4Health Magazine #175 by MOO Publishing

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5 COMMON SPORTS INJURIES TO THE FOOT AND HOW THEY’RE TREATED PEOPLE WITH DEVELOPMENTAL DISABILITIES AT RISK FOR GUM DISEASE COULD YOU HAVE DIABETES AND NOT KNOW IT? AVOID A SUNBURN ON YOUR EYES! facebook.com/4healthmagazine

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

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(ISSN 1942-6801) is published monthly by MOO Publishing Corp.Copyright © 2007-2015 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 June 2015.

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

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People with Developmental Disabilities at Risk for Gum Disease

How Caregivers Can Improve Oral Care for Loved Ones

11 12 Reduce Your Risk of Alzheimer’s By Doing This One Hour a Week Studies Show Promising Results

22 Avoid a Sunburn On Your Eyes!

How to Protect Yourself This Summer

ALLERGIES: WHY SUFFER? TREATMENTS CAN HELP YOU FEEL BETTER IMMEDIATELY

REGRET YOUR STRETCHED EARS? COSMETIC SURGERY CAN HELP

HOW TO AVOID LIVER DISEASE

MASTECTOMY OR BREAST-CONSERVING SURGERY?

AFTER A CONCUSSION: WHEN SHOULD YOU GO BACK OUT ON THE FIELD?

WHAT’S CAUSING YOUR BELLY FAT?

Dangerous Disease Can Exist Without Symptoms

26 What Did You Do To Your Foot?

Plastic Surgeons Can Now Help Repair Large Earlobe Holes

Dr. Weissman Answers Our Questions

Patients with Breast Cancer Making Surprising Choices

Second-Impact Syndrome Can be Deadly

By Dr. Prab R. Tumpati

REDUCE YOUR RISK OF ALZHEIMER’S BY DOING THIS ONE HOUR A WEEK

A NEIGHBORHOOD OPHTHALMOLOGIST OPENS A ONE-STOP PRACTICE

61-YEAR-OLD WOMAN REJUVENATED BY HEALTHY LEGS

BOTOX, FILLERS, OR FACE-LIFT? WHICH OPTION IS RIGHT FOR YOU?

NEARLY HALF OF ADULTS OVER 40 EXPERIENCE SYMPTOMS OF PAD

IN PAIN? WE CAN HELP!

24 Could You Have Diabetes and Not Know It?

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Studies Show Promising Results

When it Comes to Patients, Dr. Rona Appel Follows the Golden Rule

Grandma Feels 20 Years Younger with the Help of USA Vein Clinics

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Check with Your Doctor to Avoid Complications Like Heart Attack and Stroke

USA Vascular Center Treats Uterine Fibroids, Varicose Veins, and More

5 Common Sports Injuries to the Foot and How They’re Treated

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| Allergy

ALLERGIES: WHY SUFFER?

TREATMENTS CAN HELP YOU FEEL BETTER IMMEDIATELY

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Lev BARSKY, MD SPECIALTY: Allergy & Immunology

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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 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

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REGRET YOUR STRETCHED EARS? COSMETIC SURGERY CAN HELP PLASTIC SURGEONS CAN NOW HELP REPAIR LARGE EARLOBE HOLES ■■■

Gordon Barclay

The first time I saw the “ear-plug” style of earrings — also called ear gauges or “tribal” ear piercings — I did a double take. Ouch! Doesn’t that hurt, I wanted to ask? Since then, I’ve seen so many I don’t think much of it anymore. It turns out, though, that those getting their ears “stretched” as they call it may end up regretting it as they get older. Desiring a job or a spot in the military, young people are finding doors closed to them because of the large, gaping holes in their ears. Fortunately, there is a solution. In fact, according to recent reports, cosmetic surgery to fix these tribal piercings is on the rise.

WHAT IS EAR STRETCHING? It was back in 2011 that BBC News reported stretched ear lobes as becoming more and more popular as part of a counter culture movement. It seemed to really take off when more celebrities like American Idol winner Adam Lambert and Linkin Park band member Chester Bennington started walking the red carpet with see-through holes in their ears. The practice involves stretching a typical ear piercing to accommodate a much larger plug, usually around a half-inch or wider. Fans use “tapers” (cone-shaped pieces of jewelry) of different sizes to gradually increase

the diameter of the hole, allowing each to slowly stretch the skin until a bigger taper can be inserted. For the braver souls, there is the option of an instant hole punch, but that can leave scars behind. Those who are careful can end up with the holes they desire, but may find later on that they’ve made a mistake. Others go too quickly and end up with split lobes. In still other cases, the ear lobe can actually become damaged and deformed from ear stretching.

SOME REGRET STRETCHING THEIR EARS Though ear gauges, as they’re often called, may be popular in high school or college, many young people find themselves in trouble when they go to apply for that new job. Once the holes are larger than half-an-inch in diameter, there’s no going back — not naturally, anyway. The holes will not naturally shrink or close, no matter how much time passes. Many businesses simply won’t accept applicants with gaping holes in their ears. In fact, the U. S. Army cracked down on piercings larger than standard earring piercings in May of 2014, creating a new regulation against it. Some individuals find that professional organizations like the Professional Golfers Association won’t accept gauged ears, either. Educational professionals, as well, often find they need to have gauged ears fixed. Faced with these situations, people who once enjoyed ear stretching are now turning

to cosmetic surgeons for help. Though repair is possible, it may be a bit more complicated than people expect.

COSMETIC SURGERY FOR GAUGED EARS In most cases of gauged ears, there is a lack of tissue available to make repairs. A torn earlobe, for example, can simply be stitched together. An ear hole, however, needs new tissue to close up the gap. Though surgeons could just suture the hole shut, it would create an abnormal looking earlobe, creating a distorted and overly narrow appearance. Instead, surgeons take tissue from surrounding areas of the external ear just behind the hole or from the remaining earlobe skin. The process is basically a reconstructive surgery for the ear lobes, requiring a trained and experienced professional that can create as normal looking an ear as possible. Though the procedure can be done under local anesthesia, it can take an hour or more to complete. Regardless of how good the surgeon is, patients can be expected to have a scar on the ear from the middle of the lobe down to the edge. Surgery typically costs around $1,500 to $3,000 for both ears. If you choose to have surgery, be careful of those who offer “cheap” services. Always ask for credentials, references, and photos of other ears that were similarly repaired before agreeing to go under the knife. www.4health.net

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PEOPLE WITH DEVELOPMENTAL DISABILITIES AT RISK FOR GUM DISEASE HOW CAREGIVERS CAN IMPROVE ORAL CARE FOR LOVED ONES ■■■ Morgan Rice Everybody needs to take good care of their oral health. We all know that brushing and flossing on a regular basis helps us to avoid cavities and gum disease and other oral health problems. If we don’t do these things, we have only ourselves to blame if we suffer tooth pain! But what about people who can’t take care of themselves? According to the University of Minnesota, over 6 million people in the U.S. have developmental disabilities, and many of them cannot manage the basics of self-care, such as brushing their teeth. Unfortunately, according to a recent study, these people are more likely to suffer significant dental disease.

STUDY SHOWS ORAL CARE LACKING IN THOSE WITH DEVELOPMENTAL DISABILITIES For the study, researchers from the Tufts University School of Medicine and School of Dental Medicine conducted a large-scale survey of over 800 caregivers who had a lot of experience caring for people with developmental disabilities in either family homes or living residences. They focused on factors that may influence the oral care provided by these caregivers. The survey results showed the following: ■ 85 percent of disabled adults received help with brushing their teeth

79 percent brushed twice daily 22 percent flossed daily 45 percent never flossed at all 63 percent of caregivers reported that behavioral problems were the main factor making oral health difficult This study showed that nearly half of people with developmental disabilities weren’t flossing their teeth at all, which can lead to inflammation, gum disease, and tooth loss. Of those who were brushing their teeth, over 20 percent — a fifth of this population — were not brushing twice a day. Researchers noted that while professional caregivers often receive training in giving oral care, family caregivers are less aware of the importance of brushing and flossing every day.

■ ■ ■ ■

DANGERS OF NOT FLOSSING When patients don’t regularly floss, bacteria can take up residence between teeth, where they can cause damage over time. Gingivitis is the first stage, in which the bacteria cause the gums to become inflamed, red, and swollen. Without treatment, the disease moves into its second stage — periodontitis. Pockets form around the teeth that trap food and bacteria, and the gums may recede from the teeth. The damage at this point is irreversible, but treatments can clean out the pockets and stop the progression of the disease. Without treatment, periodontitis can move into an advanced stage, after which the patient

may suffer tooth loss. Risk is also increased for other potential diseases, like heart disease, as the bacteria from the mouth moves into other areas of the body.

TIPS FOR CAREGIVERS If you’re a caregiver for someone with developmental disabilities, you may be finding it difficult to manage physical or behavioral problems that interfere with oral care. Talk to your dentist, and consider the following tips to make it easier: Routine. Set up a regular routine for oral care, and stick with it. Make it the same time and place every day, and stay calm. Over time, regular routines can help patients feel more comfortable with what you’re doing. Show and tell. If your loved one is frightened, brush and floss your teeth first to show him or her that there is nothing to fear. Go slowly. Explain each step. Allow your loved one to touch and feel the toothbrush, floss, and toothpaste. Get creative. Maybe your loved one would feel more comfortable holding a special toy. Maybe playing music during oral care would make it more fun. Try making a game out of it — how many teeth did you clean? Make it easier. If your loved one can brush his own teeth, but has trouble holding the toothbrush, cut a slit in the side of a tennis ball and slide it onto the handle of the toothbrush. Use flossing picks rather than floss alone. Provide a booster chair if needed. www.4health.net

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Gastroenterology | 4HEALTH15

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

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.

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MASTECTOMY OR BREASTCONSERVING SURGERY?

PATIENTS WITH BREAST CANCER MAKING SURPRISING CHOICES ■■■ Lynn Merrell It used to be that if you were diagnosed with breast cancer, you wanted to do everything you could to save those parts of the breast that were not yet affected by the disease. “Breast conserving surgery (BCS)” was the preferred method of treatment in the 1990s, in which surgeons removed only the areas of the breast affected by cancer, but not the entire breast. A recent study, however, showed that BCS has been declining in popularity, with more women choosing mastectomy (complete removal of the breast) and reconstructive surgery instead. Why would that be, and is it the better choice for women?

TWO CHOICES FOR WOMEN WITH BREAST CANCER Women diagnosed with breast cancer often need to have surgery to remove the tumor. They have two options: mastectomy and breast-conserving surgery. Breast-conserving surgery (BCS): Also called a partial mastectomy or lumpectomy, this option removes only part of the breast. There is a risk that some cancer cells will be left behind, after which the surgeon may need to go back in and remove more tissue. For women with stage I or II breast cancer, BCS plus radiation has been found to be as effective as a mastectomy. Mastectomy: In a total mastectomy, the surgeon removes the entire breast. In a double mastectomy both breasts are removed. Though some women will need radiation, many will not.

Though women with more advanced stages of breast cancer may have no other choice but to go through a mastectomy, women with early-stage cancers can choose. It used to be that women would choose BCS whenever possible, but that’s changing.

MORE WOMEN CHOOSING MASTECTOMY A study published in 2014 in JAMA Surgery reported that more and more women who are eligible for BCS are choosing mastectomy instead. Researchers used the National Cancer Database to analyze data from more than 1.2 million women treated for breast cancer between 1998 and 2011. Results showed the following: ■ Just over 35 percent of the women went through a mastectomy. ■ The proportion of women eligible for BCS who chose mastectomy increased from 34.3 percent in 1998 to 37.8 percent in 2011. ■ Younger women were more likely to choose mastectomy regardless of tumor size. ■ The number of women choosing to have both breasts removed even when they had cancer only in one increased from 1.9 percent in 1998 to 11.2 percent in 2011. ■ In women going through mastectomy, rates of breast reconstruction increased from 11.6 percent in 1998 to 36.4 percent in 2011. Why would more women choose mastectomy? Researchers suggested that increased insurance coverage may be part of the rea-

son. Ever since 1998, when the Women’s Health and Cancer Rights Act passed, insurance companies have been required to cover postmastectomy reconstruction. The fact that women can now be tested for the BCRA gene, which greatly increases the risk of cancer, may also explain why more women are choosing to have both breasts removed.

WHICH OPTION IS BEST FOR YOU? What’s the best choice for you? Talk to your doctor. Though Angelina Jolie may have made the double mastectomy more acceptable after she went through it, a recent 2014 study showed that it may not always be the best choice. In that study, researchers examined results from over 130,000 patients going through breast conservation therapy (which included radiation) vs. mastectomy (without radiation), and found that patients who underwent breast-conservation therapy had a higher survival rate compared to those treated with mastectomy alone or even with mastectomy and radiation. Other studies have shown a slightly higher risk of the cancer returning with BCS, however. Talk to your doctor. With a lumpectomy, you preserve part of the breast, but you may face side effects with radiation. With a mastectomy, you may need to have the entire breast reconstructed, but you may be able to escape the radiation. Everyone’s cancer is different—educate yourself, and then make the choice that seems best for you. www.4health.net

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AFTER A CONCUSSION: WHEN SHOULD YOU GO BACK OUT ON THE FIELD? SECOND-IMPACT SYNDROME CAN BE DEADLY ■■■ Colleen M. Story Tray was flying high in life. He was skiing at his highest level ever, and had placed in the top three in his last two competitions. He was doing great in school his senior year and had applied to three colleges, one of which had already accepted him and granted him a skiing scholarship. Everything changed when during one training trip in Colorado he tried a new jump, fell, and hit his head. He recovered that day and thought he was fine, but then the symptoms started showing up. He suffered from nightmares, blurry vision, headaches that wouldn’t respond to pain medications, and frequent “woozy” periods where he felt he might pass out. His doctor diagnosed him with a “mild” concussion and advised a period of rest. Tray complied, and then went back to skiing, but even months later, he continued to have

symptoms, including brain fog, difficulty concentrating, and trouble sleeping. After several months had passed, Tray started to worry — might he have suffered permanent brain damage? We’ve learned a lot about concussions in recent years, particularly as some of our major league athletes have shared their stories of how multiple head hits affected them later in life. If you’re a young athlete, it’s important to be aware of the risks, and to do everything you can to protect yourself.

WHAT IS A CONCUSSION? A concussion, also called a mild traumatic brain injury (MTBI), is an injury to the brain caused by a blow to the head. The injury actually causes the head to shake back and forth inside the skull. It’s called “mild” because it typically produces only mild symptoms in the short-term, but we now know concussions

can also cause long-term complications, particularly if people suffer more than one. The three main causes of concussions include car crashes, accidents or falls, and sports injuries. Symptoms that usually appear shortly after the injury include: ■ Headaches and dizziness ■ Temporary loss of consciousness ■ Nausea and vomiting ■ Slurred speech, delayed response to questions, confusion ■ An inability to remember the event that caused the concussion ■ Fatigue Symptoms that may show up days or months after the injury include: ■ Depression or irritability ■ Sensitivity to light and noise ■ Memory and concentration problems ■ Difficulty sleeping ■ Changes in taste and smell ■ Loss of balance www.4health.net

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WHEN SHOULD YOU GO BACK? Even after symptoms fade, some victims may still show signs of brain injury months or even years down the road. A 2013 study, for example, found that the brains of 50 concussion patients still showed signs of abnormalities four months after the injury, even though symptoms had faded. Another 2013 study also found that patients who were still suffering periods of dizziness months after a concussion were more at risk for another injury — perhaps another concussion — than those who weren’t experiencing these symptoms. Doctors refer to these and other studies to show that people need to be even more careful about when they return to potentially risky activities. “Just because you feel you’re healed doesn’t mean you are,” said study author Andrew Mayer, associate professor of translational neuroscience at the Mind Research Network in Albuquerque, New Mexico. Suffering a second concussion before the first has fully healed can be deadly. It’s called “second-impact syndrome” and it can be extremely damaging and sometimes deadly. High school football player Cody Lehe, for example, suffered a head injury in a 2006 football game. His CT scan came back normal, so he went to practice. He took a shoulder hit, suffered a seizure and later fell into a coma. Years later, he can no longer walk on his own or remember things that happened just hours earlier. If you’ve suffered a concussion, before diving into a sport or other risky activity, make sure you have your doctor’s permission, and then think twice. We don’t yet have tests that determine for sure whether your brain has healed or not (as Lehe’s case demonstrates), and brain damage can be permanent.

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Obesity Medicine | 4HEALTH21

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

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:

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

SPECIALTY: Internal Medicine, Sleep and Obesity Medicine

INSURANCE: Accept All Major Insurance Plans

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

(888) 283-0399 www.w8md.com

4HEALTH

REDUCE YOUR RISK OF ALZHEIMER’S BY DOING THIS ONE HOUR A WEEK STUDIES SHOW PROMISING RESULTS ■ High blood pressure increased risk by 61

■■■

Colleen M. Story

The Alzheimer’s Association states that as many as 5.1 million Americans may have Alzheimer’s disease. By the year 2050, they estimate that the number of people aged 65 and older who have the disease may nearly triple, to a projected 13.8 million. You’ve probably heard that eating a healthy diet and regularly challenging your brain with puzzles and reading will help reduce your risk. Turns out that there’s something else that is likely to be much more effective — and you have to do it for a minimum of only one hour a week.

STUDY FINDS EXERCISE MOST PROTECTIVE AGAINST DEMENTIA For this recent study, researchers looked at data from almost a decade of studies on risk factors for dementia. These included smoking, diabetes, high blood pressure, lack of exercise, obesity, depression, and a low level of education. Results showed the following: ■ Participants who did not exercise every

week — either by doing three 20-minute bursts of vigorous exercise, or five 30-minute sessions of moderate activity — were 82 percent more likely to go on to develop dementia. ■ Depression increased risk by 65 percent. ■ Obesity in midlife increased risk of dementia by 60 percent.

percent. ■ Low educational attainment increased risk by 59 percent. ■ Smoking increased risk by 59 percent. ■ Diabetes increased risk by 46 percent. ■ Depression and a low level of education also significantly increased risk. After analyzing all the results, researchers concluded that just one hour’s exercise a week could reduce the risk of Alzheimer’s by nearly half.

bottom 10 percent in terms of the amount of daily physical activity were more than twice as likely to develop Alzheimer’s as those in the top 10 percent. Other studies have shown that exercise can help improve cognitive performance, and that it may reduce cognitive decline later in life. Researchers have even noticed actual physical changes in the brain in some studies, with exercise increasing the size of the hippocampus (which is involved in memory) and to help prevent “brain shrinkage” associated with dementia and aging.

IT’S NEVER TOO LATE TO START This isn’t the only study to suggest that exercise protects the brain. A 2013 study of over 2,200 men found that many lifestyle factors, including eating a healthy diet and avoiding smoking, had an impact on preventing illness in older age, but that exercise had the single biggest influence on dementia levels. An earlier 2011 meta-analysis found similar results, with researchers noting a significant reduction in risk of dementia associated with midlife exercise. According to the Alzheimer’s Society in the U.K., it’s never too late to start. They note that of “all the lifestyle changes that have been studied, taking regular physical exercise appears to be one of the best things you can do to reduce your risk of getting dementia.” Exercise in mid-life has shown in studies to reduce the risk by 30–45 percent. Exercising later in life has also shown to be beneficial. One study of 716 people with an average age of 82, for example, found that people in the

OPTIONS FOR MODERATE OR VIGOROUS EXERCISE If you’re convinced it’s time to get moving for your brain’s sake, you may wonder what kind of exercise is necessary, and how much. Most experts recommend 20–30 minutes at least five days a week. The activity must get your heart pumping and your skin sweating a little bit. Moderate exercise includes walking, swimming, cycling, gardening, cleaning house, and the like, and usually requires a longer period to be effective (at least 30 minutes). More intense exercise includes jogging/running, cycling fast, playing tennis, and hiking up a hill, and requires less time (about 20 minutes). You can tell you’re exercising vigorously if you’re breathing hard and fast and you can’t say more than a few words without pausing for breath. Always check with your doctor before starting any exercise program. www.4health.net

Ophthalmology | 4HEALTH23

A NEIGHBORHOOD OPHTHALMOLOGIST OPENS A ONE-STOP PRACTICE WHEN IT COMES TO PATIENTS, DR. RONA APPEL FOLLOWS THE GOLDEN RULE With a total commitment toward eye care and over 20 years experience, ophthalmologist Rona Appel, M.D., recently opened a state-ofthe-art office on the ground floor at 2928 West 5th Street in the Trump Village area of Coney Island. Dr. Appel specializes in retinal disease, macular degeneration, diabetic retinopathy, general ophthalmology and cataract surgery for patients of all ages. The modernly furnished, newly renovated office has five examination and treatment rooms with the latest digital equipment to diagnose, treat, and prevent diseases, while helping to keep patients’ eyes healthy. “I needed this larger facility and made a considerable investment to get state-of-the-art equipment so I could provide comprehensive care to my patients,” said Dr. Appel. “My idea was to have an office where patients can receive an examination, testing and treatment in one stop.”

THE LATEST TECHNOLOGY IMPROVES DIAGNOSES Walking through the spacious office between patients, Dr. Appel’s love, passion and expertise is apparent as she shows off some of her latest equipment. “This is a Zeiss Series 800 ultrasound machine (OCT) and Fluorescein Angiography Camera that can study the eye from front to back,” she says. “It’s the latest highly sophisticated digital machine that allows for an instant diagnosis.” The machine detects conditions such as macular degeneration, for example, which usually affects older adults. Once diagnosed, it can be successfully treated with injections and/or laser treatments as indicated by the latest protocol. “There are some hidden diseases like glaucoma that a person may not be aware of, and yet it can threaten their vision. That’s why it’s really important to have regular eye exams for www.4health.net

screening—at least once a year to determine if there is any pathology. Also, some people have a family history of glaucoma and retinal disease. Because these diseases are hereditary, it’s important these patients have regular eye exams.”

ADVICE FOR PROTECTING YOUR EYES When it comes to eye care, Dr. Appel says it’s very important to wear sunglasses. The ultraviolet light of the sun can accelerate cataracts and some retinal diseases. Additionally, a healthy lifestyle, including regular exercise and eating a nutritious diet, helps keep your eyes functioning optimally. When she was only a child, Dr. Appel immigrated with her parents to the United States from Kiev in the former Soviet Union. Today, she practices what she preaches. She is a regular road runner and has completed 15 marathons. She runs 5K races to raise money for the eye bank. She also strongly believes in giving back, and has traveled to St. Kitts and Grenada where she has performed laser eye surgery and treated diabetic eye disease. Her interest in ophthalmology began while she attended New York University School of Medicine. All students there must study the various medical specialties. “I fell in love with the instrumentation and loved the micro surgery involved in ophthalmology,” she said. Dr. Appel passes on this love through teaching. For 10 years, she acted as director of the Retina Clinic at Long Island College Hospital, teaching Downstate ophthalmology residents.

DR. APPEL’S PHILOSOPHY When it comes to her patients, Dr. Appel follows the golden rule: “I really believe in doing unto others as you would like them to do unto you, because we are all patients at some time or another. I work to provide the care that I would like to receive myself.”

NAME:

Rona Appel, MD SPECIALTY: ophthalmology

MEMBERSHIPS: American Board of Ophthalmology American Academy of Ophthalmology New York State Ophthalmological Society

INSURANCE: Accept All Major Insurance Plans

CONTACT: 2928 West 5th Street, Brooklyn, NY 11224

(888) 994-1474 97-77 Queens Blvd, Fl. 11, Rego Park, NY 11374

(888) 317-5886

4HEALTH

AVOID A SUNBURN ON YOUR EYES! HOW TO PROTECT YOURSELF THIS SUMMER ■■■ Colleen M. Story You know that when you go outside, your skin is at risk for sunburn. But did you know that your eyes, too, can get burned? It happened to CNN newsman Anderson Cooper. Back in 2012, according to an article

in USA Today, he spent two hours on a boat in Portugal. He wasn’t wearing his sunglasses. Later that night, he woke up feeling like his eyes were on fire, and he couldn’t see. Splashing his eyes with water didn’t help. He went to the doctor, who promptly diagnosed him with “photokeratitis.”

Here’s more on the condition, and you can avoid suffering from it.

WHAT IS PHOTOKERATITIS? Also called “snow blindness” because skiers often suffer from it, photokeratitis is a condition in which the sun’s rays burn www.4health.net

4HEALTH the eyes’ corneas—the outermost layers that cover the front of the eyes. When this happens, it can cause a painful, temporary blindness. It may feel like you’ve got sand stuck in your eyes, or as if your eyes are on fire. Those with lighter colored eyes are believed to be at a higher risk for photokeratitis because they don’t have as much pigmentation to protect the eyes. Treatment includes cool, wet compresses and artificial tears to reduce pain and keep eyes moist while they heal. Doctors recommend you see your ophthalmologist immediately, as he or she can diagnose the condition and may also prescribe eye drops that can help reduce eye pain and speed along healing. Recovery usually takes about one to three days, depending on how severe the burn was. During that time, the gritty feeling will likely remain, as the cornea will actually peel to make way for new tissue.

UV RAYS CAN CAUSE LONG-TERM DAMAGE TO EYES Though photokeratitis isn’t serious—your eyes will recover— exposing eyes to UV rays can cause a number of other problems over time. Scientific studies have shown that unprotected eyes are more likely to develop cataracts and macular degeneration. The Skin Cancer Foundation also warns that years of unprotected exposure to UV rays can increase risk of eyelid cancers and conjunctival cancers (malignant cancers that grow on the surface of the eye).

www.4health.net

HOW TO PROTECT YOURSELF FROM “EYEBURN” My eye doctor has always called the sun “enemy number one” when it comes to the health of the eyes. If you want to enjoy your best vision for the rest of your life, be sure to take these precautions. Protect when tanning: Tanning isn’t good for your skin, and it’s equally hard on your eyes. Avoid it! If you insist on stepping into the tanning booth, be sure to always wear eye protection—closing your eyes isn’t enough! Get the best protection you can: There are a lot of sunglasses out there to choose from. Always make sure that whatever ones you buy have 100% UV protection for both UVA and UVB rays. Wear your sunglasses! Even on cloudy days UVA rays penetrate even inside your car to potentially cause damage. Protect your eyes with a lighter shade of sunglasses if you need, but get used to wearing your sunglasses every time you step out the door. Use hats and umbrellas: If you’re going to be out in the sun for more than a few minutes, consider wearing a hat or using an umbrella. Sunglasses help, but if you have the sun beating down on you for any length of time, extra protection from above can help protect your eyes from rays that can sneak in over the top of your glasses. Wrap-around glasses also help. Power it up when around the water: Water, snow, sand, and pavement can all reflect UV rays, putting your eyes at risk. Make sure you wear the strongest protection you have when around these surfaces.

4HEALTH

COULD YOU HAVE DIABETES AND NOT KNOW IT? DANGEROUS DISEASE CAN EXIST WITHOUT SYMPTOMS ■■■ Lynn Merrell

Could you be one of those people?

The Centers for Disease Control and Prevention (CDC) reports that nearly 30 million people in the U.S. have diabetes. The Diabetes Research Institute Foundation states that in the last decade, the number of people living with the disease has jumped almost 50 percent. Diabetes causes more deaths than AIDS and breast cancer combined. It’s also the leading cause of heart failure, stroke, kidney failure, blindness, and amputations. Once you know you have diabetes, you can take steps to control your blood sugar levels to reduce your risk of complications. The problem is, according to the CDC, nearly 30 percent of people with diabetes don’t know they have it. That means that they are living with blood sugar levels that are higher than they should be, which over time, can cause serious long-term health problems.

DIABETES LEADS TO OTHER HEALTH COMPLICATIONS Diabetes—and especially prediabetes—can exist in its early stages without causing symptoms. “Prediabetes” is a condition in which the blood sugar levels are higher than normal, but not high enough for the patient to be diagnosed as having full-blown diabetes. Some estimates suggest that those with prediabetes who don’t manage their blood sugar levels have a 15–30 percent risk of developing type 2 diabetes within five years. (Type 1 diabetes is usually diagnosed in childhood.) Diabetes develops when the pancreas can no longer make enough insulin (the hormone that ushers glucose into the cells of the body) or when it can’t use the insulin it has as well as it should. The body breaks down all food into sugar (glucose) that it then uses for fuel. Insulin carries the sugar to the cells that need it. When insulin isn’t www.4health.net

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doing its job, the blood ends up overloaded with sugar, creating high blood glucose levels. High blood glucose causes a number of issues.

■ Your skin starts to get darker around your neck or in the armpit area ■ You have cuts and bruises that seem to take forever to heal ■ You seem to get sick more than you used to, or may suffer more

■ It makes the kidneys work harder, as they try to get rid of the extra

■ You feel like you’re always tired ■ Your vision seems blurry lately ■ You have tingling, numbness, or burning in your hands and/or feet

frequent yeast infections sugar through urine. ■ As a result of this process, the person may feel tired and thirsty. ■ Blood sugar coats red blood cells, making them stiff, which then in-

terferes with blood circulation. ■ Sticky red blood cells also create buildup in blood vessels, narrow-

ing them. ■ Blood vessel damage, over time, can lead to vision problems, gum disease, nerve damage in the feet and hands, kidney problems, and later, cardiovascular issues.

POTENTIAL SYMPTOMS OF DIABETES If you have prediabetes, you probably won’t notice any symptoms at all. That’s why it can be particularly dangerous—you have this disease creeping up on you and you don’t even know it. As the disease progresses, usually into full-blown diabetes, you may notice some of the following symptoms: ■ ■ ■ ■

You have to urinate frequently You often feel thirsty, to an excessive level You lose weight rapidly and unexpectedly You experience sharp pangs of hunger on a regular basis

www.4health.net

A BLOOD TEST IS THE ONLY WAY TO BE SURE Even if you don’t have these symptoms, you could still be at risk for prediabetes or diabetes, particularly if you have a parent or sibling with the disease, you’re overweight, you are 45 years or older, you are black or Hispanic, or you tend to have a sedentary lifestyle. A normal blood sugar level is less than 100 mg/dL after fasting for at least 8 hours. It’s also qualified as 140 mg/dL about two hours after eating. The only way to be sure of how you’re doing is to get a blood test. It’s easy. You fast for about 8 hours, let the doctor draw some blood, and that’s it. He or she can then tell you how your blood sugar levels are doing, and you can make adjustments from there if you need to. The good news is that if you catch the disease in the prediabetes stage, you can usually make lifestyle changes that will protect you from the more serious form of the disease. Even if you are diagnosed with diabetes, your chances of avoiding complications are much better if you start taking control of your blood sugar as early as possible.

4HEALTH

GRANDMA FEELS 20 YEARS YOUNGER WITH THE HELP OF USA VEIN CLINICS 61-YEAR-OLD WOMAN REJUVENATED BY HEALTHY LEGS ■■■ Colleen M. Story Paula just couldn’t get around like she used to. For two years she had struggled with worsening pain, heaviness, and fatigue in her legs. She couldn’t even sleep well anymore. The throbbing pain often woke her up at night. Even worse was the fact that the veins on her legs were now so prominent that Paula was embarrassed to wear skirts. One vein on her left leg bulged out so much that kept it covered all the time with long stockings and slacks. She talked to her friends and researched her condition, but it wasn’t good news. She was afraid she had deep vein thrombosis—a serious condition in which a blood clot forms in the veins of the legs. She feared her situation could be life threatening. What if she suffered from a stroke? Or ended up in the hospital? Finally, things got so difficult that Paula made an appointment with USA Vein clinics. Today, she’s so pleased with the outcome that she wishes she had gone in years ago.

TOO TIRED TO PLAY WITH GRANDCHILDREN

SYMPTOMS OF DEEP VEIN THROMBOSIS AND VARICOSE VEINS Could you have deep vein thrombosis? It’s hard to tell—many times a blood clot occurs in the leg with no noticeable symptoms. If you experience any of the problems below, however, see your doctor at USA Vein Clinics right away: ■ Swelling in the leg, ankle, or foot ■ Pain in the leg, ankle or foot; typically

■ Pain, soreness, throbbing, aching,

starts in the calf and can feel like cramps ■ Changes in skin color, such as turning pale or blue ■ Varicose or spider veins

■ Veins that appear twisted or bulg-

cramping, and fatigue in the legs ing, or that turn dark purple ■ Worsened pain after sitting or

standing for a long time

Paula had always been an active person, and loved spending time with her family. Her grandchildren were very special to her, and she would do anything to see the smiles on their faces. Unfortunately, as her veins got worse, she not only worried about blood clots, but felt her life was slowly slipping away from her. At first, she felt just a little extra tired after work. She was on her feet 8–9 hours a day, and when she came home she felt so sore that she couldn’t do much more than sit on the couch or the easy chair until it was time for bed. Gradually, as her legs became worse, they bothered her so much that she found herself cancelling activities with her grandchildren, which just broke her heart. She also could no longer think about traveling or even going shopping—activities she used to enjoy doing all the time. Finally, she couldn’t stand it anymore. What did she have to lose? Surely the right doctor could do something to help her. Now she just had to find that person. www.4health.net

Vascular Surgery | 4HEALTH29 DECIDING ON USA VEIN CLINICS Paula looked around for a while, and one day read an article in a magazine about the experienced cardiovascular specialists at a place called USA Vein Clinics. The article talked about symptoms like hers, and how they could be relieved with inpatient services that could be performed right in the doctor’s offices. Imagine! The idea that she wouldn’t have to go to the hospital and go through surgery to relieve her condition made Paula feel more hopeful right away. She was even more impressed when she read that Medicare and most other insurances would cover these non-surgical treatments, which mean that she wouldn’t have to come up with any upfront costs. Finally, the clinic offered a 100 percent guarantee of satisfaction, so she took a deep breath, called and made an appointment. In October 2013, she had her first consultation.

TREATMENT FOR PAULA’S CONDITION The doctor at USA Vein Clinics diagnosed Paula with venous insufficiency and varicose veins disease. At first she was relieved, thinking her condition was much less serious than she suspected, but the doctor informed her that varicose veins if left untreated, in addition to causing heaviness, burning, aching, tiredness, and pain, could also lead to deep vein thrombosis. As Paula feared, deep vein thrombosis is a serious condition in which blood clots may form in the deep veins of the body, typically in the legs. These clots can then travel through the bloodstream to the lungs, where they may block blood flow and cause a pulmonary embolism. The result may be lung damage, low oxygen levels, damage to other organs in the body, and without treatment, even death. Paula realized that it was a good thing she hadn’t waited any longer to make her appointment. As her doctor told her, her condition would have only gotten worse. Fortunately, under the doctor’s care, Paula could now get treatment for her varicose veins. The doctor recommended Endovenous Laser Therapy (EVLT), a technique considered the “gold standard” in the elimination of large varicose veins. He explained that the procedures are done under local anesthesia and are typically painless. A light beam from a laser machine permanently seals the affected vein, rerouting blood circulation to other healthier veins. Paula agreed, and scheduled her first EVLT treatment for January 12, 2014. www.4health.net

DON’T WAIT TO PUT THE LIFE BACK INTO YOUR LEGS! Today, Paula says she couldn’t be happier. “My legs don’t feel tired anymore,” she says, “and finally I can wear dresses and skirts and feel comfortable and confident about it.” Her health has given her new energy, and Paula says that everyone around her has noticed. “I still have a job, and lately my younger co-workers have a hard time keeping up with me!” Paula had a total of three EVLT treatments—which is typical for most patients— with very little pain in her calves and some pain during treatment on her thighs. With the help of the clinic’s insurance specialists, all of the coverage negotiations were handled on her behalf, and as a result, all her treatments were fully covered. Paula couldn’t believe how easy it was. “The doctor was very professional and very knowledgeable,” she says, “and the staff was so warm and helpful. I have to say I was nervous at first going in there, but they all made me feel so comfortable.”

LOOKING BACK Looking back on everything she’s been through, Paula is amazed she went as long as she did experiencing so much pain and discomfort. With the way she feels now, she can’t imagine the time she wasted with the problems she had. “I tell people now, ‘Don’t wait! If you delay, your veins will just get worse, which could cause you more problems.’ I wish I had made my appointment a lot sooner, but now I’m just so happy to be able to enjoy an active life again.” Paula notes that she still wears her compression stockings sometimes, but mostly only when she has to sit for long periods, like on the airplane. She’s thrilled that she can wear her skirts again, though, as they are much more comfortable while traveling! In fact, she can’t believe that at 61 years old, she feels this young and full of energy. She’s already recommended USA Vein Clinics to her cousin in Boston and her friends in Los Angeles. “I’m going out to see them soon, so they’d better be ready to have some fun!” she says. As for her grandchildren? You can bet that whenever they want to play, their grandmother is never too tired anymore! If you suffer from varicose veins and are interested in setting up an appointment, call our offices 718-509-0906, or see our website at www.usaveinclinics.com.

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. Their expert cardiovascular physicians have cured over 10,000 patients nationwide.

INSURANCE: The EVLT treatment covered by Medicare and most insurance plans, like Health First, 1199, GHI, BCBS, United Healthcare, Aetna, and many others.

CONTACT:

(718) 509-0906 NEW YORK Manhattan, Brooklyn, Bensonhurst, Queens, Valley Stream, Staten Island NEW JERSEY Red Bank BOSTON West Roxbury, Lynn CHICAGO Chicago, Elk Grove Village, Northbrook LOS ANGELES Glendale, Valley Village, West Hollywood, Huntington Park PHILADELPHIA FLORIDA Hollywood SEATTLE Seattle, Bellevue, Kent ATLANTA Decatur, Marietta

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

304HEALTH

| Plastic Surgery

BOTOX, FILLERS, OR FACE-LIFT? WHICH OPTION IS RIGHT FOR YOU?

NAME:

Roman RAYHAM, MD SPECIALTY: Plastic and Reconstructive Surgeon

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

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

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

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

(877) 582-0400 www.NYPlasticSurgeryCenter.com

LANGUAGES: ENGLISH • RUSSIAN

Not long ago, we couldn’t do anything about the appearance of aging on the face.We just had to accept the wrinkles, sagging skin, and overall lack of definition. Today, we have so many options that it’s become a bit overwhelming. If you’re looking in the mirror and wishing for a few changes, you may be asking yourself: Do I need a full face-lift? Or would I be happy with a little Botox? Dr. Rayham of the RR Plastix/New York Plastic Surgery Center volunteered to give us a little clarification. “When I have a consultation with a patient,” he said, “I evaluate the deteriorations that are occurring on different parts of the face, and then I find out what the patient hopes to change. Together, we decide which treatments will produce the best results.”

a “fat transfer” is used. “We can volumize or enhance the cheeks and nasolabial folds,” Dr. Rayham says, “and even increase the volume around the lips by transferring fat in the belly to the skin in the face. The nice thing about this process is that it also transfers the stem cells from the belly fat to the facial skin, which helps improve the appearance of skin over time— even decreasing the appearance of scars.”

FACIAL TREATMENTS OF TODAY When considering treatments for the face, we start from the surface and work our way down. That means the doctor looks first at the condition of the skin. If you want to remove dark spots, regain that youthful glow, or simply rejuvenate the skin overall, he recommends certain creams, chemical peels, and perhaps some laser treatments. Singly or in combination, these could be all you need to get that fresher, younger look. If you want to target subtle or beginning wrinkles, however, like those that appear around the eyes or on the forehead, Botox may be the best option for you. “Botox relaxes the muscles and prevents the wrinkles from forming,” Dr. Rayham says, “while reducing the appearance of wrinkles that are already there.” Botox can also be used as a preventative measure, to prevent wrinkles from deepening over time. If you have more noticeable, deeper wrinkles, such as those that appear at the sides of the mouth (marionette lines), the doctor would suggest you get those lines filled with one of several different products known as “fillers.” “There are a group of fillers out there that we use depending on what particular type of problem we’re addressing,” Dr. Rayham says. “We can fill those spaces around the nose and lips, or under the lips, and we can also enhance the cheeks and cheekbones.” To provide more volume to a certain area of the face, when a filler won’t cut it, sometimes

CHANGES IN FACIAL STRUCTURE All these treatments are considered fairly minor and are typically used on patients aged anywhere from 20 to 50 years old. In the senior population, however, the doctor often sees additional problems like atrophy in the facial muscles, loose connecting tissues under the skin (which contributes to sagging and drooping), or looseness in the soft tissues (which can cause heavy jowls and eyelids). It is in these cases that a surgical face-lift may be the best option. “When we’re addressing these kinds of problems,” Dr. Rayham says, “we can best correct them by tightening the muscles and pulling the skin back up. We can do a face-lift, a neck-lift, and even a brow-lift to move the face back into a supported, lifted position.” In patients who have lost calcium and shape in the skeletal structure, chin, jaw, and cheek implants can also be put in place during surgery. “During an operation, we can correct most of the concerns that patients have,” the doctor said. If you’d like to talk with Dr. Rayham about the best approach for your face, call the RR Plastix/New York Plastic Surgery Center. Double Board Certified by the American Board of Plastic Surgery and the American Board of Surgery, Dr. Rayham can answer any questions you may have. Call 877-582-0400, or visit the website at www.rrplastix.com. www.4health.net

4HEALTH

NEARLY HALF OF ADULTS OVER 40 EXPERIENCE SYMPTOMS OF PAD CHECK WITH YOUR DOCTOR TO AVOID COMPLICATIONS LIKE HEART ATTACK AND STROKE ■■■ Morgan Rice Are you 40 years or older? If so, you may have already experienced symptoms of peripheral arterial disease (PAD). This is concerning, as PAD may be a sign of other problems to come, including heart disease and stroke. Fortunately, if you catch it early, you can make changes to protect both your legs and your heart.

WHAT IS PAD? Peripheral artery disease is a gradual narrowing of the arteries that run from the heart to the legs, stomach, arms, and head, but most commonly affects those that run to the legs. These arteries take oxygenated blood to the “peripheral” areas — those areas on the outer edges of the body. Like the arteries around the heart, these peripheral arteries may become clogged with a substance made up of cholesterol, fat, calcium, and other substances in the blood. Over time, this substance can harden into a type of “plaque” that then narrows the opening in the arteries, increasing the risk of reduced blood flow and blood clots.

WHAT ARE THE SYMPTOMS OF PAD? Researchers surveyed more than 2,000 adults in the United States. The results of that survey showed: 43 percent of Americans aged 40 and older have experienced one or more of the most

common symptoms of PAD63 percent had never heard of PAD Only 34 percent of those who had experienced symptoms talked with their doctor about them The most common symptoms of PAD include fatigue when walking or climbing stairs, pain that disturbs sleep, pain when walking or climbing stairs, not being able to exercise as much, and having to stay home more. Researchers noted that many adults may dismiss symptoms like these as typical signs of aging, but that ignoring them can be dangerous. Left untreated, PAD can lead to other major health issues.

UNTREATED PAD CAN LEAD TO SERIOUS COMPLICATIONS Though PAD is a very common disease, it does need to be treated to prevent further narrowing of the arteries and potential complications like heart attack and stroke. If you’re diagnosed with PAD, that means you have an increased risk of coronary heart disease, heart attack, stroke, and transient ischemic attack (mini-stroke). PAD can also increase your risk of suffering an infection in your legs, and of developing sores that won’t heal. In severe cases, blocked blood flow and infected sores can lead to leg amputation.

TREATMENT FOR PAD Fortunately, your doctor can diagnose PAD in a simple, easy way. Typical tests include a physical exam, ultrasound, blood pressure tests, and blood tests. In some cases, doctors may recommend an angiography, in which a dye is injected into the blood vessels to allow doctors to see what’s going on in the arteries. Treatment for PAD can help ease symptoms, stop the progression of the disease, and reduce the risk for other health problems. Your doctor may prescribe medications to lower blood pressure, reduce blood cholesterol, prevent blood clots, relieve symptoms, and control blood sugar. He or she may also recommend a supervised exercise program if you’re having trouble walking. Surgery is a last resort, and is used to treat those arteries that are severely narrowed or blocked and at risk of creating a blood clot. If you have suffered any of the symptoms noted above, be sure to check with your vascular doctor. Early treatment is always best!

USA Vein Clinics (718) 509-0906 www.USAVeinClinics.com www.4health.net

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WHAT DID YOU DO TO YOUR FOOT? 5 COMMON SPORTS INJURIES TO THE FOOT AND HOW THEY’RE TREATED ■■■ Lynn Merrell Derek came limping off the field. He’d done something to his foot, but he wasn’t sure what. His ankle hurt, which could mean a sprain, but his heel also hurt when he stepped on it. He sat on the bench and wondered if he could go back in to play soon, or if this injury was going to sideline him for the rest of the game. According to the American Academy of Orthopaedic Surgeons (AAOS), doctors have seen a significant increase in overuse injuries in children and young adults — the most common of which affect the knee and the foot. In most sports, the foot is under a great amount of stress, bearing the weight of the entire body and absorbing forces that can be many times that.

Below are five of the most common foot injuries that may result from playing sports.

FIVE COMMON FOOT INJURIES Most foot injuries occur because of trauma to the foot — something happens during play that causes the injury. An improper warm-up, improper footwear, playing on hard surfaces, and overusing certain muscles can also cause injuries. Before starting any sport, it’s best to talk to your foot doctor to be sure you have the right shoes, and orthotic supports if you need them. You can save yourself a lot of pain if you go into the game prepared. 1. Ankle sprains: If you have an ankle sprain, it means that some of the ligaments in the ankle have been torn. Usually the injury afwww.4health.net

4HEALTH fects the ligaments on the outside of the ankle. Perhaps your foot rolled underneath your ankle or leg, and later, you experienced swelling and perhaps some bruising. You may or may not be able to put weight on the foot, depending on the severity of the tear. It’s best to check with your doctor to rule out any fractures or torn tendons. Treatment usually involves rest, ice, compression with a wrap, and elevation. Those who can put some weight on the foot may recover in a couple days. More severe sprains take up to several weeks. 2. Fractures: These are small breaks in the bones of the foot or ankle. They are common in running sports, like basketball and soccer, and may result from repeated periods of running and jumping. They are most likely to occur in the second and third metatarsals in the foot, which are located in the ball of your foot, in that area where you “push off ” when walking or running. They may also occur in the heel, ankle, and at the top of the midfoot. They’re usually caused by increasing the intensity of your workouts or practices, or from other factors like using improper technique or equipment. Symptoms include pain, swelling, and tenderness that gets worse with weight-bearing activity. Always check with your doctor if you suspect a fracture. Treatment includes rest, ice, compression, and elevation, and your doctor may also recommend crutches to keep the weight off the foot, protective footwear, and casting in some cases. 3. Turf toe (or sprained big toe): This is a sprain of the big toe joint, usually caused when the toe is bent up too far. The name “turf toe” came from the increase in toe joint sprains in athletes who play on artificial turf. The surface is harder than regular grass and doesn’t give when athletes move quickly, increasing risk that

the toe will bend back rather than dig into the ground. Symptoms include pain, swelling, and bruising, with difficulty moving the big toe. Treatment includes rest, ice, compression, and elevation, along with taping, and a walking boot in more serious cases. 4. Plantar fasciitis: This is the most common cause of heel pain that radiates into the arch of the foot. It’s usually caused by excessive pronation during walking and running, which stresses the thick band of tissue that runs from the heel to the front of the foot (the “plantar fascia”). It may also be brought on by a dramatic increase in training intensity, or by repeated stress to the heel bone such as that which occurs in dance and aerobics. Symptoms include pain under or on the side of the heel that is usually worst first thing in the morning and eases up with movement. Treatment includes rest, orthotics, night splints (to help stretch the plantar fascia), and physical therapy. 5. Achilles tendonitis: The Achilles tendon stretches from the heel to the calf — you can feel it at the back of your ankle. It’s commonly injured by overuse and too much stress, which causes it to become inflamed, swollen and painful. Other factors that increase risk of this injury include flat feet, overpronation, and tight muscles and tendons, as well as improper footwear. Symptoms include pain along the back of the foot and above the heel, swelling, stiffness, and difficulty flexing the foot. Usually these come on gradually over a period of days or even weeks. Treatment includes rest, ice, heel pads, taping, massage, and orthotics if needed. Always check with your doctor, as he or she can diagnose problems that may be contributing to the injury and provide solutions to reduce risk in the future.

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IN PAIN? WE CAN HELP! USA VASCULAR CENTER TREATS UTERINE FIBROIDS, VARICOSE VEINS, AND MORE Do you have a heavy, tired feeling in your legs? Do you require treatment for a spinal fracture? Are you a woman suffering from uterine fibroids? All these conditions may sound very different to you, but at USA Vascular Center, we treat them all using minimally invasive, non-surgical techniques. A comprehensive care facility, we provide highly skilled physicians who can develop a customized treatment plan just for you. In fact, if you’re in pain, chances are we can help you.

WHAT IS A VASCULAR CARE CENTER? A vascular care center is a medical facility offering services for all types of problems involving the vascular system, which includes the arteries and veins. This system—also called the circulatory system—involves all the blood vessels that carry blood and oxygen throughout the body. A vascular disease is one that affects the arteries, veins, and capillaries, causing something to go wrong that either slows or blocks blood flow. Below are some examples of vascular diseases and conditions: ■ Varicose veins/venous insufficiency ■ Clogged arteries or artery narrowing (such

■ ■ ■ ■

as that which occurs in cardiovascular disease) Blood clots Deep vein thrombosis (DVT) Peripheral artery disease (PAD) Pelvic congestion syndrome (caused by varicose veins in the lower abdomen)

At USA Vascular Center, we offer treatments for all of the above, plus a few more unique to women’s health and spinal injuries.

HOW USA VASCULAR CENTER CAN HELP YOU TO FEEL BETTER Going to the hospital is not always the most optimal solution, especially if you can avoid surgery by going to a medical office instead. At USA Vascular Center, we offer a more personalized treatment in an outpatient setting, while providing the latest, cutting-edge technologies that allow the fastest possible recovery. Below is a general overview of the kinds of treatments we give our patients: www.4health.net

Vascular treatments: These include treatments for conditions like varicose veins, PAD, ulcerous sores in the legs, May-Thurner Syndrome, and other related ailments. If your legs hurt, feel heavy, or if you’re having difficulty walking, we can help with that. Realize that vein problems won’t always be visible. You may not see anything on your legs, but if you’re feeling symptoms like cramps, restless leg syndrome, or a burning-itching sensation, it’s best to get your legs checked. Women’s health: Are you suffering from uterine fibroids, pelvic congestion syndrome, or blocked fallopian tubes? Our physicians can help diagnose and treat all three of these conditions. Uterine fibroids are benign tumors in the uterine area, and can cause pain, heavy bleeding, constipation, bloating and more. We have the latest, minimally invasive treatments that can have you feeling better fast. We also provide non-surgical embolization for treating painful pelvic congestion syndrome, and can reopen blocked fallopian tubes with nonsurgical treatments. Vascular access: If you require kidney dialysis, chemotherapy, or other treatments requiring catheters, we can help create and maintain your vascular access. If you experience any problems or complications, including infections, leaking, or swelling, contact our office and we can help get the access working right again. Come to us for implementation and maintenance of port catheters, PICC lines, Hickman catheters, and hemodialysis catheters. Spinal conditions: If your back hurts, we may be able to help. We provide kyphoplasty, a minimally invasive treatment for repairing spinal fractures caused by osteoporosis, as well as radiofrequency ablation procedures to provide longer-term back pain relief and to treat spinal tumors.

CALL US TODAY There’s no reason to go through life in pain. There are so many ways we can help. Even if you’re not sure whether we have a solution for you, please give us a call and we can direct you (855-328-5525). We have offices in Brooklyn and Valley Stream and can be found online at www.usavascularcenters.com.

YOU’RE IN TRUSTED HANDS

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

INSURANCE: We accept Medicare and most insurance plans, like Health First, 1199, GHI, BCBS, United Healthcare, Aetna, and many others.

CONTACT:

(855) 328-5525 New York 2444 86th St, Ste A, Bensonhurst, NY 11214 260 W Sunrise Hwy, Suite 102, Valley Stream NY 11581

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

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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

Medical offices for rent: 1500 sq ft, 2327 83rd St., Brooklyn, NY 1500 sq ft, 7819 18th Ave, Brooklyn, NY For additional information please call Joe 917-208-4291

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

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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ALLERGY & IMMUNOLOGY

Lev BARSKY, MD

728 Oceanview Ave, Ste 1 Brooklyn, NY 11235

FAMILY PRACTICE

Lloyd A. CYPRUS, DMD

Nataliya SAFONOVA, DDS

(718) 372-4077

(718) 376-1090 (800) 801-0603

3054 Brighton 7 St Brooklyn, NY 11235 th

(718) 787-0700

2211 Ocean Ave Brooklyn, NY 11229

CARDIOLOGY

2960 Ocean Ave, Fl 3 Brooklyn, NY 11235

(888) 358-4636

Eduard LEVY, MD

(888) 610-3892

(718) 416-0303

202 Foster Ave Brooklyn, NY 11230

63-118 Woodhaven Blvd Rego Park, NY 11374

INTERNAL MEDICINE

GASTROENTEROLOGY

Dmitry EPELBOYM, DDS

7708 4 Ave Brooklyn, NY 11209 th

Don BANDARI, MD

Lucia AVANY, MD

Sam WEISSMAN, MD

(888) 502-6245

1664 E 14th St, Ste 101 Brooklyn, NY 11229

19 West 34th St, Ste 1201 New York, NY 10001

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DENTISTRY ORTHODONTICS

(718) 787-0400

Asya LEVY, MD

Stephanie YAMPOLSKY, DDS

Irina BERLIN, MD

40 West Brighton Ave, Ste 104 Brooklyn, NY 11224

Victoria ALEKSANDROVICH, MD

3080 W 1st St, Ste 102 Brooklyn, NY 11224

(718) 207-7071

63-118 Woodhaven Blvd Rego Park, NY 11374

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NEPHROLOGY

(718) 627-8300

Abraham ESSES, DDS

2245 Ocean Ave Brooklyn, NY 11229

Wissam N. HOYEK, MD

(718) 376-5557

Adam PRISTERA, DDS

271 Mason Ave, Fl 1 Staten Island, NY 10305 8014 13th Ave Brooklyn, NY 11226

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Alexander BRODSKY, MD

8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214

Alexander BEYLINSON, DO

4434 Amboy Rd Staten Island, NY 10312

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321 Edison St Staten Island, NY 10306

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Yana SHTERN, MD

NEUROLOGY

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Igor GROSMAN, DO

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Brilliant SMILE

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Tatyana GIRSHIN, MD

248 Ave P Brooklyn, NY 11204

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Igor COHEN, MD

(718) 332-0600 2063A Bartow Ave Bronx, NY 10475

80-15 Main St, #1A Jamaica, NY 11435

(718) 379-8800

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Yekaterina LEVIN, DDS

DERMATOLOGY

7000 Bay Pkwy, Ste C Brooklyn, NY 11204

Lilia LEVITZ, MD

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Sofia NOVAK, MD

Ivan CHAPLIK, DDS

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105 Smith St Brooklyn, NY 11201

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Leonard LEVITZ, MD

1749 E 16th St Brooklyn, NY 11229

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Ellen EDGAR, MD

1642 W 9th St Brooklyn, NY 11223

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4HEALTH OB/GYN - UROGYNECOLOGY

Dmitriy GRINSHPUN, MD

174 Brighton 11 St, Fl 1 Brooklyn, NY 11235 th

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OPHTHALMOLOGY

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Mila MOGILEVSKY, DO

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THE HERITAGE REHABILITATION & HEALTH CARE CENTER

5606 15th Ave Brooklyn, NY 11219

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ONCOLOGY

Sergey ZHIVOTENKO, MD

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Aleksandra ZLOTNIK, OD

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1910 Ave U Brooklyn, NY 11229

Roman RAYHAM, MD, BOARD CERTIFIED IN PLASTIC SURGERY

(718) 759-6979

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

ORTHOPAEDIC SURGERY

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Michael RISKEVICH, MD

OPTOMETRY

PODIATRY

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PHYSICAL THERAPY

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948 48th St, Fl 2 Brooklyn, NY 11219

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3632 Nostrand Ave, Fl 3 Brooklyn, NY 11229

Paul GLIEDMAN, MD

2101 Ave X Brooklyn, NY 11235

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Margarita BAUMAN, OD

133-55 Lefferts Blvd South Ozone Park, NY 11420

Isak BADALOV, DPM

(516) 775-0272

67-09 75th St Middle Village, NY 11379

1910 Ave U Brooklyn, NY 11229

(718) 894-9291

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Arkady LIPNITSKY, DC

2279 Coney Island Ave Brooklyn, NY 11223

Prabhakara R. TUMPATI, MD

2003 Bath Ave Brooklyn, NY 11214

(888) 283-0399 OB/GYN - GENERAL

David SCHWARTZ, MD

800 Poly Pl, Ste 114A Brooklyn, NY 11209

(718) 630-3605

www.metropolitanradiation.com

Ideal OPTICAL

(718) 336-1909 629 Park Ave New York, NY 10065

(212) 744-0392

www.4health.net

97-32 63Rd Rd Rego Park, NY 11374

(718) 275-2224

7602 5th Ave Brooklyn, NY 11209

www.orthobrooklyn.com

PAIN MANAGEMENT

(718) 238-2020

Vladislav RUDNER, PT

Birch & BIRCH, DPM

(718) 490-2416

(888) 645-1338

www.magichandspt.com

1725 E 12th St, Ste 301 Brooklyn, NY 11223

(718) 939-0609

Natalya UROVISH, MD

1901 82nd St Brooklyn, NY 11214

Hayama BRILL, MD

43-32 Kissena Blvd Flushing, NY 11355

David EDELSTEIN, MD

(888) 829-5059 www.orthobrooklyn.com

6419 Bay Pkwy Brooklyn, NY 11204

482 Manor RD Staten Island, NY 10314

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VASCULAR SURGERY

Svetlana LUVISH, DPM

520 Neptune Ave Brooklyn, NY 11224

(718) 946-8586

Vitaly RAYKHMAN, MD

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

USA VEIN CLINICS

www.nyui.org

2511 Ocean Ave, Ste 102 Brooklyn, NY 11229

(347) 508-3991

1153 First Ave New York, NY 10065

AESTHETIC CENTERS

VK SKIN SPA

162 Brighton 11th St, Fll 2 Brooklyn, NY 11235

(646) 200-5856

MEDICAL SUPPLY

2444 86Th St, Ste A Brooklyn, NY 11214 116-02 Queens Blvd Forest Hills, NY 11375 1975 Hylan Blvd Staten Island, NY 10306

Alina VASILYEVA, DPM

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

(718) 646-0131 PSYCHOLOGY

Leonid VOROBYEV

7819 18th Ave, Ste A Brooklyn, NY 11214

(888) 416-5055 UROLOGY

Ridwan SHABSIGH, MD

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

(718) 283-7746

David SHUSTERMAN, MD 800 2nd Ave, Fl 9 New York, NY 10017

(212) 931-8533

69-15 Yellowstone Blvd Forest Hills, NY 11375

260 W Sunrise Hwy, Ste 102 Valley Stream, NY 11581

(718) 509-0906 www.usaveinclinics.com

ALTERNATIVE MEDICINE - GENERAL

Ada KULAGINA, LAC

8635 21st Ave Brooklyn, NY 11214

(888) 410-3442

Globe SURGICAL SUPPLY 2029 Bath Ave Brooklyn, NY 11214

(888) 418-0442

USA VASCULAR CENTERS

2444 86th St, Ste A Brooklyn, NY 11214

(855) 328-5525

(718) 360-9550 www.drshusterman.com

LAW NUTRITION AND DIETETICS

Yuly CHALIK, MD

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

(347) 508-3991 www.nyui.org

Alexander SOKOL, MD

2493 Richmond Rd, Ste 2 Staten Island, NY 10306

(718) 227-5505

Albert GROSS, CNS, NYS, CDN

1942 E 8th St Brooklyn, NY 11223

(718) 376-8317

Leon KUCHEROVSKY, ESQ

115 South Corona Ave Valley Stream, NY 11580

(516) 881-7755 www.lkesq.com

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