Updated on Jun 30, 2022 | Dermatology, Diabetes, Geriatrics, Surgery
By Jeffrey M. Levine MD, and Michael Cioroiu, MD
Pressure ulcers are breaks in the skin over boney areas, such as the heel, elbows and tailbone. They occur in people who are at special risk for skin breakdown, including:
• Patients with spinal cord injuries
• People who are bed-bound with advanced dementia or chronic debilitating neurologic disease like multiple sclerosis
• Individuals with acute illness requiring stays in the intensive care unit (more…)
May 15, 2013 | Geriatrics, Health Tips, Safety
Whether you are at home, work or out having fun, it is important to ensure your safety by avoiding anything that can cause you to slip, trip or fall. Below are the top causes of slips, trips and falls, and tips for preventing them. (more…)
Updated on Jun 30, 2022 | Geriatrics, OB/GYN, Urogynecology, Women's Health
There have been a lot of media reports (as well as lawyer ads) lately about mesh implants used in gynecological surgery to treat pelvic organ prolapse. What is all the fuss about?
In 2008, the U.S. Food and Drug Administration (FDA) issued a warning about “mesh implants” and “slings” used to treat stress incontinence and pelvic organ prolapse in women. In 2011, the agency issued a stronger warning against the use of mesh implants placed vaginally to treat pelvic organ prolapse. To understand what this all means, it is important to know the history. (more…)
Updated on Jun 30, 2022 | Diet and Nutrition, Gastroenterology, Geriatrics, Speech Pathology
There are times during a hospital stay when the care team may ask a patient (or family member on behalf of the patient) to consider having a special feeding tube, or PEG, placed to prevent medical complications, such as dehydration, malnutrition or aspiration pneumonia. (more…)
Updated on Jun 30, 2022 | Cancer, Endocrinology, Geriatrics, Surgery
The thyroid gland got its name from the Greek word for “shield,” due to its physical appearance in the neck. In many ways, it acts like a shield by protecting our bodies from losing functional balance. The thyroid gland produces and releases thyroid hormone, which is crucial in regulating overall metabolism (the physical and chemical processes in the body that convert or use energy). Digestion, weight, temperature regulation and reproduction all are affected by the thyroid gland.
The thyroid gland works like a thermostat via its connection with the brain. If there is not enough thyroid hormone in the blood stream, the brain will stimulate the thyroid gland to produce and release more. Blood tests are an easy way to detect both the level of thyroid hormone circulating in the blood — generally free thyroxine (T4) — and the stimulating signal from the brain (TSH, or thyroid stimulating hormone). The most common thyroid problems involve abnormal production of thyroid hormone.
Hypothyroidism
Hypothyroidism is the term used to describe an underactive thyroid.
Symptoms
Symptoms include:
• Fatigue
• Feeling colder than usual
• Changes in skin and hair
• Weight gain
Causes
A common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune disorder in which cells in the body prevent the thyroid from producing and releasing enough thyroid hormone. Other causes include surgical removal of the thyroid gland for thyroid cancer; treatment of hyperthyroidism (an overactive thyroid gland) with radioactive iodine; or being born with an underactive thyroid gland.
Treatment
The treatment for hypothyroidism is to replace thyroid hormone in the form of a pill taken once a day, preferably by itself and on an empty stomach so that it is fully absorbed. The dose is easily adjusted based on blood tests.
Hyperthyroidism
Hyperthyroidism describes an overactive thyroid gland.
Symptoms
Symptoms include:
• Increased sweating
• Heart palpitations
• Increased anxiety
• Diarrhea
• Weight loss
Causes
A number of conditions can cause hyperthyroidism. Opposite to hypothyroidism, cells in the blood stream called antibodies make the thyroid gland secrete an excessive amount of thyroid hormone.
Treatments
The two most common treatments for hyperthyroidism are radioactive iodine and medication. Radioactive iodine works by destroying part of the thyroid gland to restore a normal level of thyroid hormone in the body; however, it is possible that hypothyroidism may then develop. Radioactive iodine has the benefit of generally being a more permanent treatment, although medications used to treat hyperthyroidism can be very effective in certain people, too. Just as in hypothyroidism, blood tests should be done routinely to monitor treatment.
Thyroid Cancer
Thyroid cancer can develop and, in the majority of cases, is curable by surgical removal of the thyroid gland by an experienced surgeon. Radioactive iodine may be used after surgery to destroy any small remaining cancer cells. An endocrinologist should be directly involved in monitoring care.
Extremes of thyroid function can certainly have an impact on your quality of life; the beauty is that with the correct diagnosis and management, these conditions can be greatly improved!
To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.
Mar 6, 2013 | Geriatrics, Health Tips, Safety, Uncategorized
Winter in New York City often means unpleasant weather, like snow and freezing rain—common culprits of slippery sidewalks, streets and stairs. Snow also can block visibility of curbs, curb cuts, sidewalk cracks and other elements that may affect how you walk about.
Falling on an outstretched hand is the most common way people fracture their wrists. During poor weather, one of the best things you can do to prevent a wrist fracture is to follow the fall prevention tips below:
1. Avoid going outside unnecessarily during poor weather.
• In anticipation of poor weather, stock up on household staples ahead of time.
• If poor weather has already begun, order food and household items to be delivered to you.
2. If you must go outside during poor weather:
• Travel outside during daytime hours. More light means increased visibility and increased pedestrian presence.
• Wear sensible footwear. Don appropriate shoes, such as boots, with good support and tread. Avoid heels and open-toed shoes.
• Use handrails and ramps whenever possible. This is especially important for people who have difficulty navigating stairs during the best of weather.
• Take well-travelled streets. Walking on heavily travelled streets is safer, because traffic will have decreased snow accumulation, and if you do fall, an increased pedestrian presence means there will be other people around to assist you and call for help.
By Jeffrey M. Levine MD, and Michael Cioroiu, MD
