27 Incontrovertible Health Tips

A Prescription For Health



Illustrations by Sophie Blackall

So many things can run afoul in the human body, you might be tempted to leave your health to fate. After all, you’re stuck with the genes you’re born with. But here’s startling news: you are in the driver’s seat, my friend.

“About half of all deaths, including heart disease and cancer deaths, are preventable,” says Westchester County Health Commissioner Joshua Lipsman, MD. “And the preventable deaths are associated with tobacco, diet, and exercise.”

In Westchester alone, the two top killers—heart , disease and cancer—accounted for 67 percent of all deaths in 2005, according to the most recent statistics reported by the county health department. What’s more, a county survey finds that one in three of our children is overweight, putting kids at heightened risk for obesity, diabetes, and hypertension in adulthood.

Beyond the human toll, the cost of treating chronic health conditions that could have been prevented in the first place is staggering. A study in the health policy
journal Health Affairs pegs the cost of Americans’ bad habits at $100 billion to $150 billion a year.

Lower obesity rates alone could avoid $60 billion in annual treatment costs, says the Milken Institute, a nonprofit think tank based in Santa Monica, California.

We wanted to know what we can be doing to ward off the ravages of disease, to better manage health problems, and to look and feel healthier. So we asked physicians and other top health professionals across Westchester to weigh in. What follows are their best health tips.

But first a word of caution from Dr. Lipsman: “Don’t try to change everything at once.” Better to take baby steps—one fewer cigarette and one smaller scoop of mashed potatoes at a time—because small changes are easier to make, and you’re more likely to succeed. Plus, over time, they add up.

a plate of salmon   1. Fuel Your Mind


Omega-3 fatty acids, the healthy fat found in fish, seafood, and supplements, aren’t just heart-healthy—they’re brain food. The human brain is 60 percent fat, and these essential fatty acids make up an important part of the membrane surrounding human brain cells, says Alan C. Logan, author of The Brain Diet: The Connection Between Nutrition, Mental Health, and Intelligence. “Without adequate intake, the brain cells become rigid and less flexible, which in turn compromises normal communication within and between brain cells,” he says. Studies show that nations around the world whose populations consume the greatest amounts of fish and seafood have the lowest rates of depression. While these studies don’t prove a cause-and-effect link, small clinical studies involving humans are beginning to demonstrate the mental health benefits of fish oil. Following a review of the evidence, a subcommittee of the American Psychiatric Association in 2006 recommended that all adults eat fish two or more times a week. People with mood, impulse control, or psychotic disorders should consume one to two grams of two kinds of omega-3 fatty acids, known as EPA and DHA, it said. If your goal is to maintain a positive mood and boost your resiliency to stress, omega-3 fatty acids can help, says Logan, who facilitates stress-management courses at White Plains Hospital. “In a stressful world with ever-increasing demands, any extra edge is a valuable commodity.”

2. Get a Memory Test


Forget where you left your keys? A momentary lapse doesn’t necessarily signal trouble. On the other hand, you may be experiencing a side effect of a medicine you’re taking. Or, worse, it could be a sign of cognitive decline. As we age, we may become slower learners or need new information to be repeated. These changes are a normal part of aging, according to the Centers for Disease Control and Prevention. Senility and forgetfulness, however, are not normal. Yet one in four older adults will experience these kinds of lapses, signaling a higher risk for dementia later in life. Instead of worrying about it, put your mind at ease and get a memory evaluation, suggests Gary Gibson, a research scientist at Burke Medical Research Institute in White Plains. While there’s no cure for dementia or its most common form, Alzheimer’s Disease, there are treatments that may help with cognitive and behavioral symptoms. As for preventing or slowing mental decline, some people swear by brain games, like crossword and Sudoku puzzles. Others suggest exercise or antioxidants to ward off mental decline. But nothing is proven to work, Gibson says.

3. Mix It Up


Not exercising can do more harm to your health in the long run, according to the National Institute on Aging. The good news: it’s never too late to shape up, Still, you don’t want to overwhelm your joints. To prevent injury and spice up your fitness regimen, try cross training. The American Academy of Orthopedic Surgeons describes cross training as an ideal way to develop a “balanced” fitness program, one that incorporates aerobics for cardiovascular health, strength training for muscle mass, and flexibility exercises to stay limber. If you’re a runner, try biking or swimming a few times a week, suggests George Burak, MD, an orthopedic surgeon at Phelps Memorial Hospital Center in Sleepy Hollow. “By doing that, you don’t overstress the knees and hips and you prevent the development of arthritis, which ultimately will lead to knee and hip replacements,” he says.

4. Put a Captain in Charge


You wouldn’t take flight without a pilot navigating the way. Why would you leave your medical care in limbo? Every adult should establish a healthcare relationship with a primary-care physician, says Barney Newman, MD, medical director of the Westchester Medical Group in White Plains. “This relationship serves as a patient’s entry into the healthcare system and his or her medical-care home.” Studies show that patients with primary-care physicians are more likely to receive preventive services, have better management of chronic diseases, fewer hospitalizations, and are more satisfied with their care, he reports. Yet a study published last year in the British Medical Journal finds that the average American spends just 30 minutes a year with a primary-care physician, about half the average of New Zealanders and one-third of Australians. “Having a personal physician as captain of your healthcare team increases your chances of getting the best answers to questions you have regarding your health, treatment, and medications,” Dr. Newman says. “He or she is also an excellent source of referral to specialists if you need them.”

scene of Leave it to Beaver family saying grace5. Leave It to Beaver


Back in the day, mothers shooed their kids outside to play. At dinnertime, the whole family gathered around the table for a home-cooked meal--veggies and all. Ah, the good ol’ days! Nutritionists like Linda Arpino, who practices in Rye Brook and Scarsdale, worry that our stressful, sedentary, eat-on-the-run lifestyle is damaging our bodies, setting us up for depression and chronic disease. “Too many of the patients I see are grabbing fast food, have overscheduled lives, and make no time to enjoy sports, physical activity, and personal time,” she says. Stress plays at least some role in weight gain. Last year, an international team of scientists, funded in part by the National Heart, Lung, and Blood Institute, found that mice under chronic stress gained more belly fat on a comfort-food diet--high in fat and sugar--compared with mice on a normal diet. Arpino advises patients to plan ahead for meals and exercise, and to take time out from life’s daily pressures. We’re sure Mom would approve!

6. Go to Bed Angry


angry coupleIt turns out the old adage, “Never go to bed angry,” is not productive advice for the health of a marriage. Renowned marital researcher John Gottman of the University of Washington in Seattle showed when a person’s heart rate exceeds 100 beats per minute, adrenaline kicks in and the ability to engage in civil conflict resolution is undermined. Couples who are steamed are more apt to lash out at one another, using phases like, “You always…” or “You never…,” says Jim Walkup, a marriage counselor for the Counseling Center in Bronxville. “Normal reasoning goes out the window.” Dr. Walkup recommends a cooling-off period before returning to the discussion. Take a timeout—go for a walk, take a bath, go to bed—anything that helps you “become disconnected” from going over and over the hurtful thing your partner had the audacity to say to you, he says.

7. Know Your Numbers


Need to get a grip on your blood sugar? A fasting-blood glucose test will reveal the amount of glucose, or sugar, in your blood. This blood test usually is performed after fasting eight or more hours or overnight. You want the number to be below 100 milligrams per deciliter (mg/dL). If it’s between 101 and 125 mg/dL, you may have “pre-diabetes,” a precursor to this metabolic disease. A fasting glucose level higher than 125 mg/dL signals diabetes, meaning your body isn’t making enough insulin—the hormone responsible for helping the body use and store glucose—or the cells of your body have become resistant to insulin. Having this information enables people to begin making wise choices about diet, exercise, and better glucose control, says David K. Bloomgarden, MD, an endocrinologist with the Westchester Medical Group in White Plains. “The scientific literature has clearly demonstrated that with better blood-glucose control, one can prevent or forestall many of the so-called dread complications of diabetes,” he explains.

8. Share Your Story


In the popular Sci-fi series Star Trek, Dr. McCoy deployed a high-tech scanner to peer within a patient’s body and make the diagnosis. It doesn’t really work like that in real life. Roughly 80 to 90 percent of diagnoses are based on a patient’s history, says Daniel Miller, MD, assistant professor of family medicine at New York Medical College’s family practice resident program at St. Joseph’s Medical Center in Yonkers. Blood draws, diagnostic images, and other medical tests are used to confirm diagnoses, not make them, he says. Studies show that physicians who do a better job of obtaining patients’ histories also render better diagnoses and treatment. But Dr. Miller fears the conversation is being cut short. “Due to changes in the financing of medicine, doctors are spending less and less time with patients,” he says. In one well-known study, physicians interrupted their patients after just 18 seconds. Patients need to think about what’s troubling them before going to see the doctor, Dr. Miller says. If your doctor doesn’t value your perspective, Dr. Miller cautions, “I suggest you find somebody who does.”

illustration of family exercising9. Sweat with Your Sister


Richard A. Noto, MD, chief of pediatrics at New York Medical College and director of pediatrics at Maria Fareri Children’s Hospital in Valhalla, sees a lot of overweight kids. Research shows overweight children are at greater risk of becoming overweight or obese adults, and they’re more likely to suffer from heart disease and diabetes. Instead of singling out a child, Dr. Noto targets the family. He advises Mom, Dad, child, and siblings engage in a half hour of physical activity each day (and riding the treadmill while watching the widescreen counts!) If a parent or child fails to meet that goal? No TV or computer time. What do families think of his stringent fat-busting recipe? “They like it,” he says.

10. Learn Self-Hypnosishypnosis illustration


Managing stress, coping with discomfort, or motivating yourself to take on a challenge may be as simple as harnessing the power of your mind. Wendy Packer, a certified hypnotist and registered nurse who practices in New Rochelle, became convinced of this after working with her mother, who experienced extreme sensitivity to touch and pressure at the site of her bypass surgery incision. Packer’s mom visualized a numbered dial, with being the most uncomfortable and one the least uncomfortable. “So when she hypnotized herself, she would actually see herself lowering her discomfort level by lowering the dial and doing something that she enjoyed, which distracted her from thinking about her discomfort,” Packer says. Using thoughts to influence beliefs and, in turn, improve physical symptoms is a key element. She cautions, however, that self-hypnosis is an adjunct to mainstream medicine and should not be used to eliminate pain, because pain is a symptom requiring medical intervention. Still, scientific literature supports self-hypnosis as a tool for self-improvement and better overall well-being, she says.

11. Lose the Jimmy Choos


Flip-flops and four-inch heels may be fashion-forward, but they’re not very kind to aging feet. Improper footwear can set you up for falls and pressure sores, says Michael Giannone, DPM, of Mount Kisco Podiatry. “As we get older, we should start wearing a flatter shoe, a lower shoe, or a sneaker-type shoe. You get better balance standing in that.” Dr. Giannone also sees a lot of people with diabetes who develop “neuropathy” in their feet, robbing them of the sensation of pain. He advises checking feet—and shoes—daily. Recently, a patient developed a pressure sore because he hadn’t noticed a baby’s “binky” stuck in the tip of his shoe.

12. Brush Off Pricey Toothpaste


If you’re spending top dollar for toothpaste with tartar control plus whitening, you could be rinsing money down the drain. “Not only don’t they work, they don’t work better than any other toothpaste and, in general, they’re more abrasive,” cautions Michael Teitelbaum, DMD, with the Briarcliff Dentist Spa in Briarcliff Manor. In fact, regular use can cause tooth wear and make teeth more sensitive, he says. In a test of 41 whitening toothpastes, Consumer Reports found no correlation between toothpastes’ claims of whiter, brighter teeth and their ability to remove stains. While none of the products was deemed excessively abrasive, the consumer products testing outfit recom­mended that people with sensitive teeth or those at risk for tooth or gum erosion consider a gentler product. Any regular toothpaste with the American Dental Association Seal of Acceptance, indicating the product is safe and effective, will do the job, Dr. Teitelbaum says.

tick13. Go on a Nature Walk


Don’t let tick-bite paranoia spoil your outdoor fun. Sure, Westchester is a hot spot for Lyme disease. But if you get a tick bite, don’t panic. Studies show it takes 24 to 36 hours for the disease to be transmitted. “The most important fact about Lyme disease is that, if you remove the tick within twenty-four hours, you cannot get Lyme disease, period,” assures David Goldberg, MD, an infectious-disease expert with the Scarsdale Medical Group. If you’ve been outdoors during tick season, simply do a thorough tick-check in the evening. To remove a tick, use tweezers and grab it by the head, not the body. “People should feel free to enjoy golfing, gardening, a walk in the woods,” Dr. Goldberg says.

14. Clean Your Teethteeth cleaning implements


Visited the dentist lately? Regular cleanings—at least twice a year—along with daily flossing or use of a Waterpik can help avoid gum disease. And, says Dr. Michael Teitelbaum, DMD, of the Briarcliff Center for Esthetic Dentistry in Briarcliff Manor, this regimen may prevent heart disease and stroke. The
exact relationship between periodontal disease and heart problems isn’t clear, but it’s believed that bacteria from diseased gums travel through the bloodstream to other parts of the body. Bacteria “roughen up” the arteries, allowing fatty plaques to accumulate, Dr. Teitelbaum explains, which can result in reduced or blocked blood flow to the heart or brain. In addition, a Harvard Medical School study suggests people with gum disease face an increased risk of pancreatic cancer. The bottom line? Call your dentist for an appointment and pick up a new dispenser of dental floss on your way home.

15. Nix Nanoparticle Sunscreens


For years, sunscreens have contained zinc oxide and titanium dioxide. These metal oxides scatter sunlight, including harmful UV rays, and give sunscreens their milky white appearance. In recent years, manufacturers have begun using “nanotechnology” to shrink the size of these metallic crystals, making sunscreens transparent. But are these concoctions safe? Some people are worried: New Rochelle’s Alan M. Dattner, MD, a holistic dermatologist, is among them. Although there have been no studies in humans, he cites test-tube and animal experiments suggesting that “nanoparticles” of titanium can be toxic to cells. His fear is they could penetrate the nucleus of cells in our bodies, altering the DNA and posing a cancer risk. Friends of the Earth, a Washington, DC-based advocacy group, has called for a moratorium on personal-care products that contain engineered nanomaterials. If you’re concerned, there’s an easy fix: don’t buy clear sunscreens.

two women drinking milk16. Do Vitamin D


Calcium isn’t the only bone builder. You also need vitamin D, and the good news is we make the vitamin ourselves when our skin is exposed to the sun’s ultraviolet rays. But here’s the problem. “Westchester County is located too far north for the sun to provide enough vitamin D much of the year, and using sunscreen blocks it out completely,” says Susan S. Blum, MD, founder and director of the Center for Nutritional Medicine in White Plains. Vitamin D also is found in some fortified foods, as well as in milk and other dairy products, but if you’re avoiding dairy for dietary reasons, you could be coming up short. “I have found that at least half of my patients are deficient,” Dr. Blum reports. Low vitamin D levels are linked to numerous health problems, from depression and osteoporosis to certain cancers and autoimmune disorders. Have your doctor check your vitamin D levels and recommend the amount of supplementation you require, Dr. Blum advises.

17. Treat Your Gut to Yogurtyogurt with berries


Fiber is a commonly recommended fix for constipation. But there’s increasing evidence that having a daily cup of fresh, plain yogurt or a nutritional supplement containing beneficial bacteria can keep you regular, too. “It supplements the normal flora of your GI tract, allowing you to digest your food better,” explains Robert Antonelle, MD, a White Plains gastroenterologist. Yogurt is a probiotic, meaning it contains bacteria that help maintain the natural balance of organisms in your intestines. Some evidence suggests it is helpful for managing irritable bowel syndrome, a condition that can cause abdominal pain, bloating, gas and constipation, and/or diarrhea. “It’s actually one of the first lines I use for treating patients with irritable bowel syndrome,” he says. Yogurt also has been shown to be helpful in treating and preventing diarrhea caused by antibiotic use.

illustration of a thumb with a giant blackberry on it18. ALL KEYED UP


Americans’ love affair with handheld electronic devices has given rise to “BlackBerry thumb,” a repetitive stress injury that causes pain and numbness in the thumb and hand joints. Constantly composing emails, text messaging, and accessing the Internet on small keyboards can lead to nerve or muscle damage, explains Joseph Cole, MD, a physical medicine and rehabilitation specialist at the Westchester Medical Group’s Rye office. The number of patients’ complaints is bound to swell as people insist on using these devices for prolonged periods and in awkward positions, says the American Physical Therapy Association. “If you are a frequent user of a BlackBerry or other personal digital assistant, you should take immediate steps to prevent injury,” Dr. Cole advises. Use shortcut keys, for example, to reduce the need for scrolling. Instead of typing the same things over and over, take advantage of the “AutoText” feature, and answer low-priority e-mails from a computer. Dr. Cole recommends keeping hands and fingers loose while typing and taking frequent breaks. “Don’t type for more than five minutes on your PDA at one time,” he says.

19. Hear Me Out


Do you or a loved one say “What?” all the time? “If you’re not hearing words clearly, that’s an initial sign of hearing loss,” says Robert A Cohen, AuD, of Sprain Brook Audiology in Scarsdale. Some 28 million Americans have hearing loss, the Hearing Loss Association of America reports. “Sensorineural” hearing loss, the most common type, involves damage to the tiny hair cells of the inner ear. Causes include disease, aging, viral and bacterial infections, heredity, trauma due to loud noises, and exposure to powerful antibiotics or chemotherapy. Scientists are exploring ways to restore hearing using gene therapy, stem cells, and techniques to regenerate and protect hair cells. While a cure could be a decade or more away, that’s no reason to live in a communications void. Many people can benefit from hearing aids, assistive listening devices, or cochlear implants. Dr. Cohen urges people to have their hearing evaluated, and not just for the sake of understanding conversation. “The implications of hearing loss far exceed hearing problems,” he says. Untreated hearing loss can be isolating, leading to anxiety and depression, the American Speech-Language-Hearing Association maintains.

20. Listen to Your Legs


If you experience leg pain when you walk or exercise, consider this a wake-up call. According to the American Heart Association, some 12 million Americans have peripheral artery disease (PAD), a blockage of the arteries that supply the legs with blood. The problem often is mistaken for arthritis, says Sateesh C. Babu, MD, co-chief of vascular surgery at Westchester Medical Center in Valhalla. But the symptoms are completely opposite. PAD sufferers typically experience fatigue or cramping in their legs with activity but not when they rest. People with arthritis, by contrast, are stiff and sore in the morning but improve throughout the day as they move and their joints become lubricated. Often, people with PAD stop walking and exercising, exacerbating the problem. At worst, it can lead to amputation. To stimulate circulation, Dr. Babu advises patients to walk a bit, rest, and walk again. The risk factors for PAD are the same as those for heart disease, including smoking, high cholesterol, diabetes, and hypertension. But many patients will improve with lifestyle changes, medications, or both.

bottle of pills21. Break the Cycle of Pain


Don’t keep popping over-the-counter pain relievers to treat recurring, nagging headaches. Get an accurate diagnosis because the pain could be migraine, says Bronxville neurologist Ronald Silverman, MD. Taking too many over-the-counter medications can lead to more frequent headaches, a condition known as “transformed migraine,” he warns. With better diagnosis and reporting of this neurological disease, the number of cases in the population has risen 60 percent over the last decade, reports MAGNUM, a public-education organization for migraine awareness. Migraine sufferers need to approach their headaches differently than those with “tension” or “sinus” headaches, says Dr. Silverman. “Getting enough sleep, hydrating properly, exercising, avoiding excess caffeine, and avoiding overuse of over-the-counter medications can frequently be very helpful,” he says.

22. Work Up to Your Workout


Beginning a new sport or exercise program? Don’t pull a Bruce Jenner or Florence Griffith Joyner on day one. You’ll be setting yourself up for trouble. Overuse injuries, including stress fractures and tendon injuries, frequently occur when people first begin a sport or activity and try to do too much too soon. A runner, for example, may log several miles three times a week without a problem. But when he or she begins putting in longer distances at a faster pace in training for a marathon, injury can result, according to the American Orthopaedic Society for Sports Medicine. “I implore people to initiate activity at a very low level of impact and low level of aerobic stress,” says Howard J. Luks, MD, chief of Sports Medicine and Arthroscopy at University Orthopaedics in Hawthorne. Starting at a low level of intensity and building up over the following weeks and months can minimize the risk of injury, he says. Recent evidence suggests exercising, within reason, when injured is okay, too, and might actually aid in the healing process, Dr. Luks adds. When in doubt about the frequency, intensity, or duration of your exercise program, consult a physician.

tomato on fork23. Dawdle Over Dinner


For decades, health experts have advised us to eat slowly and enjoy food. But does a leisurely pace really matter when it comes to weight control? Until recently, the data had been mixed. But researchers at the University of Rhode Island who’ve studied the question are finding that the age-old advice may be true. In one study, women who paused between bites and spent more time chewing their food consumed fewer calories and had a greater sense of fullness after finishing a meal and during the 90 minutes afterwards. “It takes the brain about ten to fifteen minutes to receive the neuro-hormonal signal from the stomach that you are full after eating,” says Michael S. Wein, MD, an internist in the Mount Kisco Medical Group’s Katonah office. “So, many people will keep eating long after their stomach is full. If you eat slowly, you will enjoy your food more and will give the brain the time it needs to get the signal from your stomach to stop eating.” He adds: “I suggest that patients serve themselves half the size portion that they would usually serve and eat it slowly. Then wait ten minutes. If you are still hungry, then serve the second portion.”

24. Bone Up on Grandma’s Genesilliustation of a grandmother knitting


Did Mom have endometrial cancer? Does heart disease wreak havoc among your father’s kin? People need to know what diseases affect family members and at what ages these diseases occur, says Susan Klugman, MD, of Montefiore Medical Center’s Womens’ Center in Larchmont and director of the Reproductive Genetics Division of Montefiore Medical Center. You can’t change your genes, but you can take steps to reduce your risk factors. “Diabetes, hypertension, stroke, and asthma are all influenced by genetics and environment,” she explains. Yet only one-third of Americans have ever tried to gather and record their family’s health history, according to the U.S. Surgeon General’s office. As a specialist in reproductive genetics, Dr. Klugman sees patients before and during pregnancy whose family members have been affected by very rare disorders. “We are able to counsel them and offer them testing options for current and future pregnancies,” she says. She also counsels patients with or at risk of reproductive cancers. Today, for example, genetic testing may be used to determine if a woman has an abnormal “BRCA 1” or “BRCA2” gene. Women who have these mutations have up to an 85-percent risk of developing breast cancer in their lifetime and are at increased risk of developing ovarian cancer, according to the National Cancer Institute.

25. Take Your Brain to the Gym


If you have depression but experience unpleasant side effects from pills or don’t want to take prescription medicines, there are non-pharmaceutical alternatives. Deborah Schuessler, a White Plains psychologist, uses neurofeedback to help people learn to control their brain activity. While hooked up to electrodes, a patient plays a video game harnessing his or her own brain waves to make things happen. (There are no hand controls.) One activity mimics the classic arcade game Pac-Man, in which the goal is to move a character through a maze and eat up dots. Although there are no double-blind, controlled studies of neurofeedback for depression, the technique is considered promising, according to a report published last year in an the Handbook of Neurofeedback. “We know that, in depression, there tends to be under-activation in the left frontal part of the brain, so I would apply an electrode there and I would reward the person for producing brain waves in a certain frequency range in that part of his or her brain,” Schuessler explains. “You’re working your brain out in a way so that it just becomes more flexible and more regulated on its own.” The result? If being treated for depression, “most people find that it helps them feel more energized, more activated, more on top of things. They’re able to think more clearly, so it really counteracts a lot of the symptoms of depression.”

26. “Gard” Against a Deadly Cancer


Should you have your daughter vaccinated against the human papilloma virus (HPV)? In 2006, the U.S. Food and Drug Administration approved Gardasil, the first vaccine to target this sexually transmitted disease. HPV can lead to cervical cancer—the second leading cause of cancer death in women. While some critics initially raised concern that the vaccine would promote promiscuity, physicians by and large see it as potentially lifesaving. “Vaccinating against HPV can add another ‘safety net’ of protection for women,” says Mark H. Einstein, MD, of Montefiore Medical Center’s Department of Obstetrics & Gynecology and Women’s Health. In multinational studies, the vaccine was shown to be safe and effective. Although four deaths have been reported in women who have had the vaccine, the Centers for Disease Control and Prevention says none of the deaths appear to have been caused by vaccination. “As a gynecologic oncologist, I would be very happy to never have to see another patient suffer from cervical cancer again,” Dr. Einstein says.

27. Don’t Blow Off a Cough


A persistent cough is a nuisance, but do you really need to see a doctor? The answer is an unequivocal yes. Under guidelines issued by the American College of Chest Physicians (ACCP), a “chronic cough” is one that lasts more than eight weeks. While an occasional cough is normal, excessive coughing is not. “Chronic cough could be a sign of asthma,” says Mamaroneck allergist Kira Geraci, MD. Asthma is a serious and potentially life-threatening condition, yet many parents of children with asthma fail to recognize cough as a symptom. Asthma should always be considered as a potential cause of chronic cough, the ACCP advises physicians. If you don’t know your child has asthma, know what to look for, Dr. Geraci adds. “You shouldn’t be ignoring a cough in a child who has asthma or wheezing; you shouldn’t be waiting for noises or distress,” she says. “That’s way too late.”

Karen Pallarito, a freelance writer in Port Chester, has covered healthcare for more than two decades.