What is Pre-Diabetes?

Posted on January 29, 2016 by Joann Ariola

Are you one of the estimated 54 million people in this country who have pre-diabetes?

Pre-diabetes is a silent health condition that has no symptoms and is almost always present before you develop type 2 diabetes.

It is a condition in which blood glucose levels are higher than normal, but not high enough to be classified as full-blown diabetes. If you haven’t visited your doctor, a good way to see if you are at increased risk for pre-diabetes is to take the American Diabetes Association’s (ADA) Diabetes risk test by visiting

Among those who should be screened for pre-diabetes include overweight adults age 45 and older or those under age 45 who are overweight and who have one or more of the following risk factors:

Habitually physically inactive
Have previously been identified as having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
Have a family history of diabetes
Are members of certain ethnic groups (including Asian, African-American, Hispanic or Native American)
Have had gestational diabetes or have given birth to a child weighing more than 9 pounds
Have elevated blood pressure
Have elevated cholesterol
Have polycystic ovary syndrome
Have a history of vascular disease

That said, if you have pre-diabetes, your risk of developing type 2 diabetes can be reduced by a sustained modest weight loss and increased moderate-physical activity, such as walking 30 minutes a day.

Through weight loss and increased physical activity, a dietitian may direct you on how to make food choices that cut down on the amount of fat and carbohydrates by:

Eating more foods that are broiled and fewer foods that are fried
Decrease the amount of butter you use in cooking
Eat more fish and chicken
Eat more meatless meals
Re-Orient your meals to reflect more vegetables and fruit

If you have symptoms such as increased thirst, frequent urination, fatigue and blurred vision, you may have crossed from pre-diabetes to type 2 diabetes.

It’s best to consult a physician if you’re concerned about pre-diabetes or if you notice any type 2 diabetes signs or symptoms. Jamaica Hospital Medical Center’s Ambulatory Care Center is centrally located and has convenient hours. To make an appointment, call 718-206-7001.

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.

Vitiligo: Causes, Myths, and Facts

Posted on January 25, 2016 by Zakiya Hazel-Jemmott

Vitiligo (vit-uh-lie-go) also called ‘leucoderma’ is a condition in which there is a development of milky-white patches on the skin. Anyone can get this skin disorder. Millions of people of all races and ethnicities worldwide have Vitiligo. It occurs in 0.5-2% of the general population. Some well-known cases of vitiligo have occurred in celebrities such as Michael Jackson, supermodel Winnie Harlow, and comedian Steve Martin.

So what causes vitiligo? Vitiligo is usually seen on the skin but other areas such as the scalp, lips and genitals can also be affected. Patches of hair can turn white. It develops because color producing cells in our skin called melanocytes, die.

Scientists have not completely understood why these cells die. Multiple factors such as genetics, a weak immune system which attacks its own cells, and increased free radical-induced damage (oxidative stress) may be the cause. Those whose parents have vitiligo and associated autoimmune diseases are more likely to get it as compared to the general population, although in most cases there is no family history of the condition. Certain factors such as skin injury and severe sunburn can cause development of new patches in a predisposed individual as well.

There are several myths associated with the spread of vitiligo but the fact is that vitiligo is not contagious. People also think that it is caused by eating white foods and drinking too much milk which is also false. Certain prescribed medications can stop the spread of new vitiligo spots but is not guaranteed, as new spots may appear but recover as treatment proceeds. Although vitiligo is not life-threatening it is life-changing. Those afflicted with vitiligo and their families face social stigmatisation leading to low self-esteem, anxiety, embarrassment, anger and even serious depression.

The Division of Dermatology at Jamaica Hospital offers several services, including adult and pediatric dermatology, dermatologic and skin cancer surgery, and cosmetic dermatology. For an appointment, please call (718) 206- 6742.

Information About Varicose Veins

Posted on December 4, 2015 by Michael Hinck

According to the U.S. Department of Health and Human Services, approximately half of Americans age 50 and older have varicose veins. These veins are most commonly located in the legs, appear to bulge from the skin and are dark purple or blue in color.

The veins in a person’s legs carry blood back up to the heart and should only allow blood to flow in one direction. However, when the valves in a person’s veins become weak and allow blood to flow away from the heart, blood pools and the veins in that area become stretched or enlarged, thereby, creating a varicose vein.

While varicose veins are very common among both men and women, there are several factors that can increase a person’s risk of being affected. These include:
 Heredity
 Hormonal changes, such as puberty, pregnancy, and menopause
 Increasing age
 Obesity
 Sun exposure

Not only can varicose veins cause discomfort and embarrassment for the men and women who have them, but they can also sometimes lead to more serious health conditions. If left untreated, varicose veins can lead to:

 Blood Clots- These are extremely dangerous, as they may dislodge from the vein and travel to the lungs or heart, preventing either from functioning properly.
 Sores and Ulcers- Varicose veins may lead to sores and ulcers of the skin because of long-term buildup of fluid.

Varicose veins may also cause ongoing swelling, rashes, and pain, and can increase a person’s chances of infection.

Varicose veins may signal a higher risk for circulatory problems. If you have varicose veins that cause pain, swelling, itching, tiredness, or numbness in the legs, you should seek medical attention. Jamaica Hospital Department of Vascular Surgery offers a variety of options to treat varicose veins.
Treatment options available include:

 Sclerotherapy: A solution is injected to seal off the area in which blood is pooling.
 Laser treatment: Without the use of needles or incisions, strong bursts of light are delivered precisely onto varicose veins to make them fade and eventually disappear.
 Endovenous Radiofrequency: A catheter is inserted into the vein and radiofrequency or laser energy seals the vein wall. This approach is used in treating deeper varicose veins.
 Surgical litigation and stripping: Varicose veins are removed entirely.

If you have varicose veins and would like to schedule a consultation with a vascular surgeon at Jamaica Hospital, please call 718-206-7108.

Shingles

Posted on October 1, 2015 by Andrew Rubin

Shingles is the term used for a skin rash that is caused by the herpes-zoster (varicella) virus, the same virus that causes chickenpox. After a person has had chickenpox, and the symptoms have resolved the virus can lie dormant dormant in their nerve roots for years. In some cases it can reactivate and cause shingles. Some of the factors that can cause the virus to become activated are stress, advanced age, exhaustion or a weakened immune system.

This rash is very painful and can last for many weeks. It is most frequently located on one side of the body, usually it shows up on the abdomen, the back or the buttocks as a band or stripe of fluid filled lesions that later are covered with scabs. They can also be found on the face and when they do, extra precautions must be taken so as to not affect the eye. Shingles isn’t contagious to people who have already had the chickenpox. There is the possibility of people contracting chickenpox if they come in contact with the open sores and if they have never had it before, however that risk is very low.

Signs and symptoms of shingles:

• Itching
• Red rash on one side of the body
• Pain
• Sensitive to the touch
• Headache
• Weakness
• Fluid filled blisters
• Tingling sensation
• Exhaustion
• Fever

Symptoms will last for several weeks, sometimes months. There isn’t a cure for shingles but a physician will usually prescribe medications to make the symptoms less intense. Antiviral medication will shorten the length of time that the symptoms will be present. Medication for pain will also help. People with shingles also get some relief by using certain skin creams, oatmeal baths, and cool compresses while the skin rash is active.
There is a vaccine for chickenpox which is given to children and to adults who have never had the disease. There is also a shingles vaccine that people who have had chickenpox can be given. It doesn’t guarantee that a person won’t develop shingles but can reduce the chances of developing complications. To learn more about vaccines for chickenpox or shingles please make an appointment with a physician at Jamaica Hospital by calling 718-206-7001.

Facts About AFib (Atrial Fibrillation)

Posted on July 21, 2015 by Xavia Malcolm

Atrial Fibrillation or AFib is a type of heart arrhythmia (an irregularity in the rhythm of the heart), which is caused by a disorder of the heart’s electrical system.

Normally, the heart’s electrical system rhythmically contracts the upper chambers (atria) of the heart in synergy with the lower chambers (ventricles). However, with AFib the heart’s two upper chambers contract rapidly and out of sync with the lower chambers.

Each person’s experience with AFib may differ; some people may have no symptoms, while others may have incidents of:

Heart palpitations
Dizziness
Chest discomfort
Fatigue
Shortness of breath

If you are frequently experiencing these symptoms, make an appointment to see your physician. Your doctor will run the following to diagnose atrial fibrillation: electrocardiogram, trans- telephonic monitor, holter monitor or portable event monitor testing.

If symptoms are ignored and AFib goes untreated it can develop into serious health complications such as:

Coronary artery disease
Heart failure
Pulmonary embolism
Cardiomyopathy
Hypertension
Stroke

There are many options available to treat or improve the symptoms of AFib. Your doctor may prescribe medications that can help in controlling the heart rate, reducing the risk of stroke and normalizing the rhythm of the heart. He or she may also recommend exercising and eating a healthy diet, as well as several lifestyle changes which can be incorporated into your daily routine.

Do You Have a Deviated Septum?

Posted on July 16, 2015 by Michael Hinck

If one side of your nose is often more congested than the other and if you have difficulty breathing, the problem might be a deviated septum.

What is a septum? It is the wall of bone and cartilage that separates your left and right nasal cavities. When this wall is crooked or displaced to one side, it can obstruct airflow and make breathing more difficult.

Some people are born with a deviated septum and others develop one as a result of an injury or a trauma to the nose. A deviated septum is not at all uncommon. In fact, four out of every five people have some degree of non-symmetry to their nasal septum. For most, the misalignment is not significant enough to cause any complications, but those with a more severe imbalance can suffer significant breathing problems and require treatment.

Common symptoms of a deviated septum are:
• Nasal congestion
• Difficulty breathing through your nose
• Recurrent sinus infections
• Frequent nose bleeds
• Sinus headaches and facial pain
• Post nasal drip
• Loud snoring or breathing while asleep

For some, a deviated septum can be treated with medications. If medications are unsuccessful in correcting the deviation, an otolaryngologist, or an ear, nose, and throat (ENT) doctor can perform a surgical procedure called a septoplasty to repair a crooked septum and improve breathing.

The surgery is usually performed in an out-patient setting under either local or general anesthesia. The procedure is usually completed in one to two hours with the patient being able to go home within three to four hours after surgery. There is normally little or no swelling after the procedure.

Jamaica Hospital’s team of ENT specialists can diagnose and treat patients with deviated septum. To make an appointment, please call 718-206-7001.

ADHD

Posted on June 10, 2015 by Andrew Rubin

Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental disorder diagnosed in children, as well as found in teens and continue into adulthood. Children who are diagnosed with ADHD tend to be hyperactive, have difficulty staying focused, and can’t control their impulses. Boys tend to be affected more frequently than girls. There isn’t a definite cause for the illness but there is a hereditary component, or result of a chemical imbalance in people who are diagnosed with ADHD. Mothers who smoke, drank alcohol, had poor nutrition, or were substance abusers during their pregnancy tend to have children with a higher incidence of the disease.
Children with ADHD:
• Are easily distracted
• Have trouble sitting still
• Have trouble waiting their turn
• Have difficulty organizing themselves
• Talk excessively
ADHD cannot be cured but can be managed through therapy and medication. Dr. Teresita Ruiz a psychiatrist at Jamaica Hospital Medical Center, recommends that a parent who suspects their child is showing signs of abnormal behavior, seek professional help for an evaluation. Early intervention is an important component of successfully managing ADHD. To schedule an appointment with a child psychiatrist at Jamaica Hospital, please call 718-206-7160.

Rheumatic Fever and Heart Valve Complications

Posted on May 20, 2015 by Andrew Rubin

Rheumatic Fever is caused by a bacterial infection, resulting from having strep throat or scarlet fever. Most commonly found in 5 to 15 year old children, it can occur in people who are younger or older, and affects women more frequently than men. It usually results from a strep throat infection that wasn’t treated appropriately with antibiotics. Rheumatic fever affects the body’s connective tissue in the brain, joints, and especially the ones found in the heart valves. It causes scarring of these heart valves which doesn’t allow them to open and close properly. This is called rheumatic heart disease and is permanent unless surgically corrected.

Symptoms of rheumatic fever usually begin anywhere from a week to six weeks after a strep infection. They include:

• Fever
• Joint stiffness – ankles, knees, hands and elbows
• Joint swelling
• Chest pain
• Shortness of breath
• Stomach pain
• Loss of appetite
• Skin rash

To diagnose rheumatic fever a physician will perform a throat culture, blood tests, listen to the heart for signs of a murmur, take an x-ray and an electrocardiogram. Anyone who has a sore throat should see a physician to rule out strep throat. If a diagnosis of strep is made, antibiotics can be prescribed which should prevent the bacterial infection from spreading. In cases where the heart valves have been affected, a patient may need to be placed on a long term antibiotic, and also anti-inflammatory medication. In severe cases, surgery may be required to replace the affected heart valves.

Anyone who has a sore throat that is mild to severe should seek medical attention right away. You may schedule an appointment at Jamaica Hospital’s Ambulatory Care Center by calling 718-206-7001.

Hepatitis B

Posted on May 5, 2015 by Joann Ariola

Hepatitis B is a viral disease that has a distinct effect on the liver. Each has different symptoms and treatments. Some causes of Hepatitis B can be misuse of recreational drugs and prescription medications or by sexual transmission. The only way to determine if you have Hepatitis B is by submitting to a laboratory test.

Persons with Hepatitis B may not realize they have it at first. Often times, the disease does not present with any symptoms or you might not get the right diagnosis since the disease shares some of the same signs as the flu, such as:

Loss of appetite
Fatigue
Mild fever
Muscle or joint aches
Nausea and vomiting
Stomach pain

People with hepatitis may notice darkness to their urine, light-colored stools, a yellowing of their skin (jaundice) or an itchy feeling all over your body. In more advanced cases, there can be bleeding inside your body or the mental feeling of being in a daze or stupor.

It is always smart to check with your doctor if you have any signs or symptoms, or are in an at risk atmosphere.

Not seeking treatment for Hepatitis B can lead to cirrhosis, a serious scarring of your liver.

If you would like to make an appointment with the Jamaica Hospital Medical Center’s Ambulatory Care Center, please call 718-206-7001.

Cardiomyopathy

Posted on March 26, 2015 by Joann Ariola

Cardiomyopathy is a disease which causes the heart muscle to become enlarged, thickened or rigid. The cause of cardiomyopathy is often unknown; however, many believe genetics or previous and chronic heart disorders are contributing factors. Cardiomyopathy is not specific to any age group but it is more prevalent among adults.

This condition may lead to weakening of the heart, which makes it incapable of pumping sufficient blood throughout the body and maintaining a normal electrical rhythm.

The inability of the heart to function properly can potentially cause heart valve problems, heart failure and arrhythmias. Additional complications that can also occur include fluid build-up of the lungs, ankles, feet, legs and abdomen.

Symptoms of cardiomyopathy can vary. In the early stages of the disease, there may not be any symptoms but as the condition advances, they begin to appear. Some symptoms may include:

Breathlessness with exertion or even at rest.
Coughs.
Fatigue.
Irregular heartbeats which are rapid, pounding or fluttering.
Dizziness, lightheadedness and fainting.

Cardiomyopathy cannot be reversed or cured; it can be controlled with lifestyle changes and treated with medications such as diuretics, surgically implanted devices such as pacemakers and defibrillators. As a last resort heart transplant surgery may be recommended.

It is advised that you see your doctor if you have one or more of the symptoms associated with cardiomyopathy. You can contact Jamaica Hospital Medical Center’s Department of Cardiology at 718-206-7100 for an appointment and evaluation.