Saturday, Sep 28th

menshealthThis article was written by Dr. Matthew Zeppieri, Family Medicine

Remembering to prioritize your physical and mental health can be challenging, especially while balancing work, social life, and family. Despite this, it is important for men to follow some basics in order to remain healthy and prevent future illness.

1. Attend Annual Physicals
Given the high likelihood of prostate and colon cancer in men, it is important to schedule annual physicals. In addition to prostate cancer, colorectal cancer is more common in men. While men and women are essentially equally at risk for colon cancer, men are more likely to get rectal cancer, according to the Centers for Disease Control and Prevention (CDC). Both prostate and colorectal cancer screenings can be critically important, as the earlier those diseases are detected, the better the chances of successfully treating them.WPHospitalBest

With patients under 40, I inquire if they are experiencing any typical prostate cancer symptoms, including multiple trips to the bathroom at night to urinate; general frequency and urgency associated with urinating; and hesitancy or weakening of the urine stream. Other concerning indications include unexplained fevers and/or unintentional weight loss.

With patients over 40, I recommend conducting a Prostate Specific Antigen (PSA) screening and a digital rectal exam. Although some patients are more resistant to these procedures that others, there is value in conducting these screenings and catching these illnesses early on.
With colon cancer, since we are finding an increase in cases of younger men, the recommended age for a colonoscopy has been lowered from 50 to 45. In addition, if an individual has a family history of colon cancer, it is recommended that a screening be done 10 years prior to when that family member’s diagnosis took place.

2. Active Lifestyle
The American Heart Association recommends 150 minutes of moderate exercise weekly. This type of exercise includes any activity other than sitting at a desk – including, but not limited to, household chores or going for short walks.
Another option to maintain an active lifestyle is 75 minutes of vigorous exercise weekly. This type of exercise includes a more intense regimen like jogging, swimming, playing racquetball, etc. With both of these options, the overarching goal is to remain active regardless of the ways in which that activity is accomplished.

3. Balanced Diet
Maintaining a balanced diet and consuming the appropriate amount of calories can be difficult, given the multitude of different diet options and discussions around calorie intake. Daily calorie intake recommendations are 2,400 for those aged 21 to 40; 2,200 for those aged 41 to 60; and 2,000 for men aged 61 and older. To lose one pound a week, those numbers can be decreased by 500 calories.

I recommend accurately counting your calorie intake. It is important to be honest with your physician and yourself when calorie counting, as inaccurate reporting does not help your physician – or, more importantly, yourself.

A diet that I and many other physicians recommend is the Mediterranean diet, which emphasizes plant-based foods and healthy fats. Additional details can be found here.

Zeppieri Matthew FINAL scaled e16648162696924. Monitor Mental Health
Checking up on the mental health of my patients is a priority. Every time I see a patient, I always inquire about feelings of depression, anxiety and stressors in their lives. Given the still-present stigma around their emotional needs, it can be hard for some men to openly discuss their mental health with their physician. Despite this, it is imperative to have these discussions with your physician, instead of allowing an illness to remain untreated.

Again, it is vital to prioritize receiving your annual physical and age-appropriate screenings as a preventative measure to remain safe and healthy. If you have not already done so, I urge you to schedule any visits that you may have let slip by; your doctor, and your body and mind, will thank you.

Dr. Matthew Zeppieri is a family medicine physician at White Plains Hospital Physician Associates of New Rochelle. For an appointment, call 914-235-8224.

LupusSystemic Lupus Erythematosus (SLE), a.k.a “lupus,” has been back in the news lately, with actress/singer Selena Gomez and vocalist Toni Braxton making headlines for their experiences with the autoimmune disease. Earlier this year, Gomez began openly discussing the effects of lupus, which she was diagnosed with in 2015; more recently, Braxton, who was diagnosed in 2008, has publicly shared her experience with lupus and one of its major complications, lupus nephritis, where the disease affects the kidney.

The Mayo Clinic defines lupus as Lupus can be defined as Lupus is “a disease that occurs when your body’s immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems – including your joints, skin, kidneys, blood cells, brain, heart and lungs.”

With May being Lupus Awareness Month in the U.S., it is worth discussing the potential symptoms of, as well as treatments for, this disease whose name might be familiar but whose details may be murky for many readers. WPHospitalBest

The Lupus Foundation of America (LFA) reports that about 1.5 million Americans have the disease, with an estimated 16,000 new cases diagnosed each year. Worldwide, over five million people have some form of lupus. While it is most common in women between the ages of 18 and 45, it can also affect men; in addition, the disease currently affects an estimated 5,000 to 10,000 children.

Lupus can affect almost any organ in the human body; not just the kidney, but also the skin, blood, joints, heart, lungs, and brain. Fatalities directly attributable to the disease are few; with close follow-up and treatment, 80-90% of people with lupus can expect to live a normal life span, according to the LFA.

There is no cure for lupus, and the exact cause(s) of contracting it are yet to be conclusively identified. However, there appears to be a genetic factor at play; while no single gene or gene group has been proven to cause the disease, it can appear in some families. People of African, Asian, Pacific Island, Hispanic/Latino, Native American or Native Hawaiian descent are more susceptible to lupus, again indicating a possible genetic factor.

Common triggers of the disease include infection or injury; overwork/lack of sleep; and prolonged exposure to the sun or fluorescent/halogen light. Symptoms may include:

• Muscle and joint pain
• Prolonged fever
• Rashes
• Chest pain
• Hair loss
• Sun or light sensitivity
• Kidney issues
• Mouth sores

With all of this uncertainty, how can one tell if they do have lupus? The prolonged presence of these symptoms – especially if one more than one is present at a time – should be taken seriously. A visit to your physician should quickly be arranged; blood and urine tests can screen for the disease, and you may ultimately need to be referred to a rheumatologist, who can confirm the diagnosis and prescribe a treatment, tailored to your clinical presentation.

If you are found to have lupus, there are many treatments available. Depending on the person and the severity of the case, these range from antimalarials, such as hydroxychloroquine, to the corticosteroid prednisone, all of which can help reduce swelling, tenderness and pain. Immunomodulators such as azathioprine and mycophenolate can also prove effective, and for severe cases, targeted biologic immunotherapy may be recommended.

Petros Efthimiou Dr. Petros Efthimiou In any event, close supervision by a rheumatologist is highly advised. They can help find the right approach to the disease for you and guide you on what may be a difficult – but not necessarily life-threatening – journey.

Dr. Petros Efthimiou is a board-certified rheumatologist and a published lupus expert at WPHPA of Larchmont. For an appointment, call 914-849-7400.

SVAC17According to the National Heart, Lung, and Blood Institute, cardiac arrest results in about 300,000 to 450,000 deaths in the United States each year. Cardiac arrest is a medical emergency that requires immediate medical attention—90% of people who have a cardiac arrest outside of a hospital die within minutes due to insufficient blood flow to vital organs. However, the American Heart Association states that the immediate administration of cardiopulmonary resuscitation (CPR) to a patient can double or even triple that person’s chance of survival.

Recognizing that bystander intervention is a critical aspect of pre-hospital care, Scarsdale Volunteer Ambulance Corps (SVAC) organized a Friends & Family CPR Class at the Scarsdale Public Highschool. Morning and afternoon training sessions were hosted on May 7th, 2023, where a total of 150 residents learned how to perform hands-only CPR. The program was truly a community effort, with instructors from SVAC, Larchmont Volunteer Ambulance Corps, and Irvington Volunteer Ambulance Crops attending to teach. The combined effort of the participating organizations was essential to the success of the program.CPR guide

According to Angela Manson, a dedicated member of SVAC, the organization is always looking for new volunteers. Manson stated that SVAC runs year-round EMT classes and that no experience is needed to participate in their programs. Above all, she emphasized that the programs would equip participants with the knowledge and skills needed to manage medical emergencies. More information on available courses can be found here

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Allergy pills Shutterstock 1702567021

Seasonal allergies can be irritating not just for the upper airways, but also for the eyes. Seasonal allergic rhinitis (hay fever) is an allergic response to airborne pollens such as trees, grasses, and weeds, which can be particularly bothersome as it spans from early March to the first frost, here in the tri-state area.

According to the Asthma and Allergy Foundation of America, in 2021 some 81 million people in the U.S. were diagnosed with seasonal allergic rhinitis – equal to about 26% (67 million) of adults and 19% (14 million) of children.

The “seasonal” part of the equation can be defined by these simple facts: Tree pollen is common in spring; grass pollen in late spring into summer; and ragweed pollen in late summer into fall. And as unpleasant as dust mites and cockroaches sound, these allergens, along with animal dander, are present year-round, and are considered triggers for perennial symptoms.

Once diagnosed, allergic rhinitis treatment options include avoidance (if possible) and eliminating or decreasing your exposure to the triggers. This can of course be difficult to achieve in the case of pollen unless one lives roughly three quarters of the year indoors. Alternatively, with regards to dust mites, no matter how clean your home is, it is probably still a little dusty.WPHospitalBest

Treatments that patients initially rely on for their allergies include antihistamines (oral, intranasal, ocular), and intranasal corticosteroids, which provide temporary symptomatic relief. Allergen immunotherapy (also known as allergy shots) has been shown to be effective in treating patients with allergic rhinitis. Unlike allergy medications, allergy shots modify the underlying cause of the disease and can provide long-term benefits. However, patients can find it challenging to commit to the recommended allergy regimen: weekly injections for about six months to build their tolerance to the allergen(s), followed by a maintenance schedule of once monthly injections for the next three to five years.

Fortunately, there is another type of treatment available: sublingual immunotherapy (SLIT). This involves allergy tablets and has emerged as an effective, safe, and possibly more feasible alternative to allergy shots for some individuals. Currently in the U.S., the FDA has approved four allergy tablets: two are directed at grass pollen (Oralair and Grastek); one is for short ragweed (Ragwitek); and one is for dust mites (Odactra). Oralair, Grastek, and Ragwitek are approved for children 5 years old and above. Odactra is approved for children 12 years old and above.

The tablets are placed under the tongue for at least one minute, then swallowed as they dissolve. They are generally taken once a day during therapy. The dosing regimen varies depending on the targeted allergen, where one could benefit from starting SLIT several months before the season (as with pollens), while others may benefit from year-long SLIT (as with dust mites). Treatment typically is continued for around three years for continued effectiveness. 

Side effects of allergy tablets are usually mild for all ages: itchy mouth (if present, would occur early in treatment and usually is transient) and, less commonly, an upset stomach. Severe allergic reactions are rare; however, as there is the possibility of severe allergic reactions in patients receiving immunotherapy (whether allergy tablets or allergy shots), for safety purposes, an epinephrine autoinjector is always prescribed.

SLIT is only appropriate to consider for certain patients who have allergic rhinitis to the allergen contained in the allergy tablet of choice. As such, patients with multiple allergies would likely benefit from allergy shots instead.

Knowing that they may be able to “breathe easier” without injections is an attractive option for many patients; however, whether these tablets are adequate or recommended for you is a matter for discussion with an allergist.

chan angela

Dr. Angela Chan is a board-certified pediatrician and allergist-immunologist at the Scarsdale Medical Group in Harrison. For an appointment, please call 914-723-8100.

Mussels3As part of the “What the Doctor Ordered” series from White Plains Hospital, they asked some local restaurants to create heart-healthy meals with five cardiologist-approved ingredients. White Plains Hospital Director of Cardiogenetics Dr. Marc Waase challenged Andy Bennett, Executive Chef at Half Moon Restaurant, to create a dish using mussels, almonds, chickpeas, oranges, and low-fat Greek yogurt.

Chef Andy created a Steamed Mussels dish with Spinach and Almond Pesto, paired with Chickpeas and Oranges.

Heart-Healthy Benefits Include:
• Oranges are a great source of fiber and potassium.
• Mussels are high in omega-3 fatty acids.
• Almonds help keep blood vessels healthy, reducing heart disease risk.
• Greek yogurt offers twice the protein of traditional yogurt.
• Chickpeas are high in magnesium and potassium.

Try this delicious meal at Half Moon or using the recipe below.

Steamed Mussels with Spinach & Almond Pesto, Chickpeas and Oranges
Makes 2 entrees or 4 appetizers

Sauce
4 oz. Spinach – washed
2 Tbsp. Chopped parsley
2 Cloves garlic – chopped
0.75 oz. Toasted Almonds – chopped
3.5 oz. Olive oil
1 Orange – zested, (segments and juice reserved)
1/8 tsp. Chili Flakes
1/8 tsp. Za’atar spice blend
1.75 oz. Plain Greek yogurt
Salt to taste

Dish
2 lbs. Mussels – cleanedWPHospitalBest
4 oz. Canned Chickpeas
4 Tbsp. Water
1 Orange – segments and juice from above

Instructions
1. Place all the sauce ingredients except the yogurt into a food processor.
2. Blend until everything is combined.
3. Add the yogurt and mix enough to combine. Check seasoning.
4. Preheat a large pot or sauté pan.
5. Add mussels, chickpeas and 4 Tbsp. of water.
6. Cover with a lid until the all mussels have opened.
7. Remove the lid and add in the sauce so it combines with all the cooking liquid.
8. Pour everything into a large serving bowl and sprinkle the orange segments on top.

Notes:
• It’s great to serve alongside some thick-sliced crusty bread for mopping up the broth.
• Be careful when seasoning — there is a natural amount of brininess from the mussels already. Season lightly and you can add more at the end if needed.

Half Moon is located at 1 High Street in Dobbs Ferry, NY. For reservations, visit halfmoonhudson.com or call (914) 693-4130.