Social Anxiety Disorder

Posted on August 22, 2025 by Patrick Hercules

Social anxiety disorder (SAD) is a medical condition that causes fear and anxiety when you are around people in social situations and causes an intense fear of being judged or watched by others.

Social anxiety disorder typically begins in the early to mid-teens, though it can sometimes start in younger children or adults.

Like many other mental health conditions, social anxiety disorder likely arises from a complex interaction of biological and environmental factors, which may include:

Inherited traits
Brain structure
Environment

Several factors increase the risk of developing social anxiety disorder, including:

Family history
Negative experiences
Temperament
New social or work demands
Having an appearance or condition that draws attention to them

There are many signs and symptoms of social anxiety disorder, including:

Emotional and behavioral symptoms
- Fear of situations in which you may be judged negatively
- Worry about embarrassing or humiliating yourself
- Intense fear of interacting or talking with strangers
- Fear that others will notice that you look anxious
- Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling, or having a shaky voice
- Avoidance of doing things or speaking to people out of fear of embarrassment
- Avoidance of situations where you might be the center of attention
- Intense fear or anxiety during social situations
- Analysis of your performance and identification of flaws in your interactions after a social situation
- Expectation of the worst possible consequences from a negative experience during a social situation
Physical and physiological symptoms
- Blushing
- Fast heartbeat
- Trembling
- Sweating
- Upset stomach or nausea
- Trouble catching your breath
- Dizziness or lightheadedness
- Feeling that your mind has gone blank
- Muscle tension

People living with social anxiety may avoid social situations such as:

Interacting with unfamiliar people or strangers
Attending parties or social gatherings
Going to work or school
Starting conversations
Making eye contact
Dating
Eating in front of others
Using a public restroom
Taking or making phone calls
Performing in front of people

The symptoms of social anxiety disorder can change over time. They may flare up if you’re facing many changes, stresses, or demands in your life.

Although avoiding situations that produce anxiety may make you feel better in the short term, your anxiety is likely to continue over the long term if you don’t get treatment. Therefore, you should speak to your doctor about the symptoms you are experiencing. Your healthcare provider will want to determine whether other conditions may be causing your anxiety or if you have a social anxiety disorder along with another physical or mental health disorder. They may determine a diagnosis based on the following:

A physical exam to help assess whether any medical condition or medication may trigger symptoms of anxiety
A discussion of your symptoms, how often they occur, and in what situations
A review of a list of situations to see if they make you anxious
Self-report questionnaires about symptoms of social anxiety
Criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Treatment depends on how much social anxiety disorder affects your ability to function in daily life. Treatments can include:

Psychotherapy (the most common treatment)
- Cognitive behavioral therapy (CBT) is the most effective type of psychotherapy for anxiety
Medications
- Antidepressants
- Anti-anxiety medications
- Beta-blockers

If you or someone you know has social anxiety disorder, you can call or schedule an appointment with a mental health provider at Jamaica Hospital Medical Center. Please call 718-206-5575.

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.

Summer Recipe: Comforting and Delicious Rigatoni with Summer Bolognese for the Cool Summer Nights

Posted on August 15, 2025 by Patrick Hercules

As summer winds down, the nights will be getting cooler. Here is a recipe for a comforting, delicious, and hearty rigatoni with summer Bolognese.

Rigatoni with Summer Bolognese Recipe | Food Network Kitchen | Food Network

National Immunization Awareness Month

Posted on August 14, 2025 by Patrick Hercules

August is National Immunization Awareness Month (NIAM). It is a day observed to highlight the importance of vaccination for people of all ages.

Vaccinations are important at every stage of life. They are one of the safest preventative care measures available and help play a vital role in keeping you healthy.

Vaccines work by stimulating the immune system to protect the body against viruses or bacteria that cause infection. After vaccination, the immune system is better prepared to respond quickly when the body encounters the disease-causing organism.

From infants to older adults, immunizations play a critical role in preventing serious diseases such as measles, whooping cough, flu, shingles, and HPV-related cancers. Skipping vaccines can leave you and your family vulnerable to these illnesses.

Getting vaccinated plays an important role in keeping your family and community healthy, as vaccinations help protect you from infectious diseases and can lessen the severity of illness. They don’t just help protect you; they also help keep diseases from spreading to others, such as your family, neighbors, classmates, coworkers, and others in the community. Especially those most vulnerable to illness, such as infants, elderly people, and those with weakened immune systems.

National Immunization Awareness Month offers a timely reminder as families prepare for back-to-school and flu season approaches. If you would like to help raise awareness about the importance of vaccination, encourage friends and family to talk to a healthcare provider they trust about staying up to date on their vaccinations.

What Happens If a Polyp is Found in Your Colon

Posted on August 13, 2025 by Patrick Hercules

Colorectal cancer is one of the most preventable forms of cancer, but only if you have been screened for warning signs while you are still healthy. Cancer screenings can find precancerous growths or polyps, as most colorectal cancers start as polyps.

There are different types of colon and rectal polyps. They include:

Hyperplastic polyps: These polyps are not precancerous, and doctors generally remove them anyway, just to be safe.

Adenomas: These colon polyps are precancerous and can take seven to 10 or more years to evolve into cancer—if it ever does. Overall, only 5% of adenomas progress to cancer, but your risk is hard to predict. Doctors remove all the adenomas they find.

Sessile serrated polyps: These polyps were once thought harmless; however, this type of adenoma is now known to be risky and is also removed.

Thankfully, polyps aren’t cancer, and most of them will not develop into cancer. This can only happen if they are caught in the precancerous phase before they have a chance to grow and turn into cancer.

After polyps are removed, you will need to return for an additional colonoscopy. There is a 25% to 30 % chance that a repeat colonoscopy will find additional polyps. You may need to come back for follow-up testing to see if more polyps have grown in the future.

The follow-up care you will need if polyps were removed during your colonoscopy depends on your family history, personal risk factors, and the type of polyps found. Your healthcare provider can help you understand your risk and next steps.

If the polyps found were benign, your healthcare provider might recommend continuing your usual recommended screening schedule. Sometimes, if many benign polyps were found, your healthcare provider might recommend a more frequent schedule for getting routine colonoscopies.

If the polyps were pre-cancerous, your healthcare provider may recommend getting a repeat colonoscopy within one to three years. Sometimes, repeating the procedure within six months may be best, because your healthcare provider will want to check the area where each polyp was removed and look for other polyps or problems.

If polyps were removed during your colonoscopy, this can put you at a higher risk for developing colorectal cancer. This is especially true if you had multiple polyps found, if they were large, or if they are the types of polyps that have a higher risk of becoming cancerous.

Along with getting routine testing, there are several steps you can take to help reduce your risk of colorectal cancer, including:

Maintaining a healthy weight

Getting regular physical activity

Avoiding red meat and processed foods

Avoiding alcohol

Quitting smoking

You can receive a colorectal cancer screening from a gastroenterologist at Jamaica Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 206-7001.

When Should You Be Concerned with Your Stool?

Posted on August 7, 2025 by Patrick Hercules

Everybody poops. That is a fact of life. Therefore, it is important to be aware of changes in your bowel movements, as they can indicate if there are potential health issues.

For example, hard, lumpy poop can mean you’re dehydrated. Red poop may be a sign of rectal bleeding. Pungent poop could indicate an infection or other concerns.

Some stools can be big or small depending on the day. It can be round or oblong. Or it can be hard, soft, or even liquid in form. The Bristol Stool Chart gives a sense of what’s ideal and what isn’t. It classifies stool into seven types based on shape and consistency. The types include:

Type 1: Separate hard lumps, like little pebbles

Type 2: Hard and lumpy and starting to resemble sausage

Type 3: Sausage-shaped with cracks on the surface

Type 4: Thinner and more snake-like, plus smooth and soft

Type 5: Soft blobs with clear-cut edges

Type 6: Fluffy, mushy pieces with ragged edges

Type 7: Watery with no solid pieces

Gastroenterologists suggest Type 3 or Type 4 is optimal and reflective of a healthier diet and lifestyle, and is easier to pass.

The other five types can signal that something may be off internally. For instance:

Type 1 and Type 2 stool signals constipation and can be difficult or painful to pass. The most common cause is not enough fluids. Adding fiber to your diet and exercise to your daily routine can also help move things along.

Type 5 stool can indicate a lack of fiber, which can help soak up fluid and firm things up. Continually pooping in this part of the scale may be a sign of bowel issues.

Types 6 and 7 are in diarrhea territory and could signal an illness, food poisoning, or some other digestive or intestinal issue. Stress can cause this too. See a doctor if your stool consistently registers on this part of the chart.

Your poop should be a basic brown color. This color comes from the mixing of the various ingredients in your digestive tract, including:

Bile that breaks down fats passing through the digestive system

Bilirubin, a substance created when red blood cells reach the end of their life cycle and exit your body as a waste product

The digested remnants of all the food you ate

Sometimes, poop can be a color other than brown due to something we ate. Vegetables, fruits, and food dyes can change the color of poop, which is perfectly normal.

It is important to know that a food-related tint should disappear within a day or so once the source is out of your system. However, if this color lasts longer than normal, it could be a warning sign of other medical issues. For example:

Greenish poop could be due to a bacterial or viral infection, a parasite, or irritable bowel syndrome. It can also be connected to new medications you’re taking

Reddish poop could indicate rectal bleeding or conditions such as hemorrhoids, anal fissures, inflammatory bowel disease, ulcers, or even colorectal cancer

Blackish poop could signal that there is blood in the upper digestive system from ulcers. It may also be a byproduct of taking iron supplements

Yellowish or greyish poop could signal liver, gallbladder, or pancreas disorders

Contact a healthcare provider if your poop lingers on the wrong part of the color chart for more than a few days.

Poop smells bad. However, some poop can smell worse than others. Foul-smelling poop is often connected to unwanted bacteria living in your gut, disrupting your usual digestive process.

Symptoms should clear up quickly if the smell is because of something you ate. Speak to a healthcare provider if the issue lasts longer than normal to see if there could be an underlying medical condition that is causing the smell.

Staying aware of the size, shape, color, and smell of your poop is good to do, but not necessary to do every day. If something is wrong with your digestive system, you will know.

If you would like to speak with a gastroenterologist at Jamaica Hospital Medical Center’s Ambulatory Care Center, please call (718) 206-7001 to schedule an appointment.

Chronic Traumatic Encephalopathy (CTE)

Posted on August 5, 2025 by Patrick Hercules

Chronic traumatic encephalopathy (CTE) is a degenerative brain condition that happens after repeated head injuries. CTE usually affects athletes who play contact sports or military personnel.

CTE causes neurodegeneration, which means it permanently destroys nerve cells in your brain. Over time, this damage can cause changes in your behavior and mental abilities. It has been associated with second impact syndrome, when a second head injury occurs before symptoms of a previous head injury have fully resolved.

Experts are still trying to understand how repeated head injuries and other factors might contribute to the changes in the brain that result in CTE. Researchers are looking at how the number of head injuries someone experiences and how bad the injuries are may affect the risk of CTE.

There are no specific symptoms that have been linked to CTE, as it shares symptoms with other brain conditions that cause neurodegeneration. It can affect your:

Cognitive function, which can cause:

Memory loss

Trouble solving problems or making plans

Trouble making a choice or judging what you should do next

Mild cognitive impairment

Mood and personality, which can cause:

Anxiety

Depression

Mood swings, especially acting or feeling more aggressive or impulsive

Personality changes

Thoughts of self-harm, suicide, or suicidal behavior

Motor function, which can cause:

Balance issues

Loss of coordination

Tremors, twitches, or other muscle movements you can’t control

There is no way to diagnose CTE in a living person. The only way healthcare providers can confirm CTE is by examining samples of a person’s brain with a microscope during their autopsy.

Even though a healthcare provider may not be able to definitively diagnose CTE while a person is alive, they can still make an educated assumption by building a diagnosis using a few factors, including:

A physical exam

A neurological exam

The symptoms a person is experiencing

A person’s medical history, especially if they have had head injuries

Experiencing CTE symptoms doesn’t automatically mean a person has it. There are a lot of conditions that can cause similar symptoms. A healthcare provider will use tests to help diagnose or rule out these other issues. Tests include:

Blood tests

CT scan

Lumbar puncture

PET scan

There is no treatment for CTE because there is currently no cure for it. Unfortunately, if a person has CTE, their symptoms will continue to get worse. Avoiding head injuries is the only way to lower your risk of developing CTE. Wear the right protective equipment for all activities and sports, especially helmets or protective headwear.

If you are experiencing any symptoms of CTE, you can schedule an appointment with a doctor at Jamaica Hospital Medical Center’s Ambulatory Care Center by calling (718) 206-7001. If you are experiencing an emergency, call 911.

World Lung Cancer Day

Posted on August 1, 2025 by Patrick Hercules

August 1st is observed as World Lung Cancer Day. It is a day dedicated to the global initiative of raising awareness about lung cancer, its impact, and the importance of prevention, early detection, and advanced treatments.

According to the World Health Organization, lung cancer is the leading cause of cancer-related deaths among both men and women, and it is so prevalent that more people die from it than from colon, breast, and liver cancers combined every year.

World Lung Cancer Day was established in 2012 by the Forum of International Respiratory Societies (FIRS) in collaboration with other health organizations. The day focuses on educating the public about risk factors such as smoking, air pollution, and occupational exposures, while advocating for research and improved access to care.

World Lung Cancer Day serves as a platform to support those affected by the disease and to emphasize the critical need for collective action in the fight against lung cancer.

Lung cancer screening helps to identify cancer at an early stage when treatment can be most effective. Early detection through a low-dose computed tomography (LDCT) scan can improve survival rates in individuals with the disease.

The MediSys Health Network is committed to improving the morbidity and mortality associated with lung cancer. For more information about our program, please contact the Lung Cancer Screening Program at 718-206-LUNG (5864).

MediSys Health Network Research Day

Posted on July 30, 2025 by Jamaica Hospital Medical Center

The MediSys Health Network of Jamaica Hospital and Flushing Hospital Medical Centers held its Fourth Annual Research Conference and Poster Competition.

The posters submitted are broken into three categories: Case Reports, Empirical Research, and Quality Improvements. They are then graded on a rubric of five areas: format, visual, content 1, content 2, and impact.

The first-place winning posters in Case Reports were “Osler-Weber-Rendu Syndrome: Diagnosis and Management of Pulmonary Hypertension” by T. Okan, M. Al-Dmour, M. Hussein, S. Mohammed, V. Patel, A. Doshi, S. Jain, and K. Doshi (JHMC) and “HIV and Miliary Tuberculosis Co-Infection: A Case Series” by A. Inghirami, M.A. Burrola-Suarez, and J. Shakil (FHMC).

Second-place winning posters of the category included “A Case of Bilateral Pulmonary Embolism Treated with Catheter-Directed Thrombolysis in a Patient Who Presented with Syncope and Chest Pain” by R. Maharjan, S. Rao, Z. Lasic (JHMC), and “Spontaneous Splenic Rupture in a 74-Year Old on Apixaban” by C. Montesano, D. Egbo, N. Marfo, M.A. Louis, and N. Mandava.

And finally, the third-place posters were “The Use of Intravenous Thrombolytics for Acute Ischemic Stroke in Patients with Thrombocytopenia Complicated by Hemorrhagic Conversion Due to Undiagnosed Malignancy” by A. Sivapalan, C. Ninan, and A. Waddell (JHMC) and “Breast Cancer and Tumor Lysis Syndrome: A Rare Critical Issue” by V. Khachatryan, M.A. Burrola-Suarez, M.T. Rahman, N. Tasnim, K. Cappas, and A. Khan (FHMC).

In the Empirical Research Category, the posters that were awarded first place were “Assessing Patient-Providers’ Conversations about Stress and Health” by F. Khan, A. Mir, L. Gance, S. Chemouni Bach, M. Basant, A. Chorzepa, L. Keating, C. Nienaber, A. Roth, D. Chen, and E. Brondolo (JHMC) and “Circadian Variations of Glucose Challenge Test Results in Pregnancy: Examining Non-Linear Trends” by A. Makol, L. Keating, R.J. Robitsek, T. Tang, Lien B, L. Woo, and I. Ngai (FHMC).

Second-place winning posters were “Comparing Acidity and Dental-Hypersensitivity Between Arginine Mouthrinse and SDF” by M.R. Mears, L. Keating, and J. Weiss (JHMC) and “Exploring Potential Under Diagnosis of Hypophosphatasia” by R. Faridizad, K. Cappas Cordero, S. Khalid, H. Sadia, M. Mafi, A. Russo, L. Keating, and K. Robinson (FHMC).

Lastly, the third-place winning posters of the category were “Point of Care Fentanyl Testing VS. Standard Testing in a Chemical Dependency Unit” by M.S. Radeos, J. Cintron-Hernandez, B. Balchan, G. John, B. Joseph, A.M. Radeos, J. Wong, and D. Chen (JHMC) and “Adipose Rebound in Patients with Congenital Hypothyroidism in an Urban Multiethnic Community Hospital” by N.L. Sands, A. Glowacki, A. Gogenini, M. Roland, and L.Q. Lew (FHMC).

In the final category Quality Improvements, the first-place winning posters were, “Improving Pain Documentation in Osteopathic Manipulative Treatment: Efforts to Support a Developing Standard of Care” by H. Liu, H. Jaber, A. Jaramillo, F. Khan, Z. Sagarwala, C. Pang, R. Resendez Rodriguez, E. Siaw, S. Varughese, H. Woo, A. Eromosele, L. Keating, P. Cruz, C. Nienaber, A. Roth, and E. Brondolo (JHMC) and “QI Project: Assessing Internal Medicine Interns’ Confidence in Various Tasks Over the Course of Intern Year” by S. Dubey, M. Roland, and K. Beekman (FHMC).

Congratulations to all of those who placed, the honorable mentions of each category, and everyone who participated in this year’s Research Day Conference and Poster Competition.

Asthma in the Summer

Posted on July 25, 2025 by Patrick Hercules

Summer can be a difficult season for people with asthma. The heat and humidity can affect airways, with the hot air causing them to tighten and narrow. This can trigger symptoms such as wheezing, breathing difficulty, shortness of breath, and other symptoms that increase the likelihood of asthma attacks.

Similarly, humid air is not only heavy and hard to breathe in, but it can trap irritants and allow allergens such as dust mites and mold to thrive and diminish air quality, triggering asthma symptoms. This effect occurs regardless of the type of asthma a person has. If a person has allergic asthma, they may find managing their asthma to be especially difficult in the summer. The same is true if a person has exercise-induced asthma and tends to be more active during the summer.

Asthma symptoms are usually more common in the fall and winter; however, summer creates unique risks as there are more causes of summer asthma. Causes of summer asthma symptoms include:

Having asthma means the lungs are sensitive to extreme heat. Breathing in hot air can aggravate airways and trigger symptoms. Becoming dehydrated can cause a person to breathe more rapidly than normal, which can also play a role in setting off symptoms.

Ozone is a product of atmospheric chemicals and sunlight. Although more research is needed to discount statistical uncertainty and better assess adult lung function in response to different levels of exposure, many researchers believe this pollutant can exacerbate asthma, especially in children. This is based on studies that show lung function worsens in the days after ozone levels peak, affecting people with asthma and even people without it.

If you have allergic asthma and are triggered by certain allergens that are especially prevalent in June, July, and August, it stands to reason you’re more likely to have asthma attacks during these months.

March through June: tree pollen is high

May through early June: grass pollen is high

June: outdoor mold spores peak and decrease after the first frost

August through the first frost: weed pollen is high (daily peaks around noon)

Whether it is a small campfire or a raging wildfire, exposure to smoke is more likely in the summer months. Smoke carries fine particulate matter that can get into a person’s airways and have a major impact on asthma.

If you have a history of worsened asthma in the summer, an asthma healthcare provider will work with you to create a seasonal action plan, which may include incorporating additional medications and/or lifestyle measures into your overall management measures.

It is key to head into summer with your asthma well under control. It is not under control if:

You use a rescue inhaler more than twice a week

Asthma symptoms interrupt sleep more than twice a month

You need a new rescue inhaler more than twice a year

Avoiding allergens altogether may be difficult, especially if you enjoy being outside in warm weather. In addition to following your prescribed treatment plan, this may involve taking some special precautions in the summertime, including:

Checking the pollen counts for your area

Staying indoors and/or limiting outdoor activities on days with extreme heat, high humidity, high pollen counts, wildfire smoke days, thunderstorm warnings, and ozone alert days

Showering after outdoor activities

Not letting dust accumulate in your home

Using a dehumidifier and an air conditioner

Considering immunotherapy

It is important to follow your asthma action plan, try to avoid triggers, and stick to the asthma medication regimen prescribed by your healthcare provider. These steps may include taking daily asthma controller medication to prevent asthma symptoms and rescue medications to treat acute symptoms.

If your asthma symptoms are becoming difficult to deal with, you can visit Jamaica Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 206-7001.

Employee Spotlight Shines on Shiv Kumarie Santram, RN

Posted on July 23, 2025 by Andrew Rubin

This month we are proud to shine our Employee Spotlight on Shiv Kumarie Santram, RN, Clinical Nurse Manager. Shiv began her nursing career at Jamaica Hospital Medical Center in 2016, on 4 South Telemetry. In 2017 she was promoted to Assistant Head Nurse of the unit and in 2020 Shiv was promoted to Clinical Nurse Manager. She is currently on 6 South, a Med-Surgical Unit.

Shiv was born in Endeavour Leguan, Guyana where she attended Eastern Leguan Primary School, Leguan Secondary School and West Demerara Secondary School. She emigrated to the United States in 2001 and continued her education at Long Island University, obtaining her BSN degree in 2015, and her MSN/MBA in 2022 from Grand Canyon University. Shiv is currently pursuing her DNP at Grand Canyon University with an expected graduation date of 2027.

Shiv married her husband Navindra Santram in 2004 and he also works at Jamaica Hospital. They have two teenage sons and live in South Ozone Park, Queens. Their family also includes a dog named Summer and a cat named Spring. In her free time Shiv enjoys online shopping, watching tv shows without commercials and she volunteers in the community with her family at health fairs, cleaning up the beach in Rockaway and in local parks. She likes to travel, and her favorite places to visit are Florida and Jamaica. Shiv likes her cultural food from Guyana, especially crab curry with eggplant and eddo. She enjoys listening to Bollywood music, playing cricket and outdoor camping.

Over the years, Shiv has received several recognitions and awards. These included: Excellence in Patient Safety; Making a Difference, certificate of appreciation (outstanding courage, strength, leadership and professionalism), CARE recognition (providing exemplary compassion, advocacy, respect and engagement to patient and family members); and in 2024 Leadership of the Year.

Shiv’s dedication to patient care extends well beyond the walls of our hospital. She was a member in October 2024 of the MediSys Disaster Medical Response Team: Humanitarian aid in Asheville, NC affected by hurricane Helene.

Shiv represented Jamaica Hospital in 2024 at the Sigma Theta Tau International Research Congress Sharing Insights; Advance Care: Disseminating Nursing Research and Evidence for the Future in Singapore, Indonesia. Also in 2024, she represented Jamaica Hospital – 1199 SEIU in missionary work at Montego Bay Jamaica ” Empathy in Action: Caring Beyond Ourselves; Honoring Self-Care”.

Shiv likes working at Jamaica Hospital because she wants to make a difference in people’s lives. The people she works with have become like family to her and assisting patients on a daily basis provides her great satisfaction. We look forward to her continuing to work with us for many more years in to the future.