2013 Guide to Good Health by Austin Woman Magazine

2013

YOUR GUIDE TO HEALTHY LIVING IN AUSTIN

Specializing in Quality of Life & Healthcare for Women

Left to right: Britnie Ortega; Jessica Gergen; Jen Vasquez, WHNP; Hannah Richards; Lisa M. Jukes, M.D.; Kelly Zimbelman, Practice Manager; Ofelia Olaguez; Mary W. Brown, CFNP; Jocelyn Octaviano; and Alaina Shillington.

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Do you struggle with urinary incontinence or persistent pelvic pain? We offer specialized testing to identify your issue and therapeutic techniques to solve them in the comfort of our office. Not happy with your weight? Start our Ideal Protein Diet for the perfect new you!

Have you been diagnosed with fibroids, endometriosis or ovarian cysts? We specialize in minimally invasive DaVinci Robotic Surgery. Do you experience heavy bleeding every month? We perform in-office Endometrial Ablation procedures to end those painful periods.

2013

CO-FOUNDER AND PUBLISHER Melinda Maine Garvey

VICE PRESIDENT AND CO-PUBLISHER Christopher Garvey

ASSOCIATE PUBLISHER Cynthia Guajardo

MANAGING EDITOR, GUIDE TO GOOD HEALTH Molly McManus

We all understand the importance of family and friends when facing a life threatening illness. The Care Communities create a volunteer family to help those who are confronting their illness alone. Can you imagine being that person?

COPY EDITOR, GUIDE TO GOOD HEALTH Chantal Rice

We have several opportunities for volunteering with The Care Communities! Check out our website and see how you can help those around you.

ART DIRECTOR AND AD DESIGNER Jennifer Day

thecarecommunities.org 512-459-5883

ART ASSISTANT Katie Holmstrom

Anthony Mendez DDS

MARKETING AND OPERATIONS DIRECTOR Rhonda Rushing

General and Cosmetic Dentistry Se Habla Español

MARKETING AND OPERATIONS ASSOCIATE Lauren Lara

ACCOUNT EXECUTIVES Kelly Keelan, Justin Toon, Anne Van Eaton, 512.328.2421

CONTRIBUTORS Jennifer Morgan, Jaime Netzer, Ashley Lauretta Guide to Good Health is a free publication of AW Media Inc. and is available at more than 1,200 locations throughout Austin and in Lakeway, Cedar Park, Round Rock and Pflugerville. All rights reserved. No part of the magazine may be reprinted or duplicated without permission. For copies of articles, call 512.328.2421.

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CONTENTS

12 ASK AN EXPERT 6 Painful Periods 8 Breast Surgery 10 Varicose Veins & Pregnancy 12 Your Skin Solution 14 The Future of Medicine 16 Home Help 18 Chiropractic 101 20 Back in Business 22 Orthopedic Issues for Women 24 Cosmetic Dentistry

4 â&#x20AC;&#x201A; Guide to Good Health 2 0 1 3

20 26 Bunions 28 Emergency Relief 30 Single-site Hysterectomy 32 Incontinence Innovation 34 Beauty Enhancement 36 Higher Brain Living 38 Dental Awareness 40 DOCTOR PROFILES 45 DIRECTORY LISTINGS

Ch Cr hirsitsop t op h er h er W.W. B rBen r en n ingi,gM , M . D. .D . CerTIfIeD: CerTIfIeD: The American The American BoardBoard of General of General Surgery Surgery SuB-SPeCIAlTy SuB-SPeCIAlTy CerTIfIeD: CerTIfIeD: The American The American BoardBoard of Vascular of Vascular Surgery Surgery

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Austin Austin Vein Vein In In s tsittiu tt uet e state-of-the-art state-of-the-art varicose varicose veinvein treatment treatment

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Dr. Brennig Dr. Brennig is Board is Board Certified Certified in Vascular in Vascular Surgery Surgery andand in General in General Surgery. Surgery. He is Herecognized is recognized for his for his expertise expertise in the in the minimally minimally invasive invasive treatment treatment of of varicose varicose veins, veins, spider spider veins, veins, recurrent recurrent varicose varicose veins, veins, andand complex complex venous venous disorders disorders including including DVT. DVT.Please Please call call the the Austin Austin VeinVein Institute Institute to to schedule schedule a comprehensive a comprehensive consultation. consultation.

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Painful Periods Dr. Lisa M. Jukes outlines the causes and treatment options for heavy menstruation and agonizing cramps. By Molly McManus

Most women experience discomfort when Aunt Flo comes to visit. However, there are varying degrees of pain associated with menstruating, as it affects women differently depending on the symptoms and causes. Heavy menstruation and severe cramps not alleviated by healthy lifestyle and use of over-the-counter pain relievers should be evaluated further by a specialist. When your body doesn’t respond to these tactics, it could potentially be more serious and even require surgery. Endometriosis, adenomyosis, uterine fibroid tumors, ovarian cysts and prolapse are some of the common diagnoses for women suffering from pelvic pain and/or abnormal bleeding. WHAT ARE THE SIGNS OF AN ABNORMAL PERIOD? One sign is pain that doesn’t respond to Motrin, or [the patient] has to dose frequently and take several Motrin to be able to get relief and go about their normal activity. As far as unusually heavy bleeding…changing a Kotex every hour or two…that would be considered not normal. Staining bed clothes at night or having to get up a couple times in the night to change a Kotex would also be considered not normal. If your pain does not respond to various therapies (healthy diet, exercise, pain relievers, birth control), if you are bleeding between periods, experiencing a heavy flow or if your menstrual cycle is interfering with your quality of life, preventing you from going to work or leaving the house, then it is time to seek help from a women’s health professional.

WHY DO HEAVY MENSTRUATION AND CRAMPS OCCUR? Painful menstrual cycles can occur as young as the early teenage years, but tend to peak in a woman’s 20s and 30s. The painful symptoms

typically go away with pregnancy and then oftentimes return for women in their 40s. Pregnancy can provide relief of symptoms from endometriosis and pelvic pain for several years. Endometriosis is a condition in which endometrial type cells have implanted outside the uterus, causing severe cramps, abnormal bleeding and other pain, including pain with intercourse. Endometriosis can affect at least 25 percent of women. It can be genetic or even associated with congenital uterine anomalies. There’s a condition related to endometriosis called adenomyosis and that’s a common reason for severe menstrual cramps as well as heavy bleeding. It’s a condition where the endometrial lining has implanted in the muscle wall of the uterus. Pain can also be caused by uterine fibroids and can cause bleeding problems if the fibroid is affecting the lining of the uterus. Fibroids are benign, noncancerous, fibrous-like tumors in the myometrium (muscle layer of the uterus). Pelvic pain should be further investigated to assure that it is not related to a gastrointestinal, urologic or musculoskeletal disorder. Heavy bleeding can even start with a young woman’s first few menses. Up to 25 percent of these adolescents may have a hereditary bleeding disorder, which can be determined by simple blood work. Later on, heavy bleeding, bleeding between cycles or with intercourse can be secondary to overgrowth of the endometrium, uterine polyps, fibroids or adenomyosis.

WHAT ARE THE TREATMENT OPTIONS? The first step would be to see how the body responds to pain relievers and possibly hormonal contraceptives. If the body is not responding, the next step is evaluation and possible ultrasound in order to determine the etiology.

“Heavy menstruation and severe cramps should be evaluated further by a specialist.” 6 Guide to Good Health 2 0 1 3

The treatment depends on what we find and whether that person wants to have children or has completed their family. If the findings are suggestive of endometriosis based on history and physical exam, then we typically proceed with a laparoscopy, which, in my experience, I prefer using da Vinci surgery. The da Vinci robotic system gives me 3-D visualization, better magnification and use of instruments that have more precise movements. Laparoscopy allows me to see into the abdomen through small incisions in order to diagnose what is causing the pain or bleeding. I am now able to perform more complicated, minimally invasive surgeries rather than making large abdominal incisions, including single-site umbilical laparoscopic surgery. With da Vinci, patients experience less pain, less risk of infection and scarring, and shorter recovery time, among many other benefits.

Lisa M. Jukes, MD Dr. Lisa M. Jukes, MD 512.301.6767, lisamjukesmd.com Lisa M. Jukes is a board certified OB/GYN who specializes in gynecologic health + wellness and focuses on minimally invasive procedures.

Grayson James and Jorden & Madison Shook

Photos by Robin Stevens, JingerSnaps Photography

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Do Your Homework Before Considering Breast Surgery Do your research to ensure the best results for your breast augmentation and to minimize the need for revision surgery. By Jennifer Morgan

The kids are back in school, but they are not the only ones who should do their homework. If you have been considering breast augmentation or breast revision surgery, Kelly Tjelmeland, FACS, plastic surgeon and founding partner of Meridian Plastic Surgery Center, has some advice for you. HOW DO YOU KNOW IF BREAST AUGMENTATION IS RIGHT FOR YOU? You need to consult with a board certified plastic surgeon to make sure that you’re a good candidate and that you have realistic expectations on what you can expect after surgery. You have to do it for yourself and for the right reasons. Also, [it’s important to know] what you have going on anatomically. A lot of people come in wanting a breast augmentation but may also get a breast lift for a better result.

WHAT SHOULD SOMEONE WHO IS SEEKING THIS SURGERY LOOK FOR IN A SURGEON? First of all, you want to make sure that they are board certified by the American Board of Plastic Surgery. Other places to look would be at any disciplinary actions against them as well. It’s important to do your homework. If you end up having a bad result or complication from a non-plastic surgeon, typically it’s more expensive to get it fixed. It’s best to do it right the first time.

HOW DO YOU DETERMINE THE RIGHT IMPLANT OR BREAST SIZE FOR YOUR PATIENTS? Several factors go into determining the correct implant size for a patient. Most important are anatomical factors, such as the amount of breast tissue present and skin elasticity, as the patient’s tissues must be able to support the implant without causing issues. An implant that is too large can stretch out the breast and skin, creating more problems. We also take into account how large the patient wants to ultimately be. I often have patients bring in pictures of what they like, which also helps to make sure we are all on the same page. Generally, the vast majority of patients want to look natural and proportionate.

WHAT ADVICE DO YOU GIVE TO WOMEN WHO HAVE HAD PREVIOUS BREAST AUGMENTATION SURGERY AND NOW EXPERIENCE SAGGING, SCARRING OR OTHER PROBLEMS? Secondary breast augmentation or breast augmentation revision, especially involving previous scar tissue or capsular contracture, can be a very complex operation. These problems can result from aging, pregnancy or scar tissue from old implants. Secondary surgery usually means switching out implants, or putting the implants in a different location, whether it’s above the muscle or below the muscle. It can involve lifting [or] the use of biologic dermal matrix to help support the implant. It is almost a breast reconstruction on the

“You have to do it for yourself and for the right reasons.” 8 Guide to Good Health 2 0 1 3

inside in some cases. In other cases, it can be as simple as exchanging the implants for new ones, but usually there is more involved. Certainly, a patient would want to do their research and choose a surgeon that does a fair amount of breast revision work. On my end, it’s a lot more complicated and involves a lot more surgery on the inside of the breast, depending upon the issues that you have.

HOW LONG DOES IT TAKE TO RECOVER? For a breast augmentation, recovery is generally five days. For a breast revision recovery, it can take anywhere from one to two days for minor revisions and as long as 10 days for more extensive revisions.

Kelly E. Tjelmeland, FACS Meridian Plastic Surgery Center 512.617.7500, meridiansurgery.com Dr. Kelly E. Tjelmeland, board certified plastic surgeon, has been named one of Texas Monthly’s Best Plastic Surgeons for four years, and is the founding partner of Meridian Surgery Center.

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Varicose Vein Treatment and Pregnancy Treating varicose veins can help ease discomfort and pain during pregnancy. By Jennifer Morgan

When left untreated, varicose or spider veins can make a pregnancy even more uncomfortable. Chris Brennig, MD, a board certified vascular surgeon and founder of Austin Vein Institute, shares facts and treatment options for women with vein damage. Brennig offers sage advice and urges women to think about evaluation before or between pregnancies in order to supply better health and happiness to the legs supporting their baby bump. WHAT IS IMPORTANT TO KNOW ABOUT VARICOSE VEINS? Number one: Varicose veins can cause clinically significant symptoms including pain, swelling and skin problems. Number two: They get worse with time if left untreated. Number three: Treatment is safe and effective with no down time. All procedures are performed in the office with most completed in under an hour.

WHAT ARE SOME OF THE COMMON MISCONCEPTIONS AND ISSUES SURROUNDING VARICOSE-VEIN TREATMENT WITH REGARDS TO PREGNANCY? There’s a lot of information [suggesting] that patients should wait until they are certain that they’ve finished having children before they treat their varicose veins. This is false. With each pregnancy, pre-existing varicose veins will get significantly worse. By treating them prior to future pregnancies, the problem is eliminated. Another misconception is that varicose-vein treatment is cosmetic. That’s not true. Varicose veins are certainly often visually unappealing, but they are also unhealthy and will continue to cause

worsening health problems if left untreated.

WHAT OPTIONS DO PREGNANT WOMEN HAVE? If they know they have varicose veins, then the earlier they get evaluation, the sooner the treatment can be completed. We don’t treat varicose veins during pregnancy, but we do treat people between pregnancies or before they plan to get pregnant. We also see a lot of women during pregnancy for varicose veins, pain or clots in their varicose veins. We are often able to reassure them, help manage symptoms, and feel better so they can focus more on their pregnancy instead of leg pain.

WHAT’S YOUR PROCESS WITH HELPING PAIN? We educate the patient about conservative treatment options, which include certain exercises and semi-custom compression stockings. We’ll often perform an ultrasound to see how efficiently their veins are functioning. We make sure they don’t have any venous blood clots or any other potentially significant medical condition besides the varicose veins.

WHAT ABOUT PREGNANCY WORSENS THIS CONDITION? There is a big hormone shift at the beginning of pregnancy. This can cause veins, particularly varicose veins, to enlarge. Swelling of these veins often results in inflammation and pain. Secondly, in the third trimester, the baby’s position can compress venous blood return from the legs, causing swelling and pain in the legs. The third thing is that during pregnancy, the tendency for blood clots to form increases. Some women may develop painful blood clots in their varicose vein during pregnancy.

THESE THINGS WON’T GO AWAY SPONTANEOUSLY AFTER DELIVERY? Within a day or two of delivering the baby, a lot of these enlarged varicosities will decrease in size dramatically and pain symptoms can improve significantly. Despite that remarkable improvement, the underlying problem almost always still exists and will slowly return either during the next pregnancy or over time.

“Varicose veins can cause clinically significant symptoms including pain, swelling, bleeding and serious skin problems.” 1 0 Guide to Good Health 2 0 1 3

HOW DOES THIS TREATMENT WORK? The number one key to getting good treatment is having an accurate, knowledgeable evaluation. We use endovenous ablation, or EVLT, in our office. We use a water-targeting laser—a 1470 nanometer, the most gentle laser—which can be used to close down and eliminate large varicose veins. [We also use] ultrasound guided sclerotherapy and visual sclerotherapy. We use for almost all our patients a brand of medicine called Asclera, which is the newest FDA-approved medication for treatment of varicose veins and spider veins. Microphlebectomy, [another treatment option], is a removal of grapelike clusters of veins through a small needle hole under local anesthetic, which does not require any stitches or lengthy recovery. The final [treatment option] would be rescue therapy. It’s basically when we evaluate patients who have undergone previous treatments, sometimes years or decades earlier, and they’ve developed recurring varicose veins. Most people who get treatment get a combination of two or three of these procedures.

WHAT DOES THE RECOVERY PROCESS LOOK LIKE? There’s not much to the recovery process except that we want patients to remain active and walk. There’s no limitation on most normal activities.

Chris W. Brennig, MD The Austin Vein Institute 512.346.2727, veinaustin.com Dr. Chris Brennig, the founder of The Austin Vein Institute, is Austin’s only board certified vascular surgeon focused exclusively on the treatment of venous disorders.

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Your Skin Solution The top three products for healthy skin, why they work and how to use them. By Jaime Netzer

The skin we live in may protect us, but too often we forget to return the favor— or we simply don’t know how to best care for our skin. You might know to wash your face every night, for instance, but do you know for how long? Or with what type of product? We asked medical esthetician and skin-product line owner Ann Webb for her top three skin-care products for maintaining a healthy, vibrant appearance. She let us in on what to use, how to use it and what to avoid on the path to optimal health for your skin. 1.) CLEANSER What to look for: Check to make sure your cleanser has a high level of hyaluronic acid. In combination with low levels of lactic acid, such a balance creates ultimate cellularwater retention. In other words, your face retains moisture. How to use it: Treat your cleanser like a facemask. Make sure that you leave the cleanser soaking on the skin as a mask during a bath or shower, or while you are running around in the morning getting ready for your day. Make sure to wash away the grime and dead skin cells with a warm, wet washcloth. This will in turn get rid of bacteria, which gets rid of blemishes and dead skin. Dead skin, ultimately, ages your face. So not only does cleansing prevent pimples, but it also keeps you looking younger. Look for a cleanser that has active ingredients that are designed to treat whatever condition you are looking to improve, and to use it both morning and night. Try: Ann Webb’s Peppermint Milk Skin Brightening Cleanser, $14 (4 ounces), a hydrating and rejuvenating cleanser

providing gentle exfoliation to address uneven skin tone.

2.) MOISTURIZER What to look for: The first purpose of a moisturizer is to do exactly what its name suggests: to moisturize the skin. Ideally, a moisturizer should serve another purpose as well: protecting against free radicals. These radical oxygen molecules are looking to pair with other oxygen molecules and do not care if it destroys a healthy cell in the process. To combat these cellular assassins, we pack our products, especially our moisturizers, with anti-oxidants. The ultimate trifecta for a perfect moisturizer is one that includes sun protection. Here, it’s important to avoid chemical sun-protection ingredients, which may actually harm the skin. We recommend the known physical sun blockers like zinc oxide and titanium dioxide. They are also calming to the skin, so you get multiple uses out of them too. How to use it: Spread moisturizer with sun protection on the face but also on exposed skin on throat and chest area to help combat the signs of premature aging, or mix it with mineral makeup to help distribute the makeup evenly on your skin. Try: Ann Webb’s Pomegranate Daytime Protection Moisturizer, $34 (3.5 ounces). This safe, mineral-based, lightweight daytime cream is packed with mineral elements and potent antioxidants to guard exposed skin from environmental elements.

3.) FACE MIST What to look for: A good facial mist can help refresh and hydrate your skin, much like a tall drink of water. While internal hydration is important, water ingested must first make its way through the digestive tract. Our skin is able to absorb a lot of nutrients topically as well. The external misting allows us to put the ingredients

“Make sure that you leave the cleanser soaking on the skin as a mask during a bath or shower.” 1 2 Guide to Good Health 2 0 1 3

directly where we want them without the interference of the digestive process. Look for one designed to go over or under makeup, for convenience. Also look for one containing hyaluronic acid, which is said to increase cellular water retention by six times. This helps get the water to where your body can use it. How to Use it: After your skin loses those dead skin cells from the cleansing, it needs a mist to balance the skin’s pH level and hydrate the dermal layers. But in addition to cleansing, I think you should mist your skin three to five times a day. Also, make sure to inhale the scent infused into your face mist, as it can provide an instant moment of calm. Try: Ann Webb’s Cucumber Sage Balancing Mist, $12 (4 ounces), a calming, purifying tonic to balance blemish-prone complexions and promote clear skin.

Ann Webb, LE AW Skin Clinic; Skin by Ann Webb 512-795-0145, awskinclinic.com, skinbyannwebb.com Ann Webb is a medical esthetician, combining more than 18 years of research and hands-on training with her own protocols for treating skin.

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The Future of Medicine

different things, but they actually represent the same thing: ideal or perfect functioning of the body. To achieve these goals, I always use the same approach or philosophy: Find and resolve the underlying cause of the problem instead of just treating symptoms.

By using personalized medicine and WHAT DOES THIS MEAN FOR THE nonsurgical beauty options your doctor FUTURE OF MEDICINE? can help you maintain optimal health and a youthful appearance throughout your lifetime. In the health world, this means that By Molly McManus

The one-size-fits-all approach has become a thing of the past. With personalized medicine now emerging, doctors can approach their patient’s health and beauty challenges by understanding how each person’s unique biochemistry, genetic makeup and lifestyle choices can affect their health and appearance. Ruthie Harper, MD, founded Nutritional Medicine Associates in 1999 and The Laser and Skin Care Clinic in 2000 with this concept in mind. After having consulted with thousands of patients, her practice has become internationally recognized for its unique approach. Harper offers her take on the future of medicine using personalized health care, genetics and a non-surgical approach to rejuvenation and beauty. WHAT IS PERSONALIZED MEDICINE? Personalized medicine is the understanding that each person is unique and different with different health and beauty challenges. Using a person’s unique genetic profile allows the practitioner to understand and address the needs of each patient based on their DNA. I became interested in personalized medicine after the human genome project was released in 2000. This represented a huge breakthrough in medicine because it revealed that many of the reasons we develop diseases or age are hidden in our genes. My practice is unique in that we focus on helping each individual achieve optimal health without medication and/or surgery, and restore the natural youthful face and body without surgery. Health and beauty may seem like two

instead of prescribing medication, I determine what is not functioning in the body and use nutrition, supplements, bio-identical hormones, specific exercise prescriptions, stress reduction and lifestyle changes to regain function and optimal health. In the beauty world, instead of taking a surgical approach to aging (performing a surgical facelift or body work), we determine what is making the individual look old and resolve it without surgery. We are able to address and treat many causes of aging including loss of volume causing sinking and sagging of the skin, loss of creamy color of the skin from red or brown age discoloration, wrinkles from loss of collagen, cellulite caused by loss of collagen and excess body fat, to name a few.

HOW ARE THE UNDERLYING CAUSES OF A PROBLEM DETERMINED? To personalize your health and beauty, we begin with a simple swab of your cheek to obtain your genetic profile, which provides critical information about what diseases you are prone to, how to achieve optimal health, and how to reverse or slow the aging process for you.

CAN YOU CHANGE YOUR GENETICS? You can’t change your genetics, but you can change what happens as a result of your genetics. This is why determining your genetic road map is so important through DNA testing. Once you know where your genetic road map is leading you, you can decide if this is a destination you want to get to or if you want to change course. It was previously thought that your genetics were an absolute; if you had the genetics for high cholesterol, you were

“Personalized medicine is the understanding that each person is unique and different with different health and beauty challenges.”

1 4 Guide to Good Health 2 0 1 3

destined to have high cholesterol. If you had the tendency toward wrinkled skin, you were going to age faster than your friends. It is now known that our genetics represent tendencies toward conditions or diseases but are not an absolute. Our genetic tendencies can be strongly influenced by what we eat, how we exercise, what supplements we take and the lifestyle choices we make. Our beauty is strongly influenced by the skin-care products we choose, the lifestyle choices we make and the medical aesthetic treatments we choose. By knowing your genetic roadmap, we are able to customize both health and beauty treatments in my practice. Patients in my practice are accomplishing tremendous improvements in their health, taking years off their appearance quickly and easily, and are empowered by having the scientific roadmap that their genetics provide.

Ruthie Harper, MD Nutritional Medicine Associates The Laser and Skin Care Clinic 512.343.9355, ruthieharper.com Dr. Ruthie Harper focuses on achieving optimal health and beauty through the creation of individually customized programs for her patients.

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Home Help What to look for and expect when seeking personalized in-home care. By Ashley Lauretta

In general, home care is a service provided in someone’s residence—whether in their own home, a family member’s home or even assisted living—to help maintain independence. There is a common misconception that home care is only for seniors, but that is not always the case. Visiting Angels is a home care service, helping people 18 through 118 years of age who may have had an accident, a recent surgery or an illness, terminal or otherwise. Visiting Angels provides anything from companionship to running errands, meal planning and preparation, bathing and dressing; this can be part time throughout the week, temporary or around the clock. The “angels” range from companions to certified nurse aids, and are personally matched to meet the needs and wants of clients. Amber Jordan is the director of Visiting Angels, and highlights when in-home care is needed and what to look for when seeking care.

WHEN SHOULD SOMEONE CALL YOU? As a family member of, or as a person who may need care, you should call us when you start to feel a gap in your day-to-day living. Here are a few examples: ➤ Falls are becoming a concern or a realization. ➤ Meals and nutrition cannot be kept up with as before. ➤ Children living far away become concerned. ➤ Regular companionship and interaction with others dwindles. ➤ Hygiene and bathing decline or similar routines cannot be maintained alone. ➤ Daily routines are faltering and there is a desire to have regularity in the day’s routines. ➤ Families are challenged with the care of someone who is facing a long-term illness or is terminally ill, i.e. Alzheimer’s or cancers.

WHAT IS THE BEST WAY TO TALK TO A

SENIOR, PARENT OR FRIEND ABOUT RECEIVING IN-HOME CARE? Sometimes, this process can be quite emotional, but it is important for the family to have a plan so everyone is on the same page. Making sure your parents know that they have options is important. Make sure your loved one is the focus of all discussions and that they have a voice, and all parties are sensitive to each other’s perspectives. It may take several conversations to devise a plan that everyone is happy with, so start planning early and take comfort in small accomplishments.

WHAT SHOULD SOMEONE LOOK FOR IN A HOME CARE AGENCY? A few things to check on include verifying that they are licensed by the State of Texas Department of Aging and Disability (DADS), and are bonded and insured. Check the DADS website to find out if there are any deficiencies or citations. Definitely inquire about the agency’s cancellation policy and if there is a minimum requirement, and remember that cost is not the only factor in choosing an agency. Take time to learn about the agency’s philosophies as well as supervisory policies.

WHAT CAN SOMEONE EXPECT FROM HOME CARE? ➤ An initial in-home visit so we can learn the wants, needs and concerns of the client as well as their family members. ➤ Personalized plan of care to ensure complete client satisfaction. ➤ System of matching so each client is personally matched with a Visiting Angel based on the wants and needs outlined. ➤ Support staff of office personnel to ensure each client has a point of contact for any changes in plan or schedule. ➤ A 24-hour number for any emergencies related to in-home care. ➤ System of supervision for added comfort for clients and their families. First, we come out and visit with the potential client and their family in the environment where the care will be provided. We love to take the

“Sometimes, this process can be quite emotional, but it is important for the family to have a plan.” 1 6 Guide to Good Health 2 0 1 3

time to get to know our clients, allowing us to customize our caregiver and client matching. After meeting with those involved, each client is assigned a care manager who continues to ensure proper caregiver matching and manages any scheduling changes. This care manger is our client’s go-to person; their relationship continues to develop as changes in wants and needs arise.

WHY SELECT VISITING ANGELS RATHER THAN HIRING YOUR OWN CAREGIVER? Being the employer of a caregiver is challenging, and we have perfected this process to find the experts in this field. Here are a few things you can avoid by allowing an agency to be involved: ➤ Thorough and ongoing screening and supervision. ➤ Background checks at the initial hire and re-checks annually. ➤ Payroll taxes and employee liabilities. We alleviate you becoming a liable employer. ➤ Workers’ compensation and professional liability insurance. We carry the burden. ➤ Change in personnel. We have backup caregivers and can make changes to meet your needs, wants and schedules. This process would be too cumbersome for an individual.

Amber Jordan Visiting Angels 512.250.2103, GotAngels.com Amber Jordan is the director of Visiting Angels Living Assistance Services and a Certified Senior Advisor.

Karen E. Frazer, DDS

General, Family & Cosmetic Dentistry Cosmetic Dentistry • Root Canals • Periodontics • Dental Implants • Porcelain Veneers • Family Dentistry • Teeth Whitening • Oral Surgery • Sedation Dentistry Call today to schedule your appointment! 512.442.2295 southaustinsmile.com

4407 Manchaca Rd, Austin, TX 78745

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Chiropractic 101 The importance of your spinal health. By Molly McManus

“People often ask me, ‘How did you go from being a pharmacist to being a chiropractor?’ ” shares Dr. Katerina Sheffield. “It began with weekly visits to Whole Foods for a ‘tune-up’ (aka, chair massage) for my upper back and neck tightness, which I thought was normal and caused by stress. The massage therapist told me after two to three months of these visits that the amount of tightness I still had in my neck was not normal. He recommended I get checked by an upper-cervical chiropractor. I cannot describe how grateful I am that he recognized that my muscular problems were structural. My chiropractic spinal evaluation proved him right! I had major spinal misalignment that was putting pressure on the nerves in my neck and back.” After receiving care, Sheffield experienced a dramatic decrease in all-over body pain, headaches and the tightness in her neck and upper-back muscles. “It truly changed my life. I had no idea that the physical traumas I had experienced as a child and young adult had caused that much damage to my spine and nervous system, and that it could be corrected,” Sheffield says. Pharmacists play a critical role as “navigators” in the Western healthcare model, and although Sheffield enjoyed helping people in that role for more than 16 years, she says, “After getting such life changing results with upper-cervical chiropractic, I decided that this is how I want to help people.”

HOW CAN CHIROPRACTIC CARE BENEFIT THE BODY? Trauma, aging, disease, poor posture and muscle weakness can cause the spine to misalign and lose its ability to move freely. These misalignments can cause irritation to the delicate nerves that run through the vertebra, resulting in nervous system dysfunction, and ultimately, poor health. Chiropractic care

restores structural integrity to the spine and relieves pressure on nerves, allowing them to communicate freely and effectively. When you remove pressure on a nerve, it decreases inflammation, increases information flow and allows the body to heal itself. It’s common for patients to experience positive benefits from care, such as improved sleep, cognition and digestion, as well as relief from headaches, asthma and other pain. According to exercise physiologist Sean Atkings, “Ninety percent of all world-class athletes use chiropractic care to prevent injuries and to increase their performance potential.”

WHY IS CHIROPRACTIC CARE PREFERABLE TO OTHER METHODS OF TREATMENT? Chiropractic is a drug-free, non-surgical healthcare solution that focuses on wellness and prevention. Because the nervous system regulates and innervates every other cell in the body, it is preferable to care for your spine, eliminate pressure on your nerves caused by spinal misalignments. Both motion and function are optimized. According to a study published May 2007 in Journal of Manipulative and Physiological Therapeutics, research showed that chiropractic care can save people money by decreasing hospital admissions by 60.2 percent, shortening hospital stays by 59 percent, reducing outpatient surgeries by 62 percent and reducing pharmaceutical costs by 85 percent.

HOW QUICKLY SHOULD PATIENTS EXPECT TO SEE RESULTS FROM CHIROPRACTIC CARE? Some patients see dramatic, early results, and for others, the process is slower and progressive. Typically, it depends on the amount of trauma a patient has been subjected to, and how long it has gone untreated. People who exercise and eat a healthy diet usually respond faster.

WHAT HAPPENS TO THE BODY WHEN YOU DON’T SEEK CHIROPRACTIC CARE? Physical trauma accumulates over time. Car wrecks, sports injuries, even childhood roughhousing can cause trauma that accelerates aging.

“Over 90% of professional athletes utilize chiropractic care because they understand how chiropractic care improves the body’s ability to move and function as well as decrease pain.”

1 8 Guide to Good Health 2 0 1 3

It’s like having a tire out of balance on your car. Not only will the tires wear faster but the entire car will also because of the abnormal motion. As for pressure on nerves caused by spinal misalignments, that is like having a fuzzy radio signal. Research shows that our bodies function best with “clear radio signals” from the central nervous system to our cells. The longer spinal misalignments are allowed to remain, the greater chance that decreased motion, increased pain, disc problems, vertebral degeneration and even spinal fusions can occur.

HOW SHOULD A PATIENT DECIDE ON A CHIROPRACTIC DOCTOR? That choice is indeed a personal one. There are many different chiropractic techniques, so the patient’s experience from one doctor to another can vary widely. Results are key. If you haven’t gotten results with one chiropractor, try one with a different approach. The top-down approach I use now worked for me as a patient when general chiropractic alone was not enough. I prioritize the atlas bone, or C1, which is located at the top of the spine, right underneath the skull. This bone is a global balancer because of its unique structure and function. Starting upstream first, at C1, allows all the work downstream on the rest of the spine to go faster and last longer. I love the efficiency of this top-down approach.

Katerina Sheffield, DC, RPh Westlake Chiropractic 512.306.1625, westlakechiropractic.com Dr. Katerina Sheffield is one of few doctors in Austin to specialize in a gentle, specific, upper-cervical approach to chiropractic care.

You’re feeling confident about your life and career. Why not feel equally positive about your appearance? Dr. Kelly Tjelmeland has dedicated an entire practice to exceptional patient care, with a state-of-the-art facility devoted to cosmetic surgery. Sophisticated technology, including the Harmonic Scalpel™, shortens recovery times and promotes healing. A private skin care clinic also brings a full range of treatments to rejuvenate and refine. Call for a free consultation and see the difference that our specialized care and advanced resources can make for you.

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Back in Business Get your life back by relieving chronic pain nonsurgically through spinal cord stimulation. By Molly McManus

Back pain is the leading reason for doctor visits in the United States along with the common cold. According to the US National Library of Medicine, eight out of 10 people will experience back pain in their lives. Regardless of your occupation or lifestyle, you’re most likely putting strain on your back in one way or another. From posture, lifting and twisting movements, to gravity and overexertion, the spinal area is extremely susceptible to pain. The human spine is complex and may explain the frequency in which back pain occurs. Made up of strong bones, flexible ligaments and tendons, large muscles and extremely sensitive nerves and nerve roots, the spine provides our bodies with so many different benefits that help us through our day-to-day lives. Our spine provides us with a variety of tools: structure to stand upright and move with accuracy; protection of the spinal cord and nerve roots to safely relay messages to and from the brain and the rest of the body; absorbing shock as we move around; flexibility in the joints to allow us to move our heads and bend our

bodies in a variety of positions. Oftentimes we take our back and spine for granted. Our strength, structure and flexibility doesn’t come into question until we injure ourselves and back pain takes over, sometimes to an extent that makes menial tasks seem overwhelmingly difficult. With five locations across Central Texas, Advanced Pain Care offers relief for chronic back pain through a variety of methods. Mark Malone, MD, founder of Advanced Pain Care, frequently utilizes spinal cord stimulation with his patients, a less invasive and painful option to back surgery. Approved by the FDA in 1989, spinal cord stimulation has become a standard treatment for patients with chronic pain in their back and/or limbs, who have not found pain relief from other treatments. Spinal cord stimulation is a device that is inserted into the epidural space of the spine, sending pulsed electrical signals to the spinal cord to control chronic pain. “It consists of a simple wire, which stimulates the nerves to think that they are not experiencing any pain. Instead, a patient feels only a mild vibration. Essentially, what the stimulator is doing is blocking or jamming the pain signals,” explains Malone, allowing for muscles to loosen, the discomfort dissolving away with each pulse.

WHO IS A GOOD CANDIDATE FOR SPINAL CORD STIMULATION? Most people who have chronic back pain will experience relief from spinal cord stimulation. Which is oftentimesa good and viable alternative to back surgery. A lot of people experience even more pain after spinal surgery through post-operative pressure on a spinal nerve, altered joint mobility, disc herniation, as well as more atypical symptoms of depression, anxiety and sleeplessness. This post-surgery pain is referred to as failed back syndrome and spinal cord stimulation may help in addressing these issues as well. In addition to failed back syndrome, spinal cord stimulation can help with complex regional pain syndrome, ischemic leg pain and peripheral arterial disease. Back pain can cause people to miss

“Regardless of your occupation or lifestyle, you’re most likely putting strain on your back in one way or another.” 2 0 Guide to Good Health 2 0 1 3

work, social events and normal, everyday affairs. This small device can help them get back to living their lives by eliminating or reducing their levels of pain.

HOW DOES THE PROCEDURE WORK? HOW LONG IS RECOVERY TIME? The procedure is relatively quick and easy. On the day of the procedure, the patient receives a light sedation. Through a skinny needle, a small wire is placed into the back, which connects to an external stimulator, or what is commonly called a pulse generator. The needle is then removed and a small bandage is applied to the skin. A patient is able to recover within an hour and can typically resume normal activities by the next day. A 50 to 70 percent reduction in overall pain is common, followed by an increased ability to participate in normal family and work activities.

HOW DOES A PATIENT KNOW IF THE STIMULATOR WILL WORK FOR THEM? After the procedure, the patient goes home to begin a five-day trial. The pulse generator will continue to create painjamming signals throughout the body each time it is used. Patients have a remote control that can turn the signals up or down, on or off. After the trial, if it is determined that the patient has experienced at least a 50 percent reduction in pain, a permanent device can be implanted just under the skin. The device is about the size of two silver dollars stacked together and the entire procedure takes about 30 minutes.

HOW LONG CAN A PATIENT EXPECT RELIEF OF PAIN AND HOW LONG WILL THE DEVICE LAST? Many patients report that after undergoing spinal cord stimulation they can decrease or stop taking painkillers or other pain medications altogether, positively impacting the quality of their lives. The spinal cord stimulator has a battery life of six years. If a patient is still in need of the device after six years, the batteries can be replaced in a simple outpatient procedure.

Mark Malone, MD Advanced Pain Care 512.244.4272, austinpaindoctor.com After years of successful pain management experience and serving as clinical instructor at Baylor College of Medicine, Waco native Dr. Mark Malone launched Advanced Pain Care in 2002.

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Orthopedic Issues for Women Protect your knees and joints from painful wear and tear. By Ashley Lauretta

We all know that women are different than men, which means that injuries between the two sexes are different also. A common injury in women—often more in younger women ranging from teens to 20-year-olds—is the anterior cruciate ligament (ACL). More so, they tend to get ligamentous injuries near the time of their menstrual cycle every month. This is because the hormones tend to weaken women’s ligaments, which makes them more prone to injury at that time. Often, when a woman visits the doctor with an ACL injury, the doctor will ask when her cycle occurs. Because women are at a higher risk during the week of their cycle every month, if they train or workout appropriately and try to do workout prevention, most likely they can avoid injuries at that time. Another very common orthopedic problem in women is knee problems. As women mature, their hips widen. This changes the angle of pressure put on the patella, or kneecap. Though it is only a change of a few degrees, it is enough that it causes women to have more problems in the knee than men. Christina Sheely, DO, is the chief of surgery at Seton Medical Center Hays, and provides helpful information on preventing injury and treatment options. Always an athlete, Sheely understands what is involved when seeing an orthopedic surgeon, especially since she has had a hip replacement herself, and she can directly relate to her patients.

HOW CAN YOU PREVENT INJURY? To prevent orthopedic injury, especially around a cycle, women can try to avoid high-impact exercise and CrossFit. If going to

the gym, women can use controlled weights with machines to ease the high risk during the week they are more prone to injury. Other exercises that are great for this include cycling, the elliptical, circuit machines, walking, yoga and Pilates. It is good to avoid high-impact sports such as running, soccer and CrossFit. Besides simply being aware to prevent injury, quadriceps strengthening is also very beneficial. Often, women don’t do this for purposes of appearance, but any quad strengthening will be good for your knees. Additionally, the heavier a person is, the more of an increase in the angle of pressure put on the kneecaps. Weight maintenance will help with that. It is also good to avoid sports or exercise that involve deep knee bending, such as squats. Pressure to the knee can cause wear and tear of the kneecap, which is synonymous to arthritic changes.

WHAT SHOULD A PATIENT LOOK FOR WHEN SEEKING CARE? For any orthopedic problem, it is good to go see an orthopedist sooner rather than later. Often, people think because they are going to visit a surgeon that the final outcome will be surgery. This is not always the case. So much more can be done conservatively if caught in the early stages, such as injections, therapy and myofascial release. There is a lot that can be prescribed. It is especially important to not wait too long or until the pain is horrible. Often, because women are the caregivers, they take care of everyone else before themselves. In the case of orthopedic problems, if this happens, women can end up needing larger

“To prevent orthopedic injury, especially around a cycle, women can try to avoid highimpact exercise.” 2 2 Guide to Good Health 2 0 1 3

procedures, such as knee replacement. If women find themselves with joint pain or a joint injury that doesn’t resolve within a week, it is important to go see an orthopedic surgeon, as they may be able to help with no surgery or a more minimal surgery or procedure to correct the problem.

WHAT ARE SOME OF THE OTHER TREATMENT OPTIONS? In the case of cartilage injuries, there is a treatment that is fairly new in orthopedic surgery that can help patients avoid knee or hip replacement. This treatment is adult stem-cell therapy. We take the patient’s stem cells and graft it to the area that has cartilage deficit. This works, as stem cells are “baby cells” in your body. Once they are in an area, they grow to match where they are (cartilage, bone, etc.), so we can help patients grow back knee cartilage, for example. With this lesser procedure, women may never end up needing joint replacement, depending on how soon they come to see us.

Christina Sheely, DO Seton Medical Center 512.504.0866, seton.net Dr. Christina Sheely is the chief of surgery at Seton Medical Center Hays, specializing in orthopedic surgery.

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Smile Like You Mean It Cosmetic dentistry brought to you with consideration and care, perfecting your smile once and for all. By Molly McManus

These days, a great smile is like a firm handshake. With straight, white teeth (and some eye contact, of course) confidence is radiated outward, producing an effect of people drawn to the warmth of your perfect smile. Want to improve your smile but don’t know where to start? Dr. Karen Frazer has close to 30 years in dentistry. “Most people usually get a combination of things to get to the point they want to be,” she explains. Braces can oftentimes be avoided with porcelain restorations, one of Frazer’s most common dental corrections. While cosmetic dentistry is an important aspect of her practice, Frazer believes that dental work should look completely natural in order to improve the appeal and maintain the integrity of your smile. Frazer addresses some of the most basic cosmetic dental needs, defining common issues patients come in with, services to help get to the root of what a patient wants and how to reach the desired result.

WHAT ARE THE COMMON ISSUES PATIENTS HAVE WHEN VISITING YOUR OFFICE? There tends to be a lot of anxiety surrounding a visit to the dentist. To address these fears, we utilize an almost spa-like environment with aromatherapy and calming music. There is little to no wait time, as we value our patients’ time. There is a significant amount of people in this world who are high anxiety in the dental office, so we treat patients with a VIP level of service—and maybe some mild

numbing—to ease the worries surrounding a dental visit. In addition to anxiety, the most common issue I see is that [patients] don’t like the color and/or shape of their teeth, which is why people frequently seek out cosmetic dentistry. I work to create a consistent and normal shape while addressing any discoloring a patient wishes to eliminate.

WHAT TYPES OF SERVICES CAN ACCOMMODATE THESE ISSUES? For inconsistent shape and staining of the teeth, there is a wide variety of options available. While each patient’s mouth is unique, a different approach is required depending on the individual. Oftentimes, multiple services are needed in order to achieve the patient’s preferred outcome. Fillings, teeth whitening, porcelain veneers and crowns are some of the most popular services we provide at our South Austin office. As one of the first practices in Austin to have a CEREC machine, we can create restorations in-office in as little as 15 minutes. However, for some of the more involved cosmetic procedures that require acute exactness, like crowns and veneers, we prefer sending the work to a laboratory. We work with three of the top labs in the country. There’s a golden proportion rule of aesthetic dentistry of the length, height and width of the teeth. It can be extremely difficult to do, say if you’re doing six to eight teeth in the front, with a CEREC machine. To get the true translucency that you can with the porcelain veneers or crowns, you want to go with ones made in the lab that highlight a more natural look.

WHAT DOES TREATMENT ENTAIL? Porcelain veneers and crowns are bonded over the top of a tooth after a thin layer of enamel has been removed from the natural tooth. This can correct fractures, tooth size, and can also lengthen shorter teeth, change undesirable tooth color or close unattractive spaces between teeth. With aesthetics, my personal opinion is that you get a better result by taking an impression and sending it to a lab.

“There’s a golden proportion rule of aesthetic dentistry of the length, height and width of the teeth.” 2 4 Guide to Good Health 2 0 1 3

BEFORE

AFTER

AFTER Procedures used: All porcelain crown, 2 veneers, and a custom implant abutment with an all porcelain crown

Once veneers or crowns are created, the finish is applied in office, perfectly matching the natural tooth with the restoration. Then light numbing or complete sedation will be applied, depending on the level or lack of anxiety a patient has. We facilitate the entire process seamlessly, and can address your cosmetic dental needs in a mere one or two visits.

Karen E. Frazer, DDS 512.442.2295, southaustinsmile.com Dr. Karen E. Frazer is a member of the American Dental Association, Texas Dental Association, Capital Area Dental Society, Academy of General Dentistry, American Academy of Cosmetic Dentistry and the International Congress of Oral Implantologists.

We’ll get you back in the game. Seton Orthopedic & Sports Medicine treats patients of all ages for a full range of sports related injuries including bone fractures, torn muscles and ligaments, and joint pain. To schedule an appointment with one of our board-certified physicians, please call 512-504-0866.

1180 Seton Parkway · Suite 220 · Kyle, TX 78644 · 512-504-0866 · SetonFamilyofDoctors.com

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The Dreaded Bunion Understanding what they are, when to seek treatment and the many misconceptions surrounding bunions. By Molly McManus

Bunions can be annoying, unattractive, inconvenient and downright painful. But do you really know what one is? Vikas Godhania, MD, chief of Austin Regional Clinic’s podiatry department, offers explanations in understanding what a bunion is, the causes of how it occurs and the various treatment options available to those wanting to take action. In addition, Godhania encourages people to know all of the available options and to be cautious of misleading information. WHAT IS A BUNION? Some people think that a bunion is a callous. A bunion looks like a growth near your big toe, but is really not a growth; it’s a joint that is not in the correct position—a malformed, malaligned joint. Over time, the entire bone has shifted outward. What you’re seeing is relatively normal bone in an abnormal position. It’s somewhat of an inherited trait, but rather than being born with a bunion, you inherit the foot type to develop a bunion. Through time, as you walk, that foot type causes the bone to shift outward.

ARE THERE OTHER CONTRIBUTING FACTORS THAT CAN CAUSE BUNIONS TO OCCUR? A misconception is that bunions are caused because you wear bad shoes. Mostly, bunions are a result of your foot type and the anatomic features that your foot has. Shoe gear can make a bunion more painful and a little worse, rather than actually causing them. Thus, if you improve your shoe gear, you can reduce your pain and make

yourself feel better. But getting yourself in to a better shoe, arch support or orthotic supports will not reverse the effects of a bunion. The only way you can stop it, reverse it, correct it is through surgery.

WHO SHOULD SEEK TREATMENT? The one feature you should have is pain. If you don’t have pain, it’s not worth fixing a bunion. Some people say, “I don’t have pain but I have to wear a shoe that is three times my size.” Or, “I’m highly limited in what I can wear.” That’s a reasonable expectation for surgery because if they were to wear something different, they would have pain. For someone who has bunions, isn’t ready for surgery, their symptoms aren’t bad enough, they can look at shoes that have greater arch support, a shoe that is wider, with more flexible material and lower heel height. When you wear a heel, all your pressure gets thrust forward on to the ball of your foot. Decreasing heel height, wearing wider shoes, and sometimes taking antiinflammatories are routes you can take to try to put off bunion surgery or to try and live without having the surgery.

WHAT ARE THE EXISTING TREATMENT OPTIONS FOR BUNIONS? There are a lot of different terms out there: the use of laser to operate [which Godhania highly deters patients from using] or minimally invasive surgery. Minimally invasive makes a small incision to shave the bone down, but very rarely is shaving down the bone the right, traditional or appropriate procedure for a bunion. Imagine someone dislocating their shoulder and part of their shoulder is sticking out. You wouldn’t consider filing or shaving that down, you’d want to put that back to where it belongs. If you shave the bone with someone that has a real bunion, it’s not going to correct that problem; they’re still going to have a bunion or they’ll come back needing more surgery. Realigning or reconstructing is essentially what we do with bunions. I will always shudder when I hear on radio commercials, “Get your bunions removed!” Removal, in the way I look at things, means

“A misconception is that bunions are

caused because you wear bad shoes. Mostly, bunions are a result of your foot type and its anatomic features.”

2 6 Guide to Good Health 2 0 1 3

that something is there in excess of what you should have. Bunion surgery is about taking the first metatarsal of the bone, where the bunion is, essentially breaking the bone and realigning the joint back to where it belongs. And you can’t do that through a tiny incision.

HOW LONG IS RECOVERY FROM SURGERY AND WHAT DOES IT ENTAIL? Typically, patients spend one to two weeks off their foot after surgery. Then we place them in a boot, allowing them to walk for another four weeks. At six weeks, they’re getting back in to normal shoes, and then each week they progressively get better and less swollen. I don’t expect all of my patients post-surgically to wear orthopedic shoes every step they take. My patients are younger, like to wear dressier shoes, but I like to instill a little common sense and practicality afterwards. I urge my post-operative patients to wear better support when they’re spending considerable time on their feet, and size their shoes appropriately. We provide education so patients can be more conscious and more aware to help with progression. I’ve heard, “Once you get bunion surgery, it returns.” That’s not true. If you do the correct procedure for the right patient, then reoccurrence rates are at 3 percent or less.

Vikas A. Godhania, MD Austin Regional Clinic 512.346.8888, austinregionalclinic.com Dr. Vikas A. Godhania is chief of ARC podiatry, board certified in foot and ankle surgery, and is a diplomate in the American Board of Podiatric Surgery.

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We’re locals, too. We’re not afraid of firsts. And we’re not afraid to stand out. Because if moving healthcare forward begins by looking back—back to a time when care was much more personal and much less complicated—then that’s how we want to operate: with an MVP team of physicians and staff who remember who you are when you walk through our doors. Welcome to Arise Austin Medical Center. How can we help you?

To learn more, visit us at AriseMedicalCenter.com or give us a call at 512-314-3800. We promise a real human will answer you.

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Emergency Relief What to do when the unexpected happens, and how to know when a freestanding emergency center is your best option. By Molly McManus

Your child falls off his mattress, cutting open his head as he impersonates one little monkey jumping on the bed. Your daughter unexpectedly comes down with a 100-plus fever late one night. Is it an emergency? Should you go to an urgent care clinic? Is it something a primary doctor can look at? How do you know? These questions not only consume a parent’s mind when an accident occurs, but also anybody who becomes injured or is struck with illness. Whether you or your child are suffering from an allergic reaction, burn, broken bone or deep gash, questions of where to go and what to do are some of the first that come to mind. Luckily, your options in Austin are continuing to expand. Freestanding emergency rooms (FSER) are part of that expansion, also known as freestanding emergency departments (FSED). Okemefuna Okpara, MD, FACEP, offers insight on what sets FSERs apart from a hospital’s emergency care unit or an urgent care clinic, and how to know where to go when faced with a crisis. Know your options so you can make an informed decision the next time an accident strikes.

WHAT MAKES AN FSER DIFFERENT FROM AN URGENT CARE CLINIC? FSEDs are open 24/7/365, while urgent care clinics usually have weekday daytime hours, usually closing anywhere between 7 and 9 p.m. Monday to Friday. Freestanding ERs, just like hospital-based ERs, are staffed and equipped to handle much more critical patients [than urgent cares]. For instance, an FSER is staffed with emergency room–trained nurses and doctors who can administer IV fluids and medication. The staff at an FSER can perform CAT scans and ultrasounds, in addition to X-rays, cardiac lab

tests and administer cardiac resuscitative medication on site. FSERs can also admit their patients directly to a hospital when needed, while an urgent care clinic cannot.

WHAT MAKES AN FSER DIFFERENT FROM A HOSPITAL ER? An FSER is equipped to handle any sort of medical emergency except for major trauma, such as serious gunshot wounds and stabbings or major motor vehicle collisions. A good rule of thumb is if you think you should call 911, you should. The clear advantage of an FSED is much-reduced wait time. Plus, the ambiance of a freestanding ER tends to be much more pleasant and warm, hopefully reducing the anxiety and stress patients experience. In addition, the doctors and nurses get to spend much more time with patients, in a relaxed atmosphere, answering all questions they or their family might have.

HOW DO YOU KNOW WHETHER TO SEE YOUR PRIMARY DOCTOR AS OPPOSED TO GOING TO A HOSPITAL ER OR FSER? An FSER can treat all conditions from broken bones to dehydration. If further care is needed, an FSER will coordinate with a hospital so that you don’t experience any wait time once transferred. Any non-emergency conditions that don’t seem to be acutely life-threatening can be seen by one’s primary care doctor, assuming the patient can wait the time it might take before they get in. For example, if something happens over the weekend or after office hours, an FSER or hospital ER are your only options, unless you can wait until your primary doctor’s office is open. Some of the potentially life-threatening conditions that would be seen at an FSER or a hospital-based ER include but are not limited to: difficulty breathing or shortness of breath; chest or abdominal pain; lethargy [pediatric or geriatric]; seizures or any type of confusion or change in mental status; severe and sudden

headache; sudden changes in vision or sudden dizziness; or loss of consciousness. For pediatrics, the presence of fever isn’t necessarily a reason to rush to the ER unless the baby is less than three months of age. It’s OK to give your child some Tylenol or Motrin if they are older than 6 months, at home first. But lethargy, difficulty breathing, high-grade fever [greater than 102 degrees], persistent vomiting or certain types of trauma—particularly head trauma—are reasons to go to your neighborhood freestanding ER.

ARE THERE BASIC QUESTIONS A PATIENT/PARENT SHOULD ASK? Any questions you might have are relevant and important. You are the best judge, and as a parent, it’s important to go with your gut. Don’t be afraid to ask questions and always ask what symptoms to look out for [that would warrant] return to the ER. The next time an accident happens, assess the seriousness. If it doesn’t demand a 911 call, ask yourself, “Can it wait?” Meaning, can you wait to see your primary care doctor. More importantly ask, “Can I wait?” Hospitals can have you waiting for hours, but since FSERs see a significantly lower volume of patients, they are able to offer many resources a hospital cannot including little to no wait times, as well as a follow-up call the next day to check in with you or answer any questions you might have forgotten to ask during your visit.

Okemefuna Okpara, MD, FACEP

“The clear advantage of a freestanding emergency room is much-reduced wait times.”

2 8 Guide to Good Health 2 0 1 3

Austin Emergency Center 512.481.2321, austiner.com Cofounder and medical director of Austin Emergency Center Far West, Dr. Okemefuna Okpara found his passion for medicine in Nigeria, where he witnessed firsthand its power to treat illness.

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Specialized Service Everything women need to know about a single-site hysterectomy. By Ashley Lauretta

There is another significant advancement as more technology is developed in the area of robotic-assisted surgery. The procedure is called a single-site hysterectomy, and it will prove beneficial to gynecological surgeons and their patients alike. Interestingly, new procedures like this are being pioneered and advanced right here in Austin at the Texas Institute for Robotic Surgery at St. David’s North Austin Medical Center. Thomas Payne, MD, medical director of the institute, explains what a single-site hysterectomy is and how it can benefit women in the Central Texas area.

WHAT IS A SINGLE-SITE HYSTERECTOMY? In general, a hysterectomy involves the removal of the uterus only; the uterus and the cervix; or the uterus, cervix and ovaries. A single-site hysterectomy utilizes one small incision concealed within the umbilicus (navel) for surgical access in performing a hysterectomy. Previously, this procedure has proven to be very difficult utilizing traditional laparoscopic instrumentation, and it has been beyond the reach of most surgeons and, therefore, not available to most patients. The robotic platform uses software programing, scaled motion and magnified, high-definition visualization to allow a precise, safe and highly effective procedure to be performed by an increasing number of surgeons, ultimately benefiting their patients. Because the incision is hidden in the umbilicus, the cosmetic benefit is attractive to most women as well. After the small, 2.5-centimeter incision is made, a small port is slipped into the incision, allowing the operative instruments to be inserted. All of the instruments are held by robotic surgical arms, which, in turn, are completely controlled by the operating surgeon. During a roboticassisted, single-site hysterectomy, the software and innovative design of the instruments allow the surgeon to operate with ease, precision and unparalleled vision.

WHEN CAN A SINGLE-SITE HYSTERECTOMY BE PERFORMED? A single-site hysterectomy is performed for the

“The benefits of a single-site hysterectomy include less pain and less blood loss than traditional open surgery.” 3 0 Guide to Good Health 2 0 1 3

same reasons a patient would need a traditional (open-incision) or laparoscopic hysterectomy. A few examples would be excessive bleeding, pelvic pain or endometriosis.

WHAT ARE THE BENEFITS OF A SINGLE-SITE HYSTERECTOMY VERSUS THE TRADITIONAL METHOD? The benefits of a single-site hysterectomy include less pain and less blood loss than traditional open surgery, as well as a faster recovery and a quicker return to work and normal activities. Because we are able to perform the surgery through an incision hidden in the navel with the new robotic platform, there is an added cosmetic and aesthetic benefit that is not available during surgeries performed with a single large incision or multiple small incisions.

WHAT MORE CAN YOU SHARE ABOUT THIS PROCEDURE? With the benefits the single-site robotic platform provides, the majority of gynecologists will be able to offer this procedure within the next one to two years. Here at the Texas Institute for Robotic Surgery at St. David’s North Austin Medical Center, we are able to perform the procedure now. Because of our national reputation as leaders in quality and innovation, as well as our partnership with talented local surgeons who are members of the institute, our medical team was selected not only to be among the first in the country to start offering this procedure, but also to help educate our fellow surgeons from around the nation.

HOW CAN SOMEONE INTERESTED IN A SINGLE-SITE HYSTERECTOMY GET MORE INFORMATION? The most important thing is for women to be fully informed about all of their options. They should talk with their physician as they explore their options, and they should consider speaking with a physician who is trained in this robotic-assisted procedure. To learn more about this and other robotic procedures, visit TexasRobotic.com or call 512.901.2101.

Thomas Payne, MD Texas Institute for Robotic Surgery, St. David’s North Austin Medical Center Dr. Thomas Payne, medical director of Texas Institute for Robotic Surgery, is known both nationally and internationally as a thought leader in benign robotic-assisted gynecologic surgery.

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Incontinence Innovation Take the pain out of surgery, medications and ineffectual exercises to treat incontinence once and for all. By Molly McManus

A surprising number of women are affected by bladder leakage and urinary incontinence. Although incontinence can be just as embarrassing to have as it is to confront, it’s a common problem facing females. According to the Agency for Healthcare Research and Quality, about 25 to 45 percent of women suffer from urinary incontinence, defined as leakage at least once in the past year. Stress incontinence can occur doing everyday tasks, such as lifting, sneezing, coughing, laughing or exercising. Urge incontinence is the unwanted and sudden need to urinate. Both can be caused or intensified by childbirth, obesity, excessive exercise, lack of exercise, age or trauma. As women age, the chances of having bladder leakage increases: 20 to 30 percent of young women, 30 to 40 percent of middle-aged women, and up to 50 percent of older women experience urinary incontinence. However, the real problem lies in this statistic: two-thirds of women who “leak” have never mentioned it to their physician, and up to two-thirds of women do not use any treatment or product to manage their incontinence. Fear not, there is now an easy solution to treat incontinence and it is up to you to put embarrassment aside and take the next step. InTone is a nonsurgical device that helps women overcome bladder leakage and incontinence. What’s even better is that the wonderful Obstetrics and Gynecology team at The Austin Diagnostic Clinic can now prescribe the device.

WHAT IS INTONE? Developed by InControl Medical, LLC,

InTone is a medical device available by prescription for treatment of bladder incontinence. “It is a vaginal device that we teach you to insert and use,” says Yvette Gutierrez-Schieffer, MD, of The Austin Diagnostic Clinic. “It’s like going to work out at the gym for your pelvic floor muscles but you do it in the privacy of your own home and don’t have to pay per physical therapy session.”

HOW DOES IT WORK?

InTone combines a daily program of volitional exercises, voice-guided instruction and micro-current stimulation to strengthen muscle tone in the pelvic floor. “InTone shows the patient how to properly do Kegel exercises and actually gives you biofeedback per session. Intone also has a four-minute session where the device does electrical stimulation and makes your muscles stronger,” says Gutierrez-Schieffer. “You must maintain a ritual of exercise,” she says, advising to initially use the device daily. After about eight weeks, daily exercises become unnecessary, and you just need a little “maintenance” of the muscles a couple times a week. Each session takes about 10 minutes—quick and easy for the woman on the go.

ARE THERE ANY SIDE EFFECTS? “There are no side effects,” says GutierrezSchieffer. “It is not painful and works very well for most women. Almost all of my patients have seen dramatic improvement by the fourth week for sure and some by the second week.” This is amazing since until now, available options for treating incontinence had mixed results. Absorbent pads and diapers do nothing to treat the condition. Medication can cause negative side effects and

“Up to two-thirds of women do not use any treatment or product to manage their incontinence.” 3 2 Guide to Good Health 2 0 1 3

The Austin Diagnostic Clinic’s Ob/Gyns L to R: Yvette Gutierrez-Schieffer, MD, Allison Devine, MD, Stephanie McNelis, MD, Wendy Cutler, MD Angela Meyer, DO and Kiran Mechineni, MD

does not always prove successful. Surgery is a more invasive option and is oftentimes ineffective. In-home exercises also can be futile as research has shown that even when properly taught how to perform pelvic floor or Kegel exercises, about half of all women do them incorrectly. After prescribing InTone, GutierrezSchieffer and the Ob/Gyn doctors at The Austin Diagnostic Clinic customize the settings for InTone and the patient is shown how to use it at home. A sensor in the unit measures pressure to determine if the patient is doing the exercises properly.

WHAT DOES IT COST? “The device coverage varies on what your insurance pays for,” explains Gutierrez-Shieffer. Some insurance will fully cover the device while others do not. The full price of InTone is $595 and the device is yours to keep. “Medicare covers it fully if you have evidence that you have tried Kegels,” offers Gutierrez-Schieffer. Not a bad option—or price for that matter—for tackling incontinence and saving you from the pain, inconvenience and/or embarrassment incontinence can bring. InTone is sourced and manufactured entirely in the United States. Visit incontrolmedical.com for more information.

Yvette Gutierrez-Schieffer, MD The Austin Diagnostic Clinic, Ob/Gyn 512.901.4063, ADClinic.com Dr. Yvette Gutierrez-Schieffer specializes in incontinence and prolapse, seeing adolescents and women of all ages for all uro-gynecologic reasons and obstetrics.

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Beauty Enhancement Everything you need to know about facial injections. By Jaime Netzer

Maybe you’ve thought about Botox but you’re worried about retaining movement in your facial muscles. Or maybe you’re interested in the idea of a liquid facelift but are concerned about the possibility of pain. To answer all your most pressing questions about skin injections, we chatted with Iris Taylor, LE, a medical esthetician and injectionist at Body Tonic Med Spa. She explains two common types of injections, elaborating on what they are, how they work and what to expect when you receive one. (Hint: You shouldn’t worry too much about frozen muscles or pain!) Read on to discover the expert’s point of view on dermal fillers, Botox, liquid facelift and micro-cannula. WHAT ARE DERMAL FILLERS? Dermal fillers are gels that are injected where wrinkles, shadows and folds occur. Filler adds immediate volume and gives a smoother, softer look. Many people are looking for that slightly fuller shape for their chin or cheeks. Just a touch of additional volume can make an enormous difference in your appearance. Fillers are most commonly used on the lower twothirds of the face, where there is more facial fat and the skin is thicker. This allows the filler to be hidden well while still restoring volume to the hollows of the face.

When the muscles can no longer contract, the lines start to soften and overtime may even disappear. In contrast to dermal fillers, Botox is typically used in the upper third of the face. This area is targeted because relaxing BEFORE AFTER muscles around the mouth can Liquid Face Lift Botox and Fillers: Smoothed & tightened skin, lifted jowls, create problems turned up corners of mouth, enhanced lips, drastically improved texture of with smiling, or skin, tightened skin. Body Tonic Liquid Facelift Client by Iris Taylor even speech. However, filler and Botox, when administered properly can nerves and vessels. This means less pain, very carefully be placed anywhere on the bruising and swelling, as well as a more face and still look natural. In my opinion, a precise outcome. good Botox treatment allows for some movement of the muscles treated. HOW CAN YOU TELL WHICH INJEC-

TION IS RIGHT FOR YOU? WHAT IS A LIQUID FACELIFT? Liquid facelift is the name for a technique that allows strategic placement of injectable filler and/or Botox. In other words, without having to go under the knife, you can look like you’ve had a facelift. Plus, it’s natural looking. There are many different liquid facelift techniques that can redirect your own tissue upwards. Often, liquid facelifts include both Botox and fillers. In some cases, I will administer different product types in both the upper and lower areas of the face to achieve the right effect. This is most common with the liquid facelift procedure. But advanced techniques like this must be performed by a highly experienced injector to ensure your treatment is safe and benefits are optimal and natural looking.

WHAT IS A MICRO CANNULA? WHAT IS BOTOX? Botox, a brand name, is a natural purified protein prescription medicine. Very low doses of Botox are carefully injected directly into the overactive muscles that are responsible for creating certain wrinkles.

A micro cannula is an extremely thin, flexible hollow tube. To a patient, a cannula may look very similar to a needle. However, cannulas are much more gentle and cause less damage to your tissue. Cannulas are flexible and travel below your pain sensory

Every successful procedure must start with a thoroughly comprehensive consultation. I listen very carefully to the patient’s needs and desires. I help [the patient] prioritize these goals and then develop a plan meant to achieve the safest, most beneficial results possible. The location of concern, patient skin type, age, medical history and many other variables factor into deciding what is best for that person. It is a good thing that there are temporary fillers available. If they were permanent, your skin would begin to sag and the filler would remain static leaving the hollows of the face even more apparent. Permanent fillers remove your wrinkles, but they also make you look older, plastic, and less animated in the process. Techniques also get better over time and permanently filled patients miss the opportunity to have the most advanced treatment possible. Permanent fillers start to look bad after two to five years and the damage is irrevocable. With added recent advancements in techniques, we are using less product with less downtime and longer lasting results.

Iris Taylor, LE

“Every successful procedure must start with a thoroughly comprehensive consultation.” 3 4 Guide to Good Health 2 0 1 3

Body Tonic MedSpa 512.383.5204, mybodytonic.com Iris Taylor is a medical esthetician and injection specialist with 12 years of experience.

Taylor’s photo by Kim Francois

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Higher Brain Living Introducing a revolutionary technique and system to achieve a higher sense of purpose and consciousness. By Molly McManus

Higher Brain Living (HBL) is based on the most progressive knowledge of 21st-century neuroscience with roots in ancient wisdom dating back to yogi mystics 5,000 ago. With centers located throughout the United States, HBL pairs clients with a facilitator who has experience in a variety of healing and personal development techniques. Dr. Michael Cotton, a leading evolutionary theorist, founded HBL with a mission to awaken the human potential for a lifetime of joy, purpose and potential. With a chiropractic background, Cotton works with wellness practitioners worldwide to implement HBL in to their practices, has opened six HBL centers and has plans to open 30 more during the next year. Zach Polsfuss is an advanced facilitator and national presenter who will give a HBL demonstration in Austin Oct. 10. Stressing the idea that “you’ve got to see it to believe it,” Polsfuss explains the revolutionary advancement HBL has achieved with its almost unbelievable outcomes. Polsfuss outlines the system and technique, as well as his own personal experience with going through the HBL program.

WHAT IS HIGHER BRAIN LIVING? HBL is a method in which the physiology of your brain is altered through a gentle touch protocol, elevating the state of your physical and mental consciousness. [You’ll have] guaranteed positive change in your life by 22 sessions with the HBL technique. Clients have reported experiencing better relationships, greater financial freedom, increased work satisfaction and a healthier body. But it’s more than simply a physiological change in your brain; HBL offers you the methodology and insight to create a lifelong map toward limitless and meaningful personal growth. Each session is paired with an advanced mapping system, which gives you a pathway

into your fearless, purposeful life. With the innate intelligence of the higher brain activated, clients report everything from easier decision making to deeper connections with everyone around them.

HOW DOES A HIGHER BRAIN LIVING SESSION WORK? Our lower brains fear change. It is a region of our brain that developed in a predator-rich environment, and it is extremely skilled at identifying possible danger in order to keep us alive. An HBL session facilitates a surge of energy into the higher brain. When this new discipline is applied, a spontaneous movement of breath surges through the body, creating a feedback mechanism that brings life-sustaining oxygen up through the body and increases metabolism in the higher brain. Through this process, your brain is able to release stress, rejuvenate and reorganize every cell in your body for rapid vertical transformation in your brain. This one-of-a-kind technique literally frees your fear-based lower brain and shifts the energy into the higher brain, where your potential lives. The system offers the chance to let go of stress, anxiety and depression, and experience a higher sense of purpose and higher consciousness while you continue to grow and evolve. Never before was this process repeatable. Throughout history, we have heard about people achieving this enlightened state. Now it is accessible to everyone and anyone through HBL.

HAVE YOU PERSONALLY GONE THROUGH THE PROGRAM? WHAT HAS BEEN YOUR EXPERIENCE WITH IT? I had and have had the most powerful lifechanging experiences of my life from HBL sessions. This is my own personal experience; this is not what HBL as an organization would say. This is me as an individual telling you about

“The system offers the chance to let go of stress, anxiety and depression, and experience a higher sense of purpose.” 3 6 Guide to Good Health 2 0 1 3

my experience. I had a sales career. I left that to do the HBL training because it spoke to me at a level deeper than I had ever seen. I started to take the sessions, and I immediately felt a change in my breath in the very first session. I knew that if this protocol was somehow making me breathe a different way, that it was legit and that it wouldn’t serve me any more to be skeptical of anything else. I surrendered to the process fully at that point. I ended up getting trained and licensed in it. During training, there’s a few days where there are more intense group sessions, and it was during one of those that I had the most powerful experience of my entire life. It’s really hard to explain because I went to a place where there are no words. When I came out of that state, I immediately lost 30 pounds, stopped drinking, stopped smoking and started eating differently. That’s a quick synopsis of what happened. Ever since, I’ve been living a life that’s so on purpose with where my career direction is headed, it was only stuff you read about. My vocation is my vacation. Higher Brain Living demonstration, Oct. 10, 6:30 to 8:30 p.m., Austin Marriott South. For more information or to register, visit higherbrainlivingevents.com.

Zach Polsfuss Higher Brain Living 855.418.5491, higherbrainliving.com Zach Polsfuss is the national sales director for Higher Brain Living. He is also an accomplished advanced facilitator and national presenter with Higher Brain Living.

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Dental Awareness You may not be saying a word, but your mouth is speaking volumes. By Molly McManus

You may think of dental work as mainly a cosmetic measure when, in fact, dental health is extremely important in maintaining overall health. Furthermore, certain dental imperfections that raise red flags can point to other, more serious health problems. Misti James, DDS, takes great pride in educating her patients on what is happening in their mouths and how it can be linked to other health concerns. From sleep and breathing disorders to acid reflux and even cancer, Dr. James outlines what conditions are directly correlated to your dental health, emphasizing the importance of a regular checkup and adequate care to protect your overall health. WHAT INDICATORS LINK DENTAL ISSUES TO OTHER ISSUES GOING ON IN THE BODY? Many times, damage to the teeth can be one of the first visible signs of gastroesophageal reflux disease (GERD). This chronic digestive disease occurs when the stomach acid flows back into your esophagus. The acid not only irritates the lining of your throat, but can also erode your enamel, leading to tooth structure loss and increasing cavity risk. I work hand in hand with my patients’ physicians to ensure that all aspects of GERD are treated.

WHAT OTHER TYPE OF DENTAL AILMENTS ARE REGULARLY SEEN THAT SIGNIFY OTHER HEALTH PROBLEMS? Sleep disordered breathing (SDB) is a common and growing problem affecting the health of our children. If you notice your child snoring or grinding their teeth, it may mean that your child is having difficulty breathing in their sleep. During our examinations, we talk with the parents and consider factors such as tooth wear, tonsilar size and craniofa-

cial development that may indicate SDB. Recent studies have shown that snoring and teeth grinding, also called bruxism, may be an indicator of obstructive sleep apnea (OSA). OSA is an involuntary cessation of breathing that occurs while we sleep. Untreated, OSA can lead to high blood pressure, heart disease, stroke, automobile accidents caused by falling asleep at the wheel, diabetes, depression, memory problems, weight gain, impotence and headaches. These episodes can result in tooth wear from bruxism when the body goes into fight-or-flight mode and releases a burst of adrenaline in an attempt to “wake up” the brain and reopen the airway.

WHAT ARE THE TREATMENT OPTIONS FOR OSA? The most common treatment for OSA is a medical breathing device called CPAP, which stands for continuous positive airway pressure. While a CPAP device can provide an effective solution, some people are unwilling or unable to use CPAP. In these instances, oral appliance therapy may be considered as an alternative to CPAP. The oral appliance is an excellent choice because it is effective, comfortable to wear and can be performed in the dental office under the care of a physician.

WHY ARE REGULAR CHECKUPS IMPORTANT? Routine screenings that involve a thorough examination of your intra-oral and extra-oral soft tissues can be a valuable tool in detecting cancerous and pre-cancerous conditions. Like any other cancer, oral cancer can be life-threatening if not diagnosed and treated early. One of the most important factors in successful treatment of oral cancer is early diagnosis. While we are all aware of the increased risk associated with smoking and alcohol consumption, HPV (human papillomavirus) is gaining more attention. Symptoms can include hoarseness, sore throat, pain or difficulty swallowing, pain when chewing, lump in the neck and non-healing mouth sores. We have the benefit of examining our dental patients at least two or more times a

“Routine screenings can be a valuable tool in detecting cancerous and pre-cancerous conditions.” 3 8 Guide to Good Health 2 0 1 3

year. It is important to share any concerns that you are having with your healthcare provider. It just may save your life!

WHAT OTHER ISSUES ARE CAUSED BY IMPROPER AT-HOME DENTAL CARE? While brushing regularly is vital for healthy teeth and gums, you can overdo a good thing. Known as “toothbrush abrasion,” over brushing can wear down tooth enamel, as well as damage the gingival tissue, exposing sensitive root areas. This can lay the foundation for other dental problems such as periodontal disease and cavities on the sensitive roots of the teeth, which can be treated with gingival grafts, fillings, root canals and tooth extraction. Brushing vigorously is not necessary to remove soft plaque. What’s important when brushing is not how hard you scrub, but that you have the right technique and tools.

WHAT DO YOU SUGGEST FOR TECHNIQUE AND TOOLS? Use a soft-bristled toothbrush, low-abrasive toothpaste and brush in a circular motion at a 45-degree angle. Even better, let a mechanical toothbrush do the work for you, minimizing the urge of scrubbing back and forth. All toothpastes have a relative dentin abrasivity (RDA) level that you can Google. We suggest you use toothpastes with the lowest RDA ratings to prevent stripping of the tooth enamel and gingival tissues. You will find many of the toothpastes with whitening and tartar control are within harmful limits. If you desire whiter teeth, use professional whitening products such as whitening trays or in-office whitening versus abrasive whitening pastes.

Misti Phillips James, DDS River Place Dental 512.795.2800, riverplacefamilydental.com Dr. Misti James is currently president of the Capital Area Dental Society and was recently presented with the 2013 Texas Dental Association New Dentist Leadership Award.

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ACUPUNCTURE Sage Acupuncture Sage Acupuncture 512.968.2605 ReproductiveAcupuncture.com Helping couples conceive and carry healthy babies for over a decade, we understand how important growing your family is to you. Whether trying to conceive naturally, or with the help of Western medical intervention, the Sage program is designed to optimize fertility by supporting each individual’s unique circumstances. Our reproductive acupuncturists have obtained the highest credentials in the field. All practitioners hold Masters of Science degrees in Oriental medicine,

are licensed by the Texas State Board of Medical Examiners, and are certified by the National Certification Commission for Acupuncture and Oriental Medicine. “I have found the Sage Acupuncture team to be indispensable in my fertility journey as their treatments have not only greatly reduced my stress and improved my outcomes, but also they have been a significant support and advocate for me during this challenging time. I recommend them highly to anyone having issues with conceiving or maintaining pregnancy.”

DENTISTRY Bethany Petersen, DDS FLOSS Westlake 512.782.0820 flossdental.com

closely with people. She loves chatting with her patients and learning about their lives while she helps them to achieve their perfect smile! Dr. Bethany Petersen is originally from At FLOSS Westlake we offer the latBozeman, Montana. She attended Monest technology and are an Elite Premiere tana State University in Bozeman where Provider of Invisalign, the Clear Alternative she received her undergraduate degree in to Braces. FLOSS Westlake is a general Biomedical Science. After graduating, Dr. dentistry practice that performs all aspects Petersen made the move to Texas where she of dentistry while making sure our number attended University of Texas Health Science one goal is to make the dentist an enjoyable in Houston to receive her DDS. She is an experience for patients! active member of the American Dental Association, Texas Dental Association and the Academy of General Dentistry. Dr. Bethany loves being a dentist because it gives her the opportunity to work

AnnMarie Olson, DDS, PA AnnMarie Olson, DDS, PA 512.345.9973 austincosmeticexcellence.com A visit to Dr. AnnMarie Olson’s office will reinforce what many around Austin already know: Dr. Olson is committed to bringing Austin “high touch” dental care in a “high tech world.” She is one of Austin’s most talented Cosmetic Dentists, is a leader in Sedation Dentistry, and utilizes CAD CAM Cerec Technology. Dr. Olson is a Past President of the Capital Area Dental Society and was the first woman elected to this position since 1947. She served the Texas Dental Association as Chair of the Council on Peer Review, as Delegate

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to the TDA House of Delegates and many other positions. Dr. Olson was a Trustee to the American Association of Women Dentists, and was recently inducted into the International College of Dentistry. Dr. Olson enjoys her work with the Smiles for Success Foundation assisting women in transition from Public Assistance to the workforce who cannot afford the cost of dental care. With Sedation Dentistry, Dr. Olson and her team care for patients who are phobic about dentistry or have had traumatic dental experiences as children. Dr. Olson finds time to travel, garden, sing, and cycle. She is a certified Master Gardener for Travis country, and a Cantor and Soloist at St. Theresa Catholic Church.

DERMATOLOGY Corina Corbeille, RN, BSN Tru-Skin Dermatology 512.451.0139 tru-skin.com Corina is the Cosmetic Nurse Specialist for Tru-Skin Dermatology and is certified and trained in several types of cosmetic procedures, and is highly educated and knowledgeable in her field. Working in Beverly Hills for 7 years with high profile clientele, kept her on the cutting edge of technology; and she perfected her cosmetic skills with Botox ®, Dermal Fillers, Lasers, Skin Care, Acne Prone Skin, Chemical Peels, and many other procedures.

Ms. Corbeille has a true talent and aesthetic passion for beauty and making people feel confident in the fact that they are putting their best face forward. As Cosmetic Nurse Specialist, she performs wrinkle reducing treatments such as Botox®, Dysport®, and Xeomin®, as well as anti-aging dermal filler injections such as Juvederm®, Restylane® and Radiesse®. Facial rejuvenation is accomplished not only by science, but by looking at each individual’s face with an artistic eye. Corina wants to make people feel as beautiful on the outside, as they feel on the inside, so they can conquer the world!

Daniel Ladd, DO Tru-Skin Dermatology 512.451.0139 tru-skin.com Daniel J. Ladd, Jr., D.O. is Medical Director and Founder of Tru-Skin™ Dermatology, a full service Dermatology practice offering the latest advances in skin cancer prevention, diagnosis and treatment plus a full range of cosmetic dermatology services in Austin, Bastrop and LaGrange. He earned his BA from the University of Texas at Austin and received his medical degree from Des Moines University in 1999 and is a board certified Dermatologist and Mohs surgeon. Dr. Ladd has been named by his peers to the Super Doctors® list for 2013.

Dr. Ladd founded the non-profit “Shade Project” (www.theshadeproject.org) and hosts The Dr. Dan Show, about health on KLBJ 590AM. He is a trustee for the AOCD, Past President of the TOMA, member of the AAD, American Society of Dermatologic Surgeons, American Society of Cosmetic Dermatology and Aesthetic Surgery, and the ASMS. Dr. Ladd is a lifetime member of the Skin Cancer Foundation’s Amonette Circle, an elite group of the country’s foremost dermatologists and Mohs surgeons who have made a commitment to skin cancer education and prevention.

FERTILITY Anthony Propst, MD Texas Fertility Center 512.451.0149 roundrockfertility.com Nationally recognized infertility expert Dr. Anthony Propst directs patient care at Texas Fertility Center Round Rock. Dr. Propst, an accomplished reproductive surgeon, has over two decades of clinical care and research experience, including fellowship training at Brigham and Women’s Hospital - Harvard Medical School. His patients and peers recognize him as a compassionate physician and noted researcher. After completing an appointment to the United States Air Force Academy, and earn-

ing a degree from the University of North Carolina School of Medicine, Dr. Propst went on to serve his country, and the men and women seeking reproductive care, by serving in the military. He served as Chief of Reproductive Endocrinology at Wilford Hall Medical Center in San Antonio as well as the Chief Consultant to the Air Force Surgeon General for Obstetrics and Gynecology. In July 2013, Dr. Propst retired from the USAF at the rank of Colonel. Now in private practice, Dr. Propst will continue to pursue excellence in reproductive medicine, providing both initial care and advanced treatment options in his new hometown. AWGUIDETOGOODHEALTH.COM 41

GENERAL SURGERY Francis Buzad, MD, FACS General Surgery, Robotics The Austin Diagnostic Clinic adclinic.com Dr. Francis Buzad is an internationally recognized leader in robotic surgery. Compassionate and focused on exceptional patient care, Dr. Buzad introduced the use of robotics for general and colorectal surgery to Austin in 2008 and was chosen to be one of the first in the nation to bring the benefits of robotic Single-Site surgery to patients. Dedicated to furthering surgical education, he is also one of only seven surgeons in the nation who have been designated as an educational epicenter in single site

robotic surgery, hosting surgeons from across the country who come to observe his surgeries and receive training. He is a frequent lecturer across the US and overseas on the safe and effective use of robotic surgery and has authored publications and presentations on a costfavorable approach to Single-Site gallbladder surgery, improved techniques for intraoperative diagnostic imaging, and best practices for robotics in the OR. A board certified general surgeon, he attended University of Pittsburgh medical school, completed his general surgery training at UTMB and a fellowship at OHSU.

Nancy Marquez, MD, FACS 512.498.4860 southwestbariatric.com capitalsurgeons.com Dr. Nancy Marquez, a native Texan from El Paso fluent in Spanish, received her medical degree from Baylor Medical School in Houston and completed her surgical training at Baylor University Medical Center in Dallas. She taught at LSU in New Orleans before returning to Texas in 1994 to begin her private practice joining Capital Surgeons Group in 1999. Several members of CSG also started Southwest Bariatric Surgeons in 2002 offering a variety of bariatric procedures for the first time in this area as part of a comprehensive weight loss surgery program.

Dr. Marquez received advanced training in laparoscopy and the Da Vinci robotic system to perform bariatric surgery including the gastric bypass, sleeve gastrectomy, revisional bariatric surgery as well as other complex abdominal procedures in a minimally invasive manner. As a board certified general surgeon, Dr. Marquez also has an interest in the management of benign and malignant breast disease employing the latest technology and surgical techniques. She offers in office cryoablation of fibroadenomas with the only Visica device available in central Texas.

OB/GYN Devin M. Garza, MD, FACOG Director Minimally Invasive Surgery Renaissance Women’s Group Texas Institute for Robotic Surgery, Austin, Tx drgarzadavinci.com Devin M. Garza, MD, has devoted more than 20 years to women’s healthcare here in Austin. As a second generation Ob/Gyn, he feels a calling to take care of people like he would family. A native of Corpus Christi, he graduated from UTAustin and UT Health Science Center-San Antonio. After medical school, Dr. Garza performed his residency at Johns Hopkins and Franklin Square Hospitals. He is board certified in Obstetrics & Gynecology. Dr. Garza serves as Director of Minimally Invasive Surgery at Renaissance Women’s Group,

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and brings to each case extensive experience in advanced minimally invasive surgery, especially da Vinci ® Robotic surgery. A pioneer in robotic surgery, Dr. Garza has performed & instructed over 700 robotic procedures, and teaches Advanced and Masters level surgeon training courses. 98-99% of all hysterectomies preformed at Renaissance Women’s are now done in minimally invasive fashion. That means less pain and a quicker recovery for patients. Robotic surgery has also proven safe and effective for the treatment of fibroid removal, pelvic prolapse, treatment for infertility, and endometriosis. Dr. Garza and his college sweetheart, Catherine, have been married since 1988 and have four children.

Sherry Neyman, MD Renaissance Women’s Group 512.425.3875 sneymanmd.com rwgdocs.com For 18 years, Sherry Neyman, MD, has had the privilege of providing OB/GYN care to Austin women. In 2013, she transitioned her medical practice, to focus on women’s wellness, gynecology and infertility. Dr. Neyman’ s warm and outgoing practice style is perfect for addressing issues such as hormone replacement therapy, stress incontinence , and menstrual issues. To provide the very latest surgical options for endometriosis, PCOS and fibroids as well as other women’s surgery needs, Dr. Neyman has completed advanced training in minimally

invasive and robotic surgical techniques. She has performed hundreds of da Vinci robotic surgeries including the cutting edge single incision hysterectomy. Dr. Neyman attended UT Southwestern Medical School and completed her residency at Parkland Memorial Hospital in Dallas. She is board certified in Obstetrics and Gynecology. A leader in the Austin medical community, Dr. Neyman serves as Chairman of the Board of Trustees with the North Austin Medical Center and is recognized in Austin Monthly’s “Best Doctors in Austin”. In her spare time, Dr. Neyman is passionate about volunteering in animal rescue and is the current President of House Rabbit Resource Network.

OPTIMAL HEALTH & BEAUTY Kelly Carney Ann Webb Skin Clinic 512.795.0145 awskinclinic.com

All treatments are customized, and therapists are encouraged to spend as much time with their clients as needed.

Kelly Carney is a medical aesthetician at Ann Webb Skin Clinic. Ms. Carney received her Aesthetic license in 2005 from The Nuvani Institute in Austin,TX. Kelly has over nine years experience as a medical aesthetician. She is also a licensed laser technician and esthetics educator. She has worked for some of the area’s top doctors, perfecting the medical side of her business. The mix of spa pampering with laser and medical solutions drew her to AW Skin Clinic. For Kelly, the best part of the Clinic is the focus on the clients’ individual needs.

As someone who struggled with skin issues her whole life, Kelly was excited to learn that there was a career path focused on helping people become their best self. For her, the most rewarding part of this business is consulting with someone and being able to say “I can help.” Kelly makes sure every client’s visit is a perfect mix of pampering and results.

Brittany Cantu Ann Webb Skin Clinic 512.795.0145 awskinclinic.com Brittany has been an Esthetician for over eight years. She studied at the prestigious Atelier Esthetique in New York City followed by an advanced Holistics course to become an internationally recognized Beauty Specialist. Over the years she has worked at three top-rated spas in Austin. She has a passion for providing in-depth treatments and education for the ongoing health and wellness of her clients. Let your daily stresses and skin woes melt away with her unique Cranial Facial Massage included in all of her facials. Her touch is one

of a kind and will leave you utterly tranquil as your skin is detoxed and beautified. Her treatment specialties include peels, acne, pigmentation and eyelash extensions. Brittany strives to provide the most effective treatments for your skin concerns and find a suitable home regime for your lifestyle and specific skin needs. She has completely transformed clients who suffer from teenage and hormonal acne as well as severe pigmentation. Her attention to detail with each of her clients sets her apart in the spa industry.

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PAIN CARE Mark T. Malone, MD Advanced Pain Care 512.244.4APC (4272) austinpaindoctor.com

cine for six years. He is double board-certified in anesthesiology and pain management by the American Board of Anesthesiology, with a sub-specialty in pain management; this is the Mark T. Malone, M.D., is a board-certified pain only board certification for pain management specialist and a native Texan. He received his endorsed by the American Board of Medical undergraduate degree from the University of Specialties. Texas at Austin, and went on to attend the UniDr. Malone is a member of the American versity of Texas Southwestern Medical School. Medical Association, the American Society of Dr. Malone attended Baylor College of Medicine Anesthesiologists, the International Spinal Interfor residency and training in anesthesiology, and vention Society, the American Society of Interthen completed a pain management fellowship ventional Pain Physicians, and the Travis County at Texas Orthopedic Hospital in 1998. Medical Society. He has successfully treated Prior to founding Advanced Pain Care in thousands of patients suffering from acute and 2002, Dr. Malone was a member of an Austinchronic pain. He and his wife, Tracy, live in Austin based group practice for twelve years, and a with their three children. In his spare time, he clinical instructor at Baylor College of Medienjoys water-skiing, cycling, and travel.

PLASTIC SURGERY Deirdre Rhoad, MD Rhoad to Beauty Plastic Surgery and Med Spa 512.476.9149 rhoadtobeauty.com

believes in listening to her patients’ concerns, educating them on available options, explaining things so that the patient understands, and most importantly, delivering exceptional treatment Dr. Deirdre Rhoad received her B.A. in Microbioland follow-up. ogy from the University of Texas and her mediDr. Rhoad provides invasive aesthetic surgical cal degree from the University of Texas Medical procedures of the face, eyes, ears, nose, neck, Branch in Galveston. She did residency training breasts, extremities and trunk with lifts, liposucin General Surgery at St. Vincent’s Hospital in tion, implants, and fat grafting. Dr. Rhoad and NYC, Burn Surgery and Plastic Surgery training at her aestheticians also provide minimally invasive Wayne State University in Detroit, and Cosmetic and non-invasive procedures such as Botox, Plastic Surgery training at the prestigious Manhat- Restylane, Juvederm, photofacials, microdermtan Eye, Ear, and Throat Hospital in NYC. She is abrasions, peels, and eyelash extensions. board certified by the American Board of Plastic Surgery through the Board of Medical Specialties. Awards received: This year Dr. Rhoad is celebrating 20 years of Patients’ Choice Award 2012 service practicing plastic surgery in Austin. She America’s Top Plastic Surgeon 2010

PSYCHIATRY Nadia Bening, MD General Psychiatrist Happy:) Mental Wellness Center 512.730.0402 happymentalwellness.com Dr. Nadia Bening is the founder of Happy Mental Wellness Center, located in the Four Points area of Austin, Texas. She attended medical school at the UT Health Science Center in San Antonio, and then completed her four year general psychiatry residency training in Austin, Texas through UT Southwestern Austin Regional Programs. Her services include medication management as well as psychotherapy for adolescents and adults, with a special 4 4 Guide to Good Health 2 0 1 3

interest in women’s mental health. Dr. Bening believes in taking a proactive stance in working with clients to help them achieve their mental wellness goals; she helps them develop tools they can use to create the kind of life they desire and deserve to live. It is important to Dr. Bening that there be both collaboration and mutual respect within the doctor-patient relationship, and treatment plans are custom tailored to meet the unique needs of each individual. Dr. Bening is committed to offering an exceptional experience by providing compassion, dependability, promptness and competence at every patient encounter.

ACUPUNCTURE SAGE ACUPUNCTURE 512.968.2605 3921 Steck Ave., Suite A100 Austin, TX 78759 reproductiveacupuncture.com

Helping couples conceive and carry healthy babies for over a decade, we understand how important growing your family is to you. Whether trying to conceive naturally, or with the help of Western medical intervention, the Sage program is designed to optimize fertility by supporting each individualâ&#x20AC;&#x2122;s unique circumstances.

DENTISTRY KAREN E. FRAZER, DDS

ANTHONY MENDEZ, DDS

512.442.2295 4407 Manchaca Rd, Austin, TX 78745 southaustinsmile.com

512.345.5885 7320 North Mopac Expy. #200 Austin, TX 78731 AnthonyMendezDDS.com

Providing the latest dental technology in a spa-like environment. Voted dentist of the year in 2009 by The Capital Area Dental Society. Special interest areas include cosmetic and general dentistry, as well as implantology and sedation.

Anthony Mendez is a General and Cosmetic Dentist who is focused on maintaining the highest caliber of patient care. In addition to a warm and friendly atmosphere, Dr. Mendez and his staff strive to provide each patient the most effective, pain-free and pleasant experience available.

CHIROPRACTIC WESTLAKE CHIROPRACTIC

ANNMARIE OLSON

FLOSS

512.306.1625 300 Beardsley Lane Bldg C101 Austin, TX 78746 westlakechiropractic.com

512.345.9973 11623 Angus Rd. #23 Austin, TX 78759 austincosmeticexcellence.com

512.782.0820 2785 Bee Caves Rd Rollingwood, TX 78746 flossdental.com

Dr. Katerina Sheffield is a Board Certified Doctor of Chiropractic and a Registered Pharmacist specializing in advanced upper cervical specific chiropractic and gentle full spine adjusting. Your trusted source for the best in chiropractic care. Restorative, cosmetic and sedation dentistry. Quality individualized care with an emphasis on you.

FLOSS is a new experience in dentistry! Weâ&#x20AC;&#x2122;ve brought into perfect alignment the concept of a full-service dental office, in a modern, high-tech environment, at in-network pricing with Free Teeth Whitening. Our goal is to give patients the best dental experience by focusing on their comfort and providing exceptional service.

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DENTISTRY

DERMOTOLOGY

LEGEND DENTAL

TRU-SKIN DERMATOLOGY

THE CARE COMMUNITIES

legenddental.com

888.451.0139 tru-skin.com 3500 Jefferson St., Suite 200 Austin, TX 78731

512.459.5883 314 E Highland Mall Blvd Austin, TX 78752 thecarecommunities.org

2525 W. Anderson Lane. Suite 300 Austin, Texas 78757 512.420.0050

Offices in Austin-Bastrop-LaGrange

1013 W. University Ave. Suite 345 Georgetown, Texas 78628 512.869.4850

We offer a unique dental experience that is fun, affordable, interactive, and effective. Combining the right mix of personal care, high technology, and continuing education, we maintain a commitment to our patients in every facet of our practice. If you are searching for extraordinary dental care delivered in a kind, gentle, and ethical manner we invite you to become our patient.

Premier Medical, Cosmetic and Surgical Dermatology Experts in Central Texas. Skin Cancer & Mohs Surgery specialists and proud founder of The Shade Project. www.theshadeproject.org. Look good, Feel good, Do good! Tune in to KLBJ 590AM, Sundays at 11AM for The Dr. Dan Show, “the best medicine on radio”.

No one should have to face a serious illness alone. The Care Communities surrounds people who are battling serious illness with a dedicated family of volunteers and connects them to social workers who help ensure they have adequate housing, food, and income. Care Teams work together to help with non-medical daily tasks and offer true companionship to our neighbors who need it most.

ELDER CARE

GENERAL SURGERY

RIVER PLACE DENTAL

AGE OF CENTRAL TEXAS

512.795.2800 10601 FM 2222, Suite S Austin, TX 78730 riverplacefamilydental.com

512.451.4611 AGEofCentralTX.org

NANCY MARQUEZ, MD, FACS

Austin Adult Day Health Center 3710 Cedar St., Austin, TX 78705 Round Rock Adult Day Health Center 475 Round Rock West Dr. #120, Round Rock, TX 78681

Dr. Lynley A. Shook and Dr. Misti Phillips James practice a full scope of general and cosmetic dentistry with expertise ranging from porcelain veneers to dental implants, crowns and bridges. Dr. Shook and Dr. James can correct a wide variety of cosmetic dental problems that can redesign your smile.

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Affordable, licensed program providing medical care and socialization to older adults during the day. Includes full-time nurse oversight, nutritious meals and snacks, and engaging activities in a community-oriented environment.

512.498.4860 southwestbariatric.com capitalsurgeons.com 3705 Medical Pkwy #210 Austin, Texas 301 Seton Pkwy #102 Round Rock, Texas

Dr. Marquez specializes in bariatric and general surgery using laparoscopic and robotic minimally invasive techniques. A comprehensive program provides compassionate and personalized care. Experience how weight loss surgery can improve or resolve so many medical problems such as diabetes, hypertension, sleep apnea and high cholesterol.

GENERAL SURGERY FRANCIS BUZAD, MD FACS 512.901.4069 12221 North Mopac Expressway Austin, Texas 78758 adclinic.com/biography/ francis-buzad

THE AUSTIN DIAGNOSTIC CLINIC

THE AUSTIN DIAGNOSTIC CLINIC - INTERNAL MEDICINE

512.901.1111 ADClinic.com

512.901.4009 ADClinic.com 12221 MoPac Expressway N. 1250 S. Cap of TX Hwy 360 Austin and Westlake Board certified internal medicine doctors provide annual exams, preventive care and chronic care management for adults and seniors.

THE AUSTIN DIAGNOSTIC CLINIC - MENOPAUSE & OSTEOPOROSIS CENTER Dr. Francis Buzad is an internationally recognized leader in robotic surgery. Compassionate and focused on exceptional patient care, Dr. Buzad introduced the use of robotics for general and colorectal surgery to Austin in 2008 and was chosen to be one of the first in the nation to bring the benefits of robotic Single-Site surgery to patients.

HEALTHCARE ARISE AUSTIN MEDICAL CENTER 512.314.3800 3003 Bee Cave Road Austin, Texas 78746 arisemedicalcenter.com

AUS TI N ME D I C A L CE N TE R

By offering distinguished surgeons, spacious and private patient rooms, and individualized care by specialized staff, Arise Austin Medical Center is the hospital Austin trusts for superior healthcare. Our commitment to innovation, clinical quality and patient care fosters a sense of well-being and aides your recovery. Experience healthcare thatâ&#x20AC;&#x2122;s distinctly different.

Since 1952, the doctors at The Austin Diagnostic Clinic have cared for Central Texans. We continue our tradition of care for the next generation of Texans with 115 doctors practicing in 21 medical specialties at 7 locations throughout Central Texas. Most major insurances including Medicare accepted.

THE AUSTIN DIAGNOSTIC CLINIC - CARDIOLOGY 512.901.4001 ADClinic.com 12221 MoPac Expressway N. 1250 S. Cap of TX Hwy 360 North Austin and Westlake Board certified cardiologists provide women and their families care and education to help diagnose, manage and treat cardiac disease.

THE AUSTIN DIAGNOSTIC CLINIC - PEDIATRICS 512.901.4016 (North) 512.334.2504 (Circle C) www.ADClinic.com 2400 Cedar Bend Dr, 5701 W. Slaughter Ln. North Austin and Circle C Board certified pediatricians provide annual exams, immunizations and preventive care for infants, children and teens. Same-day, after-hours and weekend care available through EasyCare Pediatrics. Newborn care classes available at ADC Circle C.

512.901.4022 ADClinic.com 12221 MoPac Expressway N., 1st Floor South Wing Austin, TX 78758 Board and clinically certified menopause and densitometry specialists provide women the expert care and support needed through the changes occurring during mid-life and beyond.

THE AUSTIN DIAGNOSTIC CLINIC - OB/GYN 512.901.4013 ADClinic.com 12221 MoPac Expressway N., East Entrance Austin, TX 78758 Providing medical and surgical care for women at all stages of their life from the board certified Obstetric/Gynecology specialists at ADC.

THE AUSTIN DIAGNOSTIC CLINIC - FAMILY PRACTICE 512.901.4026 ADClinic.com 1499B Old Settlers Blvd. 2400 Cedar Bend Dr. 5701 W. Slaughter Ln. North Austin, Round Rock and Circle C Board certified family practice doctors provide annual exams, preventive care and chronic care management for teens, adults and seniors.

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HEALTHCARE AUSTIN REGIONAL CLINIC AustinRegionalClinic.com

AUSTIN EMERGENCY CENTER (AEC) 3563 Far West, Ste. 110 Austin, TX 78731, 512.481.2321 4015 South Lamar, Austin TX 78704, 512.774.5780 austiner.com OPEN 24/7/365

Family Medicine | General Surgery | Pediatrics Austin Regional Clinic began in 1980, and is one now of the largest multispecialty health care groups in central Texas. We emphasize the importance of long-term doctor/patient relationships and the coordination of care across 23 specialties and 18 locations in 6 cities. ARC Cedar Park 512.259.3467 | 801 East Whitestone Blvd, Bldg B, Cedar Park, TX 78613 After Hours Clinic | Family Medicine ARC Cedar Park Medical Plaza 512.260.1581 | 1401 Medical Pkwy, Bldg B, Ste 200 & 220, Cedar Park, TX 78613 Allergy & Asthma | Dermatology | Ear, Nose, Throat (ENT) | Family Medicine | General Surgery | Internal Medicine | Obstetrics/Gynecology ARC Discovery 512.528.2300 | 715 Discovery Blvd, Ste 117 Cedar Park, TX 78613 Pediatrics ARC Medical Park Tower OB 512.451.0161 | 1301 W. 38th St, Ste 205 Austin, TX 78705 Obstetrics/Gynecology ARC Medical Park Tower Orthopedics 512.454.4561 | 1301 W. 38th St, Ste 102 Austin, TX 78705 Orthopedics ARC Kyle Plum Creek 512.295.1333 | 4100 Everett St, Ste 400 Kyle, TX 78640 Allergy & Asthma | Ear, Nose, & Throat (ENT) | Family Medicine | General Surgery | Internal Medicine | Pediatrics | Podiatry ARC Hutto 512.846.1244 • 877.846.1244 151 Exchange Blvd, Ste 500 Hutto, TX 78634 Family Medicine | Pediatrics ARC Pflugerville 512.989.2680 | 15803 Windermere Dr, Ste 103, Pflugerville, TX 78660 Family Medicine | General Surgery | Pediatrics

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ARC Far West 512.346.6611 | 6835 Austin Center Blvd Austin, TX 78731

Austin Emergency Center brings conciergelevel, fast emergency care to the local community. The same cutting-edge technology of a modern hospital ER is used here—onsite CT, ultrasonography, X-ray, full laboratory— all in an upscale environment, without the typical inconveniences of a hospital. AEC is staffed by board certified ER Physicians.

ARC Quarry Lake 512.338.8388 | 4515 Seton Center Pkwy, Ste 220 Austin, TX 78759

Family Medicine | General Surgery | Internal Medicine | Pediatrics ARC Seton Northwest 512.338.8181 | 11111 Research Blvd, Ste 475 Austin, TX 78759

Endocrinology | Infertility | Obstetrics/Gynecology ARC South 1st 512.443.1311 | 3828 South 1st St Austin, TX 78704

CEDAR PARK REGIONAL MEDICAL CENTER 512.528.7000 1401 Medical Parkway Cedar Park, TX 78613 CedarParkRegional.com

Extensivist Medicine | Family Medicine | Internal Medicine | Rheumatology ARC South 1st Specialty 512.443.1311 | 3816 South 1st St Austin, TX 78704

Obstetrics/Gynecology ARC Southwest 512.282.8967 | 1807 Slaughter Ln, Ste 490 Austin, TX 78748

CPRMC is a quality-driven hospital with sophisticated technology, clinical expertise, and compassionate physicians and staff. An array of services are offered, including a 24-hour emergency department, interventional cardiology, da Vinci Robotic-Assisted Surgery, Women’s Services with a Level II NICU, Imaging Services, Sleep Medicine, Nuclear Medicine, and General and Bariatric Surgery.

HEALTHCARE

HEALTHCARE SPECIALISTS

ST. DAVID’S HEALTHCARE

ARISE RIVERPLACE IMAGING + WOMEN’S CENTER

stdavids.com

512.314.3900 6611 Riverplace Blvd. Austin, Texas 78730 arisemedicalcenter.com St. David’s Medical Center 919 East 32nd Street Austin, Texas 78705 512.544.7111 St. David’s South Austin Medical Center 901 West Ben White Blvd. Austin, Texas 78704 512.447.2211 St. David’s North Austin Medical Center (including St. David’s Women’s Center of Texas) 12221 North Mopac Expressway Austin, Texas 78758 512.901.1000

Heart Hospital of Austin* 3801 North Lamar Blvd. Austin, TX 78756 512.407.7000

512.306.1833 9415 Burnet Rd. #104 Austin, TX 78758 intelligentsleep.com

R IV E R PLACE I MA G I N G + W OME N’S CE N TE R

Our aim is to know you, not just your patient number – and to ensure you feel cared about and cared for. We provide MRIs, ultrasounds, mammograms, and the lowest dose CTs in all of Central Texas. Let us work to make your care about you. Experience healthcare that’s distinctly different.

St. David’s Round Rock Medical Center 2400 Round Rock Avenue Round Rock, Texas 78681 512.341.1000 St. David’s Georgetown Hospital* 2000 Scenic Drive Georgetown, Texas 78626 512.943.3000

INTELLIGENT SLEEP

Dr. Bruce Wayne Meleski created Intelligent Sleep to empower clients to improve sleep by embracing natural rhythms and mindfulness. Scientifically based solutions for insomnia, sleep surface comfort, relaxation, and brain nutrition provide sleep and energy for life. Seminars, intelliGel™ mattresses, and programs available.

AUSTIN RADIOLOGICAL ASSOCIATION

IN-HOME CARE

512.453.6100 ausrad.com 15 Locations in Central Texas

VISITING ANGELS 512.250.2103 9811 Anderson Mill Rd #175 Austin, TX 78750 GotAngels.com

St. David’s Rehabilitation Hospital 919 East 32nd Street Austin, TX 78705 512.544.5100 *St. David’s Georgetown Hospital is a St. David’s Medical Center facility, and Heart Hospital of Austin is a campus of St. David’s Medical Center. With more than 90 sites across Central Texas, St. David’s HealthCare includes seven of the area’s leading hospitals and is one of the largest health systems in Texas. Known for compassionate, highquality care, the organization employs more than 7,900 associates and is supported by more than 2,000 medical staff members all working together to care for the people of Central Texas.

Austin Radiological Association (ARA) is a specialty healthcare organization dedicated to providing quality imaging services in Central Texas.

At Visiting Angels, we care every day in every way. With our services, individuals can continue to live independently in their own homes. Care is based on our client’s needs and wants; you are in control. Your Visiting Angels team is fully committed to ensuring you receive the best home care services possible!

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MOBILITY SERVICES ADVANCED MOBILITY SYSTEMS OF TEXAS

RENAISSANCE WOMEN’S GROUP

866.211.8267 (Option 3) 239 Commercial Drive Buda, Texas 78610 advancedmobility.net

512.339.6626 rwgdocs.com

Specializing in adaptive aids and wheelchair accessible vehicles, our awardwinning service team can help you regain your safety and independence. Our individualized solutions are designed to meet your unique needs. Come in and meet us and whether you need service, sales or rentals - let us help you “Keep Going”.

OB/GYN

Renaissance Women’s Group’s team of board certified Ob/Gyns passionately provide for each life stage, from wellness strategies, fertility and maternity care, to hormone replacement and bone density testing. We are innovators in minimally invasive gynecologic surgery. Our practice offers same day and early evening hours, and on-site mammography.

OPTIMAL HEALTH & BEAUTY

LISA M. JUKES, M.D.

ALITE LASER

512.301.6767 5656 Bee Cave Rd., Suite B101 Westlake Hills, TX 78746 lisamjukesmd.com

AliteLaser.com

ANN WEBB SKIN CLINIC 512.795.0145 11701 Jollyville Rd #103 Austin, TX 78759 awskinclinic.com

The Ann Webb Skin Clinic is a prestigious medical spa in Northwest Austin. AW Estheticians use Ann’s proven treatment protocols to help improve clients’ skin. Treatments offered include customized facials, photofacials, laser hair removal, cellulite reduction, body treatments, eyelash extensions, massage, acupuncture, and cosmetic injections.

BODY TONIC MEDICAL SPA 512.383.5204 6836 Bee Caves Road, Suite 310 Austin, TX 78746 mybodytonic.com

Austin Central 512.328.1555 504 West 17th St., Austin, TX 78701 Onion Creek 512.292.9410 11111 South Interstate 35 Frontage Rd, Suite 101, Austin, TX 78747 Round Rock 512.467.4656 3000 Joe DiMaggio Blvd. Building 600, Unit #19, Round Rock, TX 78665

Lisa M. Jukes, M.D., is a Board Certified OB/GYN who focuses on all gynecological services. Dr. Jukes is a highly-trained physician who listens well and offers competent, up-to-date treatment options for the health and wellness needs of her patients.

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“Austin’s Laser Hair Removal Specialists” for over 20 years, welcomes you to our ‘Alite Family’. We are delighted to serve the Austin community, and we pledge to do our best to fulfill all your hair removal & skin rejuvenation needs in the most relaxed, personal and effective way possible.

Body Tonic Medical Spa is a Westlake Hills premier provider of advanced cosmetic dermatology and medical aesthetics. Our locally owned business encompasses a state-of-the-art laser and anti-aging facility that is nestled in the heart of Austin’s Hill Country. Enjoy the beautiful views while you relax in an upscale, modern clinic under the supervision of our Board Certified Physician, Dr. Davis and our highly trained and certified clinicians.

OPTIMAL HEALTH & BEAUTY RUTHIE HARPER, MD 512.343.9355 3901 Medical Parkway, Ste. 100 Austin, TX 78756 ruthieharper.com

PAIN CARE ADVANCED PAIN CARE

KELLY E. TJELMELAND, M.D.

512.244.4APC (4272) austinpaindoctor.com South Austin 6000 South Mopac, Austin, TX 78749 Central Austin 6818 Far West Blvd. Suite 205 Austin TX 78731 Round Rock 2000 South Mays St., Suite 201 Round Rock, TX 78664 Cedar Park 1401 Medical Parkway, Suite 101B Cedar Park, TX 78613

Meridian Plastic Surgery Center & Skin Care Clinic

Ruthie Harper MD, is an Austin-based physician accomplished in nutritional medicine, non-surgical aesthetic transformation and genetically designed health and beauty. Her approach is unique in that it identifies and treats the underlying causes of disease and aging and has recently been recognized on Good Morning America, The Doctor’s, Prevention and Allure.

At Advanced Pain Care, your comfort and improvement is our primary concern. Our experienced doctors and staff will closely monitor your condition and work with you on a personal level. We treat most types of chronic pain including back pain, neck pain, headaches, post-surgery pain, degenerative disc and joint disease, spinal stenosis, neuralgia/neuropathy and complex regional pain.

ORTHOPEDIC

PLASTIC SURGERY

SETON ORTHOPEDIC AND SPORTS MEDICINE

RHOAD TO BEAUTY - PLASTIC SURGERY AND MED SPA

Dr. Christina Sheely 512.504.0866 1180 Seton Parkway Ste 220 Kyle, Tx 78640 Seton.net

512.476.9149 11671 Jollyville Road Ste 103 Austin, TX 78759 rhoadtobeauty.com

512.617.7500 4220 Bull Creek Road Austin, Texas 78731 MeridianSurgery.com

Board-certified surgeon Kelly E. Tjelmeland, M.D., provides unparalleled care and exceptional results on a full range of cosmetic surgery procedures, including breast enhancement, facial surgery, body contour surgery and liposuction. Less-invasive surgical techniques and advanced technology shorten recovery time, and the onsite surgery center offers complete privacy and comfort.

REPRODUCTIVE MEDICINE TEXAS FERTILITY CENTER 512.451.0149 6500 Mopac, Building 1, Suite 1200 Austin, TX 78731 txfertility.com

Texas FertilityCenter Dr Sheely treats patients of all ages for bone fractures, degenerative joint disease, joint pain as well as other orthopedic condition and /or sports related injuries.

Dr. Deirdre Rhoad is celebrating 20 years of service practicing plastic surgery in Austin, Texas. She believes in listening to her patients’ concerns, educating them on available options, explaining things so that the patient understands, and most importantly, delivering exceptional treatment and follow-up.

A combined 100 years’ experience and a passion for helping women become mothers has helped bring over 13,000 babies into the world. Expect compassionate care from our nationally recognized physician team: Thomas Vaughn, M.D.; Kaylen Silverberg, M.D.; Lisa Hansard, M.D.; Natalie Burger, M.D.; Summer James, M.D.; and Anthony Propst, M.D.

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TRANSFORMATIONAL LIVING HIGHER BRAIN LIVING®

VEINSOLUTIONS

info@higherbrainliving.com higherbrainliving.com higherbrainlivingevents.com

512.452.VEIN (8346) 866.452.VEIN (8346) 1010 W. 40th ST. Austin, TX 78756 VeinSolutionsAustin.com

VERICOSE VEINS AUSTIN VEIN INSTITUTE Christopher W. Brennig M.D Board Certified Vascular Surgeon 512.346.2727 7000 N Mopac, Ste 320 Austin, TX 78731 veinaustin.com

Matt Caskey vibodysuccess@gmail.com 254-702-2448

With the right nutrition as our foundation, the Body by Vi 90 Day Challenge is the solution to a truly healthy lifestyle change. We’re here to challenge you to make your health a priority.

Over a series of 22 Higher Brain Living® sessions, a licensed facilitator uses a carefully mapped gentle-touch technique on energy-dense areas, compressing them in the right sequence at the right time with the right pressure at the right vector. Tension stored in your body’s connective tissue releases and your true, lasting and sustainable awakening begins with a visible shift of energy into the Higher part of your brain. You’ll experience dramatic releases and a newfound clarity, joy and peace after each session.

ARE YOU UP FOR THE CHALLENGE?

The Vi Mission? To transform VeinSolutions Austin brings together a group of experienced and specialized board certified cardiothoracic and vascular surgeons dedicated to using the latest technologies in the diagnosis and treatment of varicose and spider veins.

millions of lives by educating, inspiring, motivating and sharing the success of healthy living with others.

DAY 1

WEIGHT LOSS BODY BY VI Matt Caskey vibodysuccess@gmail.com 254.702.2448 vibodysuccess1.bodybyvi.com

Austin Vein Institute State-of-the-art varicose vein treatment (512) 346-2727

V ein A ustin.com

The Austin Vein Institute provides an exceptionally high level of care, utilizing the latest technology to treat your varicose veins. With proven, safe procedures, performed in the security of our comfortable office, we can quickly make your varicose and spider veins a thing of the past.

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With the right nutrition as our foundation, the Body by Vi 90 Day Challenge is the solution to a truly healthy lifestyle change. We’re here to challenge you to make your health a priority. The Vi Mission? To transform millions of lives by educating, inspiring, motivating and sharing the success of healthy living with others.

DAY 90 Join the challenge today ➤

vibodysuccess1.bodybyvi.com