10 Signs That You Might Have Anemia

Westchester Health Blog - Mon, 05/29/2017 - 11:30

More than 3 million people in the U.S. are living with anemia, a common blood disorder that develops when a person’s red blood cell count is low or when red blood cells do not have enough hemoglobin. This is something we see here at Westchester Health but if diagnosed properly and treated promptly, anemia in most cases can be successfully reversed.

What causes anemia?

Margaret Andersen, MD

Since organs and tissues all need oxygen to function correctly, being anemic can cause widespread health problems. According to the U.S. Department of Health and Human Services, women and people with chronic diseases are at the greatest risk for anemia, but it can affect anyone.

The most common cause, especially in women, is iron deficiency. Iron is an important component of hemoglobin and if you don’t have enough iron, your body cannot make enough healthy oxygen-carrying red blood cells. You can also become iron deficient from not eating enough iron—this is very common in pregnant women because they have to eat enough iron for two. In addition, some people may eat enough iron but have problems absorbing it, due to gastrointestinal disorders such as Crohn’s disease.

Other causes of anemia include:
  • severe injury
  • surgery
  • ulcers
  • poor diet
  • inadequate intake of vitamins and minerals
  • very heavy menstrual periods
  • childbirth
  • extreme blood loss
  • sickle cell disease
  • gastritis
  • hemorrhoids
  • colorectal cancer
  • inherited conditions such as the blood disorder thalassemia
  • environmental exposure to lead
10 symptoms of anemia to watch out for

You may have no symptoms at first, or very mild ones. However, as anemia gets worse some telltale signs become apparent. Here are the most common ones.

  1. You’re exhausted and weak

The most common symptom of iron-deficiency anemia is fatigue. Without enough oxygen being delivered to your cells you aren’t able to break down nutrients and make energy. Without energy, you continually feel tired and weak throughout the day and it can be difficult to complete your daily tasks.

  1. You have strange cravings for things that aren’t food

People who are anemic may develop a syndrome called pica, which causes strange cravings for non-food items such as dirt, ice or clay. There are some theories as to why iron deficiency leads to pica, but the true cause is unclear. Research shows that the cravings seem to go away when patients receive iron supplements.

  1. You get headaches or feel dizzy

Headaches, dizziness and lightheadedness can all be symptoms of anemia caused by a lack of oxygen to the brain. For some people, this may even lead to fainting.

  1. Your heartbeat is irregular

Heart palpitations, an irregular heartbeat or an increased heart rate can be signs that your body is attempting to compensate for its lack of energy. By circulating blood faster your body is trying to spread around the small amounts of available hemoglobin in order to deliver more oxygen.

  1. You’re short of breath

When your organs do not get enough oxygen your lungs may start to overcompensate and work harder to bring in more oxygen. For example, if walking up stairs leaves you winded or you can barely catch your breath during a workout (and these are new occurrences) your iron levels may be far too low.

  1. You have chest pain

Your heart needs oxygen to function. Without enough hemoglobin and oxygen, the heart tissue will behave as though you have impaired blood flow. In very severe anemia this can lead to a myocardial infarction or what is more commonly known as a heart attack.

  1. Your legs tingle

Low iron stores are associated with restless leg syndrome. This is a strong, unpleasant urge to move your legs. This can also make it hard to fall asleep at night. Fortunately, iron supplements have been shown to help make this condition go away in people who are deficient.

  1. Your skin is pale

When your heart and brain, your two most vital organs, are not getting enough oxygen your body sends more blood there, depriving other parts of your body in the process. When less blood flows to your skin you’re likely to lose some of your color or skin tone. With severe anemia, the skin can look grey or ashen.

  1. Your nails are brittle

Nails like every other living cell in your body need oxygen to breathe and grow. Without it, the nail beds stop making healthy new cells leading to weak and brittle nails over time.

  1. Your hands and feet are always cold

Although it may sound harsh, your extremities are treated by your body as non-essential body parts, and consequently, blood flow to those areas may become limited when you are anemic. Limited circulation in your hands and feet can cause them to feel cold and often numb.

How to treat anemia caused by iron deficiency

I typically recommend to my patients iron supplements that contain the ferrous form of iron, which your body can absorb easily. If you are seriously anemic you may need to continue taking iron supplements for up to a year. In this case, you should heed the following precautions:

  • Excess iron intake can be harmful. Symptoms of iron overload include fatigue, vomiting, diarrhea, headache, irritability, heart disease and joint problems.
  • Iron supplements (and all supplements and medications) should be kept out of the reach of children. Iron poisoning is one of the most common causes of accidental poisoning in young children and can prove fatal in a matter of hours. Symptoms of iron poisoning in a child include dizziness, confusion, nausea, vomiting and diarrhea. Seek medical help immediately.
  • Watch for side effects. Taking iron supplements with food can help prevent common side effects which may include nausea, diarrhea, constipation, and stomach pain. Let your doctor know if you continue to have side effects. Different formulations are available.
  • Watch for drug interactions. Tell your doctor if you are being treated for another condition. For example, calcium supplements interfere with iron absorption, so it is best to take them at different times of the day.
  • The body absorbs iron best when taken in a mildly acidic medium. For this reason, your doctor may suggest taking iron with a half-glass of orange juice or with vitamin C. Your doctor may also recommend that you increase the amount of iron in your diet. Good dietary sources of iron include red meat, beans, egg yolk, whole-grain products, nuts and seafood. Many processed foods, as well as milk, are also reinforced with iron.

Your doctor will monitor your red blood cell counts during treatment. If your anemia doesn’t improve with iron supplements, he/she will look for some other underlying cause. In rare cases, your doctor may prescribe iron injections or give you iron intravenously. In extremely rare cases of life-threatening iron-deficiency anemia, treatment may involve a blood transfusion.

Worried that you may be anemic? Come see us.

If you think you may have anemia, or would like to learn more about how to prevent it, please make an appointment with Westchester Health to see one of our specialists. We will perform tests to determine if you are in fact anemic or are at risk of developing it. If you are anemic, we will work closely with you to determine the best treatment plan to reverse this potentially serious health condition. We also may prescribe medication, if appropriate.

By Margaret Andersen, MD, an internist with Women Caring For Women, an internal medicine practice focused solely on women.

Categories: Blog

Signs And Symptoms That Your Baby Is Sick

Westchester Health Blog - Thu, 05/25/2017 - 11:33

“Is my baby sick or just tired/hungry/wet?” “Is a fever good or bad?” “Is this a hospital emergency or should I simply phone the pediatrician?”

At Westchester Health, we’ve taken care of thousands of babies (and their parents) over the years and know how important it is to be able to recognize the signs that their baby may be sick. We pass along our time-tested advice here in a terrific blog by Lauren Adler, MD, a pediatrician in our Westchester Health Pediatrics group, in hopes that it can give parents everywhere some peace of mind, as well as timely information.

What constitutes a fever and is a fever bad?
  • Anything over 100.4 F is a fever.
  • Any fever in a baby under 3 months old should be checked by a doctor as soon as possible.

    Lauren Adler. MD, FAAP

  • Any temperature over 101°F in a baby under 6 months old also should be checked by a doctor as soon as possible.
  • If your baby is over 6 months old with a fever, you can observe and see how he/she is the next day.
  • A fever is the body’s way of combating infection and if not too high, is actually a good thing. If your baby is not suffering too much, resist the urge to administer fever reducers and instead, let the fever break on its own.
  • Fever is not dangerous for your baby. If your baby is older than 6 months old and still taking in fluids, is not acting listless and is not crying a lot, you don’t need to rush to the doctor.
How to know if your baby is dehydrated (which is actually quite serious)

Since your baby can’t tell you what’s going on, parents need to be very observant because the effects of dehydration can escalate quickly in babies under 2 years old. The easiest dehydration symptom to spot is the number of wet diapers. If your baby is passing hardly any urine, or the urine in the diaper seems very dark and concentrated, he/she may be dehydrated.

Other things to look out for:

  • Moistness of the mouth (should not be dry)
  • If baby is floppy or listless
  • If the fontanelle (soft spot on the top of the head) seems especially sunken
  • If the baby has no tears when crying

If a baby is not drinking milk (either breast milk or formula) or is having diarrhea or vomiting, the chances of him/her becoming dehydrated are high and parents should head to the doctor as soon as possible. Babies that are severely dehydrated may need to have IV fluids.

Does your baby have a rash?

There are many viruses, allergies and non-serious conditions that can cause rashes in babies but if a rash is accompanied by a fever, parents should seek medical advice, especially if there is a purple or bruise-like rash on the baby.

Another common cause of viral rashes is roseola, a mild virus which causes babies to have a high fever and be irritable for a few days. When the fever stops, a red, blotchy rash breaks out. Rashes are also symptoms of measles and rubella which can have complications, so if in doubt, take your baby to your pediatrician.

If your baby is listless, whiney or unresponsive

This is usually a giveaway that baby is very sick, particularly when accompanied by a fever. If your baby is under 3 months old, you need to head straight to the doctor.

What persistent diarrhea can signal

Diarrhea can cause dehydration which can be serious in a small baby. Diarrhea can cause a temporary lactose intolerance which can lead to ongoing diarrhea for a few weeks after a stomach bug.  If this is the case, see your doctor who will probably advise stopping all dairy for a day or two.

Abnormal crying

Different from a hungry, wet, tired or painful cry, a high-pitched, moaning cry or whimpering can be a sign of meningitis, which is very serious. As a rule of thumb, if the crying does not sound normal to you, seek medical attention immediately.

Trust your instincts

Most of the time, parents can sense when something is wrong with their baby. If you have any concerns at all, you should always contact your pediatrician–this is what we’re here for.

Best way to take your baby’s temperature

At Westchester Health, we recommend taking your baby’s temperature rectally, the most accurate way. Here’s how:

  • The normal range for a temperature taken rectally is 97.9°F-100.4°F
  • Using a digital thermometer, lay your baby on his/her back and bring the knees up over the abdomen
  • Make sure the thermometer is clean, then dip it in water-soluble jelly
  • Insert the thermometer into your baby’s rectum, about 1 inch
  • Wait for the thermometer to take the reading (usually indicated by a beep)
  • Clean the thermometer after each use with soap and water or rubbing alcohol
When you should take your baby to the pediatrician

Contact your pediatrician right away if you notice any of the following signs:

  • rectal fever above 100.4 for babies younger than 2 months
  • rectal fever of 102 or higher for babies older than 2 months
  • fever lasting more than 48-72 hours
  • crying inconsolably
  • listless or limp
  • having convulsions (seizures)
  • swelling of the soft spot at the top of the head (fontanelle)
  • pain
  • purple splotches on the skin, or another type of rash
  • pale
  • problems breathing
  • refuses to breastfeed or drink from a bottle
  • has trouble swallowing
  • persistent vomiting or diarrhea
Want to learn more about how to tell if your baby is sick? Come see us.

If you’re wondering how to tell if your baby is truly sick, or if you have any other questions relating to your child’s health and well-being, please come in to see one of our Westchester Health pediatricians. Together, we’ll discover what’s going on with your child and decide on the best course of treatment, if needed.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

How Kids Benefit From Different Parenting Styles

Westchester Health Blog - Mon, 05/22/2017 - 11:11

Throughout our years of experience with many kinds of families, we at Westchester Health realize that moms and dads often have different parenting styles and that in almost all cases, kids do just fine. In fact, they usually thrive with two different parental methods. To explain it more fully, here is a great blog on the topic by Rodd Stein, MD in our Westchester Health Pediatrics group.

Dads’ and moms’ parenting styles: different but equal

Here are 8 ways that fathers’ and mothers’ approaches to childrearing differ but can still result in a happy, healthy, confident child.

  1. Dads can turn chores into playtime

Rodd Stein, MD, FAAP

What moms often see as repetitive routines (diaper changing, meal time, brushing teeth), dads often turn into a fun interlude. A diaper becomes a hat, a spoonful of strained carrots can be a choo-choo train, clean-up time can turn into a race. The tasks still get done but Dad has made them fun.

  1. Not so quick to fix the problem

When a toddler falls down, moms often swoop in to pick him/her up and soothe. Dads do the opposite: they let the child get back on his/her own two feet, figure out what went wrong and continue on their way. By letting their children work through problems themselves, dads are teaching them resilience and “stick-to-it-tiveness,” which are very important qualities in life.

  1. Use grown-up words

Men tend to speak to their kids as equals, using bigger words and less baby talk. They are more inclined to teach them independence and less inclined to coddle. They are also quicker to offer constructive criticism. By giving “straight talk,” they’re subtly teaching their kids the way the world works and how to navigate it.

  1. Let kids take a risk

Dads are usually less overprotective than moms, allowing their kids to take risks, recognizing these as important steps in making their own way in the world.

  1. Trust their gut

While moms have a tendency to seek guidance and advice on what to do and how to do it, dads tend to follow their instincts. From potty-training to bedtimes, dads go with what makes sense to them and what seems right for their child.

  1. Get goofy

A lot of dads love to kid around. By being spontaneously silly and yet still keeping the house from falling apart, they’re teaching their children important lessons in balancing business with pleasure, chores with fun.

  1. Pick their battles

With a headstrong toddler or preschooler (or teenager), it often feels like everything’s a fight. Dads tend to compromise, redirect the child’s attention or revisit what’s causing the tantrum at a later time. They often just seem to have an innate sense of what’s worth fighting over and what can be let go.

  1. Don’t sweat the small stuff

Dads are notorious for not worrying about certain details like stripes with polka dots, purple hair and untied shoelaces…and in the great scheme of things, we think that’s perfectly okay. We see a lot of angry, depressed kids who resent being micromanaged when they would rather be allowed to express themselves in creative ways.

For more tips and advice on healthy ways to parent your child, come see us.

If you have questions about parenting styles or any other aspect of your child’s health, please come in to see one of our Westchester Health pediatricians. Our #1 is to help you raise a happy, healthy child, and whether you’ve been with us for years or you’re a brand new parent, when you need us, we’re here for you.

To read Dr. Stein’s blog in full, click here.

Categories: Blog

How to Help Your Toddler Start Talking

Westchester Health Blog - Thu, 05/18/2017 - 11:17

Whether you realize it or not, parents have a huge impact on their children’s language and speech skills. The more you encourage your toddler to talk, the better he/she will do in preschool and in life. Conversely, if your child does not develop a solid verbal foundation as a toddler, he/she may struggle to keep up with peers, possibly for years to come. That’s why talking to your toddler, all the time, is very important, writes Robert Pitaro, MD, a pediatrician with our Westchester Health Pediatrics group, in a recent blog.

6 tips for helping your toddler learn to talk

Drawing on our years of experience at Westchester Health, we’ve put together a list of ways you can encourage your little one to develop his/her language skills.

1) Read to your child

Robert Pitaro, MD

Reading is one of the best ways to help your toddler begin to talk. Not only does reading provide very meaningful one-on-one time with your little one, it teaches important language skills such as the pronunciation of words, voice inflection and the rhythm of speech.

2) Repeat yourself

It’s important to use a new word in more than one sentence to help it stick in your child’s memory. (“Wow, you’re getting so big!” “Doesn’t Daddy have big feet!”) Toddlers need to hear words over and over again before they become permanent parts of their vocabulary.

3) Be descriptive

Take time to describe objects, emotions, colors, smells…everything, rather than just naming them. Talking about how something looks, feels or tastes is a great way to introduce new words, such as, “This apple is round and red. Our kitten’s fur is so smooth and soft.”

4) Give your toddler simple instructions

Asking your child to do things like “Pick up the ball and throw it to me” or “Bend down and touch your toes” promotes speech and language comprehension, while also strengthening his/her ability to follow directions.

5) Don’t take over the conversation

In your enthusiasm to teach your toddler words, make sure he/she has plenty of opportunities to say them. Many of our parents tell us that a toy telephone works well. You can pretend to talk to Grandma, then pass the phone to your child and encourage him/her to chat too.

6) Plan playdates with other toddlers to encourage talking

When toddlers hear other kids their age talking, they typically want to join in. In this way, playdates help your child practice his/her conversation skills with peers and also help him/her make friends. A win-win!

How to recognize if your toddler has a speech problem

It can be difficult to tell whether your child is just delayed in his or her ability to communicate or has a problem that requires professional attention.

To get some clues, listen for these red flags:
  1. By age 2, your child does not make requests like, “Can I have a cookie?” or is unable to string two words together.
  2. You can’t understand most of what your child is saying by the time he/she is 3.
  3. Your child communicates by grunting rather than babbling or talking.

Remember: All children develop at different rates, but if you’re concerned that your child’s vocabulary and language skills are not progressing, contact us at Westchester Health.

If you’re worried that your child is not saying enough words or talking early enough, come see us.

If you’re concerned about your child’s language development, or if you have other questions relating to your child’s health and well-being, please come in to see one of our Westchester Health pediatricians. Together, we’ll determine if there’s a problem and what steps need to be taken.

To read Dr. Pitaro’s blog in full, click here.

Categories: Blog

10 Tips for Dealing With Your Child’s Acne

Westchester Health Blog - Mon, 05/15/2017 - 11:04

At Westchester Health, we pay a good deal of attention to how acne is affecting our patients on the inside. A recent study has shown that even having mild acne can bring on feelings of low self-esteem, depression and suicidal thoughts in adolescents and teenagers. Coming at the same time as puberty only adds to the feelings of uncertainty about body image, self-esteem and other emotional issues that young people experience. To alert parents to the potentially damaging psychological effects of acne, Glenn E. Kaplan, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, has written an excellent blog.

As well as visible skin problems, acne can have the following psychological effects:
  • social withdrawal
  • decreased self-esteem
  • reduced self-confidence
  • poor body image
  • embarrassment

    Glenn Kaplan, MD, FAAP

  • feelings of depression
  • anger

If you notice that your child is experiencing any of these symptoms, please bring him/her in to talk to us. We have years of experience treating young people with acne and we’re here to help yours. If we feel it might help, we may refer your child to a counselor or therapist.

10 effective tips for dealing with acne

To help adolescents and teens get rid of acne, and to dispel some myths, we offer these 10 important tips:

  1. The old wives’ tale of certain foods causing acne is NOT TRUE. Chocolate and fatty, greasy foods do not cause acne.
  2. Pimples SHOULD NOT be squeezed.
  3. Some cosmetics can cause acne by blocking the skin’s pores. Your child should use products that are labeled “non-comedogenic.”
  4. Brief sun exposure can be helpful for acne but extended sunbathing can cause skin irritation that will worsen the condition.
  5. If your child’s acne is mild, start with OTC products, beginning with an acne cleanser/wash at least twice a day, then use a medicine containing 5% benzoyl peroxide at bedtime. If this does not work, change to a 10% concentration of the OTC medicine. As with all acne creams, the three most common side effects are dryness, burning and redness.
  6. If OTC medicines do not do the trick, speak to your pediatrician — he/she has stronger creams such as retinoids which have an anti-inflammatory effect, plus they remove excess skin cells to prevent them from causing pimples. Another type of cream you can get from your pediatrician combines benzoyl peroxide with a topical antibiotic. These two creams can be used as alternating therapy.
  7. If creams do not work, the next step is an oral antibiotic (erythromycin or tetracycline). This should be used along with the acne skin creams and is usually reserved for the more inflammatory acne conditions (large, deep pimples, cysts or nodules).
  8. In girls, estrogens (female hormones) in the form of oral contraceptives can be used if other treatments have failed and if there seems to be a relationship between the acne and ovulation or her menstrual period.
  9. An additional option is Accutane (oral isotretinoin). This medicine is prescribed by a dermatologist. There are some associated side effects that need to be monitored and so this medication is reserved for severe cases.
  10. The cause of your child’s acne may be allergy-related. If nothing seems to be helping, try removing dairy (lactose intolerance) and wheat-based foods (gluten allergy) from your child’s diet and see if this makes a difference in his/her skin.
Acne and puberty can be tough but we can help

At Westchester Health, we’re here for you and your child, whenever and wherever you need us, with advice, guidance and even just a listening ear. Acne and puberty together make it a very emotional time for all involved and we want to help your child get through it in a healthy way, mentally and well as physically.

To read Dr. Kaplan’s blog in full, click here.

Categories: Blog

5 Best Ways to Prevent Diaper Rash

Westchester Health Blog - Thu, 05/11/2017 - 11:43

If you have a baby, chances are you’re going to have diaper rash. Most babies get it at some point, but thankfully, it’s generally harmless if treated. With a newborn wetting and/or soiling diapers approximately 10 times a day (70 times a week), that’s a lot of diapers and a lot of potential diaper rash. But rest assured, at Westchester Health we’re here to help, with tips and advice for keeping your little one clean, dry and rash-free. Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group, has written a great blog on how to prevent diaper rash and how to diaper your new little bundle of joy like a pro. New parents, take a read.

Lauren Adler, MD, FAAP

Most cases of diaper rash occur because your baby’s skin is sensitive and can easily become irritated by a wet or soiled diaper. Typically, diaper rash looks red and bumpy and will go away in a few days with warm baths, diaper cream and a little air time out of the diaper. With a diaper rash, the skin underneath the diaper area is red and irritated. It may appear all over your baby’s bottom or genital area, or only in certain places, and may or may not involve the folds of the skin.

5 tips for preventing diaper rash
  1. Change your baby’s diaper frequently, especially after bowel movements.
  2. Thoroughly clean and air-dry the diaper area at each changing. Sometimes sitting your baby in a few inches of lukewarm water does the best job of getting the skin clean.
  3. After cleaning the area with mild soap and water or a wipe, apply a diaper rash or “barrier” cream. Creams with zinc oxide are preferred because they form a barrier against moisture.
  4. If you’re using cloth diapers, wash them in dye- and fragrance-free detergents.
  5. If possible, let your baby go un-diapered for part of the day. This gives the skin under the diaper a chance to air out.

NOTE: If diaper rash continues for more than 3 days or seems to be getting worse, call your doctor. It may be a fungal infection that requires a prescription.

How to diaper like a pro
  1. Always wash your hands thoroughly before and especially after changing a diaper.
  2. After each bowel movement or if the diaper is wet, lay your baby gently on his/her back on a flat, secure surface. A changing table with raised sides (so your baby can’t roll off) is best.
  3. Remove the dirty diaper and using the wet washcloth or wipes, gently wipe your baby’s genital area clean. With girls, wipe from front to back to avoid a vaginal or urinary tract infection. Note: when removing a boy’s diaper, be aware that exposure to the air may make him urinate, so be careful!
  4. To prevent or heal a rash, liberally apply diaper ointment or cream.
  5. If there appears to be chafing, sprinkle some cornstarch baby powder (not talc) on the area.
Contact your pediatrician right away if these conditions develop:
  • The rash does not get better despite treatment in 4-7 days.
  • The rash is getting significantly worse or has spread to other parts of the body.
  • The rash appears also to have a bacterial infection, with symptoms such as a pus-like drainage or yellowish-colored crusting. This is called impetigo and needs to be treated with antibiotics.
  • You are not certain what may be causing the rash.
  • You suspect the rash could be from an allergy. Your pediatrician can help you pinpoint the possible allergen.
  • The rash is accompanied by diarrhea continuing for more than 48 hours.
Want to learn more about diapering your baby? Come see us.

If you have questions, want more tips on diapering your baby, or would even like to come in and practice diapering, please come in to see one of our Westchester Health pediatricians. We’re here, whenever and wherever you need us.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

10 Tips to Prevent Heart Disease And Stroke

Westchester Health Blog - Mon, 05/08/2017 - 11:50

Cardiovascular disease is the major cause of death in America, accounting for 34 percent of deaths, many suddenly and almost all of them premature. If you have diabetes, your risk rises even higher—dramatically. You have an increased risk of heart disease if you are a man over age 45 or a woman over age 55. You also are at greater risk if you have a close family member who had heart disease at an early age.

Yet, in spite of all the negative statistics about heart disease, the good news is that these numbers can be reversed. By making a concerted effort to monitor your blood pressure, to watch your weight, to stop smoking and to get regular exercise, along with a few more simple steps, you can be well on your way to having a healthy heart and a decreased risk of serious problems.

10 important ways you can lower your risk of heart disease and stroke

James W. Catanese, MD, FACC

There are many things you can do reduce your chances of developing heart disease. At Westchester Health, here are our top 10:

  1. Take responsibility for your health

At Westchester Health, we tell all our patients that the best prevention against heart disease and stroke is to understand the risks, warning signs and treatment options. The first step in preventing heart disease is to take responsibility for your health.

  1. Know your risks

The biggest risk factor for cardiovascular disease is age. The older you are, the greater your risk. The second biggest risk factor is your genetic make-up. If your parents, grandparents or other close relatives experienced or died of heart disease, diabetes or stroke, your risk is much greater.

  1. Don’t smoke or expose yourself to second-hand smoke

The evidence is overwhelming that cigarette smoking and second-hand exposure to smoke increases the risks of heart disease, lung disease, peripheral vascular disease and stroke. If you smoke, stop. If you don’t smoke, don’t start.

  1. Maintain a healthy blood pressure

High blood pressure (hypertension) is commonly known as “the silent killer” because it typically has no symptoms in most individuals. High blood pressure does damage to your heart by causing wear and tear of the delicate inner lining of your blood vessels. The higher your blood pressure (BP), the greater your risk of heart disease. Heredity and increasing age put you at greater risk. If you can, get an in-home blood pressure measuring device, which will more accurately determine your true blood pressure at rest than having it taken in a physician’s office.

  1. Monitor your cholesterol (blood lipids)

Abnormal or high blood lipids (fats) are a major contributor to cardiovascular disease. Your blood lipids include the LDL (bad cholesterol), HDL (good cholesterol) and triglycerides. The lower your LDL and the higher your HDL, the better your prognosis. The amount of cholesterol in your blood is determined mainly by three factors: the amount produced by the liver, the amount absorbed from the intestinal tract and your age (your cholesterol increases with age). If you are at risk, medication and/or a change in diet are almost always necessary to lower the LDL or to raise your HDL.

  1. Limit your calories

The obesity rate in Americans is alarming, contributing to a widely-considered epidemic of diabetes, which is a cardiovascular disease. If you have diabetes, your risk is the same as someone who has already had a heart attack. Eating less and exercising more are the two most effective, tried-and-true solutions.

  1. Make exercise a daily habit

Lack of exercise is greatly contributing to the prevalence of obesity in America, but is something that can be easily turned around. Exercise does more than burn calories—it also activates genes that are beneficial to your health in other ways. Plus, exercise is one of the best treatments for depression and anxiety. However, exercise alone cannot control or reduce a person’s weight; they must also modify their diet.

  1. Choose your medications wisely

Although some vitamins have been shown to possibly help some health conditions, to date none have been shown to decrease the risk of cardiovascular disease, with some rare exceptions, such as fish oils and niacin (vitamin B). It is also important to note that high doses of some vitamins may interfere or counteract the beneficial effects of some prescription drugs.

  1. Reduce stress

Stress contributes to cardiovascular disease and, if severe enough, can cause a heart attack or sudden death. There are many ways to reduce stress, such as regular exercise, adequate sleep, laughing, volunteering, gardening, having a pet, playing an instrument, mentoring others and cultivating friends. Find what relieves your stress and commit to doing this activity at least once a day if possible.

  1. Stay informed: Science changes constantly

In medicine, new techniques and new insights are developing constantly. Keep yourself current with the latest advancements by regularly consulting accredited publications, journals and websites.

Do you think you might be at risk of heart disease? Come see us.

If you’re worried about your risk for heart disease, or want guidance about making changes in your lifestyle in order to prevent heart disease, please make an appointment with Westchester Health to see one of our specialists. We will perform tests and a physical examination to determine if you are in fact a likely candidate for a heart attack or stroke. If so, we will work closely with you to determine the best treatment plan to reverse the possibility of this serious health condition. We also may prescribe medication, if appropriate.

By James W. Catanese, MD FACC, Chief of Cardiology, Northern Westchester Hospital, Westchester Health Cardiologist

Categories: Blog

8 Ways You Can Help Your Teen Prepare for Life After High School

Westchester Health Blog - Thu, 05/04/2017 - 11:38

Whether your teenager is heading off to college or technical school, entering the work force or joining the military, graduating from high school is a big life change, often including living on their own for the first time. Helping your teen successfully navigate this transition from childhood into independent adulthood is absolutely vital, and a recent blog by Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group, can help your teen and you navigate this big shift.

8 things your young adult should keep in mind as he/she moves on and moves out

Your son or daughter will soon be making their own decisions about the direction their life will take, including decisions that affect their health, which is where we come in. At Westchester Health, we’ve been here before with lots and lots of patients and their parents, and we offer him/her these suggestions for staying healthy, mentally and physically in the days and years to come.

  1. Make sure to get enough rest (8-9 hours of sleep a night whenever possible). Too little sleep can contribute to a number of health problems, including colds, the flu, stress, depression, weight gain, weight loss, anxiety and loss of concentration (which can negatively affect schoolwork/exams or job performance).

    Mason Gomberg, MD

  2. Eat well. Fast food or junk food may be quick and cheap when you are in a rush, but eating well is important. Try to eat fruits and vegetables every day, as well as foods high in protein and calcium. Limit junk food and foods with a lot of fat, sugar and salt, as well as sugary drinks such as soda and certain sport drinks.
  3. Exercise is an important part of staying healthy. Make time each day, or at least several times a week, to fit exercise into your schedule.
  4. Avoid drugs and alcohol. Alcohol and drug abuse is a leading cause of teen injury and/or death. It also increases the risk of unwanted pregnancy and sexually transmitted diseases (STDs), including HIV/AIDS. Research has shown that when someone abuses alcohol and drugs as a teen, they are much more likely to have future alcohol and drug problems.
  5. Sexual health, safe sex, birth control, gender identification, STDs and avoiding date rape. Before you start having sex, or even if you’re already sexually active, there are a lot of things you should know and precautions to take that can have a big effect on your health. One study has found that up to 10% of female students have been date raped while attending college, often in conjuncture with alcohol or drug use.
  6. When to leave your pediatrician and start seeing an adult doctor. Many young adults see their pediatrician until they turn 21, while others choose to switch to an adult health provider much earlier. Whichever path you choose, we’re ready at Westchester Health to offer advice and guidance and to help smooth the transition.
  7. Know where to go if you are having a health problem. It’s important to know what to do and where to go if you get sick or injured, as well as for health-related advice, information and counseling. Where is the nearest student health service, hospital, clinic or emergency room?
  8. Be familiar with your health insurance. You should carry your own i.d. card from your health plan, or know how to get your own insurance.
How you can help your teen set goals

Here are our suggestions for communicating, in a non-judgmental way, with your young person who’s about to fly the coop.

  1. Listen to your teen and resist the temptation to provide unsolicited advice. If he/she is struggling to make a decision, maybe tell a story from your own life about a tough choice you had to make.
  2. Provide respect and support while giving up some control. Trying to direct your teen’s future probably won’t benefit him/her in the long run. This is the time for teens to develop their own decision-making and problem-solving skills, attributes they will need out in the real world for the rest of their lives.
  3. Prepare your teen to be self-sufficient away from home. This includes making major life-affecting decisions regarding dating, drugs, alcohol and sex, as well as mastering day-to-day living skills such as cooking, cleaning, laundry, grocery shopping, paying bills, managing a budget and last but not least, getting enough sleep.
  4. Set limits on how much you can financially support your child if he/she decides to take time off. There’s nothing wrong with wanting a break after many years of school but that doesn’t mean your son or daughter should expect you to pay their living expenses.
  5. Don’t lecture. Try to remain supportive, even if your teen keeps changing his or her mind. More than anything, he/she needs your positive influence and understanding during this transitional time.
We can still treat your teen after high school

Whether your teenager goes off to college, joins the military or starts working, we still care a great deal about his/her health and hope that they contact us any time they have questions or concerns, need information or just want to talk. If they live nearby, they can even continue to be treated by Westchester Health. Whenever, wherever they need us, we’re here for them.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

How To Know If You Are Using Time-Outs Correctly

Westchester Health Blog - Mon, 05/01/2017 - 11:08

At Westchester Health, we believe in time-outs. We’ve seen through the years that when used correctly, they really are effective in managing a child’s misbehavior or unacceptable action. As far as length of the time-out, we recommend that the number of minutes should equal the age of the child (e.g., 4 years = 4 minutes). If the misbehavior is repeated, the length of the time-out should be increased or even doubled. However, a new study from the American Academy of Pediatrics recently reported that the vast majority of parents are not using time-outs correctly. Mason Gomberg, MD, a pediatrician with our Westchester Health Pediatrics group, recently posted a blog about this very topic, which we summarize here.

 The AAP study noted that most parents did not follow correct time-out practices.

The most common mistake, the study found, was giving the child multiple warnings before putting him/her in time-out. For example, some parents told the child things like, “I’m going to count to three. One…two…two-and-a-quarter…two-and-a-half….” Or they talked to the child during time-out, or they allowed the child access to toys, books, electronics or other people.

Mason Gomberg, MD

All of these parent behaviors undermine and even negate the purpose and effectiveness of the time-out, which is designed to help the child understand what he/she did wrong and to be willing to change the behavior.

Guidelines for when and how to put a child in time-out

Ideally, a parent should give one warning prior to imposing a time-out. If the warning is not heeded, a time-out is warranted, with a short reason for why (no hitting, no biting, etc.). There should be no stimulation during time-outs, including talking to or lecturing the child. If the child tries to escape from “detention,” the parent should return the child to the time-out area with minimal interactions and should restart the time.

Got questions about time-outs? Come see us.

With years of experience helping parents raise happy, healthy kids, we at Westchester Health can honestly say that from time to time, time-outs serve an important role in a child’s growing-up process. Although time-outs are often as hard on the parents to administer as they are on the child to get them, if they are done properly and consistently, they will work, serving to create healthy boundaries in your child’s world. And take it from us, this will make life a lot easier in the future!

If you want to talk about time-outs or any other aspect of your child’s health, please come in and see one of our Westchester Health pediatricians. Whenever, wherever you need us, we’re here for you.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

How It Benefits Your Child To Do Chores

Westchester Health Blog - Thu, 04/27/2017 - 10:58

After decades of taking care of thousands of children, we at Westchester Health feel strongly that doing chores is very good for children, brings them (and you) many valuable benefits and should be encouraged. Doing assigned tasks develops your child’s character, teaches him/her a sense of responsibility and helps take some of the burden of household duties off of you. In a recent blog by Mason Gomberg, MD, a pediatrician with our Westchester Health Pediatrics group.

Is it worth the struggle of getting your child to do chores?

Mason Gomberg, MD

We understand that trying to get your kids to do their chores often can feel like a never-ending battle. In fact, a lot of our parents tell us that it’s easier just to do the tasks themselves and bypass all the reminding, nagging and consequences.

Yet research shows that children who do chores have higher self-esteem, are more responsible and are better able to deal with frustration and delayed gratification, all of which contribute to greater success in school. Plus, doing chores enables kids to see themselves as important contributors to the family, having met their obligations and completed their tasks.

If you do everything for your children, they won’t learn how to do things for themselves

Parents who do too much for their children are actually failing to teach them the skills of everyday living. This can limit children’s ability to function at age appropriate levels, which can be embarrassing for them. But by expecting your children to complete household and self-care tasks, you’re actually equipping them with the skills to function independently in the outside world, begin to take care of themselves and learn skills they will need as an adult.

Even very young children can do chores

Children even as young as three can be assigned their own age-appropriate tasks, such as putting away their toys, making their bed, placing napkins on the table or sorting the laundry. The size of the task does not matter, it’s the responsibility associated with it that’s important. For younger children who are not putting away their toys, etc., the toy might be taken away for awhile, or rewards like TV or video games might be withheld until the issue is resolved.

Giving children allowance: a personal decision for your individual family

One question we frequently get from our parents is whether they should give their kids allowance and whether this should be tied to the completion of chores. At Westchester Health, our position on this topic is that it is a personal call, to be decided within your family. Plus, this decision (like the assigning of chores) can be re-visited from time to time.

Have questions about chores? Come see us.

If you’re wondering which chores are appropriate for your child or whether or not to give allowance, or if you have any other questions relating to your child’s health and well-being, please come in and see one of our Westchester Health pediatricians. Whenever, wherever you need us, we’re here for you and your child.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

10 Foods That Boost Your Immune System

Westchester Health Blog - Thu, 04/20/2017 - 17:47

Even though we’re well into spring, here at Westchester Health, we’re still seeing a lot of colds and viruses. To try and help keep everyone healthy and germ-free, we continually emphasize to our patients that their diet plays an important role in the strength of their immune system. Certain foods may actually decrease their chances of getting sick, while others can help them recover more quickly if they do get ill.

Regularly consuming the foods listed below can make a real difference in strengthening your immune system, helping you resist illnesses and shortening the time you are sick.

If you are unable to eat some of them, you may want to consider taking supplements which have immunity-boosting properties. No matter the season, keeping your immune system healthy is very important to your overall health and well-being.

10 foods to eat if you want to boost your immune system
  1. Iron-rich foods

    Margaret Andersen, MD

    Iron plays an important role in immune function. A diet containing too little iron can cause anemia and weaken the immune system. Foods rich in iron include meat, poultry, fish, shellfish, legumes, nuts, seeds, cruciferous vegetables and dried fruit. You can also improve your absorption of iron from foods by using cast-iron pots and pans to cook with, and avoiding tea or coffee with meals. Combining iron-rich foods with vitamin C can help boost your absorption even further. Keep in mind, however, that overly high iron levels in your blood can be harmful and may actually suppress the immune system. Therefore, it’s best to take iron supplements only if you have an iron deficiency or on the advice of a doctor.

  1. Probiotic-rich foods

Probiotics are beneficial bacteria that live in your gut and help stimulate your immune system. They also help maintain the health of your gut’s lining, which may help prevent unwanted substances from “leaking” into the body and provoking an immune response. In fact, recent studies show that probiotics may reduce the risk of developing upper respiratory tract infections by up to 42%. Studies also show that when people do get sick, those who regularly consume probiotics are 33% less likely to need antibiotics. In certain cases, regularly consuming probiotics may also lead to a faster recovery from illness. Effective sources of probiotics include sauerkraut, naturally fermented pickles, yogurt, kefir, buttermilk, kimchi, tempeh, miso, natto and kombucha.

  1. Citrus

Vitamin C is known for its antibacterial and anti-inflammatory properties. It also helps maintain the integrity of your skin, which acts as a protective barrier against infection. In addition, vitamin C can act as an antioxidant, helping protect your immune cells against harmful compounds formed in response to viral or bacterial infections. Therefore, getting enough vitamin C is a great way to strengthen your immune system and may reduce your likelihood of infection. Some studies also report that increasing your vitamin C intake during a cold may help you get better more quickly. Fruits like oranges, grapefruits and tangerines are high in vitamin C. Other foods high in vitamin C include bell peppers, guavas, dark leafy greens, broccoli, berries, tomatoes, papaya and snap peas.

  1. Ginger

Ginger is rich in gingerol, a bioactive substance thought to help lower the risk of infections. In fact, ginger has antimicrobial properties that may inhibit the growth of several types of bacteria, including E. coli, Candida and Salmonella. Fresh ginger may also help fight the human respiratory syncytial virus (HRSV), a virus responsible for many respiratory infections. However, more studies on this are needed. As many people know, ginger is also effective at combatting nausea, and may help decrease your nausea symptoms when you have the flu.

  1. Garlic

Like ginger, garlic also contains active compounds that may help reduce your risk of infection and improve your immune cells’ ability to fight off colds and the flu. Garlic also seems to have antimicrobial and antiviral properties that may help it fight bacterial and viral infections. To maximize garlic’s immune-boosting effects, eat one clove two to three times per day. Crushing the garlic and allowing it to stand for 10 minutes prior to cooking can also help increase its immune-supportive effects.

  1. Berries

For centuries, berries have been used by Native Americans to treat infections like the common cold. This could be because berries are a rich source of polyphenols, a group of beneficial plant compounds with antimicrobial properties. Studies show that berries and their polyphenols have the ability to protect against the influenza virus responsible for the flu. They may even offer a defense against bacterial infections such as Staphylococcus, E. coli and Salmonella infections. Berries also contain good amounts of vitamin C, which adds to their immune-boosting properties.

  1. Coconut oil

Coconut oil contains medium-chain triglycerides (MCTs), a category of fats with antimicrobial properties. The most common type of MCT found in coconut oil is lauric acid, which is converted into a substance known as monolaurin during digestion. Both lauric acid and monolaurin have the ability to kill harmful viruses, bacteria and fungi. In fact, researchers report that coconut fats may help fight off the types of bacteria that cause stomach ulcers, sinusitis, dental cavities, food poisoning and urinary tract infections. Researchers also believe that coconut oil may be effective against the viruses responsible for influenza and hepatitis C. It may also help fight Candida albicans, a common cause of yeast infections in humans. You can easily add coconut oil to your diet by using it instead of butter or vegetable oils in cooking or baking. Consuming up to two tablespoons (30 ml) per day is recommended, allowing you to include other healthy fats in your diet, such as avocados, nuts, olives and linseed oil.

  1. Licorice

A spice made from the dried root of the Glycyrrhiza glabra plant, licorice has been used in traditional Asian and European herbal medicine for thousands of years. Studies show that licorice has the ability to fight some fungi and bacteria, including E. coli, Candida albicans and Staphylococcus aureus. It may also be able to fight the viruses responsible for the flu, gastroenteritis and polio. However, many products containing licorice are also very high in sugar. If you are trying to reduce your sugar intake, look for lower-sugar options, such as licorice tea. In addition, consuming too much licorice may have a number of adverse effects, including high blood pressure, abnormal heart rhythm and an increased risk of premature birth. If you’re at risk for any of these, you should limit your consumption.

  1. Nuts and seeds

Nuts and seeds are incredibly rich in nutrients, including selenium, copper, vitamin E and zinc, all of which play a role in maintaining a healthy immune system. Sesame seeds and almonds are particularly good sources of copper and vitamin E, while pumpkin seeds and cashews are rich in zinc. To get your daily requirement of selenium, eating just a single Brazil nut per day will do it. Nuts and seeds are also great sources of fiber, antioxidants and healthy fats, all of which are beneficial for health.

  1. Sweet potatoes

Sweet potatoes not only taste great but they’re also rich in vitamin A. Not consuming enough vitamin A can lead to a deficiency, which studies link to a weaker immune system and a higher sensitivity to infections. However, excessive vitamin A intake can lead to adverse effects such as nausea, headaches, weaker bones, coma and even premature death, especially if you take vitamin A in supplement form. High intakes of vitamin A supplements during pregnancy may also increase the risk of birth defects. Therefore, it might be safest to meet your vitamin A requirements through diet instead of supplements. As well as sweet potatoes, other foods that are high in vitamin A include carrots, dark-green leafy vegetables, squash, romaine lettuce, dried apricots, red peppers, fish and organ meats.

Immunity-boosting supplements

A well-functioning immune system requires an adequate and consistent intake of several nutrients. Individuals eating a well-balanced diet rich in the foods described above should have no difficulty reaching their daily requirements. However, some may be unable to meet their recommended daily nutrient intakes through diet alone.

If this is the case for you, consider adding the following supplements to your diet:

  1. Probiotics

Ideally, Lactobacillus or Bifidobacterium strains in amounts between 2–3 billion colony-forming units (CFUs) per day.

  1. Vitamin C

Take approximately 75–90 mg per day, and increasing your daily dose to 1 gram per day may provide extra benefits during illness.

  1. A multivitamin

Look for one containing iron, zinc, copper, vitamin E and selenium in amounts sufficient to help you meet 100% of the RDIs.

  1. Zinc lozenges

Doses of at least 75 mg per day at the first onset of cold symptoms may help reduce the duration of the infection.

  1. Vitamin D

Low blood levels of vitamin D may increase the risk of respiratory infections, including the flu, sinus infections and bronchitis. Therefore, those living in northern climates where sunlight is limited might also want to consume at least 600 IU (15 mcg) from vitamin D supplements per day.

Want to know more about boosting your immune system? Come see us.

If you’d like more information on ways to improve your body’s immune system, please make an appointment with Westchester Health to see one of our specialists. We can discuss the details of an immune-boosting diet with you and determine if you would benefit from certain supplements. We can also perform tests to determine if you have a weakened immune system and should make adjustments to your diet and lifestyle.

By Margaret Andersen, MD, an internist with Women Caring For Women, an internal medicine practice focused solely on women.

Categories: Blog

4 Tips To Help Your Child Safely Make It Through Puberty

Westchester Health Blog - Mon, 04/10/2017 - 11:50

Puberty is an exciting time for kids and parents, but it can also be scary, emotional and frustrating. Lots of children are not comfortable with all the changes happening to them or what they mean. They may be concerned or embarrassed about their skin, their body image, their voice, sexual feeling, romantic attraction and/or any number of other changes. At Westchester Health, we understand all the changes your teen or pre-teen is going through and we’re here to help, with advice, information and a listening ear. To make what can be a rough ride a little smoother, we recommend this recent blog by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

4 tips to help your child safely navigate the ups and downs of puberty
  1. Reassure your child that everything that’s happening is normal. Their friends are also going through the same changes and probably have similar feelings, although they may not admit it.
  2. Celebrate the changes. Puberty signals that your child is becoming an adult – a young man or woman. Respond with praise, encouragement and support. Also, it’s important at this stage of your child’s development to increase their responsibilities and in a parallel way, your trust of them.

    Lauren Adler, MD, FAAP

  3. Emphasize inner and outer beauty. If you have a daughter, she may say things like, “I’m fat” or “I’m ugly.” Reassure her that she is beautiful, inside and out, and that her body will eventually reach a balanced state.
  4. Encourage your son or daughter to eat healthy, get enough sleep (a tough one at this age), exercise regularly and find healthy ways to de-stress.
Physical development


  1. In girls, the first sign of puberty is usually breast development. Your daughter’s breasts may swell or feel sore, and one breast might be larger than the other. This is normal, but if one breast is significantly different in size, or if the size doesn’t level out in time, you may want to consult your pediatrician.
  2. After breast development, girls will start growing hair in the pubic area and armpits. If your daughter doesn’t already use deodorant, now is a good time to start. Most girls want to start shaving their legs and armpits at this stage, and become very interested (obsessed?) with makeup, body shape, clothes and overall appearance.
  3. They will start to develop hips.
  4. Girl will also start their menstrual period, usually between 12 and 14.


  1. The first physical sign of puberty in boys is testicle and penis growth.
  2. Like girls, they will grow hair in their armpits and pubic areas.
  3. Their muscles will grow and their voices will deepen.
  4. Facial hair usually shows up last.
  5. They develop an Adam’s apple in their throats.

Both girls and boys:

  • Have growth spurts
  • Can develop acne or skin problems; girls may develop these earlier, around age 13
  • Produce body odor
  • Can experience “growing pains” in joints
  • Can become overly sensitive or get upset easily
  • Have an increased sense of body image
  • Experience sexual feelings
Emotional development

Boys may seem more sullen, while girls may cry or yell more easily. Of course, how your child specifically responds to changes will depend on his or her personality.

For girls, expect emotions to run high before and during menstrual periods. If mood swings are severe, your pediatrician might recommend dietary changes, vitamin supplements and more sleep.

Questions or concerns? Please come see us.

If you’re concerned about any aspects of puberty and your child, come in and talk with us at Westchester Health. We’re here to help with advice, guidance and years of experience helping kids and parents make it successfully through this often difficult time.

To read Dr. Adler’s blog in full, click here.

Categories: Blog

10 Ways To Help A Depressed Teen

Westchester Health Blog - Thu, 04/06/2017 - 11:17

Teenagers face a host of pressures, from the physical and emotional changes of puberty to wondering who they are and where they fit in. To help parents, teachers, coaches and anyone else involved with teenagers recognize the signs of depression and how to get help, we offer this excellent blog written by Mason Gomberg, MD, a pediatrician with our Westchester Health Pediatrics group. Here at Westchester Health, we see a lot of teenagers, which also means that we see our fair share of teenage depression.

The most common symptoms of depression in teens

Recognizing teen depression can be difficult because the signs aren’t always obvious but here are the most common signs you should look out for:

  1. Sadness or hopelessness
  2. Irritability, anger or hostility

    Mason Gomberg, MD

  3. Increased drug use (illegal or legal drugs)
  4. Absence form school
  5. Frequent crying
  6. Withdrawal from friends and family
  7. Loss of interest in activities
  8. Poor school performance
  9. Changes in eating and sleeping habits
  10. Feelings of worthlessness and guilt
  11. Lack of enthusiasm and motivation
  12. Fatigue or lack of energy
  13. Difficulty concentrating
  14. Unexplained aches and pains
  15. Thoughts of death or suicide
10 ways to help a depressed teen
  1. Focus on listening, not lecturing. Resist the urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. Simply letting your teen know that you’re there for them, completely and unconditionally, is huge.
  2. Be gentle but persistent. Don’t give up if they shut you out at first. Talking about their depression can be very tough for teens. Even if they want to, they may have a hard time expressing what they’re feeling. Be respectful of your child’s comfort level while still emphasizing your concern and willingness to listen.
  3. Acknowledge their feelings. Don’t try to talk your teen out of depression, even if his/her feelings or concerns appear silly or irrational to you. Your well-meaning attempts to explain why “things aren’t that bad” can often come across as not taking their emotions seriously. To make your teen feel understood and supported, simply acknowledging the pain and sadness they are experiencing.
  4. Trust your gut. If your teen claims nothing is wrong but has no explanation for what is causing the depressed behavior, you should trust your instincts. If your teen won’t open up to you, consider turning to a trusted third party: a school counselor, favorite teacher or coach, or mental health professional. The important thing is for them to start talking to someone.
  5. Encourage social connection. Depressed teens tend to withdraw from their friends and the activities they used to enjoy. However, isolation only makes depression worse, so do what you can to help your teen connect to others. Encourage him/her to go out with friends or invite friends over. Participate in activities that involve other families and give your child an opportunity to meet and connect with other kids. Suggest activities—such as sports, after-school clubs, or an art, dance, or music class—that take advantage of your teen’s interests and talents.
  6. Set aside time each day to talk. The simple act of connecting face to face where you’re focused totally on your teen (no distractions or multi-tasking) can play a big role in reducing his/her depression.
  7. Promote volunteerism. Doing things for others is a powerful antidepressant and self-esteem booster. Help your teen find a cause they’re interested in and that gives them a sense of purpose. If you volunteer with them, it can also be a good bonding experience.
  8. Make physical health a priority. Physical and mental health are definitely connected. In our experience as pediatricians, we’ve seen that depression is exacerbated by inactivity, inadequate sleep and poor nutrition. As a parent, you can combat these behaviors by establishing a healthy, supportive home environment.
  9. Set limits on screen time. Teens often go online to escape their problems, but excessive computer use only increases their isolation, making them more depressed. When screen time increases, physical activity and face time with friends goes down. Both are a recipe for worsening the symptoms of depression.
  10. Encourage plenty of sleep. Teens need more sleep than adults to function optimally—up to 9-10 hours per night. Make sure your teen isn’t staying up until all hours at the expense of much-need, mood-supporting rest.
Don’t ignore the problem

Depression is very damaging when left untreated, and waiting and hoping that the symptoms will go away often just makes the situation worse. If you suspect that your child is depressed, voice your concerns in a loving, non-judgmental way. Let your teen know the specific signs of depression you’ve noticed and why they worry you. Then ask your child to share what he or she is going through—and be willing to truly listen. Refrain from asking a lot of questions but make it clear that you’re ready and willing to provide whatever support he/she needs.

Suicide and teens

Seriously depressed teens often think about, speak of, or make “attention-getting” attempts at suicide. However, since an alarming and increasing number of teenage suicide attempts are successful, suicidal thoughts, behavior or comments should always be taken very seriously.

For the overwhelming majority of suicidal teens, depression or another psychological disorder plays a primary role. In depressed teens who also abuse alcohol or drugs, the risk of suicide is even greater. Because of the very real danger of suicide, teenagers who are depressed should be watched closely for any signs of suicidal thoughts or behavior.

Suicide warning signs to watch for
  1. Talking or joking about committing suicide.
  2. Saying things like, “I’d be better off dead,” “I wish I could disappear forever” “There’s no way out,” or “I just want the pain to stop.”
  3. Speaking positively about death or romanticizing dying.
  4. Writing stories and poems about death, dying or suicide.
  5. Engaging in reckless behavior or having accidents resulting in injury.
  6. Giving away prized possessions.
  7. Saying goodbye to friends, family and pets as if for the last time.
  8. Seeking out weapons, pills or other suicide facilitators.
How to get help for a suicidal teen
  1. If you suspect that your teenager (or someone you know) is suicidal, do not delay—TAKE IMMEDIATE ACTION. For 24-hour suicide prevention and support in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK.
  2. To find a suicide helpline outside the U.S., visit the International Association for Suicide Prevention website or
  3. To learn more about suicide risk factors, warning signs, and what to do in a crisis, read this article on Suicide Prevention by
Valuable resources to have If you think your child might be suffering from depression, please come see us.

If your teenager is showing signs of depression, please come in to talk to one of our Westchester Health to come in and  pediatricians. We will meet with you and your child and perform screening tests for signs of depression. We’ll then evaluate his/her condition, and together, try to determine the cause and severity of the problem. If we feel it is needed, we will refer your child to a mental health specialist. Rest assured, we will do everything we can to help your child become healthy and happy, physically and emotionally.

To read Dr. Gomberg’s blog in full, click here.

Categories: Blog

Is It Okay To Have Sex During Pregnancy?

Westchester Health Blog - Mon, 04/03/2017 - 11:06

Sex during pregnancy is often the absolute last thing on some women’s minds, especially when they are dealing with nausea, vomiting and constant fatigue. Other women, however, may crave sex during this special time. Similarly, men seem to fall into two groups regarding sex during pregnancy. Some find nothing sexier than a pregnant woman, but others are too afraid of hurting the baby or their partner to even attempt it. At Westchester Health, we’ve witnessed all of these emotions in our patients over the years and thought we’d offer some helpful advice on the subject.

Is sex during pregnancy safe?

For most women with uncomplicated, low-risk pregnancies, yes, sex during pregnancy is very safe. Here’s how you can think about it trimester by trimester:

Dennis McGroary, MD, FACOG

In the 1st trimester: Sex is often not on the agenda for most pregnant women—they’re tired, nauseous and trying to cope with the many changes their bodies are going through.

In the 2nd trimester: By now, they are usually feeling better and there is more genital lubrication, making sex more appealing and satisfying for both partners. Also, most women are still fairly comfortable with their bigger shape during the second trimester because their stomach is not overly rounded yet.

In the 3rd trimester: Sex becomes more physically difficult, especially during the final weeks of pregnancy as a woman’s stomach grows and fatigue returns, but with some modifications and a willingness to accommodate the bulging belly of a mom-to-be, it can certainly be enjoyed. is It’s an old wives’ tale that having sex close to your due date during the third trimester will bring on labor, but having an orgasm does cause the release of prostaglandins, which can theoretically cause contractions.

The bottom line when it comes to sex during pregnancy? Have fun, listen to your body and be open with your partner.

What about when dads-to-be are nervous that sex will hurt the baby?

In these cases, we tell them that their baby is well protected and will not be harmed by sex. It is an egg surrounded by a pillow and then another pillow and there is no way they can hurt the fetus.

Sexual positions to consider during pregnancy

As a woman’s belly grows bigger and bigger, the traditional man-on-top position becomes more uncomfortable for pregnant women. Other, more comfortable sexual positions during pregnancy may include intercourse from behind or side-to-side (spooning).

Also, at a certain point a pregnant woman should not be flat on her back because the growing uterus can compress major blood vessels, potentially causing pelvic pressure and pain. This typically occurs during the third trimester. Lying flat on her back can also cause a woman to develop supine hypotensive syndrome, which results in a change in heart rate and blood pressure that can lead to dizziness and other symptoms.

One sexual act to avoid during pregnancy is blowing air into the vagina during oral sex. This can cause an air embolus to develop, which can travel to the lung and have potentially fatal consequences.

5 reasons to avoid sex during pregnancy
  1. Sex during pregnancy may not be safe for women with a history of repeated miscarriages, preterm labor, bleeding or an incompetent cervix (when the cervix effaces and dilates without contractions in the 2nd or early 3rd trimester due to the baby’s weight putting increasing pressure on it).
  2. Women with placenta previa (a condition where the placenta is covering the cervix) are at risk of hemorrhaging if they have sex during pregnancy.
  3. Women with premature rupture of membranes (PROM), which occurs when the sac containing the developing baby and the amniotic fluid bursts or develops a hole before labor, should also avoid sex during pregnancy.
  4. If a woman has bleeding or foul-smelling discharge after sex during pregnancy. If this occurs, you should contact your doctor right away. Discharge may be a sign of an infection that can travel upward to the uterus, and bleeding may be a sign of any number of problems.
  5. If a woman’s partner has an STD, she should use a barrier method of contraception, such as a condom, to protect herself and her unborn baby.
Want to know more about sex during pregnancy? Come see us.

If you’d like more information on whether it’s safe for you and your partner to have sex during your pregnancy, please make an appointment with Westchester Health to see one of our OB/GYNs. We will evaluate your health history and current condition and from there, make a recommendation. Our #1 goal is for you to have a safe, uneventful pregnancy and deliver a healthy baby.

By Dennis McGroary, MD, FACOG, Department of OB/GYN, Westchester Health

Categories: Blog

10 Ways to Help Minimize Morning Sickness

Westchester Health Blog - Mon, 03/27/2017 - 11:29

For many of our patients here at Westchester Health, morning sickness should really be called “morning-noon-and-night sickness.” For some pregnant women, the symptoms are worse in the morning and ease up over the course of the day. For others, they last all day long. The intensity of symptoms can also vary from woman to woman. Although morning sickness usually subsides after the first three months of pregnancy, it can be a real hardship for some women. Even a mild case of nausea can wear women down, and constant nausea and vomiting can leave them exhausted and miserable (on top of all the other demands on their body from the pregnancy).

As we tell our expectant mothers-to-be, pregnancy can be really tough but it’s all worth it in the end!

What causes morning sickness

Although doctors don’t know with certainty what causes nausea during pregnancy, it’s probably a combination of:

  • Human chorionic gonadotropin (hCG), a hormone that rises rapidly during the early stages of pregnancy

    Tiffany Werbin-Silver, MD, FACOG

  • Estrogen, another hormone which rises rapidly in early pregnancy
  • An enhanced sense of smell and sensitivity to odors (possibly resulting from higher levels of estrogen)
  • A sensitive stomach
  • Stress
How long will it last?

About 50% of women who experience nausea during pregnancy will feel complete relief around 14 weeks. For many others, however, it takes another month or so for the queasiness to ease up. In either case, it may return later and/or come and go throughout pregnancy. A small percentage of women have symptoms that persist continually until delivery.

NOTE: If you have severe, persistent nausea and vomiting and are unable to take in fluids (causing dehydration), see your doctor right away, as this may be a condition called “hyperemesis gravidarum” (H.G.). H.G. is characterized by severe nausea, vomiting, weight loss and an imbalance of electrolytes. Mild cases are treated with dietary changes, rest and antacids, but more severe cases often require an inpatient stay in the hospital so that the patient can receive intravenous (IV) fluids and nutrition.

To help lessen the severity of morning sickness, we offer these 10 important tips:
  1. Eat small, frequent meals and snacks throughout the day so your stomach is never empty.
    An empty stomach can make nausea worse so eat several small meals through the day instead of three large meals. High-protein foods and complex carbohydrates might be especially helpful. And whatever you eat, eat it slowly.
  2. Keep simple snacks, such as crackers, by your bed.
    When you first wake up, nibble a few crackers and then rest for 20-30 minutes before getting up. When you do get up, do so slowly. Snacking on crackers may also help you feel better if you wake up nauseated in the middle of the night.
  3. Avoid lying down after eating (especially on your left side).
    This can slow digestion. Stay upright for 1 hour after meals.
  4. Stay hydrated.
    Drink a lot of fluids, such as a sports hydration drink, as well as water, broth, juice or ginger ale.
  5. Eat more protein and cut out fatty foods.
    Avoid barbecue ribs, fried chicken, cheesy pizza and burger with fries which can only make your morning sickness worse (and your baby doesn’t need the grease).
  6. Avoid smells and foods that make you feel nauseated.
    Citrus juice, milk, coffee and caffeinated tea typically make nausea worse.
  7. Get lots of rest.
    Stress and fatigue can make morning sickness worse so if at all possible, get as much rest as you can, even it’s just a short nap or taking a few minutes to put your feet up.
  8. Get fresh air.
    Taking a walk or opening a window might ease your nausea.
  9. Try aromatherapy.
    Some women find scents such as lavender, lemon, mint or orange useful in combatting morning sickness. Try putting a drop or two of an essential oil on a handkerchief of Kleenex to sniff when you start to feel queasy.
  10. Consider anti-nausea medication.
    If you’ve been unable to find relief from your nausea no matter what you’ve tried, talk with your doctor about prescription medication that could help. There’s no need to suffer, and waiting too long to take appropriate medication may make your condition more difficult to treat.
Some pregnant women are more likely than others to get morning sickness

You’re more likely to have nausea or vomiting during your pregnancy if any of the following apply:

  • You’re pregnant with twins or higher multiples. This may be from the higher levels of hCG, estrogen or other hormones in your system.
  • You had nausea and vomiting in a previous pregnancy.
  • You have a history of nausea or vomiting as a side effect of taking birth control pills (This is probably related to your body’s response to estrogen.)
  • You have a history of motion sickness.
  • If your mother or sisters had severe morning sickness, there’s a higher chance you will, too (genetic predisposition).
  • You have a history of migraine headaches.
  • You’re carrying a girl. Several studies have found that about 55% of women with severe nausea and vomiting in the first trimester give birth to a girl.
Having a hard time with morning sickness? Please come see us.

If you’re experiencing persistent morning sickness and want some relief, please make an appointment with Westchester Health to see one of our OB/GYNs. The sooner we can evaluate and start treating your symptoms, the sooner we can help you feel better and enjoy your pregnancy.

By Tiffany Werbin-Silver, MD, FACOG, an OB/GYN with Westchester Health.

Categories: Blog

How Often Should You Get a Colonoscopy?

Westchester Health Blog - Tue, 03/21/2017 - 10:31

A colonoscopy is a diagnostic screening exam that a physician, usually a gastroenterologist, uses to look inside your large intestine for colon polyps or possible signs of colorectal cancer.  How often you should be screened depends on the specific test, your age and your risk for colon cancer.

At what age and how often to have a colonoscopy

If you’re at average risk of colon cancer, we at Westchester Health, recommend that you have a colonoscopy every 10 years, starting at age 50. The procedure may be performed earlier and more often in people at increased risk, including those with a personal or family history of:

  • polyps (abnormal growths)

    Elie M. Abemayor, MD, Sc.M.

  • colorectal cancer
  • inflammatory bowel disease
  • a hereditary syndrome such as familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer (Lynch syndrome)

Colorectal cancer screening generally starts at age 50 because colon cancer risk increases with age, and more than 90% of cases occur in people aged 50 and over.

Most colorectal cancers start as polyps. The progression from precancerous polyp to cancer is believed to take 10 years or more, although experts don’t really know because clinicians remove polyps when they find them, before they become cancerous. Screening also identifies colon cancer early, when it’s most treatable.

Some guidelines recommend that routine screening continue until age 76, with screening then being an option between ages 76 and 85, depending on overall health and risk factors. Screening is not recommended after age 85.

If you choose colonoscopy, seek out a gastroenterologist with plenty of experience performing the procedure and a facility equipped to handle potential problems.

Why get tested? It’s the best way to prevent colon cancer.

The American Cancer Society believes that preventing colorectal cancer (not just detecting it early) should be a major reason for every individual to get tested. There are a variety of tests currently available. Those that have the best chance of finding both polyps and colon cancer are preferred, if these tests are available to you and you are willing to have them.

Starting at age 50, men and women at average risk for developing colorectal cancer should get one of the screening tests below:

Tests that find polyps and cancer
  • Flexible sigmoidoscopy every 5 years*
  • Colonoscopy every 10 years
  • Double-contrast barium enema every 5 years*
  • CT colonography (virtual colonoscopy) every 5 years*
Tests that mainly find cancer
  • Guaiac-based fecal occult blood test (gFOBT) every year**
  • Fecal immunochemical test (FIT) every year**
  • Stool DNA test every 3 years*

*Colonoscopy should be done if test results are positive.
**Highly sensitive versions of these tests should be used with the take-home multiple sample method. A gFOBT or FIT done during a digital rectal exam in the doctor’s office is not enough for screening.

Is a rectal exam enough to screen for colorectal cancer?

In a digital rectal examination, a healthcare provider examines your rectum with a lubricated, gloved finger. Although a DRE is often included as part of a routine physical exam, it’s not recommended as a stand-alone test for colorectal cancer. This simple test, which is not usually painful, can find masses in the anal canal or lower rectum. However, by itself it’s not a good test for detecting colorectal cancer because it only checks the lower rectum.

Doctors often find a small amount of stool in the rectum when doing a DRE. But testing this stool for blood with a gFOBT or FIT is not an acceptable way to screen for colorectal cancer. Research has shown that this type of stool exam will miss more than 90% of colon abnormalities, including most cancers.

People at increased or high risk

If you are at an increased or high risk of colorectal cancer, you might need to start colorectal cancer screening before age 50 and/or be screened more often. The following conditions make your risk higher than average:

  • A personal history of colorectal cancer or adenomatous polyps
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • A strong family history of colorectal cancer or polyps (see Colorectal cancer risk factors)
  • A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
How to prepare for a colonoscopy

For your colonoscopy to be diagnostically successful, your colon must be empty and “clean.” This means you need to restrict your diet at least 24 hours before the procedure. Clear liquids rather than solids are recommended, such as:

  • Coffee
  • Broth
  • Water
  • Sports drinks

Then you need to empty your bowel the night before and the morning of the procedure, typically by taking a series of enemas or drinking a solution of magnesium citrate that causes you to go to the bathroom.

You’ll need someone take you home after the colonoscopy. You will be sedated during the procedure, therefore it won’t be safe for you to drive or operate machinery for at least 8 hours afterward.

How is a colonoscopy performed?

During your colonoscopy, sedatives will be administered through an IV in your arm, putting you to sleep. Then your physician will put a tube-like instrument called a colonoscope into your rectum, with a light and video camera on the tip so he/she can see the lining of your colon and detect if there is a problem. The colonoscope also includes a tube that lets your physician pump in air and inflate your colon, giving him/her a better view of your colon and its lining.

During the exam, your physician can use the tool to take tiny samples of your colon for testing (biopsy). He can also use the tool to remove polyps.

Is it time for you to have a colonoscopy? Please come see us.

If you are age 50 or over and have never had a colonoscopy, please make an appointment with Westchester Health to see one of our gastroenterologists. If you have had the procedure but it’s time to have another one, please make an appointment, too. The sooner we can detect potential problems, the sooner they can be treated before they become more serious.

By Elie M. Abemayor, MD, Sc.M., a gastroenterologist with Westchester Health.

Categories: Blog

7 Effective Ways to Manage Spring Allergies

Westchester Health Blog - Mon, 03/20/2017 - 10:46

Spring is on its way! While many people look forward to this season of renewal, warm weather and beautiful blossoms, for those with allergies it can be something to dread. At Westchester Health, our patients with eye, nose and respiratory spring allergies usually find themselves symptomatic from late March until late May, although the onset of symptoms could be earlier depending on warm weather trends.

What causes spring allergies?

James Pollowitz, MD, FAAAAI, FACAAI

The biggest spring allergy trigger is pollen: tiny grains released into the air by trees, grasses and weeds for the purpose of fertilizing other plants. When these pollen grains get into the nose of someone who is allergic to them, their immune system mistakenly sees them as foreign invaders and releases antibodies to attack the allergens. This leads to the release of chemicals called histamines which trigger a runny nose, itchy eyes and other symptoms of allergies. The higher the pollen count, the greater the symptoms.

Allergy symptoms tend to be particularly high on windy days when the wind picks up pollen and carries it through the air. Rainy days, on the other hand, cause a drop in pollen counts as the allergens get washed away.

The worst culprits for allergy-causing tree pollen

Some of the more common trees that can cause allergies in the Northeast are:

  • birch
  • maple
  • elm
  • oak
  • sycamore
  • alder
  • ash
  • beech
  • hickory
Symptoms of spring allergies

As trees and flowers start to bloom and pollen takes to the air, spring allergy sufferers begin to sniffle and sneeze. The typical symptoms are:

  • Runny nose
  • Watery eyes
  • Sneezing
  • Coughing
  • Itchy eyes and nose
  • Dark circles under the eyes

Allergens also can trigger asthma, a condition in which the airways narrow, making breathing difficult and leading to coughing, wheezing and shortness of breath.

How to manage spring allergies

It’s nearly impossible to completely avoid spring allergies if you live in an area with an abundance of trees, flowers and plants. However, you can lessen the sniffling, sneezing and watery eyes by avoiding spring allergies’ main triggers. At Westchester Health, we recommend:

  1. Try to stay indoors whenever the pollen count is very high (it usually peaks in the morning).
  2. Keep your doors and windows closed whenever possible during the spring/summer months to keep out allergens.
  3. Use an air purifier.
  4. Clean the air conditioner filters in your home often.
  5. Clean bookshelves, vents and other places where pollen can collect.
  6. Wash your child’s hair after going outside (pollen can collect there).
  7. Vacuum twice a week. Be sure to wear a mask because vacuuming can kick up pollen, mold and dust trapped in your carpet.
Treatment for spring allergies

Spring allergies can be treated with a number of over-the-counter medicines, including:

  1. Antihistamines reduce sneezing, sniffling and itching by lowering the amount of histamine (the substance produced during an allergic reaction) in the body. Note: All of the 24-hour non-sedating antihistamines (Claritin, Allegra and Zyrtec) are now OTC as brand and generic products. The older medications such as Benadryl last only 2-4 hours and are very sedating.
  2. Decongestants clear mucus from the nasal passageways to relieve congestion and swelling.
  3. Antihistamine/decongestants combine the effects of both of the above drugs.
  4. Nasal spray decongestants relieve congestion and may clear clogged nasal passages faster than oral decongestants.
  5. Steroid nasal sprays reduce inflammation. Several products are now available over-the-counter including: Nasacort AQ, Flonase (both of these are available as generic store brands), Clarispray (the same medication as Flonase), Rhinocort and Flonase sensimist (previous brand name was Veramyst).
  6. Cromolyn sodium nasal spray can help prevent hay fever by stopping the release of histamine before it can trigger allergy symptoms.
  7. Eye drops relieve itchy, watery eyes.
  8. Immunotherapy (allergy shots) should be considered when medical management with nasal sprays, eye drops and oral liquid/pills do not adequately control allergic symptoms.
If your suffer from spring allergies, please come see us

If spring allergies are making you miserable, please make an appointment with Westchester Health to see one of our allergy, asthma and immunology specialists. The sooner we can diagnose the triggers and symptoms, the sooner we can get you relief so you can start enjoying the spring.

By James A. Pollowitz, MD, FAAAAI, FACAAI, an allergy, asthma and immunology specialist with Westchester Health

Categories: Blog

10 Signs You May Have A Parasite

Westchester Health Blog - Mon, 03/20/2017 - 10:43

Even though the thought of having a parasite is pretty unpleasant, parasites are far more common than you might think. We actually see quite a few cases of them here at Westchester Health. Not restricted to underdeveloped countries, parasites exist around the world and can afflict anyone of any race, gender or socioeconomic status. They can cause a myriad of symptoms, only a few of which affect the digestive tract, but the good news is that yes, they are treatable.

What is a parasite?

Elie M. Abemayor, MD, Sc.M.

A parasite is any organism that lives and feeds off another organism. Examples of parasites include:

  • roundworms
  • tapeworms
  • pinworms
  • whipworms
  • hookworms
  • lice
  • giardia
  • mosquitos
  • bedbugs
  • scabies

Because parasites come in so many different shapes and sizes, they can cause a very wide range of problems. Some consume your food (from inside your body), leaving you hungry after every meal and unable to gain weight. Others feed off your red blood cells, causing anemia. Some lay eggs that can cause itching, irritability and even insomnia.

How do you get parasites?

There are a number of ways to contract a parasite. Here are the most common causes:

  • contaminated food and water
  • undercooked meat
  • contaminated water
  • unclean or contaminated fruits and vegetables
  • the bottom of your foot

Once a person is infected with a parasite, it’s very easy to pass it along. If you have a parasite and don’t wash your hands after using the restroom, you can easily pass microscopic parasite eggs onto anything you touch: the bathroom door handle, salt shaker, your phone or anyone you touch. Traveling overseas is another way that foreign parasites can be introduced to your system. It’s also very easy to contract a parasite when handling animals.

10 signs that may mean you have a parasite

The signs of a parasite are often caused by the toxins that it releases into the human bloodstream. Here are the most common symptoms:

  1. Unexplained constipation, diarrhea, gas, bloating, nausea or other symptoms of Irritable Bowel Syndrome
  2. You traveled internationally and got diarrhea on your trip
  3. You have had food poisoning and your digestion has not been the same since
  4. You have trouble falling asleep or you wake up multiple times during the night
  5. Skin irritations or unexplained rashes, hives, rosacea or eczema
  6. You grind your teeth in your sleep
  7. Painful, aching muscles or joints
  8. Fatigue, exhaustion, mood changes, depression or frequent feelings of apathy
  9. You never feel satisfied or full after your meals
  10. You’ve been diagnosed with iron-deficiency anemia
How to test for parasites

The best way to test for a parasite is to get a stool test. Most doctors will run a conventional stool test if they suspect a parasite.

Treatment options
  1. Drug therapies. Your doctor will choose the drug that is most effective for your particular parasite. You may need just one dose or you may have to take the medication for several weeks. Be sure to take the medicine exactly as it is prescribed or it may not work.
  2. Complementary and alternative therapies. Conventional medical treatments can get rid of parasites more quickly and with fewer side effects than most alternative treatments. Yet, alternative treatments may be helpful alongside conventional medications. However, your doctor must find out what kind of organism is causing your problems before you start treatment.
  3. Nutritional guidelines to help keep parasites from growing:
  • Avoid simple carbohydrates, such as those found in refined foods, fruits, juices, dairy products, and all sugars, except honey.
  • Eat raw garlic, pumpkin seeds, pomegranates, beets and carrots, all of which have been used traditionally to kill parasites.
  • Drink a lot of water to help flush out your system.
  • Eat fiber, which may help get rid of worms.
  • Probiotics (Lactobacillus acidophilus, Lactobacilus plantarum, Saccharomyces boulardii and bifidobacteria) help keep your digestive tract healthy but they may not be appropriate in some severely immune compromised patients.
  • Digestive enzymes will help restore your intestinal tract to its normal state, which makes it inhospitable to parasites.
  • Vitamin C supports the immune system. Lower the dose if diarrhea develops.
  • Zinc supports the immune system but may interact with certain medications, particularly some antibiotics, and it may not be appropriate for people with HIV/AIDS.
  1. Herbs are a proven, effective way to strengthen the body’s systems. As with any therapy, you should work with your doctor to diagnose your problem before starting treatment. You can take herbs as dried extracts (capsules, powders or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts).
Worried that you may have a parasite? Please come see us.

If you’re experiencing any of the symptoms listed above and think you may have a parasite, please make an appointment with Westchester Health to see one of our physicians. The sooner we can test for parasites, identify which type you have and start treating you, the sooner you can start to feel better.

By Elie M. Abemayor, MD, Sc.M., a gastroenterologist with Westchester Health.

Categories: Blog

10 Tips for Keeping Your Joints Healthy and Pain Free

Westchester Health Blog - Thu, 03/16/2017 - 10:36

Exercise is an excellent way to tone up and lose weight. Plus, it builds muscle which supports your bones (which helps prevent osteoporosis) and improves your cardiovascular health. However, exercise can also be hard on the joints, often making them stiff or sore after a workout. If joint pain is severe enough, it can keep you from exercising, which negatively affects your health by keeping you from getting the benefits of physical activity. The best course of action is to keep your joints, muscles, ligaments and bones strong and stable. To help lessen and even prevent joint pain, we at Westchester Health recommend these 10 tips to follow before, during and after exercise.

10 ways to prevent joint pain

In cases other than arthritis, joint pain is most often caused by overuse or injury (for example, tennis elbow, pitcher’s elbow or weightlifter’s knee). We tell our patients to follow these guidelines for 2-3 months and see if they experience less joint pain. The goal is to enjoy exercise, not be in pain because of it.

  1. Choose low impact exercise whenever possible

Bryan E. Dorf, DO, MBA

For many people, the best type of physical exercise involves activities that do not pound the joints, such as walking, bicycling, swimming, yoga or strength training.

  1. Don’t stretch before exercise

Contrary to popular belief, it is not good for your muscles and joints to stretch when they are cold. Instead, we recommend stretching daily or at least three times a week, but not immediately prior to a workout. Before exercising, start with a light warm-up, such as walking for 10 minutes, to loosen up your joints, ligaments and tendons, then gradually build up the exertion.

  1. Build muscle to support your joints

Strong muscles give your joints better support. This is especially important for people with weakened bones due to osteoporosis. Even a little more strength makes a difference. If you have joint problems, it is best to avoid quick, repetitive movements; slow and fluid is better.

  1. Improve your flexibility

If your joints are stiff and not very flexible, it’s important to increase your range of motion. The more flexible you are, the better your balance and overall joint health, and the less likely you are to fall.

  1. Keep your bones and muscles strong

For strong bones, it is vital to take in enough calcium and vitamin D every day. Dairy products are the best sources of calcium, but other good sources are green, leafy vegetables such as broccoli and kale. If you think you are not getting enough calcium from your diet, consider supplements. In addition, your muscles need protein. Exactly how much you need depends on your age, sex, and how active you are. Good sources include lean meats, seafood, beans, legumes, soy products and nuts.

  1. Apply ice to painful or swollen joints

Ice is a natural pain reliever which also reduces swelling. For a sore joint, apply a cold pack or ice wrapped in a towel, leaving it on for up to 20 minutes at a time. You can also try a bag of frozen vegetables (green peas are best) wrapped in a towel. Never apply ice directly to your skin, as this could cause freeze burns or blistering.

  1. Pay attention to your posture

To protect your joints from your neck down to your knees, always stand and sit up straight. When walking, making sure your shoulders are back and your spine is straight. If you work at a desk, take a break every hour to stretch and readjust your posture. Swimming is also a good way to help keep your posture aligned.

  1. Develop a strong core

Strong abs and back muscles greatly improve your balance, making you less likely to fall or get injured. Concentrate on core strengthening exercises which work on your abdominal, back and hip muscles when you exercise. Pilates and yoga are great workouts for strengthening your core.

  1. Maintain a healthy weight

The amount of weight your skeleton must carry around directly affects your hips, knees and back. If you are overweight, it’s important to slim down. Even a little weight loss can help your joints. Consider this: Every pound you lose takes 4 pounds of pressure off your knees.

  1. Treat joint injuries right away

A joint injury (shoulder, knee, ankle, wrist, neck, back) can quickly cause the loss of cartilage in that joint, making the injury more serious. If you have injured a joint, come see us right away for evaluation, diagnosis and treatment. But just as important as getting your injury treated is taking steps to avoid more damage in the future (such as following these 10 tips). If your joint injury is serious enough, you may have to stop doing certain activities that put too much stress on that joint, or use a brace to stabilize it.

In some cases, joint pain might signal something more serious

If following these tips do not alleviate your joint pain, you may have a more serious condition such as Lyme disease, rheumatoid arthritis, bursitis, osteoporosis or tendonitis. If your symptoms persist or get worse, it’s important to see a physician right away so you can get a proper diagnosis.

If you are experiencing stiff or sore joints, come see us

If you are feeling pain in any of your joints, please make an appointment with Westchester Health. The sooner we can evaluate and start treating the problem, the sooner you feel better and start enjoying exercising again.

By Bryan E. Dorf, DO, MBA, an Internist with Westchester Health.

Categories: Blog

5 Best Ways To Treat Knee Arthritis Without Surgery

Westchester Health Blog - Thu, 03/16/2017 - 10:00

If you’re like a lot of people over age 50, knees that have served you well for years gradually start hurting and swelling. They may start making cracking or popping sounds, and you may even feel a grinding sensation in your knees as you move. Most likely, you’ve developed arthritis of the knee, something we see quite often at Westchester Health.

The term “arthritis” simply means inflammation of a joint and is used to describe 200 rheumatic diseases and conditions that affect joints, the tissues that surround the joint, and other connective tissue. Healthy cartilage is shiny white and smooth, and its function is to allow joints to glide and move smoothly. Arthritis is the damage or loss of this cartilage between bones in a joint. When it is damaged, it results in pain and swelling.

Arthritis can result from many causes:
  • Trauma or injury

    Lori Sloane, MD

  • Normal wear and tear
  • Age
  • Inflammation
  • Infection
The knee joint is the most common joint to develop arthritis

The joint that most frequently develops arthritis is the knee, and osteoarthritis is the most common form of arthritis in the knee. This is a degenerative, “wear-and-tear” type of arthritis that occurs most often in people 50 and older, but may occur in younger people, too. In osteoarthritis, the cartilage in the knee joint gradually wears away. Knee pain that wakes you up from sleep can be a symptom of osteoarthritis.

Another type of arthritis that can develop in the knee, usually following an injury to the knee joint, is called post-traumatic arthritis. This can result from a torn meniscus, an injury to a ligament, or a fracture of the knee, sometimes years later.

Arthritis pain can begin suddenly but typically it develops slowly

Knee arthritis pain is usually worse in the morning and after a lot of walking or running. Going up and down stairs is especially painful, as well as squatting. Some of our patients with arthritis say that damp weather or other changes in weather can bring on pain.

5 things you can do to treat knee arthritis without surgery

There are many effective options for relieving the pain of arthritis of the knee and improving joint function before resorting to surgery. Here are the 5 most effective ones:

  1. Physical therapy. The first line of treatment for arthritis of the knee is physical therapy. Stretching your quadriceps and hamstrings takes stress off the knee. In addition, strengthening these muscles helps maintain proper knee alignment and helps decrease the pain.
  1. Anti-inflammatories are effective in treating knee swelling and pain for most people.
  1. Ice is a very safe and effective treatment and should be used after strenuous activity, including extensive walking.
  1. If your knee pain persists after trying the above three therapies, the next treatment for knee arthritis is injections. Steroid injections work quickly and are effective for most people, but only last an average of 4 weeks. Injections of hyaluronic acid, a natural lubricant and anti-inflammatory, are also very effective and last an average of 6 months but may take a few weeks to work.
  1. PRP therapy. Another highly-effective type of injection is Platelet Rich Plasma (PRP). In this treatment, platelets are taken from your own blood, spun in a high speed centrifuge and then specific portions are injected into your knee. Many physicians consider PRP treatment to be experimental, but several studies have shown it to be very effective.
Sometimes, knee surgery is your best option

If none of these non-surgical treatments work, your pain is still significant and you cannot function the way you’d like, it may be time to consider knee replacement surgery, one of the most successful surgeries today. The procedure involves removing the damaged cartilage and underlying bone and replacing it with smooth metal and plastic. Pain relief is almost immediate and dramatic.

How to know if you have knee arthritis

Arthritis of the knee is very common but before you begin treatment for it, it’s wise to make sure you have the correct diagnosis. The only way to be certain is to have a thorough physical exam by a specialist.

If you think you have arthritis in one or both of your knees, come see us

If you are experiencing pain, swelling and/or stiffness in your knee(s), please make an appointment to see one of our Westchester Health specialists. If you do in fact have knee arthritis, we can determine the course of action that will give you the best possible outcome.

By Lori Sloane, MD, a specialist in rheumatology and internal medicine with Westchester Health.

Categories: Blog


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