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HOW MUCH DENTAL CARE IS TOO MUCH?
GLAUCOMA CAN INCREASE RISK OF DANGEROUS FALLS
SIGNS OF ALZHEIMER’S MAY BE PRESENT UP TO 18 YEARS BEFORE DIAGNOSIS
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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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How Much Dental Care is Too Much?
When to Draw the Line on Oral Health Procedures
11 10 Glaucoma Can Increase Risk of Dangerous Falls
Protective Measures are Key to Prolonging Health and Independence
12 Signs of Alzheimer’s May Be Present Up to 18 Years Before Diagnosis
Study Shows Early Warning Signs Should be Taken Seriously
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Women Don’t Have to Suffer—Alternative Treatment Options
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Study Shows Dizziness is Sometimes Serious
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FALL—THE BEST TIME TO PEEL AWAY IMPERFECTIONS
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DENTAL PROBLEMS COULD BE CAUSING YOUR HEADACHES
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Fade Summer Dark Spots, Acne Scars and Fine Lines
By Dr. Namik Yusufov, DDS, MDT
HAVE YOU GOTTEN YOUR BONE DENSITY TEST? Knowing Your Risk Can Help You Avoid Fractures
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DIZZINESS—WHEN IT MAY BE A SIGN OF HEART DISEASE
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DIZZINESS—WHEN IT MAY BE A SIGN OF HEART DISEASE STUDY SHOWS DIZZINESS IS SOMETIMES SERIOUS
■■■
Colleen M. Story
We all feel a little dizzy from time to time, especially after having one too many beers or after spinning around the living room playing games with the kids. That dizziness you get when you stand up, however—particularly if it happens fairly frequently—may not be as harmless as you think. A new study shows that sometimes, it may be a sign of heart failure.
WHEN DIZZINESS MAY BE MORE SERIOUS Researchers from the University of North Carolina (UNC) took a look at a certain type of dizziness called «orthostatic hypotension (OH).» You may feel this kind of dizziness when your head whirls after you get up in the morning, or when you feel dizzy when standing up after you’ve been sitting for a while. Most people pass off this kind of dizziness as «nothing,» but researchers found that it may be more serious. OH happens when your blood pressure drops. Usually when you stand up after sitting or lying down, your body compensates by telling the heart to beat faster, constricting your blood vessels, and forcing more blood into your head. If you regularly feel dizzy when standing up in this way, it may be a sign that your heart and circulatory system aren’t working as well as they should.
OH MAY INDICATE EARLY HEART DISEASE How do you know when your OH may be serious? It’s not a simple diagnosis, as several things may cause it, including dehydration, diuretic medications, ACE inhibitors, beta-blockers, or having a naturally low blood pressure from being in good physical shape. The researchers from UNC looked at data from a long-term study of heart disease risk factors, and found that participants who had OH had a higher risk of developing heart failure than those who didn’t have OH. Lead author Christine Jones noted that OH could be an early marker for atherosclerosis—artery narrowing.
WHEN DIZZINESS IS EVEN MORE SERIOUS Feeling dizzy may not only be a sign of early heart disease. It may also be a sign of a heart attack. Since dizziness is typically caused by reduced blood flow to the brain, it may signify the presence of a blood clot in an artery near the heart or in a heart valve. This type of dizziness may lead to fainting or loss of consciousness, and may be accompanied by chest pain, nausea, or soreness in the neck and arm.
WHEN DIZZINESS IS NO BIG DEAL Sometimes, however, when you feel dizzy, it may be a sign of inflammation in the inner
ear, or it may simply be a side effect of a bad headache or migraine. Occasional dizziness is usually nothing to worry about. It’s only when it happens fairly frequently—several times a month, for instance—that you may want to check with your doctor. Those with OH can best protect their health by reducing their risk factors for heart disease, like high cholesterol and high blood pressure. A doctor can test your levels for you and recommend any lifestyle changes or medications that may be necessary.
HOME REMEDIES If you find you’re feeling dizzy, below are some precautions you can take to safeguard your health until you can see your doctor. ■ Sit or lie down immediately until the diz-
ziness passes. ■ Remove falling hazards like area rugs and
electrical cords to prevent falls. ■ Avoid driving or operating heavy machin-
ery until you find out what’s causing your dizziness. ■ Avoid caffeine, alcohol, and tobacco, as they can restrict your blood vessels and make dizziness worse. ■ Make sure you’re getting enough water to drink every day. www.4health.net
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HOW MUCH DENTAL CARE IS TOO MUCH? WHEN TO DRAW THE LINE ON ORAL HEALTH PROCEDURES
■■■
Morgan Rice
Most of us growing up learned that we needed to visit the dentist once every six months. That remains good advice for children, whose teeth are developing quickly and need more consistent check-ups to make sure they’re maintaining good oral health. Adults, however, are now told that one appointment a year is sufficient, as long as they’re practicing good dental hygiene at home. In fact, there’s been a general trend in health care as a whole to be a bit more conservative when it comes to a number of things, to avoid not only excess cost, but additional stress and treatments that patients don’t need. The same trend is occurring in oral health care. The best advice now is to get the care you need, but not to overdo it. So what does that mean?
SOME TREATMENTS THAT ARE UNNECESSARY Turns out that in many cases, certain dental tests and treatments may not be necessary. Knowing what these are can make you a more informed patient, so you’re sure to get only the care that you really need. At the same time, there are some cases where you definitely want to take what your
dentist has to offer. Follow these tips to know when that may be. Checkups: As mentioned above, the old twice-a-year checkup can be too much for adults. As long as you’re brushing and flossing (or using a water irrigator) every day, you can go for a year between cleanings. Exceptions do exist—if you tend to develop plaque quickly, for example, or if you have other health conditions that affect your mouth, you may benefit from more frequent appointments. Sedation: A lot of dentists now offer what they call “sedation dentistry” in which they use sedation or even general anesthesia before a cleaning or other type of procedure. Make sure you really need these. Though fear of the dentist remains a common problem, there are other ways to help you relax in the chair, including music, deep breathing, and an understanding with your dentist that you need him to go slow and help you through the appointment. Nitrous oxide, or “laughing gas,” is the most minimal form of sedation dentistry, and can be helpful for some patients. For more serious oral procedures, local anesthetic is usually all that’s needed, and offers you a faster recovery. X-rays: Dentists used to take at least the bitewings every six months. That’s a lot of exposure to radiation, though, even though
it’s a low dose. Today, experts recommend x-rays only every 2-3 years. Panoramic xrays can be reserved for once every 10 years, unless you have a specific issue the dentist needs to check. CT scans: These can help the dentist better see the way your teeth and jaw appear in a 3D format. They’re usually unnecessary, however, unless you are scheduled for jaw surgery or other more complicated procedure. A CT scan exposes you to more radiation than Xrays, so it’s best to avoid them as often as possible. Painkillers: After a dental procedure, your dentist may give you a prescription for a powerful pain reliever, such as hydrocodone or oxycodone. These can be very helpful in the short term, but they come with risks for side effects and misuse. Ask your dentist if standard, over-the-counter pain medications may work for you. If not, don’t be fearful of these drugs, but just keep in mind that they are for short-term pain relief only. Replacement fillings: If you’re filling is breaking down, then replacing it makes sense. Simply removing mercury fillings just to replace them with composite ones, however, is often unnecessary. The American Dental Association notes that they have no evidence of health problems from exposure to low levels of mercury in amalgam fillings. www.4health.net
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GLAUCOMA CAN INCREASE RISK OF DANGEROUS FALLS PROTECTIVE MEASURES ARE KEY TO PROLONGING HEALTH AND INDEPENDENCE
■■■
Gordon Barclay
Glaucoma is the second-leading cause of blindness worldwide, affecting 60.5 million people in 2010, with an expected increase to 79.6 million by 2020. A complicated group of diseases, glaucoma damages the optic nerve, and can gradually cause blind spots and loss of peripheral vision. Without treatment, the damage can become so extensive that blindness results. A recent study found that in addition to the vision problems, glaucoma can cause something else that can lead to very serious health problems: loss of balance. Balance problems, in turn, can lead to an
increase in falls, which are the leading cause of injury-related death in older adults. Fortunately, technology may offer a way to improve balance in those with glaucoma: virtual reality.
GLAUCOMA DISRUPTS BALANCE Glaucoma and balance problems go hand-in-hand. Scientists have been trying to figure it out for years. In 2012, for instance, they published a study that showed that people with glaucoma had more trouble keeping their balance than those without the disease. They were more likely to sway when standing, and researchers concluded that the balance problems were related to the loss of vision they were experiencing. www.4health.net
4HEALTH An earlier 2010 study noted that in a glaucoma focus group, difficulty walking was the most common complaint after difficulty with lighting, with nearly half having difficulties with steps, 42 percent with going shopping, and 36 percent with crossing the road. Other studies have indicated that people with glaucoma bump into things more often, and have more trouble with balance tasks like placing the heel of one foot next to or in front of the big toe of the second foot, and swaying more when standing. This spells bad news for the elderly, who are already at an increased risk of falls.
FALLS ARE DANGEROUS FOR SENIORS According to a recent 2015 study, more and more older adults are falling. Researchers looked at data from 1998-2010 among adults aged 65 and older. They found a relative increase in falls of 30 percent—and the results weren’t because of the increasing senior population. “We expected an increase because older adults are getting older and there are more 80- and 90-year-old adults than before,” said lead author Christine Cigolle, “ but we were very surprised to find that the increase in falls was not due to the changing demography.” Those falls can be deadly. A 2010 study found that when the elderly fall, they are more likely to suffer from bone fractures, pelvic fractures, and intracranial injuries, and are more likely to die than those who don’t fall. Other studies have found similar results.
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GLAUCOMA AFFECTS BALANCE—PATIENTS NEED TO TAKE PRECAUTIONS Considering what we know, it’s best if the elderly can avoid falling. Glaucoma, however, can make it harder. A 2007 study found that people with glaucoma have a more than three times greater risk of falling than those without the condition. What can be done? A team of ophthalmologists, vision scientists, and engineers decided to try something. They studied 42 patients with glaucoma and 38 with normal vision. They gave all participants Oculus Rift stereoscopic goggles—“virtual reality” goggles that simulated different settings. The participants wore these goggles while standing on a platform that measured their balance and movement. Results showed that those without glaucoma were able to recover their balance much more quickly than those with glaucoma, and that this lack of balance control was strongly linked to a history of falls. The researchers hope that the technique will help identify patients in the future that are at risk of falling so they can take preventative measures to protect themselves. Until this technology is more widely available, glaucoma patients are advised to practice balance daily, by standing on one leg, walking toe-heel (as if on a tightrope), put your socks on standing up, picking up a towel with your toes, or walking backwards. (Make sure to always have something to hold onto, or something soft nearby to land in, like a bed.) In addition, check with your eye doctor for other tips on improving balance and reducing risk of falls. He or she may have other suggestions, such as rearranging furniture in your home or installing railings to make falls less likely.
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HAVE YOU GOTTEN YOUR BONE DENSITY TEST? KNOWING YOUR RISK CAN HELP YOU AVOID FRACTURES
■■■ Colleen M. Story When should you get your first bone density test? How often should you get it? A recent study published in the New England Journal of Medicine raised these questions and more. Meanwhile, osteoporosis and low bone mass affects an estimated 44 million Americans, increasing the risk of fractures and bone breaks that can lead to disability. It’s important that you know the condition of your bones, so you can take steps to protect them. But what does that mean, in terms of medical tests?
WHAT IS A BONE DENSITY TEST? Also called bone densitometry or bone mineral density scan (BMD), a bone density test is a simple, non-invasive procedure that assesses the strength of your bones, your risk for osteoporosis, and the probability of a future fracture. Certain types of X-rays are used to measure how many grams of calcium and other minerals are packed into a segment of bone. Doctors use bone density tests to identify any weakness in your bones and to monitor osteoporosis treatment once you start it.
WHO NEEDS A BONE DENSITY TEST? The U.S. Preventative Services Task Force recommends a bone density test at least once for all women age 65 and older. A recent
study published in the New England Journal of Medicine then recommended that those women whose bones test normal may safely wait as long as 15 years before having a second test. The study followed nearly 5,000 women ages 67 and older for more than a decade. Researchers reported that fewer than one percent of women with normal bone density when they entered the study, and fewer than 5 percent of those with mildly low bone density, developed osteoporosis in the ensuing 15 years. A viewpoint article published in the Journal of Bone and Mineral Research cautioned, however, that such a lengthy interval is not appropriate for many adults. In their article, osteoporosis experts wrote that postmenopausal women at high risk for fracture, patients whose scans indicate bone mineral density values substantially below normal, those with prior fractures or clinical risk factors for fractures, and patients already receiving osteoporosis drug therapies should be re-tested at much shorter intervals.
WHO’S AT RISK? For best results, talk to your doctor about your risk factors. People who have lost at least 1.6 inches in height, who have fractured a bone, received an organ or bone marrow transplant, experienced a drop in hormone levels (such as during certain cancer treat-
ments), and those who take steroid medications have a higher risk of osteoporosis, and should be tested. Those who are thin, have a small frame, have a family history of osteoporosis, smoke cigarettes, or rarely exercise are also at risk.
THE ADVANTAGES OF TESTING Determining your bone mineral density can help you clarify your individual risk of osteoporosis. Your doctor will use the information to decide whether or not medications are warranted to help reduce your risk of fracture. In patients with low bone mass at the hip or spine, there is a two-to- threefold increase in the incidence of fracture. Early detection and therapy is the best defense. In addition to bone mineral testing and osteoporosis therapies, lifestyle habits reduce your risk of osteoporosis and its complications. ■ Exercise: it keeps bones strong, strengthens muscles, and gives joints support; exercise also keeps you flexible and balanced, reducing your risk of falls ■ Eat a healthy diet with plenty of key nutrients like potassium, magnesium, phosphorus, calcium, and vitamin D ■ Stop smoking ■ Maintain a healthy weight ■ Clear floors of anything that could trip you, and install night-lights and railings to help avoid falls www.4health.net
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SIGNS OF ALZHEIMER’S MAY BE PRESENT UP TO 18 YEARS BEFORE DIAGNOSIS STUDY SHOWS EARLY WARNING SIGNS SHOULD BE TAKEN SERIOUSLY ■■■ Gordon Barclay If you forget your keys more than once in awhile, is that a sign of Alzheimer’s? What if you forget someone’s name, neglect to pay a bill, or fail to keep an appointment? We all have memory glitches now and then, but that doesn’t mean we’re at risk for Alzheimer’s disease or dementia. A recent study, however, shows that performing poorly on certain memory tests may sig-
nal Alzheimer’s as much as 18 years in advance. That’s a good thing, as early detection can help prolong memory and improve long-term care.
STUDY FINDS MEMORY TESTS PREDICT ALZHEIMER’S 18 YEARS IN ADVANCE In the study, researchers looked at data from 2,125 people from Chicago with an average age of 73 years. None of them had Alzheimer’s at the time the study started. The researchers then followed them for
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4HEALTH 18 years, assessing their cognitive abilities with memory and thinkingskills tests every three years. At the end of the study, results showed the following: ■ 23 percent of African Americans developed Alzheimer’s disease. ■ 17 percent of European-Americans developed the disease. ■ Those who scored lower on the thinking and memory tests had an
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Probably not—unless you tend to forget doctor’s appointments often. You can use the following symptoms as a guideline. If you see yourself in any of these, check with your doctor. Early memory tests may help shed more light on how your brain is doing. If you and your doctor both see signs of memory impairment, early treatment can help. Don’t forget that regular exercise, a healthy diet, and good cardiovascular health can all be protective for brain health.
increased risk of developing the disease. ■ Those with lower tests scores in the first year of the study were
■ Short-term memory: You frequently have trouble remembering
about 10 times more likely to be diagnosed with the disease than those with higher scores. ■ The odds increased by 10 for every standard of deviation that the score was lower than the average. ■ One unit lower in performance score on tests completed 13 to 18 years before the final assessment was associated with an 85 percent greater risk of future dementia.
what you had for breakfast, what you drove to the store for, or when your daughter told you she was coming to visit. Asking repetitive questions: Do those around you look at you funny when you ask a question, because you just asked it a short time before? Do you have trouble remembering the details of a story your friend just told you? Reliance on memory crutches: Do you find you can’t remember anything without your electronic devices or handwritten lists? Do you often forget things unless you write them down? Changes in memory: Did you always remember everyone’s birthday, but now have a hard time doing so? Did you used to know your favorite recipes by heart but now need to refer to written instructions? Taking longer: Does it take you longer to do things that you have normally done very quickly? Examples include feeding the dog, organizing your bills, cooking a meal, determining your budget for the month, planning a family visit, etc. If you find yourself having to go back and re-do what you’ve done, or you forget what step to take next, it may be a sign of memory problems.
Researchers concluded that even subtle declines in cognitive function could affect future risk of dementia and Alzheimer’s disease. They noted that a better understanding of how the disease begins near middle age may help improve future treatments and prevention efforts.
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EARLY SIGNS OF DEMENTIA The results of this study indicate that we may be able to detect signs of dementia long before we thought we could. But just what are those signs? Should you worry if you forgot your regular dentist appointment, for example?
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MENOPAUSE CAN GO ON, AND ON, AND ON… WOMEN DON’T HAVE TO SUFFER—ALTERNATIVE TREATMENT OPTIONS ■ 6 percent of postmenopausal women 60
■■■
Lynn Merrell
Most women dread menopause, but believe that at least it won’t last forever. A year or two of hot flashes and other symptoms and you move on, right? Well, maybe not. According to a recent study, a lot of women suffer from “personal summers” a lot longer than that. Why would that be, and what can you do about it?
STUDY FINDS MENOPAUSAL SYMPTOMS PERSIST For the study, researchers looked at data from 2,000 women aged 40 to 65. Most were suffering symptoms of menopause. Results showed that women of all ages can suffer from hot flashes, and that they can persist for longer than we thought. ■ 33 percent of premenopausal women
and 74 percent of postmenopausal women younger than 55 had hot flashes. ■ A total of 42 percent of those between 60 and 65 years old were still suffering hot flashes. ■ Only 3 percent of premenopausal women rated hot flashes as bothersome, but 28 percent of postmenopausal women under the age of 55 said they were. ■ 15 percent of postmenopausal women 55 to 59 years old said hot flashes were bothersome.
to 65 said hot flashes were bothersome. ■ Among all the women, 10 percent of the 60–65-year-olds were using hormone therapy to treat their symptoms. ■ Among women using no vaginal estrogen, 44 percent of premenopausal women and 68 percent of postmenopausal women experienced sexual symptoms, including pain during intercourse. ■ Sexual symptoms persisted in 62 percent of women 60 to 65 years old. The researchers noted that most of the women were not taking hormonal therapy to help soothe symptoms.
RESEARCHERS SAY MENOPAUSE REMAINS AN “UNDERTREATED CONDITION” The Women’s Health Initiative study in 2003 indicated that hormone therapy for menopausal symptoms could increase risk of coronary heart disease and breast cancer. After that study came out, doctors and patients were warned to avoid hormone therapy unless absolutely necessary, to protect women’s overall health. Women who did take it were advised to continue on it only for a limited time—three to five years, in most cases. The researchers in this study noted that this often leaves older women with few op-
tions when it comes to treating symptoms. Hormone therapy remains the most effective way to ease hot flashes and other symptoms of menopause. Because of the concerns, however, many women don’t take it, which means they simply have to deal with symptoms that can be difficult and troublesome. “The use of vaginal estrogen and nonhormonal prescription therapy with proven efficacy for treatment of menopausal symptoms is strikingly low,” the researchers wrote, “suggesting that menopause remains an undertreated condition.”
OTHER TREATMENTS AVAILABLE The researchers concluded that women still have options for treating their hot flashes and sexual symptoms—even when they don’t want to use hormone therapy. Other treatments include low-dose vaginal estrogen (which has not been connected to an increased risk of cardiovascular disease or breast cancer); medications like paroxetine (Brisdelle), which is specifically approved for hot flashes; antidepressants, and anti-seizure medications. Many women continue to suffer from symptoms of menopause long after they thought they would be gone. If you are one of them, check with your doctor. There is no reason for these symptoms to continue to affect your life when there are other potential treatments that may work for you. www.4health.net
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Summer is coming to a close. How does your skin look? Did you get too much sun? Are you noticing dryness, hyperpigmentation, age spots, or wrinkling? According to the Skin Cancer Foundation, more than 90 percent of the visible changes we see and call “aging” are caused by the sun. After a good three months of summer play, you could end up looking older than you did last spring, and that’s no way to go into fall! Fortunately, Dr. Rayham of the RR Plastix/ New York Plastic Surgery Center has a solution. There’s a brand new way to erase sun damage, fade dark spots, and get your youthful glow back with minimal downtime. It’s called “Halo Laser Skin Rejuvenation,” but this isn’t the laser you’re used to hearing about. Forget the weeks of downtime. Now, you can come in Thursday, get one treatment, and go back to work Monday looking fabulous!
WHAT IS HALO LASER SKIN REJUVENATION? Dr. Rayham’s office is one of the first in the area to have the new Sciton Halo laser, a breakthrough new technology that combines the effectiveness of laser treatments with the accelerated healing experience customers love. Laser resurfacing is a treatment that uses a laser to treat facial flaws and improve the appearance of skin. An ablative laser removes thin layers of skin, allowing new and improved skin to form in its place. A non-ablative laser is less invasive, and stimulates collagen growth while helping to tighten and firm skin. In the past, patients had only two options: 1) get ablative, or “fractional” laser treatments, and spend weeks to heal, but enjoy dramatic results, or 2) get non-ablative, or “non-fractional” laser treatments, and enjoy a short downtime, but only subtle results. Now, with the new Sciton Halo laser, customers can take the middle road: enjoy great results with little downtime. The Halo is a “hybrid” fractional laser machine that offers both ablative and nonablative resurfacing at the same time. Double Action of the Halo Laser Provides Customized Options This “double-action” of the Halo laser allows plastic surgeons to address both surface issues in the skin, and flaws in the deeper layers. That means they can, in one pass, address both hyperpigmentation on the surface, while also
treating deeper skin tissues to tone and tighten skin. The technology is so advanced that the doctor can tailor the treatment to each individual, treating each patient in a way that uses only the energy needed to address the problem, while offering a precise, even treatment that allows for faster healing.
WHAT CAN THE HALO HYBRID LASER DO FOR ME? Dr. Rayham is excited to introduce this new treatment just in time for fall. If you’ve suffered sun damage over the past several months, this is the treatment for you. You can choose to go in for just one treatment, and after a weekend’s rest, head back to work looking like you turned back the clock. The Halo can do much more, though. In addition to treating sun damage, it can also: ■ Reduce the appearance of scarring, such as acne scarring ■ Reduce fine lines and wrinkles ■ Fade age spots hyperpigmentation ■ Smooth out uneven skin tone ■ Reduce the appearance of pores ■ Improve the overall texture of skin ■ Customized to You! Dr. Rayham invites readers to call his office today for a personal consultation. No matter what you’re seeing in the mirror, the Halo Laser Skin Rejuvenation system can help improve your appearance and boost your confidence. Do you have sun damage and sagging skin? Age spots and wrinkles? Whatever your concerns, treatments can be customized to target exactly what you need, and no more. You’ll notice improvements within days, and be able to return to work with a healthy glow. If you’re looking for a more aggressive treatment, you can have that, too. It just depends on the results you’d like to see. Treatments generally take 30 minutes to an hour, and a topical anesthetic is used to increase comfort. After the first 24 hours, patients are able to return to most of their normal activities. Within a few days to a week, you’ll start to see more smooth, vibrant skin that has a youthful glow. For more information, check with Dr. Rayham. He has offices in Manhattan, New York City, Brooklyn, and Staten Island. Call the RR Plastix/ New York Plastic Surgery Center, 1-877-582-0400, or visit our website at www.rrplastix.com. www.4health.net
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Vascular Surgery | 4HEALTH23
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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
TM
www.USAVascularCenters.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: 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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MY PLANTAR FASCIITIS CAME BACK— IS THERE A SOLUTION? HEEL PAIN CAN BECOME CHRONIC ■■■ Colleen M. Story Jared was only in his early thirties, but he was a runner, and lately, his heel was hurting. It started out bad in the morning, and then eased up throughout the day, but when he went running, it seemed to get worse. Jared’s podiatrist diagnosed him with plantar fasciitis, a common cause of heel pain. Jared followed his doctor’s instructions and within a few months was feeling better, but then about a year later the pain returned. About 10 percent of the population suffers from plantar fasciitis at least once in their life. Unfortunately, it has a reputation of being rather difficult to treat, and can come back to create chronic pain.
strong band of tissue (similar to a ligament) that runs from the bones in the middle of your foot to your heel. Its regular job is to provide cushioning, absorb shock, and support the arch of the foot. When this band becomes injured and inflamed, it causes pain that feels mostly focused in the heel area. Collagen fibers near the heel bone may have also broken down. Symptoms include a sharp, stabbing pain in the heel or bottom of the foot that’s usually worst first thing in the morning, and tends to ease up as you walk throughout the day. It can also flare up when you’re exercising vigorously, standing for long periods of time, or when you get up from a seated position.
HOW IS PLANTAR FASCIITIS TREATED? WHAT CAUSES PLANTAR FASCIITIS?
WHAT IS PLANTAR FASCIITIS? The name “plantar fasciitis” means “inflammation of the plantar facia.” This is a
tion and thickening of the tissue. As a result, it’s stiffer then normal and doesn’t bend and move with the foot like it should. There are a number of things that may cause injury to the plantar fascia Most are considered “overuse” factors, in which the foot was just subjected to more pressure than it could handle. High-impact activities (like running), prolonged standing, tight calf muscles (that cause pressure on the plantar fascia), high arches, improper footwear, a sedentary lifestyle, overweight and obesity, and a sudden change or increase in physical activity are all potential risk factors for the condition.
When you have this condition, it’s evidence that something has stretched and torn the plantar fascia, causing possible inflamma-
Standard treatments for the condition include over-the-counter pain relievers, physical therapy, night splints, orthotics, and stretches and exercises that you can perform at home. www.4health.net
4HEALTH For more severe cases, doctors may recommend steroid shots, which may provide temporary pain relief, but are limited in their effectiveness because overuse can backfire. Those who suffer from chronic heel pain that doesn’t respond to therapy may be presented with a couple other options: extracorporeal shock wave therapy and surgery. The shock wave therapy, which delivers sound waves to the painful area, is said to help promote healing, but results have been mixed, and the procedure itself can cause swelling and pain. Surgery is usually considered a last resort, and involves actually detaching the plantar fascia from the heel bone. This usually leaves you with a weaker arch in your foot.
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HOLISTIC THERAPIES MAY PROVE MORE EFFECTIVE Considering the number of people who suffer recurring plantar fasciitis, scientists and doctors are working to find better treatments. Some doctors recommend a more holistic approach, which may include a yoga program, massage, acupuncture, and even diet and supplement recommendations to reduce inflammation. Examining your regular exercise routine and making changes to put less pressure on your feet, such as adding swimming, tai chi, rebounding, or other low-impact activities can also help. Runners can learn to adjust their stride to put less pressure on the plantar fascia, and some invest in foot-strengthening devices to improve strength and flexibility in the foot muscles. Check with your podiatrist for more information. Relief for your foot pain may be found not in a single orthotic or physical therapy appointment, but more likely in a change in lifestyle that involves more attention to the health of your feet and your body as a whole.
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SHOULD YOU SEE AN ONLINE DOCTOR? CONVENIENT SERVICE CAN BE HELPFUL WITHIN LIMITS
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Colleen M. Story
Gary was coming down with something. He could feel it. His head was stuffy, his nose running, and he was a little more tired than usual. He had an important meeting that day, though, and didn’t really have time for a doctor’s appointment. He looked at his smart phone and remembered that his friend, Ned, had recently found help from an online doctor. Gary wasn’t sure, though. Could a digital doctor really be trusted? It’s a question facing many Americans today. New online doctor apps are popping up all the time, and who wouldn’t enjoy the convenience of a quick, on-the-spot consultation? Still, there are questions, such as what a digital doctor can really do for you. Can you get a prescription from him, for instance? Get a diagnosis for a health problem? And most importantly, how much can you trust these people?
ADVANTAGES OF ONLINE DOCTOR VISITS Many of us already turn to the Internet with our health questions, hoping to diagnose ourselves or find a quick at-home treatment that will help us feel better and save us the trip to the doctor’s office. Technology isn’t slowing down, though, and with today’s online services, you can now actually set up a video chat with an online doctor and potentially receive a diagnosis that way. Several so-called “telehealth” companies now make it possible for patients to visit with a licensed physician using their computer,
tablet, or phone. This type of consultation is perfectly legal, usually covered by insurance, and can certainly provide some advantages to trying to diagnose yourself. An online physician can be particularly helpful to patients who live a long ways away from the nearest doctor, and is obviously much more convenient than taking half a day to go into the doctor’s office. Of course, you can see your regular physician this way too, if he or she is set up to receive online patients. If not, you may be able to see another doctor in your insurance network, and follow up later with your regular physician if you need to. Other advantages include less time in the waiting room, lower costs than in-person visits, and a convenient way to get a second opinion.
WARNINGS ABOUT TELEMEDICINE Despite the advantages, most doctors warn their patients to be cautious. This is still a new area of technology, and it’s best to proceed slowly. There is a risk of diagnosis errors—if your online doctor gets your condition wrong, for example—and some studies have also shown that e-visits are more likely to result in prescriptions for antibiotics, even when they may not be needed. Since we’re dealing with a rising problem of antibiotic-resistant bacteria, it’s wise to be cautious before taking them, as many conditions will clear up on their own without them. For now, keep the following precautions in mind. Don’t be afraid to try an online doctor, but always rely on your regular doctor for your overall care.
1. Don’t use it for serious conditions: If you’re suffering from a few sniffles, a urinarytract infection, or the stomach flu, an online physician can probably help you. For more serious conditions, such as excessive bleeding, suspected heart attack, a potential broken bone, and the like, be sure to see your real doctor. 2. Make sure you can trust the site: Though this is still a new area of technology, it’s growing fast, and there are a number of options out there. Watch out for warning signs. If the site is marketing products, fails to list their doctors’ training or licenses, urges you to get tests that don’t seem to fit with your condition, or fail to make plain their privacy policies, move on to another more trusted site. Look for sites certified by the American Telemedicine Association service. (See safeonlineehealth.org for more information.) 3. Don’t get scammed. Make sure you know how much the visit is going to cost before you start, and whether or not your insurance will cover it. Check with your insurance company (they usually only cover in-network providers), and look for fees on the site itself. 4. Think twice about prescriptions: Online physicians usually can prescribe medications, within limits. Standard antihistamines, antifungals, and antibiotics are usually on that list. Just be sure you really need the antibiotics before taking them. 5. Take charge of your own follow-up: Follow-up care isn’t always standard with online physician visits. Ask your doctor when you should start feeling better, and be prepared to see your regular doctor if you don’t see improvement. www.4health.net
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WHAT TREATMENT IS BEST FOR CHRONIC VENOUS INSUFFICIENCY? PATIENTS TODAY HAVE OPTIONS
According to a 2005 study, up to 40 percent of women and 17 percent of men suffer from chronic venous insufficiency, a condition in which the veins in the legs have trouble sending blood back up to the heart. They may have varicose veins as a result, or other problems, such as swelling in the legs, ulcers on the lower parts of the legs, and more serious complications like deep vein thrombosis (blood clot in the legs). Fortunately, there are a number of treatments available for venous insufficiency. The difficulty can be in choosing the right one.
WHAT CAUSES VENOUS INSUFFICIENCY? In the body’s circulatory system, the arteries are responsible for carrying oxygen-rich blood from the heart out to the rest of the body, and the veins are responsible for bringing it back to the heart once the oxygen has been used up. To accomplish this job, veins have little valves inside them that open and close to allow the blood through. This is particularly helpful in the legs, as the veins have to work against gravity to get the blood back up into the heart. The valves, when they are functioning properly, close behind the blood to stop it from sinking back down again. Patients who have chronic venous insufficiency, however, often have veins that are weakened and/or damaged. The valves no longer work like they’re supposed to, which causes the blood to pool in the legs. Though doctors aren’t sure what causes the veins to malfunction in the first place, they do www.4health.net
know that things like age, heredity, obesity, pregnancy, a sedentary lifestyle, and a history of deep vein thrombosis can all increase the risk of developing venous insufficiency. Tall people, or those who have to sit or stand for long period of time, may also be more at risk. How Can I Tell I Have Venous Insufficiency Varicose veins are one of the most common symptoms, but you may also experience a dull aching or heaviness in the legs, as well as painful cramps, swelling, ulcers, thickening of the skin on the legs and ankles, and itching and tingling in the legs. If your symptoms aren’t too bad, you may be able to treat the condition with compression stockings, exercise, elevating your legs as often as you can, losing some weight, and exercising more often. There are also some medications that can help improve blood flow and reduce swelling. If you have a lot of pain, however, or the look of your varicose veins embarrasses you, there’s no reason to live with symptoms.
WHAT’S THE BEST TREATMENT? It used to be the main way to treat varicose veins and venous insufficiency was a treatment called “stripping.” In essence, the physician removed the affected vein. This is rarely required today, however, because of more advanced, less invasive options. Sclerotherapy: For this treatment, the physician makes a small incision and injects a chemical into the affected vein. The chemical shuts down the vein so it no longer carries blood,
encouraging the blood to find other, healthier veins through which to travel. This option is most effective with small, problematic veins. Endovenous Laser Therapy (EVLT): This is a non-surgical treatment that involves inserting an extremely small fiber into the affected vein, and then applying laser or radio frequency energy to shut it down. Other healthy veins then take over. This treatment is considered the “gold standard” of venous insufficiency treatment today.
YOU DON’T HAVE TO SUFFER If you have varicose veins or other symptoms of venous insufficiency, it’s important to check with your doctor. Though your condition may not be serious, it can cause pain and discomfort that can interfere with your normal activities. You also want to be sure that you don’t have other circulatory conditions that may be more serious. The professionals at USA Vein Clinics are highly recommended in New York, Chicago, Boston and now, in Los Angeles. They perform all the tests you need for correct diagnosis, and then create a treatment to fit your needs. Call today at 718-509-0906 or go to www.USAVeinClinics.com to schedule a consultation.
USA Vein Clinics (718) 509-0906 www.USAVeinClinics.com
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ALLERGY & IMMUNOLOGY
Lev BARSKY, MD
728 Oceanview Ave, Ste 1 Brooklyn, NY 11235
(718) 787-0700
DERMATOLOGY
Nataliya SAFONOVA, DDS
2211 Ocean Ave Brooklyn, NY 11229
(718) 376-1090 (800) 801-0603
Leonard LEVITZ, MD
1749 E 16th St Brooklyn, NY 11229
OB/GYN - UROGYNECOLOGY
Alexander BEYLINSON, DO
Dmitriy GRINSHPUN, MD
(718) 984-9658
(888) 747-8009
4434 Amboy Rd Staten Island, NY 10312
174 Brighton 11th St, Fl 1 Brooklyn, NY 11235
(718) 375-4747
1529 Richmond Rd Staten Island, NY 10304
(888) 538-2717
GASTROENTEROLOGY
Wissam N. HOYEK, MD
1749 E 16th St Brooklyn, NY 11229
19 West 34th St, Ste 1201 New York, NY 10001
(718) 375-4747
(877) 434-7889
271 Mason Ave Staten Island, NY 10305
Irina BERLIN, MD
8014 13th Ave Brooklyn, NY 11228
(718) 627-8300
(718) 351-3933
40 West Brighton Ave, Ste 104 Brooklyn, NY 11224
(718) 836-3933
ONCOLOGY
Lilia LEVITZ, MD
Stephanie YAMPOLSKY, DDS
7206 Narrows Ave Brooklyn, NY 11209
(888) 404-5046
321 Edison St Staten Island, NY 10306
CARDIOLOGY
Harout MARGOSSIAN , MD
321 Edison St Staten Island, NY 10306
NEPHROLOGY
Sergey ZHIVOTENKO, MD
2797 Ocean Pkwy, Fl 2 Brooklyn, NY 11235 20-04 Seagirt Blvd Far Rockaway, NY 11691
(888) 757-3877
NEUROSURGERY
Anella BAYSHTOK, MD
2101 Ave X Brooklyn, NY 11235
(718) 512-2160
158-06 Northern Blvd Flushing, NY 11358
DENTISTRY - GENERAL
(718) 445-3700 www.brooklynroc.com
Namik YUSUFOV, DDS, MDT 305 W 28th St New York, NY 10001
(212) 804-0500
170 Morris Ave, Ste A Long Branch, NJ 07740
(732) 728-7075
Abraham ESSES, DDS
DENTISTRY ORTHODONTICS
Alexander BRODSKY, MD
8622 Bay Pkwy, Ste 1 Brooklyn, NY 11214
(718) 333-2121
2245 Ocean Ave Brooklyn, NY 11229
Yana SHTERN, MD
Amit SCHWARTZ, MD
(718) 513-6060
(718) 283-7219
1642 W 9th St Brooklyn, NY 11223
321 Edison St Staten Island, NY 10306
(718) 980-2525
948 48th St, Fl 2 Brooklyn, NY 11219
OB/GYN - GENERAL
2101 Ave X Brooklyn, NY 11235
NEUROLOGY
(718) 376-5557
Paul GLIEDMAN, MD
(718) 512-2160 OPHTHALMOLOGY
Vladimir LEMPERT, DMD
3037 Ave U Brooklyn, NY 11229
(888) 607-9725
Adam PRISTERA, DDS
7708 4th Ave Brooklyn, NY 11209
(888) 502-6245 DENTISTRY - PEDIATRIC
Igor GROSMAN, DO
1517 Voorhies Ave Brooklyn, NY 11235
(718) 332-0600 2063A Bartow Ave Bronx, NY 10475
(718) 379-8800
Hayama BRILL, MD Igor COHEN, MD
80-15 Main St, #1A Jamaica, NY 11435
(877) 251-4750
INTERNAL MEDICINE
1725 E 12th St, Ste 301 Brooklyn, NY 11223
(718) 336-1909 629 Park Ave New York, NY 10065
(212) 744-0392
Rona APPEL, MD
2928 W 5th St Brooklyn, NY 11224
(888) 994-1474
97-77 Queens Blvd, FL 11 Rego Park, NY 11374
(888) 317-5886 www.mynyeye.com
Yekaterina LEVIN, DDS
7000 Bay Pkwy, Ste C Brooklyn, NY 11204
(888) 838-6212
Marina KREPKH, DDS
7708 4th Ave Brooklyn, NY 11209
(888) 502-6245
Victoria ALEKSANDROVICH, MD 3080 W 1st St, Ste 102 Brooklyn, NY 11224
(718) 207-7071
Generations NEUROSURGERY
1148 5th Ave, Fl 1 New York, NY 10128
(212) 876-7575 2601 Ocean Pkwy Brooklyn, NY 11235
(718) 616-4909
www.4health.net
4HEALTH PHYSICAL THERAPY
Mark TANNENBAUM, MD 2928 W 5th St Brooklyn, NY 11224
(888) 994-1474
97-77 Queens Blvd, FL 11 Rego Park, NY 11374
(888) 317-5886
Ahava MEDICAL & REHABILITATION 2555 Nostrand Ave Brooklyn, NY 11691
(718) 951-8800
www.mynyeye.com
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VASCULAR SURGERY
Alina VASILYEVA, DPM
Ridwan SHABSIGH, MD
2116 Ave P Brooklyn, NY 11229 2646 E 14th St Brooklyn, NY 11235
3121 Ocean Ave Brooklyn, NY 11235 944 Park Ave New York, NY 10028
(718) 646-0131
(718) 283-7746
PSYCHOLOGY
USA VEIN CLINICS
6417 Bay Pkwy, Brooklyn, NY 11204
1153 First Ave New York, NY 10065
(718) 234-6767
2511 Ocean Ave, Ste 102 Brooklyn, NY 11229
(718) 896-2333
2444 86Th St, Ste A Brooklyn, NY 11214
OPTOMETRY
Michael PATIN, MD
102-51 Queens Blvd, Forest Hills, NY 11375
MEDICAL SUPPLY
116-02 Queens Blvd Forest Hills, NY 11375 1975 Hylan Blvd Staten Island, NY 10306
David SHUSTERMAN, MD
Arkady LIPNITSKY, DC
2279 Coney Island Ave Brooklyn, NY 11223
Margarita BAUMAN, OD
(718) 998-9890
Chloe CARMICHAEL
230 Park Ave, Fl 10 New York, NY 10196
(212) 729-3922
1910 Ave U Brooklyn, NY 11229
(718) 759-6979
260 W Sunrise Hwy, Ste 102 Valley Stream, NY 11581
800 2nd Ave, Fl 9 New York, NY 10017
4159 Broadway Washington Heights, NY 10033
69-15 Yellowstone Blvd Forest Hills, NY 11375
www.usaveinclinics.com
(212) 931-8533
(718) 509-0906
(718) 360-9550
NUTRITION AND DIETETICS
2029 Bath Ave Brooklyn, NY 11214
Alexander SOKOL, MD
Albert GROSS, CNS, NYS, CDN
USA VASCULAR CENTERS
(718) 227-5505
(718) 376-8317
nyurology.com
Globe SURGICAL SUPPLY (888) 418-0442
UROLOGY
Vladislav RUDNER, PT
1901 82nd St Brooklyn, NY 11214
Farnoush SHAHKOHI, OD
2928 W 5th St Brooklyn, NY 11224
(718) 490-2416 www.magichandspt.com
PLASTIC SURGERY
Yuly CHALIK, MD
97-77 Queens Blvd, FL 11 Rego Park, NY 11374
2632 E 14th St Brooklyn, NY 11235 107-15 Jamaica Ave Queens, NY 11418
www.mynyeye.com
www.nyui.org
(888) 994-1474 (888) 317-5886
2493 Richmond Rd, Ste 2 Staten Island, NY 10306
1942 E 8th St Brooklyn, NY 11223 www.nylifex.com
2444 86th St, Ste A Brooklyn, NY 11214
(855) 328-5525 LAW
AESTHETIC CENTERS
(347) 508-3991
Roman RAYHAM, MD, Aleksandra ZLOTNIK, OD
1910 Ave U Brooklyn, NY 11229
(718) 759-6979 PAIN MANAGEMENT
BOARD CERTIFIED IN PLASTIC SURGERY
1616B Voorhies Ave Brooklyn, NY 11235 161 Madison Ave, Ste 11W New York, NY 10016
(877) 582-0400
www.nyplasticsurgerycenter.com
PODIATRY
Leon KUCHEROVSKY, ESQ
VK SKIN SPA
Vitaly RAYKHMAN, MD
162 Brighton 11th St, Fl 2 Brooklyn, NY 11235
2632 E 14th St Brooklyn, NY 11235 107-15 Jamaica Ave Queens, NY 11418
(646) 200-5856
115 South Corona Ave Valley Stream, NY 11580
(516) 881-7755 www.lkesq.com
(347) 508-3991 www.nyui.org
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2736 Ocean Ave, Ste 1A Brooklyn, NY 11235
(718) 934-8484
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520 Neptune Ave Brooklyn, NY 11224
(718) 946-8586
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