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How To Avoid Poison Ivy, Even In The Fall

Westchester Health Blog - Wed, 11/15/2017 - 10:47

You may think that summertime is the worst season for contracting poison ivy, but actually it’s highly active in the fall, too. In fact, here at Westchester Health, we see a spike in poison ivy cases during this time of year (mid to late fall) because many families go apple picking, and poison ivy tends to hug the bases of apple trees. To know how to avoid poison ivy, and treat a reaction to it, refer to this timely blog by Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group.

Best 6 ways to avoid poison ivy

Mason Gomberg, MD

  1. Steer clear of areas where you know poison ivy grows.
    It typically grows as a vine or shrub, and it can be found throughout much of North America (except in the desert, Alaska and Hawaii). It grows in open fields, wooded areas, on the roadside and along riverbanks. It can also be found in urban areas, such as parks or backyards.
  2. Cover up.
    If you know you will be walking/hiking in areas where poison ivy is present, cover all exposed skin with closed shoes, socks, long pants, long sleeves and gloves.
  3. Wash your skin asap.
    Immediately wash skin that has come in contact with the plant. This may help remove some of the oil from your skin and lessen the severity of your reaction.
  4. Wash the clothes you were wearing, along with anything that may have touched the plant. Although the rash can’t spread, the oil that caused it can.
  5. Scrub under your fingernails.
    You can spread poison ivy to other parts of your body if the oil is on your fingers. Try not to scratch because this will only make things worse. While it may bring immediate comfort, scratching will only prolong symptoms. You may even develop an infection if you break the skin, causing itching to intensify.
  6. Wash gardening tools and other outdoor items with soap and water
    that may have come in contact with the plant. Unfortunately, oil from poison ivy can remain potent for as long as 5 years.
Poison ivy changes color with the seasons. Here’s how to know what to look for

Just when you think you know how to identify poison ivy, it changes color. Depending on the season, its leaves are:

  • Reddish in the spring
  • Green in the summer
  • Yellow, orange or red in the fall

The main thing to remember is the old saying: leaves of three, let it be. In addition, with some types of poison ivy, the leaves have notched edges. With others, the edges are smooth. It can grow as a bush or vine, can grow up trees, and sometimes has white berries. Plus, the leaves can have a shiny sheen to them or be dull. Nature doesn’t make it easy!

8 important facts about poison ivy
  1. Poison ivy isn’t really poisonous.
    The plant itself isn’t the problem, it’s the plant’s sticky, long-lasting oil called urushiol that causes an itchy, blistering rash after it touches your skin. Even slight contact, such as brushing up against the leaves, exposes your skin to the oil.
  2. A poison ivy rash is not contagious.
    Once you have washed the urushiol oil off your skin, the rash itself is not contagious. It may continue to spread due to varying amounts of exposure on different areas of the body, but touching the rash does not cause it to spread. The rash usually peaks within a week, can last as long as 3 weeks, and looks like patches or streaks of red, raised blisters.
  3. Urushiol adheres to your skin within minutes.
    If you know you’ve come into contact with poison ivy, wash the area with lukewarm water and soap. If there’s no water available, rubbing alcohol or alcohol wipes can remove it. Keep the area cool, dry and clean. Thoroughly wash your clothes and clean your boots or shoes, and also hose down any garden tools that might have touched the plant.
  4. Urushiol can cling to your dog or cat’s fur and rub off on you.
    If your pet has been in areas where poison ivy is growing and then rubs against your skin, you can definitely have a reaction. To avoid this, bathe your pet with soap and cool water wearing gloves, then locate the poison ivy plants he/she is coming in contact with and remove them.
  5. See your doctor if a rash develops close to your eyes or is widespread over your body.
    Once a rash appears, keep it clean, dry and cool. Calamine lotion, an antihistamine such as Benadryl, and/or hydrocortisone cream can help control itching. Cool compresses or baths with baking soda or oatmeal can also soothe the rash. Don’t scratch—it won’t spread the rash, but can cause scars or infection. There are also prescription medications you can take by mouth that will help with swelling and itching. If you experience a severe reaction in addition to a rash, such as nausea, fever, fainting, shortness of breath, extreme soreness at the rash site or swollen lymph nodes, call 911 or get to an emergency room immediately.
  6. Never burn poison ivy. 
    Particles of urushiol remain in the fire’s smoke and can severely aggravate your eyes, nose and respiratory tract, as well as your skin. Instead of burning poison ivy to get rid of it, completely cover yourself with clothing and dig out the plant, getting as much of the root as possible. Then put it in a plastic trash bag and throw it away. Weed whacking poison ivy plants is also not recommended because when the leaves and stems are cut, urushiol is released into the air as vapor and can easily come into contact with your eyes, lungs and skin. Alternatively, a plant killer may work on poison ivy but be sure to read the label carefully and use it at the right time of the year. Remember: Urushiol remains active, even on dead plants, so be careful when handling them.
  7. Subsequent exposures to poison ivy are usually worse each time. That’s why it’s really important to try to avoid coming into contact with it in the first place.
  8. When using OTC cortisone creams, apply 3 times a day for at least one week.
If your child is having a severe reaction to poison ivy, please come see us

If your child has developed a rash from poison ivy that is not going away or is getting worse, please make an appointment with Westchester Health to see one of our pediatricians as soon as possible. Together, we’ll determine the best course of treatment to control the reaction so your child can feel better soon and not develop scarring. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Ever Wondered What Determines The Color of Your Eyes?

Westchester Health Blog - Wed, 11/08/2017 - 10:23

Do you like the color of your eyes? Do you wish it was different? Do you wonder what color your children’s eyes will be? Here at Westchester Health, we get these kinds of questions all the time, especially from our younger patients, so we thought we’d create a blog explaining the fascinating subject of eye color.

What makes your eyes the color they are?

William B. Dieck, MD, FAAO

There are two main factors that determine your eye color:

1) the amount and pattern of dark brown pigment (called melanin) in the part of your eye called the iris, and

2) the way in which the iris scatters light that passes through the eye. The more important of the two factors is pigment, which is determined by your genes.

It’s all in the genes

Inside the nucleus of your body’s cells are 46 chromosomes, divided into 23 pairs. You inherited one chromosome from each parent to make each pair of your chromosomes.

Chromosomes are made up of strings of DNA called genes. These genes, which also come in pairs, determine the range of characteristics you inherited (hair color, eye color, height, body type, straight or crooked teeth, foot size, and much, much more). Researchers believe that as many as 16 different genes play a role in determining eye color. The two main genes believed to be responsible are OCA2 and HERC2, both of which are part of chromosome 15.

Furthermore, genes are made up of alleles that ultimately determine which particular characteristics you will develop. For most inherited traits, there are generally two alleles. If the two alleles are the same, they are homozygous. If they are different, they are heterozygous.

For each trait, the dominant allele is expressed, while the recessive allele is unexpressed. Recessive alleles are only expressed if there is no dominant allele present.

The alleles for eye color can be separated into blue, green and brown.
  • green alleles are dominant over blue alleles
  • brown alleles are dominant over both blue and green alleles
  • If you received a blue allele and a brown allele, your eye color would be brown because brown is the dominant allele.
  • If you have blue eyes, this means you received blue alleles from both parents.

Your genes also determine your eye color by dictating how much (and where) melanin is produced in your iris. The more melanin produced, the darker the eye color will be.

Why are babies’ eyes blue?

Since melanin production does not begin at birth, babies’ eyes appear blue. Their true eye color will be determined over time. It’s usually not until age three that a child’s permanent eye color becomes apparent.

Can your eye color change?

Have you ever noticed how some people’s eyes seem to change color depending on the lighting? That happens because the iris has two layers and sometimes there is pigment in both layers. In people with blue or green eyes, however, the front layer will have very little or no melanin. Depending on the amount and diffraction of light, their eyes may appear to change colors.

What about people with two different eye colors?

This results from a condition called heterochromia, which occurs due to differences in the early stages of their iris development.

Have questions about your eye color? Come see us.

If you’re concerned about the color of your eyes, or are wondering what eye color you might pass on to your children, please make an appointment to come in and see one of our eye specialists at Westchester Health. He/she will answer all your questions and if needed, perform a thorough eye exam to make sure your eyes are healthy. Whenever, wherever you need us, we’re here for you.

By William B. Dieck, MD, FAAO, Vice President, Westchester Health; Director, Ophthalmology Division

Categories: Blog

Men, Don’t Delay! 10 Signs That You Should See A Urologist

Westchester Health Blog - Wed, 11/01/2017 - 10:06

If you have a possible urological issue, even if it seems like no big deal, it’s important to visit a urologist to get it checked out. If it’s minor, it can often be treated quickly and easily, and if it’s something more serious, the earlier it’s detected, the better your chances of a positive outcome and full recovery. At Westchester Health, we remind our male patients all the time, particularly as they get older, how crucial it is for them to pay attention to warning signs. To help men everywhere know what to look for, we put together this list of signs and symptoms to look out for.

10 signs that you need to see a urologist…soon

Jerry Weinberg, MD

As important as good nutrition and proper exercise, a urologist needs to be part of your overall health maintenance too. Even though urologic and sexual problems are uncomfortable to talk about, they’re a crucial part of your overall health and need to be monitored by a urologic specialist.

A urologist can correctly identify and diagnose a problem, determine the level of severity and offer the best treatment options for you. Remember: The sooner you catch a potential health issue, the better the chances of treating and reversing it before it develops into something major.

If you notice any of the following 10 signs, we urge you to visit a urologist.

1. Erectile Dysfunction: Erectile Dysfunction, or ED, is the inability to achieve or maintain an erection. As well as affecting sexual performance, it can also reveal potentially serious conditions such as vascular disease, hypertension or renal failure. It may be uncomfortable to talk to a doctor about ED but remember, if you have underlying conditions, it’s really important to treat them as early as possible.

2. Blood in your urine: If you see this, you should see a urologist immediately because it could be an early sign of bladder or kidney cancer. Even if you only experience blood in your urine from time to time, it means that you have a condition that needs immediate attention.

3. Testicular pain, lump or masses: If you have pain in your testicles that is persistent and does not go away within two weeks, it’s time to see a urologist because it could signal testicular cancer. Fortunately, when caught early, cancer in the testes is one of the most curable cancers.

4. Abnormal prostate exam: Men over the age of 40 are advised to get a yearly exam by the same doctor, if possible. This way, any changes can be monitored more closely and early detection of prostate cancer is more likely. If any firmness, small nodules or irregularities are detected, you should then be referred to a urologist to diagnose your condition and discuss treatments, if necessary. Remember: If caught early, prostate cancer has a high cure rate.

5. Difficulty urinating: While not life-threatening, difficulty with urination can be annoying and uncomfortable. A common symptom of getting older, this is typically caused by an enlarged prostate. To help with urination, medications can relieve the symptoms and even shrink the prostate.

6. Painful urination: Infections can occur along any part of the urinary tract, most often caused by bacteria. A urologist can determine the cause of the infection and recommend targeted treatment.

7. Frequent urination or the urge to urinate often: It’s time to see a urologist if incontinence (leaking urine) starts suddenly and/or is interfering with your lifestyle. Male urinary incontinence is fairly common and can usually be managed and treated successfully.

8. An elevated or change in Prostate Specific Antigen (PSA) level: The PSA test is one of the ways doctors can detect early prostate cancer. Typically, a very low level of PSA is present in men’s bloodstream. When there is a change or a higher level of in the blood, a urologist needs to determine the cause.

9. Kidney abnormality: If your doctor detects anything unusual on an abdominal X-ray, you should be referred to a urologist.

10. Male infertility: Though rare, male infertility (including decreased sexual desire) can be a sign of testicular cancer and you should be seen by a urologist right away.

Concerned that you may have a urologic issue? Come see us.

If you’re experiencing any of the signs and symptoms discussed above, or have questions about your sexual or urologic health, please make an appointment with Westchester Health to see one of our urology specialists. After examining you, conducting a thorough health history and answering all your questions, he/she will determine if you need treatment, medication or any further tests. Always, our #1 goal is to do whatever we can to help you be as healthy as possible. Whenever, wherever you need us, we’re here for you.

By Jerry Weinberg, MD, a Urologist with Westchester Health.

Categories: Blog

How To Reduce Your Child’s Risk Of Heart Disease

Westchester Health Blog - Wed, 10/25/2017 - 11:06

Although most parents would not want to admit it, the beginnings of heart disease can be seen in kids as young as 10 years old. The important fact here is that if the beginnings of this serious disease are left untreated, children can develop heart disease later in life, which can prove to be fatal. But there is good news, which you can learn about in a recent blog by Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group.

Heart disease risk factors

Mason Gomberg, MD

Heart disease is the #1 killer of men and women in the U.S. and often stems from unhealthy childhood habits. The chief risk factors of heart disease are:

  • Smoking
  • High blood pressure
  • Diabetes
  • High blood level of cholesterol
  • Physical inactivity
  • Obesity
  • Family history of early-onset heart disease
The most important way your child can avoid heart disease is by a healthy diet

Unfortunately, American children and adolescents, on average, eat more saturated fat and have higher blood cholesterol levels than young people their age in most other developed countries. Not surprisingly, the rate of heart disease tends to keep pace with cholesterol levels. One study from autopsies showed early signs of hardening of the arteries (atherosclerosis) in 7% of children between ages 10 and 15 years. The rate was twice as high between ages 15 and 20.

Heredity is clearly an important risk factor for conditions such as heart disease, cancer and diabetes. However, researchers are finding more and more that there is a direct link between diet and the development of diseases. According to the American Heart Association, a heart-healthy diet from an early age lowers cholesterol, and if followed through adolescence and beyond, should reduce the risk of coronary artery disease in adulthood.

Do you have a family history of heart disease?

When you first took your child to a pediatrician, you may have been asked if there was a history of heart or vascular disease in your family. This is important information for both you and your child’s doctor to know. Has either set of grandparents, maternal or paternal, ever had a heart attack, stroke or any other type of heart disease? If the answer is yes, be sure to bring it to your pediatrician’s attention.

Get your cholesterol tested

At your child’s next checkup, your pediatrician may recommend a cholesterol and triglyceride screening blood test. For adopted children, even for those adopted in open proceedings, complete biological family medical histories are often not available. To help prevent heart disease linked to high blood cholesterol levels, we at Westchester Health strongly recommend that adopted children are screened periodically for blood lipid (fat) levels throughout their childhood.

3 important ways you can help reduce your child’s risk of heart disease
  1. Nutrition

Starting even at birth, good nutrition can decrease the risk of heart disease. What can you do? Encourage your child to eat vegetables and fruits every day. Reduce soda, sugary beverages and empty-calorie foods such as potato chips, candy bars and cookies. Saturated fats should be definitely avoided. A saturated fat is generally solid at room temperature and includes fatty meats, cream, butter, cheese, palm and coconut oils. Discuss portion control with your child, but before that, learn how much or how little constitutes a healthy portion.

  1. Physical Activity

Physical activity in childhood sets the tone for good exercise habits in adulthood. Children under 17 should exercise at least 60 minutes a day. You can help motivate your child to exercise by doing the activity with them, such as biking, hiking, swimming, soccer, basketball, rollerblading or running. Even jumping rope for 20 minutes is an excellent exercise!

  1. Smoking/Tobacco

One of the most important things you can do to help prevent heart disease in your child is to maintain a smoke-free environment in your home and your car so that your child is not exposed to the harmful effects of secondhand smoke. Because children’s lungs are still developing, they are especially vulnerable to the effects of breathing in secondhand smoke. At Westchester Health Pediatrics, we also strongly advise you to discourage your child from smoking or other forms of tobacco use.

A nutritious diet and active family routine can help all of us lead healthier lives

Adhere to these guidelines to reduce your entire family’s risk of heart disease:

  • Eat a healthy breakfast every day
  • Eat low-fat dairy products such as low fat cheese, yogurt skim milk
  • Regularly eat meals together as a family
  • Limit fast food, takeout food and eating out at restaurants (typically high in sodium)
  • Avoid fried foods and highly-processed fatty foods
  • Prepare foods at home as a family
  • Eat a diet rich in calcium
  • Eat a high fiber diet
  • Try to eat 5 servings of fruits and vegetables every day
Want to know more about preventing heart disease in your child? Come see us, we’re here to help.

If you’d like an evaluation of your child’s current heart disease risk, as well as advice for improving your child’s diet and exercise level, please make an appointment with Westchester Health. One of our pediatricians will examine your child, discuss the findings with both of you, and offer guidance on things that can be done to reduce the risk. Our #1 goal is for your child to be as healthy and happy as possible. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Achoo! How To Survive Fall Allergy Season

Westchester Health Blog - Wed, 10/18/2017 - 11:24

For many people with allergies, spring is the worst season of the year. But here at Westchester Health, we’ve observed that for a large number of our patients, fall is right behind it in severity. People with nasal and eye allergies, as well as asthma, often suffer throughout the fall, from late August thru November.

2 ways fall allergies differ from spring allergies 1. Ragweed pollen

James Pollowitz, MD, FAAAAI, FACAAI

Ragweed is the best known fall allergen, pollinating between August 15th and the first frost (usually late September‒early October), usually hitting its peak around Labor Day. Ragweed pollen is very small and light and amazingly, can travel up to 200 miles.

Symptoms of ragweed allergy include:

  • nasal congestion
  • sneezing
  • watery, runny nose
  • eye itching, tearing and redness
  • itchy throat
  • post nasal drainage

Asthmatic patients who are allergic to ragweed often experience an increase of symptoms (coughing, wheezing, shortness of breath, chest tightness). In addition to ragweed, other weed pollens can cause allergies too, including lambs quarters, pigweed and cocklebur.

2. Molds

Molds are another very common fall allergen. The mold season is somewhat later than weeds, usually October and November. Molds grow on dead vegetation (especially fall leaves) and its spores (the mold equivalent of pollen) are then carried by the wind, causing the same type of allergy symptoms as pollens. Molds grow well in low light and in areas of high moisture, both of which often occur in the fall.

Being indoors more in the fall also triggers allergies and asthma

In the fall, most of us spend more time indoors (home, school, office) and are thus more exposed to indoor allergens such as pets (especially dogs and cats), mold and dust mites. Allergic reactions usually increase during this season and trigger asthma attacks and sinus and ear infections. Cold air, cigarette smoke and climatic changes are other important triggers. Typical asthma symptoms include cough, chest tightness, wheezing and shortness of breath.

Best ways to treat fall allergies

Treatment of fall allergies (or any allergies) involves taking three important actions:

1) Avoid or eliminate triggers

To reduce the irritants that are triggering allergic reactions:

  • use allergen encasings on all pillows and mattresses
  • remove and control mold in your home by frequently cleaning and repairing any water leaks or dampness
  • remove pets or restrict them to certain areas in the house
2) OTC medications

Many medications used to treat allergies are now available without a prescription. These include long acting, less sedating antihistamine OTC medications such as Claritin, Zyrtec Allegra (also available as generic brands) and most recently Xyzal. There are now several OTC nasal steroids: including: Nasacort AQ, Flonase, Flonase Sensimist and Rhinocort. They have also become available without a prescription over the past few years. These medications are more effective than antihistamines, especially for relief of nasal congestion.

3) Rescue medications

Rescue medications such as albuterol are important in managing acute symptoms but should not be used regularly. Using them more than twice a week indicates that you need asthma controller medication such as inhaled steroids (Flovent, Asmanex or Qvar) or a non-steroid such as Singulair (montelukast).

More severe asthma is often treated with combined steroid/long-acting bronchodilator inhaled medications such as Advair, Symbicort, Dulera or Breo Ellipta. Persistent asthma requires a treatment action plan and ongoing follow-up, similar to other chronic diseases such as diabetes, hypertension or arthritis.

4) Immunotherapy (allergy shots)

Allergy shots (immunotherapy) are a very beneficial therapy and have been used for more than 100 years for millions of patients. People with pollen, cat and dust mite allergies can experience as much as 90% improvement compared to medical therapy alone. A usual course of therapy is 3-5 years of treatment. When the shots are stopped, most patients do not relapse for at least 5-10 years.

5) Immunotherapy (tablets)

A new type of allergy immunotherapy involves tablets placed in the mouth under the tongue, where they dissolve. Currently, there are now four available products: Grastek and Oralair to treat grass pollen allergies, and Ragwitek for ragweed allergy. A product to treat dust mite allergies (Odactra) was recently approved for treatment of patients age 18 to 65. This product will be on the market soon (by early 2018).

Even with allergies, you can still enjoy the fall

If you dread the fall because of allergies, you’re not alone. But neither should you suffer unnecessarily. The correct diagnosis and treatment for your allergies can actually help you enjoy this beautiful time of the year.

Suffering from fall allergies? Come see us.

If you’re experiencing any of the allergic reactions discussed above, or want to know how to better manage your allergies, please make an appointment with Westchester Health to see one of our allergy/immunology specialists. Along with you, he/she will determine the best course of treatment and/or medication, and order any necessary tests so that hopefully, you’ll soon be able to enjoy the fall season, every year. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Parents: It’s Not Tainted Candy You Need to Fear On Halloween, It’s Car Injuries

Westchester Health Blog - Wed, 10/11/2017 - 20:17

With Halloween just around the corner, now is the time that parents and children need to be reminded about how to stay safe while trick-or-treating. Many parents worry about tampered candy and strangers approaching their children, but we at Westchester Health want everyone to know that the real danger is injury from car accidents. For your child’s safety, read this timely and very important blog from Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group.

Halloween is the #1 day for child-pedestrian car accidents and fatalities

Lauren Adler, MD, FAAP

Car accidents constitute the majority of Halloween fatalities. Kids between 12-18 years old account for 1/3rd of all fatalities, followed by 5-8 year olds, who account for 23%.

BE AWARE: The peak time period for car accidents on Halloween is 6:00-7:00pm.

Thrown objects and propellants (i.e., shaving cream, paints, silly string, eggs) can also cause serious injury, especially if they collide with your child’s eyes and/or head.

How to prevent your child from being injured by a car on Halloween
  1. Parents should make sure that costumes and masks do not obscure their child’s vision or ability to walk.
  2. Children, if walking without their parents or other adult, should carry glow sticks or flashlights, or have reflective tape on their costumes.
  3. Children should not use cell phones or other electronic devices while trick-or-treating because they not only distraction them while they’re walking but they can prevent them from noticing or hearing an approaching car.
  4. Children should trick or treat in communities that they’re familiar with, especially those with sidewalks and well-lit areas.
  5. Adults should supervise their children’s trick-or-treating if they are under the age of 12.
  6. If you’re following your children’s trick-or-treating in your car, drive slower and with caution, keeping on the lookout for children who may not see you.
The fear of tampered candy is a common (but overblown) concern

Even though the public seems to think that tainted candy can be found in every trick-or-treat bag, in reality, the incidence is extremely low. However, you should check that the treats your child brings home are sealed in the original packing and have not been opened.

TIP: Children should avoid large amounts of candies that contain sorbitol (sugar substitute) to avoid abdominal pain and diarrhea.

Remember your child’s teeth

At Westchester Health, we recommend that parents set a limit on the amount of Halloween candy their children eat after the event. Parceling out small portions each day often works well, with a time limit for getting rid of what hasn’t been eaten (say, a month after Halloween). You should also make sure your children brush their teeth each time after eating their candy.

Especially on Halloween, an ounce of prevention is worth a pound of cure

By following our tips on this Halloween, hopefully accidents can be prevented and you and your child will have a happy, exciting time. If you have further concerns about Halloween safety or worry that your child has eaten something tainted after the fact, please make an appointment at Westchester Health to see one of our pediatricians. We’ll examine your child, answer your questions and do whatever we can to put your mind at ease. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Tips On How To Talk To Your Children About Recent Tragedies

Westchester Health Blog - Fri, 10/06/2017 - 21:28

There has been a lot of disturbing news information and images recently, concerning a number of tragedies. Whether it is a natural disaster or terrorist/deranged citizen attack, we at Westchester Health want parents to know that we think it’s very important to discuss these difficult issues with their children, when appropriate. They should, of course, consider the child’s age and developmental stage in deciding what information to share or watch on TV or the computer. Very good guidance about how to do this is offered in a recent blog by Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group.

It is important to be honest with your child when discussing a disturbing recent event

Mason Gomberg. MD

A good place to start is by asking your child what they have heard or know about the event. Focus on the basics. Ask what they understand about the event and correct any misinformation they might have. Also, address any underlying fears they may have. Answer questions truthfully and at a level they can understand without going into great detail or speculation. Parents should convey that it is ok to be bothered by this event and that they are here to support their child and make him/her as safe as possible.

If your younger child gets scared by news coverage of an upsetting event, try to shield them from graphic details

Parents need to reassure a younger child that they are safe. They may also need help separating fantasy from reality. Young children might become “clingy” or regress in behavior. This may include bedwetting, sucking one’s thumb and/or using baby talk. It is important at such a time to support your child and give extra hugs and kisses.

For older children who have access to more information, discuss the news together

Adolescents and teenagers will have more questions and want more in-depth information and suggestions about preventing future tragedies. They may want to help in the recovery efforts. Together, your family can organize donations to victims or charity organizations.

Above all, reassure your children that they are safe

Our suggestions for helping children get through difficult times:

  • Review your family’s plans for an emergency
  • Maintain your usual routines
  • Try to keep on a regular time schedule for meals, homework and school/sports/outside activities
  • Spend extra family time together
  • Foster a sense of security and encourage your child to express his/her feelings
  • Stay as calm as possible
  • If you see signs that your child is not coping well, call your pediatrician. These include: sleep disturbances, behavioral regression, physical complaints (fatigue, headaches, abdominal pains), sadness and anxiety.
If you need help with these difficult topics, all of us at Westchester Health are here for you

If you’re concerned about your child’s ability to cope with recent tragic events, or want guidance regarding how to talk to your child about difficult issues, please make an appointment with Westchester Health to talk with one of our pediatricians. We understand that times like these can be very difficult for children of all ages, and we want you to know that whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Signs That Indicate That Your Child Might Have A Vision Problem

Westchester Health Blog - Wed, 10/04/2017 - 11:55

Have you noticed that your child sits too close to the TV or computer screen? Holds a book too close when reading? Closes one eye when trying to see something? Does he/she have trouble seeing things up close, or far away? These are signs that your child might have a vision problem. To learn more, here is an excellent blog by Lauren Adler, MD, FAAP, a pediatrician in our Westchester Health Pediatrics group.

Signs to look for to determine if your child has a vision problem: Babies up to 1 year of age

Lauren Adler, MD, FAAP

  • Before 4 months, most babies’ eyes occasionally look misaligned (strabismus). However, after 4 months of age, inward crossing or outward drifting that occurs all the time is usually abnormal. If one of these is present, let your child’s doctor know.
  • Babies older than 3 months should be able to follow or track an object with their eyes, such as a toy or ball, as it moves across their field of vision. If your baby can’t make steady eye contact by this time or seems unable to see the object, let your pediatrician know.
Preschool age

If your child’s eyes become misaligned, contact your pediatrician right away. Other vision problems, such as a lazy eye (amblyopia), may have no warning signs, and your child may not let on that he/she is having trouble seeing things. That’s why at Westchester Health Pediatrics, we tell our parents that it’s important to have your child’s vision checked before he/she starts school, because there are special tests that can be performed even before your child can read.

All children

If you notice any of the following signs or symptoms, contact your pediatrician:

  1. Eyes that are misaligned (are crossed, turn out or don’t focus together)
  2. White or grayish-white color in the pupil
  3. Eyes that flutter quickly from side to side or up and down
  4. Eye pain, itchiness or discomfort reported by your child
  5. Redness in either eye that doesn’t go away in a few days
  6. Pus or crust in either eye
  7. Eyes that are always watery
  8. Drooping eyelids
  9. Frequent eye rubbing
  10. Over-sensitive to light
  11. Squinting to read
  12. Sitting too close to the TV or computer, or holding a book too close in order to see the print
  13. Frequent complaints of headaches
  14. Lower-than-expected grades in school
  15. Using a finger to guide eyes when reading
  16. Closing one eye to read
When to get your child’s eyes checked by an eye professional

Vision screening is a very important way to identify vision problems in your child. During a typical eye exam, a vision specialist checks to see if the eyes are working properly and looks for signs of eye disease. Children with a family history of vision problems are more likely to have them also.

The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that children have their eyes checked by a pediatrician at the following ages:

  • All babies should have their eyes checked for infections, defects, cataracts or glaucoma before leaving the hospital. This is especially true for premature babies, babies who were given oxygen for an extended period, and babies with multiple medical problems.
  • By 6 months of age. As part of each well-baby visit, eye health, vision development and alignment of the eyes should be checked by your child’s pediatrician.
  • 1 to 2 years. Special screening techniques allow your child’s pediatrician to start detecting potential eye problems.
  • 3 to 4 years. Your child’s eyes and vision should be checked for any abnormalities that may cause problems with later development.
  • 5 years and older. Your child’s vision in each eye should be checked separately every year. If a problem is found during an exam, your child’s pediatrician may refer him/her to a pediatric ophthalmologist, an eye doctor specially trained and experienced in the diagnosis and care of children’s eye problems.
Concerned that your child might have a vision problem? Come see us, we can help.

If you’re noticing signs that might indicate that your child may have a vision problem, please make an appointment with Westchester Health. One of our pediatricians will examine your child’s eyes and vision, make a diagnosis and if warranted, refer you to an eye specialist (ophthalmologist) so that hopefully your child will be seeing clearly soon. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

How To Cope With Your Child’s Car Sickness

Westchester Health Blog - Wed, 09/27/2017 - 11:38

At Westchester Health, an issue that a lot of people don’t think about but one that causes a lot of problems is car sickness. Car sickness is the most common form of motion sickness in children, but stress, excitement and/or the fear of vomiting also can set it off. To help parents deal with this troubling condition, Lauren Adler, MD, FAAP, a pediatrician in our Westchester Health Pediatrics group, has written a great blog on the subject.

5 ways you can help your child cope with car sickness

Lauren Adler, MD, FAAP

If your child starts to develop the symptoms of motion sickness, the best approach is to stop the activity that is causing the problem, when possible. Obviously, on a bumpy plane, there’s not much you can do to stop the motion.

  • If it occurs in the car, stop as soon as safely possible and let your child get out and walk around. If you are on a long car trip, you may have to make frequent short stops, but trust us, it will be worth it in the long run. If the condition develops on a swing or merry-go-round, stop the motion and take your child off the equipment.
  • If your child has not eaten for three hours, give him/her a light snack before the trip. This also holds true for a boat or plane ride. The snack relieves hunger pangs, which seem to add to the symptoms.
  • Try to focus your child’s attention on something other than the queasy feeling. Try listening to the radio, singing or talking.
  • Have your child look at things outside the car, not at books or games. Playing the “license plate game” or some other activity that requires looking outside of the car often helps.
  • Stop the car and have your child lie on his/her back for a few minutes with eyes closed. A cool cloth on the forehead also tends to lessen the symptoms.
Medications can help, too

If you are going on a trip (car, plane or boat) and your child has had motion sickness before, you may want to give him/her medication before you board to prevent problems. Some are available without a prescription, but ask your pediatrician before using them because they often cause side effects, such as drowsiness (when you get to your destination, your child might be too sleepy to enjoy it), dry mouth/nose or blurred vision.

When to call a doctor

If your child has symptoms of motion sickness when he/she is not involved with a movement activity—particularly accompanied by a headache or with difficulty hearing, seeing, walking or talking—tell your pediatrician about it. These may be symptoms of problems other than motion sickness.

Wondering what you can do about your child’s car sickness? Come see us, we can help.

If you’d like guidance for preventing, or at least dealing with, your child’s motion sickness, please make an appointment with Westchester Health. One of our pediatricians will examine your child to rule out any physical causes, listen to the symptoms, answer your questions and offer tips and advice so that hopefully, you and your child can actually enjoy taking trips without getting sick. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

How To Recognize Scoliosis In Your Child And What To Do Next

Westchester Health Blog - Wed, 09/20/2017 - 11:56

About 1 in 25 adolescent girls and 1 in 200 teenage boys develops scoliosis. At Westchester Health, scoliosis is something we see often. It’s a fairly serious condition that we feel parents need to be aware of so they can recognize the symptoms in their child and if need be, seek treatment. That’s why we’d like to share this excellent blog by Lauren Adler, MD, FAAP, a pediatrician in our Westchester Health Pediatrics group, about the causes of scoliosis and the different ways it can be treated.

Scoliosis shows up most often during growth spurts, usually when children are between 10 and 15 years old. Scoliosis that is diagnosed during the teen years usually continues into adulthood. The greater the angle of the spinal curve, the more likely it is to increase over time.

The many causes of scoliosis of the spine

Lauren Adler, MD, FAAP

When looking at someone’s back, the spine should run straight down the middle. When a person has scoliosis, the backbone curves to the side in a pronounced S shape. The angle of the curve may be small, large or somewhere in between, but anything that measures more than 10 degrees is considered scoliosis. You can often tell that someone has scoliosis by their body posture. They tend to lean to one side, have a sunken chest and have uneven, rounded shoulders.

Scoliosis can occur as a complication of polio, muscular dystrophy or other central nervous system disorder, but 80% of cases are idiopathic—of unknown cause. Very often, a family member has also had scoliosis. If you or one of your children has scoliosis and you have other children, make sure they are screened regularly.

But having said that, some kinds of scoliosis do have clear causes. These are divided into two types: structural and nonstructural.

In nonstructural scoliosis, the spine works normally but looks curved. This may be due to one leg being longer than the other, muscle spasms or inflammations (such as appendicitis). When these problems are treated, this type of scoliosis often goes away.

In structural scoliosis, the curve of the spine is rigid and cannot be reversed. This can be caused by:

  • Cerebral palsy
  • Muscular dystrophy
  • Birth defects
  • Infections
  • Tumors
  • Genetic conditions such as Marfan syndrome and Down syndrome

NOT TRUE: Contrary to what some people believe, scoliosis is not caused by childhood sports injuries, heavy backpacks or poor posture.

2 most common treatments for scoliosis

The decision to treat scoliosis depends upon both the severity of the curve as well as the patient’s skeletal maturity.  Patients who are less skeletally mature have more growth ahead of them and therefore their curve is more likely to progress.

  • Curvature of the spine of more than 25 degrees may call for bracing. There are two main types of orthopedic back braces: 1) The Milwaukee brace has a neck ring and can correct curves anywhere in the spine, and 2) the thoracolumbosacral orthosis corrects deformities involving the vertebrae of the thoracic spine and below. The device fits under the arm and wraps around the ribs, hips and lower back. Scoliosis patients can expect to wear the brace all but a few hours a day until their spinal bone growth is complete, which for girls is usually between ages 17 and 18, and between 18 and 19 for boys. Wearing an orthopedic brace usually interferes only minimally with a person’s physical activity, with contact sports and trampolining being the only “off-limits” activities.
  • The procedure to surgically correct scoliosis is called posterior spinal fusion and instrumentation, and is typically recommended when the spine’s curvature is 40 degrees or more. It fuses the affected vertebrae using metal rods and screws to stabilize that part of the spine until it has fused together completely. People who have this surgery still face some restrictions on physical activity but can stop wearing the brace.
How you can help your child wear a back brace

Only about 50% of teenage scoliosis patients wear their braces. This is why parents play such a significant role in getting their child to comply with their doctor’s instructions, hopefully by explaining how it will pay great benefits in the future.

At the same time, we stress to our parents that they need to be sensitive to the tremendous impact this condition has on a young person’s body image, self-confidence and social standing at school, not to mention the restrictions it puts on their physical activity. In some cases, we refer young patients who are having trouble with the emotional aspects of scoliosis to get professional help from a therapist or counselor.

Does your child have scoliosis? Come see us, we can help.

If your child has scoliosis, or if you are concerned that he/she might be developing it, please make an appointment with Westchester Health. One of our pediatricians will examine your child, make a diagnosis and if warranted, refer you to a specialist for further diagnosis and treatment. Working together, we’ll make sure your child gets the help he/she needs. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

The Flu Vaccine Is In!

Westchester Health Blog - Fri, 09/15/2017 - 11:46
Our flu vaccine is in! Book your appointment now to get your family vaccinated.

Even though winter is still a few months away, now is the time to get your family vaccinated. Don’t delay — protect yourself and everyone in your family by getting the flu vaccine at any of our Westchester Health locations. Call (914) 232-1919 and we’ll help you find the Westchester Health office closest to you or click here.

Yes the flu shot works and at Westchester Health, we strongly recommend it!

Some people do not get the flu shot because they say it gives them the flu. This is a misconception; whenever you get any vaccine, your body mounts an immune response to produce antibodies to defend itself in case it contracts that illness in the future. REMEMBER: A mild reaction to the flu shot is always better than what the actual flu virus would be like.

Learn more about the flu
  • Maryann Buetti-Sgouros, MD, one of our WHP pediatricians, has written a very informative blog about the flu, the difference between the flu and a cold, and why everyone should get vaccinated. To read Dr. Buetti-Sgouros’ blog, click here.
  • Rodd Stein, MD, FAAP, another of our WHP pediatricians, has written a detailed, in-depth white paper and produced a highly educational webinar on immunization, its history, its importance, and what would happen if we all stopped vaccinating ourselves and our children. To download the free white paper and webinar, click here.
Call for an appointment for a flu shot.

Please call now to make an appointment with Westchester Health to get your family vaccinated against the flu. Whenever, wherever you need us, we’re here for you.

Categories: Blog

How To Take The Stress Out of Flying With Your Baby

Westchester Health Blog - Tue, 09/12/2017 - 11:37

There’s nothing worse than being seated near a screaming baby on an airplane (unless, of course, you’re that baby’s parent). To help everyone—babies, parents and fellow passengers—have a more pleasant flight, Maryann Buetti-Sgouros, MD, FAAP, a pediatrician in our Westchester Health Pediatrics group, offers these important bits of advice in a recent blog.

Best ways to keep your baby from crying on an airplane

Maryann Buetti-Sgouros , MD, FAAP

First, is your baby hungry, wet or dirty, cold or hot, or bored? If it’s bright outside, try closing the window shade. If your baby seems to want a view, direct his/her attention outside of the window or in the pages of the airline’s magazine. If all else fails and your little one wails incessantly no matter what you do, try not to let other passengers’ dirty looks bother you.

Ear pain might be the problem

Anyone who’s flown before knows that ears can be very sensitive to changes in pressure. This is because the outer ear is separated from the middle ear by a thin membrane called the tympanic membrane, or ear drum. Experiencing a difference in pressure across this membrane causes a sensation that as many as 1 in 3 passengers (children more so than adults) experience as temporary muffled hearing, temporary discomfort, or even pain. Unfortunately, having a stuffy nose or a head cold increases a child’s chances of ear problems.

If your baby has a cold or ear infection and absolutely needs to fly, consider giving him/her an infant pain reliever. (Decongestants are not recommended for infants.) If your baby is exhibiting significant ear discomfort from the cold and/or ear infection, it may simply be best, if possible, to postpone the flight. If your travel plans are not flexible, be aware that you may very well be dealing with ear pain and be prepared.

Giving your baby something to suck on works wonders

As many a parent knows, a tried and true deterrent to crying on an airplane is sucking. Try to get your baby to take a bottle, breast or pacifier during the times when the pressure changes in the cabin are likely to be greatest, namely, during takeoff and initial descent (not landing). The pressure change is typically most noticeable as much as a half hour or more before landing, depending on a flight’s cruising altitude. The higher up you are, the earlier in the flight the descent usually starts. If sucking doesn’t keep your baby quiet, or if he/she won’t take the bottle/breast/pacifier, try rubbing the ears, rocking and singing a soothing song.

Anxious about flying with your baby? Come see us, we can help.

If you’re planning a trip with your baby that involves flying, please make an appointment with Westchester Health. One of our pediatricians will answer all your questions and offer guidance and advice for preventing crying while in the air, as well as ways to deal with it if it does happen, in spite of all your efforts. Whenever, wherever you need us, we’re here for you.

To read Dr. Buetti-Sgouros’s blog in full, click here.

Categories: Blog

How To Recognize And Avoid Asthma Triggers In Your Child

Westchester Health Blog - Tue, 09/05/2017 - 11:24

At Westchester Health, we see a lot of kids with asthma and a lot of worried parents wondering how to treat and/or prevent this disease. To help kids and their parents know how to manage this challenging condition, Mason Gomberg, MD, a pediatrician in our Westchester Health Pediatrics group, offers the following information, tips and advice in a recent blog.

Diagnosing asthma is sometimes very difficult

Mason Gomberg, MD

Especially in young children, it’s sometimes hard to be entirely certain that asthma is the diagnosis. The following details help us determine if your child does, in fact, have asthma:

  • The type of symptoms: specifically, wheezing, coughing, shortness of breath, vocal cord dysfunction
  • What triggers the symptoms or when the symptoms get worse
  • Medications that were tried and if they helped
  • Any family history of allergies, asthma or eczema (allergic triad)

After gathering this information, the next thing we do is test your child’s airway function. One way to do this is with a pulmonary function test using a device called a spirometer. This measures the amount of air blown out of the lungs over time.

We may also test your child’s pulmonary function after administering asthma medication. This helps confirm that the blockage in the air passages that shows up on pulmonary function tests goes away with treatment.

Most common triggers
  1. Allergens (things your child might be allergic to). Most children with asthma have allergies, and allergies are a major cause of asthma symptoms.
  • House dust mites
  • Animal dander
  • Cockroaches
  • Mold
  • Pollens
  1. Infections of the airways
  • Viral infections of the nose and throat
  • Other infections, such as pneumonia or sinus infections
  1. Irritants in the environment (outside or indoor)
  • Cigarette/cigar smoke and other smoke
  • Air pollution
  • Cold air and/or dry air
  • Odors, fragrances, irritating compounds in sprays, and cleaning products
  • Wood burning stoves in the winter
  1. Exercise. Approximately 80% of people with asthma develop wheezing, coughing and a tight feeling in the chest when they exercise.
  1. Stress
7 best ways to help your child avoid asthma triggers

While it is impossible to make your house completely allergen or irritant-free, there are many things you can do to reduce your child’s exposure to triggers and limit the severity of a possible asthma attack. In addition, limiting your child’s exposure to triggers will help decrease symptoms as well as the need for asthma medications.

  1. Do not smoke or let anyone else smoke around your child.
  2. Reduce exposure to dust mites. The best way to do this is to cover your child’s mattress and pillows with special allergy-proof casings, wash his/her bedding in hot water every 1-2 weeks, remove stuffed toys from the bedroom, and vacuum and dust regularly. Other avoidance measures, which are more difficult or expensive, include reducing the humidity in the house with a dehumidifier or removing carpeting in the bedroom. Bedrooms in basements should not be carpeted.
  3. If your child is allergic to furry pets, the only really effective means of reducing exposure to pet allergens is to remove the pets from your home. If this is not possible, keep the pets out of your child’s bedroom and consider: putting a high-efficiency particulate air (HEPA) filter in his/her bedroom, removing the carpeting, covering mattress and pillows with mite-proof casings, and washing the pets regularly.
  4. Reduce cockroach infestation by regularly exterminating, setting roach traps, repairing holes in walls or other entry points, and not leaving food or garbage exposed.
  5. Mold in homes is often due to excessive moisture indoors, which can result from water damage due to flooding, leaky roofs, leaking pipes or excessive humidity. It’s important to repair any sources of water leakage and to control indoor humidity by using exhaust fans in the bathrooms and kitchen. Add a dehumidifier in areas with high humidity. Clean any mold contamination with detergent and water. You may need to replace porous materials (such as wallboards) if they have become contaminated with mold.
  6. Pollen exposure can be reduced by using an air conditioner in your child’s bedroom (with the vent closed) and leaving doors and windows closed during high pollen times.
  1. Reduce indoor irritants by using unscented cleaning products and avoiding mothballs, room deodorizers and scented candles.
  1. Diligently check air quality reports (radio weather forecasts or on the internet). When air quality is poor, keep your child indoors and be sure he/she takes the prescribed asthma control medications.
Worried that your child may have asthma? Come see us, we’re here to help.

If you think your child might have asthma, or if you want guidance for managing his/her asthma and the triggers that make it worse, please make an appointment with Westchester Health. One of our pediatricians will diagnose whether or not your child does indeed have asthma and if so, we will decide on the best course of treatment. Our #1 goal is for you and your child to be as informed as possible about this serious health condition so that you can better manage it and help your child live a healthy, happy life. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

What You Need To Know About Lyme Disease Going Into Fall

Westchester Health Blog - Tue, 08/29/2017 - 11:56

Even though the summer is winding down and we’re heading into fall, we at Westchester Health still want to emphasize what a serious disease this is. For up-to-date information about how to avoid Lyme disease and what to do if you think you’ve been bitten by a tick, we refer you to an excellent blog written by Lauren Adler, MD, FAAP, a pediatrician in our Westchester Health Pediatrics group.

Lyme disease has three stages: early localized, early disseminated and late Early stage

Lauren Adler, MD, FAAP

Fortunately, 90% of children infected with Lyme disease exhibit the classic red “bullseye” rash that is typical of this early stage, developing within 7-14 days after a tick bite. This rash is usually flat, not painful, is at least 5 cm in diameter and continues to expand over days, possibly weeks. It may also be accompanied by additional symptoms, including fever, headache, dizziness, body aches and fatigue. Testing for Lyme infection at this stage is not helpful because results are often negative and an accurate diagnosis can be made visually. Early stage Lyme disease is easily treated with 14-21 days of oral antibiotics and 90% of patients have complete resolution of symptoms.

Early disseminated stage

The early disseminated stage of Lyme disease occurs 3-5 weeks after the initial bite and can cause multiple red bullseye rashes, facial nerve palsies (Bell’s palsy), meningitis and carditis. In children with Lyme, 3% will exhibit facial nerve palsy and 1% meningitis.

Late stage

Late stage Lyme disease includes arthritis with redness, pain and swelling of a joint, as well as more significant cardiac and neurologic symptoms. Depending upon the individual case, early disseminated Lyme and late stage Lyme can be treated with 21-28 days of oral or IV antibiotics.

What to do if you’ve been nitten by a tick

Checking your children and yourself for ticks at the end of a day spent outdoors is the best prevention. If a tick is removed quickly, it cannot transmit Lyme.

The best way to remove a tick: Using a wet, soapy towel, rub counterclockwise over the tick. This technique removes the majority of ticks without leaving mouth parts behind. However, it is important to note that if parts are left behind, they are not dangerous and will not cause Lyme disease. Similar to removing a splinter, the best thing to do is clean the area with soap and water, then continue to soak the area with wet compresses or in the tub until they come out.

Insect repellent is also important. The most effective repellents are ones that contain 10-30% DEET. If used properly, they are safe to use on infants and children over the age of 2 months.

We do not recommend sending a tick to a lab for testing. Many of our parents ask us if they should get a tick tested for Lyme after they have removed it. This is not helpful for several reasons. First, if the test is positive, it does not mean that the tick has actually transmitted Lyme to its human host, and therefore treatment would not be recommended. Second, chances are that it will take several weeks for the test results to come back. However, if a child develops symptoms during that time, we would recommend starting treatment regardless, right away. Third, a negative test can give a false sense of security. Many cases of Lyme disease are likely contracted from tick bites that go undetected, and even though one test may be negative, it does not mean that a different bite from an infected tick has not happened as well.

Antibiotic prophylaxis for a tick bite. In certain cases, a single dose of doxycycline can be used as prophylaxis after a tick bite. Small studies have shown effectiveness when the tick was an adult or nymphal ixodes tick, it was attached for at least 36 hours, treatment is initiated within 72 hours of the bite and the patient is able to take doxycycline. Doxycycline is not recommended for children less than 8 years of age due to concerns over tooth enamel hypoplasia and permanent discoloration of the teeth. Again, it is important to remember that many cases of Lyme are caused by undetected tick bites. If the tick is detected and removed within 48 hours, Lyme disease will not have been transmitted.

If you think you or your child has been bitten by a tick, please contact us

If you suspect you or your child may have contracted Lyme disease from a tick bite, please make an appointment with Westchester Health to see one of our physicians for an accurate diagnosis and treatment. The sooner we can begin treatment, the faster we can stop the development of the disease and prevent long-lasting consequences.

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

Categories: Blog

How To Know If You Have A Detached Retina

Westchester Health Blog - Mon, 08/21/2017 - 11:32

A detached retina is a serious condition that could possibly cause vision loss in that eye, and occurs when the retina becomes separated from its underlying supportive tissue. If the retina gets torn, the fluid inside the eye can leak underneath and separate the retina from its underlying tissue. Because the retina cannot function when these layers are detached, it needs to be reattached as soon as possible or permanent vision loss can result. I tell all of my patients that if they experience any of the symptoms of a detached retina, they should not wait but come see me, or another eye doctor, immediately.

Symptoms and signs of a detached retina

William B. Dieck, MD, FAAO

If you suddenly notice spots, floaters (small flecks or threads), flashes of light or a darkening of your peripheral (side) vision, you may be experiencing the warning signs of a detached retina. Your vision might become blurry, or you might have poor vision. Another sign is seeing a shadow or a curtain descending from the top of the eye or across your field of vision from the side.

These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches all at once. Up to 50% of people who experience a retinal tear will have a retinal detachment. No pain is associated with retinal detachment, so sometimes people don’t realize what is happening.

If you experience any of these signs, consult your eye doctor right away. Immediate treatment greatly increases your odds of regaining any lost vision.

What causes retinal detachments?
  1. An injury to the eye or face.
  1. Extreme nearsightedness (myopia) because very nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.
  1. LASIK surgery in very nearsighted people (on rare occasions).
  1. Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease.
  1. New blood vessels growing under the retina (which can happen in diseases such as diabetic retinopathy) may push the retina away from its support network.
  2. Sometimes fluid movement in the eye pulls the retina away.
  3. Family history of retinal detachment.
How to treat a detached retina

If you have a detached retina, you’ll need surgery to repair it. The procedure is usually performed by a retinal specialist—an ophthalmologist who has undergone advanced training in the medical and surgical treatment of retinal disorders.

The sooner the retina is reattached, the better your chances that your vision can be restored. There a few surgical procedures used to treat a retinal detachment, including:

1. Scleral buckling surgery. This is the most common retinal detachment surgery. This procedure consists of attaching a small band of silicone or plastic to the outside of the eye (sclera). This band compresses (buckles) the eye inward, reducing the pulling (traction) of the retina and thereby allowing the retina to reattach to the interior wall of the eye. The scleral buckle is attached to the posterior portion of the eye and is invisible after surgery.

2. Scleral buckling surgery often is combined with one of the following procedures to fuse the retina to its underlying supporting tissue:

a) Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back onto the RPE.

b) Pneumatic retinopexy. In this procedure, the eye surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the RPE. If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to attach the retina firmly onto the RPE and underlying tissues and thereby seal the tear.

Be aware that surgical reattachment of the retina is not always successful, and depends on the location, cause and extent of the retinal detachment, as well as other factors.

Also, successful reattachment of the retina does not guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.

Things you can do to prevent a detached retina
  1. See your eye doctor immediately if you develop new floaters, see flashing lights or notice any other changes in your vision.
  2. Get regular eye exams. A vision specialist can detect problems that you may not have noticed. Treating them early could prevent more serious problems later.
  3. Get your eyes checked more often if you have conditions such as diabetes that make eye disease more likely. Regular eye exams are also important if you’re very nearsighted, which makes detachment more likely.
  4. Keep diabetes or high blood pressure under control. That will help keep the blood vessels in your retina healthy.
  5. Wear eye protection for sports or work if you need it. Try sports goggles with polycarbonate lenses if you play racquetball or other sports that could harm your eyes. You may also need special glasses if you work with certain machines, chemicals or tools.
Concerned that you may have a detached retina? Come see us.

If you’re experiencing any of the symptoms mentioned above, you may indeed have a detached retina and should see an eye specialist right away. Please come see us at Westchester Health to see one of our ophthalmologists as soon as possible. He/she will examine you, make a diagnosis and start treatment right away so that hopefully you can retain your vision. Whenever, wherever you need us, we’re here for you.

By William B. Dieck, MD, FAAO, Vice President, Westchester Health; Director, Ophthalmology Division

Categories: Blog

Are You Color Blind? Here’s How To Tell.

Westchester Health Blog - Tue, 08/15/2017 - 04:11

Do you have trouble distinguishing between red and green? Do you confuse the colors blue and purple? Do many of the crayons in a box look the same? If you answered yes to any (or all) of these, you may be color blind.

William B. Dieck, MD, FAAO

Affecting approximately 1 in 12 men and 1 in 200 women, color blindness is the inability to distinguish the differences between certain colors. This condition results from an absence of color-sensitive pigment in the cone cells of the retina, the nerve layer at the back of the eye.

Most color vision problems are inherited and are present at birth, although some people become color blind as a result of diseases such as diabetes or multiple sclerosis, or they develop the condition over time as they age.

There are different levels of severity of color blindness

Almost half of all color blind people are unaware of their condition, while 60% of sufferers experience many problems in everyday life.

Most color blind people are able to see things as clearly as other people but they are unable to fully distinguish red, green or blue light. In extremely rare cases, some color blind people are unable to see any color at all (achromatopsia).

The most common form: red/green color blindness

Most color blind people suffer from this type of color blindness. The term red/green, however, does not mean people mix up red and green—it means that they see red and green as the same color, and they also mix up colors which have some red or green in them. For example, a red/green color blind person will confuse blue and purple because they can’t “see” the red element of the color purple.

Similar problems can arise across the whole color spectrum, affecting not reds and greens but oranges, browns, purples, pinks and greys as well. Even black can be confused as dark green or dark blue.

What does a color blind person see?

Most people with a moderate form of red/green color blindness will only be able to accurately identify 5 or so colored pencils from a standard box of 24 pencil crayons.

They may have:

  • deuteranopia (green color blindness)
  • protanopia (red color blindness)
  • tritanopia (blue-yellow color blindness).

  4 visual tests for color blindness

Typical color vision tests check for the most common types of color vision deficiencies. Here are 4 that you can try yourself!

1.

If you have normal color vision, you see a 42.
Red color blind people see a 2.
Green color blind people see a 4.

2.

If you have normal color vision, you see a 73.
If you are color blind, you do not see a number.

3.

If you have normal color vision, you see a 74.
If you are red/green color blind, you see a 21.
If you are totally color blind, you do not see a number.

 4.

If you have normal color vision, you see a 26.
If you are red color blind, you see a 6.
I
f you’re only mildly red color blind, you also see a faint 2.
If you are green color blind, you see a 2.
If
you’re mildly green color blind, you also see a faint 6.

Treating color blindness

There is currently no treatment for inherited color blindness. Color filters or contact lenses can be used in some situations to enhance the brightness between some colors, but many color blind people find these actually confuse them further rather than help.

Wondering if you’re color blind? Come see us.

If you’re having trouble distinguishing certain colors and think you might be color blind, please make an appointment to come in and see one of our eye specialists at Westchester Health. We will perform a thorough eye examination, get a detailed family history and determine if indeed you have some form of color blindness. Also, we may suggest some adjustments you could make in your lifestyle to feel more confident about your inability to see certain colors. Whenever, wherever you need us, we’re here for you.

By William B. Dieck, MD, FAAO, Vice President, Westchester Health; Director, Ophthalmology Division

Categories: Blog

10 Ways to Keep Pollen Allergies From Ruining Your Life

Westchester Health Blog - Tue, 08/08/2017 - 11:44

If you have seasonal allergies, you know awful they can make your life, especially in summertime when you really want to be outdoors. They can make you feel tired, keep you from sleeping at night and negatively effect the way you function at work. Here at Westchester Health, a good number of our patients suffer from seasonal allergies, especially pollen. What we’ve found over the years is that if people can make certain adjustments to their lifestyles, they can minimize their exposure to a lot of the things that are making them sneeze, cough and feel miserable. We share those here:

10 ways to prevent, avoid or at least minimize pollen allergies
  1. Don’t exercise outside in the morning

    James Pollowitz, MD, FAAAAI, FACAAI

    The pollen count is highest in the morning, so exercising outdoors at this time can really affect how you feel for the rest of the day. Instead, work out in the evening when the pollen count is lower, or indoors where your pollen exposure is much less.

  2. Track your local pollen count

    The National Allergy Bureau has pollen counters situated across the country which reveal how high the pollen is for different types of plants on any given day in any given location. We advise checking these often. On a low pollen day, you’re probably fine depending on how severe your allergies are, but on a high pollen day, it’s best to stay indoors as much as possible to limit your symptoms.

  3. Get some big sunglasses

    During allergy season, pollen spores float through the air and land all over your body, including in your eyes. We recommend investing in a pair of oversized sunglasses and wearing them as much as possible when you’re outside. It may seem farfetched but the glasses really can act as a physical barrier to prevent pollen from getting in your eyes, where it can cause redness, itching and watering.

  4. Scale back on your hair products

    Hair gels and sprays can actually turn your hair into a pollen magnet. This can cause pollen to end up on your pillow at night where it can stir up your allergies while you sleep.

  5. Shower and change your clothes as soon as you get home

    If you’ve been outside, it’s highly likely that some amount of pollen has ended up on your hair, skin and clothes. That’s why it’s a good idea to change out of your clothes and wash your hair and body when you come inside. If you don’t, you can drop pollen all over your house, making it more likely that it will continue to bother you even indoors.

  6. Don’t line-dry clothes outside

    Since pollen is constantly blowing around during allergy season, drying your sheets, blankets and clothes outside and then bringing them into your house brings the pollen inside, too.

  7. Take off your shoes at the door

    Pollen tends to settle on the ground where it then gets picked up by your shoes. And if you wear your shoes around your house, you’re spreading that tracked-in pollen everywhere, increasing your exposure and making your symptoms worse.

  8. Use your air conditioning

    Many people like to open windows on low pollen count days but be aware that pollen is still floating around, even when counts are low. Opening your windows—especially often—not only brings it into your home but allows it to accumulate.

  9. Try a saline rinse

    A simple OTC nasal saline rinse used daily can help lessen your allergy symptoms significantly. If you don’t want to rinse every day, at least use it on high pollen count days—it can make a big difference in how you feel.

  10. Invest in a HEPA filter

    Common air purifiers don’t do a great job of blocking pollen since it’s too small of a particle to filter out. HEPA filters, on the other hand, use a fine mesh that more effectively traps pollen in your indoor air. We recommend running one in your bedroom to decrease the allergen load while you’re sleeping.

Pollen allergies got you down? Come see us.

If you suffer from pollen or any other type of allergy, please make an appointment with Westchester Health to see one of our Allergy and Immunology specialists. He/she will examine you, make a diagnosis and determine the best course of treatment so you can soon get relief and feel better, now and during future allergy seasons. Whenever, wherever you need us, we’re here for you.

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

Categories: Blog

Prostate Cancer Screening: What All Men Should Know

Westchester Health Blog - Sat, 08/05/2017 - 02:20

Screening—which basically means testing for a disease in people without symptoms—can help find some types of cancer early, such as prostate cancer, when it’s more easily treated. But for some men, the risks of prostate cancer screening may outweigh the benefits. This is something we emphasize to our male patients at Westchester Health, make sure they understand both the risks and benefits before deciding to undergo screening. To clarify the subject, here is some helpful information.

The 2 main screening tests for prostate cancer: 1. PSA test

Jerry Weinberg, MD

Prostate-specific antigen (PSA) is a substance made by cells in the prostate gland (both normal cells and cancerous ones). PSA is mostly found in semen, but a small amount is also found in the blood. The chance of having prostate cancer goes up as the PSA level goes up.

Most men without prostate cancer have PSA levels under 4 nanograms per milliliter (ng/mL) of blood. When prostate cancer develops, the PSA level usually goes above 4. However, a level below 4 does not guarantee that a man doesn’t have cancer. About 15% of men with a PSA below 4 will have prostate cancer on a biopsy.

Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%.

If your PSA level is high, your physician may advise either waiting a certain amount of time and then repeating the test, or getting a prostate biopsy to find out if you have cancer. When considering whether to do a prostate biopsy to look for cancer, not all physicians use the same PSA cutoff point. Some may advise it if the PSA is 4 or higher, while others might recommend it starting at a lower level, such as 2.5 or 3. Other factors, such as your age, race and family history, may affect this decision.

Factors that might affect PSA levels

A number of factors other than prostate cancer can also raise PSA levels:

  • An enlarged prostate: Conditions such as benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that affects many men as they grow older, can raise PSA levels.
  • Older age: PSA levels normally increase slowly as you get older, even if you have no prostate abnormality.
  • Prostatitis: This refers to infection or inflammation of the prostate gland, which can raise PSA levels.
  • Ejaculation: This can make the PSA increase for a short time, and then decrease again. This is why some physicians suggest that men abstain from ejaculation for a day or two before testing.
  • Riding a bicycle: Some studies have suggested that cycling may raise PSA levels (possibly because the seat puts pressure on the prostate), although not all studies have found this.
  • Certain urologic procedures: Some procedures that affect the prostate, such as a prostate biopsy or cystoscopy, can result in higher PSA levels for a short time. Some studies have suggested that a digital rectal exam (DRE) might raise PSA levels slightly, although other studies have not found this. Still, if both a PSA test and a DRE are being done during a screening exam, some physicians advise having the blood drawn for the PSA before having the DRE.
  • Certain medicines: Taking male hormones like testosterone (or other medications that raise testosterone levels) may cause a rise in PSA.

Some factors that might cause PSA levels to go down (even if a man has prostate cancer):

  • 5-alpha reductase inhibitors: Certain drugs used to treat BPH or urinary symptoms may lower PSA levels. These drugs can also affect prostate cancer risk. Tell your physician if you are taking these medicines because they may lower your PSA levels.
  • Herbal mixtures: Some dietary supplements may also mask a high PSA level. This is why it’s important to let your doctor know if you are taking any type of supplement, even ones that are not necessarily meant for prostate health.
  • Obesity: Extremely overweight men tend to have lower PSA levels.
  • Aspirin: Some research has suggested that men taking aspirin regularly may have lower PSA levels. This effect may be greater in non-smokers. If you take aspirin regularly (e.g., to help prevent heart disease), talk to your physician before you stop taking it for any reason.
  • Statins: Some studies have linked the long-term use of cholesterol-lowering drugs known as statins with lower PSA levels.
  • Thiazide diuretics: Thiazide diuretics are a type of water pill often used to treat high blood pressure. Long-term use is linked to lower PSA levels.

For men not known to have prostate cancer, it’s unclear whether lowering the PSA is helpful.

In some cases, what lowers the PSA may also lower a man’s risk of prostate cancer. But in other cases, it might lower the PSA level without affecting the risk. This could actually be harmful, if it were to lower the PSA from an abnormal level to a normal one, as it might result in not detecting a cancer. This is why, again, it’s important to talk to your physician about anything that might affect your PSA level.

2. Digital rectal exam (DRE)

A digital rectal exam (DRE) is less effective than the PSA blood test in finding prostate cancer, but it can sometimes find cancers in men with normal PSA levels. For this reason, it may be included as a part of prostate cancer screening.

For a DRE, a physician inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that might be cancer. Prostate cancers often begin in the back part of the gland, which might be felt during a rectal exam. This exam can be uncomfortable (especially for men who have hemorrhoids), but it usually isn’t painful and only takes a short amount of time.

At what age should you have your first screening test?

The American Cancer Society recommends that men at average risk of prostate cancer should be screened starting at age 50. Men at higher than average risk should be screened at age 40 or 45.

Some men are at higher risk than others

African American men and men who have a father, brother or son who were diagnosed with prostate cancer when they were younger than 65 are at high risk. Men with more than one close relative diagnosed before age 65 are at even higher risk.

Should all men be screened for prostate cancer?

It would seem to make sense to check all men to determine if they have prostate cancer. But screening isn’t perfect. Sometimes screening misses cancer, and sometimes it finds something suspicious that turns out to be harmless. Also, there aren’t reliable tests yet to tell the difference between prostate cancer that’s going to grow so slowly it will never cause problems, and dangerous cancer that will grow quickly. Plus, studies have not been able to show that annual PSA screening helps men live longer.

Additionally, treatments for prostate cancer can sometimes have urinary, bowel and sexual side effects that may seriously affect a man’s quality of life. Therefore, screening really is a decision that each individual man should make after having all the information available.

Resources to learn more Wondering when and if you should get screened for prostate cancer? Come see us.

If you think you should get screened for prostate cancer but want more information, please make an appointment to come in and see us at Westchester Health. We will perform a thorough examination, get a detailed family history, discuss all your options with you and take all the time as is necessary to answer your questions. Then together, we’ll decide the best course of action. Whenever, wherever you need us, we’re here for you.

By Jerry Weinberg, MD, a Urologist with Westchester Health.

Categories: Blog
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