Your Health | Mount Sinai Today

Why Are My Fingers Locking?

Nov 21, 2022 | Occupational Therapy, Orthopedics, Your Health

A common complaint from patients in the hand therapy clinic is that their fingers are “locking.” Locking in the fingers is most commonly associated with a condition called trigger finger, which occurs when there is inflammation around the tendons that bend the fingers.

To bend our fingers or thumbs, we use tendons connected to muscles located in the forearm. These tendons must travel through a series of pulleys, or tunnels, that hold the tendons close to the bone. The entrance to the first pulley is often a site of inflammation. If there is inflammation in the area, the tendon does not glide easily and can get stuck, causing the finger to lock in a bent position.

Patients often report pain, clicking, and popping in the affected finger. As people continue to bend their fingers, the inflammation and triggering increases. Over time, the finger becomes stiff or more difficult to move, and pain may continue to increase.

Amanda Walsh, MD

In this Q&A, Amanda Walsh, MD a fellowship trained hand and upper extremity surgeon and Assistant Professor of Orthopedic Surgery at the Icahn School of Medicine at Mount Sinai, explains what you can do about this condition.

How can I treat finger locking?

The best way to prevent worsening of the symptoms of trigger finger is to stop the cycle of inflammation. Try the following to decrease triggering:

Avoid repetitive and sustained gripping tasks, such as playing golf, hitting balls in the batting cages or gardening with tools.
Maintain motion of the fingers by gentle flexion and extension, which can help prevent stiffness.

What if my symptoms persist?

If symptoms persist for more than one month, seek medical attention. A hand surgeon can help diagnose a trigger finger and provide treatment, which may include corticosteroid injection and/or an occupational therapy referral. If these treatments do not work, some people need to undergo surgery for this problem.

How do corticosteroid injections help?

A corticosteroid injection delivers a strong anti-inflammatory to the area of inflammation in the hand. In the majority of patients, corticosteroid injection can provide permanent relief of symptoms after just one injection.

How does occupational therapy help?

Occupational therapy can be very beneficial for decreasing the pain and stiffness associated with trigger fingers. Patients are often taught about modifying daily tasks to decrease triggering, such as avoiding gripping tasks and performing gripping tasks in a manner that avoids using the inflamed tendons. Therapists also may teach patients range-of-motion exercises to decrease the stiffness and enable the patient to bend and straighten the finger fully.

To make an appointment to see one of our hand specialists, call 877-636-7846 or email orthopedics@mountsinai.org.

Learn more about the C.V. Starr Hand and Upper Extremity Center

A Generous Gift Advances Breast Cancer Screening at Mount Sinai

Nov 20, 2022 | Artificial Intelligence, Featured, Your Health

Joyce Glasgold and her daughter, Ellen Glasgold Lange, know firsthand how important early detection can be in breast cancer, which is why a generous gift from the Glasgold Family Foundation made possible the purchase of an ultrasound reading platform powered by artificial intelligence. From left: Alexandra Lange, Ellen Glasgold Lange, Joyce Glasgold, Olivia Lange, and Trevor Lange.

When it comes to breast cancer, Joyce Glasgold and her daughter, Ellen Glasgold Lange, know firsthand how important early detection can be.

Joyce Glasgold’s mother died of breast cancer, and many of her family members had the disease. Mrs. Glasgold herself was diagnosed in 1991 at age 50. Fifteen years later, her daughter Ellen was diagnosed with lobular carcinoma in situ (LCIS), a condition that indicates an increased risk of developing breast cancer and that, along with her family history, led her to have a bilateral mastectomy.

So when they learned about Koios DS Breast—an AI-powered, ultrasound-reading software platform that can spot cancer in two seconds—they were eager to make it available to women throughout New York City. A generous gift from the Glasgold Family Foundation to the Department of Radiology supported the purchase and installation of the software at The Mount Sinai Hospital, ensuring that physicians have advanced technology to aid them in making rapid, accurate diagnoses and reducing unnecessary biopsies.

This is particularly important for women with dense breasts, which can make it much more difficult to spot cancers. Nearly 50 percent of women over age 40 have dense breast tissue, and mammograms miss more than half of cancers present in those individuals. These women often require an ultrasound in addition to mammography to capture images of areas of the breast that may be harder to see.

“This new software potentially allows us to increase the ability of breast ultrasound to find cancer that might have gone undetected,” says Laurie R. Margolies, MD, FACR, FSBI, System Chief of Breast Imaging for the Mount Sinai Health System. “The radiologists at Mount Sinai are excited to be able to use cutting-edge technologies for the betterment of our robust ultrasound screening program and the benefit of all our patients.”

Using artificial intelligence and machine learning algorithms, Koios DS Breast compares ultrasounds to an archive of hundreds of thousands of images from patients from around the world with confirmed benign or malignant diagnoses, providing radiologists with an instant “second opinion” in classifying suspicious lesions. The technology not only helps clinicians identify cancer sooner so patients can begin treatment as quickly as possible, but it also reduces the need for biopsies in benign tissues.

Because the Mount Sinai Health System serves a large and diverse patient population, the Glasgolds are also pleased that women from medically underserved communities will now have access to state-of-the-art diagnostics.

“We all know that catching breast cancer early saves lives, so our family was compelled to accelerate the adoption of this exciting new innovation,” says Joyce Glasgold. “We are honored and thrilled to help bring this game-changing technology to Mount Sinai.”

Learn more about the Center of Excellence for Breast Cancer at Mount Sinai

Is Dry Air Causing Your Nosebleeds?

Updated on Nov 17, 2022 | Ear Nose Throat, Your Health

Nosebleeds are common—nearly 60 percent of us have had to deal with one at some point in our lives—and the pesky problem usually comes out of nowhere. You may be enjoying a walk on a brisk day or wake up in the morning and suddenly your nose starts dripping red. As the seasons change and the weather becomes colder and dryer, nosebleeds are more likely to occur.

“As we head into winter, the change in temperature and humidity has a significant effect on our overall well-being,” says Isaac Namdar, MD, Assistant Professor of Otolaryngology-Head and Neck Surgery at the Icahn School of Medicine at Mount Sinai. “One of the more common side effects that we see from the cold, dry winter months is nosebleeds.”

Nosebleeds are normally not serious and stop on their own within about ten minutes. Still, stopping the bleeding is an important first-aid skill everyone should know in case it happens to you—or someone in your family. And you may be surprised to learn that experts say don’t tilt your head back.

What causes nosebleeds?

The nose is one of the most common areas of the body for spontaneous bleeding to occur. “There is a very rich blood supply to the nose, which allows the nose to change the humidity and the temperature of the air you breathe, and the vessels are more close to the surface than other places in the body,” explains Dr. Namdar. This makes the vessels in the nose more delicate and susceptible to damage.

Nosebleeds are particularly problematic in the winter when the weather is cold and dry; when there is less heat, there is usually less humidity and moisture. This dryness can damage or crack the delicate nasal membrane lining the nose, resulting in a bleed.

The environment inside our homes also makes this dryness worse. Central heating is the source of heat for most people in the United States. This type of heat further dries out the air as it is warmed.

Trauma is another major cause. When the nose is scraped or banged up, the small blood vessels inside it can burst. That is why young children who pick their nose or stick objects into their nostrils are more susceptible to nosebleeds.

Allergy sufferers are also at risk since anything that causes inflammation to develop in the nose can cause it to bleed. People with allergies also commonly use nasal sprays, which can make matters worse.

“Inserting the nasal spray tip into the nostrils can scrape the inside of the nose. Or if the medication is not evenly dispersed when it is sprayed, it can accumulate in the front of the nose and cause irritation,” says Dr. Namdar.

Some individuals with certain medical conditions are prone to nosebleeds. Patients with uncontrolled high blood pressure or genetic conditions such as Von Willebrand disease or hemorrhagic telangiectasia are more likely to bleed. People who take blood thinners, such as aspirin or warfarin, are also more likely to have nosebleeds.

How do I stop a nosebleed?

Even if you know the reason behind the nosebleed, getting one can be disconcerting. Follow these simple steps to stop the bleed:

Stay calm. Breathe through your mouth. Remind yourself—or the person you are helping—that the bleeding will stop soon.
Pinch the nostrils. Use two fingers to apply firm pressure to the fleshy part of the nostrils below the bridge of the nose. This pressure will allow the blood vessels to form a clot over the leak. Continue to hold this position for about ten minutes.
Sit up tall and lean forward. Do not lie down or tilt your head back. Avoid blowing your nose. If you need to remove a blood clot, wipe gently with a tissue.
Use an ice pack. Take a bag of frozen peas or something similar in the freezer and place it on top of the nose. The cold will shrink the blood vessels and reduce the bleeding.
Make a plan. If the bleeding continues after 15 minutes or begins to spurt, go to the emergency room.

When should I be concerned about a nosebleed?

Nosebleeds are generally not cause for alarm. However, there are some red flags that could indicate something more serious is happening. If you experience any of the following symptoms, seek medical attention immediately:

A nosebleed that lasts more than 15 minutes
Blood that is squirting rather than dripping from the nose
The amount of blood from the nose could fill an eight ounce cup

When you have a nosebleed, a blood clot may come out of your nose or mouth. These clumps of blood may look concerning, but they are actually the body’s way of trying to stop the bleed. Since the airway is connected, the clot may end up in the throat.

“If the nosebleed starts to form a blood clot, gently spit it out,” advises Dr. Namdar. “When clots are swallowed, they can end up in the stomach and cause discomfort.”

If you suffer from recurrent nosebleeds—more than two in a season—it is probably time to make an appointment with an ear, nose, and throat physician.

When nosebleeds are recurrent, they may require medical attention. Specialists like Dr. Namdar can seal the leaky blood vessels by either packing or cauterizing the area to prevent bleeding.

How do I prevent nosebleeds?

Since dryness is the main culprit for nosebleeds, finding ways to moisturize the nasal passageways are key to prevention.

“These are basically saline solutions, or a mix of salt and water, and some of them have moisturizers built in. I generally recommend using a nasogel spray. Some patients also use bacitracin ointment or petroleum jelly,” says Dr. Namdar.

Hydrating your body and drinking plenty of water is a good start. Dr. Namdar suggests using a humidifier—which puts moisture back into the air—in the bedroom. And if you spend several hours a day in your living room or office, you may want to consider having a humidifier in those spaces as well.

Make an appointment with Dr. Namdar

Is It Worth It to Take Tamiflu?

Nov 2, 2022 | Cold and Flu, Your Health

The peak season for the flu in the United States typically runs from December through March, according to the U.S. Centers for Disease Control and Prevention.

If you have not already gotten your annual flu shot, now is the time to do so. You can go to a Mount Sinai urgent care center for flu shots. Mount Sinai offers testing and treatment for those who show symptoms or have been exposed to the flu.

If you already caught the flu, there are ways to reduce its effects, such as taking antiviral medications like Tamiflu. However, managing the illness can be complicated, as some medical providers advocate the use of antiviral medications, while others treat flu symptoms and prescribe rest.

Joseph Feldman, MD

As an urgent care physician, Joseph Feldman, MD, Medical Director of Mount Sinai Doctors-Urgent Care, sees many patients with flu-like symptoms who have questions about how to treat their illness. In this Q & A, Dr. Feldman, Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai, weighs the pros and cons of the ubiquitous antiviral medication and provides insight on how to best manage the flu so that you and your loved ones are healthy this flu season.

What is Tamiflu and when is it used?

Oseltamivir, also known as Tamiflu, is one of the more well-known antiviral medications that can be used to treat or prevent influenza. It is approved for use in adults, pregnant women, and children as young as two weeks of age. For patients who are otherwise healthy and who present with flu-like symptoms—these include painful body aches and fever coupled with sore throat, cough, congestion, headache, or even an upset stomach—Tamiflu may be an appropriate choice. If taken within 48 hours from the start of symptoms, it may provide some benefit by reducing the amount of time you feel sick.

Tamiflu can also be taken to help prevent the flu. If you or your child has been in close contact with someone who was recently diagnosed with influenza, it might be recommended to take Tamiflu—especially if you did not get the flu vaccine this year.

How effective is Tamiflu?

Unfortunately, the effectiveness of Tamiflu is marginal, as it cannot “cure” the illness. Most studies have shown that the medication will reduce the length of symptoms by only 12 to 24 hours, and if started after two days of symptoms, it does not help at all.

It is important to keep effectiveness in mind, as expectations for Tamiflu are often very high and, frankly, overhyped. The drug is usually taken for five to seven days and, if paying out of pocket, can cost more than $100. It can be challenging to find as it is often out of stock at multiple pharmacies given the high demand. Additionally, as with any medication, Tamiflu has potential side effects which may bring more harm than good. The most common of these are nausea, vomiting, and headaches that could exacerbate pre-existing conditions or lead to worsening dehydration. Other side effects, such as a severe allergic reaction, confusion, abnormal behavior, seizures, and life-threatening rashes, can occur but are extremely rare.

So, do I need the medication?

Maybe. The U.S. Centers for Disease Control and Prevention and the Infectious Disease Society of America recommend Tamiflu for patients who have a higher risk of developing complications such as pneumonia that may follow influenza.

These “at risk” patients include:

Those who are hospitalized
Pregnant women
Morbidly obese patients
Children less than five years of age
Adults older than 65 years of age
Patients with chronic heart, neurologic, or respiratory conditions such as asthma or stroke
Patients with immunosuppressing conditions such as HIV
Transplant recipients or those with diabetes and/or sickle cell disease

If you or your child fall within any of these categories, it is likely beneficial to take Tamiflu if you test positive for influenza. If you have been exposed to the flu by a close contact and have any of the previously mentioned conditions, it is also recommended that you start Tamiflu to help prevent getting sick.

For those who do not fall into a high-risk category, the decision to take Tamiflu should be made in conjunction with your health care provider. There are many times when it may not be worth the cost and the potential side effects.

Find a Mount Sinai Doctor

At Mount Sinai Urgent Care, we are always available to answer any questions so that you can make the most informed decision for yourself and your family.You can walk in without an appointment during our convenient daytime, evening, and weekend hours. We accept most insurance providers.

Visit a Mount Sinai Urgent Care location

For Parents on Halloween: Tips for a Happy and Safe Holiday

Updated on Oct 20, 2024 | Your Health

Halloween is a special time for kids and parents alike. But it can be important for parents to exercise some caution, as some activities can create potential hazards, especially for younger children.

To help keep the holiday healthy and fun, Tessa Scripps, MD, Assistant Professor, General Pediatrics, at the Mount Sinai Kravis Children’s Hospital, offers parents some simple tips around picking a costume and trick-or-treating safety. She also shares advice on handling treats and how to navigate trick-or-treating with food allergies, including the significance of the teal pumpkin.

Click here for eight suggestions from our expert on pediatric obesity on how to let your children enjoy the holiday and the candy without going overboard.

Costumes:

When choosing a costume, make sure it fits well and is comfortable to prevent falls and ensure that your child can enjoy the evening.
Be mindful that temperatures on Halloween can vary significantly and that costumes can sometimes be too hot or too cold depending on the weather. Pack layers just to be safe.
Make sure the costume’s fabric is “flame resistant.”
Consider non-toxic make up and wigs instead of masks. If you choose a mask, enlarge the eyeholes as masks can obstruct a child’s vision.
Some costumes can be associated with unpleasant allergic reactions. Here are some more tips on that from a Mount Sinai dermatologist.

Tessa Scripps, MD

Street Safety:

Add reflective tape to costumes or use glow sticks or flashlights to help children see and be seen by drivers.
Pay attention, be alert. Cross the street at corners and use traffic signals and crosswalks. Always walk on sidewalks or designated paths. If there are no sidewalks, walk facing traffic as far to the left as possible.
If your child gets lost or is separated from the group, make sure they know their home phone number and address. If your child is too young or has special needs, consider writing your telephone number in a bracelet, sticker on the costume, or even with a marker on their arm.
Sometimes it is helpful to choose a designated “meet up point” where your child can go if they get lost or separated from the group or from their adult.
Explain to your child that they should never enter an unknown person’s home or vehicle while “trick or treating”.
In case of an emergency, teach your child how to call 9-1-1.

Treats:

Wait until children are home to sort and check treats. Throw away candy that has an unusual appearance or discoloration or is spoiled or unwrapped. Homemade items or baked goods should be discarded unless you know who made them.
Remove all choking hazards like gum, nuts, or hard candies from younger children’s goodie bags.
Eat candy in moderation and ensure your child brushes their teeth before bedtime.
Instead of eating all of the collected candy, you can encourage your child to donate to “candy drives” run by local schools, churches, doctor, and dentist offices.
Another option to reduce candy is through a game called “Switch Witch” or “Candy Fairy” where a special toy is left in exchange for a bag of candy placed outside your child’s door at the end of Halloween night.

For Kids With Food Allergies:

Be proactive and prepared when you have a child with food allergies, as most Halloween candies contain a variety of highly allergenic foods like nuts, soy, and dairy.
You may want to sort candies and treats at the end of the night and replace the removed candies with treats you have purchased beforehand that you know are safe for your child to eat to avoid feelings of disappointment and exclusion.
Reinforce which candies are safe for your child to eat before you go trick-or-treating and keep some allergen-free candy in your pocket, in case your child wants to have a treat while you are still out.
Carry an EpiPen with you while trick-or-treating in case an accident happens.
Become familiar with allergen-free candy brands, including “No-Whey” chocolate lollipops and sunflower buttercups, “Enjoy Life,” “Free2B,” “Yum Earth,” and “Annie’s Organic” fruit bunnies.
Be on the lookout for houses that place a teal pumpkin sign on their doorstep—this sign indicates that they have a separate allergy-free container stocked with allergy-free treats or toys. You too can put a teal pumpkinsign on your home to identify your house as having allergen-free treats or goodies.

What Is the Safest Way for My Baby to Sleep?

Updated on Oct 26, 2022 | Pediatrics, Your Health

Just a few important tips: Infants up to one year old should sleep on their backs, in a crib free of loose bedding and toys.

Did you know that because of the special shape of babies’ throats, they have much less risk of choking while lying on their backs? This is one of many safe sleep facts that pediatricians want parents and other caregivers to know.

Every year in the United States, about 3,500 babies die during sleep due to unsafe sleep environments, and SUID (Sudden Unexpected Infant Death) is the leading cause of death among infants between 1 month and 12 months of age.

“It is imperative that safe sleep is practiced, especially for preterm and low-birth-weight infants, who have a higher risk of sleep-related deaths,” says Malorie Meshkati, MD, a physician in Neonatal Intensive Care at Mount Sinai Kravis Children’s Hospital. The American Academy of Pediatrics (AAP) has a longstanding policy on safe sleeping environments for infants, Dr. Meshkati says. In this Q and A, she explains the basics.

What exactly is a safe sleep position?

Infants should be placed on their backs for every nap and sleep on a surface that is firm and flat. The sleep area should be clear of soft objects such as pillows, pillow-like toys, quilts, comforters, mattress toppers, fur-like materials, and loose bedding such as blankets and non-fitted sheets. Infant sleep clothing, such as a wearable blanket, is preferable to blankets and other coverings. Swaddling is okay until three to four months of age, when babies may start to roll. You should not swaddle your baby once they start showing signs of rolling. Avoid overheating and head coverings such as hats at home.

My baby has reflux. Can I still put them in safe sleep position?

Yes. Sleeping flat and on their back does not increase the risk of choking or aspiration in infants, even in those with reflux who may often spit up. In fact, babies are at less risk for choking when they sleep on their backs because the shape of their throats keeps fluid from flowing into their lungs. The AAP recommends a video that explains this. You can view it here.

Should my baby sleep in bed with me?

No. The AAP recommends that infants sleep in their parents’ room, close to their parents’ bed, but on a separate surface designed for infants. Evidence shows that the risk of SIDS can be decreased by as much as 50 percent if infants sleep on a separate surface while in the same room as their parents. Room sharing without bed sharing is especially important in the first six months and continues to protect against SIDS for the first year of life.

How old should my baby be when I stop putting them in safe sleep?

The AAP recommends infants be placed in safe sleep, every time they sleep, until they are one year old.

What else should people know about safe sleep?

Consider breastfeeding; this has been shown to be protective against sleep-related infant deaths. Avoid exposing your baby to nicotine, alcohol, marijuana, opioids, and other drugs. Stay up-to-date on routine immunizations. And let your baby have supervised tummy time every day. You can read more about safe sleeping on the AAP website or watch this helpful video.