The Inside Press

Magazines serving the communities of Northern Westchester

White Plains Hospital

Summer Kidney Stone Prevention: Stay Hydrated, Stay Healthy

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Hot weather and dehydration can create the perfect conditions for kidney stones. Learn how they form, when to seek medical care, and what you can do to help prevent them.

Dr. Fara Bellows counsels a patient.

As temperatures climb and hydration habits slip, doctors see a seasonal spike in kidney stones during the summer months–thanks in large part to dehydration. “The painful condition is very common, with about 10 percent of the population having a kidney stone at some point in their life,” notes Dr. Fara Bellows, a urologist at White Plains Hospital Physician Associates in Scarsdale.

What causes kidney stones? While healthy urine contains many chemicals dissolved in fluid, those chemicals (including calcium, oxalate, uric acid, cystine, and phosphate) can crystallize when hydration levels drop, explains Dr. Bellows.

For some, tiny stones pass on their own with minimal discomfort. For others, stones can become lodged in the ureter – the thin tube that carries urine from each kidney to the bladder. Symptoms can include:

  • severe pain, often in the back or just under the rib cage
  • nausea
  • vomiting
  • fever
  • bloody or cloudy urine

If your pain is not improving with over-the-counter pain medications, or if you have difficulty urinating, persistent vomiting, or a fever, you should seek care in an Emergency Department. A urine test and imaging can help determine the cause and guide treatment, which may include medication or, in some cases, a procedure or surgery.

The good news: while there are many causes of kidney stones, most risk factors are modifiable. Dr. Bellows recommends the following during hot summer months:

  1. Stay well hydrated. Most people prone to kidney stones should aim for close to 100 ounces of fluid daily to help produce enough urine to dilute stone-forming minerals. Individual fluid needs vary, so prioritize consistent intake and monitor your urine color, which should be clear to pale yellow.
  2. Watch your diet. Avoid foods high in salt, sugar, and fat. Limit salt intake to about two grams per day (roughly one teaspoon), and keep animal protein to one serving daily, about the size of a deck of cards.
  3. Make balanced choices. Limit alcohol and incorporate more fruits, vegetables, and calcium-rich foods into your diet.

Certain factors can also increase risk, Dr. Bellows adds, including a family history of kidney stones and conditions such as diabetes, gout, hyperparathyroid­ism, or a history of gastric bypass surgery. Recurrence is common: about three out of four people who devel­op a kidney stone will experience another.

As always, it’s best to consult with your doctor to develop a plan tailored to your individual risk. Bottom line: with the right hydration and dietary choices, many kidney stones can be prevented before they ever start.

To make an appointment with Dr. Bellows, call 914-949-7556.

This story originally appeared in Health Matters, a White Plains Hospital publication.

 

Tick Season Is Here: How to Protect Yourself from Lyme Disease

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Tick season is ramping up across Westchester and the Hudson Valley, where Lyme disease remains a persistent concern. Experts say this year’s mild weather and active tick populations are a reminder to take precautions before spending time outdoors – even in your own backyard. Dr. Laura Rivera Pizzoli, infectious disease physician at Scarsdale Medical Group, shares what you need to know.

When is Tick Season?

Black-legged ticks–also known as deer ticks–can be active any time temperatures are above freezing. That said, the highest risk is from spring through fall, roughly April through November, when ticks are most active and people are spending more time outdoors.

How to Protect Yourself

The Infectious Disease Society of America recommends:

  • wearing long sleeves and pants
  • tucking pants into socks
  • using EPA-approved repellents (DEET, picaridin)
  • treating clothing with permethrin

After spending time outdoors, conduct thorough tick checks on family members in areas like the underarm, nape of neck, ears, navel, groin, and back of the knee. If your pets go outdoors, remember to check them as well.

Bathing or showering within 2 hours of outdoor activity and drying clothes on high heat for at least 10 minutes can also be helpful. Early tick removal within 24 to 48 hours may prevent disease transmission entirely.

What To Do if You’re Bitten by a Lyme-Carrying Tick

 In most cases, a tick must be attached for at least 36 to 48 hours to transmit Lyme disease. Early symptoms usually appear within 3 to 30 days and may include:

  • a slowly expanding “bull’s-eye” rash
  • fever
  • headache
  • fatigue
  • muscle or joint aches

If left untreated, symptoms can worsen over weeks and may lead to complications such as arthritis, nervous system involvement, or heart rhythm problems. If you have been bitten by a tick and are concerned you may have been infected, contact your physician, as antibiotics may be recommended. Treatment of Lyme disease is tailored to symptom onset and duration.

Dr. Laura Rivera Pizzoli is a board-certified Infectious Disease physician at Scarsdale Medical Group. To schedule an appointment, call 914.723.8100.

This story originally appeared on Health Matters, a White Plains Hospital publication.

White Plains Hospital Expands Its Team-Based Approach to Multiple Sclerosis Care

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Cases of multiple sclerosis (MS), a chronic autoimmune disease affecting the brain, spinal cord and optic nerves (the nerves that transmit signals from the eyes to the brain), are on the rise in the United States, impacting nearly 1 million people nationwide. For many patients, a diagnosis can feel overwhelming and raise questions such as:

  • What does this mean for my future?
  • Will I be able to work or maintain my lifestyle?
  • What treatments are available?

At White Plains Hospital, patients have expanded access to specialized, comprehensive MS care close to home at its Multiple Sclerosis Center, which has been based at the Hospital since 2004. Over the years, the Center has continued to grow and evolve, expanding its team of dedicated MS specialists and broadening its treatments and resources for patients.  

White Plains Hospital is the only healthcare organization in Westchester designated as a Center for Comprehensive MS Care through the National Multiple Sclerosis Society’s Partners in MS Care program.

Coordinated Care Led by an MS Specialist

The Center is led by Dr. Ute Traugott, an internationally recognized MS specialist with more than 40 years of experience. She specializes exclusively in MS and related neuroimmunologic disorders and serves as Program Director, guiding a highly coordinated, multidisciplinary team.

“Certification by the National Multiple Sclerosis Society is very important,” Dr. Traugott says, “as it assures patients that there is a highly qualified group of specialists forming a treatment team to provide the best and up-to-date comprehensive care.”

The program recently expanded with Dr. Mark Tullman as Associate Director, who brings two decades of MS-focused experience, and Dr. Samantha Epstein, enhancing patient access to expert care across the disease spectrum.

A Team-Based, Patient-Focused Model

With a team of experts working together under one roof, patients at White Plains Hospital’s MS Center experience care that is coordinated, comprehensive and supports every aspect of living with MS. Key benefits include:

  • Expert evaluation and diagnosis: Accurate diagnosis using MRI, blood tests, and spinal fluid analysis, distinguishing MS from related conditions.
  • Personalized treatment plans: Disease-modifying therapies tailored to reduce relapses and slow disease progression. Pharmacologic and nonpharmacologic therapies to alleviate the daily symptoms of MS often play an integral part in patient care.
  • Access to advanced therapies: At this time, over 20 FDA-approved treatments are available. In addition, new medications are in clinical trials targeting inflammation and myelin repair.
  • Integrated specialty services: Physical and occupational therapy, urologic care, pain management, and mental health support.

In addition, the team meets regularly with colleagues specializing in neuroradiology to review complex cases, ensuring that every patient receives the most appropriate care.

Understanding MS: Symptoms and Diagnosis

“In patients with MS, the immune system attacks and damages the central nervous system – the brain, spinal cord and optic nerves,” says Dr. Epstein. “That damage can result in weakness, numbness and tingling, vision problems, fatigue, and difficulties with coordination and balance.”

“There is no single diagnostic test,” Dr. Epstein adds. “MS is diagnosed through a combination of clinical history, neurologic examination, imaging, blood tests, and, if necessary, evaluation of spinal fluid.”

Specialized Care for Complex Conditions

Drs. Epstein, Traugott and Tullman also treat patients with rare autoimmune neurologic disorders such as:

  • Neuromyelitis optica spectrum disorder
  • Myelin oligodendrocyte glycoprotein (MOG)-associated disease (MOGAD)

“These conditions can resemble MS but require distinct approaches,” Dr. Tullman explains. “My focus complements Dr. Traugott’s leadership to care for patients at every stage – from newly diagnosed to long-term management.”

“We work closely with rehabilitation specialists and other subspecialists to address the full spectrum of patient needs,” Dr. Traugott says.

“Our goal is not just excellent clinical care, but an exceptional patient experience,” adds Dr. Tullman.

With the addition of new physicians and ongoing advances in treatment and research, the Center remains committed to providing patients with expert, coordinated care at every stage of their MS journey.

Learn more about White Plains Hospital’s Multiple Sclerosis Services.

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.

How to Help Children Develop Healthy Sleep Habits

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Dr. Ranaan Arens

Creating and sticking to a healthy sleep routine for every child is essential for successful school year. Getting ample sleep (9-11 hours a night) ensures that children get enough rest to meet the cognitive and physical demands of their days.

Keep in mind the following five tips to foster healthy sleep habits in children:

1. Set a regular bedtime and wake time. On weekends, don’t let them sleep more than an hour or so longer than usual.
2. Establish a regular bedtime routine – such as a bath followed by reading, and not eating close to bedtime.
3. No screens before bed. The American Academy of Pediatrics (AAP) recommends that we stop using electronic devices 30-60 minutes before bedtime. Keeping TVs and computers out of their rooms is also helpful to create a restful environment.
4. Turn off bright lights at night. Nightlights are okay, but stronger lighting can affect a teenager’s ability to fall asleep even more than usual. Teens have a delayed melatonin release, which is why their bodies naturally want to stay up later at night and sleep later in the morning.
5. Take advantage of morning light. Exposure to natural light in the morning advances the circadian rhythm to shut down brain melatonin production and promote daytime alertness.

When Trouble Sleeping Signals a Sleep Disorder

Many people think of snoring as an adult problem, but children also sometimes exhibit snorting, rasping or gasping sounds while sleeping. In some cases, the problem might be caused by oversized tonsils and adenoids or being overweight. In others, the snoring could be the sign of a sleep disorder such as obstructive sleep apnea (OSA).

This is one of the most common sleep disorders I see in children. In sleep “apnea” (which means to stop breathing), children temporarily stop breathing and have reduced oxygen supply to their brain for 10 or more seconds at a time during their sleep. This condition is harmful to their and may affect their growth, development and behavior and lead to significant conditions as high blood pressure and diabetes.

Today, up to 5-7 percent of kids have sleep apnea. The size of their tonsils remains a common cause of obstructive sleep apnea, in addition to upper airway anatomical abnormalities. As with adults, being overweight is one of the biggest causes and risk factors; 17 to 30 percent of children today are in this category. The added weight in the chest and neck impinge on the mechanical construction of the airway.

Kids themselves may not realize they are having trouble sleeping, but parents might.

Signs include:

  • Frequent snoring
  • Abrupt arousals at night and difficulty staying asleep
  • Waking with a sore throat or dry mouth
  • Waking up with headaches
  • Difficulty waking in the morning
  • Daytime sleepiness
  • Poor attention and poor school performance
  • Moodiness or other behavior problems
  • Depression
  • Bed wetting

How a Sleep Study Can Help

If your child displays any of the above symptoms – and especially if they have more than one – the AAP recommends that you have your child evaluated for a sleep study.

It’s actually a very easy process – all the kids have to do is sleep! Polysomnographic sleep studies involve spending an overnight (with a parent) in our sleep lab. At our new facility, we have a special pediatric room with a private bathroom where parents can sleep in the same bed as their children, or in a separate bed next to them. The children are monitored overnight as they sleep using highly advanced diagnostic equipment that checks for things such as airflow and oxygen intake. A sleep technician is there all night to monitor equipment and attend to any needs.

And that’s it. In about a week, we’ll have analyzed the study data and be ready to make a diagnosis. Treatment for large tonsils could be as simple as a tonsillectomy to cure the apnea. In other cases, treatments include an airflow regulating mask to facilitate breathing in cases of apnea, as well as a weight management plan. Other sleep disorders such as parasomnia or “night terrors” might warrant behavioral health treatment.

Whatever the diagnosis, our credentialed staff is dedicated to getting to the source of the problem and helping your child get the sleep he or she needs.

Dr. Ranaan Arens is a Professor of Pediatrics at Albert Einstein College of Medicine. He is the Director of the Pediatric Sleep Center and Director of the Postgraduate Training Program in Pediatric Pulmonology at the Children’s Hospital at Montefiore (CHAM).
He sees patients at White Plains Hospital’s Pediatric Specialty Center in White Plains. To make an appointment, call 914-849-5437.