MD Monthly October - Fall Chic Fashion

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October 2017 Production Media Digital Source Publisher Eliot Garza Project Manager Jessie Moore Designer Meghan Goettl Cover Designer Michael Mancha Editor Margaret Hager Writers Dr. Marc Taylor Brent Laartz M.D. FIDSA Christine Saks, MS, RD Laura Aplin Rudy Arispe Jamie Brennan Sue Carrington Jessie Moore Karen Reed ® Eric Kala CFP , CIMA ®, AEP ®, CLU ®, ChFC ®, CRPS ® Contributing Photographers Josh Huskin Paul Marshall Marc Arevalo

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Dr. Maria Palafox South Texas Breast Surgery Breast Cancer & General Surgery in San Antonio & South Texas.

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Fall Chic Fashion Leading Aestheticians Lindsay Garcia and Ashley Wendt

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OCTOBER - 2017

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In The Community

UT Health Cancer Research Buy a Partners Shopping Card to Help Fund UT Health Cancer Research in San Antonio

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Healthy Living

Snacks That Satisfy Cristine D. Saks provides healthy & filling snack options for in-between meals.

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Women's Health

Karen Reed informs you on what you need to know about breasts before and after pregnancy.

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Women's Health

Noninvasive Vaginal Rejuvenation Dr. Jennifer Walden talks new ThermiVa Radiofrequency

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Women's Health

Breast Reconstruction Dr. Erika Sato provides specialized procedures and options for breast reconstruction.

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Informed Patient

Restoring Facial Volume Fat Grafting vs. Fillers

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OCTOBER - 2017

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BUSINESS/SAN ANTONIO

RECOVER, BUILD, AND ENJOY:

OUR UNIQUE THREE-PHASE APPROACH TO

WEALTH MANAGEMENT FOR PHYSICIANS By: Eric Kala CFP®, CIMA®, AEP®, CLU®, ChFC®, CRPS®

A

s a physician, you have unique financial needs due to your high income-earning potential paired with your late-career, heavy debt-load start. Here at Avid Wealth Partners, we specialize in helping you build, protect and enjoy your wealth now and in the future. No matter what stage of your career you’re at, we’ll meet you there and help you get on the right path for financial security.

Our team utilizes a three phase model that’s designed to help you maximize and protect your wealth and give you peace of mind in knowing that your financial affairs are being properly attended to.

The Recovery Phase We refer to the first years after your residency as “The Recovery Phase” because you’re getting a late start on your income-producing years with tremendously more educational debt than most professionals. Our primary focus during recovery is to help you manage your money in a 10

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way that will get you out from under your medical school debt as quickly as possible while making sure that your assets and wealth-producing potential are properly protected. We also focus on getting you caught up with your retirement savings and helping you create a lifetime financial strategy that addresses your specific needs, goals, and risk tolerance. During this phase, we want to help you lay a solid foundation and develop great financial habits so that you maximize your wealth-building potential throughout your career.

The Wealth Building Phase The pace at which physicians graduate into “The Wealth Building Phase” varies greatly depending on their medical school debt, income, and financial discipline, but our team aims to get you to this stage as quickly as possible so that you can create and maintain the lifestyle you desire now and in the future. During the wealth building years, we will

work with you to make sure you have the proper wealth and asset protection tools in place as your career evolves and income grows, and we’ll provide the expertise you need to ensure your investment strategies are aligned with your goals, time horizon and tolerance for risk. Our goal is to empower you with the right information along the way so that you can make informed decisions for your financial health and wellbeing.

The Retirement Transition Phase Whether it comes in your 50’s, 60’s 70’s or beyond, there will likely come a time that you’re ready to start dialing back the amount of time you spend working so that you can spend more time in leisure. Making a successful transition to retirement usually begins five to ten years before actually leaving your practice, and it’s a multi-step process that begins with defining what a successful transition will be. Perhaps you already have

OCTOBER - 2017

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a partner or successor in mind, or maybe you’re looking to sell your practice to someone you don’t yet know. We will work with you well in advance to make sure you have looked at all your options and are able to choose the most advantageous path to accomplish your retirement goals. We will also focus on wealth preservation and transfer planning in “The Retirement Transition Phase”, and develop an effective cash flow management plan to help you maintain the lifestyle you’re accustomed to.

No matter what phase you identify with today, Eric Kala and the team at Avid Wealth Partners will meet you where you’re at and help you get – and remain – on the best possible path for continued financial success.

To learn more about our firm and how we may be of service to you, visit us at AvidWealthPartners.com.

Eric Ilmari Kala uses Avid Wealth

Partners as a marketing name for doing business as representatives of Northwestern Mutual. Avid Wealth Partners is not a registered investment adviser, broker-dealer, insurance agency or federal savings bank. Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company, Milwaukee, WI (NM) (life and disability insurance, annuities, and life insurance with long-term care benefits) and its subsidiaries. Eric Ilmari Kala is a Representative of Northwestern Mutual Wealth Management Company® (NMWMC) , Milwaukee, WI (fiduciary and fee-based financial planning services), a subsidiary of NM and federal savings bank. Representative is an Insurance Agent of NM and Northwestern Long Term Care Insurance Company, Milwaukee, WI, (long-term care insurance) a subsidiary of NM, and a Registered Representative of Northwestern Mutual Investment Services, LLC (NMIS) (securities), a subsidiary of NM, brokerdealer, registered investment adviser and member FINRA and SIPC.

Standards Inc. owns the certification marks CFP®, CERTIFIED FINANCIAL PLANNER™ CFP® (with plaque design) and CFP® (with flame design) in the U.S., which it awards to individuals who successfully complete CFP Board's initial and ongoing certification requirements Avid Wealth Partners Affiliated with Northwestern Mutual 17802 W Interstate 10, Ste. 114 San Antonio, TX 78257 210.446.5718 | AvidWealthPartners.com

Certified Financial Planner Board of

Coming Soon

Every Texan has a story to tell.

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Coffee just happens to be a part of our story

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SNACKS THAT

Satisfy By: Cristine D. Saks, MS, RD

H

ave you ever felt hungry between meals, eaten a few crackers, and then felt hungry again a little while later? This frustrating phenomenon can end up causing overeating as you continue to try to combat your hunger.

However, with the right combination of foods, you can prevent overeating between meals and feel satisfied after eating a snack.

keep you going until your next main meal. Carbohydrates are the body’s main source of fuel and are therefore digested and absorbed very quickly on their own. This is the reason why a few crackers will not give lasting energy. Fats and proteins, on the other hand, are digested and absorbed more slowly. Therefore, the key to a satisfying snack is to pair carbohydrates with a lean protein or healthy fat.

Think of a snack as a small meal.

If snacks fulfill their purpose, they should provide enough energy to

To get an extra boost of satisfaction choose fiber-rich foods and whole fruits and vegetables,

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rather than dried. Fiber, a type of carbohydrate found in fruits, vegetables, whole grains, beans and legumes, is not digestible by the body and adds bulk to the foods we eat. In addition, the water content in whole fruits and vegetables also helps fill us up. Lastly, to make sure your healthy snack doesn’t turn unhealthy, choose nuts, seeds, or nut/seed butters without added oils, sugar, and salt.

Here are a few examples of some healthy snacks to get you started: whole grain toast with avocado or nut/seed butter, fruit

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HEALTHY LIVING/SAN ANTONIO

or popcorn paired with 1 ounce of nuts, whole grain crackers and cheese, raw veggies dipped in hummus or guacamole.

It may seem simple, but by making this small shift, you will feel satisfied and energized to continue through your day. So, don’t forget, pair up a carbohydrate with a lean protein or healthy fat and kill those mid-meal hunger pangs!

Cristine Saks is a Registered Dietitian Nutritionist practicing in the Women Infants and Children (WIC) program at CommuniCare Health Centers.

She received a Bachelor of Science in Biology from St. Mary’s University and a Master of Science in Nutrition from University of the Incarnate Word.

Carbohydrates • Fruits • Vegetables • Whole Grains • Whole Grain Bread • Whole Grain Crackers • Baked Tortilla Chips • Air-Popped Popcorn • Low-Fat Milk • Low-Fat Dairy Yogurt/Greek Yogurt • Bean Dip • Hummus

Lean Proteins & Healthy Fats • Low-Fat Cheese/Cottage Cheese • Greek Yogurt • Boiled Eggs • Canned Tuna or Salmon • 1oz Nuts or Seeds • 2 Tbsp. Nut/Seed Butter • Avocado • Olives • Olive oil • Bean Dip • Hummus

2017 - OCTOBER MD Monthly

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HEALTHY LIVING/REGIONAL

Empowerment:

TAKING A NEW APPROACH TO DEMENTIA PART 2: SEEKING THE SOLUTIONS By: Sue Carrington

C

aring for a person with Alzheimer’s disease or related dementias (ADRD) is an intricate process. As we explored in Part 1 of Empowerment: Taking a New Approach to Dementia, poor outcomes, such as too many hospitalizations, negative behaviors, and overuse of psychotropic medications, have been pervasive.

Innovators in memory care services are taking new approaches to ADRD focused on person-centered care, improved quality of life, and a perspective that sees, not disabilities, but abilities.

Filling the gaps with a cognitive assessment According to Kim Warchol, an occupational therapist and nationally recognized specialist in dementia care, effective care for those with ADRD starts with a thorough cognitive assessment.

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“If someone begins to experience changes in thinking, whether living at home or in a senior living community, that person needs to visit a physician specialist, such as a neurologist, for symptom evaluation. This can determine the root cause of their memory loss—whether it is normal aging or a disease process.”

she calls the “just right challenge”’ in meaningful daily activities.

Along with a physician specialist assessment to identify the root cause of the cognitive changes, the person should be seen by an occupational therapist specializing in dementia therapy, Warchol points out. This professional can conduct functional cognitive assessments that help to identify the stage of the disease and can also assess the demands of everyday life, creating plans that improve the person’s safety and level of function through environmental modification, care partner training, and creating what

“Without this type of intervention to identify which stage of the disease the person is in, we start guessing what the person is capable of. We may wrongly conclude that they’re helpless, creating excess disability and dependence and perhaps even failure to thrive. Or, if their verbal skills are good, we may mistakenly decide that they don’t need individual supervision. An accurate assessment by members of the specialized interdisciplinary dementia care team can help caregivers develop an effective daily life care plan

Too often, she notes, specialized assessments by a neurologist or occupational therapist are skipped.

As a result, treatment interventions and care plans can be insufficient or even inaccurate.

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HEALTHY LIVING/REGIONAL

that enables the highest level of independence and safety possible.”

As described in the previous blog, understanding the dementia stage or cognitive level of a person with ADRD is essential to developing an appropriate care plan.

“Cognitive assessments need to be administered from the perspective not only of what the person has lost but also of what the person can still do. Then, we can start talking about hope and quality of life at each stage of the disease progression.”

Furthering workforce development Another essential step in effective ADRD care is creating what Warchol calls a “dementia-capable workforce,” one that can support people through every step of their experience of the disease and walk the journey with them.

Key also to a strength-based care is proactively valuing each resident’s uniqueness, Warchol notes.

For example, StoneGate Senior Living, a leading provider of senior living services in Texas, Colorado, and Oklahoma, offers a Music & Memory™ program to help reawaken memories for residents with ADRD. A personalized playlist of songs sparks renewed meaning and connection— and keeps staff members further

tuned into the life story of each person in their care.

Staff training also includes the critical element of behavior management. Warchol points out the need to stop thinking of negative behaviors—such as agitation, aggression, and anxiety—as normal symptoms of dementia. “Instead, we need to think of these expressions as a normal response to a situation, such as being forced to shower.

Then, as care partners, we need to understand how we can approach situations differently to cultivate trust and agreement.”

Finding the light within One of the greatest rewards of this new approach to dementia care is its positive impact on residents’ families, Warchol notes.

She tells the story of a daughter who had moved her mother into a dementia care facility—and was told there was little hope for improvement or quality of life. The mother hadn’t spoken a word in several years, couldn’t walk, and was described by her daughter as a shell of her former self. As a part of a pre-admission interview with the memory care facility where Warchol worked, Warchol picked up on “glimmers

of the mother’s capabilities that were perhaps being shrouded in the negative paradigm, such as, ‘We were told Mom can’t do anything anymore,’.”

Yet Warchol probed and heard the report that her mother could hold a magazine and turn the pages.

“Why weren’t the abilities to focus attention and use hands to hold and use meaningful objects being promoted? Why wasn’t Mom participating to some extent in her beloved activities of gardening and cooking? Why wasn’t she talking? It appeared failure to thrive may have begun,” Warchol explains.

The daughter decided to move her mother to Warchol’s memory care facility, and within a few days, the mother was walking through the garden, talking about flowers, and picking up bowls in the kitchen to assemble ingredients.

“We called the daughter to share the good news,” Warchol remembers.

“At first she was incredulous. ‘Put my mom on the phone,’ the daughter said. Her mother’s words to her daughter: ‘You did good. I’m happy.’

“These were the first words the daughter had heard from her mother in years. Exceptional memory care can’t heal the brain and reverse the disease process, but we can stop the suffering by uncovering and facilitating use of abilities retained— and by healing the human spirit that remains bright within.”

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, D.C. area.

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DOCTOR'S CHOICE/CORPUS CHRISTI

DOCTOR’S CHOICE:

RAW BAR

HEALTHY CHOICES ARE THE BEST CHOICES By: Jessie Moore

K

eeping a healthy diet while working in the medical industry can be challenging.

You’re always on the go, and often grabbing something quick. But, the quick way isn’t always the healthiest way.

The MD Monthly team is consistently traveling and eating at places that are quick and easy.

But eating healthy can sometimes be difficult when you have a busy 16

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OCTOBER - 2017

lifestyle. While in Corpus Christi we stopped by the very popular restaurant, Raw Bar, to grab a bite to eat. That was THE BEST DECISION EVER. The healthful food options we chose there definitely gave us the fuel we needed to last the rest of the day. Now we know why this is the #1 Doctor’s Choice for a healthy meal selection.

As the Raw Bar story tells us on their website, “Whether you are

taking the beginning steps towards a healthier lifestyle or looking to integrate new delicious choices into your wellness plan, Raw Bar is committed to supporting your journey by providing smoothies, juices, breakfast, and lunch options made with organic ingredients enriched with essential vitamins and nutrients.”

Many doctors choose Raw Bar over fast food or other restaurants for their afternoon fuel. The first time you PHOTOGRAPHY BY Paul Marshall

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visit Raw Bar you’ll look at the menu and not even know how to pronounce the names of their items. But, trust me – when you walk out you’ll know everything on the menu.

“We help people get all the nutrients they need for a healthier body through raw fruits and vegetables,” said Kristy Aleman, owner of Raw Bar in the Del Mar District, as well as its newest

location, which opened in April on the South Side, at 6330 Saratoga Blvd.

If you’re looking for a creative twist to your traditional smoothie, we recommend that you go for the Acai Berry Bowl. It includes spinach, banana, mixed berries, acai powder, and almond milk—and it doesn’t stop there— it is topped with: granola, berries and honey.

Need a quick to-go lunch to take back to the hospital or office? Try their Strawberry Salad, Pesto Pasta, or Turkey Wrap.

If you’re into energy drinks and caffeine, throw out the Red Bull and coffee. Grab one of their 16-oz. juices such as the Awaken “Energize!” It includes beets, carrots, cucumbers, celery, green apples, lemon, pineapple and mint. The result is a smooth, dark-red juice that gives you long-lasting energy. The best part? It’s all natural and healthy for you!

Pair your Awaken juice with a protein Power Bowl. It includes bananas, almond milk, almond butter, oats, organic yogurt, raw honey, and cinnamon, and is topped with pumpkin seeds, chia seeds, granola, blueberries, bananas, and honey.

Another reason Raw Bar is the Doctor’s Choice is because every item on the entire menu is under $10!

Drink. Eat. Live Raw. Visit Raw Bar in Corpus Christi!

361.692.8466 | RawBarCC.com

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EVENT/SAN ANTONIO

Special to MD Monthly

L

ights flashed and music blared on Thursday, September 14, 2017 at the 12th annual American Cancer Society Ranch Chic Fashion Show held at the University of the Incarnate Word’s Rosenberg Sky Room. The show featured models who are Cancer Survivors along with Oncologists (cancer doctors), local celebrities, and professional models wearing “Ranch Chic” fashions presented by Wrangler, featuring fashions from Cavender’s, Jewelry by Kendra Scott, and Furs by Lourosa.

Over 450 attendees were present at this distinguished celebration which showcases the sophisticated modern Western fashions that attendees will be wearing to the upcoming American Cancer Society Cattle Baron’s Gala which will be held on Saturday, October 14, 2017 at Estancia at Thunder Valley.

Information and tickets are available at www.

CattleBaronsGala.org or by calling 210-595-0221. #AttackingCancer #AmericanCancerSociety #CattleBaronsGala

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PHOTOGRAPHY BY Jessie Moore

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EVENT/SAN ANTONIO

2017 - OCTOBER MD Monthly

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South Texas Breast Surgery: DR. MARIA PALAFOX OFFERS GENETIC COUNSELING FOR

HEREDITARY BREAST AND OVARIAN CANCER By: Rudy Arispe

D

r. Maria Palafox knows a lot about the actress Angelina Jolie – not because of her Hollywood film career or well-publicized, overseas charity work, but for the preventative double mastectomy that Angelina Jolie underwent four years ago.

In fact, when counseling her breast cancer patients, Dr. Palafox often cites the movie star as an example when discussing breast and ovarian cancer.

“Her mom had ovarian cancer and she had two aunts who had breast cancer, so she tested for the gene

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based on that family history,” Dr. Palafox said. “It turns out she carries the gene, so she had a higher than normal risk for breast cancer and ovarian cancer.

People think only of their mom’s side, but we get half of our chromosomes from our fathers, so you have to consider your dad’s side, too.

-Dr. Maria Palafox

“Most patients know about their breast cancer history and some of the other cancers that have some of the same syndromes, for example, prostate, pancreatic, colon and uterine. There are actually quite a lot of other cancers associated with certain mutations.”

In addition to being a breast cancer and general surgeon, Dr. Palafox specializes in genetic counseling for hereditary breast and ovarian cancer syndrome (HBOC) at her practice, South Texas Breast Surgery. She explained there are two types of breast cancer susceptibility genes, known as BRCA1 and

PHOTOGRAPHY BY Paul Marshall

MDMONTHLY.COM

BRCA2, which can be tested through an individual’s saliva.

“A little spit can tell us a lot,” she said.

Dr. Palafox provided another example of how important genetic testing for mutations in BRCA1 and BRCA2 can be.

“I had a patient who had a lot of pancreas cancer in her family,” she explained. “She said, ‘But I don’t have any breast cancer in my family.’

We tested her, and she did carry a mutation. The reason she didn’t have a lot of breast cancer in her family was because she mostly had male relatives.”

When scheduling an appointment with patients, Dr. Palafox has them fill out a 10-question, family history form.

“I try to encourage other doctors to ask about family history,” she said. “People think only of their mom’s side, but we get half of our chromosomes from our fathers, so you have to consider your dad’s side, too.”

So what are the next steps if a patient does indeed test positive for the BRCA1 or BRCA2 gene mutation for breast and ovarian cancer?

“Depending on the gene, we tell those patients they at least have to screen more often, especially if they choose not to have a mastectomy,” Dr. Palafox said. “I would do a mammogram and a breast MRI, alternating every six months. For instance, do a mammogram in January and then a breast MRI in June. We would also screen for other cancers such as ovarian cancer. This

Most people don’t carry a mutation, but at least it’s good to know whether you do or not.

-Dr. Maria Palafox way, you catch the cancer when it’s small and curable.”

Dr. Palafox notes that among the Hispanic population, there is a specific mutation in the BRCA gene that is regional and has been traced to an area around Mexico City.

“Say you have a patient from Mexico City who happens to have a sister or mom also living in that region. Because of the area in which they live, they should get tested.

These are things we all need to be aware of,” she said.

She advises patients to know their family history and recommends that they ask their family doctor about genetic testing for cancer, if their doctor hasn’t already done that.

“Most people don’t carry a mutation,” Dr. Palafox said, “but at least it’s good to know whether you do or not.”

For more information or to schedule an appointment, visit MariaPalafoxMD.com or call (210) 504-5053.

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Christopher J. Busken, M.D. Dr. Christopher J Busken, is a Vascular Surgery specialist in San Antonio, Texas. He attended and graduated from University Of Missouri School Of Medicine in 2006, having over 11 years of diverse experience, especially in Vascular Surgery.

He is affiliated with many hospitals including Methodist Hospital, Baptist Medical Center, Christus Santa Rosa Hospital, Southwest General Hospital. Dr. Christopher J Busken also cooperates with other doctors and physicians in medical groups including University Of Texas Health Science Center At San Antonio.

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WOMEN'S HEALTH/REGIONAL

Everything

YOU NEED TO KNOW

About Your Breasts BEFORE AND AFTER

Pregnancy By: Karen Reed

͈

our pregnancy will change your breasts. This isn’t just to help develop milk for your baby, but also due to the hormones in your body and your changing body shape. Even once you’ve finished breastfeeding, you may find your breasts just aren’t the same as they were pre-baby.

However, there will be some changes that shouldn’t happen. These changes could mean an underlying medical condition that you need see a doctor about.

It’s important to track all the changes that happen to your breasts.

You need to know about normal types of discomfort or pain and what the signs could point towards. These facts will help to make sure you have healthy breasts and a healthy body throughout your life.

Here’s all you need to know about your breasts before and during pregnancy to ensure a healthy life.

Breasts Change Every Single Month Even before you’re pregnant, your breasts will change on a day to day basis (pregnant breast). While they are usually similar, there will be elements about them that are not the same. They change in shape and size, and these changes are perfectly normal and healthy.

Once you hit puberty, your breasts will start to grow. The size does depend on a number of hormones that are in your body. Once you are in your mid-20s, the natural changes should stop or at least slowdown. However, hormonal imbalances, changes in medication, and weight fluctuations will all affect the size of your breasts.

find that your breasts get smaller.

Unfortunately, we can’t pick and choose where the weight falls on us.

We’d all have the hourglass figure then, wouldn’t we?

Throughout the month, hormones change. Our bodies get ready for the possibility of pregnancy, which means that the breasts get ready for the chance of breastfeeding in a few months’ time. They start to get bigger and change shape to make sure they are ready for the upcoming possible major changes to your life.

When you have your period, the breasts will go back to normal.

However, the changes will explain why some of us experience pain and discomfort in the lead up to menstruation. The changes to size and shape cause the nerves in the breasts to become more sensitive.

As you lose weight, you may 28

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Some Lumps Are Normal and Nothing to Worry About!

You’ll hear all the time about lumps and how they shouldn’t occur.

The truth is that some lumps in the breasts can be normal and they may be nothing to worry about. The breasts are full of glands, which tend to be lumpy. When you have hormonal changes, the glands can swell or shift position, and you may find that the lumps in your breasts are more prominent.

What you should look out for are solid lumps. The glands will be soft to touch, and you should find that it’s not painful to touch them. They may move around easily under the skin. If the lumps are solid and/or painful, you will need to discuss this with your doctor.

This could be a sign of something more serious, like breast cancer.

If you are pregnant or you have had a baby, a lump forming could also be mastitis. This is when the milk ducts become blocked. The breasts may be itchy and hot, and there may be some inflammation in the surrounding area or some redness.

Most blocked ducts will repair themselves within 24 hours. You can also help by massaging the areas to remove the reason for the blockage.

If the milk ducts don’t unblock themselves within 24-48 hours, you will need to see a doctor to prevent infection and other problems.

Nipple bumps that look like pimples on your nipples are completely normal and nothing to worry about. Everyone has them, but hormones can make them grow.

They are usually enlarged during pregnancy. Like with other pimples, just leave them alone, and they will disappear on their own.

Do look out for the density of your breasts. You should always have

some fatty tissue around the area.

This is a sign that you have more connective tissues in the area, which make it harder to spot abnormalities on mammograms. Earlier signs of breast cancer could be missed.

One of the other signs of breast cancer is discharge from the nipples.

This can be normal, and it will depend on the color. Brown or straw-like discharge is completely normal, but you shouldn’t see any blood.

If there is blood coming from your nipples, then you will need to see a doctor. While pregnant, you may see some milk discharging, which is also completely normal.

Breast Changes Start from the Beginning of Pregnancy One of the most common signs of pregnancy is discomfort or tenderness in the breasts. This is because your breasts will start to change the moment you are pregnant. Your body is naturally getting ready for you to start breastfeeding in the future. It needs to start creating the milk, which means expanding the breasts to make room.

Swelling in your breasts may be one of the first signs that you are pregnant, even before you miss your period. Remember that conception occurs around two weeks before your next period, so you will be pregnant long before you even realize. The dating starts from the last period you noticed.

It is possible to make yourself a little more comfortable when your breasts are starting to change. Try removing your bra or buying one with less restriction. Those without underwires are good for the creation of the milk ducts and supply.

You may find a slight change in your diet will help. Reduce your salt intake and drink more water. This will

help to reduce salt and fluid retention, which can lead to swelling breasts.

Stretch Marks and Itchy Skin During Pregnancy During the second and third trimester, the growth of your breasts should start to slow down. The main growth has happened, and your milk supply is ready. You may experience some white liquid leaking from your nipples, which is the colostrum before your milk. Don’t worry about this. Your body is just getting ready for your full milk supply for your baby.

Weight gain during pregnancy can make your breasts expand even more. If you can keep your weight gain between the recommended 25 and 35 lbs for the average female, you should find that your breasts don’t enlarge too much.

The discomfort and pain should disappear, but you may experience some itching of the skin. This is often due to the skin expanding, as the nerves are affected by the changes.

Stretch marks may also start to appear. You can reduce both side effects by using moisturizer on the skin on your breasts. The moisturizer will help to add the fluid back into the skin to help the production of collagen. More collagen means better flexibility within your skin.

More Swelling After Your Baby Is Born After the birth, the milk production is intensified. Once your placenta is removed from the body, the hormone releases change again. Your body gets the signal that your baby is born and your body needs to start producing the milk to nourish your baby. This can take a couple of days, but your breasts will start to change shape and weight.

Your milk production can be heavy.

You will likely feel that weight in your

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WOMEN'S HEALTH/REGIONAL

breasts, especially when it comes to feeding time for your baby. Your breasts will expand to keep hold of the milk, ready for feeding time.

problems. This is when mastitis is likely to happen since your body hasn’t been able to get rid of the milk that is being produced.

However, there is only so much liquid they can hold. You may experience some leakage of the milk in between feeds, especially if you miss a feed.

If you aren’t breastfeeding, you may want to express a little bit of milk still. This can help get rid of the heavy and full feeling in your breasts. You will also keep the risk of mastitis and leaks occurring. However, doctors tend to recommend wearing a tight sports bra to help support your breasts and tell your body that you don’t need to produce the milk. After about a week, the body will get the idea and stop the production. Within a month, you should see your milk production stop completely.

Your nipples will also change color. They should darken, and this is completely normal and nothing to worry about. The darker nipples help your baby know where to go for food.

The eyesight in new-borns is poor, and they work more on colors and blurry shapes, rather than the actual sight of the nipples.

There are steps that you can take to avoid leakages. The first is to stick to a schedule for your baby’s feeds, which is great if you’re at home with your baby all the time. Avoid missing a feed at all. This will also help your baby’s growth.

If you can’t stick to a set schedule, you can always express your milk.

This will help to improve the milk production since your body gets the message that your baby still needs more milk. You can express by hand or with a breast pump. There are now hands-free breast pumps, meaning you can get on with other things throughout the day.

Those who have babies that sleep through the night may find that their breasts leak while asleep.

Try sleeping on a towel overnight to avoid damaging your sheets and your mattress. You can also set a timer to express your milk during the night if you would like. If you are bottle feeding, opt for pads and a towel to help prevent the leakages.

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Do keep in mind that expressing your milk will encourage your body to make more. It doesn’t know that you’re not feeding a baby! If you want to keep up your supply while your baby is in ahospital or unable to breastfeed for a medical reason, opting for expressing can help to keep the supply until you are ready.

Changes to the Shape of Your Breasts After Breastfeeding When you’ve stopped breastfeeding, or your breasts have stopped producing the milk, the shape and size will start to return to normal. However, there are plenty of women who say that their breasts never return to the exact same shape or size as before.

Many women complain that their breasts are much bigger than before.

This is more likely to do with weight gain rather than the pregnancy hormones. If you have gained weight during pregnancy, it will need to go somewhere. The chest, hips, and butt are the three places that will see most of the weight gain.

Some women experience saggy breasts, which is linked to the skin

stretching. If you haven’t helped the production of collagen or it is naturally poor, you will find that the skin’s elasticity is poor. When the skin stretches, it should bounce back like an elastic band. If it has been stretched too far, it won’t return to the old shape and instead remain saggy.

You can help to tone up and repair some of the skin, but not all of it.

You’ll need to consider using bras to help improve the look and shape of your breasts.

There may be lumps afterward.

You should check your breasts periodically, before, during and after pregnancy. Lumps are a sign of cancer, especially if they are solid and painful. Check the whole breast area, including up into the armpits.

If you notice other abnormalities, it is worth mentioning them to your health provider. This will help to rule out any other serious problems that could affect your overall health.

Understanding the Changes Is Important When you understand all the changes that will happen to your breasts, you are more informed to know of problems to look out for.

Some changes are perfectly normal, even before and after pregnancy. You may find that your breasts get larger even when you’re not pregnant, as hormone fluctuations will affect the things happening within your breasts.

By knowing the changes, you can avoid panic if you feel some softer lumps. If you are concerned about anything, talk to your health provider to rule out anything serious. This is especially the case if you have painful lumps or you see blood coming from your nipples. These changes should be discussed before, during and after pregnancy, whenever they occur.

OCTOBER - 2017

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WOMEN'S HEALTH/AUSTIN

Thermiva Vaginal

TIGHTENING & REJUVENATION Provided By: Dr. Jennifer Walden, Cosmetic Plastic Surgeon

E

xcessive relaxation of the vaginal muscles is a common occurrence after vaginal birth, or due to aging. Damage can diminish sensation during intercourse, reduce sexual satisfaction and change the relationship between partners. Laxity of the skin is caused by numerous factors; and no area is immune to this natural decline.

What is the benefit of vaginal tightening and rejuvenation?

Vaginal rejuvenation serves many functions: it can improve the appearance of the vagina, relieve discomfort, aid in proper hygiene, increase sexual satisfaction, and boost self-confidence. Vaginal rejuvenation restores the vagina to its youthful appearance and performance by tightening and strengthening the vagina and pelvic floor, as well as making any desired cosmetic adjustments.

Dr. Walden is proud to be the first physician in Austin to use ThermiVa for Vaginal Tightening and Rejuvenation.

ThermiVa is a unique temperature controlled radio frequency system, used for non-surgical dermatological 32

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application in aesthetics and other medical specialties.

Dr. Walden uses ThermiVa treatments to deliver controlled thermal energy to the desired areas – external (labia) and/or internal (vaginal) – using the same technology that has been used for years in ThermiTight and ThermiSmooth procedures to reduce the effects of aging. The complete ThermiVa procedure includes three separate treatments over a period of three months. There is no downtime other than the office appointments, and no anesthetics are required.

ThermiVa can be used to treat vulvovaginal laxity as well as the symptoms listed below: • Urinary Incontinence – Urinary incontinence (UI) is a common condition that involves the involuntary loss of urine. Although it is not usually a serious condition, UI can be embarrassing and affect a person’s daily life.

UI can affect men and women of all ages, but is more common in women, especially during and

after pregnancy.

• Stress Incontinence – Stress incontinence is a common condition involving an involuntary loss of urine that occurs when a physical movement places pressure, or stress, on the bladder.

While stress incontinence can affect men and women of all ages, it is most common in women who have multiple pregnancies, as childbirth tends to stretch the urethral sphincter.

ThermiVa was developed by Thermi, a women’s wellness company whose mission is to help women reclaim, restore, and revive.

Visit www.drjenniferwalden.com/ or call (512) 328-4100 to learn more.

OCTOBER - 2017

MDMONTHLY.COM

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Our surgeons provide neurosurgical care in many of the major hospitals in Corpus Christi, Texas. Our surgeons and staff provide individual and conservative treatment using the most effective and modern technologies available in the world.

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WOMEN'S HEALTH/HOUSTON

Breast Reconstruction Special to MD Monthly

Provided by Dr. Erika Sato, Board Certified Plastic and Reconstructive Surgeon

B

reast reconstruction is surgery to reconstruct the breast after a partial or total mastectomy. This is a specialized procedure that is highly individualized for each patient’s needs. It is usually covered by health insurance, as it is considered to be an adjunct to breast cancer treatment.

taking into consideration both safety and aesthetics.

Dr. Erika Sato is sensitive to both the physical and emotional concerns of female patients who require breast reconstruction. She uses a variety of techniques, depending on the needs of the individual patient,

The two main types of reconstruction are (1) implant-based reconstruction and (2) reconstruction using autologous tissue (fat, skin, or sometimes muscle). Multiple factors contribute to the availability of either

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Breast Reconstruction Considerations During your breast reconstruction consultation with Dr. Sato, she will spend considerable time with you to help you understand the many options available for breast reconstruction.

procedure type to the individual patient. Examples include cancer staging, body habitus (the physique of the body), and general health.

Breast Reconstruction with Implants Implant-based breast reconstruction has several advantages over autologous reconstruction, such as shorter operative time, technically easier surgery, shorter recovery time, and fewer scars. This method of breast reconstruction involves two stages. The first stage is tissue expander placement. The tissue expander, which is an empty breast FIRST PHOTOGRAPH BY Marc Arevalo

MDMONTHLY.COM

WOMEN'S HEALTH/HOUSTON

implant, is slowly inflated with saline solution over a period of several weeks during office visits until the final size of the breast is attained. A second surgery is then performed to remove the tissue expander and replace it with an implant.

Breast Reconstruction with Autologous Tissue Autologous tissue reconstruction involves using the patient’s own tissue to reconstruct the breast.

This entails taking skin and fat from another area of the body and moving it, along with its blood supply, to the chest to recreate a very naturallooking breast. A DIEP (deep inferior epigastric perforator) flap is an example of this type of reconstruction that uses the abdominal tissue normally discarded in a tummy tuck.

Choosing the right method of breast reconstruction for you depends on a number of factors which Dr. Sato will discuss with you at your consultation.

Dr. Sato will work very closely

with your breast surgeon. Keeping cancer treatment as the top priority, she will plan the best and safest reconstruction for you.

Who is a Good Candidate for Breast Reconstruction?

Breast reconstruction is for women

who have had breast cancer and a resulting mastectomy, or for women who have had a lumpectomy or partial mastectomy, and are left with a defect or breast asymmetry.

What Can I Expect While Recovering from Breast Reconstruction Surgery?

Recovery is widely variable dependent upon the type of procedure and individual patient.

Learn More Are you interested in breast reconstruction in Houston?

Contact Dr. Erika Sato today for a consultation.

For more information visit HoustonBeautifulBody.com Office Address: 9230 Katy Freeway Suite 600, Houston, TX 77057

2017 - OCTOBER MD Monthly

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INFORMED PATIENT/REGIONAL

3

TIPS TO KEEP

YOUR CHILD SAFE FROM

THOSE PESKY

MOSQUITOES

I

t’s likely that itchy bump on your child’s arm is nothing much to worry about. Most mosquito bites are harmless, and the symptoms will subside in a few days.

Still, if you’re a parent who pays attention to news about mosquitoborne illnesses, it’s hard not to be concerned. A year ago, the Zika virus dominated U.S. headlines. In 2014, it was Chikungunya Fever, and West Nile Fever before that.

“Nothing spreads faster across most of the world than a mosquitoborne virus,” says Dr. Brent W. Laartz, a board-certified infectious diseases specialist and author of How to Avoid Contagious Diseases (www.drlaartz. com). “It seems we just become accustomed to diagnosing one virus

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By: Brent W. Laartz M.D. FIDSA

when the next one is discovered.”

And though fears die down in the fall and winter, when mosquitoes disappear in most of the U.S., the threat never really goes away.

Predictions of a massive Zika outbreak in the U.S. were especially alarming because it is associated with a birth defect called microcephaly.

There is also concern because the virus can be transmitted through sex.

“All it takes is one person returning from the Caribbean or Asia with Zika virus in their bloodstream to infect a mosquito, which then will carry it to many others, especially in Southern states,” Laartz says.

The symptoms of Zika,

Chikungunya, Dengue and a few other mosquito-borne viruses are similar, and can include muscle and joint pain, fever, headache, red eyes and a rash. Zika symptoms usually clear up in less than a week, are mild, and rarely require hospitalization, according to www.healthychildren. org. And only 1 in 5 of those infected will have symptoms. But what parent wants to play the odds?

Here are Laartz’s tips for protecting children against mosquito bites and mosquito-borne illness: • Cover as much of your skin as possible. “All it takes is a small amount of skin exposure for a mosquito to land and start feeding,” Laartz says. If it’s too hot to cover up with long

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INFORMED PATIENT/REGIONAL

sleeves and long pants, apply an EPA-rated repellant to skin and clothes. The repellant should have DEET with a 25 percent concentration, he says.

• Use sunscreen first, then repellant. If you can’t find a product with both sun and insect protection, use sunscreen first, let it dry and then apply the repellant, Laartz advises.

(Sunscreens can inactivate repellants.) Keep the product away from your eyes and mouth, and take special care with small children. Do not use insect repellent on babies younger than 2 months old; cover your crib, stroller and baby carrier with mosquito netting.

• Don’t count on treated wristbands and stickers for

complete control. They should be coupled with repellant, Laartz says. And wear protection all day. “The mosquito that carries the Zika and Chikungunya viruses bites during the day and lives closer to human dwellings,” Laartz says. “It also bites multiple times and bites multiple people, so it can spread these viruses more rapidly.”

In March, the National Institute of Allergy and Infectious Diseases entered the second phase of a clinical trial for a Zika vaccine. But it could take years before it’s declared effective and safe enough to be used in the U.S.

About Dr. Brent W. Laartz Dr. Brent W. Laartz (www.drlaartz. com), author of How to Avoid Contagious Diseases, is a boardcertified infectious diseases specialist in Safety Harbor, Fla., with years of experience in infection control at hospitals, nursing facilities, rehab facilities and outpatient clinics. He graduated with his BA and MS degrees from Northwestern University and his MD degree from the University of Iowa.

He finished his training in Tampa, Florida, where he completed a residency in internal medicine and a fellowship in infectious diseases and tropical medicine at the University of South Florida.

For now, Laartz says, mosquito avoidance is the mainstay of prevention.

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Lindsay Garcia I am a medical aesthetician at Halcyon Medspa & Wellness Center by trade and a mother of two by heart.

Age: 31 Food: Chocolate, hummus, and strawberries Color: Black Favorite quote: “The greatest discovery of all time is that a person can change his future by merely changing his attitude.” – Oprah Winfrey Can you tell us a little more about your background and what made you want to become an aesthetician?

My home is Corpus Christi, Texas but I had the absolute best childhood, getting to grow up on the beautiful island of Okinawa, Japan. I knew very early on that I wanted to be like a little Japanese porcelain doll.

Everywhere I went I walked around with an umbrella and I wore gloves during the summer because that’s what all of my peers did. This care of my skin and avoidance of sun was the beginning of my trek across the caring-for-the-epidermis profession!

What is your favorite part about your job?

Being an aesthetician isn’t only about giving facial treatments and selling skin care products, it’s about helping create change in people’s lives.

It is a very emotionally rewarding profession. Making people look good also makes them feel good; which in turn, makes me feel good. It creates happiness for all! I truly enjoy every minute of my career as a medical aesthetician, and I feel like I’m just getting warmed up.

What questions do you get asked the most, and what questions should patients ask you when considering aesthetician services?

The most frequent question asked in my room is “What sunscreen

should I use, and will this help with my wrinkles.”

If I leave anything with my clients it is the importance of a zinc oxide and titanium dioxide broadspectrum sunscreen. Skin cancer is a preventable condition, and the solution is simple: use a broadspectrum sunscreen. A sunscreen with sun protection factor (SPF) absolutely must be worn!

Who are your three top favorites to follow on Instagram?

Halcyon Medspa & Wellness @HalcyonMedSpa Katy Goree @KatyGoree Anna Kendrick @AnnaKendrick47

improve the skin’s texture. The treatment reduces fine lines, fades acne scarring, decreases redness, and diminishes pore size. It is the “perfect go and glow” treatment!

Botox is also popular when used to reduce the appearance of crow’s feet wrinkles, minimize the frown lines in the forehead known as 11’s, and to correct a sagging brow. Fillers are popular when used to soften the nasolabial folds (smile or laugh lines), marionette lines (which run downwards from the mouth), and smoker lines.

What new services are available that the general public may not know about yet?

What is your most cherished beauty product?

Services the general public may not know about:

My most cherished beauty product is StemFactor by Osmosis Pür. After age 30, the activity of stem cells in your skin progressively declines, impacting the skin’s ability to produce growth factors necessary for healing.

StemFactor stimulates collagen and elastin production. Skin is IN!

• We are very fortunate to have a talented Dermatology Physician Assistant on site • Sculptra Aesthetic is an injection which stimulates your own natural collagen production • The silk necklace treatment uses filler to fill the necklace lines around the neck for a soft, youthful neck • Radiesse hand filler covers tendons and veins, giving your hands a hydrated and youthful appearance in just one visit

In relation to your work, what is the most popular service that your patients are coming in for these days? (i.e. lip injections, Botox, etc.)

A laser facial is number one. Laser Genesis is an excellent non-invasive laser treatment promoting the production of healthy collagen to

Social Media Links Facebook: Halcyon Med Spa Instagram: @HalcyonMedSpa

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Ashley Wendt Aesthetician at the Corpus Christi Institute of Cosmetic & Plastic Surgery under Dr. Vijay Bindingnavele

Age: 32 Hobbies: I have small children, so hobbies have taken a back burner, although I do like to read and paint. However, with small children, my reading material has shifted to children books, and my painting is done with lots of interesting watercolors.

Food: Regarding food, I love all things with carbohydrates. Seriously–I won’t pass up a slice of pizza.

Color: I gravitate towards the blue spectrums Favorite quote: “Keep your face always toward the sunshine–and shadows will fall behind you.” – Walt Whitman

Can you tell us a little more about your background, and what made you want to become a aesthetician?

I have been in the aesthetics field for about 14 years. Throughout my career I have worked with physicians and nurses to help develop aesthetic practices. I am very passionate about this, so I love working with medical professionals to show them how these aesthetic treatments can add much value to their practice and patient care.

Aesthetics just fell in my lap. I was in Los Angeles for a bit after I graduated from high school. I was watching the E! network and saw a woman performing laser hair removal, microdermabrasion, and a skin tightening procedure.

I thought it was the coolest thing ever and I was so curious to know how I could become the person who performed those procedures. I dawdled around in California for a while.

When I went back home to Wisconsin, all my friends were going off to college. I didn’t know what I wanted to do in life except perhaps doing something like that laser technician on E!.

At that time, my best friend said she was going to sign up at a school to be

an aesthetician. I didn’t know what that was, but she said, “Oh Ashley we will have our own spa.”

I was 18 and thought, “Well yeah!

That’s sounds fun.”

I eventually signed up for that same school, not fully knowing what I was getting myself into. In the meantime, my friend bailed on the aesthetic school.

Once I got in there I knew it was the right place for me. I also knew I wanted to study more of the medical aspect of aesthetics.

I really lucked out when I graduated from the school because in Milwaukee I met a plastic surgeon R.N. who took me under her wing.

At the time she was a laser trainer for the Palomar system, so I soaked up a lot of her knowledge. She was helping a physician start a Medspa and I became their aesthetician. Since then I have been extremely fortunate in my career. I have practiced in Wisconsin, California, and now Texas.

What is your favorite part about your job?

My job has never felt like work.

That cheesy quote “Do what you love and you’ll never work a day in your life” is so true for me. I love educating people to make them more

knowledgeable about how to take care of themselves and their skin. I love mentoring other aestheticians and showing them the ropes, and I still help develop practices. I am ridiculously passionate about this field, in case you can’t tell.

What questions do you get asked the most, and what questions should patients ask you when considering aesthetician services?

I get asked questions such as “Why is my skin so dry even though it is oily or I have acne?”

A lot of times our skin is dehydrated.

It is lacking water content. To compensate for that water loss in the skin, our oil glands freak out and produce more oil. So I tell everyone that a light-weight moisturizer is good to add to your regime.

If the skin is extra thirsty, apply a hyaluronic acid serum before your moisturizer, which helps retains moisture. That will help to leave your skin a bit more balanced.

Definitely get to know your aesthetician and their background. Also fill out the questionnaire that the practice gives you. You come to us with a concern and we want to be as helpful and thorough as possible with you to give you the best treatment plan.

Who are your top 3 favorite people to follow on Instagram?

Dr. Vijay @CorpusPlasticSurgery Dr. Lara Devgan @NYPlasticSurgeon Chelsea Handler @ChelseaHandler What is some advice you would tell the younger generations who look up to social media for beauty standards?

Oh man! There are a few words I would share. All of these things are not real. I wish no one would compare themselves to most of the unattainable media with all the photoshopping. There is something beautiful about you just the way you are, and there is a lot more to beauty than just external beauty.

What is your most cherished beauty product?

I am going to say a moisturizing sunscreen with a sun protection factor (SPF). Over the years sunscreens have

come a long way cosmeceutically (with anti-aging factors). My skin is practically translucent so I won’t leave the house without SPF. In relation to your work, what is the most popular service that your patients are coming in for these days? (i.e. lip injections, Botox, etc.)

Injectables such as Botox and fillers are always hot! Dermaplaning, which for some reason has been around for decades, has made quite a comeback in the past year or so. Dermaplaning is a gentle resurfacing treatment to remove dead skin and vellus hair, aka “peach fuzz.”

Dermaplaning works really well when used with other treatments, such as peels, microdermabrasion, and laser treatments. Microneedling, a skinrejuvenating process, is also gaining more popularity in recent years. It gives really nice results with little to no downtime. This is excellent for lines, scarring, and to even out skin tone.

What new services are available that the general public may not know about yet?

These days the public is pretty knowledgeable. There is a new generation of dermal fillers out that are less hydrophilic, or less readily dissolvable in water, which I think is quite amazing, as they give subtle yet substantial results.

Other treatments are the newer non-invasive fat reduction, light-based treatments such as Sculpsure® and truSculpt®. I think these are great for people with a healthy body mass index (BMI) who have small pockets of fat that just do not go away through diet and exercise. The Radio-Frequency technology with these machines is a big bonus for the improvement of laxity and freedom of movement.

Social Media Links Facebook: Dr Vijay Bindingnavele Instagram: @CorpusPlasticSurgery

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INFORMED PATIENT/SAN ANTONIO

RESTORING FACIAL

Volume: FAT GRAFTING VS. FILLERS By: Dr. Marc Taylor

F

acial rejuvenation has taken many paths over the years. Although initially limited to various face lift and other surgical procedures, deep chemical “peels” and dermabrasion (superficial sanding) of wrinkles became very popular several decades ago. With the advent of lasers that provided safer and better controlled skin resurfacing collagen (elastin) stimulation, a new era began. With time there have been numerous technological advances in

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laser and other electrical devices so that today there are many options available to treat the superficial and collagen layers of the skin.

Along with these improvements, plastic surgeons have also gained greater knowledge and understanding of the facial aging process and how, as we age, fat atrophy occurs in specific regions of the face, resulting in “stereotypical architectural changes,” which of course are commonly referred to as “looking

old.” Plastic surgeons can now add “volume” back to those areas to fill and to refresh the face. In order to achieve a youthful but natural appearance for patients, I use a combination of laser resurfacing and tightening, as well as volume restoration. Ultimately, when the battle of gravity versus skin plays out over time, surgical repositioning is required.

What are the available filler options?

One option for facial

volume restoration is what I call “off-theshelf materials” such as hyaluronic acid— in various structural manifestations (Restylane, Juvederm)—as a direct filler. Another option is a polymer of lactic acid (Sculptra), which acts as an inflammatory material inducing collagen synthesis to create tissue volume over time. The off-the-shelf fillers are administered in the office.

These are safe, give good results in most people, and only have minimal

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INFORMED PATIENT/SAN ANTONIO

swelling and bruising after the injections. The disadvantage of these fillers is that treatment of large volume losses or treatment of many different areas can be very expensive, and depending on the area(s) treated, results only last six months to a maximum of two years.

stem cells may direct cellular differentiation in some individuals leading to improved overall skin quality. Although some people might require more than one fat injection to an area to obtain the desired filling effect, fat is much cheaper in the long run than repeated injections using the manufactured fillers.

Fat grafting, using your own natural fat, is another source of filler material to restore volume to the face. I perform the procedure using only local injections or combining oral sedation with the local anesthetic injections.

The fat is easily harvested from the abdomen or the thighs using a gentle form of “mini” liposuctioning.

The fat then requires a minimal amount of immediate processing, which is then followed by immediate injection using specially designed tiny, blunt cannulas (thin tubes) to place the fat cells into the tissues.

The disadvantage of using fat is that it requires a “surgery” to harvest and to inject the fat. As a result, it takes approximately one to two hours to perform. Also, as with any surgery the liposuctioned areas and injected areas require post-surgery care, and there will be some degree of swelling, tenderness, and bruising in the areas.

Although most bruising and swelling is down in a few days, in some individuals it can take 1-2 weeks for it to resolve.

The advantage of using fat is that once it develops a good blood supply, the fat that remains is permanent, and the appearance is as good as with manufactured materials. Furthermore, there is good research to show that peripheral

Give us a call at 210-305-5797 or visit www.marctaylormd. com to learn more or to make an appointment to see Dr. Taylor. At your appointment, Dr. Taylor will examine you and discuss what he thinks are your best facial rejuvenation options.

2017 - OCTOBER MD Monthly

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IN THE COMMUNITY/SAN ANTONIO

BUY A PARTNERS SHOPPING CARD TO HELP FUND

UT HEALTH CANCER RESEARCH IN SAN ANTONIO The card is available online now!

Shopping Days: October 20 to October 29, 2017 By: Laura Aplin

I

n October the SA Cancer Council is offering San Antonio shoppers special discounts through local businesses as part of its mission to support critical research at the UT Health Cancer Center, part of UT Health San Antonio.

By purchasing a Partners Shopping Card for $50, shoppers receive a 20 percent discount on items from over 225 local retailers and restaurants.

The entire $50 goes toward research initiatives aimed at preventing or curing cancer. Cardholders will save at highend outlets at The Shops at La Cantera and The Quarry, including popular stores such as Brooks Brothers, Coach, The Container Store, Tory Burch, Tumi, and Williams-Sonoma.

Local businesses and partners also include Julian Gold, Satel’s, Sunset Ridge Home & Hardware, and Hanley Wood, among others.

The shopping card and the full list of participating retailers is available

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online now at www.sacancercouncil. org. Starting October 20th, a hardcopy version of the card and the corresponding retailer list can also be purchased at participating businesses. The card is valid only during the designated October 20–29 shopping timeframe.

“During this special shopping period in October, San Antonio shoppers will have a great opportunity to receive limited-time offers at their favorite participating shops and restaurants while joining the fight against cancer,” says Ginny Peacock, chair of the Partners Shopping program. “The SA Cancer Council is privileged to be a part of an impactful fundraising effort to support critical cancer research at the UT Health Cancer Center.”

The SA Cancer Council’s Partners Shopping program has raised nearly $2 million since 2006. Shoppers, underwriters, and retailers alike

contribute to this program. To help ensure that all sales fund cancer research, generous sponsors such as the Mays Family Foundation and Valero Energy underwrite the program’s promotion costs.

Over the past 30 years, the SA Cancer Council has donated approximately $4.8 million to patients and research at UT Health Cancer Center. Council volunteers also work with patients by providing companionship, identifying support resources, and assembling clinical trial kits.

Website: www.sacancercouncil.org Facebook: SACancerCouncil – www.facebook.com/SACancerCouncil www.facebook.com/UTHealthCancer Hashtags: #BuytheCardFightBack #Give50Save20 #MyCancerMyStory For additional information, call (210) 450-5571 or email: SACancerCouncil@ uthscsa.edu.

OCTOBER - 2017

MDMONTHLY.COM

Melissa Y. Macias, MD, PhD Neurosurgery Dr. Macias treats a spectrum of adult degernative spine and brain pathologies and conditions: • Complex Degenerative Spine Disease, Disc Herniations, Spinal Stenosis, Acquired Adult Scoliosis • Infections • Tumors • Stroke • Trauma Through compassionate and individualized care, Dr. Macias uses minimally destructive techniques, as well as stem cell technologies in her procedures. She also offers treatment of chronic pain and compressive peripheral nerve disorders.

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IN THE COMMUNITY/SAN ANTONIO

North Park Lexus and ThriveWell Cancer Foundation Team Up for Breast Cancer Awareness By: Jamie Brennan

N

orth Park Lexus at Dominion and North Park Lexus of San Antonio today announced they will be teaming up with ThriveWell Cancer Foundation for Breast Cancer Awareness Month in October, 2017. Both North Park Lexus stores will be making a donation to ThriveWell for every new Lexus sold and every service ticket written in the month of October.

“We are thrilled to have both North Park Lexus stores teaming up this year to promote Breast Cancer Awareness and to contribute to the success of such an important organization here in San Antonio,” said Lee Willis, General Manager for both North Park Lexus at Dominion and North Park Lexus of San Antonio.

“The ThriveWell Cancer Foundation currently enables over 400 San Antonians to take advantage of their Patient Assistance Programs and we are honored to support the work that

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they do in our community. Last year was a huge success, and with both stores participating this year, we can make an even bigger impact.”

In addition to the donations that both North Park Lexus stores will make for every sale and service work order written in the month of October, North Park Lexus at Dominion and North Park Lexus of San Antonio will also be hosting a variety of topical Breast Cancer Awareness community events at their respective locations.

North Park Lexus of San Antonio

will have a Mammogram Bus parked at their store on Saturday, October 21, and North Park Lexus at Dominion will host mini-community events on each of the four weekends in October.

For more information or to view the complete North Park Lexus Calendar of Events for October 2017, you can visit North Park Lexus at Dominion online at: LexusDominion.com/Community.

About ThriveWell Cancer Foundation: ThriveWell is dedicated to finding a cure for cancer by funding cancer research, providing patient support, and offering programs to improve the quality of life for patients and their families. Founded in 2007, ThriveWell offers three different but equally important programs to those battling cancer in San Antonio and the surrounding areas: ThriveWell Cancer Foundation’s Patient Assistance Program is focused on ensuring that cancer

PHOTOGRAPHS PROVIDED BY North Park Lexus at Dominion

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IN THE COMMUNITY/SAN ANTONIO

patients are able to comply with their prescribed treatment plan by providing transportation and financial assistance to those in need.

Currently, more than 400 patients are able to take advantage of this program each year.

ThriveWell also provides free exercise, nutrition, and wellness classes to cancer patients and survivors through their Diva & Dude program.

ThriveWell is committed to advancing efforts towards finding a cure. The promise of curing cancer depends upon the advances in science through clinical trials, particularly those focusing on individually-designed cancer treatments. ThriveWell funds cuttingedge research that is happening right here in our community and has provided $525,000 to 26 research projects covering prostate, ovarian, brain, lung, and other cancers.

Follow the ThriveWell Cancer Foundation: Facebook: ThriveWell Cancer Foundation Twitter: @ThriveWellSA Instagram: @ThriveWellSA About North Park Lexus at Dominion:
 Since opening its doors in late 2014, the goal for North Park Lexus at Dominion has been to provide its customers a home away from home. An Elite of Lexus dealership and member of the prestigious Kahlig Auto Group, North Park Lexus at Dominion has earned the Elite of Lexus designation for every year they have been open for business.

The Lexus Dominion resort-style showroom is one-of-a-kind, as it provides customers a relaxing luxury environment and a host of exclusive perks not commonly found in a car dealership. North Park Lexus at Dominion combines

a vast selection of the finest new and pre-owned Lexus models as well as a top-notch service center to ensure excellence throughout the ownership experience.

Connect with North Park Lexus at Dominion online at LexusDominion.com or follow the dealership via social media: Facebook: North Park Lexus at Dominion Twitter: @LexusDominion Instagram: @LexusDominion Contacts: Jamie Brennan North Park Lexus at Dominion 210-816-6000 jbrennan@nplexusdominion.com Erin Ercoline
 ThriveWell Cancer Foundation erin.ercoline@thrivewell.org

2017 - OCTOBER MD Monthly

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IN THE COMMUNITY/CORPUS CHRISTI

Corpus Christi Rehabilitation Hospital Prepared for Disaster Special to MD Monthly

Staff members of Corpus Christi Rehabilitation Hospital safely evacuated all patients from the hospital prior to Hurricane Harvey making landfall in Corpus Christi recently.

A

s Hurricane Harvey approached the Texas coast, staff at Corpus Christi Rehabilitation Hospital was ready. “Patient care and safety always come first every day of our operations,” says Nicholas Nilest, Chief Executive Officer of Corpus Christi Rehabilitation Hospital. “So we were monitoring Hurricane Harvey closely from the very beginning to ensure the safety of patients, family members, and staff.”

The hospital has emergency management plans in place to maintain a constant level of preparedness. The plans cover events that can occur outside or inside the hospital. This can include incidents like fires, flooding, power outages, chemical incidents, hurricanes, and more.

“We keep a close watch on anything that can greatly interrupt the care and safety of our patients,” Nilest explains. “As we monitored Hurricane Harvey, we knew that this could be one of those situations.”

As Hurricane Harvey continued to grow in magnitude, the hospital’s emergency preparedness team

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monitored the storm 24/7 and assessed potential ramifications.

“We were evaluating the storm to determine how it could potentially affect the care and safety of everyone at the hospital – patients, family members, visitors, and staff,” Nilest says. “This included considering the likelihood of a power outage, flooding, structural damage, and loss of water supply.”

Nearly two days prior to the storm hitting the Texas coast, the emergency preparedness team made the decision to evacuate patients and close the facility. The evacuation process included staff members meeting with each patient and their family members to assess their medical needs and to explain the departure process. The few patients who were medically able were discharged. For the majority of patients who required continued medical care, the hospital arranged transportation to Laredo Rehabilitation Hospital and Laredo Specialty Hospital in Laredo, Texas, which are affiliate hospitals of Corpus Christi Rehabilitation Hospital.

“It’s pretty amazing how the staff came together to make this all happen,”

Nilest says. “We made the decision at 12:30 p.m. that day to evacuate. We had all patients, visitors, and staff evacuated before 8 p.m. that evening. I couldn’t be prouder of our staff’s efforts to make sure our patients remained safe and continued to get the care they needed.”

Nilest says the transferred patients continued to receive medical care at the Laredo hospitals until they were transferred back to Corpus Christi Rehabilitation Hospital five days later.

“You always prepare for these types of events with planning and drills, but hope that you never have to use them,” Nilest says. “I couldn’t be prouder of all those who rallied to ensure the patients’ continued safety and care.

From our staff, to our transport team, to our affiliate hospitals in Laredo and their teams, to the community…everyone came together to ensure that a bad situation wasn’t made even worse. I offer my heartfelt thanks.”

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

OCTOBER - 2017

MDMONTHLY.COM

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