Dr. Josyann Abisaab

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.

 

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 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: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

Abdominal Pain and Emergency Room Visits

As an emergency room physician, Dr. Josyann Abisaab treats many people for abdominal pain. About 5% of all visits to the emergency room are due to abdominal pain. The emergency room doctor discharges the vast majority of these patients after examination. In about 10% of cases is emergency surgery required for patients complaining of abdominal pain who visit the emergency room.

Emergency Room Diversity

The extraordinary reality of the emergency room is the sheer diversity of the types of patients who come, the symptoms they present, and the illnesses that are diagnosed. ER doctors, like Dr. Josyann Abisaab, must be trained to assess, diagnose and treat a vast range of conditions. These include: Car accidents, sports injuries, broken bones, burns, bleeding, chest pain, heart attacks, breathing difficulties, strokes, sudden loss of vision or hearing, fainting and unconsciousness, drug overdoses, severe allergy attacks, high fevers, food poisoning, and psychological dysfunction.

Understanding the complex nature of the emergency room can help people to correctly identify when, and when not, to visit the emergency room, and to appreciate the immense responsibility the ER team must demonstrate in treating each incoming patient.
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Head Injuries and the ER

Many people are not sure when a visit to the ER is necessary. Some people are more inclined to play it safe and go regardless of the severity of the condition, while others prefer to wait things out. ER doctors such as Dr. Josyann Abisaab stress that it is important for people to be familiar with different levels of emergency, to avoid unnecessary visits or lack of necessary care.

Head injuries are common in sports. Parents often see their children take a blow to the head, and then get up and continue playing. They may even sit out for a few minutes. It is important to understand that concussions are a type of brain trauma, and they do not always result in unconsciousness. While an ER visit is not always necessary, it is important that you take the hit seriously and pay attention to any changes in the child’s demeanor. Sudden drowsiness, vomiting, uneven pupil dilation and even a split second of unconsciousness are probably signs of a concussion. Consult a doctor before making the trip, if you’d like, but don’t brush the occurrence off. Also, if a laceration occurred at the time of the blow, the child should definitely be examined.

Emergency Eye Care: Dr. Josyann Abisaab

Most of us are fortunate enough to have healthy eyes. We don’t pay a great deal of attention to our eyes and we don’t think about issues that might occur.  However, eye emergencies are quite common, with nearly 2 million people in the United States seeking care in any given year for eye trauma.  Eye trauma is the number one cause of vision loss in people who are under 25, according to the Illinois Eye and Ear Infirmary.  Eye trauma may be due to an object penetrating the eye, to chemical injury, and to other issues.

Along with trauma, it’s important to know about other eye emergencies that might cause you to visit your primary care physician or to make your way to the emergency room for care from doctors like Dr. Josyann Abisaab.

If you experience a sudden loss of vision, either with or without pain, you should certainly seek assistance.  Sudden vision loss can be due to stroke, vitreous hemorrhage, bleeding into the clear gel in the center of the eye, inflammation of the blood vessels and more.  If you experience flashes of light or large amounts of specks that seem to appear in front of the eye, you also need to seek help.  These can be retinal tears or detachments.

Diagnosing and Treating Lyme Disease: Dr. Josyann Abisaab

Lyme disease diagnosis can be very difficult, and emergency room doctors like Dr. Josyann Abisaab will often have to use their own discretion and skills to deem if Lyme disease testing is necessary.  Certainly, if a patient exhibits symptoms of Lyme disease, shows physical signs like the bulls-eye rash, or has a recent history of a tick bite, the doctor will do testing to see if it’s Lyme disease. The problem is that many patients don’t remember getting a tick bite and they don’t show symptoms that are easily recognizable as Lyme disease symptoms.

When Lyme disease testing is done, an ELISA (enzyme-linked immunoassay) or IFA (immunofluorescent assay) antibody test is usually done first. If one of these tests is positive, then a Western blot test for IgM and/or IgG Lyme disease antibodies is performed.

Treatment for Lyme disease usually includes antibiotics. The type of antibiotic and the length of treatment will depend on the length of time that patient has had Lyme disease and the severity of the situation.

Diabetic Heat Issues: Dr. Josyann Abisaab

Emergency room doctors, like Dr. Josyann Abisaab, see an increased number of emergency room visits in the summer months from diabetics.  Researchers have found that diabetics show an increased frequency of emergency room visits, hospitalizations and even deaths due to heat illness during the hottest times of the year.  There are a number of reasons for this trend, many of which are addressed in this informative article.

Certainly, for anyone with diabetes, and for those treating them, it is essential to understand how heat influences and impacts diabetes.