Healthy Living 12/14/22 edition is published monthly by Anton Media Group.

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Lead Hazards In Toys

Many children get toys and toy jewelry as gifts during the holiday season. Some toys, especially some imported toys, antique toys, and toy jewelry may contain lead. Although lead is invisible to the naked eye and has no smell, exposure to lead can seriously harm a child’s health. Young children tend to put their hands, toys, or other objects—which may be made of lead or contaminated with lead or lead dust—into their mouths. If you have a small child in your household, make sure the child does not have access to toys, jewelry, or other items that may contain lead.

Lead may be found in the paint, metal, and plastic parts of some toys and toy jewelry, particularly those made in other countries, and also antique toys and collectibles.

In 2008, the Consumer Product Safety Improvement Act (CPSIA) was signed into law, requiring toys and infant products to be tested to mandatory standards before being sold.

The use of lead in plastics has not been banned. Lead softens plastic, making a toy more flexible to return to its original shape. Lead may also be used in plastic toys to stabilize molecules from heat.

Lead dust can form on toys when some plastics are exposed to sunlight, air, and detergents that break down the chemical bond between the lead and plastics.

Lead also may be combined with other metals, such as tin, to create alloys that are used to make toys.

To reduce children’s risk for lead exposure, the U.S. Consumer Product Safety Commission (CPSC) tests and issues recalls of current products that may potentially expose children to lead. Check the CPSC website (www.cpsc.gov/recalls) to be sure your child’s toys are safe. You can find photos and descriptions of currently recalled toys on that website.

Protect children from exposure to lead in metal and plastic toys, especially imported toys, antique toys, and toy jewelry. How can I test a toy for lead?

Only a certified laboratory can accurately determine how much lead is in a toy. Although do-it-yourself kits indicating the presence of lead are available, they do not show how much lead is present and their reliability at detecting low levels of lead has not been determined.

What should I do if I am concerned about my child’s exposure to lead in a toy?

If you think your child has been exposed to a toy containing lead, or if your child has a recalled toy, take away the toy immediately and contact your child’s healthcare provider. Most children who are exposed to lead have no symptoms. A blood lead test is the best way to find out if your child has been exposed to lead. Your child’s healthcare provider can help you decide whether a blood lead test is needed and can recommend appropriate follow-up actions if your child has been exposed. As levels of

Toy jewelry often contains a lot of lead.

lead in the blood increase, adverse effects from lead may also increase.

Lead in Toy Jewelry

What are the effects of wearing toy jewelry?

Just wearing toy jewelry that contains lead will not cause your child to have a high level of lead in their blood. However, young children often place their toys, fingers,

Lead exposure is preventable.

and other objects in their mouths as a part of their normal development. Chewing, sucking on or swallowing toy jewelry that contains lead will expose your child to lead.

Make sure children in your home do not have access to jewelry or other items that may contain lead. Additionally, regularly washing children’s toys and hands can prevent them from swallowing or breathing in lead or lead dust.

Regular handwashing can reduce lead poisoning.

If you think your child put jewelry containing lead in his or her mouth, take the jewelry away from your child and contact your child’s healthcare provider. Your child’s healthcare provider can help you decide whether a blood lead test is needed and can recommend appropriate follow-up actions if your child has been exposed. Many private insurance policies cover the cost of testing for blood lead, and blood lead testing for children enrolled in Medicaid is covered by the Centers for Medicare & Medicaid Services (CMS). For additional information on local resources, contact the childhood lead poisoning prevention program in your area.

No safe blood lead level in children has been identified. Even low levels of lead in blood have been shown to affect a child’s intelligence, ability to pay attention, and academic achievement.

The good news is that childhood lead exposure is preventable.

—National Center for Environmental Health

What should I do if I think my child put lead jewelry in his or her mouth?

Five Healthy Eating Tips For The Holidays

Your recipe for staying on track no matter what’s cooking

‘Tis the season for family, festivity, and food—lots of food. Temptations are everywhere, and parties and travel disrupt daily routines. What’s more, it all goes on for weeks. How do you stick to your diabetes meal plan when everyone around you seems to be splurging? Here are five tips that can help:

1. Holiday-Proof Your Plan

You may not be able to control what food you’re served, and you’re going to see other people eating tempting treats. Meet the challenges armed with a plan:

• Eat close to your usual times to keep your blood sugar steady. If your meal is served later than normal, eat a small snack at your usual mealtime and eat a little less when dinner is served.

• Invited to a party? Offer to bring a healthy dish along.

• If you have a sweet treat, cut back on other carbs (like potatoes and bread) during the meal.

• Don’t skip meals to save up for a feast. It will be harder to manage your blood sugar, and you’ll be really hungry and more likely to overeat.

• If you slip up, get right back to healthy eating with your next meal.

2. Outsmart the Buffet

Savor a serving of the foods you really love.

When you face a spread of delicious holiday food, make healthy choices easier:

• Have a small plate of the foods you like best and then move away from the buffet table.

• Start with vegetables to take the edge off your appetite.

• Eat slowly. It takes at least 20 minutes for your brain to realize you’re full.

• Avoid or limit alcohol. If you do have an alcoholic drink, have it with food. Alcohol

can lower blood sugar and interact with diabetes medicines.

• Also plan to stay on top of your blood sugar. Check it more often during the holidays, and if you take medicine, ask your doctor if the amount needs to be adjusted.

3. Fit in Favorites

No food is on the naughty list. Choose the dishes you really love and can’t get any other time of year, like Aunt Edna’s pumpkin

pie. Slow down and savor a small serving, and make sure to count it in your meal plan.

4. Keep Moving

You’ve got a lot on your plate this time of year, and physical activity can get crowded out. But being active is your secret holiday weapon; it can help make up for eating more than usual and reduce stress during this most stressful time of year. Get moving with friends and family, such as taking a walk after a holiday meal.

5. Get Your Zzzs

Going out more and staying out later often means cutting back on sleep. Sleep loss can make it harder to manage your blood sugar, and when you’re sleep deprived you’ll tend to eat more and prefer high-fat, high-sugar food. Aim for seven to eight hours per night to guard against mindless eating.

Most of all, remember what the season is about—celebrating and connecting with the people you care about. When you focus more on the fun, it’s easier to focus less on the food.

—Centers for Disease Control and Prevention

If you plan for it, no food needs to be on the naughty list.

Dara Jones Joins HSS Long Island

A pediatric physiatrist, she sees a strong need for services here

Dara Jones, MD, of Port Washington has joined HSS Long Island, the Uniondale location of Hospital for Special Surgery. Jones is a pediatric physiatrist—a medical doctor specializing in physical medicine and rehabilitation in children and teenagers. Her practice is dedicated to the diagnosis, treatment and management of physical conditions and impairments present at birth or that develop during childhood. In addition to Long Island, she will continue to practice at the main hospital on Manhattan’s Upper East Side.

With patients generally ranging in age from infants to 18-year-olds, Jones seeks to improve quality of life for those with cerebral palsy; developmental disorders; musculoskeletal and neurologic conditions; gait abnormalities; muscular dystrophy; traumatic brain injuries; spinal cord injuries; spina bifida; and acute injuries affecting the muscles, bones and joints.

With only a handful of pediatric physiatrists on Long Island, she sees a strong need for services here. “Many of my Long Island patients have been making the trip into Manhattan, often for treatments

that require multiple appointments,” Jones said. “I am delighted that I can now provide services on Long Island, which will make it so much more convenient for them. Plus, the Uniondale location is a beautiful, modern facility that’s easy to access with ample parking.”

Jones knew she found her calling early on−the first time she saw a child’s face light up during a consultation. She was explaining to the seven-year-old, who has cerebral palsy, that she could do anything she wants to do, even if it looks a little different from the way others do it.

“It’s always about what patients can do; it’s never about what they can’t do,” she said. “I work with a team of experts at HSS to optimize treatment and provide care to meet the needs of each family and achieve the goals and reach the full potential of each patient.” The team often includes pediatric orthopedic surgeons; physical, occupational and speech therapists; social workers; and experts who make adaptive equipment and assistive devices.

Board certified in Physical Medicine and Rehabilitation, Jones received her medical degree from Louisiana State University Health Sciences Center in New

Orleans. She completed her residency in Physical Medicine and Rehabilitation at the Icahn School of Medicine at Mount Sinai Hospital in New York City and a fellowship in Pediatric Rehabilitation Medicine at Montefiore Medical Center/ Albert Einstein School of Medicine.

She joins 36 specialists in orthopedic surgery, sports medicine, adult physiatry, rheumatology and pain management at HSS Long Island, located in The Omni professional building off Hempstead Turnpike in Uniondale.

“The HSS system and standards are as strong on Long Island as they are in New York City,” Jones said. “And the recent expansion, additional imaging services and new rehab facility at the Nassau County location are impressive.”

Jones, who moved to Port Washington this year with her husband and two young sons, says she couldn’t be happier in her new home.

“We love the water; we love the beach. We go boating, we fish,” she said. “We are really happy here. It’s exactly what we wanted, a great place for our sons to grow up in.”

—HSS Long Island

Dr. Dara Jones

Double Up On The Guac?

Those avocados are good for your heart health

Adding avocados to a healthy diet could reduce your risk of cardiovascular disease, including lowering your cholesterol, according to research published by the American Heart Association (AHA). That’s especially good news because the consumption of avocados in the U.S. has nearly tripled in the past two decades, up to nearly 2.6 billion pounds a year.

Avocados contain high amounts

of fiber, potassium, magnesium, folate, vitamin C and vitamin K.

The fruit is a known source of healthy, unsaturated fats and a great replacement for certain fat-containing foods like butter, cheese or processed meats.

lower risk of cardiovascular disease and a 21 percent lower risk of coronary heart disease, compared to those who never or rarely ate avocados.

A study published in the Journal of American Heart Association found that eating one avocado a day as part of a moderate-fat diet resulted in lower “bad” LDL cholesterol.

A study recently published in the Journal of the American Heart Association found that:

• People who ate at least one avocado each week had a 16 percent

• Replacing half a serving daily of margarine, butter, egg, yogurt, cheese or processed meats such as bacon with the same amount of avocado was associated with a 16 to 22 percent lower risk of cardiovascular disease events.

The research on avocados aligns with the American Heart Association’s guidance to follow the Mediterranean diet – a dietary pattern focused on fruits, vegetables, grains, beans, fish and other healthy foods and plant-based fats such as

olive, canola, sesame and other non-tropical oils.

The AHA website (www.heart.org) has a number of hearthealthy recipes using avocados.

Cirrhosis-Related Readmissions Are Common

People with cirrhosis require frequent hospitalizations and often are readmitted soon after discharge, many times within 30 days. This is an obvious cause of concern for patients and their families who often question why this is happening.

This topic is a subject of much thought among all parties involved. The reasons why this phenomenon occurs are complicated and multi-factorial. Are the patients taking their medications correctly after leaving the hospital? Are the health care providers

providing timely outpatient follow up to these patients? Are insurance companies paying for needed outpatient medications after discharge?

A study recently released from the University of Indiana addresses this issue. Their findings were striking. Almost 40 percent of all patients with cirrhosis who were discharged from the hospital were readmitted within 30 days of discharge. Only 12 percent of these were preventable readmissions. The most common indications

for readmission were hepatic encephalopathy, gastrointestinal bleeding and acute kidney injury.

Focus on the reasons behind these preventable readmissions such as the patient is discharged before being ready to go home, the lack of appropriate outpatient follow up being arranged prior to discharge and the inability of the patient to get the medications which were prescribed upon discharge in the outpatient setting.

Patients with cirrhosis routinely require hospitalization

and this impacts their overall quality of life. While most readmissions are secondary to disease progression and not preventable, there remains a subset which are preventable.

It behooves the medical profession to do all that it can to keep these patients from being unnecessarily admitted to the hospital by implementing policies that enable patients to obtain the care they need.

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Angelina Stanco-Stone

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

THE SPECIALIST David Bernstein, MD