Small Steps, Big Changes
Many people feel they do not have the time or energy to live a healthy lifestyle, however, establishing a healthy diet and exercise routine can make a huge difference to your overall health.

What are you eating?
With larger portions being served, it’s no wonder America is experiencing an obesity epidemic.  Many restaurants have implemented the ‘bigger is better’ idea, but portion control is a factor in maintaining your weight and creating a healthier lifestyle.  When dining out, try choosing appetizers instead of a full meal. Instead of choosing a meal upgrade option, stick to a kids meal which can be more moderate in calories and fat content.

Another factor is the type of foods served in your meals. A good starting point toward healthy eating is to make sure your diet is rich in whole grains, vegetables, fruits and various lean proteins and to eliminate processed sugars.  Your body breaks down food and produces the energy it needs. Having too much sugar in your diet doesn’t always provide you with more energy  but can cause a list of several health issues including dental cavities, diabetes, energy slumps, hyperactive behavior in some, and weight gain.

Kelly McGuire, Registered Dietician of Flushing Hospital’s Food and Nutrition Department states, “The occasional slice of cake offered at a party is okay but sweets should be consumed in moderation.”

She adds: “Eating healthy foods doesn’t have to be boring. Find the foods you enjoy and create recipes in advance to help with your goal of healthy living.”

Become Active, Stay Active
Even minor changes in your activity can help. Many people believe they need to have a gym membership and get at least an hour of intense exercise to be healthy, but if your body isn’t used to, an extensive workout can do more harm than good. Begin by adding a simple walk, or extend your current walking routine. A good way to do this is by parking your car a bit further away than usual from your intended destination to get an extra 10-20 minutes of exercise per day. Another way of increasing you exercise routine is to choose the stairs over an elevator. Exercising every day is not necessary. Initially aim for three times a week for at least 20-30 minutes a day and notice your stamina increasing as weeks go by.

Invest in You
Small changes make the biggest impact. Begin your healthy diet exercise routine today and begin to feel the difference in your energy, appearance and overall health with time. Your annual health check-up can be the jumpstart to a new you.  Invest in you and meet with your primary care physician prior to beginning any changes in diet and exercise.

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.

Many people gain a few pounds when they quit smoking, some more than others.  Research has shown that, on average, individuals can gain between two to 10 pounds once they stop smoking. This, however, shouldn’t affect your decision or effort to quit smoking, since weight gain is dependent upon your eating habits and your level of physical activity.

Smoking and Weight Gain
There are a several  reasons why people gain a few pounds after they stop smoking. Smoking is known to increase the body’s rate of metabolism, which helps burn calories. Once someone stops smoking, their rate of metabolism may slow down, lessening the amount of calories they burn throughout the day. Over time this could lead to a weight gain.

Also, people who smoke tend to have an oral fixation. When they stop smoking, the act of chewing usually replaces the oral fixation for smoking and most people find themselves eating more. In addition, smoking also acts as an appetite suppressant, which also causes a person to eat more frequently once they stop the habit.

How to Avoid Weight Gain
Learning to eat healthy snacks and exercising will help keep weight under control. More specifically:

• Eat foods that are low in calories but filling, such as carrots, apples, air popped popcorn or low fat yogurt
• Drink plenty of water throughout the day
• Exercise on a regular basis; join a gym, take the stairs, or walk whenever possible

Weight gain is a real concern for people desiring to kick the habit but fortunately, it can be minimized or completely avoided. The damage smoking causes the body is far greater than adding a few extra pounds. The decision to stop smoking can be the first step to leading a healthier life.

Please call 718-670-5486 if you would like to schedule an appointment with a physician who can help with smoking cessation.

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.

Tummy time is an important and highly encouraged activity for infants. It strengthens the neck, upper back, and shoulder muscles and allows babies to enjoy their surroundings in a new way.  According to physical therapists at Flushing Hospital, tummy time is also very crucial in the development of newborns and infants with torticollis.

Torticollis, also known as “twisted neck”, is a condition in which the head is tilted toward one side and the chin is elevated and turned toward the opposite side. It is commonly present at birth or can take up to three months to develop. Torticollis is believed to be a result of cramping in the uterus or abnormal positioning of the fetus.

“We don’t know exactly why some infants develop torticollis and others don’t,” explained Flushing Hospital Physical Therapist Dakshesh Sanghavi. “However, we do know that tightness of the neck muscle due to stiffness makes it difficult for a baby to turn their neck.”

Though infants with torticollis can reach their developmental milestones like most babies, when participating in activities that involve turning their neck, babies with torticollis might:

• tilt their head in one direction more than the other side.
• prefer looking at you over one shoulder instead of turning to follow you with his or her eyes.
• have difficulty breastfeeding on one side or prefers one breast only.
• work hard to turn toward you and becomes frustrated when unable to turn his or her head.
• develop a flat head or a small neck lump (similar to a knot in a tense muscle).

“Torticollis appears to be a very painful condition, but it usually is not,” said Mr. Sanghavi. “Although babies may have some pain when being stretched, the consequences of not treating the condition are much more serious.”

If torticollis is left untreated, babies and infants can develop scoliosis and/or impaired visual tracking. These problems can lead to developmental delays.

How to Treat Torticollis

The most effective treatment for babies diagnosed with torticollis is physical therapy. Physical therapy is aimed at helping babies and infants develop a full range of motion in their neck, arms, and shoulders, and increasing the strength of muscles surrounding their head and neck so that they can reach developmental milestones, such as rolling and crawling.

Physical therapy can range from simple neck stretching exercises to more intensive treatment. Mr. Sanghavi recommends that parents continually encourage their baby to turn their head in both directions. He recommends the following exercises:

• Encourage tummy time several times throughout the day for 10 to 15 minutes per session. When doing so, position the baby’s head away from you so that they have to turn to face you.
• Offer the bottle or breast in a way that encourages your baby to turn away from their favored side.
• Put your baby to sleep on his/her back and position him/her in a way that he/she will actively turn toward the opposite side. This will enable the tightened muscles to be stretched toward the opposite side.
• Draw your baby’s attention with toys and sounds to make him or her turn in both directions.

If you suspect your infant may have torticollis and you would like to schedule an appointment with a Flushing Hospital pediatrician, please call 718-670-5515.

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.

Whether used for a midday boost, an all-night study aid, enhance athletic performance, or recreational consumption with alcohol, “energy drinks” or “energy shots” pose serious risks to its many users and is increasingly a source of concern being raised in the public arena.

Hospitals across the United States are reporting increased numbers of emergency room visits linked to the consumption of energy drinks. In 2009, over 113,000 people were taken to hospitals due to complications from energy drinks, ten times the number reported in 2005, according to a report by the Substance Abuse and Mental Health Services Administration.

According to Dr. Robert Crupi, Chairman of Emergency Medicine at Flushing Hospital, “one of the biggest risks associated with these products is their potential effect on the heart. With products containing 35 mg of caffeine per ounce, energy drinks can possess nearly three times the caffeine content found in a cup of coffee. The consequences of ingesting such large amounts of caffeine include elevated blood pressure, accelerated heart rate and abnormal heart rhythms (arrhythmias).” In addition, energy drinks are loaded with sugar and taurine, an amino acid, also know to boost heart rate.

Even though most agree that consuming energy drinks in moderation is unlikely to pose a medical risk in healthy individuals, medical professionals do urge individuals with existing heart disease to avoid energy drinks. Persons with a history of hypertension or heart arrhythmia are also warned to stay away from these beverages.

It is also recommended that individuals not combine energy drinks with alcohol.  Mixing caffeine (a stimulant) with alcohol (a depressant) can make it more difficult for individuals to gauge their level of impairment. Believing the caffeine has sobered them up, those who mix alcohol and energy drinks may experience “wide awake impairment,” a feeling of increased alertness associated with both impaired judgment and reflexes.

The marketing of energy drinks has sparked some controversy. They have been promoted to provide a quick boost of energy to athletes looking to increase their performance. Dr. Crupi adds “The problem with this idea is, exercise already increases heart rate and blood pressure. Adding a boost of caffeine only puts unnecessary strain on the heart.  In addition, caffeine is a known diuretic, causing athletes to lose water when they should be trying to stay hydrated”.

What many do not realize is that energy drinks are considered dietary supplements, and therefore, are not regulated by the FDA in the same manner as soda or other drinks that contain caffeine. In fact, the manufacturers of these products often do not disclose the amount of caffeine they contain. Many lawmakers are now calling for increased regulations for the energy drink industry, including improved labeling disclosures.

Dr. Crupi provides this tip to individuals looking for an alternative to energy drinks, “If you eat healthy, exercise daily and sleep between seven and eight hours every night, you will naturally have more energy.”

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.

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 718-670-5486 to schedule an appointment with one of our physicians who specialize in treating this disease.

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.

Breast Cancer awareness campaigns have empowered women to take a pro-active approach to early detection of the disease. While regular check ups greatly help in prevention for any illness, individuals with specific risk factors should pay extra close attention. 

Common Risk Factors
There are risk factors that you cannot change or control such as:
• Gender: Just by being a woman you are placed at risk.  Male breast cancer is not common but it isn’t unheard of. Men are less likely to be affected by breast cancer because they have less of the female hormones, estrogen and progesterone, which can promote breast cancer cell growth.

Age: A woman’s chances of developing cancer increase as she gets older. Statistics reflect a woman’s median age of breast cancer diagnosis to be 61.  This means that half of women who develop breast cancer are 61 or younger at the time of their diagnoses.

Family History: Women who have had a ‘close blood’ relative diagnosed with breast cancer are at higher risk of developing breast cancer. ‘Close blood’ relative is defined as a first degree relative such as mother, sister, and/or daughter.

Race and Ethnicity: Caucasian women are slightly more likely to develop breast cancer than African-American women.  However, African-American women under the age of 45 are more commonly diagnosed with breast cancer. The American Cancer Society has statistically noted Asian, Hispanic and Native American women are at less risk from developing breast cancer.

“Generally speaking, an early first period or delayed menopause can also be associated with an increase risk for breast cancer,” states Dr. St. John, Director of the Breast Clinic at Flushing Hospital Medical Center.  “These are things that we cannot control, but knowing your risk factors and raising your awareness can increase your chances of early detection.”

Lifestyle Related Factors
In addition to certain genetic predispositions, certain lifestyle choices can be contributing factors in developing breast cancer.  “Lifestyle related” factors can increase a woman’s chances for breast cancer.  Some of these factors can include:

Having Children/ Breastfeeding: Having several pregnancies and becoming pregnant at a young age reduces the risk of breast cancer. Studies have shown that women who have no children or had their first child after age 30 have a slightly higher risk of developing breast cancer.  Some studies have suggested that breastfeeding may slightly lower breast cancer risk, especially if it is continued for 1 ½ to 2 years of age.

Hormone Therapy after Menopause: Women who receive Hormone Therapy (HT) to relieve the symptoms of menopause can possibly be at an increased risk of breast cancer if used for a prolonged amount of time. This can be due to the dual dosing of progesterone and estrogen administered. However, a woman’s risk of breast cancer seems to return to normal within five years of stopping the combined treatment.

Drinking Alcohol/ Smoking: Women who consumed more than 2 to 5 drinks daily increase their risk of breast cancer as opposed to non-drinkers. Although there have been limited studies, smoking has been linked to increasing a woman’s chances of developing with breast cancer.

Being Overweight or Obese:  women who are overweight tend to have higher insulin levels, which has been linked to some cancers, including breast cancer. 

Dr. St. John suggests “By limiting alcohol consumption, quitting smoking and managing your weight, not only can you improve your quality of life, but also decrease your risk of breast cancer.  Maintaining a healthy lifestyle, exercising and conducting regular self examinations can be helpful to preventing breast cancer.”

Flushing Hospital’s Ambulatory Care Center has a variety of services including a dedicated breast clinic.  Our clinic can help you take your first steps to prevention and provide peace of mind.

For more information or to schedule and appointment, please call 718-670-5487.

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.

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. Chopra, Pediatrician at Flushing 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. Chopra 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. Chopra.  Children with vaccine-preventable diseases can be denied permission to attend school or child 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 diseases in the future

Flushing Hospital Medical Center’s Pediatric Ambulatory Care Center offers same day services for walk-ins. Please call 718-670-3007 and make an appointment with one of our Pediatricians.

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.

As the summer is nearly over, parents are now turning their attention to back to school preparations. One of the many things parents should be prepared for is the transmission of head lice.

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 Flushing Hospital by calling 718- 670-8939.

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.

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 Deborah Asnis, MD, Infectious Disease Specialist and Chief of Infectious Diseases at Flushing 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. Asnis..

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. Asnis. “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 718-670-3012.

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.