Tuesday, March 23, 2021

Social worker Joseph Alvino on how ‘connecting with others can really help’

By Chandra Wilson 

March 23, 2021

During the April peak of the COVID-19 pandemic in New York City last year, social worker Joseph Alvino was sick with COVID-19 himself. 

“I had every symptom in the book,” he says. He was also mourning the loss of his father from the illness. But Joe, who has been with VNSNY for over 25 years, opted to continue visiting patients by telephone, in keeping with COVID-19 protocols, a heroic act that gave him purpose and provided patients with a compassionate and expert resource.

“It was important for me to keep my mind busy and active, doing the best I could to help my patients with all they’re dealing with,” says Joe.

A full-time social worker with VNSNY Home Care in Queens, Joe cares for patients coping with a variety of medical conditions and for their often-overburdened family caregivers. During last year’s peak, at a time when even the simple act of going to the grocery store felt riddled with peril, he helped clients get through the day, bringing them updated information on the virus and preventive measures and assisting them in navigating the anxiety and depression amplified by the need to socially distance from friends and family members.

Joe recalls one client telling him that his phone call made her day.

“A phone call might not seem like much on the surface,” he says, “but considering what everybody was going through, it meant a lot. Reaching out and just having a conversation goes a long way, especially when people can’t visit with their families. I ask open-ended questions about their concerns, validate their feelings, and try to normalize what they are going through. I don’t sugar-coat things—they have every right to be anxious. It’s a frightening time, but connecting with others can really help.”

“While the pandemic has limited access to many community resources and services, Joe and his fellow VNSNY Home Care social workers, along with colleagues across VNSNY, have coordinated closely to share information and problem-solve together to address the needs of patients and each other.

Joe is particularly grateful for the compassion he received from his colleagues as he battled COVID-19 and mourned the death of his father on April 14. “Everybody has been so supportive,” he says. “Everybody stands out. That makes a difficult situation just that much easier.” 

Visit www.VNSNY.org or call 1-800-675-0391 to learn more about home- and community-based services that can be integrated into your health and wellness needs. 

Wednesday, March 3, 2021

Helping you prevent a heart attack

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Dr. Leandro Slipczuk, PhD, FACC, cardiologist; director, Advanced Cardiac Imaging; and director, Cardiovascular Atherosclerosis and Lipid Disorder Center, Montefiore Health System

February is American Heart Month. At Montefiore, we offer a full range of cardiac care and advanced screening tools which help us not only treat people with current health conditions, but also prevent new conditions from developing. 

Cardiovascular disease (CVD) –  disease of the heart and blood vessels – is the leading cause of death worldwide. The main cause of CVD is one or more blockages in the arteries that bring blood to the heart.

Plaque, which are small bunches of fat made up of cholesterol, can build up inside the arteries without producing any symptoms – that is, until the plaque breaks off.

As the plaque breaks, artery obstruction accelerates through the formation of a blood clot. Obstructive plaques prevent the free flow of oxygen-rich blood to the heart muscle, causing a heart attack. This build-up of plaque is a particular type of CVD known as coronary disease. 

Currently, up to half of patients with coronary disease don’t know they have a blockage until they’re being rushed to the hospital, having a heart attack. Unfortunately, about 16% of these heart attack patients die, and many more are left with long-lasting health consequences, such as heart failure and arrhythmias (an irregular heartbeat).

Fortunately, coronary disease is a treatable condition. But, seeking help after symptoms have developed is too late. 

Adopting a healthy lifestyle is key to preventing CVD, which includes eating a heart-healthy diet; having well-controlled blood pressure, cholesterol and blood sugars; quitting smoking; staying physically active; and losing excess weight. 

How do doctors determine who’s most at risk for a heart attack? 

Traditionally, doctors have used tools and special equations to determine a person’s risk for CVD, and have based a person’s care plan on these tools. This approach works well when generalizing the health of a large population, but not as well when determining an individual care plan. 

Since the goal is to identify and help patients before they have a heart attack or stroke, it’s important that our screening tools are as accurate and efficient as possible.

For patients without a history of heart attack or stroke, the best way to measure how much plaque is built-up in a patient’s heart is a figure known as a coronary calcium score (CAC). CAC can be measured by taking a picture of the heart, known as a CT scan, which allows health professionals to see how much plaque build-up is present. Then, health professionals compare these results with the average findings for a person’s age, gender and ethnicity.

CAC is a much better way to determine who’s most and least at risk of experiencing a heart attack. In fact, CAC has been particularly useful in patients deemed at low-to-intermediate risk – which is why it’s an excellent approach for catching CVD before it turns into a much larger health issue.

Once plaque is detected by CAC, medications can be tailored to the patients’ individual risk. In addition, lifestyle changes can be discussed, and together, this personalized care plan can significantly decrease a patient’s 10-year risk of having a heart attack. If there is no plaque, lifestyle interventions can play a larger role than medications in preventing a heart attack avoiding unnecessary medications.

But, when there is significant calcification, lifestyle modifications alone are usually not enough. In this case, a group of medications called statins (which decrease blood cholesterol) together with aspirin can significantly decrease a patient’s risk. Moreover, we currently have a wide pool of medications for prevention that can be used on top of statins for patients at high-risk of cardiac events, like a heart attack. 

How can I learn if I’m at risk?

Getting your CAC score taken is painless. During the scan, patients simply lie down on a table which then slides the patient into the CT machine, scanning the heart in seconds. The entire procedure takes about 15 minutes and results are available on the same day. The patient’s doctor will then be able to incorporate the CAC score with other risk factors and discuss a personalized care plan to decrease a person’s risk of a heart attack.

Based on the results of a person’s first CAC, health professionals can determine how frequently this test should be repeated, but most times it’s not repeated at least for five-to-10 years. Interestingly, studies have even shown that CAC can help patients stick to lifestyle modifications, such as diet and weight loss!

CAC score is currently available at multiple locations at Montefiore. Speak with your doctor to determine for risk for CVD and whether you should schedule a CAC test soon. 

For more information, please call 646-670-5120.