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AN ANTON MEDIA GROUP SPECIAL
HealthyLiving ealthy JULY 13 - 19, 2016
Taking Care of Yourself Healthy eating and natural remedies
INSIDE: Beach Snacks • Coconut Oil • Gluten-free recipe
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Things are looking up.
NUMC has changed for the better. So I’m feeling better. Sweeping, hospital-wide improvements are enhancing the health care options for all of Nassau County.
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Yes, the differences are astounding — across many segments of the hospital — structural, technological Heart Attack Heart Failure Pneumonia Surgical Care VTE Perinatal Care
and clinical enhancements that have elevated NUMC to world-class stature. Our vision of bringing a greater level of health care to central Nassau has clearly taken shape, and our commitment to upgrading the quality of care is ongoing. • Physical Medicine and Rehabilitation Unit • Emergency and Level One Trauma Center • Hypertension, Diabetes and Vascular Care Center • Cardiac Care Center Including State-of-the-Art Cardiac Catheterization Lab • Neurosurgery/Stroke Center • Multiplace Hyperbaric Chamber • Primary Care Center • Maternity and Newborn Center • Oncology Center • Orthopedic and Spine Center • Burn Center
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516.572.0123 • www.numc.edu Victor F. Politi, MD, FACP, FACEP, President/CEO • Michael B. Mirotznik, Esq. Chairman, Board of Directors
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HEALTH LIVING NEWS
State’s New Mammogram ‘Text Line’ New York State has launched a new “text line” to help women get access to breast cancer screenings. To use the service, residents should text “get screened” from their cell phones to 81336. After providing their zip code, the service will reply with a message containing nearby screening locations that offer extended hours. “Mammograms save lives, which is why we need to make it as easy and convenient as possible for women to access these early detection services,” said Senator Jack Martins. “Using this new technology, residents will be able to quickly find nearby locations offering breast cancer screenings simply by sending a text message.” Information on breast cancer screenings and support services can also be obtained by contacting the New York State Department of Health at 866-442-2262.
Free Prostate Cancer Education Program As part of its ongoing Prostate Cancer Education Series, Winthrop-University Hospital’s Department of Urology will offer a free lecture, “Supportive Oncology,” on Wednesday, July 13, from 6:30 to 7:30 p.m. The lecture will be held at the Winthrop Wellness Pavilion, located at 1300 Franklin Ave., Suite ML5 in Garden City. Speaker Gina Pavel Groysman, DO, from the division of palliative medicine and bioethics at Winthrop-University Hospital, will offer the program. A question and answer period will be included. Email prostatecancersupport@winthrop.org or call 516-663-2316 to reserve a seat.
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July Is Cleft And Craniofacial Awareness Month The American Cleft Palate-Craniofacial Association (ACPA) and Cleft Palate Foundation (CPF) are raising awareness of cleft lip and/or cleft palate this month. Established by AmeriFace and cleftAdvocate, July is National Cleft and Craniofacial Awareness and Prevention Month, promoting public awareness of a condition commonly associated with other countries but often overlooked at home. “We are pleased to join forces with more than 20 organizations nationwide to raise awareness,” said Richard Kirschner, MD, president of ACPA. “ACPA represents professionals who strive to provide optimal care for individuals with oral cleft and craniofacial conditions. Our goal is to spread awareness of these conditions and promote the diverse needs of our patients.” The Centers for Disease Control and Prevention (CDC) estimates that about 7,000 babies will be born with a cleft in the U.S. this year, a condition created when tissue in the baby’s upper lip or the roof of the mouth does not join together
completely during pregnancy and leaves an opening. “This national month of awareness provides an opportunity for dialogue about facial differences and the treatment options currently available,” said Marilyn Cohen, LSLP, president of CPF. “We hope that by spreading awareness we can bring understanding and education about treatment and prevention.” Despite unique health challenges, those born with cleft and craniofacial conditions can lead fulfilling, successful and accomplished lives. Clefts are usually repaired surgically in the first year of life, though many children require additional surgeries and treatments through adolescence to correct challenges to breathing, eating or speech development. Individuals born with cleft lip or palate often need specialized dental or orthodontic care throughout their lives as well. Visit www.nccapm.org for more information and about how to get involved.
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Healthy Beach Eats
What’s better than grabbing some friends and heading CHOOSING to the Hamptons HEALTH for a beach day? With the beautiful Stefani Pappas weather among us, CPT, CWMS the weekends are filled with trips out East and opportunities to enjoy the scenic beaches that Long Island has to offer. If you forget to pack food for your beach excursion, it can be tempting to purchase snacks at the beachside food truck or local fast-food spot. However, planning ahead and putting together a few quick snacks the night before can make a huge difference when it comes to your health. I’ve compiled a few of my favorite healthy snacks that are perfect for your beach getaway. You’ll notice that all of these foods don’t require utensils. When you are lounging at the beach, you want something that is easy and light. These healthy “finger-foods” are simple, easy to prepare, and kid-friendly. Another important concept when it comes to beach eats is single-serving portions. If you’re reading a magazine on the beach or catching up with family and friends, you may not be paying attention to your meal. Snacking while you are distracted can contribute to overeating, so it’s important to emphasize portion control and choose single-serving snacks when you can.
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When you grab your beach snack, take a second and sit down while you enjoy your food. Avoid leaving an open bag of snacks next to your chair, and always eat mindfully and sensibly. Don’t forget to stay active on your exciting beach day. Take 15 minutes the night before to assemble these snacks in a cooler or insulated bag, and you’ll be good to go. Now, here are my top healthy beach eats:
Whole Wheat Tortilla Wrap with Low-Sodium Turkey Breast
Whole wheat tortilla wraps are a healthy alternative to the classic sandwich. More importantly, they hold their shape much better than regular bread, and often won’t get as soggy in transit to the beach. Low sodium turkey-breast
is a light alternative, and adding some fresh veggies to this wrap can add a nutritious crunch. Choose vegetables that hold their shape well, such as red peppers or sugar snap peas. If you want to add tomatoes or light dressing, be sure to pack these on the side so the wrap doesn’t get soggy.
Jicama Sticks & Single-Serve Guacamole
Guacamole is packed with healthy mono-unsaturated fats, fiber, and several vitamins. Instead of enjoying this snack with chips, try cutting up some fresh vegetables. Jicama, in particular, is a very low-calorie root vegetable that pairs well with guacamole. Peel and slice the jicama, and portion the jicama sticks into small sandwich bags. Throw this into a cooler with single-serving guacamole containers, and you have the perfect nutritious snack.
Apple Slices & Single-Serve Peanut Butter Packets
Adding a protein, such as peanut butter, when eating fruit can help stabilize blood sugar levels and leave you feeling satiated. Several brands now make single-serving peanut butter packets that are perfect when you are on-the-go. Slice a few apples, squeeze some lemon juice on them to retain their freshness, and pack your peanut
butter packets for a filling snack.
Single-Serve Light Popcorn Bags
Popcorn is an easy and simple beach eat. Avoid buttery popcorn varieties that rack up excess sodium. Stick with very lightly salted popcorn that is already popped and individually portioned. Popcorn makes for a light, fiber-packed, nutritious snack.
Fruit-Infused Water
When you are enjoying your time at the beach, it’s easy to forget about hydration. Fruit-infused water is a fun and flavorful way to make hydration easier and enjoyable. Fill your favorite water bottle about ¾ of the way, and
then add fresh cut or frozen fruit of your choice. Some refreshing combinations include: • blackberries, lemon, mint • strawberries, cucumber, lime • orange, blueberries, basil Enjoy these delicious and healthy beach eats. Make the most of your summer, and always make your health a top priority. Stefani Pappas, RDN, CPT is a clinical dietitian at St. Francis Hospital. She is a personal trainer, fitness instructor and contributing writer for Elite Daily. Visit her website www.stefhealthtips. com for more information.
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SUMMER Safety Strategies BY PENNY STERN SPECIALSECTIONS@ANTONMEDIAGROUP.COM
For many of us, summer is the most wonderful time of the year – in childhood, we rejoice at the end of school and in adulthood, we often plan vacations for sometime during the warm months. One of the best parts of the summer is the ability to engage in outdoor activities, such as swimming, hiking, and biking. To stay safe during summer activities, it’s helpful to consider a few key points. First of all, the summer is virtually synonymous with sun. We love the sun and, in fact, can’t live without it. But it’s vital to protect our skin from the sun’s UV rays. Skin cancer is by far the most common type of cancer but you can help prevent it. Using sunblock with an SPF of at least 30 is a minimum first step. It’s not enough to apply sunblock once, when you’re outdoors, you need to do so at least
every two hours and more frequently especially after swimming in order to ensure its protective effect. And, don’t be stingy; use an adequate amount which is generally determined to be equivalent to what would fit in a shot glass. You can easily get sunburned after a short time as the water reflects sunlight right back up into your face and upper body so be sure that you are adequately protected both in terms of amount and frequency of sunblock applied and the SPF level. Second, avoid getting burned – that means trying to protect yourself from the sun at its strongest (from 10 a.m. to 2 p.m.). Wear a hat with a brim that protects your face, neck and ears. When you do participate in outdoor activities, make sure that shaded areas are available. Don’t forget your eyes by wearing sunglasses that
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clearly have UV protection. This isn’t a fashion statement; make sure the lens is dark enough. Protecting your eyes can help avoid cataracts down the road. And while you’re in the water, remember that water can be dangerous, particularly to the youngest among us. Drowning is the leading cause of injury and death in children ages 1 to 4. Never leave a child unattended in or around water. Only a few inches of water can spell disaster for a child. Private pools must be secured with a lockable fence to ensure that children (and others) do not get into the water. Make sure that you stay well-hydrated at all times and especially during the summer, when we naturally perspire in order to keep our bodies cool. If you feel thirsty, you’re already dry, so keep ahead of the game and carry a water bottle with you at all times. Remember, water is your best beverage for hydration; sugary drinks do not quench thirst. We are all potentially vulnerable to heat and dehydration. When it comes to biking, don’t forget that the rules of the road apply to those riding on two wheels as well. Each year in the U.S., an estimated 500,000 bicycle-related injuries occur that result in an emergency room visit. Make sure that you and your family members are safe riders. Bike helmets are life-saving so wear them and require that all family members do. It’s an excellent idea to wear helmets for other activities, including skateboarding and in-line skating. Other protective gear, such as pads, reflective tape and lights can also help prevent accidents that lead to injuries. Finally, who doesn’t love to walk in the balmy weather of summer? Keep in mind that there are other creatures about, especially ticks. These tiny
bugs can transmit a number of diseases, especially Lyme disease, which annually infects more than 300,000 people and can have serious consequences. So, if you love to walk in areas known to be infested with ticks (and it’s getting harder and harder to find places that don’t have ticks), take a few precautions. Avoid high grasses. Try to walk in the center of trails. Don’t leave your skin exposed. Wear long pants tucked into socks for maximum protection and don’t forget tick repellents. Pets are not immune, so check both people and your pets for ticks. They’re tiny but easy to spot if you know what you’re looking for. If you do find a tick, it must be removed very carefully. The Centers for Disease Control and Prevention (CDC) recommends that a finetipped tweezer be used to grasp the tick as close to the skin’s surface as possible. It should be pulled upward and after removal, the area should be cleaned with either soap and water or an iodine scrub or rubbing alcohol. Never crush a tick with your fingers. Summer can be a great season as long as you take some simple precautions to make sure that everyone stays safe. If you have specific questions about summer safety, be sure to consult with your health care providers. Penny Stern, MD, MPH, FACPM, FACOEM, is the director of preventive medicine at Northwell Health.
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The Many Virtues Of Coconut Oil
Anyone who knows me well knows that I use coconut oil the way the way our favorite Greek Papa on “My Big Fat Greek Wedding” uses Windex. When I recently suggested to my mother that she use coconut oil to heal a cut on her finger, she replied that this was my late-grandmother’s favorite remedy for healing all things as my mom was growing up. It seems that this healthy miracle oil has existed for years but has only recently captured the attention of the masses. Maybe it is newly recognized because of the widespread reach of social media or the increased awareness of natural, more organic methods of self-care. Whatever it is, I am thankful this all-healing oil exists today and is finally getting the positive scientific attention it deserves. The benefits of my favorite oil are not isolated events. Not only have I benefited from its virtues but so have my family, friends and clients. My new saying has become, “When in doubt use coconut oil.” It can’t hurt and is more than likely to help. Please do keep in mind however that as is always the case with all things, there is no one-size-fits-all option for everyone, so, if you are using anything for the first time, do so mindfully and thoughtfully.
LIFE EVOLUTIONS Melody Pourmoradi
Coconut Oil For Cooking
One of the more familiar uses of coconut oil has been for cooking. It has a sweet taste so I personally use it when I prepare breakfast foods and do any type of baking, however many people use it for everyday cooking and are very pleased. Because of its low smoke point in comparison to the other oils, it is best not to use coconut oil when cooking at high temperatures. Coconut oil increases your composition of good cholesterol and provides a lasting source of healthy, sustainable energy in the body.
Coconut Oil As Moisturizer
Although we live in a time where we are highly in command of the body’s nutritional and physiological needs, I believe that we are just scratching the surface on the effects of beauty products that we are using topically. Moisturizers, skin treatments and other
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personal hygiene topical formulas are absorbed into our bloodstream and it is in our best interest to use treatments and/or products that contain ingredients that are as natural and as organic as possible. In the case of coconut oil, we are dealing with a pure product that does not contain any other ingredients, which makes it a healthy option and my personal go-to choice for all things. It has even been known to heal burns, eczema and other skin conditions. I massage organic, unrefined coconut oil into my skin every morning and night and I have never felt better about the look and feel of my skin. You might prefer to use it only at night and use a cream with a higher SPF for daytime. Use your own judgment and choose a formula that works best for you.
Raw, organic, virgin coconut oil is considered a superfood and using it enables us to activate wellness in the body from the inside out. It is known to increase cardiovascular function and cleanses the body. It has even been shown that it has the power to heal damaged cells that can lead to cancer and other diseases. Coconut oil provides us with crucial nutrients not typically found in other forms of foods and is indeed at the top of my list for whole body wellness. Melody Pourmoradi is a women’s wellness and lifestyle coach at Life Evolutions Coaching. Visit www. lifeevolutionscoaching.com to learn more about her services.
Coconut Oil For Preventative Health One of my favorite things about coconut oil is that whether it is used internally or externally, it can be used proactively to promote overall good health.
A CLINICAL RESEARCH STUDY FOR INSOMNIA PATIENTS WHO ALSO HAVE ALZHEIMER’S. If you or your loved one has insomnia – and also has Alzheimer’s – we invite you to learn more about a clinical research study. To be eligible for participation, you or your loved one must:
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At Grace Plaza Nursing & Rehabilitation Center, we are dedicated to continuing At Grace Plaza Nursing & Rehabilitation Center, we are dedicated to continuing our tradition of excellence in both rehabilitation and long-term care. our tradition of excellence in both rehabilitation and long term care. Our Rehabilitation program specializes in offering a comprehensive and dynamic Our Rehabilitation program specializes in offering a comprehensive and dynamic model for patients with Orthopedic, Neurological and Pulmonary conditions. model for patients with Orthopedic, Neurological and Pulmonary conditions.
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Five Everyday Superfoods For Your Nails, Hair And Skin BY HEATHER MCCLEES
SPECIALSECTIONS@ANTONMEDIAGROUP.COM
There’s a saying that our nails, hair and skin often tell us how healthy we are and are signs of how healthy our diet is. Foods that inflame our cells and cause a breakdown end up tearing apart the collagen, keratin and elastin that provide supple skin, strong and silky hair, and strong, fast-growing nails. Toxic overload, stress and poor diet all contribute to lackluster skin, dry and brittle hair, and brittle nails that never seem to grow. Here are five of the best to offer up some of the most overall nutritional components to provide amazing nails, hair and skin quickly.
1. Raw Organic Almonds
Almonds are rich in vitamin E, a natural antioxidant that supports collagen production and provides anti-inflammatory benefits for the body. Almonds also contain a large amount of plantbased protein, rich in amino acids that are
needed to support collagen growth and strengthen the body. Almonds are also a great source of calcium, that provides nutritional support for our bones, hair, skin, teeth and nails.
2. Orange Root Veggies
Sweet potatoes, carrots, pumpkin and winter squash all contain high amounts of vitamin A that support your nails, hair and skin as well. These foods are also rich in vitamin C, an antioxidant that lowers stress, which can weaken collagen, elastin and keratin in the body. vitamin C also acts as an antioxidant to combat free radical production that can lead to aging. When cooking these foods, always steam, bake or cook in a slow cooker instead of frying them. This will enhance their antioxidant content without overcooking them.
3. Raw Organic Pumpkin Seeds
Every part of the pumpkin is a superfood. Pumpkin seeds are some of the most potent, alkaline and nutritious seeds you can eat. They’re rich in protein, iron, magnesium, potassium, biotin and omega-3 fatty acids. They’re also alkaline-forming like almonds, so they build the body instead of break it down. Pumpkin seeds
improve your mood, energy and, of course, your nails, hair and skin. Eat ¼ cup a day and you’ll see stronger nails, hair and clearer skin in no time.
4. Oats
5. Greens
Your body soaks up the nutrients from green foods like a magical nutritional sponge! Vitamins A, C, E and K, and even B vitamins and iron are all provided to your body when you eat leafy greens. Green foods such as spinach, broccoli, kale, watercress and collards also contain a good amount of calcium, magnesium and potassium. Minerals are crucial to the health of your nails, hair and skin. They’re also water-rich so they won’t dehydrate your body, and they provide an alkaline environment to clear out toxins in the body.
Oats are one of the most inexpensive superfoods you can eat. Even if you don’t digest glutinous grains well, gluten-free oats are there to save you. Whole grains are important for most everyone’s diets. Whether you choose wild rice, wheat products, oats, barley, rye, brown rice, black rice or quinoa, they’re all filled with certain properties to provide your body with support. Oats have specific benefits that your nails, hair and skin will appreciate. These nutrients include: protein, biotin and other B vitamins, anti-inflammatory properties, magnesium and potassium. They are also filled with fiber and antioxidants. Oats lower inflammation, clear the skin, reduce stress, and provide your cells with nutritional support. You truly can eat your way to both good health and to natural beauty. Leave the pricey products on the shelf and fill your diet with whole foods. You won’t believe how much your body will respond and appreciate your efforts. Visit www.onegreenplanet.org for the full version of this advice feature.
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Saving Your Marriage in Times of Financial Hardship BY JEREMY SKOW
specialsections@antonmediagroup.com
Money has been documented as being the number one cause of friction in relationships. When times are tough tension mounts, fingers point and fear increases. The breadwinner in a single-income family may feel resentful that their spouse hasn’t been trying to find work. One partner may feel that the other isn’t trying hard enough to replace a lost job or that they are spending too much. These feelings only escalate as time goes on, money tightens and savings dwindle. Ultimately this tension may lead to discussions of separation and divorce. Even if the financial hardship eases later, the inertia of the process and ill feelings towards one another often becomes too great to save the marriage. An understanding of some of the ways money may negatively affect your marriage can help. An Ohio State study revealed several correlations between income and satisfaction with a marriage. Researchers found that a woman’s employment status has no effect on the likelihood that her husband will opt to leave a marriage. However, if a man is unemployed it will not only increase the chances that the wife will initiate a divorce, but also that he will be the one who opts to leave even if he is relatively happy otherwise. This suggests that the image that many men
and women have about spousal roles in a marriage includes a man who at least contributes towards total household income. While the national average for divorce in the United States hovers around 50%, an article published by the Psych Central website indicated that when married women earn an independent income and have access to money of their own, the divorce rate drops as low as 20 percent. This may suggest that spouses with access to money of their own argue less about money and how it is spent. A University of Utah study found that spouses who fight or disagree about money every day are much more likely to divorce than those who fight or disagree a couple of times a month or less. A 2007 survey by the Pew Research Center indicated that 53 percent of spouses reported that “adequate” income is an important factor in a satisfactory marriage. The impact of financial hardship can be felt in several ways. There may have been pre-existing problems in the marriage. In such cases, financial difficulties can be a marital dissatisfaction amplifier. The loss of a job is just another reason to end the relationship. The pesky habit that she has that was a minor annoyance is now blaring
Jeremy Skow
in your mind like a voice through a megaphone. The lack of effort he shows to help with housework is like a thousand fingernails scraping against a chalk board. Instead of creating a way to stay together, thoughts turn towards dissatisfaction and an exit strategy.
If finances are strained, both spouses may be fearful and anxious about their future. The uncertainty of sustaining their lifestyle is like a flame accelerant, feeding negative emotions to new heights. Tension mounts as the duration of unemployment increases. Accusations regarding the job search effort increases. It is not always possible to predict when monetary problems will occur. The loss of a job is not often predictable. Stress may not be avoidable and anxiety may spike and subside. The key is to cope with these problems together and to support your partner when times get tough. Decide to fight for your marriage. People often claim to want a great relationship but not everyone gives their all to maintain one. Saying to yourself and your partner that you firmly ARE going to get through this and will not allow it to deteriorate your
relationship is a crucial step. It focuses you away from negative conversations about the relationship and creates renewed energy to deal with your mutual financial problems. You never know how tough you are until tough is the only option you have. Be tough for your partner and you help each other through it. Attack the problems, not each other. The more effort we expend on blaming and fighting, the less we are putting towards getting our problems solved. Not talking is the worst mistake you can make. Review your whole financial situation and start talking together to figure out creative solutions. Be determined to focus on loving each other and knowing that as long as the two of you are in this together, that’s what counts. Give yourself permission to have fun. We have a tendency to stop all fun during tough financial times because we feel that we’re supposed to be sad and overworked. It’s irrational to think that if you feel sad it will improve your situation. If it does not help you then you might as well work on keeping your spirits up. Jeremy Skow, LMHC, CASAC, MBA maintains a private practice in Great Neck. Visit www.mentalhealthcounselingny.com or call 516-322-9133 for more information. 151879 C
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In a perfect world (at least my perfect world), meals would consist of appetizers and desserts. Obviously, it is not practical to eat appetizers and desserts at every meal—I mean it would be a little time-consuming coming up with all that mini-food—but we can certainly entertain that way. In fact that is my very favorite way to entertain, cocktail parties with small bites, some savory, some sweet. When I am the one hosting a party, I get to choose all the foods I personally adore. This is one of the many reasons I really like entertaining! I love Greek food, but being gluten-intolerant I often can’t indulge in some of my favorites from before. However, that doesn’t mean that I can’t reinvent them to be gluten free. These Spanakopita Bites are a perfect example. Traditionally, spanakopita is a spinach-cheese filling folded into triangles with layers of filo dough, brushed with butter. I have yet to master (or to be perfectly honest, ever even tried to make) gluten free filo dough so I improvised and baked a traditional spanakopita filling into little cups made with gluten-free focaccia mix. Doing so makes them not only gluten-free but grain-free as well. This recipe makes a lot of little bites, perfect for a party. If you have too many (and I seriously doubt that) you can always freeze them. Just wrap them up well after being baked and cooled, then freeze for up to a month. Defrost and then re-heat at 350 for a few minutes until hot.
Spanakopita Bites
Gluten-free, non-stick cooking spray 2 Tbsp pine nuts 2 (7.5 ounce) boxes gluten-free focaccia mix 6 Tbsp olive oil, divided use 4 large eggs ½ cup water 1½ cups grated Parmesan cheese, divided use 1 small white onion, chopped 2 scallions, minced 1 (10 oz.) box frozen spinach, thawed 4 oz. feta cheese, crumbled ½ cup ricotta cheese ¾ tsp salt
SIMPLY GLUTEN FREE Carol Kicinski
½ tsp freshly ground black pepper ½ tsp freshly grated nutmeg Preheat oven to 375 degrees. Spray two (24 each) mini-muffin tins with cooking spray. Put pine nuts in a dry skillet and cook over medium heat, stirring frequently, until lightly browned, 4 minutes. Set aside. In a large mixing bowl combine the focaccia mix, 4 tablespoons olive oil, four eggs, water, and 1 cup Parmesan cheese. Dump the mixture out onto a clean work surface and knead until a smooth dough forms, about 2 minutes. Divide into 48 equal sized balls. Place the balls in the muffin tins and make an indentation with your thumb into each ball forming a cup. Heat the remaining 2 tablespoons of olive oil in a large skillet over medium-high heat. Add the onion and cook, stirring often, until soft and translucent, about five minutes. Add the scallions and cook for 1 minute. Squeeze all the moisture from the spinach and add to the onions. Cook, stirring, until the spinach is totally dry. Put in a mixing bowl; add the reserved pine nuts, feta, ricotta, salt, pepper, and nutmeg. Stir to combine. Spoon the filling into the cups. Sprinkle the remaining ½ cup Parmesan on top of the cups and bake for 15 minutes or until lightly browned. Serve hot, warm, or at room temperature. Makes 48 appetizers.
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HEALTHY LIVING • JULY 13 - 19, 2016
Many Viruses Associated With Hepatitis THE SPECIALIST David Bernstein, MD
tests may show abnormal liver tests. These findings do not mean that liver damage has occurred or that a further evaluation is necessary at that time. The commonsense approach would be to wait for the symptoms to get better and then repeat the blood tests. Don’t forget, many people will also have abnormal blood tests because they took over-the-counter medications or health store products or old antibiotics that were lying around in the cabinet in the hopes of making themselves feel better. In the vast majority of people, after an appropriate wait, the liver enzymes will normalize. Infectious mononucleosis, or “mono,” the kissing disease, is a disease of young adults. This condition, caused by the Epstein-Barr virus (EBV), typically infects teenagers and young adults 15-25 years of age. It is especially common in schools, camps, hospitals and military areas. The transmission of
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this virus is by close personal contact such as such the transfer of saliva during kissing. Once infected, the duration of the disease can vary tremendously from a few days to a few weeks. This condition usually starts with fatigue, sore throat, a high evening fever and enlarged, tender lymph nodes in the neck area. Over time, an enlarged liver and/or spleen may develop associated with a rash and swelling of the areas around the eyes. Liver enzymes may be dramatically elevated but diagnosis is based solely on determining the presence of antibodies in the blood to the Epstein-Barr virus. There is no treatment for mononucleosis other than supportive care, including drinking plenty of fluids. Liver test abnormalities quickly resolve with clearance of the virus. Classically, people with mononucleosis may become jaundiced if given antibiotics. There are no long-term deleterious effects in the liver related to this infection.
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Many other viruses have been associated with hepatitis. Some other examples which are less common in our area include yellow fever, Ebola virus, German measles, herpes simplex and cytomegalovirus (CMV). It is very important to understand that not all abnormalities of liver enzymes resulting in hepatitis are caused by the named hepatitis A-E viruses. Appropriate testing, when indicated, may help solve the case and place the patient at ease as most of the other viruses causing hepatitis are self-limited, usually benign infections. David Bernstein, MD, is chief of gastroenterology, hepatology and nutrition at North Shore University Hospital and Long Island Jewish Medical Center.
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There are many infectious causes of hepatitis and most people are familiar the common ones, aptly named hepatitis A, B, C, D and E. While these are best known, there are many other viruses which can cause hepatitis and are important to be aware of as we enter summer. Almost all viruses can cause mild, transient elevations in the liver chemistries, including the virus that causes the common cold. Some viruses may even cause liver tests to become markedly elevated or cause jaundice but it is rare for these viruses to cause liver failure. Adenoviruses are common causes of bronchitis, pneumonia, conjunctivitis and gastroenteritis. People infected with these self-limited infections usually complain of cough, fever, abdominal pain, diarrhea or eye pain. Enteroviruses are another family of virus that are common in our area and can cause hepatitis. Coxsackie viruses, common amongst children in summer camps and pools, may cause a variety of complaints ranging from stiff neck to cough to chest pain to rash to diarrhea. All of these viruses commonly cause mild liver test elevations. Most people infected with these types of viruses never see a doctor for their complaints. Some, however, will seek medical care and routine blood
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HEALTHY LIVING • JULY 13 - 19, 2016
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