from concussion rehabilitation with an occupational therapist if you are experiencing any of the following post concussion: • Decreased confidence in your daily life • Difficulty returning to daily activities including work, school or leisure activities • Decreased awareness of your environment • Trouble with fine or gross motor coordination • Difficulty sleeping. Return to Sports The NWH Concussion Rehabilitation Program helps reduce post-concussion symptoms. We help both the casual and competitive athlete return to play safely. • We give our athlete patients a post concussion exercise program that helps them return to all other activities of daily living. • We customizes a training program and concussion therapy that is sport-specific. — From nwhrehab.org
Continued on page 6A
Medicine-free Continued from page 1A
pain in our body. Rather than relying on opiates for pain relief, APM addresses the underlying causes to eliminate pain and inflammation.” Speaking about massage therapy as another option, Silverman said there is still a need to explain why this alternative therapy can provide relief. “Many people still view massage therapy as purely for relaxation,” he said “That is one of the main factors associated with massage, obviously. At Mount Kisco Acupuncture & Massage, I do focus on the stressrelieving properties, as well as medical massage, which is more focused to help break up adhesions and eliminate trigger points in our muscles to promote pain relief. I explain to the person that the functional outcome is to be taken into concern and that this will help with their pain. Medical massage therapy is a great in conjunction with someone’s doctor treatment or as an initial course of action to be assessed after a few visits.” Christian DeStefano, licensed acupuncturist and owner of Scarsdale Health & Wellness, said acupuncture is based on the insertion of needles into the body’s meridians to cause change in the body. “If you have back pain it’s what’s called a referred pain pattern — where the pain is and where the problem is are in two different places,” he said. “Having evolved over thousands of years, acupuncture is one of the oldest continually practiced medical modalities in the world,” DeStefano notes on his practice website. “A treatment involves the insertion and manipulation of flexible, hair-thin needles at specific points along the body’s meridian pathways, which are channels through which the body’s energy is thought to flow. Acupuncture is a safe, effective, chemicalfree way to promote the body’s remarkable self-healing abilities. It is used to prevent and treat disease, relieve pain, balance mood, enhance athletic performance, increase fertility, and improve overall health and wellness.” DeStefano said his main treatment principle is based on “going after what is causing the pain rather than treating where the pain is. A lot of times the tools that a doctor has are somewhat limited — a patient might have physical therapy before steroidal shots and heading into surgical intervention. There’s a lot of ground in between that’s not being addressed by the medical system to utilize the body’s innate healing systems.”
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Listening to patients, watching them move, then asking when and why the pain appears are primary components to eliminating pain and its triggers, DeStefano said. “People can arrive here at their wit’s end,” he said. “The acute issues tend to resolve relatively quickly, while chronic issues tend to take a longer period of time to resolve, because patterns have become so entrenched in the body. As what is often a last resort for patients, I try to solve the patient’s problem. The expectation is to fix it.” Silverman said pain is the main reason people visit his office. Additional issues include anxiety and stress, gastrointestinal problems, headaches, IVF support and adverse reactions to radiotherapy and/or chemotherapy. “I see first-hand how well these issues are alleviated with acupuncture and massage therapy,” he said. “I often get asked how quickly one should see results, especially when it concerns their pain, since we as a western society are so used to having immediate results with prescription medication, and I will reply that of course there is an accumulative healing process — but after every session they should feel like something beneficial has taken place to alleviate their chief complaint. “Prescription painkillers/opiates do not always completely help every pain someone has. So to educate someone and to explain why alternative therapies can provide relief is still of much importance. By utilizing the combining of acupuncture and massage therapy for pain, for some patients, the medicine that is being taken can sometimes provide better results.” Opiates may be a “quick fix,” Silverman said, “yet acupuncture and massage therapy have long-term benefits as well, with no negative side effects as compared to addictive opiates. Pain medication needs to be limited as the first thought for a person to relieve their discomfort. I utilize acupuncture and other oriental medicine modalities alongside massage therapy to relive my patients’ discomfort. That is why I believe it really is needed to explain why alternative therapies can provide relief. “Even though we are all accustomed to hearing the term alternative/complementary medicine, the reality is that it is very confusing to decipher when so many modalities are out there and new ones being discovered. Acupuncture and massage therapy have been around for 2,500 and 5,000 years, respectively. And we are still asking what they are and can they provide relief?”
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The annual election period for MVP Health Care Medicare Advantage health plans is Oct. 15–Dec. 7, 2016. MVP Health Plan, Inc. is an HMO-POS/PPO/MSA organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Y0051_3110 Accepted 09/2016
Page 6A | To Your Health!
The Record-Review | Friday, October 7, 2016
REGULAR MAINTENANCE: A 4-point plan for joint health
hether it’s a brand-new Bentley or a classic 1970 Mustang, most people have a car they dream about. If they’re lucky enough to own it someday, you better believe they’re going to take care of it. Regular maintenance is an essential part of keeping a vehicle in tiptop shape. The same is true of the human body, particularly the joints. “Prevention is the only thing that actually prolongs the health of your joints, similar to the care of a machine,” said Matt Johnson, health and performance expert and president of On Target Living. “If you want something to last as long as possible, and to cost as little as possible over the long run, you have to do maintenance, checkups, and change the oil. Taking care of your body is no different. If you do, your joints can last until you’re 80, 90 or even 100 without tendon or ligament issues.” Johnson notes that joint issues are some of the most common concerns he sees in his practice. These issues can happen at any age, although many start to manifest between the ages of 40 and 50 after years of wear and tear cause pain and inflammation. Johnson’s mantra: “If you take care of the body it will take care of you.” To help people of any age maintain joint health, he provides this four-point joint maintenance plan. 1) Rest: The first part of healing the joints is to rest the joints. Massage, meditation, light yoga, stretching and cool baths are great ways to rest the joints.
Additionally, quality sleep each night is essential. (Quick tip: take an Epsom salt bath once a week.) 2) Healing Nutrients: Studies show that omega-3 fats can help support joint health by limiting inflammation after exercise and boosting hormones that help the body heal. Take a daily, high-quality omega-3 supplement like Nordic Naturals that has been third-party tested for purity, and is known for its non-fishy taste.
3) Superfoods: Superfood herbs and spices help the body get maximum nutrients in minimal amounts. For example, curcumin and bromelain are both great for helping joint pain and repair. Remember, limited processing of the product is ideal for optimal absorption. 4) Exercise and body alignment: You can’t have optimal joint function if the body is out of alignment. There are five key joint checkpoints: ankle, knee, hip, shoulder and neck. This is where you
start to achieve perfect posture, after which you can focus on strengthening the large muscles. “The best age is always now,” Johnson said. “Start as soon as possible and think about it like you take care of a car or nice jewelry. Joints are meant to last as long as you live. The key is to take care of them with quality nutrition, normal exercise and adequate rest.” — BPT
NEWS NOTES Not your grandmother’s nursing home “Welcome to Our Home” reads the sign at the front door. Ring the doorbell and a resident will wave you in. This is not your grandmother’s nursing home. The “Small Houses” at The New Jewish Home, Sarah Neuman, have brought a new era in elder care to Westchester County in Mamaroneck. These self-contained skilled-nursing residences reflect the groundbreaking Green House® vision of long-term care, a highly personalized model in which 12-13 residents share their lives within a “real home” setting. Green House homes have nothing to do with plants, but everything to do with nurturing. Rather than being seen as collections of physical problems to be managed, residents are viewed as human beings who deserve to be treated with respect and dignity and to experience joy and fulfillment. In Small Houses, the impersonal feel of traditional nursing homes is replaced by the intimacy of a true family household. Everyone has a comfortable bedroom and bathroom and shares a living room, dining room and large, open kitchen. Every space is beautifully designed just as it would be in a private house. Caregivers build a rapport with the elders, which ensures that residents’ physical and emotional needs are always met. Decisions don’t come “from the top,” but from within the tightly woven fabric of the household. Residents make decisions together with their caregivers, helping to direct both their care and their lives. This approach is nothing less than revolutionary compared to that of even the best nursing homes, where the institution manages the schedule and caregivers have fixed responsibilities. The Small House difference is what convinced Norma Coppoletti, 98, a former dressmaker from Rye, to move in. She had come to Sarah Neuman for rehab, but was transferred to the facility’s traditional nursing home when it became clear she needed round-the-clock care. Her “care was wonderful,” said daughter Lee Capasso, “but the residents around her weren’t as mentally alert or physically capable as she was.” When a Small House room became available, Capasso grabbed it for her mom, saying that it has “added years to her life.” Though Coppoletti was a life-long painter, she hadn’t lifted a brush since moving into the nursing home. But since becoming a Small House resident, she has created 67 pieces of art. Resident Marilyn Weiss, 88, a former jewelry trade association administrator from Bergen County, N.J., can attest to the Small House advantages. “This is our home,” she said. “We have programs, activities, games, ceramics and painting. Or we can watch a movie in the lovely den. I can do what I want. I can do nothing if I want, too.”
cal Group focuses on providing care for the entire family and with access to primary dical specialties, we offer everything your family needs.
mmunology Nutrition Hematology & Oncology ology Obstetrics & Gynecology Infectious Disease atology Pediatrics Internal Medicine inology Podiatry MindBody Medicine nterology Pulmonology & Critical Care Nephrology atrics Rheumatology Neurology e Medicine Wound Care Scarsdale Medical Group focuses on providing care for the entire family and with access to primary
The first of what are now three Sarah Neuman Small Houses opened its doors in 2014. By next summer there will be five Small Houses and, by the following summer, seven. To learn more visit www.SarahNeuman.org or to schedule a tour of the Small Houses contact admissions director Melanie VanDorn at 864-5807.
Apogee Women’s Fitness offers aerial yoga Apogee Women’s Fitness in Bedford Hills will begin offering aerial yoga classes. Integrating asana, Pilates and acrobatics with the support of a silk hammock, aerial yoga fits the needs of every client. Depending on the class, hammock heights range from barely off the ground to chest height. The hammocks support moves like downward facing dog, lunges and wheel while assisting students with new poses in the air. Instructors will teach members and nonmembers their restorative yoga Asana mix, where students will learn how to improve strength, flexibility, and posture. Assisted by silk hammocks, fluid movements build lean, elongated muscles. Instructor Roseanne Carlo began her career at age 14 in a variety of different dance practices, later becoming a choreographer and earning an associate degrees in musical theatre, dance, and voice. After discovering her love of aerial arts, it was only natural for her to begin teaching. Caryna Wong uses yoga for health and healing by combining vinyasa, hatha, aerial and restorative methods. She has used yoga for pain management, reducing her scoliosis curves, injuries and overall strengthening to maintain good posture and coordination. She has studied with Dr. Loren Fishman and Alison West and teaches Dr. Fishman’s methods that include Yoga for Osteoporosis, Yoga for Arthritis, Yoga for Back Care & Scoliosis and his Rotator Cuff “Cure.” From the front desk to the spin studio to all the way up in the aerial hammocks, you can find Heather Rack at the studio day or night. She is always seeking out new and exciting ways to stay smiling and fit. Rack happily shares her personal experience of once living an unhealthy lifestyle, then turning her life around after joining the Apogee team 3 years ago. For an aerial class on Apogee, contact Kathy Margiasso at 244-1606 or Kmargiasso@apogeewellness.com. Classes are Monday at 1 p.m. with Rack, Wednesday at 6:30 p.m. with Wong and Thursday at 10:30 a.m. with Carlo. Apogee Women’s Fitness is a fully integrated health and wellness center. With a focus on inspiring healthy living at its core, the goal is to provide healthy living through integrative offerings of movement, wellness and mind-body practices. Apogee is your source for achieving optimum physical and mental well-being.
care and 20 medical specialties, we offer everything your family needs.
Allergy Nutrition Allergy & & Immunology Immunology Nutrition Hematology Hematology & & Oncology Oncology ssionate, comprehensive care has never been more convenient. We have Concussions Cardiology Obstetrics Cardiology Obstetrics & & Gynecology Gynecology Infectious Infectious Disease Disease Dermatology Pediatrics Dermatology Pediatricsradiology services Medicine Internal Medicine hours for adult patients as well as Internal an inhouse, stateoftheart • Nausea or vomiting Endocrinology Podiatry Endocrinology Podiatry MindBody MindBody Medicine Medicine • Balance problems • Double or blurry vision Gastroenterology Pulmonology Gastroenterology Pulmonology & & Critical Critical Care Care ratory. Nephrology Nephrology • Sensitivity to light Continued from page 5A
Geriatrics Geriatrics Headache Headache Medicine Medicine
Rheumatology Rheumatology Wound Wound Care Care
• Feeling sluggish, hazy, foggy or confused • Feeling down. If any of these symptoms persist, worsen or intensify, it could be something worse, like a blood clot. “I think it’s important to see how the symptoms persist,” Hirshson said. “Obviously if they get worse immediately you should go to an emergency room to make sure there is no bleeding. We’re talking more mild TBI with a concussion and you do want to make sure you’re not dealing with something that’s more severe. “If there is anything completely life-altering like loss of speech, loss of balance, those are immediate things. If there is ever a loss of consciousness you should go in to see somebody right away. If somebody knocks their head on a cabinet and they’re a little dazed and confused and had a headache all night and the next day if they still have a headache then go see a professional.” Returning to work can be difficult for some. “Being at a job 9 to 5 and being at a computer, you start with a couple of half days and every 20 minutes get up and take a walk around,” Hirshson said. “There are accommodations one can put in place after they’ve seen a professional.” The good news is that since Omalu’s
Accepting new patients. Walkin hours and same day Getting compassionate, comprehensive care has never been more convenient. We have appointments available. extended office hours for adult patients as well as an inhouse, stateoftheart radiology services and onsite laboratory.
For an appointment or to find a physician, visit us at: www.scarsdalemedical.com For an appointment or
Accepting new patients. Walkin hours and same day appointments available.
to find a physician, visit us at: www.scarsdalemedical.com or call us at 914.723.8100 or call us at 914.723.8100
2002 discovery of chronic traumatic encephalopathy — the deterioration of the brain caused by repeated concussive and subconcussive blows to the head — there has been a lot of research and progress on dealing with concussions. While there is no prevention and no cure, there is help to be had as medical professionals are arming themselves with the most up-to-date information in order to best serve patients. “We’ve been researching traumatic brain injury and concussion management for many, many years,” Hirshson said. “For the public to have a better sense of a what the real risks of having a concussion are, I think recent sports stuff, the movie ‘Concussion,’ it’s raising people’s awareness. I think people are taking concussions a little more seriously, especially with the schools and the CDC. Everyone is coming up with their own return to play guidelines. There’s a reason for that. Guidelines have to be in place. Ten or 15 years ago you would just go back to playing what you were playing. We know a lot more now.” Education has been key and it’s working with coaches, athletes, trainers and schools. There’s no reason others shouldn’t be aware of the dangers of concussions. “The best thing to take home about it is we’re learning more every day,” Hirshson said. “Concussions should be taken seriously. Cognitive and physical rest is recommended and is the best bet. “The worst thing to happen is to have someone who is suffering and winds up suffering for a long period of time because their symptoms were mishandled or ignored when they first started.”