Doctor's Notes


Leave a comment

Celebrating Disability Pride

2

Written by Lilian Lin

Throughout July, we took part in celebrations that honored the 26th Anniversary of the Americans with Disabilities Act. These events were especially meaningful to us because of our efforts to support families with children with special health care needs.  Spearheaded by the Health Center’s Pediatric Special Needs Team and generously funded by the family and friends of Mrs. Vicki Chang, the Special Needs Initiative is a comprehensive effort aimed to meet the multiple challenges faced by Chinese immigrant parents and caregivers of children with special needs. Through providing parent workshops, training programs, referrals to parent networks, and enhancing community collaboration, the Special Needs Initiative engages, empowers, and improves services for immigrant families with special needs children.

One of the major goals of this Initiative is to bring about systematic changes to address the complex barriers to care for children with special needs. To date, our Special Needs Team has built collaborative relationships with several community service agencies in Manhattan and Brooklyn that serve children with special needs and their families. Taking part in advocacy activities, such as the July Disability Pride Month events, has strengthened the voice of the disability community.

On July 10, 2016, the Pediatric Special Needs Team and two Health Center volunteers participated in the Festival of Fun and Fraternity which took place at Madison Square Park following the 2nd Annual New York City Disability Pride Parade.

1

The New York City Disability Pride Parade was started in July 2015 by Mike LeDonne, jazz pianist and Hammond organist, to promote inclusion, awareness, and visibility of people with disabilities, and to celebrate the anniversary of the signing of the Americans with Disabilities Act (ADA), legislation that demands equal access and equal treatment of people with disabilities.

3

Our team set up a booth to distribute free educational materials about issues related to children and teenagers with special needs, as well as provided fun activities, such as bubble guns and temporary tattoos, to attract visitors of all ages. Our booth had a great turnout from individuals, families, and staff from agencies serving individuals with disabilities and their families.

306

On July 24, 2016, the Pediatric Special Needs Team and three Health Center volunteers participated in the Chinatown Weekend Walk Disability Pride ADA Birthday Party which took place in Chinatown on Mott Street (between Canal and Worth Streets). Many cultural organizations and local businesses joined together to celebrate the diverse disability community and the 26th anniversary of the ADA.

4

5

We appreciated joining this opportunity to raise awareness of the rights of people with disabilities and celebrate diversity among the Chinatown community.

Lilian Lin is the program coordinator of the Special Needs Initiative at the Charles B. Wang Community Health Center. She has an MPH in Sociomedical Sciences from Columbia University Mailman School of Public Health. She is passionate about working with people and supporting families.

 

 

 


Leave a comment

Summer Fun in the Sun – UV Safety Tips

thinkstockphotos-4764772891

Written by Erica Wan

Though summer is a great opportunity to unwind and spend some time with family on the beach, it is important to remember that more time outdoors means more sun exposure. Sunlight is a great source of vitamin D, but ultraviolet (UV) rays from the sun can also damage your skin, causing premature aging, wrinkles, and an increased risk of skin cancer. UV rays can even be a concern even on cloudy days, as up to 80% of UV rays can pass through clouds. Here are some tips for having a fun, relaxing summer without the sunburn.

Monitor UV levels. It’s a good idea to check how high UV levels are in your area for a better idea of how to prepare and what activities to plan for a given day. You can find the UV index for your local area in the weather forecast or on epa.gov.

Use sunscreen. Sunscreen is one of the best ways of reducing UV exposure. You should use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30.  Broad spectrum means it protects against the major types of UV rays that cause damage (UVA and UVB). Don’t forget to check the expiration date on your sunscreen, and consider using a water-resistant sunscreen if you will be in the water. Since sunscreen can wear off, it’s important to reapply throughout the day, especially if you swim or exercise.

Cover up. Wearing clothing such as long-sleeved shirts or long pants will help protect against UV exposure. Tightly woven fabrics offer better protection against UV exposure.

Accessorize with sunglasses and a hat. A wide-brimmed hat can help protect the sensitive parts of your face, neck, and ears from too much sun exposure. UV rays can also damage your eyes, increasing your risk of developing cataracts. Opt for UV-absorbent sunglasses to protect your eyes; most sunglasses sold in the U.S. offer broad-range protection against UV rays.

Limit exposure, and stay hydrated!  Generally, UV rays are the strongest from 10am to 4pm. If you have to be out in the sun during this time, don’t forget to take breaks in the shade. It’s important to stay hydrated throughout the day, so you lessen the risk of heat exhaustion or heat stroke. Check out our tips for healthy summer drinks. Keep drinking, even when you’re not thirsty.

Now that you’re all summer ready, get out there and have some fun!

Written by Erica Wan. Erica is currently a health education intern at the Charles B. Wang Community Health Center. She is studying Biology, and Culture, Health & Science at Smith College, with an interest in immunology and medicine.


Leave a comment

Let’s Talk About Colon Cancer

 

Eng

Written by Dr. Ady Oster

People do not talk about colon cancer very much.  Perhaps this is because it’s embarrassing to discuss, perhaps because they do not know much about it. That is a shame, because colon cancer is common and it is one of the most preventable cancers.

Colon cancer is the fourth most common cancer among Asian Americans, for both men and women (after breast, prostate, and lung) and (because it is more deadly than prostate cancer) colon cancer is the third most common cause of cancer deaths. While a few people with colon cancer have family members who also had colon cancer, most colon cancer occurs in people who do not have a family history of this cancer.

Cancers occur when a group cells grow out of control. Initially, they remain in one organ forming a lump. In time they can spread to other organs.  Most cancers are much more easily treated when they are still in one organ. Colon cancers start as a polyp. These are small, warty-looking bulges in the inside lining of the colon.  Over time, some of these polyps can become cancers (10% in ten years), invade the lining of the colon, and eventually spreading to other organs. Because polyps are small, they do not cause pain, diarrhea or constipation.  It is impossible to feel polyps.  The only way to know if you have a polyp is by having a doctor look at the inside of the colon.  If polyps are removed, they can no longer become cancer. Therefore, the best way to prevent colon cancer is to have a colonoscopy to look for and remove polyps.

Most polyps and cancers cause bleeding (not visible) into the stool. Usually it is too small to be visible, but it may be detectable with special stool tests. Another way to look for polyps or colon cancer is to have stool tested for microscopic blood. Older tests required eating a special diet for several days and collecting several stool samples. Newer tests do not require any special diet and only one stool sample. If any blood is found, a colonoscopy will be required to find the source of the blood and remove any polyps that are found.  If no blood is found, stool tests will need to be repeated every year in order to provide adequate reassurance that no polyps or cancers are in the colon.

During a colonoscopy, a doctor uses a long, flexible fiberoptic scope to examine the entire colon.  If any polyps are found, they are usually removed at that same time. Since polyps take several years to develop and will take even longer to become a cancer. People without any polyps can safely wait ten years between each colonoscopy. People who do have polyps will need to have colonoscopies more often, depending on how many and how big these polyps were. People are usually sedated for a colonoscopy, so most people do not remember having the procedure.  Unfortunately, in order for doctors to clearly see the lining of the colon, it must be cleaned of any stool. Therefore, people are asked to drink only clear liquid on the day or two prior to the test. On the evening before the test, they need to drink medicine that cleans the stool in the colon by causing diarrhea. This can be uncomfortable for a few hours.

The risk of cancer increases with age. Most people should begin testing for polyps or colon cancer at age 50.  People who have family members with colon cancer should talk to their healthcare provider about the right age to start.

Despite the embarrassment or discomfort, it is important to talk about colon cancer. Talk to your primary care doctor about whether colon cancer testing is appropriate for you.  Talk to your loved ones to make sure they have talked to their doctor about colon cancer. You can make an appointment to meet with a primary care provider here at Charles B. Wang Community Health Center by calling (212) 379-6998 for Manhattan, and (718) 362-3006 (37th Ave) or (929) 362-3006 (45th Ave) for Queens. For more information, visit the internal medicine webpage.

Written by Dr. Ady Oster. Dr. Oster is the section chief of internal medicine at the Charles B. Wang Community Health Center. He received his medical degree from the Albert Einstein College of Medicine, and completed his residency training at Yale-New Haven Hospital and University of California at San Francisco. Dr. Oster is board-certified in internal medicine.


Leave a comment

Man Up – Talk to Your Doctor About Sexual Health

Portrait of Mid Adult Man in Nanluoguxiang, Beijing

Written by Dr. Gail Bauchman

Women are more likely to see a doctor for regular check-ups than men, and yet it is so important that men have regular checkups to discuss all aspects of their health. Sexual health is one area that is incredibly important for men to understand. As a doctor at the Charles B. Wang Community Health Center, here are a few aspects of sexual health that I discuss with male patients.

When you see your health care provider for a routine physical exam or to be screened for sexually transmitted infections (STIs), you will be asked some rather personal questions. These questions are important for your provider to better understand your health risks and provide the best possible treatment.  Some of the questions may involve your sexual practice. For instance, what are you doing to prevent pregnancy? What is your partner using to prevent pregnancy? How many partners have you had in the last year? Do you have sex with men, women or both? What do you do to protect yourself from sexually transmitted diseases and HIV?  Do you know how to use a condom appropriately?

Condom use offers protection against some sexually transmitted infections, including HIV infection. They also offer some protection against pregnancy, but condoms along with the withdrawal method are considered to be the least effective methods to prevent pregnancy.  About 18 women out of 100 will get pregnant within the first year with condom use.

That is why it is important to know what your partner is using to prevent pregnancy. Your health care provider can help answer your questions about contraceptive methods for both you and your partner and help you decide on the most suitable methods. Learn more about birth control and family planning by reading this factsheet.

Question: if the condom breaks and your partner is not using an additional contraceptive method, do you know what to do next to protect her from getting pregnant? The answer is having your partner use emergency contraception.  One of the easiest options is if you or your partner buys a pill that does not require a prescription, called Plan B. The pill should be taken within 5 days of having unprotected sex, but the sooner it is taken the better. Plan B is not 100% effective, but does help reduce the chances of pregnancy.

Your provider may also ask you questions about whether you ever had any STIs. STIs can be transmitted through vaginal, anal, and oral sex and many of them do not cause symptoms, at least in the beginning.  If you do have symptoms such as urinary frequency, discharge from the penis or ulcers on the penis, seek out medical care to get treated. A urine sample is all that is required to test for the most common STIs, such as chlamydia and gonorrhea. Without testing and treatment, you may unknowingly pass these infections on to your partner. Chlamydia and gonorrhea can cause a serious pelvic infection in women that may lead to infertility. Some STIs in pregnant women can also impair fetal development or be passed on to their babies during childbirth. Learn more about STI’s by reading this factsheet.

For the protection of yourself, your partner, and your child, we encourage all men to receive annual physical exams and be screened for STIs whenever they have a new partner.

Come visit us at the Charles B. Wang Community Health Center to get your annual check-up and discuss these as well as other important health issues. Our OBGYN department offers family planning services and counseling to both men and women to help you improve your sexual health and achieve your reproductive life plan, whether you are seeking to have children or preventing pregnancy. You can make an appointment at our OBGYN department by calling (212) 966-0228 for Manhattan or (718) 886-1287 for Queens. Find more information by visiting our OBGYN webpage. You can also make an appointment to meet with a primary care provider by calling (212) 379-6998 for Manhattan, and (718) 362-3006 (37th Ave) or (929) 362-3006 (45th Ave) for Queens. Visit the internal medicine webpage.

Written by Dr. Gail Bauchman. Dr. Bauchman is a physician at the Charles B. Wang Community Health Center. She attended Stony Brook Medical School, and specialized in family medicine. She is board certified from the American Board of Family Medicine.


Leave a comment

Act Fast to Save a Life – Know the Signs of Stroke

GettyImages_514589515_senior couple man woman outdoors

Written by Bonnie Tse

In the event of a stroke attack, “time is of the essence,” says Dr. Ji Y. Chong, the Site Chief of Neurology and Director of the Stroke Center at NewYork-Presbyterian Lower Manhattan Hospital.

During a stroke, blood flow and oxygen to the brain is cut off and brain cells begin to die. Recognizing the signs of a stroke and calling 911 immediately is vital. Quick treatment increases your chances of surviving and lessens complications that happen as a result of stroke. For Stroke Awareness Month, Dr. Chong shares how to act in case of a stroke:

DN: What is important to know about stroke?

 JC: We need to know the signs of stroke because stroke can be unexpected. “BE FAST” is an easy way to remember them. Sudden onset of these symptoms may point to a stroke:

Balance – loss of balance
Eyes – loss of vision
Face – droopiness on one side
Arm – weakness in an arm
Speech – slurred speech, inability to talk or difficulty understanding
Time – call 911 immediately

Download our stroke symptoms card in English and Chinese.

People should be aware that they need rapid evaluation to see if they are eligible for immediate treatments such as blood clot dissolving medication like tPA. To work best and help decrease the long term consequences of a stroke, it has to be injected by IV within 4.5 hours from the start of a stroke.

DN: What is the first thing someone should do when they experience a sign of stroke? How do we get help or help others?

JC: The most important thing is to call 911. Do not wait for family members or the primary doctor—stroke is an emergency. The Emergency Medical Services team or ambulance will assess the patient and transport them quickly to the nearest Primary Stroke Center. Stroke Centers are designated by New York State to hospitals that have demonstrated they can provide rapid, high quality care to stroke patients.

DN: What advice do you have for seniors or family members who are living alone? How can they best protect themselves from stroke?

JC: People living alone should make sure they have a way to call 911 or have someone who can call for them. Independent seniors should maintain social networks or join senior centers so there are people who can check on them. Home attendants who often care for seniors should also be informed of what to do in case seniors have a stroke.

Prevention is also important. Knowing the risk factors and addressing them is key. High blood pressure, diabetes, high cholesterol, and heart disease are all risk factors that need to be monitored and treated. Smoking also puts you at high risk for stroke. Don’t smoke—and if you do, quit. Eating a healthy diet with fresh fruits and vegetables, lean meats and fish, nuts, and beans is also beneficial. People should avoid foods that are processed and high in sugar and salt such as preserved meats or vegetables, fried foods and sweetened drinks.

Learn more about the signs and how to prevent stroke here.

Dr. Ji Y. Chong is board certified in Neurology and Vascular Neurology. She is involved in the clinical care of stroke patients from acute treatment to long-term secondary stroke prevention.  Dr. Chong has been involved in several clinical trials and epidemiologic studies of stroke. She is also the Director of the Stroke Center at the NewYork-Presbyterian Lower Manhattan Hospital and committed to quality improvement and education initiatives to improve stroke care for the community.

Written by Bonnie Tse. Bonnie Tse is a health educator at the Charles B. Wang Community Health Center. She has a bachelor’s degree in Nutrition and Food Science from Hunter College.


Leave a comment

New York City Advocates Come Together to Address the Viral Hepatitis “Silent Epidemic”

1

Written by Janice Lyu

On May 12, 2016, Charles B. Wang Community Health Center, along with many other local community members, gathered at the steps of New York City’s City Hall. More than 100 hepatitis advocates and press came together on this day to share their stories to commemorate the annual National Hepatitis Testing Day (May 19) and Hispanic Hepatitis Awareness Day (May 15). The month of May is also designated as National Hepatitis Awareness Month, a time to raise awareness and educate the public about the importance of getting tested for viral hepatitis.

Despite the growing efforts nationwide to combat the viral hepatitis epidemic, the burden of viral hepatitis is still high while the awareness is low. A lot more needs to be done to address this issue. Viral hepatitis disproportionately affects the Asian, African, and Latino community. It is the leading cause of liver failure and liver cancer. Recently, CDC reported that death rates for most cancers continue to decline with the exception of liver cancer.

2

In the United States, an estimated 800,000-1.4 million persons are chronically infected with hepatitis B and as many as 3.2 million persons may be chronically infected with hepatitis C. The burden is particularly high in New York City. It is estimated that 146,500 people live with hepatitis C and 100,000 people in NYC live with hepatitis B. Yet, because viral hepatitis can persist in the body for a long period of time without any signs of symptoms, it is estimated that two-thirds of those with hepatitis B and half of those hepatitis C do not know they are infected. These reports are truly alarming since there are preventive measures such as vaccines and medications to manage the condition. Hepatitis B can be prevented and treated, and hepatitis C can be cured.

Charles B. Wang Community Health Center along with other partners of the NYC Hep B Coalition and NYC Hep C Task Force came together at the steps of City Hall to remind healthcare leaders, providers, and the public about the importance of identifying and testing for viral hepatitis.

3

Hepatitis B disproportionately affects Asians. Dr. Perry Pong, Chief Medical Officer of Charles B. Wang Community Health Center, was invited to speak for the Asian American community and provide more awareness about hepatitis B at the City Hall press conference. Dr. Pong stressed that language and culture should not be a barrier to testing, access to care and treatment of this disease.

4

In the last 16 years, the Charles B. Wang community Health Center has screened more than 100,000 patients and identified more than 7,000 individuals with chronic hepatitis B infections. Our hepatitis B practice is one of the largest in the U.S. based in a community health center. The program includes awareness campaigns through ethnic media and community outreach, free community screening emphasizing linkage to care, culturally effective and accessible treatment for all patients regardless of ability to pay, training of primary care providers to diagnose and manage patients, and policy advocacy at local, state and national levels. This program would not be possible without our community partnerships and the support of the Robin Hood Foundation and Miranda Tang.

Hepatitis need not be a silent killer. There are vaccines available for those without immunity to protect their liver from the virus. If detected early, you can keep the disease under control with routine check-ups and medications. You should talk to your doctor today and get tested for hepatitis.

Janice Lyu is the hepatitis B program associate at the Charles B. Wang Community Health Center. She has a M.S. in Biomedical Sciences from Tufts University School of Medicine. She cares about public health and healthcare issues.


Leave a comment

Smoking Cessation Medications

2013_11_22_78012

Written by Michelle Chen

At the Health Center, we see many patients who believe willpower is the key to quitting smoking. However, it often takes more than motivation to quit successfully. When you smoke, your body becomes addicted to nicotine, a substance found in cigarettes and other tobacco products. Nicotine can make you feel good, but leaves you wanting more. You may feel irritable, anxious, or depressed when you do not smoke for a period of time. These withdrawal symptoms make quitting hard.

Fortunately, there are safe and effective medications to help you manage withdrawal symptoms. Nicotine replacement therapy (NRT) is one of them. It gives you a small dose of nicotine without 7,000 of the toxic chemicals that the typical cigarette has. NRT is available as patches, gum, lozenges, an inhaler, and nasal spray. There are also pills (Zyban® and Chantix®) that you can take to fight discomfort and help you quit.

Nicotine Replacement Therapy (NRT)

Method Availability Description
Nicotine Patches Over-the-Counter The nicotine patch is placed on the skin and gives users a small and steady amount of nicotine.
Nicotine Gum Over-the-Counter Nicotine gum is chewed to release nicotine. The user chews the gum until it produces a tingling feeling, and then places it between their gums and cheek.
Nicotine Lozenges Over-the-Counter Nicotine lozenges look like hard candy and are placed in the mouth. The nicotine lozenge releases nicotine as it slowly dissolves in the mouth.
Nicotine Inhaler Prescription A nicotine inhaler is a cartridge attached to a mouthpiece. Inhaling through the mouthpiece gives the user a specific amount of nicotine.
Nicotine Nasal Spray Prescription Nicotine nasal spray is a pump bottle containing nicotine, which is put into the nose and sprayed.

Other Medications

Method Availability Description
Bupropion (Zyban®) Prescription Bupropion helps reduce nicotine withdrawal and the urge to smoke. Bupropion can be used safely in combination with NRT.
Varenicline (Chantix®) Prescription Varenicline helps to reduce nicotine withdrawal and the urge to smoke. It also blocks the effects of nicotine from cigarettes.

Speak to your doctor to learn if smoking cessation medication is right for you. Some smokers may need to use smoking cessation medication for 3 to 6 months before their withdrawal symptoms end. Most insurance companies will cover the cost of prescription drugs.

We know quitting can be hard, but your health improves the moment you stop. Just one day without smoking can lower your blood pressure and your risk for heart attack. Your loved ones will be thankful for it, too. Are you ready to take the next steps, but don’t know where to begin? Check out our posts for reasons to quit and more ways to handle cravings, and learn about secondhand smoke.

At the Health Center, we can help patients quit or cut back on smoking.

You can also get free patches and help from:

This article is made possible with funding from the RCHN Community Health Foundation. Medication information is from CDC.

Michelle Chen is a Health Educator at the Charles B. Wang Community Health Center. She has a B.A. in Women’s, Gender & Sexuality Studies from Barnard College. She is interested in the intersection of public health and Asian American activism.