12 minute read
HEALTH GUIDE
HEALTHY SMILE HEALTHY LIFE
By Dr. Edwin Smith, DDS
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Dentistry is often thought of as a field of medicine primarily focused on esthetics, which makes sense when you consider the power of a smile. Not only does seeing a loved one’s smile brighten up your day, but studies show that even forcing a smile has been shown to decrease stress and even lower your heart rate. Smiling makes you feel good during your day to day activities, and taking pride in your smile can make you healthier and happier.
However, the mouth is a lot more than a feel-good tool you smile with.
It’s often forgotten the degree to which the mouth is integrated with the body. Systemic diseases often have oral manifestations, and oral diseases can have systemic consequences. Gum disease causes chronic inflammation, and those
inflammatoryfactorscannegatively affect other chronic diseases such as diabetes, heart disease, respiratory disease, all of which can increase your chances of heart attack and stroke. The body functions as a whole, and the mouth is the opening to the body.
Like all parts of the body that are exposed to the elements, the mouth is packed with bacteria, and the bacteria forms a sticky biofilm known as plaque. In a perfect world, we would remove the plaque by brushing and flossing twice a day and avoid sweets. But, as we all know, the world is not always perfect. In fact, dental caries is the most common disease in children, and some studies show that nearly 75% of adults have gum disease.
Poor oral hygiene can allow for the overgrowth of bad bacteria in the mouth. Enough bad bacteria can lead to dental caries and gum disease in the form of gingivitis or periodontitis. Untreated periodontitis can lead to bone loss, dental pain, dental abscesses, tooth
necrosis, and ultimately tooth loss. It is a common misconception that teeth just decay and fall out with old age, when in fact there isn’t any time limit on your teeth at all. Teeth are strongest tissue in your body, and they don’t fail because enough time has passed. They fail because of poor oral hygiene or poor oral and systemic health.
Everyone wants a beautiful smile to make their lives and the lives of their loved ones a little better every day. The key to a healthy smile is regular brushing and flossing, and regular dental visits to catch and treat oral disease in the early stages. A healthy smile can help lead to a long, happy and healthy life.
ABOUT DR. EDWIN SMITH:
Dr. Edwin Smith is a devoted, caring, and highly-skilled dentist who graduated from Columbia University College of Dental Medicine in NYC. He was raised in Miami, Florida, attending Chaminade-Madonna College Preparatory HS, and graduated with a Bachelors in Science from Florida International University. In 2013 he was awarded the Pre-doctoral Student Achievement Award from the Internation Congress of Oral Implantologists.
CONTACT INFORMATION:
Next Dental Oral Health in Medicine 16125 NE 18th Ave., North Miami
Beach, FL 33162 305) 949-2766 fhadimac@hotmail.com
Website: www.nextdentalcare.com
successful Conjoined twins separation
UROLOGISTS TREAT
WOMEN WITH BLADDER AND PELVIC FLOOR CONDITIONS
By Dr. Angelo E. Gousse, MD Board Certified Urologist Fellowship Trained
Female urology, also called Female Pelvic medicine and reconstructive surgery, is a subspecialty of urology that focuses on the diagnosis and treatment of urological conditions that affect the quality of life of women. Because women have a different anatomic and hormonal milieu compared to men, the urologic conditions and treatment options vary significantly. Over the past ten years, there have been significant advancesinthefieldofFemalePelvic Medicine and Reconstructive Surgery (FPMRS), both in the understanding of the disease processes, as well as management options. Furthermore, strict guidelines for management have been developed, supported by evidence-based studies to guide the clinician. Common urologic conditions within the domain of Female Urology include recurrent UTIs, overactive bladder, pelvic organ prolapse, urinary incontinence, urethral syndrome, urinary fistula, interstitial cystitis (Bladder Pain Syndrome), urethral diverticula, and female urethra stricture.
WHAT IS CHRONIC URINARY TRACT INFECTION (UTI)?
Many women suffer from recurring urinary tract infections (UTIs), otherwise known as chronic UTIs. A recurrent UTI is defined as at least two infections in six months, or three infections in one year. This condition is typically caused by a gram negative bacterial infection. In most cases, each new infection is caused by a different strain of bacteria. Common UTI symptoms include frequent urination, urgent dysuria, suprapubic discomfort, and cloudy, foul-smelling urine. More severe symptoms may include fever or chills,flankpain,nauseaandemesis, typically involving the upper urinary tract (i.e., the kidneys and associated collecting systems). Patients with febrile UTIs are thought to have complicated UTIs cases and should undergo an upper urinary tract examination to evaluate the kidneys and take a more aggressive course of antimicrobial agents.
WHAT IS PELVIC ORGAN PROLAPSE?
Pelvic organ prolapse (POP) is a condition associated with laxity and defects in the muscles, ligaments, and skin surrounding a woman’s vagina. These anatomic weaknesses cause pelvic organs such as the uterus, rectum, bladder, urethra, small bowel or vagina to prolapse out of their normal position. There are several grading systems which illustrate the degree of POP. Cystocele (Bladder prolapse), rectocele (prolapse of the rectal wall/posterior compartment), enterocele (weakness of the cul de sac, associated with bowel and intestinal herniation), and vaginal prolapse are the most common pathologies. Often POP is more a diffuse disorder of the pelvic floor and involves multiple conditions simultaneously. This condition most commonly affects older women whose pelvic muscles and tissues have been weakened or stretched by the effects of gravity, have an increased body mass index (BMI), estrogren loss, or strains from childbirth or previous pelvic surgery. Symptoms may include pelvic pressure and discomfort, sexual discomfort, and problems urinating or defecating. Numerous transvaginal, abdominal, laparoscopic, or even robotic techniques have been developed to treat pelvic organ prolapse. Recent controversies and FDA warnings in the US have diminished the usage of synthetic mesh over the past 3 years. Usage of biologic allograft, or native tissues, has become more popular. Some patients prefer a nonsurgical approach, such as the usage of pessaries. A specialist in female urology should be familiar with the various types of pessary and the surgical options.
WHAT IS URINARY INCONTINENCE?
Urinary incontinence, or involuntary leakage of urine, is one of the most common problems treated in female
urology. It is important for the clinician to realize that there are several different types of urinary incontinence, each with a different cause and potential treatment options. These include stress incontinence, urge incontinence, overflow incontinence, mixed incontinence (simultaneous stress and urge incontinence), total incontinence, and functional incontinence. Improper diagnosis of the type of
urinary incontinence is probably the most common reason for treatment failure. A detailed history and physical examination is of paramount importance to the proper diagnosis and sub-typing of urinary incontinence. In select cases, urodynamic testing or cystoscopy may be useful. A neurologic history and physical examination should be obtained in order to rule out a neurogenic bladder. Patients with “pure” stress urinary incontinence describe activityrelated urinary leakage that interferes with their quality of life. Any increase in abdominal pressure such as coughing, sneezing, laughing, exercising, jumping, running, or sexual activity may precipitate urinary leakage. Stress incontinence may or may not co-exist with pelvic organ prolapse. In most cases, urethral hypermobility is noted, with rotational descent of the urethra upon straining. The need for treatment is largely dictated by the degree that it affects the woman’s quality of life. Pad usage and pad weights are sometimes used to gauge disease severity. The current most popular surgical treatment to treat stress urinary incontinence is the suburethral ( midurethral ) sling. Transurethral bulking agent is another less successful and shorter-duration treatment option. The suburethral sling can be performed using a synthetic mesh or biologic allograft, or autologous rectus fascia. Abdominal procedures such as Burch urethropexy are effective but more invasive than transvaginal sling procedures. Currently, there is no approved
medication for stress urinary incontinence. There is no evidence that estrogen therapy is effective in the management of stress urinary incontinence. Patients with urge urinary incontinence report involuntary urinary leakage with bladder spasms and strong urges to void. Urge incontinence is one of the symptoms associated with overactive bladder. Overactive bladder is not necessarily caused by aging or prior surgery. Most cases of overactive bladder and urge incontinence are idiopathic. Urge urinary incontinence is often associated with urinary urgency and frequent urination . A neurologic cause should always be ruled out, particularly in younger patients. Conclusion Female urologic disorders affect a large segment of the population. Female Urology, also known known as female pelvic medicine, is a broad field. The surgical techniques are varied and technically challenging. The treatment options are best dictated by an accurate diagnosis. The most successful female urologists are the most astute diagnosticians.
In severe cases of prolapse, female patients may develop bladder outlet obstruction and even swelling of both kidneys. However, many women remain free from symptoms.
ABOUT DR. ANGELO GOUSSE
Dr. Angelo Gousse is a fellowship trained and Board-Certified Female Urologist (FPMRS). He currently directs a Female Urology Fellowship Program at the Bladder Health and Reconstructive Urology Institute in Florida. He is a nationally recognized leader and researcher in the field.
CONTACT INFORMATION
1951 SW 172nd Ave #305,
Miramar, FL 33029 21150 Biscayne Blvd #304, Miami,
FL 33180 321 15th St #100, West Palm
Beach, FL 33401 (954) 210-7051 www.gousseurology.com
PREPARING
FOR SURGERY
By Dr. Linda Moleon Louis + Photo by Mackinley ‘Spex’ Madhere
Preparing for a scheduled surgical procedure can be stressful. You should be physically and mentally prepared for the stress your body will endure on the operating room table, as well as the recovery after the procedure. Here are some tips that will make your preoperative journey a lot less stressful and help boost your speedy and safe recovery.
BEFORE SURGERY
• Have a discussion with Primary
Care Physician regarding any underlying medical issues you may have, such as hypertension, diabetes, asthma, high cholesterol and other chronic diseases. • Discuss the planned surgery and how it might affect your current health and recovery. • Make sure all your medical issues are optimized. Are these conditions well controlled with your current medication regimen? • Be sure to inform your doctor of all medications, herbs and supplements you routinely take, and follow your doctor’s instruction about taking them before surgery. This is especially important if you take medications for hypertension, diabetes, and blood thinners. • Make sure you have your updated labs, EKG and Chest
Xray on file. • If you have an extensive cardiac history such as a history of heart attack, cardiac surgeries/stents, chest pain or congestive heart failure, you may want to consider getting a cardiac clearance from your cardiologist. This also applies to patients with a significant history of pulmonary
conditions such as Obstructive
Sleep Apnea, COPD or asthma. • If you are a smoker, seriously consider quitting. Patients who are non-smokers are less at risk of having respiratory complications and infections after surgery than active smokers.
• The Night before
Surgery: Discuss with your anesthesiologist or preoperative team when you should stop eating and drinking before surgery. Most hospitals and surgical centers will advise patients to stop eating at midnight and will allow clear liquid drinks up to two hours before your surgery. Research
has shown that drinking clear liquids two hours before surgery reduces nausea, vomiting and pain after surgery. Examples of clear liquids: • Water • Fruit juices (without pulp) • Gatorade • Clear tea • Black coffee (no milk or cream)
ON THE DAY OF THE SURGERY
• Please be prepared to remove glasses, contact lenses, dentures, and all jewelry and body piercings. • Wear clothing that is loosefitting and easily changed. • Bring a list of all your medications, herbs and supplements, and include the full name, strength and number of times that you take these each day. • On the day of your surgery, you will meet a member of the anesthesiology team (either your CRNA or Anesthesiologist) who will gather all your information and develop an anesthesia care plan best suited for you. • They will discuss the best type of anesthesia for your specific surgery and health needs (e.g., general anesthesia, monitored anesthesia care, spinal/epidural or sedation, or regional block). • The use of recreational drugs such as alcohol, marijuana, narcotics and stimulants should be discussed thoroughly. These substances can affect how you react to anesthesia. • It’s natural to fear surgery and anesthesia. Most patients are more fearful about the anesthesia than they are of the surgery itself. If you’re afraid, feel free to discuss this with your anesthesiologist. He or she can give you information and medication to ease your anxiety and help you feel comfortable. • Bring a friend or family member who can advocate, take notes, and ask questions on your behalf before and after surgery. • Your anesthesia team will continue to care for you immediately after surgery while you recover, so ask about how your pain will be managed
and any concerns you have about the recovery process. • You will need an adult driver with you, as you will not be able to operate a motor vehicle following surgery.
In preparation for your surgery, take good care of yourself and follow your doctor’s advice. Surgery puts a significant amount of stress on the body. The stronger you are physically and mentally, the better equipped you’ll be to handle it. Get adequate sleep, eat a healthy diet, and if you smoke, please stop for at least two weeks prior to your surgery. Follow your doctor’s instructions when it comes to which meds to continue and which ones to stop before surgery.
ABOUT DR. LINDA MOLEON LOUIS
Where were you born?
- Miami, Florida, at Jackson
Memorial Hospital
Formal Training?
- Undergraduate: Florida
International University - Medical School: Howard
University College of
Medicine - Residency: University of Florida and Jackson
Memorial Hospital/
University of Miami
Professional Career
- Graduated Residency 2018 - Worked at Jackson North
Medical Center for 1.5 years - Will start at Memorial
Hospital Pembroke- January 01, 2020
Hobbies?
- Home decorating, party planning, designing - Running an online store:
HoneyHoneyShop.com - Spending time with my husband, Attorney Pierre
Louis, and my dog Storm
