HealthWorks: Summer 2019

HealthW ks SUM ME R 2019

STROKE: KNOW THE WARNING SIGNS PROTECT YOUR KIDNEYS HEALING CHRONIC WOUNDS

KEEPING

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e Nyack Hospital Updates

FROM THE PRESIDENT

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ith spring winding down and summer in reach, we look forward to seeing accelerated progress on the Hospital’s Transformation Project. The second floor of the building has been framed and the roof and walls are in place, further signaling the tremendous progress being made. The newly constructed portion of the Emergency Department (ED) should open in October of this year, at which time we will transfer our existing ED operations into the new space. At that point, we will begin renovation of the existing space, all to be joined into one new Emergency Department by the third quarter of 2020.

In April, we celebrated the opening of our new Transitional Care Unit, welcoming patients who require additional care to transition from the hospital to a safe return home or skilled nursing facility. The Hospital also received a grant to establish a Cardiac Rehabilitation Center in partnership with Burke Rehabilitation Hospital. Located at the Hospital, the Center will offer a comprehensive exercise area complete with gym equipment, locker room, nurses’ station, medical exam rooms and a dedicated entrance. Construction on this project is scheduled to begin later this year.

Our Community Paramedicine program’s Innovation grant was renewed by the Montefiore Hudson Valley Collaborative. The program is a partnership with Rockland Paramedics designed to reduce avoidable visits to the Emergency Department by providing appropriate support at home. The success of the program has been evidenced by a 20 percent reduction in ED revisits and a 40 percent reduction in new user ED repeat visits.

Finally, Montefiore Nyack Hospital was recognized in May with a Pinnacle Award from the Rockland Business Association for outstanding achievement by a non-profit organization. This award was bestowed because of the dedication and level of excellence in care provided by the entire Montefiore Nyack Hospital team.

Be safe, stay healthy and enjoy the summer.

Best regards,

SAME-DAY APPOINTMENTS AVAILABLE WITH PRIMARY CARE PHYSICIANS. Access care when you need us and where you need us. Highland Medical, P.C., the trusted network of physicians and specialists who have been providing care to our community for years, helps you and your family stay healthy.

CALL 1-866-550-HMPC. FOR A COMPLETE LISTING OF PROFESSIONALS AND SPECIALTIES, VISIT

HIGHLANDMEDICALPC.COM.

LISTEN FOR BETTER HEALTH We’re pleased to offer two new podcast series: “Health Talk” features medical advice and health news from Montefiore Nyack Hospital’s physicians, and “Sound Advice” features timely health and wellness-related topics from Highland Medical’s healthcare providers.

Both podcasts are available free of charge.

Subscribe on iTunes, Google Play and other satellite radio apps, or visit each homepage for podcast access: • MONTEFIORENYACK.ORG • HIGHLANDMEDICALPC.COM

Mark Geller, MD President and Chief Executive Officer

facebook.com/MontefioreNyack

@MontefioreNyack

@MontefioreNyack

EDITORIAL STAFF Lauren Malone, Director of Public Relations and Marketing Rose Croke, Marketing Manager Briana Puncar, Marketing Manager, Highland Medical, P.C. Celia Vimont, Contributing Writer

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IN THIS ISSUE

summer 2019

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KNOW YOUR RISK For women with certain genetic mutations, enhanced cancer screening saves lives.

STAYING STRONG AS A CAREGIVER It’s critical for caregivers to maintain their own health by taking time to care for themselves.

STROKE: KNOW THE WARNING SIGNS Getting early treatment can save a life.

HEALING CHRONIC WOUNDS New treatments offer patients new hope.

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PROTECT YOUR KIDNEYS Maintaining a healthy blood pressure can help to prevent kidney damage.

PLANNING FOR A HEALTHY PREGNANCY How a proactive visit to your OB/GYN can benefit baby and you.

6 PROTECT YOUR HEARING Follow our tips to use earbuds and headphones safely.

KEEP TICKS AT BAY Expert tips to help you guard against Lyme disease this summer.

MS CENTER RECOGNIZED FOR EXCEPTIONAL CARE

The Madlyn Borelli Multiple Sclerosis Center at Montefiore Nyack Hospital has been officially renewed as a Center for Comprehensive MS Care through the National MS Society’s Partners in MS Care program. This formal recognition honors the Center’s commitment to exceptional patient care; providing coordinated, comprehensive MS care; and a continuing partnership with the Society to address the challenges of people affected by MS. The Hospital’s Center is led by Jai S. Perumal, MD, Director, and Jennifer Reardon, ANP, who focus on the total care of their patients with MS and facilitate a multifaceted approach involving a variety of specialties and expertise.

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For more information about the Montefiore Nyack Hospital Clinical Cancer Genetics Program and to schedule a consultation with a genetic counselor, call 845-348-8507.

Location: The Breast Center, 160 North Midland Avenue, Nyack, New York.

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KNOW YOUR RISK FOR WOMEN WITH CERTAIN GENETIC MUTATIONS, ENHANCED CANCER SCREENING CAN BE LIFESAVING.

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omen with genetic mutations that put them at increased risk for breast cancer should have more frequent breast cancer screening to increase the chance they can be treated successfully, says Nelly Oundjian, MD, Director of the Cancer Genetics Program at Montefiore Nyack Hospital.

“We offer women with mutations in BRCA and other cancer susceptibility genes enhanced cancer screening to prevent cancer or to find the disease at an early stage,” says Dr. Oundjian.

The majority of cancers are not due to an inherited gene mutation: Only five to 10 percent of people diagnosed with breast cancer have inherited an increased risk of developing the disease, she explains. However, in these cases, breast cancer runs in the family and often occurs earlier than the noninherited form of the same cancer.

GENES THAT INCREASE CANCER RISK Inherited mutations, or changes, in genes called BRCA1 and BRCA2 increase the risk of female breast, ovarian and pancreatic cancers. The breast cancer may develop at an early

age and in both breasts. According to the National Institutes of Health, 12 percent of women in the general population will develop breast cancer sometime during their lives. In contrast, up to 87 percent of women who inherit a harmful BRCA1 or BRCA2 mutation will develop breast cancer by age 80.

The lifetime risk of ovarian cancer in BRCA1 and BRCA2 mutation carriers is up to 60 percent. They might also be at increased risk of pancreatic cancer.

Men with BRCA mutations also have an increased risk of getting breast, pancreatic and prostate cancers.

Dr. Oundjian strongly urges women with inherited mutations in BRCA and other cancer susceptibility genes to have frequent breast cancer screening.

There are many types of screening, including mammograms, MRI exams, ultrasounds, breast exams performed by a physician and monthly breast self-exams.

Women with BRCA mutations may choose to have surgery to reduce their cancer risk. For example, the breasts can be removed to prevent breast cancer, and the ovaries and fallopian tubes can be removed to prevent ovarian and fallopian tube cancer.

Individuals with genetic mutations might pass them along to their children.

WHO SHOULD SEEK TESTING? It’s recommended that genetic testing be considered by: • Women with a personal history of breast cancer diagnosed before age 50, cancer in both breasts or who have both breast and ovarian cancer • Women with a family history of two or more close relatives with breast, ovarian or pancreatic cancers • Women of Ashkenazi Jewish descent with breast or ovarian cancer at any age (they have higher chances of carrying mutations in the BRCA1 and BRCA2 genes) The Cancer Genetics Program at Montefiore Nyack Hospital offers comprehensive cancer risk assessment, cancer genetic counseling and predictive genetic testing to those who have a personal or family history of cancer, including breast and ovarian cancer. If a genetic change is found, other family members will be tested for that same mutation.

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PROTECT YOUR HEARING USING EARBUDS AND HEADPHONES SET AT HIGH VOLUMES CAN DAMAGE YOUR HEARING. FOLLOW OUR TIPS TO HELP KEEP YOUR HEARING SHARP.

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hether you’re using headphones or earbuds to listen to music or to watch TV or movies, it’s important to control the volume to protect your ears. “The louder the volume, the less time it takes to damage the ears,” says Shelley Berson, MD, a board-certified otolaryngologist, sleep medicine physician and allergist at Rockland Ear, Nose & Throat Associates in West Nyack, New York. Listening to loud noises can damage the inner ear.

Music played at volumes louder than 85 decibels for long periods can cause permanent hearing loss, she says.

HOW LOUD IS TOO LOUD? The National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention allow workers to listen to 85 decibels for eight hours in a row. But for every three

decibels above that, the time that is considered “safe” is divided in half.

Here are some examples of how long it would take to damage your hearing listening to various decibel levels: • 6.5 hours of 86 decibels (city traffic) • 1.5 hours of 92 decibels (highway traffic) • 45 minutes of 95 decibels (jackhammer 50 feet away) • 12 minutes of 101 decibels (hand drill at 3 feet away) • Less than a minute of 113 decibels (power saw or rock concert) According to the American Academy of Otolaryngology–Head and Neck Surgery, cell phones or listening devices in the United States can produce a maximum of 115 decibels.

“My advice for teens is, if you can’t hear your parents and your music at the same time, it’s too loud,” says Dr. Berson.

TIPS FOR SAFE LISTENING Use these tips to preserve your hearing when listening to music: • Consider using headphones instead of earbuds. “A lot of audiologists recommend over-the-ear headphones because they’re not as close to the eardrums, so they aren’t as loud,” says Shelley Berson, MD, of Rockland Ear, Nose & Throat Associates.

• Set the volume limit on your device to no louder than 70 percent of possible volume.

• Don’t listen for too long.

Use the 60/60 rule: Listen at 60 percent volume for 60 minutes, then take a break for at least 30 minutes to allow your ears to rest.

• Noise-cancelling headphones can be a good choice if you listen to music in loud environments—you don’t have to play your music as loud to drown out background noise.

“If you experience ear pain while listening or if you experience ringing or hearing loss when you take out your earbuds, it’s also too loud.” She noted that while ringing in the ears or hearing loss after listening to loud music is often temporary, it is a sign you could be contributing to long-term permanent hearing damage.

“I see people whose hearing has been damaged from years of exposure to noise at work, including musicians,” says Dr. Berson. “It’s important to start protecting your hearing when you’re young. Once you lose hearing, you can’t get it back.”

Visit the Physician Finder at montefiorenyack.org to find an otolaryngologist.

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STAYING STRONG AS A CAREGIVER IT’S CRITICAL FOR CAREGIVERS TO MAINTAIN THEIR OWN HEALTH

BY TAKING TIME TO CARE FOR THEMSELVES, TOO.

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hen you’re a caregiver for a loved one, it’s important to remember you need to pay attention to your own needs in order to stay strong for the person you’re caring for, advises Rob Carter, Director of Pastoral Care at Montefiore Nyack Hospital.

“I ask caregivers how they’re making sure they’re doing simple things for themselves like eating and sleeping, and I ask about their physical routines or exercise,” says Chaplain Carter.

“If you’re taking care of someone all day, then it’s too easy to neglect yourself.”

ACCEPT ASSISTANCE Asking for help can be difficult for many people, but it’s necessary for caregivers to avoid burnout. “Caregivers can easily become overwhelmed and depressed,” says Chaplain Carter. “It’s important to understand you don’t have all the answers.” He suggests reaching out to family members, friends and neighbors. If you’re part of a faith community, let them know what’s going on. “Your church or synagogue, Scout groups, even middle or high school honor student groups may give community service credits to teens who volunteer,” he says. “Or there may be members who are happy to cook or provide other services.”

Susan Mazzarella, Director of the Employee Assistance Program at Montefiore Nyack Hospital, agrees that there are a

number of resources in the community that can help caregivers.

“Besides local religious organizations, there are services such as Meals on Wheels that deliver meals to seniors,” she says. The Rockland County Office for the Aging (http://rocklandgov.com/ departments/aging/) has resources including caregiver respite services, information on support groups and information on adult day care.

STAY SOCIAL In addition to having assistance, having a social network is important for caregivers. “Whether it’s church, golf buddies or a book group, you need some regular social contact,” says Chaplain Carter.

Support groups can be a big help. In addition to the Office of Aging, other good resources for support groups are patient health organizations such as the American Cancer Society or the Alzheimer’s Association. “In-person support groups are very valuable, but if you don’t have one near you or you can’t find time to go, then online support groups can be helpful, too,” says Mazzarella.

Make it a priority to set aside time to de-stress. “If stress is making you sick,” Mazzarella points out, “then you won’t be well enough to care for your loved one. Find time for exercise. Try meditation or yoga. And be kind to yourself—know that no one is really prepared for this—you learn as you go through it.”

To view additional resources for caregiver/counseling services, visit http://bit.ly/rocklandgov.

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KEEPING TICKS AT BAY GUARD AGAINST LYME DISEASE THIS SUMMER BY FOLLOWING OUR EXPERT TIPS. Lyme disease is on the rise, and its prevalence in Rockland County is high. The ticks that carry the disease are most active from May through July, so it’s vital to take steps now to protect yourself and your family (including pets).

“It’s so important to check yourself and your family for ticks after you’ve been hiking, gardening, camping or doing other outdoor activities,” says Azfar Chak, MD, Chief of Infectious Diseases at Montefiore Nyack Hospital.

PREVENTING TICK BITES Take these CDC-recommended steps to protect against tick bites: • Cover yourself up as much as possible if you’re going to be hiking, gardening or doing other outdoor activities. Tuck your pant legs into your socks and your shirt into your pants.

• Wear light-colored clothing. Dark ticks are more easily spotted against a light background.

• Avoid areas with high grass and leaf litter and walk in the center of trails when hiking.

• Use insect repellent containing DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol or 2-undecanone.

• Use products that contain permethrin to treat clothing and gear, such as boots, pants, socks and tents, or look for clothing pre-treated with permethrin.

• Shower soon after coming indoors to more easily find and wash off crawling ticks before they bite you.

• Conduct a full-body tick check using a handheld or full-length mirror to view all parts of your body when you return from tick-infested areas.

Help your children check thoroughly for ticks, and remove any you see immediately. “If you find a tick, grasp it with tweezers, as near the skin as

you can, and gently pull it straight out,” says Dr. Chak. “If you remove it before it’s been embedded for 24 hours, the tick should not be able to transmit Lyme disease.”

• Tumble dry clothes in a dryer on high heat for 10 minutes (or more if the clothes are damp) to kill ticks after you come indoors.

To protect your dogs and cats from tick bites, try to keep them out of tick-infested areas as much as possible. Check them daily for ticks and remove any you find right away. Talk to your vet about the use of tick-control products for your pets.

LYME DISEASE TREATMENT If you or someone in your family does get bitten, the most common symptom is a bull’s-eye rash, which tends to appear anywhere from three days to a month later. If possible, take a picture of the rash in case it disappears before the doctor sees it.

The standard treatment for Lyme disease is two to four weeks of antibiotics. People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely.

If Lyme disease is not discovered in its early stages, it can cause serious problems later on for the heart, nervous system and bones. In these cases, treatment is more complex and may involve IV antibiotics.

Some doctors describe patients who have certain symptoms—such as fatigue, pain, and joint and muscle aches—after the treatment of Lyme disease as having post-treatment Lyme disease syndrome, or chronic Lyme disease. There is disagreement among doctors about chronic Lyme disease, including how to test for it and treat it, notes Dr. Chak. “There are some tests that are used to diagnose chronic Lyme disease, as well as treatments for it, but none are approved by the U.S. Food and Drug Administration,” he says. “More research is being done in that area.”

For more information, visit our Physician Finder at montefiorenyack.org.

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5,000+ LYME DISEASE CASES EACH YEAR IN NEW YORK STATE

70-80% OF INFECTED PEOPLE DEVELOP A BULL’S-EYE RASH WHERE THE TICK BIT THEM

2mm SIZE OF NYMPH (IMMATURE) TICKS THAT MOST COMMONLY TRANSMIT LYME DISEASE

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STROKE:

KNOW THE WARNING SIGNS GETTING EARLY TREATMENT CAN SAVE A LIFE.

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hen it comes to treating stroke, time is of the essence.

“If you think you may be having any signs of a stroke, call 911 right away,” says Jeffrey Rabrich, DO, Medical Director of Emergency Medicine at Montefiore Nyack Hospital.

“Stroke drugs only work if they’re given within the first three hours after symptoms start. If someone comes in after that, these drugs are no longer a treatment option.”

WHAT IS A STROKE? According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people have a new or recurrent stroke each year.

A stroke occurs when a vessel in the brain is blocked by a blood clot or ruptures. About 85 percent of strokes in the U.S. are caused by a clot. This is called an ischemic stroke.

A stroke drug called TPA, or tissue plasminogen activator, can dissolve the clot and improve blood flow. Immediate treatment with this clot-busting drug may reduce the long-term effects of a stroke and even prevent death.

Stroke patients receive topquality treatment at Montefiore Nyack Hospital, which is designated a Certified Stroke Center by the New York State Department of Health. Institutions with this designation are recognized as being best able to address the comprehensive medical needs of stroke patients.

The Hospital also has received the American Heart Association/American Stroke Association’s Get With The

Guidelines® Stroke Gold Plus Quality Achievement Award. This award recognizes the Hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, researchbased guidelines built on the latest scientific evidence.

REDUCE YOUR RISK High blood pressure and diabetes are the biggest risk factors for stroke.

“The best way to prevent a stroke is to control your blood pressure,” says Dr. Rabrich, “and if you have diabetes, to keep your blood sugar under control.”

Getting regular exercise and eating a heart-healthy diet are also key ways to prevent a stroke. “By controlling your risk factors, you can lower your risk of death or disability from stroke,” says Dr. Rabrich.

STROKE SIGNS At Montefiore Nyack Hospital, we recommend that people remember stroke signs and symptoms via the acronym F.A.S.T., which the American Stroke Association uses. F.A.S.T. stands for:

FACE DROOPING: Does one side of the face droop or is it numb? Ask the person to smile.

Is the person’s smile uneven or lopsided?

ARM WEAKNESS: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

SPEECH: Is speech slurred? Is the person unable to speak or hard to understand?

Ask the person to repeat a simple sentence.

TIME TO CALL 911: If the person shows any of these symptoms, even if the symptoms go away, call 911 and get him or her to the hospital immediately.

OTHER SIGNS OF STROKE CAN INCLUDE SUDDEN: • Numbness or weakness of face, arm or leg, especially on one side of the body • Confusion, trouble speaking or understanding speech • Trouble seeing in one or both eyes • Trouble walking, dizziness, loss of balance or coordination • Severe headache

Montefiore Nyack Hospital is proud to be designated a Certified Stroke Center by the New York State Department of Health. For more information, visit www.montefiorenyack.org/stroke.

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PROTECT YOUR

KIDNEYS KEEPING YOUR BLOOD PRESSURE AT A HEALTHY LEVEL CAN HELP TO PREVENT KIDNEY DAMAGE.

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igh blood pressure can lead to kidney damage or failure. Getting your blood pressure checked once a year, and taking steps to control it if it’s high, are key ways to help prevent kidney disease, says Michal Tracz, MD, a kidney specialist at Highland Medical, P.C., Rockland Renal Associates in West Nyack, New York.

“Among people with kidney failure, 30 percent of cases are due to high blood pressure,” says Dr. Tracz. If you’re diagnosed with kidney disease, it’s very important to start seeing a kidney specialist, called a nephrologist, as soon as possible. “Chronic kidney disease related to high blood pressure isn’t reversible, but it is preventable,” says Dr. Tracz. “And damage to the kidneys can be managed by keeping your blood pressure under control.”

HOW BLOOD PRESSURE AFFECTS KIDNEYS The kidneys help filter waste and extra fluids from the blood, and they use blood vessels to do so. Eventually, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden. These damaged arteries can’t deliver enough blood to the kidneys.

Both high blood pressure and kidney disease are silent—they don’t usually cause symptoms until they’re in very advanced stages. That’s why it’s so important to get your blood pressure checked regularly—at least once a year

if you don’t have high blood pressure, and much more often, per your doctor’s recommendation, if you do have high blood pressure, says Dr. Tracz.

According to new guidelines from the American Heart Association, normal blood pressure is now considered less than 120/80 mm Hg. The guidelines say high blood pressure should be treated earlier with lifestyle changes and, in some patients, with medication—at 130/80 mm Hg instead of the previously recommended 140/90. “Blood pressure management needs to be a shared decision-making process between the doctor and patient so each person’s treatment is individually tailored,” says Dr. Tracz.

Diabetes is another important risk factor for kidney disease. “Anyone who has had high blood pressure or diabetes for 10 years or more should be screened for kidney disease with a simple blood test and urine test once a year,” he advises.

PREVENTING OR SLOWING KIDNEY DISEASE There are a number of steps you can take to reduce your blood pressure to prevent or control your kidney disease.

The first is to take prescribed medication.

Certain blood pressure medications are recommended for people with kidney disease because they’re safer for the kidneys. The second key step is to control your diet. “Salt intake is particularly tricky,”

To schedule an appointment with a board-certified nephrologist at Highland Medical, P.C., call 866-550-4672.

says Dr. Tracz. “Most people think they don’t consume a lot of salt because they don’t use a salt shaker. But it’s already in the food, especially if you eat out a lot or eat kosher meat.”

TESTING FOR KIDNEY DISEASE If you’re at risk, your doctor may order tests that can help raise the alert if your kidneys are damaged. Those tests may include: A blood test to check for levels of a substance called creatinine, which can tell your doctor how well your kidneys are working.

Your doctor also will calculate your glomerular filtration rate (GFR), which indicates how well your kidneys are working. The GFR is calculated using a formula that includes the amount of creatinine in your blood, along with other factors like your age, race and gender.

A urine test to look for the presence of albumin, a protein in the blood that can pass into the urine when the kidneys are damaged.

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A POWERFUL TOOL TO HELP

HEAL WOUNDS FOR STUBBORN WOUNDS AND INFECTIONS, HYPERBARIC OXYGEN THERAPY CAN STIMULATE THE BODY’S NATURAL ABILITY TO HEAL.

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hen chronic wounds don’t heal, hyperbaric oxygen therapy can stimulate healing. The treatment can help diabetic patients with foot ulcers, people with bone infections that aren’t responding to antibiotics or other treatment, and those with soft tissue injury caused by radiation. The Wound Care Center® at Montefiore Nyack Hospital recently opened a hyperbaric treatment area complete with two new state-of-the-art hyperbaric chambers.

Hyperbaric oxygen therapy is a powerful tool. It’s used to help heal wounds that have not responded to traditional treatments. By increasing the amount of oxygen to wounds, it allows them to heal from the inside.

WHAT’S TREATMENT LIKE? A person receiving the therapy lies on a bed encased in a large seethrough plastic shell, surrounded by 100 percent oxygen at higher-thannormal atmospheric pressure. In this environment, the lungs take in more

oxygen than usual, bringing more of that life-supporting gas to the bloodstream.

The heart then pumps this oxygen-rich blood, which helps fight bacteria and stimulate healing, throughout the body.

Patients generally receive 30 treatments, which are given daily Monday to Friday. Each treatment includes about 90 minutes in the chamber, plus an additional 30 minutes of preparation time.

Patients are examined weekly to see how their wound is healing. In two to three weeks, the Center’s team usually can see if a patient is responding to treatment.

ADDRESSING UNDERLYING ISSUES At the weekly visit, the patient’s wound is cleaned out and the medical staff addresses the patient’s medical issues related to the wound. For patients with diabetes, that includes making sure their blood sugar levels are optimized. The Wound Care Center works with a patient’s primary care doctor and other specialists to ensure his or her other medical conditions are being addressed. Montefiore Nyack Hospital’s

Wound Care Center also offers other wound treatments, which can be used in conjunction with hyperbaric oxygen therapy. These include: NEGATIVE PRESSURE WOUND THERAPY, a medical procedure in which a vacuum dressing is used to enhance and promote wound healing in acute, chronic and burn wounds. The therapy involves using a sealed wound dressing attached to a pump to create a negative pressure environment in the wound. The treatment promotes the growth of new blood vessels and healthy tissue.

BIOENGINEERED SKIN GRAFTS, or the use of synthetic skin, is used to jumpstart the body when a wound won’t heal.

At the patient’s first visit to The Wound Care Center, the doctor will take a complete medical history and conduct a physical.

The medical staff designs a wound care plan with the patient, taking advantage of the multidisciplinary team that includes podiatrists and surgeons.

Treatments are typically covered by Medicare, Medicaid and most insurance plans. Self-referrals are accepted.

The Wound Care Center® at Montefiore Nyack Hospital is located at 160 North Midland Avenue in Nyack, New York. For more information and to make an appointment, call 845-348-7600.

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PLANNING FOR A HEALTHY PREGNANCY A PRE-PREGNANCY VISIT TO YOUR OB/GYN CAN HELP TO ENSURE THAT YOU HAVE A HEALTHY PREGNANCY AND YOUR BABY GETS OFF TO THE BEST POSSIBLE START.

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hinking about trying to get pregnant? Even before you start trying to conceive, a visit to your OB/GYN will help to ensure that you have the healthiest pregnancy and baby possible. Your doctor will begin by taking a complete medical and family history. “The doctor will discuss your prior pregnancies and any complications that may have occurred,” explains Sharon Quayle, MD, Assistant Director of Obstetrics & Gynecology at Montefiore Nyack Hospital.

Your doctor will screen you for chronic health conditions like high blood pressure and diabetes, which can adversely affect the chance of a healthy pregnancy. He or she also will likely talk to you about the importance of a healthy weight and a nutritious diet.

A HEALTHY START A healthy weight at the start of pregnancy will help to reduce your risk of preeclampsia, a serious pregnancy condition in which your blood pressure increases. Along with a nutritious diet, it also will decrease the likelihood of developing gestational diabetes (diabetes that develops in the second half of pregnancy). In some cases, your doctor may suggest delaying getting pregnant until you have begun a diet that’s low in sugary and fatty foods and high in fruits, vegetables and lean protein.

In addition, your doctor will ask about your family history. Many genetic conditions that can seriously affect the health of a baby, such as Tay-Sachs disease, cystic fibrosis and sickle cell disease, can be screened for before you conceive.

SCREENINGS AND IMMUNIZATIONS Your doctor also will make sure that you’re current with other screening exams, such as a mammogram if you’re age 40 or older.

It’s important to make sure you have been vaccinated for measles, mumps and rubella, says Dr. Quayle. The measles vaccine cannot be administered during pregnancy, but immunity to this disease is important for a safe and healthy pregnancy. Your doctor also may recommend a flu vaccine, which can be safely administered before or during any stage of pregnancy.

Other topics of discussion are likely to include: • the importance of exercising regularly • stopping the use of alcohol, tobacco and marijuana products • any medications you’re taking and whether you can continue them—and if not, possible safe alternatives • advising you to take a prenatal vitamin if there’s any chance you might get pregnant. The folic acid in the vitamin helps reduce the risk of certain birth defects. Folic acid is most effective at reducing risk when a woman starts daily prenatal vitamins before conceiving.

“Planning for a pregnancy is a special time in life when you can take important steps to have the best health possible before parenthood,” says Dr. Quayle. “Enjoy the journey!”

Visit the Physician Finder at montefiorenyack.org to find an obstetrician.

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160 North Midland Avenue Nyack, NY 10960

Same Day Appointments Now Available at Our Primary Care Offices.

The Doctor Will See You Now.

1-866-550-HMPC

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