Your Health | Mount Sinai Today

October Is Breast Cancer Awareness Month

Oct 9, 2020 | Your Health

One in eight women will be diagnosed with breast cancer at some point in their lives. Early detection is key to surviving this disease.

For interesting facts about breast cancer, check out our October Breast Cancer Awareness Month Facts of the Day. A new fact will be added every day. Also follow the hashtag: #BreastCancerFact.

Finding breast cancer early maximizes treatment options and improves the likelihood of a good outcome. Screening mammography on a regular basis is the best way to find breast cancer before symptoms appear.

Mount Sinai offers a mobile mammography program that brings diagnostic technology to all five boroughs of New York City. Our goal is to help all women 40 and over get annual screening mammograms.

We want to catch breast cancer as early as possible, when it can be most easily treated. Talk with your health care provider and schedule your mammography at one of our convenient locations or through our mobile mammography service.

My Child May Have Trouble Hearing. Will Remote Learning Hurt Their Progress in School?

Oct 8, 2020 | Children's Health, COVID-19, Ear Nose Throat, Your Health

This academic year, many children have returned to school virtually. While remote education may be a safer option for some, it is not without its drawbacks—particularly for children who are hearing impaired.

Enrique R. Perez, MD, MBA, an expert in managing adult and child’s hearing disorders and Director of Otology at The Mount Sinai Hospital, provides advice for parents who are concerned about their child’s hearing when learning remotely.

What are the signs my child may have trouble hearing?

To figure out if your child has hearing issues, I recommend that parents or guardians ask themselves a series of questions:

Do you find yourself raising your voice or calling out your child’s name several times before they respond?
Is your child not startled by loud noises?
Do you notice that your child often turns their head or shifts their body position when listening to others or the TV?
Does your child raise the volume on the television, computer, or their phone to an uncomfortable level?
Is your child struggling with academic work?
Is your toddler not learning to speak at the expected rate?
Does your child have a history of recurring ear infections?

If the answer to any of these questions is yes, your child may be struggling to hear. Pediatricians often perform routine screening for hearing loss and they may be able to uncover even subtle degrees of hearing loss.

I am concerned about taking my child for a check-up during the COVID-19 pandemic. Can I delay their hearing exam?

Deciding whether to seek medical care during the pandemic can be difficult, but delaying care always comes with some risk. Delaying a hearing check-up is especially worrisome for children with significant hearing loss who are not being aided with a hearing aid or other hearing device. This is true for children of all ages. Young children, learning to speak may experience delays in achieving appropriate communication milestones, and those who are speaking well but cannot hear properly may fall behind in school. Studies have shown that these setbacks may be irreversible and may limit your child’s academic achievement.

However, I understand the concern, especially if your child has a condition that makes them more vulnerable to COVID-19. Fortunately, most healthcare facilities follow strict guidelines to screen for and minimize the risk of contracting the virus. If you are apprehensive, I suggest that you contact the facility and ask about their protocols.

How can I help my child who is struggling with hearing issues?

The first step in helping your child is to schedule a proper evaluation by a doctor. You might start with your child’s pediatrician, who can screen for hearing issues, and then, if appropriate, can refer you to a specialist for diagnosis and treatment.

Additional ways that you can help a child struggling with hearing issues include:

Minimizing background noise when you are speaking to your child.
When talking to your child, face them directly and speak slowly and clearly. Try not to shout as that can distort your speech and make your child feel uncomfortable.
Make sure your child’s teachers and school are aware of your child’s hearing issue so that they can help.
Address any insecurity your child may feel regarding their hearing issues as stigma could prevent them from using devices, such as hearing aids. You want to help your child to be comfortable and confident when used a hearing assistive device, especially during these formative years.

How should I set up my child’s space for remote learning?

Remote learning can create new challenges—and some opportunities—for educating children with difficulty hearing. With the proper set-up and equipment, remote learning may be easier than in-person schooling for a child with hearing difficulties.

The first step is to give your child a quiet area in the home for schooling. They will also need a computer with a reliable internet connection and the ability to adjust the volume.

A strong, stable connection enables your child to see the teacher clearly. Importantly, it allows them to see visual cues—such as facial expressions—which are important communication tools for everyone, especially those with hearing loss. And, being able to adjust the volume enables your child to mute other students, allowing them to focus on the teacher. Your child may also benefit from using headphones, including noise cancelling ones, which are normally not allowed in a classroom.

How else can I help my child with remote learning?

I encourage parents and guardians to build a relationship with their child’s teacher. Often, teachers are the first to notice that a child may be struggling to hear. But fostering a connection with your child’s teacher may be easier with in-person schooling than remote learning. Additionally, it helps to stay involved with your child’s education so that you don’t miss any of the early signs of hearing loss that could compromise their ability to learn.

How Mount Sinai Is Keeping Patients Safe

Why Cancer Screenings are Important and How to Talk about them with your Doctor

Sep 29, 2020 | Your Health

While we are making significant strides in treating cancer, the fact is that no one is immune, and that is why regular cancer screenings are so important.

Regular screenings are recommended for a number of the most common forms of cancer, and they can be critical in detecting cancers at earlier stages, thus improving the possibilities for treatment.

“We know the best way to treat cancer is to actually diagnose cancer earlier,” says Kai Tsao, MD, a cancer specialist who is Medical Director of the Ruttenberg Treatment Center at The Tisch Cancer Center at Mount Sinai, and Associate Professor of Medicine at the Icahn School of Medicine at Mount Sinai.

One more important point: Cancer screenings are typically recommended by your primary care physician. So now that many may have delayed seeking medical dare during the COVID-19 pandemic, it can be especially important to talk with your doctor about these screenings.

In this Q&A, Dr. Tsao explains what you need to know about cancer screenings and some of the things to discuss with your doctor.

Why are cancer screenings important?

The earlier we find cancer, the better chance we have for more effective treatment, leading to better outcomes for patients. We have witnessed, with the implementation of cancer screenings for at-risk populations, a significant decrease in cancer deaths over the past decades. Without appropriate screening, patients will only begin appropriate treatments when they begin to experience symptoms, and by then a higher percentage of these diagnoses will be more advanced cancer. With effective screening, we are seeing what we call a “stage migration,” with more patients being diagnosed in early stages of disease rather than more advanced cancer.

How can I learn more about screenings?

Education campaigns and resource groups supported by the government and philanthropy (such as the American Cancer Society) have led the effort in promoting cancer screening to the general public. Importantly, patients can learn about screenings by engaging their primary care physician to discuss what type of testing may be appropriate.

What if I am still concerned about the safety of visiting the doctor during this pandemic?

At the Ruttenberg Treatment Center at The Mount Sinai Hospital, we have developed a number of measures to mitigate COVID-19 risk for patients, including both remote and onsite screening for all patients and visitors. We have a strict visitor policy to minimize the volume of visitors on site. We also require everyone, including our staff, to wear a mask at all times, and to maintain appropriate social distance. Similar measures have been implemented throughout the hospital. Patients should feel comfortable while receiving their health care here at The Mount Sinai Hospital.

How do I know which cancer tests I need?

A number of guidelines, based on the type of cancer, have been accepted as a standard to guide cancer screening. Currently, most practitioners rely on the recommendations of the U.S. Preventative Services Task Force, an independent panel of national experts in primary care, disease prevention, and evidence-based medicine. However, appropriate cancer screening requires a conversation with your doctor who can gather the most accurate information and consider a number of other personal factors, such as your age, prior medical history, family history of cancer, and possible genetic test information. It’s important to note that testing recommendations can change over time.

What are some of the most common cancer screenings?

In the United States, the most common cancer screenings that have been established are for breast cancer (breast exam and digital mammography), cervical cancer (Pap smear and HPV testing), colorectal cancer (stool testing and colonoscopy), lung cancer (Computed tomography (CT) scan of the chest), and prostate cancer (prostate exam and PSA). There are many factors that can change the timing and frequency of cancer screening beyond the established guidelines. For example, having a family history of prostate or breast cancer may require appropriate genetic counseling or testing, and earlier or more frequent cancer screening. It is important to know that every decision for cancer screening should be a shared one, between the patient and the doctor, to review the risk and benefit of the agreed approach.

People generally do not like to talk about cancer. What overall advice would you offer?

First, it is important to understand that cancer can occur in any age group, and maintaining routine health checkups with your primary care physician is essential. During such visits, use this opportunity to discuss whether cancer screening is appropriate for you. This is particularly important now given the ongoing COVID-19 pandemic, as delayed care will lead to worse outcomes. So make sure you continue to communicate with your primary care provider. That could be a telephone call, a video visit, or an office visit. That will ensure you continue to get the appropriate care to maintain your health.

COVID-19: How to Safely Commute to the Office

Updated on Sep 18, 2020 | COVID-19, Your Health

As New York City adjusts to the post-COVID-19 world, more people are going back to the office. If you are one of them, you may be wondering how to do so safely; after all, while New York has done comparatively well at controlling the spread of the virus, the pandemic is far from over.

The first thing to remember, says Dana S. Mazo, MD, MSc, Assistant Professor of Medicine (Infectious Disease) at the Icahn School of Medicine at Mount Sinai and physician lead for Infection Prevention at Mount Sinai Queens, is that the skills we need to safely go back to the office are the same ones we’ve been practicing since New York was the pandemic’s epicenter in March.

In this Q & A, Dr. Mazo provides salient advice for those returning to the office in addition to the basic tools of social distancing, wearing a face covering, avoiding face touching, and hand washing.

I commute using a cab/car service. How can I ride safely?

First, everyone in the vehicle should wear a mask for the entire ride. To improve the air flow, keep the windows open if possible and, if you need to turn on the air conditioning, don’t recirculate the air as that will only spread germs.

The virus can also be spread by touching a contaminated surface and then touching your face—especially the mouth, nose or eyes. To prevent this from happening, you should sanitize your hands and/or use antiseptic wipes on frequently touched surfaces especially before handling your own belongings or face.

If you are the passenger, be sure to use hand sanitizer soon after you first get in the car when you will have just touched the door handles, seat belt and possibly window controls. Then, try not to touch anything during the trip—especially your face—and use hand sanitizer, if you do. If possible, use a contactless payment option. When you leave, and again have to touch seat belts and door handles, don’t forget to again use hand sanitizer as soon as possible and definitely before touching your belongings or face.

If you are the driver, or you share your car, be sure to sanitize the steering wheel, dashboard, gear shift, and any other frequently touched surfaces. As an extra step to help keep passengers and our city safe, use a wipe to clean between passengers, pay special attention to highly touched surfaces such as interior door handles and seat belts. Make sure to sanitize your hands after touching anything the passenger may have touched. And, if you use valet parking, remember to sanitize everything the valet may have touched before you start for home.

Finally, if you are sharing a car with someone outside your household “bubble,” you will need to be especially cautious since you will have to sit close to that person in an enclosed space for presumably more than 10-15 minutes. Even if you are both wearing face coverings, there is still some risk; although much less than if one of you were not masked. Are you willing to be at risk from everyone that person has had contact with? Remember, it’s not just the car mate, it’s also everyone they interact with. If you don’t want to take on that risk, sharing a car becomes more complicated.

Should I take special precautions when using public transportation?

While you may be nervous about public transportation, just keep using the same public health tools you have been practicing. The most important step is to wear a face covering and to walk away from someone who is not wearing one.

These days, subways and trains are less crowded than they used to be, so social distancing is less difficult than it would have been at the start of the year. Stand apart from others on the subway or train platform or at the bus stop.

Try to avoid touching the handrails on stairs or escalators, the turnstiles, the gate—or anything else, for that matter. Opt for contactless payment whenever possible. While onboard, don’t touch anything if you don’t have to—sanitize your hands immediately if you need to push a button, pull a cord, or touch a pole—and try to keep at least six feet of space between you and anyone else. When you are settled in your seat, you can sanitize your hands just in case. Remember to hit the hand sanitizer again once you’re back on the sidewalk, and, when you get to your building, sanitize again if you must push or pull a door open.

How do I deal with my anxiety about going back to the office?

Anxiety is normal. We are in the middle of an international crisis; this is not business as usual. Remember, you have been practicing social distancing, mask wearing, and hand sanitizing for months now. These skills will now be applied to a new situation: commuting and the office environment. The key is to plan ahead and stay vigilant. To protect yourself and your loved ones from COVID-19, you must assume everyone around you may be an asymptomatic carrier of the virus.

And, if you feel sick, stay home. If you start to feel sick on your way to work, go back home. If you start to feel sick when you’re at the office, pack up your stuff and go home. Given the dangerousness and high communicability of COVID-19, this is not the time to tough it out.

How Do I Prepare My Child to Go Back to School?

Sep 10, 2020 | Children's Health, COVID-19, Mental Health, Psychiatry, Your Health

As children head back to school—whether in person or virtually—parents may have some concerns about how they will adapt to a new, potentially stressful academic year. Aliza Pressman, PhD, Co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, answers some of your questions.

How can I address my children’s anxiety about going back to school in person?

Start by making sure that you are calm and not imposing your own anxiety onto the conversation. Your children will pick up on your energy and you want to be focused on their concerns. Also, remember that your anxiety—and your child’s anxiety—is very reasonable at this challenging time. If your child is anxious, don’t try to get rid of that anxiety. Instead, validate their feelings. Tell them that what they are feeling makes sense. Children have been out of school for a long time and for months have been hearing about the importance of staying away from people. Now they’re going to head back into a building full of people. Of course they are nervous.

Once you’ve validated your child’s emotions, explain that you would not send them back to school if you did not think they would be safe. Go over the precautions that the school is taking to protect teachers and students and, for younger children, remind them about what COVID-19 is and what individual measures they can take to keep themselves safe while at school.

Will my child’s learning be affected by having their teachers wear masks?

This is a natural concern. Our facial expressions are part of how we communicate and masks obscure half the face. One way to prepare your child is to practice communicating and reading people’s emotions when they are wearing a mask. Make a game of it. Have everyone at home wear a mask and guess what each person is trying to say by just using body language. Once your kids go back to school, you can reinforce the lessons they are receiving in the classroom; for instance, have them read to you. You’ll probably pick up cues from your children about what they need, and you can adjust accordingly. Remember, kids are incredibly adaptable, more so than adults.

How can I help my child connect with their friends while attending school remotely?

If your child is attending school remotely, they will probably miss spending time with their friends, and interactive screen time is a great way for them to safely connect. Since screen time may be your child’s only opportunity to socialize, you might even want to allow more screen time than you permitted before the pandemic. Just make sure it doesn’t interrupt family mealtime, homework, or replace outdoor activity.

Also, remember that some kids don’t enjoy online interaction. Some children enjoy a more passive interaction like being in the same virtual room as a friend while doing an art project. This allows children to chat with each other without the pressure of an ongoing conversation. As kids get older, they will be able to tell you how they want to connect with their friends. It may be through a video game, taking an exercise class together, or watching a movie together. Or, they may just want to talk on the phone or text.

How do I talk to my child about what is happening in the world?

Before you talk with your child about current events, make sure that you have come to terms with your own state of mind. You don’t want to enter the conversation with the weight of your own feelings. When you are ready to talk, determine what you want to discuss before beginning the conversation. Whether it is COVID-19, social unrest, or something else, begin by asking what they know and what they’re thinking about regarding the topic. You want to be your child’s first resource with any questions and concerns. Be prepared to explain your opinions.

When should I seek professional help?

If you or your child cannot manage to sleep or eat or are feeling out of control, consider seeking the guidance of a mental health professional. It is completely reasonable to feel overwhelmed; this is an enormously stressful time. And, remember, if your child sees that you are willing to seek help, they will know that it is okay for them to do the same.

What You Need to Know About Quarantine and COVID-19

Updated on Jun 30, 2022 | COVID-19, Your Health

Several months into the COVID-19 crisis, most people in the New York metropolitan area are intimately familiar with the first line of defense against the virus—social distancing, face coverings, and impeccable hand hygiene.

But, as reopening expands and more New Yorkers feel comfortable travelling, the risk of encountering someone who may have the virus increases. To combat a rise in cases due to this surge in movement, local leaders have implemented quarantine guidelines.

In this Q & A, Krystina Woods, MD, Hospital Epidemiologist and Medical Director of Infection Prevention at Mount Sinai West, answers questions about quarantine and explains why it is an essential tactic in preventing the spread of COVID-19.

Who needs to quarantine? Why does it last 14 days?

Quarantine is recommended for someone who has had close contact with an individual who tested positive for COVID-19 as well as anyone who returns from international travel. Quarantine is required by law if someone has returned to New York State from one of the states listed on the quarantine list, as ordered by Governor Andrew M. Cuomo. This list also applies to residents of and visitors to New Jersey and Connecticut, where governors have put the same order in place. The list of states changes rapidly, so make sure you keep up to date.

While we are still learning more about COVID-19, we know that patients typically develop symptoms between 2 and 14 days after being exposed to the virus. Quarantine guidelines are in line with this 14-day exposure window.

I just returned from a COVID-19 hot spot and need to quarantine. Does that mean I cannot leave my apartment for the entire two weeks?

If you are on quarantine you should not leave your apartment. In fact, it is against the law to do so if you are returning from a “hot spot” state.

Thankfully, we can get just about anything delivered. So, those who are under quarantine should plan on having groceries and other necessary items delivered. Also, you should not socialize with anyone outside of your household. Do not invite people over until your quarantine is complete.

If someone in your household did not travel to the COVID-19 hotspot and does not require quarantine, you should quarantine yourself from those household members.

What should I do if I begin exhibiting COVID-like symptoms during quarantine?

If you begin to exhibit symptoms of COVID-19 while quarantining, step back and consider how you are feeling. If you are well enough to treat yourself at home with rest, fluids, and medication for fever, then you should do so.

If you are not well enough to stay home, if your symptoms suddenly worsen, or if you are experiencing trouble breathing, difficulty maintaining consciousness, confusion, chest pain/pressure, or have blue lips, you should seek medical help immediately. If you need an ambulance to bring you to the emergency room, let the dispatcher know that you are having COVID-like symptoms. This will allow emergency medical personnel to take the proper precautions when taking care of you.

If I remain asymptomatic throughout the 14-day quarantine, should I still get tested for COVID-19?

No. If you have completed your 14-day quarantine and have not experienced symptoms throughout, you do not need to get tested for the virus.

Do you have any more advice for those who will need to self-quarantine?

If you are sharing your home with someone who does not need to quarantine, make sure you have ample cleaning supplies—particularly if you don’t have a separate bathroom—so you can clean high-touch surfaces like faucets, the toilet flusher, door knobs, and shower door handles. If possible, sleep in a separate bedroom–with the window open to allow for fresh air to circulate–and remain in that bedroom/separate space for as much of the day as possible. If you need to leave your separate room, make sure to wear a face covering and try not to touch anything more than is necessary.

Also, make sure you have a COVID-19 emergency care kit, stocked with a working thermometer and non-expired fever-reducing medications. And keep your doctor’s phone number handy, just in case you develop symptoms that require medical attention.

Remember, the purpose of the quarantine is to prevent spreading COVID-19 throughout our community. Currently, the New York metropolitan area has a very low COVID rate, and we want to keep it that way. Although you may feel well, those without symptoms have the potential to spread the virus. So it is important to take all precautions.

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