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“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

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4HEALTH | Table Of Content

Arm-Lift Surgery Explodes in Popularity Young-Lookinng, Toonedd Arrms— —Are You a Canndiidaate?

11 10

By Dr. Lev Barsky MD

14 Don’t Wear Your Dentures Overnight! Stu udy Sh how ws It In ncreases Risk of Pneu umon nia

ALLERGIES: WHY SUFFER? TREATMENTS CAN HELP YOU FEEL BETTER IMMEDIATELY PREGNANT? BREASTFEEDING? WHY YOU STILL NEED TO EAT FISH FDA Issues New Guidelines to Protect Unborn and Young Children

HOW TO AVOID LIVER DISEASE Dr. Weissman Answers Our Questions

HIDING VARICOSE OR SPIDER VEINS USA Vein Clinics on a Non-Invasive Treatment

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

10 Ways to Help Your Parents Lose Weight

GET RID OF PAINFUL VARICOSE VEINS DURING YOUR LUNCH BREAK USA Vein Clinic Professionals Discuss Cutting-Edge Treatments

Obesity Dangeerou us Evven in n Seniorr Yeaars

COULD A DIFFERENT DIET HELP WITH EPILEPSY? Two Studies Show Promise with Dietary Interventions

7 SIGNS YOU NEED TO FIND A NEW THERAPIST Sometimes the Connection Just Isn’t There

7 Medications that May Cause Vision Loss Sid de Efffectts Can Lead to Glauco oma and AM MD

22 Cancer Screening: What Tests Do You Need?

LOOK GREAT FOR SWIMSUIT SEASON WITH A BREAST LIFT NOW! By Dr. Roman Rayham MD

PERIPHERAL ARTERY DISEASE INCREASES RISK OF AMPUTATION USA Vascular Centers Provides Cure

WHAT’S CAUSING THIS PAIN IN THE BALL OF MY FOOT? 10 Potential Causes and What to Do About Them

DEEP VEIN THROMBOSIS: WHEN DANGEROUS BLOOD CLOTS FORM IN THE LEGS By Dr. Lev Khitin MD

Recom mmen ndatio ons Have Changed d—W What You u Need to Kno ow

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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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4HE 4H HEA EALT EALT LTH LTH

ARM-LIFT SURGERY EXPLODES IN POPULARITY ARE YOU A CANDIDATE?

■■■

Morgan g Rice

DO YOU HAVE TONED ARMS? Only a few years ago, most of us didn’t care. That’s changed. The American Society of Plastic Surgeons (ASPS) states that since 2000, arm-lift surgery — meant to make arms appear more toned and youthful — has increased a whopping 4,378 percent. In 2012, more than 15,000 women had their arms done. What is an arm-lift surgery, and why has it become so popular?

WOMEN WANTING TONED, YOUTHFUL ARMS Most would agree that sagging, droopy arms are unattractive. We’ve tried for decades to trim them up with exercises, push-ups, weight lifting, and more, all no little avail. People who lose a lot of weight have been even more disappointed with the results on their arms, as so-called “bat wings’ flop around embarrassing them, particularly when they’re wearing sleeveless shirts and dresses. Then along came first lady Michelle Obama. Often praised for her toned arms, she set a new standard that many women wanted to emulate. According to a poll conducted by

the ASPS, nearly a third of women wanted to have arms like the first lady. Mrs. Obama isn’t the only one leading the trend, though. Women are also noticing other famous women like actresses Jennifer Aniston, Jessica Biel, and daytime TV talk show host Kelly Ripa, and admiring their smooth, youthful looking arms. Wouldn’t it be lovely to look like that?

WHY DO WE GET DROOPY ARMS? Arms get heavy and droopy for several reasons. One of the main ones is weight loss — as the fat goes away, the arm shrinks, but the skin doesn’t, leaving behind the floppy excess. Natural aging also has an effect. We lose muscle as we age, which can cause arms to sag. Skin naturally sags too, as the internal structure begins to break down — similar to why we get sagging on our faces and necks, as well. Exercise helps, but after a certain age, it becomes very difficult to tone up the arms to the point where they look like they did when we were younger.

WHAT HAPPENS IN AN ARM-LIFT? Medically called a “brachioplasty,” an arm-lift is a surgical procedure in which the surgeon removes excess skin, smoothes the underlying tissue, and reduces pockets of

fat in the upper arm, from the armpit to the elbow. The surgeon goes about this by making an incision on the inside or back of the arm. It often extends down toward the elbow. He then works to smooth and reshape the tissue underneath, performs liposuction if needed, removes any excess skin or tissue, and then closes the incision. The procedure is usually performed in an operating room under general anesthesia. There is some scarring associated with the surgery. Massage and creams and lotions applied after surgery can help minimize it. Most patients can return to normal activity in two weeks, though it takes longer to recover enough for exercise regimens.

AM I A CANDIDATE? If you’d like to get rid of your bat wings, talk to your plastic surgeon. Those who are in good health, who have had a stable weight for at least a year, have a lot of excess upper-arm skin and fat, and are willing to accept the fact that there will be scarring, are typically good candidates for the procedure. Risks are similar to those for most operations, and include bleeding, infection, swelling, fluid accumulation, and healing issues. www.4health.net ww.4h w.

4HEALTH

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4HEALTH

DON’T WEAR YOUR DENTURES OVERNIGHT! STUDY SHOWS IT INCREASES RISK OF PNEUMONIA g Rice ■■■ Morgan

You probably already know that seniors are more at risk for pneumonia than younger people. You may not know that it is a major cause of death among those 65 and older. The Centers for Disease Control and Prevention (CDC) state that pneumonia kills more people every year than car accidents do. The elderly are more at risk for many reasons, including the fact that they often have weakened immune systems, they may have other diseases like diabetes or chronic obstructive pulmonary disease (COPD), or they may have to undergo surgery, which can result in mucus buildup in the lungs. This is why major health organizations recommend all individuals 65 and older be vaccinated against pneumonia. Recently, scientists found out something else that seniors should be doing to keep their lungs healthy—making sure to remove dentures before sleep.

ORAL HEALTH LINKED WITH PNEUMONIA RISK Did you know that your oral health could influence your risk for pneumonia? In a 2005 study, researchers noted that bacteria in the mouth can migrate to the lungs, increasing risk for pneumonia. The risk is greatest inseniors who have gum disease, cavities and poor oral hygiene along with other health problems. A later 2011 study found that particularly in nursing home residents, oral hygiene was critical to health. “Development and maintenance of an

oral hygiene program is a critical step in the prevention of pneumonia,” the researchers wrote. Other studies have shown that poor oral hygiene is among the most common risk factor for pneumonia in nursing homes. It’s not just brushing and flossing and dental visits that are important in senior dental care, however. Researchers now know that seniors need to be careful of their dentures, as well.

STUDY SAYS DON’T WEAR DENTURES OVERNIGHT Dentists always recommend regular cleaning of dentures. The Mayo Clinic suggests that denture wearers remove them after eating to rinse them off; brushing dentures at least once daily by soaking and brushing with a nonabrasive denture cleanser; using a soft toothbrush to clean the tongue, cheeks, and roof of the mouth; and soaking dentures overnight in a denture-soaking solution. It’s this last step that’s turned out to be particularly critical in avoiding pneumonia. According to a recent study, seniors who failed to take their dentures out during sleep were putting their health at risk. For the study, scientists observed about 500 seniors with an average age of 87.8 years. They found that over a three-year period, just over 40 percent of participants who wore their dentures during sleep were at higher risk of pneumonia than those who always took their dentures out at night. They were also more likely to have tongue and denture plaque, gum inflammation, and higher levels of inflammation in their bodies. Researchers concluded that denture wearing during the night should be discouraged, particularly in elderly patients. www.4health.net ww.4h w.

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4HE 4H EA A ALT L H

PREGNANT? BREASTFEEDING? WHY YOU STILL NEED TO EAT FISH FDA ISSUES NEW GUIDELINES TO PROTECT UNBORN AND YOUNG CHILDREN

■■■ Colleen M. Storyy Expectant moms who like fish are often confused about the potential dangers. Once you’re pregnant, can you still eat certain kinds of fish, or is it best to avoid it all? Is it really a concern, or an overblown danger? Is there anything wrong with just staying completely away from all fish while pregnant and/or breastfeeding? For the longest time, women have been told it’s best to be safe than sorry, and just stay away from fish. Recent studies, however, have shown that when women don’t eat fish at all, they can actually rob their unborn children of critical fatty acids that are important for development. It’s time to take a second look at what’s best for mom and baby during this critical time.

MOMS NEED OMEGA-3 FATTY ACIDS As adults, we’re often told to eat several servings of fish every week, particularly the fatty kind that are good sources of omega-3 fatty acids. These are vital for brain function, eyesight, and healthy blood vessels, and may help to reduce risk of heart disease. These nutrients are equally important for a developing fetus. They help the baby’s brain and eyes develop properly, and are important for other areas of development as well. Studies have found that when moms get enough omega-3 fatty acids in their diet during pregnancy, children grow

up to have better fine motor coordination, IQ scores, and communication skills. Because these nutrients are so important, moms need to be sure they’re getting enough. There are other foods that have them, including grass-fed beef, flaxseed oil, and walnuts, but some moms may have difficulty getting enough with these foods alone. Supplements may seem like a good option, but research has found that fish oil supplements don’t seem to work as well or provide the same benefits as eating fish.

MERCURY IN SOME FISH IS DANGEROUS Some fish are just the perfect sources of the critical fatty acids that baby needs, but at the same time, some of these same fish can be dangerously high in mercury. In adults, the level of mercury is small enough that it’s not considered a health concern, but those same levels can harm the developing nervous system of an unborn child. Some studies have found links between a woman’s exposure to mercury from eating fish and an increased risk of attention-deficit hyperactivity disorder (ADHD). Other studies have found, however, a reduced risk of ADHD in babies born to moms who ate fish—because they ate “safer” fish with extremely low levels of mercury.

CURRENT RECOMMENDATIONS So the key is to eat the right kind of fish that give your baby the omega-3 fatty acids

that he or she needs, with an extremely limited exposure to mercury. The Food and Drug Administration (FDA) recently announced updated advice for fish consumption in pregnant and breastfeeding women. They noted that over the past decade, emerging science has pointed out that women and children need fish in their diets for the nutritional benefits. “For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, M.D., the FDA’s acting chief scientist. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.” Now, the FDA advises women to eat at least eight ounces and up to 12 ounces (2-3 servings) of fish per week that are low in mercury to support fetal growth and development. The fish to avoid that have been linked to higher levels of mercury: 1. Swordfish 2. King mackerel 3. Shark 4. Tilefish from the Gulf of Mexico Low-mercury fish that are good choices during pregnancy include shrimp, salmon, canned light tuna, tilapia, cod, catfish, and pollock. www.4health.net ww.4h w.

Gastroenterology o t o g | 4HEALTH HE L H15

HOW TO AVOID LIVER DISEASE: DR. WEISSMAN ANSWERS OUR QUESTIONS The liver is a very important organ located directly under the right side of the ribcage. Every single day, it protects other organs from harmful materials in what we eat, drink, breathe, and put onto our skin. According to the American Liver Foundation, at least 30 million people have some form of liver disease. How can we prevent it? Are there new treatments that are more effective at treating it, once we have it? Gastroenterologist Doctor Sam Weissman answers our questions. Q: What does the liver do? A: If you compare a human being to an automobile, the liver would be the motor, helping all of the other systems work. An adult liver weighs approximately one-and-a-half pounds and completes over two hundred different functions in the body. Two thousand liters of blood flow through a person’s liver every day. We can think of it like a natural chemical laboratory. Every 24 hours, it performs hundreds of chemical processes, including splitting nutrients, saving energy, and cleansing the blood. Q: Sounds like the liver is as important as some other organs, including the brain and heart. What happens if it stops working? A: The liver is an essential organ. Even if it is very sick, it cannot be removed, though it can be transplanted. The liver has a unique ability to regenerate its own cells, though. The ancient Greeks are familiar with this shocking capability. They describe it in the myth of Prometheus: Every morning an eagle flies to this tragic hero and picks at his liver until evening. Overnight, Prometheus’ liver grows back. Today, we know that the liver is able to continue functioning and regenerating, even if 75% of its cells have been destroyed or removed. Q: What are the symptoms of an unhealthy liver? A: The liver is a silent organ. It doesn’t have nerve endings, which is why people with liver disease rarely have symptoms until the disease becomes very advanced. There are nerve endings surrounding the liver membrane, however, which is why if it swells up or enlarges, an individual will feel pain in the side. In its more advanced stages, liver disease can result in fatigue, weakness, unpleasant breath, www.4health.net w.4hea .4

bitterness in the mouth, strained feeling in the stomach, and yellowing of the skin and eyes. Q: How can you prevent liver disease? A: Careful attention to your overall health will also help keep your liver healthy. Eat a nutritious diet, including fruits, dark greens, vegetables, salads, herbs, and nuts, as well as foods high in sulfur—which help detoxify the liver— like garlic, onions, egg yolks, and cabbage. It’s also important to drink no less than two liters of liquids every day. Watch your weight, and stay away from sweet and fried foods. These can increase risk of diabetes and obesity, which are key negative conditions that affect the liver. Drinking too much alcohol or eating too many fatty foods can also lead to liver problems. Q: What about when you develop liver disease? Are there treatments for it? A: Treatments for liver disease have improved over the years. We now have vaccines for hepatitis A and B. In addition, we’ve found some methods for actually curing hepatitis C. Over the last year, the FDA approved newer, more effective and safer medications for hepatitis C. To all those who were born between the years 1945-1964, I suggest they get tested for hepatitis C. Q: What is the secret behind your success and prevention of liver disease? A: I think every patient deserves quality time and attention from a doctor. That’s why each of my patients is welcome to contact me not only during working hours, but also in case of emergencies, on evenings and during weekends. I also feel it’s very important to establish a relationship with a patient, and let them know that I want to help. Of course, I keep up with advances in my field, learning new techniques and applying new treatments in my practice. In the 1990s, for example, I was one of the first to fully heal hepatitis C with the help of injections. Now I prescribe harmless tablets, which are 95% effective after only 8-12 short weeks of treatment. If you are concerned about liver disease, or if you want to solidify the health of all surrounding digestive organs, please contact our office. We’d be glad to help, and are always there to help you.

NAME:

SAM WEISSMAN, MD BOARD CERTIFICATIONS: American Board of Internal Medicine Gastroenterology (Internal Medicine)

SPECIALTY: gastroenterologist

HOSPITAL AFFILIATIONS: New York Methodist Hospital

PROFESSIONAL MEMBERSHIPS American College of Physicians American Gastroenterological Association

AWARDS AND PUBLICATIONS Roth Scholarship for Biomedical Research

CONTACT: 202 Foster Ave, Ave Suite C, C Brooklyn, NY 11230

(888) 610-3893

4HEALTH

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Vasscular Vas scular l Surgery r r | 4HEALTH HE L H17

HIDING VARICOSE OR SPIDER VEINS THIS SUMMER? YOU MAY BE A CANDIDATE FOR THIS EASY, OUTPATIENT TREATMENT With the summer weather comes the shorts, skirts, capris, and other leg-baring clothing that for most of us, feels freeing and breezy and adds to summer fun. If you have varicose or spider veins, however, you may feel a little self-conscious about showing them off. Worse, you may be suffering other effects like pain, burning, swelling, tiredness, heaviness, tender areas, or skin pigmentation. Varicose and spider veins are somewhat embarrassing, at best, and can be dangerous, at worst. Advanced stages of the condition can lead to blood clots, trophic ulcers, bleeding, and phlebitis. Fortunately, there is a solution. It’s called Endovenous Laser Therapy (EVLT), and in a multi-center study of over 1,000 patients, it showed a 99% success rate in effectively closing the vein and eliminating its side effects.

WHAT IS EVLT? “Closing” the vein or, in essence, shutting it down, has long been the solution to varicose veins. This procedure, however, used to require extensive surgery that left scars and various other side effects. Today, EVLT is considered the most effective way to eliminate venous insufficiency. In our centers, EVLT is performed exclusively by highly qualified physicians specializing in vascular medicine and dedicated to vein care and management. We finish in 30 minutes, use local anesthesia (so you don’t experience any pain). When you leave the office, you won’t

have to change your routine except for limiting strenuous exercise for about two weeks. Here’s how it works. Once you’ve made the appointment with us, we will perform an extensive ultrasound study of the lower extremities and make sure you’re a good candidate for EVLT. We’ll answer any questions you may have. When you’re ready to undergo the procedure your doctor will perform a painless ultrasound on your veins to mark them. Next, the nurse will clean the skin of your legs with an antimicrobial solution. The doctor will inject a local numbing medicine, and finally will perform the laser treatment. A thin laser fiber is inserted through a tiny entry point, laser energy is delivered, and the vein is permanently sealed, restoring normal circulation. Depending on the number of diseased veins, more than one procedure may be required. When the sealing is complete, we’ll apply a compressing wrap to your legs and you’ll be able to go home. That simple! Pain, swelling, and other side effects will be gone, you won’t suffer any scarring, and your legs will look better and healthier within weeks.

USA VEIN CLINICS EVLT requires a physician who’s experienced in the field of vascular surgery. Varicose veins can be complex and each patient is unique, so the physician needs to be familiar with the entire spectrum of the disease and able to perform percutaneous (i.e., through the skin) as well as precise conventional surgeries. The medical staff at USA Vein Clinics ensures the most professional care to all patients. We do all therapy in our office on an outpatient basis with the patient awake and able to resume normal activity immediately. All our procedures are formed by doctors, not nurses or technicians, and our office will check with your insurance company to ensure coverage before we start any treatment. If you’re tired of your varicose or spider veins, call our clinics today, before the summer’s gone! Our clinics are conveniently located in New York, Chicago, Boston and Los Angeles. www.4health.net w.4hea .4

YOU’RE IN TRUSTED HANDS

www.USAVeinClinics.com

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.

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

CONTACT:

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

4HEALTH

10 WAYS TO HELP YOUR PARENTS LOSE WEIGHT OBESITY DANGEROUS EVEN IN SENIOR YEARS ■■■ Colleen M. Storyy Hannah wanted to help her mother, Renee. Ever since Renee had been in the hospital with some health problems a year before, she’d been gaining weight. It was more difficult for her to move, and she was no longer working. Hannah often found her in an easy chair watching television or sitting at the table reading a book. Many adult children find themselves in Hannah’s shoes. As parents age, health problems, mobility issues, and more can result in weight gain. Though a few extra pounds may actually be protective in older

age, too many can result in additional health complications. Talking about the issue can be extremely difficult, though. Are there any solutions?

OBESITY IS DANGEROUS FOR SENIORS Waistlines typically expand as we age, but that doesn’t mean it’s good for us. According to a 2013 study, obesity is even more dangerous for seniors than it is for younger people. Researchers looked at data from about 800,000 adults surveyed between 1986 and 2004, and found that risk of death from obesity increases with age. www.4health.net ww.4h w.

4HEALTH These findings differed from some previous studies that had suggested a little extra padding in the senior years could actually be protective. Researchers argued that these studies were flawed because they excluded people who were in hospitals and nursing homes, where many seniors are. Other studies have also shown that overweight and obesity can cause depression, mobility problems, chronic pain, diabetes, heart disease, and more in seniors.

RESISTING WEIGHT GAIN IS DIFFICULT Ask your parents and they’ll tell you — it’s really hard to resist weight gain as one gets older. There are all those factors working against you, including: ■ Decreasing muscle mass, which reduces metabolism and makes it harder to burn calories ■ Decreased mobility and activity, which burns fewer calories ■ Hormonal changes ■ Less efficient digestive system ■ Reduced access to exercise and fitness centers ■ Increased eating out Considering the fact that losing weight can be difficult, how can adult children help?

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TEN TIPS TO HELP YOU HELP YOUR PARENTS Fortunately, you can encourage your parents to be healthier, but it takes the right approach. Try the following tips: 1. Be respectful: Your parents may feel ashamed about being overweight. Approach the subject carefully and respect the other person’s feelings. 2. Express your desire for them to be healthy: It helps if your parents know you’re coming from a loving place. Let them know you want them to be around as long as possible, and that being overweight is a threat to that. 3. Express your desire to help: Don’t try to control the situation. Simply express your desire to help if you can. 4. Cook together: Sometimes seniors go out too much because they don’t want to cook or find it difficult to cook. Offer to share some home-cooked meals together. 5. Shop together: Offer to take your parents grocery shopping, and help fill the cart up with healthy items. Just make sure they’re items your parents want and like. There’s no sense in paying for things that will remain on the shelf or go into the trash can.

6. Exercise together: Invite your parent on a walk or bike ride. Go bowling, or play some golf. Do something active together. 7. Gift healthy gifts: Think about healthy activities your parents enjoy, and give them gifts that support those activities. Maybe it’s gardening tools, something new for your dad’s bicycle, or a membership to the local walking club. 8. Look for senior exercise centers: Let your parents know about healthy activities taking place around their community. They may not be aware of these, and may try them out if you encourage them. 9. Ask about sleep: Many seniors gain weight because they’re not getting enough sleep. Find out how your parents are doing in that department, and see if you can help. Maybe you can make a doctor’s appointment if sleep apnea is a possibility (often associated with snoring). Maybe the bed is old, or the pillow is no longer comfortable, and your dad just hasn’t replaced anything. Changes in the bedroom can help improve sleep, which can help tame appetite. 10. Don’t be controlling: Your parent may not go along with your suggestions. Remember that she is an individual with a right to make her own choices — even if those choices are unhealthy.

Obe esity y Medicine M d n | 4HEALTH HE L H21

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 inter-related fields together so you can lose weight, sleep better, and enjoy a healthier and perhaps even longer life. Our delicious and affordable W8MD weight loss meal replacement supplements start as low as $2.25 cents per meal replaced and can save up to 15% on grocery food cost. The biweekly program cost of $45.00 includes up to two appetite suppressant weight loss medications such as Phentermine, Topiramate etc. when appropriate.

NAME:

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SPECIALTY: Internal Medicine Medicine, Sleep and Obesity Medicine

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CONTACT: 2003 Bath Avenue Brooklyn, y , NY 11214 1718, Welsh Rd, 1718, Rd, Philadelphia, p , PA,, 19115 987 Old Eagle g School Rd, Rd, Ste 712, 712, Wayne, y , PA,, 19087 543 45th St St, Union City, NJ 07087

(888) 283-0399 www.w8md.com

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7 MEDICATIONS THAT MAY CAUSE VISION LOSS SIDE EFFECTS CAN LEAD TO GLAUCOMA AND AMD y Merrell ■■■ Lynn

We take our eyes for granted, but if something started happening to them, you can bet we’d take notice in a hurry. Vision is the primary sense for most of us, and it’s not fun to imagine what we’d do without it. Fortunately, most of us are able to preserve our eyesight as we age. Regular activity, a healthy diet, and annual checkups with the eye doctor all help. Even if we’re especially careful, though, some of us can end up suffering from dry eyes, vision loss, and even glaucoma and age-related macular degeneration because of something we’d never imagine—the medications we’re taking.

MEDICATIONS THAT MAY AFFECT YOUR VISION Medications can have a number of side effects, some of which may not affect you at all, and others that might. What’s important

is to understand the risks, and then talk to your doctor. Other factors usually come into play, such as how much of the drug you use, how long you use it, and your overall health condition. In some cases, it may be best to change medications to protect your eyesight. 1. High blood pressure drugs: According to a recent study, some high blood pressure drugs called “vasodilators” can increase risk of age-related macular degeneration (AMD). This is a progressive disease that can eventually cause loss of vision and blindness, particularly in people 65 years and older. Researchers found that using a vasodilator was associated with a 72 percent greater risk of developing early stage AMD. In addition, those taking beta blockers were also at a 71 percent increased risk of a more advanced form of the disease, though the overall risk was low—only 1.2 percent of participants developed it. 2. Medications for BPH: Alpha-1 blocker medications (like Flomax) for benign prostatic hypertrophy (BPH) in men and bladder problems in women have been linked with a condition that increases www.4health.net ww.4h w.

4HEALTH operative time during cataract surgery and may affect dilation of the pupils. Talk to your doctor about these medications before having cataract surgery. 3. Steroids: Steroids, such as those used to treat asthma, arthritis, lupus, and other inflammatory conditions, may increase risk of cataracts, according to several studies. They can also increase risk of â&#x20AC;&#x153;posterior capsule opacification (PCO),â&#x20AC;? which is a complication after cataract surgery that causes vision to become cloudy. Inhaled steroids have also been linked to an increased risk in glaucoma, but it depends on how much is used each day and for how long. 4. Acne medication: Drugs like Accutane and Claravis that are used to treat severe acne may cause dry eyes and a decrease in night vision. Be sure to monitor your eyesight while taking it. 5. Antihistamines, antidepressants, antipsychotics: All of these can cause dry eyes, and may decrease focusing ability. Watch your eyes while taking them, and check with your doctor if you notice any changes. 6. Birth control pills: Research in 2013 found that oral contraceptives taken for several years or longer can increase risk of glaucoma. More specifically, women who used the pills for three years or longer had a five percent risk of developing the disease, compared to a risk of about 2.5 percent in the general population. Other studies have found a modest increased risk with long-term birth control risk. The overall risk remains low, however. 7. Migraine headache medications: Topamax and medications like it, used to treat epilepsy and migraine headaches, have been associated with an increased risk of glaucoma. A 2012 study, for example, found that first-time users were at a slight increased risk.

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GET RID OF PAINFUL VARICOSE VEINS DURING YOUR LUNCH BREAK USA VEIN CLINIC PROFESSIONALS DISCUSS CUTTING-EDGE TREATMENTS A lot of us have heard about vein problems, but may be confused about what they are, how dangerous they can be, and when it’s best to seek treatment for them. To help clear up the confusion, we asked leading specialists at USA Vein Clinics to answer some of our questions. Q. What is venous insufficiency? Can it be dangerous? A. Venous insufficiency is when your leg veins cannot pump enough blood back to your heart. Veins in the lower parts of your legs are usually affected. Early detection is a challenge—quite often it takes years for this disease to show its ugly face, and by that time it could be very dangerous. Complications can include deep vein thrombosis, bleeding, and phlebitis, but some patients can also get ulcers, serious inflammations and even cancer. Q. We’ve heard vein stripping is a common treatment. Is that performed in your office? A. Stripping is commonly performed on superficial veins. The doctor makes a small incision in the groin area, and usually another one in the calf, then disconnects and ties off all veins associated with the saphenous vein—the main superficial vein in your leg. But since the newer laser intravenous treatment was introduced, stripping is no longer the best choice. Laser treatment is 100% effective and does not require surgery. Q. Spider veins are notorious for looking unattractive and stubbornly resisting treatment. What is your approach to spider veins?

A. Spider veins appear alongside with vein insufficiency, so they are, so to speak, “allies” of the veins affected by the disease. To get rid of them, doctors need to find and treat the main source of the problem—the malfunctioning vein. If it’s treated properly, spider veins disappear, never to come back. Q. Physical exercises—are they good or bad for your veins? A. Moderate physical activity is great for your veins! There are no specific types of exercises that target the venous system, but walking, cycling, jogging, swimming, and most any other aerobic activity is very beneficial. Those who have already been diagnosed with poor veins should avoid heavy lifting and strenuous exercise, but can still benefit from regular walking. Q. What about crossing your legs while sitting, bright sun exposure, or wearing high heels? Will any of these things cause vein disease? A. None of these factors contribute to vein insufficiency development. But when you already havee vein problems, it’s more challenging (and often painful) to wear high heels, and crossing your legs can become uncomfortable. As for sunlight, only after certain procedures like sclerotherapy do people need to avoid sun exposure to prevent possible skin pigmentation. Q. What is sclerotherapy? A. Sclerotherapy is an injection therapy that fixes small veins. The doctor introduces various liquids

into the vein to either fix or completely eliminate it. This procedure is helpful only when the main vein problem is treated. Improperly done, sclerotherapy could even lead to deep vein thrombosis (DVT), which is a very serious disease. Q. Tell us more about DVT. A. DVT can be very serious. Illness, injury, vessel damage, and inactivity can all slow blood circulation, causing blood to “pool.” This stagnating blood creates an ideal environment for a clot to form. Without proper and timely treatment, DVT can sometimes lead to life-threatening complications. Fortunately, with increased awareness of symptoms and patient risk factors, DVT can be diagnosed early and treated successfully. Q. For a patient with any of these vein issues, what is the best course of action? A. The best and shortest way to an effective treatment is to get an accurate and timely diagnosis. USA Vein Clinics is well known and highly recommended in New York, Chicago, Boston and now, in Los Angeles. We perform all the tests you need for correct diagnosis, and then we custom create your treatment to fit your needs. There’s no reason to put off consultation—if you’re having pain or discomfort in your legs, or know you have vein problems, put your faith into the hands of the professionals at USA Vein Clinics. Call 718-509-0906 or go to www.USAVeinClinics.com to schedule a consultation. www.4health.net ww.4h w.

Vasscular Vas scular l Surgery r r | 4HEALTH HE L H25

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(718) 509-0906 509 0906 NEW YORK Manhattan Brooklyn, Manhattan, Brooklyn y Bensonhurst, Bensonhurst Queens, Valleyy Stream, Staten Island NEW JERSEY Red Bank BOSTON West Roxbury, y Lynn y CHICAGO Chicago Chicago, g Elk Grove Village, Village g Northbrook LOS ANGELES Glendale Valleyy Village, Glendale, Village g West Hollywood, y Huntington g Park PHILADELPHIA FLORIDA Hollywood y SEATTLE Seattle, Bellevue, Kent ATLANTA Decatur Marietta Decatur, Dr. Yan Katsnelson was named an American Heartsaver in 2002. He has numerous honors and awards both in his clinical and scientific work. Dr. Yan Katsnelson was the youngest person in Israel to perform heart surgeries – at 23 he was already performing complex open heart surgeries. Dr. Yan Katsnelson saved thousands of lives.

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COULD A DIFFERENT DIET HELP WITH EPILEPSY? TWO STUDIES SHOW PROMISE WITH DIETARY INTERVENTIONS ■■■ Gordon Barclayy The Epilepsy Foundation states that epilepsy is the fourth most common neurological problem affecting Americans today—behind only migraine, stroke, and Alzheimer’s disease. About 150,000 people are diagnosed every year, with the total number of people with the disorder ranging from 1.3 to 2.8 million. Most people with epilepsy can reduce the frequency of their seizures with medications, and many will eventually be able to stop taking medications after a few years of treatment and remain seizure-free. For some individuals, though, seizures can be particularly

difficult to treat. Others may prefer not to take medications because of side effects. In these cases, patients may wonder about alternative solutions. Is it possible to reduce seizures through a special type of diet?

LOW-DOSE FISH OIL MAY HELP There have been some studies that show that in certain cases, dietary changes may be helpful for epileptic patients. In September 2014, for example, researchers found that low doses of fish oil may help reduce the number of seizures in people who were no longer responding to medications. www.4health.net ww.4h w.

4HEALTH For the study, researchers from the University of California, Los Angeles, recruited 24 patients with epilepsy who were no longer responding to antiepileptic drugs. Options for these types of patients are usually limited to surgeries and brain-stimulating devices. Researchers gave the patients three separate treatments instead for 10 weeks each:

The Atkins diet involves eating more protein and fatty foods, like bacon, eggs, heavy cream, butter, leafy green vegetables and fish. It also includes balancing carbohydrate and protein intake in a one-to-one ratio. The ketogenic diet requires a different ratio of protein to carbohydrates—three to four to one. More specifically, results showed:

■ Low-dose fish oil (about 1,080 milligrams) a day plus three placebo

capsules containing only corn oil.

■ On the Atkins diet, 29 percent of participants reduced seizures by 50

■ High-dose fish oil (about 2,160 milligrams) a day plus six placebo

capsules of corn oil. ■ Placebo treatment of six capsules of corn oil.

percent or more. ■ On the ketogenic diet, 32 percent of participants reduced their sei-

zures by 50 percent or more. ■ On the Atkins diet, 5 percent reduced their seizures by 90 percent

Between each treatment regimen, the patients went through a sixweek “wash-out” period. Once the study was over, the researchers analyzed the results, and found that in the patients taking the low-dose fish oil decreased their seizures by about 33.6 percent compared to the placebo group. Two of the patients experienced no seizures at all while taking the low-dose fish oil. The high-dose fish oil produced no significant effects. This was a small study, but may hold promise for some epileptic patients.

HIGH-FAT, LOW CARB DIETS SHOW PROMISE A second study showed that a high-fat, low-carb diet may help those patients with hard-to-treat epilepsy. For the study, researchers reviewed 10 studies with a total of 72 participants. They found that in all studies, a significant number of people improved with either the Atkins diet or the ketogenic diet.

or more. ■ On the ketogenic diet, 9 percent reduced their seizures by 90 percent

or more. Improvements happened quickly—within days for most patients. The problem was that many of them had a hard time sticking to the diets. About half stopped early, after which their seizures returned. Researchers noted that while to can be difficult to stick with a particular diet, those patients with hard-to-control seizures may appreciate having another alternative to drugs or surgery. Additional research may reveal more lifestyle methods of treatment that can help reduce seizures. In the meantime, if you’re struggling with medications or they’re not working for you, talk to your doctor about potential dietary interventions. They may help you to feel better.

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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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7 SIGNS YOU NEED TO FIND A NEW THERAPIST SOMETIMES THE CONNECTION JUST ISN’T THERE ■■■ Colleen M. Storyy You did it. You took that step and now you’re working with a recommended psychiatrist. You’ve gone to three appointments. You’re trying. You’re keeping your mind open and you’re doing what the doctor tells you.

But something just doesn’t feel right. Is it you, or is this therapist just the wrong one? Though it takes time to establish a trusting relationship with any doctor, with a therapist, such a bond is even more important for you to feel comfortable enough to share your feelings. Though most physicians are ethical and truly care about helping you to get better, somewww.4health.net ww.4h w.

4HEALTH times you may run across someone who doesnâ&#x20AC;&#x2122;t seem to have your best interests at heart. Or it may just be you two donâ&#x20AC;&#x2122;t gel. Either way, it can be difficult to know when you should make the decision to look for another doctor. The following 10 tips may help. 1. You just donâ&#x20AC;&#x2122;t feel comfortable. Therapy is often uncomfortable. Itâ&#x20AC;&#x2122;s not easy to divulge our private thoughts and memories to someone else. But your therapist should make attempts to help you feel more relaxed. Give it time, but if after a month or so you still feel uncomfortable with this person, it may be time to try someone else. 2. You donâ&#x20AC;&#x2122;t feel important. During your appointment, your wellness should be the focus. If your doctor is taking other calls, texting, researching on the Internet, or otherwise distracted, heâ&#x20AC;&#x2122;s not the right doctor for you. Everyone has an emergency now and then, but if you notice this behavior on a frequent basis, get out. 3. You feel judged. If youâ&#x20AC;&#x2122;re bringing up things that happened in the past, you may feel judgmental of yourself. You may also think your therapist is judging you when she really isnâ&#x20AC;&#x2122;t. At the same time, if your doctor looks visibly offended by what you say, puts you down, criticizes your past actions, or engages in other types of behavior that remind you of an overly critical elementary school teacher, she is not going to help you get better. Itâ&#x20AC;&#x2122;s time to find someone else. 4. You feel like a minion. Your doctorâ&#x20AC;&#x2122;s job is to relate to you, and to help you find solutions that will work in your life. Though doctors are supposed to be knowledgeable, and use

that knowledge to help you understand what may be going on in your thoughts or emotions, they are not supposed to parade their knowledge about as if giving a speech. If you find that you get only two or three words out before he begins pontificating about what you are really suffering from (though it seems to have nothing to do with you), or goes on about himself and what heâ&#x20AC;&#x2122;s experienced, heâ&#x20AC;&#x2122;s more interested in his own brilliance than your recovery. 5. You donâ&#x20AC;&#x2122;t feel safe. If you ever feel unsafe for any reason, leave. Letâ&#x20AC;&#x2122;s say your psychiatrist yells at you or threatens you. Not good news. Same goes for any sort of flirting or harassing behavior. 6. You feel alone. One of the benefits of therapy is that someone is there to help you figure things out. Every doctor is different, but if you feel yours is in another world, she may not be the right one for you. Maybe she doesnâ&#x20AC;&#x2122;t look at you. Maybe she takes notes without conversing with you. Maybe she stares into the distance and leaves long periods of silence when you donâ&#x20AC;&#x2122;t know what she expects you to do. If youâ&#x20AC;&#x2122;re not feeling a connection or youâ&#x20AC;&#x2122;re just not feeling heard, move on. Notice, too, if after a given amount of time (letâ&#x20AC;&#x2122;s say six visits) whether youâ&#x20AC;&#x2122;re feeling any better. If you get frustrated and she has no other options for you, she may not have the expertise needed to help you. 7. You feel he may breach your confidence. Itâ&#x20AC;&#x2122;s strict policy that a psychiatrist is to keep everything that happens between you confidential. Most doctors abide by this, but once in awhile there are exceptions. One important clueâ&#x20AC;&#x201D;your doctor tells you about one of his other patients. Take this as a huge red flag and cancel the rest of your appointments.

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| Plastic la i Surgery S g y

LOOK GREAT FOR SWIMSUIT SEASON WITH A BREAST LIFT NOW! BOOK YOUR APPOINTMENT TODAY

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

Deflated balloons, spaniel’s ears, saggy breasts. No matter what you call them, women don’t like them, but it seems few can escape them. As we age, gravity and other factors in life work to stretch ligaments, breakdown collagen, and pull the breasts down from their original position, so they look “droopy” and lifeless. According to a survey by Mamamia, an Australian news source, 48 percent of women would have a cosmetic procedure if money wasn’t an issue, and over 20 percent would do something about their breasts. If you’re wishing you could look like you did years ago when your figure was a little more flattering, now is the time to do it. “Women who want to look great for spring break are advised to book an appointment now,” says plastic surgeon Dr. Rayham of the RR Plastix/New York Plastic Surgery Center. “Getting a breast lift in winter gives the body time to recover before swimsuit season begins.”

WHAT CAUSES SAGGING BREASTS? Women used to think that breastfeeding caused their breasts to sag, but a recent study says that’s not true. Researchers from the University of Kentucky interviewed 132 women who came in for breast lifts between 1998 and 2006, and found that 93 percent had experienced at least one pregnancy, and 58 percent had breast-fed their babies. The results showed no difference in the degree of sagging between women who breast-fed and those who didn’t. All women will eventually experience drooping breasts — though women with small breasts will notice it less — and it can start at most any age. The breasts are made of ligaments and connective tissues, and over time, gravity pulls the breasts down and the ligaments can stretch, letting the breasts sag. Other factors can accelerate this drooping, including smoking (which breaks down supportive tissues), multiple pregnancies, diet, weight loss, and genes.

WHAT IS A BREAST LIFT? Called a “mastopexy” in medical terms, a breast lift helps elevate and reshape saggy breasts. The surgeon simply removes the excess skin, then tightens the surrounding tissues to

reshape, lift, and elevate the breasts to a higher position, providing a firmer and more youthful appearance. The procedure is possible for women over the age of 21, and does not affect your ability to breast-feed. Dr. Rayham is a Mayo-Clinic-trained Plastic and Reconstructive Surgeon with additional training in the field of Aesthetic or Cosmetic Plastic Surgery. He’s performed hundreds of breast lift procedures that have resulted in women feeling more fashionable, shapely, and confident. He performs the procedure in the hospital or ambulatory surgery settings in Manhattan/ NYC; Brooklyn; or Staten Island, New York; and recommends women avoid wearing a bra for about six weeks to allow proper healing and to prevent undue pressure on the incisions.

AM I A CANDIDATE? If you’re in overall good health and you’d like to lift, firm, and reshape your breasts; reduce the size of enlarged or misshapen areolas; or reposition the nipples; you are a good candidate for a breast lift. The procedure will not change the size of the breasts, however, so if you’re looking for augmentation or reduction, talk to your doctor. The best way to communicate your vision is to bring pictures of the size and shape of breasts you’d like. The breast lift alone lasts for about 1.5 to 3 hours, and does leave behind minimal scarring, though the position of the scars will depend on the type of incision chosen for your particular case. Complications are rare, and may include bleeding, infection and scarring, but following your surgeon’s directions for follow-up care greatly reduce your risk. Patients who live in town can normally go home the same day. Out of town patients usually stay overnight in a hotel and go home the next day.

FOR MORE INFORMATION Dr. Rayham has offices in Manhattan, New York City, Brooklyn, and Staten Island. For more information on a breast lift procedure and to find out if you may be a candidate, call the RR Plastix/New York Plastic Surgery Center, 1–877–582–0400, or visit our website at www.rrplastix.com. www.4health.net ww.4h w.

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Vasscular Vas scular l Surgery r r | 4HEALTH HE L H35

PERIPHERAL ARTERY DISEASE INCREASES RISK OF AMPUTATION USA VASCULAR CENTERS PROVIDES CURE Movement is life. The ability to move independently, exercise, work, and enjoy an active lifestyle really depends on the health of our feet and legs. Have you ever imagined life without them? Fortunately, most of us don’t have to worry about it, but if you have peripheral artery disease (PAD), your risk of one day having to lose one or both legs is higher than normal. Nearly five percent of men and women from 44 to 74 years of age suffer from PAD, and many of them aren’t even aware of it. According to the National Limb Loss Information Center, in 1996, an estimated nearly 130,000 people lost a limb because of the disease. Here’s more, and how you can protect yourself from such a tragic fate.

WHAT IS PERIPHERAL ARTERY DISEASE? Blood saturated with oxygen and nutrients flows from the heart to the organs and tissues in the rest of the body. PAD is a form of atherosclerosis (hardening of the arteries), and gradually narrows blood vessels, restricting blood flow. As this occurs, there is a shortage of nutrients and oxygen delivered to parts of the body, particularly the legs, though critical organs may also be affected. Over time, the arteries that supply blood to the legs can become narrowed or even completely clogged.

WHO IS AT RISK? Those who smoke, or who have high blood pressure, high cholesterol, or diabetes, are more at risk for PAD. Another risk factor is age: as the years go by, arteries are more likely to show wear and tear. People who lead a sedentary lifestyle, who are overweight or obese, or who have a family history of PAD, are also more likely to develop the disease.

WHAT ARE THE SYMPTOMS OF PAD? In the early stages of the disease, the patient may experience fatigue, numbness, tingling or coldness in the affected limb. As the disease progresses, the patient may experience “intermittent claudication,” or cramping leg pain. From time to time, when walking, a sharp pain occurs in the leg, making it difficult to continue. This pain occurs because some groups of www.4health.net w.4 w.4hea .44hea

muscles are not receiving enough oxygen-rich blood, which strains the muscle and causes the painful reaction. After staying still for a time, the pain goes away, and the person can walk again. As the disease progresses, the distance a person can go on foot without pain decreases. In the later stages of the disease, open sores may develop on the skin of the legs and feet. Again, these are usually caused by poor blood flow, and may take a really long time to heal. Though these symptoms are common, many people with PAD experience no symptoms in the early stages. That’s why it’s always important to have regular physical check-ups, particularly if you have some of the risk factors mentioned above.

DANGERS OF PAD Pain and fatigue in the legs, accompanied by disrupted blood flow, is a relatively innocuous manifestation of PAD. When the disease progresses, ulcers may develop. If they don’t heal, gangrene may occur due to insufficient blood supply of tissues, and that can lead to a potential amputation. If treatment is not started early, in many cases, the patient may not only lose a leg, but also his or her life. According to statistics, a quarter of patients with PAD experience complications related to gangrene. Therefore, when the earliest signs of the disease appear, patients should seek medical help. Experienced doctors specializing in cardiovascular medicine can stop the progression of the disease and protect against the risk of leg amputation.

EXPERIENCED DOCTORS AT USA VASCULAR CENTERS USA Vascular Centers is proud to provide a number of doctors qualified to treat PAD. If you are suffering from pain in the legs when you walk, we can help. Modern methods of PAD treatment are so effective and safe that leaving the disease untreated becomes a real crime against yourself and your loved ones. Professionals at USA Vascular Centers successfully treat the disease, as well as varicose veins and other vascular diseases. Treatment is covered by most insurance types, including Medicare.

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4HEALTH

WHAT’S CAUSING THIS PAIN IN THE BALL OF MY FOOT? 10 POTENTIAL CAUSES AND WHAT TO DO ABOUT THEM ■■■ Gordon Barclayy Danny couldn’t figure it out. Most of the time he was fine, but about a mile into his daily run, his left foot would start to hurt. The pain was localized in the ball of his foot. He’d tried rest, massage, and new shoes, but nothing had helped to ease the pain. Every day, about one mile in, there it was again. You may have had an experience like Danny’s. There’s pain there, and you can’t figure it out. Below are seven possibilities, but it’s best to always check with your doctor to be sure you get the treatment you need to start feeling better.

10 CONDITIONS LINKED WITH BALL-OF-FOOT PAIN Pain in the ball of the foot is called “metatarsalgia,” because it usually involves one of the five metatarsal bones that connect your toes to the rest of your foot. Increased pressure on these bones can cause pain, and that increased pressure can come about for a lot of reasons. 1. Sports: No surprise Danny was experiencing ball-of-foot pain, as running is one of the main sports that can put excess pressure on the foot. Other sports that involve a lot of running, jumping, or even standing, particularly on concrete, can wear down the metatarsal bones. 2. Overweight and obesity: Excess pounds increase pressure on the foot. 3. Ill-fitting shoes: Shoes without the appropriate arch support or cushioning can cause pain in the ball of the foot over time. Shoes that

are too small, or have toe boxes that are too small, can also increase pressure on the ball of the foot. 4. Stress fractures: Tiny cracks in the bones can develop after an extended period of pressure, or in response to an injury. 5. Age: As we age, the protective fat pad under the ball of the foot begins to diminish, leaving the foot less protected. 6. Bunions: If you have bunions, they could be causing your pain, as they put more pressure on your metatarsal bones. 7. Hammertoes: These transfer more weight to the ball of the foot, increasing pressure. 8. Tight calf muscle: If you don’t stretch your calf muscle after working out, you could suffer pain. A tight Achilles tendon, for example, which links the calf muscle to the heel, can cause the foot to pronate, which places additional strain on the ball of the foot. 9. High arches: If you naturally have high arches, they put pressure on the ball of your foot to stabilize you. 10. Nerve damage: Damage to the nerves in the feet can occur because of injury, diabetes, or even noncancerous growths in the nerve tissue.

NON-SURGICAL TREATMENT OPTIONS For many of these conditions, better-fitting shoes, metatarsal arch supports, orthotics, stretching exercises, rest, massage, ice packs, avoiding high-heels, and losing weight can help ease the discomfort. Danny had some orthotics made and was soon running again without pain. Surgery is always a last resort. Check with your doctor, particularly for recurring pain. www.4health.net ww.4h w..

718.646.0131

384HEALTH 4 E L H

| Vascular a c a Surge u erry

DEEP VEIN THROMBOSIS: WHEN DANGEROUS BLOOD CLOTS FORM IN THE LEGS

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Almost everyone knows someone who has suffered from a blood clot, either in the legs, lungs, heart, or brain. Blood clots can be extremely dangerous, and may cause organ damage, difficulty breathing, and sometimes even death. What are blood clots, who gets them, and how do we get rid of them?

HOW BLOOD CLOTS DEVELOP The development and presence of blood clots in a vein is called deep vein thrombosis (DVT). These blood clots usually occur in veins that exist in the lower extremities, since the blood flow in the legs is the most stagnant and has to fight gravity to climb all the way up to the heart. Blood clots more rarely develop in arteries that have been affected by atherosclerosis and are therefore narrowed by cholesterol and calcium deposits, making it more difficult for blood to flow through them. Sometimes blood clots that initially form in the legs can break away and travel through the bloodstream to the lungs. Such a loose or traveling blood clot is called an “embolus.” This clot can then lodge in a vessel in the lungs, blocking blood flow and causing a condition known as pulmonary embolism (PE). PE is a very dangerous condition that can damage the lungs or other organs and even cause death.

WHO’S AT RISK? Since the sixteenth century, doctors have understood that risk factors for DVT can be lumped into three categories: ■ Abnormal blood flow, which can develop when one sits for an extended period of time, such as on an airplane flight. ■ High viscosity of the blood, which includes a variety of “hypercoagulable” conditions or states when blood is too “thick,” such as what may occur in those who suffer from cancer, blood-clotting disorders, or dehydration, or in those who smoke, are overweight, or use oral contraceptives. ■ Irregularities of the inside lining of the blood vessel, which may occur during trauma and surgery. Those with a history of DVT may also suffer damaged blood vessels, as the condition usually traumatizes the inside wall

of the vein, making it “rough” and therefore more attractive to passing blood cells—giving them a place to harbor and form a clot.

WHAT ARE THE SYMPTOMS? Despite the dangerous nature of DVT, many people who have it do not experience any clinical symptoms. If symptoms do occur, they may include pain, swelling, and tenderness to the touch of the affected area. Severe chest pain or difficulty breathing may indicate that a clot has traveled to the lungs. If symptoms like these do occur, the person experiencing them should go immediately to the emergency room to be treated by a qualified physician.

HOW TO REDUCE YOUR RISK If you suspect you may be at risk for DVT or blood clots, see your doctor as soon as possible. If you don’t have one of the above blood-clotting disorders, malignant tumors, or traumas, you can try the following measures to help reduce your risk of a dangerous blood clot. ■ If you have to sit still for four hours or longer, such as when taking a trip on an airplane, regularly change your leg positions, and periodically move and stretch your legs and feet while seated. Your doctor may suggest leg exercises at regular intervals, which should be performed at least once every hour. If conditions allow, get up and walk around when you can. ■ Avoiding crossing the legs at the ankles or knees for prolonged periods. ■ Drink an adequate amount of non-diuretic fluids and minimize alcohol and caffeine intake. ■ Wear graduated compression stockings when needed. Some people may find that with the above measures, they can avoid DVT, but others may experience it anyway. It is also possible that some of the measures listed above may not be recommended depending on an individual’s health situation. It is crucial, therefore, to see an physician immediately if you have a reason to believe blood clots or DVT might be affecting you or members of your family. www.4health.net ww.4h w.

4HEALTH

CANCER SCREENING: WHAT TESTS DO YOU NEED? RECOMM MENDATIONS HAVE CHANGED— WHAT YOU NEED TO KNOW

y Merrell ■■■ Lynn

In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended changes in breast cancer screening, suggesting women wait to begin at age 50, not 40, as was previously suggested. In 2012, the same group recommended less frequent screening for cervical cancer as well. They urged women to get a Pap smear no more often then every three years. The American College of Obstetricians and Gynecologists and the American Cancer Society agreed. These changes, though based on sound scientific research, have left some women and men confused about just what cancer screenings they should be getting. If you’re one of them, here’s a quick overview of the cancer tests you need.

BREAST CANCER Though the USPSTF recommended fewer mammograms, other medical organizations don’t necessarily agree. The American Cancer Society, for instance, still suggests women start at the age of 40 and continue annually. The Mayo Clinic recommends women discuss the risks with their doctors to decide what’s best, but they also support screening at age 40 to catch those cancers that start in younger women. The USPSTF states that women in their 40s are 60 percent more likely to experience harms from mammograms than women 50 and older, and are less likely to have cancer. The new guidelines were based on studies that showed for every 1,000 women screened starting at age 40, about 0.7 deaths were prewww.4health.net w.4hea .4

vented, while about 470 women received a false-positive result and 33 had to go through unnecessary biopsies. The National Breast Cancer Coalition and Breast Cancer Action welcomed the new guidelines. The current recommendations say that women 50 to 74 year should have mammograms every two years. Those 75 and older should talk to their doctor about potential risks and benefits (recent studies show little benefits from mammography after the age of 75).

PROSTATE CANCER Men used to think they needed a PSA (prostate-specific antigen) test to screen for prostate cancer, but the USPSTF now recommends against it for men without symptoms, as does the American Academy of Family Physicians. PSA levels can change for many reasons, only one of which might be the presence of cancer. A positive test result can lead to unnecessary treatments. In addition, most prostate cancer cases are slow growing and will not cause problems over the course of a man’s lifetime, making treatment unnecessary. Men between the ages of 50 and 74 should understand their risks for prostate cancer, and see their doctors if they experience symptoms.

COLON CANCER Standard recommendations are for men and women between the ages of 50 and 75 to get screened for colon cancer once every 10 years. If the screening finds polyps, a repeat test may be scheduled for earlier—at five years.

CERVICAL CANCER Recommendations have changed. Today, women aged 21 to 30 are told to have a Pap smear every three years; women 30 to 65 once every five years if they have a human papillomavirus (HPV) test at the same time (to check for the virus that causes cancer), and women over 65 who have gotten normal results to go without retesting.

LUNG CANCER There is no reliable screening for lung cancer for the general population. For individuals who were long-term heavy smokers, however, an annual low-dose CT scan may help reduce the risk of death from lung cancer. Current recommendations are that individuals between the ages of 55 and 80 who smoked a pack a day for 30 years or two packs a day for 15 years—even those who stopped within the past 15 years—may benefit from CT scan screening.

OVARIAN CANCER We don’t yet have reliable screening for ovarian cancer.

SKIN CANCER The USPSTF concluded in 2009 that current evidence is insufficient to recommend the benefits of whole-body skin examinations by a physician. The Skin Cancer Foundation, on the other hand, disagrees, saying the conclusion is based on outdated data, and that skin cancer screening saves lives. Your best bet: Keep your eye out for any unusual moles or skin growths, and check with your doctor on any that you find.

CLASSIFIEDS

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4HEALTH

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4HEALTH

VASCULAR SURGERY

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