Dr. Josyann Abisaab

Heart Attacks and the Emergency Room

 One of the leading causes of death today is from heart attacks. It is crucial to recognize the symptoms of a heart attack so that prompt action can be taken which can mean the difference between life and death.

• Chest Discomfort: The majority of heart attacks involve discomfort in the center of the chest. The pain or discomfort can last more than a few minutes, or it can come and go away, and then come back again. The discomfort can feel similar to uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in other Upper Body Parts: It is possible to have a heart attack and feel it in one or both arms, in the back, or in the neck, jaw or even in the stomach.

• Shortness of Breath: Can be accompanied with chest pain, but sometimes not. • Other signs include nausea, lightheadedness, or breaking out in a cold sweat.

When having a heart attack every moment counts, so if you or someone you know has any of these symptoms, don’t hesitate to call 9-1-1 and get the help which is needed.

ER Departments Get More Concussion Visits

According to a recent news article, it seems that over the last ten years, there has been an increase of 60 percent of visits to the ER by children experiencing some type of traumatic brain injury (TBI).  Apparently though, this is a good thing.  It has been suggested that it means that there is an increased awareness which results in people taking their kids to the ER, when they suspect they might have a concussion or other TBI.

According to the U.S. Centers for Disease Control and Prevention (CDC), in 2001 there were 153,375 ER visits from children with TBI’s that had occurred during sports or recreation.  In 2009, this figure increased to 248,418.  The results are published in the Morbidity and Mortality Weekly Report, from the CDC.  The main sports that led to TBI’s in these cases were: basketball, cycling, football, playground activities and soccer.

It’s not like there are more cases of TBI these days; it’s just that there is a greater awareness and that is why doctors like Josyann Abisaab MD, Assistant Attending Physician at New York Presbyterian Hospital in New York City, is seeing more of them.  If you’re ever in doubt about a TBI, err on the side of caution and get it checked out as clearly thankfully, more people are doing today.

 

Josyann Abisaab: Emergency Room Treatment of Snakebites

Perhaps not in New York specifically, but as a general problem snakebites are significant in the United States. There are about 7 to 8 thousand bites reported each year, but because of the high quality and readily available medical care in the US, there are only about six deaths per year from snakebites.

The successful rate of treating snakebites is due to a quick medical evaluation, a methodical clinical assessment, and the prompt administration of antivenom to selected patients. According to a study on the management of Crotalinae (rattlesnake, water moccasin or copperhead) bites in the United States, it is highly recommended that a medical toxicologist or other doctor experienced in treating poisonous snakebites be consulted before giving the antivenom. A medical toxicologist is available by phone through a US regional poison control center at 1-800-222-1222.

Some analysts believe that due to the recent earthquake and hurricane on the east coast poisonous snakes are present in greater numbers among people than normal, posing a greater threat than usual. In one county in Maryland there have been three snakebites in the past few weeks, the same number that the county usually has in an entire year.

Josyann Abisaab, MD is an emergency room physician at New York-Presbyterian Hospital.

New York-Presbyterian Center for Emergency Medicine

The department of emergency medicine at the New York-Presbyterian Hospital in Manhattan is one of the busiest emergency rooms in the country. Giving highly expert care to almost a quarter of a million people each year, the department has a reputation for excellence and professionalism.

Of those 250,000, about one fifth are consequently admitted into the hospital for the full treatment that they need.

Josyann Abisaab, as a physician in the emergency room at New York-Presbyterian, she sees the full gamut of issues commonly seen in emergency room settings, the most common of which are: chest pain, abdominal pain, infectious diseases, head trauma and gastrointestinal bleeding.

The emergency room at New York-Presbyterian is an officially designated 911 Ambulance-Receiving Center, offering Level I adult trauma services to patients arriving there.

Asthma Symptoms and Issues: Dr. Josyann Abisaab

Emergency care doctors like Dr. Josyann Abisaab are familiar with asthma and the stress it often causes in parents. Doctors and health care providers suggest preparing for ER visits in advance, as well as becoming familiar with symptoms that require a trip to the hospital.

Some of the more severe symptoms include:

* Changes in lip and/or finger nails colors (to blue or gray)

* Talking difficulties

* A peak flow lower than 50%, which does not improve with medication

* Repeated use of medications for severe, reoccurring flare-up symptoms which take five-ten minutes to eliminate

* The pulling in of the area between and below the ribs, as well as the neck, during inhalation

Josyann Abisaab and the Emergency Room

Getting to the Emergency Room can be somewhat overwhelming. You don’t feel good – or you are with someone you care about who doesn’t feel good – there is a lot of chaos around and it is only natural that panic will ensue. To avoid this – or least reduce its severity – there is some good advice out there which should render your first few moments somewhat easier.

Make sure you give the staff as much information as possible about your current status as well as your medical history and a list of drugs you are using. As well, know your blood type and other such vital information. If you are able to go with someone, ensure they are on the case if you are having difficulty communicating etc. Should you be alone, ask the personnel to contact someone on your behalf as having someone with you will make things much easier and help you relax.

Try to glean as much information from the caretakers as possible. First, this gives you necessary knowledge and second it shows you are engaged and the more you do this, the more attention the physicians will give to your care. Try to find the balance however between being assertive but not too pushy. You are allowed to request that anyone who examines you wash their hands before doing so as infections tend to run very high in hospitals.

They know this so won’t be offended; at times during the craziness of an ER, they may forget.

Josyann Abisaab is an ER physician who currently works at the Columbia Presbyterian Medical Center in New York City and is very accustomed to dealing with such situations.

Josyann Abisaab and Summer Fun Safety

Summer is a great time for potential fun for the whole family.  But unfortunately, as too many hospitals nationwide are witness to, it’s also a haven for potential disaster vis-à-vis the safety element.  Thus it is important to follow some basic rules to ensure you and your family  have a great summer, and keep safe at the same time. 

First, make sure you consume plenty of liquids, even when you are not thirsty.  When you’re exercising, ensure to up your beverage intake to a further 3 glasses.  Choose beverages that do not contain sugar or alcohol as this will simply result in further body fluid loss.  As well, people often make the mistake of going for extremely cold drinks, but this is wrong as they can lead to stomach cramps.  When you are outside, try to only be there during early morning and evening hours.  Avoid dark color and tight-fitting attire and be especially careful with young children and the elderly as they are even more prone to overheating. 

If you are struck with sunburn, be aware that the healing process takes a few days and that the best way to at least alleviate some of the pain is with a pain medication from the pharmacy and by keeping the area moisturized using an aloe based lotion.  You can use cold compresses or try and relax in a cool bath too.  But in general it’s always best to avoid this problem in the first place.

Josyann Abisaab works at the New York-Presbyterian Hospital as an MD in the Emergency Room.

Josyann Abisaab: Irritable Bowel Syndrome-Some Facts

IBS is a Common Problem

It is estimated that about 20 percent of Americans have Irritable Bowel Syndrome, also referred to as IBS. The syndrome is also sometimes called Spastic Colitis, Spastic Colon, Spastic Bowl, or Functional Bowel Syndrome.

Since IBS involves bodily processes which are not properly functioning, this disorder can be placed in the category of illnesses which are known as functional disorders. Discovering the true origin of this problem is notoriously difficult due to the problem of making an accurate diagnosis using normal methods.

Unknown Origin

IBS has not been linked to infections, any inflammation or structural defect. Both x-rays and blood tests do not show the presence of IBS in the patient’s body.

Symptoms of IBS include diarrhea, cramps, pain, and an abundance of gas, bloating and nausea. If a person has these symptoms over a period of time it is recommended that he or she be examined by a physician.

A doctor will try and ascertain whether or not the symptoms do indeed point to IBS by a thorough questioning of the patient, asking questions about eating habits, how long the problem has existed, and getting a complete medical history. If the doctor sees certain patterns he/she might conclude that the cause is IBS.

Some Foods Bad, Others Good

Although foods in and of themselves do not cause IBS, the ingestion of certain foods can exacerbate the symptoms. It is recommended that people with IBS avoid foods like dairy products, chocolate, high-fat foods, alcohol, caffeine and carbonated drinks. Keep a diary of what you eat and how you feel after. This is an excellent way to find out which foods cause the most trouble after eating.

Other foods might actually help to relieve some of symptoms of IBS. Fiber-rich foods such as apples, peaches and other fruits; or vegetables including broccoli and cauliflower can sometimes be quite helpful in reducing the symptoms.

Dr. Josyann Abisaab is an emergency room physician working at New York Presbyterian Hospital.

Josyann Abisaab:Symptoms of Reyes Syndrome

Reyes Syndrome is an illness that can be difficult to diagnose, but unless Reyes is treated early, it can prove to be deadly. As of now, the cause of Reyes Syndrome is not known, but research has deduced a link between Reyes and aspirin and other medications containing salicylate, whether they are prescription, over the counter or topical ointments.

Children Most at Risk

Reyes Syndrome can affect anyone at any age but is most common in children under the age of 18, and particularly dangerous for infants and babies. The illness attacks all the body’s organs, with an especially devastating effect on the liver and brain. Reyes is frequently misdiagnosed and is often mistaken as encephalitis, meningitis, diabetes, drug overdose, poisoning, Sudden Infant Death Syndrome, or a psychiatric disorder.

Prevalent in Winter

The most common months for Reyes to appear are January through March, the months when the flu is most frequent. This is because Reyes is also associated with the patient just recovering from a previous infection, like a cold, the flu or chicken pox. When the flu or chicken pox strikes in epidemic numbers, there is also a spike in the number of cases of Reyes syndrome. Because there is also a connection between Reyes and treatment with aspirin, aspirin should always be avoided during viral infections, and a substitute pain and fever reducer should be used instead.

Early Diagnoses Crucial

When Reyes syndrome is diagnosed early and treated quickly, the chances of a complete recovery are high. It is important therefore, to be diligent when recovering from a viral illness and be on the lookout for symptoms of Reyes Syndrome. If you believe there is a chance of the patient having Reyes, then go to the emergency room, where physicians such as Dr. Josyann Abisaab will diagnose and treat the illness.

Symptoms in the Stages of Reyes Syndrome:

Stage I

•    Persistent or continuous vomiting
•    Signs of brain dysfunction:
•    Listlessness
•    Loss of pep and energy
•    Drowsiness

Stage II

•    Personality changes:
•    Irritability
•    Aggressive behavior
•    Disorientation:
•    Confusion
•    Irrational behavior
•    Combative
•    Delirium, convulsions, coma

Lebanese Society for Emergency Medicine: Fourth Annual Conference

The Lebanese Society for Emergency Medicine held its fourth annual conference at Beit Al Tabib in Beirut, Lebanon, last month. The conference brought together like-minded medical professionals from a range of places, including Dr. Josyann Abisaab, who came from New York to attend the conference. Dr. Abisaab was also a member of two committees, the Scientific Committee and the Organizational Committee. The well-attended conference provided an opportunity for members of the emergency medicine field to discuss relevant issues, including trauma, emergency diagnostic techniques, and burn treatments. One full day of the conference was devoted to issues related to pediatric emergency medicine, including head trauma, pain management, pediatric septic shock, infant fevers, pediatric respiratory illness, pediatric triage, and considerations in pediatric oncologic emergencies.

TypePad Conversations » Answer this question!