April Special Section
2 | April 2020 | NorthFulton.com
HEALTH & WELLNESS • Sponsored Section
The benefits of midwifery DR. J. REYES
By LIZ COLEMAN, CNM, FNP Modern OB/GYN Midwifery services are becoming increasingly popular across the United States, including Georgia. A CerLIZ COLEMAN, tified Nurse Midwife CNM (CNM) is a licensed healthcare professional specializing in women’s reproductive health and childbirth. CNMs are certified through the American Midwifery Certification Board after completion of a master of science in nursing degree that includes extensive classroom and clinical education. During pregnancy, a woman may choose to see a midwife over a physician because midwifery care focuses on pregnancy and labor as a normal life process rather than a medical condition to be treated. Certified Nurse Midwives develop trusting relationships with patients throughout the pregnancy and empower
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NURIA NELKIN, CNM
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women to focus on wellness. Midwives encourage women to take greater ownership of their health, their pregnancy and the outcomes of their pregnancy. According to the American College of Nurse Midwives (ACNM), benefits of midwifery care during pregnancy include decreased labor induction, augmentation and cesarean rates, reduced rates of regional anesthesia, decreased infant mortality, decreased risk of preterm birth and fewer third and fourth degree tears. ACNM also reports midwifery care
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increases successful breastfeeding as well as satisfaction with quality of care. Certified Nurse Midwives traditionally provide care of low risk pregnant patients. However, through collaborative management, midwives are able to continue care for many high risk patients as well. Should a pregnancy become high risk, a midwife will consult supervising physicians, perinatologists and other healthcare professionals and make appropriate referrals as needed. During the labor and delivery process,
In choosing a midwife, women are choosing personalized women’s healthcare and wellness across their lifetime. a backup physician is readily available at all times should the maternal or fetal status necessitate additional assistance or intervention from an obstetrician. Certified Nurse Midwives not only provide care during prenatal visits and childbirth, but also assist women with family planning, annual visits and certain gynecologic problems and concerns. In choosing a midwife, women are choosing personalized women’s healthcare and wellness across their lifetime. Modern ObGyn invites you to our Midwife Meet and Greet at our Johns Creek office (10692 Medlock Bridge Rd., Suite 100-A Johns Creek, GA 30097) on Monday, April 20, 2020 from 6-8PM. Meet our Midwifery team, see our Johns Creek office, enjoy delicious food and be entered to win pampering giveaways just for attending! Please RSVP to pr@ reyesobgyn.com or on our Facebook or Instagram pages @ModernOBGYNPC. We look forward to meeting you!
Arbor Terrace of Johns Creek offers exemplary memory care Arbor Terrace of Johns Creek uses Teepa Snow’s trademarked Gem Programming, Positive Personal Approach and other techniques in caring for residents with a dementia challenge. This approach helps families relate to their loved one in a meaningful, engaging way. They offer personal appointments and tours for families to come and learn more about the Arbor Advantage and their 60-day guarantee of satisfaction. This exemplary resort-style community offers beautiful apartments for Seniors at every stage of their care needs. They have several floorplans for Assisted Living and in their Bridges neigh-
borhood. Families love Bridges higher engagement activities designed for early cognitive challenges. Their Evergreen Memory Care Neighborhood is available for when higher care is needed on their dementia journey. They also offer a furnished suite when needed. Families can now focus on the relationship with their loved one in a less stressful manner and begin to feel the peace of mind that comes from knowing their loved ones are exceptionally cared for by a well trained caring team of professionals. Call Arbor Terrace of Johns Creek at 770-676-2410 to schedule a personal tour.
HEALTH & WELLNESS • Sponsored Section
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4 | April 2020 | NorthFulton.com
HEALTH & WELLNESS • Sponsored Section
COVID-19 and cancer: What you need to know By JONATHAN STEGALL, MD The Center for Advanced Medicine In the midst of the COVID-19 pandemic, there is a lot of fear and uncertainty. This is true DR. STEGALL when it comes to COVID-19 and cancer as well. At this point, it is unclear if cancer patients and cancer survivors are at an increased risk. However, patients who are receiving immunesuppressing treatments such as high dose chemotherapy are likely to be at increased risk, as their immune systems aren’t able to mount a response as easily. Research has shown that cancer patients who contract the COVID-19 virus are at an increased risk of complications, including death. For this reason, we must do all that we can to follow guidelines to reduce transmission. Whether you have cancer or not, the following are essential:
Dentistry and Covid-19 • Practice social distancing. Stay home and avoid crowds. • Wash your hands regularly. • If you must cough or sneeze, do so into your elbow. • Be careful about inadvertently touching your face. I also recommend several strategies for optimal immune health. Regular exercise, spending time outside, staying hydrated, and optimizing vitamin D levels are all important measures. Stay well, and stay positive. We will get through this together!
By DR. VEENA BHAT North Fulton Smiles By the time you are reading this article, many of you have settled into a new-ish nornal. We hope you are finding joy in the small things that surround you and maintaining good self-care. In these unprecedented times, we are all called to reconnect with our priorities and realign ourselves. We at NFS thank all of the medical professionals who are at the front lines of this disease pandemic. We wish you and your families the utmost safety and owe you a debt of gratitude. We are also grateful for our economic system- including the legislation, banks, CPAs-- for their fervor in helping to restore small businesses. At this time North Fulton Smiles remains closed for routine dental care and maintenance. We are open for emergencies on a need basis. If you are experiencing a dental emergency — as defined by pain, infection swelling, excessive bleeding — please call our office at (770)569-0613. You will be instructed how to contact Dr. Bhat directly. We shall triage your concern and deliver care in the office as necessary. For those concerned with being off track with their care, we will do our level best to accommodate you immediately after it is safe to return. We are monitoring the communications of the practice, so please feel free to contact us via phone or email northfultonsmiles@gmail. com. Please follow us on FB or Instagram @ North Fulton Smiles for updates and tips. We are here for you. One quick and easy tip: let the last thing that touches your teeth be water. Meaning, after eating a meal or after every snack or soft drink or juice, swish your mouth with water for at least 30 seconds as you would with mouthwash. It will help loosen food between teeth and help with plaque control. Of course brush twice and floss before bedtime. Be well. 770-569-0613 www.northfultonsmiles.com
HEALTH & WELLNESS • Sponsored Section
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The COVID-19 pandemic is having wide-ranging impacts on our everyday lives, including scheduled dental and other appointments. We all need to work together to prevent the spread of the virus.
How will the COVID-19 outbreak impact my dental appointment? By DR. DAVID REMALEY Roswell Dental Care
us at 470.288.1152. We can help decide if you need to be seen immediately.
In a statement issued March 16 the American Dental Association, called on dentists nationwide to postpone nonurgent dental procedures for until the end of April or later in order to help slow the spread of COVID-19. Our office will follow those guidelines but we will be available by phone. The Centers for Disease Control and Prevention has urged Americans to follow social distancing measures, including by working from home and limiting social gatherings to no more than 10 people. The time period according to the White House's guidelines, which Americans were told to follow, is set to expire April 30th. Concentrating on emergency and urgent dental care only during this period will allow dentists and their teams to care for emergency patients and reduce the burden that dental emergencies would place on hospital emergency departments.
1. Dental care you can reschedule for another time: • Regular visits for exams, cleanings and x-rays • Regular visits for braces • Removal of teeth that are aren’t painful • Treatment of cavities that aren’t painful • Tooth whitening
How do I know what is considered a dental emergency? Here’s a guide to what you can reschedule for a time when your dentist has resumed normal operations, and what you should consider an emergency. If you’re not sure whether your dental care need counts as an emergency, call
2. Dental care that you should have taken care of immediately: • Bleeding that doesn’t stop • Painful swelling in or around your mouth • Pain in a tooth, teeth or jaw bone • Gum infection with pain or swelling • After surgery treatment (dressing change, stitch removal) • Broken or knocked out tooth • Denture adjustment for people receiving radiation or other treatment for cancer • Snipping or adjusting wire of braces that hurts your cheek or gums • Biopsy of abnormal tissue Even during this outbreak, it’s important to maintain good oral hygiene habits. As usual, we always welcome new patients. For more information or to schedule an appointment to have your oral health evaluated and receive an accurate estimate for your treatment, give Roswell Dental Care a call at 470.288.1152. www.RoswellDentalCare.com.
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Crowns and Bridges in a few days Veneers that match your natural enamel color Teeth Whitening- no sensitivity Oral Cancer Screenings on all patients Teeth Cleanings, Digital X-rays and Comprehensive oral exams on all new patients Remove Dental Vibe (no longer use) Cosmetic Smile Makeovers and Full Mouth reconstruction Occlusal guards that prevents destruction of nature teeth Snore and sleep analysis and custom appliances that help correct this issue Digital X-Rays (90% less radiation) and Intra-oral Cameras Digitally scanned dental impressions that are uploaded to the dental lab- No more gooey impressions! Electronic records and online registration Complimentary cosmetic consultation 13- Accept and file all major insurances
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6 | April 2020 | NorthFulton.com
HEALTH & WELLNESS • Sponsored Section
COVID-19: Helping older adults cope Adults age 65 and older are at a higher risk of contracting severe illnesses, including coronavirus (COVID-19). That’s why it’s especially important for older adults to take preventative health measures during a pandemic. At this time, practicing social distancing—the act of reducing time spent in society and around others—can help seniors stay safe and healthy. Under normal circumstances, older adults are already prone to loneliness and depression. But with the cancellation of many community events and disruption of everyday activities due to COVID-19, the senior population can feel even more isolated. “Typically, when we reach retirement, we tend to form daily and weekly routines that become very important to us and ensure we are socializing with others and living a fulfilling life,” said Dr. Jeffrey L. Tharp, Wellstar Health System Chief of Primary Care and Medicine Service Line. “Now that our elderly are practicing social distancing, they no longer have these outlets. This may lead to further downstream effects, such as exercise limitation, nutritional deficiencies and lack of compliance with medical appointments and treatments,” Dr. Tharp explained.
As stress and anxiety about the outbreak increases, your loved ones may also experience changes in sleep patterns and worsening signs of depression and dementia. However, just because you are social distancing to keep your loved ones safe, doesn’t mean you can’t find ways to connect with them. Dr. Tharp shared some easy ways to help older adults cope with the stress by: • Making a virtual visit. Setting up a
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video chat, making a phone call or sending a quick text message can go a long way in helping older adults feel connected. • Sending snail mail. Take the time to write a physical letter or send pictures of your favorite memories together. This small act of kindness can bring older adults comfort and hope. • Brightening their space. Help seniors feel upbeat and positive by keeping their living spaces well-lit. Gift a flower arrangement to add a cheerful pop of
color to their home. • Encouraging proper hygiene. Send little reminders to your loved ones to wash their hands often and bathe daily. • Being mindful of mental health. Remind older adults to think positively and relax with fun activities like puzzles and other games. • Taking a walk down memory lane. Reminiscing about happier times can help improve memory function and bring older adults hope, even while they’re staying inside their home. • Keeping news to a minimum. The constant media coverage about COVID-19 can be overwhelming for older adults. Suggest they only check one or two reputable news sources a day for the latest information. • Lending a helping hand. Offer your care and support during this challenging time. Let your loved one know you’re just one phone call away if they need anything. Finding ways to help your loved ones cope with anxiety and stress can help them stay healthy and hopeful. If you notice stress beginning to interfere with your loved one’s daily life, encourage them to reach out to their healthcare provider. For more information, please visit CDC.gov for information on keeping older adults safe both physically and mentally.
Plan to LIVE By MICHELLE WILSON Wilson Legal, PC COVID-19 first instinct: Stop everything and stay home! I think most of us found ourselves thinking this way. We cancelled appointments with doctors WILSON and dentists that were well-checks and any other appointment that would be in-person. We did not stop to think of ways we could still get those things done safely. There’s a Charlie Brown and Snoopy comic where both of them are sitting on a dock. Charlie Brown exclaims: “Someday, we will all die, Snoopy!” Snoopy replies: “True, but on all the other days we will not.” That’s right. On all the other days we will live. Let’s plan to live. I just spoke with a client this morning. They both got sick with normal annual upper respiratory issues (not with COVID) and are now better and wanted to scrap their plans with my office. I explained that they needed those plans now more than ever because their healthcare directives are part of their plan. Both are over 65 and have un-
derlying health issues, but here’s how we are going to take care of them. We will be reviewing their documents using Zoom – an online meeting website. Then we will be scheduling a front yard signing assuming elder law attorneys are defined as an essential business by our governor under a shelter-in-place order. We will put the documents with disinfected pens by the front door, back up into the front yard, call them, they will come out and we will tell them where to initial and sign. Then they will put the documents back in the envelope (keep the pens) and go back inside their home. We collect the documents and take them back to the office to scan and bind. Then we will send them their originals and copies through USPS or courier. In just a few weeks, they will have their original healthcare directives and copies which they will need if either of them becomes sick with COVID-19 or another illness. Are you protected? Call us at 770205-7861 if you want to protect your family as well. We are happy to be your Legal First Responder. Join us for one of our webinars listed on the Contact page of our website: https://wilson-legal. com/contact.
HEALTH & WELLNESS • Sponsored Section
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8 | April 2020 | NorthFulton.com
HEALTH & WELLNESS • Sponsored Section
Viruses, skin cancers and therapeutic advances By DR. BRENT TAYLOR Premier Dermatology and Mohs Surgery of Atlanta What a challenging time for our country and the world. In response to the coronavirus, governments, businesses and individDR. TAYLOR uals struggle to respond appropriately. An excessive lockdown could threaten businesses, jobs, and individuals’ livelihoods, but an inadequate response could result in a spike in cases that surpasses hospitals’ and intensive care units’ capacity to care for the sick. Either scenario results in loss of life and suffering. Now is certainly a time for patience and grace. In the world of dermatology, we are gaining an increasing understanding of the role that viruses play in disease and skin cancer, and recent discoveries are giving us cause for hope. Unlike the coronavirus pandemic, these cancer-causing viruses are endemic – they have lived with us for years, and recent discoveries indicate we are winning the fight. Of the seven viruses that are most associated with cancer in humans, five viruses are linked to to different types of skin cancer. The seven viruses most commonly associated with human cancer are Epstein-Barr Virus (EBV), the human papillomavirus family (HPV), human herpes virus 8 (HHV-8), human adult t-cell leukemia virus (HTLV-1/2), Merkel cell polyomavirus (MCV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Only the last two (HBV and HCV) are not linked to skin cancer (but rather liver cancer). A summary of these viruses’ role in skin cancer is as follows: EBV and HTLV-1/2 are often associated with lymphomas, which may present in the skin. HHV-8 causes Kaposi’s sarcoma (a cancer of blood and lymph vessels classically seen in the immunocompromised). HPV is linked to squamous cell carcinomas including those of the penis and cervix but is increasingly implicated in non-genital squamous cell carcinomas as well. Merkel cell polyomavirus causes a cancer of cells called Merkel cells that are in our skin and that are partially responsible for our ability to feel touch. Advances are taking place for each of these cancers. For EBV-associated lymphomas, experiments are taking place looking at using white blood cells specific for this virus to help fight the lymphoma. HTLV-1 is a cousin of HIV and both HTLV-1 and its cancers appear to respond to some of the antiretroviral medication developed to treat HIV.
Kaposi’s sarcoma that occurs in the setting of HIV often respond when HIV is treated with antiretrovirals and is now generally a very treatable disease. HPV-related cancers are expected to decline as the HPV vaccine (e.g., Gardasil®), is being used to prevent penile cancer, cervical cancer and genital warts. Just as exciting, preliminary evidence suggests that HPV vaccine-based therapies may be useful in treating the greater than 1 million cutaneous squamous cell carcinomas that occur in adults each year. In late 2018, Cemiplimab gained FDA approval for treating locally advanced or metastatic cutaneous squamous cell carcinoma. Cemiplimab works by releasing the brakes on the immune system allowing a person’s own immune system to fight off the cancer and is one of many new immune system-based medications making tremendous progress in our fight against multiple cancers including melanoma. Finally, Merkel cell carcinoma had no FDA-approved treatment prior to 2017. Since then immune system based therapies have made great strides in treating Merkel cell carcinoma just as has been the case for cutaneous squamous cell carcinoma. Prior to 2017, survival from Merkel cell carcinoma was often less than 10% after 3 years. With new therapies, survival at 3 years is now exceeding 60%. For the most common skin cancers – basal cell carcinoma, squamous cell carcinoma and melanoma, the most effective treatment is still Mohs surgery when caught early. For non-recurrent basal and squamous cell carcinoma of the skin, cure rates with Mohs surgery are typically 99%. If you or a loved one has a skin cancer diagnosis or another dermatologic issue, consider Premier Dermatology and Mohs Surgery of Atlanta. Fellowship-trained Mohs surgeon and vein specialist Dr. Brent Taylor and highly accomplished and experienced physician assistant Kathryn Filipek, PA-C are here to care for you and your family.
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The Memory Center Atlanta The Memory Center Atlanta is the most unique and comprehensive community for those living with Alzheimer’s and dementia. Devoted specifically to memory care, our expertly designed program meets the challenging conditions of an aging brain with a caring, interactive community. We understand a diagnosis of dementia doesn’t mean you or your loved one stops living, rather it means finding new ways to live by providing assistance to maintain an active and meaningful lifestyle. Our residents enjoy music, dancing, live entertainment, art, gardening, - even outings, pet therapy and religious services. Enjoy a drink in the Chattahoochee Tavern, grab a movie in the Fox Theater or ice cream at the Bull Dog Café. All residents experience socialization and activities accessible across all levels of dementia. Even those who need 24/7 care benefit from life at The Memory Center. Overseen by our medical director who
specializes in the field of geriatric healthcare, our team of Licensed Practical Nurses and Certified Nursing Assistants provide the best 24/7 care. Don’t let a crisis determine where your loved one receives care. If you are considering memory care, we encourage you to explore options as early as possible. Take the time to ask questions, tour and include your loved one in the decision making process. Transitioning to memory care early ensures the best quality of life with daily socialization and engaging activities designed to meet the needs of you or your loved one. Get in touch - ask us a question or schedule a tour of The Memory Center Atlanta to learn more about how our team provides a seamless transition for your loved one into their new home. Located at 12050 Findley Rd, Johns Creek, GA 30097, less than ½ mile from Medlock Bridge Rd. directly behind Emory Johns Creek Hospital. Call Today, (770) 476-3678.
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10 | April 2020 | NorthFulton.com
HEALTH & WELLNESS • Sponsored Section
Hospitalists make hospital stays better By JON-PAUL CROOM President, WellStar North Fulton Hospital Senior Vice President, Wellstar Health System A hospital stay can make you anxious. You want tests and procedures ordered quickly, CROOM and results right away. If there’s an emergency, you expect – and deserve – immediate attention. You want answers and reassurance, and so does your family. Thankfully, at Wellstar North Fulton and 75 percent of other U.S. hospitals, we have hospitalists addressing all these important needs. If you’re my age or older, you probably remember a time when your family doctor would visit you at the hospital. During the 1990s, some of these physicians realized they preferred focusing only on hospital patients, and the term “hospitalist” was born. If you’ve been in the hospital during the last decade, you’ve probably been seen by a hospitalist: a physician who has dedicated his or her career to caring for hospital patients. Most hospitalists do not have their own practices; instead they work
only in the hospital, and are available 24/7. The trend toward hospitalists has grown; today, there are more than 60,000 in the United States, and it’s one of the fastest growing specialties. The reason for that is clear: Hospitalists improve quality outcomes, reduce length of stay and create many best practices for inpatient care. It makes sense to have doctors solely dedicated to hospital patients. They give their complete attention to hospitalized patients, working closely with surgeons and other specialists. They communicate with primary care physicians, keeping them up to date on their patients’ care. Hospitalists are there to deal with emergencies and questions, and they know our hospital and all its departments. That means they can easily order tests, consult specialists and adjust care plans. Hospitalists are also great resources for families. They facilitate family meetings, and are on site to answer questions and address concerns. No one looks forward to a hospital stay. But hospitalists, like the outstanding Wellstar North Fulton team led by Bhavi Purohit, M.D., make being in the hospital better.
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12 | April 2020 | NorthFulton.com
HEALTH & WELLNESS • Sponsored Section
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