Osteoporosis, the silent disease

Osteoporosis affects 10 million Americans; 8 million women and 2 million men. It’s a disease in which bone loses its mineral content, there is a change in its structure and bone becomes weaker. A fall, sneeze or bumping into furniture can cause it to break.

Osteoporosis is a silent disease. You don’t know you have it until you fall and break a bone. Last year it caused two million fractures. These fractures can lead to pain, disability and even death. In fact, osteoporotic hip fractures caused more deaths than breast cancer in women and more deaths than prostate cancer in men.

Frank Bonura, MD, FACOG, NCMP, CCD, director of Osteoporosis Program at St. Catherine of Siena Medical Center, a member of Catholic Health Services, shared some insight in how to identify osteoporosis, how to treat it and potentially how to minimize your chances of getting it.

How do I know if I have Osteoporosis?

“We can diagnose osteoporosis by measurement of your bone mineral density (BMD) using a DXA Scan Machine. The BMD is the amount of mineral in an area of your bone. Osteoporosis can also be diagnosed clinically, if you are 50 years or older, fall from a standing height and sustain a fracture.

You are entitled to a DXA Scan if you are a woman 65 years or older or a man 70 years or older. Younger women age 50 to 64 and men age 50 to 69 years old who are at risk for osteoporosis (family history, rheumatoid arthritis, chronic kidney disease, diabetes, etc.) or are taking medications that cause loss of BMD are entitled to have a DXA scan.” Dr. Bonura

If I have Osteoporosis, can it be treated?

“Once the DXA results demonstrate a diagnosis of osteoporosis, your physician should order lab work to confirm if your osteoporosis is due to your age, family history, a medical condition or to a medication you are taking. We do that because all medications used for osteoporosis have serious side effects. If you have a medical condition, we might treat that before prescribing a medication for osteoporosis. If it’s due to a medication you are taking, we may adjust the dosage or change the medication.” Dr. Bonura

What is the treatment for Osteoporosis?

“Osteoporosis can be treated but it can’t be cured in all cases. Some medications used (Fosamax, Boniva, Actonel, IV Reclast, Prolia) stop the bone cells that destroy the bone. Other medications (Forteo, Tymlos) stimulate the bone cells that build bone. All of the medications have side effects but they are rare and only should be used in patients who are at high risk for fracture.” Dr. Bonura

Do I need Calcium and Vitamin D?

“Calcium is necessary for bone health; therefore, all individuals should have an adequate amount of calcium and Vitamin D in their diet. If you are 50 years or older it is recommended that you take 1200mg of calcium per day. Our diet gives us 600mg per day. To obtain the other 600mg, the best sources are dairy products. An 8 ounce glass of milk gives us 300mg of calcium, as does a yogurt or 3 ounces of cheese. You can also get calcium from foods that are fortified with calcium (cereals, soy milk, and juices) or green leafy vegetables. If you are lactose intolerant then you can take a calcium supplement. They are best taken with foods in divided doses. To absorb calcium you need adequate Vitamin D. Without Vitamin D only 10-15% of calcium is absorbed. Vitamin D can be obtained from supplements and can also be made when your skin is exposed to sunlight." Dr. Bonura

For more information about CHS call 1-855-CHS-4500 or visit https://www.chsli.org/.

Romaine Lettuce Still Unsafe; Director of Food & Nutrition Shares Tips

Last week, the Centers for Disease Control (CDC) issued this warning about an E. coli outbreak, “Do not eat any romaine lettuce, including whole heads and hearts, chopped, organic and salad mixes with romaine until we learn more. If you don’t know if it’s romaine or can’t confirm the source, don’t eat it.”

Today, that is still an active warning. Good Samaritan Hospital Medical Center's Director of Food & Nutrition Services Richard Doscher, RD, CDN, shared some expert thoughts on how to combat the E. Coli outbreak:

"Although the CDC has only issued a warning, I would highly recommend that the public take it very seriously. 32 people have been affected, 13 of whom have been hospitalized as a result of contaminated lettuce. Most sources of E.coli are harmless and may only cause a brief stint of diarrhea. However, the more dangerous strain, E. coli O157:H7, can cause severe abdominal pain, bloody diarrhea, vomiting and, possibly, a mild fever. The toxin generally enters the body through contaminated food sources like ground beef and fresh produce.

Combat this is by thoroughly cooking ground meat to 160F to kill the E.coli bacteria. Use a calibrated thermometer and insert the tip in the thickest part of the formed patty. Also, be sure to thoroughly wash all fresh produce like lettuce to remove any dirt or debris that may be harboring this dangerous bacteria. This does not mean the lettuce is free of the toxin but less will be present. Finally, avoid cross-contamination when preparing foods; wash hands before and after preparing individual food items, keep raw foods separate from ready-to-eat foods and always wash your utensils, knives and cutting boards with hot soapy water in between tasks."

Good Samaritan Hospital is a member of Catholic Health Services, an integrated health care delivery system with six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity. 

For more information, visit www.chsli.org.

Is the Keto Diet Safe for Diabetics?

While the ketogenic (keto) diet has recently gained popularity as one of the new “it” diets, it’s important to think twice before starting any diet that severely restricts any food groups, especially if you're diabetic. The keto diet limits carbohydrates and encourages a high fat intake. 

Beth Freedman, MPH, RD, CDN, CDE, certified diabetes educator and diabetes program coordinator at Mercy Medical Center, said, "While keto diets may be beneficial for those suffering from seizures, this type of eating plan would not be recommended for patients with diabetes whose medications are working under the assumption that the person is eating carbohydrates.

Additionally, carbohydrates are our main source of energy and should represent 45-65% of our daily intake. The keto diet is not sustainable over a long period of time and a new study shows that it can even be detrimental when a person starts eating carbohydrates again, possibly leading to a carbohydrate intolerance and/or diabetes. Because the ketogenic diet is a high fat diet it may also be detrimental to overall heart health including cholesterol levels."

The bottom line: think of eating as a meal plan, not a diet. Be sure to include a variety of fruits, vegetables, whole grains, lean proteins and healthy fats every day.

For more information, visit www.chsli.org or call 1-855-CHS-4500.

Breast Cancer Prevention Checklist

October was Breast Cancer Awareness Month but it’s always a great time to assess your risks and evaluate your healthy (and unhealthy) habits.

Did you know that about 1 in 8 women will develop invasive breast cancer in their lifetime?

As of January 2018, there are more than 3.1 million women with a history of breast cancer in the United States.

There is no one perfect strategy to prevent breast cancer; however, some foods and lifestyle habits can make your body the healthiest it can be and keep your risk for developing breast cancer as low as possible.

Stefanie Pappas, clinical dietitian at The Cancer Institute at CHS’s St. Francis Hospital, created the following checklist of lifestyle habits for breast cancer prevention.

Get Screened Regularly. While mammograms may not help prevent breast cancer, it can help find cancer when it is early and most treatable. For most women, regular mammograms can begin at age 40.

Stay Lean. Overweight or obesity dramatically increases the risk of breast cancer and other chronic diseases; this is especially true if obesity occurs later in life. If you are not sure what an ideal weight is for your body type, calculate your body mass index online using a BMI calculator. A healthy BMI range falls between 18.5 to 25 kg/m^2. 

Follow A Plant-Based Diet. This consists primarily of fruits, vegetables, beans/legumes, nuts/seeds, and whole grains. Aim to eat 8 to 10 colorful fruit and vegetable servings daily; this will also help you meet your daily fiber goals and keep your body in peak nutritional state. A study of about 3,000 postmenopausal women found that women who consumed 25 or more servings of vegetables weekly had a 37% lower risk of breast cancer compared with women who consumed fewer than 9 vegetable servings weekly.

Avoid Processed and Refined Carbohydrates. High sugar foods tend to be very processed and low in nutritional value. These foods also appear to increase serum insulin and insulin-like growth factor that can stimulate cancer cell growth. Try your best to limit white bread, pasta, and rice. Be careful with white sugar and items such as cakes and cookies. Opt for whole grains when possible, and indulge in moderation when it comes to sweets.

Focus On Healthy Fats. Research has found a protective relationship between omega-3 fatty acids and breast cancer. Some studies even show that omega-3’s can inhibit breast cancer tumor growth and metastasis. Strive to include healthy fats such as salmon, chia seeds, flaxseeds, walnuts, olive oil, and avocados in your diet.

Check Your Vitamin D. Some studies have found an inverse relationship between breast cancer risk and serum 25 (OH) vitamin D levels. Ask your doctor about having a vitamin D blood test. Maintain your level above 40 ng/mL through diet and, if needed, supplements.

Stay Hydrated. Water is essential for carrying nutrients throughout the body. Don’t neglect the simple task of meeting your hydration needs. Plus, increased fluid intake is needed for proper digestion of a high fiber diet.

Exercise Regularly. Women who are physically active for at least 30 minutes a day have a lower risk of breast cancer. There is no one perfect form of exercise- the ideal form is truly the type of exercise that you will stick to. If you hate cardio, try strength training or pilates. Find a form of exercise that you enjoy and can commit to on a regular basis.

Limit Alcohol. Even small amounts of alcohol can increase your risk of breast cancer. Try to slowly decrease the amount you drink, and consider diluting alcoholic beverages with seltzer.

Quit Smoking, For Good! Did you know that at least 15 cancers, including breast cancer, are linked to smoking? More evidence is suggesting that there is a strong link between smoking and breast cancer risk, particularly in premenopausal women. Plus, smoking causes bad breath, poor teeth, and wrinkles. Take control and make a change to quit smoking today.

Research on diet and breast cancer is ongoing. In the meantime, focus on maintaining a healthy body weight and choosing a primarily plant-based diet. Stay as active as possible, and don’t neglect important strategies such as adequate hydration.

For more information about Breast Health at CHS call 1-855-CHS-4500 or visit https://www.chsli.org/. 

Fall Back Into Your Routine: 10 Tips on How to Adjust to Ending of Daylight Savings

When it comes to sleep, it’s important to be consistent. But how can you do that when every six months you have to adjust to a new sleep schedule?

Rolling back the clock this Sunday, November 4, has its advantages. We get an extra hour sleep! However, we can experience natural “jetlag” as the amount of light and darkness shifts with the new times. If you think one hour of sleep doesn’t matter, ponder this:

• The Monday after daylight savings starts there’s a 24% increase in heart attacks
• The Tuesday after daylight saving ends there’s a 21% decrease in heart attacks 

Some experts from Catholic Health Services (CHS) five sleep centers shared top 10 tips on how to manage the impending change with ease.

1. “Stick to your regular schedule. Wake up at your usual time on Sunday, Nov. 4. For example, if you awaken at 7 am most days, do the same on Sunday (clock will read 8 am).” Director of Center for Sleep Medicine at Mercy Medical Center Chrisoula Politis, MD.
   
   
2.  “Get out in natural sunlight early in the morning to reset your circadian clock. However, if it’s dark when you wake up, turning on all of the lights will help.” Sleep Center Coordinator at St. Charles Hospital’s Sleep Disorders Center Brendan Duffy, RPSGT.
   
   
3. “Stay active! The temptation to skip those morning jogs will be great, but you will feel better for doing them and it will help you to keep your routine.” Sleep Medical Director at St. Joseph Hospital Iwona Rawinis, MD.
   
   
4.  “The added darkness in the early evening can cause sluggishness and drowsiness if you work in an office. Try to get a workspace by a window so you can get natural light during the workday. Or, get up and walk around or exercise in the afternoon.” Duffy, St. Charles Hospital
   
   
5. “Eat healthy meals. In the colder weather we seek heavier meals. Try a soup to warm you, with a salad with grilled chicken instead of a heavy beef stew filled with gravy and potatoes.” Dr. Rawinis, St. Joseph Hospital
   
   
6. “If you are dealing with being sleepy in the morning by drinking coffee or energy drinks, remember that caffeine takes 20 minutes or so to have any effect on your alertness. So wait before you drive in a sleepy state. But be careful of resorting to caffeine in the afternoon as it could interfere with your sleep at night.” Duffy, St. Charles Hospital
   
   
7.  “If you feel the need to nap, make it short – no more than 30 minutes. Anything more will interfere with your sleep cycle.” Dr. Rawinis, St. Joseph Hospital
   
   
8. “Avoid screen time prior to bed. The light emitted from electronics (cell phones, iPads and laptops) inhibits melatonin and delays sleep.” Dr. Politis, Mercy Medical Center
   
   
9.  “Daylight savings can be managed by going to bed 30 to 60 minutes earlier than usual. The brain can usually accommodate a 90 minute shift (adaptation), such as with time zone changes with air flight, every 24 hours.” Director of Sleep Disorders Center at St. Catherine of Siena Brian Margolis, MD.
   
   
10. “Don’t eat too closely to bedtime. Some food can give you energy and interfere with falling asleep. For example, caffeine and sugar.” Dr. Rawinis, St. Joseph Hospital
    

If you want to take a quick quiz to determine if your drowsiness might be related to sleep apnea, go to https://goodsamaritan.chsli.org/sleep-apnea-quiz.

CHS is home to five sleep centers across Long Island. Go to www.chsli.org to find the one closest to you or call 1-855-CHS-4500 for assistance.

All CHS sleep centers offer sleep apnea tests and are located at:

• St. Joseph Hospital, Bethpage
• St. Charles Hospital, Port Jefferson
• St. Catherine of Siena, Smithtown
• Mercy Medical Center, Rockville Centre
• Good Samaritan Hospital, West Islip

How to Find a Good Therapist?

It’s hard to find a therapist. Beyond that, when you do find one sometimes it can be tricky to know if the therapist is the right fit for your personality and needs. Most people seek recommendations from friends or through their employers’s EAP service. Many try going to web-based referral sites, where there is unfortunately little to no outside authority confirming a therapists quality.

David Flomenhaft, LCSW, PhD, and director at Mercy Medical Center’s Behavioral Health Services provided insight on the matter. He said, “There are some differences in how one seeks out a therapy referral. Some people are comfortable speaking about personal issues with friends and acquaintances. In general, men typically will call their insurance plan for an in-network referral. High copay and high deductibles are barriers. Many experienced therapist do not accept insurance so this becomes a prohibitive cost.”

Taking time to develop a strategy and considering the first session as a mutual interview, will greatly help you assess whether or not the therapist is the right fit for you. Dr. Flomenhaft suggests trying to ask a few questions to clarify the fit with the prospective therapist:

• What is their specialty?
• Are they familiar with _____ (a specific need)? If it is for child and adolescent, ask if the therapist has experience with that age group.

He also offers the following pointers:

•  Be aware: patients are often looking to address current stressors of loss, transition, illness or chronic relationship struggles, it’s good to have that awareness in mind when seeking help. 
• Do your research: most therapists have a social media or an internet presence. Be sure to research that website to become familiar with their practice and style.
• Be patient: finding a good therapist takes time. Many clients report that they have to call many in-network providers to find one with openings.
• Confirm their network: If you have moderate to severe depression, anxiety or more severe needs make sure that therapist has a working relationship with a psychiatrist or NP-Psychiatry.
• Always be honest: If the problem involves substance abuse make sure you are honest and inquire if that therapist has experience and can provide the right care.

 If the ‘interview’ goes well, ask yourself if you’d like to see that therapist for a regular appointment.

“A general plan of care for therapy should be at least 12 or more visits. It takes a while to work through issues, identify priorities and implement a plan of change or acceptance of the circumstances that brought on the crisis to seek help,” added Dr. Flomenhaft.

For more information and/or to connect with a CHS doctor call 1-855-CHS-4500 or visit www.chsli.org

Can Aspirin Prevent First-Time Heart Attacks?

Aspirin is often used as a pain reliever for minor aches and to reduce fever. As an anti-inflammatory, it can serve as a blood thinner and is often given to patients immediately after a heart attack to prevent further clot formation and cardiac tissue death.

Many take a low-dose aspirin daily to reduce the chances of another heart attack, stroke or other heart problem, but new studies (U.S./Australia and Europe) indicate that taking daily low-dose aspirin may not prevent a first heart attack.

Kimon Bekelis, MD, system chairman, neurointerventional services; director, stroke & brain aneurysm center, Good Samaritan Hospital explained. “New studies shed more light on the use of aspirin in the primary prevention of stroke. We still have very strong evidence that aspirin is a great drug to prevent strokes or heart attacks in patients who have already suffered from one. The two studies demonstrate that the jury is still out on using aspirin in patients at moderate risk of stroke or heart attack who haven’t suffered from one already.

In similar patients with diabetes, there appears to be a benefit but the risk of bleeding is significant. More studies are needed to identify the role of aspirin in the primary prevention of stroke or heart attack.”

The jury’s verdict may be pending but there are actions you can take to help lower your risk of first time stroke or heart attack, such as: lowering your blood pressure, losing unhealthy weight, exercising consistently, treating diabetes or quitting smoking. Speak with your primary care physician to discuss your options.

For more information and/or to connect with a CHS doctor call 1-855-CHS-4500 or visit www.chsli.org.

How Do You Know if it’s Allergies, the Cold or the Flu?

As kids and parents settle into their back-to-school routines, fall weather brings allergy, cold and flu season. It can be difficult to tell the difference between the three which often result in people seeking antibiotics, fueling the threat of antibiotic resistance.

Louis Guida, MD, pediatric and pulmonology expert at CHS’s Good Samaritan Hospital Medical Center and St. Charles Hospital, explains the difference between allergies, a cold and the flu and why it’s important understand antibiotic resistance.

 “Allergies, the cold and flu will share the following symptoms: sore throat, runny or stuffy nose, cough and fatigue. For allergies, that’s usually where symptoms end,” said Dr. Guida. “It’s important to note, a typically unique symptom to allergies is itchy or watery eyes. Anyone with a cold may also experience minor headaches, mild body aches, and possibly a low fever. In addition to these symptoms, most people with the flu will exhibit a high fever (100-102, sometimes higher especially in young children) for a few days, have a headache, general body aches and sometimes the chills.”

According to the CDC, antibiotics are a type of drug that can kill or stop the growth of bacteria. However, cold and flu are caused by viruses, not bacteria, and allergies are your body’s immune system reacting to an outside trigger such as pollen.

Dr. Guida confirms antibiotics are not meant to treat allergies, the cold or flu. “Antibiotic use contributes to antibiotic resistance. Antibiotics are designed to kill bacteria but sometimes a few bacteria survive, building an immunity to the antibiotic. In this case, the bacteria keeps growing, multiplying and spreading to other people or animals. When it spreads to others, the original antibiotic won’t be able to kill the bacteria.”

Unfortunately, some patients are still being prescribed antibiotics to treat allergy, cold and flu symptoms. According to Dr. Guida, “There’s no one answer as to why this is happening. In some cases, a clinical provider may feel pressure from patients to walk out with a treatment plan that includes a prescription. Or perhaps at the time of the visit the doctor suspects the illness is of bacterial etiology, like bacterial sore throats.”

The next time you or someone in your family is faced with allergy, cold or flu symptoms, Dr. Guida offers the following, “For allergies, avoiding allergens like pollen, house dust, mold and pet dander will help. For colds, make sure to wash your hands often and avoid close contact with people who have a cold. For the flu, be sure to get the flu vaccine each year, wash your hands and avoid close contact with anyone who has the flu.

As for treatment, over-the-counter medications are available to help combat allergy, cold and flu symptoms. If you have allergies look for antihistamines, nasal steroids or decongestants. If you have a cold or the flu it’s important to drink plenty of fluids, get lots of rest and look for aspirin, decongestants, acetaminophen, or ibuprofen.”

If prolonged symptoms occur, consider making an appointment with your primary care doctor to discuss your options.

For more information and/or to connect with a CHS doctor call 1-855-CHS-4500 or visit www.chsli.org.

Not All Oils Are Created Equal

Last week, a Harvard professor went viral in a video calling coconut oil, “pure poison”. But before you decide to give it up completely, clinical dietitian at The Cancer Institute at CHS’s St. Francis Hospital, Stefani Pappas provides further insight.

Pappas says, “Not all oils are created equal. When we break down the composition of each oil, we get a ratio of fatty acids that include polyunsaturated, monounsaturated, and saturated fats. Over 90 percent of coconut oil is composed of saturated fat! A diet rich in saturated fat has been shown to increase cholesterol levels, especially our LDL or “bad” cholesterol.  Just to put things into perspective, olive oil contains less than 15 percent saturated fat, with over 70 percent of its composition containing healthy monounsaturated fats.

If you enjoy the taste of coconut oil, then using a small amount on occasion will likely not be harmful.

There currently is not enough evidence to support the proposed health benefits of using large amount of coconut oil on a daily basis. Stick to primarily unsaturated oils such as olive oil and avocado oil, and don’t neglect other heart-healthy habits such as following a plant-based diet and physical activity.”

A high cholesterol can lead to an increased risk of heart disease and as Pappas pointed out, there are healthier alternatives. If you choose to continue using coconut oil speak with your physician/dietitian to see what works best for your diet.

*The original video was delivered in German and can be found here.

For more information about CHS 1-855-CHS-4500 or visit www.chsli.org.

In Honor of Breastfeeding Week, CHS Lactation Specialists Offer Tips

Lactation Specialists at Good Samaritan Hospital in West Islip, NY

August 1 kicks off World Breastfeeding week, highlighting the benefits that breastfeeding can bring to the health and welfare of babies and mothers. For babies, this includes improved digestion, a boost in immunity and enhanced mental development. In fact, according to the Centers for Disease Control and Prevention, babies who are breastfed are less likely to develop infections, diarrhea, allergies, sudden infant death syndrome and diabetes later in life. Mothers benefit too. Breastfeeding stimulates the uterus to contract back to its normal size quicker and there’s reduced bleeding. In addition, more evidence-based research suggests other long-term benefits such as a lower risk of breast/ovarian cancers and Type 2 diabetes.

Four Catholic Health Services hospitals — St. Catherine of Sienna Medical Center, Good Samaritan Hospital, St. Charles Hospital and Mercy Medical Center — continue to raise awareness about the benefits of breastfeeding and provide the resources. At each location, new mothers who choose to breastfeed receive guidance ranging from breastfeeding support groups to meetings with a lactation consultant to educational materials, all helping to promote successful breastfeeding beyond discharge. 

Kristin Thayer

St. Catherine of Siena Medical Center; Smithtown, NY

St. Catherine of Siena is a designated Baby-Friendly hospital, meaning it has policies and care practices that meet the gold standard for mother/baby care related to breastfeeding. Newborns, mothers and fathers stay together day and night (also known as rooming in) to promote family bonding, ensuring they have the best chance to bond and encourage breastfeeding as soon as they are ready.

St. Catherine’s Lactation/Perinatal Education Clinical Nurse Specialist Kristin Thayer, an International Board Certified Lactation Consultant® (IBCLC), is one of the pioneers of the Baby-Friendly initiative and breastfeeding support. She helps new mothers who intend to breastfeed and addresses a common concern mothers have when exclusively breastfeeding, “is my baby is getting enough to eat?”

She says “A full-term healthy newborn is born with enough reserves, so they do not need to eat very much in the first few days of life. We know they are getting enough to eat if they are urinating and stooling, and they are not losing too much weight. All babies lose some weight in the first few days as their output is greater than their input. More than a 10 percent weight loss is a warning sign, but if the newborn is breastfeeding well and the mother’s milk is coming in, the baby should be fine.” Click here for well-fed baby checklist, found on page 8. 

Event: Celebrate World Breastfeeding Week with St. Catherine of Siena; August 7, 11:30 am – 12:30 pm

Good Samaritan Hospital; West Islip, NY

Good Samaritan Hospital, an International Lactation Consultant Association Award recipient, provides a lactation program five-to-seven days a week for breastfeeding mothers. This includes its free support group called the Breastfeeding Café, as well as a breastfeeding helpline (631-376-3901) that’s available 24/7.  

Lactation Consultant Rita Ferretti, BS, RN, C-NIC, CBC, IBCLC, recognizes that breastfeeding can be very challenging, especially after moms have been discharged.  She says, “You may be asking yourself, ‘How do I know I am making enough milk?’; ‘How often does my baby need to nurse?’; ‘When do I sleep?’ The questions are endless and can cause you to lose confidence.” But she adds, “Successful breastfeeding is a combination of 10 percent making milk and 90 percent confidence.”

The first weeks at home with the baby are crucial as it’s a time to get acquainted with one another and recover from delivery. Rita explains, “After delivery, milk production depends upon stimulation of the breasts from the baby’s suckling and hand expression of the breast milk, but moms should also remember to take care of themselves. It’s important to accept help from friends and relatives when they visit, so new moms can rest their body and mind and reduce stress.”

To support the needs of the mother and infant, all Good Samaritan nurses are trained in breastfeeding. Most hold the credential of Certified Breastfeeding Counselor. Additionally, the Maternal Child Services staff provide lactation support. They offer training in education in perinatal, labor and delivery, maternity and more.

Eileen Lamanna

St. Charles Hospital; Port Jefferson, NY

To help parents to prepare for childbirth, St. Charles Hospital offers "Steps to Parenthood" classes that can help ease any fears or anxiety parents might have. Because knowledge of what to expect leads to a positive childbirth experience, these classes give the entire family the opportunity to be involved in the parent-child bonding process. Classes include The Art of Breastfeeding, the free-based, Breastfeeding Mother's Support Group and Newborn Partnering 101, to name a few.

Internationally Board-Certified Lactation Consultant Eileen Lamanna, RN, based at St. Charles, acknowledges that opting to breastfeed is a big decision and assures women who are considering breastfeeding that they will have education and support on every level. At St. Charles, this includes internationally board certified lactation consultants, the more than 40 nurses who are certified breastfeeding counselors and support from other moms in the hospital’s Breastfeeding Support Group.  Eileen says, “These support groups have proven to be successful for moms at St. Charles as they come together to share personal experiences and encourage one another.”

Lamanna also reinforces the benefits of breastfeeding and says, “Breastmilk is natural and provides infants with antibodies that protect them from illness. One drop of colostrum provides your infant with approximately one million antibodies.”

Mercy Medical Center; Rockville Centre, NY
Lactation Consultant Christine Foley at Mercy Medical Center reminds new mothers that breastfeeding doesn’t look the same for all. Newborns, especially Neonatal Intensive Care Unit (NICU) babies, might not be able to directly breast feed right after birth, but mothers are still encouraged to provide breastmilk to their babies. Mercy strongly supports mothers who wish to breastfeed by assisting with feeding and/or pumping and providing up to date breastfeeding information.  

Christine says, “Sometimes breastfeeding means that a new mother is pumping and then using a bottle or a syringe to feed her baby, particularly babies in the NICU. The end goal is really for the baby to receive the antibody-rich colostrum – often referred to as “liquid gold” -- in the first days of life, helping protect the baby from bacteria and infections. We are committed to helping new mothers successfully breastfeed while in the hospital and to continue breastfeeding well after discharge from the hospital”.

Christine reminds all new mothers that in most cases a personal use breast pump is available at no cost through one’s medical benefits and many times can be delivered to expectant mothers before the baby arrives.  While in the hospital mothers are able to use the hospital grade breast pumps on the maternity unit.

Mercy Medical Center is home to a Level III NICU, the only such facility on the south shore of Nassau County. This New York state designation signifies that the unit provides specialized complex care to all premature and sick newborn infants. Mercy offers 17 maternity beds, a NICU parent room and a pumping room. Mercy Medical Center also offers a weekly breastfeeding support group free of charge to nursing mothers.

For more information about the breastfeeding services offered at CHS call 1-855-CHS-4500 or visit, www.chsli.org.

Tips For Navigating An Easter Buffet

By Stefani Pappas, MS, RDN, CDN, CPT

Easter is a wonderful time to celebrate with friends and family. However, the abundance of food can encourage overeating and overindulging. Learn how to enjoy to keep your health in check and navigate any Easter buffet:

Survey Your Options
When it comes to buffets or family-style eating, it can be tempting to fill your plate with everything offered. Instead, take a minute to scan the buffet or table before placing anything on your plate. Reviewing the options can help you decide which foods to select. Think about those food aren’t available often and add those to your plate instead of wasting calories on items you have access to year-round.  

Fill Half Of Your Plate With Vegetables
Vegetables are packed with heart-healthy fiber and water that fills us up more than processed carbohydrates. Load half of your plate with fresh salad and steamed or roasted vegetables.  They are a fantastic low-calorie, nutrient-rich option that will keep you satisfied throughout the day. When choosing a dish to bring to your Easter feast, volunteer to toss a large salad or vibrant vegetable crudité to ensure there is a veggie-packed option for all to enjoy.

Remember Your Serving Sizes
You don’t need fancy measuring cups or food scales to determine the appropriate portion size. Instead, just look at your hand! An open palm is equivalent to a serving of about three to four ounces of lean protein such as poultry, fish, shellfish, or beef. A tight fist equals approximately one cup, which should be the limit of cooked pasta, rice, or a medium-sized baked potato. An ounce of cheese is approximately the size of your thumb, and one teaspoon of a high-fat food such as mayonnaise or butter is similar in size to the tip of your thumb. Keep in mind that larger plates may make you midjudge portion sizes and lead to overeating. If you can, try placing your food on a smaller dish such as a salad plate.

Stay Hydrated
Between preparing food for an Easter feast or getting involved in an Easter egg hunt, it is easy to forget about drinking water. Hydration is crucial for regulating body temperature, boosting immunity, aiding metabolism, and assisting in weight management. Be sure to drink lots of fluids before, during, and after any festivities. Drink two glasses of water first thing in the morning, and try to take a few sips of water with your dinner meal. Since you’re want to stay hydrated, be careful with caffeinated and alcoholic beverages which can dehydrate the body. Opt for a water with lemon or naturally-flavored seltzer with your meal.

If you are enjoying an Easter buffet this weekend, now is the perfect time to implement some of these strategies. However, these tips are great for any function.

Stefani Pappas, MS, RDN, CDN, CPT, is a clinical dietitian nutritionist at St. Francis Hospital, The Heart Hospital®.

February is American Heart Month

Did you know the number one killer in New York is cardiovascular disease?

Physical activity is important to prevent heart disease and stroke. Doing at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise can help improve your health.  For those who would benefit from lowering their blood pressure or cholesterol, the American Heart Association recommends 40 minutes of aerobic exercise of moderate to vigorous intensity 3 to 4 times a week to lower the risks.

The American Heart Association urges all Americans to know the warning signs of a heart attack and stroke and call 9-1-1 immediately if symptoms occur you can also become trained in cardiopulmonary resuscitation (CPR), and support the placement of automated external defibrillators (AEDs) in their communities.

Knowing the warning signs for heart attack, stroke and cardiac arrest can help prevent serious illness. To learn about these signs visit http://www.heart.org/HEARTORG/Conditions/911-Warnings-Signs-of-a-Heart-Attack_UCM_305346_SubHomePage.jsp.

Watch CHS's Executive Vice President & Chief Clinical Officer Patrick O'Shaughnessy, DO discuss heart disease:

If you need a physician, please visit www.chsli.org or call 1-855-CHS-4500.