Bleeding Disorders

Posted on March 6, 2025 by Patrick Hercules

Bleeding disorders are a group of conditions that affect the way the body controls blood clotting. The clotting process, known as coagulation, changes blood from a liquid to a solid.

When you’re injured, your blood normally begins to clot to prevent a massive blood loss. However, these conditions prevent blood from clotting properly, which results in heavy or prolonged bleeding.

Bleeding disorders can cause abnormal bleeding outside and inside the body. Some disorders can drastically increase the amount of blood leaving the body, while others cause bleeding under the skin or in vital organs, such as the brain.

There are numerous bleeding disorders. The most common include:

Hemophilia A and B- are conditions that occur when there are low levels of clotting factors in your blood. It causes heavy or unusual bleeding in the joints. Although hemophilia is rare, it can have life-threatening complications
Factor II, V, VII, X, or XII deficiencies- are bleeding disorders related to blood clotting problems or abnormal bleeding problems
Von Willebrand’s disease- is the most common inherited bleeding disorder. It develops when the blood lacks the von Willebrand factor, which helps the blood clot

For blood to clot, the body needs blood proteins called clotting factors and blood cells called platelets. Normally, platelets clump together to form a plug at the site of a damaged or injured blood vessel. The clotting factors then combine to form a fibrin clot, keeping the platelets in place and preventing blood from flowing out of the blood vessel.

For people with bleeding disorders, however, the clotting factors or platelets don’t work the way they should or are in short supply. When the blood doesn’t clot, excessive or prolonged bleeding can occur. It can also lead to spontaneous or sudden bleeding in the muscles, joints, and other body parts.

Some bleeding disorders are present at birth and are passed down or inherited through families. However, other bleeding disorders can be caused by:

Medical conditions, such as liver disease
A low red blood cell count
A vitamin K deficiency
Side effects from certain medications

Symptoms of bleeding disorders can include:

Bruising easily
Heavy bleeding
Heavy menstrual bleeding
Nosebleeds that do not stop easily
Excessive bleeding due to surgical procedures
Umbilical cord bleeding after birth

A doctor will diagnose a bleeding disorder by asking about your symptoms and medical history. They will also perform a physical exam and run blood tests to make a proper diagnosis. These tests can include:

A complete blood count
A platelet aggregation test
A bleeding time test

Treatment options for bleeding disorders vary depending on the type of bleeding disorder and its severity. Although treatments can’t cure bleeding disorders, they can help relieve the symptoms associated with certain disorders. Treatment options include:

Iron supplementation
Blood transfusion

If you experience symptoms of a bleeding disorder, it’s important to get diagnosed as soon as possible; even if your symptoms are mild, talking to a doctor can help you avoid potential risk factors that may worsen them. You can schedule an appointment with a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center by calling (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.

Stroke Treatment Options

Posted on February 28, 2025 by Patrick Hercules

Strokes happen when a blood clot or broken blood vessel prevents blood from getting to your brain. The lack of blood flow deprives brain cells of the oxygen and nutrients they need to survive, causing them to die in minutes.

There are two types of strokes: ischemic and hemorrhagic.

Ischemic strokes usually happen because a blood clot blocks a blood vessel connected to your brain. Hemorrhagic strokes occur when a blood vessel in your brain breaks or ruptures.

Strokes can be fatal. Therefore, you must know the symptoms and pay attention to them when they occur. Symptoms of strokes include:

Trouble speaking and understanding what others are saying
Numbness, weakness, or paralysis in the face, arm, or leg
Problems seeing in one or both eyes
Headaches
Trouble walking
Confusion
Dizziness or vertigo
Blurred vision or double vision
Loss of coordination

Seek immediate medical attention if you notice any symptoms of a stroke, even if they seem to come and go or disappear completely.

To diagnose a stroke, a healthcare provider will use a combination of neurological exams and tests that include:

Blood tests
CT scan
Electroencephalogram (EEG)
Electrocardiogram (EKG)
MRI
Carotid ultrasound
Cerebral angiogram

Some treatments are most effective when given soon after a stroke starts. Emergency treatment depends on whether you’re having an ischemic or hemorrhagic stroke.

To treat an ischemic stroke, blood flow must quickly be restored to the brain. This can be done with:

Emergency IV medicine
Emergency endovascular procedures
- Medications delivered directly to the brain
- Removing the clot with a stent retriever
Other procedures, such as a carotid endarterectomy and angioplasty and stents

Emergency treatment of hemorrhagic stroke focuses on controlling the bleeding and reducing the pressure in the brain caused by excess fluid. If the area of bleeding is large, surgery may be needed to remove the blood and relieve pressure on the brain. Surgery may also be required to repair blood vessel damage due to the hemorrhagic stroke. A healthcare professional may recommend a procedure if an aneurysm, arteriovenous malformation (AVM), or other blood vessel condition caused the stroke. Procedures include:

Surgical clipping
Endovascular embolization, also known as coiling
Surgical removal of a tangle of thin-walled blood vessels, known as AVM
Stereotactic radiosurgery

Stroke rehabilitation is an important part of stroke treatment. Rehabilitation will help you adjust to changes in your brain and body after a stroke. You may need to regain abilities you had before or need to adjust to new or different disabilities. You may need a combination of:

Cognitive rehabilitation
Occupational therapy
Physical therapy
Speech therapy

Maintaining your overall health is the best way to reduce your risk of a stroke. Some ways you can sustain your overall health include the following:

Eating plenty of healthy foods and maintaining a healthy weight
Engaging in regular physical activity
Managing your blood pressure, cholesterol, and any health conditions you may have
Quitting smoking

If you are experiencing any symptoms of a stroke, call 911 immediately. If you need assistance managing your health to prevent a stroke or maintaining your overall wellness, visit Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Tuberculosis

Posted on February 25, 2025 by Patrick Hercules

Tuberculosis is a serious infectious disease that mainly affects the lungs. It is caused by a bacteria called Mycobacterium tuberculosis. Tuberculosis can spread when a person with the illness coughs, sneezes, or speaks, releasing tiny droplets of germs into the air. Another person can breathe in the droplets, and the germs will enter the lungs.

When tuberculosis germs survive and multiply in the lungs, it is a TB infection. A TB infection can happen in one of three stages, each with symptoms.

Primary TB infection is the first stage of TB infection. Immune system cells find and capture the germs, which the immune system may destroy. However, some captured germs can still survive and multiply.

Most people don’t have symptoms during primary infection. Some people may have flu-like symptoms, including:

Low fever
Tiredness
Cough

Latent TB infection is the stage following primary TB infection. Immune system cells build a wall around lung tissue with TB germs, which keeps them under control. However, the germs survive. There aren’t any symptoms during latent TB infection.

Active TB disease happens when the immune system can’t control an infection. Germs cause disease throughout the lungs or other parts of the body. Active TB disease can happen right after primary infection, but it usually occurs after months or years of latent TB infection. Symptoms of active TB disease in the lungs begin gradually and worsen over a few weeks. Symptoms can include:

Cough
Coughing up blood or mucus
Chest pain
Pain with breathing or coughing
Fever
Chills
Night sweats
Weight loss
Loss of appetite
Tiredness
Not feeling well in general

Extrapulmonary tuberculosis occurs when an active TB infection spreads from the lungs to other body parts. Symptoms vary depending on what part of the body is infected. Common symptoms can include:

Fever
Chills
Night sweats
Weight loss
Not wanting to eat
Tiredness
Not feeling well in general
Pain near the site of infection

Common sites of active TB disease outside of the lungs include:

Kidneys
Liver
Fluid surrounding the brain and spinal cord
Heart muscles
Genitals
Lymph nodes
Bones and joints
Skin
Walls of blood vessels
The voice box or larynx

People with active TB infection can spread tuberculosis easily, especially in crowded spaces.

To diagnose a TB infection, a healthcare provider will perform an exam that includes:

Listening to you breathe with a stethoscope
Checking for swollen lymph nodes
Asking you questions about your symptoms

Your healthcare provider will order tests if:

Tuberculosis is suspected
You were likely exposed to a person with active TB disease
You have health risks for active TB disease

Your healthcare provider will determine whether a skin or blood test is best. X-rays, sputum tests, and other lab tests can also diagnose a TB infection.

Your healthcare provider may treat you with drug treatments if you have a latent TB infection. This is especially true for people who are at an increased risk of active TB disease. Most latent TB infections are treated for three or four months. Active TB may be treated for four, six, or nine months. Specialists in TB treatment will determine which drugs are best for you.

It is important to take every dose as instructed when your healthcare provider prescribes medication. You must complete the full course of treatment, as it is important for killing the bacteria in your body and preventing new drug-resistant bacteria.

If you are experiencing symptoms of tuberculosis, you must receive treatment from a doctor as soon as possible. You can schedule an appointment at Flushing Hospital Medical Center’s Ambulatory Care Center by calling (718) 670-5486.

Robotics: Gastric Bypass

Posted on February 19, 2025 by Patrick Hercules

Gastric bypass or “Roux-en-Y” is a metabolic and weight-loss procedure that works by modifying your digestive system so that you consume and absorb fewer calories. It modifies your stomach and also your small intestines.

Similar to other bariatric surgery operations, gastric bypass is recommended for people who have clinically severe obesity. It has been shown to help relieve a long list of obesity-related health conditions, including:

Type 2 diabetes
Hypertension
Obstructive sleep apnea
GERD (chronic acid reflux)
Heart disease
Hyperglycemia
Fatty liver disease
Hyperlipidemia
Osteoarthrosis

The Roux-en-Y procedure gets its name from how it changes your digestive system. “Roux-en-Y” means “in the shape of a Y”. The procedure divides your stomach and small intestine, connecting each new segment to form a “Y” shape. This procedure reduces the functional part of your stomach to a small pouch, separating it from the rest with surgical staples, and restricting the amount of food your stomach can hold. Then, it connects the new stomach pouch to a lower segment of your small intestine. This means that when food goes through your digestive system, it will now bypass most of your stomach and the first part of your small intestine, causing your digestive system to not absorb all of the nutrients or calories in your food.

Gastric bypass surgery requirements are similar to those of other bariatric procedures. A qualified healthcare provider must recommend you for surgery. You may be a candidate for gastric bypass surgery if you:

Have been diagnosed with class III obesity
Have a BMI of at least 35 with at least one obesity-related condition
Have obesity-related type 2 diabetes

Most Roux-en-Y surgical procedures today are laparoscopic, a minimally invasive surgical technique. However, sometimes they are done with robotic assistance.

There are many potential advantages of robotic-assisted surgery over other types of surgery including:

Robot-assisted surgery provides the surgeon with 3D images of inside your abdomen that create a clearer picture for them to reference as they operate compared to the 2D images used during laparoscopic surgery
Under the surgeon’s direction, the robot can move more freely and with more versatility than a human hand
You’ll have a few tiny scars rather than one large incision scar (as with open surgery)
You’re more likely to experience less pain and less bleeding after surgery compared to open surgery
You’re more likely to have a quicker recovery time than with open surgery

To learn more about the robotic surgical procedures at Flushing Hospital Medical Center or to schedule an appointment, call (718) 670-5000.

Signs Your Blood Sugar is Too High

Posted on February 14, 2025 by Patrick Hercules

Hyperglycemia, also known as high blood sugar, is common in people who have diabetes. It occurs when too much sugar (glucose) is in the blood and the body has too little insulin or if the body can’t use insulin properly to regulate blood sugar levels.

People with diabetes can experience hyperglycemia episodes frequently.

Hyperglycemia usually doesn’t cause symptoms until blood sugar levels are high – above 180 to 200 milligrams per deciliter (mg/dL), or 10 to 11.1 millimoles per liter (mmol/L).

Symptoms for hyperglycemia develop slowly over several days or weeks. The longer sugar levels stay high, the more serious symptoms can become. However, some people who’ve had type 2 diabetes for a long time may not show any symptoms despite high blood sugar levels. Early symptoms of hyperglycemia include:

Frequent urination
Increased thirst
Blurred vision
Feeling weak or unusually tired
Headache

Recognizing early symptoms of hyperglycemia can help identify and treat it right away.

If hyperglycemia isn’t treated, it can cause toxic acids called ketones, to build up in the blood and urine. This condition is called ketoacidosis. Symptoms include:

Fruity-smelling breath
Dry mouth
Abdominal pain
Nausea and vomiting
Shortness of breath
Confusion or disorientation
Loss of consciousness
Dehydration
Rapid heartbeat

Hyperglycemia most often results from a lack of insulin. This happens due to insulin resistance and/or issues with the pancreas, the organ that makes insulin.

However, other hormones can contribute to the development of hyperglycemia as well. Excess of the stress hormone cortisol or the growth hormone can lead to high blood sugar.

Chronic hyperglycemia over the years can damage blood vessels and tissues in your body. This can lead to a variety of complications, including:

Retinopathy
Nephropathy
Neuropathy
Gastroparesis
Heart disease
Stroke

Hyperglycemia is diagnosed when a healthcare provider orders blood work to screen for the condition and diagnose diabetes. These tests may include:

Fasting glucose tests.
Glucose tolerance tests.
A1c test.

Injected insulin is the main way to treat hyperglycemia episodes. Everyone requires different doses. Your healthcare provider will work with you to determine which dose is best to treat and prevent high blood sugar. Dietary changes and exercise plans can also help manage your blood sugar to prevent hyperglycemia.

If you’re experiencing symptoms of hyperglycemia, you can receive treatment from an endocrinologist at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

The Link between Alcohol and Cancer

Posted on February 13, 2025 by Patrick Hercules

The Office of the Surgeon General recently issued an advisory calling for updated warnings on alcoholic beverages, cautioning that the consumption of alcohol heightens the risk of several types of cancer.

The current labels on alcoholic beverages warn about drinking while pregnant, drinking while driving, and operating machinery, as well as other general “health risks”. The Office of the Surgeon General noted that alcohol consumption contributes to approximately 100,000 cancer cases and 20,000 cancer-related deaths each year. Therefore, the public needs to be warned about the link between alcohol consumption and an increased risk of cancer.

Alcohol has been classified as a carcinogen “primarily due to its metabolite, acetaldehyde, which has the ability to bind to DNA and potentially cause mutations”, says Dr. Vasilis Vasiliou PhD, chair of the Department of Environmental Health Sciences and the Susan Dwight Bliss Professor of Epidemiology at the Yale School of Public Health. Acetaldehyde may also increase the risk of aerodigestive cancers, which are cancers that affect the upper respiratory and digestive tracts. Aerodigestive cancers include cancer of the lip, tongue, salivary glands, and other oral and nasal regions. “Furthermore, acetaldehyde may have a more pronounced effect on individuals with mutations in DNA-repair enzymes, such as BRCA1 and BRCA2. Mutations in these BRCA1 and BRCA2 enzymes can increase the risk of developing breast or ovarian cancer”, Dr. Vasiliou says.

Dr. Vasiliou acknowledges that the adverse effects of alcohol are significantly influenced by the dose-response relationship, which considers both the quantity of alcohol consumed daily and the duration of consumption over time. These factors, along with co-exposures to environmental contaminants, play a pivotal role in determining the severity of alcohol-related risks. Such interactions suggest that alcohol’s harmful effects cannot be fully understood in isolation but should instead be evaluated within the broader context of combined exposures to other environmental and lifestyle-related carcinogens.

Dr. Vasiliou offers this advice when it pertains to alcohol and its link to cancer:

Do not start drinking for health reasons
Limit consumption
Consider personal and family health risks
Seek non-alcoholic sources of antioxidants

Synergistic interactions with other environmental carcinogens and lifestyle factors influence the risk of cancer from alcohol consumption. Reducing alcohol intake, alongside minimizing exposure to other known carcinogens such as tobacco smoke, environmental pollutants, and chemical toxins, is a critical strategy for lowering overall cancer risk. Comprehensive prevention efforts should address not only alcohol consumption but also broader environmental and lifestyle factors.

Appendicitis

Posted on February 6, 2025 by Patrick Hercules

Appendicitis occurs when the appendix becomes clogged, infected, and inflamed. It can cause acute pain in your lower abdomen, however, for most people, pain begins around the belly button and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes serious.

Symptoms of appendicitis include:

Sudden pain that begins on the right side of the lower belly
Sudden pain that begins around the belly button and often shifts to the lower right belly
Pain that worsens with coughing, walking, or making other jarring movements
Nausea and vomiting
Loss of appetite
Low-grade fever that may rise as the illness worsens
Constipation or diarrhea
Belly bloating
Gas

Additional symptoms that may develop later in some people can include:

Malaise
Urinary symptoms- needing to go more frequently or more urgently
Bowel paralysis

The size and location of the appendix make it easy for it to become clogged and infected. Your large intestine is home to many bacteria. If they become trapped in your appendix, they overgrow and cause an infection. The bacteria then multiplies quickly causing the appendix to become inflamed and filled with pus. If it is not treated right away, the appendix may burst or break open.

Some common causes of inflammation, swelling, obstruction, and infection in your appendix include:

Hardened poop (appendix stones)
Lymphoid hyperplasia
Colitis

Other factors that could block the opening of your appendix can include:

Tumors
Parasites
Cystic fibrosis

Risk factors for appendicitis include:

Age – anyone can develop appendicitis, but it most often happens in people between the ages of 10 and 30
Your sex – men have a slightly higher risk of appendicitis than women

To help diagnose appendicitis, a healthcare provider will likely take a history of symptoms and examine the abdomen. Tests used to diagnose appendicitis can include:

A physical exam
Blood tests
Urine tests
Imaging tests

Appendicitis may spontaneously resolve if the cause suddenly goes away on its own. This might happen if an obstruction in your appendix gets unblocked and passes through the intestines, or if an infection causing lymphoid hyperplasia in your appendix suddenly improves. However, you shouldn’t assume this will happen or that it has happened, even if your pain has reduced.

The standard treatment includes medicine such as antibiotics and surgery to remove the appendix. Appendicitis is considered an emergency, so it is treated in the emergency room.

If you are experiencing symptoms of appendicitis, visit Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486. If there is an emergency, please call 911.

Tips for Strength Training as You Age

Posted on January 29, 2025 by Patrick Hercules

As we age, concerns about strength, balance, and mobility arise. Age-related mobility limitations are a fact of life for many older adults. Studies have shown that about 30% of adults over 70 years of age have trouble walking, getting up out of a chair, or climbing stairs. In addition to making everyday tasks difficult, mobility limitations are also linked to higher rates of falls, chronic disease, nursing home admission, and mortality.

Weight lifting and stretching are useful at any age, but there are specific benefits for older adults such as preventing or delaying the onset of many age-related ailments. Integrating resistance training and stretching into your routine can keep you feeling healthy and strong.

Committing to and maintaining a strength training program, whether it is at the gym or at home can improve your strength, balance, and mobility.

Your strength training program should include:

Three weekly sessions
Work out your whole body
Consistency

Here are six strength exercises for an effective and comprehensive full-body workout:

One-leg balance
Squat
Wall pushup
Resistance band row
Bird dog
Glute bridge

Unless otherwise noted, do three sets of 10-12 reps of each exercise.

Here are five stretches to include in your fitness routine to hit all of the major body parts and help improve your flexibility and mobility:

Hamstring stretch
Seated hip stretch
Chest opener
Side-lying thoracic rotation
Side-to-side reach

If not indicated, hold each stretch for about 30 seconds total. As you focus on breathing, deep inhale, deep exhale, and try to go deeper into the stretch.

Please note that when beginning strength training, your healthcare provider must clear you before starting. Start slowly and gradually increase your physical activity level over time.

If you experience medical problems while exercising, you can schedule an appointment with a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

What is Smoker’s Flu?

Posted on January 27, 2025 by Patrick Hercules

Smoker’s flu is a term used to describe the set of symptoms people can develop when they stop smoking tobacco. It is the direct result of nicotine withdrawal, which causes cold and flu-like symptoms.

About 80-90% of people who smoke have a nicotine addiction and may experience some form of withdrawal after they quit. Symptoms are worse if the person quits cold turkey, however, most symptoms tend to subside within two weeks. Symptoms of smoker’s flu include:

Coughing
Sore throat
Sneezing
Chest tightness
Body aches
Headache
Fatigue

Smoker’s flu can occur on its own, but it is more likely to accompany classic physical and mental symptoms of nicotine withdrawal, including:

Slowed heart rate
Upset stomach
Constipation
Gas and bloating
Diarrhea
Increased hunger
Anxiety
Depression
Apathy or general unhappiness
Irritability
Difficulty concentrating
Nicotine craving

One study showed that 61.1% of smokers who quit experience symptoms of nicotine withdrawal when they stop. Some symptoms, especially affective ones like anxiety, can start as early as four hours after their last cigarette. Smoker’s flu can be unpleasant, but it isn’t dangerous. Unlike withdrawal from alcohol or opioid drugs, nicotine withdrawal won’t cause harm to your health.

Smoker’s flu is not a diagnosis and there are no specific guidelines on treatment, however, its symptoms will resolve over time. Until they do, several things can help manage the symptoms of smoker’s flu, including:

Treating the cough
Using over-the-counter pain relievers
Exercising
Practicing mind-body therapies

Nicotine replacement therapy can also help ease or prevent nicotine withdrawal symptoms.

Flushing Hospital Medical Center provides extensive assistance for people who want to quit smoking. It offers a free smoking cessation support group and one-on-one sessions, both in person and by phone. For more information, please call 718-206-8494.

How to Prepare for an MRI

Posted on January 24, 2025 by Patrick Hercules

MRI, or magnetic resonance imaging, is a medical technique that uses a magnetic field and computer-generated radio waves to create detailed images of the body’s organs and tissues.

MRI is a noninvasive way for a medical professional to examine your organs, tissues, and skeletal system, producing high-resolution images of the inside of the body that help diagnose several conditions. The MRI machine also produces 3D images that can be viewed from different angles. Parts of the body that MRI takes images of include:

Brain and spinal cord
Heart and blood vessels
Internal organs
Bones and joints
Breasts

Before an MRI exam, eat as you normally would, and continue to take your usual medicines, unless you are told otherwise. You will typically be asked to change into a gown and to remove things that might affect the magnetic imaging, such as:

Jewelry
Hairpins
Eyeglasses
Watches
Wigs
Dentures
Hearing aids
Underwire bras
Cosmetics that contain metal particles

Most MRI machines are large, tube-shaped magnets. When you lie inside an MRI machine, its magnetic field works with radio waves and hydrogen atoms in your body to create cross-sectional images.

If you have a fear of enclosed spaces, also known as claustrophobia, you might receive a drug to help you feel sleepy and less anxious. An MRI exam can last anywhere from 15 minutes to more than an hour. You must hold still because movement can blur the images. Most people get through the exam without difficulty.

If you haven’t been sedated, you can resume your usual activities immediately after the scan.

For the results, a radiologist will look over the images from your scan and report the findings to your doctor. Your doctor will then discuss important findings and next steps with you.

To schedule an appointment with the Flushing radiology department, call 718- 670-5458. To schedule an appointment for an MRI or for more information about the MRI, please call 718-670-8851.