Difficulty Swallowing Food? Learn the Facts About Dysphagia

Posted on June 21, 2019 by Michael Hinck

Swallowing is a function of our body that we do every day and give very little thought as to how it is achieved. We consider it to be a simple accomplishment, but in fact, it is very complex and involves the coordination of the brain, nerves, and muscles in mouth, pharynx and esophagus.

For some however, swallowing can become difficult or even impossible. This may be due to a range of diseases, commonly referred to as dysphagia. This category of health conditions can become a serious problem that requires medical attention.

There are generally two different types of dysphagia.

Esophageal dysphagia – This refers to the sensation of food getting stuck in the base of your throat or chest after you’ve started to swallow. This type of dysphagia can be caused by a number of issues, including a narrowing of the esophagus due to tumors or scarring, poorly coordinated contractions or spasms in the esophagus, or the lower esophageal muscle not allowing food to enter the stomach.
Oropharyngeal dysphagia – This focuses on swallowing issues that involve the process of moving food from the mouth to the throat when you begin to swallow. Causes for this type of dysphagia are often related to neurological disorders, such as multiple sclerosis, muscular dystrophy, or Parkinson’s disease. It can also occur after sudden neurological damage from a stroke or spinal cord injury.

Swallowing problems can occur at any age, but they are more common in older adults. Symptoms include:

Having pain while swallowing
Drooling
Being hoarse
Regurgitating food
Having frequent heartburn
Having food or stomach acid back up into your throat
Losing weight without explanation
Coughing or gagging when swallowing

In addition to the constant risk of choking, dysphagia can also introduce bacteria into the lungs when food enters the airway, leading to aspiration pneumonia. Other complications from dysphagia include malnutrition, weight loss and dehydration.

Treatment for dysphagia depends on the underlying cause. On some occasions the condition can be managed easily while complex swallowing problems may require treatment by a specialist.

Those with swallowing problems can do many things to manage their condition, including sitting upright or standing while eating and for 15 minutes after eating, cutting up food into small pieces, eating slowly, and drinking plenty of fluids while eating.

To make an an appointment with a doctor at Jamaica Hospital’s Division of Gastroenterology, please 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.

Heart Murmurs

Posted on June 19, 2019 by Joann Ariola

heartmurmur, heartdisease, calcification, heartcondition, lubdub, swishingwhooshing

According to the Mayo Clinic, “Heart murmurs are sounds during your heartbeat cycle made by turbulent blood in or near your heart.”

While using a stethoscope to listen to your heart, your doctor may hear a ‘swishing’ or ‘whooshing’ sound instead of the ‘lub-dub’ sound that a normal heart makes. This slight change in the sound of your heart may mean you have a heart murmur.

Often times, murmurs can be identified at the time of birth or they may develop later in life. Although they are harmless and do not need treatment, they may be an indication of an underlying issue with the heart such as endocarditis (an infection of the inner lining of the heart) or valve calcification (a hardening or thickening of the valves in the heart).

If you have what is referred to as a “harmless” heart murmur, you won’t experience any symptoms at all. If it is an abnormal heart murmur caused an underlying medical condition, the symptoms are:

Skin that appears blue, especially on your fingertips and lips
Swelling or sudden weight gain
Shortness of breath
Chronic cough
Enlarged liver
Enlarged neck veins
Poor appetite and failure to grow normally (in infants)
Heavy sweating with minimal or no exertion
Chest pain
Dizziness
Fainting

Heart murmurs can be genetic. Having blood relatives with a heart defect, puts you at greater risk of a murmur. Additionally, medical conditions such as hypertension, hyperthyroidism, and pulmonary hypertension can increase your risk of a heart murmur.

In adults, a heart murmur may improve once the underlying medical condition is addressed. In children, murmurs may go away on their own as the child matures.

If you have or are at risk of getting a heart murmur and would like to speak with a cardiologist at Jamaica Hospital Medical Center, call 718-206-6742 to schedule an appointment.

Smoking Cessation Medications and Therapies

Posted on June 14, 2019 by Tasmia Ahmed M.D.

Smoking damages almost every part of the body. Along with nicotine, cigarettes contain tar and carbon monoxide which are linked to an increased risk of dementia, gum disease, heart attacks, stroke, lung disease, acid reflux, stomach ulcers, erectile dysfunction, diabetes and infections- just to name a few.

Quitting smoking is one of the most important steps to reducing the risks of developing these conditions and achieving better health; however, doing so can be difficult. Eighty percent of smokers who attempt to quit on their own smoke again within the first month. This is because the nicotine found in tobacco products is addicting.

When the smoke from a cigarette is inhaled, nicotine is carried into the lungs and within 10 seconds reaches the brain. In response, the brain releases dopamine, a substance that induces feelings of pleasure. However, the effects of nicotine disappear within a few minutes which make people feel the need to continually smoke throughout the day.

Additionally, smoking often becomes a habit that is linked to social situations or emotions. For example, smokers may need a cigarette after a meal, when drinking alcohol, with a cup of coffee, or when they feel irritated or frustrated. These types of associations can create a powerful urge to smoke.

When attempting to stop, smokers may experience withdrawal, which can lead to a depressed mood, anxiety, difficulty concentrating, feelings of hunger, and trouble sleeping. These negative feelings can further trigger intense cravings for a cigarette.

All of these factors can make it difficult for smokers to quit on their own. There are FDA approved smoking cessation treatments available that can make the process of quitting easier. They are:

Nicotine replacement therapy (NRT), such as nicotine gum and patches. They relieve nicotine withdrawal symptoms. NRT is effective and increases quit rates. The nicotine found in NRT is not addictive and does not cause cancer since it produces a lower level of nicotine in the blood than smoking a pack of cigarettes daily. Your doctor will recommend a single product or combination of products. The suggested dose is based on your smoking frequency and will be lowered typically over two to three months. However, some people may need to use products longer if there is a high risk of relapse.
Medications that block nicotine from binding to receptors in the brain thereby reducing its addictive quality. Common side effects of these medications are nausea, insomnia, and abnormal dreams which can be avoided by dose adjustments. The dose will be increased over 1 week and then taken for 11 weeks at a stable dosage.
Medications that help keep dopamine levels stable in the brain and alleviate withdrawal symptoms. Common side effects are insomnia, agitation, dry mouth, and headache. The dose may be adjusted to decrease side effects. These types of medications should not be used if you have a seizure disorder.

Quitting smoking is a long and hard journey but the health benefits are enormous. Smokers have a life expectancy 10 years shorter than non-smokers, but quitting before age 40 reduces the risk of dying from smoking-related disease by 90%. Every attempt at quitting is a step in the right direction and your doctor can help develop a personalized smoking cessation plan.

To speak with a Family Medicine doctor at Jamaica Hospital Medical Center about smoking cessation, please call (718) 206-6942.

Tasmia Ahmed MD, Family Medicine

Measles Outbreak Updates

Posted on June 12, 2019 by Amelia MacIntyre D.O.

Measles is a highly contagious virus that causes a red spotted rash to spread all over the body, along with high fever, runny nose, cough, red eyes and sore throat. The virus can be very dangerous and potentially fatal for infants and children.

Recently, there has been an outbreak in the New York City area, and in an effort to contain the spread of the virus health officials are urging communities to keep up with the latest information and comply with recommendations.

To help educate our community, Jamaica Hospital is sharing the following information:

How has the measles outbreak affected NYC communities?

Close to 600 cases of measles have been reported in NYC since the fall of 2018, majority of which are from Brooklyn (Williamsburg, Borough Park, Crown Heights, and more recently Sunset Park); although most cases have been linked to unvaccinated travelers within Orthodox Jewish communities, the disease has also affected non-Orthodox Jewish residents in other boroughs including Queens.

How is the virus spreading?

Measles spreads when people breathe in or have direct contact with fluid that contains the virus. For example, it can pass through droplets sprayed into the air when someone with measles coughs or sneezes.
Measles can spread to others from four days before a rash appears through the fourth day after the rash disappears.
The best way to stop the spread of the virus is through the measles (MMR) vaccination.

How safe and effective is the MMR vaccine?

The MMR vaccine is very effective. Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.
Despite many claims that autism is linked to the MMR vaccine, multiple studies have scientifically proven that the measles vaccine is safe and not linked to autism.

Who gets the MMR vaccine?

All children should receive vaccination. The CDC recommends “children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.”
Infants aged 6 to 11 months traveling abroad to high-risk areas should receive an early dose of MMR ( This dose would be in addition to the regular schedule of MMR vaccinations)
Teens and adults should also be up to date on their MMR vaccination.
Adults with no evidence of immunity (Individuals who may not have previously received vaccination, have no laboratory or written evidence of immunity)
Adults with no evidence of immunity and are at a higher risk for contracting measles. This group includes healthcare workers, international travelers, college students or those exposed to people with measles in the outbreak areas. (Adults who are at a high risk of transmission should receive two doses, 28 days apart).

Amelia MacIntyre DO- Family Medicine

Invisible Braces Pros and Cons

Posted on June 11, 2019 by Xavia Malcolm

Invisible braces are a set of clear, plastic aligners that are sometimes used instead of metal braces to straighten teeth. They have become a popular choice for many because they are far less noticeable than conventional metal braces.

Although there are a growing demand and popularity for invisible braces, they may not be the right choice for everyone. There are pros and cons to consider before making a commitment.

Here are a few pros:

Invisible braces can be more attractive. The clear, plastic aligners are virtually invisible and molded to your teeth. This makes it less obvious that you are wearing braces.
Due to the smooth, flexible plastic they are made from, invisible braces tend to be more comfortable. There are no wires or brackets to contend with.
Unlike metal braces, invisible braces can be removed to eat, brush your teeth or floss. This can be a great benefit when practicing proper oral hygiene.
Computer software is used to plan your treatment in advance; therefore, less follow up visits are required.

The cons to keep in mind include:

Depending on your plan of treatment, Invisible braces can be more expensive than conventional braces.
Discipline is required to get the best results. Invisible braces must be worn a minimal 22 hours per day. It is important that you put them back on shortly after removing them. Neglecting to wear your aligners for 22 hours each day can prolong treatment.
You may feel some pressure or discomfort as your teeth adjust to a new set of aligners.
Invisible braces are most effective when treating those with mild or moderate bite issues, not those with more complex orthodontic issues.

Overall, invisible braces are a safe and effective form of treatment. However, depending on your lifestyle or the complexity of your case, they may not always be the best choice. If you are interested in receiving invisible braces, you should speak with your dentist to determine if you are a good candidate. To speak with a dentist at Jamaica Hospital Medical Center, please call 718-206-6980.

Tips To Make Sure the Ice in Your Freezer is Clean

Posted on June 7, 2019 by Michael Hinck

There is nothing more refreshing on a warm summer day than an ice-filled cold beverage, but before you host your next summer gathering, make sure that the ice you serve is clean and free of harmful bacteria.

While ice is rarely considered to be the source of trouble, there are good reasons to take a second look at how ice is dispensed in your own home. You may think most bacteria wouldn’t survive the icy conditions of a freezer. But they can. Bacteria and viruses such as listeria, E-coli and salmonella can live in freezing temperatures, meaning they may be alive in your ice cubes. With proper precautions however, you can eliminate the risk of these contaminants existing in the ice you serve.

Here are some tips:

Change Your Filter – Most ice makers in freezers use a secondary water filter to stop particles from contaminating the ice. To keep your ice clean, change the freezer’s water filter as frequently as the manufacturer recommends, about every six months.
Regular Cleaning – Don’t forget to defrost and deep clean your freezer at least once a year. As a rule of thumb, if the ice buildup in your freezer is a quarter-inch or thicker, then it’s time to defrost and clean it.
Use Ice Regularly – The slight melting and refreezing of cubes can allow pathogens to take hold. To avoid this, remove the ice storage bin from the freezer and dump any clumps into the sink. Since inactivity causes ice clumps to form, the easiest solution is to use the ice maker more frequently.
Organize Your Freezer – Make sure frozen foods are properly sealed or double-wrapped and avoid having them come into direct contact with ice in trays or bins. Also label all food with a use-by date and remove all expired foods from your freezer.
Don’t Use Your Hands – While all of the above tips are useful, the fact is that the most common way to spread germs is by placing unwashed hands in an ice container. Instead of using your hands, use a designated scooper or other tool to handle ice.

It is important to note that while the existence of contaminants in your ice might be disturbing to learn, the health risks associated with it is fairly minimal to the average immune system and the transmission of viruses are rare. Those more at risk are pregnant women, children, and people with a compromised immune system.

Regardless, it is always a good idea to take the proper precautions to reduce your chances of getting yourself or your guests sick.

Safety Tips for Driving at Night

Posted on June 5, 2019 by Andrew Rubin

The National Safety Council estimates that even though we do only a quarter of our driving at night, approximately 50% of all traffic accidents occur after dark. This leaves many wondering why so many accidents take place at night.

One of the main reasons is that at night, our depth perception is reduced, as is peripheral vision and the ability to see colors. We are also more likely to be more tired at night which can affect our reflexes. People who don’t get enough sleep or who have been working long hours are more prone to having an accident.

Another factor that can affect our ability to drive and see well at night is age. According to the National Safety Council, a person who is older than fifty years of age may need twice as much light to see well as a person who is only 30. Older drivers may also have compromised vision as a result of degenerative eye diseases or cataracts.

There are a few precautions drivers can take to prevent accidents while driving at night. Jamaica Hospital’s Trauma service and the National Safety Council recommends the following:

Keeping the windshield clean
Making sure headlights are aimed properly
Reducing your speed
Turning your headlights on as soon as it starts to get dark so others can see you
Increasing the distance between your car and the car ahead
Pulling over if you feel too tired to drive
Getting at least seven hours of sleep

Older drivers are encouraged to get annual eye exams to make sure that their eyes are healthy. These annual exams can also see if there are cataracts forming which can impair vision, and can check to see if eyeglass prescriptions are needed.

If you would like to schedule an appointment with an eye doctor at Jamaica Hospital Medical Center, please call 718-206-5900.

Over The Counter Readers vs. RX Glasses

Posted on June 5, 2019 by Joann Ariola

If your vision is blurred or you are having issues with your sight, an eye doctor will conduct a regular exam, assessing your overall eye health. At the end of the exam, it may be suggested that you are in need of glasses. If you do not have a serious eye condition, the doctor may suggest magnifiers or over the counter (OTC) “readers.”

When making the decision to get glasses, many people wonder if there is difference between prescription lenses and OTC glasses. The answer is, yes.

Some differences between OTC and prescription glasses are:

Over the counter (OTC) readers are best used for age-related presbyopia. Presbyopia is an age-related issue where your eyes become less flexible, making it harder to focus on close objects.
OTC readers have the same prescription in each lens. Having the same eyesight in both eyes is extremely rare. Therefore, your vision will not be properly corrected and you may still experience difficulty focusing even when wearing OTC readers.
Prescriptions glasses offer more options and benefits, such as quality in materials, accurate vision correction, lens clarity, as well as scratch and glare resistance. Additionally, unlike OTC readers, prescription glasses can help with astigmatism, myopia or glaucoma.

If you are having difficulty with your vision, you should schedule an appointment to have your eyes examined. To schedule an appointment with the Jamaica Hospital Medical Center’s Ophthalmology Center call 718-206-5900.

Mesothelioma

Posted on June 4, 2019 by Xavia Malcolm

Mesothelioma is an aggressive form of cancer. It affects the tissue that lines the body’s internal organs. There are four main types of mesothelioma based on location, they include:

Pleural Mesothelioma (Lungs)
Pericardial Mesothelioma (Heart)
Testicular Mesothelioma (Testes)
Peritoneal Mesothelioma (Abdomen)

Most people who develop the disease are those who have swallowed or inhaled asbestos particles over a period of time (Mesothelioma can take many years to develop after exposure; it may take anywhere between 20 to 60 years to form). There are other contributing factors that increase the risk of the mesothelioma including living with someone who works with asbestos, having a family history of the disease or receiving radiation therapy to the chest.

Symptoms of mesothelioma may vary depending on the location of which the cancer develops. They can include:

Painful coughing
Chest pain
Shortness of breath
Fluid buildup around the lungs
Abdominal pain and swelling
Bowel obstruction
Nausea
Unexplained weight loss
Irregular heartbeat
Pain in the testes
Swelling in the scrotum

If you are experiencing any of these symptoms and are at risk for developing mesothelioma, it is advised that you see your doctor as soon as possible. Your doctor can order a series of tests that may include a biopsy, imaging or blood tests. Testing can help your doctor detect mesothelioma and assign a stage.

There is no cure for mesothelioma. Treatment for the disease is dependent on the stage and location of the cancer, as well as certain aspects of your health. According to the National Cancer Institute, treatment may include surgery, radiation therapy, chemotherapy or targeted therapy.

To learn more about mesothelioma, please visit the National Cancer Institute’s website at www.cancer.gov.

Shining the Employee Spotlight on Yanina Levanidova

Posted on May 30, 2019 by Andrew Rubin

This month Jamaica Hospital is proud to shine its employee spotlight on Yanina Levanidova, a nurse in the Emergency Department who has been with the hospital for ten years.

Yanina is originally from St. Petersburg Russia and came to New York in 1994. Prior to leaving Russia, she graduated from college in St. Petersburg with a degree in computer science. Yanina received her nursing degree from Molloy College in 2001 and received her Nurse Practioner degree from Stony Brook University in 2006.

Yanina currently lives in Queens and enjoys the diversity of the different neighborhoods that are in the borough.

She enjoys going to the movies, going out to eat, and visiting museums. Her favorite artist is Salvador Dali. Yanina says her favorite way to spend her free time is visiting new places. She loves to travel and she tries to do it as often as possible. Her favorite destinations to travel to, besides her native St. Petersburg, typically have a beach and an ocean.

Being a nurse in the ED can be very challenging, but it has many rewards as well. Helping people who are very sick who come in to the Emergency Room to feel better is a very satisfying. Yanina says that working at Jamaica Hospital is like being with family. Ever work swell together. We are very fortunate to have Yanina as a member of our team.