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Men’s Biggest Health Risks

Here are the top five questions men should be asking themselves – and their doctors – when it comes to a longer, healthier life.

“Don’t wait until you get sick to start paying attention to your health,” says family medicine physician Sandra Arango-Fahmy, D.O. “You might assume that a heart attack or cancer is something you only need to worry about when you’re older, but these problems are all too common in younger men. Talk to your doctor, know your risk factors and take steps to prevent disease and keep yourself healthy for decades to come.”

Will I Have a Stroke?
Stroke kills more than 50,000 men each year, according to the American Heart Association. Think only old people are at risk? You’d be wrong. One in 14 stroke victims is under age 45. Strokes don’t just happen spontaneously. They could be stalking you for years.

“The odds of having a stroke seem to spike when men hit their 40’s,” says Dr. Arango-Fahmy. “Risk factors include high cholesterol, smoking, high blood pressure and diabetes. There is also evidence in a new study that single or unhappily married men seem to run a greater risk of dying from a stroke than those with good marriages.”

What If I’m A Smoker?
Nearly 60,000 men died from chronic obstructive pulmonary disease (COPD) in 2006, according to the CDC. This includes chronic bronchitis and emphysema. Smoking causes 80 percent of COPD deaths. Tobacco use is also linked to other serious men’s health conditions, including heart disease and cancer. “If you’re a smoker, all that matters is that you find a way to quit.  Quitting at any age, no matter how long you have been smoking, has definite health benefits,” says Dr. Arango-Fahmy. “Raritan Bay Medical Center has smoking cessation programs to help you kick the habit for good.”

Am I A Safe Driver?

The third greatest threat to a man’s life is a deadly accident. Car accidents, fires, poison and other unexpected traumas killed almost 80,000 men in 2007, according to the CDC. Automobile accidents
accounted for 37 percent of these deaths. Car crashes can happen to anyone so always take extra precautions behind the wheel. Never drink and drive. Don’t text and drive. If you must use your
cell phone while driving, get a hands-free connection. Pull off the road if you’re having a hard time staying awake, and if getting enough sleep is a problem, see your doctor.  Dr. Arango-Fahmy reminds
us, “For everyone’s safety, the road deserves your undivided attention.”

Am I At Risk of Cancer?

Cancer is the second most common cause of death in men, taking almost 300,000 lives in 2010 according to the American Cancer Society. Lung cancer tops the list, accounting for 29 percent of all cancer deaths, followed by prostate cancer (11 percent), and colon/rectum cancer (9 percent). You may already know the deadly risks of smoking but the factors for these cancers are less obvious.  “Talk with your physician about your personal and family health history and take steps to reduce your odds,” says Dr. Arango-Fahmy.

Will I Have A Heart Attack?

Heart disease is the biggest threat to a man’s life.  More than one in three men have some sort of heart disease and more than 390,000 men died of heart disease related issues in 2007, according to the American Heart Association. Not every heart attack victim is overweight or out of shape. Dr. Arango-Fahmy says, “Family history, stress and other lifestyle factors play an important role in who does – and doesn’t– have heart problems.” A recent study published in Britain’s Lancet found that stressors such as depressison, anger, and anxiety may contribute to heart attacks as much as smoking, obesity, high blood pressure and high cholesterol.

Team Up To Beat The Risk
“If we wait until men turn 50,” Dr. Arango-Fahmy concludes, “the risk factors for all of these health issues are already fairly well established and causing problems. Men need to team up with their physicians to develop preventative strategies when they are between the ages of 35 and 45, or even earlier.”

Kick Off A Healthy School Year

Your child spends more time at school than anywhere else except home. Schools deal with specific health problems in students, such as asthma and obesity, and also work to prevent risky behaviors such as alcohol and tobacco use and bullying.

“Parents can team up with educators and coaches to help reinforce positive behaviors,” says Dr. Jennifer Turkish, M.D., a family medicine physician. “Parents need to be aware of what their children are doing and set positive examples. If you feel any cause for concern about your child’s behavior or overall health, consult your family physician.”

Alcohol Abuse
According to a national survey, 16 percent of eighth graders reported drinking alcohol within the past month. Girls 12 to 17 reported drinking alcohol more frequently than boys the same age.

“Kids often begin drinking to look ‘cool’ or fit in with their peers,” says Dr. Turkish. Many kids begin drinking as early as middle school or even sooner. Kids who drink are more likely to be victims of violent crime and sexual assault, be involved in drinking-related traffic crashes, and develop problems with alcohol later in life.


Nearly a quarter of high school students smoke cigarettes. Another 8 percent use smokeless tobacco. “Everyone knows that smoking has lasting health risks,” says Dr. Turkish. “The younger you are when you start smoking, the more problems smoking can cause.”

People who start smoking before age 21 have the hardest time quitting. About 30 percent of youth smokers will continue smoking and die early from a smoking-related disease. Teen smokers
are more likely to use alcohol and illegal drugs, have panic attacks, anxiety disorders and depression.


Bullying is when a person or group repeatedly tries to harm someone who is weaker or who they think is weaker. Sometimes bullying involves hitting, name calling, teasing or taunting; sometimes it is indirect, such as spreading rumors or trying to make others reject someone. Cyber-bullying takes place online.

“Often people dismiss bullying among kids as a normal part of growing up,” says Dr. Turkish, “but bullying is harmful. It can lead children and teenagers to feel tense, afraid and otherwise affect their physical and emotional well being. In severe cases, bullied teens may take drastic measures. Sadly,
some children who have been bullied have attempted, and even succeeded, at suicide. The effects of bullying can last a lifetime.”

Asthma causes airways to become sore and swollen. Nearly nine million children in the US have asthma. “Children have smaller airways than adults, which makes asthma especially serious for them.
Children with asthma may experience wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night,” says Dr. Turkish.

Many things can cause asthma, including allergens such as mold, pollen, animals; irritants such as cigarette smoke or air pollution; cold air and changes in weather; exercise; and infections such as the flu and colds.

“Children grow at different rates, so it isn’t always easy to know when a child is obese or overweight,” says Dr. Turkish. “Ask your physician to measure your child’s height and weight to determine if he or she is in a healthy range.”

If a weight loss program is necessary, involve the whole family in healthy habits so your child doesn’t feel singled out. Encourage healthy eating by serving more fruits and vegetables and buying fewer sodas and high-calorie, high-fat snack foods. “Movement mobilizes the immune system,” says Dr. Turkish.  “Kids who sit too much – especially indoors – get sick more often. Movement also mellows the mood, as stress depresses the immune system. Encourage children to actively participate in recess and extracurricular, outdoor activities to keep their immune systems strong and their weight
in control.”

“Put hundreds of kids together in an enclosed space and you’re bound to have germs,” says Dr. Turkish. “The first and easiest line of defense against spreading germs is washing hands frequently,
or use a hand wipe or hand sanitizer. Also personal items that you put in your mouth – from water bottles to wind instruments to mouth guards –should not be shared.”

Getting To Bed + To Sleep

If you answered “yes” to one or more of these questions, you may have a sleep disorder, and you’re not alone. According to the National Commission on Sleep Disorders Research, at least 40 million Americans suffer from chronic, long-term sleep disorders and another 20 to 30 million experience occasional sleep problems.

Sleep disorders include problems like snoring, sleep apnea, insomnia, sleep deprivation and restless leg syndrome. “Good sleep is necessary for optimal health,” says Sandra Arango-Fahmy, D.O., a board certified family physician. “Even minimal sleep loss takes a toll on your mood, energy, efficiency, and ability to handle stress. Ignoring these problems can lead to poor overall health, accidents, impaired job performance, and relationship stress. If you want to feel your best, look your best and perform up to your potential, good sleep is a necessity.”

It’s not normal to always feel sleepy during the day, have problems falling asleep, or wake up feeling un-refreshed. “If someone has struggled with sleep problems for so long that this state begins to feel ‘normal,’ there are still steps that can help,” says Dr. Arango-Fahmy. “Start by keeping a sleep diary tracking your symptoms and sleep patterns. Then, make an appointment with your physician, who will examine you to make sure there are no underlying health issues, and who can help you make healthy changes to your daytime routines and sleep habits.” Together, Dr. Arango-Fahmy says, you can identify the causes of your sleep problems and find ways to improve both your sleep and your quality of life. Dr. Arango- Fahmy also cautions, “Always check with your doctor before taking any sleeping medications.”

What to Expect at The Center for Sleep Medicine
Your physician may refer you for a sleep study, especially if your main problem is daytime sleepiness, if you experience gasping, choking or have problems breathing during the night, or if you sometimes fall asleep at inappropriate times, such as while walking, talking or eating.

Your sleep study can be conducted at The Center for Sleep Medicine at Raritan Bay Medical Center.  This state of the art facility provides diagnosis and treatment for a variety of sleep disorders and ailments in children and adults ages 4 and up.  A sleep study is a non-invasive test which records sixteen different channels of information including sleep pattern, heart rate, brain waves, oxygen level and muscle tone while you sleep overnight or during the day in a private, hotel-like room.  A sleep specialist will analyze the results from your sleep study and work with your physician to design a treatment program, if necessary.

Nearly everyone has occasional sleepless nights. But if you have trouble sleeping on a regular or frequent basis, see your doctor. Identifying and treating the cause of your sleep disturbance can help get you back on the road to a good night’s sleep. The Center for Sleep Medicine at Raritan Bay Medical Center is one of only a few sleep centers in New Jersey accredited by The American Academy of  Sleep Medicine. For more information about The Center for Sleep Medicine at Raritan Bay Medical Center, call 732.360.4255 or visit www.rbmcsleepcenter.org.

Top Ten Tips for Fun in the Sun

“It’s important to think safety when you’re having summer fun. Away on vacation, spending a day at the beach, or enjoying your own back yard, accidents can happen when you least expect it,” says family medicine physician Jennifer Turkish, M.D. “Keep these tips in mind for a sure bet on summer fun.”

1) Swimming & Pools

Alcohol and swimming don’t mix. Don’t swim alone. Watch children at all times in the pool and near pools and spas. If you have a pool, make sure you have up-to-date safety equipment. Each year, about 300 children drown in residential pools, and another 2,300 under age 5 are hospitalized. Always use life vests on boats, docks, and around deep or swift water.

2) All-Terrain Vehicles

If you ride ATVs, take a training course, don’t ride double, wear protective gear, don’t ride on paved roads, and don’t drink when you ride.

3) Barbecues

Learn how to properly operate your barbecue, keep a fire extinguisher handy, put the barbecue in a safe place (preferably not on a wooden deck), check the equipment frequently, keep your grill clean, and don’t drink alcohol when you grill. It’s also important to watch children playing around hot grills.

4) Dehydration & Heat Stroke

It’s easy to get overheated in the summer as the temperature climbs. To prevent dehydration and heat stroke, drink lots of water, wear cool clothing, stay out of the sun, and don’t drink alcohol. Don’t leave your children or the elderly in a vehicle unattended. On warm days, the temperature can rise to 120 degrees in minutes, even with the windows slightly open. According to a study done by General Motors, 120 children died between 1996 and 2000 from being left in hot cars during the summer. Most were under the age of three.

5) Playgrounds

The surface temperature of playground equipment can climb to 140 degrees or more. At that heat, a child can suffer second and third degree burns in just a few seconds. Parents should touch the surfaces of play equipment with the back of their hand before letting children play. Children wearing light colored clothing are at the least risk of bee stings and other bug bites. Always keep a helmet on a child who is riding a bicycle, rollerblading or skateboarding. According to the U.S. Department of Transportation, 85 percent of bicyclists killed in 2003 reportedly were not wearing helmets.

6) Lawn Mowing

About 75,000 Americans adults and children are injured in lawn mowing accidents each year. Don’t let a child sit on your lap when you’re operating a riding lawn mower. It’s a good idea to keep children out of the yard when you’re mowing. Remove rocks and sticks from the yard before mowing, use protective equipment, turn off the motor before removing debris from the blades, and add fuel properly.

7) Food

Food poisoning increases during the summer because bacteria grow faster in the heat. Keep everything clean, keep raw meat and poultry chilled, use a meat thermometer, and don’t let food sit out for more than two hours. If it’s more than 90 degrees, it’s one hour.

8) Eye Care

The eyes of both adults and children can be damaged by powerful UV rays. Wear sunglasses that filter out UV light.

9) Car Accidents

Driving accidents are the number one killer of young people in the U.S. Don’t drink and drive. Don’t text and drive. Take a break on long trips – never drive if you’re tired. Make sure children are strapped in correctly in a properly fitting seat belt, car seat or booster seat.

10) Sunburn

More than one million new cases of skin cancer are diagnosed in the U.S. annually. Getting sunburned can increase your chances of getting skin cancer. Limit sun exposure, wear protective clothing, and always use an SPF of at least 20 or higher, applied 20 minutes before going outside. Reapply sunscreen after swimming, sports and other activities.

Keeping a Lid on High Blood Pressure

1 in 3 Americans suffer from high blood pressure, a precursor to cardiovascular disease.

Every 33 seconds, someone dies of cardiovascular disease.

High blood pressure is often the first step toward heart disease, the leading cause of death in the United States, as well as stroke and heart or kidney failure. So, preventing high blood pressure or controlling it is essential. Thirty percent of Americans have high blood pressure, which is known as hypertension. Because hypertension has no symptoms, almost one third of this group doesn’t even know that they have it.

High blood pressure is known as a silent killer because a person can have high blood pressure for years without even knowing. “By learning how to manage your high blood pressure, you can lower your risk of heart disease, stroke and other lifethreatening illnesses,” says family medical physician Sandra Arango-Fahmy, D.O.

Blood pressure is the force at which the heart pumps blood. One measurement refers to systolic pressure, which measures blood pressure during heart contractions. The other measures diastolic pressure, or the force when the heart is relaxed. Blood pressure is expressed as systolic pressure over diastolic pressure. The optimal blood pressure is 120 over 80, while any measurement above 140 over 90 is classified as hypertension. While high blood pressure is cause for concern, lifestyle changes and medication can often help control this potentially deadly condition.

“Watching what you eat is the first step to lowering high blood pressure,” says Dr. Arango-Fahmy. “If you have hypertension, shake that salt habit. Most Americans ingest at least ten times the daily requirement.” Replace salt with other tasty spices like basil, dill and rosemary.

The only way you can know for sure if you have high blood pressure is by having your physician check your blood pressure. “The most important thing you can do to combat high blood pressure,” says Dr. Arango-Fahmy, “is to get your blood pressure tested by your doctor during your annual check-up. This 10 second procedure could save your life.”

Physician Focus: Dr. Jennifer Turkish

For Jennifer Turkish, M.D., a medical career seemed a likely next step in life. “I grew up in a medical family,” says Dr. Turkish. “I used to go to the hospital with my dad, accompanying him on rounds, hanging out at the nurses’ station,” she recalls.

Her father, Dr. Sheldon C. Turkish, is an obstetrician/gynecologist. Her brother Jonathan is also an OB/GYN, in practice with his father. Both father and brother are on staff at Raritan Bay Medical Center, as is Dr. Turkish. “My mom is also a nurse,” adds Dr. Turkish. “So I guess you could say there was a medical influence while I was growing up at home.” Dr. Turkish grew up in East Brunswick and currently lives in Morristown, N.J.

Dr. Turkish first considered becoming a veterinarian. “We always had animals around the house when I was growing up,” she recalls “If any got sick, we all nursed them back to health.” Over time, Dr. Turkish realized she liked taking care of people more than animals. “I love animals but taking care of people is more rewarding,” she maintains.

Jennifer received a Bachelor of Science degree from the University of Massachusetts at Amherst. She received her medical degree from Medical University of the Americas in Saint Kitts and Nevis.

Dr. Turkish completed her medical residency at Warren Hospital, Coventry Family Practice, where she was chief resident. In this leadership role, she was responsible for overseeing all residents as well as handling scheduling, completing daily reports and working on quality improvement initiatives as she continued her residency, focusing on inpatient medication and critical care.

“At Bay Family Medicine, people are my passion,” says Dr. Turkish. “I take care of everyone from babies to geriatric patients, and I treat each one as my priority. I always try to answer questions thoroughly, and when I need to call a patient I try to do it promptly. I treat each patient like a person, and I am concerned about their individual care and well being.”

Making Weight Loss a Family Affair

An alarming statistic that one third of U.S. adults meet the criteria for obesity has created a call for more family medicine physicians to identify and intervene in patient obesity during childhood, when some long-term health effects can be prevented or at least minimized.

Obesity treatment – and prevention – begins at home. Here’s how to make weight loss a family affair.

“The thing to remember is that obesity can be reversed,” says family medicine physician Jennifer Turkish, M.D. “The earlier the intervention occurs the more potential there is to change contributing lifestyle and eating factors,” says Dr. Turkish. Early intervention is especially important because it is now known that childhood and adolescent metabolic syndrome, in which hypertension, impaired glucose tolerance, and high cholesterol occur concomitantly, can lead to premature atherosclerosis and significantly increased cardiovascular disease risk early in life.

As physicians in many specialties have learned, “scare tactics” are ineffective when talking to adult obese patients about obesity’s health effects — cardiovascular disease and diabetes in particular — before those effects compromise patients’ lives. With adolescents, scare tactics are even less effective because most children don’t think about the long-term effects of any issue, especially health related ones.

It may be more instructive to have the child (in concert with parents, if appropriate) identify concrete issues he or she faces because of obesity, whether it’s social ostracization by peers or the sheer physical discomfort of being overweight, and craft a “treatment plan” accordingly. Unhealthy behaviors may be contagious, but so are healthy ones.

Sometimes it’s difficult to be healthy, and we may start adopting behaviors that really don’t work well.”There are some things we can do consciously and even small changes can make a long-term difference in weight,” says Dr. Turkish.

To curb the childhood-obesity epidemic, health experts have long urged parents to make healthy changes to their family’s lifestyle — such as eating nutritiously, reducing TV time, exercising and getting a good night’s sleep.

Obesity experts stress that the key is to start somewhere, and these routines are as good a place as any. “We don’t have to be running marathons every day,” says Dr. Turkish. “Even moderate improvements can translate into a marked effect on body weight.” And when it comes to controlling weight, especially in youngsters, every pound counts.”

Physician Focus: Dr. Sandra Arango-Fahmy

Jersey Girl Sandra Arango-Fahmy, D.O. always valued what was close to home and in her heart. She grew up nearby, in Sayreville, and from an early age wanted to be a dancer, or maybe a pediatrician.
Dr. Arango-Fahmy achieved her goals, majoring in biology and minoring in Spanish at Rutgers, while earning the spotlight as captain of Rutgers’ national championship- winning 1998 Dance Team. She left New Jersey to attend the Philadelphia College of Osteopathic Medicine and received her Doctor of Osteopathic degree in June 2003. Returning to New Jersey, Dr. Arango-Fahmy completed her internship and residency in the Family Medicine program at St. Barnabas’ Union Hospital in 2006.

“I was always interested in medicine. I just realized along the way that I liked the family aspect of medicine a little more than focusing just on pediatrics. I enjoy treating all the members of a family, and I am happy to be practicing in a community where I feel a sense of belonging,” says Dr. Arango-Fahmy, who lives in Morganville with her husband and two children, with a new baby on the way. Once Dr. Arango-Fahmy knew she wanted to become a family medicine practitioner, she also chose to become an osteopath. Everyone knows that the initials M.D. after a person’s name indicates that he or she is a medical doctor, but fewer people encounter the initials D.O. and understand the basic principles of osteopathy.

Equal Training, With an Added Focus on Wellness

Osteopathic medicine is a holistic system of medical care that combines the needs of the patient with the current practice of medicine and surgery, but also places a strong emphasis on the inter-relationship of the body’s nerves, muscles, bones and organs. Doctors of osteopathic medicine, or D.O.s, look at the whole person in order to prevent, diagnose or treat an illness, disease or  injury. It is their guiding philosophy.

Dr. Arango-Fahmy believes her education as an osteopathic physician enhances her expertise as a family medicine practitioner. “My training helps me to assess each patient I see as a whole person, not just as an isolated ailment or disease,” she says. “Each person’s entire physical and psycho-social condition are aspects I consider in deciding how to treat the patient. From babies to geriatric adults, I care for the whole person. Osteopathy was definitely the route for me.”

Go from Smoker to Non in 2011

For all of the efforts to curb smoking in America,today one in four men and one in five women still smoke.  For those who have never smoked, this is a bewildering fact. Don’t smokers understand that cigarettes are the number one killer in America, that they dramatically increase risk for heart disease, stroke, cancer, high bloodpressure, low birth weight babies, and almost everyother health concern? What about the effects of second hand smoke? What about the high cost of purchasing cigarettes and tobacco products, especially in a tougheconomy? How could any habit be worth this?

Truth is, most smokers do understand but quitting isnot that easy. Many smoke because the nicotine in cigarettesis highly addictive. Others smoke because it providespsychological comfort. Millions smoke becausequitting is so hard.

Jennifer Turkish, M.D., a board certified family medicinephysician, says “If you smoke, think about makingthis New Year the time to finally quit. Working withyour doctor, you can develop a step-by-step plan. Youdon’t have to do it cold turkey, and you don’t have to doit alone.”

“Often patients who come to see me about quittingsmoking have tried – and failed – to quit before,” saysDr. Turkish. “Sometimes they or someone close to themhas had a health scare. Sometimes they are just readyto start making positive life changes.”

Dr. Turkish discusses their past attempts at quitting,finding out what worked for each patient and what didn’t.“Then we get out a calendar and set goals so thatquitting becomes a gradual process. Very few people can quit cold turkey. I usually tell patients that if theysmoke a pack a day, take one or two cigarettes out of cigarettesyou carry around with you to make the process easier. We also discussmedication options, emotional support and positive lifestyle changes to breakthe pattern of smoking. Some patients need their doctor to tell them to quit,reinforcing what they already know.”

Quitting has major health benefits that start right away. Former smokerslive longer than people who smoke. According to the AmericanCancer Society, people who quit before age 50 have one-half therisk of dying in the next 15 years compared with people who keepsmoking.

Quitting lowers the risk of lung and other cancers, heart attack,stroke, and lung diseases such as emphysema and chronic bronchitis.

Women who stop smoking before they get pregnant, or even during the firstthree to four months of pregnancy, reduce their risk of having a low birthweightbaby.

“There’s a range of prescription and over-the-counter medications availableto help people quit,” says Dr. Turkish. “Some patients also find successthrough acupuncture, hypnosis and meditation.” Telephone and online supportis also effective.

“I suggest that husbands and wives try to quit together,” says Dr. Turkish,who tells patients to get their families on board for emotional support, especiallyif someone else in the family is a smoker. “Another good strategyis to replace your usual smoking routine, such as an after-dinner cigarette,with new activities like walking, exercising or spending timewith family, friends or pets.”Dr. Turkish keeps in contact with her patients as they go throughthe cessation process. “Especially for long-term smokers, it’s importantto keep checking your goals, revising them if necessary,checking on progress and getting good positive reinforcement.”Dr. Turkish feels like each patient’s coach. “I’m right there with them,” shesays. “Quitting tobacco is not easy but it can be done. Whether you’re asmoker, someone who uses smokeless tobacco, or just someone trying tohelp a friend or loved one, it is never too late to quit smoking.”

Managing Your Diabetes

“Living with diabetes is a journey best taken with others,” says Dr. Sandra Arango-Fahmy, D.O. a board certified family physician. “I encourage anyone who has been recently diagnosed with diabetes to work closely with your physician to learn all you can about the best ways to manage your diabetes.”

At least 1 in 14 people has diabetes, and the risk of diabetes for people of color over the age of 50 can be four times greater. Although there is no cure, diabetes can be managed by keeping blood sugar levels normal, maintaining proper nutrition and exercise, and monitoring insulin and other medications.

Your physician will advise and support you, but control depends on you. Every three months, see your physician for a thorough check-up to monitor blood sugar levels and see if your medications are appropriate or need to be altered. It is common for your physician to change your medicine or treatment plan over time because your diabetes changes and can worsen over time if not carefully monitored.

Nutrition and exercise, along with diabetes medications, are important for good diabetes control. While people with diabetes have the same nutritional needs as anyone else, they have to take extra care to make sure that their food is balanced with insulin and oral medications, and exercise to help manage their blood sugar levels. A healthy meal plan is one of the most important things you can do to help control your diabetes. Be sure to check with your physician before starting an exercise program.

“Work together with your physician,” says Dr. Arango-Fahmy, “and you will find that living a full and active life while managing your diabetes can definitely be a reality.”