The Inside Press

Magazines serving the communities of Northern Westchester

heart disease

Weight Watch

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Ultra-processed foods & increasing screen time have fueled rise in the obesity epidemic, putting more people at increased risk of heart disease.

When the World Health Organization recognized obesity as a global epidemic in 1997, less than 20% of Americans were considered obese, with a body mass index (BMI) greater than or equal to 30. Less than three decades later, the numbers are staggering. Obesity rates in the United States have doubled to 40% according to a 2021-2023 report by the Centers for Disease Control. As rates continue to rise, it’s predicted more than 250 million Americans will be obese or overweight by 2050.

“Obesity is one of the most common conditions I see in patients,” says Dr. Angel Rodriguez, Medical Director of Primary Care at White Plains Hospital Physician Associates. “Over the past several decades, we’ve seen a shift toward high-calorie diets comprised of processed foods that are full of salt, sugar, fats, and artificial colorings. They are designed to entice people to eat more, but they’re not very healthy and lack nutrients.” Though Westchester’s obesity rate sits well below the national average at 24% of the population, residents still report overindulging in ultra-processed foods. In the most recent Westchester County Community Health Assessment, 20% of adults self-reported consuming one or more sugary drink daily and 23% said they ate less than one fruit or vegetable daily.

Increasingly sedentary lifestyles also contribute to weight gain–a trend that’s been exacerbated in
recent years by increased screen time and work-from-home culture. “COVID brought that out more than anything. Now we sit in front of the computer eating and talking,” Dr. Rodriguez says. “I can relate. As with everyone else, I gained weight during the pandemic and am working hard to get back to a healthy weight.”

Shedding excess pounds has a positive impact on heart health. “Carrying extra weight is like carrying a backpack full of rocks,” Dr. Rodriguez says. “Your heart has to work harder, and the extra weight causes added stress in the whole body, including on the joints and liver as well.” Obesity is also tied to increased incidence of other chronic conditions, including hypertension, high cholesterol, insulin resistance, and diabetes–all risk factors for heart disease–as well as inflammation and joint pain.

Dr. Rodriguez recommends this commonly prescribed regimen for reaching a healthy BMI:

  • Follow a healthy diet and swap those processed foods for fruits, vegetables, whole grains, lean proteins, and healthy fats.
  • Aim for at least 150 minutes of exercise per week.
  • Eat slower to help with portion control.
  • And drink lots of water – it’s good for you and filling.

Before starting an exercise regimen, patients should visit their primary care physician for a physical–a step Dr. Rodriguez notes is often overlooked. A comprehensive exam confirms the heart is healthy enough for cardio and can identify other factors linked to weight gain, like genetics, hypothyroidism, and in young women, polycystic ovary syndrome. “Most patients who are obese are relatively sedentary,” he notes. “You want to have a sense of what their heart can handle before they go run on a treadmill.”

Physicians can also advise on injectable weight-loss (GLP-1 and GIP receptor agonists) medications for appropriate patients to help with weight loss and lower the risk of heart attack. “You still need to eat right and exercise, but the good thing is that these meds are working for the right patients,” says Dr. Rodriguez.

To combat this growing epidemic, small, sustainable changes to diet and lifestyle can make a significant impact over time. With the right support and resources, maintaining a healthy weight and reducing heart-disease risk is within reach, Dr. Rodriguez notes.

The Surprising Facts about Heart Attacks in Women

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Heart disease is the number one killer of women in the United States. But the good news is that it’s 80 percent preventable.

The statistics are staggering: According to the American Heart Association, heart disease is the number one killer of women in the United States. And heart disease and stroke cause one in three deaths among women each year–more than all cancers combined.

Yet heart disease continues to be considered a “mostly male health issue.” Because of this misconception, women who are experiencing signs of a heart attack often don’t seek the immediate, life-saving care they need. In fact, it is common for women to wait more than six hours after first feeling the symptoms of a heart attack before going to the ER. Often, they believe they are experiencing nonlife-threatening conditions like acid reflux, the flu or normal aging. As a cardiologist, I encourage women to think about their heart health, and the heart health of the women they love, as the actions you take now could save your life.

Know The Symptoms

We’ve all seen the crushing left-sided chest pain of a heart attack that’s dramatized on TV. It’s important to know, though, that women don’t experience heart attack symptoms the same way men do. Women can feel chest pain, but more often will feel a little chest tightness or some weakness, shortness of breath or pain anywhere in the upper body, like the back of the neck or jaw. Indeed, chest pain is absent in 43% of women having a heart attack.

Women, particularly older diabetic women, tend to have more vague symptoms that make it difficult to tell what exactly is going on. These symptoms could be as common as weakness or fatigue. This is a primary reason why women delay seeking treatment or calling 911 and why there is sometimes a delay in doing an EKG or cardiology consultation for women. It is important for women to know the signs and to seek help immediately for any troubling symptoms.

Get Screened

As women, we know to schedule regular mammograms, but we continue to lag behind men in getting screened for heart disease. According to the AHA, almost two-thirds (64%) of women who die suddenly from coronary heart disease exhibit no previous symptoms. This is why physicians and cardiologists stress the importance of regular cardiac screening for women.

Lower Your Risk

Lifestyle changes can profoundly affect heart health in women. According to the AHA, nearly 80% of cardiac events can be prevented, yet cardiovascular diseases continue to be a woman’s greatest health threat. To help combat this threat, consider the following recommendations:

• Get moving: We recommend 150 minutes of aerobic exercise a week–that’s 30 minutes, five days a week. Anything that gets you moving counts, so walk, take the stairs or park far away and walk to the store. Then, as your body is able to accept a higher level of activity, move more. Exercise also helps with stress.

• Avoid sitting for long periods: A sedentary lifestyle is dangerous for overall health. If you’re sitting at your desk all day, set a timer every hour as a reminder to get up and get moving.

• Adjust your diet: When you start exercising, the endorphin release will make you motivated to make better food choices. Avoid processed foods and stick to natural, whole foods. We recommend a Mediterranean diet for optimal heart health.

• Get annual checkups: Regular checkups should start at age 40 or sooner if you have a family history of diseases. Once you know your numbers, your doctor can better guide you on how to reduce your chances of having a heart attack.

• Stop smoking: According to the AHA, smoking increases the risk of heart disease and stroke by two to four times. Also, women who smoke have a 25% higher risk of developing heart disease as compared to men who smoke. Discuss a smoking cessation plan with your doctor and kick the smoking habit.

While it’s frightening to know that someone dies of a heart attack every 42 seconds, this statistic is something our team of highly skilled cardiologists and heart health specialists are working hard to reverse. Relying on evidence-based research, and using the most advanced equipment and techniques, we can provide world-class cardiovascular care to women and men here in Westchester County, close to home. Know the symptoms of heart disease, get screened and practice prevention.

Northern Westchester Hospital’s Emergency Chair: 50 Percent Decline in ER Visits Impacting Patients with Life-Threatening Conditions

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Dr. James Dwyer, Chair of Emergency Medicine at Northern Westchester Hospital (NWH), discussed the alarming decline in visits to the ER among patients with serious, life-threatening medical conditions, including heart attacks, strokes, and appendicitis.

“We are seeing similar scenarios over and over again,” said Dr. Dwyer in an interview this week. “A patient, for example, who has abdominal pain is afraid to come into the Emergency Department, so they tough it out and think: ‘it will go away, it will go away..,’ and then by the time they realize it won’t, they come in with a ruptured appendix as opposed to catching the appendicitis before it’s ruptured and getting to the operating room earlier.”

Dr. James Dwyer, Chair of emergency Medicine (standing) with Michael Pancoast (seated) at the triage station just inside the emergency room at Northern Westchester Hospital.
Photo courtesy of NWH

According to Dr. Dwyer, ERs around the country are seeing a drop in overall patient volume due to patient fears about COVID-19. As a result, untold numbers of people may be dying at home or risking long-term health consequences by ignoring serious symptoms.

Meanwhile, “when appendicitis (removal of the appendix) is performed as a routine procedure, the outcomes are outstanding; most of the people are out the same day,” said Dwyer. In contrast, a life-threatening rupture can spread infection in the abdomen requiring more involved surgery and longer recovery times.

Since the pandemic started March 11, about 50% of the appendicitis cases have presented as ruptured–a normal scenario is 5-10 percent,” he elaborated. “1 in 2 ruptured versus 1 in 10… people are definitely waiting to get this taken care of.”

NWH is seeing about a 50 percent drop to their usual ER volume, Dr. Dwyer said. At NWH, the ER typically sees more than 80 patients per day and is now seeing as few as 30. “The decline in ER visits among people with serious, life-threatening conditions, including heart attacks, strokes, infections and trauma, is taking a toll on the health and wellbeing of people in the United States and around the world.

Dr. Dwyer said some patients experiencing symptoms may not be calling their doctors because they are afraid their doctors will tell them to go to the Emergency Department. “It’s possible not enough people experiencing symptoms are reaching out to their primary doctors,” he said adding that the many excellent practitioners in the area could properly discern symptoms and steer patients to the ER, as needed.

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“I saw a patient who had been short of breath for six days before he decided to see his primary doctor;  when he finally saw him,  he found a very rapid heart rhythm, an atrial fibrillation. We immediately admitted him to the hospital.”

“We need people to understand that it is safe to go to the ER, and far more dangerous to stay home and wait for serious symptoms to disappear.”

Before coronavirus, 12% (just over one in 10) people with stroke symptoms waited one day before visiting the ER; now, 25% (one in four) wait at least one day, despite symptoms that can include loss of vision, speech, sensations and weakness on one side.

Surviving stroke, he explained, is very time dependent. “For those who present early– within 4.5 hours–we can give medication that breaks up the clot. The window for treating more severe stroke–via an endovascular procedure to open up the blood vessel–is traditionally within six hours, and in a small minority of cases, up to 24 hours.”

“The earlier you get these therapies, the more successful they are at preventing a bad outcome,” he said.

“We want people to know that it’s safe to visit the ER,” he emphasized. “At NWH, people are screened at the front door of the Emergency Department, everyone in the entire institution wears a mask, and patients are treated in private rooms.”

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Dr. Dwyer added: “The precautions we take here are working. Very few staff members have been diagnosed with COVID since this started.” Dr. Dwyer also pointed out that only a small number of visitors are allowed in the hospital so as to protect overall populations. These include partners of women giving birth, parents to a pediatric patient, and close family members to those dying of COVID-19 or any other condition.

As of this morning (May 13), NWH was caring for 19 COVID-positive patients in the hospital, which is significantly down,” Dr. Dwyer said.  “We were up in the 80s at the beginning of April, so it has come down quite a bit.  We still have 10 people on ventilators who are COVID positive. Some of these critically ill people require an extended period  of time for their lungs to recover on the ventilator.”

“We happen to have had some success treating patients on ventilators. The 10,000th discharge from Northwell in fact was from Northern Westchester Hospital, someone who was severely infected who is now recovering.”

“From our institution alone, we have had 247 live covid discharges.  That’s very encouraging.” There have been 58 COVID-related mortalities.

Dr. Dwyer elaborated: “We have worked very, very hard to make sure this is a safe environment, and in the ER, especially. When you come into the ER, you are screened at the door, and given a surgical mask and then escorted to one of 26 private rooms–there is very little chance of being exposed to COVID at NWH.

He pointed out that his nine-year-old nephew was a patient recently.  “He had a laceration. He had cut his ear on a branch outside running around–he came into the ER, and one of the nurse practitioners sewed his ear up. I feel comfortable having my own family here.”

Dr. Dwyer urges people to recognize the signs and symptoms of the following life- threatening conditions:

Heart attack

People who survive a heart attack may have weakened heart muscles and are at risk for life-threatening complications including another more serious heart attack. Go to the ER immediately if you have any of the following symptoms:

  • Chest pain, including tightness, and pain that spreads to the arms, neck, jaw or back;
  • Sudden onset of shortness of breath, sweating, dizziness or lightheadedness;
  • Unexplained nausea, indigestion, or heartburn.

Strokes

When caught early, immediate treatment may prevent death and minimize the long-term effects of a stroke. Even if a stroke is minor, it is important to receive an evaluation and treatment in order to prevent another, possibly devastating, stroke: Go to the ER immediately if you have any of the following symptoms:

  • Body weakness, especially on one side;
  • Facial droop;
  • Difficulty speaking or finding words;
  • Sudden loss of vision;
  • Numbness or loss of sensation;
  • Unsteadiness on your feet.

Appendicitis

When caught early, a surgeon can remove the appendix and often send you home the same day. If the appendix ruptures, a patient will spend days in the hospital and be at risk of life-threatening conditions that include peritonitis and sepsis. Go to the ER if you have the following symptoms:

  • Pain in the right lower quadrant of the abdomen (which typically increases when you move and intensifies over 24 to 48 hours), sometimes with
  • Loss of appetite;
  • Nausea and vomiting;
  • Fever.

Cheers to Good Health!

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012-(2)By Beth Besen

When Inside Chappaqua’s esteemed publisher/editor Grace Bennett advertised for a Guest Editor, I jumped at the opportunity! Not because I love the magazine (though I do!) or because I love writing (though I do that too!), but because I COULD! Jump, that is.

A year ago, such was not the case. Based on the results of an otherwise routine mammogram, I was diagnosed with a rare form of Non Hodgkin’s Lymphoma. Cancer, the Big C. I underwent intensive chemotherapy followed by radiation. The future looked uncertain, and it was all I could do to get through each round, make the best and most of each day. Jumping for anything was out of the question.

Happily, things turned out very well for me. Love, support and care came from near and far as family and friends joined and kept company on my journey; I am eternally grateful to every single one of them. Likewise, I am grateful to the doctors, nurses, therapists and technicians who, quite frankly, saved my life; it’s worth noting how very lucky I was–we are–to live as we do here in Westchester, so close to many of the world’s finest medical centers and communities.

I hope you’ll never need the Cancer and Wellness Center at Northern Westchester Hospital. But, if you do, you’ll find comfort, as well as great care, there; take a tour through this issue with Vicki de Vries.

Do you worry about heart disease? Suffer from headaches? Get S.A.D. at this time of year? Flip forward through the magazine as we share info that may help you or someone you love.

On the lighter side of health, there’s always the hope that a much needed break from routine restores us to our best selves. Let Kate Stone Lombardi inspire you to volunteer, follow Heather Skolnick’s lead and plan a family vacation.

You’ll also find smart insider tips of all kinds (visual “soundbites” if you will) throughout the magazine; just look for our Rx and pushpin note to advise, inspire and help you help yourself!

All those exclamation points in my lead paragraph? Not poor editing, deliberate editorial choices; they represent excitement and happiness, grateful appreciation, humility and even honor. While Descartes gave us I think, therefore I am, I suggest I exclaim because I can! Like many survivors before me, I’ve learned that life is for living. Exclamation point!

As I approach the one-year anniversary of my official remission date, I simply can’t imagine better payment forward than jumping into this issue 
of Inside Chappaqua!

Be well, and enjoy!

Credits: Beth’s hair styled by Aura Salon owner Leticia utilizing 
AVEDA products’ “pure flower and plant essences’’;  aurasalonchappaqua.com. Beth’s makeup provided by Kathryn (formerly Kathryn Ellen Makeup Studio); kathrynwbg@aol.com including “botanically based, vegan and toxin-free” Arbonne makeup; sharonh.myarbonne.com.

 

rx-noteBarbara Daniel, Local Dog Walker: Dog hikes can be enjoyable in every season when you’re prepared. My favorite winter hiking tool is Yak-Traks. These ‘snow tires’ or ‘chains’ for shoes make it possible to navigate over, or through, snow or icy surfaces. Many local stores sell them or similar brands.

—

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