10/13/13 3:00pm
10/13/2013 3:00 PM

According to the National Institutes of Health, one in four adults nationwide experiences mental illness in a given year — however, the person diagnosed is not the only one who’s affected.

The North Fork will soon be home to a new, free, family-to-family mental health education program, a type of support system area residents have previously lacked, said Sharon McHugh, administrative assistant at the Family Service League’s North Fork Counseling center in Mattituck who is helping to run the program.

“Mental illness really affects the whole family and there are people who try to suffer through that alone,” Ms. McHugh said. “There are going to be people there that have been through, or are going through, the same thing, support there that you can’t get from a clinician.”

Ms. McHugh said the program, created by the nonprofit advocacy group National Alliance on Mental Illness, was instrumental in helping her and her family navigate the mental health system.

“I am the granddaughter, the daughter, and the sibling of someone who suffers from mental illness,” Ms. McHugh said. “It taught me how to advocate for myself and the person who’s ill. It taught me how to find the correct type of services and what was out there in the community and how to make it work for us. I didn’t feel so alone.”

She said she used to travel an hour and 20 minutes to take part in weekly meetings, and worked to bring the program to the North Fork so other families could benefit.

The 12-week-course is designed for parents, siblings, spouses and significant others who have been affected by an individual with severe and persistent mental illness, whether they are overcome by depression, panic or compulsive disorders, schizophrenia or addiction. The classes will be held every Thursday from 6:30 to 9 p.m. at Mattituck Presbyterian Church.

Families will receive guidance on how to locate services within the community, along with up-to-date information about illnesses, medications, side effects, and strategies for medication adherence. The program teaches problem solving, listening, and communication techniques, along with strategies for handling crises and relapse, according to the NAMI website, nami.org.

Along with learning how to help those with mental illness, group members will also learn how to focus on their own care, coping with worry, stress and the emotional overload that may accompany being a caregiver, according to the program.

“It seems so much of the focus goes over to the person with the illness; the other people and their needs become neglected,” said Susan Dingle, a private practice therapist in Southold. “But it’s really quite a well-known thing that if you’re not taking care of yourself, how can you take care of someone else?”

Those interested in the program should contact Sharon McHugh at 631-680-0849 to register. Classes begin Oct. 17. Class size is limited.

Got a health question or column idea? Email Carrie Miller at cmiller@timesreview.com. Follow her on twitter @carriemiller01.

09/15/13 3:00pm
09/15/2013 3:00 PM
GARRET MEADE FILE PHOTO | Bishop McGann-Mercy’s Reggie Archer, right, runs into Babylon’s Andrew Watson in a 2012 game.

GARRET MEADE FILE PHOTO | Bishop McGann-Mercy’s Reggie Archer, right, runs into Babylon’s Andrew Watson in a 2012 game.

In March, the American Academy of Neurology updated its “return-to-play” guidelines for young athletes — the procedures coaches and athletic trainers use to decide whether a child who has sustained a tough hit during a game should go back on the field or sit it out on the sidelines.   

The new recommendations advise that athletes of high school age and younger be managed more conservatively, because studies show they take longer to recover.

“When in doubt, sit it out,” said Dr. Rosanna Sabini, brain injury and concussion rehabilitation physician at North Shore-Long Island Jewish Southside Hospital, where she has taken a special interest in protecting young athletes.

Dr. Sabini has worked with professional boxers and mixed martial arts competitors, authored several studies regarding “return-to-play” guidelines and testified in the Senate regarding concussion legislation to protect youth athletes.

Q: What do you think are the common misconceptions regarding concussions? 

A: In the end, a concussion is always a traumatic brain injury. There has to be more significance given to it and I feel that sometimes the names and the descriptions move away from their severity. Some people may call it a mild concussion, but there is nothing mild about it.

You don’t actually need a direct hit to the head. It could be someone in a car accident, for example. When your head flexes forward fast and comes to a halt, your brain is going hit the inside of the skull. There are different types of tissues in your brain and when you go from 60 mph to 0 mph — those densities are all going to decelerate at different speeds. That leads to some structural nerve injuries and biochemical changes.

Q: What symptoms should parents and coaches look out for after a player takes a hard hit?

A: The typical symptoms are headaches and feeling dizzy and nauseous. They may feel that light and sounds really bother them. There’s a lot of information and stimulation coming in and they can’t make sense of it so easily because of the injury, so they are very sensitive. They usually occur pretty quickly from the time of the hit.

Q: What makes concussions so difficult to identify?

A: Sometimes people can’t even identify a concussion happened. Kids get up and they look fine. You have to try and educate the athletes as much as possible on what to look out for. Some kids may completely deny it, but if they never say anything to anyone they are putting themselves at risk for another concussion.

Q: What if a child were to return to play too soon?

A: A person who has had a concussion won’t be able to perform like normal. They are more likely going to get hit again because they won’t have the reaction time. They are at risk of getting another concussion.

It’s important that you get them out. If you get them out sooner and get them resting ASAP, they are more likely to get better quickly. It’s all about prevention.

Q: What should parents tell a player if they have to sit it out? 

A: There will always be another game they can play. But there won’t be if you go back out there and you get hit again.

The kind of thing I try to tell kids is you won’t to be 100 percent. You could lose a play or miss a catch. A veteran came to see me for a concussion and said, “I’m part of a team and if I’m not good, I can put the rest of my team at risk.” I always remembered that. I ask children if they want to put their team at risk and they’ll usually tell me, “No.”

It’s continual education of everyone around athletes so that we can prevent it.

Got a health question or column idea? Email Carrie Miller at cmiller@timesreview.com. Follow her on twitter @carriemiller01.

07/06/13 8:00am
07/06/2013 8:00 AM

BARBARAELLEN KOCH FILE PHOTO | Summertime at Iron Pier Beach in Northville.

It’s Fourth of July weekend and locals and visitors alike are touring grapevines and splashing in local waters – marking the official kickoff of summer on the North Fork.

Carrie Miller

Carrie Miller

While you’re out having fun in the sun, it’s important to remember to protect your skin.

“It is the largest organ of the body and the gateway into your internal system,” said Dr. Mitchell Meyerson, a dermatologist in Riverhead with 16 years’ experience.

Skin cancer is the most common of all cancers, accounting for almost half of all cancers in the U.S., according to the American Cancer Society. Most people have heard of melanoma, the most harmful type of skin cancer, but there are several other types that can develop, Dr. Meyerson said.

Damage is caused by the sun’s UVA rays, which cause wrinkling and sunspots, and UVB rays, which are what burn the skin, according to the American Cancer Society.

“It has been know that UVB are the very damaging rays. But in the last five to 10 years, it was found that cumulative exposure to UVA rays is supposedly just as bad,” Dr. Meyerson said.

One reason why, he said,  is that the more damaging UVB rays are blocked by glass, while UVA rays are not.

“And we see a lot more skin damage on the left side of the face or arm because of all those years of driving,” he said.

So whether you’re out for a joyride or digging your toes in the sand, sunscreen is a necessity.

When choosing sunscreen, look for one that offers protection from both types of rays.

The U.S. Food and Drug Administration has changed sunscreen labeling language from “UVA and UVB protection” to “broad spectrum,” but they mean about the same thing, Dr. Meyerson said.

The American Academy of Dermatology recommends choosing an SPF of at least 30, higher than its initial recommendation of SPF 15.

“When moving from SPF 15 to SPF 30, we think there is a significant increase in protection factor,” Dr. Meyerson said.

He noted that higher SPFs tend to be more costly, but don’t necessarily offer that much more protection.

While lotions, creams and sprays are all OK, the doctor cautioned that they need to be applied  properly.

“I think they are all good but there is a misconception about sprays. They are easier to put on but people don’t realize they still need to be rubbed in,” he said. “They spray little dots, and there are openings between those dots. You’re going to have areas that are missed.”

When swimming or sweating for more than 15 minutes, be sure to reapply, he cautioned.

The sun’s rays are not the only trigger for skin cancer, which can develop even on parts of the body that have not been exposed to the sun, he explained.

It’s also important to know your skin.

“Know your moles. Knows your growths,” Dr. Meyerson said. “You want to do self-exams. If you see anything changing in size, shape, or color or a new growth, you should  get it checked.

“Early detection is vital, especially in dermatology,” he said.

Got a health question or column idea? Email Carrie Miller at cmiller@timesreview.com.

Follow her on twitter @carriemiller01.

11/14/11 9:35am
11/14/2011 9:35 AM

Q: I’ve been gaining weight in recent years. But as long as my doctor doesn’t tell me I need to lose weight, can I assume it’s not really a health issue?

A: Not necessarily. According to a recent federal health survey, doctors don’t always talk to their overweight patients about weight. These results are similar to results from earlier studies. In the government survey, more than 70 percent of people classified as overweight and almost 30 percent of those classified as obese said their health care professional never told them they were overweight. This can happen for a variety of reasons. But it’s a problem, because in the same survey, nearly a quarter of women and nearly half of men who were overweight identified their weight as being appropriate. And weight alone does not identify all people with excess body fat.

That’s the reason health experts now recommend checking your waist size, too. It’s clear that health-related risks are greatest at highest levels of obesity. However, even moderate overweight poses some increased risk of cancer and other health problems by promoting inflammation and unhealthy levels of certain hormones. For example, even weight gains of 15 pounds or so over adult life carries some increased risk of postmenopausal breast cancer. If your doctor hasn’t brought up your weight gain, at the very beginning of your next appointment bring it up as something you want to discuss.

Q: Does eating more fiber lower risk of other cancers, too, or only colon cancer?

A: According to the most recent report from the American Institute for Cancer Research and World Cancer Research Fund on how diet may reduce cancer risk, the cancer most clearly related to fiber is colorectal. There is now convincing evidence that eating relatively high amounts of dietary fiber lowers risk. However, fiber could lower risk of other cancers, too. A recent analysis of 10 population studies, involving more than 712,000 women, linked higher consumption of dietary fiber with lower risk of breast cancer. Overall, the women who consumed the most fiber were 11 percent less likely to develop breast cancer than those who consumed the least. In this analysis, the women in the highest fiber group generally ate at least 26 grams of fiber per day, which is the minimum recommendation for good health. Women consuming the least amount of fiber generally took in about 12 to 16 grams per day, comparable to average U.S. adult fiber consumption. Population studies like this one don’t explain how fiber might provide protection, but other types of research suggest that fiber could act from within the gut to bind estrogen and reduce amounts of estrogen circulating in the blood.

Fiber could also act by reducing levels of insulin, which seems to act as a growth factor promoting development of breast cancer. This analysis also does not tell us whether some high-fiber foods might offer more protection than others. Vegetables, fruits, whole grains and beans all offer a variety of natural plant compounds that seem to put the brakes on at several different points in the process of cancer development. Some studies also link higher consumption of foods providing dietary fiber with reduced risk of other cancers, but there is much less data on this and, again, it’s hard to separate lower risk due to fiber consumption from protective benefits of other components in vegetables, fruits, whole grains and beans. Eating enough high-fiber foods is clearly smart for overall health, whether it’s due to the fiber or not.

Karen Collins is a registered dietician and certified diabetes nutritionist with the American Institute for Cancer Research, the cancer charity that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk.

11/05/11 3:42pm
11/05/2011 3:42 PM

Each winter, millions of people suffer from the flu, a highly contagious infection. It spreads easily from person to person, mainly when an infected person coughs or sneezes. Viruses that infect the nose, throat, and lungs cause the flu, which is the short name for influenza. The illness is usually a mild disease in healthy children, young adults and middle-aged people. However, it can be life-threatening in older adults and in people of any age who have chronic illnesses such as diabetes or heart, lung or kidney diseases.

The flu is a respiratory infection caused by a variety of flu viruses. It differs in several ways from the common cold, which is a respiratory infection that is also caused by viruses. For example, people with colds rarely get fevers or headaches or suffer from the extreme exhaustion that the flu viruses can cause. Still, it’s easy to confuse a common cold with flu symptoms, but cold symptoms are usually milder and don’t last as long as flu symptoms.

If you become infected with the flu virus, you will usually feel symptoms one to four days later. It’s important to note that you can spread the flu to others before your flu symptoms start and for another three to four days after your flu symptoms appear.

Influenza usually starts suddenly and may include the following symptoms: fever, chills, a dry cough, sore throat, runny or stuffed nose, headache, muscle aches and extreme fatigue.

If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications from the flu, consult your health care provider. Those at high risk for complications include people 65 years or older, people with chronic medical conditions, such as asthma, diabetes or heart disease, pregnant women and young children.

In some people, the flu can cause serious complications, including bacterial pneumonia, dehydration and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetes. Children and adults may also develop sinus problems and ear infections.

The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose or eyes.

The single best way to protect yourself and others from the flu is to get a flu vaccination each year. Yearly flu vaccinations should start being offered in September or as soon as vaccine is available and continue throughout the influenza season, into December, January and beyond. That’s because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.

You can be your own best defense against germs that cause cold and flu. Wash your hands frequently with soap and hot water to help prevent the spread of infection. Waterless hand cleansers are also highly recommended, especially while traveling.

Avoiding stress, getting plenty of rest, exercising and eating properly are all crucial to assist in boosting your immune system, so that you will be less susceptible to viruses. Be considerate of others. If you suspect you have the flu, you can reduce the transmission of disease by staying home and taking care of yourself or by seeking medical treatment.

Dr. Lloyd Simon is board certified in internal medicine and addiction medicine and serves as the medical director for Eastern Long Island Hospital.

11/01/11 2:00am
11/01/2011 2:00 AM

Dear Marci,
Does Medicare cover hospice care?
Anu

Dear Anu,
Yes, Medicare will help pay for your hospice care if you meet all of the following criteria:
• You have Part A;
• the hospice medical director and your doctor, if you have one, certify that you have a terminal illness with a life expectancy of six months or less;
• you sign a statement electing to have Medicare pay for palliative care such as pain management, rather than care to try to cure your condition;
• your terminal condition is documented in your medical record; and
• you receive care from a Medicare-certified hospice agency.

The hospice benefit is always covered under Original Medicare. If you have a Medicare Advantage plan, but  elect hospice, your hospice care will be paid for by Original Medicare.
The hospice benefit includes two 90-day hospice benefit periods followed by an unlimited number of 60-day benefit periods. Starting April 1, 2011, you must have a face-to-face meeting with a hospice doctor or nurse practitioner if you reach your third benefit period.

Dear Marci,
I have hypertension and am at high risk for diabetes. Will Medicare pay for diabetes screenings?
Niamh

Dear Niamh,
Yes, Medicare will pay for diabetes screening tests once a year if you are considered high risk. You are considered high risk if you have hypertension, dyslipidemia or any kind of cholesterol problem; have a prior blood test showing low glucose tolerance or are obese with a body mass index of 30 or more.

Also, you must meet at least two of the following criteria:
• you are overweight with a body mass index between 25 and 30;
• you have a family history of diabetes;
• you have a history of gestational diabetes during pregnancy or have had a baby weighing over nine pounds;
• you are 65 years of age or older.

Medicare will pay for 100 percent of its approved amount for the diabetes screening test even before you have met the Part B deductible. You will pay no co-pay or deductible for these tests if you see doctors who take assignment. Doctors and other health care providers who take assignment can’t charge you more than the Medicare-approved amount. If you are in a Medicare Advantage plan, you should check with your plan to see what costs and rules apply.

Starting in 2012, Medicare Advantage plans will cover all preventive services the same as Original Medicare. This means Medicare Advantage plans won’t be allowed to charge cost-sharing fees — coinsurances, co-pays or deductibles — for preventive services that Original Medicare does not charge for as long as you see a network provider.

Dear Marci,
My income is too high for me to qualify for Extra Help, but I still can’t afford the cost of my drugs. Are there any other programs that can help me?
Benedict

Dear Benedict,
Even if you don’t qualify for Extra Help, you may be able to get help paying for your prescription drugs if your state has a State Pharmaceutical Assistance Program (SPAP). Many states offer an SPAP to help their residents pay for prescription drugs. Each program works differently.

Many states coordinate their drug assistance programs with Medicare’s Part D drug benefit. If you don’t have Part D but qualify for your state’s SPAP, you will have the chance to sign up for Part D, and may be required to enroll in a Part D plan. If a drug is covered by both your SPAP and your Part D plan, both what you pay for your prescriptions plus what the SPAP pays will count toward the out-of-pocket maximum you have to reach before your Medicare drug costs go down significantly. Your SPAP may also help pay for your Part D plan’s premium, deductible, co-payments and coverage gap. Many SPAPs give you coverage during your Part D plan’s coverage gap, also known as the doughnut hole.

Marci’s Medicare Answers is a service of the Medicare Rights Center, the nation’s largest independent source of information and assistance for people with Medicare.

10/27/11 3:00am
10/27/2011 3:00 AM

Halloween candy displays have been up since early September and you may already have bought your share of goodies for trick-or-treaters.

But if you bought candy ahead and it’s been open in your house, you’ve probably already dipped into it and eaten more than you planned yourself.

Research from Brian Wansink of Cornell University shows that the easier food is to obtain, or if it’s anywhere in sight, the more likely we are to eat it. So the evidence is that the earlier you purchase the candy, the more likely you will be to need to purchase it again before Halloween. Stores and candy companies know this and simply keep their shelves resupplied.

A treat once in a while is fine; that’s why it’s called a treat. But we have so many opportunities to have “treats” — sugary drinks, snacks from the vending machine, office doughnuts and more — that they aren’t just occasional treats. They’ve become household staples.

That means extra sugar, added fat and more calories, which can lead to weight gain, overweight and obesity. Excess body fat increases your risk for several cancers, diabetes and heart disease. Now that’s scary.
So this year, if you participate in giving out candy to little witches, princesses, superheroes or ghosts, think about how much you’ll need and whether you’ll be tempted to eat candy that isn’t part of your eating plan if it’s in your house.

Better yet, try something different. Trick-or-treaters will get a lot of candy from others. Why not be creative and think of other treats that are fun, colorful and don’t involve loads of sugar and fat?

Think about fruit, nuts and other healthier snacks, such as boxed raisins. They’ll not only help protect the health of the children, but help you avoid those extra calories that come with the candy you’d ordinarily have around the house.

There are also inexpensive toys likely to delight the children without filling them with unnecessary and unhealthy calories.

And if you have already purchased candy, get it out of your house once the trick-or-treaters have made their rounds.
Most people buy more candy than they need for ttrick-or-treaters and end up eating it themselves, stretching a one-day holiday into a month-long binge that only leads to Thanksgiving and the December holiday season when much unhealthy food abounds.

That two-month binge can easily result in weight gain of five pounds or more and increase your chance for serious illnesses.

So do yourself and your family a favor now by avoiding the Halloween binge and begin to plan healthy snacks to help you throughout the holiday season.

This column was adapted from a column provided by the American Institute for Cancer Research that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk. The organization funds cutting-edge research provides practical tools and information to help them prevent — and survive — cancer.

10/20/11 2:00am
10/20/2011 2:00 AM

Most Americans know health risks such as high blood cholesterol and blood sugar are important to monitor, but a growing number of researchers believe that other major factors with far–ranging effects on heart disease and cancer should be getting more attention. Among them is inflammation.

Basic healthy lifestyle choices are the key to fighting inflammation, but we need to beat the epidemic of excess abdominal obesity to take the most powerful anti–inflammation step of all. A recent study in the Journal of the American Medical Association showed that among 500 adults with diabetes, medical treatment reduced blood sugars to near normal levels, but markers of inflammation, present in all subjects, were not reduced. Researchers suggest that this may help explain why several large studies of heart disease among patients with type 2 diabetes did not show any lower risk of heart disease despite intensive blood sugar control. Reducing high blood sugar is crucial to limit small blood vessel damage in the kidney and eye caused by diabetes, but it doesn’t appear to be enough to stop the heart disease–diabetes link.

The body’s ability to respond to infections and injury with inflammation is an immediate response crucial to health. But chronic, low–grade inflammation seems to damage body tissues in ways that lead to and accelerate development of chronic health problems linked with age. Scientists now consider atherosclerosis, hardening of the arteries, an inflammatory process and inflammatory cells have been found in the fatty plaque that builds up in blood vessels. Inflammation may also promote cancer development by damaging genes, increasing cell turnover and increasing development of blood vessels that allow cancer cells to grow and spread.

A variety of lifestyle changes can reduce or prevent chronic low–grade inflammation. Studies show lower levels of inflammation markers in those who don’t smoke and those who exercise regularly. One recent study showed that several inflammation markers dropped within weeks among women in a smoking cessation program. Good dental care that prevents the gum inflammation known as gingivitis may even help to reduce overall body inflammation. Moderate exercise like walking seems to directly reduce signs of inflammation, even after adjusting for its impact on weight control.

A plant–based diet with plenty of vegetables, fruits and beans also seems to decrease inflammation. Studies link a Mediterranean–style diet with lower levels of an inflammation marker called CRP. Scientists emphasize that it’s the impact of the overall diet and whole foods that supplies interacting antioxidant and anti–inflammatory phytochemicals like carotenoids and flavonoids with vitamins like vitamin C that provide protection, rather than just a single compound. A Mediterranean–style diet is traditionally higher than the typical American diet in omega–3 fat, found especially in fish. A healthy balance between omega–3 and other fats reduces production of hormone–like substances that stimulate inflammation.

While all these lifestyle choices impact inflammation, research suggests that obesity may be the single largest influence. Fat cells secrete certain proteins such as interleukin–6 and tumor necrosis factor that stimulate inflammation throughout the body. Fortunately, even a modest 7 percent to 10 percent weight loss as part of a healthy lifestyle is enough to reduce markers of inflammation.

Karen Collins is a registered dietician and certified diabetes nutritionist with the American Institute for Cancer Research that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk.