July / August 2014 by Austin MD Magazine

GOT LOW-T? HERE’S HOW TO TREAT IT!

THE CONTAGIOUS SPREAD OF WORLD CUP FEVER!

SEX ADDICTION THE FIRST STEP

JULY/AUGUST 2014

JARED LEGER EXPLAINING HEALTHCARE AND WHY ARISE IS DIFFERENT pg.43 SHREDDING FAT WITH

DR. IAN SMITH FROM THE SHOW

THE DOCTORS

MEN’S HEALTH ISSUE

Our focus on proactive wellness helps you manage your own healthcare.

At WellMed, our clinics have established a reputation of being an innovative leader in senior healthcare services that stretches over a span of more than 20 years. Our emphasis on healthy lifestyle education allows you to become an active partner in managing your healthcare. Combined with our team of dedicated physicians, nurses and technicians, along with a schedule of annual exams and screenings, you will have the help you need to live your senior years to the fullest. In addition, we believe that you deserve a truly VIP-level of personal attention under our care, and everything we do in all our WellMed clinics is dedicated to fulfilling this goal. I want to be your partner, call to learn more about the advantages that WellMed clinics offer, or if you wish to become my patient, please give us a call at 855-795-1511.

855-795-1511

wellmedmedicalgroup.com PRT-PRA-TJ080613

TABLE OF CONTENTS JULY/AUGUST 2014

Co-owner & Publisher

Angela Strickland

Events: Austin X-Games

Investor Aman Bandali

Austin Welcomes it’s first alternative style sporting event

Account Executive Rachel Escobar

Editorial Manager

Lifestyle: A Guisness a Day Keeps the Doctor Away

Kat DelGrande

Art, Graphic & Web Designers

Who says beer is not healthy for you? We beg to differ!

Daniel Arpaia

Events: World Cup

Sheldon Jackson

Austin Welcomes it’s first alternative style sporting event

Brandon Tipton

Photographer Steve DeMent

Contributing Editors

Cover Story: Jared Leger

Mary DelGrande Jake Harding

Healthcare as it was originally intended

Malena Manning Samantha Schak

Contributing Writers

Mental Health: Sex Addiction

Stefon Andrews, Dr. Michael Bishop,

How to talk to your doctor when you’re embarrassed or uncomfortable

Jon Black, Lydia Blankenship, Dr. Phyllis Books, Susan Brister, M.D., Dr. Patrick Carnes, Allison Cassone,

Nutrition: Shredder Diet Interview

Kat DelGrande, Mary DelGrande, Omar Dyess, Rachel Escobar,

Austin MD talks with Dr Ian Smith on his famous weight loss program

Steven Galvan, Robert D. Greenberg, M.D., Wendy Muse Greenwood, Sam Jackson, Kyle Jerome, Brad Kennington, Megan Kniskern, Dr. Shirat Ling, Malena Manning, Ryan Michaud, M.D., Dr. Michael Moossy, Dr. Okpara, Dr. Avinash Ramchandani, Samantha Schak, Redza Shah, Grace Singstad, Laura M. Smith, Aissa Vallecillo, Zachary Wassmuth, M.D., Aaron Wells, Dr. Dongxun Zhang

www.AustinMDmagazine.com For advertising and/or editorial information, please call Rachel Escobar (512) 963-5544 or email rachel@AustinMDmagazine com. Copyright © by Green Iceberg Publications LLC. All rights reserved. Reproduction without the expressed written permission of the publisher is prohibited.

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JULY/AUGUST 2014

PUBLISHER’S LETTER

he Austin heat has finally arrived, and Austin MD Magazine is heating up our publication with an issue devoted solely to Men. Following our wonderful Women’s issue, which supported local and global female physicians, leaders, chefs and policy changers, Austin MD Magazine decided it was time for a “Men’s” issue. For our July/August 2014 issue we created a theme geared towards our male readers with innovative articles, educational pieces and interviews with some of the most intriguing, game-changing leaders of the community. This summer issue sizzles with healthy food alternatives, technological fitness innovations and physicians that are leading our advancement in medicine within the community.

Right around the corner is Austin MD Magazine’s 2nd Annual “Date A Doc” Charity Auction scheduled for late September. Last year’s event was a huge success with over 300 attendees and thousands of dollars raised. Austin MD Magazine predicts that this year’s event will be bigger and better with Austin’s hottest medical professionals raising money for charities of their choice. Keep an eye out for event dates and information, and be sure to cast your votes on the Austin MD Magazine Facebook page for the doctors/physicians we are selecting this year. You can of course see all our auctionees in the September/October 2014 issue complete with photos and editorials highlighting their exceptional talents and looks. For tickets and tables please call or email our account executive Rachel Escobar (rachel@austinmdmagazine.com) for more details.

MEET OUR TEAM

ANGELA STRICKLAND CO-OWNER

AMAN BANDALI INVESTOR

RACHEL ESCOBAR ACCOUNT EXECUTIVE

KATHLEEN DELGRANDE EDITORIAL MANAGER

angela@austinmdmagazine.com

aman@austinmdmagazine.com

rachel@austinmdmagazine.com

kat@austinmdmagazine.com

STEVE DEMENT PHOTOGRAPHER

DANIEL ARPAIA ART DIRECTOR

SHELDON JACKSON GRAPHIC DESIGNER

GRACE SINGSTAD PR INTERN

stevedphoto@gmail.com

darpaia22@gmail.com

sheldawnjaxsun@gmail.com

grace@austinmdmagazine.com

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MEN’S HEALTH SPECIAL SECTION

MAN UP AND CHECK'EM Erectile dysfunction, testicular cancer & infertiliy

Throughout life, men need to be ready for a lot of things, including some of the most debilitating diseases that can strike them at any time, three of which specifically go by the names of erectile dysfunction, infertility and testicular cancer. The first (erectile dysfunction) is definitely rife in America, and the causes can be legion, ranging from alcohol and drug abuse, to hormonal imbalances, or even anxiety. For Dr. Loren Jones of The Urology Team though, he has seen a more frequent issue. “The most common causes of erectile dysfunction [are] aging and a decrease of blood flow to the penis,” he says. There are exceptions in younger patients which Dr. Jones attributes to hormonal imbalances or low testosterone. Of course we have all heard about those little wonders known as Viagra and Cialis, the latter of which is Dr. Jones’ go-to remedy for ED, which is also said to be making a move over the counter. “In general, I think that the commercially available oral medications work well, and I don’t have a strong preference

BY SAM JACKSON

toward any of them,” he said. “I think they work well, and they’ve been proven to work well.” That being said, there are cases which require heftier doses, namely local medicine-like injections, or even surgery and prosthetics. Then there is testicular cancer. Considering that it involves a very sensitive, crucial body part, and has “cancer” in its name, it seems obvious that it worries men quite a bit. The most terrifying aspect of testicular cancer is that it can impact your life much sooner than you would imagine. The majority of patients are diagnosed between the ages of 20 and 34, including Matt Ferstler who got his grim news at a mere 22 years old. “Testicular cancer is the most common cancer in men ages 15 to 35 in the United States,” he remarked in a phone interview. “It’s a hormone disease hitting right after puberty, so it’s kind of the young man’s disease.”

A lot of young men are in for a surprise then each year, since about 8,000 cases of testicular cancer are expected to crop up, which is the average annual rate according to the National

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MEN’S HEALTH Cancer Institute. Research has also uncovered possible genetic factors affecting probabilities of the diagnosis as well as other causes like smoking and HIV/AIDS, but findings haven’t been traced back to one specific cause. “Probably about a month and half after [the diagnosis], I was looking around trying to find resources for young men like myself being diagnosed, like where do I go, what do I do. I was lost, confused, angry,” he said. Using frustration as fuel, he started the Testicular Cancer Foundation in 2009, and he has since managed to provide young men with the help and information that was not accessible to him such as the process of detecting and identifying cancerous lumps. “You check yourself in the shower, where your scrotum is loosened by the heat, and roll your finger over your testicle. If you find any bumps, [or] anything abnormal, go see your urologist,” he says. “If anyone’s diagnosed, they can always call me,” he adds. Fortunately, testicular cancer isn’t too dire. According to Ferstler, if it’s rousted early before it can spread, then things will be sunny. “[Treatment is] 99 percent successful if caught at Stage 1 – meaning no chemotherapy, no radiation, just a surgery where you remove the testicle. And if we could catch that in everybody, we’d have no deaths from testicular cancer,” he says. You’d be out a testicle, true, but you’d also be looking at a ninety five percent chance of living another five years. Ferstler also promises that the leftover testicle will quickly “pick up the slack.” He also points to testosterone issues, a common cause of the cancer, as being easily solvable with a non-FDA approved drug called Clomid. Of all three of these diseases though, infertility is possibly the most worrying. Like ED, it’s difficult to nail down one cause, and people are usually considered infertile after failing to conceive a child for at least one year. Infertility is also somewhat interconnected to the other two diseases, with infertile men being three times more likely to develop testicular cancer, according to the National Health Service in the UK.

Albeit erectile dysfunction certainly doesn’t help fertility much. ED and testicular cancer-related treatments for infertility tend to focus on correcting hormonal imbalances, sometimes through surgery or an injection of sperm directly into the egg.

As a side note, testicular cancer treatments and surgery may cause erectile dysfunction or full blown infertility, so Ferstler recommends taking some preventive measures if you still want to check “having a kid” off your bucket list. “Some of the stuff we tell people right away is that if you are going to go through chemotherapy, you check and find a place you can bank sperm,” he says. “With chemo, there is only a small chance that you will not be infertile. [So] why risk it?”

Yes, why indeed? Because all men, young and old, need to keep alert for signs of these diseases. Check yourself, and when in doubt go see your urologist or doctor... Health care professionals have far more experience dealing with scrotums than they’ll ever want to share.

“If it’s rousted early before it can spread, then things will be sunny” For More Information

“Check yourself, and when in doubt go see your urologist or doctor...”

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The Testicular Cancer Foundation at singlejingles.org, and for information on ED and infertility visit The Urology Team at urologyteam.com

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MEN’S HEALTH

Beating Stress with Good Nutrition Healthful diet and exercise tips for those prone to stress

SPECIAL CONTRIBUTION TO AUSTIN MD BY BAYLOR SCOTT & WHITE - ROUND ROCK

As men, we all experience stress at some point in our lives, and it can often take its toll on the body and mind. Furthermore, having poor nutrition habits, combined with a lack of exercise, will only add to that stress. Some stressful situations can cause us to fall back into old, unhealthy habits and behaviors. For instance, TV journalist Peter Jennings quit smoking several years until the overwhelming events of 9/11 happened in New York City. It could also include someone turning to fast food during a difficult time in their life when they had previously been eating healthier alternatives. According to Lianne Marks, M.D., Ph.D, Internal Medicine Physician at Scott & White Clinic Round Rock, “These bad habits, also known as maladaptive coping behaviors, may provide fast relief helping to deal with a stressful experience, but they eventually backfire and don’t help us in the long-term.” Unhealthy habits for men are often based on fear and self-protection. We develop behaviors that think protect us, but in actuality are destructive. Sometimes we try to fill the void with a behavior, a person, place or substance, giving us the feeling that we have what we really want. However, there are healthy ways to deal with stress in our lives. Some “coping” tips from Marks include: - Staying consistent in your usual healthy routines as much as possible - Expressing feelings and emotions in a constructive way with family and trusted friends - Maintaining a positive outlook · Staying focused · Avoiding self-defeating behavior and attitudes · Scheduling time for yourself to work out and relax daily · Considering contacting a mental health professional if bad habits persist or compromise your health

for

Dr.

Good Nutrition is Key for Men After a stressful event like 9/11, for example, many Americans went on a national binge. In fact, 15 percent of Americans confessed that they were turning to comfort foods while another 14 percent reported eating more sweets. A few months later, 1 in 10 Americans had gained weight due to stress-related eating. During these stressful times, it is easy to turn to food for comfort, but this only provides a short-term sense of pleasure that can lead to an increase in body fat. Some tips for men who are coping with stress-related eating: “Back-tracking to

- - - - - - - -

When cravings hit, wait 15 or 30 minutes to eat; the cravings will likely pass Drink water consistently throughout the day to curb unhealthy cravings old habit happens Eat regular, healthy small meals or snacks every three to four hours out of a need Keep track of what you eat and how it makes you feel Consider working with a nutritionist who has experience with clients who struggle with stress-eating behaviors for comfort or Eat slowly and only when seated and not otherwise occupied. If you focus on eating, you tend to eat less normalcy” Put a Post-it note on your bathroom mirror or at your office, reminding you to think before you eat Know your vulnerable times and places, and be prepared with healthy coping strategies

Your Fitness Routine is Just as Important Stress can cause us to fall out of our fitness regimens every now and then. Many people will allow things to slip while they are out of a normal environment and usual routine. Back tracking to old habits happens out of a need for comfort or normalcy. Advice to avoid these pitfalls include:

- -

Realizing your reaction is normal and does not indicate a lack of willpower Poor nutrition and lack of exercise will only add to your stress; try to keep track of what you are eating with a food diary Exercise is a healthy, therapeutic way to take care of yourself; workout when and where you can Some additional tips for men that may help you get back on track if you are feeling tempted are: Learn to relax by taking deep breaths Try a change of scenery. Go outside, or go to a different room. You can also try changing what you are doing. Swimming, running, lifting weights, playing tennis, bike riding, or shooting baskets Keep healthy foods handy to snack on: lean meats, low-fat dairy, celery, low-sugar fruits, sugar-free gum, coffee or tea If things get more problematic, consider contacting your doctor

FOR MORE INFORMATION

For more information contact Scott & White Healthcare- Round Rock at (512) 509-0200 or online at sw.org. IMAGE FROM SHUTTERSTOCK

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MEN’S HEALTH

HOW TO TREAT LOW T The Surprising Truth About Testosterone In Men

SPECIAL CONTRIBUTION TO AUSTIN MD MAGAZINE FROM ADVANCED PAIN CARE BY RYAN MICHAUD, MD

Testosterone is the hormone in a man that helps him build muscle,

as weakening of the bones. Testosterone is also important for cognition and

deepen his voice, mature in puberty, and, in short, it’s what makes a man a man.

memory, and it can play a role when the body is low in insulin production.

Testosterone is produced by the testes in men, and it is produced in smaller

quantities in women by the ovaries.

in testosterone. As a greater percent of our population ages, there are much

After the age of 30 most men begin to experience a gradual decline

Hormone levels have significant effects on the human mind and body.

larger levels of low testosterone affecting men. Some men experience significant

Often times, men are so busy with their day-to-day functions and responsibilities

changes starting in their middle-aged years, or more commonly, at the age of 60

that they may not recognize when a testosterone deficit is causing unfavorable

and older. This drop in testosterone level is sometimes termed hypogonadism, or

changes in their bodies, and therefore in their lives. Signs and symptoms that

as what some may call male menopause.

testosterone levels are low could be: a decreased sexual desire, erectile dysfunction,

fatigue and loss of energy, depressed mood, diminished mental aggressiveness,

which may be used in treating chronic pain, can also lead to low testosterone

loss of body hair, decrease in strength and symptoms of osteoporosis, such

levels. This can be frustrating for many people suffering from debilitating pain that

Additionally, some research has shown that ongoing opioid therapy,

“After the age of 30 most men begin to experience a gradual decline in testosterone” will not go away. Fortunately, there are treatments available for low testosterone

Advanced Pain Care treats patients with a multidisciplinary approach. This means

so that patients do not have to suffer in pain and experience negative symptoms

that we believe there is more to treating pain than just medication management.

of low testosterone. To treat low testosterone, some doctors may use injections,

We take a full analysis of pain symptoms and physical health so that we can order

patches, topical creams or gels that contain the necessary testosterone hormone.

the right treatment to address the pain and any other side effects. Whether it

However, not all men may be candidates, so please check with your doctor.

is providing the most advanced techniques for procedures, utilizing available

Furthermore, testosterone treatment can have side effects.

resources for behavioral and physical therapy or lab testing to check testosterone

levels, we want to review the full scope of a patient’s health in order to provide the

Your doctor may order a testosterone test that measures the amount

of testosterone in the blood. A blood sample is needed and the recommended

best options available.

time for the sample should be between 7 a.m. and 10 a.m. Normal testosterone levels in men are 270-1,000 ng/dL (nanograms per deciliter) and for females 15-70 ng/dL.

Factors that can lower your testosterone are: Insufficient sleep because most testosterone is produced during sleep; poor quality sleep can result in a 20 to 30 percent reduction of testosterone.

Excessive alcohol consumption can also lower testosterone levels. As the liver breaks down alcohol, it produces compounds that inhibit the release of testosterone, reducing its overall level in your body.

Replacing meat with soy A combination of the plant estrogens and a lack of essential amino acids that cannot be absorbed on a soy diet alone, have shown a 10 percent drop in testosterone levels in just 4 weeks. 10

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For More Information For more information on Advanced Pain Care visit austinpaindoctor.com or call 512-244-4272.

MEN’S HEALTH

BODY DYSMORPHIA

The changing face of the diet industry SPECIAL CONTRIBUTION TO AUSTIN MD TO ROSEWOOD RANCH BY MEGAN KNISKERN MS, RD, CEDRD

by Megan Kniskern MS, RD, CEDRD It used to be that conversations around the water cooler included women discussing their weight, current diet failures and food cravings. Meanwhile, the men would roll their eyes, tell us to let it go, stop obsessing and just enjoy the food already! However, within the last decade or so, water cooler conversations have changed as gender roles involving weight and eating have become less clearly defined. At a dinner just the other night, sitting with a table of male peers, the majority of the conversation revolved around food, diets, health and exercise. We know that Americans spend $30 billion annually on largely unregulated and unproven diet and health related products, and that approximately 85 percent of those on a “diet” at this moment are in fact female. However, there are some aspects to the dieting trends of men that may be more subtle, and therefore are being overlooked. One aspect is the supplement industry, specifically Vitamins, Minerals and Supplements (VMS), which produced about $32 billion in revenue in 2012 and is projected to be at $60 billion by 2021 (Nutritional Business Journal). As a dietitian, with a focus on food for energy and nourishment, the concern with the marketing and growth of these products is that they are not regulated by any organization (e.g. the FDA), unless there is seen to be a widespread issue with the use of a specific product. Without the regulatory cautions, these products can easily be misrepresented, making consumers more susceptible to abuse. Muscle Dysmorphia (or bigorexia) is becoming more of a mainstream concept; it describes someone

who is obsessed with the need to become more muscular, as they are never “muscular enough.” Dysmorphia relates to the distortion that they see in their appearance, and as a result of the inability to resolve this obsession, it can consequently lead to depression, isolation and dramatic negative impacts on other areas of life. Weight loss programs such as Weight Watchers and Jenny Craig have almost always been targeted towards women. However, shows like The Biggest Loser and MMA (Mixed Martial Arts) fighting, along with the Atkins Diet and Paleo Diet, have given a full spectrum of males looking to change how they look and feel a new motivation. The ability to easily access food, diet and supplement information online allows some anonymity for men to feel comfortable about learning how to make changes that will result in a change of physical-appearance. Women have forever laughed at the fact that men can make one little change in what they eat and immediately see results, which is a result of the higher lean body mass in males (the greater LBM, the more energy the body will utilize and burn at a rested state); but, it would seem that men have come to this realization too. Men have less food “cravings” than do females, and therefore have a greater ability to stick to a diet or follow a plan that has a small variety of foods and still feel satisfied. However, we also know that 95 percent of those who go on a “diet” gain it back within three years. As with all things, moderation is critical, and this is why, instead of jumping on board to whatever the next diet trend is, it is important to make changes

that you can sustain within your lifestyle. Orthorexia nervosa is a term that was introduced by Steven Bratman, MD. in the late 1990s that has the literal meaning of “correct appetite.” This is further described as a harmful fixation with healthy eating and healthy lifestyles; to the point that it interferes with the ability to live a balanced life. For the most part it is not about obtaining a specific weight, but rather to feel better than others by bringing the need to eat pure and healthy to an extreme. While it can present for both women and men, it does appear to be more common in men. Neglecting the fine line between wellness and obsession can be a slippery slope. To all of the men out there who are looking to make changes to your diet and exercise plan in order to be more fit and to feel better about yourself, we support you! Caution yourself to take the time to truly understand and research the information that you are obtaining. Talk with your doctor if you feel it may be extreme, consult with a registered dietitian to ensure that you are not missing out on any key nutrients and be sure that your focus on health only occupies one area of your life and lifestyle: do not let it become who you are.

“Dysmorphia relates to the distortion that they see in their appearance” Megan is the Director of Nutrition and Culinary Services at Rosewood Centers for Eating Disorders and A New Journey. She brings ten years of experience working with wellness programs, eating disorders, and addictions in men, women and adolescents. Megan is passionate about exploring tasty food combinations and creating new dietary approaches that allow patients to build a positive relationship with food. She is a Certified Eating Disorder Dietitian and an Approved Supervisor through IAEDP, and is passionate about educating dietary professionals to further understand the unique challenges of working with eating disorders. Believing that the mind body connection is an important part of the treatment and recovery journey, Megan has been a certified yoga instructor for nine years; and combines mindfulness practices and meditation techniques with traditional nutritional models. Megan teaches basic nutrition courses along with a graduate course on Eating Disorders and Addictions at Arizona State University, and she has presented at Universities, conferences and events across the country.

FOR MORE INFORMATION

To learn more about body dysmorphia or to seek help please go to rosewoodranch.com or call (800) 845-2211. IMAGE FROM SHUTTERSTOCK

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MEN’S HEALTH

GAMING...AND SOME HEALTHY SOLUTIONS A team at a hospital in London designed a typical video game in which a tank commander shoots the enemy and dodges enemy fire. The experiment showed that dopamine—the reward neurotransmitter—is released in the brain as a result of playing these games (from The Brain that Changes Itself, by Normal Doidge).

Gaming among young adult males is on track to becoming a widespread addiction. This behavior is changing the brain chemistry of young adult males at very vulnerable times in cognitive development. Gaming is not always innocent entertainment.

“Gaming is not always innocent entertainment” Scenario 1 The desperation was evident in the voice message left by the father of a 15-year old young man. “Hank won’t come out of his room, and his mom and I are really worried.” Hank was really angry, belligerent and had not come out of his room for days. Until recently, he was very involved in sports and known to be a “team player.” Now, however, according to his parents, he was sullen, withdrawn, without an appetite, uninterested in hanging out with his friends and began making errors in his sport so he could sit on the bench. What happened to Hank? Why did his behavior change so radically? We conducted a neurotransmitter test to see what was going on with his brain chemistry. Just as I expected, there was an issue with Hank’s dopamine levels. It turns out, he had been on low levels of natural amino acids that helped elevate his dopamine levels, but he had run out of the bottles and no one noticed, until now… When I told Hank’s parents that with any sort of addiction, that person is usually suffering from a dopamine deficiency. Hank’s behavior starting making sense. The adrenaline rush from gaming was a way for him to feel “normal,” the way people feel with standard levels of dopamine. Dopamine is often called the “feel good chemical,” and it is a factor in all addictions. According to Dr. Ken Blum and David Miller (authors of Overload: Attention Deficit Disorder and the Addictive Brain), addictions involve a lack of dopamine, which creates a cascade of problems in the brain. If the brain is not making enough of this neurotransmitter, an individual will often figure out how to get the “feel good” effects any way they possibly can. If the brain is not naturally producing enough of it, many people will go to drastic measures to generate the adrenaline rush or the feel-good state. It could be drinking, drug use, excess sugar consumption, over working or gaming. This is a frequent scenario for many young adult males. Gaming addiction can take hold of adult males as young as eight years old. The young brain is vulnerable, plastic and capable of change. However, not all the changes are good.

Scenario 2 Among young men in their late teens and early 20’s, gaming is an insidious time and motivation killer. The mother of a 24-year-old son asked if I could help “get [her] son to figure out what to do with his life.” When I agreed to see Sam, he told me that he often stayed in his room for the entire weekend. He gamed the whole time and also consumed an entire case of beer (apparently his only intake of calories for the entire weekend). In Sam’s case, we did some intense detoxification of liver and kidney levels, based on lab testing, which revealed high levels of aluminum and some malabsorption issues in his digestion. We also worked on neurological and emotional issues that were impacting his decision making. Eight months later, Sam is clear on his business goals, his mother is thrilled with his turn around and he feels good about himself. 12 12

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MEN’S HEALTH

Negative effects on the young male’s mind BY DR. PHYLLIS BOOKS

Characteristics of Dopamine Deficiency Chronic boredom; loss of satisfaction; apathy; fatigue; low physical energy; lethargy; lack of ambition. How does one become dopamine deficient? Possible causes include: family history of brain chemistry imbalances; poor nutrition or assimilation; stress or lack of sleep. People Addicted to Computer Games Show Some Signs of Serious Addictions: Experience cravings when they stop; neglect of activities (that were previously enjoyable); feel a sense of euphoria when using the computer; and have a tendency to deny or minimize their actual use.

Healthy Solutions It is best to be pro-active; however, this list is helpful if you suspect a gaming addiction, or if gaming, is already a significant issue: - Get plenty of exercise and good, quality sleep. Exercise releases endorphins and enkephalins, which are natural mood elevators. Research validates that exercise trumps drugs used to treat anxiety, depression and ADHD, hands down. - Good nutrition from balanced meals, good quality protein in the morning for sustained energy throughout the day, good fats to feed the brain, decrease sugar and caffeine which are quick energy fixes, but long term can create a more severe imbalance. - Do neurotransmitter testing to locate the brain’s chemical imbalances. - Do lab testing for heavy metal toxicity and mineral imbalances. - Be around supportive, positive people. - Seek out care from a well-rounded, open-minded health care provider who can oversee various treatment strategies. - Encourage family interaction. Talk to each other without electronic devices around. Do things together as a family. -If you know someone that may be struggling with a gaming addiction, encourage them to seek professional help from a qualified healthcare practitioner who can address the chemical, emotional, neurological and nutritional elements involved. Over the years, patients with ADHD, various addictions, dyslexia and other disorders have shown up in my office. Thirty years in the trenches has given me a back-to-basics approach to many modern problems, such as gaming. Getting back into balance naturally, without drug intervention, is the backbone of my practice. Gaming is a modern health care issue. Protect your loved ones from potential addiction.

“Among young men in their late teens and early 20s, gaming is an insidious time and motivation killer” “ FOR MORE INFORMATION

To book an appointment contact Dr. Phyllis Books at (512) 331-0668 or visit dyphyllisbooks. IMAGE FROM SHUTTERSTOCK

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MEN’S HEALTH

ANCIENT MEDICINE FOR MODERN DISEASES Low T in Men

by Dr. Dongxun Zhang D.AOM, LAc

One of the most common health problems for men today is hypogonadism, resulting from low testosterone, or “Low T.” This condition occurs when a man’s sex glands produce too little of this hormone or none at all. Each year, about 13 million men are diagnosed with Low T. Approximately 30 percent of men in their 50s and 60 percent of men in their 60s suffer from problems associated with a drop in testosterone levels. Testosterone plays an important role in men’s health; it is responsible for the male sex drive, helps to maintain muscle strength, size and mass and helps to maintain bone density. When testosterone levels drop, it can cause many problems for men, including the well-known condition of erectile dysfunction (ED). In the United States today, about 30 million men suffer from erectile dysfunction and many take medication to treat it. There are other symptoms associated with Low T.

Treatment with Synthetic Testosterone

The most common treatment for Low T is the application of a synthetic testosterone. This is applied in various ways, for instance patches taped on the skin, testosterone gels or creams applied to the chest or pellet insertion. Although such treatment can raise testosterone levels to normal, usually the symptoms of Low T do not go away, and the problems remain. The synthetic testosterone can even produce mild to serious side effects and may even put a man’s overall health at risk. For example, a recent study published in the Journal of Clinical Endocrinology and Metabolism showed that men who had undergone testosterone replacement therapy had no reduction in cardiovascular risk. In fact, according to one recent study published in the

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journal PLOS ONE, heart attack rates increased by 50 percent among men over 65 during their first three months of testosterone replacement therapy.

Ancient Knowledge Provides a Solution

Chinese medicine addresses the problem of Low T with traditional natural healing methods such as natural herbal medicine and specific physical exercises, like Qi Gong (pronounced Chee Gung). Men suffering from Low T are considered in Chinese medicine to have a kidney “deficiency,” or weakness. In men, the kidneys are associated with sexual function and with the production of testosterone. Kidney deficiencies can be generally classified as either Kidney ‘Yang’ deficiencies (these are more common), or Kidney ‘Yin’ deficiencies. Although all symptoms may not be present, the more symptoms a man experiences, the worse his kidney deficiency is. To treat a Kidney Yang deficiency, Chinese medicine gives herbal formulas to warm up the yang. When there is a Kidney Yin deficiency, a formula is given to tonify the Kidney Yin and to reduce the “fire,” or heat in the body. The result is that testosterone levels gradually return to normal levels. For thousands of years, many different formulas have been used to effectively treat the problems of kidney deficiency and its effects on testosterone production. One example is “Liu wei di huang wang,” an herbal formula that is designed to correct Kidney Yin deficiency. Herbal formulas can also be

combined with certain exercises to help correct the underlying problems of Low T.

Symptoms Associated with Low T

Infertility Depression Fatigue Insomnia Decreased muscle mass Increased fat mass Cholesterol Imbalance Osteoporosis Inability to focus/ concentrate Low sex drive

“Men suffering

from Low T are considered in Chinese medicine to have a kidney “deficiency,” or weakness”

MEN’S HEALTH

“A recent study published in the Journal of Clinical Endocrinology and ‘Metabolism showed that men who had undergone testosterone replacement therapy had no reduction in cardiovascular risk”

Golden Shield Qi Gong

For many years, Austin Natural Healing Center has combined special herbal medicine formulas with Golden Shield Qi Gong to treat yang and yin kidney deficiencies and to relieve the symptoms of Low T. Golden Shield Qi Gong is a very ancient method of exercise. In the early days, Daoist practitioners and even some Chinese generals practiced this type of ancient Qi Gong to improve their health, increase physical strength and promote longevity. In the old days in China, Golden Shield Qi Gong was one of the valuable systems that were kept secret from the general public. Only in modern times have such systems been taught more openly. At Austin Natural Healing Center, many people have learned and been practicing this ancient type of Qi Gong for over 10 years. Men with Low T have experienced definite improvement from doing Golden Shield Qi Gong. Some of the male practitioners are able to retain their sexual function well into an advanced age, including the ability to have children while in their 70s. Golden Shield Qi Gong has also helped with other Low T symptoms such as erectile dysfunction, fatigue, bone density, osteoporosis and low sex drive. Although the modern drug approach to Low T can bring testosterone levels back to normal, the problems associated with Low T remain. The good news is that ancient medicine can provide a solution to Low T through the use of herbal formulas and Golden Shield Qi Gong.

Symptoms of Kidney ‘Yang’ Deficiency

Erectile dysfunction Premature ejaculation Male infertility Low sex drive Frequent urination Night time urination Nocturnal emission Ringing in the ears Degeneration of hearing Grey hair and eyebrows at an early age Loose teeth when young Excess fat around waist Cold feet and hands Lower back pain

Symptoms of Kidney ‘Yin’ Deficiency

Erectile dysfunction Infertility Low sex drive Insomnia A lot of dreams Hot hands/palms Hot feet- do not like feet to be covered at night Prefers cold drinks over hot Feel hot Night sweats Red tongue, dry mouth Muscle mass degeneration Sore throat FOR MORE INFORMATION To learn more or to schedule an appointment, visitaustinnaturalhealingcenter. com Call 512-306-0535 or stop by the Austin Natural Healing Center at 3701 Bee Caves Rd, suite 102

IMAGE FROM SHUTTERSTOCK

A U S T I N MD M A G A Z I N E . C O M

MEN’S HEALTH

GOOD SLEEP, GOOD HEALTH Mens’ guide to healthy living through proper sleep hygiene

SPECIAL CONTRIBUTION TO AUSTIN MD MAGAZINE BY TEXAS SLEEP MEDICINE BY STEVEN GALVAN For hundreds of years, sleep was thought to be the time where a person’s body simply shut down and allowed the mind to enter a state of play. While this belief still holds true, science has begun to uncover the countless other benefits that sleep provides to the human body and mind, other than pleasant dreams. Sleep Medicine has grown immensely over the last 20 years and has proven that poor sleep can be directly linked to cardiovascular diseases, diabetes, mental health and so much more. Although some sleep disorders, such as Narcolepsy, can stem from both genetic and environmental factors, sleep doctors are able to successfully treat the majority of disorders. There are many variables that can influence the way people sleep. Whether it is gadgets, bed partners or even pets, reducing these negative variables can improve the life of any person seeking better sleep. Texas Sleep Medicine has compiled a short list of proper sleep hygiene “to-dos” that every man should follow in order to live a happier, healthier life. Guys, we know it is tough to follow yet another list of to-do’s, but this advice can help you sleep and feel better. We promise.

“Whether it is gadgets, bed partners or even pets, reducing these negative variables can improve the life of any person seeking better sleep”

To-Do #1: Lose the phone! No, we do not mean throw your fancy new device out the window. It means charging your phone in a place where you cannot reach it at night. Studies have shown that the blue light emitted from devices like iPads, laptops and smart phones have the ability to reduce sleepiness and can even lead to insomnia, in some cases. If you want to feel better in the morning and stay sharp throughout the day, charge your device at a desk or dresser. This can prevent you from checking those pesky Facebook notifications that are keeping you up all night.

To-Do #2: Midnight snacks can wait 'til morning No, we do not mean throw your fancy new device out the window. It means charging your phone in a place where you cannot reach it at night. Studies have shown that the blue light emitted from devices like iPads, laptops and smart phones have the ability to reduce sleepiness and can even lead to insomnia, in some cases. If you want to feel better in the morning and stay sharp throughout the day, charge your device at a desk or dresser. This can prevent you from checking those pesky Facebook notifications that are keeping you up all night.

FOR MORE INFORMATION If you or someone you know snores at night, give us a call at (512) 440-5757 or visit us at txsleepmedicine.com to learn more about sleep disorders and treatments

To-Do #3: If You Snore, Get Help! Here at Texas Sleep Medicine, we cannot stress enough the importance of healthy sleep. When snoring becomes an issue for yourself or your bed partner, you should seek medical advice from an academy accredited sleep doctor. Snoring loudly can be an indicator for a much more serious problem, such as Sleep Apnea. Sleep Apnea can be directly linked to heart issues, weight-gain and in rare cases, death. Texas Sleep Medicine is here to help the men of Austin lead healthier, happier lives.

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A U S T I N MD M A G A Z I N E . C O M

EVENTS

The X-Games 2014 Texas only does things in one size: BIG. The first ever X-Games Austin were hosted at the Circuit of the Americas taking over the Formula One race track with the best athletes from all over the world. Attendees and athletes for this alternative Olympic-style celebration were greeted with open arms by over 160,000 of our closest friends. Four days of high-flying, nail-biting, gravitydefying action sports along with interviews and entertainment from renowned musical performers such as Kanye West, Pretty Lights, and the Flaming Lips, X-Games Austin is sure to become another great iconic Austin attraction!

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EVENTS

The Horn Celebrity Golf Tournament

The Horn Celebrity Golf Tournament hosted by Falconhead Golf Club and sponsored by Apple Leasing and Donate Life was right on par creating an amazing opportunity for a great cause. Donate Life supports organ, eye and tissue transplants offering patients a new chance at a healthy, productive normal life and return them to their families, friends and communities. You have the power to change someone’s world by being a donor; it’s about living, it’s about life and playing golf is just an added bonus for this fun event!

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LEARN & PLAY

under real course conditions at Nicklaus designed private practice hole course. 3:1 (or lower) student teacher ratio. Rated by Golf Magazine as one of America’s Top 25 Schools.

NOBODY OFFERS MORE.

NOBODY!

1.800.879.2008

WWW.GOLFDYNAMICS.COM

45 Club Estates Parkway • Austin, TX 78738

EVENTS EVENTS

ThePerfectly Perfectly The PinkParty Party2014 2014 Pink The third Annual Perfectly Pink Party sponsored by Texas Oncology The and thirdTexas AnnualBreast Perfectly Pink Party by Texasraising Oncology Specialists wassponsored a huge success funds for and Texas Breast Specialists was a huge success raising funds for the Austin community of families with breast cancer and research the Austin community of families with breast cancer and research advances for cures. This yearâ&#x20AC;&#x2122;s event hosted at Brazos Hall included advances for cures. This yearâ&#x20AC;&#x2122;s event hosted at Brazos Hall included complimentary valet parking, scrumptious food and drinks by complimentary valet parking, scrumptious food and drinks by Sterling Affairs, a Club Pink after-party with entertainment by DJ Sterling Affairs, a Club Pink after-party with entertainment by DJ Johnny Bravvo and signature Pink and Pizzazz giveaways. The night Johnny Bravvo and signature Pink and Pizzazz giveaways. The night was filled with amazing honors, great people and a plethora of pink! was filled with amazing honors, great people and a plethora of pink!

M AM GA AG ZA I NZEI .NCEO. C M O M1 22 A UAS UT SI NT MD I N MD 1

EVENTS

The White Party 2014 This year’s White Party was incredible. LifeWorks’ annual sell-out event was a hit with returning primary sponsor Kendra Scott and Patron Tequila making its debut as the exclusive spirit sponsor. The philanthropic elite gathered once again at the Long Center terrace to mingle, dance, and give back to the community. Thanks to our fantastic sponsors, party goers enjoyed a fun-filled evening beneath Austin’s gorgeous skyline while raising vital funds to help fulfill LifeWorks’ mission.

To l e a r n m o r e a b o u t L i f e Wo r k s , please visit our website w w w. l i f e w o r k s a u s t i n . o r g or our facebook page facebook.com/lifewor ks.austin

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confidence is beautiful.

look your best. feel your best. Live your best.

the cosmetic surgery center of scott & White in round rock Let us empower you.

512-509-3963 cosmetic-surgery.sw.org

Meet our board certified plastic surgeons: Susan M. Pike, MD (left) and Staci J. Hix-Hernandez, MD

BEAUTY

CONFIDENCE SHOULD NOT COME WITH A PRICE Finding your happiness at Novopelle by Samantha Schak Photography by Steve DeMent

B eauty is a luxury. Services like laser hair removal, skin

rejuvenation and professional weight loss programs are reserved for the wealthy. One medical spa, Novopelle, is working to reverse these widely held beliefs. Starting in Dallas in 2008 and eventually expanding to Austin and Houston, Novopelle offers medical cosmetic services where everything is upscale, except the price. They have found a way to cut their overhead with reasonable rent prices and reducing their advertising budget, with 90 percent of their business comes from referrals. Like many Austin businesses who thrive on word of mouth, their customers are their advertisements. Their business starts and ends with personalized customer services from their qualified staff. Each member of their staff is certified by the Texas Department of State Health Services. Regardless of experience, new hires are trained for two weeks on Novopelle treatment guidelines; although, you will find new hires hard to come by since they take such great care in choosing. Larger chains can afford to disappoint a customer or two. Novopelle does not take such chances. Their staff must be both passionate and meticulous when it comes to following a strict protocol. Their skin care services vary from laser hair removal to facials to skin rejuvenation. After researching and working with multiple laser hair removal technologies, they work with the Candela Gentle Lase and the Gentle Yag for optimum results within fewer treatments. All parts of the body can be treated except the area underneath the eyebrows. Waxing, shaving and tweezing is painful, time consuming and expensive in the long run. For anyone looking to experience laser hair removal before purchasing a package, Novopelle offers a free session to see the results.

Skin rejuvenation is a laser skin treatment that tightens the skins and contracts collagen proteins to reverse the signs of aging. This non-surgical procedure can be used on the face or the entire body. The laser used creates a beam of highintensity light that penetrates the skin, delivering a targeted amount of therapeutic heat. A cooling device is also administered to protect the upper layer of skin, allowing for minimal side effects. Novopelle also offers routine facials and skin peels. Austin has 300-plus days of sunshine per year. Their facials help remove impurities from the upper layer of skin while their peels remove the damaged outer layer of skin altogether. Novopelle also offers VI Peels. This procedure reduces or eliminates age spots, freckles and irregular skin pigmentation while stimulating the natural production of collagen to the face. Additionally, Novopelle is the first facility in Texas to offer the KE Diet. Here is how it works: for ten days, the body is supplied with a low calorie, protein and fat-rich solution, delivered through a feeding tube. This tube goes through the nose directly to the stomach. The solution is delivered 24 hours a day through a small pump easily carried in a small shoulder pack. This solution, filled with proteins and fats, forces the body into a state of ketosis. Without sugar or carbohydrates, the body starts to burn its own fat. The result is losing up to 20 pounds in ten days. After the ten day procedure, consultants are on hand to maintain a healthy lifestyle and reach ultimate weight loss goals. Everyone deserves to feel good. Everyone deserves to have services like these performed by well qualified, caring consultants and doctors; these are the standards Novopelle works to uphold.

FOR MORE INFORMATION Visit novopelle.com or call 512-462-1433 IMAGE FROM SHUTTERSTOCK

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BEAUTY

Men are heading to their doctor’s offices to get nipped, tucked and polished before heading out for a second chance

BASIC SKIN TENETS FOR ALL HUMANS... Dr. Ling’s handy-dandy guide to men’s skin Special Contribution to Austin MD by Dr. Shirat Ling, D.O.

hree very burly men meet in a dimly-lit bar sporting shaggy beards, loose t-shirts and generic jeans. They greet each other with strong handshakes and order beers. Then, the inevitable question arises when I meet them, “So...what do you do?” I reply, “I play with people’s faces,” which of course draws their curiosity. I explain, “I am a cosmetic physician. I sculpt people without the use of surgery...you know, botox, fillers and lasers.” Then I flash a large smile, and await their response with a hint of amusement. Most guys become a little uncomfortable and half-jokingly ask if I can give them fuller lips. But a bizarre phenomenon unexpectedly occurred that night; these men started talking about how much botox they use to tame their angry 11’s, or “frown lines.” They proceeded to asked how much I charge for botox and then inquired what else I could recommend for them. I was floored, and yet I felt quite honored to have been privy to such information. I honestly did not believe heterosexual men would be so open to freely discussing such things with a total stranger, let alone with other heterosexual men in such a relaxed public setting. Why is it that men seem to age more gracefully than women do? Women experience a precipitous decline in female sex hormones during menopause. The ‘male menopause,’ or andropause condition, has recently gained more attention. However, this is not a proper representation of the changes associated with the male aging process. True, men do experience declines in hormonal levels, but not nearly to the extent to which females do. Their testosterone promotes a better foundation (bone density and muscle mass) to their faces from the start, so the skin has more to hold on to than a woman’s does when things start to go south. Men today are more often feeling the pressures that many women have classically been concerned with. Working later in life means competing with younger men in the workforce. Trends in cosmetic procedures also reflect these changes. Men are heading to their doctor’s offices to get nipped, tucked and polished before heading out for that proverbial second chance. Guide to Men’s Skin:

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Stay hydrated by drinking half your bodyweight in ounces as a baseline, PLUS two cups of water for every cup of caffeine or alcohol, and more if you exercise. Cleanse your face and body daily; wash in the morning with your shaving routine and most thoroughly in the evening before bed. Use a face cleansing brush with soft bristles to remove the dirt and oil from your pores to minimize their apparent size. Do not borrow your significant other’s face wash; you probably do not share the same skin type. Also, avoid harsh body washes when possible. Splash your face with lukewarm water after working out; this helps prevent both Wrinkles face and body acne. Apply sunblock daily with a minimum SPF of 30. Always apply 30 minutes prior to exposure, then reapply every hour (the waterproof version is only good for 80 minutes) while exposed. Do not forget the back of the neck, earsDull (those baseball caps will Lifeless Skin not protect them) and hands. Remember, most clothes have a UPF of 5, so apply SPF on your skin underneath. Another defense tactic: Wash your clothes with a laundry additive called SunGuard (sunguardsunprotection.com). One wash gives any shirt an SPF of 30—the same as a UV-shielding shirt—and the protection lasts for 20 wash cycles. Despite some thicker skins, American men on average have a greater incidence of skin cancer than women. This obviously goes without saying: avoid tanning booths as they are pure cancer boxes with unadulterated UVA (aging) and UVB (cancer) rays. Look for lighter versions of sunblock that do not clog skin. Try this regimen for a week to get used to wearing a moisturizer; it might feel heavy at first, but your skin will realize its helpfulness and gradually accept it. Do not smoke cigarettes and avoid secondhand exposure whenever possible. Smoke erodes the skin’s natural collagen and has proven detrimental to one’s health. Get enough sleep! It will help keep off the weight by managing Leptin-hormone levels and helps allow your body to naturally do its remodeling and regenerating. Guys need beauty sleep too! Exfoliate. Our skin does not turn over as we age in comparison to women. Exfoliate mechanically with a face brush or microdermabrasion, chemically with Alpha Hydroxy Acids or retinoids at home, or use chemical peels during down time in the office. This helps you to maintain an even and bright complexion.

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BEAUTY Most men exfoliate with a razor every day, so limit the exfoliation to the upper half of your face. Avoid excess alcohol consumption. It dries out your cells and leaves you looking puffy and tired. De-stress with exercise, yoga and other leisurely activities. Exercise consistently. Past the age of 40, we lose approximately one percent of our muscle mass each year. Laxness of facial muscles and loss of muscle mass are only two factors that lead to facial sagging. Our facial bones continue to change over time, with some expanding and others slowly breaking down or melting away in a process called retrusion. Exercise helps build and maintain bone and muscle mass curbing the process of retrusion. One specific concern with regards to the aging male may include the crux of a receding hairline. This process can be delayed by the use of products such as rogaine and propecia. Hair transplants usually range in the thousands of dollars. Ear hairs are another concern. Consider tweezing or laser hair removal. Droopy eyelids are an issue that can be easily addressed through CO2 fractional laser therapy that is used near the eyes to build collagen, strengthen and tighten the skin around the eyes. Blepharoplasty is a surgery that removes excess tissue and sometimes fatty-like pads from the eye area. If the ptosis is severe enough, your insurance may cover the cost of this surgery. Jowls might be of concern to some. Mesotherapy can be used to dissolve spot fat, however liposuction is usually avoided above the jawline due to the salivary glands and nerves in the area. Skin Tightening with IPL, or CO2 fractional laser therapy, also helps tighten the skin. Pseudofolliculitis (ingrown hairs from shaving) can be reduced by shaving in the direction of the hair growth to prevent driving bacteria under the hair follicles. Use a single blade or a blade covered with wire and shave every other day if possible. Unless you feel compelled to grow out all your facial hair and have a wildman experience, you may consider laser hair removal (at least on the neck) to reduce your chances of nicking and possible lifelong scars. Pseudofolliculitis Nuchae, a related condition, occurs on the back of the neck, often along the posterior hairline, when curved hairs are cut short and allowed to grow back into the skin. As for aftershave and moisturizer, you need to use both. Aftershave only returns the pores to a normal size while moisturizer keeps the skin from harmful dehydration. Gynecomastia (aka “Man Boobs”) usually develop with obesity and are a result of testosterone converted to estrogen. First, balance your hormones, then address the cosmetic appearance with mesotherapy or liposuction to dissolve the spot fat.

A monthly regimen may include: • Microdermabrasion • Chemical peels, • Botox • Dysport or Xeomin (recommended every three to four months) • Microneedling Annual recommendations include dermal fillers—Juvederm, Restylane or Perlane—in deep wrinkle and CO2 fractional laser therapy. For those uneven pigments such as brown spots, daily preventative methods include some type of antioxidant or Vitamin C serum in the morning underneath your recommended sunblock application. Treatment methods incorporate bleaching agents such as hydroquinone or azelaic. Monthly procedures entail such things as photofacials, microdermabrasion, chemical peels and microneedling. One annual option is CO2 fractional laser therapy. Recommended daily prevention of acne includes applying sunblock daily with your normal skin regimen, using alpha hydroxy acids face wipes, retinoids and regenerative epidermal growth factors. Monthly preventative techniques consist of acne treatments on the IPL, microdermabrasion, chemical peels, and facials with extractions. Both jowls and sagging skin can be lessened by incorporating the same daily preventative measures of utilizing a daily skin regimen with sunblock, exfoliating with alpha hydroxy acids, applying retinoids cream and ingesting epidermal growth factors for rejuvenation. Recommended monthly procedures for jowls include mesotherapy; sagging skin requires microneedling, and both can utilize skin tightening with IPL. Annual CO2 laser therapy can help keep these issues at bay. For under eye circles, revention includes a daily skin regimen with sunblock, the use of alpha hydroxy acids, retinoids, epidermal growth factors to help regenerate the skin, and eye cream. Annual procedures incorporate dermal fillers—Juvederm, Restylane, Perlane, Radiesse, and Belotero—in deep wrinkles, and CO2 fractional laser therapy that helps build the collagen to thicken this fragile skin area. You too can age gracefully with just a few tweaks in your routine. Stay juicy my friends, and be confident enough to discuss botox in a bar with your bros.

For those concerned with wrinkles or acne scars, here are some daily preventative methods:

• Applying sunblock daily • Using alpha hydroxy acid face wipes and • Ingesting epidermal growth factors to help regenerate collagen. IMAGE FROM SHUTTERSTOCK

FOR MORE To book an appointment or schedule a consultation please go to innatebeauty.com or call (512) 656- 5464.

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LIFESTYLE

A Guinness A Day Keeps the Doctor Away A breakdown of beer

BY MARY DELGRANDE

“There are a handful of chemical reactions that take place in the brewing process” Beer—the worlds oldest and most widely consumed alcoholic beverage— is produced from four simple ingredients: water, grain, hops and yeast. When properly combined at the right temperature and under a specific set of conditions, the end result is a delicious, liquid concoction of alcohol and carbonated bubbles. The brewing process is anything but simple; however, the yield is exceptionally tasty. Archaeologists estimate that ancient Egyptians brewed the first beer in the sixth-century. It is thought that they left cereal grain outside, overnight in the desert heat, and upon returning in the morning the grain fermented and turned into the drinkable substance that we know today as beer. Ever since, beer is known to bring people and communities together to celebrate life’s milestones, enjoy delicious food and help spawn meaningful conversations that build emerging civilizations. There are a handful of chemical reactions that take place in the brewing process. The first step is called malting, which combines grain with water to reduce the complex grain molecules, or polysaccharides, down to simple sugar molecules, monosaccharides. Water is typically unfiltered to add necessary micronutrients such as calcium and magnesium. When the substance is boiled, the water evaporates as steam, and the remaining minerals, calcium and magnesium, extract the bitter compounds from hops to balance out the sweetness from the yeast and magnesium, which is responsible for the production of the sex hormones, testosterone and progesterone. This is done by soaking the grains in hot water for an extended period of time at high heat to extract the flavors and strength necessary for the brewers final product. One might think of malting grains as steeping tea leaves or coffee beans in boiling water to extract their caffeine for enhanced energy, taste and aroma. In the case of brewing, the polysaccharides are broken down into monosaccharides at a fast pace at high heat to extract their cellular energy for flavor, taste and strength. The malted grains are then dried in a kiln for fermenting. The

malting process creates a mash known as liquid wort, which is drained off to be mixed with the hops plant after fermentation, adding bitterness, flavor and aroma that acts as both an antibiotic and a natural preservative. Depending on the strength and head, or foam, of the beer desired, more or less hop seeds are added. The dried substance undergoes the process of fermentation, where malted grain and brewers yeast combine to convert this liquid material of sugar and water into ethanol as alcohol and carbon dioxide as gas in a copper kettle. For this conversion to happen during fermentation, the environment must be anaerobic, or without oxygen, so the sugars can react to convert into ethanol and carbon dioxide in a controlled environment at high heat. The heat, combined with the copper metal, speeds up the natural fermentation reaction that might occur when some type of seeds or sugars are left out for an extended period of time. Frequently, if oxygen is present, the sugars will not convert to alcohol; instead, they may yield a sugary, watery substance. The amount of ethanol in the liquid from fermentation determines the alcohol by volume (ABV) percentage. The greater the yeast content, the higher the ABV. According to a 2008 article written by the Journal of the American Dietetic Association, those who drink one-to-two glasses of beer a day reduce their risk for heart disease, and increase their levels of the good cholesterol (HDL) while lowering their levels of bad cholesterol (LDL). Moreover, some dietetic experts believe that beer prevents blood from coagulating, or sticking, which allows blood to smoothly flow throughout our arteries and veins, preventing blood clots. So, even though you might have beer to thank for giving you liquid courage or thinking like a genius, when consumed in moderation, the health benefits of beer may limit your doctors visits to normal checkups and improve your physiological health overtime.

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LIFESTYLE

Around Town With the Doctor

DR. OKEMEFUNA OKPARA SHOWS US WHERE AUSTIN’S TOP YOUNG DOCS STAY FIT AND HAVE FUN BY DR. PATRICK CARNES PHOTOGRAPHY BY STEVE DEMENT

3. What do you do to stay healthy and

1.What do you like to do in your free time? active? Do you have any favorite places Traveling is one of my great passions, so when I am not at work I am usually off to someplace fun. The further and more off the beaten path, the better. At this point, my list of countries visited has topped 40! I will be going Brazil for the World Cup in June/ July. If, however, I am free and in town, then relaxing on a friend’s boat in town lake on a warm afternoon is also a favorite pastime.

2. What do you do to unwind? When I need to unwind after a stressful week, I go get a massage. It may sound cliché, but I schedule a two hour massage every two weeks, come rain or shine. As a huge fan of movies and film, I will also look up Fandango’s latest movie section and go watch a movie on a whim if it pops into my mind.

to exercise?

Being healthy not only requires physical commitment but also a particular state of mind. I simply eat healthy and will avoid anything fried. Period. Admittedly, I may have some French fries once a month or have fried plantains whenever I visit family (plantains are a staple in the diet of my west African heritage). I have had a personal trainer for over two years and schedule workouts routinely, at least twice a week at his house. If not there, I will hit the gym at 24 Hour Fitness on my own. Finally, I also try to run the 3-mile circuit of town lake once a week, and because I live so close to the trail, I can actually run straight from home! When I really want to push myself to the limit, I will stroll down to Zilker park for a pick-up game of soccer.

Enjoying the outside patio at Perla’s with his Austin Emergency Room Staff

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LIFESTYLE

Enjoying a pick-up soccer game at Zilker Park

4. What is your favorite restaurant in Austin? Do you have a favorite healthy snack? My favorite Austin restaurant has to be Perla’s Seafood on South Congress. If weather permits, sitting on the open air deck selecting from an assortment of yummy seafood and oysters that are out of this world is an experience my girlfriend and I enjoy very much. The grilled octopus is delicious. Otherwise, picking out food from the vast selection at Whole Foods Market downtown frequently saves me a lot of hassle.

5. What do young, medical professionals do in Austin? Most of my friends are also physicians and as a result have somewhat busy schedules. However, we still do make time to get together often for dinner, either out on the town or at someone’s home. Most of them can cook and grill so it is always a great time. The W Hotel is a favorite place of ours to meet up and have a few cocktails. From late spring through early fall, we also try to meet up intermittently on town lake and just relax on the boat or wakeboard.

6.What’s it like having two healthcare/medical professionals in the same household? My girlfriend lives out of town, so whenever she comes to visit, she pretty much enjoys doing everything I enjoy doing. Great for me, right? She is not in the medical profession but works in retail/marketing.

FOR MORE INFORMATION Okemefuna I. Okpara, M.D. FACEP is a Medical Director at the Austin Emergency Center-Far West. This location can be reached at austiner.com or (512) 481-2321.

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LIFESTYLE

Do-It-Yourself

SHAVING CREAM

by Grace Singstad Photogrpahy by Steve DeMent

Coconut oil is one of the best organic ways to make your skin and hair smooth and nourished. There are many health benefits that come with using coconut oil. One is how hydrating it is for your skin. While soaps and chemicals used to make shaving cream dry out your skin, this recipe for homemade shaving cream hydrates skin and leaves a light glow. Using coconut oil at home is a very simple and fun way to take care of your skin! The recipe calls for rosemary and mint essential oils for smell, but make it your own by adding your favorite scent! The product does best in a jar at room temperature stored somewhere out of the sun.

Easy Steps: 1. Combine equal amounts of Shea butter (any brand, I used Dove Shea butter body lotion) and melted coconut oil into a bowl. 2. Whisk until the ingredients are evenly mixed. 3. Add 10-15 drops of scented essential oils. 4. Whisk again to mix scented essential oils with Shea butter and melted coconut oil solution. 5. Whisk again every 15 minutes until mixture takes on a pudding-like texture. Apply a thin coat of the product evenly over any area of dried skin as a general moisturizer. After shaving you can wipe off the excess cream with a damp towel or just utilize the remainder again as a general moisturizer. FOR MORE INFORMATION We found this amazing recipe at foodformyfamily.com

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FITNESS HEALTH

A MENTAL GAME

TECHNIQUES TO IMPROVE YOUR GOLF SEASON Special Contribution to Austin MD by Academy of Golf Dynamics

ow many of you have reached a point in your golf game where you feel like you have plateaued? You feel like no matter how many balls you hit on the range, you just do not seem to get any better. Well, here is another question for you: How many of you have ever spent any significant amount of time on your mental game? If your answer was, “Not much!” then you may have just found the problem. You are part of a special group...you are golfers. You picked the hardest game in the world to play. You also picked the best, and sometimes, most rewarding game in the world to play. You do not have to be built like LeBron James or J.J. Watt to be a good golfer. You do, however, need to be able to think properly and decisively on the golf course, so pay attention. 1)Your first step is to SET GOALS Setting goals is important for several reasons. Goals help give you something to work toward to make yourself better. Goals are great, as long as they are attainable. Make sure that when you set goals for yourself, think “baby steps”. The goals you set for your golf game should be attainable. If your average score is 90, you have no business thinking about shooting for 72...for now. For instance, set a goal to raising your average score down to 88. Once you have achieved that, reset your goal for 85. Resetting your goals is something you may have to do from time to time and that is a good thing. It means you are making progress. So the lesson here is: Be realistic when setting your goals. 2) IDENTIFY YOUR WEAKNESSES Identifying your weaknesses lets you know where your game needs the most work. If the brakes on your car are failing, it will not do you any good to go to the car wash. Why? Because your break problem is still there. You know what the problem is, now fix it. You can do this very easily with your golf game by keeping track of where you are losing shots. Whether you are a scratch player or a 36 handicapper, this can be narrowed down to

two categories: Loose swings or bad decisions. Keeping track and categorizing your mistakes into one of these two categories lets you know if you need to spend more time working on the physical aspects of your game or your course management. Efficiency is always the key when practicing. 3) HARNESS EXPECTATIONS Expectations are much like goals. If they are realistic they can be helpful. But if you watch Rory McIlroy on T.V. and go out the next day expecting to hit all of your shots like he does, well... Augie Garrido, the baseball coach for The University of Texas (coach Garrido has coached 6 National Championship baseball teams) has said expectations hinder performance as much as any aspect of baseball. The point here is to focus on the process and not the results. This perspective applies to golf as well. Do not focus on what you want to shoot or even what you want to make on a particular hole. Focus on the shot at hand. Build your round shot by shot. Do not expect to shoot a certain score; however, do expect to execute your shot the way you have it planned. Not only will this technique help you hit more shots the way you want but it will also help to relieve the pressure off of shooting a certain score. So rather than focusing all of your energy on hitting a plethora of balls this year, devote more time on your mental game. Keep track of your mistakes, and focus more time on your weaknesses. Remember to set goals, identify your weaknesses and harness these expectations, and with confidence let’s make this year on the range your best yet! The oldest cliché in golf is still the most applicable: One shot at a time.

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FOR MORE INFORMATION

For more information on the Academy of Golf Dynamics call (512) 261-3300 or golfgynamics.com.

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HEALTH

FAT 101

THE GOOD V. THE BAD by Avinash Ramchandani, MD Medical Director Pain Care Physicians Founder Painless Nutrition, LLC

n the early 1980s to the mid-’90s, the American Heart Association was focused on daily fat intake and keeping our saturated fat intake as low as possible. The focus was on new technology, one of which was hydrogenating vegetable oil through an unnatural process, creating things like margarine. It was thought that butter was the evil of all evils, and that saturated fat caused the preponderance of heart diseases and new world illnesses seen in the United States. We now know that although keeping fat intake below a certain amount— in general—is likely a good idea, not all fat is necessarily bad. We also now know that the picture is much more complicated than saturated fat being the sole cause of heart disease. There are many contributing factors – including total caloric intake, types of fat ingested, health history (including diabetes, hypertension and family history) and lifestyle. We also know that margarine and other items containing trans fatty acids (also known as trans fat) are extremely harmful to one’s health and have increased cardiovascular risk by 23 percent when more than 2 g are consumed per day. We know definitively that trans fat is bad for you; but, what exactly is trans fat? Without getting too far into the chemical breakdown, the major source of dietary trans fat comes from vegetable oils (which are usually unsaturated) that are artificially

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“Not all fat is necessarily bad” converted to saturated fat, such as butter. The main difference between trans fat and natural saturated fat is that when unsaturated fats are converted artificially to saturated fats, the chemical process does not allow a full conversion to saturated fats. Moreover, some of the fats turn into unnatural compounds, which “wreak havoc” on the body when consumed. Although dietary trans fat mostly comes from unnatural sources, there are some natural sources of trans fat, including a small amount from meat and diary. Bacteria that are natural in meat can convert some unsaturated fat into trans fat. Furthermore, the manner in which vegetable oils are refined using a steam process turns some of the natural unsaturated fat into trans fat. Hence, even if we eliminate all artificially produced trans fat in the body, we still would not have removed of all trans fat.

food by reading their labels, or by not purchasing anything containing a label (i.e. processed foods). If you see something that says “partially hydrogenated vegetable oil” or “hydrogenated vegetable oil,” then consider not eating it. Well, how about saturated fat? It is the fat seen in most animal fats, such as butter and lard, but it is also found in some fruits and vegetables, like coconuts, avocados, nuts and many other items. Saturated fats are natural and are processed using natural bio mechanisms. Although saturated fat does have an increased incidence in cardiovascular risk, the risk is not nearly as high in comparison to unnatural trans fat. Although limiting your fat intake may be a good idea, limiting the amount of saturated fat and eliminating almost all trans fat is presumptively the best method to maintain a healthy diet and lifestyle. In fact, the anti-inflammatory diet, as suggested by Dr. Weil and others, involves plenty of natural, unsaturated fats, which may include coconut oil or expeller-pressed canola oil.

The FDA currently requires any amount of trans fat greater than 0.5 g to be labeled on the nutrition labels. Unfortunately, this means that foods containing less than 0.5 g may be labeled as “trans fat free.” This could mean that someone who eats several items that are “trans fat free” may actually get more than 2 g of trans fat per day, which is above the recommended daily intake and FOR MORE INFORMATION increases risk of cardiovascular To learn more about Painless Nutrition disease by 23 percent when or Dr. Ramchandani visit the site at consumed consistently. nutritionispainless.com or follow them on The key to eating is to evaluate each IMAGE FROM SHUTTERSTOCK

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HEALTH

BALLOON SINUPLASTY

WHAT IT IS & WHAT YOU NEED TO KNOW Special Contribution to Austin MD Magazine by Capital Otolaryngology by Zachary Wassmuth, M.D.

tâ&#x20AC;&#x2122;s a beautiful day in Austin, Texas, but unfortunately the allergy forecast has called for high mold counts (sad face). Despite allergy medications, you know that sinus pressure and a sinus headache are in the forecast for you as well. Others may have bigger problems with ragweed, cedar, or oak. Many people dread barometric pressure changes while others fight recurrent sinus infections with antibiotic after antibiotic. Is there anything that can be done? For many years, patients with the above complaints either had simple treatment such as allergy medications and antibiotics or aggressive treatment that included sinus surgery. In 2005, the FDA approved balloon Sinuplasty. Balloon Sinuplasty is a minimally invasive procedure that relieves pain and pressure associated with sinus inflammation. It also effectively treats chronic sinusitis patients who are not responding to medications such as antibiotics, nasal steroids, or other sinus medications. Using balloon catheters similar to the ones used in angioplasty, the otolaryngology surgeon is able

to dilate blocked sinus drainage pathways. Opening the sinus drainage pathway using balloon Sinuplasty helps drain mucus and restore normal sinus drainage without cutting, bleeding, or any significant risk to the patient. This approach also preserves the natural structure of the sinuses. Balloon Sinuplasty is typically performed in the clinic setting under mild sedation. It takes about 15 minutes to dilate the sinuses. Since there is no cutting or bleeding, nasal packing is not necessary after the procedure. Most patients are back to work in under 48 hours. Interestingly, not only do most patients get immediate relief from their sinus complaints, but they also note improvement in their nasal breathing as a side effect of the procedure. Studies have shown that the sinus dilation is not short-lived and most patients can expect permanent relief. In similar studies, over 95% of patients noted improvement of their sinus complaints and over 95 percent of patients stated they would undergo balloon Sinuplasty again if necessary. IMAGE FROM SHUTTERSTOCK

If sinus problems are a constant part of your life, evaluation by an otolaryngologist who specializes in balloon Sinuplasty may be the next step to improved sinus health.

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FOR MORE INFORMATION To schedule a consultation or to learn more please visit capoto.com or (512) 339-4040

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MENTAL HEALTH HEALTH

The Best Defense Is Prevention! Heat-related Illnesses

Special Contribution to Austin MD Magazine from Scott & White by Robert D. Greenberg, M.D.

ith temperatures in the Austin area expected to hit triple digits soon, it is crucial to your health to be aware of heat-related illnesses. And with warm weather comes time for outdoor activities in one of the most active

cities in America. However, the smoldering Texas heat can be dangerous without taking the necessary precautions. Anyone is susceptible and everyone needs to be alert to the dangers of heat-related illnesses. People suffer from heat-related illnesses when their bodies are unable to sufficiently cool themselves. When the humidity is high, sweat cannot evaporate as fast, which prevents the body from releasing heat quickly. Other factors at play may include age, obesity, prescription drugs, heart disease, high blood pressure, poor circulation, dehydration and the use of alcohol.

Heat Cramps Generally heat cramps affect people who are sweating during strenuous activity. If you have heart problems or are on a low-sodium diet and being to experience heat cramps, get medical attention. Stop all activity and sit quietly in a cool place, drink sports drinks and seek medical attention if they do not subside in one hour.

There are several factors, however, that can affect the bodyâ&#x20AC;&#x2122;s ability to cool itself during extremely hot weather. We must protect ourselves when temperatures soar.

1. Slow down, avoid strenuous activity and pace yourself. 2. Drink plenty of fluids. Do not wait until you are thirsty to drink. It is also in your best interest to not drink liquids that contain alcohol, caffeine or large amounts of sugar. Warning: If your doctor generally limits the amount of fluid you drink or has you on water pills, ask how much you should drink when it is hot outside. 3. Drink sports drinks to replace salt and minerals you lose in sweat. Warning: Talk to your doctor if you are on a low-salt diet. 4. Stay indoors in the air conditioning. If your home is not air conditioned, spend time in public areas like the mall or the library. 5. NEVER leave anyone alone in a hot parked vehicle (children, pets and the elderly are particularly susceptible). 6. Electric fans may provide comfort but they may not be sufficient to prevent heatrelated illnesses. Take a cool shower or bath to lower body temperature. 7. Dress in cool, loose clothing. Wear a hat/sunglasses and use an umbrella for extra shade. 8. Wear sunscreen of SPF 15 or higher to protect skin from sunburn

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MENTAL HEALTH

“Know the signs of heat-related illness”

Heat Exhaustion Can develop after several days of exposure to high temperatures and inadequate hydration. Symptoms include: 1. 2. 3. 4. 5. 6. 7.

Heavy sweating Blanched skin Muscle cramps Lethargy Dizziness Headache Nausea

Left untreated, heat exhaustion may progress to heat stroke. Take the following steps: 1. Attempt to lower body temperature 2. Drink half a glass of cool water every 15 minutes by slowly sipping 3. Seek medical attention if symptoms worsen or last longer than an hour

Heat Stroke Occurs when the body temperature rises rapidly and is unable to cool down. Symptoms include: 1. High body temperature (above 103°F orally) 2. Red, hot and dry skin (no sweat) 3. Throbbing headache 4. Dizziness 5. Nausea 6. Confusion 7. Unconsciousness

You may be dealing with a life-threatening emergency— take the following steps: 1. Call 9-1-1 2. Attempt lowering body temperature 3. Do not give fluids to drink IMAGE FROM SHUTTERSTOCK

FOR MORE INFORMATION Dr. Robert D. Greenberg is the Emergency Medicine Physician at Scott & White Cedar Park Emergency Hospital, please visit sw.org or call (512) 684-4000

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HEALTH

DROWNING PREVENTION

BY LYDIA BLANKENSHIP RN Special Contribution to Austin MD Magazine from St. David’s Medical Center

he weather is getting warmer and with that comes an increase in outdoor activities, including boating, tubing and swimming. According to Safe Kids Worldwide, drowning is the leading cause of injury-related death among children between the ages of 1 and 4. In 2011, 70 percent of all fatal boating accident victims drowned and of those who drowned, 84 percent were not wearing a life jacket. As the summer season swiftly approaches, swimmers can reduce the risk of drowning by taking some basic safety precautions: •

Wear a life jacket. Even if you know how to swim, it is good practice to wear a life jacket. Make sure children and pets wear them at all times.

• Avoid alcohol. It is illegal in all states to operate a boat under the influence of alcohol. Even when you are not driving the boat, there is still a risk of injury if you are drinking while boating. In fact, 46 percent of all boating fatalities occur while boats are docked, anchored or drifting. • Maintain constant supervision of children. Kids are fast and require constant supervision. Any adults responsible for supervising small children should avoid distractions such as talking on the phone or playing games and they should not be under the influence of alcohol or drugs. • Learn basic life support. It is important to know CPR and to have a first aid kit available at all times. • Fence in pools. In order to prevent accidental drowning, be sure to have a fence around all backyard swimming pools. This will decrease access to the area. • Never dive in shallow water. Always enter pools, rivers, lakes or oceans feet first. If the water is shallow or if it has objects under the surface, diving can cause serious spinal cord injury. • Never swim alone. Always swim with a buddy and/or parent, or swim where a lifeguard is present. • Playing in the water is a great way for the entire family to make memories during the summer season—and to cool off! However, it is important to play it safe while enjoying outdoor activities, regardless of age. Following a few simple rules can ensure everyone has a safe summer.

FOR MORE INFORMATION To reach Dr. Blankenship or any of the physicians at St. David’s South Austin location, please call 512-447-2211 or go to stdavids.com

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FITNESS

WORLD CUP FEVER TAKING 2014 WORLD CUP OVER AUSTIN! PHENOMENON IS SPREADING ACROSS THE BY JAKE HARDING

AUSTIN COMMUNITY

It’s just past 5:30 PM on July 2nd in Austin, TX and THAT just happened. By ‘THAT’ I mean the end of the U.S. Men’s National Team’s foray into the world’s most coveted tournament; the World Cup of Soccer (Football World Cup to just about every other nation on the planet). Every four years it seems as though 90 plus percent of the entire human population dawn their country’s colors, buy a jersey, begin using terms like “pitch” and “draw” and “PKs,” and drop whatever they’re doing come game time to shout and scream and root for their team. It’s a complete blast and one hell of a good time. Regardless of how far a country’s national team progresses, it is by far the world’s most watched and followed sporting event. The Olympics? Get Real. The Super Bowl? Not even in the same conversation. The World Cup dwarfs them all and with ease. As a humongous soccer fan myself (I’ll use the term ‘soccer’ to avoid confusion and sounding snobbish), I have mixed feelings about the fervor with which the United States periodically so lovingly adopts a sport I hold close and dear to my heart. However, one thing is being proven quite clear: its popularity is soaring and not just with regards to the World Cup. Television

“One thing is being proven quite clear, its popularity is soaring and not just with regards to the World Cup.” networks are now viciously competing for broadcasting rights of the Barclay’s British Premier League which is widely considered the most popular league in the world, aside from the America’s Hispanic population’s borderline pledge of allegiance to either Barcelona F.C. or Real Madrid of Spain’s Primera División (La Liga). All of this preliminary jargon aside, soccer is one of the most physically demanding sports. Period. Women in particular have a tendency to revel in awe of the physique of some of these professionals and how can anyone blame them? These guys have virtually no body fat, often run five miles or more per match, and the control with which they execute the sometimes acrobatic handling of a soccer ball is downright amazing. While soccer is also one of the most highly injury prone sports, it’s undeniably a fantastic way to stay in shape. You drop body fat like a cheating ex, strengthen your core with compound exercises not really available in any one single workout, and develop obscene conditioning like Forrest Gump on his seemingly endless run. There are a plethora of chances to become involved in an Austin recreational league. Austin Sports and Social provides some great men’s, women’s, and co-ed leagues for a range of different experience levels and ages. If your schedule doesn’t allow for an obligatory weekend after weekend tournament style set of matches, go down to Zilker Park. I guarantee you that at any given moment you’ll be able to find at least one person kicking the ball around. Most of the time there are too many pick-up games to choose from. And guess what…it’s a great way to meet new people, get that body back into summer shape, and perhaps most appealing, it’s free. Soccer is the world’s most popularly played sport for exactly those reasons and it’s no small wonder that it continues to blossom in our diverse city of Austin as an alternative to dropping hours in and money on the gym.

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FITNESS

Teaching Your Muscles to Fail The benefits of SuperSlow training by Mary DelGrande

hysical, mental and emotional fitness plays a vital role in our everyday lives. A particular form of resistance training—SuperSlow—enables us to strengthen these characteristics to improve upon our overall health and wellness, increase our resting metabolic rate and help prevent debilitating diseases such as osteoporosis and colon cancer. SuperSlow is a specific type of resistance training that utilizes a specialized exercise mentality geared at working your skeletal muscles to complete failure in no more than two minutes, without momentum, in order to increase muscle strength and endurance, boost metabolism and reverse bone loss that is lost as part of the natural aging process. SuperSlow is not a new workout phenomenon. This model has been around since the 1970s, and was made popular in the fitness world by bodybuilder Ken Hutchins while conducting osteoporosis research at the University of Florida on geriatric women in the 80s. With the help of specialized equipment, Hutchins discovered a way to solely overload the muscles without affecting the joints to bring about complete muscle failure. This enables our muscle fibers that generate muscle contraction to tear apart and rebuild over the torn fibers as stronger layers of protein to build muscle strength and endurance. SuperSlow employs a one-to-one ratio of 10 seconds lifting, to 10 seconds lowering of weight-bearing equipment. This is a safer model compared to other strength-training programs that encourage maximizing repetition without regard to form. Injuries such as stress fractures can occur at the bone level when inconsistent momentum is applied, because bones, unlike muscles, perform most of the work. When strengthtraining programs are performed incorrectly, bones can break and life-threatening injuries can occur, which is what SuperSlow aims to prevent. There are numerous benefits of Super Slow. Not only does this type of resistance training improve physical health, it also improves mental health. Your body and brain just experienced something new: it fought and lost. Our neurological, cardiovascular and musculoskeletal systems all combined to overcomea challenge, but all of your muscle fibers crashed, as they could resist no more weight. Once you reach the twominute maximum per machine without reaching failure, your muscles have adapted, and it is thus time for a new challenge. There is no greater sense of accomplishment than resisting weight for the full two minutes after trying and failing several times prior. 42

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“This enables our muscle fibers that generate muscle contraction to tear apart and rebuild over the torn fibers as stronger layers of protein to build muscle strength and endurance” Osteoporotic effects are reversed as such: our skeletal muscles, composed of fibrous material, rest on grooves on the bone with the help of cartilage. To repair the torn protein fibers, red blood cells emerge from our bone marrow and flood the site of injury with nutrients to repair the damaged area. In this way, the bone mineral deposits that are typically lost due to age now strengthen and rebuild our bones, which helps reduce the risk of fractures caused from falls, along with improving posture, balance and overall bone health. SuperSlow also helps to reduce lower back pain and joint pain in those with arthritis. Additionally, this method also accelerates gastrointestinal transit time, which reduces one’s risk of colon cancer. By utilizing the body’s glycogen stores first, and fat stores second, the body protects itself against type 2 diabetes by revitalizing insulin sensitivity. The two main types of muscle fibers are slow and fast-twitch fibers, and they each perform best at different intensity levels. Fast-twitch fibers provide an explosion of energy in short durations, operate without oxygen and are most beneficial for short bursts of energy, such as in High Intensity Interval Training (HIIT). Slow-twitch fibers provide low levels of energy over extended periods of time, require oxygen to function and allow us to perform endurance activities such as running, biking or swimming for long distances without exhausting immediately. In SuperSlow, skeletal muscles not formerly under strenuous, non-momentous weight-bearing exercise will burn through the fast-twitch fibers almost immediately, leaving the slow-twitch fibers to resist the weight. Due to the lack of momentum and oxygen, slowtwitch fibers burn out and the muscles reach utter failure and collapse under the weight. This shocks our sympathetic nervous system, which is responsible for our fight or flight response under stress. We all fail at some point in our everyday lives, but we learn from our mistakes so that we do not repeat them. Our muscles want to fail so that they can become stronger, enabling us to better protect our bodies and internal organs, continuing to adapt to our dynamic environment.

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COVER

Arise’s Rising Star And Ceo Talks Family And His Winning Business Philosophy

By Jon Black Photography by Steve DeMent

“This is a time of rapid change in the healthcare industry,” says Jared Leger, a he says, is “pressure on medical providers to do more with less.” Fortunately, he registered nurse who is now the co-founder, managing partner and CEO of Arise also highlights a variety of new opportunities for providers, such as emerging Healthcare. “That demands changing our approach to delivering healthcare.” technologies, innovative ways to increase efficiency in healthcare as well as new ways to approach real estate. Leger is well placed to speak on the future of the healthcare industry. Austin Business Journal identified Arise as the 8th fastest growing company in the “Arise is very aware of the challenges and opportunities inherent in today’s greater Austin area. Leger has been honored by Becker’s ASC Review, a prestigious healthcare,” Leger says. “The patient must come first in any successful healthcare healthcare industry news outlet, which named him a “Rising Star” (a list of 40 system, so we take a keen interest in anything that increases the physician’s ability ambulatory surgery center industry leaders who are 40 years of age or younger) as to give their patients the best care possible.” well as naming him a “CEO to Know” for three years in a row. Leger helped build Arise from the ground up with these issues in mind. CoDrawing on his industry expertise and personal experience, Leger sees both founding Arise was the ultimate result of a journey taking him through both the challenges and opportunities in the changing healthcare landscape. The challenges clinical and business sides of modern healthcare. He began on the clinical side, he cites include declining reimbursement rates for practitioners, a population that as a registered nurse witnessing firsthand the stresses and realities of the operating is both aging and growing and the systemic changes to healthcare resulting from room. He was tapped to move to the administrative side, where he quickly rose implementation of the new healthcare law. The collective result of these challenges, through the ranks. Gaining certification by the Ambulatory Surgery Center

A U S T I N MD M A G A Z I N E . C O M

COVER Association allowed him to learn the legal, HR and financial aspects of the industry.

Putting practitioners and former practitioners in leadership positions also has as a positive impact on employment. “We’re out to hire the best because we understand what that means for our organization. It also means employees know those running the business understand their concerns.” This attitude, combined with a great HR program, as at Arise, makes for a great place to work — and a great place to receive care.

“He and I both firmly believed the ‘patient first’ philosophy,” Leger explains. Wills and Leger felt they could take their core philosophies and apply them to other areas of healthcare, notably outpatient surgery centers. Leveraging the $25 million from the sale of Stonegate, the two launched Arise Healthcare, which owns, manages and develops healthcare facilities and healthcare-related businesses. Together, Leger and Wills defined the two reciprocal beliefs at the core of Arise. First, Arise believes that putting the needs of the patient first leads to a firm’s long-term financial health. Second, it believes the financial health of an organization is a direct indicator of what it can do to be better care for its patients. From there, the two recruited a team and worked out the practical implementation of those ideals. As the rest of industry works to adapt to the face of modern healthcare, Leger believes they will embrace many of Arise’s core concepts. “What we all need to think about is how to deliver care in more efficient and cost effective ways that simultaneously assure quality patient care is delivered.” He says it is important for the healthcare industry to understand the true nature of their work. “The poet Virgil said, ‘The greatest wealth is health.’ While Arise is a business, ultimately we’re in the businesses of helping others. The patients we take care of are people’s mothers and fathers, sisters and brothers, and children.”

Leger also feels that a rigid division between business and clinical sides of healthcare enterprises serves neither patients nor providers well. It is an observation strongly rooted in personal experience. His work as a nurse not only helped inspire him to co found Arise but have influenced the company’s design, structure and daily operations. As a result he feels that healthcare enterprises benefit from executives with medical backgrounds “My knowledge of the stresses, realities and terminology of clinical practice has been crucial to my success in the healthcare business arena,” he explains, a philosophy that extends to the leadership team at Arise. “We understand what our employees face because we’ve been in the trenches, too.” With the financial pressures that physicians face today, Leger says that is essential that physicians have greater participation in the business side of operations, something strongly emphasized at Arise. “Neither aspect of the business is to be taken lightly,” he explains, “We focus on ways of delivering healthcare that are both economically and emotionally sensitive.”

Beyond his work, Leger spends his time with his wife and three daughters. He also enjoys hunting, especially with his brother. Leger is an active philanthropist, taking his commitment to quality healthcare for Austinites beyond Arise. He is a founding board member and volunteer for Chicon Pregnancy Resource Center (CPRC), which provides a multitude of pregnancy, parenting and lifestyle services and resources for patients free of charge. Leger’s role with CPRC includes recruiting and encouraging local doctors to provide medical services free of charge. He also assists with fundraising and is a contributor himself. If Arise is responding to the changing healthcare landscape, numbers suggest that patients and practitioners alike are responding to Arise. From 2010 to 2012, its revenues blossomed more than 240%. Equally powerful testimony is offered by the future plans of Leger, the rising star. “I’m going to keep doing exactly what I’m doing,” he says.

Z FOR MORE INFORMATION

In 2004, Leger was selected as Executive Director for Austin Pain Associates (APA) and the affiliated Stonegate Surgery Center, positions he held until 2009. After assisting in the sale of Stonegate for $25 million, Leger was approached by Dr. Rob Wills, founder of APA.

To learn more about Arise Healthcare please go to arisehealthcare.com or call 512-220-3890.

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MEDICAL

Depression Screenings For Seniors A great tool for keeping patients healthy Special Contribution to Austin MD Magazine from WellMed by Susan Brister, M.D.

t is not a given that as you age, you will become clinically depressed. However, there are factors that put older adults at a greater risk for depression such as having diabetes, cancer, heart disease or other chronic conditions. The combination of chronic disease and depression is dangerous. Numerous studies show that mortality outcomes—the likelihood of premature death—are not good for people with depression.

A study recently published in the Clinical Journal of the American Society of Nephrology found that diabetics who are also depressed are twice as likely to develop chronic kidney disease versus diabetes patients without depression. A UCLA-led study just published in the Journal of the American Geriatrics Society found that diabetes patients age 65 and older have a much higher mortality rate (a 78 percent chance of prematurely dying) versus non-diabetics in the same age group.

The UCLA study is particularly interesting to me as a primary care physician specializing in senior healthcare, because it examined health outcomes for seniors with depression. By comparison, the mortality risk for younger diabetics was not statistically significant, according to the study. Based on their findings, researchers are advocating depression screenings for older adults with diabetes and for treatment of those who screen positive. For nearly two years, WellMed has been using a depression screening tool for the 110,000-plus senior When you get older and you have, for example, patients we serve in Texas and Florida, regardless of diabetes (perhaps accompanied by back pain and whether they have a chronic state of disease. It is a limited mobility), it can lead to severe depression. simply worded, one-page questionnaire that asks a Being depressed makes it difficult to stay motivated series of questions about possible signs and symptoms to do the things you need to do to manage your of depression. diabetes—exercising, eating right, monitoring glucose levels and staying on an effective insulin therapy or We ask about whether patients are feeling depressed prescription medication routine. When you do not or hopeless, have had trouble concentrating and even follow an effective health schedule, you will probably if they have had thoughts of hurting themselves or feel more sick, which leads to a downward spiral, suicide. Patients rate how often they feel this way, eventually leading you to feel more depressed. from “not at all” to “nearly every day.” Answers are

Chronic disease and depression can be a dangerous problem among the elderly

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MEDICAL assigned a numeric value from 0 to 3, and the final size fits all; different medications and dosages can score suggests whether we need to investigate further. affect individuals diversely. The goal is to make sure that the medicine helps the patient feel more like If a patient is found to be moderate-to-severely themselves, so they can better handle their stress. We depressed, we try to help them find out why, look for avoid the addictive prescriptions that simply hide the possible solutions and consider whether the problem symptoms of depression without really treating the may be physiologic. For example, extreme persistent underlying causes.

There are many misconceptions about antidepressants, especially among older Americans

For me, the depression screening tool is a valuable aid in keeping my patients healthy and improving their quality of life.

fatigue could be a sign of anemia or sleep apnea. Poor nutrition and bad eating habits can contribute to depression. Alcohol consumption can also be a sign of “self-medication.” Has something changed at home? Have they lost independence due to age or chronic conditions such as no longer being able to drive due to poor vision? This isolation can worsen depression. The social programs team at WellMed can help find ways to alleviate isolation such as involvement in volunteer activities or the pet adoption program. Sometimes, however, the problem is a chemical imbalance in the brain. In those cases, we may need to refer to a psychologist or licensed counselor, and consider medications that can help lift their mood. Unfortunately, there are many misconceptions about anti-depressants, especially among older Americans. Some seniors see it as a sign of weakness. Others hear frightening stories that the drugs can turn people into “zombies.” I tell patients that finding the right antidepressant is like trying on a pair of jeans: you have to find the one that fits you best. Antidepressants are not one

Susan Brister, MD, is lead physician at WellMed at Pflugerville. Dr. Brister, Board Certified in Internal Medicine and Pediatrics, earned her medical degree from the Baylor College of Medicine, with internship and residency at the University of California-San Diego.

FOR MORE INFORMATION Visit wellmedhealthcare.com or call (888) 781-WELL (9355)

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MEDICAL

An Ideal Cleaning What to expect

Special Contribution to Austin MD by Dr. Michael Moossy, DDS e all say that we are just going in to get a “teeth cleaning,” but what does that really mean? A visit with your dental hygienist can (and should) include a lot more. This is the standard you should come to expect from a hygiene visit at Moossy General & Cosmetic Dentistry’s office, or any office for that matter.

Once seated comfortably in the hygiene chair, patients should notice the cleanliness of the operatory, which is apparent of following OSHA guidelines, barrier techniques, which prevents cross contamination from patient to patient, and an overall demonstration that our office is following the proper regulatory guidelines. Then, the hygienist thoroughly reviews and updates the medical history. This is very important as many medical conditions relate to oral health. For instance, pregnancy, diabetes and medications all have an effect on gum health. Then a blood pressure reading is taken and patients are asked about anything concerning them with their teeth, gums and/or oral cavity. This is followed by any American Dental Association (ADA) recommended radiographs that may be needed. A typical protocol is four cavity-detecting x-rays per year and a comprehensive series of radiographs every five years to see all the teeth and surrounding areas. Intraoral photographic images may be taken as well – where you can see your tooth magnified on a large monitor. The hygienist is taking these photos of anything they may find concerning, in turn using this tool to communicate issues to both the dentist and the patient. This way the patient has a full understanding of what is being discussed, whether it be an old filling or a crack in the tooth. The first thing in the exam series is the periodontal screening exam in order to check the health of the gums. This consists of a series of measurements. Pocket depths get measured, as well as whether the gums are receding and by how much. This gives us a baseline that we track overtime to determine not just the health of 48

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the gums but the supporting bone structure underneath the gums. This determines the type of cleaning or gum therapy the patient requires in getting them into good gum health. Different people’s gums need different gum management. The oral cancer screening is the next step in the exam series in which the hygienist looks for lumps, bumps, sores, tenderness or swellings, and refers the areas of concern to the doctor once he comes in for his examination. Once all of the information is collected, the hygienist uses that data to customize the patient’s at-home oral hygiene protocol. All of the dental hygiene care you receive is tailored to your individual needs and safety. Next, the cleaning takes place. A standard cleaning is typically an ultrasonic cleaning followed by polishing to remove stain and texture, and then topical fluoride is applied if indicated. Finally, the doctor is called in to review all the data collected by the hygienist and give his recommendations for treatment, if any. The patient leaves the office feeling fresh and with a hygiene appointment scheduled at the recommended time interval that is best for that patient. If your experience is far from this, you may want to question your current office. Once patients begin to realize how connected oral health is to overall health, and that a hygiene visit is much more than “just a cleaning,” the value placed on these visits should increase tremendously.

FOR MORE INFORMATION

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To reach Moossy General & Cosmetic Dentistry visit drmoossy.com or call for an appoitment at 512-459-5437.

MEDICAL

“The AlterG technology, originally created for astronauts while in space, has now been transformed for use by professional sports teams and elite training facilities throughout the world”

AlterG

Changing the way the world rehabs

Special Contribution to Austin MD Magazine from Texas Physical Therapy Specialists by Aaron Wells, PT, DPT

lterG is a state-of-the-art, lower extremity rehabilitation and training tool that utilizes NASA technology to reduce up to 80 percent of your body weight by precise one-percent increments so that you can rehab or train without pain for faster and better results. When one experiences significant pain as a result of an injury, they tend to overcompensate with other areas of their body as a means to complete day-to-day activities with as little pain as possible. When this is repeated over a long period of time, these patterns soon become habits and place an unnecessary and repeated force onto the involved joint and the structures both above and below the injured area. This pattern can lead to additional injuries and chronic pain. A patient’s pain can be reduced with a thorough physical therapy examination, followed by a combination of manipulation, soft tissue and/ or joint mobilization and exercise. However, the addition of using the AlterG in conjunction with these techniques has been shown to be even more effective, because it allows the patient to exercise without pain. The AlterG utilizes NASA-inspired technology that has the ability to remove up to 80 percent of the patient’s body weight in exact 1 percent increments, allowing rehabilitation with reduced or no pain. Various cameras positioned around the AlterG show the patient and physical therapist any change in gait mechanics as a result of the injury. Old habits that were developed due to pain can be broken and the lower extremity joints and/or spine can be used as they were prior to injury. Increased use of the joint will encourage blood flow and re-lubrication of the injured area, which is why an immediate decrease in pain is expected following use of this machine, compared to the pain felt before the start of treatment. Texas Physical Therapy Specialists, a local Austin physical therapy group, says, “The incorporation of the AlterG AntiGravity Treadmill into our practice has revolutionized the way we address our lumbar spine and lower extremity impaired patients. While we continue to incorporate the latest evidencebased practices in our treatment philosophy that includes manual therapy and progressive exercise, the addition of the ability to reduce the impact of gravity on the ankles, knees, hips and back has allowed us to get our patients back to their previous lifestyle faster without pain or limitation.” The AlterG has been successfully utilized with many musculoskeletal diagnoses, including sprain/strain injuries, post-surgical patients - including but not limited to bunionectomy, ACL reconstruction, meniscus removal/repair, hip or knee replacement, hip impingement syndrome, plantar

fasciitis, patellofemoral pain syndrome, Achilles tendinopathy, lumbar degenerative disc disease and various running injuries such as stress fracture and IT band syndrome. Evidence and experience also suggest that several neurological diagnoses such as Parkinson’s Disease, stroke and multiple sclerosis will also benefit from a trail of skilled physical therapy care including use of the AlterG treadmill. Furthermore, the AlterG is an excellent tool for weight loss. If you are having trouble running/ jogging because of pain, reducing the body weight experienced during these activities will allow you to run faster and for longer periods, which will help you to more aggressively achieve your weight loss goals. The AlterG technology, originally created for astronauts while in space, has now been transformed for use by professional sports teams and elite training facilities throughout the world. Teams such as the Dallas Cowboys, Miami Heat, New York Yankees, AC Milan, University of Texas, the Mayo Clinic, the Cleveland Clinic, U.S. National Olympic Training Centers and Nike have all utilized the AlterG for training and/or rehabilitation. In recent years, the AlterG has started to make its way into local communities for everyday use by the general public all across the United States. It is transforming rehabilitation and training so that people can achieve goals in ways that have never before been possible. It truly is changing the way the world rehabs!

FOR MORE INFORMATION Learn more about Texas Physical Therapy Specialists at texpts.com or call them at (888) 658-8483.

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Nutritional Therapy - A Novel Approach

How Bringing Dieticians to the Patient Makes for a Healthy Community Special Contribution to Austin MD Magazine from Community Care by Laura H. Smith, RD, LD, CNSC

Newer methods of delivering care allow dietitians to educate and support patients both when and where it is needed most

ith 24 locations in Travis County, CommUnityCare health centers provide care to more than 68,000 adults and children each year. Patient centered care is the focus, with primary care physicians leading teams of health professionals in providing preventative and chronic care management to patients through every stage of life. Registered dietitians are an important part of the health team, helping patients manage many chronic diseases through counseling on nutrition and physical activity. They also promote lifestyle changes that help prevent chronic disease from developing in the first place. Individual nutrition counseling and group nutrition classes are the primary ways that care is provided. However, newer methods of delivering care such as medical co-visits, group medical visits and mobile units allow dietitians to educate and support patients both when and where it is needed most. One important component of nutritional therapy at CommUnityCare is individual counseling for children and adults. Successful lifestyle changes take time, so multiple visits with the dietitian may be needed to provide support until these changes become routine. Group classes are another valuable way to provide information on managing diabetes, high blood pressure, high cholesterol and obesity. Group classes for children are also becoming increasingly important due to the growing health concerns related to childhood obesity.

the same group of patients meets once per month for six months. During each visit, patients are able to meet with their provider and a clinical pharmacist. Education is also provided on various selfmanagement topics such as including healthy nutrition. Kristin Brookshire, MPH, RD, LD, the dietitian who teaches the nutrition component, says, “The number one thing that the patients in the groups ask for is information on how to eat and cook for diabetes.” Kristin participates in each visit and is always willing to answer any nutrition related questions. Later this month, mobile medical teams, the newest method of serving patients, will be implemented. The mobile teams will travel to Travis County residents who live in areas without adequate access to medical care and to those who are unable to attend appointments at health centers. The team will consist of a physician, a pharmacist, a nurse practitioner, a medical admitting clerk and, of course, a dietitian. CommUnityCare dietitians are meeting the needs of their patients by not only providing care in traditional ways such as individual counseling sessions and group classes but also in more novel ways such as medical co-visits, group medical visits and mobile units. They continue to promote the CommUnityCare mission of providing patients with the right care, at the right time, at the right place.

In addition to these traditional methods of providing care, dietitians have also started using more non-traditional approaches such as medical co-visits. Co-visits began about one year ago and allow dietitians to meet with patients during medical appointments to answer questions and provide information on various nutrition topics. CommUnityCare dietitian Marissa Rodriguez, RD, LD, suggests implementing the co-visits as a way “to reach more patients and increase the availability of dietitians.” The co-visits allow dietitians to go to the patient, instead of having to wait for the patient to come to them. Another new approach for providing patient care is through the group medical visit. These visits were started recently at CommUnityCare to provide patients with the knowledge, skills and confidence needed to manage their diabetes. In group medical visits, IMAGE FROM SHUTTERSTOCK

FOR MORE INFORMATION For more information about CommUnityCare’s services, please contact Monica Saavedra, MPH, MCHES, Director of Marketing and Community Relations at Monica.saavedra@communitycaretx.org A U S T I N MD M A G A Z I N E . C O M

Better Sleep, Better Health, Better Quality of Life.

Ashwin Gowda, M.D. is Accredited in Psychiatry and by the American Academy of Sleep Medicine with his expertise in sleep disorders.

- Sleep Apnea - Insomnia - Night Terrors - Narcolepsy - Snoring - Bruxism (Teeth Grinding) - Sleep Walking - Restless Legs Syndrome (RLS) 1221 W. Ben White Blvd. A100 Austin, TX 78704 512-440-5757 www.txsleepmedicine.com

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where The Piazza Center really stands out is in taking a team approach. “All of our staff work hard and, from the first phone call to the final follow-up, we remain engaged and patient focused,” he explains. “A unified patient-focused team approach is the backbone of our practice and foundation of our success.” Dr. Piazza received his Doctorate of Medicine with Honors from the University of Texas Medical Branch in Galveston and completed his plastic surgery training at the Michigan State University / Grand Rapids Medical Education and Research Center in Grand Rapids, Michigan. He graduated summa cum laude from Baylor University.

Dr. Rocco Piazza

The Piazza Center

by Jon Black Photography by Steve DeMent

“Our vision is to create a personalized plastic surgery experience in which our patient’s health and well-being are foremost in the treatment plan,” says plastic surgeon Dr. Rocco Piazza, founder of The Piazza Center. “We strive to provide exceptional care by being polite, professional and punctual with predictable results.” The Piazza Center offers the most advanced procedures for breast surgery, body sculpting, facial surgery and skin care. “We focus on comprehensive care when it comes to aging successfully using the latest in non-surgical and surgical techniques,” Dr. Piazza explains. Among the procedures offered by Dr. Piazza are Mommy Makeovers, breast augmentation, short-scar breast lifts and reductions, tummy tucks, liposuction contouring, and body lifts. Facial aesthetic procedures include 56

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facelifts, eyelid & brow surgery and rhinoplasty. Non-surgical rejuvenation includes skin care treatments such as HydraFacial™, chemical peels, photofacial therapy, antioxidant infusion treatments. Injectables have a large role in aging successfully and include relaxing frown lines and crowsfeet with BOTOX® Cosmetic, and volume restoration with JUVÉDERM® Ultra Plus, JUVÉDERM® Voluma XC, Perlane®, Restylane® and Belotero Balance®. The Piazza Center makes patient education a priority. “We want to give every patient all the information he or she needs to make an informed decision.” Dr. Piazza says, “We also want our patients to take an active role in the planning process. Ultimately, it’s their decision.” According to its founder, one area

In addition to his activities at The Piazza Center, Dr. Piazza is active with outreach activities on behalf of his specialty. As a member of the Spokespersons Network of the American Society of Plastic Surgeons®, he represents the prestigious group by providing the media with information on a broad range of plastic surgery topics. Philanthropically, he is also active with The Breast Cancer Resource Centers (BCRC) of Texas, including their annual fundraisers Locally Pink as well as Art Bra Austin, a runway show in which designed art bras are modeled by breast cancer patients in a live auction. Dr. Piazza summed his philosophy up this way: “The most rewarding part of my practice is listening to my patients and providing them options for their specific desires in plastic surgery and skin care, followed through with surgical and non-surgical skills to help them achieve personal goals while making a positive impact on their lives.”

FOR MORE INFORMATION To learn more or to schedule a consultation, visit thepiazzacenter.com, call (512) 288-8200 or visit The Piazza Center – tucked away in Southwest Austin at 7900 FM 1826, Health Plaza II, Suite 206.

“I’m committed to providing the highest quality of orthopedic care possible,” says Austin native Dr. Ryan Tibbetts, an orthopedic surgeon with Seton Orthopedic and Sports Medicine. “Along with treating immediate or chronic problems, I integrate the doctrine of prevention into every treatment plan as a way to alleviate possible future difficulties.” Dr. Tibbetts uses the newest proven advances in orthopedic care to treat a full range of conditions. He specializes in shoulder and elbow surgery while also maintaining a strong interest in arthroscopy, joint replacement, fractures and athletic injuries. Among the techniques and procedures used by Dr. Tibbetts are X-ray, ultrasound, stem cell injection therapy and pharmacogenetic profiling for drug sensitivity. Sports medicine represents an important part of his practice. “No one likes to be sidelined with an injury,” Dr. Tibbetts says. “My goal is to get athletes back into action as soon as possible.” “My top priority is having a patientcentered practice,” says Dr. Tibbetts, who seeks to keep patient needs at the forefront of every aspect of his practice. Each patient’s treatment is individualized for his or her unique complaint. Dr. Tibbetts strongly encourages patients to participate in the decision-making process regarding treatment. Additionally, he also emphasizes long-term treatment strategies for patients that involve not only recovery and rehabilitation but also prevention of future injuries. To encourage patient self-education, Dr. Tibbetts’ website offers numerous orthopedic and sports medicine links as well as information on specific conditions and procedures. Dr. Tibbetts is a board certified orthopedic surgeon. He received his MD from the University of Texas Medical School in Houston and completed his orthopedic residency at Scott & White Memorial Hospital in Temple. He has also completed a shoulder and elbow fellowship

Dr. Ryan Tibbetts Seton Orthopedic and Sports Medicine by Jon Black Photography by Steve DeMent

at the University of Texas Health Science Center in San Antonio, with worldrenowned shoulder experts Drs. Charles Rockwood and Michael Wirth. He has a Bachelors degree in biomedical science from Texas A&M University. His professional affiliations include the American Academy of Orthopedic Surgeons, Texas Orthopedic Association, Arthroscopy Association of North America, Alpha Omega Alpha, American Medical Association, Texas Medical Association and Travis County Medical Society. He has hospital affiliations with nine different facilities throughout the greater Austin area. In addition to his work with Seton Orthopedic and Sports Medicine, Dr. Tibbetts also volunteers his time to assist young athletes, covering athletics for Hays High School.

Orthopedic surgery is not just a profession for Dr. Tibbetts, he finds his work extremely gratifying. “I enjoy working with patients to help them recover from injury and return to an active and healthy lifestyle,” he says.

FOR MORE INFORMATION Dr. Tibbetts sees patients at locations in both Austin and Kyle, for more information visit http://austinorthomd.com/ or call (512) 504-0866.

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As the author of four medical textbooks, Dr. Brotzman’s contributions to orthopedic surgery extend far beyond his office and operating table. His “Clinical Orthopedic Rehabilitation” is a best-selling textbook published by Mosby Harcourt Elsevier, the world’s largest medical publisher, and has been translated into 12 languages. It has become required reading in many medical schools, physical therapy schools and rehabilitative medicine programs.

Dr. Brent Brotzman

North Austin Sports Medicine by Jon Black Photography by Steve DeMent

For Dr. Brent Brotzman, working at North Austin Sports Medicine isn’t just business – it’s personal. “As a stateranked tennis player as well as a snow skier and wake surfer, I love treating athletes in a manner that allows a safe and rapid return to their sports after injury,” explains the orthopedic/lower extremity surgeon. North Austin Sports Medicine provides a variety of orthopedic services to treat sports injuries and provide fracture care as well as offering arthroscopic procedures and other services. A board certified orthopedic surgeon who conducted an additional fellowship in lower extremity surgery, Dr. Brotzman focuses on sports medicine injuries of the lower extremities: the foot, ankle and knee.

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He addresses problems by using cutting-edge treatment but also treats athletes functionally. “If an athlete comes in with, for example, Achilles tendinitis, most orthopedic surgeons will employ anti-inflammatories, a walking cam boot, et cetera.” he explains. “At my practice, I work hand in hand with the therapist to figure out the underlying problem causing the tendon overload and failure – and how to prevent that from reoccurring.” Among the things he looks for are training errors, improper shoes or gait abnormalities such as heel striking. Dr. Brotzman’s goal is to ensure that, at the end of treatment, patients not only feel better but have a better training regimen. “This type of hands-on, team approach to treating lower extremity injuries in athletes is quite rare,” Dr. Brotzman says.

A guiding principle of Dr. Brotzman’s practice is that for many procedures, such as ACL surgery of the knee, proper rehabilitation is as critical as wellperformed surgery for full treatment and recovery. “Many surgeons do a beautiful surgical procedure,” he explains, “but either don’t read up on the important progression of the patient’s post-op rehab or just are not interested in that area and turn rehab over to the physical therapist with very little input or interface regarding the progression.” Dr. Brotzman is board certified in orthopedic surgery. He received his MD from Baylor College of Medicine in Houston. He completed his internship at St. Joseph’s Hospital in Houston and a residency in orthopedic surgery at the Campbell Clinic at the University of Tennessee as well as a fellowship in lower extremities at the Campbell Clinic. Dr. Brotzman holds a BA in biology from the University of Texas at Austin. Dr. Brotzman feels that many athletes are more comfortable entrusting their sports medicine and orthopedic needs to someone who understands them, “Having played many sports over the years, I can relate to the mindset and goals of athletes as well as understand the biomechanical and physiological rigors involved with their sports.”

FOR MORE INFORMATION To learn more or to schedule an appointment, visit northaustinsportsmedicine.com, call 512-977-0000 or visit 12309 N. Mopac, Suite 150.

“It is always very gratifying to help someone and see them feel better,” says Dr. Thomas Bening, a surgeon with Austin Regional Clinic who offers a broad range of services with a special interest in upper gastrointestinal and reflux surgery. While Dr. Bening has been interested in medicine for as long has he can recall, it was as a surgeon that he found the perfect outlet for his talents and interests. “I chose the field of surgery because I enjoy the idea of being able to definitively correct certain ailments of the human body,” he explains. Dr. Bening welcomes the variety of challenges and opportunities that being a general surgeon brings, saying that “I prefer the broad scope of general surgery as it provides me with the opportunity to treat many different disease processes.” While he performs a wide variety of general surgical procedures, as a member of a large multispecialty group such as Austin Regional Clinic, Dr. Bening has also had the opportunity to focus a portion of his practice on upper GI and reflux surgery. “This has been a special interest of mine. I get to perform both lower and upper endoscopy.” Dr. Bening also has an interest and skill in the transoral incisionless fundoplication (TIF) procedure for patients suffering from gastroesophageal reflux disease, commonly known as acid reflux disease. TIF is a less invasive alternative to classic reflux surgery that many patients are a candidate to undergo. EndoGastric Solutions®, makers of the TIF device, rank Dr. Bening as one of the top three surgeons in Texas in the number of completed procedures.

Dr. Thomas G. Bening

Austin Regional Clinic by Jon Black Photography by Steve DeMent

Dr. Bening received his medical degree as well as completed his internship and residency at The University of Texas Health Science Center San Antonio. He received his BA and MS from the University of Texas at Austin. His professional affiliations include the American College of Surgeons, the Society of American Gastroenterologists and Endoscopic Surgeons as well as the Travis County Medical Society. In addition to his clinical practice, as part of his outreach and patient education Dr. Bening posts informational articles on gastrointestinal issues on the Austin Regional Clinic website.

Other surgical operations performed by Dr. Bening include colonoscopy, colon and rectal surgery, partial, simple and modified radical mastectomy, incision and drainage of abscesses, melanoma surgery and gastric surgery. He performs procedures at Arise Austin Medical Center, Cedar Park Surgery Center, Cedar Park Regional Medical When not practicing medicine, Dr. Center, Seton Northwest and Seton Medical Bening enjoys spending time with his Center Austin. family. Befitting someone who received his bachelors and masters degree from

the University of Texas at Austin, he is also an avid Longhorns fan. “I have been given the opportunity to help others who are ill and sometimes facing terrible diseases such as cancer,” Dr. Bening comments. “My faith and beliefs have allowed me the privilege of being a part of people’s lives in a unique way.”

FOR MORE INFORMATION To learn more or to schedule an appointment, visit austinregionalclinic.com/doctors/thomasbening, call 512-260-1581 (ARC Cedar Park Medical Plaza) or 512-989-2680.

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who keep our facilities clean and running efficiently.” He also has great praise for his employees, “they are a real team of great people who all hold their responsibilities to a high standard.” For Dr. Pytowski, Austin is a natural fit – both for his practice and for him personally. “I am very active and strive to live a very healthy lifestyle. I strive to give my patients all of the resources I would want so as to not interrupt that ability,” he explains. “I place a very high importance on my ability to keep my patients active and enjoying everything Austin has to offer. Austin is a very young, active and vibrant city with a diverse patient population. This allows me to use all the skills I have learned and continue to improve throughout my career.”

Dr. David Pytowski

Austin Regional Clinic by Jon Black Photography by Steve DeMent

“We walk, run and jump on our feet and ankles all day long,” says podiatrist and podiatric surgeon Dr. David Pytowski, “this creates a challenging and very rewarding task for the practitioner.” Practicing at Austin Regional Clinic, Dr. Pytowski’s office provides comprehensive diagnosis and treatment for all aspects of foot and ankle care. In addition to sports medicine, common conditions addressed include fracture care as well as deformity correction and management. He also treats typical podiatric pathologies such as ingrown toenails, bunions, hammer toes and flat feet. Pytowski utilizes a team-based approach to patient care. “I employ help from several other specialists and adjunct providers to promote a holistic approach to healing with 60

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physical therapy, regenerative medicine or custom orthotics – whatever it takes to help a patient feel better.” Dr. Pytowski says that one of the most important skills a physician can cultivate is the ability to listen. “I really feel that listening to my patient is paramount in obtaining the correct diagnosis. I can then apply my years of experience and depth of knowledge to treating the diagnosis and, more importantly, the patient correctly.” While his office enjoys all the advantages of a being part of a multispecialty practice, one of the largest of its kind in Central Texas, Dr. Pytowski feels the practice embodies many of the virtues of a smaller operation, saying “I know almost everyone involved from top line administration down to those

One aspect of podiatry and podiatric surgery he finds especially gratifying is the frequent ability to see rapid results. “I love that a high percentage of patients come in with a singular problem that can be solved during the first visit.” Dr. Pytowski also brings a genuine passion for his specialty to his practice. “I love the complexity of the foot and ankle,” he says, “nearly one quarter of the skeletal system resides in just one foot and ankle complex.” Dr. Pytowski is board certified in foot surgery and reconstructive rearfoot and ankle surgery. He received his Doctorate from the New York College of Podiatric Medicine and completed his residency at the Cambridge Health Alliance in Cambridge, Massachusetts. He holds a BA from the University of Kansas.

FOR MORE INFORMATION To learn more or to schedule an appointment, visit austinregionalclinic.com, call 512-295-1333 or 512-282-8967.

“We offer patients a boutique-style practice” says orthopedic surgeon Dr. Kalin Kelso of Austin Orthopedics and Sports Medicine. “We combine convenience, state-of-the-art facilities, and procedures as well as a friendly, caring staff. In addition to our procedures and services, we bring patients onsite physical therapy and imaging services such as MRI and X-ray.” Dr. Kelso specializes in arthroscopic surgery and total replacement of the shoulder and knee. He brings the perfectionism and professionalism of a committed, compassionate physician to his practice—finding satisfaction in developing and perfecting his expertise in shoulder and knee arthroscopy as well as total joint replacements. He has successfully completed thousands of surgical procedures and conservative treatments of shoulder and knee conditions.

Dr. Kalin Kelso

As part of its philosophy of care, Austin Orthopedics and Sports Austin Orthopedic and Sports Medicine Medicine emphasizes the formulation by Jon Black of a unique treatment plan for each Photography by Steve DeMent patient. Accomplishing this includes maintaining in-house physical therapy and rehabilitation capabilities provided by a doctor of physical therapy. Other procedures and services offered include 2011, 2012, and 2013. fracture care and bracing, non-operative treatment of frozen shoulder, shoulder Dr. Kelso is board certified in and knee total joint replacement, as well orthopedic surgery. He earned his as the treatment of osteoarthritis. medical degree at the Texas A&M University College of Medicine and H E A LT H C A R E In addition to the clinical aspect of completed his orthopedic residency at the practice, the Austin Orthopedics Scott & White Medical Center in Temple. and Sports Medicine website contains an While Dr. Kelso was Chief Resident, educational component which offers a Scott & White was named one of the variety of informative and useful links for top ten orthopedic training programs patients with orthopedic conditions. in America by Newsweek magazine. He has a Bachelor’s degree in Biology from Beyond his work with Austin Lamar University. Orthopedics and Sports Medicine, Dr. Kelso has served as Director of Sports When not practicing medicine, Dr. medicine and Chief of Orthopedics at Kelso maintains an active lifestyle by FOR MORE INFORMATION Austin Diagnostic Clinic for eight years. running, boating and spending time He has been recognized by Texas Monthly with his family, which includes his three To learn more or to schedule an appointment, magazine as “super doctor” in 2004, sons and granddaughter—all of whom visit austinosm.com, call 512-339-0440, or visit 2006, and 2007. He has received a “Most are involved in sports. 2200 Park Bend Drive, Building 1, Suite 301. Compassionate Doctor” award for 2010, A U S T I N MD M A G A Z I N E . C O M

Dr. Phyllis Books MA, DC, CCN, DACBN

Author of REVERSING DYSLEXIA

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AUSTIN MD’S MENTAL HEALTH SECTION

“If you cannot explain it simply, you don’t understand it well enough.” –Albert Einstein The (human) brain is a complex structure that provides the ability to learn, remember and to be, essentially, logical individuals. The brain is an exponentially studied organ. Even some of the most brilliant minds still do not understand its fullest potential. One of the most inviting aspects about the discipline of psychology is that there is much more to learn and discover. Mental disorders, diseases and pathologies are extensions of the complexity of the mind that continuously leave doctors, researchers and enthusiasts puzzled. For how far science has come in the study of the human brain, it is both unnerving and exciting to know how much more there is to learn. by Allison Cassone

MENTAL HEALTH

Walk & Talk Therapy in Adolesents The link between physical and mental health SPECIAL CONTRIBUTION TO AUSTIN MD BY AUSTIN CHILD GUIDANCE CENTER Working with adolescents often involves talking about troublesome situations and feelings that are uncomfortable to disclose. This is especially true for adolescent males who are often uncomfortable admitting difficulties, weaknesses or fears. However, incorporating basic physical activity into everyday life can help make teens feel less pressure and make the process of opening up a little less painful. The benefits of physical activity and exercise on mood are well established. There is no doubt that a person’s physical and mental health are uniquely intertwined. Feelings of depression or anxiety can interfere and potentially lead to compromised physical health. Despite these facts, exercise has been shown to improve mood and significantly reduce depression and anxiety.

“ After sitting all day inside at school, being outside in nature is quite beneficial for many adolescents ”

The Austin Child Guidance Center understands the connection between mental health and physical activitity and is striving to improve the connection between the primary and mental health services as well as incorporating physical activity within the therapeutic process. The agency has an outdoor children’s healing garden on site that is filled with native plants, a basketball goal, mini golf and an outdoor sensory music center. This outdoor space is utilized by many staff therapists, including Stephen Kolar, PhD, licensed Psychologist and Coordinator of Center-Based Services. Dr. Kolar says, “I often walk outside or shoot hoops with my teen clients during therapy. Incorporating some physical activity during these sessions can yield a discussion about increasing physical activity for the teen during the week. It is likely that most teenagers could benefit from more physical activity in their lives, especially given the more sedentary nature of many teens due to screen usage and video games.” Walk and Talk Therapy has made headlines in recent years, especially in working with adult and adolescent males who feel less comfortable with traditional faceto-face talk therapy. Numerous studies document the psychological benefits of exercise. An article in the American Journal of Preventive Medicine 2013 noted a correlation between increased exercise and a reduction in depression while a study published in the Journal of Neuroscience in 2005 demonstrated that exercise increases the growth of neuronal brain cells, which helps to elevate one’s mood. So combining walking or various other physical activities within the therapeutic process can enhance progress and promote emotional well-being. After sitting all day inside at school, being outside in nature is quite beneficial for many adolescents who frequent therapy at the Austin Child Guidance Center.

For over 63 years, the Austin Child Guidance Center has been the leader in mental health services for children, having brought the first child Psychiatrist to Central Texas. This year, the agency is hosting its third Annual Austin Originals Benefit Concert at the Austin Music Hall on September 26th. They will be presenting the third Annual Phyllis Richards Austin Icon for Children award to Barri Rosenbluth and Maxine Roberts. Barri will receive the award in the Community Professional Category for her work at SafePlace and her nationally recognized Expect Respect program for addressing interpersonal teen dating violence. Maxine will receive the award in the category of Community Activist for her outstanding, tireless efforts in helping to create the Center for Child Protection over 25 years ago and her constant, local advocacy in addressing childhood trauma and abuse. Both candidates carry on Phyllis Richard’s legacy in improving future outcomes for children.

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For M o

“ Feelings of emotional depression or anxiety can interfere with one’s physical health and become compromised ” re

ormatio Inf n

For more information in attending or becoming a sponsor of the event, please contact the Austin Child Guidance Center at (512) 451-2242 ext. 103 or email rhanson@austinchildguidance.org

MENTAL HEALTH

When Your Doctor Asks About Sex Addiction Sex Addiction can have many medical effects; how to open communication with your physician now BY DR. PATRICK CARNES

Much of the communication between doctor and patient is

only drug addiction, but also ‘natural addictions’ such as pathological

personal. To have a good partnership with your doctor, it is crucial to

overeating, pathological gambling and sexual addictions”.

talk about sensitive subjects like sex, even if you are embarrassed or

uncomfortable.

sex on the internet, especially on children. A pivotal study by the

University of New Hampshire found that two-thirds of adolescents,

Some of the most personal aspects we reveal about

There is urgency around the issue due to the impact of

ourselves are often sexual. However, America has a long history of

ages 12 to 16, are sexually active on the internet. The article projects

judgmentalism in regards to sex, while also having an even longer

that 34 percent of that group will go on to have a lifelong problem

history of sexual indulgence.

with sexual behaviors. This estimates to roughly six million American

kids in that age group who are vulnerable.

Consequently, when a physician has to ask questions

related to sexuality in the interests of the patient’s health, it is often

Sex addiction has medical effects in a wide variety of ways, including

a moment of discomfort. Today, these questions become more

sexually transmitted diseases, marital problems and related issues

relevant as our understanding of sexual addiction grows. A similar

such as drug and alcohol use. These highlight the reasons for doctors

process occurred in the early assessment and intervention with

to become involved in a patient’s sex life. Here are some selected

alcohol problems.

examples to illustrate the breadth of the problem:

Sexual addiction awareness started to become more

35 percent of sex addicts have been in an emergency room

understood in the mid-1970s. The first articles appeared in

because of their sexual behaviors

professional literature; we had breakthroughs in understanding the

reward centers of the brain and 12 step fellowships such as sex

tobacco use; it is the spread of HPV by adolescents during oral sex

addicts anonymous appeared both nationwide and worldwide. The

advances were formed out of the realization that sex, much like

drugs and internet porn

gambling, food and drugs, can be addictive.

spouses and partners is no longer arousing

Today, there are professional societies dedicated to the

The leading cause of throat cancer is no longer alcohol or The number one factor in college drop outs is prescription Internet porn alters arousal patterns so that normal sex with

problem. Fortunately, many facilities offer treatment to individuals

As with alcohol addiction, early intervention and

who are struggling with sex addiction. In 2011, the American Society

assessment are critical. The PATHOS questionnaire has been

of Addiction defined addiction as a brain disease and specified sex

developed to aid doctors in a quick, accurate assessment of potential

addiction as part of the illness. According to Dr. Eric Nestler of the

problems with sex addiction.

Friedman Brain Institute, “Dopamine reward systems mediate not

“America has a long history of judgmentalism about sex, while also having a long history of sexual indulgence” Dr. Patrick Carnes, Founder of Gentle Path at The Meadows, is a world-renowned speaker and author on sex addiction and treatment. Dr. Carnes is the primary architect of the Gentle Path program for the treatment of sexual and multiple addictive disorders. Dr. Carnes pioneered the founding of the International Institute for Trauma and Addiction Professionals (IITAP), which specializes in training Certified Sex Addiction Therapists. He is the author of Out of the Shadows: Understanding Sexual Addiction, the first work designed to help addicts deal with their sexual compulsions. IMAGE FROM SHUTTERSTOCK

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MENTAL HEALTH

There are six key questions doctors use as a first assessment to help determine if a more in-depth assessment is necessary. If a person can say yes to three or more of them, the doctor will recommend ways to explore further.

1. Preoccupation Sex addicts obsess about sex in ways most people do not. Everything becomes filtered through an erotic lens and in an effort to keep the stimulation, the patient will find it difficult to focus on things

2. Ashamed

“As with alcohol addiction, early intervention and assessment are critical” There are six key questions doctors use as a first evaluation to help determine if a more in-depth assessment is necessary. If a person can say yes to three or more of them, the doctor will recommend ways

Feelings of shame and fear often are at the core of sex addiction as well as core beliefs of being unworthy and unlovable. Sexual behavior and habits often hidden and kept secret.

3. Therapy Unfortunately sex addicts have a history of seeking help about their problems. They either do not find knowledgeable help or leave therapy before they can get better.

4. Hurt Others

to explore further. 1.

Preoccupation – Sex addicts obsess about sex in ways most

people do not. Everything becomes filtered through an erotic lens, and in an effort to keep the stimulation, the patient will find it difficult to focus on things. 2.

5. Out of Control

Ashamed – Feelings of shame and fear often are at the core of

sex addiction as well as beliefs of feeling unworthy and unlovable. Sexual behavior and habits are often hidden and kept secret. 3.

Therapy – Unfortunately, sex addicts have a history of seeking

professional help about their problem. They either do not find knowledgeable help or leave therapy before they see progress. 4.

Infidelity, secrets, and betrayal are frequent allies of sex addiction, therefore, often there is a number of people who have been harmed or will be in the process.

Hurt Others –Infidelity, secrets and betrayal are frequent allies

of sex addiction, resulting in the destruction of many relationships. Harm can come to romantic partners, friends, children and

Many sex addicts find they are engaging in behaviors in which they do more or for longer periods of time than they intended.

6. Sad Sex addicts feel despair about their sexual activities. Often they report not even enjoying the sex when it is happening. Depression is a common occurring problem. The six questions form the acronym

colleagues. PATHOS. They were developed specifically for physicians but are being used by therapists and pastors today in many settings. If you are asked about the issues in your life, it is important to be honest and detailed. Your doctor wants to get you the help you need. The doors that can be opened can mean a whole new life with richer and more fulfilling sexuality and relationships.

FOR MORE INFORMATION Please visit or call gentlepathmeadows.com (855) 333-6076 or visit themeadows.com (800) 244-4949 66

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MENTAL HEALTH

MEN AND RELATIONSHIPS What do men want? BY DR. MICHAEL BISHOP

What do men want? The quick answer to this question is that men want sex, attention, and leave me alone, sex, attention, and leave me alone. However, the real answer is more complicated than this—there is often a depth that is overlooked. Throughout the years of my practice, I have heard men in my office speaking about their needs in honest and sometimes disarmingly direct ways. It is true that men show incongruence in regards to their thoughts and feelings. This incongruence, however, may come from the residual effects of society’s expectation to be emotionally tough and distant while also being sure of their greater purpose. In actuality, men cannot (and often do not want to) be cast in the role of their generation’s idealized male identity and masculinity. Regardless of the intense and constant influence of modern day media bombarding us with images of male stoicism and prowess, it has become clear to me that most men would rather not oblige themselves to fit the mold of a stoic Gary Cooper, nor pretend to have the magnetic prowess of George Clooney or even an action oriented Marvel super-hero.

So then, what do men say they want in relationships?

Men hope to avoid feeling shamed within the context of their committed relationship. Once a man learns his partner wants to “talk about the relationship,” often his first thought is: “What have I done and why am I in trouble?” According to research, for generations boys have been acculturated and parented with a powerful sense of shame. Unfortunately, these deep-seated lessons from their past have been learned through these feelings of shame. Now, the feelings have crept into how men may passively or aggressively interact with a romantic partner. This can serve as a primary factor in contributing to reactivity.

Men also desire intimacy, more than many will verbally admit to, as well as more than others may recognize or assume. While they are often viewed as getting their intimacy needs met through sexual activity, men also derive and enjoy intimacy through sharing their feelings with a partner while feeling accepted and validated. However, it is their fear of rejection that heightens their anxiety around being honest with a mate. A man once said to me during a session of therapy, “My wife says she really wants me to share my feelings...right up to the point where I open my mouth. If the feelings I share are not what she wants to hear, then she is unhappy with me. If that is the payoff, why would I share?”

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MENTAL HEALTH

Men want to touch and be touched. Although men can appear to be autonomous from their partners, they experience emotional connection and compassion. Men also report being three times happier when they are being touched and receiving affection.

Men want to fulfill their socio-cultural mission in life...to fix the problem. Although men frequently misperceive the need to fix their partner’s problems, they fail to understand what may actually be required to provide a solution. Somehow, men perceive that providing advice is the best solution, but this guidance may not be what their partner wants or needs. Men view “fixing” as active and incorrectly perceive “listening” as passive.

Men want their partners to listen and converse with them about meaningful topics and issues that pertain to the relationship. However, once the conversation about the relationship begins, men often presume two things, “not only have I done something wrong, but this conversation is never going to end.” If time management is a principle used for business or education administration, then it should certainly be implemented in the dialog between romantic partners. If someone believes the conversation will never end, then consider setting a time limit on it while remaining on topic.

As Sam Keen writes in Fire in the Belly: On Being a Man, “We come to love not by finding the perfect person, but by learning to see an imperfect person perfectly.” Overall, men want to know that they have a significant role and are a valued priority in the lives of their mates. The most significant mistake a partner can make is not asking what the other wants in a relationship and assuming they would not tell you if asked. Prepare yourself to listen, without judgment or interruption, and the depth waiting to be revealed may surprise you.

FOR MORE INFORMATION For more information, you can contact Dr. Bishop at michael.bishop@ austinfamilyinstitute.org 68

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Michael Bishop, PhD, LMFT, LPC is in private practice in the Westlake area of Austin. Dr. Bishop is also the executive director of the Austin Family Institute. He is an adjunct professor at St. Edward’s University and an adjunct clinical affiliate with the UT School of Nursing.

MENTAL HEALTH

Males— The New Face of Eating Disorders Special Contribution to Austin MD by Brad Kennington, LMFC, LPC

Anorexia; bulimia; binge eating; body image disturbance. These are struggles that are most commonly heard about in regards to females. But think again. Selfinduced starvation, binging, purging, over-exercising and obsessing about ones’ bodies are becoming increasingly more common in adult men and adolescent boys. A study conducted by Harvard University several years ago found that 25 percent of those struggling with anorexia and bulimia are male, more recently with many researchers believing that it is closer to 30 percent. The same study found that 40 percent of

binge eaters are male. The idea that eating disorders are predominantly a “female problem” is an utter myth. Another myth associated with eating disorders is that they are all about food. On the surface, food and body image are the presenting issues, but beneath the starvation, binging, purging and excessive exercising resounds a violent storm of self-defeating thoughts and overwhelming negative feelings, ripping and tearing at the fabric of one’s sense of self. The behaviors around food are an attempt to manage and quell these thoughts and feelings. What is going on psychologically is projected onto the food and body so that the food

and eating, or lack thereof, are used to cope with what is causing him such tremendous pain. Our culture is a major culprit of why we are seeing an increase in eating disorders with males. Our society’s emphasis on having the so-called “perfect” male body is helping drive this increase. Research shows that when men see images of male models with their toned, chiseled bodies and six-pack abs, they experience an increase in body dissatisfaction. And a negative body image is a key variable in the eating disorder equation.

With the number of males with eating disorders on the rise, who is most at risk? For those who have a family member who has struggled with an eating disorder Research shows that, like other mental health issues (e.g. depression, anxiety, alcoholism), there is a genetic link to eating disorders. Certain athletes Guys who are involved in sports that necessitate weight restriction (running, swimming, rowing, wrestling) or are anti-gravitational (rock climbing, pole vaulting) are at a higher risk. Men who were overweight when they were a child or an adolescent and teased for their looks Studies show that 50 percent of men with eating disorders were overweight when they were younger and bullied because of their bodies.

“Beneath the starvation, binging, purging and excessive exercising resounds a violent storm of self-defeating thoughts and overwhelming negative feelings, ripping and tearing at the fabric of one’s sense of self “

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A U S T I N MD M A G A Z I N E . C O M

MENTAL HEALTH

“Research shows that, like other mental health issues (e.g. depression, anxiety, alcoholism), there is a genetic link to eating disorders” Certain professions Jockeys, models and other professions that focus on men’s physical appearance are at risk for developing eating problems. Gay and bi-sexual males Research shows that over 15 percent of gay and bisexual men struggle with disordered eating. With 10 percent of straight women struggling with eating issues, gay and bisexual men represent the highest risk group within the eating disorder population. Guys struggling with eating disorders are in hot pursuit of achieving the unachievable physical perfection. And an eating disorder, once entrenched, can become his identity and primary source of self-esteem and something he may fight to keep at the expense of everything else—physical and mental health, relationships, career, school or just about anything else that requires any amount of time and attention.

What are some of the warning signs that you or your husband, partner or son may be developing a problem with food or body image? Consider asking yourself or him the following questions: · Do you chronically worry about your weight or body shape? Are you terrified of gaining weight or not being muscular enough? · Do you obsess about the number of calories or fat grams in food? · Do you skip meals or avoid eating in front of others? · Do you feel anxious or guilty when you eat certain foods or avoid so-called “bad” foods altogether? · Do you hoard food or feel like you lose control of your eating at times? · Do you weigh yourself or body-check multiple times a day? · Do you exercise to rid your body of the calories you consumed? · Do you work out even when you are sick or injured? Are you unable to take a day off from exercising out of fear of gaining weight or losing muscularity? Unfortunately, many guys do not seek help because of the percepted shame of struggling with what is still considered by many a “female issue.” If you believe that a loved-one may be developing a problem, do not remain silent. Silence feeds eating disorders. Instead, gently point out his behaviors that concern you and let him know that you would like him to seek help. Eating disorders are Brad Kennington, LMFT, LPC the most lethal of all psychiatric disorders, so it is imperative that Brad is a therapist in private practice in the Westlake treatment is provided by a team (e.g. physician, therapist, dietitian) area of Austin. He is also an associate faculty at the trained and experienced in treating these disorders. The sooner help Austin Family Institute. Brad provides therapy to begins, the better the prognosis. Full recovery is attainable. It’s just a individuals, couples and families, and he specializes in the treatment of eating disorders, relationship matter of having the courage and support to make that first step. issues, anxiety, grief and loss. Austin MD wants to say a special thank you to Brad Kennington for guest editing our mental health section.

FOR MORE INFORMATION

For more information on eating disorders or to contact Brad please visit bradkennington.com, call (512) 517-8148 or email him at info@bradkennington.com

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MENTAL HEALTH

Austin Lakes Hospital

Revitalizing Lives Through Crisis Resolution BY MALENA MANNING

Austin Lakes Hospital, owned by Universal Health Services, Inc. and located in the pavilion at St. David’s Medical Center, offers a diverse assortment of psychiatric care for individuals ages 18 and up. The hospital specializes in the acute crisis part of mental health. According to The National Institute of Mental Health, about one in every four adults suffer from a diagnosable mental disorder in a given year. Austin Lakes provides free psychiatric evaluations to individuals in crisis, who most commonly are dealing with depression, schizophrenia, bipolar disorder and anxiety disorders. Providing exceptional individualized services while maintaining clinical excellence is desperately needed in a world plagued by mental illness. And that is precisely what Austin Lakes Hospital strives to accomplish. Austin Lakes offers two outpatient programs, Partial Hospitalization (PHP) and Intensive Outpatient Care (IOP), for those who do not necessitate around-the-clock care. PHP hospitalization is available to those in need of a more intensive and rigorous outpatient program—PHP is six hours per day, five days per week where a psychiatrist-led team of clinicians provide a variety of services that fit each patient’s individualized treatment plan. Individuals interested in IOP have the option to choose from an evening or daytime program—a more flexible treatment program is conducive and imperative for people in need of treatment but still obligated to work or tend to other responsibilities. IOP is often an appropriate transition subsequent to inpatient treatment but it is not a mandatory—IOP is available to anyone who qualifies following an evaluation.

There are also three inpatient programs available for individuals who require crisis stabilization and 24-hour hospitalization. The Inpatient program, the Psychiatric Intensive Care Unit (PICU) and the Senior Adult Program are the services that provide a higher level of care. Inpatient treatment offers medication stabilization, teaches coping skills, case management, group therapy and a wide range of other services aimed to address a diverse array of needs. The highest level of care the hospital offers is accessed through the PICU program, which consists of 30 beds—making it one of the largest programs of its kind in the community. It provides the highest level of inpatient care and crisis intervention.

“Providing exceptional individualized services while maintaining clinical excellence is desperately needed in a world plagued by mental illness.”

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MENTAL HEALTH

Director of Business Development, Robert Lerma says, “For many people we are the last stop when many interventions, at lower levels of care, have not been successful.” The hospital recently added 18 beds to the original 12 (in the PICU program) and have been full nearly full most days since the expansion. This fact alone is very telling of how great the need is for crisis stabilization within the Austin Metro area. The Senior Adult Program is the only one of its kind in Austin— providing inpatient care and crisis services to patients 55 and older. This program caters to the population it serves by hiring social workers experienced with addressing many complex senior-related issues. Austin Lakes is able to provide a service that is currently in strikingly high demand—Austin’s senior and pre-senior growth population are some of the highest in the country. The hospital recognized this need by reaching out to the community and capitalized on the opportunity to meet this demand. A community-focused hospital, Austin Lakes values the connections and resources they have found in the surrounding

area through strong relationships with area hospitals, law enforcement, mental health professionals and social service organizations. Austin Lakes keeps their focus on the dignity and worth of each patient. The primary reason people arrive at the hospital is due to thinking about or acting on thoughts of hurting oneself or others. Essentially, Austin Lakes Hospital is saving lives by stabilizing patients experiencing acute crisis and other mental health related emergencies.

“Austin Lakes keeps their focus on the dignity and worth of each patient.”

For inpatient services call 512-544-5253, for outpatient services 512-356-9065 or visit austinlakeshospital.com.

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BOOKS

Memoir of an Afflicted Mind Brain on Fire -- a review of madness by Allison Cassone

1 New York Times Bestseller, Brain on Fire: My Month of Madness is an enlightening memoir about a brilliant mind’s decline into one of the most relentless mental diseases known. Susannah Cahalan concisely illustrates her deterioration from a fast pace life of a New York Post journalist, in the dawn of adulthood, into a labeled psychotic, epileptic floor prisoner, with no memory of how she got there. She refers to this month as a “lost time,” but through her collection of interviews, medical

records, journals and video footage, this gifted journalist conjured up a first-hand account of her defiant battle through her own tragic mental sickness. Brain on Fire is an astounding personal-account of Cahalan’s fight to find her identity through a very isolating mental disease. One of the many captivating aspects of this narrative is how her incapacitated mind was able to bounce back to its innate sharpness and provide our society with a compelling story of hope. Cahalan, who was physically 74

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“entrances the reader with the clearest and most articulate understanding of her tortured mind” but far from mentally present during her affliction, entrances the reader with the clearest and most articulate understanding of her tortured mind. A young woman, usually described as outgoing, sharp and effusive, began her month of madness. Triggered by seizures and insomnia, the invasive disease rapidly presented symptoms of psychosis and bipolar disorder. The pendulum, representing her mood shifts, began violently swaying. At this point, the reader has entered her mind’s haunted roller coaster ride, expressed by Cahalan in an eerily detailed manner. The pendulum swung into what she described as “perilous happiness,” or mania. Her manic illusions, such as aging people with her eyes, were strangely enjoyable for Cahalan. Her illusive mind’s newfound powers seemed amusing but were a dangerous indication that the disease was exacerbating. Her personality deteriorated while symptoms of delusional paranoia and hallucinations escalated. Suddenly, she felt as if imposters were everywhere, taking over the bodies of her family members and nurses, a symptom of Capgras Syndrome. Cahalan’s psyche became stuck in a checked-out effect, in which her mind, or anything “uniquely Susannah,” evaporated. Cahalan experienced negative symptoms of schizophrenia such as inexpressiveness, lack of feeling, monotone and monosyllabic speech. She develops catatonia and ataxia, otherwise described as neurogenic motor inability. As if her body’s underhanded attack could not get worse, she developed a speech retrieval disorder called aphasia; a symptom that competes with a journalist’s outspoken nature and can be closely related to a more permanent “writer’s block.” This mysterious disease, took on disguises of seemingly epileptic, bipolar, schizophrenic and autistic. It was no wonder the several doctors assigned to Cahalan during this “lost time” seemed to continuously misdiagnose her, and even meaninglessly labeling her with “psychosis not otherwise specified.” Cahalan describes this diagnosis as medical jargon for “we have no clue.” Cahalan’s devoted family, and loving boyfriend were her anchors to normalcy during her peaking illness, and waning recovery. Scarred and scared, her loved ones held on to any ounce of hope, convinced that “she [was] still in there.” Cahalan’s father’s support was fundamental for her recovery; fueled by his comforting motto, “What is the slope of the line?” Answer: positive, representing her upward progression. However, it is disturbing to see what are later compared to symptoms shown in “The Exorcist,” are the same shown in Susannah’s case. Cahalan’s entire support system was vital for her progressive healing. Cahalan’s mother tried to hold an optimistic relationship with a doctor she called “Bugsy,” her own personal gangster doctor.

BOOKS He was one of the best neurologists in the country, and shortly after being assigned, gave up on Cahalan’s case. It was not until one outstanding doctor, Souhel Najjar, equipped with his own remarkable background, took the patience and gave the individualized attention Cahalan needed to save her life. From the moment he met Cahalan, he spoke to her unlike any doctor before him: directly and personally as if talking to the true Susannah, rather than the aberrant mind that seemed to have jurisdiction over her brain. Dr. Najjar came to the stimulating conclusion that “her brain [was] on fire.” A terrifying statement that determined, “her brain [was] under attack by her own body.”

haunting report of every detail from Cahalan’s sickness through her recovery has the reader in constant awe. Her charming writing style and metaphors of the brain as Christmas lights or seashell patterns, invites an audience of any degree to further understand the brain’s anatomy, disease pathology and information processing. Cahalan’s step-by-step depiction of her brain biopsy and treatment provides the reader with an alarming grasp on the grave reality of mental illnesses. Brain on Fire is a powerful examination of medical mystery, love and courageous determination to live that has spread across the globe. Dr. Najjar who faithfully stuck by Cahalan life, is now recognized by the Syrian ambassador of the United Nations and named one of New York Times Magazine’s best neurologist in the country.

Dr. Najjar, once a ten-year-old in Syria who failed every school exam, became a highly respected neurologist, epileptologist and neuropathologist in the United States. He lives by an The universe seems to have a similar plasticity as the brain inspiring principle: to never give up on any patient. Doctors does: from a tragedy, rebuilds shape and meaning. Susannah like Souhel Najjar are the people that will change the face of Cahalan continues to change lives, through her exceptional mental health care into the more subjective and personal journalistic skills and comforting understanding of what it is care system patients need to progress. Dr. Najjar keeps his like to be in such an obscure, isolated place. When asked if eyes open to every possibility, regardless of what the patient’s she would take it back, Cahalan genuinely answered, no: “too symptoms initially show. This determination will be what, in much light came out of my darkness.” Cahalan’s words, “severs the barrier separating immunology, neurology and psychiatry.” Cahalan considers herself lucky to not have slipped through the flawed system that “Cahalan considers herself lucky to not has been misdiagnosing have slipped through the flawed system patients since 1930, with that has been misdiagnosing patients since little improvement. She 1930, with little improvement” describes one doctor who astonishingly misdiagnosed her with alcoholism, as a “by-product of a defective system that forces neurologists to spend five minutes with X number of patients a day to maintain their bottom line.” Cahalan’s strength, and stand for improved mental health care will continue to be heard worldwide, through her outstanding research on a case study that is her very own. Only a few live to sanely view their own journals, and video footage during their “lost time.” Cahalan agrees some journal entries were just muddled statements from her deviant mind, however she felt other entries were some were “strangely illuminating, providing deep access to areas of [her] life that [she’d] never before examined…[she] felt as if [her] “self ” was trying to communicate with the outside world but couldn’t break past the broken intermediary, [her] body.” Cahalan, because of this subjective experience of psychosis, relates strongly to Thomas Moore’s quote: “it is only through mystery and madness that the soul is revealed.” To read such a captivating story about a lost mind that is able to return to see itself on a deeper, otherwise unknown level is a mystifying gift. It is a cruel reminder of “how fragile our hold on sanity…is… and how much we are at the utter whim of our Brutus bodies.”

“Cahalan, who was physically but far from mentally present during her affliction, entrances the reader with the clearest and most articulate understanding of her tortured mind”

Through a keen and awe-inspiring narrative, Susannah Cahalan proves her distinguished skill of journalism and passionate understanding of her “lost time.” This beautifully A U S T I N MD M A G A Z I N E . C O M 75 75

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Dr. Ruy Carrasco, MD Juvenile Rheumatoid Arthritis & the Arthritis Foundation by Aissa Vallecillo Photography by steve dement

every 250 children (ages O ne16 outandof under) are affected by

juvenile arthritis. The problem is that there is currently no existing blood test that can prove whether or not a child has this chronic illness. Fortunately, the Arthritis Foundation has helped families across the United States by providing information on different methods of treatment and promoting awareness of the signs of this illness. Dr. Ruy Carrasco, a specialist in pediatric rheumatology, practices in Austin and is one of many doctors involved in the foundation. If there is one thing to know about juvenile arthritis, it is that it enables families to become extremely close and supportive. “Success in healing depends on family input for best outcomes,” explains Dr. Carrasco. “A few words can easily answer the ‘why’ of my preference in practicing pediatric rheumatology: I love what I do!” Dr. Carrasco started his fellowship in pediatric rheumatology in 2002, and has been practicing in Austin since 2005. “No other field that I encountered in medical school involves the entire family unit, constantly challenging the latest medical breakthroughs, [and] yet makes medicine feel as rewarding as rheumatology.” Dr. Carrasco first became interested in the Juvenile Arthritis Foundation by way of families he encountered during his practice in pediatric rheumatology. “With families glowing about the Arthritis Foundation, I had to find

“No other field that I encountered in medical school involves the entire family unit, constantly challenging the latest medical breakthroughs, [and] yet makes medicine feel as rewarding as rheumatology.”

out how to become involved and [I] have never looked back,” he says. The purpose of the foundation is to create a network for patients and their families. Dr. Carrasco helps his patients and their families gain confidence by providing knowledge and resources. “The Arthritis Foundation has some of the most reliable and trusted information on rheumatic conditions, social issues, political awareness and existing treatments.” Dr. Carrasco also provides information to families about local camps with activities designed for kids suffering from juvenile arthritis. Kids Get Arthritis Too (KGAT) camps are available for children and teens to spend time with others their age that have juvenile arthritis, helping the child or teen to not feel alone in their illness. Arthritis can only be detected if the patient informs a doctor of his or her symptoms, which is referred to as a clinical diagnosis. A question every parent would like the answer to is, “what are the symptoms I need to look for in my child or teen?” Dr. Carrasco helps answer this by letting us know that lab testing cannot diagnose arthritis, but rather it is testing and long-term monitoring and that helps doctors diagnose the child or teen. “Laboratory tests do not diagnose arthritis, but are utilized to aid in monitoring disease activity, risk of eye inflammation, or monitoring adverse effects from medications,” Dr. Carrasco explains. “Clues that health care providers or

family members may see pointing to arthritis are stiffness (difficulty moving in the mornings or after a nap), swollen joints, limited movement of one or more joints, limping in the morning, weakness, loss of developmental milestones, and yes, finally, pain.” Progressive research in JA has led to the creation of new medications known as biologics. “Biologics have revolutionized the field of rheumatology and led to wonderful outcomes. I am involved in research on the best ways to educate patients about their disease, the cost of arthritis, biologic medication treatment and monitoring,” says Dr. Carrasco. Juvenile rheumatoid arthritis is an autoimmune, polygenic disease, that affects every person differently. This means that a cure for one patient may not be the same cure for the next. “My hope is that in the next 10 years we will be able to determine the best treatments for the individual person using gene, protein and metabolic fingerprints unique to the individual at each stage of the disease. This would minimize adverse effects and exposures to medications, while encouraging my belief in providing the minimal amount of medications and no more.”

FOR MORE INFORMATION For more information on Arthritis Foundation and the programs they offer, visit arthritis.org, kidsgetarthritistoo.org, japowerpack. kintera.org, and carragroup.org A U S T I N MD M A G A Z I N E . C O M

PROFILE

Stonegate Pharmacy

Providing a personalized treatment plan for patients through compounding by Stefon Andrews photogaphy by steve dement

Patients no longer have to hope that a medication will be effective or suffer through unnecessary side effects

veryone is different. This means that medication affects people differently. Not everyone can take standard medications. Factors such as allergies and size of pills allow for non-standard dosages and combination therapies, making certain medications a bad fit for certain people. This is where compounding comes into play. Compounding pharmacies design medications to specifically fit the individual needs of patients. This ensures that patients get the medication they need, optimizing their medical experience.

excellent care by providing in-depth consultations to determine the exact treatment plan necessary for each patient. The purposes of compounding are many, and include: - Hormone Restoration Therapy - Pediatric Medications - Dermatological Medications - Pain Management

Stonegate Pharmacy in Austin is at the forefront of the Compounding revolution. Founded by - Dental Preparations Rene Garza in 2007, Stonegate Pharmacy gives 78

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PROFILE Hormones are the most powerful molecules in our bodies, and as we age we lose our natural hormones. Hormone therapy performed through the lens of compounding can replace those hormones with hormones identical to the ones that were lost. This gives Stonegate patients who have this therapy a richer, fuller life as they age.

at UT; furthermore, Garza is the President of the Alliance of Independent Pharmacists of Texas. Compounding was not always thoroughly understood by the medical community. It is, however,

In addition to compounding services, Stonegate offers specific wellness consultations. These consultations include: - Bioidentical Hormone Restoration Therapy - Adrenal Fatigue - Vitamin Wellness Advice - Medication Therapy Reviews (MTR) - Osteoporosis

The idea of paying it forward is a very important concept at Stonegate

Stonegate has two locations and about thirty employees, with six pharmacists. In addition, Stonegate prides itself in being a teaching pharmacy and brings in five or six interns from The University of Texas College of Pharmacy each year. They do this for two reasons. First of all they get to cherry pick the best and brightest that UT has to offer to come work for them. The other reason is, as explained by Andy Ruiz, the Pharmacist in charge, â&#x20AC;&#x153; We try to be as involved as possible in training the future.â&#x20AC;? The idea of paying it forward is a very important concept at Stonegate. Both Rene Garza and Andy Ruiz are very involved in the medical community. Ruiz is a board of directors member of The International Academy of Compound Pharmacists and teaches

becoming increasingly well known. Compounding allows patients to receive optimum treatment for the very best results. Patients no longer have to hope that a medication will be effective or suffer through unnecessary side effects. Stonegate excels at finding exactly the right treatment for their patients through attentive consultations and extremely knowledgeable pharmacists. The pharmacists at Stonegate understand that proper compounding of medicines is only part of the equation, which is why they stress the importance of the wellness consultations. Stonegate is determined to be on the forefront of providing comprehensive plans to help their patients stay healthy and have active, fulfilling lives. FOR MORE INFORMATION To reach Stonegate Pharmacy please call (512) 707-2300 or visit the site at stonegaterx.com.

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Disclaimer: The information contained in this article is not intended as legal advice. Because the law is not static, and one situation may differ from the next, the author cannot assume responsibility for any actions taken based on information contained herein. Also, be aware that the law may vary from state. Therefore, this article cannot replace the advice of an experienced attorney. Receipt of this information does not create an attorney-client relationship. © 2014 WMG all rights reserved.

BUSINESS

IP + SME = SUCCESS? 7 Questions That Will Help You Grow Your Business BY WENDY MUSE GREENWOOD BA (HONORS) & LL.M/MASTERS OF LAW

“How to be clear on Intellectual and Industrial Property Rights” Good news, your market is a click away. You, a local SME, can market your Property Law. So, let me save you money and time (unless you want a law degree). products, services and ideas from your kitchen table if you want. It is now vital for SME’s to truly understand the role IPR plays in their profit Bad news, you might be giving away your Intellectual and Industrial Property and market share. IP can be your most valuable asset. Let me reassure you right now that you don’t have to get it all perfect immediately. Just start learning your Rights (IPR) and some of your profit possibilities without even knowing. businesses IP worth and the rest will grow from there. No worries, this is nothing to panic over, it is just something to explore. And that is what this article will do, it will give you some ideas to consider why IPR are Marshall Phelps, the former Corporate Vice President, Deputy General Counsel relevant to your SME. This article will share with you 7 questions that will help for Intellectual Property and Licensing for Microsoft, referred in his Strategic grow your business. Your 7 answers can immediately be applied to your business Innovation speech at Cornell University that 20 years ago the business balance plan. First, let’s be clear on what Intellectual and Industrial Property Rights are. sheet focused on 80 percent physical and 20 percent non-physical assets. Now the top fortune 500 balance sheets read 20 percent physical and 80 percent nonWorld Intellectual Property Organization’s (WIPO) global definition states physical. He shared that Microsoft’s balance sheet reads more like 90 percent -95 intellectual property (IP) refers to creations of the mind, such as inventions; percent non-physical and 5 percent-10 percent physical. Now, what does that tell literary and artistic works; designs; and symbols, names and images used in us SME’s? That not knowing your IP value could put you out of business. commerce. A work or invention that is the result of creativity, such as a manuscript or a design, to which one has rights and for which one may apply for a patent, Here, fellow entrepreneurs, are a few questions to get you on your way to making more money and securing your IPR. Because making a great living is not just for copyright, trademark, trade secret, etc. the Fortune 500 companies. We cannot in 500 words cover all the legal aspects of IPR; however we can start the conversation on what every SME ought to be asking in regards to their IP 1. Do you have a 5 year plan for your IP? portfolio. And I want to be clear – there is more to IPR than just making sure no 2. Name 5 IP assets in your business idea? one steals your ideas. In today’s business climate that is the smallest part of IPR. 3. What training does your local government IP office offer? How to make money from your ideas/inventions, trade secrets and services is the 4. Have you thought of how to Trademark your name/product name? Big Pay-off. 5. How much monthly will you need in savings to secure your IPR? 6. When do you need to get an attorney? This topic became vital to me when my own business suffered a huge financial 7. What subcontractors do you need to sign-over all IPR when doing work-forloss (even though we hired an attorney before launching). After that, I went to hire (i.e. website designers, graphic artists etc.)? law school to receive my LL.M (Masters of Law) in Intellectual and Industrial

“There is more to IPR than just making sure no one steals your ideas” Inspiration FX focuses on developing Company Culture Architects™. Wendy Muse has provided Training & Consulting Services to: Austin Community College, Social Media Delivered, City of San Antonio, University of Washington, UK’s National Fire & Rescue Service, Welsh Blood Service (NHS –Wales UK) and Seattle King County School District to name a few. She is a Company Culture Architect™ for SME’s both in the USA and the UK.

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For more information The Small Business Development Program provides many no-cost services to small business owners at all stages, start-up through expansion.Visit austinsmallbiz.org for more information or call (512) 974-7800. Follow and Like us @SmallBizAustin

BUSINESS

REAL ESTATE

How to choose the best real estate website when shopping for a home

BY OMAR DYESS There are numerous websites out there for all types of consumers, whether you are a first time home buyer or real estate investor purchasing your tenth rental property. Most consumers tend to stick with a few websites that seem to be offering all the information you could ask for on a home or piece of property. With hundreds of websites out there, how can we know where to get the best for information? How do we recognize the difference between what is a legitimate website and what is simply dated material, meant to draw you in and control your purchasing process? Consumers and clients ask me all the time, two in particular being where to find the best real estate websites when searching for home information, and why there are some reputable websites out there with dated information going back to one year? The truth is that there are plenty of good websites out there, and I advise you pick the one you are most comfortable with. If you are working with an agent or broker, your representative will be able to do extensive research on any home you come across online, easily notifying you on the status and background. Some of the top real-estate websites attracting the most visits are Zillow.com, Trulia.com, Realtor.com and Homes.com, to name a few. All of these are great websites that offer a plethora of information; but the one drawback I hear the most from my consumers is that a couple of these websites have a lag in information, showing properties for sale that were sold months or even years ago. On a side note, I will add that some of these websites are also offering off-market listings for sale by owner, or coming-soon listings by agents and brokers where you can find a home, so you really never know. There is a major debate taking place right now amongst our real estate officials, associations, boards and brokerages, along with there being many pros and cons to using these websites. Over 90 percent of consumers are shopping for their home on the internet, and most of the real estate websites out there directly correlate with the Multiple Listing Service (MLS) where agents and brokers upload their listings for the general public. If you want direct access to the Austin area Multiple Listing Service, visit AustinHomeSearch.com; this website offers the most real-time data with on-market

inventory. This also means less guessing for the consumer, versus on one of the larger national websites where you may find a delay or discrepancy. The biggest changes we are seeing in this seller’s market is off market or off MLS strategies listing homes for sale before they hit the market such as “coming soons” or “pocket listings” where certain brokers, agents or even consumers have an exclusive look before the general public. This is huge because as a consumer, you are not competing with multiple offers, should seller or broker allow an offer before inventory even hits the market. Each agent and broker has access to their own network and forums where they can possibly locate inventory before it goes live on MLS, so be sure to ask for this service!

If you are looking for foreclosures and would prefer an REO (bank owned property), visit the national websites offered to the general public that any agent or broker can assist you with. The most reputable foreclosure websites in the Austin area include HomeTelosFirst.com (HUD), HomePath.com (Fannie Mae) and HomeSteps.com (Freddie Mac). Remember, most foreclosures are sold as-is and will typically ask that you pay all costs associated with repairs and/or renovations.

Lastly, do not forget the city or county websites that offer public information on each property or owner. The most commonly used websites are the central appraisal district websites, which show tax records and demographics for each home or property in the “`area. Austin residents typically use the Travis Central Appraisal District (TravisCAD.com) for tax information on homes or property, which is a great resource when looking up off market listings, especially when you want to know what the county appraised value indicates for the most current year.

“The one drawback I hear the most from my consumers is that a couple of these websites have a lag in information, showing properties for sale that were sold months or even years ago”

FOR MORE INFORMATION Please feel free to contact Omar Dyess with RE/MAX 1 at (512) 337-0235 office or (512) 762-4228 cell.You can always email Omar@DyessResidential.com or visit DyessResidential.com for more information.

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TECHNOLOGY

Engineers Build World’s Smallest, Fastest Nanomotor UT Develops A Mini Machine That One Day Could Help Many Suffering With Disease SPECIAL CONTRIBUTION TO AUSTIN MD BY THE UNIVERSITY OF TEXAS AT AUSTIN

By now, we have all heard about Austin’s unprecedented growth, ranking at the top of Forbes’ America’s Fastest Growing Cities List for four straight years and boasting an economy that expanded 5.88 percent in 2013 alone. Additionally, The Business Journals ranked Austin as the top city for small businesses for a fifth straight year. Starting a successful business in Austin should be a slam dunk, right? Think again. Between 2010 and 2011 (the most recent period covered by official data), the number of small businesses in Austin increased by 1.73 percent, the largest in the nation. Entrepreneurs are coming to Austin from all over the world, and it is important to understand how to gain a competitive advantage.

“...on a scale 500 times smaller than a grain of salt...The nanomotor could fit inside a human cell with all its dimensions under one micrometer in size…” Researchers at the Cockrell School of Engineering at The University of Texas at Austin have built the smallest, fastest and longest-running tiny synthetic motor to date. The team’s nanomotor is an important step towards developing miniature machines that could one day move throughout the body to administer insulin for diabetics when needed, or target and treat cancer cells without harming good cells.

and testing of a high-performing nanomotor in a non-biological setting. The team’s threepart nanomotor can rapidly mix and pump biochemicals and move through liquids, which is important for future applications. The team’s study was published in the April issue of Nature Communications.

Looking forward, nanomotors could advance the field of nanoelectromechanical systems (NEMS), an area focused on developing miniature machines that are more energy efficient and less expensive to produce. The Cockrell School researchers believe their nanomotors could, in the near future, provide Fan and her team are the first to achieve a new approach to controlled biochemical the extremely difficult goal of designing a drug delivery to live cells. nanomotor with large driving power. The researchers coated the nanomotor’s With the goal of powering these yet-toThe nanomotor could fit inside a human cell surface with biochemicals and initiated be invented devices, UT Austin engineers focused on building a reliable, ultra-high- with all its dimensions under one micrometer spinning to test its ability to release drugs. speed nanomotor that can convert electrical in size, and is capable of rotating for 15 They found that the faster the nanomotor energy into mechanical motion on a scale 500 continuous hours at a speed of 18,000 RPMs, rotated, the faster it released the drugs. the speed of a motor in a jet airplane engine. times smaller than a grain of salt. “We were able to establish and control the Comparable nanomotors run significantly Mechanical engineering assistant more slowly, from 14 RPMs to 500 RPMs, and molecule release rate by mechanical rotation, professor Donglei “Emma” Fan led a team of have only rotated for a few seconds up to a few which means our nanomotor is the first of its kind for controlling the release of drugs from researchers in the successful design, assembly minutes.

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TECHNOLOGY

“The Cockrell School researchers believe their nanomotors could in the near future provide a new approach to controlled biochemical drug delivery to live cells” the surface of nanoparticles,” Fan said. “We believe it will help advance the study of drug delivery and cell-to-cell communications.” Researchers have addressed two major issues for nanomotors so far: assembly and controls. The team built and operated the nanomotor using a patented technique that Fan invented while studying at Johns Hopkins University. The technique relies on alternating and dependent current electric fields to assemble the nanomotor’s parts one by one. The researchers used the technique in experiments to turn the nanomotors on and off and propel the rotation either clockwise or counterclockwise. They determined that they could position the nanomotors in a pattern and move them in a synchronized fashion making them more

powerful and providing more flexibility. Fan and her team plan to develop new mechanical controls and chemical sensing that can be integrated into nanoelectromechanical devices, but first they plan to test their nanomotors near a live cell which will allow Fan to measure how they deliver molecules in a controlled fashion. Cockrell School graduate students Kwanoh Kim, Xiaobin Xu and Jianhe Guo co-authored the study while The National Science Foundation Career Award, The Welch Foundation and various startup funds from the Cockrell School supported the study.

All UT Austin investigators involved with this research have filed their required financial disclosure forms with the university. Kwanoh Kim, Xiaobin Xu and Jianhe Guo have not received any funding for any other study or work outside of university appointments during the past 12 months. Donglei “Emma” Fan has worked on projects sponsored by the Welch Foundation and government agencies including the National Science Foundation and the National Institutes of Health.

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For more information visit engr. utexas.edu/ features/ nanomotors

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TECHNOLOGY

PRODUCT DEVELOPMENT

Have a Great Idea- What You Need to Know to Get Your Product Developed

The human race has been developing products for millennia; from the earliest rudimentary cutting tools to medical products, to travel. Some of it was out of vanity and ego, but much of it was out of necessity. Whatever the catalyst, it is difficult to imagine living in a world without pizza cutters, X-ray machines or jumbo jets. As we evolve, we devise new ways of applying modern technology to solve problems and to make things better, easier, more efficient. It is inventiveness and creativity that spurs product development to this day.

BY REDZA SHAH, OWNER OF PRODUKTWORKS DESIGN

Emerging technology is impacting the medical community at a rapid pace. We are seeing great strides in medical products ranging from drug delivery systems, to patient care, to remote monitoring and preventative care. Health Care products are an important part of our business, with contributions such as glasses that aid in the treatment of spatial disorientation, including vertigo and motion sickness. We have a hearing aid that can be adjusted and calibrated via a smartphone app or a tibial saw guide used in orthopedic surgery.

Many of us have woken up and thought, “I have a great idea for a product!” followed by, “But where do I begin?”

Identifying the Need

The first rule of product development is to ask yourself, ‘What problem am I trying to solve?’ Your product idea may be related to your profession or something you are passionate about. It may be revolutionary, or evolutionary. Regardless, by identifying a problem and formulating a way to address that problem, you have planted the seed of product development.

Addressing the Need

Often, clients devise a great idea but have a hard time translating that into a tangible product that is easy to use, cost effective to manufacture and readily commercialized. We help them with the process, from concept generation, to engineering, to prototyping and manufacturing. A good development partner will be able to help you design and engineer your idea into a realized, tangible product.

Product Entrepreneurship

To come up with a viable product idea is great, but building a strong business model around the product is equally, if not more, important than the product itself. Having a great management team behind the idea makes it much more attractive to professional investors. Bring people aboard who can complement your background and skill set and who have experience in areas of business that are out of your comfort zone.

Commercialization

A great product is almost worthless if not properly commercialized. These days, the proliferation of information and resources available on the internet means almost anyone can put their product in theWRITE hands of the consumer. A PERSONAL LETTER Developing a product may be a daunting and expensive proposition. If you are passionate about the idea, build a strong leadership team and forge relationships with partners who can help you with the process, then there is little reason you not to be successful. Now go forth and create!

FOR MORE INFORMATION Produktworks Design is located at 2900 S. Congress Ave. Suite 100a, Austin TX 78704 #: (512) 440-0600 Website: Produktworksdesign.com email: discover@produktworksdesign.com 88

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Healthcare

as it was originally intended. Homegrown in Austin & Built Around You. Along with our physician partners, we believe that putting patients first will help ensure the long-term health of health care. And unlike the big hospitals, Arise is wholly owned, managed and operated from right here in Austin. Visit arisehealthcare.com to learn more. ++++++++++++++++++++++++++++++++++++++++++ RIVERPLACE | HAYS | CEDAR PARK | BEE CAVE | MANOR | SOUTH AUSTIN

TECHNOLOGY

VELSCOPE

Detecting Oral Cancer at an early stage SPECIAL CONTRIBUTION TO AUSTIN MD MAGAZINE BY ROSE DENTAL GROUP BY MARY DELGRANDE PHOTOGRAPHY BY STEVE DEMENT

According to The Oral Cancer Foundation, someone dies as a result of oral cancer every hour of every day in the United States. Baseball HallOf-Famer Tony Gwynn died on June 16, 2014 from this terrible disease at the young age of 54. Oral Cancer is found in the mouth, on the lips and throat—it is often curable if diagnosed and treated early on. Unfortunately, in its early stages, oral cancer can go unnoticed.

many reasons why the tissue looks abnormal. However I work closely with an oral surgeon on suspicious cancer cases and we decide if a biopsy is the best course of action for the patient.” In the past few years, Rose Dental Group has performed hundreds of oral cancer detection screenings with the VELscope. Of those patients seen, seven have been to the oral surgeon for a biopsy. Dr. Kelly explains, while this number is not big, the fact that anyone needs a biopsy is reason for concern. Oral

have no risk factors. The fastest growing population of oral cancer patients are young, non-smoking healthy individuals. The reason for this is the connection to the Human Papilloma Virus (HPV). According to the National Cancer Institute, it has been estimated that in 2020, HPV will cause more oral cancers than cervical cancers in the United States. The Human PapillomaVirus infects people on either their skin or their mucous membranes. This is that part that is not visible to the naked eye, and why the use of the VELscope is so critical for early detection in the younger population. Dr. Kelly remarks, “The point is to detect these cancerous lesions as early as possible before it metastasizes, otherwise it is nearly impossible to catch at an early stage.”

Dr. Kelly from Rose Dental Group demonstrates a Velscope procedure. The VELscope is an FDA-approved oral cancer detection device, which allows doctors to catch oral cancer in the beginning stages that otherwise, might not be detected. This device is a non-invasive instrument that uses a bright-blue light to detect any changes in the mouth. The LED light aids in tissue fluorescence visualization, which helps to shine brightness on lesions in the mouth that might not be readily seen to the naked eye. Dr. Kelly of Rose Dental Group’s Southwest Austin location and a practicing dentist of 43 years said, “If anything looks suspicious, it doesn’t necessarily mean the patient has oral cancer. There could be 90

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cancer, including the throat, head and neck, is increasing in rate. The Oral Cancer Foundation estimates that 43,250 Americans will be diagnosed with oral cancer this year, with only 57 percent surviving after five years. However, this problem is much larger worldwide. Even with these statistics, the experts agree—early diagnosis pushes the five-year survival rate to an astonishing 80 percent. Those at a high risk for developing oral cancer include: tobacco users, heavy drinkers and AfricanAmerican men, but anyone can develop oral cancer. According to the Oral Cancer Consortium, 25 percent of people diagnosed with oral cancer

“This device is a non-invasive instrument that uses a bright blue light to emphasize any changes in the mouth that could indicate precancerous cells.”

TECHNOLOGY Dr. Kenneth Magid, a professor at New York University College of Dentistry, noted on the Oral Cancer Foundation website, “The problem, for the most part, is that early oral cancer looks like everything else. It looks like a million other injuries and changes in the tissue in the mouth. It’s a red sport or a white spot. We see them all the time.” But according to Dr. Magid, using the VELscope to detect oral cancer can make abnormalities stand out and much more obviously, aiding in early detection and prevention of developing oral cancer. “The nice thing about VELscope is that you can catch it at an early stage, which is best for treatment, recovery and survival,” notes Dr. Kelly. Since oral cancer can affect anyone, without regard to age or gender, it is very important to have regular screenings for this deadly disease. If you are concerned that you have oral cancer, or could be at risk for oral cancer, please contact Rose Dental Group to learn more about the latest development and technologies for diagnosing oral cancer.

“Being able to detect these cancerous lesions as early as possible before they metastasize is our main goal, otherwise it is almost impossible to catch the process at an early stage.”

FOR MORE INFORMATION For oral cancer screening information, please contact Rose Dental Group at any of the following locations:

Northwest Austin

Southwest Austin

11615 Angus Road, Suite 110

6211 W. William Cannon Dr

(512) 795-9463

512) 288-4447

Round Rock 893 N. I-35, Suite 200 (512) 310-9374

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Global Exposure. Texas

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NUTRITION

Shredding Fat with Dr. Smith Interviewing a Best-Seller on Weight Loss! By Samantha Schak

r. Ian Smith, best selling author and TV personality, sat down with Austin MD Magazine to discuss his book, SUPER SHRED: The Big Results Diet. Dr. Smith is a co-host of “The Doctors” and a medical contributor to “The Rachael Ray Show.” SUPER SHRED takes the original SHRED diet and compacts it into four super-charged weeks. The plan utilizes meal spacing, snacking, meal replacement, and diet confusion to keep you engaged and give you options.

AMD: What in your life has lead you to want to focus on health and the importance of a healthy lifestyle? Dr. Smith: I have always been an avid sportsman. My interest in good health was tied to my desire to attain peak performance in the athletic arena. But as I got older 94

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and understood the implications of a healthy lifestyle I became even more passionate about the other lifechanging benefits that could be obtained. AMD: Many crash diets cause you to gain even more weight after the initial flush. How can I stop this from

NUTRITION happening with Super Shred? Dr. Smith: Super SHRED is not just about rapid weight loss. It’s also about learning how to make long term behavioral changes that will maintain weight loss. People who do this program are also so excited about their results that their desire not to gain the weight back discourages them from returning to old bad habits. Classic example of positive reinforcement. AMD: So many of us have a constant problem with sugar addiction. What are your tips for the battle against sugar? Dr. Smith: People think it’s the sugar added at the table that is a problem. The truth is that most of the sugar we consume is already in the food. Simply reading labels can go a long way in helping. Also answer your sugar fix with sugar that comes in a healthier package such as fruit, fresh smoothies, and fresh juice. Still, having a candy bar every once in a while will not do any harm at all as long as it’s done in moderation. AMD: Your diet is very strict, however gives me options within that strictness. How did you find that sweet spot of balance? Dr. Smith: I worked with hundreds of SHREDDERS from our Facebook community SHREDDER Nation when I developed Super SHRED. I listened to their feedback and incorporated it into the program. People are willing to be challenged, but they don’t want to be overwhelmed. They want a lifestyle that is realistic and rewarding. People want pizza, pasta, and pancakes. I teach them how to go have it and still win. AMD: I love that your diet is built for failure. Why was this important to incorporate?

successful. That’s why I created the SHRED 27 Burn DVD and SHRED 15 Burn workout on our website shredlife. com. Doing High intensity Interval Training (HIIT) you can get a great workout in less than 30 mins and continue to burn fat up to 24 hours even after you have stopped exercising. exercise should not be a chore, it should be fun and challenging at the same time.

Dr. Smith: No one will follow a program 100% forever. It can also be taxing to even try. We are human and life is more than just worrying about making the right decisions all the time. People need to feel okay if they mess up, otherwise they won’t try the task again. I build “failure” into my diet because I am realistic and like everyone else I want a cupcake with yummy frosting.

AMD: What is the most common mistake you see people make on your eating/exercise plan?

AMD: For those who hate exercise, how can we change our thinking that we’re doing so much ‘work’?

AMD: Give me one sentence I can tape on my fridge.

Dr. Smith: People have the wrong idea when it comes to exercise. They think you have to kill yourself to be

Dr. Smith: They set unrealistic goals and punish themselves if they slip up. My philosophy is give it your best, and even if you don’t win every battle, you’re still a winner for trying.

Dr. Smith: If God made us perfect, we wouldn’t be human, so just try your best.

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NUTRITION

Eye Opening Carrot Soup Dr Ian Smith’s favorite low calorie recipe from his latest book “Super Shred Diet”

Total Time: 40 mins

Servings: 4 Servings

Calories: Under 200

Ingredients: 2 tablespoons sweet butter

1 cup water

1 large onion, peeled and chopped

4 large strips of orange zest

1 clove garlic, peeled and crushed

2 tablespoons chopped fresh dill

2 1/2 cups carrots, peeled and diced

1/2 cup buttermilk

1/2 teaspoon grated fresh ginger root

1/4 cup sour cream

2 cups low-sodium vegetable or chicken broth

Salt and pepper

- Melt butter in a medium saucepan. Add onion and garlic and sauté under medium heat until tender, about 5 to 7 minutes. Add carrots, ginger, broth, water, strips of orange zest and dill, then bring to a boil. Reduce heat, cover and simmer until carrots are tender, about 20 minutes. - Remove orange strips and transfer soup to a food processor or blender. Add buttermilk and purée until smooth and creamy. - Return Soup to saucepan and add cream, stirring over high heat until hot, but don’t boil. - Add salt and pepper to taste. Top with sour cream. Serve hot.

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IMAGE FROM SHUTTERSTOCK

FOR MORE INFORMATION For information on shredder diets, please go to doctoriansmith.com, or reference Super Shred: The Big Results Diet.

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