What is Lymphatic Circulation?

Posted on November 5, 2025 by Patrick Hercules

The lymphatic system is a group of organs, vessels, and tissues that protect the body from infection and help it keep a healthy balance of fluids throughout the body. Lymphatic system organs include bone marrow, the thymus gland, and lymph nodes.

The lymphatic system is a vital part of the immune system because it protects the body from infection and destroys old or abnormal cells that the body doesn’t need.

Lymphatic circulation is the drainage system for your body, which functions by taking fluid that has seeped into your body’s tissues and returning it to the bloodstream. During this process, the lymphatic circulation system filters the fluid and works to remove toxins and potentially harmful waste. Other key functions include:

Helping the body absorb fats

Protecting the body against bacterial, viral, parasitic, and fungal infections

Many conditions can affect various parts of the lymphatic system. Some happen during development before birth or during childhood. Others develop because of disease or injury. Some common diseases and disorders of the lymphatic system include:

Swollen lymph nodes

Swelling or accumulation of fluid

Cancers of the lymphatic system

Lymphangitis

Lymphangioma

Intestinal lymphangiectasia

Lymphocytosis

Lymphatic filariasis

Castleman disease

Lymphangioleimyomatosis

Autoimmune lymphoproliferative syndrome

Mesenteric lymphadenitis

To check if a person’s lymphatic system is working properly, a healthcare provider may use imaging tests such as a CT scan or an MRI.

There are many ways to keep your lymphatic system strong and healthy, including:

Avoiding exposure to toxic chemicals, such as those in pesticides or cleaning products. These chemicals can build up in the lymphatic system, making it harder for the body to filter waste

Drinking plenty of water to stay hydrated so lymph fluids can easily move throughout the body

Keeping a healthy lifestyle that includes regular exercise and a nutritious diet. A healthcare provider can offer specific advice that is tailored to your medical history and needs

If you would like help with lymphatic circulation, you can receive treatment from a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

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.

Insulin Pumps

Posted on October 31, 2025 by Patrick Hercules

Insulin pumps can help people with diabetes conveniently manage their blood sugar. These small, wearable devices supply a continuous flow of rapid-acting insulin underneath the skin, delivering doses at specific times, and are an alternative to multiple daily injections.

An insulin pump mimics how the pancreas would naturally release insulin. It delivers insulin in one of two ways:

Small and continuous doses are called basal insulin. A person with diabetes will likely have multiple basal rates in increments throughout the day due to the body requiring different amounts of small “background” doses throughout a 24-hour period

Manual surges of insulin when eating and correcting high blood sugar are called bolus insulin. The pump uses the information the user enters about their carbohydrate intake and blood sugar level to calculate how much bolus insulin they need. Most pumps will recommend a dose to the user, which they can then confirm or adjust before the insulin is delivered

There are several types of insulin pumps on the market with unique features. Each type and brand of pump has various settings, including:

Integration with continuous glucose monitor (CGM) technology to automatically increase, decrease, or stop insulin release based on a person’s glucose level

Options to manually increase or decrease the basal rate for a certain amount of time

Alarms to alert the user of a low battery or a low reservoir

Alarms to alert the user if their glucose level is out of range, the CGM communicates with their pump

Connectivity to phone apps and other smart devices

There are two main types of insulin pumps: those with tubing and those without tubing.

Tubed insulin pumps have a long, thin tube that connects the pump to a cannula, a thin, flexible tube, inserted under the skin to deliver insulin. Parts of a tubed insulin pump include:

The pump machine and technology

The tubing and infusion set

Most reservoirs and infusion sets should be changed every two to three days. And the reservoir must be changed if it runs out of insulin. New infusion sets, reservoirs, and tubing should be used every time; however, the pump itself can typically last for many years.

Tubeless insulin pumps, or patch pumps, also use a cannula under the skin. However, the insulin reservoir and the cannula are part of one pod that sits on the skin with an adhesive patch. There is no external tubing, and it can be operated wirelessly with a handheld controller.

Each pump or pod can be used at a time. Like a tubed pump, it needs to be changed every two to three days and must be changed if the reservoir runs out of insulin.

Before attaching the pod, the reservoir is filled with insulin and attached with adhesive to the skin. A button is then pressed that releases a needle that is threaded through the cannula in the pod. The needle retracts back into the pod, and the cannula remains under the skin. The pump can be worn on the upper arm, stomach, hip, buttock, or thigh.

Tubeless insulin pumps are waterproof, so they can be worn when bathing or swimming.

Anyone with diabetes who requires synthetic insulin can use an insulin pump. This includes children and adults with Type 1 diabetes, some people with Type 2 diabetes, and people with Type 3c or monogenic diabetes.

Each insulin pump has different Food and Drug Administration (FDA) approvals regarding how old a person can be to use it. Some insulin pumps have approval for children as young as two years old. Most other pumps have approval for those seven years and older.

Using an insulin pump has several advantages, including:

Not having to inject insulin

It is more discreet than injecting insulin with a syringe

It is more accurate at delivering insulin

It may help with tighter blood glucose control

There are fewer fluctuations in blood glucose levels

It may result in improved A1C

There are fewer episodes of low blood sugar

There is more flexibility with diet and exercise

It helps manage the early morning rise in blood glucose levels called the dawn phenomenon

Using an insulin pump can also have its disadvantages, including:

Increased weight gain

Increased risk of diabetic ketoacidosis if the pump doesn’t work correctly

Risk of skin infection or irritation at the application site

Needing to be attached to the pump most of the time

Having to operate the pump, replace its batteries, set doses, etc.

Having to wear the pump makes it obvious you have diabetes

Learning how to use the pump and keeping it working properly

Having to check blood sugar levels several times a day and count carbohydrates

It can be more expensive than taking traditional insulin injections

There are many factors to consider when choosing an insulin pump. Fortunately, pump manufacturers have a lot of information on their products, and trainers who can answer questions.

It is very important to discuss your options with a diabetes healthcare provider.

If you have any questions about which insulin pumps are best for you, or if you would like help to manage your diabetes, you can speak with an endocrinologist at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Common Misconceptions About Bariatric Surgery

Posted on October 27, 2025 by Patrick Hercules

Bariatric, or gastric bypass surgery for weight loss, is a surgical treatment for severe obesity that involves making changes to the digestive system. It is performed when diet and exercise haven’t worked, or when a person is at risk for serious health problems due to their weight.

There are several myths and misconceptions about bariatric surgery and its outcomes, including:

Bariatric surgery is unnecessary, and people just need to eat less and exercise more
Bariatric surgery is dangerous
Bariatric surgery will make a person thin
Bariatric surgery and weight loss will make a person happy and improve their relationships
Bariatric surgery will prevent a person from overeating
Bariatric surgery is an easy way out
Most people will gain the weight back after surgery

Bariatric surgery can be a lifesaving solution for many people who are overweight. Bariatric surgery, along with a commitment to lifestyle changes, not only provides long-term weight loss but it significantly improves the health and quality of life for many.

For more information about the Bariatric Surgery Services at Flushing Hospital or procedures performed by our doctors, please call 718-408-6977 or 718-670-8908.

Should You Use Mouthwash Before or After Brushing?

Posted on October 23, 2025 by Patrick Hercules

Brushing and flossing are the most important measures for supporting your oral health. However, rinsing with mouthwash as an addition to these oral health care practices is a simple way to get more out of your dental hygiene routine.

There are two main types of mouthwash: therapeutic and cosmetic.

Therapeutic mouthwash usually contains active ingredients that fight off harmful bacteria, help reduce plaque, gingivitis, cavities, and bad breath. If they have fluoride, they can also help prevent tooth decay.

Cosmetic mouthwash may temporarily control or reduce bad breath and leave a pleasant taste in your mouth, but they do not help prevent cavities or gum disease.

According to the American Dental Association (ADA), mouthwash can reach areas that your toothbrush can’t, which can help reduce the risk of developing cavities and gum disease.

Additionally, the American Academy of Periodontology notes that untreated gum disease can lead to complications such as gum recession and tooth loss, but using mouthwash can help boost your prevention efforts.

Using mouthwash has many benefits, including:

It freshens your breath
It reduces plaque
It prevents gingivitis
It prevents cavities
It promotes overall dental health

Mouthwash can enhance your oral care routine. However, it is important to remember that it is not a substitute for regular brushing and flossing.

The ADA states that you may choose to use mouthwash before or after brushing based on personal preference. However, mouthwash manufacturers may recommend an order based on their product’s ingredients, so it is important to check the label on your product to ensure that you maximize its effects.

It is important to visit a dentist to ensure you’re receiving the most effective treatment possible. If you would like to receive a checkup, you can schedule an appointment at Flushing Hospital Medical Center’s Department of Dental Medicine by calling (718) 670-5521.

Chair Exercises for Older Adults

Posted on October 17, 2025 by Patrick Hercules

Physical activity can reduce not only the risk of heart disease but also cognitive decline. It can also help you to sustain your ability to perform everyday activities. Maintaining physical fitness as we age becomes increasingly important for our overall well-being. However, for many older adults, high-impact workouts may not be suitable or comfortable, especially if they have challenges with balance or mobility.

Fortunately, engaging in seated or standing chair-based exercises has many health benefits that can help older adults stay active safely.

Doing chair-based exercises offers many health benefits to older adults, including:

Improved flexibility
Improved balance
Improved stamina and endurance
Helps build strength
Helps burn calories
Helps maintain muscle mass
Contributes to weight management

Some seated chair-based exercises include:

Seated leg extensions
Pelvic tilts
Seated calf raises
Toe raises
Shoulder blade squeezes
Thigh squeezes
Arm raises
Bicep curls
Seated marches
Side bend stretches
Seated shoulder stretches
Seated hamstring stretches
Seated neck rotations
Sit-to-stands
Knee extensions
Seated torso twists

Some standing chair-based exercises include:

Standing leg curls
Chair planks
Standing side leg raises
Calf raises
Standing marches
Standing torso twists

Older adults should aim to do chair-based exercises regularly. It is recommended to engage in these exercises at least two to three times a week to maintain and improve strength, flexibility, and balance. Consistency is key to experiencing the full benefits.

Whether you are looking to maintain your current level of fitness or start a new journey towards better health, these chair-based exercises offer a safe and effective way to achieve your goals.

It is recommended that you consult your doctor before starting a new exercise routine. You can schedule an appointment with a doctor at Flushing Hospital’s Ambulatory Care Center by calling (718) 670-5486.

National Primary Care Week

Posted on October 10, 2025 by Patrick Hercules

National Primary Care Week is celebrated from October 6^th through October 11^th. It is a time to raise awareness about family medicine and to thank the doctors, physician assistants, nurses, and healthcare teams who help keep us healthy every day.

Primary care is the first stop you make when you’re sick, require a checkup, or have any questions about your health. These are the family doctors, pediatricians, or nurse practitioners who know you best and help you to stay healthy, catch problems early, and guide you when you need more care. They don’t just treat you when you are ill; they help keep you well.

Primary care providers do more than administer shots or check blood pressure. They listen to a patient’s concerns, help manage long-term conditions such as diabetes or asthma, and refer you to specialists when needed. They also help with mental health, food and housing needs, and other factors that may affect your well-being.

Here are some ways you can participate in National Primary Care Week:

Schedule a checkup if you haven’t had one in a while
Update your health records to make sure your healthcare provider has your latest information
Thank your doctor or nurse for the care they give
Learn more about what your primary care provider can do for you
Talk to family and friends about the importance of having a primary care provider

If you would like to receive a checkup, you can receive treatment from a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

How Having a Sedentary Job Contributes to a Higher Risk of Insomnia

Posted on October 9, 2025 by Patrick Hercules

According to a study published on January 7^th, 2025, by the Journal of Occupational Health Psychology, people with sedentary jobs, an estimated 80% of the workforce, have a much higher risk of experiencing insomnia compared with people who are active at work. Insomnia is a common sleep disorder that can make it difficult to fall asleep or stay asleep. A sedentary job is any job that requires an employee to sit for about six hours of an eight-hour workday.

Researchers surveyed nearly 1,300 people twice over a span of ten years, inquiring about their job schedules and physical activity levels while at work. They also asked about the participants’ sleep habits, identifying three sleep health categories: good sleepers, insomnia-like sleepers, and catch-up sleepers.

Good sleepers are people who exhibit optimal sleep patterns, such as regular sleep cycles with low levels of daytime tiredness.

Insomnia-like sleepers are people who experience short sleep cycles and higher levels of daytime fatigue.

Catch-up sleepers fall between both groups and often rely on naps or extra weekend sleep to compensate for irregular sleeping patterns.

Compared to active work, sedentary work was 37% likely to lead to a variety of insomnia symptoms, such as difficulty falling asleep, interrupted sleep, and frequent daytime tiredness. The findings of the study also indicated that workers who fall into a pattern of poor sleep due to their job design (defined as elements such as the amount of technology used at work, levels of physical activity, and work schedules, and specifically the time of day when the employee works) can end up stuck in such unhealthy patterns for many years. Insomnia-like sleepers, for example, reported their symptoms persisted ten years later, at the end of the study.

Those experiencing insomnia may have the following symptoms:

Having a hard time falling asleep at night
Waking up during the night
Waking up too early
Feeling tired or sleepy during the day
Feeling cranky, depressed, or anxious
Having a hard time paying attention, focusing on tasks, or remembering
Making more errors or having more accidents
Having ongoing worries about sleep

If you are experiencing insomnia, there are several ways you can improve your sleep, including:

Taking short breaks throughout the day to move
Unplugging smartphones and computers two hours before bedtime
Using light exposure to readjust your circadian rhythms if you work a night shift

If you are experiencing symptoms of insomnia, you can learn more about our outpatient mental health services at Flushing Hospital Medical Center. To schedule a virtual appointment, please call (718) 670-5316 to speak with our intake coordinator or (718) 670-5562 to reach the clinic.

What Are the Symptoms of Celiac Disease?

Posted on October 3, 2025 by Patrick Hercules

Celiac disease is an autoimmune condition where the immune system reacts to gluten, a protein sometimes found in foods containing wheat, barley, and rye.

When a person has celiac disease, eating gluten triggers an immune response to the gluten protein in the small intestines. The immune system sends inflammatory cells and antibodies to destroy the gluten molecules. Over time, this reaction can damage the lining of the small intestine, which prevents it from absorbing nutrients. This condition is called malabsorption. It can also lead to malnutrition and many other conditions that follow from the lack of different nutrients.

The symptoms of celiac disease can vary greatly. They can also be different in children and adults. Digestive symptoms for adults include:

Diarrhea
Fatigue
Weight loss
Bloating and gas
Belly pain
Nausea and vomiting
Constipation

However, more than half the adults with celiac disease have symptoms that are not related to the digestive system, including:

Anemia
Osteoporosis
Dermatitis herpetiformis
Mouth ulcers
Headaches and fatigue
Nervous system injury, including numbness, tingling in the feet and hands, as well as possible problems with balance, and cognitive impairment
Joint pain
Hyposplenism
Elevated liver enzymes

Children with celiac disease are more likely than adults to have digestive problems, including

Nausea and vomiting
Chronic diarrhea
Swollen belly
Constipation
Gas
Pale, foul-smelling stools

For children who aren’t able to absorb nutrients, it may cause:

Failure to thrive in infants
Damage to tooth enamel
Weight loss
Anemia
Irritability
Short stature
Delayed puberty
Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination, and seizures

Celiac disease is most commonly found in people of Northern European descent. It is estimated to affect 1% of the populations of Europe and North America. A person has a 10% chance of developing the disease if they have a first-degree relative, such as a parent or child, who has it. About 97% of people diagnosed with celiac disease have a recognizable gene variant associated it with it.

A person’s genes, combined with eating foods with gluten and other factors, can contribute to celiac disease. However, the precise cause isn’t known. Sometimes celiac disease becomes active after surgery, pregnancy, childbirth, viral infection, or severe emotional distress.

Several risk factors cause celiac disease to be more common in people who have:

A family member with celiac disease or dermatitis herpetiformis
Type 1 diabetes
Down syndrome, Williams syndrome, or Turner syndrome
Autoimmune thyroid disease
Microscopic colitis
Addison’s disease

Many people with celiac disease don’t know they have it. However, two blood tests can help diagnose it:

Serology testing
Genetic testing

It is important to be tested for celiac disease before trying a gluten-free diet. Eliminating gluten from your diet might make the results of the blood tests appear in the standard range.

The first and most important step in treating and the only way to manage celiac disease, is to stop eating gluten and adopt a strict, lifelong gluten-free diet. You can’t change the way your body reacts to gluten, but you can prevent gluten from triggering a reaction. Additional treatments may include:

Nutritional supplements
Specific medications
Corticosteroids
Continuous follow-up care

To schedule an appointment with a gastroenterologist or dietitian at Flushing Hospital Medical Center, please call 718-670-5486.

What Are the Healthiest Oils to Cook With?

Posted on October 2, 2025 by Patrick Hercules

When you are cooking with oil, it is important to choose the right cooking oils, as it is essential for both flavor and health.

An easy way to do this is to choose non-tropical vegetable oils to cook and prepare food. Nontropical oils are oils that come from plants that grow in temperate climates and are healthier alternatives to tropical oils, and are rich in unsaturated fats. Tropical oils are oils that come from plants that grow in warm tropical climates, such as palm oil, palm kernel oil, and coconut oil.

When you are shopping for healthy oils, choose oils with less than four grams of saturated fat per tablespoon and no partially hydrogenated oils or trans fats.

According to the American Heart Association (AHA), some common cooking oils that contain more of the “better for you” fats and less saturated fat include:

Canola oil
Corn oil
Olive oil
Peanut oil
Safflower oil
Soybean oil
Sunflower oil
Vegetable oil

Blends or combinations of these oils, which are often labeled “vegetable oil”, and cooking sprays made from these oils are also good choices.

Some oils have distinctive flavors, so it is important to try different types to determine which oils you prefer. Additionally, some oils are better for certain types of cooking than others, so you may want to have more than one type of oil in your pantry.

Some ways you can use healthy oils include:

Making your own salad dressings, marinades, dips, and sauces
Grilling, sautéing, baking, or roasting foods
Coating pans to keep food from sticking
Lightly drizzling them on foods for flavor
“Seasoning” cast-iron cookware
Substituting oil for butter, stick margarine, or solid fats

Here are some tips for cooking with healthy oils:

If your oil starts to smoke or catch fire, don’t use it. Oil starts to degrade once it reaches its smoking point
If the oil smells bad, don’t use it and throw it away. When oil is stored for too long, it can become oxidized or rancid, and it has a distinct smell
Do not reuse or reheat any cooking oil
Buy oil in smaller containers if you don’t use it frequently. This will allow you to use it before it expires
Store your healthy oils in a dark, cool place

If you would like to learn more about Flushing Hospital Medical Center’s nutritional services, you can visit the Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Stomatitis

Posted on October 1, 2025 by Patrick Hercules

Stomatitis, or oral mucositis, is inflammation in the mucous membranes, or mucosa, that line the mouth or lips. The most common types are cold sores and canker sores.

Other less common types of stomatitis include:

Angular cheilitis
Thrush
Contact stomatitis
Denture stomatitis
Gingivostomatitis
Nicotine stomatitis

Stomatitis can have many causes, including:

Viral, bacterial, and fungal infections
Mouth injuries
Allergic reactions or mouth irritation
Treatments such as chemotherapy and radiation therapy
Certain medications
Systemic conditions such as Bechet’s disease and celiac disease
Skin conditions such as Bullous pemphigoid and lichen planus
Nutritional deficiencies

Signs and symptoms of stomatitis include:

Redness and swelling inside the mouth
A tiny blister, or cluster of blisters, that appears on or around the lips
One or more sores inside the mouth that are usually white, gray, or yellow, with a red border
White or gray patches on the tongue, the roof of the mouth, or inside the cheeks
The sensation that the tongue and the roof of the mouth are burning
Mild to severe pain or discomfort that may make it difficult to eat, swallow, or talk

Many factors put you more at risk of developing stomatitis, such as:

Not regularly cleaning your teeth
Having dry mouth

Stomatitis can cause various complications. The pain and swelling that stomatitis causes can be so severe that it hurts to eat or drink. This can cause someone to skip meals. However, not getting the nutrients or fluids you need can pose serious health risks such as malnutrition and dehydration.

Although infections can cause stomatitis, they can also cause another complication that can make you more vulnerable to germs, which can trigger more inflammation and tissue damage when you have an injured mucosa.

To diagnose stomatitis, a healthcare provider may look for visible signs of more recognizable types of stomatitis, such as canker sores and cold sores, just by looking at them. Reviewing your symptoms and medical history can help as well. For instance, if you are receiving cancer treatment, your doctor may conclude that your oral stomatitis is a side effect of treatment.

You may also need tests to diagnose stomatitis, such as:

Tests to check for viruses, bacteria, and fungi
Blood tests to check your overall health or for signs of systemic diseases
Allergy tests to check for allergens causing stomatitis
A biopsy to check for unusual cells that may be signs of a more serious condition

The treatment for stomatitis depends on what is causing it. The only way to cure stomatitis is to treat or manage the issue that is creating the problems. Treatments can include:

Over-the-counter medications for canker sores and cold sores
Prescription medications for infections such as antivirals, antibiotics, and antifungals.
Vitamins or supplements that give you the nutrients you need
Staying away from foods or products that trigger inflammation
Practicing good oral hygiene to keep your mouth free of harmful bacteria while your mouth heals

All causes of stomatitis can’t be prevented. However, you can reduce your risk of developing it by doing the following:

Brushing twice a day, flossing daily, and getting regular dental cleanings
Eating balanced meals and drinking enough water daily
Choosing not to smoke or use tobacco, or quitting if you do
Avoiding sharing foods, drinks, or lip balm, and intimate contact with someone with a cold sore

If you’re experiencing symptoms of stomatitis, it is important to visit a dentist to ensure you’re receiving the most effective treatment possible. To schedule an appointment at Flushing Hospital Medical Center’s Department of Dental Medicine, please call (718) 670-5521.