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Staying Safe During Winter Sports

December 4, 2013 by The Inside Press

skiingOutdoor activities can be a great way to get some fresh air and exercise during the long, cold winter months, but freezing temperatures and icy surfaces can also lead to injuries. Winter sports also place many demands on the body.  Recreational sports like skiing and basketball are dynamic in nature and require strength, agility, flexibility, and endurance. To get the most out of sports you enjoy, be prepared for these activities so as to minimize the chance of injury.

Neuromuscular Training Benefits

Physical Therapist Adam Pliskow, owner of New Castle Physical Therapy in Millwood, recommends that people of all ages who wish to participate in sports like skiing, ice skating, snowboarding and basketball initiate some type of exercise program to avoid injury. Evidence shows that neuromuscular training including plyometric, balance, and technique training reduces the risk of serious knee injuries. A proper injury prevention program should be structured to begin with an adequate warm up and active stretch period followed by strength training, agility and plyometric drills and then a static stretch and cool down. Hopping, jumping, sprinting, lunges, heel raises, step-ups, lateral band walking, hamstring curls are just some of the exercises that should be included in such a program.

The Importance of Physical Therapy Consultations

Consulting with an exercise specialist like a physical therapist is essential in developing a well-rounded program tailored to your needs and sport specific requirements, states Pliskow. A good physical therapist will “discuss your goals, perform a detailed and objective physical exam and develop an exercise injury prevention program suited to your individual needs.”

Contrary to common belief, a prescription isn’t required to see a physical therapist in New York. New York State law allows patients direct access to consultation, evaluation and treatment by a physical therapist without a prescription. This is dependent on the therapist having a minimum of three years of experience and that the patient does not have Medicare as a primary insurance.

–Ronni Diamondstein

Filed Under: Health and Wellness with our Sponsors Tagged With: skiing, winter sports

The Power of C – More Than A Vitamin at the Center

December 4, 2013 by The Inside Press

By Vicki de Vries

The Cancer Treatment and Wellness Center at Northern Westchester Hospital
The Cancer Treatment and Wellness Center at Northern Westchester Hospital

This year, an estimated one-and-a-half-million Americans will be diagnosed with some type of cancer, according to the American Cancer Society. That dreaded C word strikes fear in the hearts of the most stalwart among us.

But thanks to the Cancer Treatment and Wellness Center (the Center) at Northern Westchester Hospital, fear has been replaced with relief. And in many cases, healing–as thousands have found what one patient calls “a safe haven.”

What kind of care does every patient in the world want? Most likely, these closely-linked C words: competent, coordinated, customized, convenient, and compassionate, all of which spell e-x-c-e-l-l-e-n-c-e.  In the process of touring the Center, speaking with numerous staff members and therapists, along with a few patients, Inside Chappaqua was pleased to discover this word exists nearby.

Skilled Professionals Provide Competent, Customized, Coordinated Care

When it comes to competent care, the Center excels. The therapists and staff are highly trained professionals. Asked how he would describe the team, head oncologist (cancer physician) Dr. Alfred Tinger, who has worked at the Center since it opened in 2005, put it succinctly: “Knowledgeable, personable, dedicated, experienced, eager to serve,” adding that “we certainly strive to make their lives and the lives of their families easier during this time. This is why we exist.”

Any successful enterprise has to maintain careful protocols. Of supreme importance is the accumulation of data about a patient’s cancer profile obtained through either the linear accelerator, which provides radiation treatment to the exact location of the cancer cells, and the gamma knife, which is not a knife at all, but a highly sophisticated, non-invasive device for treating a broad spectrum of brain lesions. Once data has been sent to resident medical physicist, Steve Iorio, he and the staff analyze it to determine the precise dose of radiation needed to treat the cancer and avoid critical organs. Therapists work closely with the technology team to ensure the highest level of quality diagnosis and treatment.

It should be no surprise that after visiting the Center, oncologists from the “sophisticated” hospitals in Manhattan, impressed with equipment and staff, will refer their Westchester patients to the Center for radiation treatments. That endorsement speaks for itself.

A Major Stress Reducer–

Conveniently Located Care

Before the Center opened, cancer patients in Northern Westchester often had to make a long trek to find quality care. Now, with the Center offering the same professional, state-of-the-art care as renowned but more distant hospitals, travel time for these cancer patients has been drastically reduced–and their stress levels as well.

When diagnosed with Cancer, Beth Besen chose to work with a Manhattan-based oncologist who specialized in her rare form of Non-Hodgkin’s lymphoma. Finding travel to the city twice every three weeks for chemotherapy hard enough, she was adamant about finding an alternative place for daily radiation.

Besen was relieved and grateful the Center was able to meet and administer the same quality protocol she’d receive in the city. Soothing surroundings and caring staff made treatment more tolerable, while staying local meant less stress and more time to recover and go about her daily routine.

Setting a Standard for Compassionate Patient Care

Certainly, many fine hospitals provide competent, coordinated, customized, conveniently located cancer care to their patients, but some would argue that compassion is often lacking in healthcare.

The Center proves otherwise. What sets it apart is not only its “high tech” level of competence, but also its “high touch” level of compassion. The staff and the therapists express a strong sense of empathy with their patients. “We’re all family here” is the oft-repeated mantra, but it sounds and seems genuine.

Start with the Twigs Healing Garden. Unlike typically sterile-looking hospital waiting rooms, Twigs reminds one of a spa. Patients await their radiation treatments dressed in waffle-weave robes while sitting on comfortable furniture, surrounded by plants under an atrium-like ceiling that allows light to enter the spacious room. “The setting was designed to be bright and airy to help patients feel more relaxed and confident,” said Adele Gargano, director of the Center. A nearby table holds the Healing Crane Tree, painted tree branches from which hang colorful origami cranes. Hope Soars Over All cards in a glass bowl offer inspirational words, and patients are encouraged to share theirs on blank cards. Bowls of fresh fruit and cookies add a homey touch. Once a week, a pianist plays soothing sounds to enhance the already relaxing atmosphere.

Integrative medicine “modalities” are also incorporated into the Center’s cancer treatment protocol. Anne E. West, the integrative medicine nurse, offers massage, acupuncture, and reflexology to patients who want them. Coordinating medical and integrative treatments in one place saves patients precious time and energy.

Details count, and the Center has worked hard to consider as many as possible. One patient shared with Besen, “when you’re lying scared on the table, look up; notice they even took the time to put tropical flowers above you so you’d have something beautiful to look at.” Details like this may be why customer satisfaction ranks high on the Center’s surveys. One can read all the brochures that an enterprise can produce, but take a look at their “Customer Satisfaction Surveys” for a glimpse of the real deal. The high marks do not surprise Director Gargano, who said: “The patients become like a family here. Everyone surrounds them with warm attention and highly professional care.”

Dr. Tinger commented that while the team is gratified by the many wonderful letters, cards and gifts received from patients and their families “after, and often during, their journey with us,” he is also appreciative “when someone has the courage to inform us how we can do things better.” That level of willingness to improve is another hallmark of a successful enterprise and further accounts for the exceptional quality care.

The counterpart to the treatment side at the Cancer Treatment and Wellness Center is the Health and Wellness Program, which, Dr. Tinger said, is part of the “continuum that helps a patient from any state of health or disease to a better state of health and wellness” and seeks to maximize the benefits of the cancer treatment.

A patient practicing yoga in a free Health & Wellness Program fitness class.
A patient practicing yoga in a free Health & Wellness Program fitness class.

Extending the Benefits of State-of-the-Art Cancer Care

Started in 2011 by Marilyn Leroy-Sterling, who is a nurse practitioner and serves as the program coordinator, the Health-and-Wellness Program owes its existence to the generous donation of a community member who wanted to ensure that all cancer patients have access to supportive therapies that have been shown to reduce stress and aid in the healing process. As a result of that gift and ongoing financial support from both Northern Westchester Hospital and other donors, patients have free access to the many services the program offers.

Marilyn Leroy-Sterling also serves as an integrative health coach, partnering with patients to help them deal with their health, nutrition, fitness and family concerns. On any given day, she might refer a patient to the medically monitored gym that the Hospital maintains at Chappaqua Crossing or to the nutritionist, who creates customized menus, or to the social worker or to the chaplain in the Mind For Wellness support team. Recognizing that writing can be a form of therapy, the program also offers an online journal-writing course.

Whether it’s setting goals or reaching them, Leroy-Sterling is available to help patients improve all aspects of their day-to-day life. In her words: “We provide a prescription to wellness.” Then, after patients complete the Health and Wellness Program, she gives them a comprehensive end-of-treatment summary that details their cancer history, diagnosis, treatment and an “evidence-based” follow-up plan of care—a roadmap to help the patient navigate successfully as a survivor.

Word has gotten out, and more and more cancer patients are participating in the Health and Wellness Program, which also receives high marks in the customer satisfaction surveys. This year, 100% of the respondents credited the program for reducing their stress levels. One such patient is Joanna Cirasella, who had aggressive breast cancer 18 months ago and expressed her appreciation this way in a video: “The love and nurturing are far beyond anything I could have imagined. Right now, I’m cancer free, and that’s all that matters. I could not have done this without them….”

What additional plans does the Center have?

Gargano said: her dream is to develop a survivorship program that further extends the benefits of the health and wellness program. Meanwhile, in the near future, a Health and Wellness Resource Center will be set up to give patients access to health journals and computers, along with practitioners who will be on hand to talk with them. That is another exciting development that will further the “continuum of care in a patient-centered, state-of-the-art community facility,” added Gargano.

Competent, Customized, Coordinated Care–big “C” meets its match in the many “C”s at the Center.

Vicki de Vries is a freelance writer/editor and educator living in Westchester “country.”

Excerpts from the many thank-you notes pinned to the Center’s bulletin board:
Thank you for giving me the strength, love, compassion to deal…One of your staff brought me to the Health and Wellness Program Coordinator.That was when the healing–beyond physical  recovery–began for me as a whole person. I was gradually guided…to different people and services…. They helped me in ways I could never have imagined and made all the difference in the world….

Filed Under: Cover Stories Tagged With: cancer, compassion, patient care

Why We Should Take Heart … seriously!

December 4, 2013 by The Inside Press

By Rich Monetti

Amanda Gisonni and her grandfather, Charlie Monetti
Amanda Gisonni and her grandfather, Charlie Monetti

When we think of hearts and holidays, our default is undoubtedly February 14–Valentine’s Day. But, with the current holiday season upon us, I find myself thinking about how much health matters and how good health is a gift we give ourselves and families. When we wish friends and neighbors “a happy and healthy holiday,” we’d do well to take those words to heart.

My father is one of those rare people whom everyone loves. He gives definition to the term “good guy.” Why? Simple. He’s got a huge heart. I’m talking end-of-Grinch-story huge; the kind of heart that knows no boundaries. Until it did. Until that day in 1985 when, at the (relatively young) age of 52, he suffered a heart attack. Luckily, a full recovery followed.

Why did it happen? Hard to say. There was no history of heart disease in the family. He didn’t smoke, he didn’t drink. Diet? Well, admittedly, his could have been better. Stress? Certainly could have played a part. The downside to a huge heart is its susceptibility to emotional stress.

To find out more, I spoke with cardiologist Dr. Dina Katz of Phelps Memorial Hospital. Dr. Katz is adamant that smoking is “the most modifiable cardio risk factor” and should be change number one. Explaining that heart attacks usually occur as plaque narrows the arteries and blood clots ultimately close them, Dr. Katz suggests that it doesn’t take her advanced degree to make the connection. “Smoking causes clotting,” she asserts.

Katz usually doesn’t get involved until people are motivated to stop. “Otherwise, she says, “forget it, all bets are off.” Instead, she tells patients to come in when they are ready to set a quit date. Katz then becomes highly pro-active, administering drugs like Chantix and referring patients for hypnosis, acupuncture and other modalities.

Dr. Dina Katz of Phelps Memorial Hospital
Dr. Dina Katz of Phelps Memorial Hospital

Another oft-mentioned risk, alcohol, is less all-or-nothing restrictive. “Everything in moderation,” Katz says, and shares that one or two daily drinks can actually be beneficial.

In terms of diet, Katz recommends less red meat and processed food to cut down trans- and saturated fats; she suggests, instead, fish at least twice a week with lots of fruits and vegetables.

Lastly, and unfortunately near and dear to all Monettis (yeah, we get worked up pretty easily), is stress. Katz suggests meditation, acupuncture and Yoga as great stress-reducers, but firmly believes exercise stands above everything else. And she says that exercise works either in 20-30 minute daily sessions of light-to-moderate activity for a total of 150 minutes a week, or more vigorous activity approximately three times a week for a total of 75 minutes.

Additionally, statins and baby aspirins work wonders. “Their introduction 25 years ago has meant a dramatic decline in heart disease,” she says. When I asked about the side-effects, a question Katz gets asked regularly, she was quick to reassure, “Long term data shows them to be safe and effective.”

While prevention is vastly preferred, it’s not always enough. Everyone should be aware that crushing chest pain, arm pain, tingling in the fingers, nausea, indigestion, sweating and vomiting are all classic heart attack symptoms.

Unfortunately, there can be many more (and diabetics may not experience any as their condition affects the nerves going to the heart). That said, doubt isn’t a dirty word for doctors. “If there’s ever any question, don’t feel silly, go to the E/R. We’d rather know,” Katz concludes.

Rich Monetti lives in Somers. With the help of Zocor and a very active lifestyle, his annual stress and cholesterol tests show excellent results.  

Advice from CVAC (Chappaqua Volunteer Ambulance Corps) Captain Joseph Gentilesco

•Dial 911 first–before anything else–when heart attack symptoms (see above) or stroke symptoms (sagging facial droop, slurred speech) occur.

Photo by Bill Bramswig
Photo by Bill Bramswig

•If the patient is conscious, have him/her sit down and take prescribed medications. But if cardiac arrest renders the patient unconscious, the 911 operator will talk the caller through CPR.

•For a stroke, note time of patient’s last normal appearance and speech. Medication given within a four hour time frame can greatly reduce the adverse effects.

•The police should arrive first to take over. Make sure lights are on, front door open and, if more than one person is home, try to clear a path for eventual evacuation. Meet the police at your home’s entrance.

Filed Under: Cover Stories Tagged With: ambulance corps, emergency, heart attack

Rx Notes Part 1

December 4, 2013 by The Inside Press

Enjoy our series of RX tips for a happier and healthier holiday season.

rx-noteBarrie Wolfe, MS RD:

Snacking is actually GOOD for you! But there’s an art to it. Instead of grazing on high-calorie junk, my clients eat a “calculated snack”–ideally something with protein and fiber to provide fullness and energy. Indulge in holiday goodies occasionally, but eat a “calculated snack” often.
BarrieWolfeNutrition.com

rx-noteEmmary Day Spa:

Like snowflakes, no two bodies are alike. This winter, make sure that you’re taking care of your skin. Dry air, holiday stresses, and too much sun on winter break or the slopes can take their toll. So gift yourself with a facial, massage, or both! And be sure you don’t hit the beach looking like Santa’s beard! Be sure to make that waxing appointment early. Spa gift certificates, scented candles make great last-minute gifts too.
Emmaryspa.com

rx-noteJulie V. Mac AFPA, Certified Group Fitness Instructor, Steffi Nossen School of Dance:

Eat breakfast! A lean protein kick starts your metabolism; drink water before and during a workout, coconut water (or other electrolytes-filled beverage) after a workout; weights before Cardio… you burn fat longer after weight-lifting;and trick your body–avoid the same workout every day/week. Try something new or simply reverse the order of your exercises.
steffinossen.org

rx-noteJodi Levine, Owner, Jodi’s Gym:

Participating in an early childhood gymnastics program is not only tons of fun and excitement but full of healthy benefits for a child’s mind and body. Gymnastics develops strength, balance, flexibility, spatial awareness, power, focus, and coordination to name just a few! An early foundation in gymnastics sets a child up for a lifetime of fitness!
Jodisgym.com

Mike Cola, Personal Trainer:rx-note

Trying to control your weight with a lot of exercise is a losing battle. Eventually you will wind up burned out, unhealthy and have a number of overuse injuries. You have to learn how to control your weight with your diet.
Mikecolafitness.com

Filed Under: Worth a Thousand Words

The Doctor Will See You Now…

December 4, 2013 by The Inside Press

By Beth Besen

Chappaqua Moms Facebook facilitator Georgia Frasch
Chappaqua Moms Facebook facilitator Georgia Frasch

“Thank you for calling. Your call is very important to us. Please listen carefully to the following options. Press 1 if you are…”

Already fuming?! Sadly, most of us are all too familiar with robotic recordings, interminable hold loops and prompts that never quite provide the answer we’re looking for. And when we’re calling a doctor? Well, let’s just say patients and patience don’t always mix; our pressing needs often make it more likely we’ll hang up than hang on.

But hanging up means our smartphones become free to tweet, text and post about the frustrating experience. That’s what happened 
with Chappaqua resident Georgia 
Frasch. Early in October, Georgia called MKMG to book a sick visit for her daughter. She dutifully left a voicemail, but never received a call back and couldn’t find an alternative way in. As she said, the experience left her feeling like she was “losing my mind.”

Georgia–one of two administrators of the very active, nearly 3000-member Chappaqua Moms (CM) Facebook Group–took her “surreal nightmare” to the CM board. Within minutes, the responses were overwhelming.

People “Liked” her post, they offered empathy and related similar stories, they suggested alternative doctors and ways to outsmart or get around the system.  But, most importantly, one of the MKMG doctors was made aware of the CM thread and reached out to Georgia. Dr. Elliot Barsh, a MKMG pediatrician with 25 years of experience, offered to work with Georgia and the community at large. He assured her that he and others were well aware of the operational problems and that constructive criticism would be welcomed and discussed.

Georgia jumped aboard right away, posting a new thread: “We have an opportunity to make a change through Chappaqua Moms.” The responses were immediate, and Georgia began collecting, editing and forwarding to a very receptive Dr. Barsh.

I spoke with Dr. Barsh to follow up for this column, and was touched by his earnest appreciation for the opportunities the CM post brought to light. As he said, “We know we can take good care of you once you are in the room; it’s what happens in between that needs work.” He shared that his wife, too, has had problems getting through so he knows firsthand the frustration patients experience while he simultaneously feels responsible to bring about change. “There’s no reason why people should leave because of service. Let’s be accountable, make this forum meaningful” were his parting words.

MKMG President & CEO Dr. Scott Hayworth
MKMG President & CEO Dr. Scott Hayworth

I next spoke with Dr. Scott Hayworth, MKMG’s CEO for over 15 years. I asked him how he felt about people taking their frustrations to social media and what feedback he could offer the community.  Hayworth replied that he has been concentrating on customer service “long before it even became popular,” that he is “happy to accept constructive criticism” and that “social media, if well controlled, can be a very good thing.”

Hayworth firmly believes that “we have the best medicine in the region,” and pointed out that MKMG serves over 300,000 patients in 25 locations. He acknowledged that the operations area needs updating, and that communication needs to be easier and more user-friendly.

To that end, he specifically mentioned work being done on a couple of different fronts: The first is a Patient Portal which will allow patients to interact directly through internet and email. I asked why the Portal had not been better publicized (seemingly some people know about it while others do not) and was told that contact data is being collected and updated-and has been for years now –but that the Portal is not yet in use; any information suggesting otherwise is premature. Hayworth doesn’t have a hard start-date for the Portal but allows that he expects it to roll out “within the next six months.”

Additionally, the group is working on a one-stop Call Center: Patients will call a central number and will be able to book any/all appointments at one time; so, for example, a Chappaqua Mom like Georgia would be able to call and book not only a child’s sick visit, but also and simultaneously her own and all of her family’s appointments.

Stay tuned, and let’s all hope that “the doctors will see” us, and we them, in a more understanding light.

Beth Besen, another Chappaqua mom, appreciates grassroots groups and the power of positive social media use.

Filed Under: Cover Stories Tagged With: doctors, medical care, mkmg

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