Adults need seven hours of sleep every 24 hours, but we often don’t get enough. Boris 
Chernobilsky, MD, director of Sleep and Airway Surgery at Mount Sinai Downtown-Union Square, explains why sleep is so essential.
Read the article in Metro New York
Veganism is trending. The controversial documentary “What the Health?” recently ignited conversation with its claim that eating animal products leads to increased disease risk. While many health professionals do not endorse the film’s claims due to a lack of supporting evidence, the idea that a diet consisting of poor-quality, cheap meat and dairy foods would be harmful in the long term is not surprising.
Whether prompted by the documentary or by celebrities promoting the values of an all-plant diet, veganism is in the news. Luckily, many vegan products are on the market, which definitely makes it easier to become vegan today. However, you should still seek guidance before jumping on board. Here are a few things to keep in mind:
Talk with your doctor
Regardless of why you want to go vegan, it is a major lifestyle change, and your health care provider should advise on how to prevent nutritional deficiencies. This is especially true for children and young adults. Before going vegan, I recommend undergoing a full blood workup. Checking lab values—such as iron, B12, and calcium/vitamin D—could be a good tool to know where you are starting from and what foods should be encouraged.
Consider Vegan-ish
It may not be necessary to go totally vegan. Ever heard of a flexitarian? That’s someone who is mostly vegan but eats meat occasionally. In addition, purchasing the best quality meat and dairy items, and only consuming them a couple days a week, may be a good step toward a healthier diet without worrying about deficiencies and relying on supplements.
Going vegan is not the same as dieting
Going vegan does not necessarily mean that you will lose weight. A lot of people end up overeating processed carbohydrates and actually gain weight. Being vegan is not a crash diet but a lifestyle change that takes a lot of planning. For example, you should experiment with non-dairy cheeses and make a list of all the plant-based proteins to structure into your day.
Remember, becoming vegan is a dietary change that should be managed with care. Be sure to consult your doctor before taking the plunge.
Valentine Reed-Johnson RD, CDN, is an outpatient dietitian in the Clinical Nutrition Department at The Mount Sinai Hospital. Previously, she worked inpatient for four years primarily with vascular and general medicine patients. Currently, Ms. Reed-Johnson works with the KPE OB/GYN clinic. She has an interest in Diabetes and Wellness Nutrition. She especially enjoys writing as it is the best way to reach the most people and clear up the overwhelming amount of conflicting Nutrition information in the media.
R. Sean Morrison, MD, at the Wiener Family Palliative Care Unit at The Mount Sinai Hospital, which recently earned recertification by The Joint Commission.
R. Sean Morrison, MD, has been appointed Ellen and Howard C. Katz Chair of the Brookdale Department of Geriatrics and Palliative Medicine at Icahn School of Medicine at Mount Sinai. Dr. Morrison, who joined Mount Sinai in 1995, has focused on one goal throughout his career: Improving quality of life for patients and families.
“Our mission is to ensure that persons living with serious illness, multiple chronic conditions, physical disability, or cognitive impairment live as well and as long as possible,” Dr. Morrison says. “We try to establish what goals are important to our patients and help them to achieve them.”
Dr. Morrison will continue as Director of the Hertzberg Palliative Care Institute and the National Palliative Care Research Center. He succeeds Albert L. Siu, MD, who was chair of the department for 15 years. “My No. 1 objective is to build on the success of my predecessors—Drs. Robert Butler, Christine Cassel, and Albert Siu. They created the first Department of Geriatrics, and then the first integrated Department of Geriatrics and Palliative Medicine in the country, and built it into the nation’s leading academic program focused on the needs of older adults and those with serious illness.”
The Mount Sinai Hospital’s geriatrics program ranked third in the nation in the 2017–2018 U.S. News & World Report “Best Hospitals” Guide. And in February, the palliative care programs at The Mount Sinai Hospital and Mount Sinai Beth Israel earned recertification by The Joint Commission. “Mount Sinai was one of the first five hospitals to receive Advanced Certification in Palliative Care in 2011,” Dr. Morrison says. “Since that time, our teams, sites, and number of patients have multiplied considerably. Yet our services continue to offer an unwavering quality of care to seriously ill patients and their families.” He thanked the Mount Sinai Health System’s leadership for their support and thanked every team member for their dedication “to removing unnecessary suffering from the world.”
Dr. Morrison earned his MD at the University of Chicago Pritzker. He completed his residency at New York-Presbyterian Weill Cornell Medical Center and his fellowship training in geriatric medicine at the Icahn School of Medicine at Mount Sinai. In 1995, he helped found Mount Sinai’s palliative care program which started with a team of four: Dr. Morrison, Jane Morris, MS, RN, ACHPN; Judith Ahronheim, MD; and another national leader in palliative care, Diane E. Meier, MD, who is a MacArthur Fellow and the Catherine Gaisman Professor of Medical Ethics, and Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. Dr. Meier now serves as the Director of Mount Sinai’s Center to Advance Palliative Care, an organization that Dr. Morrison collaborates closely with in disseminating innovative models of palliative care education and practice throughout the United States.
At the time that palliative care started at Mount Sinai, it was a novel team-based specialty focused on providing specialized medical care to relieve the symptoms and stress caused by the serious illness for patients and their families. It is still appropriate at any age and at any stage in a serious illness, and unlike hospice, it can be provided alongside curative and all other appropriate medical treatments. “As a result of the research, educational outreach, and clinical-care models developed at Mount Sinai, palliative care is now available in all major hospitals across the country making it one of the fastest growing specialties in American medicine,” Dr. Morrison says.
This is a crucial time for geriatrics and palliative care. “Those over age 80 are the fastest growing segment of the American population, and older adults living with serious and complex medical illness account for more than 60 percent of all health care spending,” Dr. Morrison says. “As baby boomers continue to age, all health care professionals will need to have the core knowledge and skills of geriatrics and palliative care in order to deliver high value health care.”
His goals for the Department are: to develop new models of high value clinical care to match the needs of an aging population; to create the science and evidence base that supports the care; and to train a work force that is well-prepared to care for older adults and those with serious illness. “This is the Department that created the fields of geriatrics and palliative care,” Dr. Morrison says. “My hope is that we become the Department that is responsible for completely infusing these specialties into the genome of American medicine.”
Sean P. Pinney, MD
Mount Sinai Heart is reducing readmissions and improving quality of life for congestive heart failure (CHF) patients with remote monitoring using new devices and apps, as well as old-fashioned compassionate care.
“We are creating a multimodal way of keeping an eye on our patients after they have left the hospital so that we can optimize their medications and keep them at home—where they want to be—rather than in the hospital,” says Sean P. Pinney, MD, Professor of Medicine (Cardiology), Icahn School of Medicine at Mount Sinai, and Director of Heart Failure and Transplantation, Mount Sinai Health System.
One of the strategies involves the ReDS™ (Remote Dielectric Sensing) system, a wearable vest made by Sensible Medical Innovations. ReDS is based on technology that allows the military to “see through walls” and find survivors in collapsed buildings. In a medical setting, a device sees through the walls of the chest, sending an electromagnetic beam through the middle lobe of the right lung, measuring the lung fluid. Based on the readings, a physician might decide to raise or lower the dosage of diuretics, or hospitalize the patient if there is an extreme overload of fluid.
Dr. Pinney’s team is participating in a randomized multicenter clinical trial of the device, sponsored by Sensible Medical, that began in September 2015 and is to be completed in June 2018. The trial will compare the readmission rates of 380 patients hospitalized for heart failure. All participants are receiving the standard care, including follow-up phone calls and outpatient visits, but one group also goes home with a ReDS vest, with their readings transmitted to care providers. Since July 2017, Mount Sinai has also been using the device in its Rapid Follow-Up Clinic for recently discharged CHF patients. “We are one of only three centers to do this, so we are in the vanguard,” Dr. Pinney says. Among the 28 patients who have used the system since July, the 30-day readmission rate was about 9 percent, compared with 22 percent for heart failure patients overall.
The CardioMEMS™ device is an implanted sensor, about as wide as a dime, that checks for increased pressure in the pulmonary artery.
Mount Sinai is an early adopter of another device, CardioMEMS™, an implanted sensor made by Abbott that checks for increased pressure in the pulmonary artery—an early indicator of worsening heart failure. A small pressure sensor is implanted in the pulmonary artery using a catheterization procedure. Sensor readings are wirelessly transmitted to a secure website for clinicians. “If the pressures rise, we increase medication, and if they come down too low, we cut back,” Dr. Pinney says. “So it gives us a feedback loop to get smarter about prescribing medicine.”
Mount Sinai is also using apps to help monitor CHF patients. One is HealthPROMISE, a system for iPhone and Android, developed by the Mount Sinai AppLab. Patients are sent home with a blood pressure cuff and a scale that send data through the app to care providers. “We can track blood pressure, weight, and the answers to simple questions about the patients’ symptoms,” Dr. Pinney says.
A pilot study by Dr. Pinney’s team found that of 52 subjects using the app, four were readmitted within 30 days of discharge. “The CHF patients had a 7 percent readmission rate compared to the national readmission rate of more than 25 percent within 30 days of discharge,” according to an abstract of the study, presented in October 2017 at the Connected Health Conference in Boston.
Another app, being developed by Dr. Pinney’s group and a startup company, RecoverLINK, is also in clinical trials. It works similarly to HealthPROMISE but asks more detailed questions about patients’ symptoms, mood, compliance with medication, and general quality of life. In addition to remote monitoring, patients also receive personalized video messages from providers.
Dr. Pinney says that heart failure patients often underestimate the severity of their condition, saying “I just have a weak heart,” when the median survival after diagnosis is about five years—“as bad as many cancers, or worse.” He sees a significant opportunity to improve the lives of CHF patients. “There is a need to identify these individuals, refer them to a heart failure center of excellence like ours at Mount Sinai, and take advantage of the pharmacologic and device therapies that now exist.”
Every minute a woman dies from heart disease and stroke in the U.S., yet most women think breast cancer, not heart disease, is the biggest health risk for women, when in fact, heart disease and stroke cause more deaths in women than all forms of cancer combined, according to Beth Oliver, DNP, RN, Senior Vice President of Cardiac Services at the Mount Sinai Health System.
Stephanie V. Blank, MD
Any cancer diagnosis will throw life as you know it into disarray. Learning you have gynecologic cancer may be even more unsettling, as these cancers cause symptoms you may not want to discuss, and diagnosis may require exams and procedures you may not want to have. Many women are uncomfortable discussing potential symptoms and risk factors even with their physicians.
But it’s imperative that you actively manage your health and seek medical attention if you experience symptoms. When detected early, gynecologic cancer can be treated successfully and cured.
In fact, how you approach a gynecologic cancer diagnosis can make a difference in your journey to recovery. Knowledge is truly empowering. Realizing the challenges ahead, while embracing the positive, is a powerful formula essential to healing.
It’s important to take charge of your health throughout the process, from diagnosis to recovery. Here’s how:
Become well informed
Learn everything you can about your condition, from symptoms to causes to treatments. Know the common symptoms and be aware of any new symptoms that might arise. Learn about potential underlying causes of your disease, including age, lifestyle habits, family history, and environmental factors, and know what you can do to reduce your risk. Understand the expected outcomes and potential side effects of treatment. Ask your doctor for reliable sources.
Find a gynecologic oncologist — a physician who specializes in gynecologic cancer — whom you trust
Getting connected with the right physician, one you trust, results in better outcomes. A gynecologic oncologist is able to work with you to manage your complete care plan from diagnosis through treatment. She or he also can provide the most current information and treatment plans available for cancers of the reproductive system. You should be comfortable talking with your physician and feel he or she is listening to your concerns.
Ask questions
Your physician wants you to be informed about your diagnosis and realizes you’ll have many questions. Don’t be afraid to ask. Write down your questions and take them to your appointment. The more you understand about your condition, the more you can help manage your care plan.
Build a strong support team
Surrounding yourself with people who care about you and who understand the challenges you face is essential for your emotional well-being. Spend time with positive people who will help keep you focused on remaining optimistic. There also are numerous support groups of women who have gone through or are currently going through a similar journey.
Focus on your wellness and strive to be healthy
Living after a cancer diagnosis is all about wellness. One of the best things you can do is take your diagnosis as a cue to embrace a healthy lifestyle. Talk with your doctor about steps you can take to manage your health. Eating a balanced diet and engaging in physical activity, preferably something you enjoy, is beneficial for recovery. Relaxation and meditation can reduce stress both mentally and physically. Striving to maintain a healthy lifestyle is one of the most significant ways to take control of your condition.
Stephanie V. Blank, MD, is a Professor of Gynecologic Oncology at the Icahn School of Medicine at Mount Sinai. She is also Director of the Women’s Cancer Program at Mount Sinai Chelsea