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E KHDO W K\ < FKRL FHV e b Y_ X Y \ physical health U Z _ U P Q ` TU _ U _ _ aQ& | Physical Health Irritable Bowel Syndrome | Family Health Poison Ivy | Emotional Health Panic Attack | Know your Numbers | Calendar of Events EDITORIAL BOARD: Elisheva Langner, Ph.D. Staff therapist and Program Director, Wellness Education, Training, and Outreach at The Center for Applied Psychology Isaac Schechter, Psy.D. Director, Center for Applied Psychology CONTRIBUTING EDITORS & REVIEWERS: Edward Lebovics, M.D., F.A.C.P., F.A.C.G. Professor of Medicine & Director, Division of Gastroenterology and Hepatobiliary Diseases, NY Medical College Yosef Gurevitch, MSW Staff therapist and anxiety disorders specialist, Department of Clinical Services at the Center for Applied Psychology irritable bowel syndrome veryone has experienced a stomachache at some point in his or her life. It may have been at age 5, after a full day of pure, blissful Purimnosh ingestion or during that very brief period of time when you thought that tuna sandwiches did not need to be refrigerated overnight. In either circumstance, these minor stomach problems usually last only a few days and then disappear. Cont. page 3 emotional health panic attacks Information is the first step towards healthy living VOLUME 1 / ISSUE 3 / SUMMER 2007 family health poison ivy “Leaves of three, let them be.” These rhyming words of caution may be one of the smartest sayings you teach your children this summer. Poison ivy, poison oak, and poison sumac are harmless looking plants that can easily create a lot of havoc on one’s skin. Poison ivy and poison oak grow with three leaves on each stem while poison sumac grows with rows of two leaflets along the stem and one at the tip (see photo). Touching any of these plants can cause contact dermatitis, which is red, itchy rashes, small bumps, blisters, or swelling. These rashes are not serious but can be uncomfortable or even painful. The poisonous oil in these plants (urushiol) can cause this reaction 12 hours to 10 days after one’s skin merely comes into contact with the plant or its oil. Treating this type of contact dermatitis can be tricky, so keep the following suggestions in mind. Cont. page 2 s I walk down the grocery store aisle, my heart suddenly starts to beat faster, my palms become sweaty and clammy, and I feel as if I can’t breathe, gasping for air in desperation. I am terrified that I am dying or having a “nervous breakdown” and I quickly run out of the store, davening that I don’t collapse on the street. Afterwards, I am filled with dread and anxiety that it’s going to happen again and I start avoiding that grocery store. Cont. page 5 Cont. family health What If I Already Touched The Plant? First, clean the area with a lot of isopropyl (rubbing) alcohol. Keep in mind that alcohol takes off the natural protecting oils of your skin along with the urushiol, so stay away from the plant the rest of the day! Next, pour water over the area. Then take a shower (not a bath) with soap and warm water. Don’t use soap before the shower because soap may spread the urushiol all around the skin as you wash. Make sure to wash under your (or your child’s) fingernails! How Can I Prevent The Reaction? Teach your children what these plants look like and tell them not to touch them- even when you’re not looking. Get these plants out of your backyard, if possible. Try herbicides or use heavy gloves to carefully pull them out, washing your gloves and hands thoroughly afterwards. Never burn these plants because their oil spreads in smoke, causing a dangerous rash inside of the body when inhaled. When going outdoors or hiking, try to stay on cleared pathways, wear long-sleeved shirts, long pants, socks, shoes and gloves if you are working in the garden. Using alcohol and water, wipe off all of your clothes, shoes, tools, and everything that might have touched the oil or plant. Remember to keep your hands covered and protected while doing this and then throw out the hand coverings. To relieve the itching, pain and swelling: use calamine lotion, creams containing menthol, cool and wet compresses, and soak in a bath of cool or lukewarm (not hot) water with colloidal oatmeal (for example, Aveeno). Teach your children what these plants look like. Before going outside, you can use lotions that block the oil from getting into your skin, such as Ivy Block. Keep in mind, however, that humidity, temperature and the condition of your skin will affect how well it works. Be careful with what you wear outside. If you walk through poison ivy, oak, or sumac and touch those shoes or clothing the next day (or even the next year!), it can cause dermatitis. Poison Sumac Corticosteroid creams (hydrocortisone) are helpful in the early stages, before blisters develop. If the reaction is very severe, is spread over a lot of the body, is near sensitive areas of the body such as the eyes or mouth, does not get better after a few weeks, or is oozing pus, go to your doctor. Sometimes, oral antihistamines (such as Benadryl) or oral corticosteroids will be prescribed. Do not use antihistamine creams, as they can make the rash worse. Sources: www.kidshealth.org, www.mayoclinic.org, www.aad.org, www.fda.gov Poison Oak SUMMER NEWSLETTER ‘07 | PAGE 2 Cont. physical health Most people are hesitant to speak about their stomach problems because it often involves private or embarrassing experiences. For this reason, many people suffer quietly without realizing that just making some minor adjustments might ease some of their discomfort. As previously mentioned, there are many different explanations for stomach pain and a doctor’s visit is the first step to taking care of yourself. It may help to make that appointment knowing that most stomach problems are not serious and, once correctly diagnosed, can be eased at home. S ome people, however, experience stomach discomfort that is very painful, lasts more than just a few days or seems to be unrelated to their eating habits. These types of stomach problems are usually difficult to identify because, without a medical examination, they can indicate anything from lactose intolerance, anxiety, or pregnancy-related issues to ulcers, celiac disease, or inflammatory bowel diseases (IBD, which includes Crohn’s disease and ulcerative colitis). Given that there are so many different possible explanations (and treatments) for more severe stomach problems, it’s very important to speak with your doctor about these types of symptoms. Many doctors find that the most common stomach complaints are due to irritable bowel syndrome or IBS*. These may include cramping, bloating, gas, constipation, diarrhea, or feeling as if you have to go to the bathroom when you don’t. These symptoms could be constant or come and go at different times. Although the cause of IBS is still unknown, it is clear that IBS occurs when the bowel (large intestine) doesn’t work the way it should. It does not mean that the bowel is damaged; rather, the nerves and muscles in the bowel may be overly sensitive to your body’s internal systems. It is therefore possible that certain things may trigger symptoms in one person with IBS while another person may not be affected. Certain foods, stress, nervousness, and even smoking may cause symptoms to appear. It’s important to note that IBS is not a psychological or emotional problem, although some emotional difficulties can trigger symptoms. Additionally, IBS does not cause more serious conditions such as Crohn’s disease or cancer, as some people mistakenly think. food choices Th e Good Stuff Foods that are high in fiber can reduce IBS symptoms. Fiber is found in fruit (especially pears, blueberries, and apples), vegetables (especially cabbage, raw carrots, and peas), beans (especially kidney and lima beans), whole grain bread, whole-wheat pastas, many cereals, oatmeal, and bran. Looking at nutrition labels when buying packaged goods can also help you figure out their fiber content. Just remember to increase the fiber in your diet slowly, otherwise it may make you uncomfortable at first. Drinking 8 glasses of water every day and eating 4-5 smaller meals at regular times instead of 3 larger ones can also be helpful. Th e Bad Stuff Certain foods are known to cause IBS symptoms. It may be helpful to avoid or decrease how much you eat of the foods that are your triggers. To find out which foods are problems for you, keep track of what you eat during the day, what symptoms you have, when they happen, and what foods always make you feel bad. The following foods are known to cause symptoms in many IBS sufferers and may be triggers for you: fatty or greasy foods (red meat, fried foods, egg yolks, butter, margarine, nuts, mayonnaise, etc.), dairy products (milk, cheese, ice cream- even the fat free kind), chocolate, alcohol, caffeine (coffee, some medications), carbonated drinks (soda, seltzer), and sugar-free sweeteners (sorbitol, mannitol). Some people find that only gaseous foods such as raw apples and pears, melons, cabbage, broccoli, cauliflower, beans, and carbonated drinks (soda, seltzer), are problematic. It’s important to figure out which of these foods trigger your symptoms, as everyone’s body is different. Keep in mind that if milk products are your triggers, make sure to eat other foods with calcium and vitamin B or use an enzyme to help you digest milk (Lactaid, for example). SUMMER NEWSLETTER ‘07 | PAGE 3 Cont. physical health How do I know if I have IBS? Your doctor will give you a physical exam, take your medical history, and perhaps a blood test, CT scan, stool culture, lactose intolerance tests, flexible sigmoidoscopy, or colonoscopy. These tests rule out other minor problems and make sure that there is no serious reason for your symptoms. Natural and Pharmaceutical Remedies Psyllium (Metamucil), a natural vegetable fiber, and methylcellulose (Citrucel), a synthetic material, are both supplements that you can add to beverages to increase your fiber intake. Peppermint or an antispasmodics can be taken 20-30 minutes before a meal to relax the muscle movements in the bowel, which helps with diarrhea and pain. Avoid peppermint, however, if you tend to get heartburn. Stool softeners and laxatives will help with regularity but should be used with caution because intestinal muscles can become dependent on or addicted to them. Anti-diarrheal medications (Imodium or Kaopectate) can also be helpful but must be taken cautiously because prolonged use can destroy certain bacteria that are necessary for intestinal functioning. Anticholinergic medications can help people with painful bowel spasms. Antidepressant medications can help relieve intestinal pain and depression, if necessary. What Can I Do? Although there is no cure for IBS, many people are able to relieve their symptoms through their food choices, natural or pharmaceutical remedies, and stress management. It may be a good idea to try each of these methods in order to find the right combination that works for you. Stress Management Many people have stomach discomfort when they are worried or nervous but people with IBS have these problems more often and more intensely. Learning how to cope successfully with stress is a powerful method for preventing and reducing symptoms. Relaxation exercises such as deep or diaphragmatic breathing, progressive muscle relaxation can help you to control your stress and relax your muscles to decrease pain. Exercise such as swimming, walking, or aerobics can help with relaxation, reduce nervousness and help with intestinal functioning. Counseling or stress management training can help you learn how to cope with life stresses as they arise, and keep your stress level down throughout your life to reduce symptoms. Other These following treatments might be helpful to some people with IBS. Acupuncture may relax muscle spasms and improve bowel function in some people. Probiotics (in yogurt and some supplements) might help ease symptoms by increasing the amount of healthy bacteria in your intestines. *IBS should not be confused with the more serious IBD (the inflammatory bowel diseases of Crohn’s disease and ulcerative colitis). IBD is when a person has stomach pain with inflammation of the intestines, as diagnosed through a doctor’s examination. SOURCES: www.digestive.niddk.nih.gov, www.mayoclinic.com, www.rush.edu, www.nlm.nih.gov, www.myibd.org calendar of events 1. CAPS IN SCHOOL COUNSELING PROGRAMS Begins in September for the 2007-2008 school year, funded by the ERCSD. Contact your school to learn more about these services. 2. BIKUR CHOLIM 26TH ANNUAL DINNER Sunday, November 11th at the Atrium Plaza SUMMER NEWSLETTER ‘07 | PAGE 4 Many people who report having an Cont. emotional health a episode similar to the one described panic attack. above, think that they are “going crazy” or having a heart attack CHV”SH. For most of these people, however, this overwhelming experience of sheer terror is actually... What is a panic attack? A panic attack is a sudden episode of intense fear that causes strong physical reactions in one’s body, usually lasting about half an hour. This type of “anxiety attack” can happen when a person is alone, with others, at home, in public, or even during a sound sleep. Signs and symptoms may include: BODY SIGNS Pounding or Fast Heartbeat Sweating Feeling Trembling / Shivering Shortness of breath Hyperventilating Numbness Tingling Nausea What if I once had a panic attack? Keep in mind that while some people experience a panic attack, most of them do not have more than one in their lifetime. A number of people experience repeated panic attacks, consistently worry about having an attack, or even change their behaviors in an effort to prevent another attack (for example, avoiding the place where they first had a panic attack). This avoidance can sometimes lead people to stay home most of the day, stop driving, and even shun public places or simchas. If any of these statements are true for you, it may indicate a panic disorder, which is effectively treated with cognitive behavioral therapy and sometimes medication as well. Cognitive behavioral therapy means speaking with a trained psychologist or social worker to learn skills that will help you control, prevent, and cope with panic attacks and the anxiety surrounding them. Before starting therapy, however, it’s important to first ask if the professional you are considering was trained to treat panic disorder. Medications for panic disorder are prescribed by a psychiatrist or your regular doctor and can be very helpful, if needed. These may take a few weeks to work and it’s important to keep regular appointments with your doctor to make sure the medicine is working best for you. Not everyone should take medication and many people only need it temporarily. Treatment can include both therapy and medication or just therapy alone, depending on the diagnosis and personal choice. SOURCES: http://www.mayoclinic.com Stomach cramps Chest pain Headache Dizziness / Faintness Rubbery legs Tightness in your throat Trouble swallowing FEELING SIGNS Feeling like you’re dying Feeling like you’re losing control Feeling like you’re going crazy Confused Disoriented What Should I Do? If you experience these symptoms, it’s important to first speak with your medical doctor because other health problems, such as heart problems, an overactive thyroid gland (hyperthyroidism) or reactions to certain medications can cause similar symptoms. If your doctor finds you otherwise healthy and you continue to have these symptoms, the next step is speaking to a qualified professional. Call The Department of Clinical Services at Bikur Cholim-Partners in Health (845-425-5252, Ext. 300) for an appointment or referral. Treatment is very effective and most people are able to resume their regular lives with the right help. Know Your Numbers Correction: The Spring Issue (Issue 2) of Healthy Choices for Life had a misprint in its BMI (Body Mass Index ) chart. Please use the corrected BMI chart displayed here for calculation of your BMI. BMI (kg/m2) 19 Height 4' 10" 4' 11" 5' 0" 5' 1" 5' 2" 5' 3" 5' 4" 5' 5" 5' 6" 5' 7" 5' 8" 5' 9" 5' 10" 5' 11" 6' 0" 6' 1" 6' 2" 6' 3" 6' 4" 91 94 97 100 104 107 110 114 118 121 125 128 132 136 140 144 148 152 156 20 21 22 23 96 99 102 106 109 113 116 120 124 127 131 135 139 143 147 151 155 160 164 100 104 107 111 115 118 122 126 130 134 138 142 146 150 154 159 163 168 172 105 109 112 116 120 124 128 132 136 140 144 149 153 157 162 166 171 176 180 110 114 118 122 126 130 134 138 142 146 151 155 160 165 169 174 179 184 189 24 25 26 Weight (lbs.) 115 119 123 127 131 135 140 144 148 153 158 162 167 172 177 182 186 192 197 119 124 128 132 136 141 145 150 155 159 164 169 174 179 184 189 194 200 205 124 128 133 137 142 146 151 156 161 166 171 176 181 186 191 197 202 208 213 27 28 29 30 35 40 129 133 138 143 147 152 157 162 167 172 177 182 188 193 199 204 210 216 221 134 138 143 148 153 158 163 168 173 178 184 189 195 200 206 212 218 224 230 138 143 148 153 158 163 169 174 179 185 190 196 202 208 213 219 225 232 238 143 148 153 158 164 169 174 180 186 191 197 203 207 215 221 227 233 240 246 167 173 179 185 191 197 204 210 216 223 230 236 243 250 258 265 272 279 287 191 198 204 211 218 225 232 240 247 255 262 270 278 286 294 302 311 319 328 SUMMER NEWSLETTER ‘07 | PAGE 5 DRIVERS NEEDED TO: Manhattan Hospitals New Jersey Hospitals Local Hospitals Calls come in daily from patients requiring transportation to medical appointments. Unable to take public transportation, they appeal to us for help. WE APPEAL TO YOU FOR HELP. Call 425-5252, EXT 525 for information about this exciting new lifestyle change program for women with high blood pressure, weight problems, diabetes, high cholsterol, or other heart issues. If you drive into Manhattan and can make some time to drop off a patient at a doctor or hospital, please call Miriam Ptalis at 845.425.7877 EXT. 107 SHABBOS ROOM COORDINATOR When a patient is hospitalized over Shabbos and Yom Tov his greatest comfort is the presence of a family member at his bedside. Our Shabbos Rooms accommodate these families by providing them with sleeping and eating accommodations on the hospital premises. If you are available to take care of our Shabbos Rooms, please call Miriam Ptalis at 845.425.7877 EXT. 107 YOUR CHESED WILL ENSURE THE COMFORT OF THE SICK. YOU CAN SAVE THE WORLD! ktrahn ,jt apb ohhenv kfW (zWf:,ufrc) Wtkn okug ohhe ukhtf Medical emergencies do not wait for 9:00 a.m. or stop at 5:00 p.m. An emergency can arise at any time of night or day and when someone is involved in a medical emergency there is no Erev Shabbos or Erev Yom Tov – there is only panic and a sense of loss. When turning to Bikur Cholim no matter what the time, the voice of the dispatcher answers calmly, reassuringly and ready to help. JOIN OUR DEDICATED DISPATCHERS AND HELP SAVE THE WORLD. Call 845.425.7877 EXT. 107 WE WELCOME YOUR COMMENTS AND SUGGESTIONS. 845.425.5252 EXT. 344 | SENIOR VISITATION Wisdom to Share Stories to Tell To a lending ear And a caring heart There are seniors among us who need you to ease the burden of their loneliness. Please call Rifke Sternfield at: 845.425.7877 EXT. 143. YEDEI CHESED OPPORTUNITIES 1. Counselors for Shabbos respite Host a special needs child in your own home, join a mini Shabbaton for a few children, or spend an hour or two with a special needs child on a Shabbos afternoon. 2. Drivers for special activities for children with special needs. We provide carseats. 3. Volunteers for a wonderful Chol Hamoed event - Friday Chol Hamoed Pesach 4. Lag B'Omer outdoor event - we need all kids of volunteers - its a Sunday! [email protected] NON-PROFIT U.S. POSTAGE This newsletter is designed for informational purposes only; it is not to be used in place of professional diagnosis or treatment of any illness. PAID PERMIT NO. 110 MONSEY, NY Dreamwo rks Designs / 845.738.2987 25 Robert Pitt Drive Suite 101 Monsey, NY 10952