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AN ANTON MEDIA GROUP SPECIAL
HealthyLiving JANUARY 11 - 17, 2017
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BOOK FEATURE
Self-advocating Patients
The Patient’s Playbook, by Leslie D. Michelson, is a call to action. It will change the way you manage your health and the health of your family...
with confidence. Some of the expert advise included will help you choose the best doctors, selection the right treatment plans, so better online research, organize your support team and prevent medical errors. Michelson has devoted his life’s work to helping people achieve superior medical outcomes at every stage of their lives. He is the founder, chairman and CEO of Private Health Management, a unique patient-focused company dedicated to helping individuals and corporate clients obtain exceptional medical care. He is a highly sought-after expert who has spent the last 30 years guiding thousands of people through our complex health care system. Prior to founding Private Health Manage-
ment in 2007, Michelson was the CEO of the Prostate Cancer Foundation. He received his B.A. from Johns Hopkins University and a J.D. from Yale Law School. He lives in Los Angeles with his wife, Beth.
Published b y Ant on Med ia Group KARL V. ANTON, JR. Publisher, 1984–2000 ANGELA SUSAN ANTON Editor and Publisher FRANK A. VIRGA President SHARI EGNASKO Executive Assistant STEVE MOSCO Senior Managing Editor CHRISTY HINKO Managing Editor, Special Sections KAREN MENGEL Director of Production ALEX NUÑEZ Art Director IRIS PICONE Director of Operations JOY DIDONATO Director of Circulation ADVERTISING SALES
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Too many Americans die each year as a result of preventable medical error—mistakes, complications and misdiagnoses. And many more of us are not receiving the best care possible, event though it’s readily available and we’re entitled to it. The Patient’s Playbook, by Leslie D. Michelson, is a call to action. It will change the way you manage your health and the health of your family, and it will show you how to choose the right doctor, coordinate the best care and get to the “No-Mistake Zone” in medical decision making. Michelson’s real-life stories impart lessons and illuminate easy-to-follow strategies that will enable you to become a smarter, better health care consumer—and to replace anxiety
13 HEALTHY LIVING • JANUARY 11 - 17, 2017
Integrity, Willpower And Your Health Honor Your Word
January 1st strikes and you’re motivated to become the best version of yourself. The New Year is a burgeoning new beginning to ignite change in your life. Motivation comes easily the first few weeks, and you start to make healthy changes every day. Suddenly, life kicks in and that healthy momentum starts to drastically slow down. This year can and will be different for you! Motivation is intrinsic; you have to believe in yourself to make your goals become a reality. Honoring your integrity and harnessing your willpower are essential keys to accomplishing your resolutions this year. Here are a few tips on effectively utilizing integrity and willpower to make lasting change.
Integrity is defined as the quality of being honest. Now that you have outlined one or two very meaningful goals, it’s time to be honest with yourself by honoring your word. Every action you make should be in line with your health goals. When real life gets thrown at you, remember that you have an important promise to keep to yourself. You have the power to push through excuses and utilize full intention in this New Year ahead.
CHOOSING HEALTH Stefani Pappas RDN, CPT
Write Down One Meaningful Goal
Resolutions are a productive way to outline your goals for the year ahead. However, it’s easy to look at every aspect of your life and make countless resolutions. First, you want to pay off your credit card debt. Next, you want to go to the gym every morning at 6 a.m. Then, you want to get that promotion at work. The list can go on and on. Don’t spread yourself too thin; try making one or two quality and
meaningful goals this year. By focusing 100 percent of your energy on that particular goal, you’ll automatically increase your chances of attaining it. Make your goal specific and practical so you can set yourself up for success!
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see what you can control to successfully achieve your goals.
Commit To Your Well-being
This year is all about you. Commit to bettering your mind, body and soul in this New Year. You can always break down your commitment if your goal seems too overwhelming. For example, a day may come where you are feeling lazy and going to the gym for an hour seems impossible. Try breaking down your fitness goal by committing to just five minutes of exercise; chances are once you get Spend Your Willpower on your workout clothes and start Wisely moving, you’ll be motivated to break a Willpower is essential, but don’t make sweat and stay active. things so hard for yourself. You want to This year is all about new beginspend your willpower wisely. If you are nings and getting out of your comfort able to control aspects of your environzone. Believe in yourself and your ment, you can increase the chances ability to make positive changes in the of maintaining your health goals for upcoming months ahead. If you slip, the year. For example, keep a bowl of pick up the pieces and start right back fresh fruit on the kitchen table or keep where you left off. healthier items at the front of your fridge. Stefani Pappas, RDN, CPT, is a By strategically placing nutritious items Clinical Dietitian Nutritionist at St. in a visible place and keeping not-soFrancis Hospital. She also provides healthy foods out of sight or out of the private and group nutrition counseling house, you’re more likely to reach for at her office in Great Neck. Visit her those wholesome foods to nourish your website www.StefHealthTips.com for body. Don’t rely solely on willpower; more information and to schedule an take a look at the things around you and appointment
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14 HEALTHY LIVING • JANUARY 11 - 17, 2017
4 Levels You Need To Get Checked To Lose Weight
Whether you’re about to start a weight-loss program or are having trouble shedding pounds, knowledge is power. Among the most important things to know: your levels of a few key health markers. That’s because abnormalities can affect your ability to lose weight -- either directly by altering your metabolic rate or by causing your energy levels and resolve to tank, says Dr. Spencer Nadolsky, a board-certified family and bariatric physician, diplomate of the American Board of Obesity Medicine and author of The Fat Loss Prescription. So getting these levels tested and, ultimately, shoring up any issues can help you ensure you’re set up for weight-loss success. Keep in mind, though, that while most of these tests are routine, some insurance providers may not reimburse for others. Every company and physician is different in its practices, so it’s important to talk to your doctor if you have any concerns over what will and won’t be covered.
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Getting these levels tested and, ultimately, shoring up any issues can help you ensure you’re set up for weight-loss success.
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Vitamin D
A full three-quarters of U.S. adults are deficient in the sunshine vitamin, according to research published in the Archives of Internal Medicine. “Vitamin D deficiency is so [prevalent] that I tell virtually all of my patients to take 2,000 to 4,000 IU per day,” Nadolsky says. Apart from contributing to a whole host of health conditions, low vitamin D levels can cause fatigue and mood disturbances, and are even linked to depression. “If people don’t feel well mentally or physically, they aren’t going to put their best
INTRODUCING
foot forward,” he says. After all, people who report depressive symptoms are at an increased risk of weight gain and abdominal obesity in particular, according to research published in the American Journal of Public Health. However, vitamin D may also affect your ability to lose weight even more directly. “This particular vitamin has hormonal functions and a vital impact on thyroid function,” explains Dr. Steven Wilson, a board-certified family medicine physician and diplomate of the American Board of Obesity Medicine at Redlands Community Hospital in California. Quick biology lesson: The active form of thyroid, called T3, is made from the less active form, T4. Vitamin D helps make that conversion happen. If you are found to have low vitamin D levels (which is likely), your doctor may prescribe taking a D supplement. Eating D-rich foods like fortified milk, pork, fatty fish and mushrooms, as well as spending more time outdoors, can also help increase your vitamin D levels.
SAY GOODBYE TO STUBBORN FAT!
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Thyroid Stimulating Hormone
Your thyroid, a small, butterfly-shaped gland situated in your neck, is in charge of producing two hormones: T3 and T4. Together, they help to set your basal metabolic rate -- the number of calories you burn each day just to stay alive. However, underactive thyroids are both common and under-diagnosed. About 5 out of every 100 people suffer from hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormones, according to research published in Endocrine Practice. Weight gain and difficulty losing weight are common side effects. “Thyroid stimulating hormone, also called TSH, is a great screening
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HEALTHY LIVING • JANUARY 11 - 17, 2017
cause energy levels to plummet (no energy to hit the gym or cook dinner?), they are linked to poor thyroid function, according to a 2016 study published in Thyroid Research. And, as we just covered, a shoddy thyroid can make losing weight exceedingly difficult. In the U.S., approximately 10 million people are iron deficient, according to the National Institutes of Health. A large chunk of them are women of childbearing age (iron is lost each month during menstruation) and/or vegetarians or vegans (meat, poultry, eggs and dairy are among the best sources of iron). If you’re in one of these groups or just feel perpetually “run down,” it’s a good idea to have your iron levels checked. Supplementation can help get your levels where they need to be.
tool for evaluating thyroid function. If that value is abnormal, then further testing should include free T3, free T4 and thyroid antibodies,” says Wilson, noting that in cases of hypothyroidism, medication can help.
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Iron
This mineral is critical to your body’s ability to produce hemoglobin and therefore deliver oxygen throughout your body. Sub-par levels not only
Fasting Blood Sugar
“About 9 out of 10 of my patients have detectable signs of insulin resistance,” Nadolsky says. In insulin resistance, the body cannot properly manage carbohydrates. Levels of glucose (aka sugar) in the blood become excessively high, and the body’s tendency to store fat, especially around the waist, increases.
A fasting blood sugar test, which is routinely included in comprehensive blood panels, is a great first sign of insulin resistance, Wilson says. (If your test results show excessive blood sugar levels, your doctor will likely follow up with an A1C test, which provides information on how your blood sugar levels have fluctuated over the past three months.) If you do have insulin resistance, prediabetes or Type 2 diabetes, talking to your doctor or a certified diabetes educator to develop a low-carbohydrate eating strategy that works for you is vital to your ability to lose weight -- and do so in a healthy way. Also, while not intended for weight loss, many medications prescribed for the management of diabetes often contribute to improved body composition. K. Aleisha Fetters, MS, CSCS, is a freelance Health + Wellness reporter for U.S. News & World Report. Copyright U.S. News & World Report, L.P. Reprinted with permission. Combining in-depth research and high journalistic standards, U.S. News publishes a wide variety of articles at usnews.com and in its publications that enable readers to make smart “life decisions” regarding careers, personal finance, education, health issues and other important matters.
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2017: A Good Year For Your Liver
This year promises to be a good year for the liver and liver patients. Each of the most common liver conditions should see significant advances in their treatment during the coming year. Here are some specifics:
Hepatitis C
The treatments for chronic hepatitis C therapies will continue to improve and to become more easily available. Over the past two years, more than half a million patients have been treated and cured with the new direct-acting, oral anti-viral therapies. These therapies cure more than 95 percent of all comers, including those with advanced liver disease, kidney disease and genotype 3. So what improvements can we expect in 2017? Despite the cure rates that vary from 95-99 percent for all genotypes, there are still about 5 percent of patients who are not cured with current therapies. Two new regimens should be approved in 2017, and each has shown a 99-100 percent cure rate in those patients who did not respond to previous therapies. Access to these therapies should also improve, as the costs of the new medications continue to decrease and the restrictions placed on access to these treatments
THE SPECIALIST David Bernstein, MD
by insurance companies appear to be easing. The challenge for 2017 is to identify the more than 3-4 million people in the U.S. with hepatitis C that have not yet been diagnosed.
Hepatitis B
Hepatitis B is treatable but not curable. The current treatments have changed the course of the disease, with improvement in fibrosis levels and fewer patients progressing to cirrhosis and liver cancer. But these are lifelong therapies that can be costly. New treatments, which will be tested in clinical trials in 2017, aim to cure hepatitis B. These new therapies, both oral and injectable, will be added to the current treatments so that the excellent therapeutic effects of standard of care treatments are not lost. Although these therapies will not be widely available in 2017, they are
available in our area and are exciting as medical science moves to cure hepatitis B once and for all.
million Americans. This condition leads to cirrhosis and liver cancer and is rapidly becoming the leading indication for liver transplantation. Primary biliary cholangitis Currently, the only treatments for Primary biliary cholangitis is a com- NAFLD/NASH are diet and exercise mon autoimmune condition that has and vitamin E. While these therapies been treated with ursodeoxycholic are used, their long-term effectiveacid (Urso) for the past 20 years. Urso ness are not dramatic and patients treatments have resulted in a dramatic continue to progress. New therapies decease in the number of patients de- are being developed to treat NAFLD/ veloping cirrhosis and requiring a liv- NASH that are based upon counterer transplantation. Still, some patients acting presumed mechanisms of fat do not respond to Urso. Obetacholic deposition in the liver. This is the acid was approved in 2016 for use in first time that direct-acting therapies patients without a complete response are being used in this condition. to Urso or those who are intolerant Numerous clinical trials with these of Urso. Obetacholic acid works well advanced therapies are now available and has been shown to normalize to patients. liver chemistries. While approved in There are many other advances in mid-2016, access to this treatment the diagnosis and treatment of liver has been complicated and difficult. disease ahead in 2017: new diagnostic 2017 promises to be a good year for tests for hereditary liver diseases, betimproved access to this treatment. ter diagnostic imaging and improved The increased availability should lead liver cancer treatments, to name a to even greater success in preventing few. I look forward to the upcoming disease progression. year and seeing how these advances will change the lives of people with NAFLD/NASH liver conditions for the better. Non-alcoholic fatty liver/non-alcoDavid Bernstein, MD, is chief of holic steatohepatitis (NAFLD/NASH) is the most common liver condition in gastroenterology, hepatology and the U.S. affecting approximately 60-80 nutrition at Northwell Health.
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Help From A “Nutritionista” BY JOSEPH CATRONE
jcatrone@antonmediagroup.com
In an age where relationship statuses are all the rage, “it’s complicated” might best describe a person’s relationship with food, at least according to Nutrish Mish founder Michelle Blum, 28. Blum, has been a nutritionist since college and started her company five years ago. What inspired her, she said, was a common problem among dieters. “I noticed a huge disconnect between what we want to eat and what we’re supposed to eat,” Blum said. “I wanted to create something that helps people lose weight, and I wanted to really change the way people think about food.” Nutrish Mish has five offices across Long Island and three in Nassau County, including locations in Farmingdale, Bethpage and Floral Park. A client’s initial consultation is free and is used to allow a nutritionist to provide a full body composition analysis,
an explanation of the client’s nutritional problems and food suggestions. From there the nutritionist creates a “path” towards a healthy lifestyle. Blum believes Nutrish Mish is unique from other nutritionist companies because of its focus on the needs of its individual clients. “I think we deal with all problems,” she said. “A lot of other places are about having people eat less, but that’s not always a problem for everyone. We’re not one-dimensional. We tailor it based
on the individual, and there’s one-on-one accountability.” Part of that one-on-one accountability, according to Blum, entails remaining candid with clients about how reachable their goals are and how long the process will take. While some dieters seek a product or service that will work instantaneously, Blum says no one should expect to find that in her office—or anywhere else. “There really is no miracle cure,” she said. “We have accelerated progress. We have
a way to do it quicker. One of the things we do is figure out a time frame and make [clients] understand what’s realistic.” On the company’s website, www.nutrishmish.com, one of the taglines is “change your relationship with food.” According to Blum, many of her clients struggle to eat the proper amount for their bodies, often aiming too low or too high. It is for this reason that Blum places so much emphasis on avoiding a paint-by-numbers approach; one of the other taglines on Nutrish Mish’s website is “never diet again.” “I think people try to do too much. They don’t eat well, they start a diet and its zero to 60, such a dramatic jump, that nothing sticks,” Blum said, before adding that the opposite is also true. “A lot of people aren’t eating enough. You could do the same damage to your body as when you eat too much. We have kids come in who want to start with good habits. I love that, the opportunity to start them off right.” Blum says the ultimate
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Michelle Blum goal is to be both truthful and encouraging with her clients. She even refers to the company’s staff as “nutritionistas,” a term that, according to Nutrish Mish’s website, refers to people who are “food relationship experts whose passion and knowledge of nutrition is contagious.” “A regular nutritionist is going to tell you what looks good on paper, but it’s not always functional,” Blum said. “One of the most important things is that we [hold sessions] every week. The way we break things down, we go out of our way to create that path.”
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