Good Health ’23 4/12/23 edition is published by Anton Media Group.

Parkinson’s Foundation Launches #Take6forPD Campaign

April is Parkinson’s Awareness Month

The Parkinson’s Foundation brings Parkinson’s disease (PD) to the forefront with the launch of a new awareness campaign, #Take6forPD. April is Parkinson’s Awareness Month, and efforts to raise awareness and funds are part of the Foundation’s mission to make life better for people with PD, their loved ones and those working toward a cure.

“Nearly one million people in the U.S. are living with Parkinson’s disease, and by 2030, the number is expected to reach 1.2 million,” said Parkinson’s Foundation President and CEO John L. Lehr. “The Parkinson’s Foundation raises awareness year-round about the early signs of PD and provides resources to support those newly diagnosed.”

A recent study found that the annual incidence of PD increased from 60,000 to 90,000 diagnoses annually, meaning that someone in the U.S. is diagnosed with PD every six minutes. This April, the Foundation

is encouraging everyone to #Take6forPD by highlighting action steps anyone can take in six minutes— the time it takes to make a cup of coffee—to advance research, improve access to care, empower and educate.

Advancing Research

In support of PD research, patrons can help the Foundation’s efforts to improve treatments and find a cure for the disease by participating in PD GENEration: Mapping the Future of Parkinson’s Disease, supporting drug discovery through the Parkinson’s Virtual Biotech, joining a research study and more.

Improving Access to Care

Research shows that seeing a PD specialist leads to better outcomes for individuals with the disease. Raising awareness for the Foundation’s care resources,

including a Helpline with support in English and Spanish, an ‘In Your Area’ resource map to find expert care, and an Aware in Care hospital safety kit, helps ensure that one day, every person with PD has equitable access to high-quality care.

Helping Empower & Educate

While living with PD can be challenging, many things can be done to maintain and improve quality of life, which often starts by enhancing one’s own awareness of available resources. Supporters can spread the word on social media with a PD infographic,

register for an educational event, listen to the Foundation’s podcast, and more.

“Parkinson’s can affect anyone, including those under the age of 50, so I wish for people with PD from all walks of life to gain hope from knowing that no gesture for Parkinson’s Awareness Month is too small,” said Vikas Chinnan, member of the Parkinson’s Foundation People with Parkinson’s Advisory Council. “Driven by my experience living with Young-Onset Parkinson’s disease, my passion is to raise awareness of the lesser-known, nonmotor symptoms—like depression and apathy—which can significantly impact mental well-being.”

To learn more about the #Take6forPD campaign, visit Parkinson.org/Awareness or call 1-800-4PD-INFO (1-800-473-4636).

—Parkinson’s Foundation

ASK AN HSS DOCTOR

Sponsored by Hospital for Special Surgery

QI’m experiencing shoulder pain, and an MRI shows I have a rotator cuff tear. The orthopedic surgeon I saw recommends surgery, and I plan to get a second opinion. How is it usually treated and when is surgery needed?

AA torn rotator cuff is a common shoulder problem, and MRIs are very reliable in showing the extent of the injury. It’s usually a good idea to get a second opinion when surgery is recommended.

The rotator cuff is a group of muscles and tendons that stabilize the joint. A tear in one of these structures can result from a sudden injury, such as a bad fall or from lifting something very heavy overhead.

Many times, people can’t recall a specific incident in which they hurt their shoulder. The injury can occur slowly over time, resulting from normal wear and tear and repetitive activities. This type of degenerative tear is more common, especially in people over age 50.

A significant number of older adults likely have a small rotator cuff tear but don’t know it because they aren’t experiencing major symptoms. They may experience occasional pain and some minor weakness and are advised to avoid strenuous overhead activities, which could make it worse.

When symptoms become more pronounced, people can experience an aching shoulder, pain at night, or “referred” pain that travels down the outside of their arm, usually not below their elbow. They may find it difficult to lift their arm above shoulder level.

Most rotator cuff tears can be treated initially without surgery, especially when it’s a degenerative tear. At HSS, we generally prescribe physical therapy, ice and anti-inflammatory medication as the first line of treatment.

When the tear is the result of a sudden injury, early surgical intervention is more likely to be considered. The orthopedic surgeon should evaluate each case on an individual basis. Considerations include the nature of the injury and whether it is a partial or a complete tear; the age of the patient; and specific symptoms. If someone tries conservative treatments and continues to have pain and difficulty with activities after two or three months, surgery may be the best option.

There have been advances in the way the procedure is performed. At HSS, the rotator cuff is repaired arthroscopically using regional anesthesia. The success rate is high in terms of pain relief, restoring shoulder movement and improving quality of life. The recovery generally takes four to six months, and patients continue to gain strength and function for up to a year.

Physicians differ in their training and surgical techniques. Patients are advised to choose an orthopedic surgeon who performs a high number of rotator cuff procedures, can communicate effectively and with whom they feel comfortable.

Answer from Answorth Allen, MD, a sports medicine surgeon at Hospital for Special Surgery (HSS) in New York City and at HSS Long Island.

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Autism Speaks Pledges To Make World Of Difference

Autism prevalence rises in U.S. children

The Centers for Disease Control and Prevention (CDC) recently released its update of autism’s estimated prevalence among the nation’s children. It is based on the active surveillance across 11 monitoring sites in the United States for eightyear-old children in 2020. The new report shows an increase in prevalence with 1 in 36 children, or more than 2.7 percent of eightyear-old children, diagnosed with autism spectrum disorder in 2020, and for the first time reveals higher prevalence rates among Black non-Hispanic (BNH), Hispanic, and Asian or Pacific Islander (A/PI) children compared to White non-Hispanic (WNH) children.

The increase reinforces progress in awareness and advocacy for early identification and diagnosis among all groups. It reiterates the need for a significant increase in funding for autism research and services to be provided across the spectrum and lifespan, particularly in diverse communities where prevalence numbers were greater than those indicated by previous studies

Key findings include:

One in 36 children, or over 2.7 percent of eight-year-old children, in the U.S. was diagnosed with ASD in 2020, increasing from 2018 when the estimate was 1 in 44.

The rate of autism per 1000 was higher in BNH (29.3), Hispanic (31.6), and A/PI (33.4) compared to WNH children (24.3), indicating an improvement in outreach, screenings and de-stigmatization of autism diagnosis among minority communities.

BNH autistic children were more likely than WNH and Hispanic autistic children to have a co-occurring intellectual disability. Autistic girls were also more likely to have a co-occurring intellectual disability when compared to autistic boys. Both findings indicate an undercounting of autism among BNH and female children, highlighting the need for greater research on the age at which BNH children and girls without intellectual disabilities receive autism evaluations and diagnoses.

The COVID-19 pandemic limited data collection, potentially leading to an under-reporting of prevalence and reinforcing

the need to explore long-term impacts of the COVID-19 pandemic on evaluation and diagnosis of autism.

The CDC findings strengthen Autism Speaks’ commitment to creating a more inclusive world for all individuals with autism and to addressing disparities that exist among different races and ethnic communities through investments in research and programs, such as Autism Speaks’ Autism Care Network, Caregiver Training Program and community events, which increase family and clinician access to innovative tools for identifying autism and understanding what children are experiencing.

“With 2.7 percent of children in the U.S. being diagnosed with autism, the autism community needs our support now more than ever,” said Keith Wargo, president & CEO of Autism Speaks. “We continue to prioritize advocacy and research efforts with the goal of supporting people across the spectrum, at all stages of life and in communities around the world, but we call on the public to recognize the growing need for services and for unity in order to achieve a more inclusive world. Together, we can make a world of difference for all people with autism.”

This World Autism Month, Autism Speaks asks everyone to demonstrate that they are standing with the autistic community, celebrating differences and including people with autism in all aspects of society. Supporters can request information, resources and tools to engage and advocate in their community, as well as learn about the mission delivery progress at Autism Speaks, in order to create a world where all people with autism can reach their full potential.

Learn more about Autism Speaks and World Autism Month at autismspeaks. org/wam. To join the conversation, find @ autismspeaks on Facebook, Instagram and LinkedIn. For personalized support and questions, contact the Autism Response Team at 1-888-AUTISM2, en Español at 1-888-772-9050 or by email at help@ autismspeaks.org

—Autism Speaks

A Complete Parkinson’s Diet Guide

When living with Parkinson’s, diet can help you stay healthy and may help with some of the symptoms. Eating a healthy diet will lead you to not only feel better but will also lead to more likely living a longer and fuller life.

It is important to say that the only evidence-based diets that are shown to be good for Parkinson’s are general healthy diets that work for everyone regardless of Parkinson’s. The Mediterranean diet is one of the healthiest diets out there, which is why we recommend it to those with Parkinson’s.

Mediterranean Diet

A Mediterranean diet for those with Parkinson’s disease is recommended because it is generally considered to be one of the healthiest diets you can follow. This diet is based on food that was traditionally

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eaten in Italy, Greece, and other Mediterranean countries.

This diet can be summarized into three categories: foods you should eat (often, moderately, and rarely).

Foods you should try to incorporate into your diet as often as you can:

• Fruits

• Whole Grains

• Nuts

• Plant based foods

• Vegetables

• Seeds

• Olive Oil

Foods that could also be added moderately into your diet and some that could be added daily:

• Seafood • Dairy

• Chicken/turkey • Eggs

Foods that should rarely make it onto your plate and should be reserved for special occasions:

• Red meat

• Sweets like cookies or candy

Foods to avoid when on a Parkinson’s diet: While eating a Mediterranean diet can help with Parkinson’s, you need to make sure you are also avoiding the foods and fad diets that are detrimental to your health and may exacerbate your Parkinson’s symptoms.

• Foods high in saturated fats • Processed foods

• Large amounts of protein

• Iron may reduce the amount of PD medication being absorbed

• High citrus juices like orange juice

• Sugary foods and drinks • Large amounts of alcohol

• Hard to chew foods

Fad diets to avoid or be skeptical of:

There are many fad diets out there that someone with Parkinson’s should be skeptical of, such as the Caveman diet, Carnivore diet, Whole30 diet and many more. While these new diets claim to be the best thing since sliced

bread, many of them are unsustainable and not healthy for you in the long run.

Something else to watch out for are diets specific for Parkinson’s. That’s right, you are reading a Parkinson’s diet blog warning you of the dangers of Parkinson’s specific diets. We do this because there are a lot of small studies out their claiming a specific food or nutrient will help with your Parkinson’s while the truth is that there really isn’t any strong evidence for any of it. Worse yet, some of these foods or nutrients when taken in excess quantities can do more harm than good. The only real evidence-based diets that are shown to be good for Parkinson’s are general healthy diets that work for everyone regardless of Parkinson’s. The Mediterranean diet is one of the healthiest diets out there, which is why we recommend it to those with Parkinson’s.

A Healthy Parkinson’s diet

While the Mediterranean diet may help people with Parkinson’s, it is important to remember that you need to focus on your whole diet and not just a small part of it. Eating healthy in general and making smart dietary decisions is what will make the difference for your overall health and well-being.

A few healthy diet tips are below:

• Reduce sugar intake

• Eat lots of fruits, vegetables and grains

• Eat foods high in fiber

• Drink lots of water

• Avoid consuming saturated fat and cholesterol

• Consume alcohol in moderation

Talk to your doctor about setting up the best diet for you.

—Zach Galati for Parkinson Foundation

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Lending A Hand

Use of robotic arm enables pinpoint accuracy during spine surgery

Severe, ongoing back pain can be debilitating. Some conditions can affect one’s ability to walk or carry out basic activities. Amanda Murdolo started experiencing that kind of pain a few years ago and, by the time she saw a doctor at Hospital for Special Surgery (HSS), she could barely walk for 10 minutes without having to stop.

“I couldn’t do much physical activity,” recalled Murdolo, now 24 years old. “Simple tasks like standing and doing dishes became painful. At times it felt like someone was pulling both ends of the nerve in my left leg really tight.”

After seeing several doctors, Murdolo, a graduate student who lives on Long Island, was referred to Darren Lebl, MD, a spine surgeon at HSS who practices in both Manhattan and at HSS Long Island in Uniondale. Around the time she saw Lebl, he had just completed his 100th minimally invasive, robotic-assisted spine surgery.

The robotic system would be used in Murdolo’s surgery to correct a spinal condition called spondylolisthesis, which causes one of the lower vertebrae of

the spine to slip forward onto the bone directly beneath it. This was putting pressure on a nerve.

Since the pandemic was a concern in 2020, Murdolo had her first consultation with Lebl remotely. After she felt comfortable talking to him, she went to his office for an examination, an explanation of her condition and what surgery would entail. He explained that he performed the procedure with assistance from a robotic arm, which allowed for an ultraprecise surgery.

“Over the past few years, advances in surgical technique and technology have enhanced the accuracy and predictability of spinal surgeries, and patients like Amanda benefit,” said Lebl. “Advances such as computer navigation, 3D imaging and robotic-assisted surgery have been tremendous in terms of allowing us to do less invasive, yet more precise surgeries.”

The use of very small incisions preserves muscles and other structures surrounding the spine, so patients generally experience less pain after surgery, a shorter hospital stay and a quicker return to activities compared to traditional open

surgery, he explained.

Murdolo had a spinal fusion in December 2020.

“A ver tabra in her lower spine had shifted or ‘slipped’ forward, causing impinge ment on a nerve root,” Lebl explained. “Through a minimally invasive technique, we were able to realign her spine and take the pressure off the nerve to relieve her pain.”

Lebl uses the robotic system to treat the condition that Murdolo had, as well as a herniated disc, spinal stenosis or scoliosis. Prior to surgery, detailed images of the patient’s anatomy are obtained to plan and customize the proce dure. Preoperative CT and Dr. Lebl with the robotic system

Tracy-Ann Moo, MD Breast Surgical Oncologist MSK in Nassau

MRI scans create a three-dimensional map of the patient’s spine that is used during surgery. Lebl performs the procedure with small incisions and robotic guidance, always maintaining full control. Visualization of the surgical field is provided by a computer console that displays the high-definition 3D image of the patient’s anatomy in real time.

Many spine surgeries, including Murdolo’s, require the use of hardware such as titanium screws to stabilize the spine, and their accurate placement is critical to the success of the surgery.

“The robotic arm, along with 3D imaging and navigation technology similar to GPS, allow for pinpoint accuracy in the placement of hardware, and this is a major advantage of the system,” Lebl said.

Murdolo said the thought of having spine surgery was a frightening prospect. It would be the first surgery she ever had, and she was worried about pain. But it was never an issue.

“I was very surprised at how little pain I had after surgery,” Murdolo said, who had the procedure on a Friday and went home on Monday. She has been painfree since the surgery and looks forward to receiving her Doctor of Audiology degree in 2024.

Lebl notes that the use of robotics in minimally invasive spine surgery requires special training and advises patients to choose a physician with

ample experience in the technique. He also recommends that patients choose a surgeon with whom they feel comfortable and who takes the time to answer all their questions. When considering where to have surgery, hospitals that perform a high-volume of such procedures have been shown to have the best outcomes.

—Hospital for Special Surgery (HSS)

Colon Cancer Is Common

Colon cancer is common. Current screening guidelines, which were recently updated, recommend screening of asymptomatic people starting at age 45. These recommendations do not mean that people in their 20s and 30s cannot get colon cancer. Forecasters have predicted that in 2023 almost 20,000 colon cancer diagnoses and 3,750 colon cancer deaths will occur in people under 50 years of age. Almost all these deaths are preventable if the cancer is diagnosed early. This is the reason why care givers now recommend that young people, even college students, talk to their doctors about any suspicious symptoms such as constipation, rectal bleeding, or sudden changes in bowel habits.

The reason for this rise in colon cancer in young people is not yet known. Certain behaviors and factors such as a sedentary lifestyle, being overweight, smoking, alcohol use, low fiber high fat diet, and diets high in processed meats have all been associated with colon cancer. One wonders what sitting in front of a computer all day, either working or playing videos or video games, does to one’s colon cancer risk, especially if that occurred when people were in their teens and twenties.

The ultimate question is, “what can be

David Bernstein, MD

done to avoid colon cancer?” Although not all colon cancer can be avoided, taking some simple lifestyle altering steps may lessen your chance of developing colon cancer. For example, if you smoke, stop! And this includes e-cigarettes. Drink alcohol responsibly. No more than two drinks a day for men and one for women. Exercise! If you are overweight, lose weight. Overweight people have a much higher risk of both developing and dying from colon cancer. Watch your diet and consume adequate fiber. Finally, make sure that you undergo colon cancer screening, by whatever method is comfortable and readily available to you.

—David Bernstein, MD, MACG, FAASLD, AGAF, FACP

Amanda Murdolo