Monmouth County's Ask The Doctor - Back to School 2014 by Gunther Publications

Monmouth Countyâ&#x20AC;&#x2122;s

Back to School 2014

Ask The Doctor

THE Health & WeLlness Magazine for you and your Family

Cosmetic Surgery Is It Right for You?

PARENT POWER Build a Bridge to Success Promising New Medical Treatments Dealing with Dementia

Eat, Drink & Be Healthy! GUNTHER

Publishing Enterprises, Inc.

Advice & Recipes

A Bold Beautiful You Breast Augmentation Body Contouring Tummy Tuck Injectables SmartLipo Facelift

5 Professional Circle Suite 107, Colts Neck, NJ

732-410-4789

Dr. Rudy Thompson is Certified by the American Board of Plastic Surgery and the American Board of Surgery and is a member of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.

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Dr. David Bertone

QUESTION: Can I see a physical therapist without a physician’s prescription? Yes! NJ state law now allows direct access to physical therapy services without needing a prescription.*

re you living with pain on a daily basis or does it come and go? Do you have pain following surgery, sports or daily activities? Being treated by an expert physical therapist can often reduce your pain without medication or surgery, and enable you to experience a more active and pain-free lifestyle. At db Orthopedic Physical Therapy, Dr. David Bertone provides a unique, personal, “one therapist: one goal” approach with patients from the beginning of their treatment until they are ready to return to their day-to-day activities. Patients are offered a continuum of care that ensures the highest level of attention and detail by one continuous therapist. This approach offers a fast, safe and drug-free path to total recovery. As a Doctor of Physical Therapy and Board Certified Orthopedic Clinical Specialist, Dr. Bertone offers his patients over 25 years of experience in orthopedic rehabilitation. Because

of his extensive practice expertise, he was appointed by Governor Christie in 2012 to the NJ State Board of Physical Therapy Examiners.

“ We can help significantly reduce your pain and move you on to a more active and pain-free lifestyle.” Dr. Bertone and the db Orthopedic Physical Therapy staff offer one-on-one patient care in their conveniently located Lincroft office, as well as a state-of-the-art facility in Manalapan. There, clinical director Dr. Jerry Moczerniuk, PT, DPT also provides patients with the “one therapist: one goal” care philosophy throughout their course of treatments. n *Some insurance may still require a referral. advertisement

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David Bertone, pt, dpt, ocs

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Over 25 years of Experience in Orthopedic Rehabilitation Call About Comprehensive Baseline Concussion Testing The only way to determine when it is truly safe to return to physical activity is to test your brain function BEFORE you or your child has a concussion.

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ASK THE DOCTOR • THE MILLSTONE TIMES THE FAMILY TIMES: MONMOUTH / OCEAN / MIDDLESEX Publisher Cami Gunther

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ASK THE DOCTOR Back to School 2014

Dr. Girija Surya

Question: Why and when do we use compression stockings?

obody knows the exact reason why one develops varicose veins. Some of the reasons include: changes in the wall of the vein, its content, and their values in the veins. In addition, the position of the superficial vein and the volume of blood within the vein all contribute to the formation of varicose veins. The primary method of reversing varicose veins is to normalize the quantity of blood within the vein. Treatment of varicose veins currently performed include wearing compression stockings. Compression of the leg provides for upward movement of blood towards the heart instead of staying in the vein, and thus increasing the pressure in the vein. External compression of the untreated varicose veins will narrow their diameter and decrease the "leak" back in the leg. It also normalizes blood flow in the skin and improves oxygenation of the skin. Patients who wear compression stockings note relief of aching symptoms such as leg pain and throbbing. Pregnant woman have also reported decreased swelling and discomfort when wearing compression stockings. In addition, patients with lymphedema and post phlebitic syndrome who find relief as well when they wear 30-40mm or 40-50mm of hg compression. Dr. Girija Surya is an MD Board Certified in Cardiovascular and Thoracic Surgery. At Vein Center for Women, our philosophy is to promote "Total Health" for our patients. We evaluate patients with their total health in perspective, including the management of other related conditions such as weight gain, smoking cessation, nutrition information, with a specific focus on the management of venous diseases. To effectively treat Venous Diseases, we offer:

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• All procedures are done by a Board Certified Vascular Surgeon at our Vein Center • Procedures are performed either under local anesthesia or with IV sedation Vein Center patients should expect proven results with attention to detail combining outstanding patient care and compassion. If you are looking for relief from varicose veins, please contact us at the Vein Center for Woman with locations in Holmdel and East Brunswick. Appointments can be made by sending an email to contact@VeinCenterForWomen.com. n

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To make an appointment, call or email: contact@VeinCenterForWomen.com

www.MonmouthCountysAskTheDoctor.com

We Deliver Excellence A

t Womans Physician & Surgeons operative hysteroscopy, endometrial ablation, and tension free tape prowe take the time to listen…and cedures for urinary incontinence. treat you with compassion. We set high We are now accepting new patients. Please call for an appointstandards such as board certification and ment at any of our locations. Here you can find a doctor that will be provide the most advanced minimally committed to providing you with the highest quality of care. n invasive procedures, in office and out patient procedures. Our caring staff Here you can find a doctor provides the most that will take you from advanced treatments to our patients, and have been adolescence to pregnancy committed to providing the highest level of to menopause care for nearly 50 years. Women’s Physicians and Surgeons has Our board certified physicians, have been recognized as Top Docs in the Consumer Research been a leader in bringing minimally invasive Council of America and consistently obtain the highest scores for patient satisfaction. treatment options and surgical techniques to our area. We were one of the very first Karen S. Krieg, D.O. Michael L. Dimino, M.D. Robert A Portadin, M.D. groups in Monmouth County to perform Stefanie Spadafino, PA-C Michael S. Kirwin, M.D. Peter C. Mandel, M.D. laparoscopic hysterectomies, diagnostic and Safrir Neuwirth, M.D.

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Call Total Hearing Care at 732-412-1721 to Schedule a FREE Hearing Screening and Consultation Today! Holmdel - 100 Commons Way, Suite 270 Neptune - 444 Neptune Boulevard, Suite 1 Manalapan - 300 Craig Road, Suite 203 Monroe Township - 190 Prospect Plains Road Sea Girt - 700 Brooklyn Boulevard Shrewsbury - 595 Shrewsbury Avenue, Suite 101 Like us on Facebook /Total Hearing Care • Follow us on Twitter /Total_Hearing Enjoy Hearing Again! • www.njhearingaids.com

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Quality Healthcare & Wellness Center 3663 Route 9 North, Suite 103, Old Bridge, NJ

732.970.8700

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question:

Dr. Errol Rummel

My child has visual challenges. How can vision therapy help?

ome visual conditions cannot be treated adequately with eyeglasses or contact lenses and are best resolved through a program of vision therapy. Treatment includes non-invasive procedures designed to enhance the brain’s ability to control: • eye alignment • eye teaming • visual focusing abilities • eye tracking movements • visual processing • visual perception Visual-motor skills and endurance are developed through the use of specialized equipment and optical devices, including therapeutic lenses, prisms, and filters. During the final stages of therapy, the patient's newly acquired visual skills are reinforced and made automatic through repetition and by integration with motor and cognitive skills.

• amblyopia (lazy eye), diplopia (double vision) and strabismus (cross-eyed, wandering eye, eye turns, etc.) • visual stress-related problems: blurred vision, eye strain from reading and computers, If your child is headaches, and/or vision-induced stomach having trouble aches or motion sickness • neuro-visual problems: traumatic brain injury reading and eye(TBI), stroke, brain tumor, whiplash, develglasses don't help, opmental delays, visual-motor deficits and vision processing/perception disorders call now for an

appointment. Errol Rummel, OD, FAAO, FCOVD, FNORA C.O.V.D. Certified in Vision Development/Vision Therapy and N.O.R.A. Certified in Neuro-Optometric Rehabilitation. n

Who benefits from vision therapy?

Rummel Eye Care

Children and adults with visual challenges, such as: • reading/learning-related vision problems • poor binocular (2-eyed) coordination • convergence insufficiency (common eye muscle disorder)

2206 West County Line Road, Jackson, NJ 732-364-4111

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Dr. Sezer Olcay

QUESTION: Is back to school time a good time to think about braces?

here is no bad time to think about your dental health. Busy families do need to plan ahead to set priorities and make the time to get it all done. A great time to fit in all of your doctor and dentist appointments is toward the end of summer. Your window of opportunity is when camps are over and before the start of the school year. Your children have an open and flexible schedule before the school routine begins and the start of homework and extracurricular activities to plan around. If you feel your child would benefit from orthodontic care, late summer is the ideal time for an evaluation. It would give you time to have the necessary appliances produced and in place

with some extra time to allow the child to adjust and get used to them. Don’t forget to get a mouth guard fitted to protect their dental appliances and teeth during sports activities! n

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NJ Specialty #5167

732-847-3065 • www.holmdelortho.com 723 North Beers St., Suite 2A., Holmdel advertisement

Parent Power: Build the Bridge to Success By adopting the following principles, you will be able to help your child learn at each step of the way and ensure success in school and in life. Be responsible. Accept your role as the parent and make education a priority in your home.

work your child brings home from school and keep it in a folder. Help him or her correct any errors.

Be committed. Once you have begun to work with your child, continue doing so throughout the year.

Be results-oriented. Gather information on how your child is performing in school. Keep notes of conferences with teachers, request progress reports and carefully read report cards and achievement test results. Ask questions about these results.

Be positive. Praise goes a long way with children, especially with those who struggle in school. Provide positive feedback. Be patient. Show your child that you care through your commitment and encouragement. Be attentive. Stop your child immediately when bad behavior appears. Show him or her what to do and provide an opportunity to do it correctly. Discipline should be appropriate and consistent. Be precise. Provide clear and direct instructions. Be mindful of mistakes. Record your child’s performance. Look over all the

ASK THE DOCTOR Back to School 2014

Be diligent. Work from the beginning to the end of the year with your child and the teacher. Be innovative. Keep learning lively and dynamic. BE THERE. Just be there for your child–to answer questions, to listen, to give advice, to encourage and to speak positively about his or her life. Be there to support your child whenever needed. For more information and the complete Parent Power Guide by age visit: www.ed.gov/parents/academic/help/ parentpower/booklet.pdf. n

Dr. John M. Young, Jr.

QUESTION: How can a dentist help with my snoring?

noring may be common but it is not normal. Snoring can be a red flag for sleep apnea. It is one of the symptoms along with shortness of breath that arouses you from sleep, sporadic pauses in your breathing during sleep, and disproportionate daytime drowsiness. If you have any of these signs, you need to determine why. Left untreated, sleep apnea can increase the risk of high blood pressure, heart attack, stroke, obesity, diabetes, heart failure, and arrhythmias; as well as increase work-related or driving accidents. I have been practicing orthodontics for adults and youth for 20 years in Monmouth County, currently in Colts Neck at the Colts Neck Center for Orthodontics and Invisalign. My involvement with sleep apnea is a personal one. My incessant snoring was an issue with my wife, so I had a sleep study done and found out that I had severe sleep apnea. I tried the standard CPAP (Continuous Positive Airway Pressure) mask, only to find it annoying and difficult to sleep with. I tried numerous devices and dental appliances, but they were all uncomfortable and ineffective. While working with doctors from Stanford University Medical Center, I was introduced

to, and now personally wear the first dental appliance for snoring, Obstructive Sleep Apnea (OSA), and Upper Airway Resistance Syndrome (UARS). It is a perfect alternative for those who cannot tolerate their CPAP therapy. This appliance is FDA approved as a medical device in two separate classifications; (1) as a mandibular repositioner for treatment of snoring and sleep apnea, and (2) as a nasal dilator for improved ease of breathing. Medical insurance will pay for this device. I have brought my many years of dental expertise, personal experience, and research into the Chase Dental Sleep Care of Central New Jersey to assist others in determining the cause of their snoring and the best treatment for it. It has impacted my own life in such a positive way; I hope to share the experience with you. Give us a call and let us help you with your sleep and snoring issues as well as all of your family’s orthodontic needs. My friendly staff and relaxing atmosphere is the perfect place to end your quest for good health and a good night’s sleep. n

stroke, obesity, diabetes, heart failure, and arrhythmias

Sleep apnea can increase the risk of high blood pressure, heart attack,

Colts Neck Center for Orthodontics and Invisalign

Chase Dental Sleep Care of Central New Jersey

273 Route 34, Suite 705 • 732-761-8300 www.snoringsolutionnj.com • www.chasedentalsleepcare.com advertisement

www.MonmouthCountysAskTheDoctor.com

By Russell Carstens

Staying Sane in September

he back to school season is hectic enough for kids, let alone parents. Keep your mental health in check during the transition with the following suggestions:

Establish good homework habits. As the Tao Te Ching advises, handle things while they are small. Upon getting home, homework is not yet a pressing issue. Keep it that way. After dinner and close to bedtime, it will become one. Speak to your children about the benefits of completing homework first thing. They have the rest of the day ahead of them, and they are still in work mode. Take advantage of that momentum. Consider summer learning programs. Students can forget what they've learned during the year over summer break. Enrolling in a program for maintenance or enrichment will keep their skills sharp and attitude motivated. This makes for a more smooth changeover back to school. Thus, less dependency on you to assist with homework and projects.

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ASK THE DOCTOR Back to School 2014

Carpool. If possible, do so in rotation with other parents. Save time and gas. This can free up time for yourself or other morning/afternoon priorities. Plus, you're being kinder to the planet by reducing your carbon footprint. Purchase supplies in advance to avoid the first week rush. After the first few days of school, office supply stores are a frenzy. Items your children need may be out of stock. As a result, they are already starting the year off behind. Again, stock up ahead of time to avoid issues. You can save money by purchasing notebooks, etc at non-office supply stores. Eat healthy. Eating at least one well-balanced meal a day with water will complement your overall well-being. Oatmeal is a simple breakfast that can be made by kids in a snap without your help. Plus, the fiber content fills them up. Avoid the lure of sugary soft drinks, as they carry virtually no nutritional value. Monitor your caffeine intake and stay hydrated. One or two cups of joe will give you the jolt needed to put a spring in your morning step. But avoid excess caffeine, which can lead to anxiousness, dehydration and other negative side effects. Instead, drink water throughout the day. If you aren't a regular water drinker, you'd be surprised at how much more energy you have by switching over from coffee or soda. The more hydrated you are, the less hard your organs have to work. You then have more energy to expend. Get plenty of rest. This is one of the most important parts of maintaining your mental health. It's also one of the most overlooked. Being under-rested makes you more prone to moodiness and less effective. Some people need more sleep than others. Generally, aim to get at least seven hours of sleep a night. If you can get more, great, but don't overdo it. You may be familiar with the lingering drowsiness that sticks throughout the day after ten-plus hours in the bed. A body at rest stays at rest and a body in motion stays in motion. Balance it out. n

Robert Frankel, MD

Question: How do you maintain your health and weight with hormonal balance and nutrition?

mprove Health Solutions is a medical practice specializing in hormone replacement, weight loss, and metabolic natural medicine. When you've had enough of living the same way and achieving no results, come to our practice, where we view you as an individual, customizing treatment for you based on your hormone balance and other factors.

Here's the Best Approach to Medical Weight Loss— The HCG Diet Unlike all other diet programs, HCG addresses the metabolic and hormonal reasons that cause you to gain weight. HCG literally resets your hypothalamus thus allowing your body to maintain your new weight. The HCG diet works with your body and not against your body. HCG (human chorionic gonadotropin) is a hormone that is produced during

pregnancy. The physician-guided, low calorie diet with the hormone targets belly fat instead of muscle. In time, the reduced fat assists in raising your metabolism. Although HCG is a hormone produced by pregnant women, the diet is safe for men and women, according to doctors. Our programs are done under medical supervision and the injections are 100% HCG that are mixed in our office so we know Joanne Feliciano, PA it is pure. Since you raise your metabolism, most on HCG keep the weight off after diet and keep losing. The drops on the Internet often are not effective and some do not even contain the hormone. Our programs are either a 23 day program for $399 or 40 day for $499.

Heres what some of our patients have to say about our medical weight loss program:

I've tried every diet out there. I'm a 47 year old woman and nothing worked for me until I tried the HCG diet. I've lost 20 lbs in 40 days and feel fabulous. —Renee After a few months on the HCG Diet, I tried on an old pair of slacks that I thought were too small. To my shock they fit and were a bit loose! I had lost 5 inches on my waist! —Donna

I've lost 41 pounds in 40 days using the HCG diet! This is not just a diet, it's a lifestyle change that is easy to live with. What I love most about this diet is that it's teaching me so much about food and my body. But best of all is that it gets rid of the UGLY FAT—the stuff that doesn't seem to go away no matter what diet your on or how much exercising you do. All you have

to do is what the diet requires. It's so easy because you're not HUNGRY! —Linda B.

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www.MonmouthCountysAskTheDoctor.com

By Susan Heckler

Tips for Preventing Sports Injury

t seems every time you turn on the news, there is another freakish accident involving youth playing sports. In many cases, these accidents go beyond sprains and broken bones; some of the injuries are life threatening. There are some contact sports that you would expect injuries as a result. Football, hockey, lacrosse and other team sports always had a higher likelihood as you are in close contact with other team members and opponents in heated battle. According to the Youth Sports Safety Alliance, high school athletes suffer 2 million injuries, 200,000 doctor visits and 30,000 hospitalizations every year. If you factor in younger athletes and those beyond high school years, the numbers are staggering. The first course of action is to be sure the athlete is fit to do the sport they choose. Schools demand a physical and medical clearance to participate for a reason. The parents should take this seriously and embrace it as a tool to keep their children sound. Another obvious but often ignored weapon in the war against injuries is to be sure your family has the proper safety equipment to use and that it is in good condition and fitted properly. It is important to educate parents, athletes, coaches, teachers and others about the signs and symptoms of sports injuries and conditions. Supervision is essential, but so are trained supervisors who know how to handle injuries and critical situations. Players need to understand the difference between pain and injury and that playing through the pain may have drastic consequences. Helmets and padding may not be a fashion statement and insisting on parental supervision at the pool may be inconvenient to you and annoying to your child, but it may mean a happier and healthier life for your child. n

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ASK THE DOCTOR Back to School 2014

Knee Pain Dr. Scot Paris

QUESTION: I have knee pain from arthritis. Is surgery my only option?

steoarthritis of the knee is the #1 leading cause of disability in the U.S. Over 27 million people suffer with knee arthritis and that number continues to grow. With knee arthritis, the cartilage breaks down and wears away, leaving the bones to rub together causing pain swelling stiffness and limited range of motion. As the cartilage breaks down, the knee loses its lubricating fluid. We found that by replacing this lubricating fluid with a natural substance called Hyalgan, the lubrication is restored and many patients experience amazing pain relief. What is Hyalgan and how does it work?

Hyalgan is a natural lubricating fluid that acts as a lubricant and shock absorber inside the knee joint. The substance in Hyalgan is hyularonic acid which is normally found in high levels in healthy joints. Replacing the hyularonic acid with Hyalgan lubricates the joint and reduces pain. Hyalgan has been administered over 40 million times and has been proven to provide long-lasting relief of knee pain from osteoarthritis.

What if you already tried knee injections? If you have had injections like this in the past and experienced poor results, there is still hope! Many doctors in this area offer similar injections, but very few use precision fluoroscopy guidance. Fluoroscopy guidance ensures that the pain relieving Hyalgan reaches the knee capsule where it bonds with the joint fluid to create a lubricating and cushioning layer. Without fluoroscopy, it is estimated that doctors “miss” the capsule over 30% of the time resulting in poor results. We want each and every one of our patients to have the greatest chance of success, so every injection is done with precision fluoroscopy guidance to ensure that the Hyalgan gets into the capsule 100% of the time. Because of this, patients who previously felt little to no relief with non-flouroscopy guided injection are now getting excellent results. The other “big difference” in our results is the multitude of other supportive care options that we have available to enhance the effectiveness of the Hyalgan procedure. These options include state of the art medical laser treatment, physical therapy, manipulation, corrective osteoarthritis bracing (takes pressure off the damaged section of the knee), and natural anti-inflammatory products. The combination of these treatments offers you what we feel is the most comprehensive non-surgical knee treatment program available.

Does it hurt? Many of our patients report that they feel little to no pain at all! We do everything possible to minimize any pain from the procedure, from pain relieving spray and a local anesthetic, to precision guidance that ensures we are always in the right spot.

Who will be performing the Hyalgan procedure? Dr. Scot Paris is the medical physician who performs the Hyalgan injection. Dr. Paris is trained as a general surgeon and has extensive experience with a variety of surgical procedures. With his conservative approach, he has excelled in the non-surgical treatment of knee pain with the use of fluoroscopy guided Hyalgan injections.

So how do I know if your knee pain treatment program will help me? If you are tired of suffering with painful arthritis of the knee, and you want to see if the latest advances in non-surgical treatment can help, all you have to do is call 732-683-1800 to set up a risk free consultation. During the consultation all of your questions will be answered in a warm and friendly environment. Knee replacement surgery is a very extreme measure to take without considering all of your other options first. Once it’s done there is no turning back. For that reason we encourage you to schedule an appointment to see if you are a candidate for Hyalgan treatment. We are proud to offer our patients a comprehensive knee pain treatment program that includes the best non-surgical methods to relieve pain all under one roof. We look forward to having the opportunity to help you feel better. Take the first step in ending your knee pain and call to schedule an appointment today! n

Will my insurance cover Hyalgan? This procedure is covered by most major insurance companies including Medicare. Our insurance department pre-verifies every patient.

Dr. Scot Paris using precision fluoroscopy guidance to ensure the best results possible.

Central Jersey Spine & Wellness 4251 Route 9 North, Bldg. 3, Suite B (Freehold Office Plaza) • 732-683-1800 advertisement

www.MonmouthCountysAskTheDoctor.com

By Susan Heckler

Promising New Treatments in Medicine

he field of medicine is constantly changing. Some say it is called the Practice of Medicine because they are always practicing in an effort to perfect it. The fortune of money poured into research seems to be paying off with some great medical dividends.

Retinitis Pigmentosa (RP) can result in blindness by the age of 40. It is a group of inherited eye diseases that affects more than 100,000 Americans. Over two decades and $200 million in funding have resulted in a potential

new treatment for RP. It’s a new FDA-approved technology that consists of a surgically-implanted 60-electrode retinal prosthesis, which decodes wireless transmissions from a pair of glasses equipped with a video camera nicknamed “bionic eyes." Genomic-based tests can help avoid unnecessary (and unpleasant) treatments like chemotherapy and radiation for cancerous tumors when they may not be warranted. Several genomic-based tests are now available that can analyze the genes in a patient’s tumor and predict the aggressiveness of the cancer, making treatment decisions easier. Approximately 30 percent of Americans with epilepsy are unable to control their seizures with medication or other treatments. Previously, surgery for epilepsy was possible but it carried risks and was often ineffective. A new treatment option supported by the FDA is a surgically-implanted neurological device that can reduce the occurrence of epileptic seizures. There has also been ground-breaking progress on treatment of blood cancers, a biomarker for heart disease, computer assisted anesthesia, and hepatitis C treatment. n

By Susan Heckler

Advance Planning May Save You Bucks

e all do it, we avoid unpleasant tasks and subjects until it is staring us in the face and we can no longer avoid it. In many cases, there are interim steps we can take which may make the task more palatable in the future. Case in point, no one wants to deal with their personal finances and think of tax preparation until April 15th is looming in front of them. BIG MISTAKE! If we take the time to do a mid-year review, it could change the outcome on our tax return, help with our cash flow and assist your retirement savings plan. The year is half over, now is the perfect time. Here are some steps toward your financial goals: • Run a projection of your income taxes to be sure you are not paying too much or too little income tax. You may want to adjust your withholding. • Double check your actual year-to-date income and expenses to be sure it measures up against your cash flow projections. • Review and rebalance your investment portfolio to determine if it best matches your goals. • Ensure you’re taking maximum advantage of your employment benefits. If your employer offers a workplace-sponsored savings plan like a 401(k), contribute at least enough to receive the maximum

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employer match. And if you’ll be at least 50 year old this year, you may want to make additional catch-up contributions. • I ncrease your savings if you can. It never hurts to bulk up your nest egg, and the more you save now, the less you may have to set aside each year in the future. •A s your kids get ready to go back to school, check if you’re on track with saving for their college education. To help, consider establishing and contributing to a Coverdell Education Savings Account or a 529 College Savings plan. • S tart thinking about your budget for the holidays. The holidays are also a good time to make tax-deductible gifts to charity so review your charitable giving program, and before you know it, it will be time to carve the turkey. The local offices of Charles Schwab hold workshops to help their clients and neighbors deal with financial decisions. There are advantages to having a financial consultant at arm’s length, while working with a long established, reputable national firm. You can visit one of the local Charles Schwab offices or call them for information about their services and seminars: 3425 Route 9, Suite #101, Freehold, NJ, (732) 298-6380 schwab.com/freehold or 70 White St, Red Bank, (732) 345-2739, schwab.com/redbank. n Note: Susan Heckler is not affiliated with or employed by Charles Schwab & Co, Inc. or any of its affiliates. The views expressed are hers alone and should not be considered personalized investment advice or recommendations. This is not intended to be a substitute for professional legal or tax advice. Charles Schwab & Co, Inc., Member SIPC

Dr. Holli Alster

QUESTION: How can my child avoid getting unsightly and painful warts on his or her feet?

arts are the most common viral infection of the skin. Plantar Warts specifically affect the feet as they grow on the plantar surface (the sole of the foot). Plantar Warts are most common among childrenÂ and produce symptoms in areas of pressure and friction. Summer is a rampant wart season, with barefoot children running around wet surfaces. Some possible ways to prevent exposure would be to avoid walking barefoot, using shower thongs or sandals in public shower rooms, changing shoes and socks daily and no sharing, keeping your feet clean and dry, and avoiding direct contact with warts from other people or from other parts of the body. Many of these are also ways to prevent Athlete's Foot. To avoid spreading the warts, don't scratch them. Warts easily spread to small cuts and scratches. Cover all warts with waterproof tape in wet environments to avoid infecting yourself or others. Tell-tale signs to look for on areas of pressure of the foot would be localized pain, warty lesions or smooth surfaces with a gray-yellow or brown color. There are some over-the-counter remedies, which you may opt to try. If they fail to resolve within a short period of time, it is time to seek medical attention. You donâ&#x20AC;&#x2122;t want to risk complications by delaying

treatment. A doctor can usually diagnose a Plantar Wart by observing it, although a tissue sample could be analyzed. Family Foot & Ankle Center of Central Jersey provides comprehensive care for infants, children, teenagers, adults, and seniors. For more information on Plantar Warts and other foot or ankle problems, feel free to contact me:

Dr. Holli Alster Family Foot & Ankle Center of Central Jersey 600 Bridge Plaza Drive, Manalapan 732-851-1617 Email: info@cjfamilyfoot.com

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Top Neurosurgeons Speak Out Against Laser Spine Surgery

he term “laser spine surgery” has become very popular on the Internet and in magazine ads. But while the laser has created substantial medical improvements in the field of medicine, this is not in the case for spine surgery. Atlantic NeuroSurgical Specialists (ANS) advises all patients to use caution when it comes to “advanced” laser spine surgery procedures.

Don’t be fooled by temporary solutions. They won’t fix your spine. With the number of Americans suffering from back pain on the rise, it’s no surprise there are so many specialists offering relief. For this reason, it is important that patients know what to look for when choosing their specialist. Don’t put yourself at risk. Only trust a neurosurgeon to diagnose and treat your delicate nervous system. At Atlantic Neurosurgical Specialists (ANS), all of our neurosurgeons are board-certified. Most notably, 5 of ANS’s neurosurgeons are fellowship-trained in spine and hold national recognition in their specialty. In turn, ANS remains the largest and most reputable neurosurgical practice in New Jersey. Don’t let insurance come before your health. Ask to speak

The only real difference between laser spine surgery and minimally invasive spine surgery (MISS) is how the damaged disc tissue is removed. As counterintuitive as it sounds, laser spine surgery is actually less precise than scalpel-based procedures. A laser is a straight beam of light that cannot bend or remove tissue from around a corner. The importance of a surgeon’s ability to delicately navigate angles cannot be underestimated. Additionally, the heat created by a laser can damage healthy nerves. A razor-sharp scalpel in the hands of a skilled surgeon maintains the same precision without the risk of inadvertent thermal injury. And lastly there is the issue of depth of penetration. Think of holding a knife up to a balloon and pressing softly. You can feel the give and take of the pressure you are applying against the balloon and thereby have a good idea of when that balloon will pop. Using a scalpel, surgeons can use this same tactile feedback to access the tissue and thereby achieve the exact depth of penetration. On the contrary, a laser will cut further down, depending on how long the beam sits at one part of the incision. Therefore, structures including nerves and healthy tissue can be inadvertently injured. Atlantic NeuroSurgical Specialists is the largest private neurosurgical practice in NJ. ANS neurosurgeons are affiliated with leading hospitals and health care systems and perform the most minimally invasive spine surgery cases throughout the state. Visit ansdocs.com or call 732-4558225 for more information. n

with our insurance counselor. For more information, visit www.ansdocs.com or call 732.455.8225.

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Dr. Steven Linker

QUESTION: After I choose frames for my prescription glasses, there are so many choices of lenses. Can you explain the pros and cons of each?

ou have already done the hard part, finding a frame that is flattering, comfortable and in your budget. Now for the part that should be easier, but it is essential you understand your options. Technology has advanced your choice of lenses tremendously in the recent past. Some of the choices are yours but others are dictated by your prescription and lifestyle. Your first decision will be what material the lenses will be made from. • The most common material for lenses is CR-39 also known as plastic lenses. Plastic lenses became popular during the 1970s because of the fashion trend for large-sized frames. Plastic lenses, also known as hard resin, are half the weight of glass lenses. This makes them more comfortable while providing excellent optics and vision correction. Softer than glass, you may opt for scratch resistant coatings. • Polycarbonate was developed in the 1970s for aerospace applications. These lenses are thinner and lighter than regular CR-39 plastic lenses while offering 100% protection from the sun's harmful UV light. They are up to 10 times more impact-resistant than plastic or glass lenses. Polycarbonate lenses have become customary for safety glasses, sports goggles and children's eyewear because they are less likely to fracture than regular plastic lenses. • Even thinner and lighter are the high-index lens materials. Thin eyeglasses are viewed as more attractive and are more comfortable than thick ones. This impact resistant design has become a popular choice of patients who want the lightest, thinnest UV protected lenses possible.

Your next decision will be what types of lenses you need. Does your vision and lifestyle require single vision, progressive or bi-focal? • Single vision is the simplest as it corrects one type of vision only, distance or close up. If you have only one vision issue, these are great. If you need corrective lenses for vision and reading, you will need different lenses or two different sets of glasses. • Bifocals are eyeglasses that treat two forms of vision issues—close up and distance. Traditionally, a line across the lens separates different segments. You will need to direct your eyes up or down depending on what your needs are for that moment. • Progressive lenses provide all the benefits of a bifocal without a separating line. You get a full range of vision correction without taking glasses on and off, just changing the direction you are looking. Your next choice is coating the lenses. • Transitions lenses are designed to be worn indoors and will automatically adapt to a darker lenses when outdoors. Transitions lenses block 100% of harmful UV rays and give you the advantage of clear lenses indoors and at night, plus distinct benefits of sunglasses when outdoors—all in the convenience of one lens. • An anti-reflective lens treatment (AR) is applied to both the front and back lens surface area. It eliminates reflections commonly seen with optical lenses by reducing glare during the day caused by natural and artificial light as well as headlight glare at night. • Polarization of the lenses allows cutting down on glare from many angles which means no more squinting. They are made with a special film that is applied to the lens during manufacture. This coating is ideal for the outdoorsy person who may be bothered by reflections off of water or snow. I invite you to visit my office for an exam to discuss eye care health for you and your family. We take most medical insurances and have a wonderful selection of frames should you need glasses. Explaining the product is very different from touching and seeing it. We will be able to show you the actual lenses to choose from so you can ‘see for yourself.’ Check out our website for more information: www.monmouthvision.com. n

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FDA Approves Botox to Treat Overactive Bladder

he U.S. Food and Drug Administration expanded the approved use of Botox (onabotulinumtoxinA) to treat adults with overactive bladder who cannot use or do not adequately respond to a class of medications known as anticholinergics. Overactive bladder is a condition in which the bladder squeezes too often or squeezes without warning. Symptoms include leaking urine (urinary incontinence), feeling the sudden and urgent need to urinate, and frequent urination. When Botox is injected into the bladder muscle, it causes the bladder to relax, increasing the bladder’s storage capacity and reducing ep-

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isodes of urinary incontinence. Injecting the bladder with Botox is performed using cystoscopy, a procedure that allows a doctor to visualize the interior of the bladder while Botox is being injected. “Clinical studies have demonstrated Botox’s ability to significantly reduce the frequency of urinary incontinence,” said Hylton V. Joffe, M.D., director of the Division of Reproductive and Urologic Products in FDA’s Center for Drug Evaluation and Research. “Today’s approval provides an important additional treatment option for patients with overactive bladder, a condition that affects an estimated 33 million men and women in the United States.” Botox’s safety and effectiveness for this new indication were established in two clinical trials of 1,105 patients with symptoms of overactive bladder. Patients were randomly assigned to receive injections of 100 units of Botox (20 injections of 5 units each) or placebo. Results after 12 weeks showed that patients treated with Botox experienced urinary incontinence an average of 1.6 to 1.9 times less per day than patients treated with placebo. Botox-treated patients also needed to urinate on average 1.0 to 1.7 times less per day and expelled an average of about 30 milliliters more urine than those treated with placebo. Treatment with Botox can be repeated when the benefits from the previous treatment have decreased, but there should be at least 12 weeks between treatments. Common side effects reported during clinical trials included urinary tract infections, painful urination, and incomplete emptying of the bladder (urinary retention). Patients who develop urinary retention may need to use a catheter until the urinary retention resolves. Patients being treated for overactive bladder with Botox should not have a urinary tract infection and should take antibiotics before, during, and for a few days after Botox treatment to lower the chance of developing an infection from the procedure. n

QUESTION: Why Is Thermography Considered the Best Breast Test?

tudies show that a thermogram identifies precancerous or cancerous cells earlier than mammograms, and produces unambiguous results, which cuts down on additional testing—and it doesn't hurt the body. Thermography's accuracy and reliability is remarkable too according to the American Journal of Surgery and the American Society of Breast Surgeons, Cornell. Thermography can be used as a whole body approach to wellness with the understanding that there is no "normal" asymmetrical heat in the body. Thermal cameras can detect heat on the skin surface that may show underlying pathologies. Heat is an indication that inflammation exists, and typically inflammation is present in precancerous and cancerous cells, too. (It's also present in torn muscles and ligaments as well as arthritic joints, which thermography can also detect.) Breast Thermography is a radiation-free state-of-the-art screening procedure that captures heat images of the breast to aid in the early detection of breast cancer. As a tumor grows it develops a blood supply that emits heat that is detected on a modern infrared device. Thermography can establish overall breast health and is an excellent test for assessing fibrocystic breasts and response to treatment. Thermography also can detect many other ailments such as Systematic Dental Disease.

Some dentists have long claimed a relationship between oral bacteria and breast cancer. With Thermography imaging, we can see how the bacteria spreads through the lymphatic (immune) system.

Overall Research The Index Medicus, a comprehensive index of medical scientific journal articles, references more than 800 per-reviewed breast thermography studies, in which over 250,000 women participated. Many of these studies involved very large groups of patients (from 37,000 to over 100,000) and some have followed patients for as much as 12 years. Among other conclusions, these studies found that when thermography has been added to a woman's regular breast health checkups, a 61% increased survival rate was realized, and when used as part of a multi-model approach (clinical examination, mammography and thermography) 95% of early stage cancers will be detected. It is well known that early detection is the best defense against breast cancer and that, if treated in the earliest stages, a 95% cure rate is achieved. The "cure" is early detection. n Don't put it off! CALL NOW to schedule your screening at: Advanced Thermal Imaging Freehold Executive Center • 4400 Route 9 South, Freehold 877-315-7266 (Ext. 448) • 24/7 Emergency: 732-902-1876 www.BTIscan.com advertisement

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What's Your Sun Safety IQ? Sun safety is not just for vacation. Are you sun-safe every day? Take the American Cancer Society's quiz and find out. 1. I can’t get skin cancer, because my normal routine (such as work, drive to work, hobbies, and vacations) doesn’t include any outdoor activities. true false 2. My husband should use sunscreen at football games, even though he only goes (and gets a burn!) once or twice a year. true false 3. If I’m wearing sunscreen, I can stay in the sun as long as I want. true false 4. A sunscreen labeled SPF 30 blocks twice as much UV radiation as one labeled SPF 15. true false 5. It’s safe to let my children stay in the pool all day if they put on a t-shirt after a couple hours and reapply sunscreen to their faces, arms, and legs. true false 6. How often do you need to reapply water-resistant sunscreen? every 2 hours or sooner after sweating or swimming after you towel dry all of the above 7. G etting a “base tan” at an indoor tanning salon is as good way to prevent sunburn when I go to the beach later this summer. true false 8. What are the two most common (and painful!) sunscreen mistakes? choosing an SPF below 15 and missing spots using too little and waiting too long to reapply 9. N ow put it all together. You applied sunscreen at 12 noon for an afternoon of reading beside the pool. At 2 p.m., which one of the following actions would best protect your skin? slip on a long cotton sundress move to the shade reapply sunscreen It is important to visit your local and trusted dermatologist 2x (every 6 months) a year to get a complete body scan to keep healthy and maintain preventative skin care. Children are recommended to see their dermatologist too. Visit the American Cancer Society's Sun Safety Pages for more info at www.cancer.org. Answers on page 38

Doctor S p otli g ht By Susan Heckler

Beware of Cosmetic Surgery Bargains Overseas

he news reported yet another story about someone leaving the United States in search of plastic surgery in a foreign country to save some money. They have coined the term “medical tourism” since it has become so popular. Since elective cosmetic surgery procedures are not covered by insurance, expense is the major selling point of cosmetic surgery tourism business. There was the case of the Long Island woman who died from complications after getting liposuction and a tummy tuck in the Dominican Republic, leaving behind her three young children and their dad. If you search the web, there are many other stories like this. Any surgery poses a degree of risk, it’s a given. When choosing your surgeon in the United States, you can research their training and experience and find out if he or she is Board Certified by The American Board of Plastic Surgery. Will you get proper administration of anesthesia, sterile technique, modern instrumentation and equipment, as well as, properly trained surgeons? Have the cosmetic surgery products or devices used in other countries been tested, proven safe and effective, or been approved by the U.S. Food and Drug Administration (FDA)? Do due diligence before undergoing any surgery. For example, compare the foreign doctor to the qualifications of our local plastic surgeon, Dr. Rudolf Thompson in Colts Neck. • Dr. Thompson is a Board-Certified Plastic Surgeon • Member of both prestigious societies within the field of Plastic Surgery, The American Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery. • He is trained in latest advances in both reconstructive and cosmetic surgery and cutting edge techniques of minimally invasive procedures including SmartLipo, Laser Procedures and injectables such as BOTOX, Juvéderm, Restylane, Perlane, Radiesse and Sculptra. • Dr. Thompson received his medical degree from Tulane University School of Medicine in New Orleans. He completed his General Surgery Residency at St. Barnabas Medical Center in Livingston, New Jersey and his Plastic Surgery Residency at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School in Newark, New Jersey. • Dr. Thompson has published articles in all three of the major plastic surgery journals. • He has been featured on The Learning Channel's Trauma: Life in the ER series for a limb–saving reconstructive surgery he performed at Jersey Shore Medical Center. You decide—are the potential savings worth being disfigured or deceased? n

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arents and caregivers should set rules that reduce “screen time” by limiting the amount of time children spend on the computer, watching TV and playing video games. The time spent in front of the screen could be better spent being more physically active. Explain to children that it’s important to sit less and move more in order to stay healthy. Health experts suggest no more than two hours of computer or television time per day unless it’s related to work or homework. Children younger than two should be kept away from the TV entirely. Don’t use TV time as reward or punishment; practices like this make TV seem even more important to children. Set Screen Time Limits and a Good Example Create a house rule that limits screen time to one to two hours every day. More importantly, enforce the rule. You need to be a good role model and limit your screen time to no more than two hours per day, too. If your kids see you following your own rules, they’re more likely to do the same. Log Screen Time vs. Active Time To get a sense of what changes may need to be made in your household, track your family’s screen time and active time. First, log how much time your family spends in front of a screen, including things like watching TV and movies, playing video games and using the computer (outside of school or work). Then, look at how much time the family spends doing physical activities, such as walking, doing active chores or playing sports together. If you see that your family logs more hours in front of the screen than being active, sit down together and set goals to increase your physical activity. Be Active During Screen Time When you spend time in front of the screen, do something active. Stretch, practice yoga poses, walk on a treadmill, or lift weights. Challenge the family to see who can do the most push-ups or jumping jacks during commercial breaks. Understand TV Ads Seeing snack foods, candy, soda and fast food on television affects all of us-especially children. Help children understand that just because it’s on TV—or their favorite TV characters eat or drink it—doesn’t mean it’s good for you. Create Screen-free Bedrooms Don’t put a TV or computer in your child’s bedroom. Kids who have TVs in their rooms tend to watch about 1.5 hours more of TV per day than those who don’t. In addition, having a TV in their bedroom can keep kids from spending time with the rest of the family.

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Provide Alternatives Watching TV can become a habit, making it easy to forget what else is out there. Give children ideas and alternatives, like playing outside, picking up a new hobby or learning a sport. Focus on Family Time During Meals Family meals are a great time to talk to each other. So, turn off the TV during meals. Better yet, if you have a TV in your eating area, remove it. Research shows that families who eat together tend to eat more nutritious meals. Make eating together a priority and try to have family meals at least two to three times a week. Begin with breakfast–it’s a great way to start the day. n

What Is Early Menopause? W

hen menopause happens before age 40, it is considered early. Early menopause can be caused by certain medical treatments, or it can just happen on its own.

Medical treatments that may cause early menopause include:

But, because their uterus is removed, they no longer have their periods and cannot get pregnant. They might have hot flashes because the surgery can sometimes affect the blood supply to the ovaries. Later on, they might have natural menopause a year or two earlier than expected.

• Chemotherapy or pelvic radiation treatments for cancer. These treatments can damage the ovaries and cause your periods to stop. Effects like having trouble getting pregnant can happen right away or several months later. The chances of going into menopause depend on the type and amount of Sometimes menopause happens early on its own. Some chemotherapy that was used. Also, the younger a woman is, the possible causes include: lower the chances that she will experience menopause. • Chromosome defects. Problems in the chromosomes can cause • Surgery to remove the ovaries. Surgical removal of both ovaries, premature menopause. For example, women with Turner's synalso called a bilateral oophorectomy (OH-uh-fuh-REK-tuh-mee), drome are born without all or part of one X chromosome. The causes menopause right away. A woman’s periods will stop after ovaries don't form normally, and early menopause results. this surgery, and her hormones drop quickly. She may immediately • Genetics. Women with a family history of early menopause are have strong menopausal symptoms, like hot flashes and diminished more likely to have early menopause themselves. sexual desire. • Autoimmune diseases. The body's immune system, which nor• Surgery to remove the uterus. Some women who have a hysmally fights off diseases, may mistakenly attack the ovaries and terectomy (his-tur-EK-tuh-mee), which removes the uterus, are prevent them from making hormones. Thyroid disease and rheumaable to keep their ovaries. They will not enter menopause right toid arthritis are two diseases that can cause this to happen. away because their ovaries will continue to make hormones.

You also can talk to your doctor or a therapist about painful feelings from the loss of fertility and other effects of reaching menopause early. How to know if you have early menopause When menopause comes early on its own, it sometimes has been called “premature menopause” or “premature ovarian failure.” But a better term is “primary ovarian insufficiency,” which describes the decreased activity in the ovaries. In some cases, women have ovaries that still make hormones from time to time, and their menstrual periods return. Some women can even become pregnant after the diagnosis. Usually, menopause is confirmed when a woman hasn't had her period for 12 months in a row. To help determine if you may be reaching menopause, your doctor will ask if you've had signs like hot flashes, irregular periods, sleep problems, and vaginal dryness. But these signs are not enough to determine that you are reaching menopause. Blood tests that can measure estrogen and related hormones, like follicle-stimulating hormone (FSH), can help determine if you have reached early menopause. You may choose to get tested if you want to know whether you can still get pregnant. Your hormone levels change daily, though, so you may need to have a test more than once to know for sure. Women who want to have children and go through early menopause may feel extremely upset. If you want to be a parent, talk to your doctor about other options, like donor egg programs or adoption. Your doctor may suggest that you see an infertility specialist. You also can talk to your doctor or a therapist about painful feelings from the loss of fertility and other effects of reaching menopause early. n

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Are You Considering I

f you are, you must be honest with yourself. Why do you want surgery and what do you expect surgery to do for you? According to the American Society of Plastic Surgeons (ASPS), there are two categories of patients who are good candidates for surgery: The first includes patients with a strong self-image who are bothered by a physical characteristic that they'd like to improve or change. The second category includes patients who have a physical defect or cosmetic flaw that has diminished their self-esteem over time. It's important to remember that cosmetic surgery can create both physical changes and changes in self-esteem. But if you are seeking surgery with the hope of influencing a change in someone other than yourself, you might end up disappointed.

Because the changes resulting from cosmetic surgery are often dramatic and permanent, it's important that you have a clear understanding of how surgery might make you feel—long before a procedure is scheduled.

Cosmetic Surgery?

ASPS list of inappropriate candidates for surgery: • Patients in crisis, such as those who are going through divorce, the death of a spouse, or the loss of a job. These patients may be seeking to achieve goals that cannot be met through an appearance change—goals that relate to overcoming crisis through an unrelated change in appearance is not the solution. Rather, a patient must first work through the crisis. • Patients with unrealistic expectations, such as those who insist on having a celebrity's nose, with the hope that they may acquire a celebrity lifestyle; patients who want to be restored to their original "perfection" following a severe accident or a serious illness; or patients who wish to find the youth of many decades past. • Impossible-to-please patients, such as individuals who consult with surgeon after surgeon, seeking the answers they want to hear. These patients hope for a cure to a problem that is not primarily, or at all, physical. • Patients who are obsessed with a very minor defect, and may believe that once their defect is fixed, life will be perfect. Born perfectionists may be suitable candidates for surgery, as long as they are realistic enough to understand that surgical results may not precisely match their goals. • Patients who have a mental illness, and exhibit delusional or paranoid behavior, may also be poor candidates for surgery. Surgery may be appropriate in these cases if it is determined that the patient's goals for surgery are not related to the psychosis. In these cases, a plastic surgeon may work closely with the patient's psychiatrist.

ASK THE DOCTOR Back to School 2014

Factors to consider Cosmetic surgery changes your appearance by altering parts of your body that function normally but don't look the way you want. Before you proceed with cosmetic surgery, consider:

•Y our expectations. Anticipate improvement, not perfection. If you expect cosmetic surgery to turn you into a movie star, you're bound to be disappointed. Don't count on surgery to save a rocky relationship, gain a promotion or improve your social life. •E xpense. Cosmetic surgery isn't covered by most health insurance plans. The cost varies depending on the procedure, ranging from hundreds to thousands of dollars. Also, consider the cost of any follow-up care or additional corrective procedures. •R isks. Dissatisfaction is possible after any type of cosmetic surgery. Surgical complications are possible, too—including excessive bleeding or infection at the surgical site. •R ecovery. After cosmetic surgery, you might need days, weeks or even months to recover. Understand the physical effects that might be part of your recovery, as well as how the surgery might affect aspects of your personal and professional life. Psychological changes. Your self-esteem might improve after cosmetic surgery, but cosmetic surgery isn't likely to relieve depression or other mental health conditions If you decide to pursue cosmetic surgery, choose a plastic surgeon who specializes in the procedure you'd like to have done and is certified in the specialty by a board recognized by the American Board of Medical Specialties, such as the American Board of Plastic Surgery or the American Board of Facial Plastic and Reconstructive Surgery. Beware of misleading certifications from unrecognized or self-designated boards. Remember, though, even if you've done your homework and found a surgeon you like—at a price you can afford—the decision to pursue cosmetic surgery is yours and yours alone. Make sure you're comfortable with the surgeon and committed to your treatment choices. n

For Men

Talk with Your Health Care Provider About Taking Aspirin to Prevent Heart Attacks How does aspirin help men prevent heart attacks? Plaque is a sticky substance that sometimes builds up and blocks arteries that carry blood to the heart. This can cause heart disease, including angina (“AN-je-nah”) and heart attacks. Aspirin can help blood flow smoothly to the heart. If you are a man aged 45–79, talk with your provider about whether to take aspirin to reduce the chances of a heart attack. What increases the chances of having a heart attack? The older you are, the greater the chances that you can have a heart attack. Other risk factors for heart attack include: • High blood pressure • Diabetes • High cholesterol level • Smoking The more of these risk factors you have, the greater your chances of having a heart attack.

How much can aspirin reduce the chance of having a heart attack? It depends on your age, your health, and your lifestyle. If you smoke, the best way to prevent a heart attack is to quit smoking.

Whether you smoke or not, taking aspirin gives you some protection against a heart attack. In general, aspirin reduces the chance of a first heart attack by about 32% in men.

Should you take aspirin? It’s always a good idea to talk with your provider before taking aspirin to prevent a heart attack. • If you have already had a heart attack, you should take aspirin unless your provider says not to. • If your chances of a heart attack are high, the benefits of taking aspirin probably outweigh the harms. • Older people are more likely to have a heart attack. But, they are also more likely to have serious stomach bleeding if they take aspirin.

Does aspirin also help women prevent heart attacks?

Aspirin is not useful for preventing heart attacks in women, but it is useful for preventing strokes. Please see the brochure Talk with Your Health Care Provider About Taking Aspirin to Prevent Strokes for more information. n

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I AM BEAUTIFUL

Battling Body Dysmorphic Disorder (BDD)

ody dysmorphic disorder (BDD) is a serious illness in which a person is preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose. A person with BDD tends to have cosmetic surgery, and even if the surgery is successful, does not think it was and is unhappy with the outcome. Symptoms of BDD:

Treatment for BDD

• Being preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose, such as acne, scarring, facial lines, marks, pale skin, thinning hair, excessive body hair, large nose, or crooked nose.

• Medications. Serotonin re-uptake inhibitors or SSRIs are antidepressants that decrease the obsessive and compulsive behaviors.

• Having a lot of anxiety and stress about the perceived flaw and spending a lot of time focusing on it, such as frequently picking at skin, excessively checking appearance in a mirror, hiding the imperfection, comparing appearance with others, excessively grooming, seeking reassurance from others about how they look, and getting cosmetic surgery.

1. The therapist asks the patient to enter social situations without covering up her "defect."

Getting cosmetic surgery can make BDD worse. They are often not happy with the

outcome of the surgery. If they are, they may start to focus attention on another body area and become preoccupied trying to fix the new "defect." In this case, some patients with BDD become angry at the surgeon for making their appearance worse and may even become violent towards the surgeon.

ASK THE DOCTOR Back to School 2014

• Cognitive Behavioral Therapy. This is a type of therapy with several steps:

2. The therapist helps the patient stop doing the compulsive behaviors to check the defect or cover it up. This may include removing mirrors, covering skin areas that the patient picks, or not using make-up. 3. The therapist helps the patient change their false beliefs about their appearance.

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he squat activates the body’s biggest muscles, those in the buttocks, back and legs. It’s simple to do and can be done anywhere. To begin, fold your arms across your chest. Stand straight and than bend your knees and lower your butt until your thighs are about parallel with the floor. Trainers recommend to do them 25 times 4-6 times a week. Then use a barbell or add weights once the body-weight squats grow easier for you. Breathing is very important for squatting because it is a very challenging exercise. Improper breathing can make you light headed, or nauseous, and in extreme cases, some people even black out. As you are lowering yourself, remember to take a deep breath in, then as you are pushing up, breathe out forcefully. Always keep this breathing pattern. Towards the last few reps, you may consider taking a few extra breaths at the top of the squat position as you are standing for some extra energy. If you're serious about increasing your leg strength and building a tighter butt, squats are by far the best weight resistance exercise to do. Squats also increases your heart rate which helps burn calories faster and even when you stop exercising. n

For the best booty all you need is one simple exercise— the squat

Be a Fit Family

Make Physical Activity a Part of Your Family's Routine Set Goals Have your family establish goals that everyone can achieve together. In the first few weeks, you may not achieve every goal, but if you stick with it, physical activity will become a part of your family’s routine. Set effective goals that are specific, achievable and forgiving. Rather than saying you will exercise more, set a goal like walking for 30 minutes a day, three times a week. Issue a family challenge to see who can be the first to achieve an award by committing to physical activity five days a week, for six weeks. Here's a tip: effective goals are specific, achievable and forgiving. "Exercise more" is a great idea, but "take a 30 minute walk" is more specific and easier to achieve.

Schedule Your Activity The best way to begin increasing your family’s physical activity is to schedule time for it. Start by identifying at least three 30-minute time slots this week for activities like taking a walk, playing sports or doing active chores. Choose times of the day or week when everyone is most likely to stick to the schedule.

Make A Date Set up a family calendar for an easy way to begin scheduling your activities. Once you’ve personalized the calendar for your family, post

it on the refrigerator or in another location where the whole family can see it and track progress. Don’t forget to celebrate your achievements; every little bit counts.

Ideas to Get Started There are countless ways to enjoy physical activity together as a family. • Play tag, swim, toss a ball, jump rope, hula-hoop, dance to music or even play a dancing video game. It doesn’t have to be sports—just get your family moving! • Walk the dog, go for a jog, go on a bike ride, take the stairs or head to the park and let kids run around for a while. • Celebrate special occasions—like birthdays or anniversaries—with something active, such as a hike, a volleyball or soccer game or playing Frisbee at the park. •G et the whole family involved in household chores like cleaning, vacuuming, and yard work. •W alk instead of drive whenever you can. If you have to drive, find a spot at the far end of the parking lot and walk to where you’re going. •P ark farther away and count with your children the number of steps from the car to your destination. Write it down and see if you can park even farther away on your next stop. •T rain as a family for a charity walk or run. n

What is your family doing to stay active? Tell us on Facebook at www.Facebook/MonmouthCountysAskTheDoctor.com and your family’s story may be featured on the pages of our Fall 2014 edition!

HEALTHY MIND & SOUL

Practical Solidarity For Thoreau (best known for writing Walden), alone time was resulting in a more productive (and more satisfying) sense of accoma means to connect with nature, and ultimately, the resource from plishment. which he withdrew wisdom. Today, enjoying alone time is sometimes Using your lunch break to spend a few minutes outside alone cirseen as a characteristic of someone who lacks social skills or is just cling your building and taking a look at the surrounding plants, trees plain weird. However, it's well-established that finding time for your- and sky will help you hit your mind's “reset” button. It also allows you self is key to improving mental and physical health, and yet it eludes to gather a fresh perspective on work-related issues you may be grapmost people. The daily grind of work, pling with. When you allow your mind to shopping, housekeeping and driving slow down and the fog has diminished, children to and from activities leaves you stop trying so hard and the answers your head spinning with hardly enough you've been looking for may finally have a time to recover and be ready for the chance to break through. onslaught of tomorrow. For those who Even if you're not in the company of don't have the luxury of building a priothers, your senses are often being bomvate cabin the woods like Thoreau, barded every few seconds by a firm grip —Henry David Thoreau fortunately there are small steps you on cell phones, tablets and other commucan take toward beneficial solitude. nication devices. Detaching from these for You have to be creative and find small pockets in the day to ob- a period of time daily allows your constantly racing mind to calm down. serve silence, gather your thoughts and reflect. Here's a personal ex- When the anxiety of being away from your devices diminishes and the ample: When I worked fifty hours a week in a crowded retail store, I dust settles, your ability to think clearly and make informed, rational arrived about fifteen minutes early every morning. I used this time to decisions increases greatly. read a religious devotional. Whatever thought or lesson stuck out most Spending time alone is also an opportunity to find yourself. Away to me, I reflected on and implemented it throughout the day. from the influence of others, you can discover your true feelings on As a result of starting your day off with solitude, you will also be everything from personal tastes to preferences that affect your life in more effective in your work with an improved sense of focus. Let- the big picture. n ting go of diversions keeps your energy directed in a laser-like point,

“I never found a companion that was so companionable as solitude.”

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THE HEALTHY PALATE

Smothered Steak with Sangría Sauce Different and easy, this dish is great for company. Serve it over brown rice or whole-grain pasta so you can enjoy all the sauce. Ingredients 4 thin boneless sirloin steaks (about 4 ounces each), all visible fat discarded Cooking spray Sangría Sauce: 1 cup sangría (white preferred) 1 medium tomato, chopped 1 small green bell pepper, chopped ¼ cup golden raisins

Directions

¼ cup dried apricots, coarsely chopped

In a medium bowl, stir together the sauce ingredients.

1 large dried bay leaf

Lightly spray a large skillet with cooking spray. Cook the steaks over medium-high heat for 2 to 3 minutes on each side.

1 tsp. dried basil, crumbled ½ tsp. dried thyme, crumbled ¼ tsp. pepper, or to taste

Pour the sauce into the skillet. Reduce the heat and simmer, covered, for 30 to 40 minutes, or until the steaks are tender. Discard the bay leaf. TIME-SAVER: Use cube steaks instead of sirloin steaks and reduce the simmering time to 20 to 25 minutes. n

Rustic Stuffed Potatoes Ingredients 4 medium red potatoes (about 6 ounces each) ½ cup bottled barbecue sauce 2 to 3 tsp. cider vinegar ½ tsp. cayenne Vegetable oil spray 12 oz. boneless, skinless chicken breasts, all visible fat removed, cut into bite-size pieces Fat-free, no-calorie liquid margarine spray 2 oz. shredded reduced-fat sharp Cheddar cheese

¼ to ½ cup finely chopped green onions (green and white parts) Directions Pierce the potatoes in several places with a fork. Microwave on 100 percent power (high) for 10 minutes, or until tender when pierced to the center with a fork, turning once. Meanwhile, in a small measuring cup or bowl, stir together the barbecue sauce, vinegar, and cayenne. Heat a large nonstick skillet over medium-high heat. Remove the skillet from the heat and lightly spray with vegetable oil spray (being careful not to spray near a gas flame). Cook the chicken for 2 minutes, or until no longer pink on the outside, stirring constantly. Increase the heat to high. Add the barbecue sauce mixture; cook for 1 1/2 minutes, or until the sauce has thickened slightly and the chicken is no longer pink in the center, stirring constantly. Remove from the heat. Cut the potatoes in half; fluff with a fork. Place 2 potato halves on each plate. Lightly spray each half with 2 pumps of liquid margarine spray. Sprinkle with the cheese. Spoon the chicken mixture over the potatoes. Sprinkle with the green onions. n

ASK THE DOCTOR Back to School 2014

THE HEALTHY PALATE

By Susan Heckler

Eat, Drink and Be Healthy Y

ou have your goal set and your means to achieve it. You want to lose weight and live a healthier lifestyle. There are so many temptations along the way and advertising budgets in the billions to try to tempt you. You want to be able to live your life and socialize along with your friends who don’t share your goal. What can you do to stay on track without locking yourself in your house with lettuce and water? • Avoid the "all-you-can-eat" buffet. • Make a smart beverage choice; ask for water, unsweetened tea, or other drinks without added sugars. • Opt for whole grain alternatives such as whole-wheat bread for sandwiches. • Oil and butter are not your friend. • Start your meal with a salad packed with veggies and dressing on the side, you will fill up on healthy fiber to help control hunger and feel satisfied sooner. • Choose main dishes that incorporate vegetables that do not have creamy sauces or gravies. • When your food is delivered, set aside or pack half of it to go immediately • Order steamed, grilled, or broiled dishes instead of those that are fried or sautéed. • Creamy, crispy, fried, breaded or smothered are words to avoid. • Slow down. Enjoy the company and give your brain a chance to realize it should be full. • Mind your portions; order an appetizer-sized portion, share a main dish with a friend, or opt for the doggy bag. • If you must have dessert, choose fruit. n

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THE HEALTHY PALATE

Can drinking wine really make a difference?

The 8 Health Benefits of Wine* • Promotes Longevity

Spinach and Red Pepper Flounder with Feta

• Lowers Risk of Heart Disease • Reduces Heart-Attack Risk • Reduces Risk of Type 2 Diabetes • Lowers Risk of Stroke • Cuts Risk of Cataracts • Cuts Risk of Colon Cancer • Slows Brain Decline

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10-ounce package frozen chopped spinach, thawed and squeezed dry 1 cup chopped roasted red bell peppers, rinsed and drained if bottled 1 teaspoon dried basil, crumbled 1/4 teaspoon salt 2 teaspoons olive oil (extra virgin preferred) 2 ounces feta cheese, crumbled 1 cup uncooked couscous 1/8 teaspoon salt 1 teaspoon olive oil Directions Preheat the oven to 350°F. Rinse the fish and pat dry with paper towels. Place the fish fillets in a single layer in a 13x9x2-inch baking pan. Top each piece with a thin layer of spinach and a single layer of roasted peppers. Sprinkle with the basil and 1/4 teaspoon salt. Drizzle with 2 teaspoons oil. Sprinkle with the feta. Bake for 10 to 12 minutes for flounder, 13 to 15 minutes for tilapia, or until the fish flakes easily when tested with a fork. Meanwhile, prepare the couscous using the package directions. Using a fork, mix in 1/8 teaspoon salt and 1 teaspoon oil. To serve, spoon the couscous onto plates. Place the fish on the couscous. Cook's Tip: To thaw a box of spinach quickly, remove the outer wrapper. Put the box of spinach on a microwaveable plate. Microwave on 100 percent power (high) for 3 1/2 to 4 minutes. n This recipe is reprinted with permission from American Heart Association One-Dish Meals, Copyright © 2003 by the American Heart Association. Published by Clarkson Potter/Publishers, a division of Random House, Inc. Available from booksellers everywhere.

ASK THE DOCTOR Back to School 2014

Sunday, September 7, 2014 Registration 11 am • Walk Start 1 pm

Grandparents’ Day! Sunday, September 7, 2014 Registration 11 am • Walk Start 1 pm

AS WE AGE

Do Something for Day!for Adult Medical Daycare DoGrandparents’ Something Golden Years Care is an adult day care center offering: • Medical & Nursing Services • Dentist, Physical Therapy, Nutritionist, Podiatrist, Optometrist and Heath Evaluations. • Medicaid/J.A.C.C. Accepted Spend the day with friends and join us for recreation & exercise, breakfast & lunch, educational programs, social activities, lectures, arts & crafts, movies, and more… FREE Door to Door Transportation

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t BARNDOORE we offer small-batch, handcrafted food with ingredients sourced from a community of local bakers, farmers, purveyors, coffee roasters and ice cream makers. we have a scratch kitchen, which allows us to hand-pick ingredients and, when in season, to use locally grown greenmarket vegetables from New Jersey family farms. Everything we use is fresh—nothing is frozen. All of our sauces and dressings are handmade, from the remoulade sauce on our BARNDOORE burgers to the avocado aioli on our house-roasted turkey BLT avocado croissant sandwich. We have created our own seasonings, such as our BARNDOORE Signature Spice for our burgers, turkey and roast beef, and our BARNDOORE Signature Vegetable Spice for our french fries and liberty chips. At BARNDOORE we believe in sustainably grown food, from our tomatoes grown by New Jersey farmers to our 100% fair trade, certified organic, shade grown coffee from Peru, Café Femenino, grown, processed and traded exclusively by women. We are BARNDOORE. Real. Fresh. Local.

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AS WE AGE

Treating Alzheimer’s Disease

Slowing, Delaying, or Preventing Alzheimer’s Disease Alzheimer’s disease research has developed to a point where scientists can look beyond treating symptoms to think about addressing underlying disease processes. In ongoing clinical trials, scientists are looking at many possible interventions, such as immunization therapy, cognitive training, physical activity, antioxidants, and the effects of cardiovascular and diabetes treatments.

lzheimer’s disease is complex, and it is unlikely that any one intervention will be found to delay, prevent, or cure it. That’s why current approaches in treatment and research focus on several different aspects, including helping people maintain mental function, managing behavioral symptoms, and slowing or delaying the symptoms of disease. Maintaining Mental Function Four medications are approved by the U.S. Food and Drug Administration to treat Alzheimer’s. Donepezil (Aricept®), rivastigmine (Exelon®), and galantamine (Razadyne®) are used to treat mild to moderate Alzheimer’s (donepezil can be used for severe Alzheimer’s as well). Memantine (Namenda®) is used to treat moderate to severe Alzheimer’s. These drugs work by regulating neurotransmitters (the chemicals that transmit messages between neurons). They may help maintain thinking, memory, and speaking skills, and help with certain behavioral problems. However, these drugs don’t change the underlying disease process, are effective for some but not all people, and may help only for a limited time.

Advancing Understanding Thirty years ago, we knew very little about Alzheimer’s disease. Since then, scientists have made important advances. Research supported by NIA and other organizations has expanded knowledge of brain function in healthy older people, identified ways we might lessen normal age-related declines in mental function, and deepened our understanding of the disease. Many scientists and physicians are now working together to untangle the genetic, biological, and environmental factors that, over many years, ultimately result in Alzheimer’s. This effort is bringing us closer to better managing and, ultimately, preventing this devastating disease.

Managing Behavioral Symptoms Common behavioral symptoms of Alzheimer’s include sleeplessness, agitation, wandering, anxiety, anger, and depression. Scientists are learning why these symptoms occur and are studying new treatments—drug and non-drug—to manage them. Treating behavioral symptoms often makes people with Alzheimer’s more comfortable and makes their care easier for caregivers.

For More Information To learn about support groups, services, research centers, research studies, and publications about Alzheimer’s disease, contact the following resources: Alzheimer’s Disease Education and Referral (ADEAR) Center P.O. Box 8250, Silver Spring, MD 20907-8250 1-800-438-4380 (toll-free) www.nia.nih.gov/alzheimers n

Life’s Good Here! Monmouth Crossing Award-Winning Assisted Living The comforts of home. An active social life. Around-the-clock care and support. It’s the best of all worlds. A great life for your loved one. Peace of mind for you. That’s the magic of Monmouth Crossing—a charming community, filled with friends and laughter, countless activities, and a staff that considers every resident a part of their extended family. Yes, you can breathe a sigh of relief. This is assisted living at its best!

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ASK THE DOCTOR Back to School 2014

ementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.

Causes Dementia usually occurs in older age. It is rare in people under age 60. The risk of dementia increases as a person gets older. Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer's disease is the most common type of dementia. Lewy body disease is a leading cause of dementia the elderly. People with this condition have abnormal protein structures in certain areas of the brain. Dementia also can be due to many small strokes.

AS WE AGE

Dealing with Dementia • Getting lost on familiar routes • Language problems, such as trouble with the names of familiar objects • Losing interest in things previously enjoyed, flat mood • Misplacing items • Personality changes and loss of social skills, which can lead to inappropriate behaviors Signs and tests A skilled health care provider can often diagnose dementia with the following steps: • Complete physical exam, including nervous system exam • Asking about the person’s medical history and symptoms • Mental function tests (mental status examination)

Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. Symptoms Dementia symptoms include difficulty with many areas of mental function, including: • Emotional behavior or personality • Language • Memory • Perception • Thinking and judgment (cognitive skills) Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They are often aware of the forgetfulness. Not everyone with MCI develops dementia. Symptoms of MCI include: • Difficulty doing more than one task at a time • Difficulty solving problems or making decisions • Forgetting recent events or conversations • Taking longer to do more difficult mental activities Early symptoms of dementia can include: • Difficulty with tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines

Outlook (Prognosis) People with mild cognitive impairment do not always develop dementia. When dementia does occur, it usually gets worse and often decreases quality of life and lifespan. Families will likely need to plan for their loved one’s future care. When to Contact a Medical Professional Call your health care provider if: • Dementia develops or a sudden change in mental status occurs • The condition of a person with dementia gets worse • You are unable to care for a person with dementia at home Prevention Most causes of dementia are not preventable. Risk of vascular dementia may be reduced by: • Eating healthy foods • Exercising • Quitting smoking • Controlling high blood pressure • Managing diabetes n

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Sun Safety IQ answers, continued from page 22 1. False. Dermatologists say brief sun exposures all year round can add up to major damage. 2. True. Many people think it’s OK to get a sunburn now and then, but studies show that even occasional exposure to strong sunlight increases the risk of the most serious type of skin cancer, melanoma. 3. False. It’s not smart to broil in the sun for several hours, even if you are wearing sunscreen. These products don’t provide total protection from ultraviolet (UV) rays. 4. False. The Sun Protection Factor (SPF) describes how long the product will protect your skin from burning if you apply the sunscreen correctly. 5. False. UV rays can easily go through a white cotton t-shirt, especially if it’s wet. 6. All of the above. For best results, most sunscreens need to be reapplied about every 2 hours or sooner, but be sure to check the label. 7. False. Our experts say a “base tan” gives you very little protection against sunburn. 8. Using too little and waiting too long to reapply. About 1 ounce of sunscreen (a palmful) should be used to cover the arms, legs, neck and face of the average adult. For best results, most sunscreens must be reapplied at least every 2 hours and even more often if you are swimming or sweating. 9. Move to the shade. While all 3 actions may help, getting out of the mid-day sun is the best choice in this situation. For more complete answers, visit www.cancer.org/healthy/toolsand calculators/quizzes/sun-safety/index. n

ASK THE DOCTOR Back to School 2014

Fertility Testing Is It Right For Me?

ou’ve been thinking of starting a family for some time now. But now you’ve noticed that it just isn’t happening as quickly as you thought it would. So you’re wondering… When should I think about seeing someone? There are many factors that would suggest a trip to a fertility specialist would be a good idea. You should consider your partner’s age, whether you are generally healthy, the method of birth control you’ve been using up until the point you decided to try to become pregnant, and you and your partners family medical history, etc.

Early Testing Could Be the Key Made popular by celebrities such as Jennifer Anison, Kim Kardashian and Janet Jackson. Many women are now opting to visit a fertility specialist even if they are relatively young and healthy. Reasons for early testing are varied, but possibilities may include pre-existing conditions in one of the partners, a family history of health issues, or simply because a woman may want to pursue a career before starting a family.

Over or Under Thirty – Rules to Remember If you are over the age of thirty and have been trying to conceive for more than six months, American Society for Reproductive Medicine (ASRM) suggests that you make an appointment to see a fertility specialist right away. The earlier would be the better in fact.

Which Medical Conditions Could Block Pregnancy Certain conditions such as endometriosis, ectopic pregnancies, blocked fallopian tubes, miscarriages, uterine fibroids or polyps, polycystic ovarian syndrome, pain during intercourse, or irregular menstrual cycles may affect your chances at successful conception on your own. If you have a history of any of these conditions and plan to start a family, you should see a fertility specialist as early as possible. The bottom line is, if you are even wondering whether you should see a fertility expert or not, you should book a consultation.

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Fertility Testing in 3 Simple Steps 1. Bloodwork Purpose: To test hormone levels and determine whether ovulation is occurring. Procedure: Blood is drawn to test the female hormones associated with egg maturation and uterine receptivity to receive an embryo.

2. Ultrasound Purpose: to determine whether the uterus, ovaries, and fallopian tubes are normal. Procedure: an intravaginal sonogram is performed where the doctor looks for follicles (eggs are inside these) on the ovaries and abnormalities in the lining of the uterus or fallopian tubes.

3. Semen Analysis Purpose: to determine the “quality” of sperm, including number of sperm and motility. Procedure: a sample is produced then examined and compared against specific criteria.

Science + Compassion = Success Allen Morgan, MD, FACOG 475 Rt. 70 West, Suite 201 Lakewood, NJ 08701

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