4Health Magazine #168 by MOO Publishing

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GRINDING TEETH: IS IT DANGEROUS?

OBESITY IN SENIORS: SHOULD THEY TRY TO LOSE WEIGHT?

LASER EYE SURGERY: SHOULD YOU GO FOR IT?

7 THINGS YOU SHOULD DO BEFORE GOING TO THE PODIATRIST

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4HEALTH

President, CEO Dmitriy Khabinski Vice President, CFO Igor Goldberg Editors Colleen M. Story Nataly Smolyanska

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Art Director Nadezhda Evgach

5 REASONS TO AVOID SMOKING MARIJUANA

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5 WAYS YOUR FLIP-FLOPS ARE DAMAGING YOUR FEET

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Contributing Writers Colleen M. Story Lynn Merrell Gordon Barclay Morgan Rice

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E-mail: info@moopublishing.com 4Health Magazine (ISSN 1942-6801) is published monthly by MOO Publishing Corp.Copyright © 2007-2014 by MOO Publishing Corp. All rights reserved. Printed in Canada. All requests for permissions and reprints must be made in writing. Reproduction in whole or in part without written permission is prohibited. Printed in November 2014.

TERMS AND CONDITIONS OF USE

“4Health” is an editorial-based medical magazine (the "Magazine") provided by Moo Publishing Corp. and by other sources. DISCLAIMER This Magazine is for consumer educational use only. Nothing contained in this Magazine is or should be considered, or used, as a substitute for medical advice, diagnosis or treatment. The opinions in this Magazine are here to educate consumers on health care and medical issues that may affect consummers’ daily lives. This Magazine does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. The Magazine advises readers to always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. Never disregard, avoid or delay obtaining medical advice from your doctor or other qualified health care provider because of something you have read in this Magazine. If you have, or

suspect that you may have, a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, please dial 911 or call for emergency medical help on the nearest telephone. WARRANTIES AND LIMITATION OF LIABILITY We do not make any expressed or implied warranties, representations or endorsements of any kind whatsoever with regard to the magazine, or with respect to any information, product, service, merchandise or other material provided in or through the magazine. We do not warrant or guarantee the accuracy, completeness, correctness, timeliness or usefulness of any information, products, services, merchandise or other material provided throughout the magazine. We are not liable to any reader or anyone else for any decision made or action taken based on their reliance upon the information contained in this magazine. www.4health.net ww.4h w.

4HEALTH | Table Of Content

Grinding Teeth: Is It Dangerous? Long-Term Grinddinng Caan Leeadd to Jaw Pain annd Brookeen Teeth

11 14 Obesity in Seniors: Should They Try to Lose Weight? The Questtionn iss Moree Complicated as Peooplle Gett Oldder

ALLERGIES: WHY SUFFER? TREATMENTS CAN HELP YOU FEEL BETTER IMMEDIATELY By Dr. Lev Barsky MD

‘TIS THE SEASON—GIVE THE GIFT OF HEALTH AND HAPPINESS! Park Place Pharmacy Has Gifts for Everyone

THE LEADING CAUSE OF DEATH—DON’T BE A VICTIM 8 Ways You Can Avoid Dying of a Stroke

CELLULITE, WRINKLES, ACNE SCARS—ERASE THEM! Advanced Cosmetic Treatments Can Help You Turn Back the Clock

INTRODUCING MESODERM THERAPY From VK Skin SPA

Laser Eye Surgery: Should You Go For It?

EVEN GOOD DOCTORS MAY MAKE MISTAKES What Patients Can Do to Reduce Their Risk

How th he Prroceedu ure May Help You Ditcch Glaasssess for Goo od

WHAT’S CAUSING YOUR BELLY FAT? By Dr. Prab R. Tumpati

24 ADHD Medications and Heart Attacks Receentt Stu udy Sayss Kids Taking thee Meds at In ncreased Risk

WHY AM I SO CONSTIPATED? 5 Potential Causes and Solution

WHAT DOES STRESS DO TO YOUR CHILD’S BRAIN? Study Expresses Concern Regarding Early Life Neglect and Abuse

BANISH TURKEY NECKS & DOUBLE CHINS WITH NON-INVASIVE ULTHERAPY By Dr. Roman Rayham

HEAL TENDON INJURIES AND OSTEOARTHRITIS WITHOUT SURGERY By Dr. Stanislav Avshalumov

USA VEIN CLINICS CHOSEN AS THE “BEST” FOR THE THIRD YEAR IN A ROW Take Your Leg Pain to the Experts

7 Things You Should Do Before Going to the Podiatrist

PMS AND POSTPARTUM DEPRESSION History of PMS or PMDD Increases Your Risk

Doctors Advisse Pattieentts to o Co ome Preepaared

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8 4HEALTH 4 E L H

| Allergy l g

ALLERGIES: WHY SUFFER?

TREATMENTS CAN HELP YOU FEEL BETTER IMMEDIATELY

NAME:

Lev BARSKY, MD SPECIALTY: Allergy & Immunology

CERTIFICATION: Diplomate of American Board of Allergy & Immunology

FELLOWSHIP: Fellow of American College of Asthma Asthma, Allergy and Immunology

It’s summertime, which for most of us, means fun outdoor activities in the sun. If you’re bothered by allergies, however, most likely your sunny days are marred by watery eyes, sinus congestion, runny nose, sneezing, coughing, headaches, sore throats, or itchy skin. Fortunately, you don’t have to continue to suffer from these irritating symptoms. A qualified allergy doctor can discover what you’re allergic to, and offer treatments that provide easy relief.

WHAT CAUSES ALLERGIES? Allergic ailments are caused by an «overreaction» of the immune system to various environmental substances. The immune system perceives some elements of the environment as a threat to the body and tries to «defend» against them. The major form of defense is an inflammatory response, which is why clinical symptoms of allergic ailments and infectious illnesses are very similar and tend to overlap.

TYPES OF ALLERGIC RESPONSES

CONTACT: 728 Ocean Ave Ave. Brooklyn, NY 11235

(718) 787-0700 INSURANCE: All major insurance plans and Medicare

Allergens can be divided into two large groups: 1) those that we encounter outside our homes, such as pollen from various plants, and 2) those that are present inside our homes, such as dust or mildew. Different plants produce pollens at particular times of the year. As a result, people sensitive to tree pollen will experience an “acute exacerbation,” or flare-up, of symptoms when trees blossom. In the New York area, this period stems from April until early June. Likewise, people with hypersensitivity to autumn grasses, such as wormwood or ragweed, will begin to feel allergic symptoms in the fall, between August and October. Very often, individuals are sensitive to several allergens, and thus the duration of their symptoms is considerably longer. This pertains particularly to people who are sensitive to allergens that are present inside houses and apartments, ranging from domestic dust and mold (fungi), to hair and saliva of various animals (so-called indoor allergens). Such people may show continuous allergic symptoms all year long. Symptoms may include headaches, sore and burning throat, itching and irritation of the eyes, and coughing. People who experience mild continuous symptoms due to household allergies

often fall victim to flare-ups in the spring and fall, as well. Allergic diseases are not limited to symptoms connected with upper airway passages, however. Other prevalent allergic ailments include bronchial asthma (with symptoms of wheezing, shortness of breath, chest tightness, and/or coughing), and asthmatic bronchitis. Of those who suffer from bronchial asthma, 50% of adults and 80% of children have allergies.

IDENTIFYING TRIGGERS WITH SKIN TESTS The most common method of identifying allergens to which an individual is sensitive through various types of skin tests. Conducted by doctors who are allergy specialists, these tests are safe and take a minimal amount of time. Results are usually available within fifteen minutes. Knowing the substances which a person may be sensitive to enables the allergist to use effective preventative measures and treat allergic diseases. Preventative measures and treatments, in general, are carried out using a combination of different medications selected by a doctor to meet the particular needs of each patient.

TREATMENTS CAN HELP YOU FEEL BETTER For those who suffer from allergy symptoms three months or more throughout the year, and want to be cured permanently, doctors might recommend injections of allergy provoking substances (such as tree pollen, animal hair, or mold), which are highly diluted in water. Patients following this therapy become “immunized,” or desensitized, to the allergens. This method is called immunotherapy, or «allergy shots.» Numerous studies have shown that the success of immunotherapy exceeds 80%. If you suspect you have allergies, you can make an appointment with a board-certified allergist, and, in many cases, walk out of the office with the mystery of your ailments instantly solved. There may be things you are exposed to that you can simply avoid. An allergist will often suggest how you can make changes in your home and work environment, so that symptoms are relieved. In addition, an allergist may prescribe a safe, non-habit forming medication that can offer fast relief from symptoms that may have been bothering you for years. www.4health.net ww.4h w..

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THE LEADING CAUSE OF DEATH— DON’T BE A VICTIM 8 WAYS YOU CAN AVOID DYING OF A STROKE

■■■ Colleen M. Storyy The Centers for Disease Control and Prevention (CDC) state that stroke is the leading cause of death in the U.S., killing nearly 130,000 Americans each year. On average, one person dies from stroke every four minutes. Even more staggering—nearly 800,000

Americans have some kind of stroke every year. Fortunately, you can beat the odds. A recent study found that people who have certain healthy habits have a reduced risk of stroke. The key is to know which habits you need to adopt that will make the biggest impact on your health.

STUDY FINDS LIFESTYLE CHANGES EFFECTIVE Researchers examined data from about 24,000 people. They analyzed each person’s stroke-related risk factors, including things like smoking, activity, alcohol consumption, and diet. Results showed the following: www.4health.net ww.4h w.

4HEALTH ■ Participants who maintained the “healthiest” profile reduced risk

of stroke by 38 percent. ■ The “healthiest” profile was defined as never smoking, maintain-

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ing an optimal weight and waist circumference, exercising, consuming a moderate amount of alcohol, and eating a healthy diet. Researchers found that an overall healthy lifestyle would reduce the number of strokes in women between the ages of 60 and 65 from 153 per 100,000 women to 94 per 100,000 women. The same lifestyle would reduce the number of strokes in men from 261 per 100,000 to 161 per 100,000. The two strongest lifestyle factors that increased risk of stroke were smoking and excess body weight. Being a former smoker was not associated with stroke risk— showing that quitting smoking was effective in preventing stroke. Men who were heavy drinkers had a higher risk of stroke, and were more affected by excess alcohol than women.

8 WAYS TO REDUCE YOUR RISK OF STROKE If you can adapt most of the following ten habits, you’ll be well on your way to living a stroke-free life. 1. Watch your numbers: High blood pressure is the leading cause of stroke. Fortunately, this is an easy one to control. Check your numbers regularly. If they creep up, talk to your doctor about how you can bring them back down. Staying active and watching your weight will help– and medication is very effective if needed. 2. Stop smoking: If you don’t smoke, you’re already ahead of the game. If you do, it’s time to renew your efforts to quit. Don’t worry if it takes multiple attempts—many smokers succeed only after three or more times of trying. Smoking forces the heart to work harder and increases risk of clots, which lead to strokes. 3. Maintain a healthy weight: As the study showed, excess body weight increases the risk of stroke. If you’re already overweight or obese, talk to your doctor about ways you can lose. Even five to ten pounds can make a difference. 4. Move: An active lifestyle is key to healthy blood vessels. You don’t have to be a gym rat. The key is to move as much as possible throughout the day. Take a walk at lunch. Exercise with your friends. Go with the family on a bike ride. Take a few trips around the mall. Get up from your chair and walk across the office. Turn on the tunes and dance. Whatever it takes to move more often. 5. Don’t drink too much: Excess alcohol also increases your risk. Limit it to one drink a day (or less) if you’re a woman, and two drinks a day if you’re a man. More than that and your risk goes up sharply. 6. Keep diabetes under control: The American Diabetes Association states that people with diabetes are two to four times more likely to have a stroke than those who don’t have diabetes. Work with your doctor to keep your blood sugar levels under control. 7. Eat real food: You know you need to eat a healthy diet, but what does that mean? You can make it simple by focusing on real food. Limit your intake of fast food and food in packages like cans, boxes, and bags. Choose more items from the produce aisle, and always look for ways to increase your intake of fruits and vegetables. 8. Manage your stress: Studies have linked stress to heart disease and stroke. In 2014, for example, researchers found that stress raised stroke risk by 59 percent! Don’t skip this step. Try yoga, long walks, warm baths, soothing music, journaling, art therapy, time with pets—whatever it takes to regularly and successfully reduce your stress levels. www.4health.net w.4hea .4

4HEA 4H EALTH EAL

CELLULITE, WRINKLES, ACNE SCARS— ERASE THEM! ADVANCED COSMETIC TREATMENTS CAN HELP YOU TURN BACK THE CLOCK ■■■

Morgan g Rice

If you’re tired of looking in the mirror and seeing cellulite, fat, and sagging skin, you may want to talk to your dermatologist. They’re finding that some advanced laser technologies may help to improve these conditions, and have you looking younger, tighter, and smoother than you thought possible.

BANISH CELLULITE According to the American Academy of Dermatology (AAD), new and improved laser and light treatments can help turn back the clock and improve appearance in a number of ways that weren’t available until recently. Take cellulite, for instance. A 2013 Harris Interactive Survey found that women with cellulite rated their own appearance on average lower than women without cellulite. A surprising 97 percent of women with cellulite said they would change a part of their body if given the chance, and had tried a number of approaches to hiding that bumpy skin. Exercise can reduce overall body fat, but cellulite is usually stubbornly resistant to change. Fortunately, the FDA approved a new minimally invasive laser treatment for cellulite and extra fat in 2012. During the procedure, surgeons insert a tiny fiber optic under the skin to break up the fibrous bands that

form cellulite. The laser beam helps remove the dimples, smoothing the appearance of the skin.

REMOVE EXCESS FAT If you’ve got love handles or other excess fat in the abdominal or flank area, there are newer treatments that may help. “Cryolipolysis” actually freezes the fat, which then slowly dissolves and disappears over time. Ultrasound is another possibility. It targets fat under the skin with high-intensity energy, reducing fat in the abdomen, thighs, and other areas.

ERASE TATTOOS Tattoos can be fun, but sometimes their appeal fades. Maybe the name you got tattooed on your arm now belongs to an ex-boyfriend or girlfriend. Weight loss may have affected the appearance of the tattoo. Maybe your artist just didn’t get it right. In 2013, the FDA approved the “picosecond laser” which helps break down tattoo colors with short, pulselike shots. Patients may need multiple treatments, but results are better than ever before.

FIRM UP SAGGING SKIN One of the most frustrating aspects of aging is sagging skin. Over time, collagen and elastin breaks down and stretches, allowing skin to droop. Most moisturizing creams, despite their promises, do little to reverse the process.

Dermatologists, however, can help firm up sagging skin with ultrasound and radiofrequency therapies. Both are non-invasive procedures approved by the FDA to tighten skin on the neck, chin, eyebrow area, and on other areas on the body. Patients can start to see results in about a month, with optimal results usually seen at around four months.

SMOOTH ACNE SCARS AND WRINKLES Laser treatments have long been used to help smooth scars and wrinkles, but improvements in the technology now allows for a faster, easier recovery. Fractionated CO2 lasers have been used to resurface the skin, fading wrinkles and acne scars, but patients had to set aside significant time for healing. A new, lower-powered fractionated CO2 laser improves downtime while still producing excellent results. Dermatologists now prefer this laser for smoothing the appearance of skin.

FIND A GOOD DERMATOLOGIST Though these treatments can help you feel youthful and renewed, they can also cause skin damage and scarring if not performed by a true professional. The AAD recommends that you always consult with a “board-certified dermatologist who is an expert in cosmetic procedures” and who can give you customized advice about what’s best for you. www.4health.net ww.4h w.

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4HEA 4H EALT TH

GRINDING TEETH: IS IT DANGEROUS? LONG-TERM GRINDING CAN LEAD TO JAW PAIN AND BROKEN TEETH ■ Stress: Stress and anxiety can lead to brux-

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Morgan g Rice

Do you grind your teeth at night? Has your dentist told you he’s noticed wear and tear on your teeth? If so, you probably have “bruxism,” a common condition that affects an estimated eight percent of Americans. Is this a serious condition? Should you be worried? Turns out that without treatment, bruxism can sometimes lead to more serious conditions, like jaw joint disorders and damaged teeth.

WHAT IS BRUXISM? The word “bruxism” comes from the Greek word brychein, which means “gnashing of teeth.” The condition occurs when people push or clench the top and bottom teeth together, and then grind them back and forth. The action is in response to the chewing reflex. Though some may do it during the day, most people grind their teeth while they’re sleeping, and don’t even know they’re doing it. It’s only when the dentist points out the wear and tear that they may realize what’s happening.

WHAT CAUSES BRUXISM? There can be a number of reasons why people may grind their teeth. These include:

ism in some people. A study published in 2010 found that experiencing stress and poorly coping with stress can increase risk. Participants who said they felt high levels of stress because of work problems, exhaustion, health issues, or other struggles were more likely to be heavy teeth-grinders. Those who tried to escape or ignore their problems were also more likely to process stress with bruxism. ■ Uneven teeth: Some dentists think that when the teeth don’t line up correctly, people are more likely to grind their teeth. ■ Sleep problems: A 2009 study linked teeth grinding with sleep apnea. Researchers found that one in four patients with sleep apnea also suffered from bruxism. ■ Emotional issues: A 2010 study examined personality traits and bruxism, and reported that traits like neuroticism and anxiety were related to teeth grinding. Other potential causes include medical conditions, medications, and substance abuse.

POTENTIAL COMPLICATIONS & TREATMENTS Once you find out you are a teeth grinder, it’s important to talk to your dentist about the possible treatments. If you let it go too long, you increase your risk of tooth pain and

damage, headaches, mouth and muscle pain, hearing loss, sore gums, and jaw joint pain and deterioration. Potential treatments include: ■ Relaxation techniques to help minimize

and cope with stress ■ Counseling to help deal with stress ■ Cut back on caffeine and alcohol in the

hours before bed ■ Lifestyle changes, such as limiting caffeine,

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improving your bedtime routine, and stopping smoking Treatment for sleep apnea Orthodontia may help align the teeth and reduce grinding Grinding mouth guard — your dentist can make one for you that helps protect the teeth, muscles, and jaw joint from the pressures of clenching and grinding Apply a heating pad to the cheek in front of the earlobe at night to help encourage relaxation of the jaw joint

HOW CAN I TELL IF I’M GRINDING? Since most people grind their teeth at night, they aren’t aware of the problem. This is why it’s important to have regular dentist appointments. Other clues include headaches or jaw pain upon awakening. www.4health.net ww.4h w.

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EVEN GOOD DOCTORS MAY MAKE MISTAKES WHAT PATIENTS CAN DO TO REDUCE THEIR RISK

■■■ Colleen M. Storyy In a September 2013 study, researchers reported that an estimated between 210,000 and 400,000 people die in hospitals every year from some sort of preventable harm. In other words, healthcare professionals make mistakes that contribute to their deaths. Doctors aren’t perfect, and because of today’s insurance requirements, are often rushed. That means that even the best doctors can make mistakes now and then. Smart patients however, can reduce the risk of suffering from serious harm by taking certain steps to safeguard their own health.

Doctors also rely on their staff members for important information. If a nurse makes a mistake and enters the wrong figures in your health record, or if a lab technician misreads a medical test, the doctor may be dealing with information that leads him the wrong direction when determining a diagnosis. Doctors may also become trapped in a certain way of thinking. They may become used to doing things a certain way, and fail to consider other possibilities. All of these factors can lead to a wrong diagnosis, or an incorrect prescription that could cause patients serious harm.

WHAT PATIENTS CAN DO WHY DO DOCTORS MAKE MISTAKES? Most of the time, it’s not because they lack knowledge or because they don’t care. Consider the challenges facing them—they usually have only about 20 minutes to examine you, ask you questions, and figure out what’s wrong, say nothing of determining the best treatment for you. Then they have to move on to the next patient and do it all over again. Think about your own workday. Are you always at the top of your game, or do you have times when you’re tired and more likely to make a mistake? Do you sometimes have other things going on in your life that may distract you, like health problems in the family? Doctors are people too, and can suffer from the same stresses.

Patients, by taking charge of their own health, can take a number of steps to reduce the risk of a mistake at the doctor’s office. These include the following: ■ Schedule your appointment early: Like

most of us, doctors are likely to be at their best earlier in the day, before they get tired and run down. This is also a good way to avoid long waits in the doctor’s office. ■ Make a list: Your symptoms are extremely important when it comes to making a diagnosis. The more accurate information you can give your doctor, the better. Make a list of all the symptoms you’re experiencing, as well as any medications

you’re taking, and be sure to take it with you. ■ Go with a partner: When you’re not feeling well, it can be difficult to remember everything you wanted to share with your doctor, or to ask the questions you need to ask to be sure you’re getting the right treatment. Ask a family member or friend to go with you. If there is no one available, take a notebook so you can make notes of any questions or treatment suggestions. ■ Don’t leave without knowing the next steps: After your visit is over, you should either know what is causing your symptoms, or know how the doctor plans to go about finding out the cause. If you don’t understand this one key thing, ask your doctor questions until you do. Sometimes primary-care providers fail to note an actual diagnosis, which can hurt you down the road. ■ Follow up on tests: If you’re scheduled for tests, follow up to make sure you receive and understand the results, and what they mean for any potential future treatment. If any of the tests are abnormal, find out what the next step is. Remember that tests can be interpreted incorrectly. Ask for follow-up tests or a second opinion. If you don’t feel better: Go back to the doctor, or seek a second opinion. www.4health.net ww.4h w.

4HEALTH

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Obe esity y Medicine M d n | 4HEALTH HE L H19

WHAT’S CAUSING YOUR BELLY FAT? YOU MAY HAVE INSULIN RESISTANCE! During the past 20 years, there has been a dramatic increase in obesity in the United States. More than one-third of U.S. adults (35.7%) and approximately 17% (or 12.5 million) of children and adolescents aged 2–19 years are obese. Another 33% of all adults are in the overweight category. Though there are a lot of things that can cause weight gain, I find the following four factors often play a crucial role in expanding my patients’ waistlines.

THREE THINGS HAVE CHANGED ABOUT HOW WE EAT Hippocrates, father of medicine, is quoted as saying, “Let food be your medicine, medicine be your food.” Over the past several decades, however, we’ve moved away from this concept, and now see food merely as “calories in, calories out,” which has changed our relationship to what we eat. Three things happened to the modern diet that now contribute to the high levels of inflammation we currently see in the population at large, leading to increased health problems and disease. Understanding these three fundamental principles forms the foundation for a healthy and long life. Belly fat and insulin resistance: Insulin resistance, or metabolic syndrome, affects one in three Americans and leads to excess belly fat. Unlike the subcutaneous fat that is protective, studies have shown that belly fat produces cytokines and other inflammation-causing chemicals that lead to the increased risk of cardiovascular disease, diabetes and other conditions. In fact, waist circumference of over 40 inches in men and 36 inches in women (lower in Asian Populations), is one of the five criteria for metabolic syndrome. This leads to belly fat which increases the risk of diabetes, heart disease and even cancer risk! Lack of antioxidants: Before the modern food processing era, our diet used to have more than 50 percent unprocessed and uncooked food items such as colored fruits, vegetables, and other natural ingredients that are high in antioxidants such as polyphenols. Studies have shown that lack of polyphenols leads to increased inflammation in the body. www.4health.net w.4hea .4

Ratio of fats: The ratio of omega-3 to omega-6 fatty acids used to be 1:1, but is now at 1:16, which also increases inflammation.

THE FOURTH FACTOR More recent research has revealed a fourth factor in this list—lack of quality sleep. According to the National Institutes of Health, 50 to 70 million Americans are affected by chronic sleep disorders and intermittent sleep problems. The Centers for Disease Control and Prevention (CDC) adds that sleep insufficiency is linked to motor vehicle crashes, industrial disasters, and occupational errors. Lack of proper duration and quality of sleep also contributes to insulin resistance, which in turn leads to weight gain. A 2012 study, for example, found that sleep deprivation impaired the ability of fat cells to respond to insulin, the hormone that regulates blood sugar. Unfortunately, this can set in a vicious cycle where sleep problems lead to weight gain and weight gain in turn—particularly if it leads to sleep apnea—can make sleep problems worse!

PHYSICIAN ASSISTED WEIGHT LOSS CAN HELP Reversing the many factors leading to weight gain such as insulin resistance, sleep apnea, lack of proper sleep, stress, nutritional deficiencies, food sensitivities, eating disorders, hormonal imbalances etc., can be very difficult to do on your own. Diet fatigue, discouragement, and the constant ups and downs can deter even the most disciplined person from his or her goals. A physician familiar with weight loss, sleep disorders and wellness can be the helping hand you need to get back on track with your weight and your health. Realizing the bidirectional relationship between sleep disorders and weight gain, we are able to address these very interrelated fields together so you can lose weight, sleep better, and enjoy a healthier and perhaps even longer life. If you’re not sure about cost, realize that your insurance might cover these services, thanks to the Affordable Care Act that mandates insurance coverage for obesity. Call Dr. Tumpati’s office at 1(888) 283-0399 or visit us online at www.w8md.com.

NAME:

PRAB R. TUMPATI, MD CERTIFICATION: Board Certified in Internal Medicine & Sleep Medicine; Board Eligible in Obesity Medicine Fellow of the American Society of Bariatric Physicians

SPECIALTY: Internal Medicine Medicine, Sleep and Obesity Medicine

INSURANCE: Accept All Major Insurance Plans

CONTACT: 2003 Bath Avenue Brooklyn, NY 11214

(888) 283-0399 www.w8md.com

A THE AS T E ONLY O L INSURANCE S R N E PHYSICIAN PH YS C N WEIGHT WE H LOSS O S PROGRAM PR OGRAM IN THE H AREA, R A, THE TH E DEMAND E A D ISS HI HIGH H AND AND ACCEPTANCE AC CE T N E LIMITED L I E TO O 100 NEW EW PATIENTS AT E T PER E W WEEK. E K.

4HEALTH

OBESITY IN SENIORS: SHOULD THEY TRY TO LOSE WEIGHT? THE QUESTION IS MORE COMPLICATED AS PEOPLE G GET OLDER

■■■ Colleen M. Storyy Acco ording to a recent Gallup survey, more elderly Americans are suffering from o obesity today than ever before. Middlee-aged adults and advanced seniors saaw the biggest increases in obesity rates b between 2008 and 2012. A study from tthe National Institutes of Health found similar results. The percentage of people ages 65 and older who were obese rose fro om 22 percent in 1988–1994 to 38 percentt between 2009–2010. The issue is serious. Obesity in seniors increasses risk of diabetes and chronic heart d disease, as well as a lower quality of life and d a shorter health span. It’s not always eaasy to know what approach is best in seniors, however, because some extra weight can be helpful in this age group. Here’s more, and what you can do if you or a lovved one is carrying a few too many extra p pounds into the golden years.

MORE ABOUT WAIST CIRCUMFERENCE THAN POUNDS In a recent study in the Cleveland Clinic Journal of Medicine, researchers noted that the number of obese older adults is on the rise, but that it’s not always cllear-cut whether to treat them or how to o treat them. Prevvious research has shown that being mo oderately overweight can offer a “survivval advantage in older people.” www.4health.net ww.4h w.

4HEALTH A little extra weight can help stave off bone loss, and may offer some protection against fractures. A body mass index (BMI) of over 30, however, “continues to be associated with many health risks in this age group.” Overweight is associated with more arthritis, diabetes, sleep apnea, urinary incontinence, cataracts, cancer, and a decline in physical function. Gaining some weight is natural in older age. According to a 2005 study, body weight and BMI gradually increase and reach their peak between the ages of 50 and 59. After the age of 60, they tend to decrease, but that decrease is likely to be associated with muscle— not fat—loss. In fact, muscle decreases by up to 40 percent from 20 to 70 years of age, with maximum fat mass usually reached between the ages of 60 and 70. During this time, seniors gain the most dangerous type of fat— intra-abdominal fat—which is associated with many diseases.

SHOULD SENIORS TRY TO LOSE WEIGHT? Should older obese people try to lose weight? This is the question. Harsh diets and exercise programs could actually increase health risks for the elderly. But at the same time, obesity-related diseases can make life

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miserable. Obese seniors, compared to normal-weight seniors, have less independence and freedom, more discomfort and pain, and more limitations that lead to increased mortality. Some studies have examined this question. Research in middle-aged people, for example (40–65 years old), found that intentional weight loss was associated with reduced mortality rates in those suffering from diabetes and other health conditions. Results from some other studies, however, showed no such benefits, and some studies have shown that senior weight loss (some of which may be associated with disease) actually increased mortality.

“The optimal weight in terms of survival increase with age,” researchers write. They further state that recommendations for the young and middle-aged, where weight loss is concerned, should “not be applied directly to older adults.” Instead, doctors need to look at a number of factors, including the following: ■ Overall health and function—if seniors

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ADVICE FOR SENIORS AND DOCTORS Researchers suggest that rather than define obesity by weight in seniors, doctors use waist circumference, instead. This measurement correlates with intra-abdominal fat, which is considered to be the most dangerous. The standard for women is less than 35 inches, while the standard for men is less than 40 inches. The Health Survey for England suggested adjusting those figures for the elderly to about 39–41 inches for men and about 39 in women 70 and older.

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are active and energetic, it may be best not to advice restricting calories; regular exercise is more important Resistance training can improve quality of life regardless of weight, and is a great way to improve physical function High-risk older adults with heart disease and diabetes should consider moderate weight loss to improve daily function and increase longevity For those who want to lose weight, studies have shown that eating a healthy diet and exercising regularly can help trim the pounds in the elderly just as well as in younger populations Medications can cause weight gain— doctors need to examine this potential connection in case medication changes may help

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Gastroenterology o t o g | 4HEALTH HE L H

WHY AM I SO CONSTIPATED? 5 POTENTIAL CAUSES AND SOLUTIONS Have you ever been constipated? Most people have. Oftentimes, it’s a passing irritation, but in many cases, especially as we get older, it can become a more regular occurrence. According to the National Digestive Diseases Information Clearinghouse (NDDIC), over 42 million people suffer from the digestive disorder — about 15 percent of the population — and most healthcare experts believe that the number may be much higher, as many patients don’t report the problem to their doctors. Constipation is defined as having fewer than three bowel movements in a week, or having stools that are hard and difficult to pass. Symptoms may include bloating, cramps, and pain in the belly. If left untreated, it can cause complications like hemorrhoids, impaction, and anal fissures (small tears that may itch and bleed). Since the condition is so common, we asked Dr. Sofia Novak of the Greater New York Endoscopy Surgical Center to tell us what causes it, and what we can do to feel better.

DO PATIENTS OFTEN COME TO YOU ASKING ABOUT CONSTIPATION? This is a very frequent complaint. On average, one in four adults suffer from some degree of constipation in the United States. I hear this complaint very frequently, with about a third of my patients inquiring about what to do to help with constipation.

WHAT ARE THE FIVE MOST COMMON CAUSES OF CONSTIPATION? ■ Lifestyle (not enough fiber, liquids, and/or

exercise) ■ Side effects of medications ■ Gastrointestinal disorders like irritable bow-

el syndrome and functional constipation ■ Manifestations of endocrine disorders (dia-

betes or hypothyroidism) or neurological disorders (Parkinson’s, stroke) ■ More worrisome causes (i. e. tumors) usually present with other accompanying signs and symptoms

WHAT ARE THE STANDARD TREATMENTS FOR EACH? Before determining treatment, my staff and I review the patient’s medical history, including other medications used. Then, depending on the symptoms, I will either recommend a diet modification plan, or do some routine bloodwork. In some cases, based on a detailed discussion with the individual person, I may perform www.4health.net w.4hea .4

a rectal exam with possible radiologic or endoscopic imaging. A treatment regimen may consist of a change of medications that the patient is on, or the addition of various laxative medications.

WHEN SHOULD A PATIENT TALK TO YOU ABOUT CONSTIPATION? Though occasional constipation is no cause for worry, if you notice any of the following symptoms, check with your doctor right away: blood in toilet; change from your normal habits (more constipation or worse constipation than usual, for example); painAbdominal distention; nausea or vomiting; fever; weight loss; feeling weak; constipation that interferes with daily activities; symptoms that come and go and persist for more than three weeks

A LOT OF US, WHEN EXPERIENCING AN ATTACK OF CONSTIPATION, WILL TURN TO LAXATIVES. YET WE’VE HEARD THEY CAN BE DANGEROUS. WHAT DO YOU THINK? It depends on the type of the laxative (mechanism of action) and the amount used, as well as whether you have any other medical conditions, especially kidney problems and heart disease, or if you’re pregnant or could be pregnant. In general, laxatives are safe if used in small doses. If you’re using them on a “routine” basis, check with your doctor, as long-term use can lead to serious complications, such as nutrient deficiency or kidney injury. There are several types of laxatives. Here’s a review of some of the main ones and how they may affect you. Fiber supplements with plenty of water are considered first-line in treatment of chronic constipation. ■ Bulk-forming laxatives or Fiber supplements ■ Hyperosmolar laxatives ■ Saline laxatives ■ Stimulant laxatives ■ Newer medications

WHAT CAN PATIENTS DO AT HOME TO HELP PREVENT CONSTIPATION? ■ Drink plenty of water ■ Eat fruits and vegetables high in fiber: beans

and berries ■ Consume natural laxatives like prune juice, cantaloupe, figs and dried apricots ■ If you feel the need to go, don’t hold it in ■ Eat small, more frequent meals

NAME:

Sofia Novak, MD SPECIALTY: Gastroenterology Internal Medicine Gastroenterology.

CERTIFICATIONS: American Board of Internal Medicine

MEMBERSHIPS: American College of Gastroenterology - ACG New York Society for Gastrointestinal Endoscopy - NYSGE

TRAINING & EDUCATION: Medical School - New York Medical College Long Island Jewish Medical Center Center, Residency in Internal Medicine Hofstra University University, North Shore-LIJ Health System Fellowship in Gastroenterology System,

INSURANCE: Accept All Major Insurance Plans

CONTACT: 2211 Emmons Ave Ave., Brooklyn NY 11235 Brooklyn,

(888) 987 987-5211 5211 www nygicare com www.nygicare.com

LANGUAGES: ENGLISH •RUSSIAN

4H HEALT EA ALTH H

LASER EYE SURGERY: SHOULD YOU GO FOR IT? HOW THE PROCEDURE MAY HELP YOU DITCH GLASSES FOR GOOD ■■■

Lynn y Merrell

The Food and Drug Administration (FDA) first approved LASIK surgery, or laser corrective surgery, in 1999. Since then, doctors and scientists have continued to improve the procedure to correct vision in the fastest, most efficient way possible, allowing thousands of Americans to enjoy better vision without corrective lenses. It’s now 2014—fifteen years later. Maybe you’re tired of your contacts and glasses. You may be thinking that now might be a good time to try the procedure, since it’s been out awhile. Perhaps you’ve talked to a friend who tried it and experienced great results. Whatever your situation, if you’re considering laser corrective surgery, here’s more information to help you make the best decision for your eyes. What is LASIK?

A LASIK PROCEDURE INVOLVES TWO BASIC STEPS: 1. The laser cuts a “flap” from the cornea. This gives the doctor access to the cornea itself. 2. The doctor then uses the laser to reshape the cornea to the patient’s particular prescription. This “fixes” the eye so that light is focused onto the retina where it is supposed to be. Once this is completed (it usually takes less than five minutes), the flap is repositioned for fast healing. There is another type of similar laser corrective surgery called “photorefractive kera-

tectomy (PRK).” It’s basically the same, except that there is no flap—PRK is done right on the surface of the cornea. Usually the flap reduces healing time, but people who are at risk for complications because of the flap—such as those with thin corneas or who are at risk of eye trauma—PRK might be the better option.

WHAT CONDITIONS DOES LASER SURGERY TREAT? Laser eye surgery helps improve your natural vision. It’s used to correct nearsightedness, farsightedness, and astigmatism. The American Society of Cataract and Refractive Surgery states that 96 percent of patients will achieve 20/20 vision or better after the procedure. Most will no longer have to wear glasses or contacts (though reading glasses are often still necessary for those 40 and over who have trouble reading). Those who feel they need more correction can opt for an additional procedure after the initial procedure is completed.

HOW LONG DO THE RESULTS LAST? This was one of the main concerns when laser surgery first came out—how long would the benefits last? The initial correction is permanent, but it doesn’t prevent future changes that may occur in the eyes. Though the eye shape usually remains fixed, things like diabetes, eye trauma, and aging (which can cause “presbyopia”—loss of elasticity in the lens of the eye

that affects reading ability), can all affect the results of laser surgery. If desired, patients can undergo an enhancement procedure to correct these changes, as long as their eyes are still healthy.

MORE ABOUT THE TREATMENT As long as your eyes are healthy and your vision is stable (you haven’t gone through prescription changes for at least two years), you are likely a candidate for laser corrective surgery. You need to talk it over with your optometrist, however, and undergo a complete evaluation to be sure. The actual procedure takes about ten minutes per eye. Doctors use anesthetic drops before the surgery that numb the eye, so the procedure is painless. After the procedure is over, many patients experience a “gritty” or “sandy” sensation in the eye for a few hours. Over-the-counter pain pills usually treat any discomfort. You’ll be able to see clearly usually between one day to one week after the surgery, and vision usually stabilizes completely after a couple months. Most patients return to their normal activities the next day. Potential complications include infection, inflammation, dry eye, glare at night, and vision loss, but these are extremely rare. Though night glare was often talked about in the early stages of laser eye surgery, new technology that custom designs each patient’s treatment have improved results. Talk to your doctor about any concerns you may have. www.4health.net ww.4h w.

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4H 4HEA HEA E LT TH

WHAT DOES STRESS DO TO YOUR CHILD’S BRAIN? STUDY EXPRESSES CONCERN REGARDING EARLY LIFE NEGLECT AND ABUSE ■■■ Colleen M. Storyy A little stress can help keep us on our toes, but too much is bad for our health. Chronic stress can lead to headaches, insomnia, weight gain, high blood pressure, heart problems, and more. And that’s for adults. When we’re talking about stress and children, the effects can be even worse. Researchers recently looked a little more closely into the issue. How do stresses like poverty, neglect, and abuse affect children? What they found is no less than alarming. Not only do children suffer from these types of stresses, but the consequences can last long into adulthood.

EARLY LIFE STRESS AFFECTS BRAIN DEVELOPMENT For the study, researchers from the University of Wisconsin-Madison interviewed 128 children around the age of 12 who had experienced poverty, neglect, or physical abuse in early life. They also talked to the children’s caregivers, and took images of the children’s brains. They then compared the data to that gathered from similar children who had not been mistreated and who were from middle-class families. The results showed the following: ■ Children who had experienced early life stress had smaller amyg-

dalas—the part of the brain involved with emotion—than children who had not suffered that type of stress.

■ Children who had lived in poverty and/or who had been physi-

cally abused had smaller hippocampuses—the area of the brain responsible for memory and learning. The researchers concluded that early life stress could affect brain development, affecting those parts of the brain involved in emotion processing and regulation, learning, and memory.

OTHER RESEARCH SHOWS SIMILAR RESULTS This isn’t the first study to indicate that early life stress can affect children’s brains. In 2012, researchers came to a similar conclusion after studying 61 children ages 9 to 14. They found that the “anterior cingulate”—which is involved in emotional and cognitive tasks—took up less space in children who had been highly stressed. They also found lower levels of both gray and white matter—areas that control communication between neurotransmitters in the brain—in those children who were overly stressed.

HOW DOES STRESS AFFECT THE BRAIN? Why would this happen? Scientists don’t yet have all the answers, but they think that high levels of stress alter chemicals in the brain and the body, affecting cellular development. They don’t know, however, how long the effects last. Do these areas of the brain achieve further growth as the children age? Do the children recover full development with time? www.4health.net ww.4h w.

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“We’re not trying to argue that stress permanently scars your brain,” said researcher Jamie Hanson. “We don’t know if and how it is that stress affects the brain. It could be that, because the brain is very plastic, very able to change, that children who have experienced a great deal of stress catch up in these areas.

HOW PARENTS CAN HELP Though stress is part of life, parents can take steps to help their children cope. Monitor your own stress: Kids take their cues from their parents. How stressed out are you? Taking steps to control your own stress—so you can be more genuinely calm around your kids—will go a long way toward helping them feel calm. Take care of your relationship: Marital conflict is extremely stressful for children. If you and your partner aren’t getting along, consider couples counseling for yourselves and for your children. Schedule time for stress-relief: This goes for both parents and children. Take a family walk or bike ride. Get out into nature on the weekends. Play a game of catch or badminton together. Do a family art project. Allow kids time to play and relax. Adults are extremely busy these days, but children are too. Try not to overschedule every hour, and allow some free time. Communicate: Parents who talk to their kids on a regular basis can head off problems before they start. Create a regular routine of open, honest conversation. The dinner table is the perfect place! Cultivate routine: Kids feel safest when they know what to expect. Try to create a weekly routine and stick to it, with regular meal times and bed times.

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Dr. Cohen participates in COURT TRIALS as an expert witness, offering expertise on neurological injuries resulting from motor vehicle accidents, work-related incidences, and other traumas. MEDICARE MA+03 */4URANCES WORKER COMPENSA5*0/ "/% NO-FAUL5 */4UR"/$& ACCEPTED www.4health.net w.4hea .4

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ADHD MEDICATIONS AND HEART ATTACKS RECENT STUDY SAYS KIDS TAKING THE MEDS AT INCREASED RISK ■■■ Gordon Barclayy A lot of kids in the U.S. are taking medications these days. A 2011 study reported that the use of drugs to treat Attention Deficit Hyperactivity Disorder (ADHD) had increased from about four percent in 1996 to over five percent in 2008. Drugs used in older children aged 13 to 18 jumped from only 2.3 percent in 1996 to nearly five percent in 2008. Overall, nearly three million children were taking ADHD medications in 2008. That means that a lot of parents need to be aware of a new study. Researchers reported this year that children and teens taking ADHD medications may be at an increased risk of heart problems later in life.

2014 STUDY SHOWS CARDIOVASCULAR RISK For the study, researchers looked at data for over 700,000 children born between 1990 and 1999. They then narrowed it down to the just over 8,000 children who had been diagnosed with ADHD. Those who were taking stimulant drugs were compared with those who weren’t. The results showed that those who were taking medications were slightly, but significantly more likely to suffer from cardiovascular prob-

lems than those who weren’t. These included things like arrhythmias, cerebrovascular disease, hypertension, ischemic heart disease, heart failure, heart disease caused by rheumatic fever, heart attack, pulmonary heart disease, and other types of cardiovascular disease. The overall risks of heart disease were still low—only 111 diagnoses diagnosed out of 8,300 children. The results weren’t entirely surprising. Prescribing information for Ritalin (methylphenidate) and similar medications list heart problems as potential side effects.

ADHD STIMULANTS LINKED TO SUDDEN DEATH This isn’t the first study to link ADHD medications with health risks. In 2009, researchers linked the drugs to a potential risk of sudden death. In the study, they examined records for over 500 children and teenagers who died suddenly, and found that they were 7.4 times more likely to have been taking stimulant medications, such as Ritalin. “Although sudden unexplained death is a rare event,” the researchers wrote, “this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment.” Three years earlier, in 2006, the FDA required an additional

warning on Ritalin’s prescribing information noting the link between sudden death and use of stimulant drugs in children with serious heart problems.

ARE THERE ALTERNATIVES? Parents of children with ADHD often note how much medications like Ritalin help with behavior, schooling, and overall well being. Particularly for children with risks for heart disease, however, these medications may be risky. Are there alternatives? It’s always best to talk to your doctor, but it’s also important to know that alternatives are available. The University of Maryland Medical Center notes that several well-conducted studies have reported good results with diets that restrict potential allergens—avoiding artificial colorings, chemical additives, milk, chocolate, eggs, and wheat, for example, if the child is allergic or sensitive. Some children have been found to be deficient in zinc, after which supplementation provides improvements. Additional alternative coping methods may include meditation, music therapy, and relaxation training. In addition to talking to your doctor, consider discussing the issue with a dietician, music therapist, or other alternative medicine practitioner to discuss the best solutions for your child. www.4health.net ww.4h w.

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304HEALTH 4 E L H

| Plastic la i Surgery S g y

BANISH TURKEY NECKS & DOUBLE CHINS WITH NON-INVASIVE ULTHERAPY PROCEDURE NAMED “BEST IN-OFFICE TREATMENT”

NAME:

Roman RAYHAM, MD SPECIALTY: Plastic and Reconstructive Surgeon

CERTIFICATION: Board-certified, American Board Board-certified of Surgery and American Board of Plastic Surgery Surgery.

TRAINING & EDUCATION: SUNY Downstate College of Medicine Medicine, Staten Island University Hospital (Residency), (Residency) Training at Mayo Clinic, Clinic Post-graduate fellowship at New York Eye and Ear Infirmary Infirmary.

MEMBERSHIPS: American Medical Association Association, Medical Society of the State of NY, NY Medical Society of Kings County, County Arnold Society Society, Priestley Society Society.

CONTACT: 1616B Voorhies Ave., Ave Ste. Ste B Brooklyn NY 11235 Brooklyn, 161 Madison Ave Ave. Ste. Ste 11W New York, NY 10016

((877)) 582-0400 www.NYPlasticSurgeryCenter.com

LANGUAGES: ENGLISH • RUSSIAN

Struggling with sagging skin? Tired of your double chin, turkey neck, or heavy wrinkles above the brow? Looking to smooth lines and wrinkles on the decolletage? You may want to consider “Ultherapy.” Named the “Best In-Office Treatment” in NewBeauty’s 2013 Beauty Choice Awards, Ultherapy is a skinlifting procedure, FDA-cleared to lift skin above the brow, on the neck, under the chin, and on the decolletage area. Non-invasive, it requires no incisions and helps create a more youthful appearance. “Droopy, excess skin on the neck and above the brow contributes to the look of aging,” says plastic surgeon Dr. Rayham of the RR Plastix/New York Plastic Surgery Center, “and has been one of the major concerns of our patients for years. Ultherapy offers a non-surgical cosmetic alternative to facelifts, with visible results and no downtime.”

WHAT IS ULTHERAPY? The FDA approved the “Ulthera System,” a therapeutic ultrasound medical device, for use in brow-lifts in September 2009. The device uses a signature imaging technology that allows physicians to see beneath the surface of the skin, and to deliver focused ultrasound energy to deep layers, targeting key areas of tissue. The energy triggers the body’s natural healing response, which stimulates the production of collagen—the skin’s own firming component. Over time, the patient experiences a gradual tightening and lifting of the skin. In October 2010, the FDA approved Ultherapy for lifting skin on the neck and under the chin, and in July 2014, for improving lines and wrinkles on the decollete. Today, well over 250,000 patient procedures have been performed worldwide, helping patients to turn back the clock.

WHAT IS THE PROCEDURE LIKE? Ultherapy requires no anesthetic or sedation, but if patients are sensitive to the ultrasound energy, physicians can choose to use local anesthetic. There are no needles or lasers or incisions. Instead, the physician uses the device over the surface of the skin to deliver ultrasound energy to the deeper layers. Some patients describe this part as “uncomfortable,” where others will actually experience a painful sensation. It lasts only as long as the device

is applied. Many patients experience no discomfort in certain areas of the skin, and only some in others. Each procedure lasts only about 30-90 minutes, depending on how many areas of your face and chest you have treated. When you’re done, you may not notice any difference in your appearance, aside from a possible bit of flushing. All the work is done under the surface of the skin, so you can go back to your regular activities immediately. You don’t even have to perform any special treatment measures at home—once you’re done, you’re done! Some patients may experience some minor swelling or redness, but most notice little immediate change.

WHAT RESULTS CAN I EXPECT? It usually takes about two to three months to see the full effects of the treatment. Your body regenerates collagen in response to the procedure, which takes time. But after a couple weeks, you’re likely to notice the gradual firming and tightening, as your jaw line and cheeks take on a new definition, your double chin fades, and your eyes appear more open and refreshed. Most patients require only one treatment, but some may benefit from additional ones, depending on the results desired. Additional touchups in the future also help keep the skin looking young.

AM I A CANDIDATE? Ultherapy works best for candidates 40 to 65 years of age who want to experience a lifting effect. These patients have mild to moderate skin sagging, such as the following: ■ Loose skin on the neck, or turkey neck ■ Sagging under the chin—double chin ■ Lines and wrinkles on the chest and decollete ■ Lowered eyebrow line; sagging skin above the eyes More severe sagging skin that occurs after the age of 65 is usually best treated with a face-lift.

FOR MORE INFORMATION Dr. Rayham performs Ultherapy treatments often, and states that they help jump-start the patient’s own collagen-producing process. “Ultherapy isn’t a face-lift,” he says, “but it’s a clinically proven way to lift and firm the skin without going under the knife. Our patients have been very happy with the results.” www.4health.net ww.4h w.

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7 THINGS YOU SHOULD DO BEFORE GOING TO THE PODIATRIST DOCTORS ADVISE PATIENTS TO COME PREPARED g Rice ■■■ Morgan

Darla had suffered from foot pain for weeks, but she hadn’t called a podiatrist. She knew she should, but there was so much to do, and honestly, she was a little worried. What would a doctor think of her feet? She had to admit they were a bit large, and she hadn’t gotten a pedicure in awhile, and then there was that unattractive bunion. Let’s imagine Darla has a friend who is a podiatrist. We’ll call him Jim. If she talked to him, he would put her concerns to rest. No one has “perfect” feet, and a professional doesn’t care about fashionably colored nails. He would care, though, about Darla’s foot pain, and would probably advise her to take the following five steps before coming to see him. 1. Take notes: We rely heavily on symptoms to make a diagnosis, so it helps to be as specific as you can. Take notes on how your foot feels throughout the day. When does it hurt the worst? When did the pain start? How bad is it, on a scale of one to ten? What, if any, treatments have you tried so far? Since you may forget some things when you come to the office, take notes and bring

them with you. They’ll help us both zero in on the problem. 2. List your medications: Just like any doctor, we need to know what medications you’re taking. You may think they have nothing to do with your foot pain, but some medication can affect circulation, for example, or other issues that may be related. We also need to know what you’re already taking in case we need to prescribe other drugs to treat your foot condition. 3. Bring your shoes: What shoes do you wear most of the time? Bring those in so we can see. If you wear any orthotics or foot supports, bring those, too. These will help us determine things like your normal walking patterns, wear patterns, and more. 4. Realize we’ve seen it all: If you’ve got foot or nail fungus, unsightly calluses or corns, or other unattractive foot problems, it can be embarrassing to show them to someone else, even a doctor. Don’t worry—that’s what we’re trained for. We are educated in all types of foot issues, and have experience with all of them. Our goal is to help you feel better, so try to be as open as you can about what’s bothering you. 5. Make a list of questions: To get the most out of your doctor’s visit, you need to have

all your questions answered. Unfortunately, the stress of the appointment may cause you to forget some of what you wanted to know. Take the time to make a list of questions before you come in. That way, you can just read your list and be sure you understand everything before the visit is over. 6. Ask a loved one to come: Bringing a friend or loved one with you can be extremely helpful. He or she can help ask questions, and if you are close, may also help in describing some of your symptoms. This person can also help after the appointment, in recalling some of the doctor’s instructions, or in making sure you get the medications or foot equipment that you need. 7. Wash & wear clean socks: Though we’ve seen everything, we still prefer clean feet to dirty ones! If you don’t have time to clean your feet before an appointment, just bring a pair of clean socks and change before you come in. We’d probably also tell Darla to skip the pedicure. Podiatrists like to observe the condition of the natural nail as part of the check-up. If you’ve already painted your toes, you don’t have to remove the polish—unless you’re suffering from nail fungus or some other condition that may require examining the nails. www.4health.net ww.4h w.

718.646.0131

Orth hopedic d Surgery r r | 4HEALTH HE L H

HEAL TENDON INJURIES AND OSTEOARTHRITIS WITHOUT SURGERY REGENERATIVE INJECTION THERAPY IN PLATELET RICH PLASMA (PRP) Platelet-rich plasma, or PRP, is a promising solution to naturally accelerate healing of tendon injuries and osteoarthritis. The PRP procedure uses a patient’s own blood components and growth factors to stimulate a healing response in damaged tissues. The body’s natural reaction to an injury is to send platelets and white blood cells from the blood to the damaged tissues to initiate healing. Your body’s platelets store numerous growth factors, which are released through signals from the injured tissue. New advancements in medicine now allow us to concentrate platelets and white blood cells from your blood, and encourage this growth factor release as we inject the solution directly into injured tissue, simulating this same healing response in a much more potent form. By enhancing the body’s natural healing capacity, this treatment has been shown to lead to a more rapid, efficient, and thorough restoration of the tissue to a healthy state.

WHAT CONDITIONS DOES PRP TREAT? ■ ■ ■ ■

Knee Pain Hip Pain Shoulder and Arm Pain Lower Leg and Foot Pain

ARE PRP INJECTIONS SAFE? There are currently no known side effects of PRP therapy. Research and clinical data show that PRP injections are extremely safe, with minimal risk for any adverse reactions or complications. Because PRP is produced from your own blood, there is no concern for rejection or disease transmission.

HOW THE TREATMENT WORKS Before you begin the treatment, your doctor will complete a full medical examination and diagnostic workup. If you are a candidate for PRP therapy, he will develop a treatment plan tailored to your needs. Next, he will review and discuss the procedure with you, including associated risks and benefits. Doctors begin the treatment by drawing blood from your arm to be placed in a www.4health.net w.4hea .4

specialized centrifuge system, which separates platelets, white blood cells, and serum from red blood cells. The platelets and growth factors are then concentrated into plasma and collected into a sterile syringe. The skin and soft tissue is anesthetized with local anesthetic, followed by injection of the PRP directly into the tissue targeted for treatment.

HOW MANY TREATMENTS WILL I NEED? Depending on the nature and severity of your injury, one to three PRP injections are suggested. Following the initial treatment with PRP, a follow up visit occurs two to three weeks later. At this visit, the doctor will evaluate your response to the initial therapy and make a decision regarding the need for additional PRP treatments. Some chronic injuries require more than one injection. Your treatment plan may include an exercise or physical therapy program to enhance the success of the PRP treatment.

WHAT SHOULD I EXPECT AFTER TREATMENT? After the initial injection, you may feel some soreness at the site of injury. This is a positive sign that the healing response has been set in motion. This effect can last for several days and will gradually decrease as healing and tissue repair takes place. It is important that you avoid antiinflammatory medications such as Ibuprofen, Naproxen®, Celebrex® and Aspirin following PRP treatments. These types of medications may diminish the effects of your body’s healing response. You can use use over-the-counter pain medication, such as Tylenol®, and in some cases, a prescribed analgesic, which does not have anti-inflammatory properties, to control discomfort as needed. You and your doctor can discuss medication options for managing your treatment plan. You will be permitted to resume normal day-today activities and light exercise following the injection treatment. We suggest that you avoid strenuous activity or high-level exercise for at least several days after injection.

NAME:

Stanislav AVSHALUMOV, DO, MD CERTIFICATION: Board Certified Orthopedic Surgeon

SPECIALTY: Minimally Invasive Orthopedic Surgery (Arthroscopic shoulder surgery surgery, Total Hip and Knee Replacements Replacements, Arthroscopic Knee surgery Carpal Tunnel Surgery, surgery, Surgery Fracture care) Platelet Rich Plasma (PRP) injections (Alternative to surgery) Orthovisc Supartz (Gel Injections for Knees, Orthovisc, Knees acts as a lubricant) Cortisone Injections (For pain)

CONTACT: 3048 Brighton 1st St St., 3rd flfl., Brooklyn NY 11235 Brooklyn, 141 East Merrick Road Road, Ste B B, Valley Stream, NY 11580

(888) 647-7515 www.advancedorthosurgeons.com

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OFFICE 1975 Hylan Blvd, Staten Island, NY 10306

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USA VEIN CLINICS CHOSEN AS THE “BEST” FOR THE THIRD YEAR IN A ROW TM

YOU’RE IN TRUSTED HANDS

www.USAVeinClinics.com Home Reporter has chosen USA Vein Clinics as the “Best Vein Clinic.” The award ceremony was held on August 12, 2014 in the clinic’s New York office. Having been awarded similar honors in the past by the readers of Newsweek, The Courier, Our Town, Daily News, and others, USA Vein Clinics is the nation’s only coast-to-coast network of centers dedicated to treating venous insufficiency in its many forms. With highly trained cardiovascular doctors and board-certified specialists, the clinics provide comprehensive evaluation and treatment of circulation disorders utilizing state-of-the-art laser equipment and an individualized approach to each patient. Do you suffer from pain in your legs? Is walking more difficult than it used to be? Rather than continue to suffer, you may want to consider what this award-winning clinic may be able to do for you.

FIND RELIEF FOR THESE PAINFUL CONDITIONS USA Vein Clinics can help treat the following conditions: Varicose veins: These are those enlarged, unattractive veins in the legs that prevent you from feeling confident in shorts and dresses. Without treatment, they are likely to continue to get worse. Spider veins: These are similar to varicose veins, but they’re smaller. They’re still visible under the skin, though, and may still make you feel self-conscious in your spring and summer wardrobe. They’re less likely to cause physical symptoms than varicose veins, but they may signal other problems in the deeper veins of the legs. Other symptoms: Vein disorders can cause swelling in the legs, pain, fatigue, cramps, achiness and ulcers. The problem is that the valves in the veins are malfunctioning, allowing the blood to collect and pool in the legs rather than returning to the heart like it’s supposed to. Without treatment, the symptoms are likely to continue to get worse. www.4health.net w.4 w.4hea .44hea

These conditions signal problems in the body’s blood flow. Without treatment, they may increase risk of blood clots, particularly if similar vein problems affect those veins deep within the leg muscles.

SPECIALTY: USA Vein Clinics has eight-of-the-art centers specializing in the treatment of venous disorders disorders. Their expert cardiovascular physicians have cured over 10 10,000 000 patients nationwide nationwide.

ADVANCED TREATMENT OPTIONS USA Vein Clinics offers a broad range of treatment options they can tailor to your individual condition: EVLT: Endovenous Laser Therapy (EVLT) is a non-surgical treatment that helps heal various veins. Doctors insert a very thin laser fiber into the affected vein. They then apply the laser energy to the vein, which closes it. Over time, the body absorbs the deadened vein, and the other veins take over the blood flow. Problem solved! ClariVein: Even less invasive than EVLT, ClariVein uses a rotating catheter and a sclerosant drug solution to collapse and close the affected vein. The latest technology in vein treatment, this non-laser method doesn’t require anesthesia and provides for nearly immediate recovery. Slerotherapy: For this treatment, the doctor injects a sterile salt solution into the affected vein to irritate the lining, causing it to seal shut and disappear over time. No anesthesia is required and patients usually feel little to no discomfort. Can be used to treat both varicose and spider veins, depending on each patient condition.

FOR MORE INFORMATION USA Vein Clinics employs highly trained vascular and cardiovascular doctors that understand vein problems are not just about appearance—they absolutely affect your overall health. Evaluation and treatment are performed with one goal in mind—to help you feel better. Treatments take little time, offer speedy recovery, and are usually covered by Medicare and most insurance plants. To find out if USA Vein Clinic is for you, check out their website at usaveinclinics.com, or call them at 718-509-0906.

INSURANCE: The EVLT treatment is covered by MEDICARE and most INSURANCE PLANS up to 100% 100%.

CONTACT:

(718) 509 509-0906 0906 New York 2511 Ocean Ave., Ave Ste. Ste 102 Brooklyn NY 11229 Brooklyn, 2444 86th Str., Str Ste. Ste A Bensonhurst NY 11214 Bensonhurst, 116 02 Queens Blvd 116-02 Forest Hills, Hills NY 11375 1153 First Avenue, Avenue Manhattan NY 10065 Manhattan, 1975 Hylan Blvd., Blvd Staten Island, Island NY 10306 New Jersey 766 Shrewsbury Ave., Ave Ste. Ste 300 Tinton Falls, Falls NJ 07724 Boston 1208 «B» VFW Pkwy., Pkwy Ste. Ste 300 West Roxbury, Roxbury MA 02132 Chicago 3927 W Belmont Ave Ste 103 Chicago IL 60618 Chicago, 800 Biesterfield Rd Ste 201 Elk Grove Village, Village IL 60007 4141 Dundee Road Northbrook IL 60062 Northbrook,

LANGUAGES: Armenian, Chinese Armenian Chinese, Farsi Farsi, Greek Greek, Hebrew Lithuanian Hebrew, Lithuanian, Korean Korean, Polish, Polish Russian, Spanish and Ukranian

4H 4 HE EA AL LT TH

PMS AND POSTPARTUM DEPRESSION HISTORY OF PMS OR PMDD INCREASES YOUR RISK ■■■

Lynn y Merrell

Have you struggled with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) in the past? Did you have more trouble with your period than some of your friends did? If so, you may be more at risk for postpartum depression (PPD), as well. These were the findings of a 2013 study from the University of Iowa. The research may help women to be more aware of the risks, so they can better protect themselves after giving birth.

WHAT THE STUDY FOUND For the study, scientists assessed nearly 500 women who had given birth over a period of a year. They used screening tools to determine which had suffered from PMS and PMDD, and then compared that with those who were diagnosed with PPD. The results showed that those who had a history of moderate to severe PMS/PMDD were about two times more likely to suffer PPD than those who didn’t suffer from premenstrual disorders. The researchers suggested that doctors should closely monitor these women during the perinatal period.

OTHER STUDIES HAVE FOUND SIMILAR RESULTS This wasn’t the first study to make this connection. Another one published in 2013 from Sweden reported that among 2,318 women, 7.1 percent had a history of PMS and nearly three percent had a history of PMDD. Those who had suffered from these disorders were more likely to report postpartum depression at five days, six weeks, and six months after delivery. “There appears to be an association between a history of premenstrual symptoms and development of self-reported postpartum depression,” the researchers wrote. An earlier study came to the same conclusion, and noted that a lifetime history of depression ranges from about 20 percent to 76 percent in samples of women diagnosed for PMS or PMDD, and that a family history of depressive illness is common in women with PMS/PMDD.

HOW TO PREVENT POSTPARTUM DEPRESSION If you’re a pregnant woman with a history of PMS/PMDD, how can you reduce your risk of suffering from PPD, as well? First, talk to your doctor. Let him or her know about your history and your concerns. Ask for his help in making sure you do everything you can

to manage any symptoms that may come up after delivery. In addition, you can also take these steps to reduce your risk: Therapy: Get in touch with a therapist before you give birth. Set it up so you can start appointments immediately after you get home from the hospital if you need it. Medications: Talk to your doctor about medications. Discuss the risks and benefits to you and your baby, particularly if you’re breastfeeding. Talk to your family: Let your loved ones know about the risks so they can be prepared. Go over the symptoms of PPD so they can help you recognize them should they come up. Get help: Ask family and friends for support in the first few weeks and months after delivery. Who can help babysit? Who can help cook meals, or take care of other children? Take care of yourself: Make sure you eat a healthy diet and get regular exercise — both can help reduce symptoms of depression. It can be hard to sleep after baby is born, so allow yourself to take naps when your little one does. Avoid things that stress you out: These may include caffeine, alcohol, meetings with certain people, etc. Cut anything out of your life that stresses you, and plan enjoyable events instead.

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4HEALTH

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CLASSIFIEDS

To Place an AD in the Classifieds Section, Please Call (212) 738-9230

FOR SALE Primary Care Clinic in Corona, Queens and Urgent Care Clinic in Jackson Heights, Queens. The owner is retiring and looking to sell fairly quickly. Please feel free to visit our website: www. instamedcare.com or call Lenny Osipov (Manager) at (917)921-7205

Large beautiful space in the brand new dental office available for rent. Walk-in basement, nice and spacious, for medical practice or esthetician/beautician. Call (718) 376-1090 (917) 400-5300

Call us if you need Mobile Ultrasound Services: Echo, Vascular and General Ultrasound. (917) 750-2275

Ultrasound technologist with five years of experience available for part time. Telephone (917) 412-3797

DENTAL OFFICE for sale (in practice since 1996). Very good location. Call (718) 376-1090 (917) 400-5300

Medical office seeks a Russian-Speaking Registered Nurse Practitioner. Please submit your resume to medicaloffice41@gmail.com

Established Colon Hydrotherapy Business for SALE located in medical building complex in Bay Ridge. Includes 4 treatment rooms that are furnished and fully equipped, spacious client waiting area, reception office, two bathrooms and plenty of storage space. Business is fully operating and ready to be taken over. Seller has expanded the family and relocating to another State. Call (347) 439-6736 Credit Card Processing Services: Free terminal with setup NURIT 2085. Low Rates â&#x20AC;&#x201D; 1.67%. Free setup. Free plug-in to your software (billing). Free evaluation of your current statement . Free customer support 24/7. FREE online access. Call now (866) 573-0604 ext 706

Licensed Ultrasound Technologist (RDMS) is looking for part time or full time position. Resume available upon request. Tel. 718-608-7402; Email at violasvu@gmail.com.

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4HEALTH

ALLERGY & IMMUNOLOGY

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DERMATOLOGY

Lloyd A. CYPRUS, DMD th

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4HEALTH OB/GYN - UROGYNECOLOGY

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OPHTHALMOLOGY

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NEUROSURGERY

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ONCOLOGY

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(718) 512-2160 158 06 Northern Blvd 158-06 Flushing NY 11358 Flushing,

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ORTHOPAEDIC SURGERY

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PLASTIC SURGERY

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OPTOMETRY

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BOARD CERTIFIED IN PLASTIC SURGERY

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Margarita BAUMAN, OD

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Stanislav AVSHALUMOV, MD DO 3048 Brighton 1st St, St Fl 3 Brooklyn NY 11235 Brooklyn, 141 E Merrick Rd, Rd Ste B Valley Stream, Stream NY 11580

(888) 647-7515

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Michael RISKEVICH, MD 2818 Ocean Ave, Ave Ste 1 Brooklyn NY 11235 Brooklyn,

(888) 849-5101

4HEALTH PODIATRY

Isak BADALOV, DPM

Leonid VOROBYEV

67 09 75th St 67-09 Middle Village, Village NY 11379

7819 18th Ave, Ave Ste A Brooklyn NY 11214 Brooklyn,

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43 32 Kissena Blvd 43-32 Flushing NY 11355 Flushing,

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ALTERNATIVE MEDICINE - GENERAL

PSYCHOLOGY

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David SHUSTERMAN, MD

LAW

Park PLACE PHARMACY

201 E 65 St New York, York NY 10021

160 Park Pl Brooklyn NY 11217 Brooklyn,

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97 32 63Rd Rd 97-32 Rego Park, Park NY 11374

Ada KULAGINA, LAC 8635 21st Ave Brooklyn NY 11214 Brooklyn,

MEDICAL SUPPLY

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(212) 390-0325

(888) 410-3442 NUTRITION AND DIETETICS

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Yuly CHALIK, MD Birch & BIRCH, DPM 6419 Bay Pkwy Brooklyn NY 11204 Brooklyn,

(888) 645-1338 482 Manor RD Staten Island, NY 10314

2632 E 14th St Brooklyn NY 11235 Brooklyn, 107-15 107 15 Jamaica Ave Queens NY 11418 Queens,

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Globe SURGICAL SUPPLY

Alexander SOKOL, MD 2493 Richmond Rd, Rd Ste 2 Staten Island, Island NY 10306

(718) 227-5505 VASCULAR SURGERY

2029 Bath Ave Brooklyn NY 11214 Brooklyn,

Albert GROSS, CNS, NYS, CDN

Gitelis LAW OFFICE 2004 Coney Island Ave Brooklyn NY 11223 Brooklyn,

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(888) 418-0442

1942 E 8th St Brooklyn NY 11223 Brooklyn,

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www.nyui.org

www.nylifex.com

AESTHETIC CENTERS

USA VASCULAR CENTERS

Svetlana LUVISH, DPM 520 Neptune Ave Brooklyn NY 11224 Brooklyn,

(718) 946-8586

Vitaly RAYKHMAN, MD 2632 E 14th St Brooklyn NY 11235 Brooklyn, 107-15 107 15 Jamaica Ave Queens NY 11418 Queens,

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Lev KHITIN, MD 406 15th St Brooklyn NY 11215 Brooklyn, 400 E 56th St, St Ste 1 New York, York NY 10022

(888) 535-0808 www.vashiveni.com

www.nyui.org

(855) 328-5525

Khavinson & ASSOCIATES 1601 Gravesend Neck Rd Rd, Ste 903 Brooklyn NY 11229 Brooklyn, th 29 W 17 St New York, York NY 10011 221 W Street Rd Trevose, PA 19053

VK Skin VKSKIN SPA 162 Brighton 11th St, St Fll 2 Brooklyn NY 11235 Brooklyn,

(646) 200-5937 PHARMACIES

Leon KUCHEROVSKY, ESQ 115 South Corona Ave Valley Stream, Stream NY 11580

Alina VASILYEVA, DPM 2116 Ave P Brooklyn NY 11229 Brooklyn, 2646 E 14th St Brooklyn NY 11235 Brooklyn,

(718) 646-0131

(516) 881-7755

Ridwan SHABSIGH, MD 3121 Ocean Ave Brooklyn NY 11235 Brooklyn, 944 Park Ave New York, York NY 10028

Alexander SHIFERSON, MD

www.lkesq.com

903 49th St Brooklyn NY 11219 Brooklyn,

(888) 812-8499

(718) 283-7746

Nostrand HOUSES PHARMACY 3031 Ave V Brooklyn NY 11229 Brooklyn,

(718) 332-0040

4HEALTH Magazineâ&#x201E;˘ gathers data from a variety of different sources, public and private. While we strive to provide the most accurate, up-to-date information possible, we can't guarantee that our listings are completely free of errors. If you feel some data is missing or inaccurate, please feel free to contact us at any time. Thank you for your support!

TO PLACE AN AD IN THE MEDICAL USA VEIN CLINICS 2511 Ocean Ave, Ave Ste 102 Brooklyn NY 11229 Brooklyn, 116-02 116 02 Queens Blvd Forest Hills, Hills NY 11375 1153 First Ave New York, York NY 10065

(718) 509-0906 www.usaveinclinics.com

DIRECTORY PLEASE CALL

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