Health Voice: You Can Survive and Even Avoid a Stroke

Your Health Voice: You Can Survive and Even Avoid a Stroke: By Kathryn F. Kirchoff-Torres, M.D. neurologist,  Montefiore’s Stern Stroke Center and Assistant Professor at Albert Einstein College o...

You Can Survive and Even Avoid a Stroke

By Kathryn F. Kirchoff-Torres, M.D. neurologist, 

Montefiore’s Stern Stroke Center and Assistant Professor at Albert Einstein College of Medicine

May was National Stroke Awareness Month, and there is no time like the present to take five minutes to get informed on this serious medical issue, which impacts someone every 40 seconds. In New York, health figures show that African Americans and Hispanics are more prone to being a victim of stroke. In fact, African Americans have nearly twice the risk for a first-ever stroke than Caucasians.

At Montefiore’s Stern Stroke Center, where I work, we treat more than 1,200 acute strokes every year, making us the second busiest stroke center in New York State. We see the need for personalized, culturally sensitive interventions and innovative treatments to care for stroke. The Stern Stroke Center is a leader in stroke services including state-of-the art acute and long-term management and preventative care. As primary stroke centers designated by the New York State Department of Health, Montefiore Medical Center Moses Division and Jack D. Weiler Division identifies, treats and provides care to victims of strokes rapidly and efficiently, offering immediate access to stroke specialists 24 hours a day, seven days a week. We also have a neuro-intensive care unit opening at our Moses campus later this year.

What is a stroke?

A stroke occurs when blood flow to the brain is interrupted by a blocked or ruptured blood vessel. Similar to heart attacks, strokes can be lethal and have some of the same risk factors, such as smoking, high blood pressure and a poor diet. Also similar to a heart attack, immediate medical help can prevent long-term disability.

What are the signs of a stroke?

The symptoms of stroke come on suddenly, often with no warning, and include weakness or numbness on one side of the body, loss of vision on one side, difficulty speaking or understanding speech, severe dizziness or difficulty walking. If suspecting a stroke, don’t wait and don’t take an aspirin – just call 911 immediately. The faster someone comes to the emergency room, the more effectively doctors can treat him or her and try to minimize any long-term effects.  Every minute counts! 

How is a stroke treated?

For patients arriving at the hospital with symptoms of stroke, we get to work right away. Within a short period of time we can give a special clot-busting medicine or do a procedure to remove the clot in the brain and restore normal blood flow. At Montefiore, we’ve seen patients recover from being unable to speak or move an arm to feeling almost normal and wondering how soon they can go home.

How can I get more information about my own risk factors?

Please check out the Stern Stroke Center website for more information about our patient resources and services. You can also access the American Stroke Association and National Stroke Association websites for additional information in both English and Spanish.

At Montefiore, we want to stress to everyone in our community that if you suspect stroke, call 911 immediately. Our goal is to provide treatment quickly and effectively and see patients walk out of the hospital on their own two feet within a few days after a major stroke. For a medical professional who specializes in the treatment and prevention of stroke, it just doesn’t get any better than that.

Your Health Voice: Mixing Household Cleaners Can PoisonYou

Your Health Voice: Mixing Household Cleaners Can PoisonYou: HEALTH- Chlorine gas, first used in wartime by the Germans in World War I, is still being used as a weapon in internecine wars being f...

Mixing Household Cleaners Can PoisonYou

HEALTH- Chlorine gas, first used in wartime by the Germans in World War I, is still being used as a weapon in internecine wars being fought in places like Syria today.

It is also being found much closer to home – in hospital ERs – accidently produced by the reaction between common household products.

“Several times a week we see the results of environmental incidents, which can happen when people carelessly mix, for example, a toilet bowl cleaner [an acid] with bleach, which can liberate chloride gas that could be fatal,” says Dr. Howard Greller, Director, Emergency Medicine Research and Medical Toxicology at SBH Health System (St. Barnabas Hospital) in the Bronx. “Using two drain cleaners together or one right after the other can cause serious injuries.”

Mixing bleach and ammonia produces chloramines that can cause coughing, shortness of breath, chest pain, wheezing, nausea, watery eyes, and irritation to the throat, nose and ears, says Dr. Greller, who is fellowship-trained in medical toxicology. In addition to the problems caused by the mixing of bleach and either ammonia and acids (which are also found in glass and window cleaners, dishwasher detergents and drain cleaners), bleach also reacts with some oven cleaners, hydrogen peroxide and some insecticides.

Research has found that even natural fragrances in cleaning products, particularly in air fresheners, may react with high levels of ozone from indoor sources, like some air cleaning devices, or from outdoor air to form formaldehyde and dangerous fine particles indoors. Ozone is a harmful, but invisible gas that worsens asthma and other lung diseases.

“As a safer cleaning alternative, warm water and soap often will do the trick, especially in the home,” says Dr. Greller. “Baking soda, for example, is good for scrubbing. A mix of vinegar and water can clean glass.  

Additionally, when using cleaning or household products, you need to open windows and doors to keep the area well ventilated. You should never use cleaning products in a small, enclosed space.”

Heroin makes Bx. Leader in Drug Overdoses

HEALTH NEWS- The rate of unintentional drug overdoses in New York City continues to rise, according to the report issued by the city’s Department of Health. The Bronx once again had the highest rate of unintentional drug overdoses with a rate of 22.6 per 100,000 residents.  This is an increase of 15.5 per 100,000 residents from 2014.

New York City saw 937 unintentional drug overdose deaths in 2015 compared with 800 in 2014. Latino New Yorkers had the largest increase (46%) compared with all other races and ethnicities. The rate increased last year from 11.2 per 100,000 residents to 16.4 per 100,000 residents from the previous year.

“The drug of choice is heroin in the Bronx, but we’re also seeing people who are addicted to pain killers,” said Dr. Jonathan Samuels, Director of Addiction Medicine at SBH Health System (St. Barnabas Hospital) in The Bronx.   

Opioid analgesics, excluding fentanyl, were involved in 214 (23%) of overdose deaths in 2015.  Heroin was involved in 556 or 59% of all overdose deaths in New York City in 2015, which made it the most common substance in overdose deaths last year.

In 2015, four of the five neighborhoods with the highest rates of heroin-involved overdose death were in the Bronx: Hunts Point-Mott Haven (18.8 per 100,000), Crotona-Tremont (18.4 per 100,000), Highbridge - Morrisania 15.9 per 100,000), and Fordham-Bronx Parkway (15.4 per 100,000). South Beach -Tottenville in Staten Island had the fifth highest rate, 14.9 per 100,000.

The hospital’s addiction medicine program is treating 50 of these patients with suboxone, an alternative to its long-standing methadone maintenance treatment program. Suboxone – a drug produced through the combination of buprenorphine and naloxone and administered in sublingual strips – offers certain benefits over methadone. With methadone, overdose is a real possibility. As such, methadone patients require more frequent monitoring and may often need to be seen on a daily basis to receive their medication. Suboxone patients typically receive a supply  monthly.

Your Health Voice: WWE Stars Visit Children's Hospital in Bx.

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4 Ways to Be an Advocate for Disabled Children

Recently at the Children’s Evaluation and Rehabilitation Center (CERC), a group of social workers and speech-language pathologists, including Noor Al Radi MS. CCC-SLP, Tammy Fried LCSW, Diana Rodriguez, LMSW, and Alexandra Nussbaum, MS CCC-SLP, held the annual CERC Parent Workshop to help caregivers of children with disabilities learn how to navigate the complex mazes that are the health and education systems.

When your child has a diagnosis of a developmental disability, the phrase “advocacy” gets thrown around a lot, and often weighs heavily upon the parents’ shoulders. The reality is that part of effective advocacy comes from collaboration between various people who are all critical in the child’s life. The goal of the workshop is to foster a team culture to better support the kids and their families.

At the CERC Parent workshop providers lead sessions on subjects relevant to the changing needs of the community, brought to our attention by parents and the realities of their everyday lives. Sessions, led by speech therapists, social workers, psychologists and developmental pediatricians, provide current and practical information, and the tools needed to navigate, advocate and approach daily challenges related to having a child with a developmental disability.

We share information about accessing services, family issues, therapeutic services/interventions and general diagnostic information. Additionally, we provide parents with the opportunity to lead sessions and meet with clinicians of all disciplines to ask individualized questions.

Through these discussions a more active collaboration has begun to emerge between clinicians and parents at our clinic. From this joint effort, key themes have emerged as critical approaches to being an effective advocate: 

There is more than one expert in a child’s life. 

Parents know their child’s everyday needs, motivations and anxieties; they are the experts on their own child. This may seem obvious, but it is a reality that is often minimized. When faced with an issue related to a child’s disability, parents seek out a professional because they are the “certified expert,” but professionals also rely on the parent’s input to fill in the blanks. Combining the professionals’ and parents’ expertise paves the way for a personalized approach in a system that often resorts to a one-size fits all model. 

Being present is essential. 

Being present allows the parent to better educate themselves and others on their child’s needs. Many parents are already doing this, for example going to their child’s school gives the parent a sense of the routines, general structure and flow of the day. Once again, parents know their child best and having a sense of the actual space puts them in a better position to tailor it to be the most supportive environment for their son or daughter. Knowing the environment also helps parents process the information being relayed by the teacher or therapist, which in turn allows for active collaboration and problem solving. 

Don’t be afraid to ask questions. 

For medical professionals, parents’ questions are both an opportunity to learn more about the child as well as a window into the parents’ understanding and point of view. These active dialogues help form and inform the parent’s support teams — clinicians can help get answers, direct them to the appropriate resources, and assist in advocating for their child’s rights and needs. We encourage you to ask anything and everything. Questions start conversations. By talking to others, parents are able to break down the jargon that comes with discussing disabilities. Knowing these terms can help open doors and prepares parents to actively participate in meetings, appointments and therapies, without feeling overwhelmed by all the terminologies and catch phrases. 

Connect. 

At the CERC Parent Workshop parents have the opportunity to voice concerns, share their sense of isolation - of having a ‘different’ child and feeling ‘different’ within their communities. By connecting with others and sharing similar experiences, that parent’s singular narrative becomes a part of a collective voice that empowers and amplifies influence. In doing this, parents are also building both a social and practical network of support where information and knowledge is exchanged. This has been one of the most meaningful outcomes of the workshop – seeing a group of parents who entered the first workshop as strangers; now sit supportively together as a group and as friends.

Collaboration is a catch-all term that is sometimes hard to define, as is advocacy. Defining both is an ongoing challenge that has to be individualized to you, the parent, and your family’s needs. As we all strive to collaborate more effectively, we urge you to remember these key themes: recognize expertise, be present, ask questions, and create supportive networks. 

5 Ways to Pamper Yourself with Your Own Home Spa

By Randi Press

Ever had one of those days when life gets to be a bit too much and you long for a bit of R&R? 

Everyone needs a bit of “me” time once in a while. Maybe you need it after a long day stuck in traffic, or after your child has been home sick from school all week with a nasty cold. Perhaps the laundry has piled up beyond your control or that big presentation you had at work just didn’t go as planned. After a stressful day, the best remedy is always time spent alone. Time utilized to unwind and distress. Time spent taking care of just YOU!

If you’re looking to recharge yourself so you can conquer the world, here a few easy steps that you can take without ever leaving the house:

Take a relaxing bubble bath.

The go-to means for relaxing is to take a bubble bath. Add a splash of your favorite bubble bath product, light a few candles, put on some music and just submerge yourself into relaxation. There’s nothing like a good, warm soak to relieve muscle tension, open up your pores and clear your cluttered mind.

Apply a facial mask.

A good facial mask doesn’t have to be done at the spa. You can experience that same, high-quality experience at home. Choose a facial mask that has an inspiring scent, like rosemary or mint. Apply it to your face, allow it to dry and simply wait for the results. I love to apply my mask while relaxing in the tub. 

There’s something about the steam, the bubbles, the aromatic scents and the ability to just chill that really pulls it all together. Masks containing bentonite clay possess amazing skin toning and absorbing properties. Plus, the feel of that silky, smooth clay against the skin really provides you with an authentic pampering experience.

Scrub away the day.

There are some days when you just want to scrub all of your problems away. Well, why not make it a self-indulgent experience and use an exfoliating scrub that smells great and contains scrubbing particles that slough off dead skin cells? Once you experience how soft and silky your skin feels, you’ll forget about your troubles.

Moisturize from head to toe.

There’s nothing like slathering on a hydrating moisturizer immediately after a good exfoliation or bubble bath. Apply when your skin is still damp to really seal in that much needed moisture. Your skin will look more youthful as a result and it will definitely feel silky and soft to the touch. Take a few extra minutes to relax, enjoy and focus on your toes, feet, legs and arms. A little massaging and some great moisturizer will definitely ease away the stresses of the day.

Find time to do… Whatever!

Everyone has something special that they enjoy doing that helps them relax. It might be a bubble bath, a brisk walk, a quick dip in the pool or many other things. Take some time to flip through your favorite magazine or get started reading that book you’ve been putting off.

5 ways to get faster results from your workout

By Randi Press

If you’ve been adhering to a fitness regime for a while, and your results have started to slow (or you’ve reached a total plateau), it’s time to start making some adjustments. Here are five changes you can make to upgrade your workouts and achieve better results. 

1. Consistency and frequency

Commit to a weekly training schedule of five or six days a week and make those days the same. Getting into a routine prevents you from postponing your workouts and limiting your gains. If you’re only training two or three times a week, or “when you can fit it in”, do yourself a favor. Quit making excuses and start prioritizing your health in the same way you do your job and your social life. There’s always time to workout – even if it’s only for 20 minutes. 

2. Don’t adapt

Stamina, strength, power, cardio, speed, balance, flexibility, coordination, agility and accuracy are the 10 general physical skills you must focus on to get optimum results from your fitness regime. If you limit your training to steady state running, for example, you are neglecting strength, flexibility, agility, balance, accuracy, strength and coordination. If you’re concentrating solely on yoga, you’re neglecting areas like cardio, speed, accuracy, and so on. Always change your workouts up; never let your body adapt. Concentrate on the general physical skills in equal parts and watch your fitness surge forward.

3. Margins of experience

Greg Glassman, the co-founder of CrossFit said, "We fail at the margins of our experience”. This is a code that is as important in everyday life as is it is in improving your fitness. If you only do what you know you can do, you will never improve. You need to try (and, more importantly, fail) new things and work yourself harder, smarter, faster, better to understand what you’re capable of. Going through the motions won’t get you anywhere. All the good stuff lies outside the margin of your experience.

4. Sign up

Enter a fun run, register for a boot camp, join a fitness challenge; sign up for something that’s more difficult that what you could achieve at your current fitness level. If you commit to something by entering with a friend or paying for registration, you’re likely to put time into making sure you can achieve it. Put your money where your mouth is and just sign up. Then post it on Facebook and tell a few friends. Then there’s no way out.

5. Seek advice

If you’re putting in the time and effort, but you’re still not seeing the results you’re after, consider seeking advice from a personal trainer. They vary in specialization, approaches and ideologies, so be sure you know what you want and ask for recommendations. A good personal trainer will assess where you’re at, help you establish your goals and work out how you can get the best results from your training. 

7 Facts About Zika you didn’t know

7 Facts About Zika you didn’t know from Health

Getting the facts on the Zika Virus

As fear of the Zika Virus grabs the attention of many Bronxites following the high-profile outbreak, doctors at St. Barnabas Hospital want to set the record straight. They released information detailing the facts about the virus and the real impact it has.

The Zika Virus has received worldwide attention over the last few weeks due to its probable link to serious birth defects such as microcephaly (an abnormal smallness of the baby’s head that is associated with incomplete brain development) and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant.

Additional studies, however, are needed to further characterize these relationships. Since many of our patients have ties with countries in South and Central America and the Caribbean, where outbreaks of the disease have occurred, we strongly encourage you to become educated about the virus.

Dr. Edward Telzak, Chair of Medicine at SBH Health System (St. Barnabas Hospital) and an infectious disease specialist, offers answers to these Frequently Asked Questions about the Zika virus:

What is Zika virus disease and what are the symptoms?

Zika is a disease caused by the Zika Virus that is spread by the bite of an infected Aedes species mosquito. The symptoms are usually very mild, typically occur 3 – 12 days after being bitten by an infected mosquito, and last several days to a week.

Symptoms include fever, rash, joint pain, muscle pain and/or red eyes, and are similar to those of dengue fever and chikungunya, which are spread by the same mosquito. People usually do not get sick enough to go to the hospital and they very rarely die of Zika. Although outbreaks have typically occurred in tropical Africa and southeast Asia, it is now being reported in at least 24 countries and territories of Central and South America, and the Caribbean.  

Who is at risk?

Anyone who lives or travels to an area where Zika virus is found and has not already been infected can get it from mosquito bites. 

However, a pregnant woman who lives or travels to a country with current Zika transmission and who gets infected can transmit the virus to her baby who, in turn, can develop serious complications.    The Centers for Disease Control (CDC) recommends that pregnant women in any trimester should strongly consider postponing travel to Barbados, Bolivia, Brazil, Colombia, Costa Rica, Curacao, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Puerto Rico, St. Martin, Suriname, U.S. Virgin Islands and Venezuela.  This list of countries with Zika transmission will likely grow.  Pregnant women who do travel to one of these areas need to follow steps to avoid mosquito bites (see wwwnc.cdc/gov/travel/page/avoid-bug-bites) during their trip. 

Is the virus contagious?

The illness is primarily acquired through the bite of an infected mosquito. It can then be transmitted from mother to baby during pregnancy.  

While there have been reports of Zika being transmitted sexually, this is considered very uncommon. Since it is not an airborne disease, it cannot be spread by coughing or sneezing. Nor, is there any evidence that it can be spread through breastfeeding or by casual contact.

Will being infected by the virus affect a future pregnancy?

The Zika virus does not pose any known risk for an infected woman’s future pregnancies. It only remains in the blood for about a week.

What is the treatment for Zika?

There is no specific treatment or medicine for the disease itself nor is there a vaccine to prevent the infection. The symptoms, which are usually very mild, can be treated by getting rest, drinking fluids and taking medications like acetaminophen to relieve fever and pain. It is recommended that neither aspirin nor non-steroidal anti-inflammatory drugs such as ibuprofen (also known as Advil or Motrin) be used.

Should I get tested?

You should consider getting tested only if you are pregnant and have developed the symptoms within two weeks of returning from a country with Zika virus cases. A fetal ultrasound can be used to detect microcephaly before birth of the fetus of a woman who tests positive for Zika.

Is this a new virus?

No. Outbreaks of Zika previously have been reported in tropical Africa, Southeast Asia and the pacific Islands.  Zika virus will likely continue to spread to new areas.

For additional information speak to your physician or look at the CDC website.