contents August 2018 Production Media Digital Source Chief Executive Officer Eliot Garza Co-Publisher Jessie Moore Project Managers Alejandra Bermea Evelyn Ekundare Miranda Paredes Account Executive Rebekah Washington Digital Marketing Coordinator Jaime Gage Creative Services Graphic Designers Aurora Balderas Vanessa Bolanos Editor Jody Marmel Writers Dr. Michael Fuentes Dr. Uchenna Umeh Dr. Melissa Macias Alexa Cyr Hillary Walker
Cover Feature
Back to School Special Appointments Organization Meals
Contributors Altus Hospice Care Communicare ENT Clinics of San Antonio South Texas Brain & Spine Center Corpus Christi Rehabilitation Hospital Kennedy Dental 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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contents 42 | Informed Patient
10 | Informed Patient
The Diabetes Lifestyle: Simple Steps to Living Well
14 | Informed Patient Cardiopulmonary Conditions
by Altus Hospice Care
16 | Informed Patient Moving with Parkinson’s
5 Tips for Maintaining Mental Health After an Injury Provided by The Recovery Village®
44 | Children's Health
8 Advantages of an Early Orthodontic Treatment by Emily Taylor
48 | Health & Wellness
Understanding Integrative Medicine by Dr. Marianne Pinkston
by Dr. Michael Fuentes
20 | Children's Health
A Pediatrician’s Healing Spirit: Treating Depressed, Anxious, and Suicidal Teens by Uchenna Umeh, MD
54 | Informed Patient
Fall-ing Out of Your Routine? by Alexa Cyr
56 | Health & Wellness
Yoga Chakras Explained: A Guide for Beginners
24 | Children's Health
Facial Sports Injuries Provided by Ear, Nose, and Throat Clinics of San Antonio
41 | Informed Patient
Can Walking Prevent Loss of Brain Volume? by Dr. Melissa Macias 8
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INFORMED PATIENT | REGIONAL
THE DIABETES LIFESTYLE: SIMPLE STEPS TO LIVING WELL Provided by 1960 Family Practice
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f you are one of the millions of people across the world who have been diagnosed with diabetes, you'll be glad to know that living well and even thriving are completely within your reach. Whether you are faced with type I or type II diabetes, your key concern in staying well is keeping your blood glucose levels in check, and maintaining your diabetes awareness also plays an important role in this. While medication may play a strong role in controlling the sugar levels in your blood, you can have a significant impact on the way you feel and the long term impacts of your diabetes by paying attention to your body's needs for a healthy diet and exercise. The Impacts of Diabetes Diabetes is a serious illness, and one that places you at risk of serious long term conditions. Some of the most
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significant effects of diabetes can include: • Stroke • Heart disease • Blindness • Kidney problems • Damage to your nerves, joints, muscles and ligaments Diabetes and Your Diet The good news about diabetes is that eating well goes a long way towards mitigating the risks of serious complications. A simple, healthy diet will not only keep your blood sugar levels on track; it will also keep you feeling well. So, what's involved in maintaining a healthy diet? • Eating mainly vegetables, beans and legumes. • Enjoying two servings of fruit each day. • Choosing whole grains wherever
possible. • Using reduced fat dairy products. • Eating proteins that are low in fat, including lean meats, seafood, legumes and nuts. • Reducing your intake of sugar, salt and fat. How Does Exercise Affect Diabetes? Another simple thing you can do to ensure you feel your best is to get active most days of the week. Including regular exercise in your lifestyle doesn't have to be grueling. In fact, you don't even have to break a sweat. A simple half hour walk, five times each week, will have you feeling your best in no time. Living with diabetes can be a challenge, but by maintaining your diabetes awareness and managing your lifestyle, you'll live your best life because you took control and chose to live a healthy and fulfilling life.
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INFORMED PATIENT | CORPUS CHRISTI
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INFORMED PATIENT | REGIONAL
Cardiopulmonary Conditions Provided by Altus Hospice Care
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ardiopulmonary Conditions are associated with impairments, activity limitations and disability with the identification of specific structural/functional impairments and any relevant activity limitations. Ultimately, in order to support a hospice plan of care, the combined effects of the primary cardiopulmonary condition and any identified secondary condition(s) and/or co-morbidities should be such that most beneficiaries with the identified impairments would have a prognosis of six months or less. Secondary and co-morbid condition(s) themselves may be associated with a new set of structural/ functional impairments that may or may not respond/be amenable to treatment.
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Symptoms persist even though patient has been treated with diuretics and vasodilators
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25%
a. Disabling dyspnea at rest b. Poorly or unresponsive to bronchodilators, resulting in decreased functional capacity c. Prior increased visits to the ER or prior hospitalizations for pulmonary infections and/or respiratory failure d. Hypoxemia at rest on room air as evidenced by PO2 less than or equal to 55mmHg or O2 sat less than or equal to 88% or hypercapnia as evidenced by PCO2 greater than or equal to 50mmHg e. Weight loss of greater than 10% of body weight over the last 6 months f. Resting tachycardia > 100/min
Close to 25% of Medicare patients hospitalized for HF are back in the hospital within 30 days. Between 2004 and 2006, those readmissions totaled 500,000.
2 3 4 5
Complicated by co-morbid conditions Complicated by secondary conditions a. Delirium b. Pneumonia c. Stasis ulcers and pressure ulcers Symptoms of CHF New York Association (NYHA) Class IV
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Decline in Karnofsky Performance Status (KPS) less than or equal to 70%
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Increased dependence on ADLs Increased frequency of respiratory infections
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INFORMED PATIENT | CORPUS CHRISTI
MOVING WITH
Parkinson’s
by Dr. Michael Fuentes
O
ne of the most important things to do while living with Parkinson’s disease is to stay active and engage in some sort of physical therapy. Research shows that a combined focus on medical management and intensive rehabilitation can dramatically improve function and quality of life in individuals living with Parkinson’s disease. The biggest challenges faced by those living with Parkinson’s disease are movement, balance, speech, and depression. Staying physically active when newly diagnosed with the disease may help to address these challenges. Some enjoyable ways to stay active include: • Couples dancing - like the tango or the waltz • Boxing classes • Tai chi • Yoga • Water aerobics • Walking • Hiking The key is to do activities that challenge the heart and lungs. Choose
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exercises that continuously change tempo, activity, and direction so that your body can be constantly moving and shifting in different ways. That being said, try to avoid exercises that keep you stationary; such as riding a stationary bike, weight lifting, and walking on a treadmill. Since Parkinson’s is a progressive, debilitating disease, medication compliance is extremely important. Medications delivered in a timely manner maximize the functional benefits of aggressive therapies and minimize the impact of possible medication side effects. The U.S. National Library of Medicine National Institutes of Health provides research publications that show evidence to suggest that noncompliance with medications results in poor response to therapy and can even increase direct and indirect health care costs. Therefore, having a strong focus on medication management and intensive rehabilitation for those living with Parkinson’s disease can drastically improve their movement, balance, and
overall quality of life. Board-certified in physical medicine & rehabilitation, Dr. Michael Fuentes is the Medical Director of Corpus Christi Rehabilitation Hospital. The hospital provides specialized rehabilitative care to patients recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. For more information, visit CCRH.ernesthealth. com, call 361-906-3700 or visit the hospital at 5726 Esplanade Drive, Corpus Christi, Texas.
Corpus Christi Rehabilitation Hospital provides specialized rehabilitation services to patients recovering from or living with injuries, illnesses, or chronic medical conditions. The hospital has earned The Joint Commission’s Gold Seal of Approval for its Stroke Rehabilitation program. For more information, visit CCRH.ernesthealth.com. 5726 Esplanade Dr • Corpus Christi, Texas 78414 • (P) 361.906.3700 • (F) 361.906.3797
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CHILDREN'S HEALTH | SAN ANTONIO
A PEDIATRICIAN’S HEALING SPIRIT:
Treating Depressed, Anxious, and Suicidal Teens
by Uchenna Umeh, MD
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had not one, but two suicidal teen patients today. This is only one day after I had an eight-year-old suicidal patient come to see me. Three weeks ago, a 17-year-old female walked into my office; she had hung herself in her closet one month earlier and was saved by the timely breaking of the crossbar of her closet. She had passed out on the closet floor and was found by her mother. A 16-year-old male came in for a routine physical examination and confided that earlier in the year, he had slept for over 36 hours after ingesting a bag of his friend’s mother’s Xanax in an attempt to take his life. Ten years ago, teen depression struck me like a bolt when it claimed
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the life of one of my patients: M.K. He had come into the office a few weeks before that fateful day with symptoms of depression. I made the diagnosis, but somehow was unable to sell the treatment and care to his mother who uttered the words that I will not forget. “I had depression, and I did okay. He does not need medication or counseling; he will be just fine, thank you.” And so, on July 4th, 2008 my beloved 15-year-old patient walked out the front door of his home, stood in the middle of the front lawn, put a doublebarreled hunting rifle in his mouth and pulled the trigger in front of his family and friends celebrating Independence Day. One does not easily recover from
that sight, even if only imagined. And so, began my relationship with depressed teens. However, before I go any further, I would like to give you a snippet of who I am, and my background. I am Nigerian by birth. The Nigeria I grew up in was a country where depression, anxiety and all forms of mental ill-health are largely viewed as demonic in origin. No one ever talks about it. It is often usually some form of a family curse or an evil relative or evil enemy put some “bad juju” on you. Or worse still, it’s an act of punishment from God for some sin committed either by you or someone else in your family lineage. It is never a medical problem, and there are only roots and herbalists to treat such afflictions.
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One can therefore imagine my position, knowing the science behind this sort of ailment, and not being able to mention it or practice it, because of the following responses. “Sweetie, this is no business for orthodox medicine,” or “I can’t believe you think my child has bipolar disorder.” Other responses included “It’s okay; we shall pray about it,” or simply, “It is well, God is able, we shall take him to our pastor for prayers and laying of hands.” Thankfully, things are slowly improving with the help of widely accessible knowledge on the internet and technological influences as a whole. However, change is slow, as such, mental illness is still widely viewed as a taboo in Nigeria, and patients are still primarily stigmatized. With that background, I plunged myself into my life as a pediatrician in the U.S., a country which allows me to practice medicine “properly” with up to date knowledge and patients who for the most part are willing to listen to the doctor and do as is recommended. That is why the loss of my first patient to suicide (a permanent solution to a largely temporary problem) in 2008 was a very hard pill to swallow. I slowly learned to live with his memory, and tried to move on, telling myself I had done everything right by him, but had I really? Could I have done more? Could I have tried harder to convince his mother? These are questions that still haunt me to this day. Every time I see yet another suicidal teen at the office, I cannot count the number of times I have had to retell that story to my patients. Like any other caring pediatrician, I take my work (and my patients and their stories) home with me. I cry with their parents. I hug my patients; I share their wins and their losses; I want to help them stop hurting; I want to make it all go away -if only I could.
The running theme in my office is: “Dr. Umeh attracts (all) the teens with the issues.” After almost 30 years in this profession, I have come to the conclusion that there is some truth to that, as no day or week passes that I do not have a depressed, anxious or suicidal teen on my “to see list.” Could it be my own personal history of depression and suicidal ideation? Could it be my own history of being bullied as a young child? Or could it be my insecurities as a teenager? My personal history of sexual assault as a young, bright-eyed medical student? Or my own history of private pain and suffering? We may never know. But one thing is for sure. I do want my patients, my teens, and tweens to stop hurting. And I plan on doing something about it. One patient’s mother thinks that I have a “healing spirit” and that is why they come to me. I say: I hear the call and am ready to be sent.
Dr. Uchenna Umeh is a pediatrician at CommuniCare Health Centers. CommuniCare Health Centers is a full-service primary healthcare system with multiple locations serving Bexar,
Kendall and Hays counties. We offer an array of services including Pediatrics, Family Medicine, Senior Care, Women’s Health, Dental, Behavioral Health, WIC services and Specialty Care. Each location offers a different combination of these services. We provide integrated primary care delivered by highly trained healthcare clinicians, utilizing state-of-the-art diagnostic equipment and electronic health records. Our focus is to always provide exceptional care and treat our patients like family. Our promise to you is to always make you Feel at Home. 2018 - AUGUST MD
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CHILDREN'S HEALTH | SAN ANTONIO
FACIAL SPORTS INJURIES Provided by Ear, Nose, and Throat Clinics of San Antonio
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laying catch, shooting hoops, bicycling on a scenic path or just kicking around a soccer ball have more in common than you may think. On the up side, these activities are good exercise and are enjoyed by thousands of Americans. On the down side, they can result in a variety of injuries to the face. Many injuries are preventable by wearing the proper protective gear, and your attitude toward safety can make a big difference. However, even the most careful person can get hurt. When an accident happens, it's your response that can make the difference between a temporary inconvenience and permanent injury. When Someone Gets Hurt: What First Aid Supplies Should You Have on Hand in Case of An Emergency? • Sterile cloth or pads • Scissors • Ice pack • Tape • Sterile bandages
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• Cotton tipped swabs • Hydrogen peroxide • Nose drops • Antibiotic ointment • Eye pads • Cotton balls • Butterfly bandages Ask "Are you all right?" Determine whether the injured person is breathing and knows who and where they are. Be certain the person can see, hear and maintain balance. Watch for subtle changes in behavior or speech, such as slurring or stuttering. Any abnormal response requires medical attention. Note weakness or loss of movement in the forehead, eyelids, cheeks and mouth. Look at the eyes to make sure they move in the same direction and that both pupils are the same size. If any doubts exist, seek immediate medical attention.
When Medical Attention Is Required, What Can You Do? Call for medical assistance (911). Do not move the victim, or remove helmets or protective gear. Do not give food, drink or medication until the extent of the injury has been determined. Remember HIV...be very careful around body fluids. In an emergency protect your hands with plastic bags. Apply pressure to bleeding wounds with a clean cloth or pad, unless the eye or eyelid is affected or a loose bone can be felt in a head injury. In these cases, do not apply pressure but gently cover the wound with a clean cloth. Apply ice or a cold pack to areas that have suffered a blow (such as a bump on the head) to help control swelling and pain. Remember to advise your doctor if the patient has HIV or hepatitis.
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Facial Fractures Sports injuries can cause potentially serious broken bones or fractures of the face. Common symptoms of facial fractures include: • Swelling and bruising, such as a black eye • Pain or numbness in the face, cheeks or lips • Double or blurred vision • Nosebleeds • Changes in teeth structure or ability to close mouth properly It is important to pay attention to swelling because it may be masking a more serious injury. Applying ice packs and keeping the head elevated may reduce early swelling. If any of these symptoms occur, be sure to visit the emergency room or the office of a facial plastic surgeon (such as an otolaryngologist-head and neck surgeon) where x-rays may be taken to determine if there is a fracture. Upper Face When you are hit in the upper face (by a ball for example) it can fracture the delicate bones around the sinuses, eye sockets, bridge of the nose or cheek bones. A direct blow to the eye may cause a fracture, as well as blurred or double vision. All eye injuries should be examined by an eye specialist (ophthalmologist). Lower Face When your jaw or lower face is injured, it may change the way your teeth fit together. To restore a normal bite, surgeries often can be performed from inside the mouth to prevent visible scarring of the face; and broken jaws often can be repaired without being wired shut for long periods. Your doctor will explain your treatment options and the latest treatment techniques. Soft Tissue Injuries Bruises cuts and scrapes often result from high speed or contact sports, such
as boxing, football, soccer, ice hockey, bicycling skiing, and snowmobiling. Most can be treated at home, but some require medical attention. You should get immediate medical care when you have: • Deep skin cuts • Obvious deformity or fracture • Loss of facial movement • Persistent bleeding • Change in vision • Problems breathing and/or swallowing • Alterations in consciousness or facial movement • Bruises Also called contusions, bruises result from bleeding underneath the skin. Applying pressure, elevating the bruised area above the heart and using an ice pack for the first 24 to 48 hours minimizes discoloration and swelling. After two days, a heat pack or hot water bottle may help more. Most of the swelling and bruising should disappear in one to two weeks. Cuts and Scrapes The external bleeding that results from cuts and scrapes can be stopped by immediately applying pressure with gauze or a clean cloth. When the bleeding is uncontrollable, you should go to the emergency room. Scrapes should be washed with
soap and water to remove any foreign material that could cause infection and discoloration of the skin. Scrapes or abrasions can be treated at home by cleaning with 3% hydrogen peroxide and covering with an antibiotic ointment or cream until the skin is healed. Cuts or lacerations, unless very small, should be examined by a physician. Stitches may be necessary, and deeper cuts may have serious effects. Following stitches, cuts should be kept clean and free of scabs with hydrogen peroxide and antibiotic ointment. Bandages may be needed to protect the area from pressure or irritation from clothes. You may experience numbness around the cut for several months. Healing will continue for 6 to 12 months. The application of sunscreen is important during the healing process to prevent pigment changes. Scars that look too obvious after this time should be seen by a facial plastic surgeon. Nasal Injuries The nose is one of the most injured areas on the face. Early treatment of a nose injury consists of applying a cold compress and keeping the head higher than the rest of the body. You should seek medical attention in the case of: • Breathing difficulties • Deformity of the nose • Persistent bleeding • Cuts • Bleeding Nosebleeds are common and usually short-lived. Often they can be controlled by squeezing the nose with constant pressure for 5 to 10 minutes. If bleeding persists, seek medical attention. Bleeding also can occur underneath the surface of the nose. An otolaryngologist/facial plastic surgeon will examine the nose to determine if there is a clot or collection of blood beneath the mucus membrane of the septum (a septal hematoma) or any fracture. Hematomas should be drained so the pressure does not cause nose damage or infection. 2018 - AUGUST MD
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Fractures Some otolaryngologist-head and neck specialists set fractured bones right away before swelling develops, while others prefer to wait until the swelling is gone. These fractures can be repaired under local or general anesthesia, even weeks later. Ultimately, treatment decisions will be made to restore proper function of the nasal air passages and normal appearance and structural support of the nose. Swelling and bruising of the nose may last for 10 days or more. Neck Injuries Whether seemingly minor or severe, all neck injuries should be thoroughly evaluated by an otolaryngologist -- head and neck surgeon. Injuries may involve specific structures within the neck, such as the larynx (voicebox), esophagus (food passage), or major blood vessels and nerves.
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Throat Injuries The larynx is a complex organ consisting of cartilage, nerves and muscles with a mucous membrane lining all encased in a protective tissue (cartilage) framework. The cartilages can be fractured or dislocated and may cause severe swelling, which can result in airway obstruction. Hoarseness or difficulty breathing after a blow to the neck are warning signs of a serious injury and the injured person should receive immediate medical attention. Prevention Of Facial Sports Injuries The best way to treat facial sports injuries is to prevent them. To insure a safe athletic environment, the following guidelines are suggested: • Be sure the playing areas are large enough that players will not run into walls or other obstructions.
• Cover unremoveable goal posts and other structures with thick, protective padding. • Carefully check equipment to be sure it is functioning properly. • Require protective equipment - such as helmets and padding for football, bicycling and rollerblading; face masks, head and mouth guards for baseball; ear protectors for wrestlers; and eyeglass guards or goggles for racquetball and snowmobiling are just a few. • Prepare athletes with warm-up exercises before engaging in intense team activity. • In the case of sports involving fast-moving vehicles, for example, snowmobiles or dirt bikes - check the path of travel, making sure there are no obstructing fences, wires or other obstacles. • Enlist adequate adult supervision for all children's competitive sports.
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Back to School
CHECKLIST for
HEALTHY KIDS
APPOINTMENTS Visit the doctor • Well-child visit • Sports physical • Eye exam • Immunizations
Visit the dentist • Dental cleaning • X-rays (if needed)
ORGANIZATION
Draft a schedule for school days and review with your child.
School supplies get all the materials
your kids need for school and homeschooling ready.
Go to bed early in preparation for school mornings.
MEALS Healthy favs 28
Always include your kids' healthy favorites. MD Monthly
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Source: health.gov/dietaryguidelines/2015/guidelines and deltadentalins.com
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APPOINTMENTS
Visit the doctor
HOW TO CHOOSE THE BEST PEDIATRICIAN FOR YOUR CHILD
T
SPECIAL TO MD MONTHLY
he best time to look for a pediatrician is not when your kid is sick at 3 a.m., and you have no idea who to call. Rather than put yourself through this stress, pediatric experts recommend finding a doctor for your little one before he or she is in need of one. That gives you time to get comfortable with the person who you will see dozens of times over the next several years. Ideally, the person you select for medical care and advice today will still be treating your child late into adolescence. Therefore, it is essential that you consider this decision carefully and choose someone who will support your parenting style and choices for your child. Questions to Ask When You Interview Pediatricians Doctors are busy people and may not have time to meet with you as soon as you would like. However, it's essential that you speak to every potential pediatrician in person to gauge whether you think you can have a good working relationship. As your child grows up, you can ask for his or her input as well. An important thing to keep in mind is that you must do what is right for your family. That means you may have to change pediatricians a few times in your child's life if the one you have no longer
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meets yours or your child's needs. There are two categories of questions you should ask of every pediatrician you interview. The first is the medical practice. These are basic yes/no questions that let you know if you should proceed with the interview further. Examples include: • Does this practice accept my insurance? • Who do I contact if my child gets sick or injured outside of office hours? • How long has the clinic been open and with what hospital is it affiliated? If the answers to these questions are satisfactory, you can move onto more in-depth questions about the doctor. The answers to these questions let you know where the doctor stands on important issues such as: • Immunizations • Behavior issues It's important to remain flexible and keep your options open when it comes to finding a pediatrician for your kids.
How to Check a Pediatrician's Credentials and Reputation Thanks to the Internet, it is much easier to investigate a pediatrician before you hire him or her. One place to start is checking state licensing boards for complaints or disciplinary action. If you feel that the person you interviewed may not have the education, accreditation, or experience that he or she claimed, this is a good way to confirm it. Additionally, online peer reviews from other parents are an excellent way to learn how the doctor typically treats and interacts with patients. Once you have narrowed down your list to a few possibilities, schedule an appointment and complete your interview in person.
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APPOINTMENTS
Visit the dentist
START THE SCHOOL YEAR OFF RIGHT WITH A DENTAL CHECKUP Provided by Kennedy Dental Care
A
recent study concluded that students with poor oral health were three times more likely to miss school due to dental pain. On average, dental issues cause children to miss just over two days of school every year. Absences from school can lead to lower grades, and constant oral pain can cause developmental issues and negatively affect children’s confidence. How can you keep your children in school with a healthy smile? Schedule a dental appointment before school begins!
Cavities are the Number One Preventable Disease in Children One of the most common chronic conditions in children is tooth decay.
Nearly 20% of children aged 5 to 11 have at least one untreated decaying tooth. The good news is that tooth decay is preventable. When detected early, tooth decay can be combated with proper oral care routines and sealants. Tooth decay is painful and distracting, and can cause your child to lose focus in school or even prevent them from participating in the class discussion. It can negatively affect their social development, which could cause more serious problems in the future.
Oral Issues Cost Time According to a recent study, more than 51 million school hours in the United States are lost each year due to dental disease. Lost school hours are closely linked to poor academic performance, and can cause your child’s grades to suffer. By scheduling your child for a checkup appointment before school starts, you can get a head start on creating a healthy smile for your child
that won’t cause them to miss any valuable class time.
Schedule an Appointment Today We strongly advise you to schedule a dental checkup for your child as a great way to start the new year. Our office will thoroughly evaluate your child’s smile and check for any tooth decay or other ailments that may need further attention. We can create a treatment plan that respects their school schedule and minimizes their time away from class.
To learn more visit online www.paulkennedydds.com
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APPOINTMENTS
Eye Exam
WARNING SIGNS THAT YOUR CHILD MAY NEED GLASSES SPECIAL TO MD MONTHLY
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round a third of young school-age children wear glasses. However, it's thought that up to half as many have undiagnosed vision issues which glasses would correct. An untreated eyesight problem at this early age can have serious consequences that last for life. It can interfere with education, slow down social development, and increase the final extent of any vision damage.
that they're having unusual difficulty. • Also watch out for your child holding books or other objects unusually close to their face, or constantly varying this distance back and forth. • Children develop at different rates, but if reading ability seems to be lagging behind general learning, this could be a clue that something is wrong. An eye exam will usually show an easily corrected vision problem, rather than any more serious issue.
Clearly, spotting any potential eyesight problems in your child is important. Here are some of the signs to look for which may mean an eye exam is a sensible idea.
• Constant rubbing of eyes can indicate excessive tiredness and muscle strain as a result of difficulty focusing. A child will probably accept this as perfectly normal, so it may take an adult to notice any issue.
• Look out for unusual physical gestures when your child is trying to watch TV or read at a distance. Tilting their head to the side, covering up one eye with a hand, or squinting heavily are all signs
• Difficulty in focusing can also lead to frequent headaches. If your child seems to suffer from headaches late in the day or evening, it could be more than ordinary tiredness.
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• Lastly, clumsiness is a normal part of childhood. But, if these other symptoms are combined with poor coordination and a reluctance to take part in sports or other physical activity, then poor eyesight could be the simple explanation. Spotting any childhood vision problems as soon as possible will help keep them under control and limit the long-term damage they do. Eye examinations are quick, painless, and inexpensive. So, if you have any doubts, then don't hesitate to contact your optometrist for an appointment.
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APPOINTMENTS
Immunizations
IMMUNIZATION REQUIREMENTS
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very school year the students shall show acceptable evidence of vaccination prior to entry, attendance, or transfer to
Vaccine Required
Diphtheria/Tetanus/Pertussis1 (DTaP/DTP/DT/Td/Tdap)
a child-care facility or public or private elementary or secondary school in Texas. 2018 - 2019 Texas Minimum State Vaccine Requirements for Students Grades K-12 are the following: Minimum Number of Doses Required by Grade Level K - 6th 7th 8th - 12th K 1 2 3 4 5 6 7 8 9 10 11 12
5 doses or 4 doses
3 dose primary series and 1 Tdap / Td booster within the last 5 years
3 dose primary series and 1 Tdap / Td booster within the last 10 years
4 doses or 3 doses
Measles, Mumps, and Rubella1, 2 (MMR)
2 doses
Hepatitis B2
3 doses
Provisional Enrollment
Varicella1, 2, 3
2 doses
A student may be enrolled provisionally if the student has an immunization record that indicates the student has received at least one dose of each specified ageappropriate vaccine required by this rule.
Hepatitis A1, 2
Not required
1 dose
2 doses
Not required
Source: dshs.texas.gov/immunize/school/school-requirements.aspx Receipt of the dose up to (and including) 4 days
child’s parent or guardian containing wording such as:
before the birthday will satisfy the school entry
“This is to verify that (name of student) had varicella
immunization requirement.
disease (chickenpox) on or about (date) and does not
2
Serologic evidence of infection or serologic
need varicella vaccine.” This written statement will
confirmation of immunity to measles, mumps,
be acceptable in place of any and all varicella vaccine
rubella, hepatitis B, hepatitis A, or varicella is
doses required.
acceptable in place of vaccine.
For more information about Immunizations visit
3
Texas law allows physicians to write medical exemption statements that the vaccine required would be harmful to the health of the child. The law also allows parents/guardians to choose an exemption from immunization requirements for reasons of conscience, including a religious belief. The law does NOT allow parents/ guardians to choose an exemption simply because of inconvenience (for example, a record is lost or incomplete and it is too much trouble to go to a physician or clinic to correct the problem). Schools should maintain an up-todate list of students with exemptions, so they may be excluded in times of emergency or epidemic declared by the commissioner of public health.
Polio1
Meningococcal1 (MCV4)
1
Exemptions
Previous illness may be documented with a written
statement from a physician, school nurse, or the
https://www.dshs.texas.gov/immunize/school/school-
Documentation Since many types of personal immunization records are in use, any document will be acceptable provided a physician or public health personnel has validated it.
requirements.aspx
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ORGANIZATION
School supplies
PREPARING TO HOMESCHOOL: A FEW USEFUL ITEMS SPECIAL TO MD MONTHLY
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he first year homeschooling with your children requires a lot of research. You must choose or create a curriculum, prepare your library, and set up workspaces. Every age group requires different items to complete the year. Some are basic and others are more specific. There are a few key items, however, that will save the day. Office Supplies It will soon be apparent how many items are used for simple organization. Invest in some quality office supplies. Purchase a good quality three-hole punch that can handle large quantities of paper at once. A printer that produces both black and white and color copies will help with projects. If you have an ink-jet printer, it is time to convert to a
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laser printer. This will help when printing a high volume of papers. Be sure the printer also has the ability to make copies. A good stapler, paper cutter, and several flash drives will also come in handy. Computer Every family will have different computer needs. Once you decide on a curriculum, it will be easier to determine the necessity of a computer. If you plan to use an online curriculum, each child will probably need their own computer. If your curriculum is based mostly on books, your children may be able to take turns on the family computer. High school students will benefit from their own laptop. High school classes require a lot of research and writing. The portable concept of a laptop is useful for group meetings and working away from
home. Storage Homeschool supplies will soon start to take over your home. The books are only part of this adventure. You will find yourself saving things you would normally throw away. Items like egg cartons and milk jars used for craft projects begin to pile up. It’s a good idea to implement organization for all the items you need and the ones you will save for future projects. Start with some designated shelves for books. Rolling carts with drawers are great for separating items for different kids. They can also be color-coded for different subjects. A large basket or plastic tub can be placed near the trash can to hold items saved for crafts. Make sure kids know where everything
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goes at the end of the day for a quick transition to family time. Workspace The beauty of homeschool is that children can work anywhere they feel comfortable. Many kids love to curl up on the couch for reading time. A formal workspace can be helpful, however, when you are trying to get in the learning mindset. A study or formal dining room can be set up as a school room. Desks or a large table can be placed in the room. It can be easier to teach multiple children of similar ages at a large table. Teenagers may prefer to have a desk in their bedroom for privacy. You will find out what works best for your family as you learn the work habits of each child.
everything will be stored. Plan where your kids will be working so you can set up the area ahead of time. Add different items as needed to supplement your learning materials. You will have your own unique organization system that will work well for you and your children.
Lab Equipment Many parents do not give lab equipment a second thought until they are faced with experiments in their curriculum. Take a look at your curriculum before the school year starts so you can be prepared for science requirements. This will give you time to find a good homeschool supply store and prepare for the expense. At minimum, you can expect to need a microscope, beakers, and a Bunsen burner. Accessories will include slides and test tubes. Be sure to also purchase protective eyewear. A lab coat or smock will protect skin and clothing from chemicals. It can be helpful to plan group labs with other parents and share the cost of equipment. Homeschool preparation does not need to be overwhelming. Take the time to review your curriculum plans well before starting. Consider what you will need for each subject and where 2018 - AUGUST MD
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ORGANIZATION
Go to bed early
7 METHODS FOR SUCCESSFULLY GETTING YOUR CHILDREN TO BED SPECIAL TO MD MONTHLY
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etting your child to agree to go to bed and remain there is a struggle that all parents face at some point. Children are often resistant to rules, especially when they are ready to stay up all night. To make matters worse, kids may try to sneak out of their bedroom, after Mom or Dad has left the room, and all seems quiet for a few minutes. To help your children approach bedtime without all the fussing, try these seven tips.
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Establish a Clear Bedtime The first tip is to establish a nonnegotiable time for your child to be in their bedroom with the lights off. Once you have a set bedtime for your child, you can plan each day more smoothly and communicate with them accordingly. Also, people are less resistant to what they already know, so when your child sees bedtime arrives at the same time each night (even if only weeknights), they will slowly but surely show less defiance. Consistent enforcement of lights-out allows them to prepare for their sleep environment
and be less likely to feel you are thwarting their fun.
Bring Out Pajamas Early Changing your child into his or her pajamas 20 or 30 minutes before bedtime will help them get prepared. When they are already in their sleeping clothes, and that time arrives, they will be more agreeable to the idea. You might even facilitate the process by providing them with comfortable pajamas they'll love to wear.
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as early as they do, but your life and responsibilities do not permit it. Explain to your child the value of a good night's rest, and how it makes them stronger, healthier, and smarter.
Make Their Bedroom Inviting Customizing your child's bedroom with wallpaper from their favorite movie, furniture they like and a color scheme that relaxes them can increase the likelihood for your child to go to bed and even enjoy it. If they feel comfortable being alone in their bedroom, perhaps with a few relaxing games or toys, they may naturally want to spend more time there.
HOW MUCH SLEEP DO THE CHILDREN NEED? NEWBORNS 0 to 3 months
14-17 hours INFANTS 4 to 11 months
12-15 hours TODDLERS 1 to 2 years
Softly Play Their Favorite Music If your child has a favorite genre of music or artist, find a small Bluetooth speaker or similar arrangement that has an easily adjustable volume. As lights-out approaches, having the music playing quietly in the bedroom can soothe the child's mind and help them to relax and fall asleep.
Accommodate Their Interests If your kids are enjoying a show or movie that will play past their bedtime, record it or agree to let them watch it another day. By helping them understand that you are not working against them and that a fun reward awaits them because of their willingness to sleep, your children may become eager for bedtime.
Show Appreciation for Sleep You might want to remind your child that you would love to go to sleep
Read Them a Story Finally, reading to your children at bedtime can entice them when nothing else does. Perhaps there's a favorite story they like to hear multiple times, or maybe they enjoy being distracted as they become tired. Use your child's personality to determine what works best, and then keep the appropriate books ready in their room. While there's no silver bullet for getting your children to bed, these techniques may help minimize the stress involved in this nightly process. Be willing to try a few new methods; you might want to ask fellow parents for their recommendations as well. Find the ones that work for you and
11-14 hours PRESCHOOLERS 3 to 5 years
10-13 hours SCHOOL-AGED CHILDREN 6 to 13 years
9-11 hours TEENAGERS 14 to 17 years
8-10 hours
Source: National Sleep Foundation
your family, and then stick with what seems most reliable. 2018 - AUGUST MD
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MEALS
Healthy favs
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WAYS TO HELP YOUR CHILD EAT HEALTHY SPECIAL TO MD MONTHLY
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etting children to eat healthy can be a struggle. Who wouldn't want to eat chicken strips and grilled cheese every day? If you start young, you can make healthy eating less of a fight and more of an adventure. The following is a guide on how you can accomplish this.
will be proud to eat what they helped make. Don't scoff when your child suggests pizza. Instead make a homemade veggie pizza with healthy toppings that your child can help choose. Make it a fun project by using the ingredients to create pictures on the pizza, but don't become consumed with making it the healthiest meal possible. For now, let your child get used to being in the kitchen and learning how to cook.
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Plan Weekly Meals
Introduce New Foods Regularly If you always serve peas and carrots because they're what your children will eat, this is a good start, but it won't expose your child to new foods. Don't forgo the foods they will eat, but add variety to the choices. If you typically allow your child to choose between corn and peas, offer corn and spinach the next night. When you do this, you know your child will at least eat the one they know and like.
Everyone in your family probably has a favorite (hopefully semi-healthy) meal. Pre-plan weekly meals and allow each family member to have a say in one of the meals. But don't stop there. Have your child help cook the meal they chose. Getting your child involved in meal preparation will help them appreciate and enjoy meals more. They
Your child may or may not try the new food, but don't force them. Just continue introducing new foods and allow them to explore on their own. Instead of serving food to your child on their plate, serve food family style and allow your child to have control over what they eat. If you only offer healthy choices, it doesn't matter what they
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choose. When they don't feel forced, they will be more likely to try a new food on their own.
LUNCH TIP
Use a lunchbox with partioned sections that mimic the Dietary Guidelines1.
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Be a Role Model If you want your child to eat well, it's important they see you eating well. You can't ask your child to be eager to eat fruits if they constantly hear you saying that you despise fruits . You don't have to love them, but don't talk negatively about them. It's also helpful for your child to see that you are willing to try new foods. If you won't, they won't. Your child pays attention to what you say and do, so you want to be a good example. Avoid obsessing about which foods have a lot of carbs and fat and which ones would help you to lose your extra belly fat you've been dying to shed. These aren't attitudes you want to put in your child's head about food.
Source: health.gov/dietaryguidelines/2015/guidelines and deltadentalins.com
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Don't Ditch Dessert Dessert doesn't have to mean cake and ice cream every night. Teach your child that dessert doesn't always equal indulgent and unhealthy (of course sometimes it can). Dessert is usually something sweet, so the choices are abundant. One night you might have fruit salad and another night you might have peach pie. If you have ice cream for dessert one evening, in addition to offering sprinkles, you can offer blueberries as well. Teach your child that eating healthy doesn't mean avoiding things they love, but enjoying a well-rounded diet.
Teaching your children how to eat healthy while still enjoying a wide array of foods will help them create a good relationship with food that will benefit them throughout their life.
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DID YOU KNOW...
BRAIN HEALTH
INTERESTING BRAIN FACTS
25
25%
Brain maturity is reached around the age of 25
1 neuron can transmit
1,000
nerve impulses per seconds
of the body's cholesterol resides within the brain without adequate cholesterol, brain cells would die
5MINUTES
without oxygen can cause some brain cells to die, which could lead to damage
73%
The brain is water, & it takes only 2% dehydration to affect attention, memory & other cognitive skills
Stress, depression and low levels of omega-35 can cause
MEASURABLE BRAIN SHRINKAGE
BRAIN MYTHS DEBUNKED
10% L R
MYTH We use only 10% of our brain MYTH You can have a left brain or a right brain personality type MYTH You have more brain cells than there are stars in the Milky Way
100% L &R
TRUTH Brain scans have shown that we use almost all of our brain TRUTH There is no such thing, we are “whole-brained� TRUTH There are 200-400 billion stars in the Milky Way and only around 86 billion brain cells in a human brain
MYTH There are 10,000 miles of blood vessels in the brain
TRUTH There are closer to 400 miles of blood vessels
MYTH High cholesterol is bad for your brain
TRUTH High cholesterol reduces risk of dementia
MYTH You are born with a set level of intelligence with a set number of brain cells
TRUTH Brain plasticity allows the development of new cells and capacity to change
Source: lumonol.com/page/resource
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INFORMED PATIENT | CORPUS CHRISTI
Can Walking Prevent Loss of Brain Volume? Article Provided by Dr. Melissa Macias
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brisk walk not only gets your blood pumping and tones your heart – it could save your brain too. According to new research published in the journal Neurology, taking a daily walk prevents brain atrophy and the loss of brain volume that goes along with aging. So, if you want to hold onto your gray matter, it’s time to lace up the walking shoes. Does Walking Prevent Loss of Brain Volume? In a retrospective study, researchers looked at the exercise habits of 299 older people with normal brain function. Nine years later, their heads were scanned using MRI to quantify their brain size and volume. Four years later, their memory and cognition were tested. The results? Healthy, older individuals who walked six to nine miles per week had larger amounts of gray matter than those who walked less – or didn’t walk at all. Gray matter is the portion of the brain
associated with intelligence and higher learning. A greater amount of gray matter is correlated with better cognitive function. Even though walking up to nine miles a week preserved gray matter and prevented loss of brain volume in this study, walking additional miles didn’t add additional benefits. So, there seems to be a law of diminishing returns when it comes to walking and brain health. Does Walking Preserve Memory and Cognitive Function Too? Individuals who walked between six and nine miles per week, not only had more gray matter, but that additional gray matter helped to maintain their cognitive function and preserve memory. Regular walkers cut their risk of cognitive problems and memory impairment by half. Pretty impressive for walking only a mile a day. Prevent Loss of Brain Volume and Save Your Brain by Walking What does this mean? Taking a brisk stroll – a mile a day – helps preserve gray matter and prevent loss of brain
volume. Who wouldn’t want that? Since the average person walks around three miles-per-hour, this translates into a twenty minute walk daily – and if you do it outdoors, you’ll get vitamin D as well. The bottom line? Don’t underestimate the power of walking. it’s a great stressreliever that could save your brain as well.
References: Medscape. com. “Walking Maintains Brain Volume, Prevents Cognitive Impairment”
For More Information visit her website: drmelissamacias.com/ 1227 3rd Street Corpus Christi, TX. 78404 (361) 883-4323 2018 - AUGUST MD
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INFORMED PATIENT
5 Tips for Maintaining Mental Health After an Injury Article Provided byThe Recovery Village®
P
eople who are active run the risk of sustaining a physical injury. Some of these are minor joint pains that heal in hours or days. However, there are injuries that can take quite a long time — weeks or months — before the person can return to the same level of activity. Sometimes these injuries require surgery which can sideline a person as the injured body part heals itself. Active people often have a difficult time adjusting to life without their favorite exercises, whether it is weightlifting, jogging, swimming or another activity. Being stuck to the couch can cause people to experience depression, anxiety or loneliness, or any combination of all three. However, there are some sciencebacked tips to help people who have suffered an injury adjust to their new daily routines — or lack of usual activities.
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Eat and Drink Healthier No more exercise means no more burning calories in mass quantities. It also means the body won’t be accustomed to burning the majority of fat slowly throughout the day. People who become less active often gain weight in the process. The injury is often something outside a person’s control. However, a diet is well within their control and is manageable. Eating healthier, drinking fewer high-calorie sodas and alcoholic beverages, and focusing on a healthy lifestyle in new ways can maintain mental health. Feeling good about oneself and one’s personal appearance can prevent depression and anxiety and preserve positive vibes throughout the healing process.
Stay Social Some people design their social lives around physical activity. They participate in running groups, lift weights at the
gym with friends, play basketball and softball with work colleagues or attend regular yoga classes. When an injury occurs, these activities often stop. If so, loneliness can set in and that could lead to depression. People who have broken bones or torn ligaments don’t need to revolve their lives around just Netflix and sleep. Stay in contact with friends digitally — text message or social media channels — and invite them to do other things such as dinner, movies, video games at home, or a happy hour event at a nearby restaurant or bar. Doing this can keep relationships alive and networks strong even if the routine activities go on a healing-frominjury break. Keep a Journal A lot of times, people who are experiencing a change in their lifestyle that is out of their control choose to keep their thoughts to themselves.
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INFORMED PATIENT
Even if they feel depressed or anxious after suffering an injury or going through a surgery, being open about these issues is not naturally comfortable for many people. Some people begin counseling or therapy as an avenue to open up about their feelings. Another option is to keep a journal, which can provide some of the same support as speaking with a therapist. Many medical experts suggest that people use a journal to write their thoughts as a way to release emotions and negative energy built up during the day.
Focus on Rehab Sometimes people feel down about their injury and the reduced number of activities they can do. However, there is one activity that can become the center of their focus. Rehabilitation is an important aspect of healing from a serious physical injury. Without it, the body never regains its muscle strength around the area where the injury and surgery took place. Additionally, people can focus on their rehab exercises and make it a positive for mental health as well. Staying determined and making rehab into a challenge can become a motivational tactic. This can help people avoid complacency and listlessness.
Understand That Feeling Bummed is Normal Feeling down about the injury is a natural occurrence, and it happens sooner or later to everyone who was physically active before getting sidelined. Professional and college athletes suffer from the same feeling — sometimes it forms into depression — when they suffer a long-term injury and have to undergo a lengthy and stressful healing process.
Feeling upset about the injury and the long path to physical recovery is not a negative reflection of a person’s character. Things that they loved to do, like exercise or play a sport, have been taken from them because of the injury. Additionally, there is a physical change in the body’s chemical makeup because exercise releases endorphins. “If you’re all the sudden injured and can’t work out every day, you’re experiencing a major dip in endorphins,” says Barbara Walker, Ph.D. a psychologist at the Center for Human Performance. However, the omission of activity
is temporary. Knowing that things will eventually return to normal in time can be a morale-booster for people. Even if an injury occurs, there are ways to keep your morale high. Stay focused on your rehabilitation, keep an active social life, and practice healthier habits and dietary planning. These tips, among others, will help prevent longterm depression and unhealthy habits stemming from a fluke physical injury.
For more information visit: The Recovery Village: https://www. therecoveryvillage.com/ (844) 229-2468 2018 - AUGUST MD
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CHILDREN'S HEALTH
8 Advantages of an Early Orthodontic Treatment by Emily Taylor
8 Eye-catching Benefits of an Early Orthodontic Treatment for Children It helps determine a better prognosis of how the permanent teeth take shape. An early treatment would ensure that the permanent teeth are properly aligned and determine a proper oral health.
These are some of the most frequently asked questions by parents in case of their child’s dental hygiene. Early orthodontic treatment suggests that children should start visiting an orthodontist by the age of seven.
If your child shows the following signs, then your child is in need of an early orthodontic treatment: • Loss of baby teeth before the age of five or after the age of thirteen • Difficulty in chewing or biting • Snores or breaths through the mouth • Sucking a thumb or finger after the age of five • Protruding front or bottom teeth • Suffers from a speech impediment • If the jaw shifts when opening or closing the mouth • If the teeth do not come together in a normal manner
This helps the orthodontist to analyze the present oral condition of the child and eventually plan an early orthodontic treatment. For example, if your child has a growing problem of crowding of teeth, then braces for kids is a plausible solution.
If you see any one of these signs, it is best to consult an orthodontist for your child’s early orthodontic treatment. These conditions should be treated as early as possible to prevent a time consuming as well as expensive treatment later in life.
It corrects problems such as overbite, crossbite, and an underbite that cause jaw pain and dysfunction. Early orthodontic treatment promotes growth modification of the jaws and early extrusion of teeth which helps solve these problems early.
W
hat difference would an early orthodontic treatment bring to my child’s oral health? How is it different than regular treatment? What are the symptoms to look out for in case of an early treatment?
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It corrects habits such as thumb sucking or tongue thrusting that may cause developmental problems later in life. These should be curbed early in life to avoid damaging a jaw’s growth pattern.
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CHILDREN'S HEALTH
It guides the growth of jaw to accommodate emerging permanent teeth. This happens while the primary teeth are still in place ensuring faster results. Their jaw being soft could easily be treated on time avoiding future problems. It helps in the palatal expansion. Without this expansion process, a child’s teeth may erupt crooked or may not erupt at all. Early orthodontic treatment prevents narrower jaw and thus eliminating the chances of crowding. It lowers the risk of damage to any protruding teeth. Braces for kids and an early treatment lower the chances of teeth damage by aligning the protruding teeth properly. It reduces the risk of tooth decay and gum disease. Crowding of teeth
treatment. It’s not too late to ensure a pain-free and confident future for your child. Have you introduced your child to an orthodontist yet?
and weaker gums due to serious bite problems can lead to improper cleaning and hence poor oral health. Early treatment helps in preventing this. Early orthodontic treatment improves your child’s appearance and confidence. Straight teeth are signs of good oral health as well as a possessor of a confident smile. Early orthodontic treatment from the age of seven facilitates early identification of oral problems and ensures timely
About the Author – Emily Taylor found the perfect fit for herself as the Online Marketing Manager at Thurman Orthodontics in Fresno CA as she believes that a great smile does more than just make a person look great – it makes them feel great as well. The power of a smile has always been a mystery to Emily and she loves researching and writing about it. She loves to write about everything to do with a healthy bite and a beautiful smile – whether is it ways to achieve it or the importance of it in the various aspects of life. What brings a big smile on Emily’s face is her family and surfing. She also likes to bake and her children and co-workers call her the cookie fairy!
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HEALTH & WELLNESS | SAN ANTONIO
Understanding Integrative Medicine by Dr. Marianne Pinkston
I
ntegrative Medicine is a relatively new term in the world of health care, and upon first hearing the term, the average layman usually has no idea what Integrative Medicine actually is. In the simplest terms, Integrative Medicine is a practice that incorporates any and all forms of healthcare in order to heal a person or prevent illnesses. Integrative Medicine, also known as IM, may involve the use of pharmaceutical medications, herbal remedies, acupuncture, aromatherapy, holistic medicine, and more. Practitioners of IM are board certified by the American Board of Integrative Medicine, or ABOIM. The ABOIM defines Integrative Medicine as "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare
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new therapy you found on the internet.
professionals, and disciplines to achieve optimal health and healing."
Instead of writing prescriptions or scheduling invasive procedures, your IM physician is likely to try the most natural and least invasive forms of healing first. He or she will want to hear your perspective concerning the treatment suggested. If you are uncomfortable using herbal teas to fight an illness and would prefer a prescription of conventional medication, your IM doctor can prescribe what you need, but he will want you to know all the available options for your situation.
When you work with an IM physician, you will find that he or she is open to all forms of healthcare. This type of physician, as compared to conventional physicians, takes the time to talk and listen to their patients. Conventional doctors prefer that you not consult "Dr. Google", while IM physicians are happy to hear about a
For example, if you are experiencing digestive problems, the IM physician will not just focus on that specific problem. Instead, he or she will take your entire being into consideration to discover what is causing the problem. You will be asked questions about your lifestyle, habits, diet and exercise routines, your social life and more.
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HEALTH & WELLNESS | SAN ANTONIO
Your doctor will also pay attention to your mood, outlook and attitude and take these into account when identifying health issues and determining what treatments may or may not work well for you. IM physicians understand the importance of the connection between your body and mind as well as your spirit. Once your doctor has a clear understanding of the ailment you are suffering from, he or she will then work with you to not only ease your complaint and symptoms, but also to make changes in your life to prevent the problem from recurring. The goal is to effectively treat you instead of just treating your illness. He may suggest changes to your diet. He may recommend that you have a deep tissue massage. He may prescribe a soothing tea that you will make at home.
At the same time, he may prescribe a pharmaceutical medication to help ease your symptoms. IM physicians believe in the power of conventional medicine and will use it if he or she feels you will truly benefit from it. If your current doctor is unwilling to consider alternative treatments alongside conventional treatments, you should consider making an appointment
with an Integrative Medicine doctor. Your current doctor may be able and willing to recommend someone, but you can also find IM practitioners in your area by doing a search on the Academy of Integrative Health and Medicine's website.
To learn more visit: pinlstonfamilypracticesa.com Or wellness4life.com
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INFORMED PATIENT | HOUSTON
Fall-ing Out of Your Routine? by Alexa Cyr
A
s winter approaches and fall is underway, now is the prime time to get in the best shape possible. With the hustle and bustle of the upcoming months, we can have the tendency to fall out of our regular workout routines, which isn’t helped by the abundance of fall treats at every get-together. Well, have no fear, because there are effective workouts and healthier alternatives and tips to stay in shape during the cooler months of the year. Working out most definitely makes a large impact on your internal health and outward appearance. If the thought of going to the gym is daunting, then try some at-home workouts. An effective fat-burning technique is interval cardio. HIIT (high intensity interval training) is short, sweet, and highly effective. Fifteen to thirty minutes on the elliptical or treadmill, with resistance, switching off every minute from sprinting to jogging, can burn fat efficiently. If a treadmill or another cardio machine is not available to you, doing circuits in
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your living room works as well. Circuit training consists of a group of exercises on different body parts repeated multiple times. Push-ups, squats, lunges, and crunches are all easy and effective ways to burn calories and build muscle. Try using resistance bands and dumbbells or kettlebells to change up and vary your workouts. Yoga and stretching, in general, are also ways to prevent injury and improve flexibility and muscle growth. Find ways to stay active, especially when it is cold outside to avoid winter weight-gain. Diet has an enormous impact on physical fitness and health, so even though you may be working out every day, weight gain will start to become apparent if you aren’t focused on how or what you eat. The recipes below are healthier alternatives to normal fall treats, but please remember “everything in moderation” even with healthy treats! Pay attention to your macronutrients and shop organic if possible.
Here are some delicious, healthy Fall treats, already taste-tested by yours truly: PUMPKIN PIE “MOUSSE”: Ingredients: • Chobani nonfat plain Greek yogurt • A couple of tablespoons of plain pureed pumpkin • Chia seeds* • Granola* • Cinnamon*
*depends on your preference 1. Mix the pumpkin, cinnamon and yogurt together 2. Top with chia seeds, granola and cinnamon CHOCOLATE CINNAMON COFFEE PROTEIN SHAKE: Ingredients: • 1 scoop of vanilla protein powder* • Dash of cinnamon • Coconut milk • Cold brew black coffee • 1 tablespoon of unsweetened 100% cocoa powder
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Mix all ingredients together in a Nutribullet
the middle. 6. Top with the spinach. 7. Roll the tortilla and enjoy!
*Whey protein tastes great, but if you’re vegan, Organify or any vegan protein powder can be substituted. TURKEY BREAKFAST WRAP: Ingredients: • Ezekiel tortilla • 3-4 egg whites • Himalayan salt • Ground pepper • Cherry tomatoes • Organic Spinach • A couple of slices of organic deli turkey breast • Extra Virgin Olive Oil • Swiss cheese (optional) 1. Cook the Ezekiel tortilla on a pan in EVOO until lightly crispy. 2. Set to the side on a plate and line the middle with one slice of swiss cheese.
3. Use the same pan and saute a handful of organic spinach and the chopped up turkey. 4. On another pan scramble the egg whites and add the salt and pepper. 5. Put the egg whites on the tortilla in
ZUCCHINI MUFFINS Recipe from Davida LaHood: Group Fitness Instructor from San Antonio, TX Ingredients: • 1 cup of coconut flour • 1 cup of almond flour • 1 tsp of organic vanilla • 1 cup of coconut oil • 1 cup of coconut sugar • 3 cups of grated zucchini • 1 cup of Enjoy Life chocolate chips • 4 eggs • 1 tbsp of ground cinnamon • 1 tsp of baking soda • 1 tsp of sea salt 1. Mix all ingredients together in a large bowl 2. Bake at 350° for 20 minutes 3. Let cool and enjoy!
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HEALTH & WELLNESS | REGIONAL
Yoga Chakras Explained: A Guide for Beginners by Hillary Walker
D
o you know something about energy portals in your body? Have you ever heard of a notion of chakra? Accordingly to the idea, which yoga is based on, there are energy portals in our body. Those energy centers are called chakras and they represent different emotions and feelings we have.
body, which represent not only your physical body, but also your emotions and feelings such as belonging, stability, and love.
Overall, there are seven chakras. Each one has its own color, emotion, feeling, body part, and balancing practice recommended to do. If you don’t know anything about this, read our beginner's introduction to chakras below and become a little bit closer to practicing yoga professionally.
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Seven Yoga Chakras Explained In yoga practice, the notion of chakra and a clear understanding of it are very important. During the practices, you focus on very different parts of your
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Each chakra has its own color and its own meaning and purpose. So, let's have a look at those seven chakras and the meanings behind them. Muladhara, or the Root Energy Center. The color is deep red. It represents calmness, security, the feeling of being grounded, etc.
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Svadhisthana, or the Sacral Chakra. The color is orange. It represents fertility, free-flowing creativity, and sexuality.
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Manipura, or the Solar Plexus Energy Center. The color is bright yellow. It is about fire, will, vitality, power, integrity, respect, and drive. If this energy center is not blocked, a
person is self-assured and able to grow.
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Anahata, or the Heart Chakra. The color is green. It is all about heart and feelings you experience through it – love, sympathy, compassion, acceptance, hope, harmonious relationships, and emotional balance.
5
Vishuddha, or the Throat Chakra. The color is blue. Vishuddha is responsible for expression and communication. This chakra is about expressing yourself easily, healing, creativity, and speaking truth.
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Ajna, or the Third Eye Chakra. The color is indigo. Ajna energy portal is directly between the eyebrows. It is about deep and reliable intuition, second sight, inner knowing, meditation, understanding your purpose, the absence of worrying and confusion, etc.
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HEALTH & WELLNESSL | REGIONAL
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Sahasrara, or the Crown Chakra. The color is purple. The seventh chakra sits on the crown of a head. It represents divine knowledge and connection with the universe and God. It is about experiencing total bliss, absolute consciousness, understanding and enlightenment. There are also oils recommended for each energy hub. For example, rose, jasmine, tea tree, lavender, and patchouli. So, check them out as well.As you can see, each of the seven energy portals has its own unique physical and moral qualities, as well as functions, senses, and the image of a different lotus flower. Supporting all of them in balance is very important. If one energy hub is blocked, then the whole body is out of balance. So, do some yoga practices if you feel that one of your chakras is weak. If you're a beginner, find a yoga teacher to guide you through chakra balance knowledge and practice on a more qualitative level.
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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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