Dodging Winter Depression

Posted on February 6, 2014 by Andrew Rubin

When Winter arrives, do you find yourself spending long hours in your house or apartment feeling fatigued, anxious, and irritable? If so, you are not alone. As many as half a million people in the United States may experience Winter-onset depression, a type of depression associated with cold-weather months. With a physician’s help, however, Winter-onset depression is a treatable condition.

Winter-onset depression is the most common variety of seasonal affective disorder (SAD), a type of depression associated with changing seasons. The cause of the condition is unclear, but it may be related to changes in an individual’s circadian rhythm (biological clock) that result from reduced exposure to sunlight in Winter.

Winter-onset SAD typically lasts from late Fall to Summer. SAD usually appears in people age 20 or older, with women experiencing more cases of the disorder than men. SAD is more likely to occur as a person ages, and individuals living in northern regions are more vulnerable to Winter-onset SAD.

Every person’s experience with Winter-onset SAD is different, but common symptoms include:

Changes in appetite
Weight gain
Low energy level and fatigue
Difficulty concentrating
Irritability and anxiety
Avoidance of social situations
Lack of interest in favorite activities

Winter-onset SAD is fairly predictable, as symptoms tend to occur at the same time each year.

“Many people with Winter-onset SAD may benefit from seeing a psychiatrist, who can assess a patient’s symptoms and formulate a treatment plan”, says Seeth Vivek, MD, Chair of the Department of Psychiatry at Jamaica Hospital Medical Center. “Possible treatments include medication, behavior therapy, and light therapy.”

Light therapy acts as a substitute for the limited sunlight during the Winter months. Patients sit in front of a light box or wear a light visor for 30 minutes per day, and if the therapy proves effective, they continue it until Spring. Light therapy has few side effects, as it can cause eyestrain and headache.

When it comes to preventing Winter-onset SAD, your best bet is to stay active. Search for odd jobs to do around the house that you put off when the weather was nice, and guard against isolation by scheduling get-togethers with friends.

To make an appointment or to speak with a member of the Department of Psychiatry, please call 718-206-7135.

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.

November is Diabetes Awareness Month

Posted on November 15, 2013 by Andrew Rubin

Every year the month of November is recognized nationally as Diabetes Awareness Month. According to the American Diabetes Association, 25.8 million people have this disease, however only 18.8 million have been diagnosed. An additional 79 million people in the United States are believed to have pre-diabetes.

Diabetes affects different race and ethnic groups more frequently than others. The prevalence of diabetes has been calculated to affect 7.1 % of Caucasians, 8.4% of Asian Americans, 12.6% of African Americans and 11.8 % of Hispanics. Diabetes is considered a chronic illness that leads to it being a cause of death, either directly or through a complication due to the disease. Some of the complications associated with diabetes are hypertension, blindness, heart disease and stroke, kidney disease, neuropathy, and amputations.

Diabetes is a chronic illness for which there is no known cure. It can however be treated successfully in many people, and very often these people lead long and healthy lives. Having a family history of diabetes can be a risk factor for developing the disease but not a guarantee that a person will definitely develop it. Other risk factors include obesity, poor diet, having diabetes during pregnancy, race and ethnicity, being over the age of 45, lack of exercise, and having high blood pressure.

Some of the symptoms of diabetes are: frequent urination, frequently feeling thirsty, blurry vision, fatigue, feeling hungry even after having just eaten a meal or a snack, wounds that are slow to heal, numbness or tingling in the extremities, and in some cases, weight loss.

The three most common forms of diabetes are Type 1 which indicates a lack of insulin production by the pancreas, Type 1 is most commonly associated with children and young adults. Type 2 diabetes is when the body produces insulin but it is not utilized adequately by the body, also known as adult-onset diabetes and the most commonly diagnosed form of the disease. Gestational Diabetes occurs occasionally during pregnancy and then frequently resolves itself once the pregnancy is completed.

Diabetes is diagnosed through blood tests. Once the diagnosis is confirmed, a physician will discuss treatment options that will work for that individual. Often this will include either an oral medication in cases that are less severe, or insulin injections for more serious cases, combined with diet modification and possibly an exercise regime. It is extremely important to keep diabetes well controlled. Uncontrolled diabetes can lead to serious complications that may be irreversible and can lead to blindness, heart disease, stroke and premature death.

If you suspect that you may have diabetes, please call 718-206-6742 to schedule an appointment with one of our physicians who specialize in treating this disease.

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Posted on November 15, 2013 by Radeeb Akhtar, MD MPH

Minimizing Risks for Children on Halloween

Posted on October 29, 2013 by Michael Hinck

Halloween is known as a kid-favorite holiday, full of spooky fun and lots of candy. However, it can also present many opportunities for injury, as children take to the streets in pursuit of trick-or-treat goodies. The Trauma Department at Jamaica Hospital Medical Center urges families to stay safe this holiday.

Statistics show that roughly four times as many children aged 5-14 are killed while walking on Halloween evening compared with other evenings of the year. Also, falls are a leading cause of injuries among children on Halloween.

According to Dr. Sebastian Schubl, Medical Director of Trauma at Jamaica Hospital, parents can help minimize the risk of children getting injured at Halloween by following these safety tips from the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the National Safety Council.
Children should:
• Go only to well-lit houses and remain on porches rather than entering houses.
• Travel in small groups accompanied by an adult.
• Use costume plastic knives and swords that are flexible, not rigid or sharp.
When walking through neighborhoods trick or treating, they should
• Use flashlights, stay on sidewalks, and avoid crossing yards.
• Cross streets at the corner, use crosswalks, and do not cross between parked cars.
• Stop at all corners and stay together in a group before crossing.
• Wear clothing or costumes that are bright, reflective, and flame retardant.
• Consider using face paint instead of masks which can obstruct a child’s vision.
• Avoid wearing hats that will slide over their eyes.
• Avoid wearing long, baggy, or loose costumes or oversized shoes to prevent tripping.
• Be reminded to look left, right, and left again before crossing the street.

On Halloween parents and adults should:
• Supervise the trick or treat outing for children under age 12.
• Avoid giving choking hazards such as gum, peanuts, hard candies, or small toys as treats to young children.
• Parents and adults should ensure the safety of pedestrian trick-or-treaters.
• Make sure children under age 10 are supervised as they cross the street.
• Drive slowly.
• Watch for children in the street and on medians.
• Exit driveways and alleyways slowly and carefully.
• Have children get out of cars on the curb side, not on the traffic side.

Jamaica Hospital’s Trauma Division Offers Tips to Avoid Falls

Posted on September 27, 2013 by Michael Hinck

September 22 was National Fall Prevention Awareness Day and Jamaica Hospital Medical Center’s Trauma Division wants to make sure you and your loved ones are taking the proper steps to avoid these preventable incidents.

According to The Centers for Disease Control and Prevention, “falls are the leading cause of injury leading to death for adults 65 or older and are also the most common cause of nonfatal injuries and hospital admission for trauma for this age group.” Falls are also the most common form of traumatic brain injuries in older adults.

As we get older, physical changes and health conditions — and sometimes the medications used to treat those conditions — increase the chances of falls. It is very important to follow these simple steps to decrease your chances of falling:

• Make an appointment to see your doctor to determine your risk of falling. Discuss the factors that increase your chances of falling, including your medical history, your muscle strength and your medications to see if they have side effects such as dizziness or weakness. You should also have your sight and hearing tested regularly.

• Find a good exercise program aimed at building balance, strength, and flexibility. Consider activities such as walking, water workouts and even tai chi. Ask your doctor to write a referral to a physical therapist, who can create a customized exercise routine for you if you are unsure.

• Wear appropriate footwear. High heel shoes, slippers, sandals, or any shoes with slick soles can greatly increase your chances or slipping and falling. Instead, wear properly fitting shoes with nonskid soles. Choose shoes with laces or fasteners over slip-ons and women should avoid walking in stocking feet.

• Look around your home and remove any tripping hazards. Remove any boxes, electrical cords or stacks of paper from the floor and move furniture from high traffic areas. Secure loose rugs with double-sided tape and use nonslip bathmats in the bathtub.

• Properly light your living space by placing nightlights in your bedroom and in your hallways. Create clear paths to light switches and always turn on lights before using the stairs. Also, store flashlights in easy to find locations in the event of a power outage.

• Speak with your doctor about the utilization of assistive device such as canes or walkers for balance. Other assistive devices that are recommended for the home are handrails for both sides of stairways, nonslip treads for bare-wood steps, grab bars for the shower, and a raised toilet seat with armrests.

Falls are a largely preventable public health problem. Jamaica Hospital’s Trauma Division urges older adults and their loved ones to follow these fall prevention measures and live safe, healthy lives.

For more information about falls or other trauma related issues, please contact Jamaica Hospital’s Trauma Division at 718-206-8552.

Back To School: Are Your Children Vaccinated

Posted on September 17, 2013 by Michael Hinck

Today’s vaccines are among the most successful and cost-effective public health tools for preventing disease and death and have helped many illnesses become distant memories. However, many parents are still unclear which vaccines their children should receive or if their children should receive any at all? School-age children, from preschoolers to college students, need vaccines. Here are five important reasons to vaccinate your child:

• Immunizations can save your child’s life
The polio vaccine is one example of the impact that vaccines can have on the eradication of a disease. Dr. Anatasia Fokas, Pediatrician at Jamaica Hospital Medical Center’s Ambulatory Care Center, states, “Vaccines have eradicated many illnesses which have caused death and paralysis in the past. Thankfully, medical advancements have eliminated diseases such as polio and today, there are no reports of polio in the United States.”

• Vaccinations are safe and effective
With extensive testing and careful monitoring of quality, safety, and effectiveness, vaccines are reviewed and approved by a panel of scientists, doctors and healthcare professionals. “Vaccines may cause pain, redness, or tenderness at the site of the injection,” but Dr. Fokas advises, “This shouldn’t deter families from receiving the vaccines. The disease-prevention benefits of getting vaccines are much greater than the possible side effects for almost all children.”

• Immunizations protect others you care about
Getting your child vaccinated at the scheduled times helps prevent the spread of diseases to you and your loved ones. In 2010, a resurgence of whooping cough (pertussis) and measles caused 26 deaths out of the 21,000 cases presented; most of the deaths were in children under 6 months. Infants need time to build their immunity and may not be able to receive vaccines at birth. For this reason, it is important for you and your children to receive the vaccinations to help prevent these occurrences.

• Immunizations can save your family time and money
“Getting vaccinated against these diseases is a good investment and usually covered by insurance,” says Dr. Fokas. Children with vaccine-preventable diseases can be denied permission to attend school or day care. Some vaccine-preventable diseases can result in prolonged disabilities and can take a financial toll because of lost time at work, medical bills or long-term disability care. Ensuring that you and your loved ones receive the scheduled vaccinations can save your family time and money.

• Immunizations protect future generations
If we have effective vaccination programs in place today we will be able to prevent the spread of disease s in the future.

Jamaica Hospital Medical Center’s On-Site Pediatric Ambulatory Care Center is located on the ground floor of the hospital. Please call 718-206-7001 to schedule an appointment with one of our Pediatricians.

Lice

Posted on August 22, 2013 by Michael Hinck

Lice are tiny little parasitic insects that receive their nutrition from the blood of their host. They do not have wings and are therefore spread by close contact with people who are infected with them or with the items of clothing or bedding that those people may be using. Since lice do not fly, it is sometimes thought that they either crawl or jump from one person to another. There are three types of lice to be aware of. , Head Lice, Body Lice and Pubic Lice. The most commonly found are the lice that live on the hair and scalp, known as Head Lice.

The signs and symptoms of head lice are itchy scalp, small bumps on the back of the neck and on the scalp that are red in color, the presence of tiny off-white or light brown insects crawling in the hair or back of the neck, and finding lice eggs also called nits, about the size of a pin head, attached to the hair shafts. Some people who are infected with lice have swollen neck glands, indicating a possible infection.

Detecting head lice can be difficult, since they can be confused to the untrained eye with other things found in people’s hair like dandruff, lint, sand, and dirt. The difference is that lice, especially their eggs (nits) are usually firmly attached to the hair follicle and do not come out with simple rinsing or combing. One method of diagnosing lice is to wet the person’s head, separate the hair in to sections, sit them under a very bright light, and using a very fine comb made specifically for this purpose, comb the hair from the scalp outwards looking for lice and their eggs.

Treating lice involves using a shampoo made specifically for this purpose. These shampoos are very different than regular hair products and they are to be used very carefully, making sure that the instructions are followed closely. Usually the recommendation is to use the product once and wait a few days to see if it is working.
Each day after treatment it is recommended to use the special fine tooth comb to remove the lice and the nits. It is also recommended that all bedding be thoroughly washed in hot water and dried at a high temperature to limit the possibility of reoccurrence. If the signs and symptoms of an infestation persist, it is advised to see a dermatologist who may prescribe a stronger medication to treat the problem.

When a person is diagnosed with lice, it is wise to limit their contact with others until the problem is resolved. This is especially true of school aged children.

If you suspect that your child has lice and over-the-counter remedies are not successful, please schedule an appointment with a physician at Jamaica Hospital by calling 718- 206-7001.

Jamaica Hospital Warns – Summer is Kidney Stone Season

Posted on July 19, 2013 by Michael Hinck

They are less than a centimeter in size, yet they can cause intense discomfort. Kidney stones are one of the most painful urologic disorders, and they occur more frequently during the summer because our bodies loose more water due to sweating, which can result in dehydration.

Kidney stones are small, hard masses made of mineral and acid salts that develop in the urine. No single factor causes kidney stones, and not everyone is susceptible to them. Several factors often work together to create an environment in which at-risk people develop kidney stones. People most at risk for kidney stones include:

• Adults
• Males
• Those with family or personal history of kidney stones
• Those with personal history of digestive diseases and/or surgery

In general, kidney stones form when the fluid and various mineral and acids that make up urine are out of balance. “With adequate hydration, calcium and other crystal-forming substances properly dissolve in the urine,” says Ricardo Ricciardi, MD, Director of Urology at Jamaica Hospital Medical Center.

Although genetics, family history, and some medical conditions can increase your odds of developing kidney stones, you can still play a role in preventing them through the following steps:

• Drink enough water. “If you’re prone to kidney stones, your best defense is to stay hydrated during hot summer months,” says Dr. Ricciardi. “Hot temperatures make your body lose more water than usual, so it is important to replenish it throughout the day, depending on your weight and activity level.”

• Eat less meat. Diets rich in animal protein increase your risk for kidney stones; so try to incorporate other protein sources, such as beans, nuts and seeds, instead.

• Limit your salt intake. Excess salt absorbs water in your system, which can also dehydrate you. Limit your daily sodium intake to 1,500 mg or less by avoiding fast food, reading nutrition labels when you buy groceries, and cooking with less salt and more herbs and spices.

• Drink less caffeine. Even though you may think you are getting enough liquid by consuming caffeinated sodas, coffee, or tea, caffeine is a diuretic, meaning it can dehydrate you.
Sneaking Symptoms

Kidney stones often do not cause symptoms. If the crystals are small enough, they may pass through the urinary tract and out of the body without being felt. If a stone is large enough to attract attention, however, the first symptom is usually severe pain in the backside that begins when the stone moves into the urinary tract, blocking the flow of urine. The pain may later spread to the groin and lower abdomen. Other symptoms include a persistent urge to urinate, painful urination, and pink, red, or brown urine.

Seek medical attention if you have pain accompanied by nausea and vomiting or fever and chills, or if pain is so severe that you cannot sit still or find a comfortable position. If you are experiencing any of the symptoms mentioned, or suspect you have Kidney Stones and would like to schedule an appointment, please contact Dr. Ricciardi at 718-206-7110.

Jamaica Hospital Offers Tips to Avoid Bug Bites

Posted on July 2, 2013 by Andrew Rubin

What’s Bugging You ?

Summer usually means picnics and family reunions, but it also means a reunion with insects that can wreak havoc on outdoor activities. Follow these tips to minimize the potential for bug bites and bee stings.

When outdoors – especially in wooded areas – wear long sleeves, pants, and socks to help protect your skin from insect bites. Be aware that insects may be drawn to scented soaps and perfumes. Also, cover food and drain or dump standing water.

“Although applying insect repellent may help adults and children avoid bug bites, these products are unsafe to use on infants,” says Farshad Bagheri, MD, Infectious Disease Specialist at Jamaica Hospital Medical Center. “Repellents containing citronella or less than 10 to 30 percent DEET are safe for older children, but they should only be applied once and washed off as soon as possible.”

Treating Bites and Bee Stings

If a sting occurs, remove the stinger as soon as possible by scraping the area with your fingernail or something with a flat surface, such as a credit card. For bee and wasp stings and non-poisonous spider bites, wash the area thoroughly with soap and water and apply ice to reduce swelling. Continue to wash two or three times daily until the skin has healed.

“Be sure to talk with your physician before taking antihistamines or other over-the-counter medications for itching to avoid potential drug interactions,” says Dr. Bagheri.

Severe Reactions

“If you notice swelling or a rash around the site of a sting or if pain persists for three days, seek medical attention,” says Dr. Bagheri. “Dizziness, nausea, tightness of the throat or chest, wheezing, or swelling of the lips, face, or tongue can indicate a severe allergic reaction, which requires immediate emergency medical attention.”

If you or your child is stung in the mouth, seek medical attention immediately. Severe swelling occurs quickly in oral mucous membranes and can block airways, making breathing difficult or impossible.

If you have a severe reaction to a bug bite, go to the nearest hospital Emergency Room or call 911. Otherwise, to schedule an appointment, please call 718-206-6742.

Erectile Dysfunction: More Common than You Think

Posted on June 18, 2013 by Natifia Mullings

It is reported that nearly 30 million American males suffer from erectile dysfunction. Defined by the National Library of Medicine, erectile dysfunction is when a man has trouble getting or keeping an erection firm enough for sexual intercourse, accompanied by a reduced sexual desire. While some men will experience erection difficulties every now and then, an ongoing erection problem indicates a larger problem.

What Happens During an Erection?
In order for an erection to occur, a male must first be sexually aroused. Next, the brain must “communicate” this sexual arousal to the body’s nervous system, which activates blood flow to the genital area. Lastly, relaxed blood vessels must supply blood to the penis. This results in an erection. If anything affects these three steps—arousal, the nervous system, or the vascular system— erectile dysfunction can occur.

Causes of Erectile Dysfunction
Since male sexual arousal is a process that involves the brain, hormones, emotions, nerves, muscles, and blood vessels, erectile dysfunction can be caused by any of these, as well as stress, fatigue, anxiety, and mental health diseases. Erectile dysfunction effects men as they age, but it can also be a sign of an underlying health problem, such as heart disease, blocked blood vessels, high cholesterol, high blood pressure, or diabetes, making it extremely important to speak with a physician.

“For most men, talking to their doctor about erectile dysfunction is awkward and embarrassing, and therefore a conversation that is often avoided,” said Dr. Riccardo Ricciardi, a Urologist at Jamaica Hospital. “Men have to speak up, especially since there are tests and procedures that can be performed to address their impotence.”

Millions of men have tried medications, such as Viagara, in an attempt to improve their erectile function and regain intimacy in their lives. While this option has proven successful for many, for approximately 30-40% of men this method of therapy is not effective. For these men, a variety of options are available, including penis pumps, penile implants, or surgery.

Jamaica Hospital’s Division of Urology currently offers an advanced surgical device for impotence. The Coloplast Titan and Titan One Touch Release inflatable penile implants are self-contained, fluid-filled systems made from Bioflex and silicone. The treatment features:

a 3-piece design for a more natural-appearing erection, providing greater flaccidity than with two-piece implants. Each part is connected by silicone tubing. The Titan implant is MRI conditional and latex free.
an ease-of-use pump, which means fewer squeezes to achieve a full erection and smooth, simplistic deflation.
a lock-out valve for less chance of unintentional inflation and smooth, simplistic deflation.
a hydrophilic coating that attracts water contained in solutions used to prepare the device.

The Coloplast Titan One Touch Release features an innovative “One Touch Release,” making deflation of the implant possible with only one hand.

For more information about erectile dysfunction or to schedule an appointment to see a Urologist for other men’s health issues, please call 718-206-7110.