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*TROPICAL STORM ISAIAS MOVING NORTHWARD ALONG THE EAST COAST* This product covers Southeast New York, Northeast New Jersey, and Southern Connecticut ***TROPICAL STORM ISAIAS MOVING NORTHWARD ALONG THE EAST COAST*** NEW INFORMATION --------------- * CHANGES TO WATCHES AND WARNINGS: - A Tropical Storm Watch has been issued for Orange and Putnam - The Tropical Storm Watch has been upgraded to a Tropical Storm Warning for Bronx, Eastern Bergen, Eastern Essex, Eastern Passaic, Eastern Union, Hudson, Kings (Brooklyn), New York (Manhattan), Northeastern Suffolk, Northern Nassau, Northern Queens, Northwestern Suffolk, Richmond (Staten Island), Southeastern Suffolk, Southern Fairfield, Southern Middlesex, Southern Nassau, Southern New Haven, Southern New London, Southern Queens, Southern Westchester, Southwestern Suffolk, Western Bergen, Western Essex, and Western Union * CURRENT WATCHES AND WARNINGS: - A Tropical Storm Warning is in effect for Bronx, Eastern Bergen, Eastern Essex, Eastern Passaic, Eastern Union, Hudson, Kings (Brooklyn), New York (Manhattan), Northeastern Suffolk, Northern Nassau, Northern Queens, Northwestern Suffolk, Richmond (Staten Island), Southeastern Suffolk, Southern Fairfield, Southern Middlesex, Southern Nassau, Southern New Haven, Southern New London, Southern Queens, Southern Westchester, Southwestern Suffolk, Western Bergen, Western Essex, and Western Union - A Tropical Storm Watch is in effect for Northern Fairfield, Northern Middlesex, Northern New Haven, Northern New London, Northern Westchester, Orange, Putnam, Rockland, and Western Passaic * STORM INFORMATION: - About 830 miles south-southwest of New York City NY or about 900 miles south-southwest of Montauk Point NY - 29.7N 79.9W - Storm Intensity 70 mph - Movement North or 355 degrees at 9 mph SITUATION OVERVIEW ------------------ Tropical Storm Isaias, located off the north Florida coast, will continue to move to the north this morning, turning north-northeast this afternoon along the southeast coast. Isaias will continue moving northeast tonight over Eastern North Carolina. Isaias will slowly weaken as it accelerates northeast on Tuesday, likely moving over our area Tuesday afternoon and evening. There is still some timing and intensity uncertainty with this storm. However, confidence continues to increase with respect to the magnitude of local hazards and impacts. The main threats with this system involve heavy rainfall, strong winds, minor to moderate coastal flooding, along with high surf and dangerous rip currents. Locally heavy rain is expected with a widespread 2 to 4 inches, with localized amounts up to 6 inches possible. The heaviest rain is most likely to occur across New York City, Northeast New Jersey and the Lower Hudson Valley early Tuesday morning through Tuesday evening, and eastern sections Tuesday afternoon into Tuesday night. The strongest winds are likely to occur across Long Island, coastal Connecticut, and the New York City Metro. Dangerous marine conditions are likely across all of the coastal waters Tuesday and Tuesday night. High surf and dangerous rip currents are expected along the ocean beaches Monday through Wednesday. The effects from Tropical Storm Isaias are expected to diminish quickly from southwest to northeast across the area Tuesday night into Wednesday morning. POTENTIAL IMPACTS ----------------- * FLOODING RAIN: Protect against life-threatening rainfall flooding having possible extensive impacts across northeastern New Jersey, New York City, and the Lower Hudson Valley. Potential impacts include: - Major rainfall flooding may prompt many evacuations and rescues. - Rivers and streams may rapidly overflow their banks in multiple places. Small streams, creeks, canals, and ditches may become dangerous rivers. Flood control systems and barriers may become stressed. - In hilly terrain, destructive runoff may run quickly down valleys, and increase susceptibility to rockslides and mudslides. - Flood waters can enter many structures within multiple communities, some structures becoming uninhabitable or washed away. Many places where flood waters may cover escape routes. Streets and parking lots become rivers of moving water with underpasses submerged. Driving conditions become dangerous. Many road and bridge closures with some weakened or washed out. * WIND: Protect against dangerous wind having possible significant impacts across Southeast New York, Northeast New Jersey, and Southern Connecticut. Potential impacts include: - Some damage to roofing and siding materials, along with damage to porches, awnings, carports, and sheds. A few buildings experiencing window, door, and garage door failures. Mobile homes damaged, especially if unanchored. Unsecured lightweight objects become dangerous projectiles. - Several large trees snapped or uprooted, but with greater numbers in places where trees are shallow rooted. Several fences and roadway signs blown over. - Some roads impassable from large debris, and more within urban or heavily wooded places. A few bridges, causeways, and access routes impassable. - Scattered power and communications outages, but more prevalent in areas with above ground lines. * SURGE: Protect against locally hazardous surge having possible limited impacts across shoreline communities. Potential impacts in this area include: - There is potential for widespread minor to locally moderate coastal flooding across the Lower New York Harbor and South Shore Back Bays, with localized minor flooding impacts elsewhere. - Localized inundation with storm surge flooding mainly along immediate shorelines and in low lying spots. - Sections of near shore roads and parking lots become overspread with surge water. Driving conditions dangerous in places where surge water covers the road. - Moderate beach erosion. Heavy surf also breaching dunes, mainly in usually vulnerable locations. Strong and frequent rip currents. - Minor to locally moderate damage to marinas, docks, boardwalks, and piers. A few small craft broken away from moorings. * TORNADOES: Protect against a tornado event having possible limited impacts across Southeast New York, Northeast New Jersey, and Southern Connecticut. Potential impacts include: - The occurrence of isolated tornadoes can hinder the execution of emergency plans during tropical events. - A few places may experience tornado damage, along with power and communications disruptions. - Locations could realize roofs peeled off buildings, chimneys toppled, mobile homes pushed off foundations or overturned, large tree tops and branches snapped off, shallow rooted trees knocked over, moving vehicles blown off roads, and small boats pulled from moorings.

Why Do Doctors Still Order PremPro Even With Negative Studies on Synthetic Estrogen ?

LongIsland.com

This is a good question that baffles and troubles me and some of my colleagues, since Bioidentical hormones are available and widely prescribed in many other states.
Bioidentical hormones seem to be safer ...

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This is a good question that baffles and troubles me and some of my colleagues, since Bioidentical hormones are available and widely prescribed in many other states.


Bioidentical hormones seem to be safer and more effective than conjugated equine Estrogens (Premarin) and medroxyprogesterone Acetate (Provera). Premarin does provide relief from hot flashes and urogenital symptoms, but it is a nonhuman formulation. It consists of about 11 compounds, each of which is further broken
down and metabolized into several other compounds. You end up with a large hodgepodge of estrogens circulating through the body that, although it does have some benefit, also exerts other effects that are not well defined and may be harmful. In
addition, we cannot monitor the level of Premarin because it is a complex mixture. On the other hand, with Bi-Est and Tri-Est (In either a topical cream or capsule form), one
can measure estradiol after the initiation of therapy to accurately determine the level of that hormone in the blood. That way, your physician knows if he/she is prescribing an inadequate dose or a possibly toxic dose (estradiol in very high doses can be harmful).
The chance of having a malignancy develop or a thromboembolic event occur exists
even when bioidentical estrogens are used, but we can monitor the blood level
of bioidentical hormones and keep their concentration in a physiologic (normal)
range.

Some studies indicate that Premarin builds up bone and protects the vagina, but
others show that estradiol, estriol, and estrone, which are derived from plants and
are identical in structure to endogenous human hormones also provide benefits.
Why use estrogen from horse urine in humans when plant-based derivatives are
identical to human estrogens?



Benefits noted by patients taking
bioidentical hormones.


Hot flashes sometimes disappear with the first dose, although more time may be required
and the dosage may have to be adjusted. When prescribed, I recommend that the physician start with a low dosage and work up. An improvement in bone density may require 3 to 6 months. Most patients treated with estrogens feel that they experience an improvement in memory and in generalized mood, and treatment with progesterone reduces irritability and emotional lability.




Is progesterone safe to use in BHRT?



Plenty of evidence points to progesterone as a safe hormone and that it should be the preferred progestin for use in hormone replacement; Many physicians have neglected it. They were taught that progesterone is not absorbed through the gastrointestinal
tract and that it can be administered only intravaginally. Actually, progesterone
is absorbed by the gastrointestinal tract (although it does undergo some first-pass
metabolism), and it works very well when applied in a cream to the trunk or the arms.
Double-blinded studies are still lacking on the use of progesterone in hormone replacement, but there is a great deal of compelling evidence that it may
protect the breast against cancer and benefit the bones, the mind, and the mood. It also does not seem to exert negative effects on the heart. When the storm of phone
calls and e-mails came in regarding the results of the Heart and Estrogen/Progestin Replacement Study Follow-up (HERS II) trial, I was able to tell all my clients not to worry, because they had not been taking Prem-Pro. That was a tremendous sigh of relief!



Are Bioidentical hormones being used more now in Long Island, since the latest studies were released?

Even with all the negative results of the HERS II trials, many Long Island physicians are still prescribing PremPro. You as the patient do have choices. Enlighten your physician about the Bioidentical hormone option; do your own research and present the possibilities to yourself to make the decision that can affect you for the rest of your life. S&P; Prescription Compounding Services can help you and your physician be guided in the options. For more information or to request a free consult call us at 516-644-2470