Your Health | Mount Sinai Today

Five Tips to Avoid the Flu

Oct 27, 2018 | Cold and Flu, Your Health

Last year’s flu season was one of the worst in recent memory. The Centers for Disease Control and Prevention says a record number of people were hospitalized in 2017, which demonstrates why it’s so important to prepare for the flu each year.

Here are five simple tips from Joseph Feldman, MD, FACEP Mount Sinai Urgent Care Medical Director, to help protect you and your family this season:

Get the flu vaccine

The vaccine is safe and does not the cause the flu. It’s often available with no copay or a low copay. The CDC recommends an annual flu shot for everyone age six months and older.

Frequently wash your hands and use hand sanitizer

Pay special attention before eating or after touching potentially contaminated surfaces like subway poles.

Avoid people who sneeze or cough without covering their mouths and noses

This can be tough in crowded spaces, but do your best. And help protect others by sneezing and coughing into your elbow.

If someone in your family gets sick, avoid close contact

Try to help your family member during their illness without getting too close and don’t share food or utensils.

Get plenty of rest

When you’re tired, your immune system may be weakened, so get enough sleep to ensure your body is prepared to fight off germs.

Following these tips will give you a good chance at a flu-free winter. But if you do feel flu-like symptoms such as fever, cough, sore throat, runny nose, or body aches, visit your primary care physician or an urgent care center immediately so you can begin treatment, if necessary.

Get your flu shot at Mount Sinai Urgent Care

“Mount Sinai Now” Offers Urgent Care Via Video Screen

Sep 10, 2018 | Community, Featured, Your Health

A virtual visit was demonstrated by Nicholas Genes, MD, PhD, Associate Professor of Emergency Medicine, and Natalya Sholomyansky, Director of IT Digital Health.

A new telehealth service, Mount Sinai Now, is available free to Mount Sinai Health System employees and their dependents who are covered by Mount Sinai’s Empire Blue Cross/Blue Shield plan. The service provides patients with urgent care from a board-certified physician, almost always a Mount Sinai clinician, via video conference. If there is an emergency, patients should call 911. But Mount Sinai Now, like other urgent care, can be a good choice for treating conditions such as allergies, colds and flu, nausea, rashes, and sprains, says Abraham L. Warshaw, MD, Senior Vice President, and Medical Director of Physician Access Services, Mount Sinai Health System.

The service, which is available 24 hours a day, is part of Mount Sinai’s mission to take the lead in telehealth and population health management. “The idea is giving the right care, in the right place, at the right time,” Dr. Warshaw says.

In a typical visit, a patient might wake up with a sore throat and nasal congestion. She logs into Mount Sinai Now, and within minutes the visit starts, with the patient communicating through FaceTime or another video tool. The physician asks about symptoms, consults the patient’s medical records, and conducts a virtual examination via webcam and monitor, for example evaluating the throat and tonsils, and demonstrating how to check for swollen lymph nodes. Finally, the physician might call in a prescription, or if the symptoms are ambiguous, recommend an appointment with a primary care physician or a specialist.

More than 1,300 staff have registered and 200 have been treated since Mount Sinai Now became available throughout the Health System in May. The team’s plan is to expand the service to other companies, unions, and the public once insurance models are in place. “Patients who use telehealth are saving money, saving travel time, and are able to continue their daytoday life without having to interrupt things or schedule an appointment that might be weeks away,” says Eric Cannan, Senior Director, Telehealth, Mount Sinai Health System.

To register for the free service, go to now.mountsinai.org or visit Google Play or the Apple App Store to download the Mount Sinai Now app.

Awards Recognize Mount Sinai’s Commitment to Quality Stroke Care

Updated on Jun 30, 2022 | Featured, Your Health

Six Mount Sinai Health System hospitals—Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai St. Luke’s, and Mount Sinai West—have received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award.

The award recognizes each hospital’s commitment to ensuring that stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines that are based on the latest scientific evidence.

Each of these Mount Sinai Health System hospitals earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period.

“We are pleased to recognize so many Mount Sinai Health System hospitals for their commitment to stroke care,” says Eric E. Smith, MD, national chair of the Get With The Guidelines Steering Committee. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates.”

Do I Need a Biopsy or Surgery for My Thyroid Nodule?

Updated on Jun 30, 2022 | Head and Neck, Your Health

Thyroid nodules are very common. These masses within the thyroid gland are composed of tissue and/or fluid and are estimated to be present in more than 50 percent of those aged 50 and older. Nodules can run in families, are more common in women, and increase in frequency with age.

Patients diagnosed with a thyroid nodule often ask if their nodule needs to be biopsied or surgically removed. Sometimes the answer is yes, but often the answer depends on a number of patient and nodule-related factors. Catherine Sinclair, MD, FRACS, head and neck surgeon at Mount Sinai West, explains why your nodule may, or may not, need special attention.

How do you know if you need a biopsy?

More than 95 percent of thyroid nodules are non-cancerous, although a family history of thyroid cancer in a first-degree relative or whole-body/neck/chest radiation exposure may increase the risk. Nodules have a low cancer risk, so whether to biopsy depends on the size and ultrasound appearance of the mass.

Over the past decade, many nodules smaller than one centimeter have been incidentally detected on imaging (CT, MRI) that was ordered for another reason. Often these nodules were inappropriately biopsied, and, if the biopsy was positive for thyroid cancer, overly extensive total thyroid surgery was performed. Recent data from Japan and the United States suggests that appropriately selected thyroid cancers can remain stable over time. Termed “microcarcinomas,” these cancers are less than one centimeter in size and may be adequately managed without surgery or with limited thyroid surgery.

How is risk measured?

In an effort to reduce “incidentally diagnosed” microcarcinomas, the American Thyroid Association (ATA) Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer classifies nodules into risk categories for biopsy based on thyroid nodule size and ultrasound appearance. Those classified as high-risk nodules should be biopsied when more than one centimeter in size, whereas low-risk nodules—depending on their appearance on ultrasound—should not be biopsied until they are one and a half to two centimeters in size. Many thyroid surgeons perform their own ultrasounds and use the ATA risk classification system (along with any biopsy results) to determine who should have a biopsy, which nodules should be operated on, and which nodules can be safely observed.

What are the symptoms and treatment for thyroid nodules?

In addition to posing a cancer risk, nodules may also need to be removed if they grow very large (greater than four centimeters) and cause symptoms like difficulty swallowing, neck discomfort, hoarseness of the voice, and airway compression with shortness of breath. Frequently, a thyroid lobectomy—the removal of a portion of the thyroid gland—may be adequate treatment for a non-cancerous thyroid nodule as well as for small cancerous nodules that are less than four centimeters. However, patients should speak with their surgeon in detail beforehand about the many additional factors affecting surgery, such as the status of the other thyroid lobe, your age, and your personal preferences.

In summary, a thyroid nodule may require an operation if there is a high risk of the nodule being cancerous or if the non-cancerous nodule is large and causing symptoms.

Non-cancerous nodules that are asymptomatic should be observed with intermittent ultrasound follow-up when appropriate. If surgery is necessary, the least aggressive option that will effectively treat the nodule should be chosen.

How to Dine Out and Still Eat Healthy

Updated on Jun 30, 2022 | Diet and Nutrition, Your Health

Dining out can be a great way to spend quality time with friends and family. Health-conscious individuals, however, may find dining out to be a challenge due to the overabundance of unhealthy options and the lack of transparency on restaurant menus. Fortunately, by following these simple steps, you can painlessly make healthy eating choices while out on the town.

Before heading out, be sure to check the menu and have a snack.

Most establishments have their menu available online. Plan a nutritious meal in advance. Selecting your meal beforehand prevents you from being tempted by less healthy options once at the restaurant. To avoid overdoing it, have a small, healthy snack that includes fiber and protein before the meal, so that when the bread basket arrives, you won’t overindulge.

Start your meal smart by avoiding liquid calories and ordering a healthy appetizer.

Try to avoid sodas and alcoholic beverages, as these can quickly add excess calories and sugar. Go for healthier options like seltzer, water with lemon, or unsweetened iced tea. If you’d like an alcoholic drink, avoid one of the pre-made, sugary ones like margaritas or daquaris. Consider a light beer, a glass of red wine, or a seltzer paired with the alcohol of your choice and a lemon wedge.

Healthy starters can keep you full so you are less likely to overeat when the entrées arrive. Some smart options include a vegetable appetizer, a tossed salad, or a broth-based soup rather than lobster bisque.

Eat your vegetables and steer clear of fried foods.

Vegetables are high in fiber, which will help you feel full without adding extra calories, so add non-starchy ones (i.e., not potatoes or corn) as side dishes. If your meal normally comes with French fries or onion rings, swap them for a side salad or a vegetable. Avoid anything fried, as well as entrees described as breaded, pan-fried, creamy, or crispy, since these are often higher in calories and fat. Instead, look for menu terms that are broiled, steamed, roasted, and baked – all healthier options.

Making smart eating choices while dining out is possible. By preparing before the meal, you can dine out without the guilt. Remember, indulging is okay occasionally; just try to get back on track for the next meal.

Healthy Pre-Dining Snacks

To avoid overindulgence, try a fiber- and protein-rich snack before dinner:

Greek yogurt with fresh fruit
An apple with 2 tablespoons of peanut butter
Hummus with vegetables

Salad Do’s and Don’ts

If you order a salad as your entrée, limit these high-calorie, high-fat add-ons and salty or creamy salad dressings:

croutons
fried noodles
candied nuts
blue cheese dressing
ranch dressing
Caesar dressing

Instead, substitute lighter options like olive oil and vinegar or lemon juice. Ask for salad dressings on the side, so that you control the amount.

Tips on Portion Control

Restaurants often provide very generous portions. Try ordering an appetizer instead of an entrée and add a small salad to complement the meal. Share an entrée with a friend and add a vegetable side to keep you full. If you do order a full-size entrée, ask to box up half of it before the meal starts to avoid the temptation of finishing the whole portion.

Could Your Sore Throat Be Caused by Acid Reflux?

Updated on Jun 30, 2022 | Ear Nose Throat, Health Tips, Your Health

Have you had a cough, tickle in the throat, itchy throat, or raspy voice that will not go away despite not having a cold or feeling sick? Is excess mucus causing you to clear your throat so often that it is annoying and, at times, embarrassing? Many who suffer from these symptoms are treated by doctors and urgent care physicians with allergy medications, nasal sprays, decongestants, and even antibiotics. Despite this, symptoms do not get better. Often these symptoms are not caused by allergies, a sinus infection, or a cold, but by laryngopharyngeal reflux (LPR). Also called airway reflux, reflux laryngitis, or atypical reflux, LPR is one of the most common diseases of the 21st century. Unlike gastroesophageal reflux disease (GERD), which primarily affects the esophagus, LPR will affect the larynx and pharynx—your voice production system. Lissette Giraud, MD, provides insight into and answers common questions about this widespread condition.

What causes LPR?

It is commonly accepted that this condition is caused by reflux of acid or bile. GERD symptoms like heartburn are not typical of the condition but may appear. The most common symptoms of LPR are hoarseness, sore throat, excess mucus in the throat, persistent cough, asthma-like, symptoms (wheezing, chest tightness, and difficulty breathing), postnasal drip, sensation of a lump in the throat, difficulties swallowing, and ear pain. However, LPR presents differently in each person.

When should I see a doctor?

If you have a sore throat, painful swallowing, cough, difficulty swallowing, or hoarseness for 10-14 days, you should seek medical attention, preferably from an ENT.

What is the treatment for LPR?

Treatment will vary in accordance with the severity of symptoms. It can be as simple as making changes to your diet, like avoiding spicy foods, tomatoes, chocolate, caffeine, citrus beverages or foods, and alcohol.

What's the difference between LPR and GERD?

Both LPR and GERD are caused by acid reflux. GERD, the more well known condition, occurs when stomach acid backs up into the esophagus. Patients with this condition may experience nausea and heartburn. LPR occurs when stomach acid reaches the back of the throat or, in some cases, the nasal passage.

Frequently, primary care physicians correctly make the diagnosis of LPR. Patients may be reluctant to start treatment since the typical “acid reflux” symptoms—like heartburn, belching, and regurgitation of acid contents—are not present. Additionally, when patients see a gastroenterologist after a referral by their primary care provider or otolaryngologist (ear, nose, and throat physician, also known as ENT), they are frequently told they do not have “acid reflux.” This confuses many patients and creates further frustration.

Learn more about ENT services at Mount Sinai