Healthline January 2016 by HealthLine

VOL 2, ISSUE 1 | JANUARY - APRIL 2016

OMEGA-3 PRODUCTS: WHAT’S INSIDE? UNDERSTANDING DEPRESSION STRESSES OF SENIOR LIVING MENTAL HEALTH IS NOT A MYTH DIABETES UNCHECKED

A VOICE OF ASIA PUBLICATION

THE BEST TIME TO LEARN THE SIGNS

OF STROKE IS BEFORE YOU HAVE ONE. STROKES

ARE THE NUMBER-THREE KILLER IN THIS COUNTRY, YET

MANY PEOPLE DON’T EVEN KNOW WHAT THEY ARE. THEY

DON’T KNOW THAT MORE OF THE BRAIN CAN BE SAVED IF A

STROKE IS DETECTED AND TREATMENT IS RECEIVED IMMEDIATELY.

A S T R O K E AT TA C K S T H E B R A I N . T H E B R A I N ALERTS YOUR BODY TO DANGER. SEE THE PROBLEM? STROKES BEGIN WHEN A BLOOD VESSEL IN THE BRAIN BECOMES BLOCKED OR

BURSTS. BLOOD FLOW IS CUT OFF. TISSUE IS STARVED FOR OXYGEN, AND

PARTS OF THE BRAIN DIE. IF NOT TREATED QUICKLY, ABILITIES AND

PRODUCTIVE LIFE CAN BE LOST. YOUR BRAIN IS YOUR MOST

PRIZED POSSESSION. GUARD IT WITH YOUR LIFE.

W I T H A S T R O K E , T I M E L O S T I S B R A I N L O S T. If you suddenly have or see any of these symptoms, call 9-1-1 immediately: Numbness or weakness of the face, arm or leg, especially on one side of the body • Confusion, trouble speaking or understanding • Difficulty seeing in one or both eyes • Trouble walking, dizziness, loss of balance or coordination • Severe headache with no known cause

PUBLISHER’S NOTE Oscar Wilde, the Irish playwright once wrote, “To live is the rarest thing in the world. Most people exist, that is all.” In this age of modern medicine and technology, it is possible to extend human life well beyond 80 years. The challenge is not in whether we are capable of extending the quantity of years; the challenge is whether we are able to improve the quality of the life that we extend. If the goal is to live life to its fullest measure, then we must take steps to preserve our good health while we still have it. To that endeavor, our goal at HealthLine is to educate and empower the public about enhancing the quality of their lives. We accomplish this goal by bringing you the latest in medicine, technology and scientific breakthroughs that impact our lives in every issue. As we all intuitively know, the quality of any life depends on our ability to successfully integrate the physical, mental and emotional components of our lives. At HealthLine, we give you the tools to live a holistic life. As we age, one of the messages that we receive from popular culture is that our lives have diminished value and significance. Often, the older we get, the more that society relegates us to living suboptimal lives. Unfortunately, many of us have learned to accept the latter as the norm. At HealthLine, we believe that with age comes wisdom. Our seniors have much to offer society in their golden years. If we are to take advantage of this source of experience and wisdom, it is incumbent upon us to cater to the needs of the aging population. One of the most pressing needs for those who are seniors is the continued need for companionship. Companionship is compromised when a long term partner dies or becomes catastrophically disabled. This is where nursing homes and community living come into play. These facilities allow for continued social interaction and provide opportunities for seniors to remain meaningfully engaged in life through their golden years. HealthLine is committed to bringing you the varied options and alternates available to continue to live in such a way that our latter years are even more fruitful that our former ones. We are happy that we were able to supply over 50 articles by eminent doctors for the benefit of people. We promise to continue with more articles and educational material to make it easier for the people.

KOSHY THOMAS Publisher & CEO, Voice of Asia Group

CONTENTS 6

OMEGA3 PRODUCTS: WHAT’S INSIDE?

MICRO SURGICAL ROBOT The answer to next gen microsurgeries

UNDERSTANDING DEPRESSION

MENTAL HEALTH IS NOT A MYTH

How South Asians perceive it

10 Seniors Coping with Seasonal Allergies and Allergy Induced COPD 14 Alzheimer’s Dementia - More than just forgetfulness 17 Stresses of Senior Living 18 New Ways to Find Misdiagnosis of Abdominal Pain in Emergency Departments 20 The Benefits of Choosing a Compounding Pharmacy 21 Diabetes Unchecked, Will Affect Vital Organs 22 Parkinson’s Disease and The Role of Dopamine 23 Practical Tips for Cutting Down the Cost of Living with Diabetes 24 Autism Spectrum Disorder 26 Ayurvedic Management of Osteoarthritis 28 Curing Skin Diseases by Naturopathy 30 Hepatitis C: If You Don’t Think You Need to be Tested, You Probably Do COPYRIGHT AND DISCLAIMER All rights reserved. No Material herein or portion thereof may be published without the consent of the publisher. HealthLine assumes no liability resulting from action taken Based on the information included herein. The opinions expressed are not necessarily those of the management. Healthline reserves the right to edit as necessary to correct errors of fact, punctuation, spelling and to comply with space constraints. HealthLine does not endorse the advertised product, service, or company, nor any of the claims made by the advertisement. Published quarterly by Free Press LLC, 8303 SW Freeway, Suite #325, Houston, TX 77074. Tel: 713-774-5140. Fax: 713-774-5143. Email for editorial submission:voiceasia@aol.com; Email for advertising inquiries and submission: ads@voiceofasiagroup.com. For reprint rights, please email; voiceasia@aol.com Subject line: Reprint rights.

Line

Health

A Voice of Asia Publication

HEALTHLINE

Jan - April 2016 Publisher Koshy Thomas

Editor-in-Chief Shobana Muratee Marketing Manager Jacob David Marketing Susan Pothanikat Accounts Manager Priyan Mathew Administration AR Vadlamani Magazine Layout Jincy Jose Cover Photo Fotolia (All Rights Reserved) Printing Richmond Printers LLC

OUR CONTRIBUTORS

Amol Chaugule MD Sumita Chowdhury MD Sheri Dark MD Sobha George MSN, CEN Manisha Ghei MD Jonathan Huang MD P. Kartik MD Lori Markel Pharm. D Lakshmi Devi Maliakkal AMP R. Preston Mason PhD Lakshmy Parameswaran MA Dipali Pathak SCS Tom Nealon CEO Thuy Hanh Trinh MD Olga Waln MD

EDITORIAL Dear Readers, Your health should be at the apex of your resolutions for the New Year 2016. If not, make it before it’s too late. Procrastination in seeking treatment for physical or mental illness could be debilitating. Although it’s equally important to keep one’s mind and body sound, it is often hard to detect mental disorders and nip them in the bud. Which is why we wanted to focus a little more on the matters that concern mental health in this issue. Preparing the current issue, we came across so much information on mental health: the types of disorders, causes and symptoms, and early onset and course of treatment, which just one issue could never do proper justice to. So we decided to post it all on our comprehensive website HealthLinemag.com for easy reading. Last year, we launched HealthLine and three issues in, we knew it was the right thing to do - provide free, accurate and timely health information to our readers. But then it wasn’t enough, especially when you take into account people’s reading habits vs viewing. So we backed it up with a website HealthLinemag.com where you can have access to digital version of the magazine plus updates and developments in the healthcare world. Our readers know that HealthLine is more than just another magazine, it’s a window to wide expanse of the medical world, a connection to the physicians and healthcare professions who are anxious to serve you, and to introduce you to the right organizations which can guide and assure you that you are not alone. We have professionals serving on the Board of Advisors to HealthLine, ensuring its authenticity and guiding us to what’s needed for the community. This year, we have gone bigger not just in size and style; we are talking about changing lives. HealthLine has already embarked on its next challenge - HealthLine Wellness Expo 2016!  It is now time to put our mission to the test, to give you that gentle push in the direction of bettering your total being.

SHOBANA MURATEE Editor-in-Chief

OMEGA-3 PRODUCTS: WHAT’S INSIDE?

Dr. Chowdhury talks with award-winning scientist Dr. Mason on his work. Omega-3 (W3) fatty acid products are widely available as highly purified, FDA-approved prescription (Rx) formulations to treat patients with very high triglyceride levels. Fish oil dietary supplements are also widely available, but at this time, there are no FDA-approved over-the-counter W3 products.

While Rx products are highly regulated and have multiple clinical trials to support their safety and efficacy, dietary supplements are not subject to the same level of regulation and oversight. As many adults in the United States are taking W3 fish oil dietary supplements and may not understand what’s inside these products, I’d like to shine the spotlight on a recent award-winning study presented at The Academy of Managed Care Pharmacy Nexus meeting by Dr. Preston Mason, a leading cardiovascular research scientist. Dr. Chowdhury: Dr. Mason, what prompted your study? Dr. Mason: Recent investigations have identified multiple issues surrounding W3 fish oil dietary supplements including high variability of product content, quality, and purity within and between brands; they also have been reported to contain saturated fats, cholesterol, other lipids, and oxidation products that may potentially compromise their purported health benefits. The key W3s with therapeutic benefit are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), but their reported content in dietary supplements would often require patients to take 3-7 times as many capsules to approximate the 4 g/day therapeutic dose provided by an W3 Rx product to treat very high triglyceride levels. Given the potentially high numbers of pills people may be taking, we wanted to better understand what’s inside the W3 dietary supplements. Dr. Chowdhury: That’s a very important consideration for W3 dietary supplements. What did you do and what did you find? Dr. Mason: We tested six leading fish oil W3 dietary supplements. While containing widely varying amounts of desirable W3s, the supplements also contained more than 30 other fatty acids, including significant levels of various saturated fats, whereas an EPA-only Rx product does not.

Healthline | Jan - April 2016 | healthlinemag.com

Dr. Chowdhury: I see your studies have confirmed past findings regarding the presence of unwanted elements in W3 dietary supplements. What else did you learn? Dr. Mason: Because little is known about the potential effects of oxidation species in W3 products, and because we know there is link between oxidative

R. PRESTON MASON PhD

• Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, and President, Elucida Research LLC, Beverly, MA • Lead author of Analysis of Omega-3 Fatty Acid Dietary Supplements With Respect to Content: Are They Appropriate for Patients? Presented at the 2015 Academy of Managed Care Pharmacy Nexus meeting, October 26–29, Orlando, FL (J Manag Care Spec Pharm. 2015;21:S34 [Abstract E21])

damage to LDL and atherosclerosis, we also tested the extent of oxidative damage and biological activity in preclinical in vitro (ie, in the test tube) studies. We observed elevated levels of oxidation products in the dietary supplements, but not the Rx EPA-only product. We also found LDL oxidation could be inhibited by non-oxidized W3s, but not with the oxidized W3s in the supplements. The data from our studies indicate that levels of saturated fat and the oxidative damage to the lipid products found in common W3 dietary supplements may interfere with their potential biological and health benefits. Dr. Chowdhury: That’s interesting and, in my opinion, suggests that there may be interplay between these oxidation products in the dietary supplements and oxidized LDL in atherosclerosis, whereby these extraneous and altered elements found in commonly available W3 dietary supplements may offset positive effects. I noted in your presentation that all of the dietary supplement products also contained DHA. Can you comment on this? Dr. Mason: Yes, it’s important for people to realize that EPA and DHA are not functionally the same; while both can lower lipids such as triglycerides, DHA has the potential to raise the “bad” LDL cholesterol, perhaps by reducing the number of LDL receptors, which plays an important role in causing atherosclerosis.

“The data from our studies indicate that levels of saturated fat and the oxidative damage to the lipid products found in common W3 dietary supplements may interfere with their potential biological and health benefits.”

An internationally renowned cell biologist and biophysicist with over 150 publications, Dr. Mason is the recipient of several awards for his research on cellular and molecular mechanisms of pharmacotherapy. Dr. Mason has traveled extensively to South Asia and is an authority on the composition of popular oils and supplements. Dr. Chowdhury is a cardiologist trained at Massachusetts General Hospital and Harvard Medical School and is an acknowledged leader in the fields of cardiovascular disease, preventive medicine, and women’s health. For more information on EPA-only RX Ω3 including important safety information go to www.vascepahcp.com.

SUMITA CHOWDHURY MD, MPH, FACC, MBA

• South Asian Heart Foundation and consultant to Amarin Pharma, Inc • Dr. Chowdhury is a social entrepreneur in Houston, host of the popular Rush Hour Health radio talk show for South Asians, and has received several awards and honors in her field of preventive cardiology.

SOURCE: “Analysis of Omega-3 Fatty Acid Dietary Supplements With Respect to Content: Are They Appropriate for Patients?” by R. Preston Mason, PhD

healthlinemag.com | Jan - April 2016 | Healthline

When someone thinks it’s easy to get over depression by being positive and moving on, obviously they do not know how serious the problem is.

Understanding SYMPTOMS, ETIOLOGY AND TREATMENT

So what is “Depression?” So how do you know if what you are going through is just normal sadness vs Clinical depression/ Major Depressive Disorder (MDD)? The DSM-V 1 defines MDD as somebody who has five or more of the following symptoms for the same 2-week period: 1. D epressed mood most of the day (nearly every day) 2. M arkedly diminished interest in activities of pleasure 3. Significant weight loss 4. Insomnia 5. Psychomotor agitation or retardation 6. Loss of energy 7. Worthlessness/excessive guilt 8. Diminished concentration and 9. Recurrent thoughts of death.

Healthline | Jan - April 2016 | healthlinemag.com

These symptoms should cause distress or impairment in functioning in order to meet criteria for MDD. The severity and duration of the symptoms would also be important to know. Severe depression can lead the person to having thoughts of ending their life. Such can be the extent of their suffering that they feel that is the only option left. Clearly this is something different from feeling sad for a few hours and then getting on with life. There are various theories that could explain why somebody can become this depressed. The most common one is called the Bio-Psycho-Social model. Neuroscience and lots of research has shown that people who tend to have depressive episodes have structural changes in their brain. These changes may be inherited (genetic) or these changes may have occurred earlier/later in life in response to the environment. There might be psychological factors involved in their depression: For e.g. they may be

Photo source: Fotolia

be somebody who tends to have a lot of negative thoughts about themselves all the time which would worsen their depression. Or the way they deal regularly with their emotions may worsen their depression. For e.g. If they feel angry at somebody rather than address that issue assertively or express themselves they may push away that anger or keep it inside which could worsen their depression. Finally, many Social factors can contribute to depression. For e.g. If somebody is fired from a job they may be more likely to go into a depressive episode. Of these: Bio, Psycho and Social factors, any one or all may be present in a certain individual.

What should you do if you feel you are clinically depressed or have Major Depressive Disorder?

Depression is a major problem affecting society. It is important to support and be empathic towards people who tend to get into these episodes.

The first thing you can do is seek expert help. A psychiatrist will typically rule out any medical cause for your depression as certain medical conditions could precipitate or worsen depression. Once that is done he/she will talk to you in detail about what might be causing your episode. The treatment that a person receives would vary based on their presenting the problem. For example somebody who has symptoms to the point that they cannot function may need a trial of medication (Anti-depressants). Many patients would benefit from Psychotherapy/Counseling alone or in combination with medications. Psychotherapy would focus on the psychological factors contributing to their depression. If they have a lot of self-critical thoughts, making them aware as to how these thoughts can worsen their depression would help them challenge these thoughts. Or helping them find better ways to deal with their emotions. Also some patients may need to change their social situation.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is the 2013 update to the American Psychiatric Associationâ&#x20AC;&#x2122;s classification and diagnostic tool. 1

AMOL CHAUGULE MD Dr. Chaugule is a Board Certified Adult Psychiatrist having a private practice in Sugar Land, Texas.

healthlinemag.com | Jan - April 2016 | Healthline

Seniors Coping with Seasonal Allergies and Allergy Induced COPD Seasonal allergies occur in an estimated 40-60 million people in the US each year. Allergic rhinitis is a medical term used for hay fever and seasonal allergies. While a number of environmental allergens can cause symptoms, research indicates that almost 75% of people in the US who suffer from seasonal allergies are allergic to ragweed. These lead not only to annoying allergy symptoms, but also allergy-induced asthma and exacerbation of Chronic Obstructive Pulmonary Disease (COPD) and other chronic respiratory conditions in the elderly, especially those with compromised immune systems. Food allergies can make environmental allergies worse and should be looked into as well. Natural alternatives should be tried before jumping to the use of over-the-counter and prescription allergy medications (anti-histamines, corticosteroids, decongestants) as they have unwanted side-effects like dry mouth, eyes and nose, drowsiness, fatigue, restlessness, abdominal distress, risk of bleeding and easy bruising, mental fog, heart palpitations, sleep issues, blurred vision and at worst, confusion. These can have serious consequences due to drug

MANISHA GHEI

MD, ABIM, ABIHM, IFMCP Dr. Ghei is Board Certified in Internal Medicine and Integrative Holistic Medicine. She is the Founder and Medical Director of Praana Integrative Medicine & Holistic Health Center, PLLC, in Sugar Land, TX. She recieved her Functional Medicine certification from the esteemed IFM.

Healthline | Jan - April 2016 | healthlinemag.com

interactions in seniors who commonly are already on multiple prescription medications for other medical conditions. Allergies are immune disorders. The older population is particularly susceptible to a weakened immune system after physical trauma or surgery, underlying illnesses, or during times of emotional and physical stress.

Building the immune system should be the first goal in anyone suffering from chronic allergy symptoms. Here are some ways to do that: � Don’t compromise on sleep. Lack of adequate sleep weakens the immune system. � Avoid stress and learn stress management techniques. Stress makes allergies worse. � Eat foods high in vitamin C: dark leafy greens, broccoli, kiwi, organic strawberries, yellow bell peppers, peas, papaya, citrus foods; foods high in quercetin: green tea, apples, raspberries, blueberries, cranberries, capers; foods high in omega-3s: wild, coldwater fish (like salmon, sardines), flax, chia, almonds, walnuts, avocado. � Take natural anti-inflammatory and mast cell-stabilizing supplements: Mast cells are those cells lining your nasal passages, sinuses, and airways that secrete histamine in response to airborne allergens. Antihistamines are the most common OTC allergy medications, but they come with unwanted side-effects as mentioned above. Your integrative medicine physician should be able to help with finding the best natural alternative for you. � Use essential oils: Try a small dab of peppermint oil at the base of your nostrils to open up nasal passages or try steam inhalation infused with a few drops of essential oil of eucalyptus. � Don’t forget the utility of a Neti pot or saline wash to simply wash out all the airborne allergens sticking to the insides of your nasal passages that are causing the symptoms in the first place. Same goes for the eyes. Isotonic sterile saline eye drops provide immediate relief for red, itchy eyes when the pollen count is high. This can be used throughout the day without any risk of overdosing. NOTE: Be rest assured, that if you do tend to have symptoms, natural remedies offer great alternatives to the usual OTC medications.

healthlinemag.com | Jan - April 2016 | Healthline

Microsurgical THE ANSWER TO NEXT GEN MICROSURGERIES

Photo source: Fotolia

Robot:

Are You Ready To Have A Surgery Performed Remotely? It may sound like science fiction, but soon it won’t be. The Kim-Dannenbaum-Shin Microsurgical Robotics Laboratory that focuses on developing next-generation robotic devices for microsurgical procedures that treat life-threatening endovascular conditions such as cerebral strokes, fetal malformations and brain abnormalities is developing a microsurgical robot – the world’s smallest surgical system – with unmatched potential, designed to dramatically transform the most delicate surgeries. These miniaturized devices navigate through small, narrow and branched blood vessels in the brain

Healthline | Jan - April 2016 | healthlinemag.com

in order to reach sites deep in the body that are inaccessible via other existing surgical devices. The project is a collaborative work by a team of engineers: Mark Dannenbaum, M.D., neurosurgeon at the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center and assistant professor in the Vivian L. Smith Department of Neurosurgery at John P. and Kathrine G. McGovern Medical School at UTHealth, Dongsuk Shin, Ph.D., (also an assistant professor of neurosurgery at UTHealth), and Daniel Kim, M.D., neurosurgeon

at the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center and Professor in the Vivian L. Smith Department of Neurosurgery at John P. and Kathrine G. McGovern Medical School at UTHealth who are working together to develop the microsurgical robot. The project, taking shape through collaboration with researchers in South Korea, will overcome the limitations of current human and robotic-assisted surgery and realize extraordinary leaps in medical technology. The device’s most revolutionary ability will allow trained physicians to perform surgeries remotely, similar to drone piloting, through tiny cameras and a system of hand controls that incorporate haptic feedback to help the operator guide the robot’s movements. This could make an especially major difference for stroke victims, who often must travel long distances to reach a major hospital for surgery while brain tissue dies en route. “Time is everything when it comes to stroke care. Our vision is that if a patient could just get to a facility that has our robot and some very basic equipment, we could do the procedure from our home base in the worldrenowned Texas Medical Center.” During surgery, it can also be a challenge to get the catheter to the brain; to navigate curves in blood vessels, sometimes we must remove it, manually adjust it, and try again – costing precious time. So we are developing a catheter with a tip made of a polymer “smart material” that turns using electrical currents – allowing the robot to steer the catheter through vessels like a car negotiating turns in a road. This is something that currently does not exist anywhere on the market, but we want to bring it to life. The robot itself will be light and portable, unlike bulky systems currently in use, able to be uniquely positioned for each patient, with interchangeable

arms that work independently. Each arm can be removed and sterilized after use, avoiding costly replacements while providing tremendous versatility. We can assemble the arms in any configuration we want for any type of surgery. It is also designed to operate a variety of tiny surgical tools through a single small incision, which will not only decrease pain and complications, but could make a significant difference in fetal surgeries to repair conditions like spina bifida. “Right now we don’t have small enough surgical tools to perform these procedures without serious risk to mother and baby, but this new miniaturized equipment could solve that problem.”

“While the project is still in its infancy, the generosity of local philanthropists has helped our team produce an initial prototype and continue developing its technology. With additional support, we can refine the prototype and begin clinical trials within two years. We know this is a bold undertaking. We’re reaching for the stars, but that’s what we do.” DANIEL KIM MD

Dr. Kim is a fellowship-trained, boardcertified neurosurgeon who is an expert in minimally invasive spinal surgery. He is a preeminent researcher in peripheral nerve repair through nerve transfer and nerve graft. Recipient of numerous awards and honors, authored hundreds of papers and published 17 surgical textbooks.

healthlinemag.com | Jan - April 2016 | Healthline

Photo source: Fotolia

Alzheimer’s

DEMENTIA More Than Just Forgetfulness

‘Where are my keys?’ ‘Now, what did I come in here for?’ These are questions that most, if not all of us have asked at one time or another. These are normal signs of forgetfulness. However, there are other questions that may be more than just normal forgetfulness. Questions such as, ‘What are these for?’, while they are holding keys. Or, ‘Do I live here?’ These and others like them are cause for concern

Healthline | Jan - April 2016 | healthlinemag.com

regarding dementia. Dementia is chronic loss of cognition, with Alzheimer’s dementia causing 5080% of these cases. Every 67 seconds, someone in the United States develops this disease. In 2015, an estimated 5.3 million Americans were affected by Alzheimer’s dementia with 5.1 million people age 65 or older. Almost two-thirds of these individuals were women. By 2025, this number of Americans

In 2015, an estimated 5.3 million Americans were affected by Alzheimer’s dementia with 5.1 million people age 65 or older.

living with Alzheimer’s disease will increase to an estimated 7.1 million people in that same age group. Almost two-thirds of these individuals are women. It is the sixth leading cause of death in the United States and is the only cause of death in that cannot be cured, prevented or adequately It is often a difficult subject in which to discuss, but communication is key in the face of a concern regarding this disease as early and proper diagnosis is key. Although it is an insidious, progressive disease, below are some symptoms/signs that can be noted with Alzheimer’s dementia: Memory Loss and Confusion severe and inconsistent and is not normal aging Agitation and Mood Swings restless, pacing especially in strange environments Impaired Judgment decisions seem silly, irresponsible or even inappropriate Money Trouble difficulty paying bills or maintaining a budget Difficulty with Familiar Tasks making a signature dish, playing a familiar game Trouble Planning or Problem Solving struggling to follow a plan, recipe, or list Misplacing Things finding keys in the freezer or TV remote in the sock drawer Confusion with Time or Place forget where they live or lose track of dates, seasons

As the disease progresses, difficulty communicating is noted as well as repetitive speech which is a hallmark sign, wandering, withdrawal, and lack of recognition of family and friends also occurs. In addition, individuals with Alzheimer’s dementia also suffer with insomnia and a phenomenon known as sundowning, in which increased agitation, restlessness, disorientation and confusion occurs. As 20% of those individuals diagnosed with Alzheimer’s will experience this, sundowning is a primary reason in which family members will put a loved one in the nursing home. Although there is no proven prevention, lowering the risk of heart disease and remaining physically, mentally and socially engaged may help. With Alzheimer’s dementia costing significant financial and social impact, it is a disease that healthcare, community and family cannot forget.

Raj. C. Shah, Rush Memory Clinic at Rush University Medical Center, Chicago, IL Lisa P. Gwyther, co-author of The Alzheimer’s Action Plan: A Family Guide Mayo Clinic, ‘Alzheimer’s Disease’, June 17, 2014. Alzheimer’s Association 2015 Alzheimer’s Disease Facts and Figures

SHERI DARK

Dr. Dark is a board certified Family Practice physician with over 15 years of experience in healthcare.

healthlinemag.com | Jan - April 2016 | Healthline

The Medical Resort at Sugar Land

The orthopedic rehabilitation program at The Medical Resort at Sugar Land helps patients in regaining function following a joint surgery or recovering from a traumatic fall or injury. We utilize advanced protocols for elective joint replacements and spinal surgeries. O U R F E A T U R E S

• Private luxury suites. • State of the art therapy gym and equipment. • Individualized physical, occupational, respiratory, and speech therapies with services available 7 days a week. • Comprehensive nursing care for surgical wounds and pain management. • Therapy courtyard with putting green. • Free high speed internet access. • Restaurant style dining room with custom meals. • Beauty salon with services that include manicure, pedicures, and facials.

1803 Wescott Ave. Sugar Land, TX 77478 (Next to Costco) 281-329-4300 • Fax: 281-240-3477 • www.tmrsugarland.com

• SENIORS FOCUSED WEBSITE • TXCSS RESOURCE DIRECTORY Brian Mertz • UPCOMING CAREGIVER EVENTS CEO • ADVERTISE IN OUR RESOURCE DIRECTORY

“We are a caregiver information and advocacy website that all Texans could use”

Visit us at: support@texascaregiversupport.com www.texascaregiversupport.com

“It is only in sorrow that bad weather masters us; in joy we face the storm and defy it.” –Amelia Barr “Courage isn’t having the strength to go on – It is going on when you don’t have the strength.” –Napolean Bonaparte “Character cannot be developed in ease and quiet. Only through experience of trial and suffering can ambition be inspired and success achieved.” –Helen Keller 16

Healthline | Jan - April 2016 | healthlinemag.com

Retirement is thought to be a relaxing time, since the stressors related to job responsibilities are no longer present. However, seniors can experience significant stress from relationship disagreements, financial concerns, and choosing a location for senior living. Moving is stressful for everyone involved. Early discussions between seniors and their loved ones can promote understanding of the best place for the senior to live, based on their preferences, financial constraints, and functional needs. Maintaining familiar surroundings is a source of comfort. It decreases confusion, and it can contribute to building relationships with others. The senior’s own home, personal care homes, assisted living facilities, and nursing homes each have benefits and disincentives. A senior’s home environment can be modified to accommodate medical and functional decline that occurs as they require more support in the activities of daily living. Home safety evaluations can expose safety hazards, such as loose rugs and areas of low lighting, which contribute to falls. As seniors require more support with bathing and feeding, paid caregivers can provide monitoring and assistance in private homes, and in personal care homes and in assisted living facilities. Nursing

THUY HANH TRINH

MD, MBA, FAAFP, FAAHPM, WCC Dr. Trinh is an Associate Medical Director at Houston Hospice and serves as the Education Liaison since 2007. She received her medical degree from Louisiana State University Health Science Center in New Orleans completed her palliative medicine fellowship at M.D. Anderson Cancer Center.

Photo source: Fotolia

Stresses of Senior Living

homes provide the most support for all activities of daily living, in addition to skilled nursing needs. Funding each of these living arrangements can also be a source of stress for seniors and their families. Several resources are available to help them discern which option would best fit their needs: Administration on Aging website: http://www.aoa.gov NIH’s website on Senior Health: http://www.NIHSeniorHealth.gov CMS’s website on Comparing Nursing Homes: http://www.medicare.gov/NHCompare/home.asp Maintaining a regular, active schedule can be a source of comfort. This can help to promote a healthy lifestyle and diet, to stimulate social interaction and intellectual creativity, and to contribute to a good night’s rest. Changes from their routine may contribute to stress for seniors, so providing them with knowledge of changes to their routine ahead of time is important to help minimize anxiety. Having a healthy exercise regimen can improve the senior’s ability to ambulate independently, improve sleep hygiene, and improve mood, all of which can reduce stress. The National Institute on Aging‘s Go 4 Life website http://go4life.nia.nih.gov/ promotes an active lifestyle for seniors. Home health or hospice teams are also available to support seniors and their families when their physical condition makes them eligible for these services.

healthlinemag.com | Jan - April 2016 | Healthline

NEW WAYS TO FIND MISDIAGNOSIS OF ABDOMINAL PAIN IN EMERGENCY DEPARTMENTS

Using electronic health records, researchers at Baylor College of Medicine studied patients who went to the emergency room with acute abdominal pain to evaluate factors contributing to an incorrect diagnosis and found that major causes of misdiagnosis included incomplete or incorrect history or exam and failure to order needed tests to determine the cause of pain. Their report appears today in the Emergency Medicine Journal. “In looking at the prior emergency medicine literature, abdominal pain was one of the chief complaints that was most frequently associated with diagnostic errors, but it had the least amount of research done on it,” said Dr. Laura Medford-Davis, assistant professor of emergency medicine at Baylor. “Not only is it fairly common as a presenting symptom, but it’s also one that could be missed or misdiagnosed,” said Dr. Hardeep Singh, associate professor of medicine at Baylor and chief of health policy, quality and informatics program for the Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey Veterans Affairs Medical Center.

Researchers used electronic health records to develop an electronic trigger to help identify patients who presented with acute abdominal pain, returned within ten days after their first ER visit and were admitted to the hospital when they returned. Within this group of 100 people with a higher probability of having a misdiagnosis than all patients seen, they further reviewed electronic records to find 35 diagnostic errors during the initial visits. More than two-thirds of these errors were related to the patient/provider encounter – often problems with the history-taking or exam – or in ordering additional tests, for example, not all necessary tests were ordered at the time patients presented. Researchers also identified a problem with

Healthline | Jan - April 2016 | healthlinemag.com

Researchers note that there needs to be better follow-up and reporting strategies implemented in the emergency room setting, both focused on the provider and the emergency room team. In addition, it’s essential to educate patients of certain risks and what they should do when their condition changes. They also note the need for more emergency department-based intervention programs to detect and reduce the risks they found in the study. Singh emphasized the importance of this work, citing a recent Institute of Medicine report that concluded that everyone will likely get misdiagnosed in their lifetime. “It’s important to have improvement strategies, and you cannot improve what you cannot measure, so this essentially is a study that can help us measure one type of emergency room related misdiagnosis. As researchers, we are trying to develop strategies that use electronic health records data to identify which people should be selected for further review and study. Without using a methodology that leverages electronic health record data, it would be really hard to identify which records to view further.”

the follow-up of abnormal test results. Two errors potentially could have caused immediate death, one had the potential for very serious damage and two more had the potential for very serious harm. “Emergency rooms are busy and often chaotic. Moreover, the diagnosis is often not clear when patients first present nor is diagnosis always black and white,” Singh said. “Our methodology of using rigorous reviews overcomes some of the limitations to measure misdiagnosis. Once these measurements are in place, emergency departments can implement improvement strategies for these types of diagnostic errors.”

Others who took part in the study include Elizabeth Park, James Suliburk and Ashley ND Meyer with Baylor and Gil Shlamovitz with the University of Southern California Keck School of Medicine. Investigators of this study were supported by Baylor College of Medicine, Center for Innovations in Quality, Effectiveness and Safety and the VA Health Services Research and Development.

DIPALI PATHAK SCS Ms. Pathak is a Senior Communications Specialist, Office of Communications, Baylor College of Medicine.

healthlinemag.com | Jan - April 2016 | Healthline

THE BENEFITS OF CHOOSING A COMPOUNDING PHARMACY problem-solvers. We love talking to and helping our patients. We offer consultation services and will sit down with you to discuss any ailments you have and how we can help with a cure. While our consultation services can be applied in any Before large situation, it is especially manufacturers helpful for women who were around, all would like to get started gluten, dyes, or preservatives, prescriptions were on bioidentical hormone we can formulate a compound compounded by the local replacement therapy. We can for you that does not have those pharmacist. In today’s age, make recommendations to your ingredients in it. We can also while most medications are doctor and if they decide to commercially available, that does make compounds that have never issue a prescription, we can get been commercially available not mean that this is the perfect you started on your customized such as bioidentical hormones medication for you. That is where medication regimen. used by both women and men. your compounding pharmacy Many patients are also interested Compounding pharmacies also and local pharmacist come in. in cosmetic and dermatology Doctors of Pharmacy are trained tend to carry some “hard to find” compounds. We can compound in the art of creating specialty items. We have pharmaceutical topical medications for acne and grade vitamins and supplements, medications to meet your specific scars and even make numbing skin care items, and essential needs. gels so that your hair removal or oils. We also carry homeopathic botox procedures are not painful. medications in case you are If a drug is discontinued, we can recreate it for you. If something is Veterinary patients are no looking for more natural problem for your compounding only available in a tablet, but you remedies for yourself or your pharmacist as we can make need a suspension for your child family. medicated treats that taste like that tastes good, we can make chicken, liver, or fish so that By this time you may be reading that too. If you have allergies to giving your pets this and thinking “this sounds medications will great, where can I find a no longer be compounding pharmacy?” Most LORI MARKEL PHARM. D difficult. Compounding Pharmacies are Dr. Markel is Doctor of Pharmacy and owner of the Sienna Compounding Pharmacy locally owned across the city and located in Missouri City, Texas. Compounding pharmacists are always available pharmacists are to speak with patients about their also really great specific medication needs. Have you ever wondered what a compounding pharmacy does and why you might need to visit one? At compounding pharmacies, we customize medications to suit a patient’s individual needs.

Healthline | Jan - April 2016 | healthlinemag.com

Diabetes Unchecked, Will Affect Vital Organs According to the American Diabetes Association, there are nearly 30 million Americans diagnosed with diabetes and an additional 8.1 million Americans with undiagnosed diabetes.1 Asian Americans, in particular, represent a high-risk segment of the population especially due to the genetic passing on of this disease from generation to generation.1 While the symptoms of diabetes can often go unnoticed, what we often forget are the devastating consequences that this disease can have on the rest of our bodies. Here’s a breakdown of how some of our organ systems are affected by diabetes: The brain: Adults patients with diabetes are 1.5 times more likely than patients without diabetes to be hospitalized for a stroke.1 Hyperglycemia and insulin resistance negatively effect blood vessels, coagulation factors, and circulation within the brain.2 The eyes: Diabetic retinopathy is the leading cause of new onset blindness in adults.3 Chronic hyperglycemia affects the eyes through mechanisms such as the accumulation of sorbitol leading to osmotic stress, the formation of advanced glycosylated end products leading to microaneurysms, as well as oxidative stress.4 The heart: Diabetes affects our hearts largely due to its association with the development of artherosclerotic plaque formation within coronary vessels as well as its direct effects on coagulation factors and platelets.4 The kidneys: Diabetes is the most common reason people go into kidney failure in the United States.1 This is due to the effect that chronic hyperglycemia can have on networks of capillaries in the kidneys, known as glomeruli.4 At centers which specialize in diagnosing and treating diabetes, they provide comprehensive care to diabetic patients by offering services administered by physicians specialized in diabetes care, as well as diabetic educators who assist

patients with the dietary and lifestyle changes they need to make to help ensure their better health and quality of life going forward.

1 2 3 4

“Fast Facts: Data and Statistics about Diabetes.” American Diabetes Association, 2015. Air EL, Kissela BM. “Diabetes, the Metabolic Syndrome, and Ischemic Stroke.” Diabetes Care 2007; 30: 3134. “Standards of Medical Care in Diabetes - 2015.” Diabetes Care 2015; 38: S49-66. Fowler MJ. “Microvascular and Macrovascular Complications in Diabetes.” Clinical Diabetes 2008; 26: 77-82.

JONATHAN HUANG MD

Dr. Huang is a physician at DiabetesAmerica, Humble, Texas. He specializes in Internal Medicine. He attended Rice University, got his degree from the Baylor College of Medicine

healthlinemag.com | Jan - April 2016 | Healthline

PARKINSON’S DISEASE AND THE ROLE OF DOPAMINE

Parkinson’s disease (PD) is a neurological disorder affecting about 1% of men and women over 60 years old, but it can manifest in much younger age. At least one million people in the USA, and more than five million worldwide, live with PD. The exact cause of PD is still unclear, but we know now that it results from neurodegeneration, or cell loss, in the dopamine-producing structure of the brain called substantia nigra. Dopamine is an important neurochemical that activates other brain areas directing and controlling normal movements of the body. Only about 5% of PD cases are genetic Clinical symptoms of PD include tremor of the hands, legs, or chin, slowness of movements, stiffness of muscles, and impaired gait and balance (motor function). Some patients have all of the above symptoms, whereas others might have no tremor or no gait problems especially in the early stages of the disease. A majority of patients also experience nonmotor symptoms such as decreased sense of smell, acting out dreams at night, constipation, erectile dysfunction, urinary urgency, drooling, low volume voice, depression, anxiety, fatigue, hallucinations, etc. Some of the non-motor symptoms can manifest years before classic motor features of PD, and they are often considered as pre-motor symptoms of PD. There is no blood test to confirm the diagnosis of PD. Thorough examination by an experienced neurologist is often sufficient to diagnose somebody with PD. Brain imaging with CT or MRI is often performed to rule out other disorders that can mimic PD such as

OLGA WALN MD

Dr. Waln is a Movement Disorders Neurologist, Houston Methodist Neurological Institute. A Board certified and fellowship-trained neurologist specialized in diagnosis and treatment of Parkinson’s disease and other movement disorders, Assistant Professor of Neurology at Weill Cornell Medical College.

Healthline | Jan - April 2016 | healthlinemag.com

old strokes, hydrocephalus (fluid entrapment inside of the brain), accumulation of iron or copper in deep structures of the brain. In some patient with less clear clinical presentation, special brain scan (DaTscan) detecting deficiency of dopamine can be utilized. A lot of research is being conducted in attempt to find a neuroprotective medication that would be able to stop or slow down cell loss in substantia nigra, but unfortunately, such drug is not available yet. Treatment of PD at present is aimed at alleviation of the symptoms and improvement of patient’s quality of life. With appropriate treatment, most patients can have long and fulfilling lives. There are multiple medications: pills, injections, patches, or gel delivered from the pump straight into intestines are available to treat PD including those supplementing and replacing dopamine (levodopa), and drugs enhancing the effect of dopamine by delaying dopamine breakdown or stimulating dopamine receptors in the brain (new treatment option that became available in 2015). In many patients, especially in more advanced stages of the disease, a combination of two or more medications is necessary. Surgical treatment options such as deep brain stimulation can be offered to some PD patients in whom treatment with medications is not sufficient. No dietary modifications, vitamins or supplements demonstrated proven influence on the course of PD; however healthy and balanced diet can improve fatigue and constipation in PD patients. Regular physical exercises were associated with slower progression of physical disability in PD in multiple clinical studies, and therefore should be considered as an important part of treatment plan for any patient with PD.

PRACTICAL TIPS FOR CUTTING DOWN THE COST OF LIVING WITH DIABETES A large majority of people living in the US have diabetes. A common stress and challenge that doctors hear from their patients is the financial cost of living with and managing diabetes. Here are some practical tips for patients to help them cut down the cost of diabetes care: Medication savings cards: If you are on a branded medication, look for savings cards that will help bring down the cost. These cards are typically available online from the drug name website and can be downloaded for free. Your doctor may also have these cards available. Compare medication prices: Prices of medications vary between different pharmacies, so shop around. Websites such as goodrx.com will compare prices from different pharmacies for you. Mail order: Ask if your insurance plan provides additional discounts when you order a 90 day supply of medications or supplies by mail order. Generic medications: Talk to your doctor and ask whether your diabetes could be managed with generic instead of brand medications. Glucose meter and supplies: Ask your insurance whether they have a preferred branded meter or whether receiving supplies by mail order will be less expensive. If the preferred meter and supplies is still too expensive, ask your pharmacy store whether they

sell generic meters and supplies which may be less expensive. Download a free fitness tracker on your phone: If you can’t afford a fitness tracker which can range from $30 to $300, you can download one onto your smart phone for free. Search for “pedometer” and many free applications are available. Aim for 10,000s steps a day for a healthy lifestyle. Make exercise a part of your daily life: Can’t afford a gym membership? Consider integrating one of these routines into your daily life instead - take the stairs instead of the elevator, park the car further so you walk more, use part of your lunch break to take a walk, take a walk with your family after dinner.

lasting longer. Eat right: If you are on insulin therapy, the more carbohydrates you eat, the more insulin you will need. Adopting a healthy diet will help you not only feel better, but may also mean less insulin which translates to cost savings. Cut costs by cutting down on weight: Weight loss and achieving a normal body weight may be the most cost effective way of managing your diabetes. Several of my patients have been able to decrease the amount of medications, some have even been able to get off all diabetic medications, with weight loss and a healthy diet. Don’t skip doctor appointments: Don’t let your diabetes get out of control by skipping doctor’s appointments. Uncontrolled diabetes can cause heart attack, stroke, kidney failure and nerve damage – all which can lead to an expensive surgery, hospitalization or visit to the emergency room. Some of these complications may also be irreversible once you develop them. Consider your regular follow-up with your physician an investment in your health that will pay dividends in the long run.

Plan before you go to the grocery store: Eating healthy does not have to be expensive. Before your next trip to the grocery store, scan the store’s weekly advertisement. The front page is typically where they advertise that week’s sale of fresh produce and meat. Make a list of on-sale lean meats, vegetables and fruit to buy and plan the following week’s meals according to those items. Another option is buying bulk frozen p r o d u c e JESSLYN LU MD which provide Dr. Lu is double board certified in essentially the endocrinology and internal medicine and same benefit sees patients at the Diabetes America – Medical Center location. She enjoys helping as fresh plus her patient achieve control of their diabetes the benefit of through lifestyle changes, medications and

the newest innovations.

healthlinemag.com | Jan - April 2016 | Healthline

Delays in growth and developmental are always alarming for parents and family members. Social and communication delays are especially concerning as it relate to neuro developmental disorders. When there is a delay in different basic skills including in ability to get involved in imaginative play.

Autism One of the most common developmental disorder is Autism Spectrum Disorder (ASD). Males are more affected by ASD than females. According to the data CDC (2011) 1 in 88 births have a diagnosis of ASD. The data shows 1 in 54 boys and 1in 252 girls have an ASD diagnosis. It is estimated that 1- 1.5 million Americans have ASD. Ability to perform may range from mild to severe. ASD can exist along with other disorders also. CERTAIN FACTS ABOUT ASD ASD consist of Childhood Developmental Disorder (CDD) Autism and Rettâ&#x20AC;&#x2122;s disorder. A reliable diagnosis can be established before 36 months of age. In the general population there is a risk of having a second child with ASD is 50- 100 times. The fathers or grandfathers who work in Engineering, Physics or Mathematics field have twice the chance of getting a child in the spectrum (Baron-Cohen, Wheelwright, Stott, Bolton & Goodyer, 1997).

SOBHA GEORGE MSN, CEN

Ms. George is a registered nurse working in the Clinical Operations Informatics Department at MD Anderson Cancer Center in Houston. She is actively involved with various organizations serving special needs populations like Heavens Own Precious Eyes (HOPE), school districts, and Texas Parent to Parent.

Healthline | Jan - April 2016 | healthlinemag.com

Spectrum

DISORDER

There is an obvious impairment using nonverbal behaviors through facial expression, body postures or gestures, delay or failure in developing appropriate peer relationships, inability to share pleasures with others as well as lack of social- emotional reciprocity are seen in this population. Impairment in social interaction is one of the most common characteristic. This along with two of the above mentioned signs will be able to establish a diagnosis. Repetitive restricted patterns of stereo typed behavior are seen with compulsive adherence nonfunctional routines or rituals. During the infancy, the child could be a model baby who is lethargic, content to left alone or an Irritable baby with sleeping problems, excessive crying and inability to be comforted or a normal baby with typical growth and development for 12-24 months. The red flags during 18-24 months include lack of socialization and communication, limited vocalization, poor eye contact, inability to attend to voices including own name and repetitive behavior. Around three years of age repetition of spoken words or singing (delayed echolalia) will also be seen. Interventions are needed in developing social skills, functional, and social communication. Addressing behavioral problems as well as sensory integration are also crucial in the management of ASD.

HOW SOUTH ASIANS PERCEIVE IT The family that rallies behind a loved one stricken by cancer or heart disease questions the same loved one suffering from depression or schizophrenia. This is especially true in the South Asian community. There is strong stigma attached to acknowledging the existence of mental illnesses and seeking treatment for the same. Why do South Asians avoid speaking about mental illnesses and seek help to achieve mental well-being? Knowing the cultural, historical and religious should give a better understanding of their attitude toward mental illness. Early South Asians are known to have associated psychological problems to external sources such as being possessed or a curse from ancestors. Symptoms of mental illness such as crying spells or involuntary movements were attributed to ‘madness’ or idiosyncrasy. People with such symptoms were shunned or feared, and family members often turned to a faith healer, astrologer or a religious leader to find answers. Prayers and rituals for the ‘possessed’ were common. There are temples for the mentally ill that stand as a reminder of this age-old misconception. Understandably, South Asians living in the United States are likely to view mental health diagnoses and psychiatric services with skepticism. Yet, having lived here for decades, working and raising families, there is still no significant improvement in their knowledge and attitude toward mental illness – that mental illnesses are legitimate and can be cured or controlled.

Many South Asians view psychiatry and counseling as frivolous options for “Americanized” folks with relaxed values. Besides, the concept of counseling itself raises the question of, “How can ‘talking’ help?” Additionally, talking to a third person even if he is a professional about one’s innermost thoughts is considered a sign of weakness and betrayal of family members who feel exposed by sharing of these

Photo source: Fotolia

ME N TA L HEALTH IS NOT A MY T H

thoughts. Unlike physical ailments, mental health issues are tied to the cultural beliefs, family reputation and personal stature of a person, thus leading to conflicting feelings of betrayal, failure, shame and guilt. Studies on mental health problems among South Asians reveal that their bi-cultural existence itself is a major cause of depression, anxiety and related problems. However, if the symptoms of depression and anxiety are perceived as unreal or imaginary it could result in families struggling in silence with problems common among immigrants: gender role changes, isolation from family, demands of the new society, generational gap between parents and children and so on. If unaddressed, these problems can lead to major depression and even suicide, not to speak of the break-up of families. As the South Asian community expands into its second and third generation, it is essential for the community to have open dialogue on mental health problems and promote acceptance and timely treatment. Psychiatry and counseling are legitimate avenues that can save enormous pain and disastrous outcomes for families struggling with the mental illness of a loved one.

LAKSHMY PARAMESWARAN MA LPC

Mrs. Parameswaran is a licensed counselor and founder/board member of Daya Inc., a Houston non-profit serving South Asian survivors of domestic violence and sexual assault since 1996. Her articles on gender-based violence, political and social issues were published leading newspapers and magazines.

healthlinemag.com | Jan - April 2016 | Healthline

Osteoarthritis or Degenerative joint disease is the most common type of arthritis among the elderly. It occurs when the cartilage between the joints breaks down, consequently degenerating the underlying bone because of the friction. This deteriorates the tendons, meniscus, muscles attached to the joints; which means the overall joint health is affected. Since the already weakened joints/tendons are being used consistently as we do our daily chores, inflammation can occur around the joints.

AYURVEDIC Management of OSTEOARTHRITIS 26

Healthline | Jan - April 2016 | healthlinemag.com

Symptoms Joint pain, stiffness, swelling, crackling sound from joints (Crepitus), limited joint movements etc.

Causes Old age, obesity (weight gain), frequent usage of a particular joint, joint injuries (fractures, ligament tears etc.) Certain jobs that require prolonged hours of standing, lifting of heavy weights, repetitive bending etc. can cause significant wear and tear of cartilages. Joint diseases like Rheumatoid Arthritis and some other metabolic disorders can also lead to Osteoarthritis.

Ayurvedic approach In Ayurveda, this disease is called as ‘Sandhi Vata’ (Sandhi means joint) As you know, Ayurveda states that there are three major bio-energies called Vata, Pitta and Kapha which governs all the bodily functions. Any imbalance in these can cause a disease cndition. Osteoarthritis is caused by excess aggravation of Vata Dosha. Major underlying reasons are weakened digestive fire (Agni) and resultant accumulation of toxins (Ama) in the joints. Errant lifestyle, improper diet etc. can weaken the digestive system, because of which the elimination of intrinsic toxins becomes difficult. Build up of these toxins in the body (joints in this case) leads to the imbalance of Vata Dosha. Vata is dry and destructive in nature. As age advances, the influence of Vata in the body is high and it absorbs a lot of fluid content from body. This also includes the absorption of Synovial fluid (lubricant between the bones) which results in the progressive erosion of the cartilage. This causes the bones to come in contact too often, causing over growth of joint margins – called as Osteophytes.

Treatment Home remedies like Turmeric and Ginger, Bala are very helpful in this condition. For effective treatment, Ayurveda targets to reduce the influence of Vata in the body and increase the Shleshaka Kapha so that the joint spaces are lubricated adequately for proper movement. This is done by strengthening the Agni and detoxifying the whole body. This in turn strengthens the muscle support around the joints, prevents the stiffness or frozen feeling and thereby improves the whole body mobility. Panchakarma has been proved very effective in preventing the condition from going worse. Ayurveda has a lot of time-proven external procedures like Snehana/Abhyanga, Swedana, Mridu Virechana, Basti etc. and very effective internal usage herbs which can significantly help reduce the intensity of Vata. Ahara and Vihara (Dietary restrictions and lifestyle changes) play a major role in an effective treatment regime. Talk to your Ayurveda consultant to get more insight into the condition and an effective prevention routine.

LAKSHMI DEVI MALIAKKAL Mrs. Maliakkal is an Alternative Medical Practitioner (AMP) and a Registered Advanced Ayurveda Practitioner, practicing at Santhigram Houston.

healthlinemag.com | Jan - April 2016 | Healthline

CURING SKIN DISEASES BY

NATUROPATHY Skin is body’s outer covering, which protects against heat and light, injury, and infection. Skin regulates body temperature and stores water, fat, and vitamin D. The skin, which weighs about six pounds, is the body’s largest organ. It is made up of two main layers: the epidermis and the dermis. The outer layer of the skin (epidermis) is mostly made up of flat, scale-like cells called squamous cells.

The negative effects of consuming corticosteroids include skin thinning (atrophy) and stretch marks, bruising and tearing of skin, peri-oral dermatitis and enlarged blood vessels (telangiectasia).

There are certain diseases like the Systemic lupus erythematosus (SLE), psoriasis, eczema and acne which affect the skin adversely. They also have various impacts inside and outside the body.

TREATMENT THROUGH

1) SLE - high inflammation, antigen, antibody reactions, hair follicular infections 2) Psoriasis - plaque formation and shedding of epithelial layer These diseases are curable through various medicinal methods, they can be treated using ordinary modern medicines or by naturapathy. The importance of naturopathy is that it has best long term solutions without any side effects.

TREATMENT THROUGH REGULAR MODERN MEDICINES Some common drugs prescribed by physicians during skin diseases are methotrexate and corticosteroids. As long as the patient consumes these drugs, the symptoms of the diseases are reduced. However, when the drug is stopped, the ill effects come back along with many other side effects. For instance, consuming methotrexate would reduce the impact of disease on the body but also suppresses the immune system, inhibit folic acid metabolism, cause liver failure, and cause many ill effects on the gastrointestinal, hepatic and hematological systems.

Healthline | Jan - April 2016 | healthlinemag.com

These medicines will suppress the symptoms of the disease in the short runbut in the long run their negative impact will overtake their positive effect.

NATUROPATHY In naturopathy diseases are treated with different perspective which has no place for any of the above side effects. A person suffering from any skin disease is treated with methods of detoxification and rejuvenation. . Detoxification includes keeping the person on liquid diet and removing undigested proteins, fats, carbohydrates and other metabolic wastes through a process of colon cleansing.

Rejuvenation includes the following steps:

Identifying the inflammatory value of each food in the patient’s body Identifying gut leakages and avoiding those food items which have high inflammatory value Preparing a diet chart according to body adaptability Topical application of different herbal formulation like neem, aloe vera, turmeric, etc.

In the last twelve years of treating patients through naturopathy I have treated about 50-60 patients with skin problems caused by SLE and Psoriasis. One patient that I treated through naturopathy for Psoriasis in the year 2013 was suffering for the last 15 years. After 52 days of treatment his skin became completely normal. Since then he has reported relapse three times but the symptoms have never been so severe. The duration between relapse has been increasing and the symptoms decreasing without medication but only with naturopathy methods of diet control, herbal applications, and physical activities.

Case of psoriasis treated at SLNS Nature Cure Hospital, India in November 2013

1st day of treatment

32nd day of treatment

52nd day of treatment Photo source: ÂŠ SLNS Nature Cure Hospital, Bibi Nagar, Telangana, India

P. KARTIK MD

Dr. Kartik is the Director of the SLNS Nature Cure Hospital near Hyderabad, India.

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Hepatitis Many people’s health concerns typically focus on heart disease, cancer, diabetes and Alzheimer’s disease. But a frequently overlooked area, and one that people should think more about, is liver disease, including hepatitis C. Especially if they are between the ages of 50 and 70, which is considered the baby boomer generation. An estimated three to four million Americans have hepatitis C and baby boomers account for 75% of that number. Most are unaware that they are infected with the virus. Hepatitis C is a deadly disease that kills more Americans each year than HIV, according to the Centers for Disease Control and Prevention. And it is much more common. Four times as many Americans have hepatitis C than HIV.

THE REASONS One is that blood and blood products were not screened for hepatitis C until 1992 and the virus is transmitted that way, so individuals who received blood transfusions, organ transplants or other invasive medical procedures before that time could have

Healthline | Jan - April 2016 | healthlinemag.com

If You Don’t Think You Need to Be Tested, You Probably Do been exposed. Universal blood screening for HIV began much earlier, in 1985. Lifestyle choices are another factor. Boomers came of age before public awareness about the risks of shared needles and unprotected sex. And younger generations do not get a pass. Young adults should be aware that getting unsafe tattoos or piercings, and IV drug use – even one time – increases their risk of contracting hepatitis C as it does for individuals of any age. Hepatitis C is called the” silent” killer because it can be present in the body yet take decades for symptoms to appear. So people have no idea that they are infected and may

In fact, hepatitis C is the most common reason for liver transplants in the United States. The good news is that there are new medications that are game-changers in treating hepatitis C, including Sovaldi, Olysio and Harvoni. These medications have cured more than 90% of patients and offered them a better quality of life while undergoing treatment. More treatments for hepatitis C are in the drug development pipeline.

unknowingly pass it on to others. Sharing razors, nail clippers and even mistakenly using a family member’s toothbrush can spread the virus. When symptoms do emerge, they may present as fatigue, nausea, achiness, abdominal pain or flu-like symptoms. “We are seeing much higher rates of hepatitis C and diseases that result from untreated hepatitis C such as cirrhosis and liver cancer,” says Andrew Muir, MD, chief of the Division of Gastroenterology at Duke University School of Medicine, and a member of the American Liver Foundation’s national medical advisory committee. “Our patients are shocked to learn that they were living with the virus for years or decades because they experienced no symptoms. We need to identity these patients and get them treated well before they get to the end stage.”

Still, many people who can benefit from these treatments will not if they do not know that they have the virus. The Centers for Disease Control and Prevention and the American Liver Foundation encourage individuals born between 1945 and 1965, as well as all at-risk populations, to be tested for hepatitis C. For more information about hepatitis C, including the latest treatments, finding a physician and supportive care services, contact the American Liver Foundation’s national helpline 1-800-GO-LIVER (1-800-465-4837) and visit its hepc123.org and liverfoundation.org websites.

TOM NEALON

Mr. Nealon is the chief executive officer and national board chair of the American Liver Foundation, whose mission is to facilitate, advocate and promote education, support and research for the prevention, treatment and cure of liver disease.

healthlinemag.com | Jan - April 2016 | Healthline

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HEALTHLINE ADVISORY BOARD ABRAHAM THOMAS MD Dr. Thomas’ clinically evaluates critically and acutely hospitalized patients and outpatients with cerebrovascular disease, including the sequelae of ischemic and hemorrhagic stroke. His primary research interests are: epidemiological and pathophysiological mechanisms of stroke, acute treatment and prevention of stroke, and the long-term sequelae of cerebrovascular disease and global systems of stroke care. He is the Associate Directory of the Neurology Residency Program at Houston Methodist Neurological Institute. Dr. Thomas graduated from the University of Texas with Honors with a Bachelor of Arts degree in Biochemistry and Philosophy. He received his M. D. from Baylor College of Medicine. After completing residency in Neurology at Emory University he served as a Neurohospitalist and the Stroke Director at Florida Hospital. Furthering his education, he graduated from University of California San Francisco (UCSF) as a Neurovascular Clinical Fellow.

CATHERINE PAPASAKELARIOU MD Dr. Papasakelariou is board certified by the American Board of Dermatology. Born in Miami, Florida, she grew up in Houston, Texas. She obtained a Masters in Virology and Gene Therapy at The University of Texas, MD Anderson Cancer Center before attending medical school at the University of Arkansas for Medical Sciences in 2010. She remained at the University of Arkansas completing her residency in dermatology and also served as co-chief resident. After her residency at the University of Arkansas in dermatology and she returned to Houston and joined the team at Bellaire Dermatology.

ARJUN GHOSE RN, MBA, CEO, DD Ghose is CEO of an international medical outreach operation. His training in the most prestigious medical center in the world has brought him through training, research, and clinical roles at Baylor College of Medicine, MD Anderson, Memorial Hermann, Methodist, and Texas Children’s Hospital. Ghose offers medical executives valuable insights from his marketing experience with leading corporations. To patients and their families he offers valuable perspectives in geriatrics, dialysis, and pediatrics. Ghose has a proven track record empowering and advocating for children affected by adoption, divorce, and abuse. Ghose studied spirituality in medicine

and has been awarded the Doctorate in Divinity.

HANH TRINH MD Dr. Trinh is Associate Medical Director at Houston Hospice in Houston, Texas. She received her medical degree from Louisiana State University Health Science Center in New Orleans and trained in family medicine at Baylor College of Medicine. Following residency, she completed her geriatric fellowship at Baylor College of Medicine and her palliative medicine fellowship at M.D. Anderson Cancer Center. She is a fellow of the American Academy of Family Physicians and a fellow of the American Academy of Hospice and Palliative Medicine. She joined Houston Hospice in 2007 and serves as the Education Liaison.

CHANDRA MITTAL PhD Dr. Chandra Mittal is a Medical Scientist. He is Professor of Biological and Biomedical Sciences at Houston Community College, Houston. He completed his Ph.D. at AIIMS in India and Fellowship at University of Virginia. He is elected fellow of American College of Clinical Pharmacology (FCP). Dr. Mittal is the Co-Discoverer of “Nitric Oxide-Cyclic GMP Signaling System” with Ferid Murad who was awarded the 1998 Nobel Prize in Medicine for this discovery. Dr. Mittal’s research has been published in international journals and he has served on expert panels of NIH, NSF, and various medical journals.

HealthLine would like to invite Medical, Scientific and Healthcare professionals that are passionate; people oriented and willing to give their time to join our Advisory Board and help us disseminate valuable information for wellbeing of the community. Please email us your published article(s), short bio and head shot at voiceasia@aol.com.

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Jacob Sanchez Diagnosed with autism

Lack of speech is a sign of autism. Learn the others at autismspeaks.org/signs.