Updated on Jan 17, 2025 | Featured, Your Health
“Learning to live with MS is an enduring, educational process. We feel strongly that this holistic approach improves people’s long-term prognosis and significantly improves their quality of life,” says Ilana Katz Sand, MD,Co-Director of the C. Olsten Wellness Program. “We want to be able to offer this to every person we treat.”
A multiple sclerosis (MS) diagnosis is life-changing. The challenge of managing doctor appointments, MRI exams, and treatments, while also focusing on how you feel, can be extraordinarily stressful. Many essential things in life, such as exercise, nutrition, sleep, work, and family, often receive insufficient attention in the face of these demands.
“Many of our patients seek and can benefit from a more holistic approach to their MS,” says Ilana Katz Sand, MD, Co-Director of the C. Olsten Wellness Program at The Corinne Goldsmith Dickinson Center for Multiple Sclerosis. “Empowering people living with MS to take ownership of their health is the goal of our Wellness Program.”
The Wellness Program is designed to enable people with MS to live their lives as fully as possible by creating healthier habits. Since its inception in 2020, more than 500 people have participated in this program, the first of its kind at a comprehensive MS care center in the United States.
The program is open to both newly diagnosed patients and those who have been receiving care from neurologists, nurse practitioners, and other Center staff for many years. Some of the original participants from 2020 are still engaged in their wellness activities, while others have found satisfaction in charting a course of action after just a few visits.
“The duration of participation is up to the patient,” Dr. Katz Sand says. “We partner one-on-one with our patients, offering each individual options that help with changing behaviors, such as assistance with scheduling workout routines, adjustments to food shopping and eating habits, or support for addressing mental health. These are all key components of comprehensive MS care.”
Deciding to participate in the Wellness Program begins with conversations between patients and their health care providers. Before the first visit, patients undergo an evaluation through the Center’s Comprehensive Annual Assessment Program at the MS Neuropsychology Clinic, which helps identify potential areas of need. The initial visit is extensive, lasting two and a half hours, and involves individual meetings with staff.
Each specialist—nurse practitioners, dietitian, physical therapist, and social worker—assess various aspects of the patient’s health, including their abilities, living environment, and support systems. Nurse practitioners Stacie Lyras, FNP-BC, and Gretchen Mathewson, NP, conduct an overall assessment and help each patient set goals. Dietitian Jessica Gelman, MS, RDN, CDN, reviews food choices, eating schedules, how groceries are obtained, and how meals are prepared. Elizabeth Pike, PT, DPT, NCS, physical therapist, evaluates the patient’s current physical activity level and exercise program. Finally, social worker Konul Azimzade, LCSW, assesses the patient’s emotional health.
At the end of each new evaluation session, the Wellness staff meet with Belenmarie Mixon, program coordinator, and Dr. Katz Sand to make sure all providers are on the same page. Each patient has a unique set of circumstances and different ways that MS affects their life. A customized plan is prepared for and discussed with the patient.
Dr. Katz Sand notes that several of her patients have had life-changing experiences with the Wellness Program. Using strategies learned from the program, some patients regained mobility through exercise. Others addressed longstanding mental health issues, or were finally able to manage their fatigue by changing diet or other lifestyle habits.
“Patients are so appreciative of the way our team listens to what is going on in their lives and what they need to feel better. Providing care that is truly holistic is a different approach that puts patients at the center,” says Dr. Katz Sand.
Dr. Katz Sand joined the Center in 2011 on a National Multiple Sclerosis Society-sponsored fellowship and became a full-time staff member in 2013. Today, she serves as the Center’s Associate Director. In addition to treating MS patients, she has spearheaded research for more than a decade on the connections between gut health and MS. Her groundbreaking work on nutrition and how food choices affect MS was key to forming the holistic approach embraced by the Wellness Program.
To further encourage people living with MS in managing their nutrition, Dr. Katz Sand’s team, led by Ms. Gelman, has produced a 73-page cookbook. It puts into practice the nutrition guidance Dr. Katz Sand has long advocated. The cookbook covers the basics of kitchen equipment, nutrition guidelines, and detailed recipes. It’s user-friendly for both beginners and more experienced home chefs. The Wellness Program cookbook is available to Wellness Program participants upon request.
As the Wellness Program becomes more popular, expansion will be necessary to accommodate more patients. This growth will require more space and staff so that more patients can take advantage of its unique offerings.
“Learning to live with MS is an enduring, educational process. We feel strongly that this holistic approach improves people’s long-term prognosis and significantly improves their quality of life,” says Dr. Katz Sand. “We want to be able to offer this to every person we treat.”
By Kenneth Bandler, a multiple sclerosis patient, advocate, and member of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis Advisory Board
Updated on Jan 10, 2025 | Cancer, Your Health
The U.S. Surgeon General recently released a report advising the public on the link between alcohol and cancer. According to the report, alcohol consumption increases your risk for at least seven types of cancer, including liver, colon, and breast cancer, and drinking is a leading preventable cause of cancer in the United States, contributing to almost 100,000 cancer cases a year.
Frances Lee, MD
“The advisory confirms what doctors have known for many years—alcohol causes cancer,” says Frances Lee, MD, Assistant Professor of Medicine (Liver Diseases), Icahn School of Medicine at Mount Sinai. “This advisory is not meant to cause shame or fear, but to empower the public. We all have the right to know the risks of our daily choices, and this advisory is a way for people to know the risks of alcohol use from a reliable source.”
In this Q&A, Dr. Lee discusses what you need to know about the relationship between alcohol and cancer, how to reduce your risk, and how to get help if you need it.
How does alcohol cause cancer?
Alcohol and its metabolites causes inflammation and damage to DNA, which is the pathway for cancer development. Additionally, when you drink alcohol, you increase the absorption of other carcinogens in your environment—for example, chemicals from cigarette smoke. Alcohol can also increase various hormones levels, such as estrogen, increasing breast cancer risk.
What types of cancer does alcohol increase my risk for?
In addition to breast cancer, alcohol increases your risk for various digestive cancers, including in the mouth, throat, esophagus, liver, and colon. Alcohol also causes chronic liver disease, and alcohol-related liver disease is also now the leading indication for liver transplant.
Is there any safe amount of alcohol that I can drink?
There is technically no safe amount of alcohol to drink; as the surgeon general advisory notes, increases in alcohol intake leads to stepwise increases in risk for developing cancer. However, we live in a society where social events are often centered on alcohol intake. For those without risks for developing chronic diseases or certain cancers, it may be reasonable to consume no more than one standard beverage a day for women and no more than two standard beverages a day for men. In the end, you have to weigh the risks and benefits of alcohol in the context of each person’s unique risk factors.
How can I reduce my risk for alcohol-related cancers?
The only way to completely reduce your risk is to not drink alcohol. That can be difficult, even for people who are not heavy drinkers, since alcohol is part of our culture. But reducing your intake by any amount will decrease your risk for developing alcohol-related cancers.
When should I see a doctor?
Alcohol can cause various chronic disease that go unnoticed. As a liver doctor, I’m most concerned about alcohol-related liver disease that goes undiagnosed until it’s too late. Whether you are a heavy or moderate drinker, I recommend getting a regular checkup with standard blood work. If there is a problem with your liver enzymes, it is important to see a liver doctor and work together to reduce alcohol intake to allow the liver to heal and regenerate.
Are there any medications that can help me stop drinking?
There are medications that are very safe, even for people with liver disease. These medications are evidence-based and well tolerated. These medications reduce cravings by targeting the central nervous system, which has altered reward signals after years of alcohol intake. To be sure, the treatment of alcohol use disorder includes therapy/behavioral interventions, along with medications.
Jan 10, 2025 | Recipes, Your Health
Whether you have a craving for lime, mango, or guacamole, these delicious dips will make a nutritious snack for you and your guests. Enjoy!
Tiny Lime Scoops
Ingredients:
1/2 to 1 small red bell pepper, chopped into small cubes
3 peaches (fresh or canned), chopped into small cubes
3 tangerines, peeled (fresh or canned, drained)
1 lime, cut into wedges
Bag of multigrain tortilla chips
Preparation:
Place the pepper, peaches, and tangerines into a bowl. Squeeze the lime over the fruit and vegetables. Stir.
Dip and scoop the mixture with multigrain grain chips and enjoy.
Each serving:
13 chips and 1/4 cup dip
200 calories per serving
While I was taking nutrition class for a certification, I learned how to put fruits and vegetable together. The lime in this dip reminds me of my culture in Puerto Rico, and the bright colors are inviting. I enjoy this while watching my son’s baseball games, and I serve it at parties. This is a guilt-free treat, because of the nutritional value of the dip. – Taynisha, Jr Secretary/Scheduler, Mount Sinai Queens
Mango Salsa
Ingredients:
3 ripe mangos, diced
1 medium red bell pepper, chopped
1/2 cup of chopped red onion
1/4 cup of packed fresh cilantro leaves, chopped
1 large lime, juiced (about 1/4 cup)
1/8 to 1/4 t salt, to taste
Preparation:
In a serving bowl, combine the prepared mango, bell pepper, onion, and cilantro.
Drizzle with the juice of one lime.
Using a large spoon, stir the ingredients together. Season to taste with salt, and stir again.
For best flavor, let the salsa rest for 10 minutes or longer.
Nutrition:
Serves 6
Calories 48
Total Carbohydrates 11.8g
Protein 0.9g
Fat 0.3g
Growing up I always loved mango which is a tropical fruit from my native Dominican Republic. It is a simple recipe that can be prepared in minutes. This tropical and colorful mango salsa is simple to make. Serve it as a healthy appetizer or side, with tortilla chips, tacos, meal bowls, seafood, and more! -Ana, Director Community Affairs, Mount Sinai Queens
Guacamole Dip
Ingredients:
4 large ripe avocados
1 clove garlic, finely minced
2 tablespoon of lime juice
1/4 teaspoon salt
2 slices whole-wheat pita bread
Preparation:
Add lime juice, garlic, and salt to a medium-sized bowl and combine. Cut avocados in half, removing the pits, and scoop the flesh into the bowl with the lime juice mixture. Mash the avocado with a fork until a creamy dip is formed, leaving some large chunks for texture.
Toast pita bread for one to two minutes until slightly crispy. Once toasted, use a sharp knife to cut into six equal triangles for dipping.
Serve the guacamole dip immediately with the toasted pita slices and cut-up vegetables, like carrots, celery sticks, or zucchini spears.
Recipe Tip: This classic guacamole is mild and creamy, making it a hit with kids. If making ahead of time, squeeze extra lime juice over the top and cover very tightly with plastic wrap to keep from browning.
Nutrition:
270 calories per serving
Makes 4 servings
Jan 9, 2025 | Infectious Diseases, Your Health
Norovirus, also known as stomach flu, is a group of viruses that cause inflammation in the stomach and intestines. There are an estimated 2,500 reported norovirus outbreaks in the United States each year, according to the Centers for Disease Control and Prevention (CDC). While norovirus is common in the winter and spreads easily, there are actions you can take to keep yourself and others safe.
Bernard Camins, MD
In this Q&A, Bernard Camins, MD, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai and the Medical Director for Infection Prevention for the Mount Sinai Health System, explains how to prevent and treat norovirus.
What are the symptoms of norovirus?
The most common symptoms are nausea, vomiting, and diarrhea. Some people may have fevers and chills.
How long does norovirus infection last?
About one to three days.
How contagious is norovirus, and for how long?
Norovirus is very contagious. Most people are contagious for at least three days, and some people are contagious for up to two weeks, even after symptoms are gone.
How does norovirus spread?
Norovirus is primarily spread through fecal-oral transmission—for example, restaurant staff or members of the same household fail to thoroughly wash their hands after using the bathroom, then spread it to others through contaminated food. You can also get it by touching shared surfaces from a sick person after they use the bathroom and less commonly from droplets contaminated with the virus when an infected person vomits.
How can I prevent norovirus?
Number one is to wash your hands thoroughly with soap for 20 seconds before eating or preparing meals. Alcohol-based sanitizers do not work as effectively against norovirus. Stay home if you are sick and avoid preparing food for others or sharing food, and avoid shared bathrooms, if possible. If you do have to share a bathroom, disinfect the toilet, sink, door handles, and any other shared surfaces, after you use it. Do not share dishes, utensils, or cups.
How can I treat norovirus?
The most important thing is to prevent dehydration by drinking water, juice, or a sports drink. Eat bland foods if you can tolerate them.
How do I know if I should see a doctor?
While norovirus symptoms are often severe, most infections clear on their own after a few days and do not require a doctor. However, if you are not able to keep liquids down, you should seek medical attention.
What should I do if my child has norovirus?
Keep them home. Norovirus can lead to severe dehydration in babies and children with underlying health problems. Learn more about what to do if you suspect your child has norovirus.
Is norovirus worse this year than previous years, and if so, why?
There is no evidence that norovirus is worse this year compared to previous years. Norovirus outbreaks usually happen around January due to people gathering for the holidays. Peak season for norovirus is November through April.
Updated on Dec 6, 2024 | Your Health
If you have been trying to conceive for some time and are considering fertility treatment, you may have been told about the options of intrauterine insemination (IUI) and in vitro fertilization (IVF).
In this Q&A, Devora Aharon, MD, reproductive endocrinologist and infertility specialist at RMA of New York, explains the advantages of each approach and how to choose the path that is right for you. RMA of New York is the Division of Reproductive Endocrinology and Infertility for the Department of Obstetrics, Gynecology and Reproductive Science at Mount Sinai Health System.
What is IUI?
Devora Aharon, MD
IUI involves preparing a concentrated sample of sperm that is inserted into the top of the uterus using a soft catheter. This brings the sperm in closer proximity to the egg to fertilize it, bypassing some of the barriers in the vagina and cervix. IUI is timed around ovulation, but for patients who do not ovulate regularly, oral medication may be used to augment your chances of success. In you ovulate monthly, these medications may cause multiple eggs to be released, increasing the chance that at least one egg will be healthy and result in pregnancy.
What is IVF?
IVF involves the use of injection medication for 1½ to 2 weeks to stimulate the ovaries to mature multiple eggs in one cycle. The eggs are extracted through a vaginal egg retrieval procedure under anesthesia and then fertilized with sperm to form embryos. The embryos can be biopsied to test for chromosomal abnormalities or specific genetic conditions before being frozen. In the same or subsequent cycle, the uterus is prepared for embryo implantation using estrogen and progesterone.
What are advantages of IUI vs. IVF?
From a practical perspective, an IUI cycle involves fewer medications and visits for monitoring and does not involve a procedure under anesthesia. However, IVF has a higher chance of success compared to IUI. Moreover, more than one healthy embryo is often created from one IVF cycle. All of these embryos can be tested and frozen for future use when age may present a greater barrier.
What are specific situations in which one might choose IUI vs. IVF?
Depending on your individual diagnosis and personal circumstances, there are important factors to consider when choosing between IUI and IVF to build your family. While the following is not an exhaustive list, below are diagnoses and factors that might lead one to choose IUI or IVF:
- Male factor infertility: If sperm counts are low, IUI can help give sperm a boost and increase chances of pregnancy. If sperm counts are extremely low, IUI is less likely to work and IVF is typically recommended.
- Tubal factor infertility: If the fallopian tubes are blocked or abnormal, IVF is needed to bypass the tubes.
- Polycystic ovary syndrome (PCOS): Many patients with PCOS do not ovulate regularly. Oral medications can induce ovulation, and intercourse or IUI timed around ovulation can be effective in achieving pregnancy. IVF is also effective in patients with PCOS because these patients often have a high ovarian reserve, which can lead to a high response to ovarian stimulation.
- Advanced reproductive age: Pregnancy becomes more difficult to achieve in your late 30s and 40s due to decreases in the quality and quantity of eggs. IVF with preimplantation genetic testing can help identify normal embryos that have a high chance of achieving a healthy pregnancy.
- Using sperm donation, egg donation, or surrogacy: Patients using a sperm donor will often start with IUI, especially if the patient does not have an underlying diagnosis of infertility. However, even in these cases, IVF can increase chances of achieving a healthy pregnancy sooner. Egg donors will undergo ovarian stimulation and egg retrieval, and the eggs will be fertilized with sperm and then transferred to a patient’s uterus or that of a gestational carrier. Patients using a gestational carrier with their own eggs will undergo ovarian stimulation and egg retrieval before the eggs are fertilized with partner or donor sperm, and an embryo will be transferred into the uterus of the gestational carrier.
The choice to undergo IUI or IVF is highly personalized based on individual factors like your age, diagnoses, timeline, and desired family size.
Updated on Dec 5, 2025 | Your Health
As the colder weather is here and children typically spend more time indoors and in close contact, it’s common to see a rise in cases of respiratory viruses, such as influenza and respiratory syncytial virus (RSV). We have also seen what we now recognize as a seasonal rise in COVID-19 cases throughout the summer. Those combined with back-to-school season make it particularly important to stay vigilant with your child’s health and vaccinations.
Jennifer Duchon, MD, DrPH, MPH, Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, offers ways you can keep your child protected and discusses vaccination recommendations.
“Vaccines for influenza, RSV, and COVID-19 are our most important tools for preventing these viruses and their complications,” says Dr. Duchon. “Staying up to date on vaccinations is critical to safeguarding not only ourselves but our most vulnerable populations, including young children, the elderly, and those with weakened immune systems.”
In addition, there are practices you can teach your child to prevent the spread of viruses. It’s recommended that everyone follow these tips:
- Wash hands often and with soap and water.
- Cover coughs and sneezes and sneeze into a tissue.
- Avoid touching your face or rubbing your eyes.
- Avoid people who are sick.
- If you are sick, try to stay home.
- Keep kids at home when they are sick.
- Clean and disinfect surfaces often.
“Recently, there has been a lot of information and ‘disinformation’ about vaccines in general, and information that seems conflicting can be very confusing. The vaccines that we give to children are safe and prevent serious complication from the disease that they target,” Dr. Duchon says. “The best place to get information is your pediatrician or other health care provider who cares for your family, and whom you trust. Part of our job as physicians is answering your questions, so please do not hesitate to ask.”
COVID-19
Though COVID-19 cases are much lower than during the pandemic, there are still cases that arise throughout the year, and it’s advised that parents remain cautious.
Some symptoms of COVID-19 include a fever, cough, shortness of breath, congestion and fatigue. Symptoms may be similar to a cold or the flu, so it’s important that if your child presents any symptoms, they get a test to determine the best course of treatment.
It’s recommended that children over six months old receive the updated 2025-2026 COVID-19 vaccine, regardless of whether they have received doses of earlier versions. The updated COVID-19 vaccines are aimed at protecting people from the latest strains of the virus. The Pfizer and Moderna vaccines are similar to earlier versions, relying on the same “messenger RNA” or “mRNA” technology and are expected to remain effective as the new strains emerge throughout the year.
RSV
The respiratory syncytial virus (RSV) commonly causes mild, cold-like symptoms in most people, but can cause very severe symptoms, including difficulty breathing, in very young infants and elderly people. The RSV “season” typically starts in October in the Northeast, and cases tend to reach a peak in December. Babies and young children are more at risk to develop severe RSV.
RSV is the most common cause of bronchiolitis and pneumonia in children younger than one year of age. Additionally, most of the deaths or severe disease from RSV occur in infants up to six months old.
The most at-risk groups are premature infants; infants younger than six months of age; children younger than two with chronic lung disease or congenital heart disease; children with weakened immune systems; and children who have neuromuscular disorders.
Early symptoms for infants and children include a runny nose, eating or drinking less, or a cough, which may progress to wheezing or difficulty breathing. Very young infants may display irritability, decreased activity, eating or drinking less or apnea (pauses in breathing for more than 10 seconds).
There are two immunization strategies available to protect infants. Babies and some young children may receive an immunization containing an antibody against RSV (passive immunization) called nirsevimab. Nirsevimab contains monoclonal antibodies, which are man-made proteins that protect against RSV. Studies on the U.S. population have shown that this immunization reduces the risk of severe RSV disease by approximately 80 percent. It’s recommended that infants less than eight months of age get this immunization between October and March.
Additionally, pregnant mothers may receive an RSV maternal vaccine (active vaccination), Abrysvo®, at weeks 32-36 of pregnancy. When a person receives this vaccine, their body responds by making antibodies that protect against RSV. These antibodies are then passed to the baby. This vaccine is more than 80 percent effective in preventing severe RSV disease through three months of age and about 70 percent effective through six months of age. Immunization is recommended between September and January.
Speak to your health care provider to learn more about these vaccines and choose the right option for you.
Influenza
Children younger than five, and especially those younger than two, are at a higher risk of developing serious flu-related complications. Children of any age with certain chronic health conditions are also at a higher risk. While children over five are not at a higher risk, they can spread the flu to vulnerable groups, such as older family members. Also, children who catch the flu will feel miserable.
It’s recommended that children over six months old get vaccinated, not only for their own protection, but to protect those around them. There are two types of vaccine options currently available: the flu shot or the nasal spray vaccine. Speak to your child’s health care provider to find out which vaccine would be right for your child. It’s recommended to get vaccinated between September and October, but vaccination can occur any time if your child has not gotten the flu vaccine yet.
