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Wellness Words March 2020

HealthLink Littauer’s


Submitted by Tammy Merendo, R.N. B.S.N.

Director of Community Education


Multiple Sclerosis Awareness

March is Multiple Sclerosis Awareness Month. According to the National Multiple Sclerosis Society, 2.3 million people have a diagnosis of Multiple Sclerosis (MS) – a disease that effects the central nervous system (CNS).

The central nervous system is made up of the brain, spinal cord and optic nerves. When damage occurs in the CNS, it interferes with the transmission of nerve signals and can cause symptoms like numbness and tingling, blurred vision, double vision, weakness, poor coordination, imbalance, pain, depression, fatigue and problems with memory and concentration.

MS is a difficult disease to diagnose because the symptoms can be vague, they differ from person to person, and there is no single lab test to confirm the disease. Magnetic resonance imaging (MRI) and spinal fluid analysis are helpful in diagnosing. Most often people are diagnosed between the ages of 20 and 50 but it can occur in any age group. Women are 2-3 times more likely to have MS than men.

There is no evidence that MS is directly inherited but there are genetic factors that increase the risk of developing MS, and there are environmental factors such as low vitamin D and cigarette smoking that increase a person’s risk.

There are 4 different courses that MS can take:

  1. Clinically Isolated Syndrome – The first episode of neurologic symptoms caused by inflammation and demyelination in the CNS.
  2. Relapsing-Remitting MS – Characterized by periods of relapses also called attacks or exacerbations that subside, a person may return to their previous state or they may have disease progression after.
  3. Secondary Progressive MS – Occurs after the relapsing-remitting and is usually more progressive.
  4. Primary Progressive MS – A gradual but steady progression of disability from the onset of symptoms, with few or no relapses or remissions or new MRI activity.

Although there is no cure for MS, there are now medications that help to change the course of the disease and limit new areas of damage in the CNS in certain courses. These drugs are called “disease-modifying” drugs and they can help reduce the frequency and severity of MS attacks, the number of new lesions in the CNS, and they may slow the progression of disability. If you have MS, talk to your health care provider to see if there is a drug that could benefit you.

The majority of people with MS do not become severely disabled. Two-thirds remain able to walk, though many will need an aid, such as a cane or crutches. Some people will use a scooter or wheelchair because of fatigue, weakness, and balance problems or to conserve energy.

Things to remember if you or a loved one has MS is that everyone is different. Some people may be able to do more than others before they need to take a rest break. It is important that people with MS listen to their bodies, pace themselves, and be aware of what triggers them.

Over all, anyone and everyone can benefit from a healthy diet and exercise, by managing stress and utilizing positive coping mechanisms, and keeping your mind organized and stimulated.

The National Multiple Sclerosis Society has MS Navigators available to help anyone with MS identify solutions and provide access to resources by calling 1-800-344-4867 for assistance.

For more information, talk to your healthcare provider or contact HealthLink Littauer at 518-736-1120. You can email us at or visit our wellness center located at 2 Colonial Court in downtown Johnstown. We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.

Wellness Words January 2020

HealthLink Littauer’sAlicia DeRuscio-Head


Submitted by Alicia DeRuscio, B.S.


Eye Health

When you think of good health, you probably picture someone free of illness or chronic conditions. What about someone with good eye health? Your eyes are an important part of your body – they help you see, connect with, and experience the world around you.

According to the American Academy of Ophthalmology (AAO), your eyes experience many changes as you age. For example, some of the cells in your eyes, called rod cells, are more likely to break down over time. These cells are responsible for helping your eyes focus and adjust, and are affected by certain lifestyle factors including smoking or excessive sun exposure. As rod cells break down, you may experience trouble with your vision.

The AAO lists several common problems that older adults experience with age:

  • A gradual loss in ability to see things up close, known as presbyopia.
  • Difficulty adjusting or focusing eyes when moving from a poor-lit area to a well-lit area, or vice versa.
  • Difficulty adjusting to light or dark when driving, especially in the rain.
  • Contrast sensitivity, or trouble separating an image from its background with a similar color or tone.

Aging also makes you more likely to develop eye diseases such as age-related macular degeneration, diabetic retinopathy, glaucoma or cataracts. Many eye diseases do not have any signs or symptoms, so it’s important to keep your eyes healthy and get them checked regularly.

In order to maintain good eye health, the National Eye Institute (NIH) recommends:

  • Getting a dilated eye exam every year to check for eye diseases.
  • Wearing sunglasses that block 99 to 100 percent of UVA and UVB radiation.
  • Wearing protective eyewear such as goggles or safety glasses when playing sports or performing manual labor.
  • Giving your eyes a rest every 20 minutes when looking at a computer or TV screen.
  • Washing your hands before putting in or taking out contacts.
  • Disinfecting contact lenses and replacing them regularly

As with any health-related disease, it’s also important to maintain good physical health in order to protect your eyes. Adopting healthy lifestyle habits like eating a nutritious diet, getting adequate sleep, quitting smoking and getting regular physical activity can decrease the risk of developing eye diseases.

Certain foods, like spinach, kale, tuna, halibut and salmon are beneficial to eye health. Sleeping also promotes eye health by providing continuous lubrication, helping eyes to rid themselves of dust or other irritants that may have built up during the day.

While some changes in vision naturally occur because of age, others do not. Low vision, or vision loss that makes daily activities difficult, is usually the result of an eye disease. Low vision can include both losses of central and side vision, as well as blurred or hazy vision. Common symptoms include difficulty reading, driving, shopping or recognizing faces.

If you experience low vision or have trouble with any of these tasks, be sure to contact your eye doctor. Scheduling a visit with an eye doctor will help determine if you have an eye condition and provide you with resources to aid with low vision.

For more information on healthy lifestyles, contact HealthLink Littauer at 518-736-1120. You can email us at or visit our wellness center at 2 Colonial Court in downtown Johnstown.  We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.

Wellness Words December 2019

HealthLink Littauer’sAlicia DeRuscio-Head


Submitted by Alicia DeRuscio, B.S.

Community Education Assistant


Preventing Illness During The Holidays

The holidays provide us with a great opportunity to celebrate life, reflect on what’s most important to us and spend time with family and friends. However, the holidays can also expose us to many germs, especially if we must travel or prepare meals for relatives, leaving our bodies susceptible to illness.  This holiday season, be mindful of your health and take some extra steps to prevent spreading germs to both yourself and others.

According to the Centers for Disease Control and Prevention (CDC), one of the most important things we can do to prevent sickness both during the holidays and throughout the year is to properly wash our hands. In order to eliminate and prevent the spread of germs, the CDC recommends the following:

  • Wash hands with clean, running water.
  • Lather your hands with soap and be sure to rub the backs of your hands, in between your fingers and underneath your nails.
  • Scrub your hands for at least 20 seconds.
  • Rinse your hands thoroughly with clean, running water.
  • Dry your hands with a clean towel or let them air dry.
  • If you do not have clean, running water and soap, use an alcohol-based hand sanitizer.
  • Apply the sanitizer to the palm of your hand and rub both hands together.
  • Make sure all parts of your hands are covered with sanitizer and continue rubbing them together until they are completely dry.

As many of us touch our face, mouth and eyes without even realizing it, following these handwashing steps will help minimize the spread of germs.

It’s important that we utilize proper hand-washing during travel time, too. The American Automobile Association (AAA) estimates that over 100 million Americans travel during holiday time.  With so many people entering airplanes, buses or trains, there’s a vast amount of germs spread throughout these areas.

If you are planning to travel, make sure to carry an alcohol-based hand sanitizer with you for your hands as well as other surfaces. If you are traveling on an airplane, bus or train, sanitize areas such as tray tables, arms rests and bathroom door handles before touching them.  If you use the bathroom, avoid touching bathroom surfaces; turn the sink off with a clean, dry paper towel and use the paper towel to open the bathroom door.  Practicing these small hygiene habits will ensure fewer germs are spread to both you and those you’re traveling to see.

While you may not necessarily have to travel on an airplane, bus or train, you will likely still enjoy a holiday meal with loved ones. Whether you are cooking for family or going to relative or friend’s house, it’s important to practice proper food safety.  If you or a loved one plans to cook, follow the CDC’s four steps to food safety:

  • Step 1: Clean – Make sure to wash hands and all kitchen surfaces with warm, soapy water before preparing food.
  • Step 2: Separate – Keep raw meat, seafood, poultry and eggs separated from one another as well as from other foods. Make sure to use different cutting boards when preparing each item and keep them stored in separate containers.
  • Step 3: Temperature – Cooking foods to high temperatures will kill germs and prevent illness. Be sure to use a food thermometer to determine if foods such as whole cuts of meat, fish, poultry and ham are cooked properly. If you have to thaw foods, do so in the refrigerator, microwave, or in cold water. Avoid thawing foods on the counter because bacteria can grow more quickly at room temperature.
  • Step 4: Chill – After the meal, refrigerate all perishable food items within two hours. Refrigerators should be kept below 40 degrees Fahrenheit. 

Handwashing, travel hygiene and food safety are all important in preventing illness in combination with practicing healthy habits. Don’t forget to continue consuming a healthy, well-balanced diet, drinking enough fluids and getting proper sleep over the holidays. While we may not always be able to avoid germs, following these guidelines will help decrease your risk of getting sick this holiday season.

For more information on preventing illness, contact your healthcare provide or call HealthLink Littauer at 518-736-1120. You can email us at or visit our wellness center at 2 Colonial Court in downtown Johnstown.  We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.

Wellness Words November 2019

HealthLink Littauer’sAlicia DeRuscio-Head


Submitted by Alicia DeRuscio, B.S.

Community Education Assistant


Vestibular Rehabilitation Therapy

Did you know that roughly 69 million Americans age 40 or older are affected by vestibular or inner ear dysfunction? According to the American Speech-Language-Hearing Association (ASHA), 40% of Americans suffer from dizziness or balance problems due to inner ear disorders. Depending on the type of disorder, dizziness and balance problems may be improved through vestibular rehabilitation therapy.

What Is Vestibular Rehabilitation Therapy?

The Vestibular Disorders Association defines vestibular rehabilitation therapy (VRT), as a specialized form of therapy aimed at relieving both primary and secondary problems that result from inner ear disorders and diminish a person’s quality of life. People with vestibular problems often experience dizziness or vertigo, trouble with vision, and balance problems that are usually worse with movement.

As a result, many people limit their activity and adopt sedentary lifestyles to avoid triggering such problems. This can lead to further health concerns including decreased muscle strength, poor cardiovascular fitness and other chronic conditions. VRT can aid in combatting these secondary problems, too.

Types Of Vestibular Rehabilitation Therapy

VRT is an exercise–based program that allows patients to adapt to inner ear disturbances by using other senses, such as vision and somatosensory or body sense, to compensate. Exercise plans are customized to fit each patient, depending on the type of vestibular problem and the symptoms that occur.  The three main types of VRT include habituation exercises, gaze stabilization and balance training.

Habituation is used to treat people who experience dizziness from motion or visual stimuli in the environment. Through repeated exposure to certain movements or stimuli, the brain learns to ignore signals from the inner ear that cause the dizziness. Over time, continued VRT helps reduce feelings of dizziness.

Gaze stabilization is used for people who have trouble seeing clearly and often feel as if their vision bounces around. In gaze stabilization, a person fixates their vision on an object and then moves their head around in different directions while keeping the object in sight.

The last form of VRT, balance training, helps to improve balance and steadiness to aid in performing daily activities such as cooking meals or taking a shower. Balance training incorporates different body positioning and movements, as well as visual cues to improve standing, bending, reaching, turning and walking. After establishing an exercise regimen specific to fit your needs, your audiologist or VRT therapist will also determine an exercise regimen to continue at home.


There are many factors that can affect a person’s recovery during vestibular rehab therapy. According to the Vestibular Disorders Association, factors include:

  • The type of vestibular disorder, such as whether it affects one ear or both ears.
  • A sedentary lifestyle which can cause other health problems.
  • Pain which contributes to limited activity, as well as overall imbalance and an increased risk for falls.
  • Medications that may cause side effects including dizziness, weakness, muscle fatigue and sedation.
  • Emotional concerns such as anxiety or depression which affect a person’s ability to manage their symptoms.

Vestibular dysfunction can affect a person both physically and mentally. Taking steps to manage symptoms to better cope with the disorder will help you stay independent and improve your quality of life.

If you would like to learn more about VRT, attend a special program entitled ‘Exercise Your Ears’ presented by Dr. Mark Caffrey, Audiologist of Littauer’s Primary/Specialty Care Services, on November 13 in Littauer’s Auditorium.

You are invited to join us for a buffet-style luncheon at 11:30 for $6 or attend the presentation only at 12 noon at no charge. To attend the luncheon, call HealthLink Littauer at 518-736-1120 or email by November 11.  We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.

Wellness Words October 2019

HealthLink Littauer’sAlicia DeRuscio-Head


Submitted by Alicia DeRuscio, B.S.

Community Education Assistant


Planning For End-Of-Life Care

Although we may not want to think about it, at some point all of us will face end-of-life experiences. These experiences may occur as a result of chronic diseases, old age or even an unexpected medical crisis. However, in order to ensure your wishes for end-of-life care are met at any age, it’s important to plan ahead and be prepared. There are many things to consider when planning ahead, but the main focus should fall on the amount and type of care you’d like to receive.

The National Institute on Aging (NIH) discusses several types of emergency treatments used for medical care in times of crisis including:

  • Cardiopulmonary Resuscitation (CPR): If your heart stops beating or your breathing stops, healthcare professionals use CPR to restart the heart and lungs. This requires pushing on the chest with a lot of force, blowing air into the lungs and use of electric shock, also called defibrillation. According to the NIH, CPR can result in broken ribs or collapsed lungs, and is often not successful for fragile, older adults with several chronic conditions. If you decide you do not want CPR as part of your medical care, you must have a DNR or ‘do not resuscitate’ order on your medical file.
  • Ventilator Use (breathing machines): If you are unable to breathe on your own, a ventilator, or breathing machine can be used to push air into your lungs to help you breathe. Breathing machines can be very useful in short-term emergency situations, but may only make the dying process longer for those nearing end-of-life. If you decide you do not want ventilator use as part of your medical care, you must have a DNI or ‘do not intubate’ order on your medical file.
  • Gastric or Nasogastric Tubes (feeding tubes): A feeding tube may be used to provide your body with nutrients if you are unable to eat or drink on your own. A gastric tube is inserted into the stomach while a nasogastric tube is inserted through the nose.
  • Comfort Care: Comfort care, or hospice care, is medical care provided during near-death circumstances in order to relieve pain and suffering.

When considering such treatments, it’s important to think about your own personal values. Do you wish to get the most days out of life or would you rather focus on quality of life? It’s also important to take into consideration your overall health. If an emergency was to occur, are you relatively healthy or do you have several physical ailments? If you are getting older, what do you picture as a “good death?” Once you have thought about the type of care you’d like to receive in either emergency or near-death situations, it’s important to write out your wishes in an advanced directive.

The National Institute on Aging defines an advanced directive as a legal document that outlines your healthcare preferences and only goes into effect if you are debilitated and unable to speak for yourself. Advanced directives are not set in stone and can be changed at any time.

There are two main parts to an advanced directive including a living will and a health care proxy. A living will lets healthcare professionals know your decisions for care and how you wish to be treated in emergency situations. A health care proxy is a legal document that names someone to make medical decisions for you if you are unable to do so yourself. A healthcare proxy can be anyone, such as a family member or friend, but this person should be aware of your wishes.

One way to ensure your family and friends carry out your wishes is to talk to them. Though it may not be an easy topic of discussion, making your wishes known can provide you with peace of mind and take some stress off of your loved ones.

If you would like to learn more, attend a special program on ‘Advance Directives’ presented by Rev. Bonnie Orth, Littauer’s Pastoral Care Coordinator on October 23 in Littauer’s Auditorium.

You are invited to join us for a buffet-style luncheon at 11:30 for $6 or attend the presentation only at 12 noon at no charge. To attend, call HealthLink Littauer at 518-736-1120 or email  We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.