Monday, February 19, 2007


Child pneumonia cases spike locally

I have seen a recent surge in the number of pneumonia cases among children in my pediatric office. It usually begins with an otherwise healthy child suddenly developing a fever and cough, and the symptoms quickly get worse over the course of a day or two. There may have been contact with someone with a similar illness, usually at a daycare or at school.

Many of my patients’ parents are alarmed to hear the word “pneumonia,” and are not quite sure what it means. Pneumonia, in simple terms, is an infection in your lungs.
Our lungs are made up of tiny airways that end in microscopic air sacs called alveoli. This is where the air exchange occurs wherein the oxygen enters our blood and carbon dioxide leaves. A cross section of our lung perhaps can be compared to that of a sponge, elastic, full of pores and containing air.

What happens to our lungs with Pneumonia?
The common variety of pneumonia generally means that the affected part of your lung no longer can hold air and perform the necessary air exchange. It gets filled with mucous and inflammatory cells so air does not reach the alveoli. Inflammatory cells are a defense mechanism of our body trying to contain the infection and seal the rest of our lung and body from the infecting agent. Left untreated, the infection can spread to the rest of our lungs and cause complications and death in certain cases.

Who is most at risk?
• Children younger than 2 years old
• Those exposed to childcare, overcrowding, smoke and bottle-feeding
• Ethnic background: African-American, Native American, Alaskan Eskimo
• People with viral respiratory tract infections
• Patients with certain underlying illnesses, such as diabetes, immune deficiency etc.

The most common cause of pneumonia is a type of bacteria called pneumococci. Other kinds of bacteria and viruses are also responsible. Pneumonia generally spreads from person to person. Viral respiratory tract infections could make you susceptible to other bacterial infections such as pneumonia. Some children may have associated ear infections as well.

Most patients with pneumonia generally have high fevers, cough and are breathing faster. They tend to get sick quickly. Doctors can usually diagnose this pretty easily, sometimes with the help of a chest x-ray.

Treatment and prevention of Pneumonia
Fortunately treatment of pneumonia is not complicated. Most children tend to get better quickly with the start of antibiotics. Rarely, some children with extensive disease may need to be admitted for intensive treatment. Fever control and maintenance of hydration and nutrition should make patients comfortable until the antibiotic kicks in, usually in less than 24 hours.

Frequent hand washing and avoiding crowded places, especially in winter months, are key ways to prevent pneumonia. Prompt attention to fever, cough and seeking medical attention early can make the illness shorter and prevent complications. Return to your doctor if your child’s fever is not going away after two or three days and your child develops a cough and you notice rapid breathing. As I mentioned earlier, pneumonia may occur after a viral upper respiratory tract infection.

With the introduction of Pneumococcal Vaccine (PCV) and Hemophilus Influenza B (HIB) Vaccine, there has been a significant reduction in occurrence of pneumonia. There is no need to panic, as most of these illnesses can be treated with antibiotics.

Ravi Prakash, MD, is Chief of Pediatrics at The William W. Backus Hospital with a private practice in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at


An athletic approach to health care part 2

In my private practice, I have the good fortune of treating many accomplished amateur and professional athletes. Some are still active in their sport, while others have long since left their days of glory behind.

These athletes often suffer from injuries and diseases no different from the rest of my patients. What distinguishes these athletic patients is their approach to illness.

Athletes receive a diagnosis as if it were the result of a match or other event. They want to hear about a plan for recovery and immediately hope to begin the rehabilitation process, as if preparing for another contest.

It is this disciplined mindset that leads to what has proven to be quicker and more complete recovery. Lance Armstrong serves as a good example of this.

One day each week, I share office space with Procare Physical Therapy in Willimantic.
It is there I get to observe many of my patients as they grind through the difficult recovery process.

One patient is a professional golfer who needed lumbar disc surgery. Often this is a career-ending event. Instead, we found a surgeon who had successfully treated golfers in the past. Post-operatively, his rehab was impressive. He followed the directions of the therapist as if working with a world-class coach. He returned to competitive golf a full year sooner than we predicted.

A potential Heisman Trophy candidate came to me for an opinion regarding a nerve injury that could have ended his athletic career. Instead, he spent two years rehabilitating his leg, and, to the astonishment of all involved, returned to NCAA Division 1 competition.

After 21 years of practice, I am witnessing what may be the greatest recovery of all. A 16-year-old Olympic-level gymnast was recently diagnosed with a brain tumor. This young lady has approached her 18 hours of surgery and ongoing chemotherapy and radiation as a seasoned, veteran athlete. She insists on continuing her physical therapy in the midst of all these treatments.

I watch as she begins with massage and gentle stretching. Her routine no longer consists of vaulting to great heights, or swinging across uneven parallel bars, but a seemingly simple yet physically demanding workout of sitting on a large ball to keep her balance. I have no doubt because of this discipline, she will recover fully and all of us involved will be inspired.

I have learned many things from these experiences. Among them is most young people who participate in sports acquire a fundamentally sound approach to life and health. We can all benefit by taking an athlete's approach to illness.

If you have any inspiring story of neurologic recovery, and you'd like to share them, please e-mail them to me at

Anthony G. Alessi, MD, is a member of the Backus Hospital Medical Staff and neurologist in private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Alessi and all of the Healthy Living columnists at

Friday, February 09, 2007


An Athletic Approach to Health Care

I was recently invited to address the annual meeting of the Connecticut Association of Sports Massage Therapists. In preparing for my talk, it occurred to me that 20 years ago, it would have been unthinkable for a neurologist to speak about sports medicine, no less to a group of massage therapists specializing in sports medicine.

In the past, the area of sports medicine was the sole domain of orthopedic surgeons and athletic trainers. Today, it is rare to find a college or professional sports team without a family practice doctor who has done a fellowship in sports medicine, a sports psychologist, nutritionist, strength and conditioning specialist, chiropractor, and massage therapist. That’s in addition to the athletic trainer and orthopedist. It’s clear that sports medicine has adopted a team approach to caring for athletes.

The rewards of using this concept become more evident each week as we watch increasingly spectacular athletic performances. Sports medicine has evolved from diagnosing and treating injuries to preventing injury by adequately preparing athletes for competition. An added benefit has been the increased longevity of athletic careers, notably Roger Clemens, Randy Johnson, Vinny Testaverde and Doug Flutie. We have also begun to see athletes like Tiki Barber retire after successful careers — not because they are unable to perform, but because they wish to pursue another career.

These success stories have led traditional medicine to follow the example of sports medicine by applying this team approach. You can see how that team approach works in this very column, which is written not only by physicians, but nurses and nutritionists as well.

The team approach works at hospitals, too. At Backus, teams are used in our centers for the treatment of trauma and cancer patients. This proven concept involves a multi-disciplinary effort toward prevention, treatment and — ultimately — longevity.

Traditional medicine has learned a valuable lesson from sports. In my next article, I’ll discuss specific examples of how this athletic approach to treatment has paid big dividends in our community.

Anthony G. Alessi, MD, is a member of the Backus Hospital Medical Staff and neurologist in private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace the advice of your personal physician. Reach Dr. Alessi and all the Healthy Living columnists at


Don't cheat yourself out of Valentine's Day treats

Valentines Day is a day marked by love, hearts, and spending time with the person that means the most to you. It is also a time for cheaters. That's right, those people who are about to cheat on their 2007 New Year's diet resolutions.

Before we get too engrossed with thinking about cheating on our self-inflicted diet plan, let's think about the most healthful choices for candy during this love-struck holiday.

As we peruse through the grocery store, we come across the well-known candy hearts. With cute phrases engraved on the front, they are hard to resist when someone you love picks a special one out for you. However, one small box of these temptations contains 110 calories, 28 grams of carbohydrates and no fat or cholesterol. Seems appealing without all the fat, but since this candy also has no fiber or protein and mostly empty calories, we'll keep looking for a better option.

Red Hots (the tiny cinnamon hearts) contain only 60 calories, 15 grams of carbohydrates, and no fat or cholesterol for half an ounce. We are literally getting warmer, but it seems we can still make a more healthful decision with more beneficial nutrients.

Chocolate. It may seem to be a "hands-off" item for our diet regimen, but let's look at the facts. Chocolate can actually be the healthiest choice for Valentines Day, if we pick the right kind. Studies suggest dark chocolate contains a compound called flavonoids, which comes from plants and have anti-oxidant affects. In some studies, these flavonoids have been found to have a favorable impact on heart disease and may reduce LDL (the bad cholesterol) levels. The caveat is that not all chocolate will have this effect. The darker the chocolate and the higher the percentage of cocoa, the more flavonoids it will have. Milk chocolate also tends to be higher in saturated fat and usually sugar. For dark chocolate splurges in small portions, try 3 pieces of Ghiradelli Dark Chocolate 60 percent Cocoa (11 grams fat, 0 cholesterol, 15 grams carbohydrates, 2 grams fiber, and 1.3 grams protein).

Final recommendation? There is no cheating on Valentine's Day. Make several pieces of high cocoa-content dark chocolate a part of your healthy diet, while getting the benefits of flavonoids on a holiday that puts hearts first.

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