Rivertowns Enterprise - To Your Health

To Your Health!

A SPECIAL SECTION OF THE RIVERTOWNS ENTERPRISE

|

OCTOBER 9, 2015

Apps

FOR FITNESS

How technology is changing the shape of our health

By EVE MARX

W

e are living in the golden age of technological applications. For almost any subject you can think of, there’s probably an app, which is a self-contained program or piece of software that is very special and focused, used primarily on smartphones. Apps are downloaded from the App Store on your smartphone. Each app has an individual icon that is loaded after purchase. To access an app,

all you have to do is touch on its icon. There are dozens of apps out now, most of them free, in fact, that will give you health and nutrition and exercise information and even empathy and encouragement. All things you want from a private nutrition coach or personal trainer.

Jessica Dietz, office manager at NY Health & Wellness, a medical weight loss and health center in Harrison, said, “Technology is useful and convenient.” She said that Dr. Timothy Morley, a bioidentical hormone expert and the center’s medical director, is currently in project development

for his own app that he can offer to his clients to aid and support them through their weight loss. “It will be journal based, so clients can record their food intake and eating patterns,” Dietz said.

Dietz said she thought apps could be extremely useful and gratifying for users who at the same time under the care of a doctor: “I think there’s a good balance.”

For the curious, even a brief Google search turns up dozens of potentially useful health apps. A few especially noted for their usefulness include: • FitStar Personal Trainer, which is rec-

ommended for those just starting out on their fitness journey to fitness fanatics. Created by former NFL star Tony Gonzalez, it’s free on iOS. • Runtastic Six Pack Abs slow motion videos of virtual trainers teaches you how to do a specific exercise correctly the first time around. This will help you avoid injuries, which often occur because you’re doing a movement wrong. This app is also free on iOS and Android.

• Pump Up is a social platform oriented app that lets you share your workouts and Continued on page 7A

Awareness and options for breast cancer

By ANTHONY R. MANCINI

INSIDE

Cup of Joe: A harmful vice or health elixir? ................................................................ 3A Health news: An alternative to make your vision AOK............................................ 4A Brain scans: from understanding to treatments ..................................................... 6A It’s personal: Medicine will soon be all about you........................................................ 8A Treatment-resistant depression: what can you do?.................................................. 10A

H

ealth care professionals in Westchester hospitals are touting recent advances in breast cancer treatment, allowing patients numerous choices in the type of medicine they receive and the amount of surgery they are comfortable with.

“I think it’s important for women to feel empowered and educated about their options,” said Dr. Ranjana Chaterji, a doctor of osteopathic medicine and breast surgeon with The Breast Institute of Northern Westchester Hospital in Mount Kisco. “It’s very scary when you’re diagnosed with breast cancer, but it’s really important to understand what your options are and feel like you’re in control over those options.”

Dr. Chaterji said that around 20 to 30 years ago, if a doctor discovered a malignant lump or abnormality within a breast, a patient going in for surgery would not know how much of her breast would be removed. The patient could potentially be left with disfiguring scars.

“If they had a lump they would go into surgery and then they would not know if they were going to wake up with a breast or not,” she said. “They would be offered no reconstruction. We definitely evolved into treating it a much more humane manner, giving patients a lot of options.”

Treating breast cancer begins at the preventative level, with annual screening recommended once a woman turns 40, unless there is a case of family history where it is recContinued on page 12A

Page 2A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

A BOUTIQUE INDOOR CYCLING STUDIO

Classes for all levels of fitness.

Our certified indoor cycling instructors inspire, motivate and improve wellness through a healthy dose of fun and exercise.

You’ll be hooked after your first ride!

Spincredible...

Dave Norfleet

Leslie Kahan

Ride Power Ride Performance Ride Cycle/Sculpt Ride

ASK ONE OF OUR RIDERS… “Spincredible is a family run business like Cheers: everyone knows your name! The instructors teach each class with their own special touch so you can find someone who really motivates you. The bikes are state of the art, the room is sunny, and the atmosphere is welcoming. It’s not about competition. It’s about personal best...and enjoying the ride!”

Barbara Vinciguerra

Laurie Goldsmith Sperandio

High School/ College Student and Senior Special Pay one price for monthly unlimited rides

– Marianne

No more lines. Convenient online registration.

www.spincredibleny.com 692 SAW MILL RIVER ROAD, ARDSLEY, NY 10502 • info@spincredibleny.com

Friday, October 9, 2015 | The Rivertowns Enterprise

To Your Health! | Page 3A

Cup of Joe: A harmful vice or health elixir?

T

By JENNIFER LEAVITT

rying to keep up with the latest research on which foods, drinks and supplements we should stock up on, and which ones we should immediately shun, can be downright exhausting. It’s enough to make you want to reach for a double espresso. And that may not be such a bad thing after all.

Coffee is a longtime staple in the western diet, and for most who drink it daily, it’s a habit that dies hard. The good news is, despite its dubious reputation over the decades, that java may actually be good for you.

For decades it seemed to be common knowledge that coffee stressed our cardiovascular systems, led to stomach ulcers and caused dehydration and insomnia. Many Americans perceived it as a necessary evil for making it through life. Then one day, our morning fuel was redeemed when food chemists announced that it was a good source of antioxidants. Soon after, a Harvard research study revealed that people who drank as many as six cups of coffee per day were less likely to die during the next five years.

That news was followed by a surge of research into the relationships between coffee and specific diseases, with surprising results. Dozens of long-term studies in the United States, Europe, and Asia have shown not only does coffee not cause heart attacks and strokes, but it actually seems to have a protective effect against these incidents.

One Kaiser Permanente study, endorsed by the American Heart Association, examined the healthcare data of 130,000 members and discovered coffee drinkers were less likely to need hospitalization for heart rhythm disturbances. One to three cups per day reduced cardiac incidents, regardless of other risk factors.

In Sweden, researchers followed 30,000 women over 10 years and learned that those who drank more than one cup per day appeared to have a 22 to 25 percent

Rivertowns Dental

lower risk of stroke than non-coffee-drinkers did. They also concluded that low or no consumption of coffee increased the risk of stroke in women.

Habitual coffee drinkers tend to have slightly lower blood pressure than non-consumers do, and a better chance of avoiding diabetes. Study participants who increased their intake of daily coffee by more than one cup over four years reduced their risks by 11 percent compared to those who made no changes.

Across hundreds of these studies, the group reaping the greatest benefits appeared to be those drinking 2-3 cups of coffee per day, but even at 5 cups, no negative cardiovascular implications were found.

Even the dehydrating myth has been labeled as such. Although coffee does indeed have a diuretic effect, that is apparently offset by the drink’s volume of liquid.

Coffee appears to be protective of our Continued on page 5A

DESPITE WHAT YOU HEAR, DO NOT WEAR CONTACTS TO BED. CHECK IT OUT FOR YOURSELF:

Dr. Samar Tannous Call today for an appointment!

Services Include:

General Dentistry ~ Root Canal Therapy

Cosmetic Dentistry Including: Bonding, Veneers, Crowns and Bridges Invisalign ~ Teeth Whitening

“Man goes blind in 1 eye after sleeping in contact lenses.”

(Read the article at the link below to see what can happen with improper contact lens wear) http://abc7ny.com/health/man-goes-blind-in-1-eye-aftersleeping-in-contacts/957812/

Hours by appointment

Don’t wait and schedule your family’s eye exam today with Dr. Sedaghati.

34 High Street, Hastings-On-Hudson, N.Y. 10706

As always “Our Focus is on YOU.”

(corner of High and Rose)

(914) 214-8228 Dr. Tannous has practiced dentistry for over 15 years. She earned her DDS and a diploma in Pediatric and Community Dentistry in 1994. Known for her high quality and good caring, Dr. Tannous shares her extensive experience and continues her dental education to solve most of today’s dental problems and concerns. She is a member of the American Dental Association and the American Academy Of Facial Cosmetics.

Bauer Optical Eye Care

45 Main Street, Hastings-On-Hudson, N.Y. 10706 478-0550 Check us out on the web: www.baueropticaleyecare.com

~ Ed Klotz, Optician ~

Page 4A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

Health News: An alternative to make your vision AOK

N

prescription. It’s these small, very tiny little incremental changes that we create with the mold that allow you to see clearly and safely.

By TODD SLISS

o eyeglasses, no contact lenses during the day, no surgery and there is still a way to see clearly?

Yes, thanks to advanced orthokeratology, also known as AOK. With AOK molds or retainers custom made for each patient that are worn like contact lenses overnight, the cornea is reshaped while you sleep, and not only does it give you a full day’s worth of vision by keeping its corrected shape, but it slows down the progression of your nearsightedness (myopia), farsightedness or astigmatism, according to Dr. Abraham Zlatin of Eye Q Optometrist in Scarsdale and Manhattan.

As AOK is not permanent, you can stop using it at any time. You can use the lenses until you are old enough to get LASIK surgery — 18 at the earliest. Once you stop AOK, your myopia will return to it’s normal state. AOK can be used for kids as young as 5 as long as the parents are comfortable with them having what looks like a normal contact lens, though smaller, in their child’s eyes overnight. It is for all ages beyond that and is very popular with athletes who don’t want to wear goggles or can’t wear contacts and can’t get their lenses wet from water and sweat.

You can see well after one or two overnights, but it takes about 10-14 days for the AOK lenses to take full effect. This all follows thorough examination, which includes a study of the topography of the eye by a trained specialist in order to create the perfect custom mold.

Dr. Zlatin has spent over half his career administering AOK since it received FDA approval in 2002 as CRT (corneal refractive therapy), which had already been in use overseas for more than a decade. There are several types of molds under the AOK umbrella.

Television personality and 1984 White Plains High School graduate A.J. Hammer is a long-time patient of Dr. Zlatin and did a promotional video for him. Hammer uses AOK for many of the same reasons as Zlatin’s other patients: doesn’t want to wear glasses, can’t do everything he needs to do with lenses and didn’t want to get surgery.

Dr. Zlatin shared the ins and outs of AOK: Q: How long have you been practicing and doing this sort of work?

A: I’ve been specializing in contact lenses since 1993 and AOK was FDA-approved in

Q: How does it work that it last the full day after wearing the molds overnight?

A: The cornea is elastic and it holds its shape. It’s something that once it’s fully shaped it will go back to its natural shape slowly over time. It’s almost like if you take a wedding ring off of your finger and you can see that little indentation there for a minute or two. That’s what we’re doing — we’re reshaping soft tissue and it will go back to its natural state. The collagen in the cornea just holds it much longer.

Dr. Abraham Zlatin

2002, which is when I started treating patients with it. Before it was FDA approved I was studying it, but I waited until we got the nod just to make sure the safety level was what we knew it was and was proven. So I’ve been doing it for many years.

Q: What do the molds look like compared to a pair of regular contact lenses?

A: They look very similar to a contact lens. They are just usually a little smaller.

They’re easier to insert, easier to remove, so children actually do better at putting them in and taking them out than contact lenses.

Q: How do the molds function in helping give patients better vision?

A: They do two completely different things. They correct and reverse the current prescription so you can see clearly without glasses, contact lenses or doing any kind of surgery. Also, especially with children, there is another prescription that is designed in the treatment that stops or slows down the progression of nearsightedness, so the children from year to year don’t end up with their eyes getting worse and worse at the same rate as if they wore glasses or traditional contact lenses.

Q: What do the molds actually do to the eye?

A: They gently remold the top surface of the cornea in a way that eliminates their prescription. We’re nearsighted or farsighted or astigmatic because of the shape of the eye. What the molds do is they reshape microns — we’re talking the thickness of a hair — and that can dramatically change a

Q: Do a patient’s molds change over time?

A: A good design on a stable eye does not need to be changed over time. It just needs to be replaced because it’s consumable.

Think of it like a windshield wiper — you’re using it, you’re cleaning it, you’re rubbing it. It can develop changes over time, so that mold itself gets replaced, but usually it gets replaced with an identical. It’s not that the mold has to keep being redesigned. In some cases it does depending on the patient, but that’s not common.

Q: How long will a pair of molds last?

A: A pair of molds generally lasts in really good shape for a full year. It’s not like a disposable contact lens that needs to be changed every two weeks. It will last you easily for the year.

Q: With a patient’s prescription not changing or getting worse with glasses or contacts as the years go on, what are some the health problems that can be avoided by using AOK? A: The problem with becoming nearsighted is the reason the eye becomes more nearsighted every year is because the eye is actually growing longer, stretching. As it stretches it thins out the retina and it starts to create more medical problems related to nearsightedness such as retinal detachment, holes, tears, maculopathy, cataracts and glaucoma. Those are all more common in high nearsighted patients than patients who are not nearsighted or have lower nearsighted prescriptions.

lenses, so if you are comfortable with the safety or the risks of contact lenses, then you should be comfortable with the safety of AOK molds. We need to understand — and it’s difficult to convey — that sleeping with an AOK mold is not the same as sleeping with a contact lens. Period. It is not the same. Sleeping with a contact lens is not recommended because the lens is on the eye all day long. The lens gets dirty. We develop a biofilm on the lens. There are dead cells underneath the lens that become trapped and are more toxic to the cornea. A soft contact lens will absorb everything, so we strongly advise patients to avoid water.

Basically AOK only go in at bedtime and they come out in the morning as soon as you wake up. They are never really on your eye while you are conscious or awake.

There is nothing really bothering you. People ask how you feel. They feel great because you don’t feel anything. When they are on your eye they are on a few minutes before you’re going to sleep. After you put them on you close your eyes — you’re not blinking, you’re not feeling them. Some patients actually tell me they feel weird if they forget to put them in at night. They feel weird sleeping without them because they get used to it. You feel funny when you sleep without them. It doesn’t bother people, it doesn’t hurt, it’s not uncomfortable. It’s like anything where maybe the first week or two there’s some discomfort because you’re not used to it. Your eye is a little sensitive, but once you get used to it they’re very comfortable.

Q: What if you don’t wear them for a couple of days or a couple of weeks? Can you just go back to wearing them at night?

A: If you regress and then start wearing them again, it begins to treat you again right away. Most patients don’t want their vision to go in and out of focus and we want to maintain myopia control in children, so we don’t want children to wear it sometimes and not other times. You get better consistent clarity if you wear it nightly. If you miss one night once you are fully treated you can still see the following day. It might not be as crisp, but it won’t be as bad as wearing an old pair of glasses usually.

Q: What is the benefit of offering this to all ages?

Q: Is there any danger wearing AOK molds overnight?

A: We do it so there’s freedom, freedom

A: The safety is the same as contact

Continued on page 15A

PERSONAL

TRAINING

No crowds. No memberships. Real results.

“PUSH has provided me with a great gym & an extremely knowledgable

Introductory Special 3 Sessions

149

$

personal trainer who has made meeting my strength and flexibility goals easier than expected. I now have much more energy throughout the day.The best antidote for aging.”

~ Mark A. - Irvington

www.PushTrainingStudio.com | 914-274-8388 50 South Buckhout St. | Suite 304 | Irvington | NY 10533

Friday, October 9, 2015 | The Rivertowns Enterprise

Cup of Joe

Continued from page 3A

liver, gallbladder, intestines and pancreas as well. Italian researchers learned that taking up the coffee habit lowered liver cancer risks by 40 percent, while drinking three cups per day could reduce the risk by an additional 10 percent.

Coffee has also been associated with reduced risks of oral, endometrium, brain, colon and rectum cancers, and one study showed strong protection against breast cancer recurrence in women who were taking tamoxifen.

The story doesn’t end there.

Word from the lab is that drinking several cups of coffee per day is associated with reduced rates and later onset of Alzheimer’s disease. Those who indulge in their favorite morning (or anytime) brew are also less likely to develop Parkinson’s.

Researchers were convinced that caffeine was the healing ingredient, until another study called that wisdom into question. While it may be the best known component in our sunrise mugs, it only accounts for 2 percent of the bean. It is highly likely that the polyphenols, chlorogenic acids, phytoestrogens and other micro ingredients contribute to our health. In fact, researchers at the Icahn School of Medicine at Mount Sinai discovered in their study on mice that decaffeinated coffee improved the brain energy metabolism seen in type 2 diabetes, and which happens to be a risk factor for Alzheimer’s disease and other forms of dementia.

An 8 ounce cup of coffee usually contains one to three percent of our daily required folate, thiamin, niacin, manganese,

potassium, magnesium and phosphorus; six percent of the pantothenic acid we need; and 11 percent of our daily requirement for riboflavin. It also contains, believe it or not, nearly half a gram of fiber.

So is this a green light to start drinking coffee by the gallon?

Yes and no, say the experts.

For starters, everyone has different physiology to some extent. What bolsters one person’s health may send another into anaphylactic shock. Pay attention to what your body is telling you.

Then too, the one entirely legitimate warning about coffee is that it can cause sleep disturbances. No one should be using caffeine as a substitute for slumber. And drinking too late in the day can cause serious insomnia that night. Plan accordingly.

Despite all the promising studies, we do know that caffeine increases catecholamines, which are stress hormones, and it can cause anxiety in some people. Caffeinated coffee is also addictive, so where you once drew on energy from adequate sleep, fresh air and balanced nutrition, you may come to need it just to feel normal, and to avoid brain fog and headaches that can start just 24 hours after your last cup.

One final word of warning is to remember that correlation does not equal causation. This means that, even though we know coffee drinkers have better health outcomes, that could be because coffee drinkers have other healthy habits that were overlooked.

Of course, coffee is not our only source of caffeine. The past decade has seen another favorite bean of ours exonerated as well — the cocoa bean. So have your coffee and eat your chocolate, too. Until they say otherwise, it’s all good.

To Your Health! | Page 5A

OM CHI WELLNESS 145 Palisade Street, Suite 369 . Dobbs Ferry, NY 10522

914-433-7135

“Phil has an innate ability to assess each individual’s physical strengths and weaknesses and tailor each workout to whatever they specifically need.

He has the tact, skills and talent to work with diverse individuals, which is truly a gift.”

Functional Training - Cutting Edge Fitness The Platform to Launch Your Fitness Goals Moving in ALL Planes of Motion Qigong (Sunday Mornings) Subtle Movements Designed to Move Energy in the Body that Cultivates Optimal Health Internal Martial Arts (Classes Now Forming) Invisible Buddha Fist with Sifu Joseph Ng

Visit us at www.omchiwellness.com Call Phillip Coyle at (914) 433-7135

exceptional dentistry

beautiful smiles Dr. Strick, dds

2015 TopDentists™ 2013

Cosmetic Dentistry Family Dentistry

Call for your appointment today!

Dr. Charles Strick, dds 20 Center Street Ardsley, New York 10502

(914)693-6990

www.charlesstrickdds.com

Page 6A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

BRAIN SCANS: from understanding to treatments

By JENNIFER LEAVITT

N

ot so very long ago, mind reading rested squarely in the domain of mysticism, while Alzheimer’s Disease could only be identified postmortem. The past 15 years, though, have seen a surge in neuroimaging advances. Our understanding of what goes on in the human brain has grown by leaps and bounds as sophisticated methods like fMRI (functional magnetic resonance imagin) have taken the field from static snapshots to 3D imagery and even into the realm of real-time videos of neurological activity.

Most of us are familiar with structural imaging, which identifies brain injury, tumors or other physical abnormalities. In functional imaging radiologists explore what the human brain looks like when we’re in love, on drugs, trying to solve a difficult math problem, experiencing depression, anxiety, mania or a wide variety of other states. It is now actually possible to witness information being processed by specific parts of the brain. Activity in an area of the brain leads to faster metabolism and greater blood flow. The areas involved then light up on the scan.

Scientists and physicians are using these technologies in a number of ways.

Cognitive scientists, for instance, are watching the changes that take place in children’s brains as they learn math. One study involved 27 children and 20 adults, along with 609 scans for each of them,

taken as learning was underway. The researchers determined that mature neural patterns in the speech and language-related Broca area were predictive of higher verbal test scores in children. For math, better scores were associated with welldeveloped transmissions in the intraparietal sulcus region, known for its role in processing numbers. Scientists are learning to identify where the processes falter in children with learning disabilities, so that targeted treatments can be developed.

One example of valuable input that has come from neuroimagery is from the year 2000, when researchers at Yale’s Child Study Center discovered through fMRI that those with autism are unable to process faces in the facial recognition center of the human brain. They use the area of the

brain that specializes in object recognition instead, which may explain why autistic children have trouble with facial recognition, do not think it’s important and often have trouble making eye contact. Scientists can now develop therapies that target the involved portions of the brain.

The Amen Clinics, where neuroimagery is the foundation of treatment, were true pioneers in this field when they began 15 years ago. Today, Dr. Daniel Amen can determine whether a patient is experiencing anxiety or, feeling physical pain or even guilt over a failed marriage.

In 2013, researchers learned through neuroimaging that our brains dump toxins out when we are sleeping at night. Our brain does not use the lymphatic system as all of our other body parts do. Among the

Have you had your mammogram?

GREENLEAF PHARMACY 544 Warburton Avenue, Hastings-on-Hudson • 478-0004 Emergency #: 309-7720 • email: greenleaf.pharmacy@yahoo.com

Stay Well!

toxins being dumped is beta amyloid, the protein implicated in Alzheimer’s disease.

The very strong implication here is that lack of sleep may be a major contributing factor to this disease.

Neuroimagery is also being used to diagnose and establish the severity of Alzheimer’s disease and other forms of dementia.

Doctors are ordering imaging to identify types of headaches so they can prescribe the right treatment. And psychiatric diseases are being diagnosed this way.

Another role of neuroimagery involves pharmaceuticals, and the corresponding neurological activity, as physicians explore the brain to determine, objectively, whether medication is working.

Functional brain imaging can also produce more specific treatment monitoring in people with traumatic brain injury. It can help researchers diagnose schizophrenia, ADHD, bipolar disorder, depression and a staggering variety of other conditions.

Now that we can look inside the brain and literally see what’s going on in there, we can expect continuous, rapid fire progress in this field.

Rarely has a cure been discovered for anything without significant scientific knowledge about the underpinnings of disease. The deep mysteries of the brain had doctors relying on subjective patient feedback and observation of behavior for diagnostics and treatment. Today, neuroimagery is leading the way in biomedicine, taking us into an entirely new world where technology is removing the guesswork and turning mind reading into a legitimate science.

Friday, October 9, 2015 | The Rivertowns Enterprise

Apps for Fitness Continued from page 1A

your results (even pictures!) with other fitness enthusiasts. The charm of this app is that you get that whole team spirit thing and support group growing. It’s free on iOS and Android.

• Map My Fitness is a tracking app with an easy to use interface and super accurate tracking. Use this app to set challenges for yourself and with friends; you can track your gear and the app even tells you when it’s time to purchase a new pair of running shoes — it’s that accurate. Free on iOS and Android.

Cecilia De Matteao, MS, CNC, CHC at Enhanced Health Coaching, Inc., in Scarsdale, specializing in nutrition education, weight management and health, has reservations about the use of apps.

“The reality is that individuals are constantly on their smartphone devices,” she said, noting that using an app to improve your health just adds to more data processing and minutiae to the day. “And that’s less incentivizing for many users. Clients have expressed that the process is tedious and frustrating, especially for the average working professional.”

Matteao said she only advises using a nutrition or fitness app as a second or tertiary option. If that. “If a client has to spend 15 to 20 minutes logging in data in an app, I would prefer they spend that 15 minutes going for a walk or preparing meal,” she said.

“We are already on technology overload, so let’s try to remove the handheld gadgets.”

One thing Matteao does like about apps is that they often remind users to drink water. “There is a ‘daily water’ app that sends

you reminders on a schedule to drink eight cups of water a day,” Matteao said. “Drinking adequate amounts of water is a major struggle for many, and the importance of hydration is poorly understood.”

Matteao likes an app called Myfitnesspal that she described as “simple, convenient and flexible for most people to use.”

According to Matteao, apps have their pros and cons: “The pros are they create awareness and short-term accountability and short-term motivation. The cons are they are complex to use and sometimes difficult to interpret results; they are time consuming, tedious, often inaccurate.” An app can never be a substitute for a personal trainer or private coach. “An app is shortterm gratification,” Matteao said. “A health professional’s expertise is to be able to comprehend the complexities of people’s lives and all the challenges and obstacles that are part of their everyday that prohibit them from focusing on their health. Clients become motivated to making changes when they feel that their personal challenges are being heard and understood.”

Matteao said that while Siri is effective helping users of smartphones find answers to questions and an app can show you recorded data, “No technology can ever replace social interaction. Communication is the missing link. Talk to me and tell me how well or not so well you are doing, what the best part of your process is and what is the worst part, and we will work on it together,” Matteao said. “Showing me data on an app provides little to no benefit in the long-term for attaining optimal health. Technology doesn’t produce change but it helps support it. All this technology is fantastic, but it doesn’t give you long, lasting results.”

OrthoCare Physical Therapy & Sports Rehabilitation

Orthopaedic • Sports Injuries Hands On • Manual Therapy Approach Pre & Post Surgical Care Knee and Shoulder • Spinal Rehabilitation Auto/Work Related Injuries

(914) 693-2350 www.orthocarept.net Hours: Monday - Friday, 7:00am - 7:00pm Saturday, 8:00am—1:00pm 1053 Saw Mill River Rd., Ardsley, NY 10502 Most Insurance Plans Accepted Including Medicare, Workers Comp and No Fault

To Your Health! | Page 7A

Fitbit: the latest health tech fad Fitbit is an activity tracker device aimed at measuring your exercise, your diet and your sleep. Worn on the wrist just as you would a watch, a Fitbit captures essential data for you. You can track even more if you take the time to enter data about your meals, your weight and other information, including how much water you drink every day.

If you enter your basic stats, like height, weight, your age, within a very short period of time Fitbit will begin telling you how many steps you took in a day, the distance you traveled on foot, how much time you spent being active, how many calories you burned.

Tell it what time you went to bed and what time you woke up and the device will use motion to tell you how much time you actually spent asleep and even how restless you were.

Fitbits come in a variety of colors and designs. While almost all the designs will track your steps and how many calories you burned, other models track heart rate and how many floors you climbed. The Surge model, which is the most deluxe, also tracks GPS, continuous heart rate, all-day activity stats and sleep. It also includes smart notifications and music control.

A random sampling of user satisfaction conducted on the Facebook page Katonah Parents yielded the following (necessarily anonymous) responses: • “Satisfied when I hit my 5,000th

step!”

• “Both my husband and daughter wear the Fitbit Charge and love it for so many reasons, including the sleep tracking.”

• “Love mine! Very helpful in keeping me active!”

• “I wear mine every day; it’s become part of my wardrobe like a watch. I use mine mostly for sleep tracking and HR. My Fitbit keeps me more active, reminding me of daily steps.”

• “I wear mine every day except the Charge can’t go in the shower so that’s a downside. I use it mostly for sleep tracking, tracking steps, tracking distance and walks.”

• “I use it for all workouts and many days all day. I love it! Make sure to buy the one that tracks heart rate; that’s the most helpful part. In an exercise Facebook accountability group, we all post pictures of our exercise stats.”

• “I just got one and once I got it all set up, i.e. connected to phone and laptop, I started wearing it all the time and tracking steps, heart rate and sleep. It’s a great motivator. I am loving it!”

• “I think I’m the only person who doesn’t love it. I was sitting at my computer typing and it kept registering as ‘steps.’”

— EVE MARX

Page 8A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

IT’S PERSONAL: Medicine will soon be all about you unique well beyond our most obvious traits.

By JENNIFER LEAVITT

M

edical science has increased the average lifespan, improved our quality of life and, in conjunction with technology, has even made it possible to better manage our own health. Doctors are not magicians though, at least not yet. (Researchers are working on it.)

Often an ailment disappears before we even get to the doctor or there is no appropriate diagnostic test for what ails us. Sometimes our symptoms are just too mysterious or vague to pinpoint. And other times ambiguous treatment guidelines mean that we have to play the trial and error game, hoping that something will agree with our personal biochemistry. And soon.

Even when diagnosis and medical care are quick and straightforward, treatment protocols are usually pretty similar whether it’s great aunt Zelda, us or the newspaper boy who is ill. Most treatment is based on standards of care and statistical outcomes and up until now that has made perfect sense. But modern medicine is on the cusp of a dramatic new age.

The age of ‘omics’ The “omics” suffix refers to a study of molecules within a specific set of cells. There are many such fields of study, including lipidomics (concerned with all lipids in the human body), proteomics (focused on proteins) and the omics that are literally paving the way to truly personalized medicine — genomics (exploring our genes) and microbiomics (investi-

gating the microbal world within us. With the help of epigenetics, these latter two omics are leading to advances in biomedicine that scientists, doctors and patients could only dream about a decade ago.

The handbook of you Thousands of genes are woven into our DNA. Each one of those genes is a biological blueprint, filled with very specific instructions for the body that houses it. Slight variations in those instructions can make the difference between red hair or blonde, freckles or olive

skin, disease or health. The entire collection of our own genes is known as our personal genome, while the study of the overarching human genome is known as genomics. Headed by the National Institute of Health, the Human Genome Project, at www.genome. gov/10001772, identified 20,000 human genes, and has been referred to as “one of the great feats of exploration in history.” This data has given the world significant insight into the physiological human condition, including both the many similarities we all share, as well as the profound differences that make us each

Not your mother’s mail order It isn’t only scientists or physicians who can access this kind of data anymore. Regular Joes and Janes can have their entire genomes mapped for a mere $99 from services like 23andme.com, a non-prescription genealogical and genomic service. After sending in a swab of DNA, customers receive their raw genetic data and can run it through free, nonprofit sites such as Promethease for interpretation. (Since New York does not allow these tests without a prescription, residents will have to relocate to New Jersey or Connecticut on the days they order, take and mail back DNA tests.)

With genetic data in hand, your average citizen may find out that one of their genes makes cilantro taste like soap to them or that their bodies will be more receptive to a lowfat vs. a low-carb diet. One woman learned that although wine raises HDL levels for most people, it wouldn’t work for her. She also discovered that she has a number of longevity genes. Other data reveals which medications a person will probably respond to, and which they won’t, as well as pharmaceuticals they are overly sensitive to.

During a chronic or acute illness, this kind of information will soon be helping doctors everywhere skip ineffective treatments, getting right to those that are most likely to work for the specific individual. Remember though, that we can inherit conflicting genes, such as one that makes us less likely to get a certain disease, and one that does the opContinued on the next page

NEW YORK GOJU KARATE BLACK BELT ACADEMY

FREE

MISSION BULLY PROOF SEMINAR WHAT ARE THE 4 TYPES OF BULLYING?

WHAT IS BULLYING?

HOW CAN YOU BE A RESPONSIBLE BYSTANDER?

BULLYING STOPS HERE

HOW DO YOU HANDLE A BULLY SITUATION? WHAT IS VIOLENCE AND ABUSE? WHAT ARE SOME OF THE SIGNS OF BULLYING?

EVERYONE WELCOME! PARENTS, CHILDREN 5 YEARS & UP AND CAREGIVERS. TELL A FRIEND!

SUNDAY, NOVEMBER 1, 2015 . 10 AM – 11:30 PM 558 Warburton Avenue, Hastings on Hudson, N.Y. 10706 onhudsonnygka@gmail.com Visit our web site: WWW.NYGKA.COM

Friday, October 9, 2015 | The Rivertowns Enterprise Continued from the previous page

posite. Then, too, not all instructions get read or followed and so it is in our microworld as it is in the world at large. Genes and their genetic instructions can be ignored, they can be turned on and off by our physical environment, by love or trauma, by our diets, and by the enormous influences of our personal microbiomes.

The micro world inside you Think of our microbiomes as our second personal genomes, only much bigger. It turns out that the 37 trillion cells that make up a human body are vastly outnumbered by some 100 trillion plus single-celled bacteria that live on and in all of us. These bugs, collectively our microbiome, are not parasites or dangerous intruders. Instead, we enjoy a symbiotic and absolutely necessary relationship with them. Representing over 1,000 different species, the “good guys” (friendly bacteria and other helpful microbes) usually outnumber the “bad guys” (damaging bacteria and other microbes) by 4 to 1. They help us ward off pathogens, retrieve nutrients from food, metabolize fat and many other physiological functions. What’s more, our microbiomes are as individual as a fingerprint. Each one of our 100 million organisms bring their unique DNA and genome to the mix to interact with our genes.

Origins of an organ Researchers have determined that a person’s microbiome, if it were gathered all together and compacted into one space, would weigh about as much as the human brain does. Some have even suggested that the microbiome be recognized as a human organ. Your microbiome is well established early in life, but it is also dynamic in nature.

Poor dietary habits, stress and antibiotics can

eradicate those friendly bacteria, while eating plenty of fiber-rich and fermented foods can help them grow and prosper. There are countless other ways to influence our own health, some of which are being explored through the science of epigenetics. Very similar to the Human Genome Project, NIH has a Human Microbiome Project — https://commonfund.nih.gov/hmp/overview — which relies on public biological samples to study and understand the incredible microscopic worlds within us.

Microscopic Manipulation In epigenetics, scientists and doctors take action based on the information garnered from a person’s individual genome and microbiome. In literal terms, epigenetics means “above genetics” and references those modifications to DNA that turn genes on or off, so to speak, basically determining how cells read and respond to the instructions contained within them. Each of our cells may all contain the same DNA, but they express themselves differently from one another.

In the future, when doctors have a full snapshot of a patient’s genetic and microbal makeup, they will have an incredible depth and breadth of insider information, much like secret codes and passwords that they can use to fine-tune human health, our health, in completely personalized and dramatically more effective ways.

Although mainstream clinical applications are 10 to15 years away, the nation’s top medical schools are already exploring and testing them. The general public can register with clinical trials or get involved with genomic and metabolomic research projects and data banks, becoming part of scientific history while getting an inside look at their own biochemistry and microbiology. Now that’s personal.

To Your Health! | Page 9A

Individualized health care for the entire family where and when you need it.

Now offering Allergy, OB/GYN & Pediatrics

• Allergy & Immunology • Cardiology • Dermatology • Endocrinology • Gastroenterology • Geriatrics

specialties and services • Nutrition • Hematology & Oncology • Obstetrics & Gynecology • Infectious Disease • Pediatrics • Internal Medicine • Laboratory Services (On-Site) • Podiatry • Pulmonology & Critical Care • Mind-Body Medicine • Radiology Services (On-Site) • Nephrology • Rheumatology • Neurology

Walk-In Extended Hours 259 Heathcote Road, Scarsdale No Appointment Necessary | Walk-Ins Welcome Mon-Fri 8am-9pm | Sat 8am-5pm | Sun 9am-5pm | Open holidays

(914) 723-8100 www.scarsdalemedical.com

THE NEXT GENERATION

OF SURGEONS C

M

Y

CM

MY

CY

CMY

K

Jonathan Arad, MD | Bariatric & General Surgery Suzanne Greenidge, MD | Obstetrics & Gynecology Har Chi Lau, MD | Colon-Rectal & General Surgery

SKILLED ROBOTIC PRECISION RESULTING IN FASTER RECOVERIES AND LITTLE TO NO SCARRING The new da Vinci Robotic Surgical Team at St. John’s Riverside Hospital’s Minimally Invasive Center provides another level of care to our patients. The da Vinci robot’s exact precision provides surgeons with an extraordinary range of motion. Gallbladder, hernia, colon or gynecological procedures are specialties of the da Vinci and some are done with a single incision resulting in virtually scarless results.

COMMUNITY

STRONG © 2015 St. John’s Riverside Hospital | All Rights Reserved.

Page 10A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

Treatment-resistant depression: what can you do?

A

By JENNIFER LEAVITT

bout 50 percent of us will experience some form of depression during our lifetimes. When periods of bereavement are included in those stats, almost no one is spared.

There is no shortage of pharmaceuticals to treat depression. Some people need to try a few different treatments before finding the right fit, but much of the time, something works, at least partially.

Unfortunately, up to 30 percent of those struggling with depression simply don’t respond to the first-line treatments that are available. There is no absolute definition or criteria, but after some time goes by without progress, a provider may label a patient as “treatment resistant,” which is such an unfortunate term because it can lead alreadyvulnerable patients into a downward spiral of despair.

The most likely explanation for failure to improve is that some less-common factor or combination of factors is driving the depression, and the effective treatment may be just as uncommon. But that doesn’t mean it isn’t out there.

First thing’s first Primary care doctors often manage antidepressant medications, but if treatment efforts have been for naught, it is wise to visit a specialist. In addition, although they cannot write prescriptions, therapists and social workers often have an abundance of treatment knowledge and referrals to share. Of course, psychotherapy is also beneficial as an adjunct to medication.

Have the most qualified available provider confirm a diagnosis. Sleep or thyroid disorders can mimic depression and comorbid mental illness or personality disorders that have not been addressed can interfere with improvement. When hyper or hypothyroid conditions are affecting mood, extra serotonin may have no effect. If depression is being treated, but anxiety is ignored, the depression may continue.

For those who have trouble remembering to take medications, once-weekly remedies might be the perfect choice, or an antidepressant with a very long half-life, such as Prozac, so that early, late or missed doses do not cause extreme mood swings.

The next important question to answer is whether the medication has done anything at all to improve mood. If it has, a stronger dose or the addition of a complementary treatment may be in order. If, however, unacceptable side effects have continued with equal intensity for two weeks or more, tapered withdrawal is probably a good idea.

Remember too that medication cannot always temper unbearable circumstances. If there is an abusive situation, a pill should not take the place of necessary change. Instead, seek personal support and professional help in taking action to change the circumstances. Once diagnosis is certain, doctors also need to know for sure whether the medications themselves are truly to blame for a lack of response. Many experts agree that patients should use at least four very different treatments for a period of at least one month each before they can be considered resistant.

That also means using them correctly and making sure no other substances are interfering. Take medications at scheduled times, as often as required. Research whether protein, carbohydrates, or other foods might obstruct proper metabolism. Grapefruit juice is the most commonly interfering dietary culprit. (Check for interactions at www.healthline.com/druginteractions or through another reputable service.)

Switching and pairing Different classes of antidepressants work in different ways. SSRIs increase the amount of feel-good neurotransmitter serotonin in the brain. Prozac, Celexa, Lexapro, Zoloft and Paxil are all examples of SSRIs. Brintellix and Viibryd also increase serotonin. SNRIs increase norepinephrine as well, and include Effexor, Pristiq and Cymbalta, among others. Wellbutrin is an aminoketone, acting on norepinephrine and dopamine and is often used in combination with other medications for full effect. The tricyclics, such as Elavil and Adapin, are very effective, but can cause drowsiness. Taking a tricyclic right before bed may be the key to success. Nardil and other MAO inhibitors target enzymes in the brain to boost a variety of neurotransmitters. Often a last resort because there are so many interactions to watch for, some patients may find the higher maintenance of these effective medications entirely worthwhile.

Another alternative is to combine two different classes of antidepressant, or to add a mood stabilizer like lithium, an anticonvulsant, such as carbamazepine, or one of the antipsychotics — Abilify or Seroquel for instance, which are also sometimes prescribed off label for persistent insomnia.

Continued on the next page

Friday, October 9, 2015 | The Rivertowns Enterprise Continued from the previous page

Some effective combinations pair pharmaceuticals with other forms of treatment, such as cognitive or dialectic therapy, music or art therapy, hypnosis, acupuncture, massage and meditation, neurofeedback, brainwave training or a variety of other options. Some of the most promising alternatives come from devices that, in one form or another, stimulate the central nervous system with electricity.

Getting a jump start The oldest, best known and most misunderstood alternative treatment is electroconvulsive therapy, often called “shock therapy.” Despite its Hollywood portrayal as excruciating and terror inducing, ECT is actually very effective and quick acting.

Though it does induce controlled seizures, is somewhat uncomfortable and has the side effect of memory loss, many people with debilitating and seemingly untreatable depression have found the trade off worth it. It is reserved for the most serious cases, but should not be overlooked as an option if the depression is severe.

A home device based on similar principles, but which is gentler, safer and with far fewer side effects, is the Fisher Wallace Stimulator. It is used at home, without physician supervision, delivering milder electrical signals to stimulate neurotransmitters. It does not cause seizures and those using it have not reported discomfort. Some insurance companies reimburse patients for the FWS, or it can be used on a rent-to-buy basis. As a bonus, the Fisher Wallace is also FDA cleared for the treatment of anxiety, insomnia and chronic pain.

Another option is vagus nerve stimulation, which some refer to as “the yoga of electrical therapies.” Chanting, singing and yogic humming all stimulate the vagus nerve, which tends to make people feel peaceful and content. When those methods just aren’t strong enough, a removable stimulator can be implanted near the collarbone. External devices have also entered the market now, and appear to work in 30 to 50 percent of those who use them, especially when combined with other therapies.

Other non-invasive options are transcranial magnetic and transcranial direct current stimulation, outpatient techniques that are also most successful when used in conjunction with other modes of treatment. Transcranial therapies are safe with few to no side effects.

Light therapy, though not formally part of this group, should not be overlooked as a viable option. Though it does not come in direct contact with the body’s nervous system, it’s an electronic device, one that does stimulate, albeit through the lens of the eye. Blue or green light boxes produce between 2,500 and 10,000 lux, and are most effective for those with seasonal affective disorder. A growing number of patients have reported, though, that these lights have worked when nothing else did, even for year-round depression.

As frustrating and challenging as depression can be, especially when treatment fails over and over again, we live in a time when there are so many options and a great deal of information at our fingertips.

The right answers are out there, waiting to be found. If at first you don’t succeed... well, you know how the saying goes.

To Your Health! | Page 11A

NEWS NOTES Pediatric center gets deficiency-free rating Once again, the Elizabeth Seton Pediatric Center was recognized for its delivery of exceptional patient care with a deficiency-free rating from the New York State Department of Health (DOH) during their annual, unannounced Quality Indicator Survey.

This is the center’s sixth deficiencyfree survey since 2004 and the second one since moving into the new facility in March 2012. According to the DOH, the average number of deficiencies cited per facility in the region is eight. The Quality Indicator Survey is a computer assisted long-term care survey process used by selected State Survey Agencies and the DOH to determine if Medicare and Medicaid certified nursing homes meet the federal requirements.

A deficiency-free survey means that the center is in full compliance with the standards required for continued participation in the Medicaid program, according to Lisa Poskanzer, vice president of operations at the pediatric center.

“We embraced the seven surveyors with our ‘All are Welcome’ gusto and four days later were blessed with hearing the coveted words from the team leader, ‘No findings!’” Poskanzer said. “It was truly a moment of overwhelming joy, tremendous humility and strong validation that we had fulfilled our mission. This accom-

plishment was the result of hard work, focus to detail and steadfast leadership that was a combination and melding of our newer and more tenured staff members being open to change, listening attentively to the needs of our children and their families and embracing our mission.”

The Elizabeth Seton Pediatric Center is a not-for-profit pediatric specialty nursing facility, serving the most medically complex children in New York State.

The pediatric center, which is a 137-bed, 165,000-square-foot complex in Yonkers, is in its 27th year of service. The center is rated as a five-star facility in the Best Nursing Homes category of U.S. News & World Report. The state-of-the-art, childcentered building is the only LEED Gold certified green pediatric facility in the country.

Children come to the Elizabeth Seton Pediatric Center with serious medical and neurological challenges. The center provides comprehensive health care, rehabilitation and special education services to all residents. Services include, but are not limited to: medical care; nursing; respiratory therapy; palliative care; pastoral care; social work services; physical, occupational, speech and feeding therapies; music therapy; art therapy; aquatic therapy; and Child Life.

Learn more about the Elizabeth Seton Pediatric Center at www.setonpediatric. org and Facebook at www.facebook. com/setonpediatric.

Looking for something special in healthcare?

WE HELP...

WHEN YOU HURT!

Central Medical, P.C./Chiro Care of Westchester Chiropractic . Medicine . Therapy...all under one roof

369 Ashford Avenue, Dobbs Ferry, N.Y. 10522

914.237.6440

Dr. Brian Nicoletti | Dr. Landis Barnes Insurance accepted

Page 12A | To Your Health!

Breast cancer Continued from page 1A

ommended that a woman seek screening 10 years before the earliest case of breast cancer in her family. Women are encouraged to seek screening every year indefinitely as long as they remain in good health.

Dr. Stefanie Zalasin, who performs women’s imaging for Northern Westchester Hospital, said that screening begins with a mammogram searching for potentially abnormal masses within the breast — masses can be quite small — to determine if there is cause for concern. Dr. Zalasin said that during a mammogram oncologists look for suspicious masses, such as those that might radiate out throughout the breast, deposits of calcium that look irregular or any other abnormalities.

She said that women with dense breast tissue receive higher scrutiny during screening.

If any suspicious masses are found, screening leads to ultrasound imaging, which can further determine if a mass is cancerous or benign.

“Our next step really is an ultrasound and an ultrasound is wonderful because it can tell you if the mass is just a cyst or not,” Dr. Zalasin said. “It doesn’t increase your risk of developing cancer. Women make cysts, particularly premenopausal women or postmenopausal women who are uncertain medications.”

Dr. Zalasin said that if any mass of concern is found, a patient can undergo further MRI screening. “Once the results come back as a problem cancer or high risk, that’s when they typically see a surgeon,” she said. “At that point, the surgeon would determine if they need to do additional imaging. A lot of surgeons are doing pre-MRIs with patients with newly diagnosed breast cancer because MRI can provide a more accurate assessment of the extent of the disease.”

The next step in determining if a mass is cancerous or at risk of becoming cancerous is a biopsy. Traditionally, biopsies involved removing the entire mass from a breast to test it, however, a technique called fine-needle aspiration now exists that involves taking a sample of an abnormality with a fine needle and syringe, which causes much less potential scarring than the removal of the mass in question.

If the biopsy determines a cancerous or precancerous mass within a breast, then surgery is always recommended. The type of surgery that a woman might receive depends on the size and shape of the cancer and its location within the breast. Types of surgery range from the removal of the afflicted part of a breast to the full removal of both breasts, known as a bilateral mastectomy. A number of women opt to completely remove both breasts, while others want to preserve theirs.

Dr. Chaterji said that in a case where the partial removal or partial mastectomy of a breast can be performed and where there is no genetic predisposition to breast cancer, it is just as effective with radiation treatment as a bilateral mastectomy.

“Survival studies have shown that there is no difference in overall survival with a mastectomy versus a partial mastectomy with radiation,” she said. “Also, mastectomy does not offer patients 100 percent risk reduction, so there’s no 100 percent guarantee.”

A bilateral mastectomy is not a surefire way to become cured of breast cancer. Many women choose to undergo the procedure as a way to prevent additional screenings for more cancerous masses and potential additional surgeries for masses that might form later on.

In either case, a patient has a range of cosmetic options. In the case of a partial removal, tissue can be moved around to so that the breasts look similar. Implants are options for those patients who have undergone full

The Rivertowns Enterprise | Friday, October 9, 2015

nology has increased, so we’re able to pinpoint targets and customize our treatments to our patients’ individually shaped breasts and to shield the normal tissues far better than we ever could,” she said.

Dr. Stevens said hormonal therapy works to fight tumors by depriving them of estrogen, as many tumors are responsive to the hormone.

“What it does is lowers the estrogen in a woman’s body to decrease the chance of tumor growth,” she said. “Basically, it’s extremely useful in breast cancer since so many of these breast tumors have this estrogen receptor.”

Dr. Stevens said some hormonal therapy drugs might have side effects that might make patients wary of taking them. She said the side effects do not happen to all patients and that different hormone drugs could be used to try to avoid them.

“Some of the drugs have a bad rap with women because they have side effects,” she said. “In some cases, some of the drugs can make patients very achy or have creaky joint aches. We tell people to keep an open mind.

There’s lots of things we can do if they get the side effects.”

Immunotherapy is also gaining ground as a treatment.

“Immunotherapy is stimulating your immune system to attack cancer cells,” Dr. Stevens said. “It’s also sometimes called biologic therapy, but it’s very important in treating the cancers and we have more and more drugs that are being developed to work in this way.”

One such immunotherapy treatment is Herceptin, or trastuzumab, which Dr. Stevens said helps improve cure rates in addition to being an alternative to chemotherapy that allows patients to keep their hair.

“It’s a targeted therapy directed at a specific protein on the tumor surface,” she said.

or partial mastectomy, as well as using tissue from other parts of the body such as the thigh, abdomen or buttocks. It is possible for women who have undergone even a full mastectomy to have their nipples saved. It is also possible to reconstruct them through plastic surgery.

Dr. Randy Stevens, the director of radiation oncology at White Plains Hospital, said the objective is to leave a breast cancer patient with an end result she can feel comfortable with.

“The goal is to do the right oncologic procedure, but also leave them with a cosmetically acceptable or pleasing result, so they really feel good about themselves in and out of clothes,” she said.

In addition to surgery, methods such as chemotherapy, radiation treatment, hormone therapy and immunotherapy could be used to further fight breast cancer.

Risks and benefits of chemotherapy are weighed with each individual patient. Dr. Stevens said it is possible to use chemotherapy in advance of surgery to reduce the mass to a more manageable size.

“Sometimes we’ll have those patients see a medical oncologist before surgery and we’ll actually give what we call systemic therapy chemotherapy to shrink the disease and get a heads start on the big picture and do the surgery afterward,” she said. “That’s a bit of a change from before, but it gives the opportunity for some women maybe with a larger size tumor to have their tumor made smaller or downsized and give them the option for a lumpectomy when they wouldn’t have had it originally.”

Regarding radiation treatment, Dr. Stevens said current equipment allows doctors to focus on radiating specific areas of the breast rather than bombarding the entire area with radiation.

“Clearly, the sophistication and the tech-

Continued on the next page

Kavita Kohli, DDS 5-STAR Government Rated Four Consecutive Years

Board Certified Pediatric Dentist

★★★★★ Skilled Nursing Care on Beautiful Long Island Sound • Short Term Rehabilitation • Subacute Care • Long Term Care • Alzheimer/Dementia Care • Respite Services We invite you to join us for lunch and take a tour of our facility

495 Central Park Avenue Suite 208 Scarsdale, NY 10583

914-725-9620

www.rivertownspediatricdentistry.com

When Getting High is Bringing You Down, Try Something INNOVATIVE!

Outpatient Chemical Dependency Treatment Alcohol • Cocaine/Crack • Ecstasy • Heroin • Marijuana • Pain Medication Steroids • Individual & Group Counseling • DWI Assessments & Treatment Buprenorphine (Suboxone) Therapy Program Initial Asssessment & Evaluation • Marital/Family Counseling Addictions Education • Alcohol/Drug Testing • Interventions • On-site Self-Help Groups Adolescent/Young Adult Program w/Parent Component Spanish/Portugese Program • Most Insurances/Medicaid Accepted

Innovative Health Systems, Inc.

Day and Evening Session

490 Pelham Road • New Rochelle, NY 10805 www.gicnr.com • email: infor@gicnr.com

(914) 636-2800

•

Certified by NYS - OASAS

7 Holland Ave., White Plains, NY 10603 914-683-8050 www.innovativehealthsystems.com

Friday, October 9, 2015 | The Rivertowns Enterprise Continued from the previous page

“It’s not what we call chemotherapy. It’s really more of a targeted antibody therapy. Our patients’ big concern after ‘Will they live?’ is ‘Will they lose their hair?’ Herceptin is one of the drugs, just as hormonal therapies, where you really don’t lose your hair.”

Like all drugs, Dr. Stevens said Herceptin has side effects as well: “The biggest side effect is that it can cause the heart to not function as well. Our doctors will usually do hard specific test every three months or so to make sure that the patient can handle the medicine.

If they see any changes they’re picking them up before there’s real damage.”

One major side effect of breast cancer surgery is lymphedema, the characteristic swelling, typically of the arm in breast cancer patients, due to the removal of lymph nodes.

Dr. Stevens tells patients lymphedema occurs when lymph nodes are either damaged from cancer or radiation treatment and their damage or removal results in the body’s natural drainage system not functioning correctly.

“There are all kinds of severities,” she said.

“In the mildest form the patient may not even be aware of it and it might just feel a little swelling or a tight ring, but in a more severe form it limits the quality of life and activities and potentially they have a sense of a heavy arm and difficulty using their arm.”

Dr. Stevens said the key to treating lymphedema is to treat it early with physical therapy. Dr. Chaterji said massages and wearing a compression sleeve are also ways to lessen lymphedema’s symptoms.

Rates of lymphedema are arguably decreasing because now breast surgeons are selectively removing afflicted lymph nodes and sparing others that would contribute to lymphedema if they are missing Dr. Stevens said. She added transferring lymph nodes to an area where some are missing is also a possibility.

“There are some surgeons doing lymph node transfers, trying to bring fresh lymph nodes into an area where drainage is not good,” Dr. Stevens said. “There is some success it doesn’t work for everybody.”

White Plains Hospital participates in clinical trials and Dr. Stevens said there are a number of potential advancements in treatment being studies, such as experimenting with implementing hormonal therapy before surgery.

“Now are we getting hormonal therapy before the surgery and then if they respond, we keep going and if not, we just see that the tumor is not changing, we switch,” she said.

“This is all now before the surgery because we know exactly what’s working and what isn’t.”

Dr. Stevens said the hospital is researching if a shorter course of radiation treatment is just as effective as a longer course and if 10 years of hormonal therapy is more effective than five years. The hospital is also looking into whether osteoporosis drugs could also help fight breast cancer. “We expect to have a lot more then, but really every couple of months there’s something new in breast cancer,” she said.

Dr. Chaterji said seeking screening, understanding risk and hearing advice from professionals is key for women’s health.

“It’s very scary when you’re diagnosed with breast cancer, but it’s really important to understand what your options are and feel like you’re in control over those options,” she said. “I also think it’s important for women to understand their risk status. A lot of women don’t even know what that is and to make sure that you’re doing breast exams and getting imaging. It’s really confusing. It can be intimidating to try to make it easily understandable. It’s important for them to go to someone who is practicing breast surgery and knows the latest advances.”

Hudson Family Dental Jacqueline Paramo, DDS

To Your Health! | Page 13A

Quad Village Physical Therapy Dedicated to helping patients obtain their optimal health.

We are proud to announce an additional service to address pain and dysfunction of pelvic floor muscles that might occur as a result of: general aging, child birth, sport injury, or surgery: • Pelvic floor pain/dysfunction/prolapse • Incontinence (involuntary & inability to control the urine flow)

Moj Rajai, PT, DPT, who is known for her passionate and personable personality in the river towns has enhanced her specialty by continued education which enables her to diagnose and treat this problem in men and women.

The service is covered under most insurances!

Call Lucy at (914) 693-5459 18 Ashford Ave, Suite 3E, Dobbs Ferry 10522

Central Animal Hospital 317 Ardsley Road Scarsdale • 723-1250 www.bestvets.net

Veterinarians… Many Doctors in One… Veterinarians… Many Doctors in One…

5 South Broadway, Dobbs Ferry, NY (at hastings border)

914-478-4448

•

email: drparamo@optonline.net

your lifetime, there doctors who will take In your In lifetime, many doctors willare caremany for you: the obstetrician, you from birth to death: the obstetrician, pediatrician, pediatrician, dentist, internist, surgeon, endocrinologist, urologist, dentist, internist, neurologist, radiologist,surgeon, dietician,radiologist, cardiologist,anesthesiologist, and geriatrist, endocrinologist, urologist, oncologist, to name neurologist, a few. dietician, cardiologist, and geriatrist, to name a few.

But, only one doctor cares for your pet through a veterinarian.

But, only life… one doctor takes

your pet through life… a veterinarian.

AUTISM:

Result-Oriented Therapy SM

Overcoming autistic tendencies Parent and Teacher Training Available

Give Your Child the Gift of Success

Robert J. Bernstein Director: Autism Speech

914.330.3393

email: rjb@autismspeech.com www.autismspeech.com

SM

The veterinarians at Central Animal Hospital perform the skills of all the differentat doctors in preventing, diagnosing, The veterinarians Central Animal Hospital perform and treating pet health issues.

We are dedicated to providing the skills of the different doctors in preventing, diagnosing, the highest quality veterinary for your pet’s life. to and treating animal healthcare problems.

We areentire dedicated providing the highest quality care for your pet’s entire life.

Stop by tous meet Stop by to meet andus.tour our hospital Tour our hospital and boarding facilities. and boarding facilities.

Available 7 days/week - Our hours are: Our hours, by appointment, Monday thru Friday 8 am – 7 pm are: Monday thru8 am Friday 8 am – 7 pm Saturday – 3 pm Sunday 9 am – 11 am (for emergencies).

Saturday 8 am – 3 pm Sunday 9 am – 11 am (for emergencies).

Michael Woltz, VMD Cheryl Gross, VMD Michael Woltz, VMD Cheryl Gross, VMD Aura Truslow, DVM Donatella Hecht, VMD Aura Truslow, DVM Donatella Hecht, VMD Jason Siegelheim, DVM Lindsay Thorson, DVM Jason Siegelheim, DVM Erin Keefe, DVM Blum, DVM • Alison Abramson, VMD DVM Alison Shireen Abramson, VMD Jeff Polisky, Erin Keefe, DVM

Page 14A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

Harm reduction the key in substance abuse treatment

By ROSS FISHMAN, Ph.D.

H

arm reduction as a concept has been around for centuries. In its broadest sense, it applies to almost all of human behavior. We all practice harm reduction everyday.

Whenever you do something to prevent yourself or another person from getting hurt or to minimize the hurt, you are practicing harm reduction.

Just a few areas to consider are health (annual physicals, vaccines, SPF lotions), children (bumper guards, helmets, training wheels) and automobiles (seat belts, air bags). If you have ever tried to lose weight, eat healthier or cut down on your smoking, you have practiced harm reduction.

If you haven’t dropped all the pounds you wanted, started eating more fruits and vegetables or eliminated smoking completely, you can take satisfaction that your effort was an improvement, an important concept too often overlooked.

When it comes to substance use disorders, however, harm reduction and its counterpart, improvement, have been difficult concepts to accept. One the one hand, many in the business of recovery promote the notion of “progress, not perfection,” while on the other hand they demand of substance abusers nothing less than total and immediate abstinence.

Although we easily rationalize the backsliding in ourselves and others when it comes to weight loss, smoking or exercise, as a society, we are incredibly intolerant of slips and relapses among people struggling

with their substance use issues.

Our current consideration for harm reduction as appropriate to the field of chemical misuse is not new. The concerns about the excesses of drinking hit a peak in the 1830s when physical injuries, spouse abuse, family neglect and chronic unemployment were rampant. While one group called for total abstinence, another group called for temperance or a reduction of alcohol consumption to reasonable levels.

If treatment programs are to be “successful,” however one might define the term, they need to have patients to treat. People needing treatment are reluctant to seek treatment for many reasons. They rationalize that they do not have a problem; they tell themselves that their current quandary is temporary; they believe they can handle their problem by themselves; they are not ready to stop using; they believe that they will be judged and labeled; and/or they are ashamed because of the stigma attached to substance misuse.

Cary ’s

Physical TheraPy

Your Local, Independent Pharmacy Eric Granick, Pharmacist

Prompt, Personal Service ~ We accept most Prescription Plans

•

Direct consultation with a pharmacist PRESCRIPTION at all times for prescription and over DELIVERY AVAILABLE the counter medication Fully computerized prescription filling, checking for drug interactions and maintaining complete drug and allergy records

• Private treatment areas, whirlpools, and exercise equipment – with a view of the Hudson.

Serving the community for more than 30 years.

Ron Miller, Registered Physical Therapist and Regina Miller, Certified Personal Trainer

Hours: Monday - Friday, 9am - 7 pm ~ Saturday, 9 am - 5 pm

e-mail: egranick1@yahoo.com ~ Fax: 693-0076 Major Credit Cards Accepted for all purchases including prescription Co-Pays

• Medication & Disease Management • Event Reminders • Companionship • Personal Care Assistance • Dementia Care • Diabetes Care & Teaching • Meal Preparation • Housekeeping Chores • Fall prevention Caregivers are insured and bonded

Call Today To Make An Appointment ... 478-7678 3 8 2 Wa r b u r t o n Av e , H a s t i n g s o n H u d s o n , N . Y. 1 0 7 0 6

Need help assisting a loved one?

ALL CARE LIVING ASSISTANCE SERVICES We have your In-home Care needs covered.

Offering comprehensive physical care, from evaluation to treatment and follow-up • We specialize in rehabilitation, pain management, sports injuries as well as conditioning, and personal fitness.

105 Main St., Dobbs Ferry ~ 693-0008

Licensed Home Care Services Agency

another person, “Why don’t you have just two or three beers? Why do you need to drink a whole six-pack?” Harm reduction.

Or, “Please go back to snorting heroin; injecting is just too dangerous?” Harm reduction. Or, “Try to smoke fewer cigarettes in a day or at least try the nicotine patch!”

Harm reduction. Every such step is a step in the right direction.

At Innovative Health Systems we ask our patients to give up all mood-altering substances while in treatment unless they are prescribed. We give them some time to achieve this as we know how difficult and dangerous it is to suddenly stop taking in certain substances because of moderate to severe withdrawal symptoms. We make the assumption that our patients were first social users and then problem users. We now want them to experience abstinence while we are helping them learn refusal skills and relapse prevention strategies.

Our mission is not necessarily to impose lifetime abstinence on them, but instead when they are ready to move on to have them experience abstinence in addition to the social and problem use they once knew. They are then free to choose which of those three lifestyles they prefer. We know that less is better and none is best.

Our hope is that they will find a way to choose abstinence in a world that, for the most part, does not.

Innovative Health Systems is at 7 Holland Ave. in White Plains. Call 683-8050 or visit www.innovativehealthsystems.com.

RONALD B. MILLER, P.T.

Since 1869

•

The media reports there is a dearth of treatment programs. Perhaps this is true in certain locations. I believe, however, that the shortage is of treatment programs that are ready to meet these users where they are. Too many treatment centers have designed programs that for the most part, though not entirely, are cookie cutters. The staff and the philosophy are already fixed and people in various degrees of difficulty are fitted into that approach. That is not the road to success. Is it the addiction or the force-feeding of approaches that do not meet the individual’s needs or both that are the cause of relapses after treatment?

Harm reduction started when volunteers went into the streets to offer heroin addicts a safer way of injecting heroin, primarily in order to reduce the likelihood of HIV and other infections that were resulting from dirty needles being shared. The volunteers knew that those users would not seek help because treatment centers would demand abstinence and they were not ready to stop. At first, simple bleach kits were offered to disinfect needles. A second wave of reaching out was to offer syringe exchange so that potentially infected “works” were less likely to be shared.

Many people argued that these attempts were just promoting the continued use of heroin. In a way, that may have been true, but from a public health perspective, bleach kits and needle exchanges were saving lives by reducing the spread of infection — by reducing harm.

Have you ever heard someone say to

Need help assisting a loved one?

WJCS Premium Geriatric WJCS PREMIUM GERIATRIC Care Management CARE MHelping ANAGEMENT you navigate life’s details

and large small & small Helping you navigate life’s large details ● ●

plans of care • Help with securing individualized plans•ofIndividualized care ● connections to home health aides entitlements • Household management household management assistance ● help with securing entitlements assistance • Assessment of financial, ● assessment of financial, legal & Medicare issues

914-667-0023 www.allcareliving.com

and much, much more legal & Medicare issues • Connections to home health aides • and much, much more

914-761-0600 x 340 914-761-0600 x 340

Friday, October 9, 2015 | The Rivertowns Enterprise

Vision alternative

early. That’s worst case scenario.

Continued from page 4A

Q: Why is this such a specialized part of the field?

for the children to swim, ski, run around without glasses on. Socially they develop with more confidence because they don’t have the glasses on their faces. They feel more accepted and they can perform better. Adults we do it so they don’t have to use contact lenses or the risky surgeries that don’t always pan out or cause other medical issues. Surgery causes many problems that are irreversible, so a lot of patients don’t want to take those risks so they choose to do AOK. I have patients from the age of 5 to 74.

It’s FDA approved for any age — there are no age restrictions period. You wouldn’t even need to do this earlier than 5. There are alternative for young children, even 5, 6, 7-year-olds that can’t do AOK. There are other forms of myopia control that we practice in our office that do not require molds.

They are not as good, but they are better than nothing for the young child to wait until they are old enough for AOK.

A: It’s a very different approach. It’s not like fitting contact lenses. You have to think of it almost in an opposite way of fitting contact lenses. It is something that takes many years to study and understand and master. Medical school, optometry school is focused on traditional refractions, contact lenses and medical eye disease. Optometry school today is so focused on eye disease and they only have four years — they don’t have eight years to do everything — so you have to decide you’re going to specialize in contact lenses and then you’re going to

Q: What is special about this for children?

A: Once we see a child and we know they are getting worse we are going to try and put the brakes on it any way we can.

You can not under correct nearsightedness because it makes your eyes progress at a faster rate. It’s a big problem. We learn things in school and then we apply them, but you don’t learn everything in school.

You have to learn it in practice. You have to continue studying and there are specialties for certain things. A lot of times today we see doctors under correcting patients that change quickly. All they are doing is putting fuel on the fire and making those children progress faster.

Kids today are 30 percent more nearsighted than the previous generation. There are doctors out there that just do everything that’s been done the same way for the past hundred and fifty years and say nothing else works. That’s not good either. Slowly over time more doctors are learning about myopia control. It’s fairly new. We didn’t know that we could control nearsightedness this way for many years, but there are many, many, many, many studies out now that show and prove how AOK can stop or slow down progression by at least 50 percent. A child that comes in with a mother who is minus 14 and instead of eventually being a minus 16 the child will only be at worst case scenario a minus 7 if we treat him or her

To Your Health! | Page 15A

have to decide you’re going to specialize in orthokeratology, which is a subspecialty. It’s something that’s very expensive for doctors to learn to do, it’s very time consuming for doctors to do and they have to do this afterwards in more of a fellowship type of training. Today it’s unfortunate that students, new doctors come out of school with so much debt that they need to start working right away. Once you start working it’s very difficult to go ahead and study something else at the same time.

Q: Do you still do glasses and contacts, or is this your only niche?

A: We still do contact lenses, we specialize in contact lenses and we even custom

make contact lenses. Aside from advanced orthokeratology there are patients out there with eye diseases that can not see clearly with any contact lenses or eyeglasses and there are other types of designs that we make called scleral shells and this is a different topic, but scleral shells are the most amazing thing. There are patients that have a disease like keratoconus, for example, that can not see with contacts or glasses and what we do for them is we mold over the entire cornea and create a whole new optical surface for them. We can take them many times to 20/20 where they may legally blind.

Bob Davidson enjoys the peace and quiet of sitting at the end of his dock and spending time with his son. He also enjoys the peace of mind he gets from his doctors at Phelps Medical Associates.

“My doctor keeps my cholesterol in check, my blood pressure in range and my fishing line in the water” Not just because his doctors keep him healthy and active, it’s the entire Phelps Medical Associates experience — from the ease of making an appointment, to the compassionate care from doctors who really listen.

Our patients say, “It’s doctors the way you wish they could be.”

Your Family of Exceptional Doctors

To Your Health!

A special section of

The Rivertowns Enterprise 95 Main Street, Dobbs Ferry, NY 10522 (914) 478-2787 www.rivertownsenterprise.net PUBLISHER..................................Deborah G. White SECTION EDITOR.....................................Todd Sliss ART DIRECTOR............................. Ann Marie Rezen AD DESIGN.......................................Suzanne Brown AD SALES.......Marilyn Petrosa, Thomas O’Halloran, Barbara Yeaker, and Francesca Lynch ©2015 W.H. WHITE PUBLICATIONS, INC. ALL RIGHTS RESERVED. REPRODUCTION IN WHOLE OR IN PART IS FORBIDDEN WITHOUT THE PUBLISHER’S WRITTEN PERMISSION.

Experience the Phelps Medical Associates difference.

Call 914-269-1900 or visit us at phelpsmedicalassociates.org Same-day appointments available in many locations.

Internal Medicine Family Medicine Cardiology Endocrinology Gastroenterology Neurology Obstetrics/Gynecology Podiatry Rheumatology Thoracic Surgery Briarcliff Croton-on-Hudson Dobbs Ferry Elmsford Ossining Sleepy Hollow Tarrytown

Page 16A | To Your Health!

The Rivertowns Enterprise | Friday, October 9, 2015

We are more than just fitness...

The Pilates and More Family is made up of highly trained professionals.

We are trained and certified in: Physical Therapy Pilates Instruction Yoga Instruction Massage Therapy Pre/Post Natal Body Conditioning

Our programs help with: Back pain Joint replacements Surgical Rehabilitation Sports Injuries Postural alignment

We can help you heal!

Come visit us and let us show you what we do!

129 Main Street Dobbs Ferry, NY 10522

914-478-3560

www.pilatesandmorestudio.com • pilatesandmore@gmail.com Now accepting Visa, MasterCard and Discover!

Look for us on FaceBook!