February 2019 - Health BeatHealth Beat

Employee Spotlight on Cristina Gonclaves

Posted on February 28, 2019 by Andrew Rubin

This month we shine our employee spotlight on Cristina Goncalves, Coordinator in Jamaica Hospital Medical Center’s Occupational Health Services Department. Cristina has been with the hospital for seven years. She started her career four years ago at Jamaica Hospital as a switchboard operator before moving to her current position three years ago.

Cristina is a native of Queens. She grew up in the Jamaica area and attended Our Lady of the Cenacle elementary school, St. Agnes Academic High School and then John Jay College of Criminal Justice where she obtained a Bachelor’s Degree in Forensic Psychology in 2013. Cristina has three children, two girls and a boy whom she enjoys spending all of her free time with. They enjoy going as a family to museums, parks, the movies and just doing anything that is adventurous. Two of Cristina’s favorite vacation destinations are Portugal and Myrtle Beach.

On Saturdays and Sundays Cristina enjoys her kick-boxing sessions. She also likes to eat different types of foods especially sushi, as well as Spanish and Indian food. She finds listening to Latin music very relaxing and also likes Disney songs.

Cristina feels that working at Jamaica Hospital is like being with family. She finds everyone to be very considerate of one another and she looks forward to having many more positive experiences here. Her long term goal is to return to school to become a social worker which she believes would be a very fulfilling career. We are fortunate to have her as a member of our team and look forward to her being with us for many more years.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

When is it Okay to Request a Second Opinion From Your Doctor?

Posted on February 21, 2019 by Michael Hinck

Receiving news that you or a loved one has been diagnosed with a serious or rare medical condition can be very overwhelming and scary. While it is important to listen to and follow your doctor’s instructions, it is also appropriate in these situations to seek the advice of other professionals and request a second opinion.

Unfortunately, less than half of the people diagnosed with a serious or life-threatening disease request a second opinion. The most frequent reasons individuals cited for not doing so include: feeling an urgency to seek treatment right away, lack of access to experts or centers of excellence, fear that their insurance carrier would not cover the cost, and concerns about offending their doctor.

In most cases, these reasons are unmerited; in reality, many conditions do not require immediate treatment and most physicians welcome a second opinion. In addition, many insurance providers allow for second opinions and can even help identify local experts that participate in your plan.

So, when is getting a second opinion a good idea? According to WebMD, the following circumstances are appropriate:

Where the treatment is very risky or toxic
Where the diagnosis is not clear, the treatment is experimental, or there is no established consensus or Food and Drug Administration-approved treatment
If you’re considering participating in a trial for a new drug
If you’re considering some new experimental approach or a procedure that involves using experimental instruments or devices.

In many cases, second opinions are very beneficial. In fact, a recent study highlighted their potential value. Researchers found that as many as 88% of those who sought a second opinion for a complex medical condition had a new diagnosis that changed their treatment plan, and 21% received a completely different diagnosis.

If you would like to seek a second opinion, but are unsure of how to start the conversation with your doctor, try some of these tips.

Tell your doctor you want to be sure that you explore all your treatment options. This may include looking into several surgical and non-surgical interventions.
Let your doctor know that you always talk to more than one expert when you need to make an important decision, whether it’s a medical, financial, or personal decision.
Explain to your doctor that a second opinion would give you peace of mind that your diagnosis and treatment plan are the best option for you.

Even if a second opinion doesn’t change your diagnosis or treatment plan, you can feel satisfied that you made a well-informed decision.

Neuropathy

Posted on February 20, 2019 by Joann Ariola

According to the Centers for Disease Control and Prevention, 25.8 million people in the United States have diabetes. Typically, 60 to 70 percent of people with diabetes have some sort of nerve problems, know as neuropathy.

Neuropathy is a shorter term for peripheral neuropathy, meaning nerve damage in the peripheral nervous system. Neuropathy from diabetes can damage the nerves in your hands, arms, feet and legs. This condition can cause pain, numbness and weakness. Depending on the degree of neuropathy, and how long you have been a diabetic, nerve problems can occur in every organ system, including the digestive tract, heart and reproductive organs.

The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathy also appears to be more common in people who have issues with controlling their blood glucose, have high blood pressure and are overweight.

Symptoms of diabetic neuropathy vary depending on the nerves affected and develop gradually over the years. Symptoms may include:

Trouble with balance
Numbness and tingling of extremities
Abnormal sensation to a body part (Dysesthesia)
Diarrhea
Erectile dysfunction
Urinary incontinence
Vision changes
Burning or electric pain in extremities

When treating diabetic neuropathy, a nutritionist may recommend healthier food choices and exercise to help lower your glucose and glycohemoglobin levels. Additionally, analgesics and low doses of antidepressants can be prescribed for pain relief, burning and tingling.

If you are a diabetic and have been experiencing symptoms of neuropathy, Jamaica Hospital Medical Center’s Ambulatory Care Center and Department of Nutrition can help. Call 718-206-7001 to get the process started.

Hidden Illnesses

Posted on February 19, 2019 by Xavia Malcolm

Ten percent of people living in the United States have a medical condition that can be characterized as an invisible or hidden disability.

Hidden disabilities may not be visible on the outside or immediately apparent; however, their symptoms can be physically and mentally limiting (impairing individuals from leading a normal life). These limitations are often the result of chronic hidden illnesses such as:

Lupus- A chronic autoimmune disease that can cause the body’s immune system to attack healthy tissue. Symptoms include damage and swelling of the skin, joints, kidneys, heart and lungs.
Cystic fibrosis – A progressive and chronic genetic order that causes persistent lung infections. Symptoms include salty-tasting skin, frequent lung infections, shortness of breath, persistent coughing, greasy or bulky stool.
Chronic fatigue- A debilitating disorder characterized by extreme fatigue or tiredness that does not go away with rest. Symptoms include chronic insomnia, frequent headaches, loss of concentration or memory, muscle pain or swollen lymph nodes.
Lyme disease – An inflammatory disease caused by bacteria that are transmitted by the bite of an infected black-legged tick. Symptoms include rashes, severe headaches, inflammation of the brain or spinal cord.
Fibromyalgia – A chronic pain disorder characterized by widespread pain in the muscles and bones. Symptoms include severe pain, fatigue or difficulty concentrating.

Living with a hidden disability or hidden illness can be difficult because those diagnosed are often met with skepticism due to a lack of knowledge. Another challenge that a person living with this type of illness or disability may encounter is social isolation.

There are a few things that can be done to overcome these challenges such as educating loved ones and others about your disability, inviting loved ones to your medical appointments or joining a support group.

Lead Poisoning Facts

Posted on February 15, 2019 by Andrew Flowers MD

The Centers for Disease Control and Prevention (CDC) estimates that “at least 4 million households have children living in them that are being exposed to high levels of lead. There are approximately half a million U.S. children ages 1-5 with blood lead levels above 5 micrograms per deciliter (µg/dL), the reference level at which CDC recommends public health actions be initiated.”

This raises concern because even low levels of lead in the blood have been directly associated with irreversible effects such as lower IQ and decreased ability to concentrate. Exposure to lead has also been shown to increase the risk of:

– Slowed growth and development

– Learning and behavioral problems

– Speech and hearing deficits

Children can become exposed to lead in several ways. Lead is a naturally occurring element that was once widely used in the manufacturing of paint, gasoline, as well as some toys and jewelry. Lead-based paint, used in homes and offices during the early and mid-20^th century, is the most common source of exposure today. Old, chipping or cracking paint found in these homes can easily be eaten by children, and old paint can become dust and be inhaled.

As a safety precaution, any house built prior to 1978 should be inspected for the presence of lead paint as this can be a potential hazard to children and pregnant women. Remove any old, chipping or cracking paint from your home and have it tested for lead if you are unsure if it was made prior to 1978. If it is found that lead is present, it is highly recommended that you seek the assistance of a lead paint remediation expert.

There are other preventative measures you can take to reduce the risk of lead exposure, they include:

Avoid using herbal remedies whose sources are unknown (Greta, Azarcon, Ghasard, Ba-baw-san and Daw Tway are all remedies from around the world that have been shown to contain lead).
Do not use cookware or other food storage containers that have not been shown to be lead-free.
Visit the US Consumer Product Safety Commission website and remove any toys or toy jewelry from your household that has been recalled.
Make sure to wash clothes and bodies thoroughly after any known exposure to lead or lead dust (i.e. renovating an old home, working with stained glass)

If you believe your home may contain dangerous lead paint, contact your state or local health department about testing the paint and dust in your home for the presence of lead. If you have further questions regarding the testing of blood lead levels and the possible effects of elevated blood lead levels, you can visit the CDC website (https://www.cdc.gov/nceh/lead/default.htm) or schedule an appointment with your primary care physician.

To schedule an appointment with a Family Medicine doctor at Jamaica Hospital Medical Center, please call 718-206-6942

Dr. Andrew Flowers, Family Medicine Physician

Psoriatic Arthritis

Posted on February 12, 2019 by Joann Ariola

According to the American College of Rheumatology, psoriatic arthritis is a type of inflammatory arthritis that occurs in some patients with psoriasis (is a chronic skin condition caused by an overactive immune system) and can affect the joints in the body.

It is a chronic disease that may present as mild with occasional flair ups or, in more severe cases, can cause joint damage in fingers and toes, as well as larger joints in the lower extremities, such as knees, back and sacroiliac joints in the pelvis.

The Mayo Clinic describes the symptoms of psoriatic arthritis as:

Swollen fingers and toes – Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes. You may also develop swelling and deformities in your hands and feet before having significant joint symptoms.
Foot pain -Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis).
Lower back pain -Some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis (sacroiliitis).

Psoriatic arthritis can go into remission. When in remission, the symptoms may alternate causing them to subside for a time and then reappearing in the form of painful, swollen joints.

Many people with psoriatic arthritis may first think they have rheumatoid arthritis since both diseases have similar symptoms. The only difference is that psoriatic arthritis is prevalent in patients who have psoriasis of the skin as well.

When seeing your doctor to determine whether or not you may have psoriatic arthritis your doctor may examine your joints for swelling or tenderness, check your fingernails, hands, feet and toes for pitting, flaking or other abnormalities.

Psoriatic arthritis is diagnosed by X-rays, Magnetic Resonance Imaging (MRI), testing the rheumatoid factor (RF) antibody in your blood or a joint fluid test to see if you have uric acid crystals in your joint fluid.

Since there isn’t a cure for psoriatic arthritis, healthcare professionals are focused on controlling the symptoms and thwarting permanent damage to the joints.

Some medications prescribed to treat psoriatic arthritis include:

NSAIDs – Non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve).
Disease-modifying ant rheumatic drugs (DMARDs) -These drugs can slow the progression of psoriatic arthritis and save the joints and other tissues from permanent damage.
Immunosuppressants -These medications act to tame your immune system, which is out of control in psoriatic arthritis.
TNF-alpha inhibitors – Tumor necrosis factor-alpha (TNF-alpha) is an inflammatory substance produced by your body. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints.

Other procedures that have been effective are steroid injections or joint replacement surgery. Steroid injections reduce inflammation rapidly and joint replacement surgery replaces the severely damaged joint with an artificial prosthesis made of metal and/or plastic.

If you are experiencing any of the symptoms of psoriatic arthritis and would like to speak with a doctor at Jamaica Hospital, call 718-206-7001 to schedule an appointment with a Rheumatology specialist.

National Organ Donor Day

Posted on February 12, 2019 by Andrew Rubin

There are currently over 120,000 people in the United States who are awaiting an organ donation that could potentially save their lives.

It all started in 1998 when the Saturn company joined together with the United Auto Workers and supported by the U.S. Department of Health to recognize the need. Every year February 14th is a day designated as National Organ Donor Day that serves to make the public aware of the importance of how an organ donation can save a life for someone else.

There are different types of donations:
• Organs
• Tissue
• Marrow
• Platelets
• Blood

Jamaica Hospital Medical Center supports organ donation. To find out how you can register to become an organ donor, go to www.liveonny.org for more information.

The History of Diabetes Testing

Posted on February 6, 2019 by Andrew Rubin

Diabetes was recognized as far back as 1500 BC by Egyptian scientists. In 600 BC scientists later noted that ants seemed to be particularly drawn to the urine of people with diabetes. The earliest documented diagnosis of the disease was during the middle ages when Chinese, Indian and Egyptian scientists tested the urine of people thought to have diabetes by tasting it for a sweet distinctive taste.

The first clinical exam for diabetes was performed by a doctor named Karl Tommer in 1841 who tested urine with acid hydrolysis which broke up the disaccharides into monosaccharides and then after the addition of other chemicals results in a reaction forming if sugar is present.

In 1850 Hermann von Fehling was able to expand on Trommer’s work to quantify the results. Later in the 19th century, Frederick Pavy developed tablets that when added to the urine would show if there was glucose in the urine. In 1907 Stanley Benedict was able to refine Fehling’s test. In 1913 Ivar Bang discovered a way to test the blood for glucose.

In the 1940’s urine test strips were developed that would change colors depending on the amount of glucose was in the urine. In more modern times, test strips were introduced in 1964 that could check the blood for sugar and the first glucometer that was able to test blood samples for elevated sugar was developed in 1970. Another test for diabetes was developed in the mid 1970’s and it tested for hemoglobin A1c.

Glucose testing has now progressed to the point where blood sugar can be determined by a sensor that can measure it through the skin, with no need to take a drop of blood.

Homemade Oat Milk Recipe

Posted on February 6, 2019 by Joann Ariola

Oat milk is a dairy-free milk alternative that is made from oats. It has a ratio of 1 cup of oats to ¾ cup of water. The mixture is then strained to create a liquid.

According to , oat milk is a healthy alternative to whole milk and skim milk. It is rich in vitamin D, iron, calcium, potassium and fiber. One cup of store bought oat milk may have up to 120 calories, 5 grams of fat, 3 grams of protein, 14 grams of carbohydrate and 2 grams of fiber.

Comparatively, cow’s milk contains 3.5% fat, 146 calories, 11 grams of carbohydrate, 8 grams of protein and 8 grams of fat and skim mild has 83 calories, 122 grams of carbohydrate, 0.2 grams of fat and 8 grams of protein. Even though the numbers for skim milk seem better than oat milk, skim milk still contains lactose.

If you’d like to try your hand at making your own oat milk, here is a simple recipe from that you may want to try.

Prep time: 15 minutes

Total time: 15 minutes

Yield: 3 – 4 cups

Ingredients:

1 cup rolled or quick oats (100 g)

3 – 4 cups water (750ml – 1liter), depending on how thick you like your milk

Instructions:

Soak the oats in water for at least 30 minutes or overnight.
Drain the oats and wash them (discard the soaking water).
Blend the oats with 3 – 4 cups of clean water.
Strain the milk using cheesecloth, a strainer, a napkin or a nut milk bag.
Store oat milk in a sealed container in the fridge for up to 5 days.

Homemade oat milk reduces the risk of cross contamination with potential allergens at the manufacturer and can is less expensive to make than to purchase.

If you’d like to read more about oat milk, visit –

Jamaica Hospital First In Queens To Join HealingNYC’s Relay

Posted on February 5, 2019 by Xavia Malcolm

The opioid epidemic continues to plague New York City communities. According to the City’s Department of Health, there were 694 confirmed overdose deaths from January to June 2018, and a fatal drug overdose reported every six hours.

More New Yorkers die as a result of a drug overdose than homicides, suicides and motor vehicle accidents combined.

In Queens, Jamaica Hospital Medical Center which operates one of the City’s busiest emergency departments, has experienced firsthand the detriment the epidemic has caused. Last year, Jamaica Hospital’s emergency department treated over 200 patients for opioid drug overdoses.

“Over the years, we have seen the numbers continue to increase significantly. This epidemic has profoundly affected many individuals and families. Opioid addiction has impacted all genders, ages, ethnicities and those of all socioeconomic backgrounds,” explained Dr. Geoffrey Doughlin, Chairman of Emergency Medicine. “No group is untouched.”

“At Jamaica Hospital our goal is to improve the health of our community in all aspects. We are committed to doing all that we can to combat the opioid crisis,” shared Dr. Shi-Wen Lee, Vice Chairman of Emergency Medicine. In addition to providing life-saving treatments in the emergency department, the hospital is the first in Queens to participate in New York City’s Relay program.

The Relay program, which was launched in 2017 under HealingNYC, targets survivors of opioid overdoses who are at high risk for a future, fatal overdose. According to New York City’s Department of Health, “In the hours after someone survives an opioid overdose, a trained Relay “Wellness Advocate” meets with the survivor in the hospital emergency department to offer overdose risk reduction counseling, overdose rescue training, and an overdose prevention kit containing naloxone. Participating hospitals can contact Relay at any hour of the day or night, on every day of the year, and a Wellness Advocate aims to arrive within the hour. Wellness Advocates stay in contact with overdose survivors for up to 90 days and connect them to appropriate services”

“Jamaica Hospital is proud to work in collaboration with Relay. Since the program’s inception in August 2018 at this facility, our emergency department has made over 50 patient referrals,” said Joshua Sclair, Emergency Medicine Administrator. The hospital’s participation in the initiative offers the community resources that can potentially reduce the number of overdose deaths and provide access to supportive services.

Any person in need of treatment for their addiction can come to the emergency department at Jamaica Hospital and receive help. The hospital has designated detoxification beds and staff that are specially trained to help patients with their treatment.