Doctor's Notes


Leave a comment

Colorectal Cancer in Young Adults?

shutterstock_355183091

Colorectal cancer affects men and women equally, regardless of race and ethnicity. It is most often found in people who are 50 years old or older. However, there is an increasing rate of colorectal cancer in those who are under 50, because of physical inactivity and an unhealthy diet. It is important for younger adults to start paying attention to their colorectal health.

According to Dr. Robert Andrew Heyding, a physician at the Charles B. Wang Community Health Center, “Colorectal cancer causes almost one out of every ten cancer deaths in the United States. Fortunately it can be prevented. You can lower your risk by choosing healthy habits and getting regular screening”.

It’s never too early to start living healthy. Here are some good health habits to lower the risk of developing colorectal cancer:

  • Do not smoke – quit smoking and try avoid second hand smoke. Talk to your doctor about smoking cessation resources. Charles B. Wang Community Health Center has bilingual quit smoking resources, you can view those here.
  • Reduce alcoholic drinks – limit to one drink a day or less.
  • Eat a healthy diet – limit high fat or sugary foods, preserved foods, and red meat. Add more fruits and vegetables to your plate.
  • Exercise regularly – walk, jog, swim, or dance. Strive to be active for at least 30 minutes a day, 5 days a week.
  • Keep a healthy weight – talk to your family doctor about what is a healthy weight for you.

Other than having healthy habits, getting screened is very important to prevent cancer. When detected early, there are more treatment options and fewer complications. The most commonly used screening methods include:

  • A Fecal Occult Blood Test (FBOT) checks for blood in stool. Blood in stool may indicate presence of diseases and a colonoscopy may be needed for a diagnosis.
  • A colonoscopy is a thin, flexible tube with a small camera and light on the end is used to examine the colon. It may also have a tool to remove abnormal tissue to be checked under a microscope for signs of disease.

In general, it is recommended that men and women of average risk levels begin screening at age 50. However, some individuals may need to begin screening earlier, such as those who have family or personal history of colorectal cancer or chronic colorectal diseases, and those who are experiencing symptoms of colorectal diseases, such as persistent abdominal pain or changes in bowel habits for at least two weeks.

Discuss with your primary care doctor about when to start screening, which screening method to use, and how often you should get screened. Also speak to your doctor regarding your risk factors or anything unusual in your body. You can make an appointment to see a primary care provider here at Charles B. Wang Community Health Center by calling (212) 379-6998 for Manhattan, and (718) 886-1200 (37th Ave) or (929) 362-3006 (45th Ave) for Queens.


Leave a comment

Repeal of the Affordable Care Act and Impact on Our Patients

shutterstock_280368896

The Charles B. Wang Community Health Center knows firsthand that this country has come a long way in in expanding health insurance coverage for millions of uninsured Americans. About 20 million Americans have gained health insurance as a result of the Affordable Care Act (Obamacare) since it became law in 2010. Congress is now vowing to repeal the Affordable Care Act, which puts this advancement in danger if an appropriate replacement is not in place.

Lanying Lee was one of the first people we assisted to enroll for health insurance through the New York State of Health exchange in 2013. The exchange was set up by New York State to meet the requirements of Obamacare and help consumers shop for health insurance and apply for government subsidies.

Lanying is a petite Chinese woman who lives in Flushing, Queens with her small family. She had been a manicurist in New York City for ten years. Her husband owns a small shop that sharpens tools used in nail salons and does odd part-time work for added income. While their modest income made them ineligible for government funded health insurance, they did not earn enough to pay the high cost of private health insurance. “I read about Obamacare,” says Lee. “We were hearing a lot about it. I thought, ‘I need this.’”

According to the Department of Health and Mental Hygiene, two in ten Asian American residents of New York City were uninsured prior to the implementation of the New York State of Health initiative under the Affordable Care Act. For Lanying Lee, Obamacare could not have arrived soon enough. “We did not have health insurance for three years. We are getting older, and we want to take care of our health. We have specialist doctors to go to and general check-ups that we should have regularly. We were not going to the doctors because we could not pay. Having insurance has made such a difference for us. We are going to the doctors on schedule, and we are staying healthy. Obamacare is what we needed. It has been a bumpy ride to enroll, but it was worth it. We are very happy.”

Since the NY State of Health exchange was implemented, the percentage of uninsured New Yorkers was reduced by half. Having health insurance means that patients are able to maintain regular check-ups and preventative care, where they otherwise might forgo care or resort to going to an emergency room.  Many plans under the Obamacare provide free preventative care and well-woman visits, and reduced costs on prescription drugs.

On January 4th, 2017, NY Governor Cuomo stated his concern for the repeal of the Affordable Care Act without a replacement in place. The repeal of the Affordable Care Act may result in over 2.7 million New Yorkers losing their health coverage.  “Since its implementation, the Affordable Care Act has become a powerful tool to lower the cost of health insurance for local governments and New Yorkers, and it is essential that the federal government does not jeopardize the health and livelihoods of millions of working families,” Governor Cuomo said.

We believe that patients like Lanying Lee may suffer great harm if they lose their health insurance. We implore our members of congress to not repeal the Affordable Care Act without a replacement in place.

*Name of client has been changed

Read our thoughts on the Repeal of the Affordable Care Act and Impact on Community Health Centers


Leave a comment

Recycle the Old and Welcome the New – Happy Lunar New Year!

85446638

Written by Larissa Ho, GrowNYC Recycling Outreach Coordinator

Many Chinese families will begin sweeping the floors and clearing the house of old items a week before Lunar New Year. Known as, “年廿八,洗邋遢 ” or Spring Cleaning, this custom is symbolic for getting rid of bad luck that happened in the previous year, and making room for good luck in the New Year. While it is common and easy to put things in the trash bin, consider recycling and repurposing old items as you clean. Recycling not only protects the environment, but also transforms old items into new items, and reduces the amount of materials (trees, oil, etc.) needed to make those new things. Make Lunar New Year extra special by cleaning your home and your Earth in an eco-friendly way.

Here are seven common items that you can recycle and repurpose for the New Year:

Clothes and Jackets

Need more space in your closet? Consider donating your clothes and jackets to those in need of one. Organizations like Bowery Mission takes gently worn clothes (including socks and gloves) and coats for the homeless. You can also recycle your old clothes, bags, belts, and paired shoes by bringing them to certain GrowNYC Greenmarkets, which accept these items to be sorted for reuse or recycling. Usable clothes will be distributed to local and international second-hand markets while clothes not fit for reuse will be recycled as wiping rags or shredded and repurposed for insulation and other uses. By recycling unwanted clothes you help prevent sending unnecessary waste to landfills.

Electronics

If you have old phones lying around, take them back to any mobile service provider to recycle. They are required to accept cell phones at no cost. Other electronics (computers and TVs) can be dropped off at collection events organized by the Lower East Side Ecology Center.  Since e-waste is highly toxic to the environment, it is banned from curbside disposal.  Learn how to avoid fines and dispose of electronics responsibly at NYC Zero Waste.

Plastic Bags

Have mounds of plastic bags at home? You can save space by shopping with a reusable bag. Be mindful about your use of disposal plastic bags, which cannot be recycled at home. Clean plastic bags can be returned to large supermarkets and other select stores.

Toothbrushes, Brooms, and Mops

After all the cleaning, treat yourselves to new toothbrushes and cleaning tools! You can recycle the old ones in the metal, glass, and plastic recycling bin (usually blue bin or has blue label) if they are mainly plastic.

Party Utensils, Trays, and Plastic Food Containers

After the Lunar New Year potluck has finished, separate and recycle party utensils, trays and food containers! The majority of the items such as aluminum trays, aluminum foil, plastic utensils, and rigid plastic food containers go into the metal, glass, and plastic recycling bin (usually blue bin or has a blue label). Be sure to empty and rinse food containers before recycling.

Bottles and Cans

When you have finished with the celebratory drinks, recycle plastic bottles, glass bottles and cans in the metal, glass, and plastic recycling bin (usually blue bin or has blue label). Be sure to empty and rinse containers before recycling.

Red Envelopes, Calendars, and Lucky Signage

You can also recycle red envelopes, greeting signs and old calendars. Simply put them in the paper and cardboard bin (usually green bin or has green label). Other paper materials include magazines, wrapping paper, paper egg cartons, cardboard boxes and clean paper cups.

As a New Year is soon approaching, start fresh by tidying up in eco-friendly and responsible ways. Happy Cleaning and Happy Lunar New Year!

For more information on what you can recycle, type your item under “How to Get Rid Of…” section in the NYC Department of Sanitation website: http://www.nyc.gov/zerowaste

 

Larissa Ho is a Recycling Outreach Coordinator at GrowNYC, where she provides education and resources to NYC residents on how to recycle. She is passionate about sustainability and taking care of the environment. She formerly worked as a Teen Health Educator with the Charles B. Wang Community Health Center.

GrowNYC’s zero waste programs are funded by the NYC Department of Sanitation. 

grownyc-sanitation-lockup-final_021016

 


Leave a comment

Protect Yourself from the Silent Killer – Ovarian Cancer

shutterstock_262532636

Ovarian cancer can happen in one or both of a woman’s ovaries.  It is also known as the “silent killer” because it usually does not cause substantial signs or symptoms until it is too late. Although rare, ovarian cancer causes more deaths than any other cancer of the female reproductive system since it is usually diagnosed at a late stage.

There is currently no recommended screening test to detect ovarian cancer in women of average risk level. Nevertheless, there are things we can do to protect ourselves from this silent killer.

Know your risks.

Age is a common risk factor for all cancers. Most cases of ovarian cancer happen in women after menopause.  Several other factors can also increase a woman’s risk for the cancer:

  • Family history of ovarian cancer and breast cancer
  • Genetic mutation (abnormality) related to ovarian cancer/breast cancer/colon cancer/uterine cancer
  • Personal history of breast,colorectal (colon), or cervical cancer, or
  • Obesity
  • Having never given birth or have had trouble getting pregnant.
  • Endometriosis (a condition where tissue from the lining of the uterus grows elsewhere in the body).
  • Hormone replacement therapy

Pay attention to the changes in your body.

Many symptoms of ovarian cancer can also be caused by other less serious conditions. “If you have any of these symptoms almost daily for more than a few weeks, and they can’t be explained by other more common conditions, talk to your doctor right away,” said Dr. Gail Bauchman, Family Medicine Physician at the OB/GYN department of the Charles B. Wang Community Health Center:

  • Bloating or abdominal swelling
  • Abdominal or pelvic pain
  • Back pain
  • Changes in menstrual pattern
  • Pain during sexual intercourse
  • Increase urinary urgency and frequency
  • Feeling full quickly during meals
  • Indigestion or constipation

Take preventive measures.

Although routine screening of ovarian cancer is not recommended for the general public, diagnostic tests are available for women who are experiencing symptoms of ovarian cancer or those who are at a higher risk. Inform your doctor if you have any of the risk factors mentioned above.

Several lifestyle factors have been shown to reduce the risk of ovarian cancer including

  • Maintaining a healthy weight
  • Using birth control pills – the longer the use the greater the risk reduction
  • Breastfeeding
  • Some at higher risk women have chosen to have their fallopian tubes tied and ovaries removed after they are done having children

Regardless of your risk level, see a gynecologist for routine check ups. Talk to your doctor about any abnormal changes you have experienced and what preventive measures are suitable for you. You can make an appointment at our OB/GYN Department by calling (212) 966-0228 for Manhattan or (718) 886-1287 for Queens, or by visiting our OB/GYN webpage.

This post is made possible with funding from the NYC Council.


Leave a comment

How to Have a Happy Holiday Without Stress or Smoke

shutterstock_176410184

Holidays are supposed to be an enjoyable time when family and friends gather together with food and drinks, but it can also be stressful as people rush from place to place. A cigarette can sound like the perfect way to de-stress, especially during a busy holiday season, but cessation coaches at the Asian Smokers’ Quitline have tips and encouragement for people attempting to quit, or want to stay quit through the season.

“Holidays are fun but they can also be stressful, so it’s important to be aware of triggers and to get extra support,” said Dr. Caroline Chen, project manager of the Asian Smokers’ Quitline. “Let family and friends know that you’re trying to quit, and ask for their support in helping you lead a healthier life.”

Here are some other general tips from cessation coaches on ways to avoid triggers and stay quit during the holidays:

  1. In the midst of holiday busyness, get adequate rest.
  2. Avoid spicy and sugary foods, and alcohol. Holidays are often all about the eating and feasting, but avoid foods that will make you crave cigarettes even more. Eat fruit or less sugary dessert on the menu. As for alcohol, put it away, and instead, reach for a sugar-free seltzer, club soda, or apple cider.
  3. If weather allows, go for a walk. To prevent taking up a new bad habit such as eating whatever you can find to avoid having a cigarette, stay active and exercise.
  4. Spend time with non-smokers. If all your friends are smokers, it may be time to make some new friends. Keep some distance from smokers, and create a community of people who are ex-smokers or non-smokers to help you keep busy and away from smoking.
  5. Having a supportive community is important on this journey. Call the Quitline! Call the Asian Smokers’ Quitline, a free nationwide telephone program for Chinese-, Korean-, and Vietnamese-speakers who want to quit. When you call, a friendly staff person will offer various services: self-help materials, a referral list of other programs, one-on-one counseling over the phone, and a free two-week starter kit of nicotine patches.
  6. Lastly, don’t give up on quitting. You can do it!

About the Asian Smokers’ Quitline:

The Asia Smokers’ Quitline (ASQ) provides FREE, accessible, evidence-based smoking cessation services in Cantonese, Mandarin, Korean and Vietnamese to Asian communities in the U.S. ASQ has been shown to double their chances of quitting successfully. Services are provided by native speakers trained in smoking cessation. Eligible callers receive a free two-week starter kit of nicotine patches.

Health care providers and others in the community are encouraged to refer Asian language speaking smokers to ASQ. To learn more about referring, email asq@ucsd.edu or see the web referral link at www.asiansmokersquitline.org. Smokers can also call ASQ directly or enroll themselves online at www.asq-chinese.org, www.asq-korean.org, or www.asq-viet.org.

ASQ is funded by the U.S. Centers of Disease Control and Prevention (CDC), and has served over 8,000 callers since it was established in 2012.

ASQ is open Monday through Friday, 7am to 9pm Pacific Time

Asian Smokers’ Quitline
1-800-838-8917 (Chinese)
1-800-556-5564 (Korean)
1-800-778-8440 (Vietnamese)

To learn more about ASQ (in English), visit: www.asiansmokersquitline.org.

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

Charles B. Wang Community Health Center
(212) 966-0461

This post was created by the Asian Smokers’ Quitline (ASQ) of University of California, San Diego


Leave a comment

Repeal of the Affordable Care Act and Impact on Community Health Centers

2013_12_04_82639

The Charles B. Wang Community Health Center Executive Team would like to respond to concerns about the impact to community health centers and our patients if the Affordable Care Act (Obamacare) is repealed by the new Administration.

Federally qualified health center advocates believe that Congress and the newly elected president will end some key provisions of Obamacare.  However, how much is changed or undone is not clear.  Any plans to repeal and replace Obamacare will take time; it can take up to two years for Congress to agree to major changes and for the president to get a new program in place.

It is hard to predict exactly how the changes will impact primary health care and our communities. However, we do know that the community health center movement in this country is strong and growing.  Throughout the past five decades, federally qualified health centers have thrived and expanded under both Democratic and Republican administrations.  We remain optimistic that the progress that we have made in ensuring accessible, high quality health care for the people who need it most will endure.  Our staff understands our mission and is the reason why we are able to provide great care to all, regardless of ability to pay.

The repeal of Obamacare will mean that many individuals and families could lose their health insurance coverage.  Now, more than ever, federally qualified health centers must continue to expand our service capacity so that we can take care of more patients. With the support of our board of directors, the Charles B. Wang Community Health Center has been working hard to develop a new site in Flushing.  This expansion project will put us in a stronger position to meet the community’s current and future health care needs.

Today, as on every day, the Charles B. Wang Community Health Center affirms our mission by doing our best to meet our patients’ and community’s needs.  We have an outstanding staff, a committed board, and many collaborative partners.  In the coming months and years, we will work together to make sure that we continue to help the lives of our patients and improve the community’s health. We will work together with other New York City, New York State and national groups to support an inclusive health care system that protects all of our residents regardless of their language, culture, economics, or immigration status.

Executive Team – Jane Eng, Dr. Perry Pong, Betty Cheng, Regina Lee, Lynn Sherman, and Kenneth Shieh


Leave a comment

Why We Support Asian Americans Living With Diabetes

shutterstock_112727437Asian Americans are at high risk to develop Type 2 diabetes. As with many health disparities faced by Asian Americans, the Charles B. Wang Community Health Center provides specialized care for our diabetes patients. We talked to Registered Dietitian and Certified Diabetes Educator Daniel Wong, RDN, CDN, CDE, about our diabetes care program—and what having a patient-centered medical home means for our community.

DN: What is your role in supporting our patients managing diabetes?

DW: I am referred both patients who are pre-diabetic and those who have diabetes. Some of our patients manage their diabetes well; some do not manage diabetes well at all. I support them on insulin injection and blood sugar checking skills, creating exercise plans, and managing their diet through meal planning, portion control, and reading food labels. I also educate them on foot care, eye care, and dental care, which is all affected by diabetes.

DN: What are barriers that diabetic Asian Americans face to manage diabetes?

DW: There are socioeconomic reasons that make it difficult. Many of our patients are Chinese American immigrants, who work long hours and have difficulty making time to go to the doctor. Some are under-insured or have no insurance. Some do not visit a doctor for decades, and at that point they may not know they have diabetes or that their diabetes is uncontrolled.

I also find that there are cultural barriers. Chinese Americans don’t like to take medicine—they think it is unnatural and often think medications damage their bodies.  When our patients are diagnosed with pre-diabetes, they turn to herbal medicine and traditional Chinese remedies. After a few years of this, their pre-diabetes turns into diabetes.

Like in many cultures, diet can be difficult to change for Asian Americans. Cutting down on starches such as rice, noodles, and bread is hard when it is a staple part of their diet. Also, Asian Americans have a lower BMI cut-off to be considered at risk for diabetes. If a doctor is not familiar with this, their Asian American patients at risk for diabetes can easily be overlooked.

DN: Can you tell us about a patient who you had success in breaking through these barriers?

DW: We had a patient in his 30’s who came in with pre-diabetes. We didn’t see him again for three years. When he finally came back, his pre-diabetes developed into uncontrolled diabetes. His blood sugar was alarmingly high. His absence was due to being incredibly busy, and feeling like he didn’t have symptoms worth visiting a doctor. This is very typical for my diabetes patients. He came to see me to learn how to take his insulin, to check blood sugar at home, and how to manage his diet better. After learning about the severity of his diabetes, he cut out starch completely and experienced low blood sugar symptoms. This isn’t necessarily good either. He lost a lot of weight in a very short period of time. We worked together on medication management, meal plans, a balanced diet, and integrating exercise into his lifestyle. Within a month his diabetes was controlled and managed.

 DN: Charles B. Wang Community Health Center is a patient-centered medical home. What does that mean for our diabetes patients?

DW: Charles B. Wang Community Health Center truly does have comprehensive services, especially for those with chronic conditions that need extra care. Most people living with diabetes have a doctor who treats their condition.  In addition to our clinical team, we have case managers and a dietitians, like me, who educate and support our patients to manage their diabetes.  We have certified diabetes educators who host diabetes support groups, workshops, and provide individual counseling. We have social workers that will work with our patients to get health insurance, if that is an issue.  Some of our diabetes patients have depression as a result of their diagnosis. We have therapists to support those patients.  All members of our team provide language and culturally appropriate care.

As a Federally Qualified Health Center (FQHC), we are held to a very high standard of care. Having improved health indicators is both important to us and expected of us. As a result, we provide top quality services to community members who really need them—like those living with diabetes.