Healthy Neighbors Spring 2013

7/29/2019 Healthy Neighbors Spring 2013

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healthyneighborsHEALTH NEWS YOU CAN USE FROM BETH ISRAEL MEDICAL CENTER

Breast CancerPatient SharesHer Story of Recovery

Also inside:

Inflammatory Bowel DiseaseWomens HypertensionBack Pain

healthyneighborsHEALTH NEWS YOU CAN USE FROM BETH ISRAEL MEDICAL CENTER

Breast Cancer

Patient SharesHer Story of Recovery

Also inside:

Womens HypertensionInflammatory Bowel DiseaseBack Pain

Spring 2013

Breast Cancer

Patient SharesHer Story of Recovery

Also inside:

Womens HypertensionInflammatory Bowel DiseaseBack Pain


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High Blood Pressure Can BeA Womans Problem, TooHigh blood pressure, or hypertension, is a silent killerbecause it often has no symptoms. Hypertension can lead theart disease, kidney damage and stroke.

Many people think that men are more at risk than women, and theres

some truth to that, but premenopausal women with risk factors can and

do develop high blood pressure, and once past menopause, women are as

equally at risk as men, says Deepika Misra, MD, FACC, cardiologist at

Beth Israel Medical Center.

Risk factors include obesity, diabetes, high cholesterol, high salt intake, a

sedentary life style, and an inherited tendency toward hypertension. African

Americans are also at higher risk.

Some women experience high

blood pressure during pregnancy

(called preeclampsia). This can posa danger to both mother and child

so an obstetrician or midwife will

follow such cases carefully during t

pregnancy and after delivery.

Blood pressure measurements

have two components: 1) Systolic

pressure (the higher number) meas

ures the pressure the heart generate

to pump blood to the rest of the

body, and 2) diastolic pressure (the

lower number) measures the pressuin the blood vessels between heart-

beats. You have normal blood

pressure if your systolic pressure is 120 or less and the diastolic pressure is

80 or less. You have high blood pressure if your systolic blood pressure is

above 140 and/or the diastolic blood pressure is above 90. You will be diag-

nosed as pre-hypertensive between those ranges.

Healthy lifestyle choices can make a difference in both preventing and

treating high blood pressure for men and women.

Get regular exercise and maintain

a desirable body weight.

Limit the amount of salt in your food.

Drink in moderation or not at all.

Eat a diet low in unhealthy fats.

Dont smoke.

Take any medications for high bloodpressure that your doctor prescribes.

Have your blood pressure checked

once a year at your annual checkup.If your doctor suspects you havewhite coat effect (some peopletense up when they visit a doctorand this reflects in their reading),you may be advised to test at homewith an ambulatory blood pressuremachine.

To find a primary care physician or a cardiologist, call our physician

referral service at 877.886.9334, or visit chpnyc.org.

Spring is here and you deserve to feel your

best to enjoy the beauty of the season.

Beth Israel Medical Center is working with

you and for you, trying to help you stay

healthy and fit.

In this issue of Healthy Neighbors, we

offer you advice on a number of common

health riskshow to avoid them and how

to treat them. We start with an article

focusing on preventing and treating hyper-

tension, especially for women. We also

focus in on your back and guide you on

how to avoid back pain. We outline ways

that sufferers of inflammatory bowel

disease can find comprehensive care and

relief. And, we present a special profile of

Susan Bernard, one of our patients who

was successfully treated for breast cancer

by our excellent team of breast and plastic

surgeons. Finally, on the back page, we giveyou an overview of the many ways you can

access primary care from Beth Israel practi-

tioners right in your own neighborhood.

We are offering more ways than ever to

deliver care through our hospital services,

practices and ambulatory care network,

as well as sound advice through ourHealthBytesblog. We also reach out to the

community through our participation in

Live Well New York, a multimedia platformto dispense valuable health information,

and through this very newsletter that you

are now reading!

Remember, we are here to help!

Harris M. Nagler, MD, FACS

President, Beth Israel Medical Center

Messagefrom the

President


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Poor posture, excess weight, improper lifting or exercise

techniques, age, and genetics are all common culprits of back

pain. Unmanaged stress can also trigger back pain because

of the tension you may hold in your shoulders and back.

Whatever the cause, back pain can be so intense that people

miss out on work and play.According to Dr. Gotlin, a few simple steps can prevent

most people from developing back pain.

Get moving. Regular exercise improves the strength and

flexibility of your muscles. Start with some simple back muscle

exercises to increase your flexibility and strength, and to ease

any existing back pain. Try these two moves:

Maintain a healthy weight. Body weight

plays a big role in the stress placed on the

spine, says Dr. Gotlin. Keep within 10 pounds of your ideal

weight to keep your back healthy.

Straighten up. Poor posture, such as slouching or standinghunched over, can lead to muscle fatigue and injury. Even if

you dont feel pain from poor posture now, it may catch up t

you in the future, Dr. Gotlin says. Make adjustments to you

workstation or your desk at home to fit your comfort level. F

example, when sitting, keep your knees slightly higher than y

hips to provide lower back support.

Lift smartly.When lifting heavy loads, make sure to lift with

your legs and thighs to avoid back strains.

Chill out. Stress causes muscle tension, which leads to achesand pains. If youre experiencing stress-related pain, develop

coping strategies like deep breathing, meditation or yoga to

help relax your body and mind.

Find a physician who can help you cope with and treat

back pain by calling our physician referral service at

877.886.9334, or visit chpnyc.org.

Be Kind to Your BackIts the nagging twinge above your tailbone after sitting toolong on the subway. Its the strain between your shoulders

when carrying groceries to your third-story apartment.Its the dull backache following a long run or walk. If these

aches and pains sound familiar, youre not alone.Eighty-five percent of Americans will have back pain atsome point in their lives,says Robert Gotlin, DO, Director ofOrthopedic and Sports Rehabilitation at Beth Israel Medical Center.

Beth Israel Medical Center, along with other members of Continuum

Hospitals of New York, has teamed up with The New York Daily News

and NBC-New Yorkto provide valuable health information to the

New York metropolitan community via a multimedia platform.

Visit www.LiveWellNewYork.com for health tips and advice from

our experts, as well as more information on the program.

Partial crunches

Lie flat on your back with

knees bent and feet flat onthe floor, crossed arms overyour chest or hands behindyour neck.

Tighten stomach musclesand raise your shoulders offthe floor, then slowly lowerback down.

Bridges

While on your back, with

your knees bent, lift your hipsoff the floor until shoulders,hips and knees are in astraight line.

Hold for 6 seconds and thenlower hips to the floor and rest.

Repeat up to 10 times.


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Ulcerative colitis, the inflammatory bowel disease that affects

the lining of the colon and rectum, can lead to severe inflam-

mation and ulceration. Patients first realize they have ulcerative

colitis with the onset of bloody diarrhea, abdominal cramping

and pain.

Unlike ulcerative colitis, Crohns affects the targeted

digestive tissue (anywhere from mouth to anus) more deeply.

People with Crohns disease are

susceptible to many complications,including bowel obstruction, ulcers

and fistulas, which are abnormal

connections between organs. Symp-

toms range from diarrhea and

abdominal cramping and pain to

weight loss and ulcers.

General symptoms that can

occur in both ulcerative colitis and

Crohns disease include fevers,

sweats, loss of appetite, weight loss

and fatigue. Some patients mayhave IBD symptoms beyond

the digestive system, including

joint pains, arthritis, mouth sores,

severe eye pain, blurry vision and skin rash, among others.

Inflammatory bowel disease occurs in genetically

predisposed individuals who are exposed to an environmental

trigger, such as an infection or an antibiotic, leading to an

abnormal immune response, says David Hudesman, MD,

Director of the Inflammatory Bowel Disease Center at

Beth Israel Medical Center. The Center provides a multi-

disciplinary approach to IBD with specialized surgeons,

gastroenterologists, radiologists and pathologists, all highly

expert at diagnosing and treating inflammatory bowel

disease. Patients have access to the newest and most innovativ

medications, surgeries and therapies, as well as various forms

of patient support.

The goals of treating IBD includerelieving symptoms and healing the

bowel damage. The medications used

range from anti-inflammatory pills and

suppositories to immunosuppressants

and biologics. In severe cases, when

symptoms are not easing through

medication, or there is narrowing and

scar tissue in the digestive tract, variou

surgical approaches may be considered

While there's no known cure

for IBD, comprehensive care cangreatly reduce the symptoms and facili

tate long-term remission. With good

medical treatment and guidance,

the majority of people with IBD are able to live a normal,

well-functioning life.

For more information about The Inflammatory BowelDisease Center at Beth Israel, call 212.420.4521.

Lifestyle modifications may also help ease

symptoms. Dr. Hudesman advises patients

with either form of inflammatory bowel

disease to:

Limit dairy products, which can aggravatediarrhea and cramping.

Opt for low-fat foods.

Keep track of foods that provoke symptomsand avoid them.

Drink plenty of liquids to help digestion.

Quit smoking, which can worsen symptoms,

especially in Crohns disease. Ease up on stress, which can triggersymptoms.

Relief for InflammatoryBowel DiseaseInflammatory bowel disease (IBD) encompasses twodiseasesulcerative colitis and Crohns disease. Whileboth are chronic conditions with no known cure, the

good news is that patients with either form of IBD havemore treatment and coping options than ever before.

Visit Beth Israels brand-new blog for health and wellness

information, featuring our doctors, nurses and other

health care professionals. Topics range from surgery, yoga and high blood pressure to dietary

supplements, heart health and how to get your kids to take their medication. Check out

Health Bytes at www.HealthBytesNYC.com and follow @HealthBytesNYC on Twitter.


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Ms. Bernard chose to undergo a bilat-

eral mastectomy (known as a double

mastectomy), says Alyssa Gillego, MD,

a breast surgeon at Beth Israel and

Continuum Cancer Centers of

New York. She also had immediate

breast reconstruction, in which shehad the mastectomy and reconstruction

during the same surgery. Prior to

surgery and while she was in the

hospital recovering from her operation,

Ms. Bernard always had a positive

outlook, a great attitude, and the

determination to beat her cancer.

Joseph H. Dayan, MD, a plastic

and reconstructive surgeon at

Beth Israel, who performed the

reconstruction immediately followingDr. Gillegos surgery, concurred. We

were able to take tissue and the corre-

sponding blood vessels supplying the

tissue from Ms. Bernards abdomen and

create new breasts for her. No muscle

was damaged and she got a tummy

tuck, as well. The advantages of this

technique, called a DIEP (deep inferior

epigastric perforator) flap, are enormous. A patients own tissue

settles in well and looks natural even as the breasts age. In some

cases the surgery addresses any cosmetic issues (making too-large breasts smaller, for instance), and the postsurgical results

boost a patients self esteem. The patient goes into surgery

with two breasts and wakes up with two breasts, says Dr. Dayan.

DIEP flaps and other microsurgical techniques are not performed

by all cancer centers, since the techniques require specific training

that not all plastic surgeons have acquired.

I was shocked by my diagnosis, but right away Dr. Gillego

and her physician assistant, Annette Valdez, PA, put me at

ease, says Ms. Bernard. I also am grateful to Dr. Dayan and

his physician assistant, Alicia Jones, PA.All these professionals

were passionate about the care they

gave me and really made my situation

as pleasant as possible.

Ms. Bernard was back to work at

Jackie Robinson Park three weeks afte

her surgery. She is a case manager

for the Parks Opportunity Programsponsored by the Parks Department.

She is thankful to her colleagues and

supervisors for their support, which

she continues to rely on as she is und

going follow-up chemotherapy and

radiation. The prognosis is good for

Ms. Bernard, says Dr. Gillego.

Beth Israel offers a full range of

screening and preventive strategies

for breast cancer, as well as genetic

counseling and ongoing managementof women who are at high risk.

The latest diagnostic tests

include digital mammography, breast

ultrasound, breast MRI, image-guided

breast biopsies and fine-needle

aspiration biopsies.

Treatments range from chemo-

therapy, radiation and biologic targete

therapies to advanced surgical techniques combined with

reconstruction using deep inferior epigastric perforator (DIEP

gluteal artery perforator (GAP) and superficial inferior epigastrartery (SIEA) flaps. Innovative offerings include oncoplastic

procedures for lumpectomies and partial breast radiation.

Support groups, acupuncture, massage and nutritional coun-

seling help support wellness.

The breast cancer services also support a broad clinical

research trial program testing medications and approaches in

all stages of the disease.

For more information about Beth Israels breast cancerprogram, call 877.226.2376, or visit www.CancerTeam.or

Breast Cancer SuccessSusan Bernard, 53, thought she might be vulnerable to breast cancer. In 2009 and 2011, she hadsuspicious findings on her mammograms that proved benign. In the fall of 2012, when she looked inthe mirror while working out, something didnt look right about the silhouette of her breasts. Again,a biopsy was scheduled. This time, the result was cancer.

Above: Ms. Bernard and her coworkers, MelvinCarey and Ellen King. Below: Ms. Bernard withAnnette Valdez, PA, and Alyssa Gillego, MD.

A Patients Story


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Nonprofit Or

U.S. Postage

PAID

Permit #310

New York, N

Beth Israel Medical Center

First Avenue at 16th StreetNew York, NY 10003

www.BethIsraelNY.org

Options for Primary and Urgent CareBeth Israel Medical Center brings the family doctor (and sometimes the specialist) to you in your neighborhood!

Beth Israel Medical GroupIf you need a primary care doctor or a specialist physician, or are feeling ill and need

urgent, but not emergency care, Beth Israel Medical Group offers same-day, evening,

weekend and walk-in medical services, with conveniently located sites listed below.

For more information, call 877.886.9334, or visit www.BIMedicalGroup.org.

Phillips Ambulatory Care Center

If youre interested in developing a long-term doctor-

patient relationship with a practice in the Union Square

area, keep in mind that all the pediatric and general

internal medicine practices at Phillips Ambulatory Care

Center (10 Union Square East) offer extended hours, a

do most of the sites specialty practices. Most also offer

the ability to make and cancel appointments 24/7. Call

our physician referral service at 1.877.886.9334, Monda

through Friday, from 9 am to 5 pm, and specify that

youre looking for a PACC practice.

Information on hypertension, back pain,

inflammatory bowel disease and breast cancer.Inside:

Primary, Urgent and Specialty Care

222 West 14th Street

212.604.1800 (adult and specialty services)212.604.1870 (pediatrics)

309 West 23rd Street

New and expanded location.212.352.2600

55 East 34th Street

212.252.6000

Primary and Urgent Care

94 East 1st Street

212.677.6000

135 North 7th Street, Brooklyn

This is a new practice in theheart of Williamsburg, Brooklyn,right off of Bedford Avenue.718.218.0450

Coming Soon!

52 West 8th Street

Keep your eye out for the grandopening in spring/summer 2013.

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Healthy Neighbors Spring 2013