Wednesday, Dec 04th

ACL knee surgery shutterstock 1605141697 1 copyAn orthopedic knee specialist sets the record straight on ACL surgery and a special technique that helps a return to natural knee movement.

Posted: Dr. Michael A. Schwartz, Orthopedic Surgery

Dear Doctor: I injured my anterior cruciate ligament (ACL) and I’ve been putting off surgery. I’m concerned about the time it takes to rehab afterwards, and that my knee won’t feel right or move “normally” anymore.

Dear Reader:

Before I answer, here’s a quick anatomy lesson. The knee consists of four bones of the thigh and shin that are held together by four primary ligaments, which also help to stabilize your knee.

The ACL is one of the most important of those ligaments. It actually consists of two parts – the slightly larger anteromedial bundle, positioned in front of the posterolateral bundle. It’s easy to injury the ACL especially if you play sports such as soccer or basketball, where you are constantly stopping and starting and changing directions.

Unfortunately, half of all injuries to the ACL are accompanied by damage to other structures, including other ligaments, cartilage and the meniscus, which is the C-shaped cartilage on the top of the tibia bone. When the ACL is strained or torn, the meniscus has to work extra hard to stabilize the knee. One study found that delaying an ACL tear reconstruction beyond six months post injury can lead to tears of the meniscus – something you would definitely want to avoid!

So, the sooner you deal with your ACL sprain or tear, the better. WhitePlainsHospitalSponsorBanner

The good news is there are great surgical options for ACL repair, with minimal pain and downtime. Most ACL reconstruction surgeries offered today are done using a single-bundle reconstruction. A single-bundle ACL reconstruction uses one graft from an existing tendon or part of a cadaver to replace the torn anteromedial bundle (the longer ligament bundle), since tears can’t be sewn or repaired.

Cutting Edge Surgery for Knees

When possible, I prefer to perform a double-bundle ACL reconstruction, when both bundles are individually replaced. Although it is more technically demanding, a double bundle ACL reconstruction restores the knee structure, function and motion better and provides more rotational stability than a single bundle ACL reconstruction.

Typically, after an ACL surgery, I have my patients up and moving (with crutches and minimal pain) in a matter of days. Following a regimen of physical therapy, patients are usually walking unassisted in about a week, and, after a regimen of guided physical therapy, are ultimately able to return to the sports and activities they love.

If you think you may have an ACL injury, the first step should be getting evaluated by an orthopedic surgeon who can assess your specific injury and recommend the best treatment and surgery for you. Your knee is one of the strongest and most important joints in the body. Take care of your knee and it will offer a lifetime of mobility and support.

Dr. Michael A. Schwartz is an orthopedic surgeon specializing in treatment of the shoulder, elbow and knee. He sees patients in White Plains and New Rochelle. Please call 914-849-7897 to make an appointment.

UnitedHealthcareThis just in: Montefiore Health System and UnitedHealthcare have reached a new long-term agreement.

Early in 2021, local patients received some distressing news. Contract negotiations between the Montefiore Health System and UnitedHealthcare had broken down. Patients who used White Plains Hospital and many of the doctors in the Montefiore network would no longer be covered in-network. For those who were already enrolled with UnitedHealthcare for 2021, there were few options: either switch doctors or pay for out of network access.

Today, October 28, 2021, Montefiore announced an agreement with UnitedHealthcare, effective December 1, 2021. Patients can return to their favorite physicians in just a few weeks.

Here is the announcement:

Bronx, NY - Montefiore Health System (MHS) and UnitedHealthcare have reached an agreement on a long-term contract that restores in-network access to all Montefiore Health System hospitals and healthcare providers effective December 1, 2021 for United Healthcare and Oxford employer-sponsored plans, as well as UnitedHealthcare’s Medicare Dual Special Needs Plan.

This agreement restores in-network access to Montefiore’s 10 hospitals and more than 200 outpatient facilities throughout the Bronx, Westchester, Rockland and Orange counties.

“The long-term health of our patients has always been the central focus of our negotiations,” said Colleen Blye, Executive Vice President, Chief Financial Officer, Montefiore Health System. “Over the past ten months, the support of our local employers, elected officials and communities has been overwhelming, and we are pleased that our patients once again have in-network access to their trusted Montefiore hospitals and providers.”

weberDr. Pamela WeberThe statistics are sobering—according to the American Cancer Society, 1 in 8 U.S. women will develop breast cancer over the course of her lifetime. Understanding cancer risk, undergoing regular screening, and adopting a healthy lifestyle are all things women can and should do now to help mitigate risk. To give women the information and support they need to be proactive about their breast health, White Plains Hospital, in collaboration with I Am More Scarsdale, will host, “Breast Cancer & Beyond,” on Wednesday, October 6 from 7 p.m. to 8:30 p.m. at the Dine the ‘Dale Tent in Scarsdale Village on Spencer Place between Harwood Court and East Parkway.

The program marks the start of Breast Cancer Awareness Month. “Breast Cancer & Beyond” is tailored to address the common concerns of women ranging in their late 30s to 60s, and will feature an esteemed a panel of women’s health experts in a dialogue about the importance of breast health and early detection of breast cancer. Additional topics will be driven by audience interest, and may include general health risk factors, facts about gynecological cancers, and small changes women can make to live a healthier life.

Expert panelists include: Dr. Preya Ananthakrishnan, Director of Breast Surgery at White Plains Hospital; Dr. Pamela Weber, Director of Imaging at the White Plains Hospital ImagingsedanDr. Sarah Sadan Center in New Rochelle; and Dr. Sara Sadan, Section Chief for the Department of Medical Oncology and the Director for Breast and Women’s Cancers at White Plains Hospital. The discussion will be moderated by Dara Gruenberg, a Vice Chair of the White Plains Hospital Foundation Board. Attendees can submit questions in advance and anonymously online when they register.

The event is inspired by I Am More Scarsdale Co-Founders, Marcy Berman-Goldstein and Abbey Solomon. I Am More’s mission is to empower women to make them feel confident, support up and coming and established women-owned businesses and designers, and to give back to local and women’s philanthropic organizations. I Am More operates as a philanthropic business, with ownership foregoing a salary to donate profits to the organizations it supports.

There is a suggested donation of $50 per person, and all proceeds will benefit White Plains Hospital. Appetizers and drinks will be served. For more information and preyaDr. Preya Ananthakrishnanto register, please click here.

daraThe discussion will be moderated by Dara Gruenberg

daraMarcy Berman-Goldstein and Abbey Solomon of I Am More Scarsdale

MammogramWhen was the last time you got a mammogram? If your answer is before the pandemic, that means more than one year has gone by without the essential screening you need to catch breast cancer early. While that might not seem like a big deal, tumors can begin to grow and advance in that relatively short span of time. The statistics tell it all: Last spring and summer 2020, breast cancer screenings dropped nearly 90% – because of this, deaths from breast cancer are expected to rise 10% in 2025.

Don’t Be a Statistic!

“About 70 percent of all breast cancer deaths occur in the portion of the population who are not getting regularly screened,” Dr. Caren Greenstein, Director of Breast Imaging at White Plains Hospital. “Also, there is no such thing as any woman being low risk for breast cancer,” Dr. Greenstein continues. “The numbers tell us that one in eight women in this country will develop it.”In the Know scarsdale 400x200

While statistics show that the majority of tumors are found in women over 50, younger women are not immune to the risk. “Today, we are seeing some younger patients, including some patients in their twenties, with breast cancer,” she says.

When to Start Screening

Guidelines for when to start regular screening often lead to different recommendations from medical organizations. At White Plains Hospital, we follow the American College of Radiology recommendations and suggest healthy women without high-risk factors is to start getting mammograms yearly at age 40.

However, doctors suggest that certain groups of women with specific high-risk factors start even sooner – as early as age 30. Women who may be at higher risk include those who have a family history of breast cancer, especially if a first or second-degree relative developed breast cancer at a young age. Breast cancer in certain ethnicities, such as African American, Asian and Hispanic women, typically is diagnosed over a decade earlier than for Caucasian women (which is in their 60s).

Greenstein Caren copyFor those women who may be considered high-risk, new legislation requires large insurance companies in New York to cover mammograms in women aged 35 to 39 upon the recommendation of a physician, making early detection and treatment more likely.
There is no excuse not to get back on track with your mammograms – or start if you haven’t already.

To find out more or to schedule an appointment click here:

Dr. Caren Greenstein is the Director of Breast Imaging at White Plains Hospital.

Posted by Dr. Caren Greenstein

childmaskSome reassuring news from a pediatrician.

In the current climate of unknowns, sending kids back to the classrooms wearing masks is not only necessary for health reasons, it’s the best way we can make sure that they can have as normal a school year as possible. That is the most important thing to focus on right now when it comes to a child’s development – particularly younger children in preschool or who may be entering kindergarten and grade school for the first time.

Many parents have been expressing concerns over the social repercussions of a return mask mandate. Will masks hinder my child’s ability to participate in class? Will my child have difficulty talking to and making friends? What about language development?WhitePlainsHospitalSponsorBanner

These are legitimate concerns and worth discussing with your pediatrician based on your individual child, especially if they have special needs. For those parents, it may also be worth a conversation with your child’s school (for instance, to assure teachers will be wearing clear masks, providing necessary mask breaks etc…).

But generally speaking, parents need not be too concerned about the impact of masks on long-term learning or social skills. Kids are naturally social and will find a way to adapt to most situations. Still, there are a few ways you can help them at home:

Help them to read eyes. Younger children naturally take visual cues based on a person’s mouth and how that translates to overall emotion and mood. With everyone in masks, you can help your child shift from reading mouths to reading eyes – in fact, this is something they will begin to do naturally without any intervention. You can practice this at home while wearing your mask and playing a game – can you guess if I am smiling? Frowning? Laughing based on my eyes alone?

Calibrate their hearing. It is sometimes hard to hear what others are saying underneath their masks, especially if they are naturally soft spoken. It’s important for you to understand what volume of voice your children can hear clearly. You can model the teacher’s speaking voice to determine if normal level is understandable, or whether a few notches louder may be optimal. Then you can mention this concern to your school and the child’s teacher.

Schedule lots of outdoor playdates. Take as many opportunities as you can to arrange get-togethers with other children and relatives outside so they can benefit from as much full facial visualization as possible when they are not in school.
Finally,

Don’t worry. There are different opinions about masks in school. I have found that some parents tend to be more concerned than the kids themselves. It’s important to remember that young children are extremely resilient and adaptable. Anything they miss they will eventually catch up to later on – and this is especially true the younger the child is. Over the past two years, I have yet to see a pediatric patient who has experienced any significant delays due to mask-wearing.

Dr.LoweIf you have specific concerns related to a young child and mask wearing, you should initiate a discussion with your pediatrician. White Plains Hospital sees pediatric patients at Medical & Wellness in Armonk and at Scarsdale Medical Group in Harrison.

Dr. Samantha Lowe is a pediatrician with White Plains Hospital Physician Associates, with offices in our Armonk location. To make an appointment, call 914-849-7900.