look north · unconditional love in exchange for a cuddle, a pat or a scratch behind the ears....

Health and well-being news from North Shore University Hospital and Long Island Jewish Medical Center

Look North

Volume 3, 2019

Back to normal

Feel-good foodPAGE 17

PAGE 32

Pancreatic cancer in retreat

PAGE 6

2 Look North | Volume 3, 2019

CONTENTS

Care where you areNorthwell Health is more than your local hospital. We’re a world-class health system with all the services your family needs at 23 hospitals and 750-plus outpatient locations. Our care ranges from checkups to transplants and everything in between. We’re also changing the future of medicine with biomedical research, and educating the next generation of clinicians.

Hospitals

Feinstein Institute

Imaging Centers

Urgent Care Centers

Ambulatory Surgery Centers

Cancer Centers

Dialysis Centers

Lenox Health Greenwich Village

Lab Patient Service Centers

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies

Elmezzi Graduate School of Molecular Medicineat Northwell Health

H

F s

New horizons for treating pancreatic cancer

6 Fresh ways to treat a once- intractable disease.

7 The surprising link between pancreatic cancer and a rare form of diabetes.

Beating cancer’s odds

8 Whole again after lung-cancer surgery — at 33 years old.

9 Stage 4 renal cancer didn’t stop his hope or healing.

Promising prostate news

12 A more accurate, less painful prostate biopsy.

13 The tests a man can get: what you need to know about urodynamic testing.

We’re all heart

14 A holistic look at heart health.

16 The Northwell Health Lipid Center offers a new tack on treating cardiovascular conditions.

18 An 87-year-old periodontal surgery assistant becomes young at heart again.

20 How to choose a cardiac surgeon.

Good bones

22 Ambulatory hip replacement means minimal down time.

24 Avoid years of pain with hip arthroscopy.

25 Better ways to care for your back.

26 Surgery gave a hand up to a Long Islander with Air Force dreams.

Life after 9/11

28 One hip, two unlikely friends: a World Trade Center story.

30 A retired FDNY inspector preps for a lung transplant.

Spine surgery

32 After a shocking spina bifida diagnosis, surgery gets her back on her feet for good.

36 Miracle man: A dentist learns to walk again after an accident nearly paralyzed him.

Here’s to your health

4 Four-legged friends on the job: How therapy dogs make everyone feel better.

10 Are CBD products a cure-all, or just hype?

17 Foods that boost your mood.

21 Breastfeeding success for “older” moms.

29 Count the ways to love your liver.

34 Give your meals a new spin with six ancient grains.

38 Community resources.

40 Senior-friendly emergency departments.

Family health and well-being news, deliveredSubscribe to any Northwell magazine by visiting bit.ly/health-wellness-news or emailing [email protected]. There’s no obligation, and you can unsubscribe at any time.

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CONTENTS

Going to the

(therapy) dogs

How these specially trained

pups help improve physical and

emotional healing


HERE’S TO YOUR HEALTH

Their mere presence boosts levels of feel-good brain chemicals. They offer their wagging tails and lolling tongues and — most importantly — their unconditional love in exchange for a cuddle, a pat or a scratch behind the ears. They’re emotional or therapeutic support dogs, and they’re increasingly afoot in hospitals, nursing homes, rehabilitiation centers, schools and in the aftermath of disasters to provide the comfort that only they can.Therapy dogs aren’t your everyday neighborhood pups — they’re specially trained to offer specific types of comfort. More than a distraction, therapy dogs may offer some of the best medicine for people in ill health or emotional distress. The act of petting a pooch releases mood-elevating hormones that can lower blood pressure and heart rate, diminish discomfort and pain, and calm anxious thoughts. For these reasons and more, Northwell Health and medical centers across the country now routinely bring in certified therapy dogs to interact with patients. Emotional support dogs with their handlers visit hospitals and other locations. Any therapy dog must be up to date on vaccinations, well-groomed and certified by a reputable national therapy dog organization before they can be “hired.”

Study after study proves their worth: According to a 2018 study by Johns Hopkins researchers published in Critical Care, emotional support dogs can ease the pain and emotional upset of critically ill patients in intensive care units. Animal-assisted therapy helps children who have experienced abuse and patients who are undergoing chemotherapy; it also reduces anxiety in people diagnosed with schizophrenia and helps nursing home residents feel less isolated. A 2017 study by the American Humane Society found that weekly visits with an emotional support dog were a therapeutic salve for children with

cancer and their parents: The families had lower levels of disease-related anxiety and worry compared to families who didn’t have the comfort of an emotional support dog. Service dogs provide another kind of animal-assisted therapy.

Trained to help individuals with specific disabilities, such as seizures, diabetes or PTSD, these dogs perform tasks like opening doors, fetching medications and pushing emergency alert buttons. Service dogs act as their handler’s aide — but like any other animal companion, they provide love and plenty of comfort, too. No wonder that in a 2019 study in the journal Disability and Rehabilitation, individuals with physical disabilities who were assisted by a service dog had significantly better psychosocial health than others who were still on a waitlist for their own four-legged helper.

Is your dog up for the job?Think your four-legged friend has what it takes to be a therapy dog? Temperament — not breed or size — matters most when applying for certification. Several different national and state organizations certify emotional support dogs. Because a tester or observer needs to see your pup actively engaging with people and following your commands, you should search online for a certifying organization closest to you. Some organizations to consider include the Alliance of Therapy Dogs, Pet Partners and Therapy Dogs International. Handlers must complete a background check as part of the certification process. Your dog should be at least one year old and possess these qualities:

– Calm, gentle disposition – Friendly – Good with groups of people – Heeds commands – Attentive – Well-groomed – Up to date on all vaccinations – Easily trained

More than a distraction, therapy dogs may

offer some of the best medicine for people in ill health or emotional

distress, research shows.

Learn about volunteering opportunities, such as pet therapy visits, at northwell.edu/volunteer.

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Hitting the brakes on pancreatic cancer Emerging treatment options provide a most precious gift — more timePancreatic cancer has offered a dire prognosis, but recent advances are beginning to turn the tables on this once-intractable disease.

“In the past six years, there’s been a dramatic change in the way we treat pancreatic cancer,” said William Nealon, MD, codirector of the recently opened Pancreatic Cancer Center at the Northwell Health Cancer Institute.

One significant game changer, according to the National Cancer Institute, is a chemotherapy regimen called FOLFIRINOX. A decade ago, only

people with advanced metastatic cancer (disease that had spread to the liver or other organs) received this treatment, Dr. Nealon said. “Once we saw a significant increase in length of survival, we began offering FOLFIRINOX in earlier stages.”

People whose pancreatic cancer would have been diagnosed as inoperable also benefit: FOLFIRINOX keeps their tumors from growing.

“It is highly complex to remove pancreatic tumors that are intertwined with blood vessels and arteries,” said

More than 56,000 Americans will receive a pancreatic cancer diagnosis this year.

Dr. Nealon. “Traditionally, doctors would only operate if chemotherapy shrank the tumor enough to minimize surgical risk. Now, as long as the tumor doesn’t grow, we can perform surgery.”

Matthew Weiss, MD, deputy physician-in-chief and director of surgical oncology at Northwell’s Cancer Institute, was recently recruited from Johns Hopkins. He revels in these complex procedures. “I do love the technical aspects of pancreas surgeries,” he said. “They are technically challenging operations.”

Following these successes in treating advanced pancreatic cancer, current studies are looking at neo-adjuvant chemotherapy for resectable, or operable, pancreatic cancer. Those who received FOLFIRINOX after tumor resection benefited from a median survival rate of nearly 20 months longer


NEW HORIZONS FOR TREATING PANCREATIC CANCER

than people who received the standard chemotherapy regimen, according to a recent study from The ASCO Post, a newspaper from the American Society of Clinical Oncology.

For those who aren’t candidates for surgery, Northwell’s pancreatic cancer specialists are researching new treatments with Cold Spring Harbor Laboratory (CSHL) and the Lustgarten Foundation, a leader in pancreatic cancer research. Northwell and CSHL researchers use organoids (tumors grown in a lab from a patient’s tumor cells) to test new therapies.

“We’re exploring all avenues of treatment for our patients,” explains Wasif Saif, MD, deputy physician-in-chief and director of medical oncology. The Northwell Cancer Institute recently recruited him from Tufts University. “We can see how a tumor responds to treatments like immunotherapy that uses the body’s immune system to attack cancer cells.”

“We understand that patients are dealing with a lot of stress and anxiety,” said Dr. Nealon. “Our goal is to make their medical care more accessible and convenient, so they can focus on healing.”

Diabetes and pancreatic cancer: A surprising link

People with Type 2 diabetes have a slightly higher risk of developing pancreatic cancer than those who don’t have the disease, according to research. Furthermore, researchers are seeing a potential link between resection for pancreatic cancer and a rare form of diabetes called Type 3c.

“Type 3c diabetes most commonly occurs when insulin production is affected due to surgical removal of a diseased, cystic or cancerous pancreas or in those diagnosed with chronic pancreatitis,” said William Nealon, MD, codirector of the Northwell Health Pancreatic Cancer Center. The unique traits of this rare form of diabetes: too-low insulin levels plus the absence of glucagon, another hormone made in the pancreas. Insulin causes blood glucose levels to dip as the glucose is transported out of the blood to fuel the body. Normally, glucagon prevents blood glucose from dropping dangerously low. But without glucagon, blood sugar may plummet after a dose of insulin — a phenomenon called “brittle” diabetes.

As many as 10 percent of those with a diabetes diagnosis have Type 3c, reported the journal Diabetes, Metabolic Syndrome and Obesity. The condition tends to affect slightly more men than women, with most patients diagnosed around

age 60, according to a study by the University of Surrey, UK.

“People with chronic pancreatitis [inflamed pancreas] have an increased risk of pancreatic cancer,” noted Dr. Nealon. “Some people inherit genetic mutations that make them more prone to a familial form of pancreatitis. These genes also raise the lifetime risk of developing pancreatic cancer.” Since Type 3c commonly occurs in patients with chronic pancreatitis, Type 3c may predispose someone to cancer.

Type 3c develops in some people who undergo pancreatic resection, though not all do, Dr. Nealon emphasized.

Doctors diagnose Type 1 and Type 2 diabetes by evaluating blood glucose levels. But screening for Type 3c is different — doctors must evaluate glucagon levels and prescribe it if necessary.

“We are still learning about how to best treat Type 3c in tandem with pancreatic problems,” explained Dr. Nealon. “At the Pancreatic Cancer Center, we bring together specialists who customize a treatment plan that addresses a patient’s specific needs.”

Our nationally recognized cancer experts can help with pancreatic conditions, including Type 3c diabetes. Call the Pancreatic Cancer Center at (833) 762-7327.

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NEW HORIZONS FOR TREATING PANCREATIC CANCER

Learn more about your own risk for lung cancer at bit.ly/lung-cancer-risk.

Krystall Alleyne and her daughter, Nyléah.


BEATING CANCER’S ODDS

At just 33 years old, lung cancer was just about the last thing Krystall Alleyne thought she’d deal with. But the young mom, who lives in Brooklyn with her husband and young daughter, had embarked on a medical odyssey after some unexplained chest pain that ultimately led her to a pulmonologist. A series of tests revealed — to her shock — a tumor in her left lung.

The pulmonologist referred Ms. Alleyne to David Zeltsman, MD, a thoracic surgeon at Long Island Jewish (LIJ) Medical Center. Ms. Alleyne found immediate comfort in his straightforward manner. “He explained what kind of tumor it was, where it was growing and what needed to happen next,” she said.

Ms. Alleyne had a form of cancer called carcinoid lung cancer, said Dr. Zeltsman. “Typically, a carcinoid tumor is treated by a lobectomy, a removal of just part

Treated as a whole personMinimally invasive lung surgery gives a young mom a chance to breathe easier

of the lung. But because of the location of her tumor, the full lung had to be removed.”

Less invasive surgery, easier recoveryDr. Zeltsman performed a minimally invasive pneumonectomy via a single one-inch incision. The approach makes recovery faster and smoother than traditional open surgery.

Still, Ms. Alleyne was frightened. “My husband, Nyckel, and I made a list of questions — things we needed to be sure about before the procedure,” she said. “We went in to see Dr. Zeltsman a few times and he was able to give us really detailed answers about what was happening now and how it would affect me physically long term.”

Dr. Zeltsman understood her concerns completely. “Getting a cancer diagnosis

can hit you like a ton of bricks,” he said. “Ms. Alleyne is young and otherwise in great shape. She thinks she’s fine and then she gets this diagnosis. There’s a lot of fear and anxiety around that.”

After Ms. Alleyne’s pneumonectomy and a short stay in the Intensive Care Unit, her recovery was quicker than either she or Dr. Zeltsman anticipated.

A human touchDr. Zeltsman and the care team at LIJ briefed Ms. Alleyne and her family about what to expect once she went home; she will get alternating CT scans and X-rays every three months for the next two years to ensure the tumor won’t return. Today, Ms. Alleyne is back in the swing of things as a working wife and mother. To build her strength and help her breathing, she joined a gym and is working hard to get into the best shape she can. “I’m going out a lot more and taking my daughter, Nyléah, around without having to worry about any challenges with my breathing,” she said.

Throughout her experience, she felt calmed just to have her worries addressed seriously. “There’s a lot of fear and anxiety around cancer,” said Dr. Zeltsman. “My job as a physician is not only to operate, it’s to take care of my whole patient. This was not a case of lung cancer. This was a human being named Krystall, a wife, a mother and a good person, who had a disease and needed my help. And I was happy that I was able to give her that help.”

A “numbers guy” beats the oddsHe’s thriving today, even though his Stage 4 kidney cancer had spread

Numbers are Frank Danza’s native language. So when he first received his diagnosis of Stage 4 renal cell carcinoma, he immediately calculated his odds of survival.

“According to my physicians and the most recent statistics from the American Cancer Society, only 30 percent of people with this condition survive three years. Only 12 percent of patients with Stage 4 kidney cancer survive five years,” he said. “Those aren’t the best numbers.”

While the odds were not in his favor, Mr. Danza persevered through faith and hope. Part of that was finding the right medical specialists — and he didn’t have to look far because he serves as Northwell Health’s senior

vice president for finance and revenue cycle operations.

“I needed to have absolute confidence in my medical team,” he said. “I have the right kind of relationship and total confidence in the doctors who cared for me.” Immediately after Mr. Danza’s 2012 diagnosis, he underwent a radical nephrectomy, a procedure to remove the kidney as well as the fatty tissues and part of the ureter, the duct that carries urine to the bladder.

Hope tested againIn 2018, the cancer spread to Mr. Danza’s brain. While others might have abandoned hope at that point, Mr. Danza kept the faith. Anuj Goenka, MD, radiation oncologist at the Northwell

Health Cancer Institute, and Michael Schulder, MD, director of Northwell’s Brain Tumor Center, offered an advanced radiosurgery treatment called Gamma Knife, which delivers high doses of radiation to brain tumors with millimeter-level accuracy.

“In the past, patients received whole-brain radiation therapy, which can be quite effective, but it increases the risk of radiation injury to the healthy parts of the brain, outside the tumor,” explained Dr. Schulder. “The Gamma Knife is also effective, with the added advantage of only giving radiation to a very small percentage of the brain.

“Mr. Danza’s tumor was a type that responded to targeted therapies as well as immune therapies,” said Dr. Schulder. “And with this current regimen, including radiosurgery, he can go about his regular life.”

Seven years after his initial diagnosis, Mr. Danza credits his medical team, faith in God and hope for beating the odds. He has made it his personal mission to help others on their path toward recovery. His book, Now I Know I’m Not Alone: A True Story of Cancer, Everyday Miracles and Hope spreads his message.

“I want other survivors to have hope, too. I want them to feel in control. I know every survivor can get there, and I want to do everything I can to help them.”

Look into the Northwell Cancer Institute’s comprehensive care by calling (855) 442-4809.

Frank Danza back at work after a bout with kidney cancer.

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BEATING CANCER’S ODDS

CBD:hope

orhype?

It’s everywhere, but the jury is still out on whether cannabidiol is the cure for what ails you

You’re not imagining it: CBD creams, lotions, oils, tinctures and pills are everywhere, promising relief from everything from anxiety to acne. Judging from the sheer abundance of products, you might think that the extract is good for whatever ails you. It’s no wonder that a 2018 survey published in Cannabis and Cannabinoid Research found that more than 60 percent of CBD users buy it to manage medical conditions. But is CBD living up to the hope people have placed in it — or is it just a lot of hype?

The ABCs of CBDCBD stands for cannabidiol, one of the active ingredients in marijuana. Unlike marijuana’s other well-known active ingredient, tetrahydrocannabinol (THC), though, CBD doesn’t get users high. Beyond that, researchers are still establishing exactly what CBD does in the brain and throughout the body.

The upside: CBD appears to be safe, although it can cause side effects like nausea, fatigue and irritability, and can interact with some medications. Researchers haven’t found any signs that people abuse it or become dependent on it.

The down side: CBD products are regulated like supplements, which means that there’s little oversight or quality control. Among other things, that means you can’t count on products containing what the label promises. A 2017 report in the Journal of the American Medical Association found that 43 percent of CBD products sold online contained more CBD than advertised, while 26 percent contained less. Only a third of the products were labeled correctly.

Can CBD help you? For now, preliminary evidence suggests CBD may help with these problems:

Anxiety: Some people swear that CBD helps calm everyday worries, while others rely on it to manage more serious issues like post-traumatic stress disorder (PTSD). They may be on to something. A 2015 report in Neurotherapeutics looked at findings from laboratory research, clinical trials and other studies. The collected evidence strongly suggests that CBD may indeed have soothing properties for people with generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder and PTSD.

Pain: There are many studies in the works examining CBD’s role in easing chronic pain and inflammation. Early findings are encouraging. One study found that CBD gel reduced joint inflammation and signs of pain in arthritic rats. Researchers are also exploring whether CBD can help people beat addictions to opioid painkillers or other narcotics.

Seizures: CBD holds a good deal of promise against seizures. In one large study of CBD in children with epilepsy, the compound reduced the frequency of seizures by more than half. And in 2018, Epidiolex became the first cannabis-derived drug to earn approval from the US Food and Drug Administration. Studies show that the oral medication, made from purified CBD, helps control seizures in children who have rare, severe forms of epilepsy. (The drug manufacturer, GW Pharmaceuticals, is currently working to obtain FDA approval for another CBD medication, Sativex, which is already used outside the US by people with multiple sclerosis to manage muscle spasticity.)

The bottom line: Talk to your doctor before trying any type of CBD product, since it could potentially interact with other medications. Keep in mind that you can’t necessarily trust that the product you buy contains what’s on the label — but if it does contain CBD, short-term use appears not to be particularly risky. More research is needed to clarify long-term effects.


CBD:hope

orhype?

It’s everywhere, but the jury is still out on whether cannabidiol is the cure for what ails you

You’re not imagining it: CBD creams, lotions, oils, tinctures and pills are everywhere, promising relief from everything from anxiety to acne. Judging from the sheer abundance of products, you might think that the extract is good for whatever ails you. It’s no wonder that a 2018 survey published in Cannabis and Cannabinoid Research found that more than 60 percent of CBD users buy it to manage medical conditions. But is CBD living up to the hope people have placed in it — or is it just a lot of hype?

The ABCs of CBDCBD stands for cannabidiol, one of the active ingredients in marijuana. Unlike marijuana’s other well-known active ingredient, tetrahydrocannabinol (THC), though, CBD doesn’t get users high. Beyond that, researchers are still establishing exactly what CBD does in the brain and throughout the body.

The upside: CBD appears to be safe, although it can cause side effects like nausea, fatigue and irritability, and can interact with some medications. Researchers haven’t found any signs that people abuse it or become dependent on it.

The down side: CBD products are regulated like supplements, which means that there’s little oversight or quality control. Among other things, that means you can’t count on products containing what the label promises. A 2017 report in the Journal of the American Medical Association found that 43 percent of CBD products sold online contained more CBD than advertised, while 26 percent contained less. Only a third of the products were labeled correctly.

Can CBD help you? For now, preliminary evidence suggests CBD may help with these problems:

Anxiety: Some people swear that CBD helps calm everyday worries, while others rely on it to manage more serious issues like post-traumatic stress disorder (PTSD). They may be on to something. A 2015 report in Neurotherapeutics looked at findings from laboratory research, clinical trials and other studies. The collected evidence strongly suggests that CBD may indeed have soothing properties for people with generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder and PTSD.

Pain: There are many studies in the works examining CBD’s role in easing chronic pain and inflammation. Early findings are encouraging. One study found that CBD gel reduced joint inflammation and signs of pain in arthritic rats. Researchers are also exploring whether CBD can help people beat addictions to opioid painkillers or other narcotics.

Seizures: CBD holds a good deal of promise against seizures. In one large study of CBD in children with epilepsy, the compound reduced the frequency of seizures by more than half. And in 2018, Epidiolex became the first cannabis-derived drug to earn approval from the US Food and Drug Administration. Studies show that the oral medication, made from purified CBD, helps control seizures in children who have rare, severe forms of epilepsy. (The drug manufacturer, GW Pharmaceuticals, is currently working to obtain FDA approval for another CBD medication, Sativex, which is already used outside the US by people with multiple sclerosis to manage muscle spasticity.)

The bottom line: Talk to your doctor before trying any type of CBD product, since it could potentially interact with other medications. Keep in mind that you can’t necessarily trust that the product you buy contains what’s on the label — but if it does contain CBD, short-term use appears not to be particularly risky. More research is needed to clarify long-term effects.

Northwell.edu 11


Larry Teatum is on the road again after a hassle-free biopsy procedure.


PROMISING PROSTATE NEWS

Diagnosis and treatment for prostate cancer has advanced significantly since the early 2000s. For example, a newly available biopsy method greatly reduces the risk of infection patients once faced.

Larry Teatum is one such patient. When the 64-year-old Staten Island resident got the results of his prostate specific antigen (PSA) test, which was high enough to indicate prostate cancer, he made an appointment with Michael Schwartz, MD, director of robotic and laparoscopic surgery at the Arthur Smith Institute for Urology in Lake Success.

A new prostate biopsy experienceMore precision, less pain and nearly zero infection risk

Dr. Schwartz has begun performing MRI-ultrasound fusion-guided prostate biopsy through the perineum (the area between the scrotum and anus) rather than the more traditional approach. Doctors typically perform prostate biopsies transrectally (through the rectum wall).

Despite best efforts to prevent infection with antibiotics and other prophylactic measures, there remains some potential for the needle puncture to allow bacterial contamination, which can lead to complications including bleeding or infections, a small percentage of which may be life-threatening. About 3 percent of men undergoing prostate biopsy require hospitalization.

By contrast, the transperineal approach avoids passing needles through the rectum, markedly reducing the risk of infection.

Fusion-guided procedures offer another benefit over the transrectal approach. By combining images from a previous MRI with real-time ultrasound images, the surgeon has a more detailed view of the area. “This allows us to precisely remove tissue samples from the areas of the prostate most suspicious for cancer,” said Dr. Schwartz. “I believe Northwell Health is the first health system in the country to use fusion-guided imaging to perform transperineal prostate biopsies in an office setting with local anesthesia.”

The tests a man can getUrodynamics identify how an enlarged prostate affects you. Determining the right method and treatment for you requires a specialist in advanced urology.

As men age, their chances increase for developing an enlarged prostate (benign prostatic hyperplasia, or BPH). Though not dangerous at first, untreated BPH can lead to serious problems.

Since the prostate, a walnut-sized gland, sits near the bladder and surrounds the urethra (the duct that carries urine out of the body), it puts pressure on the urethra when it grows. As a result, men may need to relieve themselves more frequently (eight or more times a day, multiple times at night), have trouble completely emptying the bladder, experience urinary urgency, and lose the ability to reach the bathroom in time, resulting in incontinence.

An enlarged prostate isn’t just inconvenient. Left untreated, it can lead to urinary tract infections, urinary stones and even kidney and bladder damage, said Farzeen Firoozi MD, a urologist at the Smith Institute of Urology at

Lake Success. But medications can help. Depending on a man’s individual conditions, his urologist may prescribe medication to improve urine flow by shrinking the gland to a healthier size, or by relaxing the outlet of the bladder.

“We use many tools to assess the severity of BPH and guide treatment, including physical exams, symptom evaluation and sometimes urodynamics,” said Dr. Firoozi.

Urodynamics gauge how the bladder and sphincter muscles hold and release urine. There are many testing techniques, and advanced urology practitioners most commonly prescribe these:

– Uroflowmetry: “Depending on the patient’s symptoms, we may first conduct a uroflowmetry test to measure the speed of urination,” said Dr. Firoozi. Abnormal results on this noninvasive test may indicate weak bladder muscles or blocked urine flow.

– Postvoidal residual measurement: “Also noninvasive, this test measures how much urine the bladder contains after urination. A higher volume may indicate that the bladder isn’t emptying as well as it should,” said Dr. Firoozi.

– Cystometrics: This slightly more invasive test measures how much the bladder can hold and how much pressure builds up before triggering the urge to urinate. It can also detect abnormal spasms in the bladder wall.

– Pressure flow: This study measures how much bladder pressure it takes in order to urinate and gauges the flow that the pressure generates. The pressure flow measurement helps to identify when prostate enlargement is blocking the bladder outlet.

These tests all take place in a urologist’s office, with local anesthetic as needed.

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PROMISING PROSTATE NEWS

LIJ Medical Center and North Shore University Hospital rank among America’s best for urology. To make an appointment, call (855) 963-0876.

Mr. Teatum was surprised at how painless the procedure was. “There was some initial discomfort when I got the local anesthetic, and a bit of pressure from the rectal ultrasound, but I felt almost no pain during the quick 15-minute procedure,” he said.

Dr. Schwartz is training others to perform these biopsies. To date, Northwell urologists have performed more than 250 transperineal prostate biopsies without any reports of sepsis. “This approach has been in use for years in other countries, but it’s just starting to gain traction here,” said Dr. Schwartz.

“Studies continue to show that the transperineal approach is much safer for patients with an almost zero chance of infection.”

For Mr. Teatum, the option of getting a low-risk biopsy alleviated some stress during an anxiety-inducing time. When the biopsy results showed cancer cells, Dr. Schwartz performed robotic-assisted surgery to remove Mr. Teatum’s prostate. “Dr. Schwartz has a very calming bedside manner,” Mr. Teatum said. “And I received excellent care from the post-operative nurses. I’m doing great.”

After he suffered a mini-stroke several years ago, Glenn Gruman found out he had less-than-perfect cardiovascular health, including high cholesterol levels. The 58-year-old Manhattan resident knew he needed to get those numbers under control, but the traditional treatment for high cholesterol — statins — made his muscles ache.

“I was hoping to find an alternative that would have as good an efficacy as statins, but with minimal to no side effects,” said Mr. Gruman. A referral led him to cardiologist and board-certified lipid specialist Guy Mintz, MD, director of cardiovascular health and lipidology at the Sandra Atlas Bass Heart Hospital.

Holistic heart healthLooking beyond the usual cholesterol numbers, a specialist offers highly personalized care.

Glenn Gruman finds peace in his home after a close call with cholesterol.


WE’RE ALL HEART

Dr. Mintz is also codirector, with Benjamin Hirsh, MD, of the newly opened Northwell Health Lipid Center.

The first of its kind on Long Island, the center takes a big-picture approach to cardiovascular care. While cardiac patients routinely undergo blood tests for HDL (“good”) and LDL (“bad”) cholesterol, Dr. Mintz, a specialist in lipids (blood cholesterol and fats), went further, testing for lipoprotein(a), or Lp(a). “Elevated Lp(a) levels are associated with early heart disease, early stroke and early death,” said Dr. Mintz.

Lp(a) isn’t familiar to many specialists besides lipidologists, so Mr. Gruman was never tested for it. “When I wear my cardiology hat, I’m looking at a whole organ system. When I wear my lipid hat, I’m laser-focused in that one particular area,” said Dr. Mintz.

Looking at lipidsNot only was Mr. Gruman’s LDL dangerously high, indicating a genetic disorder that compromised his ability to remove LDLs from his blood, but also his level of Lp(a) was nearly twice the normal limit.

Weighing this information in combination with other risk factors, such as a history of smoking, Dr. Mintz worked with Mr. Gruman to devise a treatment plan that included twice-monthly injectables in combination with a specific medication that blocks the absorption of cholesterol.

“Dr. Mintz thoroughly explained the newest research in genetics about lowering cholesterol,” Mr. Gruman said. “The amount of time and care he spent with me was phenomenal. I knew I was in the best hands.”

Two months later, Mr. Gruman’s LDL number was in the normal range and his Lp(a) decreased by 50 percent. “That’s significant,” said Dr. Mintz, adding that he was impressed with the improvement.

Prioritizing preventionMr. Gruman is a perfect example of prioritizing prevention over treatment, according to Dr. Mintz, and typifies how the Lipid Center helps patients. “For people who can’t tolerate statin therapy, our goal is to prevent the onset of atherosclerosis or ameliorate some of the progression over time,” said Dr. Mintz. “We want to affect the natural history of the disease. Instead of treating the effects of a heart attack or a stroke, we can make adjustments in lifestyle or medication to prevent them from ever happening.”

Dr. Mintz is always available for questions, but for now Mr. Gruman’s cholesterol is under control. That shows another priority of the Lipid Center: to see the patients for the short term. “We want to put people on the right path and send them back to their regular cardiologist,” Dr. Mintz said. “We’re a resource — not only to patients, but to physicians of all specialties.”

Make an appointment with a lipid specialist if: – Medications to lower cholesterol or triglyceride levels aren’t

effective, or their side effects aren’t tolerable for you – You require combination cholesterol-lowering therapy or

advanced treatments – There is heart attack or stroke in your family history – Your health history includes heart attack, stent, coronary bypass

surgery or stroke – You suffer from diabetes or peripheral vascular disease – You have elevated Lipoprotein(a) – You have a genetic disease such as familial hypercholesterolemia

or hypertriglyceridemia – You do not want to be on cholesterol medication and would like

dietary guidance

“ Instead of treating the effects of a heart attack or a stroke, we can make adjustments in lifestyle or medication to prevent them from ever happening.” – Guy Mintz, MD

The Northwell Lipid Center is part of the nationally ranked Sandra Atlas Bass Heart Hospital at North Shore University Hospital. Call (516) 727-7213 to make an appointment.

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WE’RE ALL HEART

What is a lipid specialist?This specialist studied pathophysiology (causes), diagnosis and management of disorders related to lipids. Though a lipid specialist is a medical doctor, the field is multidisciplinary and includes registered nutritionists and exercise physiologists who help people either prevent or recover from cardiac issues.

Should you see a lipid specialist?“Just as a diabetic might be sent to an endocrinologist, a lipid specialist can help patients who need help managing their cholesterol levels,” said Guy Mintz, MD, director of Cardiovascular Health & Lipidology at the Sandra Atlas Bass Heart Hospital. Cholesterol management guidelines were updated in 2018. The new guidelines include other populations at risk for cardiovascular diseases, including patients with chronic kidney disease, inflammatory diseases such as rheumatoid arthritis, psoriasis, inflammatory bowel disease, lupus, and issues unique to women including early menopause, pregnancy-induced

Cholesterol has gotten a bad reputation, but it’s actually present in every cell in our body and has important functions for digesting food, producing hormones and generating Vitamin D. It’s only when concentrations in the blood get too high that people become at risk for heart problems.

A clinician called a lipid specialist can determine whether you’re in danger and help you prevent cardiac issues. To figure out if you should see a lipid specialist, you need to understand what lipids are and how they impact heart health.

What are lipids?Lipids are fats, or fat-like substances, in the blood that your body uses for extra energy by converting them into fatty acids like your car burns fuel.

Cholesterol — both high-density lipoproteins (HDL) or “good” cholesterol and low-density lipoproteins (LDL) or “bad” cholesterol — and triglycerides, the most common type of fat in your body, are lipids. When lipid levels build up, they create blockages in the arteries, causing atherosclerosis, which can lead to heart disease and stroke.

Heart health goes holistic at the Lipid CenterThe first of its kind in the area, the Northwell Health Lipid Center brings a collaborative approach with referring physicians of all specialties. We evaluate cardiovascular risk and treat heart disease in a holistic way at its earliest stages to slow or prevent the progression of atherosclerosis. Patients are treated every step of the way by board-certified lipid specialists, who are also cardiologists, nurses and registered dietitians. The Lipid Center is located at 1010 Northern Boulevard in Great Neck.

For more information, call (516) 727-7213.

Not just cholesterolLipid specialists zero in on preventing and treating cardiac issues

hypertension and polycystic ovary disease. Lipid specialists can provide a personalized cardiovascular risk assessment, and then recommend the latest, most appropriate treatments for those at risk, according to Dr. Mintz.


WE’RE ALL HEART

The classic Mediterranean-style diet — low in processed foods but rich in fresh fruits and veggies, whole grains, healthy fats, � sh and beans — is good for your heart and waistline. Now, research suggests this way of eating may also elevate your state of mind.

In a 2017 study in BMC Medicine, people diagnosed with clinical depression reported a signi� cant improvement in mood after consuming Mediterranean-inspired meals for 12 weeks. That needs follow-up, but it’s in line with suggestions from other studies, including 2016 research, reported in Clinical Psychological Science, that found that people who closely followed a Mediterranean plan were 50 percent

less likely to develop clinical depression. Countries where people eat a lot of � sh also tend to have lower rates of depression.

While grilled salmon will never take the place of proven treatments like antidepressants and talk therapy, eating the Mediterranean way may improve your mental well-being in these ways:

It gives you energy. Lack of protein can make you feel run down and unmotivated. A Mediterranean diet incorporates protein in the form of beans and other legumes, � sh and other seafood, and smaller amounts of eggs, poultry and dairy. Red meat plays only a small role — it tends to be served just a few times a month.

It reduces in� ammation. Persistently high levels of in� ammation can raise the risk of depression and other mood disorders. Fruits, vegetables, whole grains, � sh and healthy oils are high in substances known to � ght in� ammation, such as natural antioxidants and protective plant compounds known as polyphenols.

It’s part of a balanced way of life. The Mediterranean diet is a style of eating, not a strict prescription, and some of its bene� ts may be due to the lifestyle that typically accompanies it. In fact, the so-called Mediterranean diet pyramid, developed by a research group that studies traditional eating patterns, is built on a base of regular physical activity and social interaction. So enjoy a meal in the company of family or friends to reduce isolation and protect against depression. If that’s not in the cards, savor your food — and then take a walk after dinner.

Food that boosts your mood

For simple healthy holiday recipes to lift your spirits, visit Northwell.edu/HealthyRecipes

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Valerie King is not your typical octogenarian. At 87, she works as the chief surgical assistant in a periodontal surgeon’s office in Lake Grove — and has done so for the past 55 years. Three days a week, she gets up extra early to greet the first patient who comes through the clinic door at 5:30am. Recently, she couldn’t shake a nagging cough, but figured it was a cold or allergies — not something to ignore, but also nothing serious.

But then Ms. King started experiencing fatigue and lack of appetite, dropping pounds from her already delicate frame. “I figured my age was finally catching up to me,” she said. Like many people, Ms. King didn’t realize that her complaints — the coughing, the fatigue, the weight loss — were all

Putting her heart back into work — and living An octogenarian gets a new lease on life


WE’RE ALL HEART

interventional cardiologist and director of the Structural Heart Program at the Sandra Atlas Bass Heart Hospital. “As a result, her body and organs weren’t getting enough blood and oxygen to function properly.”

Dr. Rutkin ordered additional tests, including a CT scan and cardiac catheterization, that revealed blockages in multiple arteries, including the main coronary artery that supplies blood to the heart.

Typically, someone with these complex cardiovascular issues would undergo open-heart surgery, specifically coronary artery bypass grafting and aortic valve replacement. But an open procedure was deemed too risky given the weakened state of Ms. King’s heart and her frailty. After reviewing her case in meticulous detail, Ms. King’s care team recommended a less invasive tactic.

Less risk, easier recoveryFirst, interventional cardiologist Barry Kaplan, MD, performed a minimally invasive procedure called percutaneous coronary intervention (PCI, also known as angioplasty and stenting), to open blocked arteries and improve flow to Ms. King’s heart. During PCI, Dr. Kaplan threaded a thin, flexible tube called a catheter through the femoral artery in the groin up to the heart. Dr. Kaplan then inserted a small mesh tube called a stent into the catheter and routed it to the blocked artery. Once in place, the stent propped open the blood vessel to restore normal flow. Ms. King had several narrowed blood vessels, and her condition put her at high risk, so Dr. Kaplan performed her PCIs over two days.

About a week later, Ms. King underwent transcatheter aortic valve replacement (TAVR), an approach that allowed Dr. Rutkin to replace her diseased aortic valve without open surgery. Dr. Rutkin threaded a valve mounted on a balloon through a catheter up the femoral artery to the heart. Once it was placed within Ms. King’s aortic valve, Dr. Rutkin inflated the balloon to expand the replacement valve and

lock it into position. The diseased valve remained in place and anchored the new valve, which began functioning immediately.

“In the past, patients like Ms. King who were deemed too high risk for open-heart surgery had few, if any, treatment options,” said Dr. Rutkin. “While TAVR was initially reserved only for high-risk patients, studies have shown that it is of equivalent safety and effectiveness for patients across the spectrum of surgical risk.”

Northwell doctors were early TAVR adopters, taking part in national clinical trials for the procedure. Since performing their first TAVR in April 2011, Northwell physicians have completed more than 2,000 of the procedures, making the health system among the busiest, most experienced TAVR centers in the country.

A faster recovery and shorter hospital stay are among TAVR’s many potential benefits. “Having avoided a surgical incision, patients usually leave the hospital in two days as compared to five. They can resume their daily activities sooner after TAVR,” said Dr. Rutkin.

Although not the norm, Ms. King was back to work within a week after her procedures.

“I feel like a new woman. My energy is back. My appetite is back. The cough is gone,” she said. “I tell people I feel like I’m 50 years old again, and I’m very grateful for the doctors at Northwell who brought me back to my former, more youthful self.”

signs of heart failure. Other potential signs include swelling in the legs, feet or abdomen, shortness of breath and changes in heart rhythm (arrhythmia).

A heart in perilBy the time Ms. King’s primary care physician detected a heart murmur and referred her to the specialists at the Sandra Atlas Bass Heart Hospital at North Shore University Hospital (NSUH), her health was already at risk. At NSUH, an echocardiogram showed Ms. King had both congestive heart failure and severe aortic valve stenosis.

“Her heart’s pumping function was significantly diminished, and the aortic valve was significantly narrowed,” said Bruce Rutkin, MD, an

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WE’RE ALL HEART

Find world-class cardiovascular care at the Sandra Atlas Bass Heart Hospital at North Shore University Hospital. Make an appointment at (855) 446-5596.

How to pick a heart surgeonGet the right doctor and the right team in your corner

Heart surgery is serious business, so getting the right surgeon and team on your side is crucial. Here are the top things to look for, according to Alan Hartman, MD, Northwell’s executive director of cardiothoracic services.

Do your research

“Your cardiologist is a great first resource for a referral to cardiac surgeons,” said Dr. Hartman. Once you have some names, do your homework: Investigate the surgeon’s and hospital’s success rate for your particular surgery, readily available through the New York State Department of Health and Society of Thoracic Surgeons (STS). Personal referrals are a great way to glean info about a doctor’s bedside manner and communication style.

Evaluate claims

Many hospitals tout their rankings and accolades, but that can be confusing if you don’t know which claims are most relevant. The STS and the New York State Department of Health both offer unbiased, dependable information because they highlight the success rates for all heart procedures at facilities and for specific doctors.

Go for experience

High-volume heart centers treat many different conditions, so they are more prepared to take on a wide range of issues. Find a heart surgeon and medical center with a proven track record in the procedure you need. Another benefit to going with hospitals and surgeons who have more experience is they have access to the latest equipment, technology and clinical trials.

Ask questions

“Don’t assume anything,” Dr. Hartman said. “Ask everything you can think of.” For example: How many of my procedures do you perform each year? What are my treatment options? Can or should my surgery be done with a minimally invasive approach? Who makes up my care team? These questions will lead to a deeper dialogue about your needs and what the surgeon can provide.

Look for a team approach

Heart surgery is a team sport. The surgeon, physician assistants, nurse practitioners, anesthesiologists, nurses, pharmacists, physical therapists, nutritionists, psychologists and referring cardiologists all need to work as a unit, so ask potential surgeons to describe their team members.

Ask about follow-up care

You should feel comfortable through your entire experience, including when you go home. Northwell offers a program called Follow Your Heart that includes post-discharge home visits by a specialized nurse practitioner or physician assistant. They can check progress, change medications if necessary, and ensure your recovery is on course. The aim of post-surgical follow up and rehabilitation is to get you on your feet and healing quicker, and also to reduce the likelihood of a hospital readmission.


WE’RE ALL HEART

How well do you know your heart? Visit bit.ly/heart-risk.

The surgeons at the Sandra Atlas Bass Heart Hospital rank among the nations’ best. Find out more at nsuh.northwell.edu/heart-hospital.

“Older” moms and breastfeedingWomen 35+ can overcome challenges with education and support If you give birth to your first child at age 35 and above — what the medical community calls “advanced maternal age” — you may face more roadblocks to successful breastfeeding than women who deliver children earlier.

Later maternal age is a factor in delayed milk production, one group of researchers found. Fifty-eight percent of new moms over age 30 reported a delay in milk production, versus 39 percent among younger mothers, according to a study in the American Journal of Clinical Nutrition. Furthermore, moms who gave birth for the first time after age 35 had the lowest rates of breastfeeding exclusively at the time of hospital discharge as well as one month later, according to a survey of new mothers published by Preventive Medicine Reports.

The key to successful breastfeeding is to start as early as possible, regardless

of your age at childbirth, said Maureen McCormick, RN, lactation coordinator at Long Island Jewish (LIJ) Medical Center. Ms. McCormick is certified by the International Board of Lactation Consultant Examiners. “Delays don’t mean you won’t be able to breastfeed, it just means that you can fall behind in producing milk,” which makes keeping at it harder, she said.

The reasons for a delay are complex, but one factor may be that “older” mothers are more at risk for pregnancy and childbirth complications, said Ms. McCormick. For example, mothers who are 35-plus have higher rates of high blood pressure, gestational diabetes and more C-sections than younger women. Each factor can make it tougher to get started.

Older moms, with a longer work history and more established career, may be more likely to return to work sooner,

and the stress over practicalities (Can I pump? Where? When?) may lead them to give up before they even start, or to stop nursing sooner than they’d like.

Stay positive about breastfeedingKnowledge and support help to counter obstacles to breastfeeding for women who are older than 35, said Ms. McCormick. “We try to address challenges around breastfeeding with education. Moms easily get frustrated, so support is critical,” no matter what a mother decides.

The most important message is that breastfeeding isn’t all or nothing. “Any breast milk is a win,” said McCormick. Her advice — for all first-time moms, but older mothers in particular:

– Take a breastfeeding class before your due date.

– Seek skin-to-skin contact. Such immediate, intimate contact between mother and child boosts both bonding and breastfeeding success. LIJ’s routine support of this practice is one reason it’s a designated Baby-Friendly hospital, Ms. McCormick said.

– “Room in” with your newborn. It’s easier to establish breastfeeding when babies stay in the same hospital room as their mom. “Rooming in helps mothers to see and hear their baby’s cues for feeding,” said Ms. McCormick. She added that rooming in is another feature of Baby-Friendly hospitals such as LIJ.

– Plan your return to work. “Find out about your rights and your employer’s responsibility to provide a time and place to pump,” said Ms. McCormick. She also encourages new mothers who are 35-plus to get insider advice by connecting with other women who’ve “been there, done that.”

See page 38 for information on breastfeeding classes.

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Go home hours after hip replacement First stop, surgery center. Next stop, the local diner.

Glen Bock lived with pain in his arthritic hip joints for more than a decade. He regularly visited a chiropractor and an acupuncturist, and also received pain-relieving injections to manage his symptoms.

“At age 58, I felt it was too soon to get surgery,” the Bellerose Village resident said.

But when the pain ultimately made it unbearable to do what he loves such as play basketball, referee football games, volunteer as a firefighter and work as a pharmaceutical sales representative, Mr. Bock he knew it was time to explore his options.


Now, they’re home in less than 12 hours,” said Dr. Danoff.

Deploying specialized equipment and using minimally invasive techniques through a small incision, Dr. Danoff replaces hip joints from the front (the anterior approach), rather the traditional side approach.

“We can now pull aside muscles and tendons, instead of cutting them,” he said. “Patients experience less pain and regain function faster.” A specialist in hip and knee joint replacements, Dr. Danoff has been performing outpatient total hip replacement at the NSUH Schwartz Ambulatory Surgery Center since February.

Mr. Bock walked out of the Schwartz Center and headed to a diner right after his second hip replacement in June. “The waitress couldn’t believe that I just had hip surgery,” he said.

After both procedures, Mr. Bock used an app called Force, provided free to Northwell orthopedic patients, to perform physical therapy exercises at

home and to send secure messages to Dr. Danoff to stay in touch after surgery.

“I felt like I was one of the rich and famous while receiving care at Schwartz. All of my needs were promptly met,” said Mr. Bock. “I recovered in a private room and worked one-on-one with a physical therapist before going home. The entire experience exceeded my expectations, which is why I tell my family and friends who have hip problems to go to Dr. Danoff and North Shore University Hospital.”

A surprise awaited him when he met Jonathan Danoff, MD, an orthopedic surgeon at North Shore University Hospital (NSUH). “I was shocked when Dr. Danoff told me I could go home the same day I got my new hip,” Mr. Bock said.

“A decade ago, patients spent two or three weeks recovering in the hospital and rehabilitation center after surgery.

To be eligible for outpatient hip replacement surgery, you must:

– be 65 or younger, – experience no significant chronic medical conditions, such as heart disease or kidney disease, and – have someone at home who can help out the first day after surgery.

“ A decade ago, patients spent two or three weeks recovering in the hospital and rehabilitation centers. Now, they’re home in less than 12 hours.” — Jonathan Danoff, MD

Call (855) 620-1853, option 1, to schedule an appointment with an orthopedic specialist.

GOOD BONES

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Avoid years of joint pain and deterioration Take advantage of a minimally invasive procedure that has helped many pro athletes

Ten years ago, a young person who consulted a doctor about hip pain would probably hear that it was a muscle strain and they’d be fine with rest and a follow-up visit. But recent advancements in imaging and diagnostics tell a different story, revealing that biomechanical issues can crop up as early as your teens, 20s or 30s.

Hip pain may result from injury to the labrum, the soft tissue that covers the hip joint; or impingement, which is when the bones of the hip joint don’t work smoothly. At this point, arthritis hasn’t set in — yet.

That’s where hip arthroscopy comes in. Arthroscopy on the knee or shoulder is already common, and now hip procedures are gaining momentum. During hip arthroscopy, the surgeon first inserts a tiny, tube-mounted video camera into the joint and then makes three, one-centimeter incisions.

The small openings are all the surgeon needs to repair a torn labrum and associated issues, and mean minimal scarring, stiffness and infection after the procedure. They also let you get up and move one or two days later.

Hip arthroscopy decreases the incidence of arthritis and the need for hip replacement in middle age and beyond. Considering that hip replacements nearly doubled between 2000 and 2010 for people over age 45, this is especially good news.

Ignoring pain in the hip joint increases your risk of arthritis, dysplasia, synovitis, infection and other issues. If rest, physical therapy or injections don’t provide lasting relief, talk to your doctor. Northwell Health’s orthopedic surgeons can repair a torn or damaged labrum, articular cartilage and other soft tissues.

If joint pain limits your life, our nationally recognized orthopedic specialists can help. Take a free assessment at bit.ly/painfuljoints.


GOOD BONES

Labral Tear

Normal Labrum

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Start simply There are several easy at-home remedies you can try before seeking medical attention, such as resting as much as you can, performing some gentle stretches, and/or using a heating or cooling pad to provide relief. Taking anti-inflammatory medications as directed can also help ease pain temporarily as you heal. These simple steps may help gradually diminish back pain so that you feel better within a few days to several weeks.

See your doctorSchedule an appointment when pain persists for weeks. A clinician will ask whether this is your first episode and what you think may have triggered the pain. The doctor will also inquire about urination or bladder function issues and any associated weaknesses. If you have no other issues, modifying your activity, engaging in physical therapy and continuing anti-inflammatories as needed can help. These therapies and modifications usually improve symptoms in about six weeks.

Go for testsIf you’re still in significant pain, your doctor may order additional assessments, such as magnetic resonance imaging (MRI). This will help determine whether your pain comes from spinal stenosis (a narrowing of the spinal canal that increases pressure on your lower back), which can trigger sciatica (pain that radiates from your lower back to your legs). Other causes of severe back pain can be muscle or ligament strains, a herniated disk, bulging or ruptured disks, skeletal irregularities, arthritis or osteoporosis and other systemic diseases.

Relief for back painLiving with back issues can make even the most basic daily activities a pain. If you’re one of the millions of Americans who experience long term chronic back pain, try these easy solutions before considering surgery:

When surgery’s the answerMost severe back and leg pain that won’t go away with noninvasive options stems from disk herniation, when the pads between the vertebrae slip out of position and put pressure on spinal nerves. In that case surgical removal of the disk may be the solution. Options include:

Diskectomy A full or partial removal of the herniated portion of a disk, which decreases inflammation within the nerve by relieving the compression.

Laminectomy

Removal of the bone overlying the spinal canal, which relieves pressure and opens the canal.

Spinal fusion Permanently connecting two or more bones in your spine, which can relieve pain by adding stability to a spinal fracture or eliminate painful motion between vertebrae caused by a degenerated or injured disk.

Call (855) 620-1853, option 1, to schedule an appointment at Northwell Health’s Orthopaedic Institute.

GOOD BONES

Air Force Lieutenant Peter Kuzniewski’s dream of becoming a military pilot evolved gradually. “Growing up, I didn’t know much about the military,” he said. “But as I got older and learned more about family members who had served as military pilots, I realized how awesome a career it really was. I wanted to fly — and started actively pursuing it as a career with the support of my family.”

But Lt. Kuzniewski, now 24, encountered a challenge. Flying military aircraft involves significant manual dexterity, and the aspiring pilot’s right hand had a congenital deformity called a bifid, or duplicated, thumb.

A bifid thumb affects about one in 1,000 babies, according to Lewis Lane, MD, chief of hand surgery at North Shore University Hospital (NSUH), who has treated Lt. Kuzniewski for more than 23 years.

“As the hand develops [in utero], some fetuses form an extra indentation that results in the thumb being not just one digit but two,” Dr. Lane said. “In Peter’s case, he had one metacarpal bone with two thumbs growing out of it.”

The future pilot was 11 months old for his first surgery. At about 15 years old, Lt. Kuzniewski underwent the first of two procedures to straighten and strengthen the thumb to allow more control and dexterity.

“Peter wanted to go into the military. He was playing a lot of sports, and

the thumb just wasn’t stable,” said Dr. Lane. “His last surgery, at 16 years old, helped stabilize that thumb, so he could continue his life and do everything he wanted.”

With the help of this surgery, the Air Force lieutenant qualified to fly the Boeing KC-135, a military aerial refueling aircraft. While hard work and perseverance helped him attain such a coveted flight position, he credits Dr. Lane’s care for helping him gain the strength and agility required to more effectively handle the airplane controls with his right hand.

“If I didn’t have the surgeries, I wouldn’t be able to use my hand nearly as well,” Lt. Kuzniewski said. “I just have much more control than I would have had without them. I’m very grateful to Dr. Lane for being there every step of the way and helping me get here.”

From routine repairs to extraordinary cases, our world-class orthopedic specialists have you covered.

Call (855) 620-1853, option 1, to schedule an appointment.

Healing hand A former Long Islander fulfills his dream of becoming a military pilot

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GOOD BONES

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GOOD BONES

Lt. Peter Kuzniewski near his Air Force base

in Oklahoma.

Joined by a hipBound together by a fateful meeting during the nation’s trauma Jonathan Judd got as far as the 83rd floor of the World Trade Center’s North Tower just before 9am on September 11, 2001, and could go no further. He faced an elevator bank engulfed in flames. Mr. Judd, then 36 and a new father, dashed into the first open office he saw, where Fred Eichler told Mr. Judd what he had just witnessed through the window: a jet airplane hitting the South Tower.

Flooded by thoughts of his wife and six-week-old daughter, Jordana, Mr. Judd remembers shaking so badly that he could hardly stand. “I told Fred I had finally gotten married at 36 and had a newborn at home, and now I wasn’t sure whether I’d live.”

Mr. Eichler, who had never met Mr. Judd before, noticed firefighters’ flashlight beams and determined that their best course was to follow the rescue workers outside. “I remember telling Jonathan that we were going to survive, that we would be OK,” said Mr. Eichler.

Their extraordinary team-up to survive was even more unusual because Mr. Eichler, now 70, had recently undergone hip replacement surgery by Stanley Asnis, MD, chief of joint reconstruction at North Shore University Hospital (NSUH).

What’s a hip got to do with it?Mr. Eichler developed arthritis after being thrown from a horse and received treatment from Dr. Asnis for years before he finally opted for surgery. “I sincerely believe I wouldn’t be alive today if I hadn’t had that hip replacement in 2000,” he said.

Alongside the firefighters, Mr. Eichler helped Mr. Judd descend from the 83rd floor, step-by-step. They took 45 minutes to reach the lobby, with just five minutes to spare before the North Tower collapsed. In the ensuing chaos, the men were separated. Weeks later, their respective bosses made the connection and were able to identify

Mr. Eichler as the one who helped Mr. Judd descend to safety. Soon after, Mr. Judd called the man he credits with saving his life.

The two men recently met again at NSUH, along with Dr. Asnis. “It’s very rewarding to see patients like Fred move on with their lives,” Dr. Asnis said. “He is a wonderful person who saw a need on that terrible day and worked to help a complete stranger.”

As they left the hospital, both men embraced. Mr. Eichler said, “Living in [Manhattan], there’s not a day that goes by that I don’t think about what happened on 9/11. I know how lucky I am to be here, and I can’t thank Dr. Asnis enough.”

Mr. Judd added, “My daughter was just six weeks old on 9/11, and all I could think of was that I wanted to get back home to see her and my wife. That baby just started college. I am a very lucky man.”

Call (855) 620-1853, option 1, to schedule an appointment with an orthopedic specialist.


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Fred Eichler, left, and Jonathan Judd catch up on a park bench in downtown Manhattan.

Your liver is an unsung hero, quietly playing a key role in digestion and regulating overall health. It helps break down fat, keeps your blood sugar at a healthy level and rids your body of harmful chemicals. No question about it: You want to keep your liver in the pink. These five steps will help.

If you drink, be moderate. Alcohol damages liver cells, and too much of it can lead to cirrhosis — a permanent scarring of the liver that can be life-threatening.

Watch your medications. Taking too much acetaminophen (Tylenol) can cause liver damage, especially if you also drink alcohol. Certain other medications — and supplements — can also be hard on the liver. Follow prescriptions to the letter, read nonprescription labels carefully and let your doctor know about everything you take.

Love your liverYour liver works hard to keep you healthy. Here’s how you can return the favor.

Consider getting vaccinated.Hepatitis viruses can cause chronic liver inflammation that can be serious — even deadly. Vaccines for several of these viruses are recommended for people in high-risk groups, so

talk to your doctor about the options. And because hepatitis doesn’t always cause symptoms, ask your doctor whether you should be tested. Eat a healthy diet.

Fiber found in fruits, vegetables and whole grains provides a natural boost to liver function. Not so friendly to your liver: processed, fried and fatty foods.

Stay fit. Excess pounds and obesity increase the risk of a condition called nonalcoholic fatty liver disease. In its most severe forms, that can lead to cirrhosis, and even liver failure.

Transplant news: Access Long Island’s first adult Liver Transplant Program at the Sandra Atlas Bass Center for Liver Diseases at North Shore University Hospital. Call (516) 530-8355 to learn more.

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At first, Kenneth Minton didn’t think he was eligible for the World Trade Center (WTC) Health Program, which provides medical benefits to first responders and others affected by the 9/11 terrorist attacks.

The Jamaica resident had spent September 12, 2001 helping to clear debris at Ground Zero. As a supervising fire inspector for the New York City Fire Department (FDNY), he returned to the area to perform a number of inspections in the weeks following the attack.

A former FDNY inspector preps for a lung transplant he needed after working in and around Ground Zero

Out of the hot zone


LIFE AFTER 9/11

He didn’t get sick — at least not right away. “One of my first assignments was going back to what they called the ‘hot zone’ downtown,” said Mr. Minton, now retired. “A lot of businesses wanted to open back up, but they needed an inspection first.”

“Something hurt my lungs”More than a decade after his final visit to the Ground Zero area, Mr. Minton, now 62, began experiencing symptoms he thinks resulted from that work. “I believe while I was down there I was exposed to something that hurt my lungs,” said Mr. Minton. “It just took a while for it to show up.”

He was having trouble breathing and sleeping. Though his primary care physician initially thought he might have sleep apnea, he was soon diagnosed with progressive pulmonary fibrosis, a life-threatening lung disease.

Since his doctors thought the condition had been caused by exposure to toxins at Ground Zero, Mr. Minton enrolled in the WTC Health Program. Operated by Long Island Jewish (LIJ) Medical Center, the program provides medical monitoring, diagnosis and treatment of health conditions suffered by first responders to 9/11, as well as residents and workers in the area. Through the plan, he was referred to Gita Lisker, MD, a pulmonologist and critical care physician at LIJ.

“Patients with pulmonary issues in the WTC Health Program are often referred to me,” said Dr. Lisker. She immediately agreed to see Mr. Minton.

From the moment he walked into her office, Dr. Lisker knew Mr. Minton needed immediate attention. “Even as he walked in the door, he was extraordinarily short of breath,” she said. “His oxygen level decreased dangerously just by walking. You could tell that he was really within months of his life ending, unless we did something.”

Gaining stabilityDr. Lisker determined that Mr. Minton would need a lung transplant and admitted him to LIJ that day. Along with her pulmonary fellow Rachel Aviv, MD, she worked to stabilize his condition so Mr. Minton would be ready when a donated lung became available.

The specialists prescribed steroids to reduce the amount of fluid in his lungs and put him on high-flow oxygen therapy. Mr. Minton also experienced atrial fibrillation (a dangerously fast heart rate),because he was working so hard to breathe, so they prescribed medication to control that, too. Once he was stable, Mr. Minton was transferred for his lung transplant.

“Thank God for Dr. Lisker’s compassion,” said Mr. Minton. “She saw I was in distress, she could see I was worried about my wife and family, and she knew I needed to get stronger so I could have a lung transplant. She and Dr. Aviv not only set it up so I could get the transplant, but made sure my health was in the right place so it would be successful.”

Dancing in the hallwayToday, Dr. Lisker calls Mr. Minton’s recovery “nothing short of amazing.” After his transplant and rehab, Mr. Minton showed Dr. Lisker how well he was doing by dancing in the hallway when she asked to see him walk.

“I’m 100 percent better than I was,” said Mr. Minton. “I’m doing great. I think so much of it has to do with my spirituality. But the other part of it is Dr. Lisker. I felt like we had a connection. I knew she was looking out for me. And when you have a great doctor and you have confidence in that doctor, you know things are going to turn out okay. I so appreciate her, and my whole care team, for everything that they’ve done for me.”

What benefits does the WTC Health Program offer?Responders receive an initial health evaluation to determine whether serious health problems, such as lung or gastroesophageal disease, asthma or cancer could be related to their service at Ground Zero. Enrollees receive annual medical monitoring.

First responders and others with a certified WTC-related health condition receive quality medical treatment for their condition.

Call (718) 650-2817 to make an appointment at the Queens World Trade Center Health Program.

LIJ is recognized as a high-performing hospital for pulmonology. Meet our lung experts at northwell.edu/BreatheSleepEasy.

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LIFE AFTER 9/11

After giving birth to her second child in 2013, a bout of numbness in Heather Christenson’s legs sent her on a search for answers.

She never thought the diagnosis would be an undetected birth defect — spina bifida. “I was shocked,” Ms. Christenson said. Prenatal ultrasound scans usually detect spina bifida, but she was born before such tests were routine.

Innovative spinal surgery gets this mom moving Remaining active after a state-of-the-art procedure prevents possible paralysis

Many infants with spina bifida (or a “split spine” in which the neural tube that protects the spinal cord doesn’t fully close up) have a noticeable sac of fluid bulging from their backs. But this telltale sign is missing for about 15 percent of these children, according to the Spina Bifida Association. As Ms. Christenson experienced, the condition isn’t detected until symptoms, such as leg weakness and

urinary incontinence, crop up long past infanthood.

Normally, the spinal cord moves freely within the vertebrae, allowing for a full range of motion. But Ms. Christenson’s spine, like many others with her condition, was attached to the inside of her vertebrae. Eventually, this can cause painful pressure.


Neurosurgeons traditionally perform surgery to detach the cord, but the surgery can cause problems and damage nerves. Since cords can reattach, this is not always a permanent solution, making repeat surgeries necessary. To make matters worse, scar tissue builds up with each surgery, increasing the risk of permanent nerve damage and paralysis.

Ms. Christenson had detethering surgery in 2013, just three months after her son was born. The procedure helped for a while, but she started experiencing more pain and leg numbness after she moved to Long Island in 2016.

A friend suggested Ms. Christenson see Ahmad Latefi, DO, director of the Spine Program at North Shore University Hospital. “Dr. Latefi knew exactly how to make things better,” said Ms. Christenson.

spine, Ms. Christenson returned to hiking and biking with her children, and swims often in a local pool. In fact, she racked up an impressive 100 miles in the pool in the six months after surgery. Best of all, she can be hopeful about her future rather than apprehensive about it. “I’m very grateful for Dr. Latefi’s excellent care,” she said.

Her new specialist is one of the few nationwide to perform a unique procedure called vertebral column shortening, which removes a small amount of vertebra to ease tension on the spine. This approach offers minimal risk of nerve damage and virtually no risk of cerebrospinal fluid leakage, which can occur during standard detethering surgeries.

“I’ve performed this procedure on close to a dozen patients, including children, with extremely successful results,” said Dr. Latefi. “Patients who undergo this procedure are less likely to experience post-surgery problems, and they don’t have to worry about needing more detethering surgeries.”

After having vertebral column shortening, which also involved inserting four rods to stabilize her

Make an appointment with our nationally recognized neurology and neurosurgery team. Call (855) 472-5801.

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After vertebral column shortening surgery, Heather Christenson is back to hiking and biking with her boys.

What’s old is new again

Liven up your plate with ancient grainsAncient grains, which are any varieties that haven’t been altered by years of selective breeding and industrial refining, are on many of our menus now — for good reason. They’re an easy way to add new flavors to the table, and they can grow with lower levels of pesticides and fertilizer, which minimizes their impact on the environment. And if you steer clear of gluten, many ancient grains offer welcome alternatives. Each type offers a different nutrient profile, and each is a healthier choice than refined grain products such as white flour or white rice. So add a little sizzle to your meals and check out these old-but-new-again grains.

Farro: A few different types of ancient wheat are called farro, but in the US, the term usually refers only to emmer wheat. Farro is loaded with fiber and protein, as well as nutrients such as magnesium, zinc and niacin. Look for pearled farro, which provides more fiber and nutrients than semi-pearled. (Like all wheat, farro contains gluten.)

How to use it: Cook farro like brown rice or quinoa for a rich, nutty flavor and chewy texture. For a healthy breakfast or snack, mix cooked and cooled farro with yogurt. You can also add cooked farro to soups and salads.

Amaranth: This gluten-free powerhouse is rich in calcium and protein, and is the only grain known to contain vitamin C. It also has plenty of iron, magnesium, phosphorus and potassium.

How to use it: Simmer amaranth seed with liquid to make a breakfast porridge, or use it as an ingredient in breads, muffins and pancakes. Or pop it on the stovetop like popcorn — just sprinkle the tiny white beads with salt or herbs.

Freekeh: Freekeh is the term for an ancient way to process wheat rather than the name of a grain. Growers pick wheat grains when they’re young and green, and this early harvesting means high levels of fiber, protein, iron and zinc. Roasting gives the grains a smoky flavor. Freekeh may be a great addition to the menu for people with diabetes because it produces a relatively small increase in blood sugar.

How to use it: Toss the cooked grain into salad for a nutty, chewy flavor boost, add it to soup or use it to make stuffing or a pilaf.

Khorasan wheat: The gluten in this wheat grain is easily digested, which makes it an attractive choice for people who are mildly intolerant to the stuff. (If you have celiac disorder, you need to avoid gluten completely — so Khorasan wheat is not an option.) Khorasan wheat has a sweet, nutty and buttery flavor. In the US, it’s grown and sold under the brand name Kamut.

How to use it: Cooked Kamut can be tossed into salads or mixed into soups and casseroles. It’s also a good alternative to brown rice. You can substitute ground Kamut flour for wheat flour in baking.

Kaniwa: Like quinoa, gluten-free kaniwa is actually a quick-cooking seed. It’s high in fiber, protein, iron, and B and E vitamins. Slightly sweeter than quinoa, kaniwa has a nutty flavor.

How to use it: Adding kaniwa seeds to pancakes, breads and muffins boosts fiber without affecting texture. To give baked goods a healthier punch, swap high-protein ground kaniwa flour for all-purpose flour.

Teff: The world’s tiniest grain, teff is so small it’s often mistaken for a seed. It’s gluten-free, and high in protein and calcium. Studies show that teff is digested slowly, so it’s less likely to cause a spike in blood sugar. That can help you feel full longer, making it easier to maintain a healthy weight.

How to use it: Ethiopians use this grain to make injera, a spongy flatbread that tastes like sourdough. Use teff as an ingredient in pancakes, breads, cookies, breakfast porridge and even pie crusts. The nutty flavor and crunch of cooked teff make it a great addition to salads.



What’s old is new again

Liven up your plate with ancient grainsAncient grains, which are any varieties that haven’t been altered by years of selective breeding and industrial refining, are on many of our menus now — for good reason. They’re an easy way to add new flavors to the table, and they can grow with lower levels of pesticides and fertilizer, which minimizes their impact on the environment. And if you steer clear of gluten, many ancient grains offer welcome alternatives. Each type offers a different nutrient profile, and each is a healthier choice than refined grain products such as white flour or white rice. So add a little sizzle to your meals and check out these old-but-new-again grains.

Farro: A few different types of ancient wheat are called farro, but in the US, the term usually refers only to emmer wheat. Farro is loaded with fiber and protein, as well as nutrients such as magnesium, zinc and niacin. Look for pearled farro, which provides more fiber and nutrients than semi-pearled. (Like all wheat, farro contains gluten.)

How to use it: Cook farro like brown rice or quinoa for a rich, nutty flavor and chewy texture. For a healthy breakfast or snack, mix cooked and cooled farro with yogurt. You can also add cooked farro to soups and salads.

Amaranth: This gluten-free powerhouse is rich in calcium and protein, and is the only grain known to contain vitamin C. It also has plenty of iron, magnesium, phosphorus and potassium.

How to use it: Simmer amaranth seed with liquid to make a breakfast porridge, or use it as an ingredient in breads, muffins and pancakes. Or pop it on the stovetop like popcorn — just sprinkle the tiny white beads with salt or herbs.

Freekeh: Freekeh is the term for an ancient way to process wheat rather than the name of a grain. Growers pick wheat grains when they’re young and green, and this early harvesting means high levels of fiber, protein, iron and zinc. Roasting gives the grains a smoky flavor. Freekeh may be a great addition to the menu for people with diabetes because it produces a relatively small increase in blood sugar.

How to use it: Toss the cooked grain into salad for a nutty, chewy flavor boost, add it to soup or use it to make stuffing or a pilaf.

Khorasan wheat: The gluten in this wheat grain is easily digested, which makes it an attractive choice for people who are mildly intolerant to the stuff. (If you have celiac disorder, you need to avoid gluten completely — so Khorasan wheat is not an option.) Khorasan wheat has a sweet, nutty and buttery flavor. In the US, it’s grown and sold under the brand name Kamut.

How to use it: Cooked Kamut can be tossed into salads or mixed into soups and casseroles. It’s also a good alternative to brown rice. You can substitute ground Kamut flour for wheat flour in baking.

Kaniwa: Like quinoa, gluten-free kaniwa is actually a quick-cooking seed. It’s high in fiber, protein, iron, and B and E vitamins. Slightly sweeter than quinoa, kaniwa has a nutty flavor.

How to use it: Adding kaniwa seeds to pancakes, breads and muffins boosts fiber without affecting texture. To give baked goods a healthier punch, swap high-protein ground kaniwa flour for all-purpose flour.

Teff: The world’s tiniest grain, teff is so small it’s often mistaken for a seed. It’s gluten-free, and high in protein and calcium. Studies show that teff is digested slowly, so it’s less likely to cause a spike in blood sugar. That can help you feel full longer, making it easier to maintain a healthy weight.

How to use it: Ethiopians use this grain to make injera, a spongy flatbread that tastes like sourdough. Use teff as an ingredient in pancakes, breads, cookies, breakfast porridge and even pie crusts. The nutty flavor and crunch of cooked teff make it a great addition to salads.

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SPINE SURGERY

The miracle man

Joseph Brofsky, DMD, section head of pediatric dentistry at Cohen Children’s Medical Center, was the one urging his friends to head into the ocean during their annual vacation, even though he’s not a huge swimmer. But there they were in Punta Cana in the Dominican Republic, and the waves looked great.

That is, until one of those waves took him unawares, knocking him down so that his head smacked the sea floor. Dazed and floating face-down, he didn’t know quite what had happened, but he

did know he couldn’t feel his limbs. For the seconds it took one of his friends to reach him and pull him out of the water Dr. Brofsky imagined the worst — that it was over. But one thought came to him: “I have a grandbaby coming,” he said. “I have to stay alive to see him.”

The rescue team pulled Dr. Brofsky ashore, but his arms and legs remained motionless. He didn’t know it yet, but he’d suffered a serious neck injury that left him temporarily paralyzed. He managed to tell his rescuers that he knew, as a medical professional, that he had a spinal cord injury and needed steroids. Lifeguards stabilized Dr. Brofsky’s neck with a cervical collar, and an ambulance took him to the nearest hospital. One of his friends called the doctor’s wife, Laurie Stone Brofsky, who headed to the island to meet him the next day.

A pediatric dentist survives, and thrives, after a traumatic brain injury.

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SPINE SURGERY

A glimmer of hopeWhile in transit to the hospital, Dr. Brofsky said he could feel his toe twitch, giving him glimmer of hope. An MRI revealed significant inflammation and damage to a number of vertebrae in his spine. He had those results emailed to a colleague back home, who urged the Brofskys to head home as soon as possible. The couple took an emergency evacuation jet back home and were transported to North Shore University Hospital (NSUH). There, Dr. Brofsky rested for a week to allow the inflammation to lessen. A week later neurosurgeon Michael Lefkowitz, MD, performed a laminectomy, spinal fusion and inserted two rods.

“I removed bone from the back of his spine to relieve pressure,” said Dr. Lefkowitz. “The rods stabilized his spine to prevent re-injury.” After surgery, Dr. Brofsky slowly began to feel with his fingers. He was transferred to Northwell Health’s Glen Cove Hospital for rehab.

Optimistic for recoveryIn rehab, Dr. Brofsky gradually progressed from being paralyzed to potentially being able to move his limbs again. He lauded the therapists at Glen Cove: “They are off-the-charts great,” he said. “They pushed me to work really hard every day for three hours.” Dr. Brofsky primarily worked with physical therapist Elizabeth Palladino, DPT, and occupational therapist Terence Fung, OTR/L.

“When he first came to us, he needed three or four people to help him walk with a platform rolling walker,” Dr. Palladino said. “He was really frustrated because he couldn’t use his arms. He couldn’t wipe a tear from his eye. But at the end, he was walking with just one person at his side in case he needed help.”

Dr. Palladino used several balancing exercises and the G-EO System at Glen Cove Hospital. This system, operated by a therapist, realistically simulates floor walking and stair climbing.

In OT, Mr. Fung retaught Dr. Brofsky the necessary motions for daily activities.

“His arms weren’t moving and his legs weren’t strong,” Mr. Fung said. “He couldn’t brush his teeth,” ironic given he’s a dentist. Mr. Fung worked with the doctor on fine motor coordination. “He played cards with his wife. We used putty to strengthen his hands.”

These days, Dr. Brofsky’s legs and arms are at close to 100 percent functionality, and he sees improvement every day as he continues physical and occupational therapy at Northwell Health Stars Rehabilitation.

A new lifeFinally, Dr. Brofsky traveled to Kansas City to visit his daughter, Jenna, son-in-law, Ethan, and new grandson, Isaac. He had actually trained to cuddle Isaac while at Glen Cove by holding nine-pound weights. Once Isaac was in his arms, “I cried like a baby,” Dr. Brofsky said. “It was a very emotional moment.”

Dr. Brofsky returned to work just over three months after the accident. He’s not performing surgery right now, but he spends his days teaching and working with residents. He’s also planning Give Kids a Smile, an annual Nassau County Dental Society-sponsored program he co-chairs that provides underserved and special-needs children with free dental screenings and oral hygiene instruction. Nearly 16,000 children have benefited from Give Kids a Smile since its inception in 2003.

“Life has been good,” he said. “People call me the miracle man.”

“ Life has been good. People call me the miracle man.”

— Joseph Brofsky, DMD

Our nationally recognized neurology and neurosurgery team can help you get your life back after a traumatic injury. For information or to make an appointment with a neurologist, call (855) 472-5801.

Free community programsThere are solutions for your aches and pains. Discover what’s possible at our free community seminars. Visit bit.ly/ache-pain-fix or call (855) 620-1853 to learn more from the Northwell Health Orthopaedic Institute.

Lifesaving CPR

Learn this important technique and other emergency strategies.

Family & Friends Infant CPR: $65 per person/$120 per couple. Available at North Shore University Hospital (NSUH). HeartSaver CPR/AED: $65 per person

Extended hours for urgent orthopedic care If you go to an emergency department (ED) with a badly hurt muscle or bone, it may take a while before you see a physician. After all, people with life-threatening health problems are the first priority in EDs. Furthermore, musculoskeletal specialists are not on-site 24/7.

A more convenient choice is to make the most of extended hours at the Northwell Health Orthopaedic Institute at 611 Northern Boulevard, Suite 200, Great Neck. The center is open Monday through Friday, 7:30am to 6pm and Saturday 8am to 4pm. For more information, call (855) 620-1853, option 1.

To your healthNews and resources in your community

Visit northwell.edu/CommunityEvents or call the Northwell Health Center for Equity of Care at (516) 614-6881 to learn more or register for classes.

Available at the Katz Women’s Hospitals:Preparation for childbirthLearn relaxation and breathing techniques, hospital admission policies and procedures, anesthesia/analgesia options, vaginal and cesarean births and postpartum expectations. A hospital tour is included. Recommended four to six weeks before your estimated delivery date.

$200 for expectant mom and coach.Available at the Katz Women’s Hospitals at NSUH and LIJ.

Breastfeeding Covers nursing basics such as pros of breastfeeding, breastfeeding techniques and effective latching, bottle use, pumping, returning to work and common facts and myths. Bring a baby doll or stuffed animal to class.

$70 per person/$85 per couple. Available at the Katz Women’s Hospitals at NSUH and LIJ.

Baby care basicsTeaches expectant parents, grandparents and childcare providers about newborn care, feeding, bathing, diapering, cord and circumcision care, safety, sleep and immunizations.

$70 per person/$85 per couple. Available at the Katz Women’s Hospital at NSUH.

Health education classes


COMMUNIT Y RESOURCES

One place, many specialties Access comprehensive care from an internal medicine physician and a broad range of specialists under one roof at Northwell Health Medicine Specialties. The new ambulatory center is located at 256-11 Union Turnpike in Glen Oaks. Northwell Health Medicine Specialties is open 8am to 7pm every Monday and 8am to 5pm Tuesdays through Fridays. Call (929) 292-7000.

North Shore University Hospital, LIJ Medical Center achieve national US News ratingsNorth Shore University Hospital (NSUH) and Long Island Jewish (LIJ) Medical Center rank among the top 50 hospitals in the nation, according to US News & World Report’s 2019-20 Best Hospitals survey. The publication evaluated 4,500 adult medical centers nationwide.

NSUH is Long Island’s highest-rated hospital — and the fourth-best in the state and metro area — with nine adult specialties, ranking nationally in: orthopedics (11th, tied); diabetes and endocrinology (15th); cardiology and heart surgery (20th); neurology and neurosurgery (21st, tied); gastroenterology and GI

surgery (33rd, tied); geriatrics (35th); urology (38th) and nephrology (46th). See pages 13, 15, 16, 19, 20, 22, 28, 32 and 37 for related stories.

“We have long felt that North Shore University Hospital is a destination medical center for a number of programs,” said Jon Sendach, executive director at NSUH. “The national rankings of cardiovascular and orthopedics in the top 20 certainly validates that belief.”

LIJ achieved national rankings in six specialties: ear, nose and throat (18th), gynecology (21st), orthopedics (24th), urology (31st), diabetes and endocrinology (33rd, tied) and nephrology (35th). Furthermore, LIJ rates as the eighth-best hospital in the metro area and state. See related stories on page 8 and 24. “The US

News & World Report ratings are meaningful to us because they affirm the hard work and dedication of our team,” said Michael Goldberg, LIJ’s executive director.

In total, five Northwell hospitals achieved 23 national rankings. US News also recognized care at Lenox Hill Hospital, Huntington Hospital and Staten Island University Hospital. In a separate analysis of children’s hospitals, Cohen Children’s Medical Center earned top-50 national rankings in nine pediatric specialties.

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COMMUNIT Y RESOURCES

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Michael Dowling President and CEO, Northwell Health

Jon Sendach Executive Director, North Shore University Hospital

Michael Goldberg Executive Director, Long Island Jewish Medical Center

Terry Lynam SVP & Chief Public Relations Officer, Northwell Health PR

Brian Mulligan AVP, Northwell Health PR

Maria Conforti Director, Editorial Services & Executive Communications, Northwell PR

Chris Gasiewski Manager, Editorial Services & Executive Communications, Northwell PR

Look North is published by Northwell Public

Relations (516) 321-6701. This information is

intended to educate readers about subjects

pertinent to their health and is not meant as

a substitute for consultation with a personal

physician. Produced by Onward Publishing, Inc.

Port Jefferson, NY 11777. (631) 757-8300. Printed

in the USA.

Look North

Northwell Health Hospitals: Cohen Children’s Medical Center • Glen Cove Hospital • Huntington Hospital • Lenox Hill Hospital • Long Island Jewish (LIJ) Forest Hills • LIJ Medical Center • LIJ Valley Stream • Mather Hospital • North Shore University Hospital • Northern Westchester Hospital • Peconic Bay Medical Center • Phelps Hospital • Plainview Hospital • South Oaks Hospital • Southside Hospital • Staten Island University Hospital • Syosset Hospital • Zucker Hillside Hospital

Affiliates: Boca Raton Regional Hospital • Crouse Hospital • Maimonides Medical Center • Nassau University Medical Center • Western Connecticut Health Network

No one is eager to go to the emergency department (ED) — but for older people, EDs present unique challenges. They’re usually bright and noisy, which can be disorienting. Plus, geriatric patients have special health needs. For example, older people metabolize medication differently, which can raise the risk of side effects.

Without careful attention, a minor emergency can cascade into delirium, a fall or a dangerous drug interaction.

“Our bodies change as we age,” said Tara Liberman, DO, associate chief of geriatric and palliative medicine at Northwell Health. “Medical issues get more complex, and the elderly may experience cognitive changes or social isolation.”

That’s why the American College of Emergency Physicians (ACEP) has created a special accreditation program for geriatric-friendly EDs to make the experience safer and more comfortable for older patients. Northwell Health

recently became the first US health system to receive this accreditation at every ED in its network.

“Northwell EDs are prioritizing geriatric care, with focused policies, ongoing education for clinical staff and a structure for quality and process improvement,” said John D’Angelo, MD, Northwell’s executive director and senior vice president of emergency medicine. “Our EDs routinely assess elderly patients for altered mental status and fall risk.”

Smart strategies to protect older loved ones:Pack a “go bag.” Include a list of all medications and supplements that your

loved one takes; copies of documents such as a health care proxy and advance directive; and doctors’ names and contact information.

Tell their story. Doctors often need more information about how an elderly patient normally functions. Do they typically

have trouble walking, or is that symptom the result of a new problem or medication change? Providing context when your loved one can’t

helps the medical team to provide faster, more effective treatment.

Keep an eye on their support system. It’s easy to forget eyeglasses or hearing aids during an emergency. But being unable to see or hear clearly makes it harder to

process information and raises the risk of anxiety, confusion or delirium. If these items were left behind in the rush to get to the ED,

send someone to retrieve them and be sure they stay with the patient if they’re admitted to the hospital.

Stick around. Your elderly loved one may feel too ill or overwhelmed to speak up, avoid asking for food or drink if the wait is lengthy, or for an explanation of a test

or procedure if they’re upset or intimidated. Your simple presence and caring involvement make a big difference.

Elder-friendly emergency departmentsExpert care tailored for the needs of seniors

Find a Northwell geriatric medicine specialist who understands the needs of seniors. Call (855) 772-9058, option 2 for appointments.

US News ranks care at North Shore and LIJ in the top 50 hospitals in the US.

look north · unconditional love in exchange for a cuddle, a pat or a scratch behind the ears....

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