MD Monthly March Cover

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contents M arch 2018 Production Digital Media Source Chief Executive Officer Eliot Garza Publisher Jessie Moore Project Manager Alejandra Bermea Account Executives Justin Zundt, Rebekah Washington Digital Media Coordinator Kristy Pierce Assistant Project Manager Sarah Washington Publishers Eliot Garza & Jessie Moore Creative Services Designer Aurora Balderas Cover Designer Michael Mancha Editors Jody Marmel Writers Jody Marnel Contributors Sue Carrington Eric Kala CFP®, CIMA®, AEP®, CLU®, ChFC®, CRPS® Dr. Melissa Macias Dr. Pradeep Mohan Leticia Morales Dr. Maria Palafox Dr. Satish Pai Karen Reed Ashley Stephens Dr. Salim Surani Dr. Jennifer Walden Douglas R. York

Cover Feature

Dr. Mathew Alexander Coastal Bend Neurosurgeon Business

Stability for Challenging Times Avid Wealth Partners

Photographer Trinity Greer FOR ADVERTISING INFORMATION, PLEASE CALL 210.373.2599 OR EMAIL HELLO@MDMONTHLY.COM FOR EDITORIAL COMMENTS AND SUGGESTIONS, EMAIL EDITOR@MDMONTHLY.COM

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10 | CCRH

contents

Exercise & Heart Disease

By Leticia Morales

12 | Informed Patient

Hair Loss & Balding Exposed

16 | Karen Reed on the

The Vegan and Paleo Combo

20 | Facetite with

Dr. Jennifer Walden

22 | Women’s Health Polycystic Ovary Syndrome

24 | Part II

Chronic Wounds: Healing

42 | Business

Douglas York advises What to do if your spouse threatens your practice

44 | News

Novus Scientific Relaunches Surgical Mesh

46| Women’s Health Breast Reduction

50 | Altus Hospice Care Hospice Myths

56 | Women’s Healt

Symptoms of Breast Cancer

By Dr. Maria Palafox

26 | March 21st

World Down Syndrome Day

28 | South Texas Brain & Spine Center

Dr. Melissa Macias

38 | Veda Medical

What’s a medical spa and why you should try it?

40 | Children’s Health

5 Tips to Help Your Child Deal with Braces Dr. Satish Pai 8

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HEALTHY LIVING | CORPUS CHRISTI

Exercise

Put Your Heart Into It!

by Leticia Morales

A

ccording to Strava, a social network for athletes, most people by now have given up on their New Year’s resolutions (“Quitters’ Day” was officially back on Jan. 12). For those whose healthy resolutions may have fallen victim to that day, here is something to consider: According to the American Heart Association, being physically active is important in preventing heart disease and stroke, which are the nation’s number 1 and number 5 killers respectively.

Regular exercise can help manage known risk factors of heart disease. Studies have shown that physical activity can help reduce high blood pressure, weight, and “bad” cholesterol, while increasing “good” cholesterol in the body.

But despite these benefits, many Americans aren’t physically active on a daily basis. According to the Centers for

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Disease Control and Prevention (CDC), only about half of Americans meet the recommended guidelines for aerobic physical activity, which is 30 minutes of moderate-intensity activity for five days a week.

Part of this problem might be caused by thinking that “moderate” exercise means heartpounding exertion and sweat, when in reality it can be as simple as brisk walking.

Understanding how to gauge exercise intensity is important and

essential in order for people to reap the benefits.

To monitor exercise intensity, you have to pay attention to your perceived exertion or how hard you feel like your body is working. Take note of how heavy you’re breathing, how much you’re sweating, and how tired your muscles feel. Studies have shown that an individual’s perceived exertion correlates to his or her heart rate.

This means that if you feel like you’re working hard, your heart rate is probably higher.

A person can estimate if he or she is reaching the moderate-intensity level of an activity by using perceived exertion. In general, on a scale of 1-20, a moderate-intensity activity would feel like an 11-14. Other clues of this level of exercise include: • Breaking a light sweat at about 10 minutes into the exercise • Quickened breathing, but you’re

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not out of breath • Being able to carry on a conversation while performing the activity Moderate-intensity exercises can include brisk walking, biking, pushing a lawn mower, water aerobics, doubles tennis, gardening, and ballroom dancing, among other activities.

What’s important to note, however, is that perceived exertion is different for each individual. The same activity may be easier for one person and harder for another, and that’s O.K. Just be sure to do the activity at the level that feels right for you. And remember, doing something is always better than doing nothing.

Leticia Morales is Director of Therapy Operations at Corpus Christi Rehabilitation Hospital. The hospital

provides specialized rehabilitative care to patients recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. It is certified nationally by The Joint Commission

for Stroke Rehabilitation. For more information, visit CCRH.ernesthealth. com, call 361-906-3700 or visit the hospital at 5726 Esplanade Drive, Corpus Christi, Texas.

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COMMON MYTHS AND TRUTHS ABOUT

HAIR LOSS AND BALDING

EXPOSED Provided by Karen Reed

F

or the millions of people who experience thinning or balding of their hair, it can be devastating. What can be even more devastating is not getting accurate information when it comes to what they can do about it. There are many myths surrounding hair loss and balding, and they can hold people back. Knowing the myths and truths about hair loss and balding can make a world of difference when it comes to addressing it properly, so that the person’s self-esteem is restored along with their hair.

“I’ve worked with enough people who have hair loss to know that it is often a big blow to their confidence level,” says Dr. John Kahen, founder of Beverly Hills Hair Restoration (BHHR). “Being able to navigate through the issue is the best way to be able to come out the other end with hair, as well as feel good about your appearance.”

In a 2016 issue of the journal CME

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Dermatology, researchers share an article that discusses alopecia (hair loss) in general medicine. They report that the psychological impact of hair loss is often overlooked, yet it causes significant psychological distress.

They also report that many sufferers experience feelings of distorted self-image and low self-esteem, and they may also display symptoms of anxiety and depression.

Knowing the truths about hair loss can help give hope to the many people who are experiencing it and the

psychological impact that accompanies it. Here are some common myths and truths about hair loss: Myth: Women don’t lose their hair.

Truth: There are many women who experience hair thinning and loss.

According to the International Society of Hair Restoration Surgery (SHRS), there were over 133,000 people who had hair restoration in the U.S. in 2016, and 39% of them were women. The psychological impact of hair loss may be even more alarming for women than it is for men.

Myth: Thinning hair is an issue only for seniors.

Truth: While most people associate hair loss and balding with older people, it happens to young ones as well. If there are others in the family who have experienced it, then it may not be such a shock. But for those younger people who haven’t seen other family members experience it, the balding at such a young age can cause a lot of

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psychological stress.

Myth: Hats or frequent shampooing make your hair fall out.

Truth: While hats and shampooing don’t lead to hair loss, it can be a problem if you are wearing hats that are too tight, or not keeping them clean. Also, some of the things people do to their hair can lead hair to fall out, including pulling the hair too tightly, such as in pigtails, as well as using hot oil treatments, which can lead to the hair follicles becoming inflamed.

Myth: Stress is what causes hair loss.

Truth: Hair loss can happen for a number of reasons. According to the National Institute of Health, some of the reasons can be diabetes, lupus, poor nutrition, thyroid problems, medications, and other health conditions. High stress levels can be a contributing factor to hair loss, but the most common reason is genetics.

Myth: Shaving makes the hair grow back thicker.

Truth: People often don’t observe the amount of hair- before and after.

Shaving doesn’t make the hair grow back thicker. If that worked, everyone losing their hair could simply shave it

Dr. Kahen, who is a world-renowned hair restoration surgeon, is a pioneer and the leading expert in using the Platelet Rich Plasma technique, called SmartPRP®. His hair restoration technique uses the body’s own tissue regeneration mechanism to strengthen small hairs and stimulate growth of new follicles. Smart PRP, a 30-minute procedure, can be performed as a stand alone treatment or in some cases, it is combined with transplant surgery which takes all day. Since Smart PRP® is an injection therapy procedure.

Patients generally return to work the next day. Hair transplants take longer

and wait for it to grow back thicker and fuller.

Myth: Hair restoration is timeconsuming and inconvenient.

Truth: Hair restoration services are easier and more convenient than ever today. The reality is that the procedure generally takes around an hour, sometimes less. Recent advances including Dr. Kahen’s SmartPRP® can generate results in as little as 30 minutes. Those who need a hair transplant will find it takes up to six

to heal – generally 10 days — as the redness, swelling and scabbing fade.

Cost of treatment varies based on the treatment(s) plan.

Dr. Kahen has performed thousands of hair restoration surgeries and has become one of the most sought-after doctors in the world. He has performed surgeries on business executives, physicians, dignitaries, and celebrities, among others. He has invented some of the most advanced restoration technology, including SmartPRP®. Located only 30 minutes from the Los Angeles International Airport, BHHR also offers a

hours for the surgery, depending on the extent of the baldness, and does require a longer recovery period.

“Myths abound when it comes to hair loss and treating it,” added Dr. Kahen. “The best rule of thumb is for those with thinning and balding hair to get a consultation. Then they will have the answers of why they are losing their hair and what options there are to do something about it. I have helped thousands of people restore their hair, along with their self-esteem.”

fly-in program, helping those who may be coming in from other states or countries for the procedure.

Beverly Hills Hair Restoration offers effective options for those with thinning and balding hair. Their services include hair transplants, the Platelet Rich Plasma technique, hairline lowering, facial body hair transplant, eyebrow transplant, female hair loss treatment, textured transplant options, and more. Their awardwinning hair transplant services have helped thousands of people achieve lifechanging results. For more information, visit their site at: www.beverlyhillshr.com 2018 - MARCH

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SECTION / CITY HEALTHY LIVING / REGIONAL

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HEALTHY LIVING

The Vegan and Paleo Combo IS IT WORTH IT?

by Karen Reed

A

Pegan diet… what is it?

The root words involved here are vegan and paleo.

Vegan refers to a diet consisting mainly of plants. Paleo, on the other hand, is a new term that is associated with a “caveman” and a caveman’s diet consisted of meat, fish, eggs, vegetables, and fruits. For the diet conscious, pegan is assimilating the best and most healthy of a vegan and paleo diet. It’s an eating style that incorporates the best of both worlds.

The Pegan diet concentrates more on the glycemic load factor. The glycemic load is associated with the carbohydrates in a food. It indicates the effect of these carbohydrates on a person’s blood glucose level. Both diets can manage sugar levels. Logically, it would be easier for Paleos to maintain their glycemic index. This is because

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their diets consist of meats and fruits and involve minimum amounts of sugars. Vegans, however, will have a tougher time controlling this factor.

A Pegan diet is a combination of the different elements of both Paleo and Vegan diets. It is a hybrid approach which combines the very best components of each and avoids the worst.

Dr. Mark Hyman, the Pegan’s creator, put together the best of both diets without any prejudice on either.

The emphasis of Dr. Hyman’s diet was eating whole foods which would apparently give the person the health benefits from both the combined lifestyles.

What are the Main Components of a Vegan and Paleo Combo Diet A Pegan diet entails a leaner version of paleo, meaning less meat and more vegetables. It also centers on whole, fresh, sustainable foods like healthy fats and veggies, but it also includes some meats and animal products. The Pegan diet is turning out to be a combination of both vegan and paleo diets.

Strictly following the glycemic factor, the Pegan plate should contain foods that fall between 55 and 69 on the glycemic index. The Pegan diet sees to it that its list of recommended foods is

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strictly followed, making the diet plan blood-sugar friendly.

Listed below are the foods to consider as well as the foods that are off limits in a Pegan diet: Dairy, sugar, soy, and legumes: Foods classified in these categories are off limits for Pegan dieters. Dieters can forget yogurt, granola, edamame, and peanuts. These foods are hard to break down. They cause certain discomforts like gas, bloating, and sometimes constipation.

Fats and grains: Now, these are the real deal. Olive oil, avocados, and most nuts are highly recommended for the Pegan plan.

So are whole grains like oats, quinoa, amaranth, millet, and wild rice.

Gluten: This substance is to be avoided by the Pegan diet. Therefore any form of wheat is a no-no as they contain gluten.

Other grains like spelt, semolina, barley, and rye are also on the off-limits list.

Plants: Most of the foods in a Pegan diet include fruits and vegetables. Plantderived foods support blood sugar levels. Favorite items on the plant list include apples, grapefruits, peaches, oranges, and almost all vegetables.

Protein: About a quarter of the Pegan diet contains lean animal protein, such as eggs, fish, chicken and lean beef.

This need is inherited from our paleo heritage. It is important though, that the sources of this protein should be grassfed and free from antibiotics.

Veggies that don’t make the cut: Sadly, not all veggies can be included in the Pegan list because of their high glycemic indices. Say goodbye therefore to beets, pumpkins, sweet potatoes,

regular potatoes, and parsnips.

The Benefits of a Vegan and Paleo Combo Diet On first impressions, vegan and paleo diets may be deemed as opposites. But, a closer analysis will demonstrate that the two have many things in common.

For starters, both diets are based on the consumption of whole foods. This means plenty of veggies and an overall healthy lifestyle. When people think of paleo diets, they immediately associate it with meat. Keep in mind that the foods paleos eat are like what our ancestors ate.

Foods in a Pegan diet are mostly plant-based. It’s almost like those of vegetarians except that the former allows the nourishing addition of eggs and meat of the highest quality. Plantbased foods take center stage on a Pegan diet with a minimum amount of meat on the side. Choosing vegetables with high nutritional contents can readily satisfy our nutritional requirements.

These prevent illnesses and inflammations.

The Pegan diet combines the best and healthiest foods from Paleos and the Vegans. This is its biggest advantage. The Pegan diet becomes

less restrictive by allowing more foods on its list. In other words, there will be more items to choose from. One can have a meal with foods derived from both the Paleo’s and Vegan’s list.

The Pegan diet, which is mainly plant-based, offers a wider selection of nutrients for a healthier lifestyle. The choice of organic-grown high-quality fruits and vegetables can amply supply the daily requirements of calcium, folate, fiber, as well as all the minerals and vitamins. Since the Pegan diet recommends choosing organic foods: those foods without the harmful antibiotics, pesticides, and other such dangerous chemicals, it appears to be ahead of other diets in terms of overall well-being. Following this diet will benefit the person with meals that are nutritionally more dense.

Will it Help a Person Lose Weight?

One sure way to lose weight is eating foods that make one feel fuller. Fiberpacked vegetables and satiating fats can do this for anyone, and this IS the Pegan way.

Eating several servings of veggies will hinder the craving for food. This is because the person will always feel full.

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HEALTHY LIVING

And much better, the calorie count of such intakes will still be low.

because the body will be needing more iron that was derived from meats before the conversion.

People need to consider some factors before starting a weight-losing plan. At the onset, one might feel a little bit restricted because they will be avoiding foods that they are used to.

With these premises, a person truly will be adopting a new lifestyle.

Making compromises in food choices ensures success. It is not necessary to abruptly change one’s eating habits and choices. Beans, for instance, are not in the Pegan plan. But one can still include them in the diet because they are a good protein and fiber source.

Just be conscious of the quality of food choices. They should be low on the glycemic index. They should be organic.

They should not have refined sugars, hydrogenated oils, and sodium.

This is especially true for athletes or people who are super-active. For such people, cutting out essential foods like workout-boosting protein, calcium, iron and other nutrients might not be a good idea. These foods help keep the body in top condition, so avoiding them might adversely affect the body.

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Anyone who wants to stick to the Pegan diet needs to make sacrifices.

Doing so would mean crossing out dairy on the food list. These are main sources of calcium and vitamin D in pre-Pegan days. So, a person might need supplements to be able to meet the body’s needs. Legumes will also be eliminated as per the plan. These were the sources of muscle-building protein and energizing iron. Crossing them out can cause problems especially for those who indulge in heavy workouts.

Following the Pegan diet may make a person lethargic at the gym. This is

The foods will still conform to the Pegan diet of eating more vegetables and less meat but with some slight customizing. It will take a little time to adjust to the rules but eventually, losing weight should not be far behind.

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COSMETICS | AUSTIN

Facetite

May Be the Non-Surgical Treatment You’ve Been Waiting For Provided by Dr. Jennifer Walden

W

e all know that facial aging cannot be avoided. The body naturally changes with time, even when we are careful to supply it with what it needs. That being said, there is no reason to sit back and accept the formation of lines and wrinkles if you don’t want to. Cosmetic plastic surgery isn’t your only option for a rejuvenated appearance. We enjoy showing patients how innovative technologies can meet their needs for the appropriate degree of facial rejuvenation. Here, we want to discuss how FaceTite™ works.

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FaceTite™ is one of several radiofrequency treatments that has been developed in the last few years.

Because there are numerous options for skin tightening without surgery, it is important to ask why you may choose one treatment protocol over another. This is when a personal

consultation in our Austin office can be most beneficial. At its core, what radiofrequency does for the skin is incite the remodeling of the superficial collagen matrix beneath the surface.

Collagen is vital to the skin’s firmness and overall resiliency, and is only effective when it is strong and in ample supply. The objective in radiofrequency anti-aging treatments is to positively affect the production of this important protein.

Here’s Where Facetite™ Stands Out Currently, the average radiofrequency skin-tightening and smoothing treatment delivers energy from the

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outside only. Most applicators focus radio waves at the skin, which allows for a degree of absorption through the epidermis and layer of superficial tissue. FaceTite™ goes a step further.

This bipolar radiofrequency treatment conducts from an outside electrode, and also from a tiny internal probe that is inserted just beneath the skin. It is the synergy between the two points of energy that creates a dramatic change in the tightness of the skin.

Advancements in technology provide benefit to our patients who want the best results without the downtime of surgery.

This facial contouring treatment is often performed on the lower and mid face, reducing the appearance of jowls and general laxity. FaceTite™

may also be performed on the chin and neck, as well as on the upper face to slightly lift the brows and rejuvenate the eyes.

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WOMEN’S HEALTH | CORPUS CHRISTI

UNDERSTANDING

POLYCYSTIC OVARY SYNDROME

by Dr. Salim Surani

26%

of women in their reproductive years are affected by Polycystic Ovary Syndrome. This syndrome is actually a hormone imbalance. The female hormones, estrogen and progesterone decline and the male hormone, androgen, increases when Polycystic Ovary Syndrome is present. This causes a lot of challenges with fertility, irregular periods, and an increase in insulin resistance.

I published a paper five years ago highlighting the link between polycystic ovary disease and sleep apnea, which Harvard and Duke use as a guideline for screening those patients.

Obesity is a key factor in this disease. If you actually lose 5-10% of your weight, this helps with polycystic ovary syndrome. Most of the time, the main symptom is an irregular period. Another symptom can be the

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metabolic syndrome, where your insulin resistance has increased and your sugar levels go up. The other challenge can be with an excess of male hormones that can lead to increased body hair. This is called hirsutism.

It is very simple to diagnose Polycystic Ovary Syndrome: If you have a history of an irregular period, then you can do a simple blood test and you can check your hormone levels. You can also have a pelvic exam or an ultrasound performed and that will show multiple cysts in the ovary.

Be proactive so you can try to cure this.

• You can lose 5-10% of your weight • You can try a birth control pill that will help with hormones • There are some medications to assist you as well

Dr. Salim Surani is the Medical Director of Critical Care Services at Christus Spohn Hospital-Corpus Christi. He has authored more than 150 articles in the

peer review journals and has written several books and book chapters. He has also served as the reviewer for more than 20 peer review journals.

Dr. Surani’s area of interests includes, but are not limited to Critical Care, Asthma, COPD, Sleep Medicine, Quality Assurance programs and pulmonary infections.

Dr. Salim Surani founded Pulmonary Associates of Corpus Christi over ten years ago on the Coastal Bend.

Visit their Facebook page: www.facebook.com/ pulmonaryassociatesofcc or call them at 361-885-772.

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INFORMED PATIENT | REGIONAL

Chronic Wounds: Healing the Problem PART 2: THE PATIENT’S PERSPECTIVE

by Sue Carrington

C

hronic, non-healing wounds have been called a “silent epidemic.”

As we explored in Part 1, problem wounds are often found in postacute care (PAC) patients. Many PAC patients have chronic conditions such as diabetes and vascular disease that weaken their immune systems and complicate wound healing. If these wounds aren’t properly treated, they can lead to severe infections, recurrent hospitalizations—and, in the worst cases, amputation and death.

“To win the war on this epidemic, leading PAC communities are delivering programs that customize interventions to each patient’s needs,” says Dr. Stephanie Newsom, a certified wound specialist physician for Vohra Wound Physicians, the nation’s largest wound

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care group serving PAC facilities. She also treats patients at Settlers Ridge Care Center in Celina, Texas, one of 27 communities served by Vohra partner StoneGate Senior Living.

Treating the whole person “Whatever the wound—from burns and rashes to pressure sores and diabetic ulcers—our goal is to create a patient-centered environment for wound healing,” Dr. Newsom notes.

“Along with minimizing pain and reducing the risk of infection, we offer each patient straightforward education on how they can expedite their own healing process.” Examples include such proactive steps as controlling blood sugar levels and complying with compression therapy, designed to increase blood flow in the lower limbs.

Care goes beyond physical treatment. The wound care team is also focused on offering patients emotional support.

“Slow-healing wounds can pose many psychological hazards for patients, from anxiety and depression to shame and grief,” Dr. Newsom notes.

“Such distress can further disrupt the immune system and impair the

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healing process. StoneGate wound teams offer compassionate listening and guidance to allay patient fears, help build resiliency, and encourage steps forward.”

Newsom tells the story of a resident in the memory care unit at Settlers Ridge who developed several wounds on her feet. “She insisted on walking around without shoes. But because she had severe diabetic neuropathy, her foot injuries went unfelt. The entire team got involved in getting her the right orthotic shoes and gently coaxed her into protecting her feet. With good shoes, daily moisturizing treatments, and vigilant monitoring, blood flow to her feet improved. Within four months, all wounds were healed.”

Taking a team approach Along with specialized physician care at the bedside, StoneGate also engages multidisciplinary teams trained in chronic-wound management to maximize positive patient outcomes.

“Because wound care stretches across several healthcare specialties, StoneGate’s perspective is to take a team approach,” Dr. Newsom says.

“From clinicians to nutritionists and physical therapists, all are involved in the healing process— following a holistic, highly personalized care plan for every chronic wound.”

“Our certified nursing assistants (CNAs) are at the front line of wound care. They have frequent contact with patients, assisting in activities of daily

living and serving as gatherers of vital information about each patient’s condition. If a patient develops a new wound or if an existing wound worsens, the CNA is the first to sound the alarm and spur the care team into critical action.”

Teaching the latest therapies As highlighted in Part 1, Vohra is focused on offering post-acute care nurses continuous education and support to stay up to date on the latest wound therapies. The company provides an 11-module, online, wound care course for nurses, covering everything from acute and chronic wounds to wound assessment, geriatric skin conditions, and treatment options.

Staff at all Vohra partner PAC facilities can earn continuing education credits and a Vohra Wound Care Certification.

“While certification isn’t a prerequisite for working in wound care, it reflects a commitment to continuous professional development,”

Dr. Newsom notes. “It also boosts patients’ confidence in the care they’re receiving.”

Transforming wound care “Patients in PAC facilities need unified care to heal their wounds and ultimately, prevent overall decline,” Dr. Newsom says. “With a teambased approach, PAC leaders, such as StoneGate, are delivering healing treatments, giving patients hope, and providing them with the best care possible. The result is an enhanced quality of life today and an improved health forecast for tomorrow.”

About the Author: Sue Carrington is a seasoned and purpose-driven journalist, with a focus on healthcare innovation. She has pursued her love of words through a diverse array of callings – from book editor to radio news director, public relations manager to corporate writer and freelance writing entrepreneur. Sue is a native of the Washington, DC, area.

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INFORMED PATIENT | REGIONAL

by Ashley Stephens

T

he word “Freedom” has several meanings including the pursuit of equal opportunity for life, liberty, and happiness. Collectively, this affords us the opportunity to create the life we want to live. Perhaps, your life choice could make an impact on genetic research as well as discovering and identifying complex disorders. The choice is yours and everyone should feel like they have that choice.

same lens as their peers, not the lens blurred by the preconceived notions of a diagnosis. This kind of clarity allows us to focus on what a person can do rather than what they can’t do. Casting aside the stereotypes and the way things have always been done gives a person with DS freedom to pursue equal opportunity for life, liberty, and happiness. Choose to see beyond the diagnosis and share freedom for all.

But, what if your life was chosen for you? The diagnosis of an individual with Down Syndrome (DS) often stereotypes the life they will live. Their diagnoses sets expectations for their health, capabilities, life-span, and quality of life. Often times, a person with DS will endure health complications that consist of congenital heart defects, leukemia, hypotonia, and much more.

World Down Syndrome Day is observed every year on March 21st.

This is a global effort to raise Down Syndrome awareness and advocate for rights to inclusion and well-being, rights of all free people, even people with a diagnosis of Down Syndrome. milestone after milestone. Life may present you with a diagnosis, but it should not choose your life.

Each complication presents a roadblock to the next milestone and it’s easy to look at their peers and be discouraged as they accomplish

As a mother of a son -Pearson with DS, an aspiration of mine is to encourage society to view individuals with Down Syndrome through the

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On this day, you can do something fun and educational. Wear your CRAZIEST pair of socks to represent the 3 Chromosomes that identify Down Syndrome. Post your crazy sock pictures with the hashtag #downswithpearson and show your support on March 21st!

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INFORMED PATIENT | CORPUS CHRISTI

Osteoporosis & Herniated Disc

+ Back Pain Prevention

by Dr. Melissa Macias South Texas Brain & Spine Center

Disc Herniation

A

common problem we are seeing is herniated discs.

This is when the disc bulges or protrudes and affects the nerve level. The consequence is commonly back pain. But more frequently, it’s associated with pain that goes down an arm, into the hand, leg or into the foot.

The bones located above and below the disc space is the intervertebral disc space. When the two bones stack up on each other they create a canal. The nerve root exists through this canal.

When the disc bulges out, it pinches that nerve against the bone. Afterwards,

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that nerve can become irritated and painful.

Osteoporosis Osteoporosis is a common problem that involves the spine. As the population gets older, we are seeing this more often. What happens in Osteoporosis is that the bone density decreases, therefore the strength of the bone is compromised. A minor trauma such as sitting firmly on a chair can cause a compression fracture.

The treatment is pain medications and bracing that allows for the bone to heal. This bone fracture can lead to

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significant pain that alters or limits a person’s mobility.

One treatment that we do for Osteoporosis is a minimally invasive procedure called vertebroplasty or kyphoplasty. This is very effective in stabilizing the fracture and helping patients get pain relief, so they can be active and mobile again.

Back Pain Prevention Back Pain is a very prevalent problem in our society. It’s one of the most common reasons for visits to the emergency room or to see your primary care doctor. There are many things we can do to prevent back pain such as a healthy diet, regular exercise, strengthening core muscles, and strengthening back muscles.

Body mechanics is also very important. For example, when lifting, it’s better to bend at your knees rather than bending forward at your waist.

If you or a loved one is experiencing back pain, please contact Dr. Melissa Macias at South Texas Brain & Spine Center.

Phone: 361.883.4323 or visit online: Southtexasbrainandspinecenter.com

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DR.Mathew

Alexander STRATEGICALLY PLACES AN EMPHASIS ON MINIMALLY INVASIVE TECHNIQUES AT SOUTH TEXAS BRAIN & SPINE CENTER

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Dr.

by Jody Joseph Marmel

Mathew Alexander grew up in Kentucky and gives his father a great deal of credit for sparking his interest in the medical field. “My father was a surgeon and he would take me to the operating room when I was younger. I found it to be fascinating and knew that I would be heading in that direction as I advanced in school.” He completed his Neurosurgery Residency from the Medical College of Wisconsin and is Board Certified by the American Board of Neurological Surgery.

Since his brother is a Cardiologist in Corpus Christi and his sister is a Neurologist in Houston, Dr. Alexander started his practice in Corpus Christi so he could be closer to his family.

“I also wanted to bring quality of care to the Coastal Bend. We take care of all facets of Neurosurgery and I knew that our services were needed here.”

South Texas Brain & Spine Center was formed in 2008 by Dr. Alexander and the team offers the best techniques available.

The other physicians are Dr. Langham Gleason, Dr. Howard Smith and Dr. Melissa Macias. Dr. Alexander explains, “Neurosurgery is the most fascinating field. We really have the opportunity to

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Photography: Trinity Greer MDMONTHLY.COM

make a positive difference in people’s lives.” While the physicians perform surgeries at a Level 2 Trauma Center, and use cutting edge technology for cancerous tumors (CyberKnife Radiosurgery), Dr. Alexander focuses on the Minimally Invasive Surgeries because the recovery rate is faster, there is less pain involved and patients prefer these type of procedures if applicable. “If we can fix a problem using a scope, we try to do that more often than the more complicated surgeries. We may not always have that option due to each individual case, but when we do, we always go with Minimally Invasive Surgeries.”

The quality of care offered by South Texas Brain & Spine Center rivals that of any big city.

“There is nothing here that we don’t offer that is offered in other cities such as Houston or San Antonio. We offer the same excellent level of care here, so that if there are any problems, we have the ability and capability of dealing with that right here on the Coastal Bend.”

The South Texas Brain & Spine Center’s goal is to treat their

patients underlying condition with an individualized approach and help each patient move toward a better quality of life. Dr. Alexander adds, “We are very passionate about what we do and we try to treat each of our patients as if they are family.”

Their compassion goes even further than this. Since there is poor access to healthcare, Dr. Alexander and his team go the extra miles and accept all insurances. “We strive to be the best in our techniques, our approach, our surgeries, and we make sure that we take care of everybody.” While this is unusual in the medical arena, it is obvious that Dr. Alexander is determined to help those patients that need treatment regardless of what type of insurance they have. The key

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and other treatments if necessary and physical therapists as well as other modalities that are minimally invasive.

“We usually keep surgery as our last option. We want our patients to come here for the help they need. Since a lot of people are fearful of seeing Neurosurgeons because they don’t want surgery, we understand that and we try our best to take the least invasive route.”

factor here is caring about people and ensuring that the community gets the best care possible.

The following is a list of procedures offered by South Texas Brain & Spine Center.

The Spine Disorders treated include: • Degenerative Facet/Joint Disease • Spinal Stenosis • Spinal Instability • Trauma—Fractures/Dislocations • Tumor—Primary/Metastatic • Infection • Compression Fractures • Craniocervical Disorders • Failed Back/Chronic Pain Disorders • Sacroiliac Joint Degeneration The brain disorders treated include: • Tumor • Infection • Trauma • Stroke • Movement Disorder—Parkinson’s Disease • Hydrocephalus/Normal Pressure Hydrocephalus • Arteritis Diagnostics • Trigeminal Neuralgia

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The Peripheral Nerve Disorders treated include: • Nerve Entrapment Syndromes • Tumor The scope of the practice ranges from young adults to older adults and focuses on the spine and the brain.

Dr. Alexander explains, “We do spine emergencies, brain emergencies as well as back pain, neck pain and a host of degenerative problems.”

South Texas Brain & Spine Center covers a diverse area from Corpus Christi to San Antonio to the Valley.

They have an office in Victoria and another one will be opening in Laredo in the coming year. The need for Neurosurgery in these cities has not been met, but Dr. Alexander and his team are sharing their expertise and medical help to those that need it the most. “These are underserved areas and we want to help those in need.”

And that is exactly what this wonderful practice is doing throughout the Lone Star State.

The practice refers their patients to pain management doctors for injections

“We can diagnose the problem so that you can get the right treatments.

It is always important to take action and not ignore a problem. We want to make the best decision on how to help you.”

With compassion, intelligence, years of experience and a genuine love for his specialty and the patients he treats, it comes as no surprise that Dr. Alexander is the Chairman of Surgery and Neurosurgery for CHRISTUS Spohn Health System. He is also Vice President of Clinical Affairs of Christus Shoreline and slated to be Chief of Staff in two years. Being involved in the policies and regulations of surgery at all five facilities is another tremendous responsibility that Dr. Alexander enjoys.

But, there is more to Dr. Alexander’s story. Approximately 30 minutes north of Corpus Christi is the DEA Ranch. He fell in love with this land and wanted to share it with everyone. The Ranch has several hunting packages to choose from and he visits the ranch every three days or as much as possible.

The Reserve at Dancing Elk is located on the ranch and it is known as one of

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the largest event halls in Texas. Many weddings are booked here because of its beauty and elegance and memories that are sure to last a lifetime.

And then there is the Brain Storm Child Care Learning Center that opened on February 12, 2018. It is located across the street from the South Texas Brain & Spine Center in Corpus Christi. Dr. Alexander decided to open this child care center to help out the nurses, medical associates and others that need the help with child care as they work and help others.

This is not the end of Dr. Alexander’s story-in fact, I am quite certain that there are going to be more amazing avenues he explores that will benefit his patients, his community and let’s go a bit further-his fellow Texans from the north, south, east, and west.

He is an incredible man that wants to

help others and share the beauty of life.

At South Texas Brain & Spine Center, Dr. Alexander continues to help others every single day.

“A lot of our patients have chronic pain. When you live with pain every day, it causes you to be unhappy and you are unable to enjoy life.”

He continues, “You don’t have to live with that pain, discomfort or weakness. We are here to help you.”

With Dr. Alexander and his team to treat your condition with minimally invasive techniques or other options tailored to meet your specific needs, you can get your pain-free life back and start enjoying the beauty all around you.

For more Information visit southtexasbrainandspinecenter.com Corpus Christi Office 1227 3rd St. Corpus Christi, TX. 78404 (361)-883-4323 Victoria Texas 302 E. Airline Victoria, TX. 77901 (361)-576-1411

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BUSINESS | REGIONAL

Stability for Challenging Times

I

Provided by Eric Kala CFP®, CIMA®, AEP®, CLU®, ChFC®, CRPS®

n volatile economic times like the ones we’ve seen recently, it’s not surprising that people want something they can count on — a stable financial asset that will be there to help them meet important financial needs, no matter what. For many, that vehicle is permanent life insurance.

Permanent life insurance (sometimes referred to as whole life insurance) is a unique financial tool. That’s because it can provide a foundation of protection for your entire life, no matter how long you live (assuming that premiums are paid to keep the policy in force). In contrast, term life, another popular type of insurance, provides coverage for a specific period of time, such as 10, 20 or 30 years. This means a term life policy might end long before your need for it does.

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Keeping pace with changing needs The ability to provide protection for your family throughout your life can be a vital benefit, especially given the fact that life expectancies are on the rise in America.

Today, it’s not uncommon for someone to live two or more decades into retirement.

And, where once expenses tended to fall as people aged, that’s not necessarily the case these days: You may be retired, but that doesn’t mean your mortgage or other expenses are retired too. Similarly, you may have a pension plan, but those benefits may pass away when you do, leaving your spouse without a financial safety net after you die.

Permanent life insurance lasts for the rest of your life; it’s there when you need it. And because permanent life provides a guaranteed payout, you don’t have to worry about becoming uninsurable later in life. Regardless

of your health, your family or your business is protected.

Planning flexibility today … and tomorrow Equally important, permanent life insurance also provides cash value that is guaranteed to grow each year, tax deferred, regardless of what’s going on in the market. This amount can be used in the future for any purpose you wish.

For example, you can borrow against your policy’s cash value, generally on a tax-free basis, and use that money for a down payment on a home, to help pay for your child’s college education or to supplement your income in retirement.

Keep in mind that any loans you take will accrue interest and decrease the cash value and death benefit of the policy if you die before paying them off.

However, if you decide to stop paying

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premiums and surrender or cancel your policy, the accumulated policy values, less any loans and interest, are yours.

A cost effective alternative Many permanent life insurance policies also are eligible for dividends, which can add to your death benefit and any cash value, which grows tax deferred.

These dividends, which are not guaranteed, can be used to pay all or part of your premiums, helping to reduce or even eliminate your out-ofpocket cost for coverage. They can also be used to increase your total death benefit over time without increasing your premiums.

The power of partnership While cost is an important factor when considering any type of insurance, it’s important to look at more than just the premium. You’ll want to also consider the financial strength of the insurance company, including its

“cash value that is guaranteed to grow each year, tax deferred, regardless of what’s going on in the market” claims-paying ability and track record of paying dividends. After all, you want a company that is likely to be there for you when you need it.

You’ll also want to understand what you’re buying. This is where a trained financial advisor can help. A good financial advisor will help you evaluate your goals and objectives, and help identify which products offer the most appropriate solution for your unique circumstances. And, equally important, a trusted advisor will review your insurance policies with you every year to ensure it continues to meet your changing needs.

Article prepared by Northwestern Mutual with the cooperation of Eric Kala. Eric Kala is a Wealth Management Advisor with Northwestern Mutual the marketing name for The Northwestern Mutual Life Insurance Company (NM), Milwaukee, Wisconsin, and its subsidiaries. Eric Kala is an agent of NM based in San Antonio, TX. To contact Eric Kala, please call (210) 446-5755, e-mail at eric.kala@nm.com or visit avidwealthpartners.com. This information is not intended as legal or tax advice.

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COSMETICS | SAN ANTONIO

WHAT IS A MEDICAL SPA and Why You Should Try It Provided By Dr. Pradeep Mohan

M

edical spas are the new beauty trend sweeping the nation; but what exactly is a medical spa? They are not as outlandish or overindulgent as you may think. In fact, many of their services are quite affordable, practical, and effective. After learning more about what medical spas have to offer, you will undoubtedly want to try one!

BEST FACE FORWARD Medical spas are a place to make your wishes come true when it comes to problem areas you may have deemed unchangeable. They can remedy common issues such as acne scars, age spots, wrinkles, sagging skin, or uneven complexions.

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Your face is what you use to interact with the world and the people around you, and you want it to be something you are proud of, and that represents you well.

problems have already taken hold, a medical spa can use a variety of lasers, fillers, and techniques to correct them.

A medical spa can help you achieve that confidence in your face, and at a reasonable cost.

QUALITY PRODUCTS Also along the lines of maintenance, medical spas typically sell high-quality facial products. Brands like SkinMedica, Dermalogica, and Skinceuticals are all worth their monetary investment to keep your skin healthy and youthful.

You can find moisturizers, sunscreen, retinol, and makeup within these skincare lines.

Regarding maintenance, medical spas offer facials and peels to improve and maintain the youthfulness and health of your skin. Prevention is, of course, the best medicine. But, once

BODY BEAUTIFUL However, it’s not always your face that causes insecurity. Medical spas have a multitude of remedies for your body as well.

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Most medical spas offer laser hair removal–a financially savvy solution to rid yourself of unwanted hair and an endless supply of tiny pink razors!

With six sessions, you can be hair-free anywhere on your body, like your legs, underarms, upper lip, bikini area, or lower back, to name a few.

Medical spas can also remedy cellulite, spider veins, tighten sagging skin, and contour your body shape. They may accomplish this with lasers, but some facilities offer minimally invasive liposuction for small problem areas.

THE WORKS Depending on the medical spa you choose, they may also offer top-of-theline pedicures, manicures, and haircuts.

A full salon at a medical spa carries highquality hair care brands to restore, color, and liven up your hair.

Massages and aromatherapy are often services offered at medical spas as well. That is where you will find highly experienced and licensed professionals to execute stellar bodyworks that heal your body. From hot stones to sugar scrubs to methodical strokes, these

professionals are guaranteed to “wow” you. Overall, medical spas can discreetly help you regain confidence in your appearance.

Now that you know what medical spas have to offer, you are probably ready to book your first appointment.

Just search for medical spas in your area, read reviews, and ensure the doctor, nurse, or esthetician is experienced and licensed.

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CHILDRENS HEALTH | REGIONAL

5 Tips

H

ave you ever wondered how stressful it can be for your child to get accustomed to braces? The thought of having a foreign material in the mouth is nerve-racking for both you and your child, but it’s worth it once you see positive changes in your child’s teeth and jaw structure. It is your responsibility as a parent to prepare your child to deal with braces by discussing its benefits, the procedure involved and the possible consequences of wearing them. Nowadays, it is common to see children of various age groups wearing braces. Now, it is socially acceptable and no longer a reason for embarrassment to the people wearing them. With the advent of technology, braces are not just a metal wire in your mouth – they have evolved into hassle-free devices that come in trendy styles and colors too.

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to Help Your Child Deal with Braces To overcome the initial apprehension about wearing braces, your child needs your support. Here are 5 ways you can help your child deal with braces:

1

Follow dietary instructions.

Following the dietary instructions that are given by the orthodontist is probably the toughest challenge children may have to face as it requires giving up many of the foods that they love. Usually, hard fruits, chips, caramel popcorns, and sticky foods are not recommended for children with braces.

Soft foods such as puddings, mash potatoes, and soft noodles that do not require a lot of chewing are generally recommended by the orthodontist.

You can help by making food tasty and interesting so that your child finds it less

difficult to cope with drastic dietary changes.

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2

Stick to the cleaning routine Brushing and flossing can be a very challenging routine for children with braces. The use of special brushes to clean the areas between the wire and the teeth and around the brackets adds to the challenge. Help your child stick to the routine by always being accessible when the cry for help comes your way.

3

Pay attention to the concerns Your child may experience low selfesteem and could be bullied at school. It is your responsibility as a parent to pay attention to the tell-tale signs that point at your child’s mental state. Hear out the concerns, however small they may seem to you, but they mean a great deal to your child. Don’t judge or ridicule your kid.

4

Reduce the pain Whenever the braces are adjusted, your child may experience intense pain and discomfort. Painkillers prescribed by the Orthodontist would help reduce pain caused by the braces. A small bowl of ice-cream can also help to soothe away the pain. If the pain persists despite all the measures taken above, then you might want to schedule an appointment with your Orthodontist in order to check the reason for persistent pain.

Dr. Satish Pai – an Ivy League trained dentist and a faculty at Columbia University, believes that a perfect smile not only makes a person look great, but a person feels great while boosting confidence. As the founder of Putnam Orthodontics, he is dedicated to not only creating perfect smiles for his patients, but also educating people with his engaging articles about all things related to a perfect smile and oral health. Spending time with his family always brings a smile on his face. In his free time, you can find him golfing, doing yoga or surfing.

5

Make the process easy The easier the process is for your child, the better are the results of the treatment. You could invest in an electric toothbrush that can make routine brushing fun and easy. A water flosser can be an excellent flossing option compared to the conventional flossing method as the pulsating water has a soothing effect on the gums.

Children mostly experience discomfort during the first few days of wearing braces and get used to it eventually. They might experience tenderness after adjustments, but once the child starts noticing the apparent

changes, the new improved smile overshadows all the discomfort and pain. Orthodontic treatment is essential, but more important is the support and encouragement you give to your child to overcome the stress of dealing with braces.

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BUSINESS | REGIONAL

WHAT TO DO IF, DURING A DIVORCE, YOUR SPOUSE THREATENS TO

“DESTROY YOUR PRACTICE”

By Douglas R. York

I

t is no news to anyone that people going through a divorce tend to be very emotional and sometimes irrational. It is not uncommon for a physician’s spouse to threaten, during a divorce proceeding, to “destroy” the practice of the physician, or to expose him or her to partners, or even to patients, as payback for perceived mistreatment during the marriage.

Often a declaration of this kind makes no sense and could even harm the interests of the spouse doing the threatening. After all, the physician’s practice is probably the heart of the community property both spouses share and will divide. If there are

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children involved, the physician’s practice will be an important source of the ongoing support of those children.

But, an angry spouse may still fling threats and promise to air a barrage of criticisms on social media, perhaps claiming that the physician’s skills are deficient in some way, or that he or she doesn’t like or respect the patients and describes them as chronic whiners or complainers, or simple minded folk who can’t follow instructions, or gullible hopefuls who want to experiment with every new medicine advertised on TV. Or the complaints may have nothing to do with the physician’s medical

abilities but, reflect on him or her as a human being, such as accusations of infidelity, abuse or some kind of financial fraud.

Who would want to keep relying for medical care on a physician who has been publicly exposed as a compulsive philanderer, an abusive spouse, or an indifferent and mostly missing-in-action parent?

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Or the spouse may take another approach entirely and threaten to take over control of the medical practice by way of claiming his or her share of community property.

The truth of the matter is that these threats are essentially empty and should not worry the physician in question for a variety of reasons. A non-physician, for instance, is not legally allowed to own a medical practice, so the threat of taking over and controlling the medical practice is simply not credible. Dividing community property will entail giving the non-physician spouse a portion of the estimated value of the practice, not ownership or control.

As for concerns that an infuriated spouse will set rumors flying and tell tall tales on social media that will discredit the physician and the physician’s practice, that is easily handled, if necessary, by requesting that a judge grant a temporary injunction prohibiting disparagement or harassment by either party during the divorce process.

That should also stop informal rumor mongering outside of social media, which can be critical to the health and survival of the doctor’s practice in a smaller community.

A judge can even enjoin the

spouse with more specific injunctions, prohibiting that spouse from posting on any social media any derogatory remarks that could harm or devalue the practice, or from contacting business partners or patients with the intent to disparage. If the spouse continues despite the injunction, he or she could end up in jail, if held in contempt of court. In short, the physician may rest assured that there is an effective response to the threat if it is handled swiftly and correctly.

It is in no one’s best interest in any divorce for spouses to denigrate each other on social media or otherwise. The person being criticized may be harmed, but the critic may also appear to be mean-spirited and vindictive, thereby losing the sympathy of the judge or jury in the case. In the case of a physician, reputation is of paramount importance.

A good attorney will not allow his or her

doctor client to be publicly slandered by an angry about-to-be ex. And the truth is that attorney will often be protecting the physician’s spouse from the consequences of his or her own worst impulses, in addition to protecting the physician.

This article offers legal information but not legal advice pertaining to specific, individual circumstances. No attorneyclient relationship is formed with readers.

This article was written by Douglas R. York, an attorney based in Houston with 17 years of experience in marriage dissolution, including multi-jurisdictional divorces involving highly complex legal issues.

There is more information at douglasyork.com.

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NEWS | REGIONAL

Novus Scientific Relaunches

Surgical Mesh in U.S. Market

Special to MD Monthly

I

nnovative resorbable surgical mesh to support and reinforce soft tissue before absorbing completely

Novus Scientific AB announces the U.S. market relaunch of TIGR® Matrix Surgical Mesh through Insightra Medical, Inc., a full-line hernia technology supplier.

Made from synthetic polymers, TIGR® Matrix is a long-term resorbable surgical mesh intended to support and reinforce soft tissue for six months before absorbing completely after three years. Primarily utilized in the U.S. for hernia surgeries, it has been FDAapproved since 2010 and is available in three sizes. Consisting of dual-stage degradation and full resorption, TIGR® Matrix provides strength and flexibility when both are most needed by patients

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during the healing phase.

Novus Scientific first announced its strategic alliance with Insightra Medical in November 2015 to tap into the U.S. company’s national direct sales channel. Distribution plans were put on hold, however, as Insightra was soon acquired and restructured by GPB Capital Holdings, LLC, a New Yorkbased alternative asset management firm with over $1.5 billion in assets under management.1 “We first chose Insightra Medical as our U.S. distributor due to its reputation as a leading supplier of hernia and soft tissue repair technology. Now, with GBP Capital’s backing, Insightra is an even stronger partner for us, and we are confident TIGR® Matrix will soon have the brand recognition and widespread

use in the U.S. that it possesses around the world,” says Thomas Engström, CEO of Novus Scientific.

“Novus Scientific and Insightra Medical are both innovators in the hernia market with a focus on reduced pain and patient trauma, which sets both companies apart from the classical hernia mesh manufacturers. GPB Capital sees enormous growth potential in the U.S. for TIGR® Matrix, and the companies’ synergies make Insightra Medical and Novus perfect partners for such a strategic alliance,” says Evan Myrianthopoulos, Managing Partner of GPB Capital responsible for the firm’s Debt Investments, and Chairman of Insightra Medical.

TIGR® Matrix’s resorbable mesh has been used on-lay to reinforce

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About Insightra Medical: Insightra Medical, Inc. designs, develops and markets a new generation of medical devices serving the hernia and general surgery market.

As a fast-growing hernia device company with a dedicated hernia sales force in the United States.

Insightra Medical is focused on improving patient outcomes such as reducing post-operative pain. For more information, visit www.Insightra.com.

midline laparotomy closures in order to avoid wound dehiscence in a study published in Frontiers in Surgery.2 Many surgeons believe using a permanent material causes unnecessary risk of long-term, mesh-related complications, like discomfort and chronic pain.

“Standard hernia meshes and plugs are often associated with numerous complications, most of all chronic pain, which is why Insightra is focused on becoming a premium provider of innovative hernia repair solutions like TIGR® Matrix,” explains Kai Trompeter, CEO of Insightra Medical.

Data presented by Dr. Bruce Ramshaw,3 chair of the Department of Surgery at the University of Tennessee Graduate School of Medicine in Knoxville, in 2016 showed a cost savings of $8,744 per patient when surgeries used TIGR® Matrix compared to the use of biologic mesh. “By

replacing the biologic meshes we used for Abdominal Wall Reconstruction, we saw significant savings for the hospital, and when combined with other process improvement ideas, we saw better outcomes,” states Ramshaw, who has used TIGR® Matrix for his surgeries since 2011.

About Novus Scientific: Novus Scientific AB, Uppsala, Sweden, develops, manufactures and markets resorbable implants that help the body’s own healing.

For more information, visit www.

NovusScientific.com.

TIGR® Matrix will be on display this March in Miami at the International Hernia Congress, presented by the American Hernia Society.

CAUTION: Read “Instruction for Use,” which accompany the product, for indications, contraindications, warnings and precautions.

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SENIOR HEALTH

WHY UNDERGO BREAST REDUCTION?

by Bree Shaw

W

hile big breasts are often considered an ideal, women who have them can attest that they can cause real problems.

In 2015, more than 40,000 women decided that breast reduction surgery was the answer for them, according to the American Society of Plastic Surgeons. Why do women decide surgery is the solution? There are multiple reasons women might elect to undergo breast reduction surgery.

PHYSICAL HEALTH ISSUES Symptomatic macromastia sounds intimidating, but it is not the name of some dread disease. It is the medical term doctors use when large breasts create physical problems. The weight of large breasts can trigger chronic pain in the chest wall, neck, back, and shoulders.

It is also linked with headaches, poor posture, and sleep disturbances. Skin rashes under and between the breasts are common as well. While nonsurgical treatments do exist for these issues, they usually are far less effective than surgery.

Unfortunately, large breasts can also set the stage for a variety of other health issues because they often make it difficult for women to exercise.

Finding sports bras that provide sufficient support is both difficult and costly, making it tough for women with big breasts to enjoy running, jumping, and other physical activities. Since being active is uncomfortable, many of these women adopt more sedentary lifestyles, increasing their risk of obesity and the many health concerns that are associated with it.

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AESTHETIC CONCERNS Like many plastic surgeries, some patients chose to undergo breast reduction for aesthetic reasons. Large breasts add significant weight to the torso, and they can make an individual look heavier than she is. For women with small frames, big breasts can look and feel disproportionate.

Clothing is another issue, especially for slender women. Finding flattering clothing that fits both a big chest and a small waist is a huge challenge; many women in this situation are forced to turn to tailors for alterations or shop in specialty stores.

Even buying bras can be a nightmare. Getting a proper fit is difficult because the larger cups sizes are often only available in larger band sizes.

EMOTIONAL REASONS In many cases, there is also an

emotional component involved in the decision to seek a breast reduction.

There is a strong cultural association between female breasts and sexuality.

This can have uncomfortable connotations for large-chested women, who often feel as though their bust size draws unwanted attention from the people around them or creates an impression that they don’t like.

For large-breasted women who are uneasy with their figures, undergoing breast reduction surgery improves their self-image and allows them to feel more comfortable in their skin. This welcome boost in confidence can have a positive impact on both their personal and professional lives.

While their specific motivations may vary, women who undergo breast reduction surgery can expect to enjoy real benefits. Transitioning to a smaller bust can eliminate chronic pain, make it easier to maintain a healthy, active lifestyle, increase the range of fashions available, and improve a woman’s body image. Perhaps that’s why plastic surgeons report that breast reduction patients are among their most satisfied patients.

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INFORMED PATIENT | REGIONAL

HOSPICE

MYTHS Provided by

The truth is:

We enrich life in surprising ways.

Here are some things you may not know about Altus Hospice care.

Myth:

“I thought that if my mother was under the care of hospice, she could no longer go to the hospital if she needed to. In the past year, she has been hospitalized several times because her pain got out of control.”

Truth:

While hospice strives to manage pain and other uncomfortable symptoms outside of the hospital setting, a hospice patient always has the choice of whether or not to go to the hospital.

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The Medicare Hospice Benefit covers short-term general inpatient care in the hospital when a patient’s symptoms can no longer be managed in another care setting.

Myth:

“I always thought that ‘hospice’ was a place - that building that I passed on the way home from work.”

Truth:

Hospice is a philosophy of care, not a place. Hospice care can be provided in any place the patient calls home, whether that is a personal home, a skilled nursing center, assisted living facility or anywhere else.

Myth: “I didn’t know that hospice care could help take care of my dad in his assisted living apartment. He could have really benefited from the support from the hospice caregiving team.”

Truth:

Hospice provides care wherever a patient calls home, including, but not limited to assisted living facilities, skilled nursing facilities, independent living facilities and personal homes.

Myth:

“The doctor said I had to sign a Do Not Resuscitate (DNR) order for my wife in order for her to get hospice. I just

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couldn’t do that; it seemed so final.”

Truth:

A patient can receive hospice without having signed a DNR. The hospice regulation actually says that hospices cannot discriminate against patients because of any advance directive choices.

Myth:

“I didn’t consider hospice care early enough because dad was still getting blood transfusions regularly. We weren’t ready to stop because each time he would get one, it seemed to make him feel better for a few days. We just wanted him to feel like himself for as long as possible.”

Truth:

The Medicare Hospice Benefit may cover chemotherapy, radiation, blood transfusions or other treatments if those treatments are providing comfort for patients eligible to receive the benefit (life expectancy of six months or less if the illness runs its normal course).

Myth:

“I thought that hospice was only for patients with cancer. I didn’t realize that my husband who suffered from Alzheimer’s disease could have benefited from support from the hospice caregiving team too.”

Truth:

More than 60% of hospice patients nationwide have diagnoses other than cancer. Many patients have other diagnoses or advanced stages of chronic diseases like pulmonary disease, Alzheimer’s disease, renal disease, HIV/AIDS and cardiovascular or neuromuscular diseases.

Myth:

Truth:

“I was under the impression that I had to be available as the designated caregiver 24 hours a day in order for my mom to get hospice.”

Patients can choose for us to meet with them and discuss the benefit of hospice at any time. We cannot provide hands-on care to a patient without a physician’s order. We work with each patient’s physician to identify each patient’s individual needs.

Truth:

While some hospices require caregivers prior to the patient being admitted, Altus does not. We help coordinate community resources to keep the patient at home as long as possible, and then help the patient find an alternative location to receive care when care at home is no longer possible.

Myth:

“My dad lives at home. We weren’t considering hospice for dad because we thought it was too expensive. Between the doctor’s visits and the cost of medications today, we have to save everything we can to make sure we can care for his ongoing needs.”

Truth:

The Medicare and Medicaid Hospice Benefits cover services at 100%, so there is no cost to the patient. If patients have private insurance or managed care, Altus assists in checking their benefit coverage to make sure patients and families understand the potential out-of-pocket costs.

Myth:

“I wanted to learn more about hospice, but thought I had to wait for the doctor to bring it up first, so he could order it for my brother.”

Myth:

“I was so scared to even say ‘hospice.’ I thought it meant I had to give up hope, give up trying and give up praying for a cure.”

Truth:

In order to receive hospice, the patient must be eligible and have an understanding that hospice focuses on comfort care (palliative), not a cure. But patients and families do not have to be “ready to die” before getting the care they need and deserve. Hospice helps patients and families deal with what is happening to them on their own terms and in their own time frame. It is important to get hospice early, so that the benefit can help patients prepare and get ready for what is happening. It is not required that patients be ready prior to receiving care.

Myth:

“Hospice is not palliative care.”

Truth:

All hospice services are palliative in nature, however, not all palliative care is delivered under the Medicare hospice benefit. Hospice focuses on physical, spiritual and emotional support to the patient and family including family counseling, help with end-of-life decisions and bereavement services.

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SOCIAL | SAN ANTONIO

MD Monthly

was thrilled to honor Dr. Pradeep Mohan of Veda MedSpa and Cesar Torres, CEO of The Pivot Point.

This exclusive mixer was hosted at a luxurious listing of The Miguel Herrera Luxury Lifestyle team. A spectacular and modern home, located at 102 Winding Lane in Huntington in Shavano Park area and built by Stadler Custom Homes.

Thank you to all our sponsors who made this event possible: Avid Wealth Partners, Party City, Scuzzi’s Italian Restaurant, GiGi’s Cupcakes, Pro Wine Guide, North Park Lexus at Dominion, Roger the DJ, Stadler Homes and Floral Basket.

Follow us on Facebook.com/ MDMonthly to stay up to date on our upcoming events!

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WOMEN’S HEALTH / SAN ANTONIO

What are the symptoms of breast cancer?

By Dr. Maria Palafox Will my body give me “signs” that I may have breast cancer?

Although I wish I could tell you that your body will give you a sign or show symptoms of breast cancer in its early stages, that is far from the truth. When your breast tumor is small (and most easily treated), there are typically no signs at all. This is why (a) knowing whether or not you have a hereditary risk of breast cancer, and (b) following recommended screening guidelines are absolutely essential.

What is the most noticeable “first” sign of a breast tumor?

Generally, the most noticeable “first” physical sign of breast cancer is your ability to feel a small, painless lump in your breast. If you remember from a few posts ago, the definition of

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“cancer” is essentially the uncontrolled duplication of cells. Cells in their own right don’t actually hurt; we have millions of cells in our body and we don’t feel them at all. It isn’t typically until the mass of cancerous cells begins to intrude or attack other systems in our body that we feel actual pain from the cancer. So what does this tell us? Outside of (a) genetic testing for hereditary cancers when indicated, and (b) getting regular mammograms, we should also always remember to (c) perform breast self exams each and every month. It’s easy to do and can save your life.

What other breast cancer signs and symptoms could I experience?

Although not as common, sometimes breast cancer can spread to your lymph

nodes early, even before the actual tumor can be felt. When this happens, you might experience a lump or swelling in your underarms.

Any persistent change or pain in your breasts should be checked out by a doctor. Most breast pain is not related to cancer, but should still be examined and treated when appropriate.

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WOMEN’S HEALTH / SAN ANTONIO

Other less common symptoms associated with breast cancer include swelling, thickness, or redness of your breast; or nipple changes such as erosion, retraction, or discharge (especially if the nipple discharge has blood in it).

Dr. Maria Palafox is a breast cancer surgeon in South Texas, with offices located in San Antonio, TX and Pleasanton, TX. Her office can be reached at www.MariaPalafoxMD.com or (210) 504-5053.

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LOSE WEIGHT, NOT HOPE.

Nilesh A. Patel, MD, FACS

Subhash Reddy, MD

Benefits of Weight Loss Surgery •

WLS may improve obesity related health conditions such as diabetes, heart disease, high blood pressure, and obstructive sleep apnea, among others.

• Diabetes cured in 80% of patients and resolved or improved in 90% of patients.

•

Hypertension is cured in 62% of patients and resolved or improved in 78.5%

• Obstructive sleep apnea is cured in 86% of patients • Risk of death is decreased by 89% • Weight Loss Surgery (WLS) can enhance fertility and lead to successful full term pregnancies.

• Average weight loss is 50-70% of excess body weight • Improvement in arthritis with reduction in pain and increased mobility.

• WLS is covered by 80% of insurances •

Texas Bariatric Specialists accepts most major insurances including Medicare.

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